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Dr. Vikas
Dr. Vikas, Psychiatrist
Category: Mental Health
Satisfied Customers: 2241
Experience:  MBBS ; M.D Psychiatry, MS. Health Informatics
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My question is about tablets I have been taking for depression

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My question is about tablets I have been taking for depression and anxiety, but I want to put you in the picture about my recent health. I recently had a d & v episode (3 weeks ago) for a few hours due to a winter bug I guess, but couldn't eat for a few days without feeling very sick, and only sipped at water and lemonade which I could tolerate. During this time I was not having any of my daily tablets and seemed not to suffer any withdrawal symptoms then. The d&v etc. cleared up but has left me physically weaker (I am 22 stone and unfit so tend to get very tired very easily anyway), now at the end of the day I still get physically weak and a physically drained dropping feeling in my limbs. (After the d&v I got vertigo from an inner ear infection, so my GP told me over the phone, and the dizziness, nausea and dreadful tiredness prolonged my general weakness, but that too seems to have gone. My GP was happy I hasn't had a stroke.)
As I had not had my citalopram and reboxetine tablets for a few days I decided to use the opportunity to get off them. I have been on them for 13 years and 9 years respectively and my depression had receded quite a bit. I would say my anxiety is only a little better. But I wanted to stop them due to the side effects especially from the citalopram, which I understand is a very bad tablet to be on now e.g. making one's mental health worse in the long run.
After the first few days after my d&v I became much more tearful, crying, angry, anxious and stressed and after a few more days went back on the reboxetine. This helped but I still have times, espcially in the evening when I am extremely tired, of great anxiety, anger and upset. Yesterday this happened in the day and I wanted to escape from being inside, I screamed a lot, and tried to push objects away from me (we live in a very untidy and cluttered house), opened windows, and needed fresh air despite the very cold weather. I felt out of control and mad.
I have a supply of diazapam for when I need them, which has been farily rarely until these past few weeks. The only way I have been able to calm down now in the evenings and certainly yesterday is to have 6g of diazapam. Yesterday I needed 12g.
Having been off the citalopram for 3 or 4 weeks now (I cannot remember) should I perservere without them and cope with these withdrawal symptoms as they die down, or have some? I was on 40mg (40g?? - I can't remember if they're in mg or g) a day e.g. 20mg every other day and see if I can cope.
I cannot stay as I am - I sometimes feel as if I am going mad now and cannot control my emotions at all now at times, and would only stay off the citalopram if I knew my emotions were going to gradually calm down as the withdrawal process takes its course.
I feel reluctant to go back on them due to what I have already gone through over the past few weeks and don't want that to have been a waste of withdrawal. I am desparate to not take them due to the bad effects they have on the body and long term mental haelth, and the erectile dysfunction they contribute to.
I have no confidence in asking my GPs as they just look gormless when I see them and cannot seem to work out what to do with my mental health issues.
I also take tablets for high blood pressure; hypothyroidism; diabetes and high chlorestarol; and insulin.

Dr Vikas :

Hello

Dr Vikas :

Most withdrawal symptoms after abruptly stopping Citalopram usually subside withing 3-6 weeks. Therefore if you are able to tolerate these withdrawal symptoms you can wait for few more days. These symptoms should subside shortly most probably.

Dr Vikas :

If you think that these symptoms are persisting or increasing in severity, in that case, a possible strategy could be to restart 20 mg of Citalopram per day which will help in controlling these withdrawal symptoms. You can take 20 mg Citalopram for 5-7 days and then start tapering slowly by reducing 5 mg every 3-5 days till you are able to stop it completely.

Dr Vikas :

In my view, second option is a better alternative, so just discuss with your GP about this strategy and hopefully you will start feeling better soon.

Dr Vikas :

Please feel free to discuss further if you have any doubt or queries.

Dr Vikas :

Kind regards

Dr Vikas :

Vikas

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