Zoloft > citalopram > escitalopram > citalopram ......please help

Hi Joanne  Thanks for your reply.  I tried to get my Pdoc to prescribe diazepam (or something similar) and she basically said 'no way'.  I don't think I have an addictive personality - but, something to temporarily help would have been really nice.  I'm hopeful the cit starts to settle in soon.  I really dislike this heightened anxious feeling!

Hi Kay (I hope that's right - I thought I'd read that somewhere in another thread),  Thank you for your thoughtful reply.  I'm generally of the opinion that these doctors are quick to prescribe dose/med changes - at least, that's been my experience.  If I could go back in time and educate myself (found this website sooner!), I might have been able to avoid all the med switching.  I'm definitely leaning towards not upping the dose for the time being (of course, how long I should give the 20mg dose a chance to work is the $64M dollar question!).  On the other hand, I feel as though I've been 'through the wringer' these past few months (I know - med changes) and I'd like to get to the point of actually feeling like myself again.  **fingers crossed**  Thanks again!  Dan

 

Hi Dan

Same here - if I'd understood anxiety, had someone told me what I'd go through, if I'd read the books I'd read sooner than I had, if the internet was around even, and if SSRI's had been prescribed sooner etc ...... it would have saved me 20 years of turmoil.  Seems we all find information everywhere other than through our doctor, which is such a shame as that's where we all go for help.  But that's with hindsight now ........ 

Anyway ...... I think doctors are quick to prescribe because I don't think many really understand what it feels like to take them - or indeed the long process of how they actually work.  The bigger the dose the quicker you'll recover ..... nope.  Everyone would think a pill would just the same as an antibiotic, a painkiller or similar ..... you take pills and you get better.  You don't expect to initially get worse, or that it takes an age, or that you get better then get setbacks or that each individual has a different journey.

It seems many people start seeing small, tiny changes around 3-4 months (or sooner) so might be an idea to try 2-3 months first and if you still feel absolutely awful by then, then maybe consider increasing?  When I recovered it was so slow it was hardly noticeable, but looking back on that time I felt slightly easier and could see a small difference.

As I went through recovery I started having little glimpses of feeling normal, and these grew slowly over many months.  However every day I'd still wake with crippling anxiety and yet at the end of each day I'd feel more rested.  Happy even.  Each day, week and month that passed it got easier until most of my days felt normal, and after about 6 months I woke and the anxiety had gone.  During that time I still had setbacks but they also got less.  Of course another person might have a completely different experience of recovering - such strange meds.

But yes - it doesn't usually happen if you rush or swap too often.  Most people get confused with the side effects and think its a sign they're not working so increase or swap, which makes it worse.  I wish doctors would understand this.

K 

Hi Kay - Yes, I agree too about the doctors.  In fact, I recently attended a group discussion about anxiety.  This group of 6 people were led in discussion by a therapist.  The topic of medications came up in the discussion and I made the comment that I had read (on this site actually) that with medications, the anxiety often gets worse before one might see improvement.  The therapist disagreed with my comment and indicated he hadn't heard this before.  I find this a little disheartening when I feel like I have a better grip on the potential effects than some of the 'medical professionals'.   I'd like to refer the Pdoc and therapist to this site for a little 'reality check'!

Thanks again for your thoughtful comments!  Dan

Omg that's unbelievable!!  The therapist is the professional and should know their stuff inside and out.  They don't obviously prescribe meds but I'd have thought they'd be more aware of these things if they're working with people, the majority of whom take meds.  How does he know if his therapy is working if he doesn't have an all round view of everything.  I'm sitting here gritting my teeth 

Yes absolutely - show them this site.

This is exactly what I hear all the time - not even some doctors know much about these meds and they're the ones who prescribe them.  Sadly its the patients who become more knowledgeable through their experience of taking them.

Really bugs me when people totally disagree or disregard what you say when they've not even taken them themselves ..... especially when you know your stuff too.  I get on my soapbox often ?

Yeah - I thought so too - that it was unbelievable     My daughter is in her early 30s and, sadly, she's had quite a lot of autoimmune health issues over the past 10+ years.  I mention her because she's exceptionally well insured (as in, she has access to the Mayo clinic and other research hospitals) and some of the stories she's shared with me about some of her interactions with a few of her docs are downright scary.  When I was younger, I remember (mostly) taking what a doctor told me as gospel - not so much anymore....

I think you're probably right in that what is likely needed for me is a heavy dose of patience (something I've sometimes been in short supply of .

 

I'm sorry to hear your daughter suffers with health issues - being well insured and access to important hospitals is good.  I take it you're in the US?  I've had some really super doctors who were very caring and understanding, yet equally I've had some pig ones too.  I'm in the UK and our NHS health service is being stretched beyond the ridiculous at the moment ... but it still doesn't warrant not fully understanding what you prescribe.

Yes I always took what was gospel too ... but not as much either now.  If my doctor says jump, I'd ask why, where, what and then probably say I'll think about.  My body, my choice.

Ah, none of us have much patience when is comes to anxiety ... but its something that we need.  Hard, but it does pay off.  They say the best things are worth waiting for 

Yes, I am in the US (California) - My daughter and her husband live in Minnesota (Brrrrrr).  I've spent several happy vacations in the UK - in my late teens.  A girlfriend (at the time) and I stayed at a Butlands (spelling?) holiday camp a couple of weeks.  A lot of fun!  I was attending high school/college at the time in Germany (dad was in service).  Anyway, I enjoyed the UK.  Nice people.

Thanks about my daughter - she's a great girl.  While she has had a few surgeries over the years, her health seems to be improving over the past couple of years and I couldn't be happier about it.  She and hubby have certainly been through a lot - especially for being so young.  Her hubby is a great guy, though, and that helps immensely.

When my original GP prescribed Zoloft (week later switched to citalopram), I had no idea what was involved with taking an SSRI (and the GP did not go over the side effects profile with me).  I won't make that sort of mistake again.  I like your comment about "my body, my choice".  It certainly applies!  In the future, I expect to carefully evaluate any med I consider....

Yes - I imagine patience is in short supply with anxiety (or really any treatable disorder).  I sort of feel like I'm 'on hold' with my life.  I had a good week over Christmas and thought 'wow - I'm cured' only to have the anxiety creep back in and remind me that all is not well.... at least not yet!

I've been to the States once - 2 years ago to San Francisco and flew over Minnesota.  Looked pretty from up there.  Loved visiting the US and can't wait to return.  San Fran was a loooong flight though and I'm not too good flying (bit nervous) 

Yes Butlins - famous holiday camps here.  People who work there are called 'Red Coats'   People vary in the UK - often said them from the North are more friendlier, but there's a mix everywhere now.

Glad your daughter's health is improving - we never stop worrying as parents do we?  We just want our children to be well and would rather be in their place and take the pain instead of them.  Good she has such a great support network.

No nobody knows about SSRI's and their impact until they take them.  I think the same goes for GP's too - they've never sampled them so don't know what it feels like.  Everyone thinks they're like most other meds where you can just taken them, feel better, stop them.  Uh uh ........  However they are good meds when taken correctly - they were my saviour.  Yes I've learnt from taking them too and indeed suffering with anxiety in the past - from how people treated me ... doctors too.

Anxiety makes you agitated and impatient, and we all want to be well now, today ..... and can't imagine suffering for another day let alone another week or month.  But to be impatient makes you tense, and anxiety likes tension.  Letting tension go and working with the anxiety there, letting it do its worst whilst staying calm (doing the opposite of fighting it) is the way forward.

I always said I wasn't living when I was ill - I just existed from day to day.  Yes those lovely glimpses of feeling normal and back to yourself again are great - but they're always followed by a setback / blip which drags you back in it again.  Those glimpses will come back ... and so will the setbacks ... but they get easier and the setbacks get less and less.  Accept those bad times as they come, remind yourself its part of recovery and wait for them to go again.  They will.

Strange meds 😳

Yes - San Francisco is a lot of fun..... super crowded (parking is tough) but, the food and atmosphere are great.

That's a great point about nobody really knowing about an SSRI until they actually take them and experience the med for themselves.  I suspect most folks don't care for uncertainty and from what I'm gathering here, the road to recovery can be quite different for each individual.  I'm hoping against hope that my road has fewer potholes in the near future...

I do have a couple questions about side effects.... Do the side effects typically come and go?  I mean, I know about 'blips' - however, in my case, it seems that I have had some side effects that have eased (headaches) over the past couple of weeks and not returned and at the same time I've had effects that did ease (morning anxiety) only to return in a few days.  Also, I didn't seem to have any nausea the first few weeks of treatment and now nausea seems to creep in on occasion (I now try to eat something as I take the cit).  I sometimes wonder if I'm going through the side effects two or three at a time with some of the effects not returning and others returning with a vengeance.  Having said this, I did manage about a 5 day stretch over Christmas that seemed mostly side effect free   I hope to return to that feeling soon!

Thanks again for your replies - the voice of experience really comes through...

Yes I've friends in San Francisco and some have moved out of the city because of prices, crowding, parking etc.  We travelled about by Caltrain (which we fondly renamed cow-train), Uber, Bart, Trolley Bus and a Rickshaw!!!  Great experience!

Everyone does have different experiences with these meds - I've taken them twice and had different side effects and second time took longer.  Both times worked though   Yep, Doctors and other medical professionals I'd imagine think the pills are just the same as any other and many have no idea a little pill can cause such havoc.  Also people who listen to others talk of their anxiety equally have no idea to full horror of what its like to live with - people imagine anxiety is like being nervous before an exam maybe, and don't realise that it interferes with your everyday life, even second of the day.

Yes some side effects will come and go and some that just start up for no reason.  Anxiety will absolutely return with a vengeance each time, or so it seems.  In a well period the anxiety eases, and I think you feel it comes back with a vengeance but in reality I think you forget how powerful it feels in those well times.  Strangely when I first withdrew from Cit I had one symptom after another, I didn't get them altogether.  I'd have one, it would ease then another would start.  Second time I withdrew I spent a year coming off and had no side effects as I did it slower with minimal reductions.

I took these meds for 16 years, starting on 20mg and when I'd recovered I reduced to 10mg for a maintenance dose and stayed there for years.

 

I'm curious - how did you determine the maintenance dose at 10mg (as opposed to 5 or 15mg)?  My Pdoc tells me that a person could stay on cit indefinitely (not that I'd want to).  I actually had a decent day today - I'm hopeful it's a sign of more better days ahead!  This Wednesday, I'll be starting week 7 @ 20mg/day.

I've read several threads that indicate taking citalopram the second time around takes longer to stabilize in their system.  Do you think this is generally true?  Of course, I'm just getting started - but, given my (limited) experience, I'd really like to minimize this transition period

Basically I just guessed about my own maintenance dose.  I'd been on 20mg for about 6 years and wondered if I'd be ok on a lower dose.  I lowered my dose to 15mg and stayed there for a few months, felt ok, lowered again to 10mg, felt ok then tried 5mg.  Didn't feel too great at 5mg so went back to 10mg, levelled out and decided to stay there.  The 10 did the same as the 20 had done so stayed on that for years.

Yes I was told I could stay on these meds indefinitely too and I was prepared to do so.  I had no intention of coming off after being ill for around 16 years.  I was well and I wasn't about to rock the boat.  However, after about 16 years on the meds curiosity got the better of me and eventually I weaned off.  I did have to restart after about a year due to the stress of family illness, but after that had passed and had another year on meds I spent a year weaning off and finally stopped about 16 months ago.  So I haven't actually had anxiety since about 1999-ish and am still well, even off meds.

Yes having decent days are a good sign.  They will be mixed with bad days, so don't be too surprised if they come back.  That's how the meds and recovery seem to work.  Those good days will come back.

I've taken these meds twice and yes my second time around took longer.  First time 6 months, second time around 8 months - and I had different side effects and a different experience both times.  Both times the meds worked - I had faith in them.

I don't think that's true for everyone though - everyone has different side effects, a different experience, different timespan, some suffer badly whilst others skip through ...... and that's maybe first time round too.  Second time round it could be completely different or the same - longer or shorter.  There's no one size fits all with these meds.  I think take what comes, don't compare yourself to others but just use their experience as a guide, and don't be in a hurry - you can't hurry it anyway.

Thank you for sharing the details of how you tapered off citalopram.  I have no idea how long I'll be on this med - but, given my experience so far, I really want to limit any transition period.  I did have a decent day yesterday - today not quite as much.  I've really come to accept this (occasional good days) as part of the recovery process - in itself, a step in the right direction (at least, for me it seems to be).

I'm fortunate in that I was able to take an early retirement.  I can't imagine having to go to work while dealing with the heightened anxiety.  I've read several threads where folks had indicated taking weeks off work.  I'd need at least that much time

When you're better you'll know when the time is right to withdraw.  I was told that the meds should be taken for at least a year before even considering coming off, as thats a good enough time to ensure the problem won't return ....

I retired from part-time early too ... its great!!

So many people suffer work related stress and is why they end up with anxiety and on this site.

Well, congrats to you on an early retirement too!  I had planned on switching to about 60% time for a year or two but, anxiety popped up and I thought I'd just wrap it up early.  Not too sure I'd manage very well if I were still at work....

I was wondering about that - how a person might know when the right time to withdraw might be.  My Pdoc seems quick to prescribe dose increases - she tells me that 'many' of her patients are at 40mg/day.  I'm of the mind that I'd like to take only what's needed - and not 1mg more.  These meds are so tricky --- A person has to a.) determine the correct SSRI and b.) determine the correct dose  all while suffering with the acclimation phase.  I still intend to give the 20mg cit two/three months (at least) to 'kick in' for me

Early retirement was forced on me really - my choice to leave though.  I worked in the museum industry and a new curator took over who was a vile individual with a classic bullying toxic personality.  Picked everyone off one by one starting with me.  I couldn't abide her, had no support from the council so told them to *** it   After me 5 more people left in the same manner.  I couldn't be doing with school playground behaviour.  Been at home 5 years now and often wonder how I fitted work it!!!  My husband retired early too to care for his father (now passed) ...... and we love doing what we want to now.

You'll know when you want to stop meds.  Usually you'll have been well and completely back to normal for a while, confidence will have grown and you'll feel very happy.  I tested the waters a little, decided it was ok and continued until I felt confident staying on the lower dose of meds.

I agree with you 100% and what I always thought too.  Why take more meds than is needed?  I recovered on 20mg so it just shows that we all don't need a larger dose.  Some people recover on less.  Our biological makeup is all so different and what one dose will suit one person will not suit another - I'd have thought the Pdoc would have know this.

Yes thats right - trials and error finding the correct meds and then the correct dose.  If one suit fitted all then there wouldn't be all the different SSRI's on the market.

When I was recovering on meds I didn't actually realise.  I had nobody to talk to about these meds, there was no forum or discussion group, in fact there was no internet around then.  I thought I had been given just another anti depressant - one that was just new on the market.  I was however told how they worked with diagrams, told of the side effects and had it all explained - but it all went in one ear and out the other.  Imagine surprise when at around 3 months I had a glimpse of feeling normal.  It only lasted an hour or so but it was the most amazing thing ever.  It grew from there.  Still I didn't realise I was recovering or that it was the meds or the relaxing and 'giving in' to it all that was doing it.  It did dawn on me eventually  

Yes give it time ... it'll creep up

I take my hat off to you!  There's an old saying 'knowledge is power'.  This site (and more specifically - you) have made my understanding of what I might expect to go through much more complete.  Hard for me to imagine how lost I'd be without the internet and websites like this

I retired a few months ago and I'm putting some effort into how to fill my days - it's a bit slow, though, without feeling like my old self....  I worked in research and (I have to admit) there's times when I kinda miss the office.  Those times typically quickly pass   I know folks that have said (like you) that they don't know how they managed to 'fit work' into their lives.  I'd like to get to that point myself!

 

Knowledge certainly has been a player in my recovery - it stops you floundering around, stops many the thoughts racing around your mind all day and it gave me one path to follow.  If you don't understand what's happening to you then you go on a constant search for answers, making you more tired, more confused and more anxious.

Friends often ask me what I do all day and aren't I bored - nope.  At first when I left I missed the office, the routine and my friends, but I see most of them still and have a different routine.  I visit the Leisure Centre every morning for either the gym, yoga or something else, cycle there / back, and then busy myself around at home or go out.  I've got involved in our local community, am the Editor of the community newsletter and website and have created websites for other people too.  Wouldn't have don't any of that if I'd been working.  Its all great fun 

 

It sounds like your life is full - I'm glad for you!  I often find myself sort of 'looking' for something to take care of each day (house, car maintenance etc).  I'm not back to my old self yet - hopeful things will take a turn for the better soon and that it's consistent.  I still generally feel tired, rundown and 'foggy' during the day with it getting much better in the evening.  I have to say that sometimes it's better during the day too.  When I get back to my old self, we plan on doing some traveling.  In fact, the UK is on our list. That'll be nice because I've been mostly house bound these past several months.  I'm still taking 20mg cit - entering into about week 7 now  *fingers crossed* 

You'll find your routine and probably won't even look for things to do ... because you'll just be doing them   It is strange when first being at home - after 16 years working full time I left to have our children, then stayed at home even when they were at school.  That adjustment from work to home was weird too but enjoyed it and found loads to do.  

That's how it worked for me - I'd feel better by the evenings, and then it started to happen during the days too.  Bit by bit the tiredness disappeared, the foggy feeling too.  It'll get better and better until you feel good all day, every day and you'll feel back to normal again.  Its true that time is a great healer.

Hey that'll be great to start travelling.  Pack an umbrella for the UK - it can rain anytime of the year!!   Spring, Summer and Autumn are best times to visit.

K

I certainly have fond memories of my time in the UK.  Can't hardly wait to make my way back there sometime soon.  I remember driving one time where the fog was SUPER thick - I actually drove off the road (fortunately, I was creeping along at about 3 kph).  I quickly came to the conclusion we had traveled far enough

I'm still struggling a bit with the side effects - today was a bit rough.  The Pdoc still wants to up the dose to 30mg - but, I'm not doing it.  Because of what I've learned on the site, I strongly want to give the 20mg dose at least 2 or 3 months.  Plus, I'm NOT motivated to potentially experience all the side effects all over again with a dose increase!

I read some where that someone mentioned weeks 5/6/7 being 'the hardest' for some folks - Have you heard that at all?

Haha yes the fog can be pretty thick here - I've had times too when I can't see beyond the bonnet of the car.  Luckily not driven off the road (only done that in snow when its hidden the road and path).  Hope you were able to get out of the edge of the road   Which parts have you visited in the UK?

Yes its wise to hold off re the increase.  You don't know which dose will be best until you've given it long enough i.e. few months.  I always say why take more meds than is needed anyway?  

I've also read many people say weeks 5 6 7 are the hardest too - personally I can't remember how it was with me as it was such a long time ago when I first took meds, but it does often seem to get bad before it starts getting better.

Some people give up on these type of meds due to the side effects, which is a shame as often just that bit more perseverance and they could turn a corner.

 

Yes this drug is a tough one to stay with. After a few good days then hit a couple of snags and feeling somewhat good again today. Will finally see someone tomorrow to at least talk about the situation and go on from there. If it wasn’t for this forum and the success people had by waiting it out I probably would have pulled the plug on it. At this point I’m sticking in with it for the long run unless advised to try something else.  

Yes that's how it works - its like being on a roller coaster.  It will settle though - stick with the same dose for a while yet, ride it through those bad days and calmly as you can.  It gets easier.

Sometimes being advised to try something else can be too early - often doctors and therapists haven't suffered with this, haven't tried the meds and many don't seem to know this process either.

Perseverance ........ 

Let's see.... Brighton, Portsmouth and of course, London - mostly stayed on the southern coast.  At the time, I was living in Germany and vacationing around Europe.  Yes, I was able to simply pull the car back on the road - no worse for wear.  It certainly startled the other passengers, though (girlfriend and her mom)

Yes, I could not  agree more - don't want to take any more than really necessary ( of anything! ).  I'm very hopeful the 20mg will eventually kick in completely   I've got a phone consultation with my GP tomorrow (he originally prescribed the 20mg citalopram before referring me to the Pdoc).  I just want to make him aware of the Pdoc's desire to up my dose to 30mg and ask him what he thinks about it.  I still intend to stick with the 20mg for 2-3 months (at least) before any change is considered....

Ah the South coast is lovely - London hectic, but lots to see and do there.  I'm about an hour away from London.  

How everything going now?

I really enjoyed the UK - can't wait to get back for a visit.  Loved the food too.  Well, I'm feeling quite a bit better - not perfect, but, better.  I spent 8+ weeks at 20mg Cit and I was struggling day to day.  I spoke with the Pdoc and I suggested that perhaps I should try 10mg Cit with 15mg Mirtazapine at night.  She seemed to think this combination would be worth a shot.  So, that's where I'm at - 10mg Cit plus 15mg of Mirt.  I've read that there has been some success with combinations.  My Pdoc was vehemently against any type of 'benzo'.  I'm just glad to be feeling better.  Eventually, I suppose I'll have  to drop one or the other.  I'm considering the idea of cutting the Mirtazapine to 7.5mg - but, I've heard/read that smaller doses make a person even more drowsy.  I'd be very happy to hear your opinion on this combination.

My GP wanted me to try upping the dose of Cit to 30mg.  This made me a bit nervous because I was having a pretty consistent headache at 20mg Cit.  Haven't had any headaches with the above combination