View Full Version : Starting Citalopram Tomorrow After Severe Relapse - Advice Needed Please
Hello folks,
I am crying as I write this so please bear with me. :weep:
A quick History - I have suffered from Agoraphobia on and off for 6 years but was able to go out with a safe person and could walk my dog by myself. In January I had a relapse and started to have panic attacks when walking my dog. This got progressively worse until I was unable to leave the house without having a severe panic attack. This led to severe panic attacks at home as well which I didn't suffer from before.
In the past 6 weeks I have suffered from severe anxiety day and night with occasional 12 hour panic attacks that keep me awake all night in a complete state of panic and despair. When I panic I feel like I will faint or collapse, my heart races, I have a tightness in my chest that makes me feel like I can't breath, I shake from head to toe, I retch and am sometimes sick, I have blurred vision, my mouth gets dry... you name it I've got the symptom.
After a particularly bad attack on Wednesday night my sister came to stay with me and I told her I wanted to kill myself. I don't want to kill myself, but I WANT THE PANIC ATTACKS TO STOP as I am no longer able to function. I cannot eat properly, I cannot sleep, I can barely look after myself and I fear that I will become too unwell to look after my dog.
This all led to me being referred the the Mental Health Crisis Team who came to my house to assess me. They have put me on Diazepam for a week and on Monday (tomorrow) I have to start taking Citalopram. I am terrified of taking this drug as I cannot imagine my anxiety being any worse and I am scared of what I might do if my attacks get any worse.
Originally I was told to take 5mg of Citalopram and to increase the dose to 10mg when I felt ready. I was also told to take them at night. I did as advised and within an hour of taking the Citalopram I was violently sick and couldn't stop shivering. This went on all night and I was in such a state of panic even my boyfriend thought I was much worse when on them so I stopped taking them.
My Psychiatric nurse has told me I have to take the Citalopram again only this time I have to take 10mg and I have to take it in the morning. Having looked at my prescription, the Dr has said I should take the Citalopram at night, so I'm now confused about when I should take it? Why have two different Drs told me to take it at night when the nurse has told me to take it in the morning? And why have two Drs told me to start on 5mg and increase the dose slowly when the nurse has told me to start on 10mg?
I am so scared. I am alone, in a state of constant panic and absolutely dreading the side effects of the Citalopram.
I would really appreciate some support/advice/guidance from anybody who has been through the same thing please.
How bad are the side effects going to be? Will my panic attacks get wose (I really don't think I could bear them to be any worse than they are)? Will the sickness pass? Please don't tell me any horror stories as I'm frightened enough as it is (understatement)!
I am genuinely scared that I will never get better and that my panic attacks will never stop. I feel like I am in hell. Please help.
*Just thought I would add that I've been crying almost non stop for 4 days now and I've been told I have depression. I have never suffered from depression before and generally have a cheerful and positive outlook despite the agoraphobia. I think if I am depressed it is because the anxiety has got out of control and I feel so helpless.
I'm sorry you've been having such an abjectly horrid time.
Re dose, it's difficult because your doc wants you to get better ASAP and therefore reach the optimum level quickly. This obviously has to be balanced against initial side effects and worsening of your condition, so perhaps it would be wise to take your doc's advice - go with 5mg and increase slowly. I know you probably don't want to be a burden on others but I feel you should stay with someone who could monitor you. At the very least, let family, friends etc know you're starting on a med that could potentially make you feel worse before it kicks in. I'm sure your MHT will also be supportive.
Re timing, citalopram can be taken morning or night but taken at night could interfere with sleep, although it has the opposite effect in some people. I would, again, follow your doc's advice here: take it at night and see how you go. It's trial and error sometimes.
I think it's pretty normal to feel a degree of depression when anxiety symptoms persist but I think treating your immediate anxiety is essential and I hope the antidepressant along with support from friends, family, bf, MHT and NMP help you to get through this terrible time.
LauraSmith27
05-06-11, 16:09
Hi Shoegal
I'm sorry to hear you've been having such a bad time. It sounds like you've reached rock bottom just as I did two months ago. I'm glad to hear though that you're going to give the citalopram another go.
Why have two different Drs told me to take it at night when the nurse has told me to take it in the morning? And why have two Drs told me to start on 5mg and increase the dose slowly when the nurse has told me to start on 10mg?
I think this is all just a case of different people having different opinions. I would try not to worry too much about it. I had one GP tell me to start on 10mg and another said 20mg. One also said morning and the other said night. I think you just have to do what you feel most comfortable with. If you want to start very slowly with 5mg, then do so. The nurse probably thinks a dose of below 10mg will barely do anything so is advising you to start off higher, but if it makes you feel better to start on 5mg, then go with that. As for the time of day, that is also up to you. I find taking my cit at night is better, but this varies from person to person. Again, I would try not to worry too much about it, just go with what you feel.
How bad are the side effects going to be? Will my panic attacks get worse (I really don't think I could bear them to be any worse than they are)? Will the sickness pass? Please don't tell me any horror stories as I'm frightened enough as it is (understatement)!
You won't know how bad the side effects will be until you start taking it. They usually pass within a couple of weeks. I had tiredness and headaches to start with, but this quickly got better. I didn't experience a worsening of my panic attacks at all, maybe you won't either. I think I mentioned taking anti-sickness tablets to you before if you are worried about being sick. I don't know if you could ask your GP about these. I've found them very useful in the past.
I really wish you the best of luck with restarting the citalopram. I know how it feels to be scared and alone. I was terrified of starting this drug too, but it has helped me loads. No matter how hopeless everything feels, don't give up. It won't be easy, but you can most definitely beat the panic attacks.
Best wishes,
Laura x
Thank you for you advice. The Psychiatric nurse said she was going to be strict with me and is coming to see me in the morning to check if I took my Citalopram. :ohmy: Personally I want to start on 5mg because last time when I took that much I felt worse than ever and I can't imagine what 10mg would do to me! My panic attacks are severe and if they get worse I'm concerned I will be tipped over the edge! I definitely don't have anyone who can be with me which doesn't help wth my fears about how I will cope with the side effects so I really think I should start on 5mg. But if I don't do what the nurse tells me I feel like I'm being naughty and will get into trouble! It's easy for them to dish out orders when they are not living in this hell isn't it?!!
I have just had another severe panic attack and the Diazepam has barely done anything. My sister phoned and heard the state I was in so she told me to ring the Crisis Team. She said they need to hear what I'm like when I'm not coping. This whole thing is so degrading. I'm begining to think that I will never recover from this nightmare. I just don't know what to do anymore. I have not eaten today because I have no energy, feel sick and can't stop crying with anxiety and panic attacks on top of that. WTF is happening to me?
UPDATE: The Crisis Team have just called me back and I told them I felt panicky and I was worried about starting my Citalopram tomorrow. My Psychiatric nurse has said I MUST take 10mg and I must take it in the morning. She said they are only prescribing Diazepam for me to help me cope with the 10mg dose of Citalopram. So in other words they are blackmailing me, and would withhold the Diazepam (the only relief I've had in months from my panic attacks) if I don't do what they tell me. I feel scared and a bit like I'm being bullied into this! I've also been told I 'have' to take it in the morning even though two different Drs told me to take it at night. I am fed up and confused.
First of all, I'm really sorry to hear that you're having such an awful time at the moment. I know from my own experiences that anxiety can be crippling, although I'm lucky to never have had real problems with agoraphobia (other than finding crowds hard work sometimes).
I can understand that you're feeling worried about taking the Citalopram - BUT don't forget that not every body has problems with side effects. A lot of people take it with no problems at all, or ones that ease off after a week or two. I've actually taken Citalopram three times now, and each time I've started them I've had different side effects. Only one time out of the three has it made me feel more agitated, but it wasn't the same as panic symptoms; I felt restless and twitchy, but it didn't translate itself into panic in the way that I'd normally describe it. I started with 10 mg and to be honest, I didn't feel much effect from it at all - it was only when I stepped up to 20 mg that I could feel that I was taking any medication.
I agree with the others that you need some urgent help, and at least the Crisis Team are very experienced at dealing with this sort of thing.
I can also understand how you're feeling at being told what to do, and I can see how you feel that you're being blackmailed. However, there are times when all of us need a bit of "tough love" (I know as I've been there myself) and we have to accept that maybe we need to take advice for our own good, even though it might not feel like it at the time.
Good luck, and keep us posted.
LauraSmith27
06-06-11, 11:12
Hi Shoegal,
How did things go with your psychiatric nurse this morning? Hope you're ok.
Laura x
Hello people,
Well... I took my 10mg of Citalopram this morning along with 4mg of Diazepam as recommended by my Psychiatric nurse. Then I went back to bed because I didn't want to think about things. Within half an hour I had to run to the loo because I had the runs (TMI) and then went back to bed and fell asleep. I woke up at noon and had to run to the loo again! I've just had some Weetabix and again I have an urge to run to the loo. I've not had an upset tummy at all even when I had severe anxiety so could this be a side effect of the meds? Other than feeling slightly more anxious than usual I can't say I've noticed any other side effects... YET! However it's early days and I don't mind admitting I'm scared. :huh:
Hello people,
Well... I took my 10mg of Citalopram this morning along with 4mg of Diazepam as recommended by my Psychiatric nurse. Then I went back to bed because I didn't want to think about things. Within half an hour I had to run to the loo because I had the runs (TMI) and then went back to bed and fell asleep. I woke up at noon and had to run to the loo again! I've just had some Weetabix and again I have an urge to run to the loo. I've not had an upset tummy at all even when I had severe anxiety so could this be a side effect of the meds? Other than feeling slightly more anxious than usual I can't say I've noticed any other side effects... YET! However it's early days and I don't mind admitting I'm scared. :huh:
Yes, I'd say it was a side effect of cit, Shoegal. Don't worry as it's transient. Drink plenty of water as you're likely to be dehydrated and take it easy. I don't think milk will help. Try eating some plain toast if you can stomach it...
Keep us updated and stay strong.
Hi Shoegal
I'm so sorry that you're going through this, it sounds awful and you have always been so supportive and kind to everyone else on here. I take citalopram, I've been on it for over two years, and am on the highest dose 60mg. I was recently changed to vensir which didn't work and am now back on citalopram. i remember starting them and as I was starting to feel so low and anxious, I also worried about the increased anxiety and possible suicidal thoughts. But to be honest it wasn't that bad, I felt nauseous for a few days and a bit anxious (but I think that was more to do with panicking in case they didn't work!!). But it really wasn't too bad. I also take mine in the morning and have never had any problems. Please take care and let us know how you are getting on.
Lots of love
Tina xx
Hi Shoegal,
Firstly so sorry that you are having such an awful time.
I have taken citalopram in the past and it did cause stomach upset (runs) when I first took it so it is a side effect of the medication. I found I just drank lots of water and ate dry toast or munched on a dry cream cracker. It will pass once your body gets used to the meds. I always started on 10mg when starting out before slowly increasing when I felt ready.
I hope that you feel better soon. You have a lot of support here.
TC
Jo.xx
I was on 20mg citalopram until last year and it worked brilliantly. The only thing i had was a feeling of being wrapped in a warm blanket which felt great!
Be strong and brave and persevere with it. It's worth it x
Hello everybody,
I had a visit from the Psychiatric nurse this afternoon and she said I had done brilliantly to take my Citalopram today (I've been really scared to take it). I said 'Wait until you hear my even BETTER news'... which was that I walked my dog around the corner with my Dad and then walked back home on my own AND chatted briefly to one of my neighbours as I passed them in the street! OK so it did make me panic and I couldn't get home quick enough, but considering I've barely left the house for weeks and I'm on day one of my Citalopram journey (shock horror) I'm quite pleased with myself for plucking up the courage to leave the house! The nurse told me there is no way I could be feeling any side effects from the Citalopram yet, but I don't believe her, lol. I've had an upset tummy, nausea and a slightly woozy feeling in my head with heightened anxiety on top of that. I know the anxiety could just be me but throughout my whole breakdown I've not had an upset tummy! Anyway... I will keep you posted (unless my side effects get really bad and I can't come online, lol).
Hi shoegal,
Well done you did really well....you will get there....just takes time.
TC
Jo.xx
I now have strange tingling sensations in my legs and I feel really panicky again. Is this the Citalopram? Oh and I've been retching as well and my limbs feel heavy.
LauraSmith27
06-06-11, 22:14
Hi. Sounds to me like it's all just side effects, or anxiety. Keep hanging in there, try doing things to distract yourself. Well done for going out today.
Laura x
paula lynne
06-06-11, 22:33
Im chuffed to bits you went out with doggy and your dad despite feeling crap. Well done x
Ive never been on Cit, but from what Ive read on here the first week or 2 cant make you feel very peculiar, but hang in there as it will pass. Hope you manage to eat something to keep your strength up. Thinking of you x:hugs:
Thanks Paula. Your support means a lot xxx
Anxious_gal
07-06-11, 04:16
Sorry to hear your panic attacks got worse :hugs:
I went through a period of sever anxiety and depersonalization, for a few days, ever so slowly I did improve but the worst part for me was the sheer fear that it would never go away but it did :)
The lack of sleep really made me worse, I went 3 nights without sleep!
I'm so sorry you had to through that too, but in the end it did make me a stronger person, I learnt how to cope better because I really didn't have a choice, I like to try and see the positives in even the worst situations x
I felt faint too, and I was shaking all the time, I usually hide my anxiety from my family but I couldn't that time,
I was getting sick too but nothing came up because I was too anxious to even eat.
It breaks my heart to hear of anyone going through that , for me it was one of the worst times in my life,
I've anxiety 11 or 12 years now and never knew it could get THAT bad, a panic attack is one thing but bad anxiety that feels never ending ,:(
I understand that some times in a weird way its nice to feel like you have an option (death) , just to stop the panic attacks and pain, I know you didn't want to do it, just more a fantasy, we all have points in our lives where we toy with the idea or fantasize about it.
I'm glad your sister was there for you x
your a good person and you do have the strength to get better :)
I got better well not 100% yet without any medication, but it took me months due to having to wait to see the mental health team.
I learnt to cope better due to basically being on my own a lot as my mum had into rehab.
I think give the meds a chance and if they don't work maybe ask for a different kind :) Also from what I've read your body does get used to the meds and the side effects decrease,
personally when a medication gave me side effects I knew it was the meds, i was having feelings and symptoms that i never had before.
but you can also work your self up by worrying and make your anxiety worse, I do this with most meds.
did they give you any sedatives just as they can really help take the edge off and help you sleep better.
"I am genuinely scared that I will never get better and that my panic attacks will never stop. I feel like I am in hell. Please help."
you will get better x x I got better and I really didn't think I would, maybe therapy will help? it helps keep me on track and motivates me, it's so nice having someone there helping you.
you need to remind yourself of what a wonderful person you are x you deserve to be well and in time you will be x
I'm replying as I'm reading through your posts,
I 100% understand feeling degraded, I have one doctor make me feel almost ashamed of my self for having a panic attack....
I found that accepting that I do become irrational, neurotic and over act when I'm having anxiety, helpful.
it's why its called a panic attack or anxiety you have very little control over it. but it really doesn't help when people make you feel like a crazy person :(
they simply cant relate to how your feeling.
if you can't eat drink your calories! milk, tea, pop, hot chocolate, even sip it, its better than nothing.
it's normal not to want to eat, when you get anxious all the blood/energy goes to your muscles, and you digestion doesn't work as well x
well done on taking the meds:)
yay you went for a walk :) believe me that going outside even for a short walk worked wonders for me x plus it gives you something to feel proud of :hugs:
Thanks for your kind reply mishel, and everybody else of coure. :)
Last night I couldn't sleep so at 4am when I was feeling quite anxious I decided to listen to a Paul McKenna Deep Relaxation CD. I fell asleep during the introductory music so I've got no idea what he said to my subconscious mind whilst I was asleep, but whatever it was it didn't work because I woke up at 7.30am in a total panic. I tried to doze until 10am (pill time) but got up at 9.30am and phoned my Crisis Team (I can just imagine them on the other end of the phone saying 'Oh it's HER again...)! :blush: Anyway, I rang them because I've been taking Diazepam to control the severe panic attacks I've been having and to help mask the side effects of the Citalopram as my body adjusts to it. I phoned the Crisis Team to tell them that I was panicking despite being on Diazepam and I thought the Citalopram was making me worse and that I was scared to take todays tablet. I was basically told that Citalopram can't make me more anxious and it's all in my mind. Erm... well why did the Dr prescribe me Diazepam to help control the increased anxiety then? I'm sure they are just fobbing me off to make me take these nasty pills like a good girl. Well, I've had some Weetabix (I have no appetite at the moment and feel very sick) and I've taken the damn tablet. So I'm just waiting for all hell to break loose now... :wacko:
Your side effects are just like mine were Shoegal ..Anyone who says Cit doesnt cause extra anxiety at first doesnt know what they are on about .All I can say is it will pass and the more you react to it the worse it seems .The sickness is horrendous I can remember retching at the very thought of food and I even found eating yoghurt wasnt easy .I found Complan and smoothies easier to get down .Tiny ammounts of food throughout the day instead of ordinary meals .Try to keep occupied and even tho its easier said then done ..it does help .You have my sympathy .:hugs:I hope this all passes soon for you and remember that its all for the good .Citalopram really has helped me and despite the start .Im glad I went on it.Im sure you will too .Take care Luv Sue xx:hugs: Ps .. Just to say Ginger and lemon tea and ,stem ginger will help with the sickness ..x
Hi Shoegal
Sorry that you are having such a bad time at the moment. I started on 20mg of citalopram just over a month ago. Although I did feel awful to start with I feel so much better now. Please hang in there and keep taking your tablet each morning. In a few weeks you'll be so glad you did.:flowers:
I've been like you shoegal and my heart feels for you it really does. I was a proper mess for many years before I started to take pills.
I get the runs all the time, upset stomach e.t.c. Just remember to drink water. Apart from that don't worry about it.
Citalopram for me made me very sleepy, increased panic attacks and feeling like crap....but! it does subside and for me it done wonders but every now and again I feel like shit but I get through it.
Get a bicycle and a buddy get some exercise on the country roads I bet that will help you loads as well. Exercise for me helped me feel the difference between good heart beating fast and the other it also made it less scary the more often I done it even though I felt terrible for like a month when I begin doing it.
Day one on Citalopram wasn't too bad, but I couldn't sleep at night and when I did finally drift off I woke up 3 hours later having a panic attack.
Day two has been awful. I feel disorientated, fuzzy headed, sick, and VERY anxious. I have told the Crisis Team that I can't bear the increased anxiety and they are basically telling me that it's all in my head and that I won't get any side effects until day 3 or 4. Well WTF am I going to be feeling like THEN then? I am so scared. Please bear in mind that I live alone and I'm struggling to prepare meals and look after myself and my poor little dog. I just don't feel like I'm functioning. How long will it take for the increased anxiety to bugger off? That is the WORST side effect for me (so far). :weep:
ShoeGal is there anything in your life that's causing this anxiety? It has to come from somewhere. Whats on your mind?...Money?, not living up to your own expectations? Listen to your thoughts is something u think you don't like? I'd like to help you with advice.
Hi Shoegal
Sorry to hear you are having such a rough time with things at the moment. I am on another SSRI (Sertraline) and from what I remember the side effects started a few hours after taking my first tablet. I felt awful for around four weeks, mostly down to insomnia and stomach problems (diahrhoea was particularly bad) and seriously considered coming off them as I felt no benefit at all, only worse due to the side effects. Then after four weeks the side effects unexpectedly cleared up and after five weeks the drug started to kick in and I felt MUCH better. I am so glad I was able to stick with it as the benefits certailnly paid off in the end.
Keep going with it if you can Shoegal. I know how tough it is at first, but just take one day at a time as these drugs are often very successful but do take a while to work and unfortunately make most people feel worse initially. The side effects do vary from day to day though, some days will feel better than others but your body should adjust to the drug given time.
Best wishes.
Tyke
Hi Shoegal
Sorry to hear that yhou are not feeling to good
How are you feeling today
I am on Citralopram but only 10mg and my doctor will not increase them
I find somedays that I could knock the world over and then othersd I have a really bad day with panic attacks which frighten me
I dont know if you are like me I go very hot and that is when the panic is starting and I cant seem to stop it and I try and fight it which makes it worse and last longer.
Keep in ther you will do it.
Joanx
Hello people,
Well it's day 4 of my Citalopram journey today and I have to say it's been pretty scary. I can cope with the funny tingles, the head zaps, the nausea, the upset tummy etc but my anxiety is escalating at an alarming rate and THAT is something I'm finding hard to deal with. I have some Diazepam that I've been given to help with this but to be honest it doesn't seem to be hleping much.
Can anybody tell me whether Citalopram will actually help with my anxiety and panic attacks in the long run because if not this is NOT going to be worth it, lol. I am hoping that once it gets into my system I will feel less anxious and will be less likely to panic. Is that what happens or am I just kidding myself?
I suppose any of us can only relate how anti-depressants work from their own experiences. For me, they most definitely do work.
I really was at my wit's end when I went on them just before Christmas last year; I'd been trying to fight it off for three years without medication and could only ever hold it off temporarily. I was utterly worn out; I couldn't sleep through a night at all, my concentration was very poor and I just never got a break from the adrenaline. This also gave me loads of physical symptoms including the worst bout of IBS I've ever had in my life.
It did take a little while to get into my system, and what I also found was that although 20 mg worked for a couple of months, I eventually had to up the dose to 30 mg, which has now stabilised me. I did have some temporary side effects but they've all gone now.
The best way I can describe it is that the citalopram have given me my life back. I can function normally; I'm very lucky in that I haven't lost any time off work (I'm far too stubborn to go off sick!), but I now sleep through most nights and don't spend the day worrying about stuff I can do nothing about. I have odd bits and pieces of anxiety, but that's OK as everybody else gets those anyway.
And the best thing about it is that I don't feel as though the medication is "making" me better - I just feel normal (for me, given that I'm naturally quite nutty :)). This wasn't the case when I took Seroxat some years ago, as it made me feel sort of "flat" and detached, which I didn't enjoy.
I am on Sertraline (another SSRI), but it has definitely helped with my anxiety. Before I took Sertraline I hated going anywhere, talking to people had constant anxiety and worsening anticipatory anxiety if something came up that I had to do that I couldn't face, now all that has largely gone. On top of that I don't feel miserable anymore too. Like blueangel says, everyone is different and there is no way of knowing exactly what it will do in your case, but there is a good chance it can really help you, so it's worth sticking with it if you can.
Don't worry if you feel you can't though. There are other medications available if this one really doesn't suit you.
Good luck :),
Tyke
Day 7 - Feeling really achy all over today, especially in my legs when I'm walking up and down the stairs. I have no appetite and feel sick most of the time. I can't sleep until about 6am and then wake up at 9.30am! I feel very anxious all the time, I feel dizzy, I have blurred vision and to top it all off I have tingles all down my legs. Is this normal for the early days of Citalopram and is it going to get any worse? On a plus note I feel less weepy and slightly more cheerful despite the horrible side effects.
Day 8 - Feeling tired, weepy, not sleeping, hurting all over, feel sick and have no appetite, very anxious, and to top it all off it's my Birthday... :weep:
On a plus note I'm 8 days in so hopefully I will start to feel better soon. Fingers crossed eh?!!
Hi Shoegal,
I don't take citalopram any more as my dr thought i needed a change. i am now on Duloxetine. I would advise you to read psychopoet guide to citalopram if you have not done so already and maybe even contaact him. he is a great guy and very helpful. i am so sorry you are going through this i know how horrible panic is. i am currently on holiday at friends villa in bulgaria. i was coping well for the first week but then panic reared its ugly head yesterday (which is why i ended up back on this site again today!) and now those horrible sypmtoms you described .... no appetite, shaking, dry mouth, hot & cold sweats are back. I totally undeststand how you feel.
stick with it tho hun as stopping and starting will make you feel worse. do you have any friends who could stay with you while you are feeling so bad? I know I hate being alone when I'm like this (i've been been bad since early January and was told a break may do me good). I stay with my parents which does help calm me somewhat.
I'm so sorry you are feeling like this on your Birthday. Hope you get some sleep and are feeling better today.
Take care
Julie xx
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