Please help!!

[Lau575]

Hi there,
I'm new here and looking for some advice.
I was on citalopram 40mg for 7 years with no problems at all. They were great! Until I felt that they weren't working anymore. My GP did a direct switch from 40mg cit to 50mg sertraline. It has been absolute mental torture and a living hell! I've been taking it for 27 days now and not seeing an improvement. I see my GP again on tomorrow , (end of the packet) I'm just wondering if a dose increase would help or if I could go back onto citalopram? I'm really regretting this switch in meds my life has been on hold for what feels like forever! Any help please?!

@Lau575 I feel your pain. I've been on sertraline since 2016 but felt my anxious episodes were becoming more frequent.
The psychiatrist tapered me off them to go onto fluoxetine. Part of it is my fault because I didn't start the fluoxetine straight away because I was feeling really well but I've been on the fluoxetine about a month now and Ive got the worst symptoms I've had in a long time. X

I just don't know what to do?! Do I increase my dose, go back to citalopram or change again?

This might be helpful: patient.info/news-and-features/how-to-switch-antidepressants-safely

A straight switch might be ok for some, but clearly not for you. I'm afraid many GPs are not knowledgeable enough about this and can be dismissive. I don't know what the answer is now. Have you been on any of the forums?

I would go back to the GP and tell them how you feel. I took citalopram for about 5 years and like you, felt as though they weren’t working as well. I too was put on a higher dose of Sertraline, and it was a nightmare. I persevered but had so many side effects. I had headaches, despite drinking plenty of fluids, felt sick and dizzy and constantly thirsty. They interfered with my sleep, despite moving the dose to the mornings, and I was significantly more agitated. I did a bit of research online and it seems Sertraline is marketed as Zoloft in the USA and has a mixed reputation. I‘ve also tried Fluoxetine (Prozac) and they just made me muddy headed and the tiredness was debilitating.

I eventually went back to my GP and after some discussion, I agreed to try something called Venlafaxine - sometimes marketed as Effexor. It’s different from SSRI’s (selective serotonin reuptake inhibitors) in that it works on two brain chemicals - serotonin and norepinephrine, so is an SNRI. Based on my own experience, I would advise you to discuss switching to an appropriate dose of this, rather than standard SSRI’s.

I found it worked much quicker on balancing out my mood. I am much calmer and my mood has lifted and evened out - not a hostage to horrible mood swings any more. I have no agitation, there is no nausea, dry mouth or sleep disturbance which are all associated with SSRIs, and although I am still taking them so haven’t experienced this for myself, I believe from talking to a couple of people who have taken Venlafaxine, that when the time comes, it’s much easier to wean off them. Talk to your GP and see if it might be worth switching. Good luck and let us know how you get on. Please don’t hesitate to PM me if you want to chat privately.

Just posted to the OP re - Venlafaxine (Effexor). Might be worth and look and consider talking to your GP about switching if you’re not getting on with Fluoxetine. I couldn’t take Fluoxetine - the side effects wiped out any beneficial effects, but Venlafaxine was a game changer for me.

Thank you for your reply. I see the GP tomorrow so hopefully she will take this suggestion.

That's all I've done for a week is look on forums! I can't find an answer as to whether or not I can go back on my previous medication.

"Based on my own experience, I would advise you to discuss switching to an appropriate dose of this, rather than standard SSRI’s."

@Rosscameasdoody, you absolutely should not advise which AD to ask for based on just your own experience!

This is the massive problem with asking for advice on this topic.

Venlafaxine is one of the hardest ADs to come off, that is well documented.

OP, this article from the Royal Pharmaceutical Society states that you can go back to your original medication if symptoms during switching are intolerable: pharmaceutical-journal.com/article/ld/switching-antidepressants-advice-and-practicalities

Once you have stabilised you can rethink.

From your GP's point of view, the NICE guidelines do say direct switch from citalopram to sertraline is possible, but it obviously has not worked out for you.

This is great thank you I will definitely bring this up at my appointment thank you

The bit in my screenshot is talking about a cross taper, but if you read the whole section it appears to apply to a straight switch as well.

Hope your appointment goes well.

Thank you for your help I'll update you all after my appointment tomorrow. God that feels so long away :(

How are things going, @Lau575?

I seen my GP yesterday we decided to give it one more week on the sertraline and if there's still not much improvement I can switch to escitslopram. I'm wondering if because citalopram worked so well in the past that escitalopram will work. It's just so hard to make a decision.

If you re-read my post, you’ll see I didn’t advise her to ‘ask’ for it, but to discuss it with her GP - I appreciate I am not an expert and was responding from my own experience and advising proper medical advice. I’m still taking Venlafaxine but before posting I spoke to a couple of people I know, who have weaned off it and they did so with no significant problems, and both said it was easier to get off than either citalopram or Sertraline - both of which I have taken myself, and both of which caused very unpleasant side effects when weaning off them. I’m not an idiot - the OP posted for advice and I don’t consider that I said anything irresponsible.

I hope it works out for you, @Lau575.

@Rosscameasdoody, Venlafaxine has an incredibly short half-life which tends to make withdrawal more brutal. See: https://www.health.harvard.edu/diseases-and-conditions/going-off-antidepressants

Personal experiences can be really useful, but I'm always very careful to say 'this is what happened to me', rather than 'discuss this [specific drug] with your doctor' when talking about psychoactive drugs.