Splitting my citalopram

[Citalopramadvice]

I have generalised anxiety, depression and acrophobia. My next appointment with the doc is 14th October.

I was still unwell on 20mg so asked for an extra 10mg, and a month off work to get out of my current funk and mental torture.

So I have a pack of 20mg and a pack of 10mg to be taken daily, I find my anxiety manifests the most in the evenings, I take my medicine at 8am pretty much every day, the last couple of days I have taken my 20mg at 8am and the ten at 5:30pm and it’s been bliss. I even ate more than a few mouthful of a meal and drove my car 🙌🙌🙌

is this what I should be doing? The doctor said take at the same time each day, I did that today and I am on such a downward spiral tonight after having a great day feeling pretty normal-ish!

Bump

I'm not entirely sure, but a pharmacist will be able to advise, it's worth popping to speak with them. Some supermarkets have weekend pharmacists so they'll be able to help.

I am on Citalopram and I take it when I go to bed. I was on 20mg but during the lockdown I asked for it to be increased to 40mg, which keeps me stable.

Honestly, I think if it works for you, why not? You are not overdosing, you have experimenting with the most effective method of taking the dose.

The only reasons I can think of for not dividing the dose would be if taking some of it in the evening was making it harder to get to sleep (doesn't sound like that's the case), or if a more complex dosing schedule made it so you were more likely to mess up in some way (forgetting doses, or taking a 10mg when you should be taking a 20mg or vice versa, so inadvertently ending up with the wrong daily dose).

It doesn't sound like you're struggling to sleep or having trouble taking the right tablets at the right times, though. If you feel like it's beneficial for you, even if that aspect of dose timing is working on a more psychological level, then it seems a reasonable enough thing to do. It apparently takes about a day and a half to remove half of a citalopram dose from your body, so even taking it once daily should mean the amount in your system doesn't fluctuate too much, but if it's working better split then it's working better split 🤷🏼

I would second talking to a pharmacist or your doctor about it (or both), to get some reassurance that this is okay to do with your citalopram.

There are a few medications where it can be better not to do divided doses — for example, I take a medication that's hard on the kidneys (I get regular bloods tests to check), and doctors used to think that split doses kept the levels moderate and protected the kidneys, but I've been instructed that it's now thought that with this medication it's actually better to take it all at once, to give your kidneys a chance to heal each day when the blood level is lowest.

But that's unusual, and lots of medications are fine to take in divided doses and might for some things work better or have fewer side effects, so please don't worry that you're doing any harm to yourself — I'm only telling you about the medication I take to show that it's a perfectly reasonable issue to want advice from a professional about, and nobody's going to think you're asking about something strange. Lots of people divide doses to help even out the amount of medication in their body and prevent side effects. I've never read anything that would suggest a problem with dividing doses with SSRIs; they usually seem to recommend single daily dosing because on average it's just as effective as split doses, but is more convenient and easier to remember to take. You are not a mathematically average patient, you are an individual

Thanks for the replies, already thought of speaking to the pharmacist tomorrow, had a lousy day today as took all 30mg in one dose and have had the anxiety olympics going off in my brain since 6 pm.

Felt fab when i have been taking it twice daily, so going to continue until I speak to the doctor on the 14th, if anything I think I need 30mg for the day and 10mg for an evening as feeling fab to function and fab to do a days work is a different feeling!

Citalopram has a half life of 35 hours approximately (so 50% of the initial dose will still be present in your body 35 hours after taking it).

Which means taking it every 24 hours should keep you daily even and splitting the dose 12 hourly is likely to have more of a placebo affect than anything else. If this is working for you, then that’s great.

I wonder though what else may be helpful for the anxiety? Good sleep if possible? Regulating blood sugar throughout the day? Gentle exercise (walking is great) could be helpful? Small steps outside that could enhance the affect of the Citalopram and help you holistically?

I think I accept it was a placebo effect now and have just taken them all at once the last two days. Boy have I been busy today, I feel like an actual human and even cleaned my oven!

Hope this continues, have another week off on my fit note and I will be a world leader by then based off how I feel 👏

Take it easy. Google activities of pleasure and achievement in relation to mood. Great to achieve lots and be productive, balance it out with some pleasure for yourself too. Whatever you find nice, chilled, enjoy etc.

Hey, don't knock placebo effect, it can be very helpful! Especially for that first couple of weeks when you start or increase an SSRI, before the drug has had time to have a pharmaceutical effect. But if you can get just as good an effect when taking it all at once, it'll probably make life slightly easier for you.

Oven cleaning… that's truly impressive levels of functionality. I dread to think how grubby mine is

I always took mine at night so I could sleep through the side effects.