Best taking one a day or half dose twice a day?

[perry12]

I have been on Citalopram 20mg for 2 months and I have just been advised to move up to 40mg

When I have been on SSRI's in the past, regardless of the dose I have always had it in one tablet. I was wondering is it best taking it in 1 hit in the morning or having half dose in the morning and half at night, so I would move to 40mg but have 20mg morning and 20mg evening

is there any real difference or not? its just I take mine in the morning and sometimes feel after work at about 6pm that I could do with something to take the 'edge' off as if my levels were dipping again

What do you guys find best?

[MyNameIsTerry]

Thats a bit of a jump, perry. Thats the max dose. They can try 30mg too so I'm wondering why they didn't opt for that?

The half life of Citalopram is quite long at 35 hours. It takes 4 hours to reach peak plasma levels. At 35 hours it only reduces by 50% so if you said 12 hours it would only have reduced by somewhere between 100-82.9% presuming a standard rate of decline (which may be wrong, it's a maths calc, nothing more)

There is a cost implication here too. Your GP can prescribe 10, 20 or 40mg. There isn't a 30mg dose. You can find out how much these all cost the NHS as it's all listed online. The odd thing is with Citalopram is that coster per year (looking at 2011 for Coventry & Warwickshire NHS, the first a Google search pops up) are 10mg = £17, 20mg = £44 and 40mg = £18. Weird eh?

So, your GP is out of pocket prescribing 10+20mg. However, this is annoying because remember that is cost per year and if you pay a prescription charge you would pay £98.40 per year and since 10+30mg would mean 2 prescription it would be double this! Eitherway, the NHS is making a profit...which they don't tell us about

If your GP has pushed you up only because it's the next dosage up I would see what others think as there are people on here taking 30mg and finding it helpful.

[perry12]

Hi Terry

Thank you for that, so there isn't really too much difference in just taking one tablet to taking the 2 tablets.

I went to pick up my prescription and it is for 28 days with one tablet of 40mg, however.. my original prescription is for 84 days of 20mg which I asked for, I think I will continue with this as it is pretty much 42 days at 40mg.

It was a psychiatrist which recommended the move from 20mg to 40mg, however the psychiatrist has also recommended if 40mg doesn't satisfy, I can then add Pregablin on top, I don't know much about the drug and don't want to be mixing things up as I have never had too many serious side effects with SSRI.

Hopefully 20mg to 40mg isn't going to be too much of a jump, I started yesterday as i have 2 weeks off work now to let things ease in.