Sandra

will i get my sleep back any idea how long im realy worried im on nightall at the moment but thats adictive im 18 days off mirt and 12 now on Citalopram thank you for your reply

yes your right Toria im taking nightall st the moment just worried how long till my sleep comes back been off mirt 18days on Citalopram 12 hoping just a couple more weeks thank you

when are you taking citalopram? morning or evening?

Hi in the morning ive tried night time to no different thanks for answering

doctor just told me to get antihistamines im 18 days of mirt noe and 12 days on Citalopram im taking nightall to sleep just woried my sleep wont come back iwas on mirt for 3mths 30 then 2 weeks on 15 then he put me o 10 mls Citalopram now been on them 12 days thank you for your reply

I think you need to see another doctor, I know you won't like this answer but I'm wondering whether you should reinstate Mirt at a low dose e.g. 7.5mg and then taper very slowly.

If the doctor wants you to use antihistamines then he/she should prescribe them and not expect you to source them yourself. (the sedative effect of Mirt is due to it being a powerful histamine blocker)

thankyou for your reply my doctor dosnt seen interested he told me through his secretary to get some carmers the pharmacist said theyre no good and gave me nightall tried it last night got 5 hrs not natural sleep but better than none

I know it's hard, but could you see a different doctor?

I assume it's Nytol you've got? If so then it's an antihistamine hence the sedation, if it's any consolation it's the antihistamine activity of Mirtazapine that causes sleep, it's just that Mirt is a very, very strong histamine blocker.

Nytol also do a 'herbal' one - it's just Valerian root the same as Kalms and H&B.

I expect you feel a bit groggy today? But 5 hours, even if it was 'chemical', is still an improvement so try to see it as a step in the right direction - I think it is 😃

Hi Charlieive asked the pharmacist about valerian he says stick with nytol just short term as they can be adictive started with diarea all day yesterday and still todsy is that another side afect wish the side afecs would supside and i can feel normal again 3weeks off mirt tommorow and 2 weeks on cit counting the days thanks for answering me helps me to understand a bit more

Hi Sandra,

Yes, loose bowel movements or even diarrhoea are a side effect.

As well as increasing serotonin in your brain the medication increases gut serotonin which can increase gut motility hence the changes you're experiencing.

In fact SSRIs are sometimes used to treat constipation!

HiCharlie when do these things settle down and you gain your sleep back thanks

It varies from person to person but for me the sleep took around a month before I started to get more than 2/3 hours, even then it was only around 5 hours.

I'd guess the diarrhoea should settle down sooner but make sure you're drinking plenty as diarrhoea can dehydrate you if it's severe.

If you're still getting bad diarrhoea by the end of this week I think you should report back to the doctor, although I still think you should try to see a different doctor this time, if possible.

Just to clarify: it took a month from starting Citalopram for my sleep to improve slightly.

The rebound insomnia from Mirtazapine withdrawal took several months.

Hi charlie the doctor has sugested i reenstate mirt in 2 weeks at 15 mls when ive been on cit for a month for sleeping im not happy at that i i thought id gotten off mirt looks like i dont have a choice other than sleeping pills scared to go back on it realy thanks for listening ive changed doctor to a woman

Great that you've changed doctor, well done!

I think the new doc might be right, reinstate Mirt on a low dose for a while then taper off very, very, very slowly.

If you do go back on see if 7.5mg is enough - it is usually more sedating at lower doses so this might be enough to get you some sleep.

Don't take Nytol with Mirt, they are both antihistamines.

Good luck, I think you're doing the right thing.

HI Charlie, i have just read your comments about the Nytol with Mitrazepine that sounds like a definate no, no.

Normal Nytol is an antihistamine (diphenhydramine) but herbal Nytol isn't, it's Valerian extract - I've tried them in the past and I could feel an effect, definitely a bit woozy/drowsy but not that strong. (for me anyway)

So its safe to take 2 tablets?

Of the herbal ones? Yes, that's fine.

Be aware they also do a 'one-a-night' strength version where, as you've probably guessed, you only take one 😉

Of the herbal ones? Yes, that's fine.

Be aware they also do a 'one-a-night' strength version where, as you've probably guessed, you only take one 😉

hi zCharlie how are you getting on with citlapram im finding side affects on sertraline headaches funny tummy and yes feeling numb only sleeping 4 hrs do you find Citalopram better im 6 weeks now hard to stick all this but dread starting again what do you think thanks Sandra

Hi Sandra,

I'm a bit wobbly at the moment due to dose reduction, hopefully it will pass soon.

Sertraline and Citalopram had slightly different effects on me but I couldn't say which was better plus my experience is likely to be different to yours.

What I can say is that Sertraline stabilised for me around 2 months and you're nearly at that point, hopefully it will for you too 😃

Funny tummy effects are quite common as SSRIs don't just affect brain chemistry, so don't worry, it's normal.

im still not sleeping head aches pain in eyes dont no if its the sertraline or not sleeping why are you reducing your Citalopram Sandra

Basically it didn't seem to be helping 😦

Hopefully your sleep will pick up soon.

Aw thats a shame what are you thinking about trying now back on sertraline or somthing else doc phoning mon about my sleep duno why its not co.ming back been off mirt two and a half mths Sandra

I'm not sure yet, one step at a time.

Sertraline may work for you (and I hope it does) but you probably need a bit longer to see if the sleep improves, when I stopped Mirtazapine my sleep was awful for several months but it might not be so bad for you, fingers crossed.

i havnt got mths my eyes are painfull head aches might be the sertraline i dont no somthing has to be done need advice off a doctor have to wait till mon hope you get sorted cheers Sandra

Charlie what did you do to get sleep all those mths what strenth Citalopram are you on i found 20 was fine when on them last time im getting headaches do they subside dont fancy them for a yr thanks for your help Charlie cheers Sandra

Hi Sandra, I pretty much didn't sleep, I'd have the odd night where for no reason I'd sleep right through but could never work out why. I tried all the usual stuff like antihistamines and valerian and when desperate I'd take a small grain of Mirtazapine or a small dose of zopiclone.

I was on 10mg of citalopram but have reduced to 7.5mg and now 5mg - the withdrawals are horrible.

I don't think you'll get headaches for a year, you can treat them with the usual stuff e.g. paracetamol.

Hi Sandra,

Something has occurred to me - I wonder if your doctor would consider letting you try Agomelatine (Valdoxan) which was originally developed to help with sleep but also has antidepressant effects?

It's quite a new medication and although the NHS do prescribe it it's expensive as it's still under patent.

would i have to come off sertraline i dont realy feel right on it how bad are the withdrawals im on a hundred how would i do it thanks Charlie Sandra

As I understand it, they can be taken together - you'd have to ask.

I don't remember much about coming off sertraline, seem to recall being really irritable/snappy. It'll be different for everyone though.

You might want to ask about withdrawal on the sertraline forum - there's bound to be someone trying right now!

its not as bad as matazapine this new drug is it Charlie docs phoning tomorrow and it helps with sleep

It's not the same as Mirtazapine, apparently it's quite easy to start/stop.

It's technically a melatonin agonist (activates melatonin receptors hence the sleep effects) and an antagonist (blocker) of particular serotonin receptors that causes an increase in norepinephrine and dopamine hence the antidepressant effect.

If you do a search in the forums you'll find quite a few who have tried it.

Hi Charlie the docs taking me down to 75 instead of a hundred see if that works i doubt it prob be more anxious going down im dreading it if i have to come off from 100 cheers zSandra

Hi Sandra,

For people these meds work for, the dose can be very different for each person so 75mg might be 'your dose'. Often you can't tell until you push it higher then realise you were better off lower - sounds like your doctor thinks you were better on 75mg so she's honing in on the right level for you.

Try to relax and go with it, you might be surprised.

Don't be alarmed if you feel a bit weird after a few days, it's just your body adjusting.

Good luck 😃

Hi Charlie i realy dont like this med im scared to come down and start again i prefered Citalopram this med is known for mot letting you sleep i know 2 people that couldnt sleep on it my eyes are bad at the mo.ent with lack of sleep if no better on 75 hsve to phone hrt back dont think i will be im om pregabblin 100 twice a day shes on about uping that wish id stuck to Citalopram cheers Carlie

If you do switch then ask the GP about cross-tapering from Sertraline to Citalopram.

what will happen then im on 75 now what will hapen to me if i switch what dose of Citalopram will I be on will i have to wait 8 wks for that to kick in thanks Charlie

the idea of cross tapering is to reduce the withdrawal effects of the current medication and reduce the startup effects of the new medication - in reality you will probably have a few wobbles though.

Hopefully your doctor will be able to cross taper between sertraline and citalopram, I don't know for sure if it's allowed.

The other possibility is that you'll be able to do an abrupt switch i.e. take your last dose of 75mg sertraline one day and then take the equivalent dose (or as near as possible) of citalopram the next day - the doctor would have to calculate the equivalent dose.

There is a study somewhere that showed equivalent doses normalised to a specific dose of fluoxetine (Prozac) so it has been looked at.

i cross tapered from Citalopram to sertraline but think i was on a lower dose of Citalopram at the time i hope i can do it do i still have to wait 8 wks for it to kick in thanks Charlie

In theory no, it should be quicker as you've already adjusted to the sertraline, but as with all this stuff only time will tell.

hi Charlie ive been on 75 mils 8 days now feel like im dipping bit anxious will that level out carnt get a docs appointment this week still not sleeping on 75 thanks Charlie for helping much appreciated how are you doing cheers Sandra

Dose changes always take time to settle, everyone seems to be different as to how long that takes - for me it's around 3 weeks.

If you do switch to Citalopram then I'd expect the doctor to put you on 20mg or 30mg to try and match the 75mg Sertraline dose.

I'm a little better, thanks - my dose change has settled a bit, which is a relief.

Hi Charlie i need your help im still on sertraline been on it 3 mths now anxious on 75 had to go back to a 100 carnt face starting over again with somthing else ben on a 100 for 2 wks feel sick a bit nervy and a bit anxious will this carry on or just till my body ajusts awfull feeling thank you Charlie for listening Sandra

Hi Sandra, it's likely that it will last a little longer, bouncing between doses (up or down) always upsets the body for a while. Have you noticed in the past how long it takes for the worst of the side effects to pass? (it's likely to be about the same every time e.g. for me 3 weeks)

I think if this extra nervousness carries on beyond 3/4 weeks at 100mg then I would talk to the doctor and see if you can get a referral to a psychiatrist to specifically discuss medication.

Hang in there, this is temporary and one way or another it will pass 😃

Hi Charlie yes your right took about 2 to 3wkswhen i went up to a 100 befor im only 11 days now thank you so much for your help i realy appreciate it how are you doing thanks Sandra

Hi Sandra,

Yep, it might sound silly but try to relax and just go with it for another week or two, then if things aren't great you can try a different approach.

I'm 2 weeks off Citalopram, still getting a few brain zaps and mood is all over the place but I expected that. At least I'm not getting the increased anxiety, muscle twitches etc. and don't feel emotionally numb anymore.

hi Charlie so sorry I need your advice I was on pregabalin for 8 months the doctor weined me down at 75 MLS morning and night for1 week then to 50 mile twice a day for 1week then25 mils a day for 1 week the withdrawal was horrendous stomache and chest pains and anxious I was off for 5 weeks pains to bad doc reinstated me 25 MLS twice a day then 50 MLS twice a day been back on 18 days now still slight chest pains and anxious I'm still on 100 of sertraline once a day need your advice please

Hi Sandra,

Sounds like stopping pregabalin destabilised things, hopefully reinstating will help.

I think you need a referral to a psychiatrist as this has been going on for a long time with lots of chopping and changing.

i thought the pregabalin was for pain which wasnt doing anything so i tryed to come off it she tapered me 50 mils over 3 weeks withdrawals hit me hard pluse anxious apparently its for anxiety as well i thought the 100 sertraline was for that i was on 200 of pregabalin now back on 100 hope it settles ill have to stay on it a while before i can try again i hate the drug but have no choice thanks Charlie Sandra