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[Justjules]

http://www.nhs.uk/news/2012/07July/Pages/antidepressant-citalopram-qt-heart-rhythm-safety-warning.aspx

Basically, I was on Citalopram 10mg or sometimes 20mg quite happily on and off for the last 20 years. As most of my HA revolves around heart, saw cardiologist about the same time and since, and apart from harmless palpitations and a slightly raised heart rate, nothing wrong ever found but was put on sotalol betablockers and have taken them alongside the Cit for years. To cut a long story short, as have already prob posted details previously, got taken off the Cit as they said there were now contraindications with the BBs I was taking and was put on Sertraline (I had been off the Cit for about 6 months then anyway as I thought I was okay)...well, we all know what a terrible time I had on the Sert for two months and am prob still feeling the withdrawals as I went cold turkey once I got to 25mg as couldn't take the affects any longer. Dr now wants me to take the Cit again but I need to stop the BBs first and she said I could stop straight away as they are such a low dose, and then start the Cit but a) I am terrified of just stopping the BBs and b) now I've read the article attached and several other warnings, I am terrified of starting the Cit again even tho GP says okay. Who do I trust?? How can you just stop BBs after 20 years of taking them when all the articles say you must never do that as it can be dangerous???

I am getting in right state about it. My family are despairing as they say I won't take GP's advice and would rather read the Internet  . One other article said that it can cause some people to develop heart probs and that's prob why they now prescribe Sert more than ever now.

I have tried to sort myself out with other things but I know I need something else and the Cit was good for me but I would be worrying every time I took one!  All rationale has gone out of window...I have follow up next week but am relying on somebody's sensible head on here....I know you're all not medically qualified!

Just had a nice 6 day break in Spain but was a wreck most days and yesterday spent the whole flight home with my head on the table tray crying....ridiculous....I'm cracking up again. All sorts of new symptoms .... Keep having to breath faster than normal, which I've never had before, mornings are still a nightmare but by night time, I get a few hours of normality. Doesn't help by the fact that the family were all dashing around on holiday and I couldn't even keep up on a stroll up the prom which then makes me panic even more thinking there is something really wrong....

Sorry for long early ramble but have had a bad night  x

Ps: had a few ecgs recently which didn't pick up anything u towards...

[coldethyl]

I can understand exactly how you feel- I'm HRT dodging if I am honest because every pill would have me wondering if the next migraine would be a stroke and so on. Citalopram has been contraindicated with beta blockers so I do get your concern and your GP is right to tell you to stop the BBs if you take it- what dose are you on of them? My GP prescribes me them in 10mg doses so I can go up and down easily and only once have I been told by duty GP to taper the down if I went up to the full 90mg a day that I am allowed. I tend to take 20 or 30 and do cut them in half to taper. Why don't you ask about tapering before you start the citalopram? Or ask for a referral to a psychiatrist who may be able to suggest other medication for you. There are always the old style ADS such as anafranil or else SNRIs like Effexor.  You appear to be in such a pickle that I do wonder if you aren't better not starting anything new at the minute until you have seen a mental health professional. x

[countrybumpkin]

Oh poor you I really feel for you as i know how awful panic is.

Right with my logical head on, you have to weigh up the benefits and risks ( applies to all drugs).  Yes cit is known to cause heart problems but you had taken it for a very long time with no heart problems appearing , it may be that the problems occured in people who were already suseptable to heart problems and the drug was the catalyst ( just a guess but maybe).  Think of people who smoke 50 cigs a day and never get lung cancer, this is because they do not carry the gene defect for lung cancer and smoking. 
Now onto quality of life issue.  With cit you had a good quality of life, without it you sound like you are in hell. You can't seem to tolerate any other anti'd drug without horrendous side effects.
So although there are risks to cit the benefits for you personally are greater I feel.
Betablockers and cit are not a good combination as you know but I like you do share a  reserve about coming off bb's cold turkey if you have been on them for so long.  Can you go back to your Dr and ask if you can reduce the dose over say 3 weeks for your peace of mind and then restart the cit.
You can also ask if you can have some sort of cardiac monitering whilst on cit say an ecg once a year again make it clear this would give you great peace of mind rather than thtat you are questioning their medical expertise.

My husband has been taking prozac for 16 years and I just wish he had been taking it for 30 years because he went from someone with severe depression and attempted suicide to a diferent person on prozac so despite the side effects he will take it for life because of his quality of life issue.

[babyjane]

JJ this article is almost 4 years old (July 2012) and as I understand it from the article and also when I questioned my GP after you rased this question before, it is at higher doses that the problems can arise which is why the 40mg dose of Citalopram is no longer prescribed.  If you were on 10mg or 20mg then this does not seem to have the same contraindications.

If the BB you were given is contraindicated with Citalopram then could you not have been given a different one?  I have taken E-Citalopram alongside the BB Propranolol for 5 months and as far as I am aware CLKD has taken these two together for years.

For your GP to be able to help you you really need to trust him/her and start to help yourself.  Unfortunately Dr Google is no help at all, he has never been to medical school and usually does a lot more harm than good  .

I do hope you can find a place of peace with all this, I sincerely do 

[Justjules]

Coldethyl, I did question re tapering but she said that 20mg twice a day of sotalol is such a low dose it didn't really matter and I could stop as I didn't actually have an existing heart problem. I have tried a couple of older type ADs in the past many years ago and had awful reactions to them. Citalopram was the only one that didn't give me any problems. I always recommended friends who needed ADs.  Will ask the question about alternative Betablockers but she is saying I don't need them at all.

CB, will have to weigh up life benefits of this because can't go on like this. Thought about asking for regular ecgs just to keep an eye on things.

BJ, I think when I read the article again, it does imply that it seems the doses above 20mg cause the probs. I honestly wasn't anywhere near as bad as this before I took the damned Sertraline so blame that totally for this spell. In the past I would have just gone back on the Citalopram and it would be sorted so wasn't expecting to have had this bad few months so it's the frustration of feeling so rubbish and having to go back to work tomorrow and resume normal life....I feel like I have months ahead of me feeling like this now and everybody's patience is running out with me which is upsetting me even more.
X

[coldethyl]

It is hard to make a decision when you are in midst of health anxiety so you have my sympathy. If it were me, I'd go back to GP and explain how worried you feel about just stopping the betablockers and would it be ok to taper for a few weeks before starting the citalopram. In the meantime, I'd be pushing for some mental health support as I personally don't think ADs are the whole solution and you seem to need regular contact with someone to work through the problem with you so that you feel you have someone to listen to you , and you aren't worried your family are sick of you. X

[Justjules]

Have made an app for Monday (yes, surgery is open on Easter Monday!!!). Blimey Coldethyl, it's costing me an arm and a leg in therapy....there's nothing on the NHS that helps and waiting list far too long. X

[babyjane]

JJ I only took my E- citalopram for 5 months and have been off it a week.  I am nowhere near as bad as you but I know I am not right and that it is still working its way out of my system

[Justjules]

BJ, have you tapered or gone cold turkey? My Mum was on Escitalopram for a while after my Dad died but she had no probs coming off them, but then she isn't a nutter like me! Although she was in the past, so gives me hope 

I am sure it is the Sertraline that has done this 100%. In the past, when I came off Citalopram, I did it so slowly, I had absolutely no problems. It was known for the AD that gave the least side affects.

X

[Halfpint]

I have had anxiety since childhood and HA for the last 15 years or so. Although I did have HA before that but nowhere near as bad. Now this is how it works for me. If I am given medication..I read all the side effects and then panic! So, this made me stop taking the contraceptive pill as I was obsessed with blood clots. Luckily for me, I have never had an accidental pregnancy even though I only use the rhythm method!
This is another reason I have never taken medication for my anxiety as even those have side effects!
As for your heart anxiety...this one has happened to me in the last few years as one day I was out cycling and I could feel my heart racing and felt like it wasn't going to calm down. When I got home, my face was red and I felt really hot. Now that was it for me, no more cycling and then obsessed with my heart. One night I got a pain in my forearm and stupidly (I hate myself for it) I googled it and the first thing that came up was heart attack! Well that was it, massive panic attack that scared my husband and he nearly rang an ambulance.
After that, I kept noticing this forearm pain for ages but in reality, it was probably down to using my laptop! However, when I would walk uphill etc, I felt the pain in my forearm. I then started feeling an angina type pain and panicking about that as I would get jaw pain and a friend told me she had angina and her symptoms were jaw pain! I am terrible for listening to someone elses symptoms and then I start to experience them!
I then had a health check and for the first time ever, my BP was slightly raised. The Nurse took it three times but I told her that now I was panicking as she told me it was slightly raised. She then said it was nothing to worry about but to get it checked with Dr but instead, I had my friend check it on a home bp monitor and it was fine but then, I got obsessed with having high BP. I had it checked last year and although it was still slightly raised, it wasn't high and i felt a bit of relief but still, I panic over high BP and heart attacks.
To be honest, it is just yet another form of my HA which is really never ending. I try my best to rationalise and find keeping a diary of my symtoms is useful as then I can go back and see that nothing untoward happened to me the last time I had that symptom! In fact, I mentioned on here the other day that one particular symptom I have been getting for 16 years and nothing drastic has happened.
Although I always panic I have some health problem or other, I rarely go to the DR. On the rare occasions I do go, there is never anything wrong with me!  I have never gone about my anxiety. Have never taken AD's or had any CBT.
I understand your panic but as your ECG's are clear it's obvious that you do not have a heart problem but your anxiety is hightened and I can fully understand that, but what you need to do is fight the anxiety and not let it win. Easier said than done of course.
I know google is not good for you but I find the website 'no more panic' a great help. I type the symptom I'm having into google then next to it ,no more panic and it will bring up people who have the same symptom on no more panic. It's amazing how many people are suffering the same HA as you at the time and I always find that reassuring and my anxiety soon fades (for the time being!).
I am not saying don't take the anxiety meds I'm just letting you know that it is possible to manage without them.

[Justjules]

Halfpint, we must be twins!! I do exactly the same. Have had all the forearm pains, (probably from having my arms flat on desk typing all day) pains in wrist because I read that was another symptom of angina or heart attack, pain when walking, so stopped walking. Took myself to a&e twice and had an ECG convinced it was an imminent heart attack or angina. No More Panic is not good for me anymore as I found I had things I had never even considered and it became an obsession. I found this site and so use this instead as I think there are more level headed people on here that are a bit more rationale. I have therapy, have had CBT, meds, everything....I just need to accept it is anxiety and that's the bit I find hard. I had a bad case of neglect when I was actually seriously ill in my twenties so that set of my HA and I was an anxious child so all in all, my life has been lived in some sort of anxious state for most of it. I have had spells of being free from it but as I am getting older, it's getting worse trying to accept that as we age, we have to suffer illnesses etc.  I am starting the diary method as my son pointed out last night that apart from two proper illnesses, I have been relatively 'well' ....it's just I think I'm constantly ill or dying with something....my default is always death, never something that can be treated!! I am determined to get on top of this somehow. I got to the stage where I wouldn't go to the Drs at all Fter having a couple of breast scares, a kidney scare and then a bowel scare all within two years which were all normal but I went over the top with panic so realised I had to take some action so resorted to the tablets and unfortunately, had a bad experience since January and it has set me back a lot. Thank you for your post, lovely of you to respond and it has helped a lot. X

[Halfpint]

Ha! That's quite interesting what you say about No More Panic and I see what you mean. I've only just joined this site and yes, there are more level headed people on here!
My HA kicked in big time after the traumatic birth of my second child when I heamorrhaged twice and was really quite ill but what set me off is one of my friends said 'you could have died'. Well that was that..I was then obsessed with what had happened and found myself laying awake every night going over it all and I've also had obsessions about death from childhood so when I had my first child if I was ever on my own I would panic what would happen to my child if I suddenly dropped down dead!
Apart from the difficult birth, touch wood, I have never actually suffered from anything serious but of course if I get a headache, it's brain tumour, pain in chest - heart attack etc, etc and like you, my default is always death. I know deep down that my new obsession with heart attacks is  due to my Dad dying from one after a serious operation so of course now I panic in case I ever need an operation I will think I'll have a heart attack afterwards! It really is a viscious circle.
I have wanted to try CBT but know the waiting lists are long. do you find it helped?
I too have had periods where my anxiety has been lessened but I know it will never leave me but it has got worse coming into peri menopause. I had an anxiety attack today as I keep getting tingling in my palm but was calmed after I put it in the search engine on here and saw that many people have suffered from it and normally just before a period which is no doubt what mine is as I'm due on but now that I think about it, it has been happening around the time of my period and then disappears again. I'm worse with panic when I'm on my own which I'm sure most people are. I also haven't slept well this week and my anxiety is alway hightened when I'm tired.
The diary is a good tip.
Nice to connect with my twin! x

[Justjules]

Halfpint, a lot of HA is set off from some sort of trauma. I personally didn't find CBT much help but then that's because on the NHS you only get 12 sessions and it's nowhere near enough and only scratches the surface. It's what the NICE guidelines have set and you can re-apply for another 12 after 6 months!  Private CBT is much more in depth but costly. Have a look up EMDR which is a form of hypno but is good for any sort of past trauma but also for anything from anxiety, depression etc. I've just had some for flying and only needed one session. I think tingling is a common meno symptom on here if you search some threads so that might reassure you. I've managed to go to the supermarket this morning, jelly legs and ran out of energy half way round but did it. Sounds so ridiculous to even think about doing something so normal and struggle...drives me mad! xxx

[Halfpint]

Hi Jules, Thanks for info on CBT. My friend went private and said it really helped but it's quite expensive. I'll have a look at EMDR. I've had no tingling today but I've been out with the family all day and it helps if I keep busy although now we're home I'm feeling a bit anxious but I'm putting that down to a big cup of strong coffee I had while out and normally I only drink 2 small cups a day and never after 3pm!
Oh Supermarkets are well known for anxiety attacks. I've read it's something to do with the lighting? I have to psyche myself up for the big supermarkets. I much prefer those small Tesco's!
x

[Kate50]

Hope I'm not speaking out of turn but all you ladies on here who have replied to this thread seem to be very rational but dogged by this anxiety.  I have suffered with these things in the past and have always said if i hadn't sorted my head out in the past I think I would be suicidal going thru menopause. 
I have taken the alternative route due to lots of different reasons personal experiences watching others etc. By doing this I was able to find a way through.  I've had allsorts of therapy my last one being the best and most successful.  Anxiety was rooted in early childhood experience and no matter what pill I took or what defence mechanism I put in place it didn't work.  The freedom of not feeling it was worth all the money spent. Its the biggest gift I could give to anyone suffering.  This gift came to me through the suffering I was going through watching my daughter go down from drug taking and all that brings to a family it pushed me to breaking point but now I look back and thank her cos in turn it pushed me to change myself which led in turn for her to change herself. So ladies yes our hormones do control us to a certain extent but not so to the point of not having a life,  that's in our heads.  Rewiring of your thoughts is possible if your open to it.  Sermon over!  Have a good day