Depression and switching from citalopram to sertraline

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Hi -- I'm in my late 60s and have been on antidepressants since I was 30 (stopped when I was pregnant, but otherwise almost continuously). Most recently was on 20mg citalopram for 3 years. It was never as good as my previous antidepressants -- imipramine and venlafaxine, but I had to stop those because of gastric side effects and raised liver enzymes. The citalopram seemed to stop working a couple of months ago -- was getting bad anxiety and my mood was low. After a middle-of-the-night panic attack (never happened to me before) and a mood crash, my GP switched me to 50mg sertraline, plus zopiclone to help me sleep and propanolol for anxiety. That was a month ago. A week later, a different doctor upped the sertraline to 100mg, and then he upped it to 150 a week and a half after that. He has also put me on 150mg pregabalin instead of the propanolol. I started getting palpitations after upping the sertraline, so after a few days, he said it would be ok to go back down to 100. That was 4 days ago.

So I have been on sertraline at varying doses a total of 4 weeks, and I still feel horrible. The initial crippling anxiety, which I had never experienced with such intensity, has gone. But I have no appetite, can't sleep without zopiclone, and my mood is in a black hole. It has never taken so long for an antidepressant to kick in before, and I am thinking that the sertraline is totally ineffective (although every now and then I have an afternoon and evening when I feel a bit better). I'd really be grateful to hear from anyone else who has experienced anything similar -- when you switch antidepressants, how long do you give the new one before you decide it's not working? Thanks for your help!

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  • Posted

    Hello Ronne

    You have been through the doses, and now it would seem are settling down.

    The problem may be the drugs need tie to get into your system. The higher and changed types of medication will possibly not have settled down because of lifting and reducing the Scripted dose. Because of that I would suggest you give your body an extended period to get used to the agreed doses you are taking now.

    The problem is some of these drugs need additional time when they are changed with somthing else. Your body needs to settle I would say from the last change of a drug in this group allow four to five weeks, it may be less than that, although give time. I work it on how many tablets that have been given on the last drug type, that will be four weeks possibly. If you feel bad after that time see the GP possibly make an appointent for a future date and if you feel ok cancel the appointment and carry on. If your GP has made an appointment for you go, do not change that.

    If you need support we are always around, remember we are not Doctors. We always bow to their decisions

    BOB

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    • Posted

      Hi Bob - thanks so much. What you say makes sense. I'm having a hard time being patient, because I feel so lousy and because my previous meds kicked in much more quickly (but they were not SSRIs; the switch from imipramine to citalopram was done so gradually I barely noticed anything). So I am frightened that the sertraline won't work and I will have to start the whole nasty process all over again. I am seeing the doc on Wednesday so I won't make any changes till I've talked to him. Thanks so much for your input - really helpful.

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    • Posted

      i was on 30 mg of citapram last time i was depressed i came off them as i felt great then 6 months after bang i was depressed again but worse so im on 40 mg of citrapram this time and 10mg propolo i think there called 4 anxierty and still im not 100% but better than i was 6 weeks ago,it somtimes can be a long process but we will feel right in the end i promiss,stay strong and never give up
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  • Posted

    Wow! That's a whole lot of dosage jumping in such a short time, no wonder you're not feeling all that great. I've honestly never heard of changing doses that quickly. The doctor didn't even give you enough time for the initial dose to be fully in your system.

    Sertaline works well once it's completely in your system, and at the dose that's best for you. Unfortunately, this medication tends to make things worse before it makes you better. You definitely need some patients during start-up, so hang in there.

    I was on sertaline for years, and it worked quite well, maybe too well. I got to the point where I thought I didn't need them anymore, and wanted to be strong enough to live without meds. Like an idiot, I quit cold turkey and that was horrible. It's now been 5 years, and I'm considering going back on them. If I do take sertaline again, I've decided that I'll stay on it for life, because the whole process of going on & off meds is so taxing. I'm 45, so I really just don't want to deal with going back and forth.

    Seeing you state that you've been on antidepressants for over 30 years caught my attention, made me smile, and gave me hope. The stigma around mental illness, and medication was another reason why I stopped taking the meds, so it's nice to hear positive stories.

    Personally, I think 150 mgs right off the bat is a bit too much. Stick with whatever dose you feel comfortable with until you see the doctor. Take it slow and steady so your body can make adjustments. In the meantime, pamper yourself a bit, and do what you can to try and stay calm. smile

    Kim

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    • Posted

      Kim, thank you so much! Yeah, you are SO right about the stigma. I grew up with a mentally ill mother, and the shame and secrecy were awful -- I am determined that I will be open about my depression, because there is no shame in it, and there is no shame in taking medication. Thank goodness for it! Thanks for your reassurance, too. Good to know that it does work eventually, and that it worked for you. Take care.

       

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    • Posted

      I started taking it in the mid 90's, and there was no computer in the home to look up the side effects of Zoloft. I'm sure I had issues when starting, but since they mimic anxiety and depression, it's hard to differentiate the problem from the side effects back then. Nowadays it's information overload, and that tends to heighten anxiety over any med, especially if you have anxiety to begin with.

      My main issue has always been anxiety, but depression was added in the mix as a secondary diagnosis. There's quite a few people in my family that have anxiety, but most don't take meds, or refused to even get checked out. I felt odd being the only one on meds, and couldn't understand why other family members could go without them. That definitely made me feel like a weak person. Once I stopped taking Zoloft, I felt really good for awhile, but anxiety kept creeping in so I stayed on xanax. However, I slowly stopped doing things that I could do while on Zoloft, but didn't notice it at the time. Now I'm back to not driving, can't go in the store by myself, and all the other lovely things that come with anxiety. In fact, now I'm afraid of trying Zoloft again, because of the info that's out there. Leave it to anxiety to make you afraid of something that could give relief. It's a vicious circle.

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    • Posted

      I've become agoraphobic once my mom passed last May. It started with stomach issues that I've had for years, but very intensified. I would end up in bed for a week or two, and was given antibiotics. That kept happening until this last March when I got really sick, sick enough to scare my doctor. In May my gallbladder was removed, but it took an extra incision, because the gallbladder was fused to my liver. The recovery time was okay, but I stayed in my bedroom. The incision above my belly button wouldn't heal properly, so I ended up with antibiotics, and more stitches which eventually tore. Well, they tore my skin because of the way I would sit. I ended up having to lay flat or on a slight incline until that sucker healed. It finally healed fully some time in July. I've had 3 upper respiratory infections recently, which were back to back. Currently, my sinuses, throat, and lungs are bad, so I'm on a antibiotic. My doctor wants to test my hormones because I keep getting waves of heat that come over me, but quickly leave. Of course he's thinking menopause, but this started not long after surgery, and doesn't happen while on antibiotics. Personally, I think it's either for the infections, or from the gallbladder being gone. So, now I've basically been in my room for a year, unless I have a doctor's appointment. It was never an everyday thing, but that's what it has become.

      With all of this down time, I do think about my mom a lot. I own a duplex, and my mom lived downstairs from me for 18 years, it was basically like one big house, so I was hands on for absolutely everything when she got sick. She went from diagnosis to death in 6 months, 2 months after her 67th birthday, and 3 days after my birthday. After she passed, I would wake up gasping for air, and my heart racing. The dreams, or bad memories were way too real. My shrink said it was heightened grief, with symptoms of PTSD. The nightmares are gone, and so is the waking up gasping for air, so most likely that means that the PTSD symptoms are gone.

      My shrink thinks I'm still on Zoloft, because I never told her that I wanted to try coping without it, mainly because I didn't want her to take away all my meds. Plus, I wanted the safety net of having Zoloft handy if I couldn't go without it. Now that I'm considering going back on them, it's the start up effects that scare me. Once on them, my emotions are pretty numb, so I would probably try a small dose, and stay on just that if I could get over the initial fear of taking them. lol That's pretty much the short version of my story. smile

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    • Posted

      Oh, Kim, my heart goes out to you - what you have been through!! I can relate to a lot of what you say - the stomach issues, the gallbladder, the respiratory stuff - all these are issues for me too (gallbladder removed 9 yrs ago; also a hysterectomy 24 yrs ago). The middle-of-the-night panics too. And I'm so sorry for the loss of your mum. In my case, I think I am in part going through very, very delayed trauma reactions to things that happened when I was a child - my mother was mentally ill, and my childhood was unhappy and scary - and I couldn't get any support because I wasn't allowed to talk about it. 

      I can imagine how traumatic your mum's death was for you, coming relatively suddenly and after you'd been so close. I hope you got support and were able to grieve properly - sounds like you are still grieving now; some losses take a really long time to get over. I hope you have people around to support you - friends, family. If you do decide to go back on the Zoloft, I really hope it helps and the side effects aren't too bad. You have immense courage and strength to have gone through all that.  Stay strong - I wish you better and better days. Wish I could reach out and give you a hug. confused

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  • Posted

    I always know if an antidepressent is working pretty quickly..for me...4 weeks would be enough.

    You don't sound like you are getting "better" I would ask to change.

    I take Wellbutrin (and I switched from Citalopram that i was on for 8 years).  Within 2 weeks...I knew Wellbutrin was better for me.

    I also figured out that SSRI's do not work well for me..they seem to make me more "excitable".

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