Is it normal to increase the dosage?

[Louise88zz]

I'm new to this site and this is my first posting. However, just reading post from other people has made me feel much better already.

I've been taking citalopram 10mg for about ten weeks now. At first I experienced all the usual stuff - no appetite, spaced out etc - but this only lasted a few days. Then my anxiety got worse. However, after about a month I started to feel great - really happy and back to my normal self. I though "this is it, I've finally cracked it!". I really didn't want to take drugs but I'd tried everything else (CBT, acupuncture, relaxation sessions) and nothing was helping the anxiety - my particular problem is 'worry thoughts'.

Anyway, over the last month, the anxious feelings have been back - about once a week, especially when I've been tired. Over the last week or so, the 'worry thoughts' have also been creeping back and I've been feeling shattered all the time.

My question is this - can your body become 'used' to the drug? I'm going to make an appointment to see my doctor in the next day or so, probably to increase my dosage. Will this keep happening to me? Will I have to increase it again in another ten weeks? How long will I have to take this drug for?

Finally, I just want to know if this is normal - I'm obsessive about keeping my flat clean and tidy. I feel out of control if it's in a mess (mess = stress!) and it's now got to the point that I can't relax if people come over in case they mess it up. I feel like a complete freak! Is this a symptom of anxiety? Will it lesson if I increase my dosage of citalopram?

I know I've asked a lot in this posting, but any advice you can give me will really help. I just want to feel normal! Thank you so much x x

[milly jones]

i think the trick is to continue staying in close contact with ur gp and discuss ur feelings openly with him.

getting the right dose is trial and error.

ive been on it 3 months and am now on 40mg. for me its about testing the dose and seeing what benefits occur when the meds have settled.

once u are feeling more normal then u can approach therapy again with a view to changing ur behaviour so meds are not necessary for life.

as to the messy house. well when i was in work i was a perfectionist. now im off sick my house is a mess, a symptom the hospital says of how im feeling about myself

take care

milly xxxx

[DeeperDown]

Your body certainly can get used to a drug but with ADs that generally doesn't stop them being effective. Instead you usually get problems if you try and stop them because your body reacts. So I wouldn't worry about becoming immune to the effects. I took citalopram for years and have started taking it again recently and it still helps me.

As for going up the doses, most likely you experienced a short term benefit when you started the treatment but it wasn't enough to sustain it for the long term. 10mg is barely a dose at all. It will help some, but a more usual dose is about 20mg-30mg, rising up to 40mg-60mg for some people. I think one person here even takes 80mg. So I wouldn't worry at all about moving up to 20mg.

To reassure you again, when you find the right dose it will work no matter how long you take it. The reason you feel you need more is because you haven't yet found your level. As molly says, its all about trial and error.

DD

[DeeperDown]

Oh I missed the messy house bit. That sounds like a very mild form of OCD. Trust me there are a lot of people with less sensible obsessions than keeping their house clean. It takes me 45 minutes at night to complete my "routine" before I will allow myself to sleep.

If it is mild OCD then it can be related to your depression and may get better, but if not there are lots of books and leaflets (and web pages) which deal specifically with this problem and can give you some useful hints.

DD

[Louise88zz]

Hello Milly and DD, thank you so much for your reassurances - I feel much better. I'm going to see my GP on Thursday and I'll start taking the new dosage next week. I'm going scuba diving this weekend so I don't want to chance taking the new dosage then, although I've been fine on the 10mg. I'll be back on here next week to report how it's going. Thanks again x x

[Louise88zz]

Well, I've been to the doctor's and I'm now taking 20mg of citalopram instead of 10mg. The doctor didn't seem surprised at all when I told him the 10mg dosage didn't seem to be working anymore. Having read the patient instruction leaflet, it seems that 10mg is usually only an introductory dosage .....but I've been taking it for 12 weeks now!

I took my first 20mg tablet this morning. The only side effects I've experienced today are a general feeling of being spaced out and I'm a bit tired this afternoon. So far, so good!

Having been on citalopram for a number of weeks now, I've got a few questions about side effects and I'd be really grateful of your thoughts:

1) I've started to wake up with a painful right index finger and a painful right elbow. This has never happened before, but is happening all the time now. I'm only 35 (!) so I'm pretty sure it's not arthritus.

2) I've put weight on. OK, I'm probably just looking for an excuse but I'd be interested to know if anyone else has found this.

3) A bit personal this one - has it affected anyone's libido? I got this from the patient leaflet. Thankfully, I havn't noticed any difference but I'm wary of the 20mg tablets. Anxiety is difficult enough in any relationship without there being stresses elsewhere!

Thanks for your help everyone!

[DeeperDown]

I'll cut the usual nonsense and just answer your questions!

1. Doesn't sound like anything related to the citalopram to me. Either it's a little bit of nerves (the morning thing might suggest this) that causes you to feel a real symptom (I used to get crippling pins and needles in both arms) or you have just knocked your hand and not noticed. If you are really worried then monitor it for a few days and if it gets worse make another GP appointment.

2. Usually depression takes weight off you. Sadly when your depression gets better you do sometimes put a bit back on. It might not be a nice thing for you, but its a really good sign.

3. Erm... I'll have to be honest and say these days I don't get sexually aroused very often. Its not that I am physically incapable, just that I never seem to feel like it. Its not as if you don't enjoy it when you do do it, or that you can't though, you just might not feel like it as often. If you are prepared to work at it then it needn't cause problems with your relationship. In any case, worry about it IF it happens. If you can do that in all walks of life then you'll be well on the way to winning your fight.

DD

[DeeperDown]

I forgot to say. Always nice to hear some positive news from someone. Thanks for updating us Louise.

DD

[Louise88zz]

Thanks DD! As always, it's great to hear your thoughts.

It's day 2 on the 20mg for me and I'm still a bit spacey but otherwise ok. I managed to go out for a run last night which made me really tired, but I didn't sleep so well unfortunately. I'm hoping this will pass.

[DeeperDown]

I'm also on the upgrade. Day four for me. And its not going as well as the first dose. I've been feeling very shaky. And my nerves today gripped my stomach and stopped me eating. But I'm getting through it. And so will you. As you begin to relax the sleep will come. And as the days go by I hope you come online and tell us how you are getting better. Its help me. I am sure it helps others.

DD

[Louise88zz]

I wasn't so great last night - I had a really fuzzy head, a tight chest and I felt sleepy, so I had to cancel a night out and just sit in fornt of the TV. The chest tightness worried me but I kept telling myself "it's just heightened anxiety from the tablets and it will not do me any harm". It went away after a couple of hours. Today I just feel sleepy.

From reading posts on here, I know things will get better and I just have to 'ride out' the next few days. It's helped me so much finding this forum.

I hope things settle down for you too DD. Make sure you eat plenty, even if you don't feel like it. I've found that low blood sugar and deghydration are panic triggers for me. Good luck x

[Louise88zz]

Well, I'm more than two weeks in and things haven't been great. As expected, after the first week the ruminating was back with a vengence and I've had a few 'tight chest' episodes. All last week I was completely drained after work and could do nothing other than sit in front of the TV. I've also put on over half a stone in weight since taking the citalopram and it's still climbing. I've been tempted to go back to the lower dosage, but I know I should give it at least a month. I just hope things get better soon.

[smokingjax]

Hi guys, you're in the early stages still, but it does get better.
I have been on them for 2 and a half years and honestly, they really helped me get back to normal. I'm always laughing at something, even moreso than those lucky people that don't have anxiety!
I have to say Louise, that i put a couple of stone on over the last 2 years, but i don't know if that was the tabs or giving up smoking? bit of both maybe.
The tabs made me very very tired for months and when I came home from work I had to sleep straight away. I also had a bad stomach, constipation etc..maybe a bit dehydrated.
I went on 5mg for a month, then 10mg, then 15mg, and that's what I stayed on, I guess everyone's different in what dose they need. Maybe you need a higher dose because you have a bigger, much cleverer brain!!
I wouldn't worry about the dose as long as it makes you feel better eventually, and it will, but don't give up, or you'll have wasted the hard bit you've already done.
Hang on in there, take care J x

[Louise88zz]

Thanks J. I'll stick it out a bit longer, but I just don't feel my normal self at all. I don't feel happy and I just don't enjoy things like I used to. On the 10mg I felt great after about 3 weeks. Maybe it takes longer with the higher dosage. Thanks for your advice though! x