How much to expect from antidepressants?

[SummerBummers]

I’m currently taking Citalopram, Amitriptyline and Propranolol for anxiety and depression. I’m also in weekly counselling. I’m not currently in work.

I don’t know how much ‘better’ I should expect to feel on these medications. I still have multiple panic attacks per week, I’m unable to go out alone unless it’s the 5 minute walk to get my kids from school which I’m very familiar with, I can’t take care of my own needs; I need prompting to take my medication, to eat, to wash, etc. Minor problems will cause me huge emotional distress and I cry several times a day. I can’t focus on anything productive and I have regular intrusive thoughts.

i am, however, better than before. I am less upset. I don’t wake up and want to instantly cry for no reason. My meltdowns although still frequent are less regular.

There is some benefit from the medication but I don’t know if it’s reasonable to go back to the GP and push for more help or if this is as good as it gets.

I find the whole process of contacting the GP very difficult and struggle to express how hard things are. I’ve tried various medications over the last two years but I can’t get to a point where I feel capable of functioning normally. I don’t want to go through the upset of more GP appointments if nothing will help me beyond this point.

Thanks in advance.

Have you been referred to a psychiatrist?

How long have you been on Citalopram, and what dose ?

I’ve never had a psychiatrist referral. I don’t know if it’s appropriate to ask.

I’ve been on Citalopram now for around 7 months. My current dose is 40mg per day. I’ve been on this dosage for 3 months.

Thank you for your replies

It sounds like you should be under a psychiatrist because your condition sounds quite severe. Was it the GP who made the diagnosis and prescribed the medication? I’m surprised the GP is prescribing a combination like this. Is the amitriptyline for pain or for depression/anxiety?

Anyway, of course it can get better than this- you can recover! But I think you need a psychiatrist referral as the next step.

The Gp added the amitriptyline a few months ago for my anxiety/ depression as I didn’t feel like the Citalopram was having enough of an effect.

I just feel like a nuisance because I keep having to ask for more help.

My understanding is that guidance states that GPs should consult a psychiatrist before combining antidepressants so perhaps they are consulting a psychiatrist in the background.

You are in no way a nuisance. Your condition is obviously on the severe end and that isn’t your fault. It’s rubbish for you. You should ask for more help and in my opinion at this stage that should include a referral.

Also I always feel compelled to ask if you feel that things are adequately explained by the depression/anxiety diagnosis?

You’re having a lot of treatment and you’re not as well as you want to be, so I think a referral is the next step.
Are you peri menopause age ?

I don’t know if I feel things are adequately explained by the diagnosis to be honest. I’m aware that things are a lot worse than other people I know who are on antidepressants but I don’t know at what point the severity points to a more serious condition.

I’m 37 so probably a little young for perimenopause and no other signs of it from what I know.

I'd ask for a psychiatrist to review your medication. Most GP’s don't really understand psychiatric drugs. Amitryptaline is a very old fashioned drug and there are probably other things that would be safer and possibly more helpful. Plus if you've not been unable to work for so long it seems sensible to request a referral. If you had back pain that stopped you working/restricted your life for years they'd refer you to a consultant!