Just thinking out loud…
I know that cortisol is higher in the morning, it starts to build in the early hours and therefore can contribute to early awakening and morning anxiety.
But I’ve also been wondering if the fact that it’s been 24 hours since the last dose of Citalopram maybe there’s a mini withdrawal scenario that’s exacerbating the problem?
Also thinking it might affect those on a low dose more than those on a high dose.
I've decided to test this a little, will swap back to taking it in the evening and see what happens. Haven't taken anything yet today, will do this afternoon and then tomorrow will push through to the evening. Weirdly I feel happier today than I have for ages!
Just FYI anyone wanting to switch from morning to night or vice versa, just had my first little brain zap, felt like a fizzing, not unpleasant or frightening, just weird.
Normally take it around 9am and have effectively stretched it until 3pm so a 6 hour shift.
no morning anxiety is not mini withdrawal. it's just hormones and neurotransmitters being unbalanced.
I have always taken my ADs in the evening and had horrible morning anxiety for the first 12 or so weeks since the start of the medication. the time of when I take the medication never influenced me nor anyone else when it comes to morning anxiety. but there are other factors that make a difference in when the medication is taken such as brain fog and sleep issues.
it made my sleep much much worse taking it at night!
Seems to be a mixed bag with that, some people find it's better, some worse.
When I used to take it in the evening I found that I fell asleep easily but always woke up about 4 hours later but seemed to be not too bad at falling asleep again.
When I took it in the morning at the start it made me really drowsy so I switched to evenings for a while, then back to mornings once the extreme drowsiness had reduced.
I think everyone's a little different in how their body processes the medication.
I was surprised to start brain zaps today after pushing back the medication by only a few hours, a lot of people report that particular withdrawal symptom after days, not hours.
I'll carry on and will report back just in case anyone finds it useful.
Agree with lala - morning anxiety is not a mini withdrawal - but, the brainzap you had IS however a withdrawal effect.
Withdrawal does not give you morning anxiety - and yes, it is to do with Cortisol.
Taking the meds morning, day or evening is a a personal preference (whatever suits you) and whatever time of day you take your meds it will not stop the morning anxiety I’m afraid.
Citalopram has a short half-life, lasting around 35 hours - meaning in many people it takes 35 hours for the drug to be 50% cleared from the body (if you don’t take another dose). However, after the drug has fully left your body it can still be detected in your urine, hair and blood up to 10-14 days.
K ;) x
To put another way, I wonder if the lower amount of drug in the system coming up to 24 hours is making the anxiety a bit worse that it would be otherwise.
I guess what I aim to find out is whether the time I'm due the medication corresponding with the naturally high cortisol is unhelpful.
The half life is interesting, I believe it's an exponential curve, rather than linear, so it doesn't fall steadily but instead falls quicker (from its peak around 4 hours) at the start.
Of course it may be different for me than others, there's no one size fits all, it would seem.
Odd to have felt improved mood this morning too, haven't had that for a while! :-)
if that were the case then those who take it in the evening would not have morning anxiety but would have evening anxiety, it has been noted on here many times that people feel very bad in the mornings but as the day progresses feel a little better, regardless of the time they take it. I know my self when on citalopram that come 6pm you would not believe there was any mental health problems going on but come next morning back to being a mess.
I think you are having better mornings because your dose is settling and starting to work and to be honest over thinking this and changing around your medication time is not going to help you
Oh dear, I'm not explaining this very well!
I'm not suggesting that the time of day you take Citalopram causes or cures morning anxiety, I'm suggesting that if someone has bad morning anxiety then the relatively low level of medication in their body at that time might be making it worse.
So if when you wake up your anxiety is, say, 8/10 then maybe the low level of medication at that time of day is making it a 9/10. I intend to test whether taking it in the evening (as I used to do) will take a little of the waking anxiety away e.g. making it 8/10. (still awful!)
Unfortunately, I'm not having better mornings, if anything they're worse and I think 4 months at the same dose is long enough to settle! (woke this morning at 5.30am with pounding heart etc. by late morning, having not taken Cit, I had a weird burst of happiness, but that's the first time that's happened for 4 months!)
Mmm ... I doubt a lower amount makes you more susceptible to morning anxiety - you get it no matter what dose you take :(
Another thing that probably contributes to morning anxiety:
Anxiety is a cycle we become trapped in - the fear of anxiety keeps it running - anxiety creates intrusive thoughts / ruminating / constant head chatter and self analysis, and this constant thinking in turn creates even more anxiety etc. One feeds the other.
Often the only escape from the racing mind is when you sleep, and it’s back immediately the second you open your eyes in the morning, and as this fuels anxiety it’s no wonder it starts all over again each morning with a jolt and the realisation you’ve another day to get through. Hence the sinking feeling.
Having a better mood could indicate recovery as thats how it works - good periods mixed with bad.
But, there's no harm in trying a different time of day - see if it suits you better ;) x
The morning anxiety will hit no matter what, it'd just be nice to shave 10% (or even 1%) off it so I think it's worth a try.
Increased anxiety is listed as a side effect of withdrawing, not surprising as anything that changes the chemical levels seems to affect it!
I am still surprised that I got brain zaps only a few hours after my dose was due, that seems very early to me but the same thing happened a few years ago with Sertraline.
The best thing to do is to accept it’s going to happen, relax towards it, don’t head chatter about it, know it will go, know that however it feels in the morning it isn’t an indication to how the rest of the day will turn out. Fighting and running from anxiety is the worst thing to do.
I used to take my meds in the mornings and if I forgot and had gone out, about midday I’d start to feel nauseous, dizzy, a bit buzzy and get a headache. These meds hang onto your Serotonin and need continuity, and any fluctuations (especially missing meds) and your body will grumble.
It won’t hurt at all to experiment with different times of the day to see if it helps ;)
Let us know how it goes!
K x
Just a quick update, took half (5mg) at 3pm, will take the other half around 10pm then tomorrow will try and push the whole dose later. (it was relatively smooth doing this when switching from night to morning)
Just reporting progress - I hate when online threads just 'stall', but apologies to those who aren't interested in this 🙂
Took the other half (although it was more like 3/4 as I used a knife not a pill cutter!) at 10.45pm last night, I did sleep better and heart wasn't thumping so much this morning but it's far, far too early to draw any conclusions. Citalopram is a mild antihistamine so that could explain the better sleep. (and drowsiness that some people get after taking it)
Held out taking anything until 11pm last night, headache started mid-afternoon but just took ibuprofen, no brain zaps yesterday, just felt fuzzy-headed. Fell asleep faster last night and woke up later than I have been. Still too early to judge but just wanted to log this in case it helps anyone else.
Took full 10mg at 11pm, struggled to fall asleep as I felt quite positive and motivated, but I think that's because I'd had a productive day, perhaps I'd better try not to accomplish anything and I'll fall asleep quicker ;-) Once asleep (somewhere between 1 and 2am) I pretty much stayed asleep until 7.30 so whilst I didn't get many hours I also didn't wake up at 5am with a thumping heart! (didn't feel great, of course, but have definitely felt worse in the past) Still too early to come to any conclusions, will persevere.
Took 7.5mg at 11pm last night, fell asleep reasonably quickly and slept ok, actually woke around 6.30am but managed to go back to sleep until 8am! (I know changing 2 things at once i.e. timing and dose, isn't the best approach scientifically)
Update: Felt irritable yesterday late afternoon, took 7.5mg at 11.30pm, fell asleep within 30mins of lights-out. Woke once at around 4.30 but went back to sleep until 7.45am. Feeling a bit groggy in the morning but not as anxious. Could be psychosomatic of course but I think that in my (n=1) experiment there's a pattern emerging - will keep going.