Anxiety, antidepressant withdrawal, side effects and health anxiety.

Mental health
1

I had been on citalopram for over 15 years, and failed to come off them before as I found the withdrawal effects very difficult.

The reasons for wanting to stop now were due to weight gain and being diagnosed with diabetes and poor sperm motility which I'm sure is at least partly due to the citalopram.

I feel I have wasted many years feeling numb and not getting on with my life or dealing with anxiety in a better way. I have lost contact with friends as I found it too much effort. It didn't help with depression over winter (SAD) and made me feel sitting infront of TV every night doing nothing was OK.

I spent over two years gradually reducing citalopram (from 60mg initially), cutting into smaller pieces for weeks at a time, even then my moods were all over the place, but I felt I had more energy but also anxious and bad tempered.

After I took the final dose (1.25mg) I felt very anxious (but also coincided with stressful circumstances) I've been off citalopram for about a year now and still feel very anxious and exhausted. I have always had social anxiety and now try and avoid all social situations.

I have had counselling through the GP but didn't really help, at the time it felt better to have someone to listen but I didn't find the CBT useful.

The GP has prescribed prozac but I am very reluctant to start taking it, due to the time it took to stop the citalopram and the side effects. It is not something I can just give a try, it is a long term commitment. I am struggling with relationships and I'm on the verge of losing my job, but I am worried that taking the prozac will make things worse and I don't want to put my physical health at risk and affecting my sperm as we would like to try for children when feeling better.

The GP doesn't understand how difficult it is to come off these drugs and dismisses the side effects although they are mentioned on the patient information leaflet.

I have asked to be referred to a psychiatrist (who I saw several years ago) to discuss about more suitable medication but didn't get anywhere due to funding cuts and not being 'ill enough'.

I asked about the side effects and delayed a couple of times, but now have lied and said I am taking them as I feel there is no other option available.

I might still need to take them but don't want to at the moment and want to keep options open with the GP.

I have health anxiety, but feel I need to get to the bottom of why I feel like this. I still think there might be some underlying health problem, last week I felt better and got quite a few things done and some exercise, but for the last two days I have had bad headaches, felt totally exhausted and couldn't get out of bed.

For years I thought it could be some type of chronic fatigue, as it wasn't better on the citalopram, which made it difficult to get to sleep at night and more tired during the day.

I have considered paying for private tests to check thyroid function, chronic fatigue etc. but then think it is probably a waste of money and some of the clinics seem dodgy, then I flip back to thinking the physical symptoms are simply caused by depression and anxiety as the GP suggests.

I don't know whether to just get the tests done, to rule out any problems and relieve the anxiety if nothing else, but it is a lot of money for me at the moment.

Sorry this is so long, all this stuff is going round in my head all the time and I don't know what to do. I'm probably not functioning as well by not taking the antidepressants, but don't feel much better taking them, it is just a different way of feeling bad.

I would be interested to hear if anyone has experience of going back on antidepressants or withdrawal or felt they were better overall not taking them.

2

Hi Capo.

You can count on a great deal of sympathy from me because your account is very similaqr to my own.

I have taken Paroxetine CONTINUOUSLY for TWENTY YEARS.

I am not a medic but I am  a qualified Psychologist (I have a good BSc in Psychology and am a member of a recognised national body). What I say is based on both personal experience and scientific training.

The first thing is that most medical practitioners (including psychiatrists) have had no scientific training, they do not know how to interpret darta scientifically and they have neither time nor (in most cases) the will to spend hours studying research data. I have the training, I have done that study and I have five years experience of trying to come off the SSRI. I know what I am talking about. Your GP probably knows squat on the topic but just keeps pumping out the SSRI to all comers to buy himself time. This is what the NHS does as a policy but its a pattern in the USA as well where between 10 and 20% of the population are on SSRIs, for things as far from depression as bachache, migraine and chronic pain. SSRI as you say numbs us to feeling.

In my own case it did much as you describe, maqking me willing to waste my life doing nothing. Since reducing the dosage to a minimum I have developed emotions and become able to have sex again. I am sorry about your sperm count. Thats not been an issue for me. But sexual dysfunction is a side effect recognised as predictable in more than half of everyone who takes an SSRI, so your GP shows their complete ignorance of the matter when they dismiss it. In fact that is quite shocking ignorance of the known and universally accepted fact that sexual dysfunction is to be expected more likely than not if you take SSRI.

In my iwn case it suppressed libido and made climax  almost impossible and painful to achieve. As an illustration, and you would need to know more about me than I want to tell here to understand the context, I even had a young woman friend who was a glamour model and very sexy try her damndest to arouse me one time without success. This almost destroyed my relationship with her. This kind of thing is typical in my experience and I have many examples.

The industry has sold the idea that SSRI is not addictive on the grounds that you get no "buzz" from taking it. But laboratory studies with rats (which, unlike humans can be dosed up under study and then dissected for examination) makes it clear as a cast iron fact that SSRI causes habituation characterised by a net shrivelling of Hydroxytriptamine receptors in the brain. Thats the actual word used in official degree level texts "shrivelling".

When I started to reduce SSRI (urged by my GP) I experienced very severe compensating effects, a sudden rise in libido to levels that nearly drove me out of my head (like a teenager, everything became about sex) and a vast range of symptoms I had never experienced before.. Worst maybe was the driving urge to kill myself.

The suicidal urge began whilst I was on my long term dosage (25MG for most of a decade). So it was logical to assume the drug caused it. I had never had it before. Of course, as I have reduced it it has got worse. Most days in most months I perpetually feel I want to kill myself. I have been seeking help with this for over two years. Like you all I get offered is more SSRI* ofa different type. I have explained to my GP that I will not take it because the only  source of hope I have is linked to my recovered ability to have sex (albeit helped by Viagra and still unable to ejaculate  in coitus). So to take more SSRI would only throw that away.

Moreover, I have been trying to get accross thatvmy diagnosis of "OCD" is  not fit for purpose as my problems now are 90% sexual in character. But they cannot see past the idea of "anxiety disorder". Funny that, I never experienced bouts of anxiety until after the first 15 years of taking the SSRI.

The latest installment is that a psychiatrist spoke to me on the phone and  said I should take a whopper dose of Fluoxetine for the next year before they will consider any therapy. I want therapy on account of the effects of being abused in childhood. Its the effect of that every day that I experience. "OCD" has nothing to do with it and SSRI certainly has no bearing on it except that the effects have got worse since trying to come off it.

SSRI is basically used to fob people off and keep them docile, much like Valium / Diazepam used to be in the Sixties. Well that was prescribed like smarties in those days, like SSRI is now. Then after ecades the system wised up to its effects and now its like getting blood out of a stone to get more than a minimal prescription for Benzodiazepines.

The statistical evidence for SSRI having any beneficial effect is very well established. No need to argue about Irving Kirsch. The results of the studies are out there in journals for anyone to read. Of course NHS medics do not do that homework, as their time is tied up with trying to keep up with targets in physical health care.

I will follow this discussion and give my opinions if you like but for now thought I would let you inow you are not alone. There are probably millions of people in this sort of situation, victims of the aggressive promotion of SSRIs whose scientifically substantiated grounds for complaint are simply being dismissed as ymptoms of a mental illness. Its the British way to blame the victim. Look how long its taken for whole swathes of sex abuse scandals to finally come to light after years of victims complaints being ignored.

If you can afford private care do it. If I could I would. I would say that anyone with the means who needs psychiatric help should seek it privately. That would free up the NHS to meet its targets on hip replacements and the like. Its also more likely to get serious treatment rather than perpetual fob offs.

I cannot afford private health. I am still fighting with the help of a mental health charity to get treatment. However, that psychiatrists letter to my GP says "his risk of suicide is not imminent" , because I said I will do it in October, when I have had time to sort out loose ends in my life.

The sub text of thatv  judgement about being no immediate suicide risk is that unless one is about to actually attempt it then they think its fine to let us continue to suffer.

 

3

Hi Cap. so sorry to hear ur in such a dilemma presently. it seems that u have done trojan work coming off citalopram on your own steam. well done you. as ur aware, it's so difficult to seperate the physical from the psychological i.e. whether the fatigue is caused by anxiety/depression or CFS/ME or depletions in vital minerals/vitamins/enzymes or other condition/s. i guess the bottom line is that once, one is out of zinc the others are affected.

i'd suggest u have a look at the 'oxford diagnostic criteria for ME/CFS'. just google it and see if ur symptoms fit. the key symptom (amongst many) is delayed post exertional fatigue. the exhaustion (depending on the severity of the ME/CFS) can be overwhelming. ask the Doc to do a full blood work up including checks on ur thyroid (T3/T4/TSH), together with vitamins d, b12 & folate. b12 deficiency is a much overlooked condition that wrecks havoc on ppl's lives both physcially (extreme exhaustion) to psychologically (anxiety/depression etc. etc. ) have a look at the Pernicous Anaemia Society (PAS) website for accessible info.

i hope u get some help from ur Doc.

All good luck Caitlin.

4

Thanks for the reply. I don't know why it has taken me so long to realise the options on the NHS are SSRI antidepressants or nothing.

Although I have had counselling a couple of times, it is short term and amounts to little more than a chat with someone sympathetic.

I initially started taking antidepressants due to my parents (who are both very anxious) taking me to the doctor when about 16 or 17 after persistant fatigue after glandular fever and being diagnosed with social anxiety. I said to a counsellor recently that I want to get to the root cause of why I feel the way I do, but they said it doesn't matter and CBT focuses on the way you are feeling now, which in someways is true but to have proper understanding and to deal with things I think it is important to know. I'm sorry to hear about the cause of your difficulties, it is something that needs months or years of therapy, which is just not available unless you can afford to pay for it.

I think that being on antidepressants from a young age has not helped with my anxiety and made my avoidance behaviour worse and now have very poor ability to cope with things as an adult and feel frustrated that I am trapped from doing positive things by my own anxiety. I am ready to quit my job as the boss and other people are judgemental, nasty people and it is making me miserable, but feel trapped as it has reasonble pay and I don't feel well enough to search for and start something new. It would be a load off my mind to quit, but then I would have money worries, as in the past I was out of work for a year, which has a negative effect on self esteem and motivation.

I don't have the money to pay for private mental healthcare, but could maybe afford a couple of hundred for some blood tests. Once diagnosed with depression and/or anxiety the GP just dismisses the physical symptoms, I'm aware that it can cause physical symptoms, but really don't know which causes which.

I have read many articles and research papers on depression, anxiety, SSRIs and through personal experience and discussion forums I feel I understand some aspects better than the GP, but am also aware it is important to get external help from someone with training and experience as sometimes I get obsessed with things or looking back on things become aware that I'm not thinking straight or make unwise descions.

It is wrong that funding for mental health services is being cut further, and people suffer, sometimes they will help when someone is at crisis point, but it is wrong that they are unable to do anything preventative.

5

Hi I was on citlopram for about 12 years started on 30mgs and went down to 20 mgs then 10 mgs which I was on for about 3 years and last November I went down to 5 mgs and March this year I stopped taking it I still feel a bit anxious but I go to work but not taking any meds at all went I went down to 5 mgs I started to get acid reflux but it seems to be settling down a bit all so had a headache for about 4 days hope this has helped you

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Thank you for the reply and the information I will read up about it and try to progress with the GP although it is hard to get the GP see past the depression side of it.

It certainly seems to be post-exertional fatigue, but I can do more than I used to and is certainly not as severe as some people, some days I can walk 4 miles now and the GP just says anyone would be tired after that, although it feels much worse than being just tired and flu like achy not muscle aches. I have tried lots of things and take a handful of vitamins every day, although they don't seem to help, but hope it means I don't have a serious deficiency of anything.

7

I had migraine type headaches with flashing lights in one eye for several weeks less than 5mg, they seem to have reduced now. It was not something I had when on the citalopram, but they seem to run in my mother's side of the family.

Do you seem to have more motivation now you have stopped the tablets and do you find getting to sleep easier now? I do, but the anxiety is very difficult, but could be due to difficulties at work and personal life is more stressful now.