Tell me about your experience on Citalopram (Celexa / Cipramil).
November 18, 2009 6:58 AM   Subscribe

I'm about to start a course of Citalopram (Celexa / Cipramil). What should I know in advance?

Despite some serious misgivings I've decided to try antidepressant medication for some ongoing depression/anxiety issues. I've been prescribed 20mg of Citalopram to be taken every morning and will be seeing my GP (in the UK) for supervision at regular intervals. I'm hoping that after a few weeks my sleep pattern will be back under control and my judgement less impaired by low mood, anxiety, and exhaustion. If that works out then I'll be in a better position to tackle any underlying issues and generally stop making so many dumb decisions. Here's hoping, anyway.

If you have any experience on Citalopram (Celexa) or similar SSRIs, is there anything you wish you'd known before starting? I'm aware of the potential side-effects and withdrawal symptoms and at this point I'm prepared to take my chances. I'm most interested in your thoughts on the first 8 weeks or so of being medicated. If you'd like to add a comment anonymously, send me a mefimail and I'll paste it in below.

I'll take the first dose this Saturday after asking a GP friend for a second opinion. Can you think of anything I should ask that hasn't been covered above?

(I'm not seeing a therapist, but I am going to start working through Feeling Good as soon as I can. Previously I've used online CBT but found it overwhelming. If you want to talk about therapy, could we do that by mefimail instead? My diet and exercise regime are okay and pretty crappy, respectively. My family/social support network is good.)
posted by SebastianKnight to Health & Fitness (21 answers total) 5 users marked this as a favorite
You mention awareness of it already, but let me emphatically say do not quit cold turkey when you start feeling better. It made me hallucinate and generally feel like crap.

It took me about six weeks to feel stabilized after starting your dose of Celexa, but it was prescribed to me after a pretty serious bout of depression / anxiety. After running out (and hallucinating, see above), my doctor put me back on and upped the dose to 30 mg. To be honest, my life was pretty rough around that time. I did experience increased thoughts of self-harm suicide; I don't know if it was because of my situation or if it was the increased dosage. I told myself it was the increased dosage and soldiered on; about three weeks later I was feeling all better.

Still, do ask your GP what to do if you feel increased (or new) thoughts of self-harm or suicide, and follow those recommendations if they happen. And, if you've found CBT to be overwhelming, but find yourself frequently making 'dumb decisions,' may I recommend looking into Dialectical Behavior Training? DBT is making all the difference in the world to me.
posted by motsque at 7:06 AM on November 18, 2009 [1 favorite]

Checklist for people with mental health problems: questions to ask your psychiatrist

I've been on citalopram, friend's been on citalopram. She had the worst side effects I've ever seen; I had absolutely no side-effects until I came off them.

20mg did nothing for me, I had to be bumped up to 40mg. Took me more than eight weeks to properly start feeling better.

I feel that I can't really tell you anything useful as reactions to psych meds are so idiosyncratic.
posted by Coobeastie at 7:09 AM on November 18, 2009

I take citalopram for Seasonal Affective Disorder (SAD). 20 mgs per day, in the morning. I've been taking it for six years.
It took about 10 days for the grey cloud to lift. Side effects in the beginning: slightly dry mouth, decreased appetite, a little dizziness when spinning around playing with the dog. [vaudeville doctor voice: "so shtop shpinning awound!"]

You write "Despite some serious misgivings..."
Please try not to have misgivings. citalopram/Celexa is a terrific SSRI.
posted by BostonTerrier at 7:27 AM on November 18, 2009

Response by poster: Thanks for the responses so far.

BostonTerrier - Purely out of curiosity, do you take the meds all year or just during the winter? If the latter, how do you manage those transitions, and isn't that bad for your noggin'?
posted by SebastianKnight at 7:33 AM on November 18, 2009

Anecdata: Celexa dramatically changed the way I interacted with alcohol. I'd always been a take-it-or-leave-it social drinker in the past, but started seriously craving booze when I went on Celexa, to the point of regular, solo, problem drinking.

This may have had something to do with compensating for the numbed affect I experienced while on the meds -- as though my heart had been removed and replaced by something stainless steel and Swiss-engineered. I was functional, all right, but felt horribly empty the whole time I was on it. Drinking inevitably made me teary, which was at least some feeling.

Also, while on Celexa, I started experiencing memory loss after only a couple of drinks -- I would be lucid and functional and only slightly tipsy to all appearances, but later would recall little of what had happened. YMMV.
posted by stuck on an island at 7:43 AM on November 18, 2009

Oh, and I also suffer from SAD, which means general system slowdown, grogginess, constant need for sleep, depressed mood etc. at about this time of year. It is particularly bad in the UK, where hours of daylight decrease so fast around the time the clocks go back. Celexa, while I was taking it, didn't do nearly as much for my SAD as daily bright-light therapy, regular outdoor exercise and occasional vitamin D hits in a tanning booth do now.
posted by stuck on an island at 7:53 AM on November 18, 2009

I've been on various antidepressants on and off over the years. Several friends have had great success with citalopram, but it's the only one that actually made me more wacked out. One morning I found myself muttering obscenities and working myself into a physical rage as I did my laundry. It wore off soon after my then-boyfriend and I got into a huge tizzy, then backed off, but it was scary for me to be so clearly not myself. But, like I said, I've tried bupropion, fluoxetine, venlafaxine and whatever Zoloft is, and this is the only time I've had something backfire like that.

If this is the first time you've been on antidepressants, particularly if you have a bad reaction to citalopram, PLEASE do not give up on the idea of medication in general.

Be gentle with yourself while you're working out what dosage/medication works for you, and if you're able to share with some people close to you that there may be a period over the next few weeks when you may be a little "off," do so. If you don't have that luxury, you'll probably still be fine, but it can help to know.
posted by Madamina at 7:55 AM on November 18, 2009

Make sure to take it regularly (every morning or evening, whichever you choose).

If, after several weeks, you think it's giving you unmanageable/unacceptable side effects, ask your doctor about trying a different SSRI.
posted by needs more cowbell at 8:03 AM on November 18, 2009

I've been on 20mg of Citalopram for a year, and have had no side effects whatsoever, luckily. I tried other SSRIs before and the side effects I've experienced have ranged from always being tired to always being anxious and even a case of hives with Welbutrin, so I'm glad that Citalopram is working so well for me. It's interesting that stuck on an island brings up drinking more on the drug; that's happened for me, too. However, I thankfully have none of the empty feeling that she mentions. I think I drink more now because a combination of circumstance (moved into a city where I can walk to bars) and being more comfortable going out due to my increased self-confidence from Citalopram (plus CBT).

((I know you mention no therapy, so for the benefit of others reading the thread: By the way, I have to recommend the treatment of anti-depressants and therapy together. I've been on anti-depressants with no therapy before, and therapy with no drugs, and the two working together has been a wholly positive experience that is actually allowing me to become more of the person I've always wanted to be, which had never happened in the past.))

Finally, I was just as apprehensive as you sound about going on Citalopram. The drugs did their magic and completely erased that thought from my mind. :) But seriously, it was a really good decision and I'm so much more at peace with myself and my surroundings now. Of course it's an on-going process, probably for the rest of my life, but I'm finally comfortable accepting that as my journey. That's enough flaky abstractness. Best of luck to you in feeling better!
posted by lagreen at 8:10 AM on November 18, 2009

In answer to your question, SebastianKnight, I take it all year long. My head doctor indicated that it would indeed cause noggin-problems if I went off it for the six-month spring/summer period. No long-term bad effects.
posted by BostonTerrier at 8:19 AM on November 18, 2009

I had a similar problem to stuck on an island, except with food. I mindlessly craved sweets all the time and didn't even really understand that I was eating tremendous quantities of junk until my boyfriend finally said something.
posted by cabingirl at 8:37 AM on November 18, 2009

Response by poster: This is terrific stuff everyone - keep it coming.
posted by SebastianKnight at 8:51 AM on November 18, 2009

Crazymeds is also a good resource on specific anti-depressants.
posted by sharkfu at 9:01 AM on November 18, 2009

I began taking citalopram just this year for anxiety. I started with 20mg and under my Dr's supervision went up to 40mg over a 4 week period of time.

It's made a dramatic difference in my life. I was also skeptical, nervous etc... about beginning an SSRI and I'm so glad I chose to take the plunge. My anxiety levels have decreased, I have more energy and feel involved with my life again.

Some things to keep in mind: [I've been on it for about 4 months now]

- I felt very strange the first few days of taking it. My head felt funny, kind of loose and tight all at the same time, I could feel my teeth and my eyes felt slow, like they couldn't keep up when I turned my head. This all evened out within a week or so and from all that I've read and been told is totally normal. I was basically high for a few days.

- I did experience some loss of appetite, nothing major. Food tasted different at first, but this went away after a few weeks.

- Figuring out which time of day to take it - I began taking it at night as my Dr said it might make me tired. I've always had problems sleeping so I figured it was this was best choice. It certainly made me tired and I fell asleep much quicker than normal, but I would be wide awake exactly 5hrs after going to bed. I hung in there for about a week, but the lack of sleep finally made me change to taking it in the morning. This also didn't work out so well as I'm not a morning person and it did make me more groggy. I now take it right after lunch and have been for the past 2 months. Taking it with food seems to combat most of the grogginess and I usually attribute any tiredness to a food coma :)

It's been a surreal process. The anxiety began slipping away from me slowly, almost undetected until one day I realized that I hadn't experienced my usual heart racing, skin buzzing nervousness. This was probably at about the 2.5 to 3 week mark. I kept feeling better and better and evened off at about 6 weeks.

I can't even begin to tell you how much more brain space I feel like I have. It was a real eye opener to see just how much of my time, emotional and physical energy was being taken up by anxiety. I'm still myself, just a much more present, grounded version.

I hope this helps!
posted by Constant Reader at 9:19 AM on November 18, 2009 [1 favorite]

10 mg Lexapro (Escitalopram, the stereoisomer of Citalopram) daily. Been a few months now.

Within an hour of the first dose, felt it coming on like Ecstacy. In five hours, I was off like a rocket. Three days of sparkles and pixie dust coming off me. Wow.

Almost-waking dreams - slipping into a dream state within seconds of lying down, not even asleep yet. Vivid, very realistic dreams, very coherent. Lasted about a month or two.

I've settled down a lot since then. Take it at night, the grogginess during the day is awful, about 5-6 hours after I take it.

The downside: loss of libido, anorgasmia, erectile dysfunction. Totally not cool. I stop the meds three days before going on a date, helps a lot.

If I quit for awhile: The brain zaps start about 36-48 hours after the last dose. 72 hours later, they come in brief flurries. If I go a week without, they occur every 5 minutes in strong staccato bursts. I have not gone more than a week.

Cigarettes took on a whole new meaning for me on the meds. I had quit for 18 years. After starting the meds, was consumed by the urge to buy a whole pack - not even the urge to smoke, but the jump in, whole hog. I did, after a few weeks of resisting. Cigarettes now act as significant mood lifters, not just a pick me up. Some cigs are almost like an orgasm.

I woke up to a 5 minute long interrupted orgasm in the middle of the night once. It was somewhere between frighteningly funky, and totally awesome. Nothing came of it *cough*. Shrink laughed, said it was a known side effect. Only happened once. Felt like my pecker was tied in a knot.

Smells smell better, sunlight feels totally awesome - now I know why people sunbathe. Food is better. People are happier around me - yeah, I know, crazy, it's just perception, but I like people a LOT more than I used to. Despite the libido issue, I am attracted to women much more...and I feel like it's reciprocal. It is. It's very cool. Like I said, sparkles and pixie dust coming off me. Everyone around me picks up on my energy and feedsback to me. Very, very cool.

Dark thoughts are much easier to banish. A lot of that is due to therapy, but I can't discount the meds. Though things are really bad right now, I am ready to kick ass and take names.

Your mileage may vary. :)
posted by Xoebe at 10:16 AM on November 18, 2009 [3 favorites]

I took brand-name Lexapro rather than citalopram, but they're supposed to be almost identical (at least according to my insurance company who didn't want to pay for the brand name) - so, this may not apply but I thought I'd throw it out there anyway.

I was taking it for anxiety/panic disorder. The minimum therapeutic dose is 10mg, IIRC. When I took this dose, I couldn't sleep for days. Days! Dropping down to 5mg did the trick.

Supposedly the hypomania that the 10mg dose triggered isn't all that common, but it's not unheard of. So, just something to be aware of.

As for withdrawal when it's time to stop - I tried unsuccessfully, twice, to go off of it, but the side effects were intolerable. Evidently third time's a charm - it can be done, but you really do need to be in the right place, emotionally speaking, to do it.
posted by chez shoes at 10:17 AM on November 18, 2009

When I first started Celexa I was tired all the time and I would sleep for about twelve hours every night. It was awesome.
posted by Dr. Send at 10:24 AM on November 18, 2009

I've been on 30 mg/day of Citalopram for 2 years now to treat generalized anxiety and moderate depression. I started at 10 mg and increased by 10 mg every week in an effort to get up to 40 mg/day. 40 mg made me feel wired and out of sorts, so I went back down to 30 mg and have stayed there ever since. I did not have any memorable side effects. Although, since it's not recommended for pregnant women, I'm not looking forward to what will happen when I have to go off the Citalopram and/or switch to a safer medication in the near future.

I was lucky that the first medication I tried has worked well for me. I can honestly say that seeking help and going on medication is the BEST thing I've ever done for myself. Listen to Madamina's advice: Don't give up on medication if this one doesn't work for you. I wish you the best of luck!
posted by clpage at 10:35 AM on November 18, 2009

The first night I took this drug, I was sicker than I've ever been in my life. Like, puking and diarrhea at the same time (literally) sick. I contacted my doctor, and she said not to take it anymore.

So, if something like that happens to you, and I really hope it doesn't, please let someone know.
posted by elder18 at 10:38 AM on November 18, 2009

I've been taking this medication for about four or five years. The only side effects I experienced were short bouts of dizziness once or twice a day for the first week. They were slightly alarming, but have since gone away completely and never returned (unless I run out of or forget to take my medication for more than one day, in which case I'm swiftly reminded to take more medication by a faint, almost gentle wave of dizziness).
posted by coffeeflavored at 11:51 AM on November 18, 2009

Response by poster: Thanks for the replies people - it's all very helpful. The comments on alcohol consumption are interesting as I'd just assumed alcohol would be completely off the menu whilst taking citalopram. I'll ask my doctor about this in a few weeks.

Here's a comment from an anonymous user (sent via mefimail):

I had been having awful job-related and other stress for about six to eight months. Got to the point where I had never-ending stress headaches, and super achy shoulders and neck from the tension. I also had lots of problems with calming down, not having my mind in "overdrive," etc. I started with 10 mg of citalopram and had it upped to 20 mg per day. I've been on that 20 mg for about ten months now, and it's pretty good. I'm significantly calmer. Headaches still frequent but manageable. I am not in therapy (never have been) and just got the drug from my GP when I said that I was having lots of anxiety.

I don't recall any odd symptoms in the first few days as I was getting on it, but it was a pretty light dose so that might be why

Downsides: What others have said: loss of libido is the big one.

Once or twice when I ran out or forgot to take it for more than two days, I would get really dizzy and headachy. Stopped pretty quickly once I got back on it, though.

posted by SebastianKnight at 4:54 AM on November 19, 2009

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