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Thread: Starting Citalopram

  1. #1

    Starting Citalopram

    Morning Everyone!

    Starting citalopram at the moment and just taken pill number 3 so I understand I am early on in the recovery, but the side effects have side swiped me a little. I thought setting this thread up might help me in the journey as I can at least look back and see when things were worse

    Background for me is that this is my 5th break in my life and the past year has been a tough one and I have not been able to keep the break from happening, lots of work stress, a death in the family and a lot of health investigations. I have PCOS, Diabetes type 2 and Severe Anemia as well as having to see a physio for a weak ankle and I hate all of it. I was on citalopram once before about 7 years ago and remember that it really was wonderful once it started working and allowed me to do my CBT and develop other techniques that worked well for years.

    So I am talking my tablets in the morning and they are not making me sleepy so far. Day 1 was ok, managed to still get out to the cinema with only my usual level of anxiety. Day 2 though WOW - anxiety through the roof, few panics, hot leaden feeling in the chest and feeling sick and struggled to eat (which I have to do for the diabetes). The night was awful, full on waves of panic and anxiety before bed and when i got in. My husband basically had to hold me until about 2am when I fell asleep and then I was awake at 5. He is wonderful and a real comfort and rock of support.

    Taken todays anyway, but scared to death of being like that again and spiked the fear that the meds are harming me in some way and that there is no way out of this. My meditations don't seem to help and panic is climbing right now just 90 minutes after the tablet. I know I could easily be doing it to myself, but as you will know well it isn't easy to switch that off.

    Anyway - a blog for myself, but if anyone has any kind or assuring experiences please feel free to share as I am struggling right now

  2. #2
    Join Date
    May 2014
    Posts
    5,590

    Re: Starting Citalopram

    Hi, you might want to look at Stressed Eric's thread who started citalopram 2 weeks ago headed 'high anxiety' and Suemarieeee who has gone past the 3 month barrier. x

  3. #3

    Re: Starting Citalopram

    Hi Carnation

    Thanks for the advice. I have been stalking the forum for a little while and have read the threads, I guess I wanted to journal for my own sanity, but will reach out to the others as well.

    I am experiencing rolling panic and sweats at the moment and even unpacking some shopping we had delivered was really difficult. It is hard at the beginning I think to see the way out

  4. #4
    Join Date
    May 2014
    Posts
    5,590

    Re: Starting Citalopram

    You just have to keep telling yourself that the reward at the end is worth the struggle now and take more tlc time in the meantime. It won't hurt to not do all the jobs you normally do for a week or two. You are more important! x

  5. #5
    Join Date
    Jan 2017
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    1,357

    Re: Starting Citalopram

    Quote Originally Posted by Dragonsblonde74 View Post
    Background for me is that this is my 5th break in my life
    Welcome to NMP,

    Have you considered staying on an antidepressants permanently given your history? Not only would you not have to go through this again, but there is evidence antidepressants become progressively less effective every time they are stopped and restarted, often requiring higher doses to achieve the previous level of control. They may also produce more severe, and/or different, initial side-effects. Two studies, Amsterdam JD, 2016 and Amsterdam, 2009 found the likelihood of antidepressants working after each restart drops by between 19-25% (see also: Amsterdam JD, 2009; Leykin Y, 2007). This applies whether returning to a previously taken antidepressant or a different one.

    The night was awful, full on waves of panic and anxiety before bed and when i got in. My husband basically had to hold me until about 2am when I fell asleep and then I was awake at 5.
    Please discuss this with the prescribing physician as there are ways of easing these side-effects. Small doses of the ADs mirtazapine, or trazodone should help you sleep better, as could the antihistamine *hydroxyzine (Vistaril) which is also pretty good at dampening anxiety, however, I've heard that UK GPs are reluctant to prescribe it for this purpose for some reason, but it won't hurt to ask.

    *Hydroxyzine comes in two forms, hydroxyzine pamoate (Vistaril) and hydroxyzine hydrochloride (Atarax). Anecdotally, the pamoate form is claimed to be the more effective anxiolytic, but just how true this is remains a matter of debate.

    My meditations don't seem to help and panic is climbing right now just 90 minutes after the tablet. I know I could easily be doing it to myself, but as you will know well it isn't easy to switch that off.
    While there is almost certainly a strong psychological component, ADs, and especially the SSRIs and SNRIs, often initially significantly increase anxiety levels. Serotonin is not the 'feel good' neurotransmitter of popular belief, nor are anxiety (and depression) caused by low brain serotonin levels. Stress actually *increases serotonin in areas linked to these disorders, particularly the amygdala, hippocampus, hypothalamus and nucleus caudatus. This increase should prevent that stress from triggering anxiety and depression if the low serotonin hypothesis was correct, but it has the opposite effect.

    While ADs do increase serotonin levels for the first few weeks, their longer term effect is to significantly *reduce them to well below pretreatment levels. Unfortunately, that initial serotonin spike often significantly worsens anxiety and is also responsible for some of the other common initial side-effects. For example, the gut is by far the most serotonergic organ of the body, not the brain, making and using over 90% of the body's output compared to less than 2% for the brain. Consequently, it is often more greatly affected by serotonergic ADs triggering side-effects such as nausea and diarrhoea, or, conversely, constipation at the beginning.


  6. #6

    Re: Starting Citalopram

    Hi there

    Thank you for such a considered and informative response.

    I have considered a scenario where I am on tablets for life and personally I don't think it would worry me at all, just not sure how hard I would have to convince a doctor that that is the right way. I know some don't seem to mind, but others try hard for you to come off.

    I had pretty anxious day again yesterday, although got off to sleep a little easier, still awake at 5, but I had to get up by 6 today to try for work anyway. Actually now sat at my desk after a few initial freezes and rushes of anxiety. Very shaky today, but trying to just let things happen as normally as possible. If the panic still stays as high and impacts too much I will try to get in to see my doctor again to see if they can help more.

    I am currently taking my table after breakfast to reduce the risk of nausea at around 8.30 and it doesn't seem to be making me sleepy so I wouldn't switch it to the evening which I know some people have done to make the days easier. Hoping that the effects at least lessen slightly as each day passes.

  7. #7
    Join Date
    Jan 2017
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    1,357

    Re: Starting Citalopram

    Quote Originally Posted by Dragonsblonde74 View Post
    I am currently taking my table after breakfast to reduce the risk of nausea at around 8.30 and it doesn't seem to be making me sleepy so I wouldn't switch it to the evening which I know some people have done to make the days easier. Hoping that the effects at least lessen slightly as each day passes.
    Citalopram has a fairly long half-life so in theory it shouldn't make a difference when the dose is taken, but in practice it frequently does so switching to evenings is definitely worth trying.

  8. #8

    Re: Starting Citalopram

    So - Day 5 today and getting ready to take my tablet. Feeling shaky and some burning in the chest, I know that I am anxious about being anxious and that foreboding that something bad or a meltdown must be just around the corner is still with me. I know it is early days though and take some comfort from the fact I did a full day at work yesterday, with a meeting in the afternoon. I am not fully 'with-it' and I can tell I am not engaging as much, but that is also a symptom of my panic issues as well.

    Slept a bit better last night, still cuddling my husband before I sleep and I know he isn't getting as much sleep as he needs, but he tells me its worth it and its not forever as I will feel better at some point. He is a great support. Did wake up at 3am and 3.30 having to dash to the toilet, but I think I remember that from last time as well. Upset stomach for sure, maybe from the panic and the not so great diet (appetite very low) as much as the tablets.

    So some good news in there

  9. #9
    Join Date
    Nov 2018
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    2,385

    Re: Starting Citalopram

    I've been on citalopram for almost a year, and I can confirm that stomach upsets can be an issue. Not sure if you consume much spicy food; I do, and I found my tolerance for it was drastically reduced.

  10. #10

    Re: Starting Citalopram

    Quote Originally Posted by BlueIris View Post
    I've been on citalopram for almost a year, and I can confirm that stomach upsets can be an issue. Not sure if you consume much spicy food; I do, and I found my tolerance for it was drastically reduced.

    Hi there. I haven't been eating much the past couple of weeks and keeping it fairly plain, but did have a chilli stir fry last night so that could have triggered something extra I guess. Like you I like spicy things so may have to watch that - thanks x

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