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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4506
Experience:  MD Psychiatry
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Back on Celexa - 40mg too high?

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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.

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 3 years 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.

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.

 

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