Citalopram - do I need a higher dose?

[Pastelesque]

I've been on citalopram (20mg) and beta blockers (40mg) for about a year now and it's been quite effective in terms of managing my anxiety and on most days I'm be able to leave the house without feeling on edge and go about my day without sudden panic attacks or random fears appearing out of nowhere. The presence of other people around me doesn't feel so draining anymore either.

However, I've recently noticed that some of the symptoms I had experienced prior to getting on citalopram have become prevalent again: I've been feeling extremely tired, nearly all the time. Even the simplest of tasks have been exhausting me lately and I find myself having to take constant breaks between whatever it is I happen to be doing, even when I've had more than enough sleep and rest. It always feels like being submerged under water and I initially thought I could just sleep it off, however sleep doesn't come easily to me either.

On a related note, another thing that seems to have returned is emotional numbness, i.e. I can't force myself to concentrate on what I'm supposed to be doing because my mind is so overtaken with lethargy so I can't bring myself to be emotionally invested in anything I'm doing, even though objectively I do know it's important (e.g. work). Every day just feels like a massive chore to be overcome.

Could it be that I need a higher dose of citalopram or is this just emotional exhaustion that should go away on its own?

[MAS_Nurse]

Hello Pastelesque and welcome to this caring community. Sorry to hear that you are struggling. Perhaps the first step to take is to go back to your GP to discuss your current symptoms and review your medications. I wonder also if you have had any counselling or other talking therapies? Our members here will share their wisdom and experience with you.

Please let us know how you are getting on.

Best Wishes

MAS Nurse & Moderator

[Hidden]

It is important you discuss the doses with your GP, we cannot advise on medications or the doses Take CBT if possible instead of an increase in medication, my standard dose in the past ten years was 20mg, now pushing down to 10mg hopefully in the next month or so.

Try to manage on the dose given, unless your GP admits you need to increase, remember the higher the dose possibly in the future you may need to withdraw over a longer period.

We need to consider our needs and expectations of any treatment plan we are on

BOB

[MaskedNinja]

20mg citalopram is the basic starting dose. You can go to at least 60, maybe higher. And a whole year with no dose adjustment? That's just awful. If it were me I'd be on to the next doc within 4 weeks if I felt no better and the doc did diddly s**t. I've move clinics recently for my own, similar kinda problems. Already looking at another. Dont just hang around, take action!

[MaskedNinja]

Oh, hi and welcome! lol I'm new here too. I like it so far. I've ranted a few times yet nobodies got funny about it, which is refreshing! Normally someone has to dissagree, so thanks everyone for letting me just drop some of this baggage and just letting it be. And a huge thanks for any imput no matter how small. Every inch of contact, including a simple "hi" is extremely appreciated. I get none of that anywhere else