Switching from citalopram to sertraline

[Bananahammock]

Hi everyone, I am 44, I have 4 year old. I've always had serious health issues. I am currently stable but every time something goes wrong with my health or I get a health scare, my anxiety hits the roof especially now that I am a mom.

My anxiety disorder started when I fainted in 2007 and I have been on citalopram since then (currently 20 mg, the maximum dose allowed). The fear of fainting stayed with me. I have fainted two more times within the last 5 years and the last one was more like a seizure. Both times I was trying to wean off citalopram. The second time I had to go down to 10 mg from 20 immediately due to suspected side effects and I had the seizure.

Recently I've been more anxious due to health issues again. Now my psychiatrist wants me to switch the Sertraline and I am terrified I'll faint or have another seizure. I am not sure I want to do that but at the same time citalopram is no longer enough for me. As I was too scared to reduce Citalopram from 20 to 10 and start 25 mg of Sertraline at the same time, my psychiatrist said to keep taking citalopram 20 mg but also start on Sertraline 25 but I am worried about the possibility of serotonin syndrome. Anyone tried anything alike that? Any insight would be much appreciated.

[panic_down_under]

Hi everyone,

to NMP,

My anxiety disorder started when I fainted in 2007 and I have been on citalopram since then (currently 20 mg, the maximum dose allowed).

The usual minimum therapeutic dose for a healthy adult is 20mg, with a recommended maximum of 40mg/day. Do you have significant liver disease, or are you on other medication which might interact with citalopram?

Both times I was trying to wean off citalopram. The second time I had to go down to 10 mg from 20 immediately due to suspected side effects and I had the seizure.

How soon after you reduced the dose did you faint/have the seizure?

As I was too scared to reduce Citalopram from 20 to 10 and start 25 mg of Sertraline at the same time, my psychiatrist said to keep taking citalopram 20 mg but also start on Sertraline 25 but I am worried about the possibility of serotonin syndrome.

As a generalization serotonin syndrome won't be an issue at those doses, however, this is subject to what other health issues you may have. Given your psychiatrist was happy to prescribe both at those doses I assume this isn't a problem. Serotonin syndrome is much rarer than online reports, and even some medical journals, claim.