Thinking of switching - advice appreciated

[RichW]

Hi Folks

GAD sufferer, previously on 20mg Citalopram for 7 years and was brilliant. Came off two year ago and suffered a major GAD episode recently which has had me seek treatment yet again. This time around I’m on Escitalopram and as bad as loading on Citalopram was for me previously, this has been an absolute nightmare. I’ve tried morning dosing and evening dosing, either way I feel completely spaced out during the day and I’m unable to sleep at night without a sleeping tab which I have no desire to be on. It’s now day 39 and I’m feeling like garbage. My anxiety has lessened somewhat to the point where I can function and kind of think and concentrate but it doesn’t take long for the spaced out, depersonalisation to overrule my days. I’m faking it so badly at work, I actually struggle to comprehend that nobody can figure out just how crazy I feel. As mentioned previously, I was on Citalopram for 7 years, the initial side effects were hell but I can’t remember it being quite this bad and for quite so long. I do remember thinking on the 8 week mark that I was feeling much more “normal” again. I’m now at the point where I’m thinking of switching to Citalopram. I have my doc’s okay for what that’s worth (not much). I’m looking for any advice from those of you who may have previously found yourself in this situation.

Thanks for reading my story, take care all.

[KK77]

Personally, I would stick with Escit because how you once tolerated a med doesn't necessarily mean you will have the same experience. Theoretically, they're both the same drug but there are differences in how the drug is absorbed (and resulting blood concentrations) which could impact efficacy and/or side effects.

Also, bear in mind that side effects usually abate in time and you appear to be on the "mend" ;)

[KK77]

Oh so you have dup posts and you've already switched. You should avoid doing this for precisely this reason or at least update them both. Admin cannot delete every dup post on here :lac:

[RichW]

Oh so you have dup posts and you've already switched. You should avoid doing this for precisely this reason or at least update them both. Admin cannot delete every dup post on here :lac:

I’ll delete the dup post KK, I have switched and am regretting the decision. I thought it’d be plain sailing but that couldn’t be further from reality. I have zero interest in anything, I’m anxious, feeling spaced out, food has no taste and quite frankly cannot see the point to this. I took two clonazepam for sleep but those have worn off, it’s 5am on Saturday morning here and I have a whole weekend in front of me and have no interest in doing a thing. A coma seems preferable at this point. My brain feels so fried I’m wondering what the heck to do. Do I risk switching back to Escitalopram (I switched three doses ago) or just power through while dosing myself up on Clonazepam to mask the pain of the void I’m feeling?

[KK77]

What dose of Cit did you switch to? If it's only 3 doses of Cit you've taken, it will barely have had time to change anything significantly, so I would switch back to previous Escit dose until you can make an appointment to see your doc.

As I mentioned before, both are essentially the same active med, but Escit is far more powerful in terms of targeted serotonin re-uptake at a far lower dose.

[RichW]

Hi KK

Thanks for getting back to me.

I was a 10mg of Esc for 39 days and switched to 20mg of Cit for the past 3.

Perhaps both doses are just too strong, is that possible? The mental health support from GP’s here in NZ is dyer, they are clueless it seems, which is exactly how I’m feeling. I’m unable to sleep naturally, I’ve tried but after an hour and a half of lying awake each night, the anxiety ramps up and I give in to taking a sleeping tab. I’ve gone from a “high flyer” to a wreck in the matter of weeks and trying to keep it together at work, where I’m responsible for technology solution sales and dealing with customers on a daily basis, isn’t helping things. Like a lot of folks, I have a family to support and bills to pay. I can’t afford to be off my game, lest I lose everything. I’ve also gone from bodybuilding (naturally) 7 days a week, to virtually no training, besides walking.

Apologies for the rambling, thanks for your help.

[KK77]

I do think dose might be too high. I would try reducing to 5mg Esc and see how you go, because I'm not a believer of "more is better" when it comes to psych meds.

The situation re GPs and mental health is similarly dire here in UK as well, so know where you're coming from. I had to take charge too when finding right combination of meds.

Try the reduced dose because I get very strong feeling you're on too much.

[RichW]

Thank you KK

Is there any potential risk associated with dosage reduction, along the lines of discontinuation syndrome i.e brain zaps etc?

Thanks again

Rich

[KK77]

I think what you're currently going through is probably worse than a few brain zaps and I doubt you'd get them anyway. Listen to your body though, and if certain symptoms persist, you can look at dosage again. Nevertheless, having so many side effects after so long suggests to me that dose is too high and not helping enough to justify the pain.

Good luck and update us on progress.

[RichW]

Thanks so much KK, shall keep you posted on progress.

[RichW]

Ended up sticking with the Citalopram, my journey continues but will now be in the Citalopram section.