Anti depressants stopped?

[ZombiePara]

I don't really have anyone in RL I can talk to so Im hoping someone here can advise!

I started citalopram just over a year ago, 10mg then 20mg, ending up on 40mg for probably the last 6-7 months.

Through work occe health and speaking to the GP, it was decided it was work-related trauma caused anxiety/depression, although personally I would have erred more on the anxiety side.

Recently (since end of November 2020), I have been under unrelenting stress at work, home, relationship and family wise.
Potentially even from September if I'm honest.

A large portion of it has concluded (relative died), and although there is still a lot ongoing, some seems to be tying itself up..or at least it's no longer a wtf is going to happen scenario, it's now a waiting game (had an offer on the house, so the end is in sight for a break from living with the ex etc).

The past few weeks, unless I have had something stuck in stone, I haven't wanted to move off the sofa, increased fatigue and lethargy, and a definite lack of fucks to give.
Thinking tonight... I think I've tupped the balance from anxious to depressed.. and that perhaps my meds aren't working anymore/in the way I meed them to

I have a telephone appointment booked with my GP in a week or so's time (for something else), but I plan to bring this up with her then as well.
Due to time constraints I want to be able to have an idea of possibilities/others' experiences/what options are out there that people have lived through, before speaking to her.

If it makes any difference, she initially suggested sertraline which I declined due to knowing a few people who had awful experiences with it...

Has anyone else had something similar?

Is it perhaps just the culmination of everything that's been happening and it'll hit a point they work again?

Or am I best to try any other meds, and if so, what have other people had good reactions to?

Hi, I haven't got any advice or prior experience but I'm in a similar situation myself at the moment.

Been on sertraline for almost 2 years, it's been working well for me but recently I've been feeling like my symptoms are returning. Not helped by an increase in life stresses still ongoing! Currently on 100mg and I'm worried about asking to increase the dosage, it feels like a backward step some how. I'm booked with the GP soon too so would be interested to see what you are advised also.

With what you've said Time I am strongly erring on the side of it being recent stressors that have tipped me past my coping line.

Definitely isn't a step back to have a dose increase though - even a temporary one to get you through what's going on at the moment!

Well done in booking a GP appointment.. first step is self recognition of things not being quite right..

I've only ever been prescribed fluoxetine so probably not much help as I guess there's a reason why this isn't the 'go to' for you? But what I found out last time when it really did not work for me was that it's metabolism-related. You probably know this already but I hadn't realised. Anyway the reason I say that is you might want to research specifically how your age affects the way certain drugs work because the older you are in general the slower your metabolism. So whereas prozac worked for me 20 years ago, now it still gives me a really quick 'up' but it also gives me insomnia, which leads obviously to worse depression. As it turns out, this is really common but like with a lot of things, GPs aren't often very holistic about this stuff. Just worth a think. it's really impressive that despite feeling the way you do, you're managing to be proactive. Best of luck

thefall that's really interesting actually, and definitely something I need to read up on... thank you!

28, and yes, first time on any sort of antidepressants

zombiepara I've just reread your first post, am I right in thinking that you are a fellow NHS worker? If so, I'm sure the first few months of 2021 have felt like a marathon at work, myself and many many of my colleagues are burnt out and on a downer at the moment even those without other life stresses going on

I was on citalopram for a few years and then it stopped being effective for me. I think this can happen, you can kind of "get used to them" and the effectiveness can wear off.

My doctor switched me to another medication - a different class of antidepressant (not an SSRI like sertraline/ citalopram but something entirely different). It might just be that you need to try something else. Good luck. I also recommend mentioning to the GP that you have another issue to talk about before the appointment because you might need longer than the 10 minutes - they can book you a double back-to-back appointment to discuss both things.

I'm also wondering if you are having any kind of counselling or therapy?

Antidepressants are great but they can only do so much. If you are under unrelenting stress and going through a lot they can't make everything better, all they can do is numb you a little bit. Talking therapies can be really, really helpful in those situations.

@nancywhitehead

I'm also wondering if you are having any kind of counselling or therapy?

Antidepressants are great but they can only do so much. If you are under unrelenting stress and going through a lot they can't make everything better, all they can do is numb you a little bit. Talking therapies can be really, really helpful in those situations.

I really agree with this. It can be nightmare to get long enough therapy on the NHS, so if possible it’s worth looking at private counselling, however totally understand that’s not an option for many. NHS counselling will be CBT and one session a week for 5-10 weeks usually. Sometimes there is leighway to request a bit longer if you and counsellor are working well on something specific. CBT can often help with immediate issues (anxiety, low mood etc) however, for lots of people they need to go a bit deeper and explore the issues behind the now and that therapy can be harder to access.

dane hopefully not a super early menopause! You certainly hit the nail on the head - it has bene one thing after another... and none have been quick either, so a very good combination of both.

timeforsinging I am yes, it was work that kickstarted it all last year, and I've had some pretty awful jobs this year (aside from Covid)... thankfully (i think) I've been off on an unrelated joint injury since the middle of March, so workwise isn't compounding it right now.. I think if i was still on shift I would...well. I would be less than coping.

nancy will definitely ask the gp for advice re the sort of medication as well, ssri vs something else.. worst case I'll discuss this rather than the other issue - this is more pressing to me than a scan result

• magpie As for counselling...i need to chase it up again through work - ive spoken to a couple of managers who have said they'll look into it, as i was due to have 10 sessions but they stopped after 3/4 when the counsellor left and I wasn't comfortable with the new one. Unfortunately I dont currently have the funds for private counselling, but it is on my list to look into... once the house sale goes through (only at the start unfortunately) I will have the money to go private with it.. but in the meantime I will try and get work to re-engage with it all as well

ADP's are designed to combat depression CAUSED by a chemical imbalance. But when the depression is caused by life circumstances, they're bound to be of little use and there's evidence to suggest they can make things worse. Nearly ALL the studies that claim they work focus on severe cases - on mild depression there's not really a proven benefit of ANY ADP above placebo.

One of the reason a lot of people think they work is that the placebo effect is quite strong and if that belief gets you through a difficult patch, then it's easy to cling to them later - however placebo effects don't last so if you're life circumstances don't change in the meantime, you'll end up crashing again.

Note - the efficacy of ADP's against anxiety seems to be better, but I've always struggled to find a study that only looked at anxiety.

I think OP that you've recognised that your issues are due to your life circumstances - it's those you need to address - and I think you are addressing them - once you get out from living with your ex into your own space, it will no doubt make a lot of things easier.

Look elsewhere in your life as well. Identify the things that eat at you and consider what you can do to change them, and don't be afraid to ask for help - it's unlikely that any single thing or person will fix everything - but the accumulation of multiple different strategies WILL make a difference.

Oh absolutely. Completely see where you're coming from on it, life has sucker punched me and that in itself has knocked me down some.

But iirc the GP was describing that stress can be a cause of lower serotonin levels as well, so it's that side i want to ensure I'm covered on.

Life wise, by Christmas I'm hoping things will be back to a good level (not just an improving state, but a good level). Gives me something to aim for, is realistic, and at worst, give me some hope and joy rather than a never ending spiral.

I'm having a more positive day today, as normally everything is some sort of spiral, but then I had a breakdown in the car driving home yesterday, over a few things, so a mini release..

Just as an update to the PP(?s) who asked..
Spoke to my GP - she was lovely and we covered a couple of things in one call - she has swapped me to sertraline as i was top dose of citalopram.

Took my first one tonight, so 🤞🏻 it doesn't all go wrong!

Feeing a bit iffy, but also drank some alcohol this afternoon for the first time in ages, so figure it may be that as well.

I’m like this right now
I’m on sertraline and it’s been great
But too many life stressors recently
I can’t get myself off sofa either

I’ve been signed to reduced hours

No advice , but you are not alone

I’m definitely depressed and anxious

@Thisisworsethananticpated I'm sorry to hear you're going through this as well...

I am also very much a sofa-dweller at the moment, and just waiting for that switch to flick to let me do more again...