Hi all,
I was browsing the web a bit looking for other people's Citalopram experiences and saw there are quite a few posts on here from people having trouble with the initial side effects, and I thought I'd offer some reassurance to you all.
I'm on week 5 of my experience at the moment, but in the past I've been on mirtazapine (Zispin) and Venlafaxine, and had side effects from both.
Firstly, I want to reassure anyone just starting that the worst of the side effects will pass. How long they take to pass will depend on your dose and the way your body reacts to things - it's very individual. Here's my experience, however.
For the first two weeks I had quite bad nausea (especially the first few days). Having experienced this before on venlafaxine I was expecting it, but that doesn't make it any better: it passed pretty quickly, though. After a few days I felt a lot better. If you do get nausea, make sure you're taking your dose with a meal rather than on an empty stomach. Eating ginger (if you like it) can also help a lot; peppermint tea, if I recall correctly, also settles the stomach.
Something new on Citalopram I'd not had on other medications was the yawning. It wasn't necessarily linked to feeling tired or anything, which was very odd. It lasted longer than the nausea; about two weeks before it was pretty much gone. I still have a good yawn now and then - especially if I'm exerting myself at the gym - but it's hardly noticeable.
Grinding my teeth hasn't been as bad now as it was on venlafaxine (my jaw still clicks from that period, over 3 years later!) but has happened a bit. Chewing gum has been good for this - it's something for your jaw to do and keeps your teeth shiny too
Feeling a bit spaced out at the start is pretty normal - this should pass in time too. I went through a spell of losing track of conversations, but this is also a symptom of depression, so if that's why you're on the drug, it's hard to tell if it's a side effect or not. Just try to go with the flow a bit - it's nothing to worry about and the people I've discussed this with have told me they didn't notice. You're far more aware of it than other people will be.
I do have fairly strong sexual side effects - my sex drive has gone completely, and I know from past experience that should I get any of it back and (I'm trying to put this delicately) be in the position to act on it, then staying power is actually enhanced... which sounds great as a man but actually ends up getting quite boring or painful. Still, with no desire, this isn't a problem, and as I'm single the lack of desire isn't a problem either. If you're in a relationship and this becomes an issue there are other antidepressants which have less effect - zispin, I think, was better - but these come with other side effects so there's a balancing act. From past experience the sexual side effects lasted as long as I was on the drugs, but this might not be the case for everyone. Remember that depression itself affects your sex drive so it can be hard to tell what's a side effect, and what's \"normal\" (if there's any such thing as a normal sex drive! Everyone's very different).
Sleep has been a bit disturbed, but wasn't exactly great when not on them, so it's hard to tell, again, if this is a side effect. Depending on the effect they have on you, try to take them either in the morning or evening - some people get drowsy and others get a bit \"buzzy\".
I don't know about alcohol - I've tried to stop drinking as much as possible. Alcohol is a depressant anyway, so it's a good idea to cut down as much as you can. Clinical guidance is to drink \"in moderation\" when on citalopram, so if you drink too much you might experience bad hangovers - especially if you've had a dry mouth as a side effect.
Generally it takes about 6 weeks for the drug to build up enough in your system to have a real effect, and by this time the side effects should have worn off, so stick in there and if you're still on your first week take it easy, don't worry about the way you feel and things will get easier. If you do find the side effects too hard to deal with, or they stick around for too long, talk to your doctor. There are plenty of other options out there but they will have different side effects too - zispin, for example, gave me terrible drowsiness.
If you're getting anxiety problems then talk to your doctor about something like venlafaxine or other norepinephrine and seretonin reuptake inhibitors - they can be better for anxiety than a \"straight\" SSRI. Citalopram is one of the cheapest options out there for depression, but that's not to say it's not a good drug and right for a lot of people; just that it's often a first choice and if it's not working for you then there's nothing wrong with asking to go on to something else.
Remember, though, that all these drugs will have side effects, many will have withdrawal symptoms, some will be worse if you miss a pill or are late taking one, and so on. There are lots of compromises to be made but lots of options as well. Hang in there and things will get better.