4 weeks into Citalopram

Treatment and medication
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Hi, I have been reading through posts and decided to post my own discussion about my experiences so far.

I noticed I am quite young compared to everyone here so my experiences are obviously different. I've suffered for as long as I can remember from social anxiety and never really said anything about it and just got seen to as a the 'quiet kid'. I would always prefer to be at home and not outside as I was worried about my appearance and what other people would think as well as my hobbies and interests (I don't do anything outside of sitting inside all day). Anyway, I am a bit off topic.

I was due to start University and had the typical nerves that you'd experience although these were quickly escalating and they were the worst feelings I had ever had in my life. The constant panic of making a mistake and worrying about meeting so many new people overwhelmed me and I dropped out and became quite suicidal during this period. I am only 18 and being at my age whilst being a man I am considered to be weak and I just need to snap out of it because that's what people my age do right? I got prescribed 10mg of Citalopram by my doctor after a couple of appointments to assess how I was coping. If I am honest the second appointment before I started taking my medication I felt a bit better, although I was still quite anxious and depressed and got diagnosed with GAD. Fast forward a couple of weeks and I was on my 2nd week of 10mg Citalopram and I didn't feel any side effects at all, "Hm, they must be working.." I thought. Oh no, no-no-no-no. Lets go to the third week, all the side effects hit me like a bus. I was crippled and bedridden they were that bad, constantly crying, worrying about family dying even though they're in perfect health (touch wood), diarrhoea, nausea, loss of appetite, weight loss, and panicing. All of these suddenly at once it was terrifying. I foolishly decided at the time after getting these side effects to up my dosage to 20mg as the doctor said I could increase the dosage to 20mg when I was ready, I don't think I was and when I went to the doctors a week after going through what I can only describe as hell on earth I was told to decrease back to 10mg and also got prescribed 2mg of diazepam for when I was getting the absolute worst of my symptoms.

I have noticed that on evenings and nights a lot of my symptoms do subside and I am able to manage myself more, although I do get the thoughts swirling around in my head and slight panic+restlessness. Although mornings are the absolute worst right now. I take my medication in the morning too and I am not sure if it would be better taking them at night instead?

I am just a bit worried that I didn't have any side effects for the first 2 weeks and my anxiety dropped before taking the meds somewhat and now I have extremely bad anxiety through the day.. I keep feeling like I made a massive mistake going on SSRI's and I have ruined my life and I am going to feel like this forever, I guess I am looking for some form of comfort because right now I am at my wits end with these side effects and thoughts like: "Should I just quit the SSRI's?" , "Are they going to make me feel this way forever?" and "I can't stop thinking about the anxiety!".

Thanks for taking your time to read this,

Kyle.

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Hey Kyle. Sorry to hear but what you are experiencing sounds totally normal. I too had exactly the same experience but all I can say is 8 weeks on, I feel 90% better. The side effects are horrific as you go through them but they do subside. Mornings are always worse as your serotonin levels are at their lowest and your cortisol levels (Stress hormone) are at their highest. By the evening it all balances so you feel better.  I used to dread going to sleep because I did not want to wake up and face the fear. It will subside but may take a couple more weeks.  You have done the right thing by continuing, just get through the next couple of weeks. I have been on and off them 7 times in 20 years and each time I get the same effects as you. You will find that you start to improve a little earlier each day after 4-6 weeks and before you know it you will have much better days. Stick at it and Diazepam helped me get through the worst of it. Don't give up. Mark

1 Like
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Hi kyle are you feeling any better on your citalopram? I've been having horrible side effects on them for a few months I have been taking them for 7 years and I think they have stopped working....hope you feel better soon x

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Hi Mark,

Thank you for the comforting words they really mean a lot to me. A lot of my problems I believe came from internet and online gaming addiction. I was and to be honest still am in a vulnerable state in relation to the internet and my life outside of computers. For as long as I can remember I loved playing on consoles and computer games and they were quite honestly my whole life. I would spend over 12 hours a day just on my computer playing games with friends I met online, and I believe this is a cause for my GAD and Social Anxiety.

It does scare me the thought of having to go through withdrawal of only spending half an hour to an hour on my computer, and only more if its absolutely necessary. Having to go through this period on top of recently starting my medication has really taken its toll I imagine. I still enjoy my computer heavily as I do have fond memories of times of enjoyment but I keep worrying I will associate games with anxiety or relapse on my computer addiction every time I turn the power on.

I do really, really appreciate you taking time to respond and share your experiences with me as I find a lot of comfort in knowing other people have went through/are going through similar periods with their ups and downs. Your words give me confidence to keep persevering through my medication and changing my lifestyle to adapt to the real world as scary as it seems at first, also as a funny plus side I am noticing my stomach has slimmed down for the first time in forever!

Thanks and take care,

Kyle

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Hi Pamela,

I can't speak from experience and only have to go on word of mouth from family members and people on this forum but I have heard that other routes of medication are available for people who don't see any improvement on the current medication they're on. Although there are so many different factors you need to take into consideration. People go through blips in the process of resolving any issues they have and you need to reassure yourself that you're a stronger person from going through the hardships and down periods in life.

As you say though, you've spent a few month on the medication without any noticeable improvements on your health or the side effects. As I say I am not a doctor or someone who has a lot of experience on the medication but it would bring you a lot of peace if you talk to your doctor about the medication, what you've experienced on the medication and that you have been constantly battling the side effects to no avail.

My thoughts are with you and I hope you make a quick recovery,

Kyle

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LOL.  For some of us, losing weight is one of the only positive side effects.  I lost 3 kg though not eating. Not the best way to do it I know but I feel healthier now I am through the side effects.  Stick at it. The mornings will pass and the afternoons will get easier, then enjoy the peace of the evenings. If you start to feel better but then have an off day, don't panic, that's normal too. Once you have come through this, you will end up being a support for others.  I would not wish this on my worst enemy but having come through it and survived, I feel privileged to have experienced it so I can help others. I am currently completing a counselling diploma to help others.  Stick at it, try not to stress too much about the cause right now. Get back to health and when you feel better, then start to focus on the causes. Good luck my friend. Mark

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Hi Mark,

Having had a few days to reflect on my lifestyle and past I believe I have isolated a lot of the reasons that spiralled into the severe anxiety I developed, I still have my background anxiety as I have only just started on ways to improve my physical and mental health. Social anxiety was caused by my abnormal development in social skills, caused by excessive use of the computer over interracting with people in the outside world. My general anxiety is because I kept living 1 week or 1 month into the future and never focused on the present and things I am grateful for.

I believe the next step over this from medication is to be able to address my problems in CBT and develop strategies to live happy and live in the present. I am redeveloping social skills from restarting my group activities and this time trying to interract and socialise consistently. It took me years to realise this but my awful diet, computer addiction, social isolation and overthinking were a large factor into my slowly deteriorating mental health.

Thanks for the kind words and I am really happy to hear how you're doing and I hope you are successful in your endeavours.

Take care, Kyle

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http://cepuk.org/2017/09/20/2017-prescribed-drug-withdrawal-survey-initial-findings/

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Aw, Bless you Mark for your good work. Helping others is one of the best things we can do in our lives. 

Good for you - Three Cheers!  Kyle, read through as many posts as you can and especially Katecogs. Just type her name in the search. She has so much information as well as Mark and others here. 

Stay in touch on here and we are all in it together.  I've just upped my dose so I'm hoping for the best. Last 2 weeks on upped dose were ok but I'm sure there will be many more ups and downs.  I read this somewhere so I'll pass it on.from someone else   

My phychiatrist says when ur cycling thru those up and downs .that means the meds are working...Jo x

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Its good to know we are all part of a group who will in time support others. Its s**t when we go through it but life on the other side is more revealing and fulfilling. Don't worry too much about the downs, focus on the ups. There will be many more in the days to come.

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Never just quit an ssri/ citalopram. Slowly tapering is a must. No more than 5% every 2-4 week's. Dig deep on all the side effects and the proper way of tapering. I won't post those as alot of ssri believers get offended. Magnesium glycinate, Omega 3's, alot of exercise, meditation, cognative behavioral therapy, alternatives to and knowledge on psych meds and long term effects is key. I wish you the best.

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You are right Mark.  I'm feeling one or two of the downs just now. Really feels like the upped dose is working on 'something'. These things take sooooo long to stabilize and the waiting game is truly patience patience patience. 

Have you ever upped the dose and how long did it take. Hoping for the best. 

Jo x

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Hi OreElect and thanks for commenting.

I am not planning on quitting cold turkey on my medication as I want to see it through until I am comfortable I will be able to be free of it both physically and mentally. Thanks for the tapering advice, shouldn't be too difficult for me since I am only on 10mg daily (although it could be up depending on the outcome of the next doctors appointment). When I do plan on stopping my medication I will reduce it by about 2mg every 2 weeks and make adjustments as needed from there.

I have restarted my jui jitsu lessons as I way to both interact with people and get a good form of exercise twice a week. On top of this I am going to start walking more as well as starting up a gym membership in the near future. I agree on meditation as I have just started mindfulness meditation and grounding therapies and they have helped me a lot. I severely cut down my time on the computer as I believe it was one of the main causes for my descent into social/general anxiety and depression. Only playing computer games for a tiny fraction of what I used to, about a few hours a week.

To address other problems I have arranged CBT therapy at Mind as I believe they will be able to assist me in seeing life from a new perspective and being more positive about it, by not worrying about what others have to say or trying to be a perfectionist in everything I do. I haven't heard of magnesium glycinate and at the moment most of my magnesium is coming from a couple bananas a day! As for omega 3, would I be able to get them in tablet form?

Thanks again, Kyle

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HI Jo, I was meant to respond yesterday but my phone crashed and I lost my mini essay lol!

I have seen a few of katecogs messages and they seem to be a really avid helper on this forum, a service which is invaluable to people suffering from mental health related issues. I have made plans to boost my active life and I have said to a few people too that I am considering much more exercise, less unhealthy and more healthy foods as well as pushing out my comfort zone a lot in the form of talking and interacting with people.

I do feel that the medication is working, but I am constantly having ups and downs almost hundreds of times a day, it's almost like I am at war with my mind having to constantly reassure myself that everything is going to be okay. I feel generally in control right now but there is always a nagging voice or thought in my mind that is pulling at my attention. I am not sure if asking to up the dose would help me stablise these thoughts because I keep having to confirm and confirm that I am doing the right thing in life. I want to be a teacher and I know it is something I have always been passionate about, but my mind constantly makes up scenarios in which I fail or I mess something up which is forcing me to worry about something that is a non-issue for at least the next few years, and the chances of the scenario are next to none because I can't tell the future.

I am not worn out physically, but mentally at having to push these thoughts to one side and tell myself that this is something I want to do and I know I am going to do well. One moment my thoughts are all positive about how I am going to succeed and they are really comforting but in the matter of a few seconds they change and become horrible thoughts where I won't be able to interract with people and will mess up at every opportunity.

I just want to know if you went through anything similar and if upped your dose has helped suppress these thoughts somewhat.

Thanks and take care,

Kyle

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Very good Kyle. Your being proactive and taking care of yourself and know what your doing. Good to hear.

Anxiety is not fun

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See my feed on Sucess onCitalopram

Yes they work but take time

I do understand exactly what you mean about panicking and thoughts in your head

I still get them and have to learn not to do them....

You need to try get some kind of therapy CBT type stuff to help you work through this 

Like U my anxiety dropped when I was given the meds ...It was the relief

The side effects do make you feel worse before you get better

I read that the reason we feel badin the morning is the raised cortisol that slowly dissapates by end if the day

I fine if I get up and exercise it helps

With my day.... am just off to a group Pilates class now 

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Hi Jo. No I have never upped them. I have always started on 20mg and stayed on that dose

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Hi Gillian. 

I have been taking citalopram for 25 days. 23 and 10mg and 2 at 20mg. 

I was prescribed them for anxiety, but I feel since I've taken them I have felt depressed.  Is this normal. Do they make you feel really low? 

Also last week I had a couple of better days and the evenings seemed to be better than the mornings and afternoons. 

In your opinion is this a good sign that the meds could be working?  

Do you think it's a good ideas that I've upped to 20mg? 

Also do you think that anxiety could mask depression? And will both of these things level out equally when the meds start to kick in? Xx

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You probably need to get yourself stable on the 20mg for another 3/4 weeks before you can properly evaluate the effect.  They do make you feel worse before better 

That’s the way it works am afraid 

I will try repost/ copy a very good explanation of this 

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'Reason why meds take so long to work and why you feel rubbish during this time 

Kate cogs posted this originally....

Hi everyone, here’s something I found online which you may find intersting.  Its about why you feel so rubbish when taking these meds, why your mood is up and down, why it takes so long and the process it all goes through.

Sorry its a long post.

When starting an SSRI or increasing it's dose often makes people feel really rubbish, which can cause a great deal of stress as you begin to wonder whats happening, why is their illness getting worse, are these meds working etc.

Somone recently posted a great post explaining what these meds do in our brains, and I’d like to add further to this.  So, as already posted ….. the brain is basically a big dense bundle of nerves which carry electrical signals around our brain and body.  The nerve cells don’t touch each other, leaving a small gap between each cell, called a synapse.  So how do signals get from one nerve to another?

Neurotransmitters are chemicals released by nerve cells that tell a neighbouring nerve cell to pass the signal along.  A bit like pass the parcel.  Serotonin is one such neurotransmitter.   So when an electrical signal reaches the end of a nerve cell that deals with serotonin, that cell releases serotonin into the gap (synapse), which then crosses the gap and interacts with the nearby nerve cell and tells it to pass the signal along.

Once the serotonin has done it's job, the serotonin is then reabsorbed from the gap so that no more signals are passed until the next one comes down the nerve.  SSRIs, (Selective Serotonin Reuptake Inhibitors) interfere with this reabsorbtion process and thus it stays in the gap longer, which equates to more serotonin and more signals.

So furthering on from there ….. why do you feel so rubbish?

So, along with the releasing of serotonin, and reabsorbing it, nerve cells also have parts that detect an increase in serotonin level and tell the nerve cell to stop producing anymore serotonin until the level drops.  These are called autoreceptors, which are the reason you feel like so rubbish.

So the SSRI will increase the amount of serotonin that’s gathered in the synapses between nerve cells, but unfortunately the autoreceptors of the nerve cell pick up on this increase and tell the nerve cell to stop producing serotonin.  The result of this is that when you first start taking an SSRI your serotonin levels drop.

How do they go up again?

Eventually with continuous use of the SSRI medication, the autoreceptors become desensitised, that is to say they've continually told the nerve cell to stop producing serotonin but yet serotonin is still there.  In short they simply give up.  They stop telling the nerve cell to stop producing serotonin and your serotonin levels start to increase.

This desensitisation takes time, it doesn't happen over night and it won't even begin to happen until the SSRI levels have stabilised.  This is why you feel so rubbish, and is why your mood drops and your anxiety increases (also fuelledd by the fear of not knowing whats going on).  Your mood will be up and down as the seronotin continues to try to stablise.

So, to summarise:

SSRIs cause your serotonin levels to drop when you first start taking them.  Your serotonin levels will not rise until the autoreceptors in your brain have stopped working (become desensitised), all of which takes lots and lots of time.  Everyone is different, so for some it can be many weeks and other months.

I hope this helps some people to understand what these meds are doing and why you don't get instant results, compared to other meds that work in different ways which is the reason they can have a more immediate effects (benzos for example).