Struggling on Day 10

[Sox]

Hi all,


I'm on my 3rd go around of Citalopram. I came off Citalopram 20mgs about 2 years ago
but have recently relapsed back into anxiety.


I'm on day 10 and suffering really bad side effects, panic attacks, intrusive thoughts, racing heart, night sweats, uncomfortable sensations and weight loss.
I have a history of panic attacks and anxiety symptoms, and these are as bad or worse than anything I have experienced.

During my previous stints with Cit I had almost no start up effects at all, but this time it's getting to the point
where I feel myself spiraling into a crisis.


I have also been on Lorazepam 1mg for about 2 months (taking a quarter to a half tablet, maybe 2 or 3 times a day)
but this is increasing to balance out the Cit effects. I'm concerned about that, I feel like I would possibly be dependent
by now and my supply is getting low.

I'm also wondering if some of these symptoms are me going into withdrawal when I try and ration the benzo.


The health system here is a shambles at the moment and I can't get an appointment with my GP for 2 weeks
The advice from the health line is it's 'my call' if I want to discontinue.


any advice would be much appreciated..

[Catkins]

It could still be related to start up side effects even though you didn't have them before. With the AD I'm on it kind of amplified my anxiety symptoms at first and it took a good few weeks to settle down.

[Sox]

Hey Catkins, Thanks for the reply. Yeah, I'm sure it was start up effects, I was prepared for an increase in symptoms, and I did ride it out of a few days but I was getting exhausted. I was starting to lose perspective and verging on 'call me an ambulance1!!1' territory....dumb.

So frustrating after being on this medication previously and having no issues.

[Scissel]

Please go easy on yourself and be forgving to yourself - its not easy.

You'll get through this, there will be rough days, and some days will be better; as well.

Will reply on your other thread too.

[rcs]

I am struggling myself just now but I think in the long term Citalopram helped me I wish it wasn't such a tough med to restart I don't think GPs realise this.
I think Keep going you have done the hard work after 10 days I think 2-3 weeks and your mood will even out .I struggled restarting Citalopram and it was a tough 2 weeks to say the least week 3 gets easier.

[Bentjillyb]

I have started taking citralopram for the second time after a relapse. I had a breakdown in 2020 which , in retrospect, was a long time coming. After two months of severe side effects, insomnia, panic, obsessive irrational thinking, I began to level out, my old robust self began to re-emerge and I was well enough to cope with some major life events including moving house and a heartbreak that shook me to my very core. Thinking I was back to the strong resilient woman I have always believed me to be I began to taper over 6 months and was off meds by July. In September I noticed low mood and my thinking becoming stuck in an ongoing situation, I wasn’t coping with being alone and I wasn’t sleeping. I went back to Doctor and he and my therapist agreed I might have taken away my support too soon and I am now 2 weeks in to taking 10 mg again. But the side effects are as bad as before and I have been having rolling panic attacks and a terror of going to bed. I know this will pass but the turmoil in my over thinking mind is making me feel crazy. Is it possible it could be as long again before I begin to feel levelled out? The doctor has given me anti anxiety meds to at least get me some sleep, last night they didn’t work. I also hate the thought of becoming dependant. This is my first post. It’s an excellent site. I have read the survival guide and found it to be the most down to earth and reassuring thing given I am avoiding the internet completely at the moment. Thanks.

[panic_down_under]

I have started taking citralopram for the second time after a relapse.

:welcome: to NMP,


I went back to Doctor and he and my therapist agreed I might have taken away my support too soon and I am now 2 weeks in to taking 10 mg again.

Antidepressants (ADs) aren't a crutch anymore than epilepsy meds are for seizures. Anxiety disorders (and depression) are the emotional manifestations of a physical brain disorder caused by high brain stress hormone levels atrophying parts (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC60045/) of the brain's two hippocampal regions. Both ADs and (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3025168/) cognitive/behavioural (CBT, REBT, etc) and mindfulness therapies work (https://doi.org/10.1016/j.biopsych.2013.05.017) by stimulating the growth of replacement cells. They provide the therapeutic response, not the meds, or therapy.


But the side effects are as bad as before and I have been having rolling panic attacks and a terror of going to bed. I know this will pass but the turmoil in my over thinking mind is making me feel crazy. Is it possible it could be as long again before I begin to feel levelled out?

Probably. It typically takes 4-12 weeks for ADs to kick-in. :weep: It takes about 7 weeks (http://cshperspectives.cshlp.org/content/7/9/a018812.full) for brain cells to bud, grow and fully mature, though improvement may begin earlier.

Another issue is that it may taken longer for citalopram to kick-in than the first time and the initial side-effects may be more severe and/or different. You might also need to take a higher dose to get the same response as the first time.


The doctor has given me anti anxiety meds to at least get me some sleep, last night they didn’t work. I also hate the thought of becoming dependant.

Is the "anti anxiety med" one of the benzodiazepines (BZDs)? If so, when taken regularly for some weeks you could become dependent to it. In fact you probably already are to some extent and have been you're entire life as BZDs, particularly diazepam (Valium) and its metabolites, plus lorazepam (Ativan) occur naturally in all foods (https://www.nomorepanic.co.uk/showthread.php?231391-lorazepam-am-I-addicted&p=1889795#post1889795). You will also develop a dependency to the citalopram and need to wean off it too.

If insomnia is the most concerning side-effect then ask your GP to prescribe a small dose of mirtazapine. It should also ease the initial increased anxiety triggered by the SSRI. While mirtazapine is classed as an AD it is mainly a very sedating antihistamine. Alternating between it and the BZD can reduce the risk of developing dependency to the latter.