Citralopram has increased anxiety - GP changing me to Mirtazapine...I'm worried

[Winksclub76]

Hi,
Advice, personal experiences please.....

Diagnosed with depression in May and put on Citralopram 20mg, didn't seem to be working so was upped to 30mg end of July.

Since then had terrible anxiety, which has co-incided with increased dose. Been advised today by GP to change meds.

Prescription for Mirtazapine.....not heard great things about it, worried about the weaning off/starting new meds (side effects etc). I don't have problems sleeping and struggle with weight so not sure this is the best one for me.

I have a couple of weeks weaning off Citralopram, so am trying to do some research.

Any answers appreciated.

Hi winks, I too was prescribed citalapram 20mg, in July, so not kicked in yet I suppose, went back to dr as I was wary of the fluoxetine that was initially prescribed for me for terrible pmd. So watching with interest with you. I have felt palpitations, possible anxiety coming on, but managed to distract myself, putting it down to side effects that will settle down.

I've taken Mirtazipine, it worked but I ate everything in sight. It's like my full button got switched off and I put on weight. However, I needed it at the time, sucked it up and lost the weight when I came off it. Good luck

Several ad's have triggered anxiety in me, well beyond the start up period.

Imipramine, sertraline despite taking it twice before, and trazadone all did this.They really put me in a bad way

I did take mirtazapine too whichwas great for anxiety butcrap for mood and I did eat a lot.

Srri's are kniown for triggering anxiety.You might want to try a tca rather than mirt. I also had a theory which the pscych I saw didn't disagree with, which was this. Ad's that hit anything other than serotonin make me worse. Anything that hits noradrenaline/dopamine fuck me up completely. Most ad's hit more than one neurotransmitter.

However, I have done well on 3 different ones that are almost the same. These are amitriptline, clomiprimine and paroxetine. All of these hit serotonin hard, with very little activation of other transmitters. The first 2 made me eat, although clomip was the best ad I haveever taken. Paroxetine is good though and hasn't made me overeat despite it's fearsome reputation.

Alos hasyour anxiety been constant or does it fluctuate? Increased anxiety is normal around a dose rise. If you put the dose up at end of July it's not that long ago.

6 weeks of anxiety on paroxetine for me, but now feel good

Hi,
Thanks for your replies....

Twosugars- I hope it works out for you. I was a bit spacey with citalopram and had palpitations the first week or so but everything settled down after 4 weeks.....till I tried to go back to work.

I had constant panic on entering the building tried to ride it out but so bad had to go back to doc who gave me Beta Blockers, got so worked up at home pacing, thoughts racing, crying alot that I regressed.

Just put it down to not being ready to work with public, so I went to do admin duties. Things settled again. Then tried to work with patients again and had two panic attacks (hyperventilating etc) in an hour and had to sit in car park. I say all this because I have never felt anxious before and always been bubbly and confident. I just think it's the medication, even when depressed (which I didn't realise) I never felt the way I do now.

Increased dose.....stayed with admin duties but starting freaking out in social situatons ie children's party (best friend's child), exercise class and avioding events in public.

Lifeis - Yeah weight gain is the thing I'm bothered by the most.....but like you say....if you need it, you need it! Also concerned it makes you a bit drowsy. I already struggle with motivation. I'm married, in my mid thirties with two young children (whom I get up with at 6am). Life is hectic and and things soon mount up if i'm not careful, think it would be living torture if really tired as well.

Orangeandlemons - I seem to have this constant bubbling of adrenaline of late that just takes over quite regulary. I can just about keep it under wraps with beta blockers but just feel uneasy all the time.

Thanks for the 3 meds you recommended, I will take a look. Really don't feel comfortable with the Mirt. If I can ask what are your meds treating? I was not initially treated for anxiety so your comment about 'crap mood' rings alarm bells.
Could you also tell me what a tca is?

Thanks guys

I am being treated for mainly anxiety, but anxiety usually stems fom low mood

Mirt was really goodagainst anxiety, but it made me feel awful. Suicidal, hated everything and everybody, found it really hard to relate to people, brooding about things, itwas awful.

A tca is a tricyclic antidepressant. Thses were around before the Srri's lke prozac etc, and imo(and many others) are less likely to trigger side effect anxiety (although impramine gave me a bad time) The others are clomiprimne, amitryptiline, doluspin (rarely prescribed) and lofepramine.

These drugs are more dangerous in overdose, but have less emotional side effects (although more physical side effects) than ssri's.

Look on the Crazymeds website. There is loads of stuff on there. www.crazymeds.us/pmwiki/pmwiki.php/MedClass/Antidepressants

Thanks orange,

Think I'd rather have the physical effects than emotional.... had lots of hair loss, massive black bruises (when knocked slightly), frequent nausea, memory loss and poor concentration from my current meds. But despite being far from ideal, are part of my life and manageable. It's the emotional side effects I can't stand anymore. and certainly couldn't cope with awful side effects of Mirt listed above!

Definately going to look into TCA's , lots of reading for me tonight :)

Thanks again.

But everyone reacts differently!

I had very very few start up effects with mirt I just felt rubbish. you might be OK on it!

I felt very hungry and exhausted. They gave me a dull, heavy sluggish feeling. The side effects did ease off after a few weeks of taking them though. I feel anxious now, but I won't take the mirtazapine in my cupboard, as I'm full of energy without them. They do make you feel less anxious though.

Hello, I was diagnosed with depression in March after practically coming to a standstill. I was prescribed Mirtazipine and have had no problems with it. I had 30mg to start with and then that was increased to 45mg after 5 weeks as I was still very tearful etc. I know that Mirtazipine is best taken at night as it can make you sleepy, but I was advised that usually this settles once you get into a routine, and indeed in my case it has. I haven't had any side effects (apart from a little weight gain ... but that is down to inactivity as well as the meds) I have had no nausea, dizziness or anything similar. I suppose each of us is different, from an emotional health point of view, it's done exactly what was expected by my GP and very much needed by me !! It has allowed me to become clearer headed and my 'old' or 'usual' self, enough so that I can begin to tackle the causes of my becoming incapacitated .... Any weight I've gained I know I can lose, to be back where I was at the beginning of all this is unthinkable, I will be on Mirtazipine for at least another 6 - 8 months and that's fine with me ... the smiling, calm, coping me ! Good luck with it & all the best.

Hi,
dontcallmehon - thanks for your post, those are the things I worry about with Mirtz.

Greeneyes - thankyou so much for your experience. I like you came to a standstill. I want the old me back too.....it saddens me that I seem to be getting worse not better.

Like both you and oranges said 'everyone is different'. I was terrified to start my current meds due to all the posts about early side effects and found they weren't all that bad to cope with in my case.

I guess you only know when you try something yourself......both you and lifeisf**kinggreat both said the weight gain is something you can tackle after.

Hi Winksclub76, When I first went to my GP he told me he couldn't use fluoxetine or citalopram with me as I take meds that I didn't want to not have the option of taking.
I skimmed through the side effects sheet ... at that point what was a bigger problem how I was on the whole or maybe a dizzy spell or a few extra pounds !

This last two weeks I have put my self onto a healthy reasonably calorie controlled eating plan ... and have lost some of the gained weight. I could do as I have done 'grin & bear' a size bigger shorts for a while, but be smiling and feel able to enjoy myself in them ... or I could have stuck to the smaller ones and not be in a position to even recognise the prospect of a happy / fun day out. I was given something so lovely very early on in my 'episode' and I had no feelings or emotions ... I was just a blank. I was hugging my daughter and could not feel the caring or emotion behind it. THAT scared me and made me cry all the more. If this is the kind of stuff you are facing, any medication is worth a try ... you don't know until you try and as with all meds, finding a suitable one may take more than one go, but when you do ... in time you WILL smile again :) xx

Hi, thanks for your sincere and honest post.

I too experienced a nothing/blank early phase to my meds, it was a relief from the crying but felt odd to be indifferent to my own children. Then after a while I started to feel the love for them and the things going on around me.....but then the anxiety kicked in.

I can't really write much more at the moment as shattered after a horrendous day at work. Had a major panic attack and had to run out, very embarrassing and messed me up for the rest of the day. Really can't go on like this and really feel like handing in my notice.

Would like to talk again soon.

Hope you feel better soon.

If you stop taking the cit the anxiety will go. It is normal to be terrified of taking ad's. Go very slowly and triate dose.