How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Kaushik Your Own Question

Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 3934
Experience:  MD Psychiatry
Type Your Mental Health Question Here...
Dr. Kaushik is online now
A new question is answered every 9 seconds

Back on Celexa - 40mg too high?

Resolved Question:

I have been off of Celexa (Citalopram) for 4 months after being on it for six years. I was taking 40mg. After feeling very anxious from work stress, I started on the 40mg again from the leftover bottle that I had, and the anxiety is now unbearable after only 5 days. I went to the doctor and was prescribed Xanax to help ease the tension. Should I reduce the amount to 20mg until the effects kick in? This is scary -- never had anxiety/depression this bad in my life.

Submitted: 10 months ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 10 months ago.

Greetings !

 

Welcome to the site.

 

I am Dr. Kaushik and i believe i can help you with your problem.

 

1) Please kindly tell why do you want to come down to 20 mg dose when you had previously tolerated 40 mg of citalopram ?

 

2) Also what dose of Xanax are you currently taking and since how long a duration ?

 

I will get back to you once you reply to my queries.

 

Regards..

 

 

Customer: replied 10 months ago.
1) I stopped taking citalopram back in February of this year, but did ween off of the drug. After work stress from this week, I started back 5 days ago on a 40mg dose. All week I have felt incredible anxiety and can't enjoy life. Like I mentioned, I had some 40mg tablets left over and took them thinking they would have the same effect before I stopped. I think the dose again is too strong to restart with so I want to drop to 20mg.

2) I was prescribed a .5mg tablet to use as needed, 2-3 times a day. I was prescribed this medication two days ago.
Expert:  Dr. Kaushik replied 10 months ago.

Thanks for the valuable inputs.

 

Well I agree that you should have started on 20 mg dose and then after a week or two titrated the dose to 40 mg / day but having said that now that you have already passed 5 days on 40 mg dose , so there is no point in going back to 20 mg dose since soon in a next few days your body will have adjusted itself to this dose, so it will only waste more time to go back to 20 mg and then up the dose to 40 mg again after 1-2 weeks.

 

Also until the 40 mg dose kicks in without causing any side effects on it's own, you shall continue to take Xanax at 0.5 mg 3 times a day so that this drug helps to counter your heightened anxiety at present until the 40 mg drug begins to kick in , that shall take place in about a week's time from now and when that happens you shall start taking Xanax only on PRN basis that is as and when required basis.

 

So to summarize--

 

-- Continue on 40 mg for another week , most likely you will start responding to it and your anxiety will be subdued.

 

-- If after 1 week of taking 40 mg of citalopram with 3 times a day dosing of Xanax your anxiety does not wane off or becomes more troublesome then in that case you may go back to 20 mg dose but I feel this scenario may not occur in the first place.

 

-- 3 times a day dosing of 0.5 mg Xanax will help you to pass this waiting time by maintaining you protected from anxiety.

 

I hope this helps.

 

Wish you all the best.

 

Please kindly leave a Positive rating if you are satisfied with the answer.

 

Regards.

 

Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 3934
Experience: MD Psychiatry
Dr. Kaushik and other Mental Health Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. Keane's Avatar

    Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/Dr.Keane/2013-8-20_204325_drkeane.64x64.jpg Dr. Keane's Avatar

    Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
  • http://ww2.justanswer.com/uploads/RE/resolutions66/2011-1-17_05728_IMG8202smilingeditedforJustAnswer.64x64.jpg Elliott, LPCC, NCC's Avatar

    Elliott, LPCC, NCC

    Psychotherapist

    Satisfied Customers:

    5024
    35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
  • http://ww2.justanswer.com/uploads/formybunch/2010-12-06_191055_img_0975.jpg Kate McCoy, M.Ed, NBCC, LPC's Avatar

    Kate McCoy, M.Ed, NBCC, LPC

    Therapist

    Satisfied Customers:

    3733
    Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
  • http://ww2.justanswer.com/uploads/DR/DrAkiraOlsen/2012-2-20_746_AkiraADpicmain.64x64.jpg Dr. Olsen's Avatar

    Dr. Olsen

    Psychologist

    Satisfied Customers:

    2336
    PsyD Psychologist
  • http://ww2.justanswer.com/uploads/norriem/2009-5-27_134249_nm.jpg Norman M.'s Avatar

    Norman M.

    Psychotherapist

    Satisfied Customers:

    2193
    UK trained in hypnotherapy, counselling and psychotherapy and have been in private practice. ADHP(NC), DEHP(NC), UKCP Registered and ECP.
  • http://ww2.justanswer.com/uploads/PsychologyProf/2010-07-15_171248_logos060400409.jpg Dr. Michael's Avatar

    Dr. Michael

    Psychologist

    Satisfied Customers:

    2177
    Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
  • http://ww2.justanswer.com/uploads/KURTEMMERLING/2010-07-23_215531_just_ask_picture1.jpg Steven Olsen's Avatar

    Steven Olsen

    Therapist

    Satisfied Customers:

    1727
    More than twenty years of expertise in counseling, psychological diagnosis and education