Citalopram week 5 - feeling off - please help!

Treatment and medication
1

For context - I’m a 25 y.o female with social anxiety, panic attacks (I think it could be a milder form of panic disorder but I’m not totally sure and I haven’t been in therapy long enough to diagnose) and deal with a lot of intrusive thoughts. I started on 10 mg of Celexa about 5 1/2 weeks ago. The first couple of days I took it, I felt a little foggy and VERY drowsy. The best way I can describe the foggy feeling is some slowness and a weird feeling of dissociation from my surroundings - this was concerning because when I do have full-blown panic attacks I tend to deal with a strong feeling of dissociation and disconnectedness from everything around me, so this was definitely triggering.

Luckily, this feeling went away quickly and for the next 2 weeks or so I felt fine, totally normal, but definitely super drowsy. This wasn’t a horrible side effect because I occasionally have trouble getting to and staying asleep so I was actually feeling pretty good at this point.

However, around the 4 week mark (still on 10 mg) I started to feel weird again. The foggy, disconnected feeling started to creep up again, and I tried to convince myself that maybe the meds were building up in my system and I just needed to give it more time, but it was causing me more anxiety and I didn’t really read anywhere else that anxiety was supposed to get worse at this point… this is when I was expecting to feel some of the benefits. Another thing to note is that I dealt with insomnia a few nights this week, meaning the drowsiness went away almost completely.

Week 5, my doctor upped my dose to 15 mg. The first day, the fogginess was so strong I almost had a full-blown panic attack - SUPER concerning because I really only have these once a year. I get anxious very often, but I’m pretty decent at managing it to the point where I can pull myself back from having really bad panic attacks all the time when I start to spiral. I called my doctor to explain the side effects but she wasn’t in, and her assistant/intake specialist/whatever told me to take 10 mg over the weekend until she was able to give me a call back. But later that day I felt super relaxed, calm, and I thought that maybe the weirdness was just a short-lived side effect of upping the dose, and I wasn’t ready to write them off yet. I decided to take 1 and 1/4 pills and just slightly decrease it (~12 mg?) for the past couple of days.

For the past couple of days, I’ve been super up and down, sometimes really calm and other times panicked and anxious. Sometimes, I’m convinced that the medication isn’t working and is having adverse effects on me (the disconnectedness is the worst and most disheartening thing :frowning:) and other times I feel calm and pretty mellow - not in a way where I couldn’t be without them, but generally easier to sit still and relax when watching a movie or something. It’s really confusing! Basically my question is if anyone else has experienced anything similar? Is it a red flag to feel heightened anxiety in waves around the 5 week mark, when it’s supposedly supposed to start working?

I know I’m probably overthinking it, which is making the anxiety a lot worse too - but that’s sort of in the nature of anxiety as a whole and I guess I was hoping the meds would lessen the overthinking and ruminating, which definitely doesn’t seem to be the case so far.

A couple of other side effects/things to note (I’m not sure if they’re important) - I’ve experienced some headaches here and there throughout this whole process. Also, this is my first time taking SSRIs/anything for my anxiety.

Thanks in advance if you read my whole essay and are sticking around to help :blush:

2

hi Sara, im in the same boat as you. im on 10mg of citalopram side effects were awful for weeks, i felt relaxed and a bit of positivity some days but im on week 5 now and my anxiety is worse than ever constant panic attacks. weird feelings im not sure if its detatchment. im not sure wether to start taking 20mg but im scared of the side effects and incase i never get better i feel awful

3

hi sara,
i am 27 yrs old and female. i have been on 20mg for 9weeks now, i was exactly the same, my anxiety was through the roof and i was convincing myself that the meds weren’t working, but after week 6 things started to calm down, it does make your anxiety worse before you get better, and i promise it will get better, please if you can stick to your recommended dose, it makes your anxiety sky rocket, no one knows why, but i somehow managed to bare through it and i am so glad i did. My actually got so bad that i couldn’t even go into my own garden, but now i am more than happy to go out if needed (with this whole pandemic and all.) And of course i don’t know if you are the same but this whole pandemic has made my anxiety worse so i fought that as well as having a Heart Warrior baby who only got out of hospital at 3 months old (she is now 8months old and strong and healthy as ever) so i have had to fight my anxiety alot before even starting Citalopram.
Bit please, if you can, keep strong, you will get better i promise.

I hope i have helped a little bit, please feel free to PM if you want to, i am always happy to try and help as much as i possibly can :slight_smile:
I hope you feel better soon, Stay strong, you can do this x

4

Hi sara, i too suffered with the disconnectedness, feeling like you were in a dream kind and just generally out of it. On your road to recovery your likely to suffer a blip or what feels like a setback like you did on week 5. 10 may of been working for you as its not straight forward to feeling better. However 20 is the recommended dose, i like you was on 10 for 6 weeks, 15 for 3 weeks and now been on 20 for almost 2 weeks. Frustratingly everytime you up some side effects will come back, for me its anxiety and tiredness for a couple weeks, im just starting to feel better on 20mg. Overall your still eary days on citalopram and you will get better, make a decision on a dose (i recommend 20) and persevere with it. The last week iv had some of my best days in a long time so i know they are working

5

Hello - this was really encouraging to read :slight_smile: thanks so much for your reply! It is frustrating that the side effects seem to come back with a bit of a vengeance every time the dose is increased (this is happening for me as well). The drowsiness I can deal with more or less, but I just hate that foggy feeling! But it’s much easier to deal with when you can see the light at the end of the tunnel.

Since writing my original post, the fogginess/disconnectedness has definitely subsided for the most part. My anxiety is still pretty high but I’m trying to be positive and thankful that the worst side effect is gone for the time being. My doctor recommended that I stay on the 12 mg or so dose for another week until I increase to 15 mg. Increasing more slowly seems to help, but I will definitely keep your advice in mind when I increase my dose next time. I will have to fight through the effects for a few days, but those of us with anxiety and panic attacks are strong, and I will continue to be too!

It is frustrating that the medication has these initial effects, especially since those of us with anxiety tend to overthink and convince ourselves that the medication isn’t working for us. Luckily, the pandemic has shut my work mostly down, so I only have to work a couple of days a week. It is a little boring, but it has been a great time to work through the effects of citalopram since I can deal with them at home.

I am so happy for you and your little one :slight_smile: it’s lovely to hear from another lady with a lot of the same struggles as I do to be doing so well and dealing with difficult things with strength.

I will definitely PM you over the next few weeks with questions or anything! Thanks again! :slight_smile:

6

Hey Adrienne - yes, it is very frustrating to deal with. It’s difficult not to convince ourselves that the medication is not working for us or that we will never get better. If it helps, like I mentioned I was taking 10 mg for about 5 weeks before I started trying to take 15 mg and even without increasing the dose the detachment got worse around this time. Since writing this post a few days ago, the detached feeling mostly has gone away. I still am pretty anxious and panicky, but it was very encouraging to read about some other people’s experiences. It seems that around 5-6 weeks things can start to feel strange, also especially when increasing the dose. But if your experience is similar to mine, the effects will subside in a few days (my doctor said even a couple weeks - everyone is different - but mine took about 3/4 days to get a little better). It’s really difficult to keep taking the medication when it is causing these feelings :frowning: it feels like it’s never going to end. But stay strong, the feelings WILL go away and we will feel better than ever!

If you want to, keep me updated on how you’re feeling. We’re at around the same point in the process so we can help each other out. It helps to know there are others in the same boat as you.

7

That’s very reassuring to hear. I am going to start 15 mg soon (my doctor recommended I take the 12 mg for another week or so) and I will keep in mind that the side effects may come back and that it’s normal. It’s difficult because these feel like some of the longest days ever, but I will try to remind myself that they’re temporary and better days are coming very soon.

If you don’t mind me asking, in what way does it feel that the medication is working? I’m curious to hear about your positive experience - it may help me to keep this in perspective over the next couple months as I navigate this difficult process.

Thanks again! :slight_smile:

8

Oh wow, it’s made me so happy to know i have helped :smiley: please do message, i will help as much as i possibly can. I’m so happy to hear that things are easing, and i agree that a slow increase is best, i haven’t had to increase luckily, but my doctor put me straight on to 20mg so i had the side effects at there worst! and omg, i wouldn’t wish it on my worst enemy! it’s horrendous. But i do agree with you, the whole side effects thing is madness in itself. My psychiatrist today advised i move my dose to morning as it was keeping me awake (apparently it actually works a stimulating thing too lol) so im missing a tablet tonight and I’m alittle worried of having side effects again, i shouldn’t do but it’s just my anxiety due to still being early days. Fingers crossed lol.

Hope you feel even better soon though :smiley: x

9

Getting put on 20 mg straightaway sounds really intense and difficult! Props to you for getting through that and coming out on the other side. The insomnia may have been a result of the anxiety/dread that came from anticipating the next day, because I’ve actually gone back to feeling pretty drowsy again. Feel better today, but had an anxious morning and a borderline panic attack last night :frowning: started to feel a little disconnected again, but I had gone all day without eating and when I did I felt better. I wonder if it’s important to eat throughout the day on this medication?

The anxiety is coming in waves and is worse during the daytime and subsides mostly by the nighttime, did you experience this at all? Also, if you don’t mind me asking, how did you know it was working/ how did you feel when you started feeling better? The idea of being less anxious is so foreign to me I’m curious to know how it feels!

Thanks again for responding. Things seem to be getting better but during the anxious moments it’s difficult not to talk myself into thinking the medication isn’t working for me or that I should quit.

10

It was hell, trust me, they don’t normally recommend starting at 20mg but i pretty much begged my doctor to do something to help, i was so drained and just didn’t feel right at all, never mind the anxiety as well. Eating is very important, i don’t eat much myself but when i do i find i feel better, so do try and eat, i know you may not feel hungry or wanting to it, but that’s partly the anxiety’s fault as i know all to well that it makes you feel like poop and tired.
The way i realized it was starting to work was my mind felt clearer, although i was still tired and not alot of energy, i was able to focus again and i could actually do stuff with out feeling i was pushing myself too much, and my anxiety slowly became bearable aswell as calmer. I know it may feel nwver ending right now but i promise, it should start getting better in the next 2weeks or so! I have my fingers crossed for you. Oh and my appitite came back too! which was strange lol. My anxiety was also worse in the day, but not so bad at night, i found i would try distract myself (although i had 0 consentration at all) but if i couldn’t focus on something them my mind would go nuts. It will get easier, i promise.

And last thing, it’s your anxiety trying to tell you the meds aint working, my Psychiatrist actually told me, when its in my mind that the meds ain’t working, tell your anxiety to go away, either out loud or to yourself, surprisingly it works! It may seem strange but right now your anxiety is fighting a losing battle to the medication, and it will try to convince you that the meds won’t work. But that’s in part that the meds are working and its not admitting defeat! Don’t give up! You’ll get through this hard phase pretty quick! It feels alot long than it actually is but soon you’ll look back and go, I did it!

keep strong hun. I’m always here x

11

Hi Sara, yhh thats a good idea, i went up slowly and think it was the right decision. You will notice your getting better slowly. Suddenly you will have a good (normal) few hours or day. It just seems to slowly creep in. However for me when i did finally go up to 20mg apart from a bad ish first week its definetly helped me in my recovery and did notice a difference quite quickly. Not saying upping your dose is always the answer though.
You will just slowly keep getting better and the side effects (feeling out of it) will slowly fade away. I am at almost 3 months on them. My first month was crap, my second was quite up and down but good in spells and now 3rd month is much better and steadier, my anxiety is minimal. Its got to the stage where i can just bat it off. Keep going and keep believing you’ll get better as you will. I also had a couple CBT sessions which really helped my handle my stress and life better as thats what caused my anxiety, so would recommend a good therapist. Always happy to help so message me if you want. Youll see i only posted a couple weeks ago asking for help so things can turn a corner quite quickly! Stay positive

12

That’s so funny, I literally find myself doing the same thing! When the anxiety is bad in the daytime I try to find anything to distract myself and for my mind to focus on. Lately it’s been wrapping presents for my whole family, I’ve been a wrapping machine this week :slight_smile: doing something with my hands I feel helps to push negative thoughts away.

My appetite has gotten much better in the last 2 days, this is definitely surprising - it had all but vanished during this whole medication process. And some great news: this morning I woke up feeling almost totally normal! My anxiety is not all gone or anything, but I feel almost like I did before taking the medication at all, with maybe some small improvements. The dose is still low, but it’s nice to finally feel somewhat normal in the daytime. I was hoping this would happen because I leave in 1 week for a big 2 week family reunion across the country, and I was just hoping to feel better in time for that. I’m going to increase the dose when I come back in early January, and I’m much more optimistic knowing that the side effects do subside given a bit of time.

Hopefully the medication starts to work a bit more on my anxiety soon, but my head feels clearer and I can focus again, just like it did for you! I felt like the last week absolutely inched by, so I completely agree about it feeling longer than it actually is. I felt like I was dealing with the side effects for months and then I realized it had just been a week and a half! Crazy.

Thank you for continuing to keep things in perspective for me. This has really helped and I honestly may have quit without knowing that things could get better for someone with such a similar experience as mine with the medication. I am rooting for you to fight a winning battle with your anxiety everyday as well! I’ll continue to keep you updated because this forum really helps :slight_smile:

13

oh wow that’s awesome! It’s really made me smile! I’m so happy you are finally starting to feel the benefits :smiley:
i would say try and keep yourself calm over Christmas, i know you feel better but you will still have some down days, try not work yourself too much but i do wish you a merry Christmas and hope you have an amazing time with your family <3 Please do keep us updated :smiley:
And remember, I’m only a message away if needed! :smiley:

14

Nice to see you are doing so well Harry, i remember reading and commenting on your post :slight_smile: its amazing how quickly the side effects fade, but like i said to Sara, it feels like forever, where in reality its only a week or so lol

15

thanks for all of your help. my psychiatrist has switched me to Zoloft (seraltine) - though some of the disconnectedness went away i felt very numb and emotionally flat once the meds started to “work”. So far things have been better. :slight_smile: while citalopram helped with some of the physical symptoms of anxiety and improved some social anxiety, it wasn’t helping my pessimism, dark thoughts that lead to panic and anxiety, and sadness (still not sure if i have depression with the anxiety - working with my therapist to figure this out). psychiatrist informed me that seraltine works on the dopamine as well as the serotonin receptors whereas citalopram works on serotonin receptors only, so it should help with improving my mood as well as working on my anxiety and helping me relax. i hope you are still doing well on the medication. continue to reach out to me if needed. enjoyed talking with you, we are all in this together <3