Question about 5mg Dosage

[kellz]

Wanted to start that I know I should talk to my doctor, and I have. Hoping to get responses from individuals based on experience or knowledge from their own doctors.

I'm pretty familiar with this drug but only in a dosage of 5mg. I've never exceeded this as my doctor thinks this is fine for me and I agree with him. What I've suffered from is, at least in my own mind, manageable and controllable with this relatively low dosage.

My question is whether or not this seemingly low dosage of 5mg still makes me equally as subject to interactions with other drugs, herbal remedies, etc as much as it would be in higher dosages..say 20mg+ which is what i hear is commonly taken. I probably know the answer but I felt more comfortable posting the question here.

I'm a bodybuilder and I've always wanted to try different supplements than I have, but am partially scared to branch out from what I've used along side citalopram due to worrying about interactions with my dosage of 5mg of citalopram with other protein brands, test boosters, multivitamins, etc. So my main concern here is really whether or not I have reason to be as worried as I am (enough to make a post) about whether or not I should feel relatively safe taking other supplements, drugs etc.

An example conversation my doc and I had about cold medicine such as day quil, is that I can easily and safely take it as long as I am within the products recommended dosage..even though there is an interaction with it's ingredients and my 5mg dosage. I have taken those medicines just fine with no side effects.

[panic_down_under]

Wanted to start that I know I should talk to my doctor, and I have.

Welcome to No More Panic, :welcome:


I'm pretty familiar with this drug but only in a dosage of 5mg. I've never exceeded this as my doctor thinks this is fine for me and I agree with him.

I don't agree.

This is a sub therapeutic dose and taking less than the recommended minimum 20mg dose for such a long time may cause the med to fail. Even worse it may desensitize your brain to all antidepressants.

Antidepressants have no direct effect on anxiety, or depression in the way say aspirin has on a headache. They work by stimulating the growth of new brain cells (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC60045/) (neurogenesis) to replace cells killed, or prevented from growing by high brain stress hormone levels. The therapeutic response is produced by these new cells and the stronger interconnections they forge, not the meds directly and this requires a minimum level of the drug in the system to initiate and sustain.

The problem with taking sub/borderline therapeutic doses is neurogenesis may be interrupted whenever plasma levels drop below the amount needed to sustain it which may lead to the second issue, the growing evidence antidepressants become progressively less effective every time they are stopped and restarted. Two studies, Amsterdam JD, 2016 and Amsterdam, 2009 found the likelihood of antidepressants working after each restart drops by between 19-25% (see also: Amsterdam JD, 2009; Leykin Y, 2007). This applies whether returning to a previously taken antidepressant or a different one. Taking a low citalopram dose for long periods may create a similar situation as stopping and restarting it. While the neurogenesis interruptions may only have be of short duration, they will be much more frequent.


So my main concern here is really whether or not I have reason to be as worried as I am (enough to make a post) about whether or not I should feel relatively safe taking other supplements, drugs etc.

Most supplements will be fine.

But I find it interesting that you're worried about taking a medication which has been thoroughly tested for efficacy and safety, yet are quite willing to take supplements which haven't been with many of the ingredients now coming from China where there is almost no regulatory oversight.


An example conversation my doc and I had about cold medicine such as day quil, is that I can easily and safely take it as long as I am within the products recommended dosage..even though there is an interaction with it's ingredients and my 5mg dosage. I have taken those medicines just fine with no side effects.

Day quil contains small amounts of the synthetic opiate dextromethorphan as a cough suppressant. Dextromethorphan affects serotonin neurotransmission and there is a theoretical risk of triggering serotonin syndrome when taken with SSRIs (also some SNRIs and TCAs). Just how real the risk is I can't say, but the main factor is how much dextromethorphan you're taking, not so much the citalopram dose. The risk is probably very low because there are millions of people taking both high dose SSRIs and cold and flu remedies containing dextromethorphan, yet true serotonin syndrome is rare. BTW-these remedies don't actually do much.

[kellz]

So it may be worth it to just stop the medication all together if the does is so low for so long. it's been about a year of the 5mg dose. I have no real issues stopping the medicine. I was on it years back for about a year at 5mg a dose for keeping anxiety down and panic attacks to a minimum, at least that's what my doctor said it was for.

Was off it for about 2 years and got back on because of some family health issues, work became a bit overwhelming and just other life stresses all seemed to happen at once and made me feel depressed and anxious all the time. I thought if I jumped back onto the 5mg dose then I would be fine, and for the most part I have been, but it does take some fight from me every once in a while to control any oncoming anxiety and depression symptoms which I overcome..even my own random episodes of believing I have brain tumors or cancers because of some itty bitty little thing! ahhaha but I get control over those thoughts pretty quick.

Perhaps I should stop the 5mg dose and stop worrying about it all together. I talked to my doctor about 2 months ago and he said to keep taking it because "I haven't been back to see him about anything related to anxiety or depression in over a year". So his thought process is there..I never really liked my doc to be honest, it kinda felt like he's like "take this and you'll be fine, goodbye".

is 5mg dose something I can just quit "cold turkey" since I've read that lowering the dose more than 5mg at a time isn't recommended.

[panic_down_under]

I thought if I jumped back onto the 5mg dose then I would be fine, and for the most part I have been, but it does take some fight from me every once in a while to control any oncoming anxiety and depression symptoms which I overcome.

I suspect the citalopram never did anything beyond maybe produce some side-effects and you've been controlling the anxiety all on your own.


is 5mg dose something I can just quit "cold turkey" since I've read that lowering the dose more than 5mg at a time isn't recommended.

Given you apparently didn't have any significant issues stopping it before you're probably not going to this time either.

[kellz]

I suspect the citalopram never did anything beyond maybe produce some side-effects and you've been controlling the anxiety all on your own.



Given you apparently didn't have any significant issues stopping it before you're probably not going to this time either.

i know exactly what I feel when I'm off of citalopram, it happens when I miss doses sometimes. It's just a feeling of "joltiness"/increased hypersensitivity to noises or like turning my head. Almost feels like someones constantly scaring me but to a much lesser extent and i'm familiar with the feeling so it doesn't bother me.

I appreciate your input on all of this. it's much appreciated! Take care :)