Starting on Citalopram, chatting and progress

hi Julie sometimes people do better on a combination of tablets rather than just one, doctors sometimes do this for example when someone has tried various different types of meds individually (and giving enough time for each med to work), but the patient hasnt had adequate response

is your main issue at the moment problems sleeping at night? how is your depression and anxiety?

hi agata sorry to hear about your current situation. if you would like my advice, my advice is certainly to not worry or be afraid to try something else if citalopram doesnt work for you. personally speaking i have switched meds countless times, and i do this when either the med i am taking feels to me like it isnt working (and i have gone high up enough in dose already and dont wish to toy around with the higher end of the dosing scale), or if the med is not working well enough, or if a med stopped working after working well for some time (and i feel i have already increased the med enough), or if the side effects from a med are too much trouble (for example i have been on some meds where they made me feel sleepy/could sleep ALL day long, so i decided that was not an acceptable trade-off for depression/anxiety and simply switched to something else).

what i do personally is, i give each med i try about 12 weeks (during this startup time i will increase or decrease the dose if necessary). during this 12 weeks i do expect some kind of progress as time move forwards. so for example, if i rated my depression/anxiety at say a rating of 10 at the start of taking the new med (10 being bad and 1 meaning 'i'm fully cured!'), then by say 4-6 weeks time (after the initial adjustment period of taking a new med, where u can feel worse...), i do expect that rating to drop, even if it is only down to a 9 or 8. if i get this reduction then i keep on going and see if this number perhaps can drop down further as more weeks (and months) go by.

however ... if i took a new med and then, (after the adjustment phase of 'feeling worse'), then by say 4-6 weeks if i have not moved at all from a 10 (or perhaps feel even worse than i did in the beginning eg. now im a rating of 11 or 12), i actually switch meds at that point. a lot of people wouldnt agree with the way i do it, and u will hear some people say "you have to often wait several months to feel better". i actually dont agree with that at all. and for some of those people who say, for example: "i beared the pain for 9 months and then suddenly one day i woke up and my depression and anxiety was all gone!", one thing they dont seem to realise is, actually if a person didnt treat their depression and anxiety at all with any meds, it will often just clear up by itself anyway after several months or a year.. so for those people who thought their meds worked but it took 9 months to kick in, - actually more likely their depression/anxiety episode just ended naturally at that point, regardless of the med that they thought was just taking several months to do anything at all.

so anyway thats why in the included leaflets for these types of meds, they state that you should start to feel better in say 2-8 weeks (although of course they warn that you may feel worse for a while during startup, as your body initially adjusts to the new medication). of course then long term they do recommend that the med is taken for eg. 1 whole year (or for life if you are someone who has had repeated episodes), but you certainly are not expected to wait one whole year to feel any change in your condition. you should start to feel better in say 2-8 weeks, and then ongoing, you should expect improvements as time move forwards . you do need to expect bad days, blips, some steps backwards during your recovery. the important thing there is to not switch meds as soon as u have one bad day along your journey and feel like you are back to the beginning. instead what u should do is give it more time, eg. some more days or a week... and see if it was just a blip after all.

so anyway after all this rambling, i guess your options are, to either increase the dose you are on, or give it more time on your current dose and see if things get better, or add something to take alongside the citalopram to see if that helps, or to switch to another med. i did notice u mentioned (after 3 months of taking citalopram): "I don't see any improvement and if any it's very minimal." which certainly rings alarm bells. personally i would be speaking to my doctor again at this point, but thats only my opinion and what i would do. im not trying to tell you exactly what u should do, as i would just be guessing. every case is different, and lets be honest even the doctors often just take a guess as what to do next, and hope for the best. dont lose hope though as you will certainly find what works best for you, its just a matter of time, so keep going and you will get there. you came here because u want to be heading in the right direction, not the wrong one. its certainly only matter of time. if u need to, try a different med, or if u want, u could give citalopram more time, on a higher dose. speak with your doctor about it, see what you both agree on and take it from there