Citalopram: Celexa Cipramil, how quick can I increase back to 60mg?

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Hi, I was on 60mg of Citalopram for over 10yrs along with epilum crono for Bipolar. 

I have been feeling no drive or interest to do anything for years. I am also a hoarder with issues around not cleaning the house. 

I slowly decreased both medications over about 8 weeks to nil.  

I was actively doing more for about 2 months. I felt more alert but easily agitated and angry. I was automatically cleaning without much thought .  

The next 2 months got worse and I have become very depressed. I can’t seem to do anything. I’m just crying and going to bed. I have put my rented home at risk due to not filling in government forms and a visit due from my landlord. The house is a mess. 

I decided to go back on my medication today following a chat with my new registrar. I did want her to start me on any different antidepressant but she didn’t want that. (My New psychiatric registrar and New consultant have only met me once as I’ve moved location, they have my medical records but don’t know me at all and I’m sure haven’t read my records in any depth ) 

My registrar said go on 20mg for 4 months!! and then they’d look at increasing it again. 

I said that seems far too long to wait to increase it. She said see how I get on and get back to them if I need to. 

I have decided to go back on 40mg. 

I wanted to know if anyone would know if I could have adverse effects going straight from 0 to 40mg. 

Any ideas or advice welcome 

Thank you 

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