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[MandieG]

Hello,
I am currently signed off of work with anxiety & depression. Lots of life stuff has happened which all got on top of me and caused a downward spiral. I stopped long term Sertraline a few months ago due to side effect issues with my jaw (now resolved), and have recently weaned off of HRT as advised by my Gynaecologist to see what my ongoing symptoms do without the oestrogen.

The GP prescribed Citalopram as an alternative to Sertraline but I have yet to start it. I am two weeks into a four week sign off - I wanted to see if I just needed some time out to rest and recuperate, but I am still up and down like a yo-yo and cannot get out of my head. I am stressing about having to return to work, stressing about what to do instead of my job and cannot seem to resolve anything or make a decision. I am still intermittently low and tearful (cried on a friend today out of the blue) and my sensible brain is saying to start the Citalopram, but I am too anxious to try it in case of awful side effects. I desperately want to be OK without medication. Has anyone else recently started Citalopram?

[CLKD]

   what on earth is your gynaecologist thinking!  That's why a dedicated menopause clinic is a better way of getting appropriate treatment for peri/menopause symptoms. 

How old R U and what are you periods up to?  Anxiety can increase as hormones rise and fall.  How long had you been taking Sertraline, the jaw clenching may well have been anxiety.

I have been on several types of AD since 1989.  Once I found 1 that didn't cause nausea my depression improved, I have different medication to ease anxiety.  All ADs helped for several years and I take escitalopram 5mg morning, 10mg at night, without problems.  Which does has been prescribed and which side effects would be intolerable for you?

Your mind is, like mine used to, whizzing.  DH asked me what my worries were but there was so much so fast in my brain that I couldn't tie anything down!  Anxiety feeds anxiety sadly  .  mayB try Citalopram on alternate nights or every 3rd initially and see how you feel.  What's the worst that could happen?

Anxiety is never logical so your lack of resolution etc. are 'within normal limits' when highly anxious.  This will pass! 

Do U have a nighttime routine?  My bath is my haven, cuppa and good book or magazine.  When severely depressed I was unable to stay in the water for more than a few moments, nor could I concentrate on much at all.  As the medication kicked in all that improved.


........ and breath.  Not easy.  Do U live alone etc.?

[K45]

Hi Mandie,
Sorry to hear you're going through a rough time at the moment. I don't know much about citalopram but in perimenopause I've found the following has helped a lot with the associated anxiety/low moods: magnesium glycinate, turmeric, vitamin d3, calm tea (esp at bedtime) and regular walks/swims. I know it's often anxiety provoking starting a new treatment. Maybe give it a month and then review as worst case scenario if it's not helpful then you can change to another approach?

[Mariab]

Hi,
I have been on citalopram for a year almost now due to anxiety increase I also have hrt.
I'm still Trying to find a balance but I am alot better than before...I was scared to start citalopram for the same reasons, the fear over took and it took faily members to stand infront of me and watch me take it, it took about 1 month before the main side effects went however they were not as bad as others I have tried...I am now on 30mg and doing ok...the anxiety will lift it just takes the right balance and alot of hard work and bravery... I had to force myself back to work after 5 months and now I love it and welcome the routine...
Things will get better.x 

[Blythe]

I started on 10mg over one month ago. Was terrified of the much read about side effects. Barely anything. Felt almost immediately better and lighter. Maybe increased afternoon tiredness and funny tummy for a while. Might increase to 20mg soon.

[CLKD]

Bravery - you've hit the nail on the head Blythe!

I find starting new meds overnight lessens any side effects though I tend to wake 2 C whether I'm OK 

[bombsh3ll]

Advising you to come off HRT for vague reasons without any clear contraindication is terrible advice from a gynaecologist.

That's the first thing I would review. What's my quality of life now and in the future with hormones vs without?

Personally I believe antidepressants are massively over prescribed, particularly to women, and they only marginally outperformed placebo in manufacturer-funded clinical trials on patients with diagnosed depression.

I'm not saying they help nobody, but they benefit far fewer people than is commonly believed. It is just the path of least resistance for an overworked GP with 8 minute appointments to print off a prescription for an SSRI and get the patient out of the room.

And they have some very concerning side effects such as anorgasmia (in 70%) cardiac arrhythmias, seizures, suicide, electrolyte abnormalities, falls and increased risk of fractures.

You mentioned coming off sertraline due to side effects, but did it make one jot of difference to your wellbeing whilst you were on it?

Do you have access to any kind of counselling or professional psychological support? This can be far more helpful than medication.

Most people that I see taking antidepressants are as miserable as sin, and I have never seen anyone come back beaming after starting an antidepressant saying what a blessing it has been and how it has transformed their life.

The ones who improve, usually they have had some other breakthrough in their life such as changing job, ending a bad relationship, taking up exercise or getting a dog etc.

If you do decide to try them, maybe set a time limit after which if there's no benefit you come off. And I would caution against accepting an antidepressant INSTEAD of hormone therapy.

If you do feel it is a legitimate treatment option there's no reason you can't take it alongside hormone therapy.

[CLKD]

My antidepressant medication saved my Life and continues to do so.  No way would I consider stopping it.  Ever.  And the emergency anti-anxiety tablet also, without it I wouldn't be here.  I did not have any 'breakthrough' or change of circumstances, that's relating more people who have clinical depression. I have both organic and clinical illness though many clinicians still don't know the difference!

It can take 2-3 months B4 the brain begins to feel better - the longer some1 has been depressed the longer it may take for the brain to recover.  Having discussed this with other suffers, many of us suddenly realised that we were feeling better 

Bombshell - where did U get the 'concerning side effects' information from?  It's alarming for a sufferer to read such information when beginning new medication.  Is there a % that suffer side effects? 

Counselling is like gold dust in the UK - the waiting lists in some areas for mental health support are as long as 18 months.  I found MIND Charity helped a lot 6 years ago.

[CLKD]

MandieG - did the gynae discuss whether your symptoms are hormonally related/not?  On what grounds did she think that you should stop HRT, was she the professional who started U on a regime and how long had you been using replacement?

What is she expecting your symptoms to be and did she give you a time frame ? 

[Gnatty]

I took sertraline about 8 years ago for the most awful anxiety. It took a good few weeks to really get going and I only ever took 25mg. But it was bloody amazing. I felt so incredibly well. I don't think I had quite realised what an anxious person I must have been for quite some time. And to suddenly have that removed felt so wonderful.  I switched over to HRT about three years later.

[Dorothy Gale]

Hi.

Just to say citalopram saved my life. Literally.

All I can say if you start it is to TRUST THE PROCESS.

I felt like abandoning it a few times early on....but I trusted my MH nurse that the initial tough time on it....will lift and I will feel better.

It's not an overnight fix. Took a good few weeks at least for me to feel any different...its very subtle....but over time you notice you feel better mentally.....happier....lighter.....more cheerful....able to cope.....optimistic....more and more.....and people notice the change.

Took I'd say a good 6 months to really feel good and level out......

I'm on 15 mg now. Initially 10mg. I only increased a bit due to med sensitivity....but it was enough of an increase for me to feel great mentally.

I won't remove every day worry and the anxiety flares a bit sometimes but not to the extreme suicidal level of before. All that is gone.

Huge hugs xxxxx

[MillieMoo10]

Hi MandieG sorry you are in feeling so bad at the moment.

I started Citalopram for anxiety 3 months ago and feel great now.  I have had no side effects other than a very slight increase in anxiety for the first 3-4 days after which I started to improve and would say felt 80% better in about 3 weeks and have gradually got better and better since then.  Ive been on it before and never had any side effects then either.  I tried to fix my horrendous anxiety with HRT but I seem to very sensitive to oestrogen and can only tolerate a very low dose - certainly not enough to fix how I was feeling.  I feel I can function normally now which is a massive relief.  Hope that helps.

[sheila99]

What happened when you stopped hrt? Did your anxiety or other symptoms get worse? If they did perhaps you should consider going back on it. Transdermal is very much safer than the older type and can be taken for life. It's only replacing what you should produce yourself.

[bombsh3ll]

Bombshell - where did U get the 'concerning side effects' information from?  It's alarming for a sufferer to read such information when beginning new medication.  Is there a % that suffer side effects? 

They side effects of SSRIs as well as approximate frequency are all listed in the patient information leaflet that comes in the box.

I know in reality many do not read this, and that is sometimes a good thing, but really when any medication is prescribed, people should read the information that accompanies it so they can make an informed decision, identify any personal contraindications that may apply, and recognise any side effects that do occur.

This is particularly relevant to sexual dysfunction which is a common side effect and which people often do not realise is due to the antidepressant.

The 70% anorgasmia was from research where sexual side effects were specifically asked about, which always yield higher reporting than spontaneously volunteered side effects, however in general sexual dysfunction is underreported.

I am not saying nobody should take antidepressants, it is great to have as many tools as possible, just that there are an awful lot of people taking them and not deriving any benefit, some of whom are actually being harmed either by side effects or by not receiving a more appropriate treatment for their condition.

[SundayGirl]

bombsh3ll -- Just wondering......Do you have a background in medicine?
Are you a doctor/nurse/medical researcher?