10mg to 20mg - What can I expect and should I keep going?

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Yesterday morning I stepped up from 10mg Citalopram to 20mg after 10 days on the lower dose.

In the first week I suffered from mild nausea, insomnia and increased anxiety which gradually subsided. I was hoping that my body would have got used to it by now and that I would not be hit by further side effects when I went up to 20mg.

But I seem to be wrong. Even after just one day on the 20mg I have horrible sweating at night, insomnia and feeling down again. I am wide awake at 2AM typing this when I should be asleep.

How have others out there found the dose increase? Do the symptoms subside again and should I stick with it?


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  • Posted

    Hiya david i know its so bloody frustrating but think your doctor should have started you on a higher dose if the symptoms are really getting to you ask him for ACITALOPRAM i know one letter different but it made one hell of a difference to my daughter in law she has night terrors has done since a baby and has very bad depression for years she would when she came to live with my son her now husband wake the whole house up with the most bloodcurdling screams of anguish and fly toward any door or window and the poor luv did not have a memory of it when awake she was on ten mg citalopram and they just did not cut it for her i made her go back the docs since being on the higher dose of acitalopram she is amazing the night terrors gone and able to function as a really good mum to a 3 year old ,there will always be side effects mate and i was started on 40 mg i have been on them for over 10 years now and am down to 20mg but i still never miss a dose sending you a good luck hug x
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  • Posted

    Hi David,

    I had the same experience when I tried to move to 20mg from 10mg.

    I think some people are very sensitive to it (and SSRI's in general) and the best approach is to go slowly and increment the dose up in 2.5mg doses..

    i.e. 12.5mg, 15mg, 17.5mg... 20mg

    That's actually how I started this med, because I had severe side effects and 2 weeks of hell when I tried Paxil, some 11 years previously (it put me off SSRI's for good). Anyway my Dr suggested I try Citalopram, so I suggested I try 2.5mg dose for a few weeks, and gradually increase like that in 2.5mg doses until I reached my optimal dose for anxiety and depression.

    She agreed it was a good approach for sensitive types or those who need to function without 2-4 weeks of intense side effects. The trade-off is of course, it takes a lot longer to reach your optimal dose, in my case, it took me 2 months+ to reach 15mg. I felt fine at that dose, but when I tried another 5mg it proved waaay too much and the side effects hit me like you describe, major anxiety, lip trembling, restless legs, feeling of malease, insomnia etc.

    I dropped back down to 10mg and felt fine after 2 days.

    If you think 10mg isn't working for you, and you need that higher dose I would suggest asking your Dr for something to help you through the difficult weeks if you don't want to try incrementing it.. at the very least, something to help with anxiety and sleep.. like diazepam. My Dr was fine giving me a weeks supply when I asked.

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  • Posted

    Hi David.

    I was ok when i moved up from 10mg-20mg. I actually started to feel better after about a week on the higher dose. Unfortunately i had to come off citalopram altogether as it caused me to have restless leg syndrome and it was ruining my life. It started as soon as i upped the dose. Just be wary as it could happen to you. I found it harder to lower the dose again than to up it but now 2 weeks later i'm feeling ok. Take care x

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  • Posted

    Hi David

    Yes, I stepped up from 10 to 20 mg, but after two weeks. I also had repeat side effects, but they were not quite as bad as the first time around.

    Stick with it - they will pass.



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  • Posted

    I had terrible side effects like you for the first 2 weeks but learning from past experience if I remember rightly it can last from 4-8 weeks on and off then after that you don't really get anything. Also helps to eat something when you take the tablet, stops you from feeling sick sometimes. Also before I use to take the tablet at night before bed and it would help me sleep but this time im finding it keeps me up lol so you may have to experiment with what time to take it
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  • Posted

    Many thanks to all who responded here. Sorry it has taken a while to get back to you. We didn't have any power over Christmas so I'm slowly catching up with things. I am coping OK on the 20mg dose and my sleep does seem to be slowly getting better. My family say they see a slight improvement in my mood too.

    Thanks again to all and Happy New Year!

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