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Ask Dr. Ed Wilfong Your Own Question
Dr. Ed Wilfong
Dr. Ed Wilfong, Psychologist
Category: Mental Health
Satisfied Customers: 1528
Experience:  Twenty-five years treating all ages; Specialities: psychopharmacology & diagnosis, MMPI-2, testing.
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I have been taking citalopram for 9 months to treat anxiety

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I have been taking citalopram for 9 months to treat anxiety and depression , I am much better now but have been experiencing a very raised mood for 5 weeks and have become preoccupied with sex and am having trouble sleeping now , Doctor to my surprise increased my citalopram from 20 mg to 30 mg, could the drug now be causing the problems I am experiancing
Yes it could. On rare occasions, Celexa can induce a mania episode, which accounts for the overly raised mood, sleep problems, and increased sex drive. I have absolutely no doubt this is the problem. It is one that Primary Care (General Practioners) don't see very often, but we are always cautious about. There is no way to predict who this will happen to. Unless you have a history of bipolar disorder, this does not mean you now have bipolar disorder. This is a chemically induced mania. Quitting Celexa is not the short term solution, although I would skip a day and cut it back to 10mg immediately. This acute mania can be managed several ways. One is with fairly high doses of benzodiazapines for a few days (Like Ativan, 2mg, 3-4 x per day for a few days. This is high dose.) It will sedate you quite a bit but ultimately low risk. Your doctor may conclude you are bipolar. Be cautious accepting that, as I said it may be chemically induced.

Ultimately, you will want to switch to a different anti-depressant and perhaps add a mood stabilizer. You will want a specialist (psychiatrist) to do this. This needs immediate attention so it doesn't get worse, as it could lead to a full manic episode where your judgment will become impaired and take unreasonable risks, spend money, stay awake for several days. It is good sign that it hasn't worsened in the 5 weeks.

If you have it available, I would call the ER and tell them that Celexa has induced a mania and it needs to be treated. (Have them look it up if they don't believe you), and need psychiatrist on call to deal with it. Tell them just what I have told you. (Or print this a take it).

You will be fine, just so you know. Just need to take care of it. They may choose different medication than I would but don't let that worry you (as long as it is not Lithium as it won't work immediately. They may suggest seroquel, which is fine. You will need psychiatrist to manage medications after this.

They likely don't see this often. I only have seen it a few times but it is unmistakable.

Good luck.
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