citalopram round 2

[colinbrad]

2nd round of Citalopram for me lived with Anxiety for 14 years then clear for just over a year, had a nasty bug over xmas and that has kicked it off again, self medicated on the wifes amatryptalyn just made me very tired and dozy, went to the docs she prescribed 10mg Citalopram per day as I had been on that prior to my recovery, day 1 ok day 2 severe stomach cramps and feeling crap day 3 decided to cut to 5mg, anxiety still bad but physically feel better, decided to swap to taking at night took 5mg and slept ok, took another 5mg last night feel quite stressed and shaky today, went for walks feel slightly better sitting here writing this at 7:00 PM resigned to just keep going as I am for now.

[panic_down_under]

back to NMP,

had a nasty bug over xmas and that has kicked it off again,

An immune system in overdrive may trigger or worsen anxiety and depression. In several respects, anxiety and depression are the symptoms of an immune system disorder. Patients taking immune system boosting meds such as interferon to treat viral diseases and cancers are now often also routinely prescribed an AD because of this (immune system proteins may also reduce the effectiveness of antidepressants).

self medicated on the wifes amatryptalyn just made me very tired and dozy,

Self-medicating is never a good idea, not least because often the available dose is too higher to start on. For amitriptyline the ideal starting dose is 25mg.

went and the docs she prescribed 10mg Citalopram per day as I had been on that prior to my recovery,

Is a dose increase to 20mg planned? ADs work by stimulating the growth of new brain cells (neurogenesis) which takes a minimum dose to initiate and sustain 10mg may be borderline. Frequent interruptions to neurogenesis may increase the risk of the med pooping-out. As you've been on citalopram before you may need to take a higher dose than the last time to achieve the same level of control.

day 1 ok day 2 severe stomach cramps and feeling crap day 3

Serotonin isn't only a brain neurotransmitter. It has many roles in the body and the gut makes and uses far more serotonin than the brain doses. It makes about 50 time more of it than the brain. The enteric nervous system (ENS), the mini brain which controls the GI tract can initially be far more affected by SSRIs than the brain is. The cramps and other side-effects should begin to diminish after a week, or two as the body responds to the SSRI driven increase in serotonin activity by reducing its synthesis and expression, but may return for a short while after dose increases. Talk to your pharmacist about the cramps as these can be diminished with otc remedies.

went for walks feel slightly better sitting here writing this at 7:00 PM resigned to just keep going as I am for now.

Exercise has been shown to induce neurogenesis too, so walks are a good idea.

Dropping the dose is probably a good idea as the side-effects may be more severe and/or different when restarting ADs. However, you should get the prescribing doctor's okay. It takes 7-8 days for citalopram plasma levels to stabilise to a steady-state. Increasing the dose sooner may significantly increase side-effects severity, but delaying an increase won't significantly reduce their severity no matter how long the delay.