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  1. #1
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    Sep 2019
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    Feeling hopeless - 5 weeks on cit second time, day 18 on 20mg

    Hi all Iíve been told not to do this as its not supposed to be helpful for my recovery but feeling really hopeless this morning. 5 weeks tomorrow on cit second time for anxiety. Today is day 18 on 20. I donít really feel like there has been any improvement and my psych said there should have been some by now. He wants me to keep going for another week and a half or so then evaluate. I donít think its working this time, Iím still more anxious than I was before I started the meds (they made everything worse because I became really anxious about the meds not working and the side effects) and I donít understand why when it worked so well last time. Iím feeling a bit desperate as I cant stay like this. Iím supposed to be going to in to work but Iím sitting in the car crying 😔

  2. #2
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    Sep 2019
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    225

    Re: Feeling hopeless - 5 weeks on cit second time, day 18 on 20mg

    Also PDU I was hoping you might be able to advise on propranalol. As you know I’ve been taking it intermittently for the morning anxiety, either 15 or 20mg. It does lower my heart rate, at times down to 59/60. Should I be worried about that? Thanks

  3. #3
    Join Date
    Jan 2017
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    2,113

    Re: Feeling hopeless - 5 weeks on cit second time, day 18 on 20mg

    Quote Originally Posted by Windywel View Post
    Hi all Iíve been told not to do this as its not supposed to be helpful for my recovery but feeling really hopeless this morning. 5 weeks tomorrow on cit second time for anxiety. Today is day 18 on 20. I donít really feel like there has been any improvement
    I would not expect an improvement after only 18 days on the recommended minimum dose. Neurogenesis is not a fast process, it takes about 7 weeks for new cells to bud, grow and mature, but improvement in mood may begin earlier, typically from around week 4.

    and my psych said there should have been some by now. He wants me to keep going for another week and a half or so then evaluate.
    That isn't the experience of most. Yes, some begin feeling great within a few days, the placebo effect is a truly wonderful thing, but it isn't reliable and tends not to last that long.

    I donít think its working this time, Iím still more anxious than I was before I started the meds (they made everything worse because I became really anxious about the meds not working and the side effects)
    Which is likely part of the issue, although not the only reason. An anxious mind expecting disaster is very capable of producing the very catastrophe it fears. However, increased anxiety in the early days of taking antidepressants, and especially the SSRIs and SNRIs, is also quite common. It is a consequence of the increased serotonin activity.

    There is no way of avoiding either the psychological, or AD induced initial anxiety, but there are ways of minimising it with meds such as the benzodiazepines and sedating antihistamines, etc.

    and I donít understand why when it worked so well last time. Iím feeling a bit desperate as I cant stay like this. Iím supposed to be going to in to work but Iím sitting in the car crying 😔
    While I suspect you might be looking at the past through slightly rose tinted glasses, the experience the second time around can be different than the first time, both in terms of the nature of the side-effects and their severity.

    Unfortunately, there is currently no quick acting, side-effects free med that can be taken over the long term. However, as per above, there are meds which can help in the short term. Use them. No one is handing out gold stars to those white knuckling through the initial side-effects. It's counterproductive.

  4. #4
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    Sep 2019
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    225

    Re: Feeling hopeless - 5 weeks on cit second time, day 18 on 20mg

    Thanks PDU - but wouldn’t the earlier weeks at 10 and 15mg count? With them in its 5 weeks with only minimal improvement ��

  5. #5
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    Sep 2019
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    225

    Re: Feeling hopeless - 5 weeks on cit second time, day 18 on 20mg

    PDU - do you think I could still be feeling side effects from the dose increase at 18 days? Also I’m due to see the psych in a week and a half and I suspect that if I haven’t seen significant improvement by then he will want to increase the dose as he says he has patients with anxiety on 40mg. Do you think I should consider that or resist for longer? How do you know when to increase?

  6. #6
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    Sep 2019
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    225

    Re: Feeling hopeless - 5 weeks on cit second time, day 18 on 20mg

    By the way I was really worried about what you were saying about benzodiazepines and their effect on antidepressants so I asked my psychiatrist about it. He said “There are rodent studies that look at hippocampal neurogenesis and benzodiazepines and very limited human studies about this. Also, there is no clear clinical significance or relevance of the results of these studies.” So I don’t think you should be saying that to people who have been adviser to use them by their clinicians but then become too scared to.

  7. #7
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    Jan 2017
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    2,113

    Re: Feeling hopeless - 5 weeks on cit second time, day 18 on 20mg

    Quote Originally Posted by Windywel View Post
    PDU - do you think I could still be feeling side effects from the dose increase at 18 days?
    Yes. Plus, as per my previous reply, at least some of the heightened anxiety may be psychological

    Also I’m due to see the psych in a week and a half and I suspect that if I haven’t seen significant improvement by then he will want to increase the dose as he says he has patients with anxiety on 40mg. Do you think I should consider that or resist for longer?
    As you've been on citalopram before you may need a higher dose to achieve the same response this time. Whether you'll need to whole 40mg is unknowable. The options are to try 30mg for a while, or go to 40mg until the med is fully effective and then after a while dropping back to 30mg to test its effectiveness.

    Personally, I've always need near, at, or above the maximum recommended dose to get a good outcome from ADs so am not stressed by that, but I do understand some prefer to take the minimum amount that does the job.

    How do you know when to increase?
    When there is still an inadequate response to a dose after a couple of months. Unfortunately, despite much effort, there is still no way of predicting whether an AD will work, much less how much of it will be required to achieve the optimal result. It is all trial and error, seat of the pants stuff.

  8. #8
    Join Date
    Sep 2019
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    225

    Re: Feeling hopeless - 5 weeks on cit second time, day 18 on 20mg

    Hi is there anyone else out there that can provide some reassurance? Now 5 weeks in on citalopram second time (it worked really well the first time) - 3 weeks on 20mg, It has made my anxiety heaps worse and because of that im feeling heaps more depressed as well. i foolishly read several stories on here last week about people trying the same med a second time and it not working and then trying other things and that not working either. Im really worried that im going to end up like that. i guess im just looking for some reassurance from others that have gone back on the meds that it does take longer and is harder the second time but still comes right. i am just feeling really hopeless and scared.

  9. #9
    Join Date
    May 2010
    Posts
    305

    Re: Feeling hopeless - 5 weeks on cit second time, day 18 on 20mg

    Hi Windywel
    my second time on Citalopram worked out well, I did have heighten anxiety the first few weeks from what I can remember , but eventually it all settled I was on Citalopram for 5 years after that and I wish now i never came off it now.
    Stay positive , 18 days on 20 mg is not even 3 weeks , give it more time for your body to adjust. I m sure you will start to feel better soon.

  10. #10
    Join Date
    Aug 2012
    Posts
    2,142

    Re: Feeling hopeless - 5 weeks on cit second time, day 18 on 20mg

    Quote Originally Posted by Windywel View Post
    Hi is there anyone else out there that can provide some reassurance? Now 5 weeks in on citalopram second time (it worked really well the first time) - 3 weeks on 20mg, It has made my anxiety heaps worse and because of that im feeling heaps more depressed as well. i foolishly read several stories on here last week about people trying the same med a second time and it not working and then trying other things and that not working either. Im really worried that im going to end up like that. i guess im just looking for some reassurance from others that have gone back on the meds that it does take longer and is harder the second time but still comes right. i am just feeling really hopeless and scared.
    I have been on citalopram 3 times, and it did take longer to work the second and third time. The third time round, I was pretty bad, and I remember how hopeless and bleak I felt in the first couple of months but I still managed to make a full recovery on 20mg. In my opinion, 3 weeks is still too early to think about increasing the dose.

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