Correct dosage?

[jayne1982]

Hello there,

I have been taking citalopram for 5 weeks now. I started on 5mg, went to 10mg for 2 weeks and have been taking 20mg for 3 weeks now.

The side effects each time I up the dose have been pretty bad. My anxiety has shot through the roof, I have been really tired (yawning constantly), and have been feeling generally very 'spaced out'. This seemed to have leveled out quite well on the 20mg, although negative thoughts have still been racing through my mind at times and I have had the odd 'blip'. The medication has also meant my panic attacks have been greatly reduced, though I also find I'm not able to be really happy either. I've kind of my muddling through in a very middle ground.

But over the past couple of days, my anxiety has become worse again, and I'm wondering if my dose isn't high enough. I suffer with obsessional thoughts, and my doctor has suggested the best dose for this is 40mg. I'm going to go to see him on Monday morning to see if he thinks I should increase from 20mg. I'm just so scared of those horrible side effects kicking in again.

I'd be so grateful if anyone could let me know their thoughts, or their experiences in knowing if they were on the correct dose of Citalopram or not. I don't want to go through the side effects if it's not going to help. How would I know if my dose is too high?

Thank you so much in advance. I hope you're all having a lovely weekend.

Jayne xx

[Keszler]

Hi Jayne,
Your experience sounds similar to mine. I would certainly suggest you express any concern to your GP, but this is my hapenny worth....
These drugs can take quite a long time to kick in, so its not unusual to get side effects/feel spaced out for 6 weeks or so. A standard dose would be 20mg a day, but if your symptoms remain severe certainly after 6 weeks you could be put on 40 mg (20mg x 2).
40mg is not an excessive dose and I wouldn't worry about it. However, if the obsessive thoughts remain after taking the revised dose for a few weeks you would be best to mention this to the doc.
One other thing, these drugs have to be taken religiously. Even one missed day can cause a return of symptoms, so its simply not worth missing a dose.
Alcohol and some other drugs will also minimise the effects, so it is worth avoiding them.
I got very frustrated when first put on these but have found them to be very helful in the long term. Good luck, and let us know how you get on.

[oldhandatthis]

I know how you feel! I was on 20mg for a few weeks and had horrible side effects, then just as they were going away my dose was increased to 30mg and the side effects all came flooding back, including increased anxiety. It's so difficult to unpick what is your illness and what is a side effect!

My GP yesterday said that when you increase the dose there should not be a recurrence of side effects so I told him there certainly was!

Anyway I am 10 days into the higher dose and am calming down a bit, I feel almost 'normall' sometimes! Still get bad moments though. Next week I'll have been on C/pram for 6 weeks and I see that as a sort of milestone.

I know that last time I was on them it took a lot longer than I was expecting.

Could you increase from 20 to 30, rather than up to 40 in one go?

[oldhandatthis]

oh and I, too, would quite like to know how you know if the dose you are on is too high....

[milly jones]

hi hun im on 40mg and yes the side effects do reoccur when each increase is introduced.

im still having bad days and the hosp are intending to increase it again soo. i believe that u can go up to 60mg a day.

however, i am having some good days too so i know the dosage is nearly right. i measure my days simply by keeping a mood diary for the hosp so they know how the days fluctuate between appointments.

only u and ur gp can make decisions together to find out when the dose is right.

i have been taking citalopram since may and im still not satisfied completely. however i do feel much better than before.

its just trial and error until u find out what suits ur body

love milly xx

[jayne1982]

Thank you so much for your messages. It makes me feel a lot better knowing I'm not completely on my own with this.

I went to my GP today, and he suggested I try 30mg. My anxiety has definitely got worse again - I had a pretty bad panic attack today, which hasn't happened for a few weeks - so I think taking a higher dose will probably help.

Dreading those horrible side effects though! I'm desperately trying not to think about them though, since I'll probably think myself into having them if I'm not careful!

I also have my first CBT session on Saturday. The therapist Dave sounds really helpful. Thank goodness! I'll let you know how I get on.

Thank you again, I really do appreciate you help so much xx

[andrewc]

Hi Jayne
Please dont worry so much about the side effects. I myself did not have any or neglieble ones when I increased from 20 to 30 and then 1 week later to 40mg. Regardless of what people say this is what appears to be the dose that most people feel good on. So have faith you will feel good. Yes it can take up to 6 weeks to get the full benefit but some people react much faster than that as in my case. After taking them for 3 weeks I went on a holiday abroad. Something that I wouldnt have dreamed about just one month earlier.

Best of luck

Andy