Switching from Citalopram to Venlafaxine

[Shattered04]

I'm currently on 10mg Citalopram, which I've been on for a couple of months. It's okay, but my concentration has gone even more to crap than it ever was, and it doesn't seem to be doing as much for my anxiety (main reason for prescription) these past few weeks either. I was on 20mg briefly for a few weeks at the start and my concentration and ability to care about anything was abysmal even though it was helping my anxiety and patience which was brilliant.

I did some research and the things I'd really like to try aren't really prescribable by a GP. I have suspected ADD, and really need to see a private doctor to get a diagnosis and prescription, but I don't have the money/energy to do that right now. I tried the NHS route and despite providing ten sides of how I fit the DSM criteria, I was told I was too high functioning and to take up yoga, so, well, yeah.

About the only thing the GP can offer me is Venlafaxine at 37.5mg to begin with. I'm happy with this as an interim measure until I can sort out seeing a private doctor. I'm aware it is awful to come off.

However, she told me to quit the Citalopram cold turkey (I'm on 10mg) and take nothing for a week before starting the Venlafaxine. Upon doing my own research, it seems plenty of people do a straight switch, or close enough. I'm very wary of having the withdrawal from Citalopram as going onto it was horrendous so I can only assume the reverse is true too, especially before Christmas with all the pressure.

What have other people done when switching from an SSRI to an SNRI?

Thanks!

I've been on both. Citalopram didn't work terribly well for me for anxiety. Venlafaxine is one of my favourites (I've tried so many!) but caused me short term memory loss which wasn't ideal (but don't worry, everyone reacts differently and I seem to have some unusual reactions!).

You are on very low doses. I absolutely do not want to encourage you to do what I did because it seems to be very exceptional, but I was on higher doses and never took a day off but did a straight switch (which is what I always do when switching - I feel rubbish if I'm off meds for a week), and it didn't have any effects (maybe the tiniest bit of lightheadedness on one occasion, but mood and anxiety stayed stable, when I switch they always do more or less). I emphasise though that this doesn't seem to be normal and there are loads of people online who seem to wean themselves off mg by mg or suffer severe side effects...

Hi there

I was prescribed Citalopram 10mg, took it for 4 weeks and found similar to you, it seemed to help my anxiety and mood, but in hindsight I think it was more that I was so spaced out and not arsed about anything, it was less about improving my anxiety and more about retreating further and further from everyday life. I was so tired, I could have just stayed in bed all day. But at least I wasn't anxious and tearful! By the 4th week I had gone back to waking in the night with feelings of dread etc. Restless legs were also off the scale, but that is always worse for me when tired.

I went back to the doctor and explained the above. She then prescribed mirtazapine instead, 15mg to take before bed. I stopped taking Citalopram straight away (docs advice), started mirtazapine the next day. The improvement is immense, although I am only on day 3! Within an hour of taking mirtazapine I am out for the count, if I need to go to the loo in the night or one of the the kids come in, I still wake up, but am drowsy enough to go back to sleep. I have had no adverse effects from stopping Citalopram and I actually had a really productive, positive day today.

Anyway, I hope some of this is useful, I know others swear by Citalopram, but it wasn't the drug for me. Mirtazapine has not made me at all lethargic in the day (other than being a bit groggy when I wake, but getting up and starting to be active helps). No regrets saying goodbye to Citalopram cold turkey (although it was only 10mg!).

Good luck

I was switched from 40mg citalopram to venlafaxin. Dr told me to take half my dose of citalopram and prescribed 37.5mg venlafaxin so I took both together for a week. Then after a week he stopped the citalopram and doubled the venlafaxin. Had no problems at all doing it this way.

I basically never tell people not to follow their GP's advice but on this instance I can't help myself.

I was on 40mg citalopram for depression and anxiety, it never did anything for my anxiety though which is why I was changed to venlafaxine, initially on 37.5mg. My GP told me to 'gradually wean' off my citalopram over the course of only four weeks and then go on the venlafaxine. This was bad advice and I was seriously ill with discontinuation syndrome for at least a month.

There is no reason for you not to switch straight away to the venlafaxine. I did not know then that this was a possibility and assumed GP knew best but on this occasion they really didn't. To avoid horrendous discontinuation syndrome I would switch straight to the venlafaxine.

Thank you all, it's very much appreciated! Normally I tend to follow GPs advice too, but I do feel (having also done my own research) that I can't find anywhere that suggests to do what she has suggested! All I could find was what you've all said here. Especially at such a low dose on both sides.

I had my doubts as to how much she knew when she said that Venlafaxine wasn't really indicated for migraines (it is) and that it's no harder to come off Venlafaxine than Citalopram (umm). And it's not fair on my husband, family or work - let alone me - to deal with coming off and going back on again at an already stressful time of year!

I'll take my last Citalopram tonight and start the Venlafaxine tomorrow night. She asked to see me in five weeks assuming I'd take a week off, but maybe I can get an earlier appointment and tell a white lie about how many I have left..!

Bit worried about the memory loss aspect, but I had that on the Citalopram as well, and it improved a lot after I took ginkgo (and maybe when it was more settled too) so fingers crossed.

Come back here for support if you need it @Shattered04 , hope it works well for you!

Thank you! It'll be interesting to see what side-effects there are, given there won't be the initial serotonin boost I had when I started Citalopram. She had me on 20mg to start, and I now know that a lot of people start on 10mg, and I took it at work and I'm amazed nobody said anything. I was on another planet, drooling, twitching, gurning for the first few days.. after about five I chose to drop myself down to 10mg and then try 20mg again a week or so later which was the best thing I could have done. It was all fine then.

This is why I'm doing it at the weekend!!

As an aside, I noticed my prescription said 37.5mg Venlafaxine, twice a day, 28 tablets. You don't have to be a maths genius to work out that's not a four week dose, and I said as much to the pharmacist. He agreed she'd got it wrong and that was really bad. So, yeah.. not entirely trusting my GP now. The sooner I can see a proper psychologist/psychiatrist the better!