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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by andy013 on July 8, 2011, at 22:19:09
Hi, I became depressed last winter and started taking 10mg of citalopram. I took it for 4 months until I started to feel a bit better and then I decided I wanted to come off it.
I weaned down off it slowly but I still felt terrible. I thought that perhaps it was a withdrawl effect and that I would begin to feel like my usual self after a few weeks. After 8 weeks drug-free I still felt depressed.
I decided to try and take the citalopram again. I have now been on 10mg for 4 weeks and I am feeling very depressed (worse than I was off the drug). I have started having impulsive suicidal thoughts and crying (something I didn't do very often even when I was depressed).
Today I woke up and felt very shivery and hot at the same time, like I had a fever. I also feel really light headed and out of it and not healthy at all. I've had diarrhoea as well. I really feel like something is seriously wrong.
I am starting to become more and more worried as it has now been almost 9 months since I became depressed and there is no sign of me getting better. I am really worried that the citalorpam caused a change in my brain that will take much longer than 8 weeks to recover.I have read about people needing to wait 12-18 months after having bad reactions to prozac before they started to feel normal again.
I really don't want to take any more drugs. I have read lots of horror stories on the internet about people becoming more and more crazy the more drugs they tried. I just want to feel normal again without taking any drugs.
I guess I'm just looking for some understanding and maybe someone who has had a similar experience to me and gotten better.
Posted by gman22 on July 8, 2011, at 22:54:02
In reply to Feeling terrible on citalopram - need advice., posted by andy013 on July 8, 2011, at 22:19:09
Andy,
This same thing happened to me with Lexapro, which is the active ingredient in citalopram. I've gone on and off drugs many times and a few of the times I ended up being profoundly worse within a few weeks of re-starting the medication. My advice (for what its worth) would be to go off the citalopram and try a tricyclic like amitriptyline or imipramine. They do have some minor side effects, but have been used for over 50 years and proven very safe and effective. By the way 10 mg is a very small dose of Citalopram, and probable wouldn't be a true therapuetic dose.
Posted by Phillipa on July 9, 2011, at 10:45:03
In reply to Feeling terrible on citalopram - need advice., posted by andy013 on July 8, 2011, at 22:19:09
Have you discussed this with your doc? What type of symtoms prompted the first trial of celexa? Phillipa
Posted by joe schmoe on July 9, 2011, at 14:05:42
In reply to Re: Feeling terrible on citalopram - need advice. » andy013, posted by Phillipa on July 9, 2011, at 10:45:03
It is possible you actually have a contagious disease, like the flu, which is giving you these severe symptoms all of a sudden. I know someone else who got a fever recently so there is stuff going around. Could also be food poisoning. There is a tendency to blame meds for everything that goes wrong in life, because they are an easily identified variable.
I have been on and off citalopram a number of times. gman22 is correct, 10mg is a very small dose. I have gone as high as 60, anything less than 20 is not considered therapeutic. So it could be you are just not using enough and what you are feeling emotionally is the underlying depression, not a side effect of the citalopram.
In my experience, if you take a low dose of an antidepressant and you don't feel better, the doctor does not take you off it, they raise the dose and try it at higher levels before giving up on it.
Anyway I hope you feel better and assuming you feel better in a day or two from your illness, I would try the citalopram at a higher (normal therapeutic) dose, especially if it helped you before.
Posted by Christ_empowered on July 9, 2011, at 19:48:28
In reply to Re: Feeling terrible on citalopram - need advice., posted by joe schmoe on July 9, 2011, at 14:05:42
Sorry you feel terrible. I've experienced antidepressant withdrawal before, and I'm not so sure that's what you're experiencing. It sounds to me that you have an underlying problem, you've been on and off a rather small dose of medication, and you're having physical problems that could be caused by a virus or something. Plus, it kind of sounds like you're having a mini-freakout over the possibility of long-term damage from the medication.
Overall, antidepressants are relatively safe. I mean, they shouldn't be prescribed the way they are--that's just nuts--but if you have moderate to severe depression they can help, at least for a while. I think you should try to calm down a little bit, talk to a doctor, and develop a game plan for getting better.
Good luck!
Posted by linkadge on July 10, 2011, at 17:45:31
In reply to Re: Feeling terrible on citalopram - need advice., posted by Christ_empowered on July 9, 2011, at 19:48:28
10mg is lowish (approximately 1/2 of a full dose). However, 10mg is not without effect.
Whenever I start an SSRI I feel worse. I don't take them anymore. I don't think they're terribly effective.
Linkadge
Posted by bleauberry on July 10, 2011, at 20:01:50
In reply to Feeling terrible on citalopram - need advice., posted by andy013 on July 8, 2011, at 22:19:09
time to say good bye to citalopram and hello to something else in replacement. Whatever the cause of the depression, right now you just need some mood assistance.
It's weird and I cannot explain it. But when a med does something good, and then is stopped and restarted, for some reason it feels like a different med the second time, and sometimes a bad one. Side effects that weren't there the first time are there the second time. An antidepressant effect the first time is a pro-depressant effect the second time.
Some people can stop and restart their med and not have that problem, but others run into bizarre stuff as you have experienced. Me too.
I personally think this has something to do with the almost pure focus on serotonin, with total disregard for the other neurotransmitters. Somehow some way that messes things up in bizarre fashion.
I usually do not favor ssri's monotherapy for that reason. That includes effexor and cymbalta which are predominantly serotonin. I instead feel a lot better about someone's prognosis when there is a balanced approach for both serotonin and norepinephrine. The only things I am aware of that do that pretty good are zoloft+nortriptyline, clomipramine, savella, and sometimes combinations involving prozac and ritalin. And the maois.
Whenever I hear a friend, associate, or whoever who is doing fine on a ssri antidepressant and they are considering stopping it for whatever reason, I usually tell them don't. If it just plain isnt' working or pooped out, that's a different story.
Posted by morgan miller on July 12, 2011, at 0:06:58
In reply to Re: Feeling terrible on citalopram - need advice., posted by linkadge on July 10, 2011, at 17:45:31
> 10mg is lowish (approximately 1/2 of a full dose). However, 10mg is not without effect.
>
> Whenever I start an SSRI I feel worse. I don't take them anymore. I don't think they're terribly effective.
>
>
> LinkadgeDude, come on, n=1.
Posted by linkadge on July 13, 2011, at 14:21:19
In reply to Re: Feeling terrible on citalopram - need advice., posted by morgan miller on July 12, 2011, at 0:06:58
Notice the phrasing I used....
"Whenever *I* start an SSRI *I* feel worse. *I* don't take them anymore. *I* don't think they're terribly effective."
Linkadge
Posted by morgan miller on July 13, 2011, at 21:15:11
In reply to Re: Feeling terrible on citalopram - need advice. » morgan miller, posted by linkadge on July 13, 2011, at 14:21:19
> Notice the phrasing I used....
>
> "Whenever *I* start an SSRI *I* feel worse. *I* don't take them anymore. *I* don't think they're terribly effective."
>
> Linkadge
>I did notice. Still, you're basically saying that you don't believe they are very effective, not that they are not very effective for you. So, it always appears you base this belief on your experience. I know you have read studies saying SSRIs are no better than placebo, but I always get the sense that your more influenced by the lack of success in your experience.
Posted by linkadge on July 14, 2011, at 17:36:03
In reply to Re: Feeling terrible on citalopram - need advice., posted by morgan miller on July 13, 2011, at 21:15:11
>Still, you're basically saying that you don't >believe they are very effective, not that they >are not very effective for you.
Yes, and thats what I believe. Nobody has to believe what I believe.
Linkadge
Posted by morgan miller on July 15, 2011, at 10:45:12
In reply to Re: Feeling terrible on citalopram - need advice., posted by linkadge on July 14, 2011, at 17:36:03
> >Still, you're basically saying that you don't >believe they are very effective, not that they >are not very effective for you.
>
> Yes, and thats what I believe. Nobody has to believe what I believe.
>
> LinkadgeI respect your belief, I really do, I just wonder if your basing it on all the right information available. I don't see how people could notice such obvious external reactions like dialated pupils and head tingling, and then notice such drastic improvements after a few weeks, with improvements lasting for years without any major episodes, with the conclusion being that SSRIs are simply not effective. I'm guess your belief might be based on the fact that you feel like SSRIs provide an artificial feeling, and because of this they are not truly effective at providing what we really need. I agree this can be the case with many. I'm going off reports of not caring about certain thing and doing irresponsible things that normally would not have been done off SSRIs. Then there are many people that do well for a long time, stay driven, take care of responsibility, still feel healthy anxiety(necessary for protecting ourselves), and maintain the ability to maintain healthy emotion connectivity and experience a healthy range of emotions.
Have you considered the possibility that there are many people out there that do not take any medication and never have, including SSRIs, that have always felt very similar to people that end up doing well on SSRIs for a long time? Do you think it's possible that some people have grown so accustomed to feeling such deep pain and such an extreme range of emotional states, that feeling somewhat "normal" or more like the majority of the population has become undesirable? I'm wondering if this could get in the way of treatment for many people. I'm not specifically talking about you. This is a concept I have considered a possibility of existing within myself, and others who have suffered for several years at a time.
Morgan
Posted by sigismund on July 21, 2011, at 15:09:23
In reply to Re: Feeling terrible on citalopram - need advice., posted by morgan miller on July 15, 2011, at 10:45:12
>Do you think it's possible that some people have grown so accustomed to feeling such deep pain and such an extreme range of emotional states, that feeling somewhat "normal" or more like the majority of the population has become undesirable?
Of course, the masses of men lead lives of quiet desperation, albeit an American said that.
Morgan, have you considered that the cultural specificity of the USA with its 'pursuit of happiness' could predispose you to believe that these emotional states are not normal?
This is the end of the thread.
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