Amiltriptyline or Citalopram?

[chasingtail]

Wonder if anyone can help with a quandry (SP??) I have.

After being on various doses of Fluoxetine for 3 years I went to the GP as I didn't feel it was working any longer. After reading up on the subject I suggested to the GP that perhaps Citralopram might be an alternative. However she said that Citralopram is "only given to old ladies" & that Amiltriptyline would be a better option.

I have now been on 25mg of Amil for a week but feel awful - really tired and wiped out. Last night took the tablet about 8pm, asleep by 9(!) and had to drag myself out of bed at 7am. I know that Amil is supposed to help with sleep problems associated with depression/anxiety but tbh that has never been my problem. No chnage in my mood as yet either

Will continue for a while longer to see if there is any improvement but does anyone think it would reasonable to go back to GP and request Cit again (maybe a higher does than those used for old ladies! ?

Has anyone else switched from Amil to Cit?

Although I'm no health professional, I have no idea what your GP was talking about. Citalopram is one of the most commonly prescribed AD's - there's loads of people on here who take and I'm pretty sure they're not all old ladies.

Amitriptyline is really sedating - I was on it a while and I could hardly move. I got on with Citalopram really well - I had no side effects from it and only stopped taking it due to complications with another health problem. Personally, I would return to your GP and mention the sedation.

I wouldn't be very happy with a clinical decision based on the fact that a particular AD is "only given to old ladies" - doesn't sound very scientific or thought-through to me.
I assume that you know that they are different types of AD. Fluoxetine (Prozac) is an SSRI, as is Citalopram. Amiltriptyline is a tricyclic. Your GP may have reasons for thinking that you would do better on a tricyclic than on an SSRI, but you need to ask her about this.
FWIW, my experience with Cit was not very positive, but perhaps I'm not old enough or ladylike enough for it to work on me! I am now on Venlafaxine which is also an SSRI and which seems to be working well.
Good luck - it's horrible when your trusted AD stops working and you have to change over. But you will get there and find an AD, or a combination of ADs, which work well for you. If you're not happy with your GP you can request a consult with a psychiatrist - they know much, much more about ADs than a GP can be expected to.

Thanks for such speedy replies!!

I think her thought process in prescribing Amil is that I also suffer from migraines, and this drug is supposed to:

1. help prevent attaks;

2 does not have contraindications with triptan medication (which SSRIs are supposed to conflict with).

However, I now feel so spaced out during the day that frankly I would rather be dealing with migraines as & when they occur (& that's saying something!). I really don't need the sedation effects as my sleep has been fine for about 18 months

My depression symptoms take on the form of having a really short fuse & feeling stressed rather than feeling down.

Bump.

WTAF? Citalopram is the most widely prescribed AD at the moment (rightly or wrongly). Cannot believe what your GP said. Will see what my DH says about it, he found it rather helpful...and he was on 10mg. There's absolutely no need for a higher dose than old ladies...

Aren't you simply on too high a dose of Amil?

Amitryptyline wiped me out all the time. Yes, I slept properly for the first time in sixteen years but I felt hungover every day and was permanently exhausted.

I have tried citalopram but cannot remember the side effects. That probably says it all.

Have to agree with everyone else that citalopram is now pretty much the standard AD to prescribe.

Yes kat, that's exactly how I feel. And far from preventing migraines, I have one for 2 days solid.

Have made an appt with GP to review as would rather be a loon than a zombie!!

I take both, the Amitryptiline is for pain though, very low dose.(20mg)
I take Citalopram for depression and it has really helped me,

What I found with the Amit is that it did take a couple of weeks to "sort out" IYSWIM.

I feel very calma dn relaxed, my depression wasn't that awful low sad feeling it was more aobut stress and anxiety, I ahd a lot going on where I live a lot of crap to deal with, but now I sail through the crap

Amitriptyline is rarely used for depression now.
Its an old fashioned AD and is very widely used for migraine sufferers.
I took it for migraines for a while and took it at night, it made me sleep like a log but also had that heavy hungover feeling.

I no longer suffer with migraines but niw take Sertraline or PTSD which i have found amazing.

But it doesnt sound like your GP is making very good decisions

i was on fluoxetine and have recently changed to citalopram.i started of on 10mg but after 3 weeks it was increased to 20mg which i've been taking for 3 weeks now.today is the 1st day in which i've not felt drained of energy but since taking them i've felt exhausted and constantly yawning so i'm hoping that downside has passed.my gp told me that citalopram are the most prescribed anti depressant.hope you find something that suits you x

I can't take SSRi's, and I thought there was an issue around citalopram and balckouts.

I was on 100-125mg of ami for years. The sedation wear off after a bit. Not suprised you feel crap on 25mg, that is a fairly useless dose.

150mg is therapuetic dose and 100mg is maintenance dose. I actually found it quite a good ad, it is meant to be the gold standard.

Ami is rarely used for depression by Gp's but is used very widely by Pyschs. All the tricyclics are

Thanks All for all your replies. Really does sound like there is no 'one size fits all' & it can be trial and error.

Can I ask as an aside - did any of you notice any change in your weight after you started on your particular AD? I know that relieving the symptoms of depression are priority but am also scared of putting on loads of weight with whichever AD I am prescribed (shallow I know ). Still trying to shift enough baby weight, let alone any increase ADs may cause!

I was prescribed Amytriptiline, as I have fibromyalgia, anxiety and depression, but I decided not to take it, as I had heard about the side effect of feeling 'hungover' all the time - as I felt foggy enough anyway, I really didn't want to feel worse, even if it did help with sleep.

After a family bereavement, I started taking Citalopram (20mg), and I have found it to be really good - my mood has lifted, I am far less anxious, and I am sleeping well.

I have some weight to lose, and find it difficult to shift, but I have not noticed any particular weight gain with Citalopram, and because I am feeling better generally, I have started exercising again recently, which I hope will make a positive difference.

Best of luck with your decision.

I used to be on Prozac for many years, eventually had no need for them which was great. However I developed hormonal migraines a few years ago and was prescribed Ami, at first I felt like I was doped up the next day but after a couple of weeks it eased off (low dose of 20mg) my migraines are still a bit hit and miss, sleep is now fabulous. No weight gain at all! Good luck

I was prescribed citalopram last for for severe depression and anxiety. I thought I was losing my mind and the citalopram really did help me so much. I did have a few weeks of feeling sick and a bit fuzzy headed (bit the state I was in I might have felt like that anyway).

However I have gained 3 stone in a year which I can only put down to the citalopram as my eating habits have not changed. I have found it impossible to shift the weight so am now slowly coming off the citalopram (although I am only doing this as I now think I am well enough not to need AD's). I would have no hesitation to go back on them though if I get my old symptoms back.

I am feeling a bit miffed at being described as an old lady at at the grand old age of 38!
I have been on citalopram for 6 years and it has also helped with my migraines.

Yes, I should have said I am the ripe old age of 31!

i'm 41 and according to my dd i am an old lady

I have been on both and I would say Citalopram as Amitrpyt was a nightmare for me. I am not an old lady either!

Now, that's intersting because cit was a nightmare for me, whereas ami was fine.

I am nota little old lady either

I put 2 stone on citalopram which I am struggling to lose.

I was actually on both tablets for a while. No wonder I was like a zombie.

I also had really bad side effects when I started on cit but would take it over ami.