How can something supposed to make you feel good feel so bad

Treatment and medication
1

Hi, what a relief to find this site - thought it was just me going mad - after all surely after one 10mg of Citalopram can't have made me feel so wierd already?!!!

Suffered from depression in past but managed without medication - been suffering from panic attacks (severe claustrophobia) and that coupled with uncertainty (and lack of support) of where I am going I suppose my depression has come back.

To the outside world I am a strong confident career woman raising a child alone who is doing a great job. At the moment I am sitting in my living room, curtains closed and trying to pick the courage up to call my boss to say I just can't make it today.

Anyway, can one dose of 10mg really make me feel so very depressed - more so that before! I feel spaced out, my mind is going like a rollercoaster, I didnt sleep last night and I just feel really weird!!

Had to then take a Xanac (prescribed for anxiety) just to help me get my child to school.

I don't even know if I can bear to take another dose. I have no family supoort around me and am frightened that I will lose it but with a young child I can't afford to do that.

Thanks in advance for any advice/support.

A

2

Hi Ang, keep at it! Keep going...your child needs you,,(,stuff what your family think). Get the help you require...If you need help, you need help...and should take any advice given to help you through! Ive been on this pill a while, and it is finally starting to help, but then I think so is this site. I have found writing it all down really helps. As does sharing your feelings with others!

You are not alone, it is painful and lonely, and most of all frightening...its scary to think that you could loose control so easily!!!! Take care.

3

smile Thanks for your reply - I totally agree that without the support that can be on offer on such a site would make it even more difficult.

Still sitting in the living room though with the curtains closed!!! Yawning like crazy but not really tired - very strange!

Thank the lord for emails and day-time TV!

4

I'm sorry you are having such a bad time. I had problems taking citalopram too.

This is because citalopram intensifies the symptoms of clinical depression before it alleviates them, so insomnia and anxiety will initially increase.

I took citalopram for 7 weeks, up to a dose of 30 mg. I had some relief of my depression, but the citalopram made my insomnia worse and my anxiety became panic attacks. After 7 weeks I was advised to stop taking citalopram, as it was causing me more problems than it solved. I was given amitriptyline instead.

The intensification of symtoms occurs because citalopram, initially, stimulates the pituitary gland in the brain before it suppresses it. This causes the release of cortisol into the blood stream.

Cortisol is a hormone that is part of the fight /flight response, causing increased wakefulness/alertness and anxiety. It also suppresses hunger.

All the medical practitioners that I saw during that 7 weeks told me that citalopram is a brilliant drug if it works for you, but that wasn't my experience.

5

Thanks for the info - this has been really helpful and it's good to know what actually the drug is doing to you.

I think with that info I will call my consultant tomorrow and discuss is this really the right drug for me - I really really don't want my anxiety to get worse as my parimeters are getting smaller all the time ie where I will go, with whom, when etc...

Also what is the usual timescale for this such treatment?

I'm still wide awake (after 2/3 hours sleep over past two days)..... due to take a pill but terrified I will spend another night pacing the floors and becoming more and more anxious..... and of course why does every creaking floorboard and rattling window frame seem to very frightening in the middle of the night!

I really need a knight on a white horse please..!

6

Hi Ang

Below is a scientific explanation of how citalopram works.

I thought that it may be useful to you when you see the person who is treating you for your depression, even though you may find the information too technical.

A lot of the information below is from scientific sources that I have researched and referenced, though some of what I have written is my personal experience of citalopram:

Mode of action of citalopram, an SSRI

‘Depression is characterised by an over activity of the hypothalamic-pituitary-adrenal (HPA) axis.’

http://www.neuroendo.org.uk/content/view/31/11/

Two significant symptoms of clinical depression in many patients are insomnia and anxiety. These symptoms are therefore the result of an overactive HPA axis in the brain. The administration of an SSRI will, initially, stimulate this HPA axis further, before the SSRI suppresses the HPA axis at the pituitary level:

‘Acute citalopram activated the HPA-axis at the hypothalamic level and long-term citalopram treatment desentised the HPA-axis at the pituitary level’

Ref: Journal of Neuroendocrinology Volume 11 Issue 6 Page 465-471, June 1999

Citalopram, by stimulating the HPA axis, causes the release of ACTH (Adrenocorticotrophic hormone). This, in turn, stimulates the adrenal cortex, causing the release of cortisol into the bloodstream:

‘…Intravenous administration of the selective serotonin (5-HT) re-uptake inhibitor, citalopram, increases plasma cortisol.’

Ref: Journal of Psychopharmacology Volume 163 Number 1 August 2002

http://www.springerlink.com/content/6x9tne5ml1nlad33/

Consequently, clinically depressed patients, who are already experiencing insomnia and anxiety, will sleep even less, feel more anxiety and may begin to have panic attacks as they are placed in an even more intense ‘fight and flight’ state by ingesting citalopram:

‘Although stress isn’t the only reason that cortisol is secreted into the bloodstream, it has been termed “the stress hormone” because it’s also secreted in higher levels during the body’s ‘fight or flight’ response to stress, and is responsible for several stress-related changes in the body.’

http://stress.about.com/od/stresshealth/a/cortisol.htm

I took citalopram for 7 weeks and during that time I experienced continuous anxiety, many panic attacks and very severe insomnia, with only limited relief of my low mood.

Whilst taking citalopram I was given zopiclone to relieve my insomnia. Zopiclone is a hypnotic and can only be taken continuously for 4 weeks or on 28 separate occasions, as it is addictive. I was advised to take the zopiclone infrequently and not continuously, so took it every third night. On the occasions I did not take it I experienced many nights when I did not sleep at all, only falling asleep for a couple of hours around 6-7 am in the morning.

Some medical practitioners prescribe propranolol, a beta blocker, for their patients when they start taking citalopram, to slow the heart rate during a panic attack.

When citalopram is discountinued and the HPA axis is no longer suppressed, more ACTH will be released from the pituitary gland and the adrenal cortex will therefore release more cortisol. Consequently, many patients have withdrawal symptoms when they stop their citalopram medication, possibly experiencing, again, anxiety/panic attacks and severe insomnia.

‘Withdrawal symptoms when treatment is discontinued are common, particularly if discontinuation is abrupt (see section 4.8 Undesirable effects). In clinical trials adverse events seen on treatment discontinuation occurred in approximately 40% of patients treated with citalopram.’

http://emc.medicines.org.uk/emc/assets/c/html/displaydoc.asp?documentid=1070

7

Okay then....are you a psychiatrist?. (no scarcasm is meant by this comment!) Or have you read all the medical journals in the library?

I am on citalopram, I have been taking it since July, in away it has helped, but I have had numerous side effects also! Insomnia is one of them. I also have been taking that jaded sleeping pill you are talking about. (Your posting gave me a panic attack!!!).

I do get anxious, and I always have. When I was a child, I used to literally jump out of my clothing , everytime a lorry passed, or a loud beeping noise passed me in the street. Now, it has reached a completely , and totally absurd level...where I cannot control my emotions. I seem to be crying an awful lot, (but then I did this before taking the tablet). If I take zopilcone(or however you spell it) I get even more irritable and snappy the next day. If i do not take zoplicone I am a complete walking zombie!!!

I have had lots of highs and lows in my life, like everyone, but as I have 2 young children and a career to pursue, my levels of anxiety got v high. My doc seems to think this is drink related, but i used alcohol to tame all my fears, and whilst I am not completely stupid, it helped me sleep. I reckon sleep is all I need, and probably, some good luck for the future. What you have said about citalopram scares me. I have been luckier than you, in that the placebo advantage of knowing that such drug will help later, rather than straight away, has helped me get through. However , I have been taking it since July, and I am sick of the nausea and the insomnia. (I was feeling like this anyway). Recently, and this is under bad circumstance, I found myself dancing and singing in the kitchen with my children, and having a laugh!

Though , later, sink and unable to move with my head buried under a pillow. as you can probably tell, i am not very scientific, nor am I very good at the old english, but while I understand what you have said. Without this pill I think I would be dead right now!! Rather than listening to music etc. There must be something good in it, take care , all of you/

8

Hi all

Thanks for your responses.

As you will see from my new posting yesterday my Consultant has advised me to stop.

For info I was prescribed the drug for anxiety as opposed to depression (but will admit there is a fine line between the two)!

Anyway I have stopped and can say that I will never take another one of those tablets again (but fully appreciate that it can and will help others).

I'm back on my St John's Wort and 5HTP, lavender oil and the like!

In fact I feel strangely very very good - is this another side effect???!!!! I hope not!

Perhaps reaching such a very low level on the tabs has made me realise I am not so bad as I thought - of course the anxiety is still there and I know and I still take the occassionaly Xanac but hey ho.......

Thanks for the responses and I hope there is light at the end of the tunnel for everyone.

A x

9

Good for you Ang!

I feel really anxious just now!

I feel sad!

My uni friends cancelled on me!!!

I feel so alone!

Nobody is responding to my v sad postings. I am fed up feeling sad! I want me back!!!

Maybe I should try your remedies, I dont know , I just know 20mg of citalopram does not do for me, except, gives me pure insomnia!!!

take care!

10

Hang on in there - but I really believe that medication is only part of the \"cure\"!

I am also seeing a life coach and have made some huge decisions in my life - was humming and deliberating for nearly 2 years - so that is probably why I am feeling good.

One suggestion (that works for me) is to get a kids scrapbook (or similar) and make it into a visualiation book ie a book you can fill with positive words/writings/pictures/sketches of what you want out of life - you don't put anything negative in it.

I've been compiling one for a couple of weeks and really now see how it has helped me focus on what I want and all I kept focusing on was what I didn't want!

Good luck

A