Has Citalopram caused anyone else depression?

[Suziewuzie]

Hi guys. I've been reading posts on the forum for a little while now & thought I would finally bite the bullet and join.
I was commenced on Sertraline for panic attacks and anxiety recently as I'd been on it some years ago and had good effect. However after 9 days I couldn't tolerate the awful side effects any longer and was switched to 10mg Citalopram.
I've been taking citalopram for 11 days now and have found I'm really depressed. I used to lead a relatively normal life with my anxiety, I had bad panic attacks but then I'd be OK after a while. But since starting on these tablets I don't want to get out of bed, I don't feel happy about anything and I just cry all the time. This isn't me at all :( and I don't know if this is normal, if it's the tablets causing this or if it's just me. Has anyone else ever felt like this?

[Darwin73]

Well, I was prescribed Citalopram for OCD about 18 years ago now. To be honest, I didn't want to take it as I didn't feel depressed (knew it was an anti-depressant), but I thought I'd give it a try. After a few days, I felt that my worries lessened, but so did my 'good' emotions. In fact I remember being on a day out at the seaside and feeling nothing looking out to sea, when usually I'd feel excited, happy, pleased to see something beautiful. I just felt nothing. I made a decision that ADs weren't for me if they stopped me from feeling like myself. I get that they are very helpful for some people, but in my case, I figured that my feelings were not caused by a serotonin imbalance. I've never regretted that decision, but at least I tried them. Have you looked at the side effects of Citalopram? I think if they are having this effect on you, you should maybe go back to your GP and tell them.

[MyNameIsTerry]

Yes, SSRI's can cause depressive symptoms when you go through the side effects window.

When I started Citalopram I went straight on 20mg and within days I was very low, crying, etc. Prior to that I had never had anything like low mood and had only developed GAD about 6 months before.

I would suggest waiting it out as this should clear, mine did. A big part of it was insomnia too and this did go away but my GP got me dependent on Zopiclone (didn't tell me the right way to use it) and this also messed my sleep up. I too felt like I couldn't move for hours in the mornings although I thought this was the Zopiclone. My sleep corrected itself after a few months and got off the Zopiclone in about 10 days after being on it daily for over a month.

Keep your GP in the loop. If it becomes too unbearable they may decide to switch. If you have any suicidal thoughts, then I'm sure you know what you need to do with being a nurse. If the thoughts are intrusive though, that can just be part of the anxiety and not real thoughts of this.

[Suziewuzie]

Thanks for the replies guys I appreciate it. Realistically I know it's incredibly early days and I don't really want to go back to my GP and tell her I'm feeling depressed because I suppose there's not much she can do aside from change my tablets again - which I'm really not keen on. My friends have been telling me to "just stop" taking them because they're convinced I'm getting worse which isn't really helpful. I know messing around with brain chemicals is never going to be plain sailing & I should expect this.
My sleep is horrendous since starting SSRIs, I'm only getting an hour or two a night but really not keen on starting zopiclone but I don't actually know why.

[MyNameIsTerry]

Some people find Citalopram causes insomnia when taken at night and once they shift if to the morning things improve. Some people find even that doesn't help bit perhaps it's worth a try?

I had insomnia like that hence going on the Zopiclone. It was very helpful initially but gradually it was doing less. You could try to use it just to get some respite for a few days. That may restore your strength.

Sadly these meds are well known to make many people whose before better so it as matter of pushing through. If it gets too unbearable your GP will understand. Like you said though, they are limited to switching to another and that may mean a period of side effects so if you can get through this, at least it will be over quicker.

Insomnia is very hard to very through. You will find many on here who understand.

[Suziewuzie]

Thanks Terry. I'm speaking to my GP tomorrow, it's been 2 weeks on citalopram now plus the 9 days I had on the Sertraline I would've thought after 3 weeks on SSRIs there'd be more of an improvement than this. I'll speak to her about the zopiclone then - I give it to my patients all the time without a second thought so don't know why I have an issue taking it myself?!
I just wish there was a tablet that I didn't need to take every day, one that I could just take whenever I was having a particularly anxious day, because before this I had plenty of normal days but now every day is grey. It's like someone's turned off all the lights in me :(

[MyNameIsTerry]

I think many of us would understand your frustration, Suzie. We tend to go by 4-6 weeks for side effects but it can be much less than this. Citalopram side effects started easing off in week 3 and then by week 5 they were gone but much more bearable in-between this period than earlier.

The thing is, whilst they are from the same drug class they do have slightly different effects. SSRI's don't only work on Serotonin, they have varying weak links to other neurotransmitters so that can change slightly when you switch. I've seen people o here say their GP's have said Citalopram is more activating and Sertraline more sedating. That would make sense given the licencing they have.

They also work in 2 stages. Initially they are just flooding the space with more Serotonin preventing it being used up but after a period of time they also plug the holes in the receptor sites which is really what they are being used for. I can't remember which SSRI it was now but I remember seeing a study of one where it said the secondary action was seen at around a month. This would make sense when we go by a 4-6 week rule for side effects. Having said that, there are always people getting effects earlier so it's always individual.

GP's are cautious on sleep aids so I'm sure they will be a good person to give you some advice on this. They may prefer not to go this way, it's only a suggestion in case a few days respite might pull you through. I wouldn't get to rely on them as that can be a bit of a crutch. I remember feeling that way about them because of how much the insomnia & mood drop hit me. I know now it would have been better to put up with some of the insomnia as long as I was catching up and a short course might have been better.

I don't think my experience of Zopiclone is typical in terms of how my GP approached it. He called the Crisis Team straight in over my symptoms but since I joined this place I realised what I went through is pretty standard on these meds so my GP's reaction was uniformed. The second time her put me on a SNRI instead and I went through much worse and never took anything despite him dishing them out aside from a couple of Diazepam at the very worst of it. I wish I had been on here back then as there is so much knowledge across the members.

[Suziewuzie]

You're being so helpful, thank you!
I did expect to feel worse before I felt better but I didn't expect to feel so deeply depressed. I suppose the lack of sleep won't be helping that though, and being off work obviously won't be helping either. If I look at it like that I suppose it makes perfect sense but in my mind all I can see is doom & gloom that wont dissapear. I haven't had any other effects apart from the lack of sleep, and I'm going to take my dose a couple of hours earlier today thrn slowly bring it forward to the morning.
Would you say 6 weeks is an appropriate time to wait before I start to think they aren't working for me?

[MyNameIsTerry]

The lack of sleep could be hitting your mood. I know the insomnia started for me first and then the mood sunk. So, a bit if respite might help you recover from this enough to keep going but with it being a side effect it could always go shortly anyway.

Doctors tend to be reviewing around the 4 week I think. I seem to recall NICE guidelines stating to review every 2-4 weeks initially. Two weeks is a bit short really but 4 is closer to when they would expect most SSRI's to be through the side effect window (except Fluoxetine as it has a much longer half life and this pushes the side effect window further).

It's hard to say about them working. I always think that you get through the side effects first and then you can see how it helps. I can't see how it can help until it gets through that point but having said that, even on my current SNRI I did experience a few good days out of nowhere after 7 days and then it dipped again but I was tapering up to the correct dosage and the dose this happened on was never expected to be helping.

I think your GP will want to assess them somewhere around that 4 week mark so it's worth getting their opinion on whether you try a bit longer or switch. 10mg is half the minimum therapeutic dose so I would imagine that if improvements don't come, they will want to increase to that to see.

For me, Citalopram starting helping after about 2 months and then the difference in month 3 was more noticeable. But plenty of others on here have seen effects far earlier than this so it's not something you can determine from one person. It would be worth having a read of a few of the threads to see what others have experienced. Many people even record diaries on the Meds board so there may be some on here somewhere to show their journey starting them.

[KeeKee]

You can become more depressed with any antidepressant before it gets better. It never happened to me but I was warned from my doctor about it