Is Cit working?

[WorryBNot]

I started a thread here http://www.nomorepanic.co.uk/showthread.php?p=1663286#post1663286 at the start of the year if anyone wants the full details.

I've been on and off citalopram for around 9 years. the first few years that i can remember went well but after being sick of feeling tired and a bit zombified every now and then started to not take it....then i'd start taking it again and so on and so on.

Last year i stopped taking it altogether without asking the doctor. i was sick of everything, tiredness and lack of sleep. for the first few months i felt good but then at the end of the year by anxiety levels went throught the roof. So i started taking 10mg. every week or two i'd feel down and my chatterbox/constant thinking happened everyday but i could still enjoy the things i liked to enjoy most of the time. i decided to up to 20mg and my head went crazy, i just couldn't control my thoughts, feeling panicky etc.

I asked on here what i should do and was told to confess to the doctor what i had been doing.

I started back on 10mg at the end of march and the doctor then up'd that to 20mg 12 weeks ago. the first month was very tough. second month i started to feel a little happier the constant over thinking chatter in my head reduced and i felt i might be on the right track. I'm also doing CBT therapy.

My big problem over the last 3 months has been my inability to enjoy and relax whilst watching films, Tv and sometimes when i 'm trying to reading. I just can't switch off can't "be lost in something" can't "be in the moment" i'm a huge film fan and this is seriously getting me down.

Early last week i felt i really started to turn a corner but this week has been very bad especially depression wise, which is something that hasn't happened for some time. my head just keeps rehearsing conversations (most of which i'll never have), my head won't stop constant checking.

Sorry for the long post. The question

If i'm having good days here and there does it sound like the Citalopram is working and i just have to wait or should i ask the DR for an increase?

I just keep thinking i'm never getting over this not being able to watch something. Did i mess up my head by stopping/starting the SSRI? Is it just anxiety stopping me or a major thing i'll never get around.

Very lost.

Thanks for any help. again apologies for the long post.

[panic_down_under]

the first few years that i can remember went well but after being sick of feeling tired and a bit zombified every now and then started to not take it.

Maybe you should try to find a med which doesn't affect you that way. Even a switch to the almost identical escitalopram (Lexapro) might do the trick. While they share the same active chemical, they can produce different side-effects.


If i'm having good days here and there does it sound like the Citalopram is working and i just have to wait or should i ask the DR for an increase?

If you've been on 20mg citalopram for 12 weeks and only getting the occasional good day then the dose needs to be raised. Almost every day should be a 'good' day by now.


I just keep thinking i'm never getting over this not being able to watch something.

If antidepressants worked for you in the past then there is no reason why they won't again, though maybe not citalopram.


Did i mess up my head by stopping/starting the SSRI?

There is growing evidence antidepressants become progressively less effective every time they are stopped and restarted, often requiring higher doses to achieve the previous level of control. They may also produce more severe, and/or different, initial side-effects. Two studies, Amsterdam JD (https://www.ncbi.nlm.nih.gov/pubmed/27805299), 2016 and Amsterdam, 2009 (http://www.karger.com/Article/FullText/226611) found the likelihood of antidepressants working after each restart drops by between 19-25% (see also: Amsterdam JD (http://www.ncbi.nlm.nih.gov/pubmed/18694599), 2009; Leykin Y (http://www.ncbi.nlm.nih.gov/pubmed/17469884), 2007). This applies whether returning to a previously taken antidepressant or a different one.

However, this doesn't mean things are hopeless, just that it may take some experimentation to gets things back on track. And once they are I suggest you seriously consider staying on the med permanently.

[WorryBNot]

However, this doesn't mean things are hopeless, just that it may take some experimentation to gets things back on track. And once they are I suggest you seriously consider staying on the med permanently.
The last few days it feels like i'm taking nothing. today my mood has been up and down so many times i feel exhausted.

I'm starting to worry the messing around with taking and not taking has messed my head up and i'm just going to be like this long term. i know i'm catastrophising and probably being melodramatic.

Is there a chance Citalopram is making things worse?

I tried to book an appointment with the doctor this week but i was told the next appointment will be on the 9th August! so i have another two weeks of this

[panic_down_under]

Is there a chance Citalopram is making things worse?

I think the issue is more that it isn't working so allowing your mind full reign to catastrophize. The easiest and quickest option would be to increase the citalopram dose, but you need to get your GP's okay first. Meanwhile try and keep mentally busy. The less time your mind has to ruminate the better.

[WorryBNot]

Yesterday was so bad i lost count of how many mood changes i had, all over the place. woke up twice in the middle of the night disoriented, panicky and unable to think straight.

Had a session with my therapist and she believes some of the problem is due to me going through CBT Therapy which is heightening my anxiety and also due to me constantly looking online for help. Feel more positive today.

Really hoping once i talk to the doctor and get an increase or a change of medication things will calm down a bit.

[WorryBNot]

Phoned the doctors surgery today to see if i could have a quick talk with a doctor. the receptionist asked me what the problem was and i told her my mood was all over the place and i needed to talk to the doctor about maybe getting an increase. she said she'd talk to the doctor. She phoned me back to tell me the doctor didn't want me to be taking 30mg a day SO i should take 40mg one day, the next day 20mg and the next day 40mg.

Its not a doctor i talk to regularly, i dont talk to a doctor regularly it's whichever doctor is working that day. Going straight up to 40mg worries the hell out of me to be honest. not sure what to do next. I feel i need to talk to a doctor and talk my problems out with him/her

[panic_down_under]

She phoned me back to tell me the doctor didn't want me to be taking 30mg a day SO i should take 40mg one day, the next day 20mg and the next day 40mg.

If you get to speak with this doctor ask what the reason is for increasing the dose this way and please let me know. It's not the first time I've heard this. Imho, it's nutz.

[WorryBNot]

My thoughts exactly. surely if they're worried about upping to 30mg i should up to 25mg for a few weeks first and then up tp 30mg?

I'm waiting to talk to a doctor

[WorryBNot]

For the last 5 or 6 days i've felt like i've turned a corner. If i start to feel anxious i sit with it until it's gone instead of looking to distract myself. i'm letting thoughts pass easily, the chatter is a lot less and i'm even starting to get a good nights sleep

BUT the problem with relaxing "being in the moment" whilst watching films or tv is still a problem. i just can't seem to relax for a long (20m, 30m, 1hour) period of time. i just can't switch off. is it just anxiety that will pass on it's own or something i've got to work through? Frustrating

Is the Cit/could the Cit be working now and it's only a matter of time until i get back to "normal"? i have this doctors appointment coming up and i don't watch to get an increase and have another month of feeling rubbish if i don't have to.

[panic_down_under]

Is the Cit/could the Cit be working now and it's only a matter of time until i get back to "normal"? i have this doctors appointment coming up and i don't watch to get an increase and have another month of feeling rubbish if i don't have to.

Unfortunately, I can't predict the future, but if you're still on 20mg then I think you were probably getting about as much as you were going to within 12 weeks. Any more recent improvement may only be part of the normal waxing and waning cycle.

[WorryBNot]

Talked to the doctor (4th Dr i've spoken to this year) she wanted to do the 20mg and the next day 40mg to 20mg etc

I asked why and she said it was the best way to get me to 40mg. i said i was worried about increasing it like that so we agreed on 30 a day. now i'm wondering if i should go 20 one day 30 the next.

I asked if there would be side effects and she said no. my mood has leveled out in the last week or two so i'm worried about shaking things up again but i'm still finding it hard to relax and enjoy most things.

I'm expecting side effects just hoping it won't be as bad and last as long as it has on 20mg