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Thread: Third time's the charm?..Right?

  1. #1
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    Third time's the charm?..Right?

    Hello all, so today after a lengthy trip to a&e driven by horrendous hypochondria I decided that it's finally time to try and bring a stop to the spiralling anxiety that is building within me. By going back onto Citalopram. I have been on it twice, the first time was 20mg for a year or so and the second was between 10 - 20mg for two years. Now a question I have is, do the side effects get easier to deal with each time you go on them? I'm picking up my first box of 10mg tablets tomorrow morning. Also how long roughly until the Citalopram actually starts to build up in your body?
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  2. #2
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    Re: Third time's the charm?..Right?

    Hi, I'm actually on my 4th time after another relapse (I'm currently on day 7 so I still have quite a way to go).

    Unfortunately, the side effects don't necessarily get easier each time. On my second and especially my third time on citalopram, my side effects were worse. This time around, they don't seem quite so bad, but I'm still getting a lot of heightened anxiety and intrusive thoughts, which I expect at this stage.

    Generally I find I feel significantly better after about 3 months. The last time (in 2015), though, it was about 10 months before I felt completely back to my usual self, but I think my anxiety and depression was particularly severe that time. I think I was so disappointed to have had that relapse, as I'd learnt a lot of coping techniques and after the second time I came off the tablets, I felt like I would never get so anxious again. So I felt really disheartened about that relapse. This time around, I feel almost resigned to the thought that I'll probably always be susceptible to anxiety and depression, so this time I may stay on a maintenance dose once I've recovered, instead of coming off citalopram completely.

    My first time on citalopram (10mg) was August 2012 to February 2013, and I relapsed just one month after being off them completely. My second time was May 2013 to around August 2014, and I relapsed about 8 months later. My third time was much longer - May 2015 to July 2019, although I cut down the dosage over a long period of 2 and a half years. That time, I also had 1 to 1 private therapy. I relapsed about 4 weeks ago, and now here I am. This time, I plan to try a different therapist once my initial side effects have begun to wear off.

  3. #3
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    Re: Third time's the charm?..Right?

    Hi Sparkle, thank you for your reply.

    I actually just got finished reading your diary of being on 10mg before. I'm preparing for the side effects but they certainly took me into a bit of a darker place with my health anxiety when I took them before.

    I'm hoping things start to improve a little after a week of being on them. I would refer myself to therapy but i'll be moving back to university in london in 6 weeks so probably wouldn't have time to continue it really.

    I made the silly mistake about 4/5 months ago of stopping cold turkey without tapering down. At first it was completely fine but i think now further down the line I'm feeling the need to be on them again because otherwise I'm going to spiral.
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  4. #4
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    Re: Third time's the charm?..Right?

    Quote Originally Posted by Aleman200 View Post
    By going back onto Citalopram. I have been on it twice, the first time was 20mg for a year or so and the second was between 10 - 20mg for two years. Now a question I have is, do the side effects get easier to deal with each time you go on them?
    Unfortunately, not.

    I'm picking up my first box of 10mg tablets tomorrow morning. Also how long roughly until the Citalopram actually starts to build up in your body?
    Antidepressants don't work directly in the way say aspirin, or benzodiazepines do. They work by stimulating the growth of new brain cells (neurogenesis) to replace cells killed, or prevented from growing by high brain stress hormone levels. The therapeutic response is produced by these new cells and the stronger interconnections they forge, not the meds directly, and they take about 7 weeks to bud, grow and mature although some improvement may begin earlier. For a more detailed explanations see: Depression and the Birth and Death of Brain Cells (PDF) and How antidepressant drugs act.

    Because of the above, taking only 10mg for extended periods may be problematic as plasma levels may drop below that required to sustain neurogenesis. Constantly interrupting the process can increase the risk of the med pooping-out.

    I made the silly mistake about 4/5 months ago of stopping cold turkey without tapering down.
    While I don't think this contributed to needing to go back on citalopram, please don't ever do this again. In fact, given this is your first third time back on ADs there is a strong argument for remaining permanently medicated as stop/start cycles gradually lessen the chance of an AD working.
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  5. #5
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    Re: Third time's the charm?..Right?

    Quote Originally Posted by panic_down_under View Post
    Unfortunately, not.



    Antidepressants don't work directly in the way say aspirin, or benzodiazepines do. They work by stimulating the growth of new brain cells (neurogenesis) to replace cells killed, or prevented from growing by high brain stress hormone levels. The therapeutic response is produced by these new cells and the stronger interconnections they forge, not the meds directly, and they take about 7 weeks to bud, grow and mature although some improvement may begin earlier. For a more detailed explanations see: Depression and the Birth and Death of Brain Cells (PDF) and How antidepressant drugs act.

    Because of the above, taking only 10mg for extended periods may be problematic as plasma levels may drop below that required to sustain neurogenesis. Constantly interrupting the process can increase the risk of the med pooping-out.



    While I don't think this contributed to needing to go back on citalopram, please don't ever do this again. In fact, given this is your first third time back on ADs there is a strong argument for remaining permanently medicated as stop/start cycles gradually lessen the chance of an AD working.
    Hi Panic, thank you for your insightful post, I always like being able to see the science behind what's happening and I can now see why things take their time to get better with AD's, given that this seems to be a re-occuring thing i'm probably going to be on them for a hell of a lot longer, that's for sure.

    I have a review due in about 3 weeks, so I think i'll discuss going back onto 20mg from there. I'm hoping the 10mg will prepare my body for it a little bit.

    I'll use this thread as a diary to keep track of things, it'll also be helpful for me to look back on later on down the line to see how far I have come.

    Day 1 - 10mg Citalopram
    Last night my anxiety peaked when I found myself in A&E worrying about a heart attack, after an ecg, blood check and chest x-ray I was released from a&e after being told it's almost definitely muscular and anxiety related. Fair enough I thought, maybe I can put it to bed now. I was wrong, my anxiety came back quite heavily later on in the evening to the point where I burst into tears in my parents bedroom from the stress. The aches in my chest continued, although this is also probably anxiety. My mother is also on Citalopram and had 10mg tablets, as i wasn't due to pick mine up until the next day, I took one in hopes of getting the system started. Sure enough the placebo effect of taking them seemed to calm me down abit and I was able to sleep. The anxiety had killed my appetite but i managed some digestive biscuits and a slice of toast, while drinking alot of water.

    Day 2 - 10mg Citalopram
    Today I'm feeling the intrusive thoughts a bit more, I end up hearing about people my age (29) dying of sudden heart attacks and it really gets into my brain and my mind starts messing with me. My left arm feels a bit numb and tingly today, almost heavy. Given that there's no pain i'm going to put it down to anxiety. I usually take citalopram in the morning but seeing as i took one last night, I might try that for a few days, see if taking it at night helps me get through the side effects more. Will update later on.
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  6. #6
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    Re: Third time's the charm?..Right?

    My Citalopram got slightly delayed by my recent appendectomy lol!

    Going to be taking my first one tonight. I had been on Co-Amoxiclav and Metrodinazole antibiotics just to clear up anything left over from the OP. (It hadnt burst) And wanted to wait until my course of those had stopped before taking any citalopram.

    I'll keep this up to date while i can.
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  7. #7
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    Re: Third time's the charm?..Right?

    Last night I was in a bit of a state worrying about Citalopram, I ended up reading through old posts of mine where I had been hyper focused on my heart and been getting ectopics while on citalopram for the first 5/6 weeks. It made me somewhat terrified to restart them.

    This morning however I bit the bullet and took my first 10mg tablet again. I'm going to update tonight to see how my day has gone. I can only pray the third time round nothing bad happens and I only get some mild side effects.
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  8. #8
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    Re: Third time's the charm?..Right?

    OK, good luck with it - it would be good to follow each other's progress during these early days.
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    Re: Third time's the charm?..Right?

    Quote Originally Posted by Sparkle1984 View Post
    OK, good luck with it - it would be good to follow each other's progress during these early days.
    Yes I agree, I think it'll be a nice comparison.

    Day 1 - Although it's not the end of the day my partner will be coming over soon and I want to focus on that, so if anything happens during the night i'll write it in tomorrow.

    Now onto the meat of the subject, I took my first tablet this morning with some water as I'm not much of a breakfast person, Mostly because I tend not to feel hungry until 10/11am. Which i guess still counts as breakfast. I still had some reservations about taking the medication which I think contributed to my anxiety today. I started off with incredibly heightened anxiety and alot of intrusive thoughts, they hit me a bit like a truck and I struggled to keep logical throughout the day. I spent my day watching youtube videos and talking with my parents every so often to break up the monotony. It's very hard when the health anxiety lurks in the back of your head telling you about your "Heart problems" which doesn't exist. The rest of the day i had the jitters, I was shaking alot just sitting down and walking around, this lasted until about 1pm which then tapered off and I felt kind of numb to the world which was interesting. I had an appointment with my GP today to check up on my sore throat which was reassuring as she was happy I had begun to take the medication. She told me that they know what to look for with heart defects and due to my previous tests being normal and anxiety being kind of cured before, she's inclined to believe it's just the anxiety again. Which would make sense. I came home and managed to eat some scrambled egg on toast which is a miracle because I have no appetite at all thanks to my surgery. Here's hoping it's all up from here.
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  10. #10
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    Re: Third time's the charm?..Right?

    Quote Originally Posted by Aleman200 View Post
    I still had some reservations about taking the medication which I think contributed to my anxiety today. I started off with incredibly heightened anxiety and alot of intrusive thoughts, they hit me a bit like a truck
    These might not be all down directly to the AD. They could also be driven by the stress of taking the med. Expect to have severe side-effects and the anxious mind is very capable of delivering them.
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    The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.

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