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Mental health

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Original poster

Is 30mg of Citalopram considered a high dose ??

22 replies

TheOriginalNutcracker · 30/12/2011 12:16

Have just been to docs to get a new prescription and it wasn't my normal doctor (infact i never see her). Anyway, this doctor asked how long i'd be on it and why. I have been on citalopram for a year now, but have only been on 30mg for about 5 months.

I started off at 10mg, quickly moved up to 20mg and then eventually settled on 30mg.

He said it was a high dose and I am only 33 and so should think about dropping to 20mg. He said he'd issue the prescription this time, but next time wants me to try 20mg.

I don't want to go back down to 20mg yet. I feel stable on 30mg, but still ocasionally have my bad days.

Non of the other doctors in the practice have ever said it is high. I won't see him again as i felt he was rude and arsey too and luckily there are enough other doctors in the practice to see. But i just wondered if anyone else had been told 30mg was high really.

OP posts:

TheMonster · 30/12/2011 12:19

No. I have been on it for four years and I have been on 20mg for just over a year. That is considered a low dose. I was only a high dose of 60mg for a while.
My doctor told me 60 was high. I saw him last week and he said 20 was next to nothing and he was happy for me to stay on that.
Don't decrease unless you are happy to otherwise you will worry about it.

Original poster

TheOriginalNutcracker · 30/12/2011 12:24

Thank's Eeyore. I do of course want to decrease it eventually, but now is not the right time. If he doc had read any of my notes he migth hve realised that.

Oh well, will stand my ground and see someone else anyway.

OP posts:

QED · 30/12/2011 12:25

I was on 40mg for quite a while which wasn't a low dose but I was never told it was high. And I have no idea why your age is meant to make a difference - I don't think depression is less because of your age. I was taking 40mg when I was younger than that anyway.

When I did come off the ADs my GP said I should feel fine for 6 months before thinking about it (which I did and then cut down v slowly and am still off them 2 years later).

I think your GP is not being helpful to you.

Original poster

TheOriginalNutcracker · 30/12/2011 12:27

No i don't think he was helpful either.

I think when he mentioned my age, he meant that at my age I didn't want to be on them for a long period of time. Imo though, if you need them, you need them and age is irrelevant.

OP posts:

MsFanackerPants · 30/12/2011 13:06

I'm currently on 40mg, have been since April and am likely to be until April next year before my GP would even consider reducing my dose. In the past I was on 60mg for about 10 months before slowly dropping down to 50, 40 etc. I was 24 at the time and I'm 31 now.

A family member works for a mental health charity and was very about my dosage, she seems to think it is a negative somehow to be on such a high dose for a prolonged period. However, as she is not a doctor or a RMN, she can think what she likes and I'll keep taking my Sanity pills. Some people do seem to still treat Anti-Ds in a very different way to other drugs. If you were on a high dose of anything else, I'm sure people would be less inclined to act as though it's somehow negative to need a high dose.

Upwardandonward · 30/12/2011 13:47

They've changed the max daily dose.

40 mg for adults, 20 mg for the over 65s.

fedupandtired · 30/12/2011 13:50

No it isn't high, it's actually low. I got told years ago, by a psychiatrist, that the clinically proven starting dose for citalopram is 40mg but the NHS in an attempt to save money start with 20mg and then move up if necessary. Other countries all have 40mg as a starting dose.

So my guess us the GP was looking at reducing his budget and thought you were an easy target. It's simply not cost effective to be on too low a dose though as you just get ill and end up costing the NHS more money.

SantaIsAnAnagramOfSatan · 30/12/2011 13:53

doctor sounds weird. it has recently been announced that no one should be on 60mg - it has been linked to heart issues or some such and new guidelines have been passed making 40mg the highest dose recommended.

normal practice is to start on 20mg and go up to 40mg a few weeks later. your doctor has treated you conservatively and done nothing wrong. the doc you saw may be against ad's and talking from his values - he's certainly not talking from fact or NICE guidelines.

ignore him.

SantaIsAnAnagramOfSatan · 30/12/2011 13:55

incidentally i'm now going through hell from switching meds as 60mg of citalopram was the effective dose for me and working well, 40mg didn't do it for me so i've had to switch and go through hell in the process! getting there though.

please don't worry. 30mg is great if it is working for you and if it stops working or you have a crisis point you have a 10mg buffer zone you can increase by if needed.

HeidiHole · 30/12/2011 14:36

I'm on 30mg (well trying to keep to 10mg as i'm pregnant but will bloody well be going back up afterwards!) never heard that it's high. I think about 60mg is high. 30mg is fine, and if you need it then thats that!

Original poster

TheOriginalNutcracker · 30/12/2011 15:07

Thank's for the posts

Does sound like a cost cutting exercise then. Oh well, he picked the wrong target. It took me years to admit that I needed ad's in the first place, and now that I am on them and feeling ok, I will make sure I stay on them as long as I need to.

Hope you start to feel better soon santa.

OP posts:

madmouse · 30/12/2011 19:15

Santais it is not necessarily normal practice to start on 20 and move to 40. It's quite normal too to start at 10 and move to 20 and stay there. 20 is a good dose for many of people. My dh is doing well on 10mg, but that is a bit light for many people.

SantaIsAnAnagramOfSatan · 30/12/2011 19:30

i think it depends what it's being described for.

dottyspotty2 · 30/12/2011 20:02

I'm on 10 mg been told I might be going on to 20 next month only been on it 5 weeks and didn't really want it but I now see a slight difference.

tiredemma · 30/12/2011 20:17

Research studies have shown very little difference in efficacy between 20mg/40mg a day, the only significant difference being more side effects the stronger the dose (obv!)

30mg is not a high dose at all, although the majority of patients who I recall having same medication are on either 20mg OR 40mg- no-one is on 30mg (??)

LadyMedea · 30/12/2011 20:43

Standard adult dose is is 10 to 40mg. It isn't about high or low really as everyone reacts differently. No shame at all being on ADs so no need to worry about your dose as long as you are following your GPs advice.

Max dose used to be 60g, now not recommended as it isn't any more effective and it has been shown in studies to effect the electrical activity in the heart - but that is a very new development, only just found out when my doctor tried to up me and the pharmacist said no!

pippamitzi · 22/04/2018 14:20

Hi, I was initially put on 10 mg for 2 weeks and then up to 20mg which I have been on for 3 weeks with very little improvement. Can anyone comment whether this means they won't work or maybe a higher dose is needed. I would be grateful for any help.

isme · 15/12/2020 14:55

Do they come in a 30mg pill. My doctor has put me on 30mg but my chemist wants me to have 2 separate prescriptions, one for 20mg and one for 10, meaning £20 per month. Thank you

emma6776 · 15/12/2020 20:59

My GP said the standard dose for anxiety is 20mg (I’m currently on 10 & about to increase) & that higher doses were for depression or anxiety with depression. Anything over 60mg has been linked to heart issues.

Yllasin · 25/02/2021 10:15

Starting these for the first time at 62. GP instructions is 10mg daily for one week then 20mg. I think that will be the maximum at my age.

Sunnydays999 · 26/02/2021 22:43

I’m on 40

CatCup · 09/03/2021 21:40

I'm on 30 - 20+10 but was only charged once.

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