Back again with another question/concern :-).
In April 2013, I was put on 20 mg Citalopram to help with some major anxiety issues I was having. I had never been on an antidepressant before, and really didn't know much about them. My husband had been on one or another for several years; had no side effects, and I assumed I'd be the same. My doctor didn't mention any side effects, other than to tell me "it might make you sleepy". (HA! I wish!).
I ended up having horrible insomnia, increased anxiety, depressive thoughts. I just assumed I was getting worse....I didn't realize it could be a side effect. I went back to the doctor after a week, and she upped my meds to 40 mg. So now in the space of 8 days I've gone from 0mg to 20 to 40. As you can imagine, the side effects were horrible. It was then I went online, did my own research, and realized that most of what was happening to me was because of the side effects.
The Citalopram did eventually work wonders for me. I've felt great the last 5 years. Last week, here came the anxiety again. Maybe due to Seasonal Affective Disorder, who knows. When I went into the doctor last Tuesday, she found I have an irregular heart beat. I was put on meds for that (Metoprolol). A very small dose to start.
I can take the Metoprolol with the Cit, but the drug interactions do say "moderate". Plus, there's been some debate (mostly debunked by more recent studies) that Citalopram can increase your risk of irregular heart beats. I've also always felt that I don't really need the 40 mg dose: I think the 20 would've worked, but since my doctor amped it up to 40 after only a week, I just don't know.
I guess my question is: how do you know if you've been on a too high dose for years? Should I try cutting down to 20 mg in a few months? (not doing anything until the heart med is fully in my system). Should I switch to a different antidepressant altogether, given the irregular heart beat?