What's it like being on Celexa?
May 31, 2019 6:01 PM Subscribe
I've been prescribed Celexa for depression, but I'm hesitant to take it due to the possible side effects. I know everyone reacts differently to antidepressants, but if you've taken it, I'd still like to hear about your experience and whether it's been worth it. Also more general thoughts on my reasoning pro and con (within) would be great.
I've had dysthymia basically all my life, and have tried antidepressants twice in the past: Effexor (which I stopped after a couple of weeks because I couldn't deal with the side effects -- incessant yawning and diarrhea), and Wellbutrin (which I stopped after two months because it didn't seem to be doing much). Recently my doctor prescribed Celexa, but I haven't started taking it, partly because the depression symptoms have improved for other reasons, but mostly because I'm worried about potential side effects.
At the time I got the prescription, a couple of months ago, I was suffering from frequent low moods and insomnia. Around the same time I started taking some new supplements, and they seem to be working -- both of those symptoms are now much better. I figured I didn't need the Celexa. But I'm in therapy, and every time I see my therapist, she says she thinks I'm still depressed and that I should try going on the meds.
My therapist's view is that although my mood is better, I still have other symptoms of depression. I have a tendency towards negative thinking, low energy, and anhedonia, as well as some degree of social anxiety, and I'm very easily knocked off balance emotionally by external stressors, of which there are a lot in my life right now (I recently lost my job and am in a complicated immigration situation). She thinks the Celexa could help with these things and help me feel more positive and motivated.
The main reason I'm wary of trying it is side effects. The ones I'm most worried about are loss of libido and emotional flattening, both of which would suck. But there seem to be a host of other possible side effects (including insomnia, which I'm already prone to) and my experience with Effexor gives me pause.
Another reason for my reluctance is that Celexa seems to be one of the harder SSRIs to go off of -- looking online it looks like withdrawal is a real issue. If this weren't the case I'd be more inclined to try it for a couple of months and give it a chance, but I worry that if it doesn't work for me, I'll then also have to go through an unpleasant withdrawal period.
Thirdly, I'm interested in the therapeutic use of psychedelics (MDMA and psylocybin), and it looks like combining those with SSRIs is a no-no. I feel like psychedelic therapy could be a richer and deeper way of addressing my issues than an SSRI, and I don't want to preempt that possibility. On the other hand, I don't have ready access to psychedelic therapy and I don't know whether I will anytime soon. But the opportunity may arise, and if it does, it would suck to be unable to take advantage of it.
A big consideration is that the next few months look likely to be a critical period in my life -- I need to find a new job and sort out my immigration situation. These are big challenges and on the one hand, it would be awesome if the meds give me some extra resilience, energy and optimism to meet them. But on the other hand, struggling with shitty side effects could make things much harder.
So there you have it, MeFi. I'm torn. What does the hive mind advise?
I've had dysthymia basically all my life, and have tried antidepressants twice in the past: Effexor (which I stopped after a couple of weeks because I couldn't deal with the side effects -- incessant yawning and diarrhea), and Wellbutrin (which I stopped after two months because it didn't seem to be doing much). Recently my doctor prescribed Celexa, but I haven't started taking it, partly because the depression symptoms have improved for other reasons, but mostly because I'm worried about potential side effects.
At the time I got the prescription, a couple of months ago, I was suffering from frequent low moods and insomnia. Around the same time I started taking some new supplements, and they seem to be working -- both of those symptoms are now much better. I figured I didn't need the Celexa. But I'm in therapy, and every time I see my therapist, she says she thinks I'm still depressed and that I should try going on the meds.
My therapist's view is that although my mood is better, I still have other symptoms of depression. I have a tendency towards negative thinking, low energy, and anhedonia, as well as some degree of social anxiety, and I'm very easily knocked off balance emotionally by external stressors, of which there are a lot in my life right now (I recently lost my job and am in a complicated immigration situation). She thinks the Celexa could help with these things and help me feel more positive and motivated.
The main reason I'm wary of trying it is side effects. The ones I'm most worried about are loss of libido and emotional flattening, both of which would suck. But there seem to be a host of other possible side effects (including insomnia, which I'm already prone to) and my experience with Effexor gives me pause.
Another reason for my reluctance is that Celexa seems to be one of the harder SSRIs to go off of -- looking online it looks like withdrawal is a real issue. If this weren't the case I'd be more inclined to try it for a couple of months and give it a chance, but I worry that if it doesn't work for me, I'll then also have to go through an unpleasant withdrawal period.
Thirdly, I'm interested in the therapeutic use of psychedelics (MDMA and psylocybin), and it looks like combining those with SSRIs is a no-no. I feel like psychedelic therapy could be a richer and deeper way of addressing my issues than an SSRI, and I don't want to preempt that possibility. On the other hand, I don't have ready access to psychedelic therapy and I don't know whether I will anytime soon. But the opportunity may arise, and if it does, it would suck to be unable to take advantage of it.
A big consideration is that the next few months look likely to be a critical period in my life -- I need to find a new job and sort out my immigration situation. These are big challenges and on the one hand, it would be awesome if the meds give me some extra resilience, energy and optimism to meet them. But on the other hand, struggling with shitty side effects could make things much harder.
So there you have it, MeFi. I'm torn. What does the hive mind advise?
Your experience with Wellbutrin didn't do much for you. For me, I curled in a fetal position on the floor of the shower, sobbing and wishing I could kill myself.
In my experience, you have to try a bunch of different drugs and figure out what meets your sweet spot of good feelings vs. side effects.
With psychedelics, I'd be worried about doses and content and unknown quantities. When you use stuff (hello stoners, me, users of psychedelics and whatever else) you don't have a standard of how any particular formula or dose will help you.
Please embrace your experimentation - and report back to us and/or the FDA - and set a personal boundary where you realize you're feeling worse or trapped and then please bail. Most of all I hope you feel better.
All my best ❤️,
Wendy
posted by bendy at 6:53 PM on May 31, 2019
In my experience, you have to try a bunch of different drugs and figure out what meets your sweet spot of good feelings vs. side effects.
With psychedelics, I'd be worried about doses and content and unknown quantities. When you use stuff (hello stoners, me, users of psychedelics and whatever else) you don't have a standard of how any particular formula or dose will help you.
Please embrace your experimentation - and report back to us and/or the FDA - and set a personal boundary where you realize you're feeling worse or trapped and then please bail. Most of all I hope you feel better.
All my best ❤️,
Wendy
posted by bendy at 6:53 PM on May 31, 2019
I've not taken it myself, though I might end up on it or something soon, as I've also been largely dysthymic most of my life I'm starting to think.
I used to work maintaining medical records for many, many nursing homes. Celexa was hands down the most prescribed anti-depressant I saw, and they tended to have fewer quick bounces onto and then back off the med than I'd see with other anti-depressants. I still saw a lot of people try it and then get cycled off of it, but people in nursing homes get soooo many meds all the time that they're always at risk of weird interactions that require quick retreats from a new therapy.
An older acquaintance recently told me she takes Celexa for panic attacks; she said it's given her by far the fewest and most tolerable side effects of any of the antidepressants she's tried.
posted by Caduceus at 6:55 PM on May 31, 2019
I used to work maintaining medical records for many, many nursing homes. Celexa was hands down the most prescribed anti-depressant I saw, and they tended to have fewer quick bounces onto and then back off the med than I'd see with other anti-depressants. I still saw a lot of people try it and then get cycled off of it, but people in nursing homes get soooo many meds all the time that they're always at risk of weird interactions that require quick retreats from a new therapy.
An older acquaintance recently told me she takes Celexa for panic attacks; she said it's given her by far the fewest and most tolerable side effects of any of the antidepressants she's tried.
posted by Caduceus at 6:55 PM on May 31, 2019
Moderate jaw clenching at night was my only side effect on generic citalopram. It helped with mood, and the jaw stuff went away when I went off it a year later.
posted by deludingmyself at 7:01 PM on May 31, 2019 [1 favorite]
posted by deludingmyself at 7:01 PM on May 31, 2019 [1 favorite]
I took it for about two years and had no meaningful side effects. Like another poster mentioned, I took my dose first thing in the morning, and didn't have insomnia issues. And eventually I tapered off and stopped it with no problems. It really worked well for me and I'm glad I had it at a time when I really needed it.
posted by BlahLaLa at 7:02 PM on May 31, 2019
posted by BlahLaLa at 7:02 PM on May 31, 2019
I’ve been on Celexa for many years. Am a weepy mess without it, am quite normal with it. No side effects ever.
posted by Yoko Ono's Advice Column at 7:12 PM on May 31, 2019 [1 favorite]
posted by Yoko Ono's Advice Column at 7:12 PM on May 31, 2019 [1 favorite]
Celexa is a really middle-of-the-road ad in terms of side effects, general functionality, withdrawal, etc. I know a few people who were like "it wasn't quite for me" and literal dozens who feel like it does the job without too steep a cost in money, time, effort, or side effects. The biggest adjustment most people I know have done is figuring out what time of day to best take it for work productivity/least sleep concerns.
My partner calls it his "don't die medicine". Aside from the most dire outlying side effects of antidepressants, which obviously can be very worrying, for the most part if you start it and don't like it, you can stop with very little issue.
posted by Lyn Never at 7:19 PM on May 31, 2019
My partner calls it his "don't die medicine". Aside from the most dire outlying side effects of antidepressants, which obviously can be very worrying, for the most part if you start it and don't like it, you can stop with very little issue.
posted by Lyn Never at 7:19 PM on May 31, 2019
I did fine on it, but didn't like the (moderate) weight gain, so eventually came off. Obviously not everyone experiences this side effect, though, and it wasn't anywhere near the magnitude of, say, one of the atypical antipsychotics.
posted by praemunire at 7:33 PM on May 31, 2019
posted by praemunire at 7:33 PM on May 31, 2019
You should try it. Going off of it isn't normally a big deal for people who aren't taking it long-term, and if you have intolerable side effects, you won't be on it terribly long. I personally had no problems with discontinuation after four months on it.
It didn't do anything positive for me and killed what little motivation and interest in the world that I had to start with, but that's just me. I don't remember if I had sexual side effects because I didn't care. I did get significant cravings for drugs and alcohol.
posted by metasarah at 7:34 PM on May 31, 2019 [1 favorite]
It didn't do anything positive for me and killed what little motivation and interest in the world that I had to start with, but that's just me. I don't remember if I had sexual side effects because I didn't care. I did get significant cravings for drugs and alcohol.
posted by metasarah at 7:34 PM on May 31, 2019 [1 favorite]
Celexa gave me bad insomnia, so I switched to Lexapro. There was a libido loss with both, but it went away after a few weeks. My switch from Celexa to Lexapro was without incident.
posted by kerf at 7:47 PM on May 31, 2019
posted by kerf at 7:47 PM on May 31, 2019
Celexa has changed my life for the better. No loss of libido, no emotional flattening. I started feeling better within 3 days.
If it doesn't work after x number of months, your doc will help you go off of it. If you find someone to help you with your psychedelic journey plans, you can go off it. But you won't know if it works until you try.
I'm not saying you're doing this, but one hallmark of depression can be a reluctance to medicate or otherwise treat the depression, and to minimize your symptoms when faced with doing something. Depression-based lack of motivation is one hell of a thing. It's okay to try this medication to see if it helps you feel more positive and motivated.
posted by Ink-stained wretch at 8:29 PM on May 31, 2019
If it doesn't work after x number of months, your doc will help you go off of it. If you find someone to help you with your psychedelic journey plans, you can go off it. But you won't know if it works until you try.
I'm not saying you're doing this, but one hallmark of depression can be a reluctance to medicate or otherwise treat the depression, and to minimize your symptoms when faced with doing something. Depression-based lack of motivation is one hell of a thing. It's okay to try this medication to see if it helps you feel more positive and motivated.
posted by Ink-stained wretch at 8:29 PM on May 31, 2019
I took it after Welbutrin did nothing for me. It also did nothing for me.
posted by Violet Hour at 8:34 PM on May 31, 2019
posted by Violet Hour at 8:34 PM on May 31, 2019
Just take it for 60-90 days. It reads like your depression is telling you not to try a thing that might work.
Celexa really helped me with insomnia and hormonal mood shifts. I have been on and off it a few times (due to other med changes) and never had issues going off. Celexa is a little tiny lifeline for me in that even a small dose (10mg) really helps me function.
posted by fluffy battle kitten at 8:39 PM on May 31, 2019 [1 favorite]
Celexa really helped me with insomnia and hormonal mood shifts. I have been on and off it a few times (due to other med changes) and never had issues going off. Celexa is a little tiny lifeline for me in that even a small dose (10mg) really helps me function.
posted by fluffy battle kitten at 8:39 PM on May 31, 2019 [1 favorite]
On citalopram, I can go to the grocery store without working myself into an anxious frenzy. I can ride in cars. I can talk to my coworkers. I can forgive myself for mistakes.
Effexor got me through a rough time once, but the side effects were hell. It was so expensive I had to stop it abruptly and I don't really even remember that whole week. If I didn't take it at exactly the same time each day I'd feel hideous.
I can't even point definitively to any side effects for citalopram; if there are any, they're lost in the noise of growing older and living my life. A slightly shy bladder, maybe. I notice if I forget to take a dose, but more in an "oh, darn" sense than an "oh god I what have I done" sense, as with Effexor.
posted by ZeroDivides at 8:48 PM on May 31, 2019
Effexor got me through a rough time once, but the side effects were hell. It was so expensive I had to stop it abruptly and I don't really even remember that whole week. If I didn't take it at exactly the same time each day I'd feel hideous.
I can't even point definitively to any side effects for citalopram; if there are any, they're lost in the noise of growing older and living my life. A slightly shy bladder, maybe. I notice if I forget to take a dose, but more in an "oh, darn" sense than an "oh god I what have I done" sense, as with Effexor.
posted by ZeroDivides at 8:48 PM on May 31, 2019
I took Lexapro (which is escitalopram instead of citalopram). It worked well and quickly. I did not feel great for the first week; serious clenched jaw, insomnia, no appetite, but all that stopped after a few days or a week at most. I had many of the common SSRI side effects but they were generally worth it. It was not hard to go off.
posted by vogon_poet at 8:52 PM on May 31, 2019
posted by vogon_poet at 8:52 PM on May 31, 2019
I had great results with Celexa. Started working the same day I took my first dose. No side effects. Just - happiness. I felt so happy and so normal- so even keeled. For the first time in so long. And I stayed that way until I had to go off it suddenly 4 months later due to pregnancy. My doctor gave me 7 days to go off it so not much in the way of ramping down. But I was fine. Am actually considering restarting again after a 6 year break.
posted by Rapunzel1111 at 10:01 PM on May 31, 2019
posted by Rapunzel1111 at 10:01 PM on May 31, 2019
I yawned like crazy for the first week or so as I adjusted. 60mg was too much, I'm on 40mg now.
It really sucks to go off it abruptly for several days if you're a dumbass like me and forget to request a refill before the weekend. Your head feels weird like your brain is being squished. So make sure you don't stop suddenly once you start.
Other than those minor complaints, it probably literally saved my life. Although ultimately I had to add Wellbutrin too.
posted by Jacqueline at 10:30 PM on May 31, 2019
It really sucks to go off it abruptly for several days if you're a dumbass like me and forget to request a refill before the weekend. Your head feels weird like your brain is being squished. So make sure you don't stop suddenly once you start.
Other than those minor complaints, it probably literally saved my life. Although ultimately I had to add Wellbutrin too.
posted by Jacqueline at 10:30 PM on May 31, 2019
Oh, fun fact: Celexa blocks ecstasy and LSD (speaking from personal experience) and shrooms (so I'm told), so if you want to do any tripping, do that *before* you start taking Celexa, since you can't just stop and start it on a whim.
posted by Jacqueline at 10:33 PM on May 31, 2019 [1 favorite]
posted by Jacqueline at 10:33 PM on May 31, 2019 [1 favorite]
Celexa is also a life saver for me. I'm on a very small dose (10 mg), and it's made an absolute positive difference in my life. I'm taking the generic version.
My depression is under control, and so is my anxiety. Most importantly, for me? When I feel myself getting wound up about something, it slows down the winding up, so I can break out of the soon to occur Infinite Loop of Bad Thoughts/Panic/Anxiety. I can then work on calming myself down with some deep breathing, calm thoughts, grounding myself by touching something, etc.
I do get some libido flattening, but that doesn't bother me much. I have gained weight on the drug, but I think that's because I have the desire to actually eat food again, and I'm a foodie - so I like to eat lots of different foods! So - it's not the drug itself, it's that I discovered chocolate humbows because my depression lifted, and boy howdy do I want to want to eat those all the time now.
posted by spinifex23 at 11:12 PM on May 31, 2019 [3 favorites]
My depression is under control, and so is my anxiety. Most importantly, for me? When I feel myself getting wound up about something, it slows down the winding up, so I can break out of the soon to occur Infinite Loop of Bad Thoughts/Panic/Anxiety. I can then work on calming myself down with some deep breathing, calm thoughts, grounding myself by touching something, etc.
I do get some libido flattening, but that doesn't bother me much. I have gained weight on the drug, but I think that's because I have the desire to actually eat food again, and I'm a foodie - so I like to eat lots of different foods! So - it's not the drug itself, it's that I discovered chocolate humbows because my depression lifted, and boy howdy do I want to want to eat those all the time now.
posted by spinifex23 at 11:12 PM on May 31, 2019 [3 favorites]
I got the dreaded sexual side effects. My libido was more or less unaffected, but I entirely lost the ability to orgasm. Dealbreaker for me, so I discontinued without any further trouble.
(Now on Wellbutrin, which as far as I can tell isn't doing jack shit, but no side effects either.)
posted by neckro23 at 11:31 PM on May 31, 2019
(Now on Wellbutrin, which as far as I can tell isn't doing jack shit, but no side effects either.)
posted by neckro23 at 11:31 PM on May 31, 2019
I took Celexa for a few years and besides the adjustment perior, the only actual side effect I've had was minor weight gain (5-10 lbs). I am currently in the process of tapering off and am not having any problems besides feeling a little "weird". Effexor is actually the one that has the famously bad withdrawal symptoms.
You should not take MDMA with any SSRI...but I did drop acid once and still got high. As always, YMMV.
posted by noxperpetua at 12:21 AM on June 1, 2019
You should not take MDMA with any SSRI...but I did drop acid once and still got high. As always, YMMV.
posted by noxperpetua at 12:21 AM on June 1, 2019
Celexa dramatically increased my tolerance for alcohol, which was not a good thing.
posted by Morpeth at 3:43 AM on June 1, 2019
posted by Morpeth at 3:43 AM on June 1, 2019
20 mgs daily of the generic Celexa here, since 2001. It was prescribed for Seasonal Affective Disorder, which had been laying me low every winter.
Celexa (and its generic counterpart) is a champ at combating SAD. It took about 10 days to kick in. My appetite wasn't up to par the first few months, then (sadly) came back to normal.
I take it year-round, rather than just in the cold-weather months, which was not as effective.
The only side effect I've had is waving bye-bye to my libido. That's a chance you take with any S.S.R. I. medicine. But it sure beats sobbing in a closet when I get home from work.
posted by BostonTerrier at 4:28 AM on June 1, 2019
Celexa (and its generic counterpart) is a champ at combating SAD. It took about 10 days to kick in. My appetite wasn't up to par the first few months, then (sadly) came back to normal.
I take it year-round, rather than just in the cold-weather months, which was not as effective.
The only side effect I've had is waving bye-bye to my libido. That's a chance you take with any S.S.R. I. medicine. But it sure beats sobbing in a closet when I get home from work.
posted by BostonTerrier at 4:28 AM on June 1, 2019
Best answer: I'm going to paste here the notes I made after Month 1 and Month 2 on citalopram (Celexa). I shared these with friends because I think it's important to break the stigma about MH and MH meds, and I'm not going to be shy about it.
# Month 1 Update
Psych meds one month update. — As I announced last month, I received a prescription for 20mg citalopram (Celexa) for depression and anxiety. I’ve been keeping a daily journal so I could track changes. I reported the following to my dr at my 1-month “is this the right med/dose” appointment. It’s important to note that the drug is not the entirety of my treatment. More about this below.
Good things —
Reduced social anxiety. There is no longer any uncontrollable anxiety around social engagements, even ones with larger crowds.
Reduced bleak moods. I do not have desolate, dysfunctional moods where nothing seems practical, useful, or warranted.
CBT is effective. If I do experience anxiety, I can talk myself down from it with a rational examination of the facts. Previously, this was not possible.
Less irritable, smaller startle reflex, reduction of misophonia. In particular, the ability to talk myself down from uncontrollable anger about certain sounds (chewing in particular) is a big deal. It’s still annoying but I can generally handle it or even just tune it out with a little work.
Improved affect, better mood. Generally more upbeat, more cheerful, more responsive.
More willing to listen. This was reported by my partner and I’m not sure exactly what it means beyond what it says on the tin, but it sounds like a good thing.
Metabolic reactions to food stabilized. Previously after carb-heavy meals I might experience a rush and then a nearly total crash. That’s mitigated — my physica/mental energy levels are more stable, but see below.
Less night-time anxiety. Sometimes in past I’d wake up with an adrenaline response going on with no understandable reason. These are reducing in frequency / severity.
Easier time making decisions, committing to actions. I am having less trouble deciding on things; paralysis of choice is reduced.
Noted changes (neither pro nor con) —
Sweet foods seem very sweet. Previously I’d be able to eat like a whole Bunner’s treat at a go, or a handful of candies or chocolates. That’s not a thing anymore. I really don’t want a lot of sweet things at a go, it’s not welcome.
Many foods in general taste “more.” Kind of vague, but flavours and smells seem more intense, though not in an unpleasant way. Allen Gardens flower displays are amazing.
More obvious when “out of gas” metabolically. If I do run out of energy, like if I haven’t eaten enough during the day, my body lets me know that I need to eat. When I have a snack, the insistence goes away. In general this is good, but it does mean I have to be more careful about food quantities (my body used to lie about this, leading to a lot of extra weight).
Less alcohol consumption. In general, I don’t reach for alcohol much any more. I still like the flavour, but there seems to be less interest. This is the hardest thing to put into words, I guess? I can’t explain why I haven’t been drinking less, I just have been.
Negative things —
Metallic taste in mouth. I have had a low-level constant “metallic” taste in my mouth since I started the initial dose. It’s not always obvious, and it isn’t particularly obnoxious, but it’s always there when I go looking for it. Maybe it’s just the taste of my mouth? The doctor says this is not a typical side effect, and we should monitor it.
Sexual desire isn’t ambient. I’m not sure if this is a reduction of libido. But it does mean that sexual interest probably isn’t going to just ramp up on its own. In past I’d get frequent “taps on my shoulder” that hey, sex would be nice now. I don’t really get those any more, though if I think about it or am prompted, my sexual response functions fine.
Going forward —
So the thing about the drug not being the entirety of the treatment, that means that it is now on me to mentally make changes in my habits. Over the past decades, I’ve set my habits to minimize triggers of anxiety and keep my mood up based on a different balance of brain chemistry. Now that my brain is responding differently, I need to retrain myself, to break those habits when they lead to negative outcomes or are just no longer needed.
The drug is making changes to habits possible; CBT can be effective now where before it was like pushing against smoke. I talked about this with the dr — since the unpleasant symptoms seem to be under control this is a good drug and dosage. Now I need to do the mental work of changing my habits to have more of the life I want to have.
Once those habits change, and my biological neurotransmitters change in response to new life and social situations (because they do), it may be possible to reduce the dose or stop the drug. That’s a possible endpoint — one worth trying for.
Ultimately we decided to continue this drug/dose for 6 months and revisit in the fall. I am expecting that, whatever happens, I’ll seek to continue for a full year so I can go through a dark season on the meds. It would be nice to be off them in a couple years, but that isn’t so much a plan as kind of a hope. The drug is overall quite cheap and the side effects are, thus far, manageable. If I need to be on it for longer, that’s probably okay too.
I hope this is useful information to folks who may have hesitated seeking meds in the past. There’s definitely a lot of prejudice about mental health issues, and psych drugs in particular. I’m here to say they are helping me become more myself, without trying to turn me into a different person, and that’s a big, big deal.
--
# Month 2 Update
It’s been two months since I started on 20mg citalopram, a.k.a. Celexa (tm), to treat generalized anxiety disorder, social anxiety, and depression. I’m taking a generic formulation, but I don’t know which manufactory.
I’m not going to break things down into pros or cons this time, and what I mentioned last month is still, in general, true this month. I do want to provide a little more detail about some things and note some changes as the honeymoon period wanes.
First and most importantly, my low-high mood continues to be quite stable. Quantitatively, I’d characterize it as a an median 6 out of 10, with a standard deviation of about 2. Several times I’ve felt a fairly grim 3, but those don’t last long and don’t require much management. I can’t say as I’ve felt a 9 overjoyed much less a 10 ecstatic lately, but those moments were pretty rare before the meds. I do frequently get 8s though. I’m staying mindful of opportunities for joy, though.
Qualitatively, my life is much more pleasant. There is a lot less dread and anxiety. I am far less concerned about mitigating the effects of bad moods. I can tackle important but unpleasant tasks in a dutiful way without fretting or dwelling ahead of time.
Of note is that I seem to be more able to handle a lack of constant social media interaction. I have recently stopped logging in to Facebook beyond once a day, and I do not scroll the news feed. I check notifications and events only. I do miss the people who I regularly interacted with there, but there are so many negatives to the platform that I don’t feel like I can justify my contribution to its perpetuation through my participation, despite the personal cost. I continue to be active more or less daily on Mastodon and, sometimes, Twitter.
Metabolically, things continue to be more stable as well. There is a propensity for wanting a mid-afternoon lie-down which might turn into a power nap, or might not. The desire for this seems to correlate with the amount of carbs had during lunch and the amount of activity I’ve had. I’ve been very careful with managing my food intake. I don’t feel strong demands to overeat, but food does taste quite good still. I am trying to gain muscle mass and lose fat at the same time, working out at the gym, and sometimes it’s a challenge to keep myself from indulging. Keeping the number of simple carbs fairly restricted except for one “dessert” a day seems to be the best approach. I don’t really note any big impact to my appetite overall from the drug, which is extremely fortunate.
Sleep has continued to be reasonably sound. Dreams are still often fucking annoying, though. I will dream about some boring or dubious task that is trying to be completed, and try to do it for what seems to be hours, and not get anywhere. Maybe waking up in the middle to go pee, and returning to sleep only to return to the same interminable tasks. I think these are starting to lessen, but I can’t be sure. A few times I’ve felt like waking up in the morning is like “Day 2” which is not great. But usually I forget the specifics after a little while. It’s just, not mentally very restful. Though I do wake up physically rested.
Possible side effects of citalopram include reduced sexual desire and anorgasmia. My note in the previous month about being less hair-triggered about sexual desire continues to hold. Also, while I can confirm that reaching orgasm is somewhat more difficult and requires more mindfulness, the orgasms themselves since going on the drug have always been quite spectacular. In the past, my orgasms would span quite a range from nigh-pointless fizzles on up to the big booms everyone likes. In the past two months all of my orgasms have been excellent. So, in general, a positive change. As a health note, it’s reasonably important for people with prostates to have fairly regular and frequent orgasms so ejaculatory fluids don’t just sit around for long periods of time waiting to be used. There’s a negative correlation between frequency of ejaculation and prostate cancer that I would prefer to stay on the better side of.
The metallic / mineral mouth taste seems to be lessening. Some days I don’t notice it at all, even if I go looking for it. Other days it’s definitely there (like today) but not at all intrusive. Definitely seems to be something that my body is acclimating to.
My in-person social interactions continue to be very positive. I have been socializing more and more with people at choir, and other opportunities as they present themselves. I’m still unpracticed at phatics (small-talk) but getting better. I don’t seem to have any social anxiety to speak of any longer. Although I do not seem to have changed into an extrovert. So, while there is still the introvert’s careful judgement of whether I have the energy to interact or not — at least there’s no anxiety about doing so. There have been a couple interactions that could have been fraught (a passive-aggressive note from downstairs neighbour, mainly, which I went to address in person immediately) but weren’t.
So, the status quo is positive and sustainable. I continue to keep a private journal every day about med-related issues, which is where this data comes from.
---
I'm now in the middle of month 3 and the only additional negative I have to report is sometimes feeling "thick" and "medicated." The fatigue is annoying but as long as I'm doing something interesting it's not a problem. Otherwise naps beckon.
posted by seanmpuckett at 4:41 AM on June 1, 2019 [6 favorites]
# Month 1 Update
Psych meds one month update. — As I announced last month, I received a prescription for 20mg citalopram (Celexa) for depression and anxiety. I’ve been keeping a daily journal so I could track changes. I reported the following to my dr at my 1-month “is this the right med/dose” appointment. It’s important to note that the drug is not the entirety of my treatment. More about this below.
Good things —
Reduced social anxiety. There is no longer any uncontrollable anxiety around social engagements, even ones with larger crowds.
Reduced bleak moods. I do not have desolate, dysfunctional moods where nothing seems practical, useful, or warranted.
CBT is effective. If I do experience anxiety, I can talk myself down from it with a rational examination of the facts. Previously, this was not possible.
Less irritable, smaller startle reflex, reduction of misophonia. In particular, the ability to talk myself down from uncontrollable anger about certain sounds (chewing in particular) is a big deal. It’s still annoying but I can generally handle it or even just tune it out with a little work.
Improved affect, better mood. Generally more upbeat, more cheerful, more responsive.
More willing to listen. This was reported by my partner and I’m not sure exactly what it means beyond what it says on the tin, but it sounds like a good thing.
Metabolic reactions to food stabilized. Previously after carb-heavy meals I might experience a rush and then a nearly total crash. That’s mitigated — my physica/mental energy levels are more stable, but see below.
Less night-time anxiety. Sometimes in past I’d wake up with an adrenaline response going on with no understandable reason. These are reducing in frequency / severity.
Easier time making decisions, committing to actions. I am having less trouble deciding on things; paralysis of choice is reduced.
Noted changes (neither pro nor con) —
Sweet foods seem very sweet. Previously I’d be able to eat like a whole Bunner’s treat at a go, or a handful of candies or chocolates. That’s not a thing anymore. I really don’t want a lot of sweet things at a go, it’s not welcome.
Many foods in general taste “more.” Kind of vague, but flavours and smells seem more intense, though not in an unpleasant way. Allen Gardens flower displays are amazing.
More obvious when “out of gas” metabolically. If I do run out of energy, like if I haven’t eaten enough during the day, my body lets me know that I need to eat. When I have a snack, the insistence goes away. In general this is good, but it does mean I have to be more careful about food quantities (my body used to lie about this, leading to a lot of extra weight).
Less alcohol consumption. In general, I don’t reach for alcohol much any more. I still like the flavour, but there seems to be less interest. This is the hardest thing to put into words, I guess? I can’t explain why I haven’t been drinking less, I just have been.
Negative things —
Metallic taste in mouth. I have had a low-level constant “metallic” taste in my mouth since I started the initial dose. It’s not always obvious, and it isn’t particularly obnoxious, but it’s always there when I go looking for it. Maybe it’s just the taste of my mouth? The doctor says this is not a typical side effect, and we should monitor it.
Sexual desire isn’t ambient. I’m not sure if this is a reduction of libido. But it does mean that sexual interest probably isn’t going to just ramp up on its own. In past I’d get frequent “taps on my shoulder” that hey, sex would be nice now. I don’t really get those any more, though if I think about it or am prompted, my sexual response functions fine.
Going forward —
So the thing about the drug not being the entirety of the treatment, that means that it is now on me to mentally make changes in my habits. Over the past decades, I’ve set my habits to minimize triggers of anxiety and keep my mood up based on a different balance of brain chemistry. Now that my brain is responding differently, I need to retrain myself, to break those habits when they lead to negative outcomes or are just no longer needed.
The drug is making changes to habits possible; CBT can be effective now where before it was like pushing against smoke. I talked about this with the dr — since the unpleasant symptoms seem to be under control this is a good drug and dosage. Now I need to do the mental work of changing my habits to have more of the life I want to have.
Once those habits change, and my biological neurotransmitters change in response to new life and social situations (because they do), it may be possible to reduce the dose or stop the drug. That’s a possible endpoint — one worth trying for.
Ultimately we decided to continue this drug/dose for 6 months and revisit in the fall. I am expecting that, whatever happens, I’ll seek to continue for a full year so I can go through a dark season on the meds. It would be nice to be off them in a couple years, but that isn’t so much a plan as kind of a hope. The drug is overall quite cheap and the side effects are, thus far, manageable. If I need to be on it for longer, that’s probably okay too.
I hope this is useful information to folks who may have hesitated seeking meds in the past. There’s definitely a lot of prejudice about mental health issues, and psych drugs in particular. I’m here to say they are helping me become more myself, without trying to turn me into a different person, and that’s a big, big deal.
--
# Month 2 Update
It’s been two months since I started on 20mg citalopram, a.k.a. Celexa (tm), to treat generalized anxiety disorder, social anxiety, and depression. I’m taking a generic formulation, but I don’t know which manufactory.
I’m not going to break things down into pros or cons this time, and what I mentioned last month is still, in general, true this month. I do want to provide a little more detail about some things and note some changes as the honeymoon period wanes.
First and most importantly, my low-high mood continues to be quite stable. Quantitatively, I’d characterize it as a an median 6 out of 10, with a standard deviation of about 2. Several times I’ve felt a fairly grim 3, but those don’t last long and don’t require much management. I can’t say as I’ve felt a 9 overjoyed much less a 10 ecstatic lately, but those moments were pretty rare before the meds. I do frequently get 8s though. I’m staying mindful of opportunities for joy, though.
Qualitatively, my life is much more pleasant. There is a lot less dread and anxiety. I am far less concerned about mitigating the effects of bad moods. I can tackle important but unpleasant tasks in a dutiful way without fretting or dwelling ahead of time.
Of note is that I seem to be more able to handle a lack of constant social media interaction. I have recently stopped logging in to Facebook beyond once a day, and I do not scroll the news feed. I check notifications and events only. I do miss the people who I regularly interacted with there, but there are so many negatives to the platform that I don’t feel like I can justify my contribution to its perpetuation through my participation, despite the personal cost. I continue to be active more or less daily on Mastodon and, sometimes, Twitter.
Metabolically, things continue to be more stable as well. There is a propensity for wanting a mid-afternoon lie-down which might turn into a power nap, or might not. The desire for this seems to correlate with the amount of carbs had during lunch and the amount of activity I’ve had. I’ve been very careful with managing my food intake. I don’t feel strong demands to overeat, but food does taste quite good still. I am trying to gain muscle mass and lose fat at the same time, working out at the gym, and sometimes it’s a challenge to keep myself from indulging. Keeping the number of simple carbs fairly restricted except for one “dessert” a day seems to be the best approach. I don’t really note any big impact to my appetite overall from the drug, which is extremely fortunate.
Sleep has continued to be reasonably sound. Dreams are still often fucking annoying, though. I will dream about some boring or dubious task that is trying to be completed, and try to do it for what seems to be hours, and not get anywhere. Maybe waking up in the middle to go pee, and returning to sleep only to return to the same interminable tasks. I think these are starting to lessen, but I can’t be sure. A few times I’ve felt like waking up in the morning is like “Day 2” which is not great. But usually I forget the specifics after a little while. It’s just, not mentally very restful. Though I do wake up physically rested.
Possible side effects of citalopram include reduced sexual desire and anorgasmia. My note in the previous month about being less hair-triggered about sexual desire continues to hold. Also, while I can confirm that reaching orgasm is somewhat more difficult and requires more mindfulness, the orgasms themselves since going on the drug have always been quite spectacular. In the past, my orgasms would span quite a range from nigh-pointless fizzles on up to the big booms everyone likes. In the past two months all of my orgasms have been excellent. So, in general, a positive change. As a health note, it’s reasonably important for people with prostates to have fairly regular and frequent orgasms so ejaculatory fluids don’t just sit around for long periods of time waiting to be used. There’s a negative correlation between frequency of ejaculation and prostate cancer that I would prefer to stay on the better side of.
The metallic / mineral mouth taste seems to be lessening. Some days I don’t notice it at all, even if I go looking for it. Other days it’s definitely there (like today) but not at all intrusive. Definitely seems to be something that my body is acclimating to.
My in-person social interactions continue to be very positive. I have been socializing more and more with people at choir, and other opportunities as they present themselves. I’m still unpracticed at phatics (small-talk) but getting better. I don’t seem to have any social anxiety to speak of any longer. Although I do not seem to have changed into an extrovert. So, while there is still the introvert’s careful judgement of whether I have the energy to interact or not — at least there’s no anxiety about doing so. There have been a couple interactions that could have been fraught (a passive-aggressive note from downstairs neighbour, mainly, which I went to address in person immediately) but weren’t.
So, the status quo is positive and sustainable. I continue to keep a private journal every day about med-related issues, which is where this data comes from.
---
I'm now in the middle of month 3 and the only additional negative I have to report is sometimes feeling "thick" and "medicated." The fatigue is annoying but as long as I'm doing something interesting it's not a problem. Otherwise naps beckon.
posted by seanmpuckett at 4:41 AM on June 1, 2019 [6 favorites]
I took it for a couple of years for dysthymia and anxiety; I did have sexual side effects that I eventually decided weren’t worth it (switched to Wellbutrin), but no other side effects after the first week - I felt very much like myself. I had no problems tapering off.
posted by songs about trains at 5:35 AM on June 1, 2019
posted by songs about trains at 5:35 AM on June 1, 2019
I took it for a few months last year for panic attacks and had, as far as I could tell, zero side effects (and also zero panic attacks.) I had no withdrawal symptoms when I went off. It was a pretty small dose if I understand correctly, and getting off the night shift was the ultimate fix for me, so it's not entirely analogous, but the drug itself worked as intended with no downside.
posted by restless_nomad at 7:53 AM on June 1, 2019
posted by restless_nomad at 7:53 AM on June 1, 2019
I posted in another thread about my experience off coming off citalopram - in summary, it was fine. I was on it for 12 months in total. It worked out really well for me and I feel much more resilient generally these days. I did get the emotional flattening and deadened libido initially but honestly that was sort of a relief at the time. No other side effects in starting or stopping.
posted by freya_lamb at 8:25 AM on June 1, 2019
posted by freya_lamb at 8:25 AM on June 1, 2019
Sweet foods seem very sweet. Previously I’d be able to eat like a whole Bunner’s treat at a go, or a handful of candies or chocolates. That’s not a thing anymore. I really don’t want a lot of sweet things at a go, it’s not welcome.
Many foods in general taste “more.” Kind of vague, but flavours and smells seem more intense, though not in an unpleasant way. Allen Gardens flower displays are amazing.
I noticed this, and for me? It's SUCH a major pro in my life. Thank you for pointing this out. I need to stay away from sweets, so it's good for me. And I love that food just tastes MORE. Means that I enjoy it a lot more. I've been eating a ton of fruits and veggies as a result.
I just remembered one completely weird side effect that I get, that my doctor hasn't heard of even: when I fall asleep? I, uh, have a tiny orgasm. I'm not masturbating at all, it just, uh happens. I don't find it bothersome most days, and masturbating before bed doesn't make this sensation go away. It's totally weird, but I've grown to accept it.
posted by spinifex23 at 10:23 AM on June 1, 2019
Many foods in general taste “more.” Kind of vague, but flavours and smells seem more intense, though not in an unpleasant way. Allen Gardens flower displays are amazing.
I noticed this, and for me? It's SUCH a major pro in my life. Thank you for pointing this out. I need to stay away from sweets, so it's good for me. And I love that food just tastes MORE. Means that I enjoy it a lot more. I've been eating a ton of fruits and veggies as a result.
I just remembered one completely weird side effect that I get, that my doctor hasn't heard of even: when I fall asleep? I, uh, have a tiny orgasm. I'm not masturbating at all, it just, uh happens. I don't find it bothersome most days, and masturbating before bed doesn't make this sensation go away. It's totally weird, but I've grown to accept it.
posted by spinifex23 at 10:23 AM on June 1, 2019
I haven't been on Celexa (actually generic citalopram) for approx 7/8 years but it's the only anti-depressant I've taken that gave me no side effects.
posted by emotionalmotionsickness at 10:45 AM on June 1, 2019
posted by emotionalmotionsickness at 10:45 AM on June 1, 2019
I love it. It has been life-changing for me. I've been taking 20 mg for a month now, and there's been a noticeable difference in my mood, outlook, energy and general ability to cope. I'd say I feel 50% better already. No side effects. The only thing is it has to be the brand name for me; I tried the generic and it did not have nearly the same effect.
posted by spicytunaroll at 9:29 PM on June 1, 2019
posted by spicytunaroll at 9:29 PM on June 1, 2019
I took Celexa for several months awhile back. Ultimately, my diagnosis was more complicated than just being depression, so it didn't end up being the right med for me. However, after being on it a couple months, I went off of it cold turkey (under the advisement of my psychiatrist), and I had zero withdrawal/discontinuation symptoms. Of course, YMMV, IANAD/IANYD, etc.
posted by litera scripta manet at 10:18 AM on June 2, 2019
posted by litera scripta manet at 10:18 AM on June 2, 2019
In retrospect, I can see the side effects I had while taking Celexa: no libido, feeling emotionally numb, and some weight gain. I had maybe some slight mood/motivation improvement. At the time I took it, I thought it was helping. It did stop my one-track mindset and ruminating thought patterns. However, I didn't realize these other things were side effects. I thought it was how everyone felt while taking the drug. So it helped, but not enough. I had no discontinuation issues.
posted by cass at 10:18 AM on June 3, 2019
posted by cass at 10:18 AM on June 3, 2019
Response by poster: Thanks, everyone. After much deliberation I decided to give it a go, and just took my first 10mg dose. We'll see how it goes.
posted by zeri at 12:13 PM on July 15, 2019 [1 favorite]
posted by zeri at 12:13 PM on July 15, 2019 [1 favorite]
I had some onboarding mild nausea, not barfy just a little oogy, from 1-3 hours after my once-daily (morning) pill. It fades after a week or two. Just FYI.
posted by seanmpuckett at 12:19 PM on July 15, 2019
posted by seanmpuckett at 12:19 PM on July 15, 2019
This thread is closed to new comments.
But no, I felt an improved mood later the same day I started taking it, very quick for antidepressants. And there was no emotional flattening that I noticed, from the inside it felt more like I had more resilience against things dragging me down. I even watched a sad movie during that initial period (Grave of the Fireflies) to see if I could still feel sad. I could.
I also have problems with insomnia, have all my life, and it actually helped with that. Although if I remember right my doctor did make a point of scheduling the dose in the morning to avoid sleep problems. There was some affect with my libido, but that returned to normal after a couple months.
When I did stop, there were discontinuation symptoms that's for sure. My doctor had me taper down to the lowest dose I could get in pill form and that wasn't too bad actually. But after that, I asked about using a liquid formulation to continue tapering down to very small doses (something I'd read about online) but she didn't think it would be necessary. I should have done the liquid taper. There was a month of brain zaps after I stopped completely and that wasn't very pleasant.
I don't think I can give you advice, all I really know is my own experience. But I was very happy with what citalopram did for me, if I ever found myself in a place needing that help again I'd have no hesitation to go back on, but I would try very hard to convince my doctor to be patient about the taper process when it was time to stop, and let me ramp down at my own pace.
posted by traveler_ at 6:51 PM on May 31, 2019 [2 favorites]