Can anyone offer advice?

[Miss-P74]

Hello everyone. Just wondered if someone could advise me please. I’ve been taking Citalapram for 5 days and I just can’t take them anymore. Feel horrific! It has increased my anxiety and intrusive thoughts 10000%! As it’s only 10mg and only 5 days in. Will I have to wean off or is it safe to stop. I couldn’t deal with taking one last night so a whole day now without Feel anxious as don’t think they are outta my system yet. Anyone help me please ? X

[Hidden]

I've been taking it for almost two weeks now... it makes me dizzy/light headed for 2 to 4 hours. It also causes a lot my my head and neck muscles to tensen. I get nausea too.

[Miss-P74 in reply to Hidden]

It’s horrible stuff isn’t it Dan. I don’t want to continue with it. That’s why I need advice on how to stop.

[Hidden in reply to Miss-P74]

Well everything I hear is that the symptoms pass after 4 weeks, so I'm barreling through... but it is scary at times, feeling like I might feint and all.

[Miss-P74 in reply to Hidden]

You’ve done very well by staying on them Dan. I know everyone has different side effects but I can’t deal with mine. I feel like I’ve had some bad ones. Not for me. I think I’ll deal with it with therapy.

[Hidden in reply to Miss-P74]

I am so sorry it's had such a negative effect on you. Best of luck with therapy!

[Miss-P74 in reply to Hidden]

Thanks Dan. Best of luck on your journey

[Hidden]

Hiya.

The safest way to wean off is to speak to your gp. Maybe ask for a telephone appointment and explain to receptionist you need drs advice about medication ASAP.

You haven’t taken them long..which is good for weaning off quickly. As I’m not a medic I wouldn’t advise as wouldn’t wish to say or advise the wrong thing...if you are in uk, dialing 111 could help, they have medics who can advise on the telephone.

Best wishes x

[Miss-P74 in reply to Hidden]

Thank you Olivia. That’s really helpful. I will call GP tomorrow I would hate to have bad side effects I haven’t taken any since yesterday and due one at 10pm before bed. I’m pondering wether to half the tablet. I’m just confused with what to do best. I guess the confusion is the tablets too. ☹️

[Neuroticgirl]

I took it for only 3 days. Horrible - panic, sweating, racing pulse, shaking! No way I was prepared to take any more. Checked with pharmacy that it was ok to just stop after 3 days and they said it was fine. So I did and thank goodness haven’t had any problem since.

[Miss-P74 in reply to Neuroticgirl]

Oh that’s really good you was able too stop ASAP. I have only been 3 days more than you. I really don’t want to take another tablet tonight. Makes me panic just thinking about it too. Anxiety sucks!

[QuarkyOlympian]

You have probably gone to bed by now but I hope you didn't take a pill beforehand because it's perfectly safe to simply stop after five days on only 10mg.

This is the lowest dose and because it can take several weeks to fully take effect, it means that during that time it's safe to simply stop if you're on a very lose dose.

The mechanism of action (how they work) of SSRIs (drugs such as Citalopram, Paroxetine, Fluoxetine - aka Prozac - etc) is quite complex, but in simple terms they manipulate the way the brain processes serotonin.

This involves a physical change to the specific brain cells which release serotonin, and because it is such a complex process it takes an average of two to six weeks - depending on the specific SSRI AND the individual - to fully complete (remember that's on average though - it can take months), during which time it is quite common for symptoms to worsen; something you'll find stated on the information leaflet in the packet. HOWEVER, whilst it can take weeks or even months to determine how a specific SSRI is going to impact on a specific person* it is not at all rare to experience either an excess or a significant reduction in the ammount of serotonin in your brain from day one, and either of these outcomes can have very unpleasant results.

Normally these will pass within a few weeks, but in relatively rare cases people can experience a dangerous excess of serotonin known as serotonin syndrome, but it's theoretically impossible to experience severe serotonin syndrome from a single SSRI (you'd need to combine it with other drugs which increase serotonin production/release/bioavailability in the nervous system - serotonin is also found in abundance in the gut, but this has nothing to do with mood. So whilst serotonin syndrome is deeply unpleasant and can even be fatal, you are NOT going to experience it on 10mg of citalipram a day for five days; you might indeed be experiencing elevated levels of serotonin beyond what would be usual, because we are all biologically unique, but such slightly elevated levels would simply be unpleasant, not dangerous. But you definitely need to speak to your GP immediately.

To reiterate because this is an anxiety forum and I know I would freak out if I read this ren years ago: Serotonin syndrome is fairly rare and you would have to ignore some very nasty symptoms for many days for it to pose any real risk. Even having said that, the reality of developing it even from extremely high doses of SSRIs is vanishingly small; you would actually need to combine them with other drugs which increase serotonin in the brain.

The possible anxiety trigger here is that even relatively small elevated levels of serotonin above what is needed to help us feel less anxious and less depressed can cause unpleasant physical and psychological symptoms, and when these occur in someone like me, whose anxiety can conjur all many of outlandish notions, however unrealistic, headaches, sweating, and feeling a bit nauseous can suddenly have me believing that I've got a brain tumour.

In the here and now, however, the fact that you are clearly having a negative reaction after only a few days does suggest that citalipram is just not for you, and because you have simply not been taking it long enough for it to have properly begun to physically alter the relevant brain cells, there is no danger in stopping immediately. In fact I am 99.99% certain this is precisely what your doctor will advise tomorrow.

* The first SSRI I took was Seroxat (Paxil, in the US) and it was amazing, not for depression but for anxiety. However, after about a month it gave me such terrrible insomnia that I had to come off it. I mention this because Seroxat is known to be one of the worst SSRIs for negative psychological effects during the adjustment phase, but if it works, it can work miracles, and with me the effects were noticable within about four days. So it was deeply disheartening when I had to stop taking it due to the way it was totally ruining my sleep; ironically the sleep deprivation was predisposing me to feeling more anxious than I had been on an average day before I started the seroxat.

So I switched to citalipram, which did nothing at low doses so I ended up on 60mg a day until research suggested this was dangerous, so I dropped to 40mg a day for seven years. At one point I went on holiday without my pills, and the worst that happened was that I suffered mild headaches and minor mood swings after about five days. I wouldn't recommend it though, because sudden cesation once they have fully taken effect can send you on an horrendous emotional roller-coaster; I was simply fortunate.

For the record, whilst I am in no way medically qualified, and therefore what I am saying should only be taken as one person's personal view, I did earn a first class psychology degree in 2014, two modules of which covered this stuff - biopsychology and the psychology of mental illness - and due to my own experiences I made a point of reading up extensively on how SSRIs work, so whilst I'm not qualified to give a medical opinion, my knowledge is considerably greater than the average SSRI user.

To recap: SSRIs take several weeks to reach the stage where stopping suddenly poses any objectively real risk, BUT whilst serotonin syndrome is EXTREMELY UNLIKELY, negative effects of elevated serotonin levels can come on very quickly and make you feel extremely unpleasant - dizziness, palpitations, overheating, feeling sick, headaches etc etc, none of which will harm you in themselves, but it's seriously unpleasant - think in terms of drinking a pint of esspresso, how damn aweful you'd feel; would you then drink more coffee whislt feeling that rotten!

So the greater risk is continuing to take them if you're feeling notably negative physical effects even after two days. With regard to suddenly stopping during the first week or two, though, because the very reason we take them is such that our brain tends to play havoc with our emotions, without knowing the facts it's entirely understandable to be worried.

The most important thing to remember, though, is that our thinking can and does have a profound impact on our neurochemistry, and this can be so powerful that simply believing that you are suffering negative effects from sudden cesation of an SSRI can send you into a spiral of anxiety which can flood your body and brain with adrenaline, noradrenaline, dopamine, and cortisol, which, in sufficient quantities can make you feel like you're going to die. Ironically, dopamine is one of the primary feel good hormones, but when it's released in response to anxiety induced stress, we are more likely to experience its impact as fear rather than elation. On a related note, cortisol is actually useful when the body needs it, and even when released in response to anxiety induced stress cortisol won't do any harm short term. However, when it builds up over time it is well established as a causative factor in a long list of health problems.

The reason I mention this is because we hear a lot about the demaging effects of cortisol, but we never really hear much about the potential negatives associated with inappropriate dopamine release, which is far more damaging short term than a bit of extra cortisol because dopamine plus adrenaline plus noradrenaline will make you feel like your brain is going to explode and possibly like you're having a heart attack.

I know this seems off-topic, but ultimately if your system is flooding with serotonin AND you're feeling highly stressed, your body and brain will also flood with these additional chemicals, creating a vicious cycle of anxiety which can prove almost impossible to break out of without help.

On this one you can trust me because over more than twelve years I have been on numerous medications, undegone huge ammounts of counselling and psychotherapy, learnt to meditate, gained a psychology degree of course, and even now, with a wealth of tools and awareness at my disposal, I still suffer chronic anxiety. The primary difference now is that whereas my mind never used to give me any peace, today I'm aware that I have a dysfunctional endocrine system resulting from a genetic disorder, so mostly my anxiety is not caused by my mind by by a dysfunctional body. So whilst I do still need medication, I no longer take things like SSRIs.; today I cycle and swim a lot, try to follow a decent diet, always try to have things to look forward to in my diary, have a few absorbing, creative hobbies, and am very boundaried about who I do and do not let into my life - because half of my problem used to be not knowing how keep emotional vampires away. It's still hard work, though, and I am chronically lonely because I struggle immesely with emotional closeness, so I've still go a way to go, but at the very least I can now strum a guitar or get into some woodwork if my head just won't shut up.

Good luck though, I hope you find the right combination of meds and other support to help you find your way to a more enjoyable life. And I hope this has helped. I only actually logged on tonight because I was in a bit of a mess myself and needed something constructive to occupy my mind so it couldn't tyranise me. So you have actually helped me. Thank you.

[Miss-P74 in reply to QuarkyOlympian]

Thank you so much for the information you’ve given me and your time to write this. Wow. Reading it has made me feel a better already. I didn’t take a tablet and haven’t taken any since Thursday evening. I’m not taking anymore. The intrusive thoughts was unbearable for me. I get anxiety that I’m going to kill myself. I must note i am NOT suicidal at all. That’s my anxiety itself. I have a fab family and friends and have no reason to end my life. It’s just the anxiety playing with my head. I live alone too so having these horrid thoughts anyway isn’t great and then having them mulitiplied 10000%! Was just to much to bear. I had a feeling of dread every minute of the day whilst on Citalapram. I’ve suffered since I had post anatal depression 24 years ago. A bad relationship for 8 years too. Which really messed me up too. I’m a positive person normally and things just went down hill in January and haven’t got better since so thought it was time for prescription help. I have had Effexor before and Prozac but that was over 20 years ago. I’m 43 now, single and life is ok I have a good job too. I just needed the spinning thoughts to stop. Plus the constant kip myself thoughts. Cos I really do not wanna die. Not at allllll!

So maybe therapy inmy way forward. Not these mind bendin drugs. I know they work for some. But maybe I’m the smal amount of the group they don’t work for. I’m not sure.

[dillydally1]

hi, most medications like this make you feel worse at first. there are lots of different one's to try, phone gp and ask for advice. I wouldn't just stop, your gp may just transfer you to another or advise you to try it for a bit longer. hope you get sorted, take care and let us know how you go on x

[Miss-P74 in reply to dillydally1]

Hello. Thanks for your reply. I did actually stop taking them. I’ve not taken any since Friday evening. Just could face the thoughts any longer. I totally now they can make you feel worse before better but I simply couldn’t go any further with them. 5 days was enough. I’m booking inwith GP this week and have a therapy session booked for Friday. I’ll let you know how things are.

Thanks for being there and reply to me. Was Great to reach out. X

[Miss-P74]

Same as me Molly side effects wasp much. I have hearburn too. Maybe Aicd reflux ?

I will book another appointment with GP. I’m new to this doctors so they don’t really know me that well even though they have my notes. There isn’t a bond yet there. I’m hoping for help with therapy. Well done for stopping them too! Nasty things.

[Miss-P74]

Crazy stuff. Just not right is it. I can’t belive what damage they can actually do!

[elainepstroud]

I remember that so well myself - I felt so badly too but I'd also say try and stick with it as although Therapy is great using the pills first is pretty important. You can stop using them when the therapy starts to work for you.

[Miss-P74 in reply to elainepstroud]

I’ve actually stopped taking them Elaine. It’s been 3 days now without them and oh gosh I feel sooo much better.

Thank you kindly for your reply.

[Starlight_ftm]

I only managed one of those and had to stop as Altho most of my friends and family take citalopram and found it so helpful! It caused me the same as you with extreme anxiety just by one I then went onto duloxetine plus diazepam instead as I also had nerve pain! I didn’t get side effects to those two

[Miss-P74 in reply to Starlight_ftm]

They are Horrible! I am now to scared at the moment to try any new tablets. Think I’m going to try Therapy see how that helps. Some books and yoga. Anything apart from Citalapram! Glad you found something to help you. Wish I Could 🙏🏻

[Starlight_ftm in reply to Miss-P74]

Can’t take at moment as 37w pregnant and def noticed difference but I came off them ok, unlike what google scares you with hehe! Always go with what feels right for you wish you well

[Miss-P74 in reply to Starlight_ftm]

Aww. Congratulations and your be seeing the little human very soon then!!! Hopefully having a new family member will help you to distract from the anxiety. I wish you all the very best in motherhood! I’m a mother to a 24 year old and also a nanny. Best feeling ever. ✨

[Starlight_ftm]

She arrived on the 9th

[Miss-P74 in reply to Starlight_ftm]

Congratulations my lovely !!! A A little bundle of love 💕 so happy for you. Hope you and bubba are doing ok ?