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Dr. Vikas
Dr. Vikas, Psychiatrist
Category: Mental Health
Satisfied Customers: 2253
Experience:  MBBS ; M.D Psychiatry, MS. Health Informatics
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Have ME and depression is secondary. Was finally making slow

Resolved Question:

Have ME and depression is secondary. Was finally making slow but significant progress with ME until last August when decided to reduce efexor from 37.5mg to half that dose -had slowly been reducing the medication over past few years from 150mg. Thatl last reduction set off massive anxiety and flooded adrenaline into system which then made ME worse. Anxiety had cleared by December last year but I went into a depression. As efexor is an old drug plus manufacture has now stopped producing 37.5mg capsules my GP swapped me to citalopram 10mg in January 2010. No real benefit happened so three weeks ago GP increased dose to 20mg. Now, for past ten days have suffered increasing anxiety (This symptom had not been present since first few weeks when I had reduced the efexor last year and I believe that was simply a withdrawal effect) and my general health seems to be worse.After three weeks I neither want nor feel it is right I should be enduring this added symptom-is citalopram wrong for me?
Submitted: 7 years ago.
Category: Mental Health
Expert:  Dr. Vikas replied 7 years ago.
Hello Mam,

It is sometimes seen clinically that just after increasing the dose of Citalopram, patient may notice worsening of anxiety symptoms and this may be the case with you also.

In your there are two possible options in my view about which you can discuss with your doctor.

1) - Addition of anti anxiety drug such as Clonazepam to the current treatment regime for a short duration till your anxiety symptoms are under control and you start noticing improvement in your condition.

OR

2) Augmenting the Citalopram with another antidepressant such as Mirtazapine as it possible that you are not responding properly to Citalopram and a combination could be more useful.

Best wishes,

Vikas

Please feel free to ask if you need clarification/more information. Kindly click the GREEN ACCEPT BUTTON if you are satisfied with the answer. POSITIVE FEEDBACK and BONUS are warmly appreciated.
Customer: replied 7 years ago.

I do not want to add any further drugs. If I reach the decsion that citalopram is not working for me, I would ask to stop it and try another drug rather than mixing one or more drugs together.

 

Do you think three weeks is enough time to say the citalopram isn't working for me? If not, how much longer do you think I should contimue to try it for before making that decision?

 

I understand that anti depressants can make you feel worse before better, but it is the fact that I have been on the citalopram dose for three weeks now and still feeling awful that is my issue.

 

Expert:  Dr. Vikas replied 7 years ago.
Thanks for your reply. Usually we recommend our patients to wait for at least 4 to 6 weeks for a drug to be effective before trying something else.

Vikas

Please feel free to ask if you need clarification/more information. Kindly click the GREEN ACCEPT BUTTON if you are satisfied with the answer. POSITIVE FEEDBACK and BONUS are warmly appreciated.
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