Citraloplam advice

[Jumpingjosephene21]

I've posted a few times about this. I was prescribed 10mg citalopram a month ago for anxiety. I tried to explain to my GP that I suffer from situational anxiety and panic attacks rather than constant anxiety. So if I'm at home or somewhere 'safe' I'm ok. But if I have to go to certain places or do certain things I have horrendous panic attacks and end up shaking, retching and often needing to dash to the loo

So a month of citraloplam and my mood feels slightly brighter but I'm still having these panic attacks, it's made no difference at all to those. And it's so debilitating because I just won't go to certain places.

I kept thinking it might just take a bit more time for the medication to work. I spoke to the GP again today for a review and tried to explain again but I felt like she just rushed me off the phone and her only solution was to up the dose to 20mg.

I just feel very unsupported and I don't know if the increase in dose is likely to help or if I need a new treatment altogether. Has this level of increase helped others? Am I being impatient? Or are the physical symptoms of anxiety and panic not likely to be cured by citraloplam?

I found that I had to be on quite a high dose (30mg) for about 9 weeks before I started to notice it took a while and a lot of trust in the process.

Ultimately it wasn't the drug for me but it was helpful for a while

I can definitely see a slight improvement in mood but it just hasn't done anything for my panic attacks and anxiety. I don't know if I'm being impatient or if I need to try something new and I feel very fobbed off by my GP

Jumpingjosephene21 So sorry to hear that you suffer from anxiety and panic attacks. I had a long history of these and I know how debilitating they can be. Citalopram never helped me but Escitalopram (one that followed Citalopram) has turned my life around and I mean enabled me to live a normal life and fly etc. It is so much better for anxiety and panic attacks believe me. It is more expensive than Citalopram but the maximum dose is 20mg. Please give this a try and give it a few months to really take affect x

My doc prescribed propranolol for anxiety to be taken as and when needed, it's pretty effective. Citalopram is great for mood stabilizing

Meant to add you wouldn't have to cut down you Citalopram before switching to Escitalopram either which is a bonus. Wanted to also add I didn't find Propanolol and Beta blockers help me because they may cut down the rapid heart rate etc but do nothing for the mental/emotional side that is why you need a antidepressent.

I have illogical thought processes when I go out, like because I always feel sick or need the toilet due to my panic attack I will actually start having a panic attack if I don't know where the nearest toilet is. It has totally stopped me from doing many things - getting on buses, going on rural walks, even the school run is a problem for me some days. Because I'm thinking oh god if I panic there's nowhere for me to go. And that in turn causes a panic.

So I accept there's probably an element of cognitive issues that need addressing to change my thought processes and break this vicious cycle. Unfortunately I've tried CBT several times and it's never helped. I just really had hoped for a magic solution with medication :(

10mg isn't a therapeutic dose, or that's what i was told. I was on 10mg for a month, very slight improvement but it wasnt until i upped it to 20mg that i really saw an improvement. They give you 10mg to let your body get used to it.

I was on citalopram for 4 years. I thought it was working because I felt better than when I wasn't on them but it didn't get rid of the tight chested feeling I would get that would get tighter and tighter and tighter so that it felt that someone was kneeling on my chest. And then I moved house to a new area and in a meet and get to know you with my new doctor he discovered this and said he was surprised I was on those ones in the first place. Apparently they are better for depression than anxiety. He changed me over to sertraline and I am so so so much better. Life changing. Perhaps citalopram just isn't the one for you either

They moved me up to 40mg of citalopram in the end. Made things a bit better with every increase of dose but none were as good as sertraline and I'm still on the lowest dose of that

I understand that different drugs do different things for different people depending on what your problem is which is why I would have liked to have had a proper chat with the GP about whether it's the right treatment for me, rather than just an increase dose. But she just kept interrupting and seemed to want me off the phone.

I guess I will have to give this a try first. I'm not depressed and my mood is fine. It's just the anxiety and panic attacks I need help with.

Is there another GP in the practice you can try? Maybe give it another month to show you have given it a go but perhaps try another GP to review it and explain that you are not sure its the right medication for your condition?
Good luck, I hope things start to improve soon

OP, I’d definitely try and change GP. Can you speak to a different GP within the same practice?

You’re right, everyone’s experience on these medications is different and it can take a bit of time trying different medications to find one that works. If your GP isn’t prepared to do that with you, they aren’t doing their job properly.

FWIW, Sertraline massively helped me with panic attacks. I had something very similar to you with regard to going out. It’s not 100% gone but is so much more manageable.

I had propranolol and dothiepin both really helped. X

If it is certain situations that are triggering your anxiety, then something like propanolol might work better. You could then take a dose before you went out and it would hopefully make it more manageable.

I never really got on with citalopram. When I went through a period of almost constant anxiety due to a traumatic experience, I found prozac was a lot better and gave me fewer side effects. But my DH took Citalopram for about two years and it did seem to help. I think you have to be a bit patient and keep pushing things with the doctor. There is bound to be something out there that works for you.

Sertraline has been much better for me than citalopram with few, if any side effects.

I'd heard that sertraline can have worse side effects but again, different things work for different people don't they. I just know I can't carry on living a half life, avoiding certain places and situations and letting anxiety control me.

Sertraline had awful side effects for me

I've been on citalopram for years. I take 30 mg 10 is a really low dose. If you aren't having any big side effects then I'd go up a dose. You can always come back down. I think propranolol could help as it sounds like anxiety symptoms are then kicking off further anxiety. I understand this as I've experienced it too.

Obviously I'm nit an expert but I think if yiu could get the anxiety under control enough to have some ok or positive experience in the situations you are triggered by then you will build confidence and begin to disassociate those situations with anxiety.

I think cbt can be mixed in it's usefulness. But maybe it's worth doing abit on your self in terms of challenging what might happen. Like so are you worries you'll vomit in public? So if you do then what?

Have you got someone to support you? I gave general anxiety but I'm also extremely claustrophobic. This juts came on in adulthood after 30. I have been able to use some lifts and the tube again with support from my partner. We discussed it before, he knows about physical ques etc. Hope this helps a bit. I do really understand this battle though.

@Jumpingjosephene21

I'd heard that sertraline can have worse side effects but again, different things work for different people don't they. I just know I can't carry on living a half life, avoiding certain places and situations and letting anxiety control me.

Also I didn't get on with sertraline but then everyone responds differently!

Second also.. You can ask to speak to a different GP so try this. Perhaps call and ask if any specialise in mental health. It definitely took me a while to find my one!

Thank you all. I will stick with it and try the increased dose, I fully admit that I'm being impatient and wanting instant results and it just doesn't work like that.

@NeonIcedcoffee that's really good advice. My therapist has advised exposure therapy so putting myself gradually in these anxiety provoking situations and trying slowly to build up confidence. If I feel stronger I might be more able to do that. Yes I'm worried about vomiting or frankly shitting myself in public because my panic attacks always lead to severe gastric issues. It's classic fight or flight response.

Case in point, I had to pick up a prescription from the doctors today and knew there'd be a wait and the surgery is closed so I can't go in and use the toilet, this instantly set off a panic attack and I had to dash home. Sometime if I use the loo several times before going out then I can convince myself that there's nothing left even if I do panic but it's still stressful.

So yeah, basically I just need to get this sorted by whatever means necessary.

I tried some reassurances when using lifts so had my phone fully charged, water, sweets, and a cup and loo roll in case I needed a wee. Could you try a big incontinence pad to just wear for reassurance. I think the chances of shitting yourself are very low! But I understand the fear of these things. So then you know if something did happen you'd be able to deal with it. Then that allows you to tolerate the situation a bit more. Rather than have to run home straight away incase yiu vomit or shit yourself.

10mg is very low. I wonder whether Sertraline would be better, with the caveat that you are also accessing talking therapy. (I am a Clinical Psychologist, but I don't expect you to believe what you read on here. See your GP or if that's not working, you can self-refer into your local IAPT

Whoops - just seen that you have a therapist. That will teach me not to RTFT. Ignore me, and good luck :)