Can citalopram cause depression?
January 31, 2011 10:20 AM   Subscribe

Can citalopram cause depression?

I've been on 10mg for panic disorder for the past 6 weeks. They really, really helped with the panic attacks....but i find myself now in a situation significantly worse. I just want to cry all the time. I get no enjoyment from anything, am irritable, can barely finish a sentence because it doesn't feel worth the effort. I've gone through periods of depression before but nothing like this. This is like a sickening blackness that robs every moment from me. I cannot, cannot go on like this. I mentioned this to my doctor this morning who said 'antidepressants can't make you depressed, just stick with your medication. It's probably just that now the anxiety has lifted, it's revealing pre-existing depression'.

I don't know about that. Perhaps. Just....HELP basically. I don't know what to do, who to turn to. I don't trust the NHS and I'm not in anything like the right frame of mind right now to properly evaluate my decisions.

Fuck this.....and sorry if this has been answered elsewhere. I just need help from somewhere. Please.
posted by deticxe to Health & Fitness (13 answers total) 2 users marked this as a favorite
Are you very young? Like many antidepressants, this is one that can have that side effect, usually in younger people.

I'd see a different doctor immediately. It's shocking that they didn't know that. Look at any TV commercial for antidepressants -- they always include this in the rapidly-muttered warnings while they're showing people frolicking in slo-mo on the beach.

Hang in there. This isn't your fault.
posted by Gator at 10:25 AM on January 31, 2011 [1 favorite]

Can you call NHS direct or get a second opinon from another doctor?

Antidepressants can absolutely cause depression as well as suicidal ideation. Unfortunately, you can't just stop taking it because of discontinuation syndrome. You need a doctor to assist you in getting off them and trying something else - but obviously not the doctor you've been seeing.

If it gets too bad you could try going to A&E?
posted by elsietheeel at 10:26 AM on January 31, 2011

Whether or not it's the citalopram causing you to feel like this, the fact is that you do feel like this and you need help with it, now. Your doctor isn't helping, but that doesn't mean you can't trust other doctors, or the NHS in general, to get you that help.

See a different doctor. You're not restricted to 'your' GP; you can phone the surgery and ask to see someone else. And when you do, it might help to write down how you're feeling at the moment; in my experience it tends to be easier to communicate with doctors that way, and you won't have to worry about missing anything out or under-representing how bad you're feeling. You can also phone NHS Direct on 0845 46 47 (in Scotland, 08454 242424). And if you feel like you're in danger of hurting yourself in any way, you can walk into an A&E department and tell them that; they will help you.

You don't need to deal with this alone, and you don't need to let one inattentive, neglectful doctor prevent you from getting help.
posted by Catseye at 10:34 AM on January 31, 2011 [2 favorites]

Response by poster: I'm 20. My doctor seemed like she really was listening to what i was saying, but yeah it's kinda shocking she didn't show more concern about my mood than just 'come back in a month'. A month sounds like a LONG time when you feel like this. Especially as i said right off the bat 'i don't want to take these anymore. they helped with my anxiety but i feel desolately, sickeningly depressed'. There's TV ads for anti-depressants? Jesus.


My theory is that when you feel depressed and suicidal, citalopram gives you the motivation and energy to do something about it. It sort of....energizes me. Some time last week something snapped inside, something broke down. It could be a good thing, that i'm finally confronting these feelings, this darkness inside me. But i can't control it, it's too much all at once. I think the drugs have opened the flood gates, just not in a controlled way, not when i'm ready for it.


blah blah..

My doctor is...i haven't a clue. She's the fourth GP i've seen and they've all said the same thing, right from the 'take these pills...' at the very beginning.

Whether or not it's the citalopram causing you to feel like this, the fact is that you do feel like this and you need help with it, now.

Yes. I'm placing an unnecessary burden on the people around me at the moment. I need some kind of professional help, someone who isn't a GP. I have an appointment with a therapist on Thursday, hopefully something good will come of that.

Everything that's been suggested here is good, i will act on much of it. It's so difficult....when you're in a vulnerable state you don't have the insight to demand from the start 'i want to see a proper psychiatrist, give me a referral,' etc.

Thank you all for your supportive help.
posted by deticxe at 11:00 AM on January 31, 2011

deticxe, I have a very close friend dealing with exactly this, right now. On a visit to a GP for a neck injury, she mentioned feeling depressed and was prescribed Celexa (citalopram) one week ago, and since then she's been feeling significantly worse, with symptoms like you described... including mild suicidal ideation (fortunately with a strong support system at home). She described it as feeling "down before, but unbelievably miserable now."

She called back the doctor, who said this is "normal" and it can take weeks to see the "real effect" of the meds. My friend has zero experience with anti-depressants; unfortunately, so do I.

I told her she should talk to a psych and not a GP about this (since SSRI might not even be the right Rx, and I frankly didn't care for the dismissive, "there there, give it time" response).

I know this isn't much in the way of a "do X or Y for a solution" answer but I hope it helps to know that this is common, and that you weren't really "pre-existing depressed" (what crazy talk).
posted by pineapple at 11:13 AM on January 31, 2011

I agree with Catseye. You should find a doctor and a psych person who will work for you, and you should do it soon. Even if you feel that you can't bring yourself to pick up the phone and dial, that you can't have a conversation with one more receptionist-- you need to. Remember: there's a constellation of folks who care about you. Lean on them, and if you can't get them on the phone try the Samaritans at 08457-90-90-90. You can do it!
posted by The White Hat at 11:24 AM on January 31, 2011

I don't have an answer to your specific question but I have general advice about depression.

I'm placing an unnecessary burden on the people around me at the moment.

Don't think this. Absolutely reach out to the people who care about you, let them know it's dark days right now and you need their help, you need some company, you need someone to check in on you. (You would do the same for them if they were in trouble, right?) You are very smart and brave to be doing things to get help for yourself with this heavy - but temporary - burden. Remember, you didn't feel this way a short time ago. It can go away. It is not forever.

Here's a link to the There Is Help part of the Mefi Wiki page, which collects a bunch of helpful threads about depression and related issues. (Just in case it's helpful to read about what other people have gone through and how they've coped during the dark times.)
posted by LobsterMitten at 12:21 PM on January 31, 2011 [1 favorite]

Talk to a psychiatrist. The GPs you've seen obviously don't know how to deal with what's happening to you.

Hang in there. You will get through this.
posted by shponglespore at 12:25 PM on January 31, 2011

I've been there, and I've found better results with other meds. For me, Prozac is the safest. I was on Celexa for a few months and it was the most useless time in my life. And I was 20.

Do NOT beat yourself up. You need to be there for you. You need to be your own ally. You will find the right treatment. Don't doubt it. Just keep putting one foot in front of the other. Take is all one step at a time. You're doing so great! I know, it sucks. But look, you're surviving and you're taking it on!

I think 6 weeks is a great time to determine that you need to change it up. I, for one, think you're right on. Ask about switching or adjusting your dose. Stand up for yourself enough to let the doctors know that you are suffering and UNWILLING TO SUFFER FURTHER. If you have to write feelings like this down and read them in order to have the nerve, do it. Tell them it's worse than it was and that you won't keep taking the pills if you keep feeling this way. Tell them something has to change. This is how you have to act sometimes as a grownup to get your needs met. You can't put yourself totally in their hands. You have to speak until you are heard. Say "I want a referral to a psychiatrist, right now."

Yes, they are the experts. That means they should be able to, with reason and data, convince you of what's right, and can work with you to scientifically determine the most effective course for you as an individual. It doesn't mean you have to take their first suggestion and live with it forever. Doctors basically guess and narrow down from likeliest malady and cure to unlikeliest. You have to make it clear that their cures-87%-of-people-pill has NOT WORKED here.

Keep talking to the people in your life who love you and whom you trust. Don't shut yourself off. That may be hard, but you need to stay in touch. Get sunlight and eat healthy if you can. Take a vitamin, drink water. Those things do help. For me, it was good just to force myself to do a block of things that were "good for me" every day so I felt not-so-hopeless-and-out-of-control. You're in charge, you're capable of self-actualization and you're on your way.
posted by Ambrosia Voyeur at 1:54 PM on January 31, 2011

As others have said, yes, it can make you worse. Usually that's a short term thing. You may find that you have to try several different anti-depressants before you settle on one that suits you. If you are finding it seriously difficult to wait it out, I suggest you go see your doctor and work on trying another one. Generally it's just the intermediate period, but if you are having trouble lasting through it then go see your doctor.

Seek help from your friends and family. If you let a few people you trust know what you are going through it will make it a lot easier for you to deal with. It's rough, I know.
Some general tips: Try to get outside, every day. Walk for half an hour. If you have a whole day with nothing to do, make an appointment early in the morning so you can't sleep in, and have to get up. Read. Go down yo the library and find some good books. Good luck.
posted by Dillonlikescookies at 3:07 PM on January 31, 2011

Please see a psychiatrist if possible. I know it's not simple to get referrals to specialists on the NHS, but if it's at all possible do so.

GPs simply can't keep up with all of the various possibilities for side effects with all of the various medicines out there for all of the various and sundry illnesses they treat. That's why there are specialists.
posted by Sidhedevil at 3:13 PM on January 31, 2011

I firmly believe in CBT (Cognitive Behavioral Therapy). A psychologist that specializes in this kind of treatment will be extremely helpful to your situation. I have panic and anxiety disorder myself, and CBT changed me from basically turning into an agoraphobic into leading a normal and enjoyable life.

I've been through several SSRI's in order to find one that works for me. Fluoxetine (Prozac) didn't. I'm now on Citalopram (30mgs) a day, and it works really well. I still get anxious when I am under a lot of stress, but the panic attacks have gone away almost entirely.

Yes the doctors are the experts, but they do not feel what you do. If you believe that the citalopram is making you feel worse, talk to a different doctor that will take your concerns seriously and perhaps offer alternative approaches.

While it's true that SSRI's can make you feel all kinds of crap in the first few weeks, there is a difference between feeling more anxious (a side-effect of many antidepressants) and feeling as if you really cannot cope. Trust yourself.

Good luck and stay strong. If you ever need to talk or just ask questions, no matter how stupid you might think they sound, feel free to MeFi mail me. I've been there.
posted by New England Cultist at 7:47 PM on January 31, 2011

BTW, if you can, switch to ecitalopram, which has all the benefits, without most of the side effects (for most people).

Citalopram is composed of equal parts of two mirror-image molecules. Ecitalopram is one of those two; it turns out that many of the side effects are caused by the other.

Natch, the drug company that makes both only discovered this just before the patent on citalopram ran out, by some incredible coincidence. Fuckers.
posted by IAmBroom at 8:27 PM on January 31, 2011

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