Citalopram side effects

May 5, 2008 8:25 AM

Citalopram: I've been taking this for two-and-a-half weeks now, with the last ten days being on 20mg. While the hand-wringing anxiety and depressed feeling seems to be fading, I am having problems with the continual desire for sleep. I've tried taking it four hours before going to bed, and last night I slept for 13 straight hours. Then when I get up, I have very little inclination to do anything other than look at the wall or mindless television. Has anyone else had these effects with Citalopram and did they get better?

I know the drug is supposed to take six weeks at least to work, but I never knew my desire for sleep would be so overwhelming. I really want to continue with these as I do feel they are starting to work, and for the first time in years feel there's colour in my life. However, I don't want to spend most of that time snoring my head off!

Also, now that the depression is lifting, does anyone have any good tips for getting motivated again? I find it hard to get anything done these days. I'm hoping that as the depression lifts, my desire to do things will increase and that the indolence and depression are related.

posted by stenoboy to health (10 comments total)

Hey, stenoboy.

I was on Citalopram for about two years. I did not have those side effects. For me, the first week or so was the worst (when I was at half dosage - 10mg). I had a lot of trouble sleeping or really shutting my brain off and I just felt very... tense. Not very encouraging for an anti-depressant! :) However, after a week or so, these feelings went away and I was left with only one nagging side-effect, which was a constant teeth grinding.

Oddly enough, I stopped taking it for awhile and, when I started up again, the teeth grinding never came up again. Huh.

So, no, I can't speak to your side effects other than to say you should suck it up for a little bit longer and see if you can power through to the "other side", if there is one. Of course, there may not be one. But you're in luck, because if it doesn't get better, there are approximately 3,000 other drugs your doctor might consider trying with you - Wellbutrin, Prozac, etc, etc..

I will tell you, though, the one thing that I think really helps getting you motivated again is exercise. Anti-depression/anxiety medication + regular exercise is pure win. Of course, finding the motivation to exercise regularly is another trick altogether.
posted by kbanas at 8:41 AM on May 5

I was on Citalopram and had excess sleepiness, which kept increasing until I could barely stay awake for 2h/day, twice a week. I quit at that point, so perhaps after then it would have decreased, but it was easier being depressed. (I was in school, not working, so I just skipped classes.) This is obviously a single person's experience, but don't be afraid to try new drugs if the side effects of one are too much for you. Side effects can really suck, and they're not always taken so seriously.

IANAD, but Citalopram is a racemic mixture, so it's possible that you'd get the same positive depression lifting effect with fewer side effects if you tried the enantiomeric version, Escitalopram (aka Lexapro or Cipralex). You should speak to your doctor about your side effects and other options.

I found I could motivate myself best with lots and lots of gifts for doing anything at all. 10 minutes of work? rent a movie as a reward. A shower? Buy new nice smelling body wash. It's the first bits that are hardest, once you've started working again you'll need fewer rewards.
posted by jeather at 9:09 AM on May 5

Hypersomnia and Insomnia are both symptoms of depression. It's not unusual for your depression symptoms to act up while you're in the process of treating it. So it's entirely possible that a little more time will get you past this phase.

That being said, if the sleepiness is more than you can work around, then a new antidepressant is certainly an option. It just depends on how you feel about it.
posted by happyturtle at 9:16 AM on May 5

I'm on citalopram as well. The zombie feeling lasts for about three weeks from your last dosage increase.

The best thing YOU can do for yourself is set a sleep cycle that you can live with. I get up at 7, go for a walk with the dog, and then continue on with my morning. Then I go to sleep at night when I get tired... which will vary between 7pm some nights, and midnight others!

If the hand-wringing has ended, it's doing it's job pretty well. The rest is up to YOU.
posted by SpecialK at 9:22 AM on May 5

If the hypersomnia doesn't get better after your body has gotten more used to the drug, you could talk to your doctor about adding Bupropion (Wellbutrin) to augment the Citalopram. It helps to improve energy and alertness, although it can increase anxiety. The effects, though, are near immediate, so it shouldn't take long to figure out if it may work for you.
posted by zachlipton at 10:25 AM on May 5

I was on it also for a while. Going from zero to 20mg in 3 weeks is pretty aggressive. You just gotta ride it out -- don't expect any sort of consistency in how you feel for at least a couple of months.
posted by randomstriker at 11:49 AM on May 5

I was on Citalopram for over two years, and had a similar problem. After the problem persisted for about 8 weeks, my doctor prescribed Wellbutrin XL to take in the mornings, as it counters the side effects of Citalopram, while letting the Citalopram do it's thing. I would talk to your doctor about your side effects and see if this might work for you as well - SSRIs combined with Wellbutrin are pretty common, since a lot of SSRIs tend to be sedating and Wellbutrin is sorta the opposite.
posted by tastybrains at 2:18 PM on May 5

Adding Wellbutrin to Citaloprom helped me enormously -- with sleepiness, general mental dullness, and sexual side effects. If your sleepiness continues to be a problem, do look into taking Wellbutrin. I did read tasty's comment -- just thought I'd amplify! I also agree with randomstriker that you might feel better in a few weeks.
posted by wryly at 3:27 PM on May 5

Is your doctor a psychiatrist or a general practioner? You really want a psychiatrist - there are dozens of anti-depressants to choose from or mix and match and psychiatrists are the expert on this.

Generally, I would expect a doctor would want to see you every two weeks if he is ramping up on a drug like this. If you are due to see him in the next couple days, it would be reasonable to call.
posted by metahawk at 3:38 PM on May 5

you can mix and match quite a bit to minimize the side effect profiles, but generally you have to get the old meds out before you start on the new ones (which generally take 3 weeks to be fully effect for most SSRI's) which can be prohibitive.

You could try splitting the dosage across the day, 10 or 5mg increments, but I suggest you consider lowering your dose. 20mg is slightly above average IIRC, and if your depression is more or less gone at that dosage then you can probably lower it and find a level which has more manageable side effects while still countering your depression and anxiety.

Other than that I would say consider trying a few other anti-depressants. assuming this is a long term problem of yours, it's worth taking the time to find one that is both effective and with minimal side effects. Most SSRI's have a wide range of possible side effects but for the most part they are minimal. luckily, there are many on the market so with a bit of work you can find the one that suits you best.

Although seeing a psychiatrist is ideal, it's not feasible for everyone for a lot of reasons. If possible go and see one or ask for a referral to a GP who deals with a lot of people with anxiety or depression.

As regards to increasing your motivation, the best things are generally exercise and a good diet. It sounds lame, I know, but it works. It's also likely your social life has suffered under your depression so working on getting out again is a good idea as well.

Hope some of that helped, but for the record IANAD.
posted by Dillonlikescookies at 10:19 PM on May 5