I don't know why they call it the Great Depression. Great makes you think there were Pony Rides.

May 18, 2009 9:34 PM

Now, after a really bad episode of Depression that has lasted the last 14 months, my doctor has prescribed Celexa for my depression. I just started taking it today and seemed to have a rather mild, pleasant day. I was on Paxil years ago and it didn't go as well. I know that YANMD, but I'd like some real world experiences. I have a few specific questions I'd love other Celexa users to answer. Please feel free to offer other advice as well.

All of this came to a head 2 weeks ago when I went on a 3 day crying jag, in a hotel, 300 miles from home, with my best friend, who I apparently scared.

- What can I expect from Celexa during the build up?
- What can I expect after it gets into my system?
- When's the best time to take it? (Because of my depression, I have never had a good sleep routine, I was either oversleeping or not sleeping at all. Taking it today, I was sleeping 5 hours later despite sleeping in this morning. I can't take a nap during my shift!)
- What are the real sexual side effects? (I've been having um... issues in that department lately that I think were caused by the depression and frankly, if I have a decreased libido AND can't reach orgasm when I do get the desire... I'm going to be a WHOLE lot more depressed.)
- Does occasional marijuana use affect Celexa at all? (And Occasional means once every month or two, give or take. I am not a heavy user, only when it's offered at gatherings.) I ask this because I was offered today, but declined as I didn't know how it'd affect anything.

My doctor has also strongly suggests counseling sessions, though I have no idea how to set these up, or how to find one in my area.

And if it has any bearing, I reacted negatively to paxil from the get-go. I was still very depressed, but after taking Paxil, I was flat and almost emotionless, extremely sensitive to light, and slept nearly 16 hours out of every day. I stopped eating, yet gained nearly 50lbs while I was on it. I will say I was only 15 at the time, was not diligent in taking my medicine at a certain time, and quit Paxil cold turkey after a month.

posted by aristan to health & fitness (16 comments total)

I can't answer all your questions, but,

I was on Celexa for about 3 years. I found it had very mild side effects -- the worst being somewhat delayed orgasmic potential(?), slight visual irregularities and sensitivity to flickering light and Moire' patterns. Otherwise it is by far the least side-effecty anti-depressant I have been on, and I have been on a few.

Particularly, it had almost no side effects for me when going off it, unlike some drugs (*cough effexor cough*)

AFAICR it has a fairly long half-life in the body so your blood levels can be fairly stable if you miss a dose or two, but it is better not to.

However -- your reaction will be unique to you -- it is good to gather other people's experiences but your body and brain will process celexa in your own way, and you may indeed have no side effects whatsoever.

My general experience FWIW is it is best to just take the drug at the same time every day (take half doses morning and evening if you detect a spike of effect) and try to forget you are taking the drug. Don't ascribe all symptoms or feelings to it, take the drug and then focus on all the other things you need to do to beat depression. Ask your doctor how to set up the counselling: talk-talk and pill-pill and getting fresh air and exercise is a really advisable and clinically proven best approach to take to beat depression. Depression is a terrible terrible burden but one that can be beat. It really can.
posted by gnome de plume at 10:33 PM on May 18 [1 favorite]

I've been practicing medicine for about 15 years and I prescribe Celexa frequently.

It usually takes about 3 weeks for an SSRI to start working. Bear in mind that SSRIs aren't "happy pills"--they don't cause elation. The main effect is numbing of the emotions. For most people, numb is better than depressed. YMMV.

Suppression of the libido is fairly common, as is difficulty reaching orgasm. This bothers people less than you'd expect.

SSRIs usually have little affect on sleepiness/alertness. With Celexa, I would guess 50% have no effect, 30% are a little more sleepy, 20% are a little less sleepy.
posted by neuron at 10:47 PM on May 18

My SO takes Celexa. In general, he doesn't suffer many side effects at all. When he's first going on the drug, he claims to feel more energized and peppy. But it's nothing serious. There are no lasting symptoms that he suffers from, normally.

With that said, when he goes off Celexa, it gets bad. Withdrawal from Celexa (at least for him) can put him in a far worse depression than he is ever in, otherwise. He feels miserable, he will stay in bed for days at a time, he has no energy what-so-ever, he will stand in the kitchen and just start sobbing. He has also had some... Well, he says they're not exactly like hallucinations, but something like it. (I don't really understand that part.) It is very, very not fun.

The reason he suffers all this is because he usually goes off Celexa cold turkey (he forgets to pick up his prescription, or he forgets to get a new prescription from the psychiatrist, or... whatever. After this happened twice, I took a more active role in ensuring that it doesn't happen again). Do not go off Celexa cold turkey. If you want to stop taking the drug, please talk to a doctor ahead of time about how to slowly get off it.

Also, I know that the science says that Celexa stays in your system long enough that missing a dose or two shouldn't matter.. But I swear that I can tell when my SO has missed just a day or two. He'll be in a particularly awful mood, in a way that just doesn't seem right, and then I ask, "Hey, did you take your Celexa?" and, sure enough, he hasn't. But this may just be confirmation bias or something.
posted by Ms. Saint at 10:48 PM on May 18

If you just took it today for the first time I'd say you're experiencing the placebo effect.

I took it and all it did was make me yawn. Non-stop. I gave up pretty quickly.
posted by You Should See the Other Guy at 10:53 PM on May 18

I've been on Celexa for anxiety and depression for six months, starting at 20 mg and then to 40 mg. It definitely levels my mood. I don't get uncontrollable fight-and-or-flight reactions anymore, I haven't lost my temper once in the last four months (which is unusual) and my negative inhibitions are much less prominent than they used to be. I feel more 'normal'. I'm working full-time and dating again. Six months ago, this would have been impossible.

Side effects for me for the first couple of months: trembling, sleeplessness, restless energy, reduced appetite, rapid weight loss (20 pounds in two months). These side effects went away. Long-term side effects for me: irregular bowels (both constipation and diarrhea), difficulty waking up and somewhat delayed orgasm. I'm good with all of the above.

No reduced libido for me.

I take it first thing in the morning.
posted by ten pounds of inedita at 11:37 PM on May 18

I've been on 20 mg for about two months.

For the first month:

1. mild feeling of scalp tightness, almost like high blood pressure in the cranium. It's completely a nerve thing, and it went away.

2. trouble ejaculating. Couldn't come to orgasm without difficulty. After a month, that went away. All back to normal now.

3. for the first couple of weeks, mild bouts of "mania" - mostly, just feeling a little giggly and silly. Slightly high, you might call it. Very mild. It was actually kind of nice.

4. one very mild "brain zap" moment as I was drifting off to sleep. (Google Celexa and "brain zap", you'll find it.)

I've a tendency towards slight headaches, which makes me wonder about intercranial blood pressure again, but I also have sinus problems, so this may be entirely unrelated.

I take it in the morning, because I have trouble sleeping at night and I don't want to risk anything that might "amp" me up and contribute to that. I have never noticed drowsiness from it.
posted by Cardinal Fang! at 1:06 AM on May 19

- during the build up, I had about four days of feeling dizzy, sick and sleepy. Had to stay in bed. After about two weeks I had no side effects apart from inability to sleep. I changed to taking it in the morning and after that it was ok.

- when in system: I didn't experience any effect on my mood. After a few months the dose was increased from 20 to 40mg. After about three months of the higher dose I started to have episodes of dizziness and blurred vision, which my doctor said were caused by the drug, and took me off it.

- withdrawal: I initially stopped taking it cold turkey. This was a mistake. I felt as I had done when I started to take it, and had to have the same amount of time off work. I also experienced "brain zaps". I then restarted taking a lower dose and came off it gradually over about a month, with no withdrawal effects.

Hope things work out for you. You might find the Crazy Meds site useful.

(Just in case anyone's searching for similar advice in the future - this drug's generic name is citalopram, has different brand names in different countries.)
posted by paduasoy at 2:01 AM on May 19 [1 favorite]

I've just been put on it. My doctor was originally going to put me on prozac, but I said I'd had sexual problems with prozac, so he switched me to citalopram/celexa, because apparently the sexual side effects aren't so bad. YMMV.
posted by Infinite Jest at 3:48 AM on May 19

My experience was this:

It takes several weeks for it to start working, but knowing that "help is on the way" made me feel better during those first weeks.

It didn't numb my feelings. Instead, without it everything was gray. It lifted the grayness, if that makes sense. I was still sad sometimes, happy sometimes, and so on... but my emotions were appropriate to the circumstances instead of just depressed no matter what was happening.

It made me sleepy for the first few weeks, so I decided to take it at night. That worked well for me, as I was not sleeping at all beforehand.

The first few weeks, I had the light-flickering thing. It was a bit like a fluorescent bulb that was not screwed in correctly -- fast flickering of light. It was weird, but not debilitating in any way, and went away after a few weeks.

Beware of drinking! When I first started taking it, I had 2 regular-sized drinks at a restaurant, and was completely falling-down drunk. When I went back to my doctor, I told him about this and he said he'd forgotten to mention it, but drinks have a stronger effect at least at first. If you drink, line up a ride home just in case.

Hang in there -- the medicine works. Every day you'll be a little better, and in a few weeks you'll be back to normal.
posted by Houstonian at 4:36 AM on May 19

I don't have experience with Celexa, but I wanted to pop in and be supportive about setting up those counseling sessions. The easiest thing would be to go to the website of your insurance provider. Almost every recent insurer I have had lets you search for participating providers on their website. Sometimes you need to set up a log in or input information about your plan. Once you have a list of mental health providers, look through to see who is conveniently located and call up a few of them. You almost always get an answering machine or office staff. Pick the one that sounds the best! Also, if you don't know already, you can call up your insurer to find out what your mental health benefits are. You'll be able to find out the costs and amount of visits per year this way. Best of luck to you.
posted by theantikitty at 6:48 AM on May 19

When I took Celexa years ago, I found that it lifted the depression, but I still didn't feel normal. I didn't really notice any side effects, but I was taking a pretty low dose.
I later took Prozac, and that helped stop the depression and anxiety episodes (I knew I was pretty bad off when I didn't sleep one night because I was afraid of the invisible monsters in my apartment - it's especially scary to be able to *see* yourself going crazy!) but I did feel pretty numb all the time. It was perfect for starting out treatment to stabilize me, but not good long-term.

I was eventually diagnosed with - not depression or anxiety - but ADHD. My brain was working so hard to keep up with itself that it screwed everything else up. Explained a lot. So I went on Wellbutrin instead. Generally people either love it or hate it - it's been amazing for me, with very little side effects, but I know many here were miserable on it.

Anyway, I tell you this to, in addition to just someone else's experience, illustrate that for many people, it's a matter of trying different things, and everyone responds differently. Also that what works for you at the beginning may not be what works later.

Also, I hope you feel better soon!
posted by dust.wind.dude at 8:23 AM on May 19

took Celexa for 2 years with good results, switched to Paxil during a particularly bad time in my life, had bad results with Paxil, stopped taking everything altogether, and 2 years later started taking Celexa again. Which, seriously & truly, has vastly improved my quality of life yet again.

To answer your questions:

- What can I expect from Celexa during the build up?
During the first month or two, I find that I experience few of the beneficial results but (1) serious sleepiness, and (2) sexual side effects, namely inorgasmia. More about that later. I also experience increased carb/sugar cravings, so I have to consciously force myself to ignore them.


- What can I expect after it gets into my system?
Subtle, gradual changes in your mood. You may realize that over the next few weeks, things don't seem as bad and hopeless ... you may find that it's easier to reason with yourself to just "knock it off" when you start dwelling on something. It's really, really important to be aware that the changes really are subtle and gradual. You are not suddenly going to wake up thinking "OMG THIS IS A GREAT DAY! I LOVE LIFE! I'M GONNA CLIMB A MOUNTAIN FOR FUN AND THEN JOIN THE CIRCUS!" Even after being on Celexa for awhile, you will have bad days. But things will seem better and you may be more able to work through bad feelings.


- When's the best time to take it?
It makes me very sleepy, especially at first, I have always had to take it right before bed.

- What are the real sexual side effects?
When I first started taking it, I couldn't orgasm even when I really wanted to for a couple weeks. It was terribly frustrating. After a few weeks, I found that I could, but it took a bit longer and felt different...maybe even a little better than before. After about 2 months, things are back to normal, completely. No change in libido, no problems with climaxing. This is different for everyone, but I have heard LOTS of first-hand experiences of having a couple months of sexual side effects that later went away on Celexa.


- Does occasional marijuana use affect Celexa at all?
I can't comment on this, I have no firsthand experience. Alcohol doesn't seem to affect Celexa in my experience.
posted by tastybrains at 8:32 AM on May 19

Oh, just a couple other things:

My doctor has also strongly suggests counseling sessions, though I have no idea how to set these up, or how to find one in my area.

Do you have health insurance? If so, call them and they can help you find something. If not, try the phone book. And in the meantime, you might want to pick up a CBT workbook so that you can work through some new behaviors on your own. I recommend the Feeling Good Handbook.

And if it has any bearing, I reacted negatively to paxil from the get-go. I was still very depressed, but after taking Paxil, I was flat and almost emotionless, extremely sensitive to light, and slept nearly 16 hours out of every day. I stopped eating, yet gained nearly 50lbs while I was on it.

IMHO, Paxil is the most evil drug on earth. I gained 70 lbs in one year while taking it (which I lost very easily after stopping taking it). I felt like crap on it, and the withdrawal was a bitch. I was a horrible person on it, and I was a horrible person while weaning myself off of it. For me, Celexa has worked completely differently. I just feel like a more balanced person on it, but I'm certainly not flat or emotionless. I am a little more sleepy than usual, but I'm talking about maybe wanting 9-10 hours of sleep instead of my usual 8. So it's not a huge deal, and I can get by on less with a strong cup of coffee.
posted by tastybrains at 8:36 AM on May 19

I've been on Celexa since October 1998 (back when it was the brand new SSRI in town), with the exception of a few short periods -- totaling a few months -- when I tried life without it. Here is my experience:

• Beginning: For a long time I resisted the (inevitable) conclusion that there was a "problem" -- I was convinced I could "pull myself up by the bootstraps." When I finally did go to a doc, I was skeptical that the medication he prescribed would work. I had essentially written it off after four weeks with no noticeable improvement, when almost overnight, my world simply didn't feel so "dark." In the nine years since that time, I've gone off the drug (Celexa) twice, diagnosing myself "cured." Both times led, eventually (not immediately), to a return of the depression, and both times resuming the treatment (eventually) got rid of it. For me, this is not a placebo effect. (From a previous post).
• Side Effects: About a 10 pound weight gain that I haven't had much luck shaking. It's kind of like my "baseline" shifted up a bit, then stubbornly stayed there. I have had no sexual side effects. I disagree strongly that Celexa "flattens" your emotions. In fact, flat emotions were my problem to begin with -- I wasn't the "crying non-stop can't get out of bed" type of depressed. I just simply felt like the pleasure and joy had seeped from my life. Celexa restored that "color."
• Withdrawal: Not good. Must be done very slowly and very carefully. Even then, on the two or three occasions when I've stopped, I haven't been able to avoid the zaps, and I feel generally crummy for a while.

In general, I truly feel like Celexa has been a godsend for me, and I don't foresee coming off of it anytime soon. Your mileage, of course, may vary.
posted by pardonyou? at 8:53 AM on May 19

Forgot to say that I also had about ten days at the start of jaw clenching - sounds minor, but was actually quite hard to deal with.
posted by paduasoy at 2:46 AM on May 20

Ah, forgot about that -- also had a couple of weeks of jaw clenching.
posted by ten pounds of inedita at 7:09 AM on May 20