Suddenly can't sleep... never had this problem before

[Gareth]

Hi all,

I've been on Citalopram for 5 weeks now. 1 week at 10mg, 1 week at 20mg, and last 3 weeks on 30mg.

Problem is, over the past 2 days, I've taken a huge turn for the worse. I couldn't really sleep Sunday night, got to sleep eventually, but woke up several times with "body jolts", and that horrible feeling of cold across the brain, that left me in a pool of sweat and confusion. I woke up yesterday and for the first time ever in my history of anxiety, I wasn't able to get out of bed, very depressed, derealisation, depersonalisation, no energy, weak muscles.

I sat on the sofa all day yesterday feeling guilty about not going to work and telling myself I just need some rest. But last night in bed was even worse - terrible confusion, not able to sleep, feeling of someone reaching into my brain and holding their fist over it, suffocating it. It seems every time I begin to drift off to sleep a huge wave of anxiety comes over me, my brain goes cold, I get shooting sensations of energy all over my body, my limbs go numb, I feel like I’m going to go insane.

This is easily the worst I've EVER felt with this condition, right at the time I would expect to start to feel a little better. I've been on Citalopram before, and basically as soon as I got to my effective dose (which last time was 40mg) I felt massively better. It’s all fuelling the fire that there is something very seriously neurologically wrong with me. I feel different this time, more desperate, less able to just get up and keep going like I used to be able to. I’m on my second sick day from work, and in five years of this horrific condition I have NEVER had a sick day with it before. My ability to keep going and support myself is hugely important to me, without it I’ve literally lost everything.

Could it perhaps be anything to do with the cocktail of different supplements I am taking? As well as the cit I am taking a high strength Omega 3, a multi-vitamin, a magnesium supplement, a B-complex supplement. I have read that these should all be safe though?

Is this normal after being on the meds for 5 weeks? If they were going to work wouldn’t they have done so by now? Or do I need to be on the high, effective, dose for more than 3 weeks to see any difference? Do I need to just stick this out, trust in the meds, keep going? Or is this proof that they are not working for me?

Thanks for any experience or thoughts you might be able to offer.

Gareth

[blueangel]

Hi Gareth

Sorry to hear that you're feeling so rough at the moment. Like you, I've always seemed to manage my anxiety without taking sick leave (even when I've been in a real mess with it), and I find the thought of having to go off sick with it deeply distressing.

Has anything happened in the last few days which you think might be a trigger for feeling worse? I've found that sometimes really stupid things can get hooked into the anxiety and make it spiral into something dreadful. I've certainly had all the symptoms you describe as a direct result of anxiety, particularly the sleeping problems, as a few times I've had sleep paralysis, which truly did frighten the crap out of me at the time. :)

If you've been on the 30 mg dose and aren't feeling any improvement yet, are you planning to go back to your GP in the near future? If last time you needed a dose of 40 mg to get any benefit, then maybe a chat with him/her is in order. Also, it might be worth asking him/her whether there is anything else that they'd recommend, as you're needing a fairly high dose of the citalopram for it to be effective. I've just looked it up in the BNF and the maximum dose is 60 mg, so you do have a bit more leeway with it if necessary.

I've always had problems sleeping with anxiety - I can either get to sleep and then wake in the middle of the night or early in the morning. I remember having months on end of this, and I would wake up terrified. Other times though, I won't be able to drop off to sleep. The sad thing is, my partner sleeps like a baby, and says that he's always been able to sleep really well since he's been with me. Shame it doesn't work on me!!

[joannap]

i do know from my own personal experience that an antidpressant i have been on once - did not work for me the second time. it sounds as though you are experiencing side effects from being on this doseage but not the benefits and after 5 weeks - i would expect to see signs of improvements. perhaps you need a word with your doctor and try a different one. there is no point being on a med where you think you are going backwards lol x