Starting on Citalopram, chatting and progress

Treatment and medication
1

Hi all,

i’m just starting out on citalopram, i’m male aged 47 and have been on and off lots of different antidepressants for about 15 years.

i just thought i would record here how its going and if anyone wants to chat about anything (for example how you are doing, or would like to share advice, please join in).

i started out on 10mg of citalopram, about 2 weeks ago, but for the last 3 days or so, i have moved up to 20mg. i didn’t really have any side effects when starting the 10mg, but its certainly a different case now i am taking 20mg. there’s a very noticeable increase in anxiety, which tends to be worse in the morning/early afternoon. i am also feeling very nauseous and am lacking appetite. i am currently splitting the 20mg dose, taking 10mg at midday, and another 10mg before bed around midnight.

i’m currently not sleeping well and feeling tired throughout the day.

i have lots of ‘automatic negative thinking’ going on but am trying to just do things through the day, and i have a part-time job i go to in the evenings, which i will continue to try to go to even if not feeling very well.

i guess that’s about it for now then, i will continue to post updates. it can be a difficult road when starting antidepressants as you dont know how long they will take to work, assuming you are on the right one which suits you, and to find the right dose also.

sending good luck your way to anyone who is reading this and is also trying to get well.

2

just an update as a couple of days have passed, i have noticed the anxiety levels in my body seem to be less now, although im certainly not in the clear, my anxiety levels are still high, which is worse when i wake up in the morning. its hard to want to get out of bed in the morning although lying in bed is not a good alternative as i am lying there with anxiety in my body and my mind is not relaxed and calm.
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im trying to do mindfulness type things, such as if i start thinking fearful/worrying/negative thoughts, to try to bring my attention back into the present moment and focus on things around me, or focus on my breath, breathing in and out, or doing something called a ‘body scan’ where you kind of ‘feel’ using your mind, different parts of your body, such as how your hands feel, or scan your entire body from head to toe. the purpose of doing this is to try to get your attention ‘out of your head’ away from your thoughts.
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im hoping as the days go on my body continues to adjust to the citalopram 20mg, and the anxiety levels go down. im also hoping soon my thoughts and thinking will be more calm, and negative thinking and rumination eases.
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i’ve come on and off antidepressants many times in the past but i really have learned now that it is so risky to stop taking them if i feel well again, and from now onwards i plan to never stop taking them again, and alongside that to try to change the way i think in general about things (try to worry less for example).

3

another update, this morning when i woke up, i could definitely feel less anxiety in me than previously, and my thoughts as i lie in bed were more calmer thoughts and less negative/worrying
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im hoping this citalopram is starting to settle in and get working now, and the difficult start-up effects are easing down
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with regards to how sometimes these type of meds work faster for some people and slower for others, i wonder if in some cases it is related to how long you have been feeling unwell. so for example if you have been feeling unwell for several months without starting any treatment, for some people could it take longer for the meds to work?
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also, i wonder if some of the depression meds take longer to work than others? for example i read that venlafaxine for many people can work quickly once started, even if you have been unwell a long time before starting it. whereas something like fluoxetine can take longer to work, as it has a very long half-life (the time it takes for the med to go through your system)
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in my case, it seems (and i very much hope) that i am adjusting to citalopram quickly and it is getting to work. if this is the case, it might be because i have not been unwell with depression and anxiety for long before starting citalopram. i was previously taking amitriptyline (75mg) about three weeks ago, but unfortunately for me it caused tachycardia so i didn’t want to stay on it any longer. so i switched directly from amitriptyline to citalopram and then experienced side effects like increased anxiety and nausea over the last several days
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ok i will continue to post updates and am hoping for the best

4

-double post my accident so deleted this one-

5

i thought i would post another update as it’s been a few days since the last one. i would say now these citalopram 20mg tablets are certainly getting to work. i tend to be feeling ok for longer periods. i wouldnt say i am in the clear or anything, as i am still tending to get that horrible ‘morning depression/anxiety’ which is common amongst sufferers, where you tend to feel worse on waking up but often feel better as the day progresses and into the evening. but thankfully even this has now been eased by the citalopram, so im remaining optimistic that further improvements will continue over time.
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i feel like some side effects of taking ssri medication in general, are perhaps finding their way back to me. the 2 common side effects i tend to get when taking ssri meds (which dont tend to go away even after several months of taking an ssri med), are firstly: feeling tired and sleepy very often (this includes often feeling very sleepy after eating food)… and often i will actually need to sleep in the daytime at some point.
… and secondly: i tend to find my dreams at night are increased, as in, i feel i am dreaming more, and i can remember the dreams more on waking. this in itself doesnt particularly bother me, but what does make this side effect annoying, is the dreams tend to be of a ‘negative theme’, so for example contain negative scenarios with people or things, etc.
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these side effects in the past have been the reasons i tend to end up getting annoyed with taking ssri meds, and taper off them. but now i feel like i have learned my lesson and will do anything to avoid that severe depression and anxiety which always finds its way back to me if i dont take meds to keep it under control. so now, whatever the side effects, im staying on these tablets, and if i find in the future they are not helping me anymore, i will simply switch to something else.
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so for now then, to summarise, im doing well and these citalopram 20mg tablets i can feel are certainly helping me and continuing to work on improving my mental health a bit at a time as the days and weeks go on. this is after the startup period though where i felt worse in the beginning taking these tablets. this was a difficult time and for some people if this becomes too distressing they are sometimes prescribed a benzo type med to take alongside their citalopram in order to help get them through the often difficult startup phase.
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i believe the reason these citalopram tablets have worked quickly for me (around 3 weeks) whereas some people seem to have to wait many months to feel better, is because, previous to taking them, i was taking a different antidepressant med (amitriptyline), which was working fine, but i had to switch due to a more serious side effect (called ‘tachycardia’).so on starting citalopram i was already feeling well and free from depression and anxiety, so the citalopram did not have to do a great deal of ‘repair work’, as the amitriptyline had already got my depression and anxiety under control. in the past from my own experience, it tends to take longer for me to recover from depression and anxiety if i am starting treatment from a point where i have been unwell for a number of months prior to the treatment, as then it seems the meds and time needed to reach feeling well again, is increased. for anyone reading this who has been unwell for a long time and are now thinking, “oh god i cant wait several months to feel better!”, dont worry there are always exceptions where some people do tend to feel better quickly when starting antidepressants, even if they have been ill a long time, and also, some of the meds are more known to work quicker than others, for example it is generally thought that the meds with a longer half life tend to take longer to work than a med with a short half life. an example of an antidepressant with a (very) long half life is fluoxetine, and an example of an antidepressant with a short half life is venlafaxine. personally in the past i found that, after being unwell for several months, taking venlafaxine made me feel better very quickly, in about 2-3 weeks!
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anyway, personally speaking for me, it seems it is much much better and safer for me to stay on antidepressant meds, rather than stop, ever. and that’s my plan from now on. i will simply stop caring about side effects which are not life threatening such as ‘feeling more tired’ or ‘vivid dreams’. i also dont care if i have to sleep more in general, as i would rather have reduced hours in the day to do things, rather than not taking any meds and thus not feeling tired at all in the daytime, but at the price of spending the entire day in hell, wishing and praying that bedtime would come quickly so i can ‘not exist’ for a while as i sleep.
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Wishing you all well in your recovery, you can and will feel better if you keep going and dont give up.

6

one more thing i wanted to say, which i think is unpopular with many, is that my attempts to help my depression and anxiety with these things: ‘working out’ type exercise, mindfulness, meditation, ‘positive thinking’.. simply did not work. please note that i do believe it does help some people, but what im saying here is it doesnt work for ME. i personally worked on these types of things for years, but they simply didnt help. if i had to guess why these dont work for me, it may well be because, i have had depression and anxiety since being a teenager, so that’s over 30 years ago, and i imagine my depression and anxiety is very deep rooted now. i think if taught that stuff from an EARLY age it can be very effective, but for someone who has had repeated severe episodes of depression/anxiety, it has taken its toll, and these repeated episodes change you. i can live with that though, as long as there is effective treatment available to stop our suffering (or at least reduce it to an acceptable level which means we can for example enjoy things)
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ps. one thing which i DO agree has an effect on (at least my) mood, is what you eat. switching to healthy food and not eating crap/snacks etc has had a very positive effect on my overall feeling of wellbeing. i highly recommend trying that :slight_smile:

7

i just wanted to mention one more thing about what i said about how mindfulness and meditation did not really work out for me (as i dont want to give it a negative review):- personally speaking for myself, practicing these things when not on effective medication, i did not seem to experience any noticeable improvement relating to my depression and anxiety (as in, for me they didnt turn out to be a ‘magical cure’), however that said i do always try to at least incorporate some mindfulness into my life if i can. i imagine a lot of people do this naturally, so for example if they find they are really stuck in their head with eg. negative intrusive thoughts, to try to take your attention out of yourself/your thoughts if you can (mindfulness). for me i personally find this is possible as long as i am on effective medication, as otherwise my depression/anxiety is too high to deal with just by trying to apply things i have learned from studying various methods of self help. so i think what i am trying to say is, for some people like me where mindfulness or meditation alone does not provide the results you hoped for, you my have more success with it if used in combination with something else (such as meds, or changes in lifestyle, etc)

8

Hi there!
This is an amazing read! I can’t believe you are feeling better after just 3weeks, I am now 6 and a half months on 20mg and they have only just started to be in full effect, I feel so much better than I did say at 3months in. I struggled really bad with heightened anxiety for about 7weeks when I first started, and the tiredness was horrible! Although I do still find I feel rather tired, I was hoping it would ease off just a little bit lol. I am a mum to 2 beautiful girls, my eldest is 5 and my baby is 1, my baby is a little Heart Warrior, meaning only half her heart works, she spent the first 3months of her life in hospital, had a cardiac arrest at 3weeks old, we was close to losing her at one point too, but she battled through everything and finally came home to her big sister at 3months old. And since then she has grown and battled 2 colds too. She is truly a little trooper. Everyone says she gets her strength from me, but I don’t think so. When she came home I hit rock bottom, I was almost put in hospital due to not eating or drinking much. But thanks to the support of my family, friends and Psychiatry, I made it through my dark patch and my baby is due to go for her next Open Heart Surgery soon, I believe that without Citalopram I wouldn’t be able to go through all of it again, I know it won’t be as bad as last time, but the fear is always there!

I hope you are having better days :slight_smile: I’m always here if you need a chat.

Jade x

9

Hi Jade thanks for joining in and i’m really glad your family are doing ok after so many scares and stress. Good to know the citalopram is helping you after a long road. sigh it can take so long for these old fashioned meds to work :slight_smile:

here i do certainly feel i have more of a way to go with recovery, but luckily those initial startup effects of increased anxiety have passed now. i’m annoyed with myself at the moment as at work last night i kind of ended up stuck in ‘negative thinking’ mode and now wish i really tried to ‘stay out of my head’ instead of just letting thoughts spiral. i’m certainly hoping as more time passes, citalopram will help with this. i guess i have to keep trying with mindfulness also and just hope to get some results.. eventually!

10

I usually find that counting helps, I count to 10 say 2 or 3 times, it takes you mind away from the negative thinking. I also keep a diary of my mood, I rate rate my emotions on a 0-5 score rate. it was recommended by my Psychiatrist and it has honestly helped me so much, just to see the improvements week to week.
Thank you for your kind words, it means a lot, it is very stressful but our girls keep us going, I also have a very supportive boyfriend who is an absolute angel, he’s helped me on my bad days too, obviously the meds work but you still get bad days, rare now though.

Hopefully you will see more improvements in the coming weeks :slight_smile: I will be sure to follow your journey though! I wish I had done the same!

Jade x

11

Thank you so much for your thread as i have just started on Friday due to panic attacks about health anxiety since a trauma and covid has made it so much worse. I started on 20mg and have had heightened anxiety, nausea, palpitations and felt so much better today but noticed my heart rate at resting dropped to 54 today as felt dizzy and checked fitbit which it never has before always been 68ish. It seems to now be early 60s at rest. 54 was lowest it has ever been and now worried tablets are affecting it and causing more worry. Has yours dropped at all?

12

hey emily, im not currently experiencing any issues here relating to dizziness or heart rate changes, but i have certainly experienced that in the past various times when taking ssri meds. what i tended to find is i might get for example dizziness when standing up, or some heart flutters like it missed a beat, but i found this tended to just pass on its own after a number of days. i would say if you are concerned you could speak to your doctor about it, they can do some tests to see if everything is ok, or otherwise, you might just find that it will just pass on its own as your continue to adjust. you are not on a high dose of citalopram so i wouldnt over-worry about things. do speak to your doctor though if you are concerned, he may just say give it a couple of days to see if things improve or otherwise they might just run some tests for peace of mind.

13

Hi

I was prescribed 20mg in december due to work stress but ended up not taking it as things improved ive recently found though that my anxiety has been increasing so i have started up properly now a couple of weeks ago started on half a tablet but have just gone up to a full 20mg tablet. Was feeling rather anxious this morning with lots on at work but am beginning to feel slightly more relaxed. Taking medication at around 9.30 pm and have been ok with sleep for the most part. Does the anxiety in the mornings subside?

14

hello Giles, if you mean you are getting increased anxiety in the morning now due to increasing the citalopram dose, then yes dont worry this stage does pass, and for a lot of us it doesnt take too long to pass.
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for me the increased anxiety from increasing to 20mg lasted days, not weeks.
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i do still have the ‘feeling worse in general in the mornings’ thing going on, but i have read around and this does seem to be something which can take a while to go away unfortunately.
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here this morning when lying in bed not feeling good i tried the focusing on my breath / ‘body scan’ methods of mindfulness, and along the lines of what Jade suggested regarding counting numbers, i did some maths in my head of just adding numbers together. im not 100% sure but it did kind of feel like doing these things helped the anxiety ease down. if i wake up feeling like crap again tomorrow morning i will try it again

15

Thanks for the reply. Good to know its normal and should subside. Woke up incredibly anxious this morning related to work stress but ive seen a way forward with a task im doing and thats made things easier…plus an update meeting was moved to monday which gives me more time. Feeling much better at the moment although need to make sure i eat and drink as didnt yeaterday. Im trying mindfulness again but mu mind quickly wanders back to my worries. Perhaps with more practice that will get better. You say you generally feel bad although the anxiety is less. How does that general bad feeling manifest?

16

hey Giles, i have found things like mindfulness or ‘challenging negative thoughts’ etc can work as long as depression/anxiety is not too high, otherwise (and i imagine a lot of people can relate to this), if the depression/anxiety is too high, you are just overwhelmed by that, and so trying things like ‘positive thinking’ just doesnt work at all. perhaps when your anxiety levels reduce then you will have more luck with mindfulness type exercises
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regarding what i said about the anxiety is less, yep absolutely, such as this morning in bed i just lied in for a couple of hours and it was good as there was zero anxiety and i could just relax and everything was fine. the ongoing issues i currently have now is, i dont have any anxiety at all, but there is definitely the depression side of things hanging around me still. i was ok this morning as mentioned, but then it creeped in during the day. in my particular case the depression manifests as a general feeling of low mood, loss of interest in things, not feeling good about or not interested in the future, negative thinking about the past and present.. you get the idea. i guess i am just playing the waiting game now hoping the 20mg citalopram can improve that… and if so, sooner rather than later would be nice :slight_smile:
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keep us posted how you are doing Giles

17

Hi

just thought I’d post an update. This week my morning anxiety has improved significantly (famous last words as tomorrow is another working day) but I feel as though I am making progress with things. I’ve found a couple of helpful mindfulness recordings which help when I wake at 5.30 am (which isn’t great). After an hour or so of being up and into my working day I feel much better for the entire day. Hope all doing well!

18

great to hear Giles! it does certainly sound like the citalopram is working, and dont worry if u do take some steps back along the way, thats what has been happening to me. so in the beginning of treatment i felt worse, then i started having some better monents here and there (usually later in the day.. mornings were always rough), and then fast forward some more weeks, and i was having the odd better entire day.. and now fast forward to now and the last 2 days for me have been really good with no depression or anxiety, morning, noon and night. it might still mean i have some dips here and there but things are definitely getting better as time moves forwards. this seems to be a very common theme with many people’s recovery timeline.

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Thanks for your account Sun47 - My story is a similar one (I’m also the same age)

I have been on and off anti depressants for nearly 30 years. Two years ago I decided I was finished with them - I felt more they had helped me as much as they were going and I was going to manage my moods without them - meditation, mindfulness and healthy eating.

Of course, the wheels have come off badly during the past year and I finally gave in when I hit the wall one time too many. You are so right about meditation - I have spent so many hours practising, on and off the cushion. I have been blaming myself for not doing it right but I now see that it’s practically impossible to practice these skills when all of your bandwidth is taken up with anxiety and depression. I attended a meditation retreat a few months ago and it was tortuous. My social anxiety levels have been through the roof.

I am on 20mg of Citalopram for four weeks now, and all I have experienced so far is 4 hours sleep at night and the most dreadful anxiety and suicidal thoughts and catastrophising. I practice body scans and mindful breathing but it’s not really working. I desperately need this medication to begin to work soon or I will have to take time off work - it’s becoming difficult to just function on a daily basis.

Please keep us updated with your progress and good luck to everyone on this thread.

20

hey Admac73 thanks for writing your story here, it really does sound like out stories are so similar. i didnt mention about suicidal thoughts so far in this thread but just to let you know, i most certainly have been getting these, but thankfully now i feel like i am moving past that stage (but when back there being in the thick of depression and anxiety, i just assumed those suicidal feelings would never go away, and neither would the depression and anxiety). so anyway like you i imagine, i just kept seeming to find myself with suicidal rumination, which was horrible and automatic, like there was part of my head responsible for either feeling suicidal or not, and this was activated.
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Regarding the whole world of mindfulness and meditation, I do wish people like Eckhart Tolle and some of the other more known names in the industry would make more of a point that, their methods DO certainly work for some people, including people for example with certain levels of depression and anxiety, but then there is a certain more severe level of depression and anxiety which (in my opinion) wont actually be cleared up just by ‘focusing on your breath’ or ‘sitting in silence’, etc. And that goes for exercise also, and even diet. There is certainly plenty of evidence to back up what i say, as in, you do get plenty of people who eat a proper diet, exercise, and practice mindfulness/meditation, and yet they still have problems ongoing with depression and anxiety. So at least to me this says, there are many paths leading into suffering from depression and anxiety, and also there are many paths leading out. there is no one answer and there is no one solution. Luckily for most of us, one pathway out is, there are meds which do help us (although annoying as you know, sometimes they take a while to get going…)
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I did keep doing the ‘body scans’ and ‘focus on breath’ practices during the earlier stages of my citalopram treatment, but honestly i have no idea if it helped at all. To be honest it just feel like what REALLY helped with me feeling better was, taking a depression/anxiety medication, at a suitable dose for me (in my case 20mg), and taking it for a long enough time so that it began to work. And to me, it really is that simple. The only other thing I had to do in the meantime, was to keep going, and that’s it (this was not easy or fun as you well know yourself. severe anxiety, depression, suicidal thoughts is no walk in the park. you know that).
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Admac did you start on 10mg citalopram and move up to 20mg after we week or two? if you didnt, i personally found that was less painful than just jumping in with a 20mg dose. that said it seems like u are past that stage now anyway so are now on the usual adult 20mg dose. 4 weeks is not that long so try not too worry, it certainly seems reasonable that u just need to give it more time and things will settle down and u will start to feel better. i know currnently pretty much every cell in your body will tell you its all hopeless, and you are flooded with anxiety, but honestly keep going because 4 weeks isnt very far in regarding recovery. keep us posted how u are doing.