Citalopram - how long / how much / when do you know?

[Marmora]

DD started on 10mg citalopram 6 weeks ago. Taken for depression and very severe anxiety after sertraline (disaster) and fluoxetine (great for low mood but didn't touch the anxiety).

Upped to 15mg 3 weeks ago.

She was agitated and angry for the first week or so of taking / upping dose but then settled. Still having terrible dreams. Low mood slightly better but she's still not in a good place - was better on fluoxetine. Doesn't appear to have touched the anxiety at all.

Psychiatrist has upped her to 20mg today. DD is willing to try it but is feeling like it's pointless, which I think is making it hard for her to prepare herself for the inevitable side effects of the next week or so.

I guess I'm asking if anyone found that 20mg worked where before that they'd had no indication that it would? Is it possible that until now it has had no effect on her anxiety but that we might notice an effect at 20mg? Surely we would have noticed something by now if it were going to work?

Psychiatrist's approach is to make sure we've given it a good try before moving onto something else and I completely agree, but I'm wondering what other people's experiences are. Would love to hear some good news.

Sorry to hear that your DD is struggling at the moment.
20mg is still quite a low dose of Citalopram (as the max dose is 40mg) so don’t lose hope if it doesn’t make much difference.

I've been on varying doses up to 30mgs at my worst- have been on and off ADs for about 20 years, have found citalopram by far the best for me. The secret to any ADs is slowly on and slowly off. I hope your dd is feeling better soon.

Meant to say 10mgs is nothing really, def with giving a go at 20mg.

*worth 🤦‍♀️

Thank you both. Did you notice any difference at all at lower doses? DD saying no but it's hard to tell if it's really the case that it's not helping.

At her worst DD was on 40mg fluoxetine plus propranolol morning and night.
I don't know the difference between citalopram and propranolol.
How old is your DD?

She's 17. Yes she also takes propranolol which stops her tipping over into a panic attack but doesn't help the low mood or anxiety.

Fluoxetine helped with low mood but didn't touch the anxiety.

I've been on 20mg for several years, tried to reduce to 10mg, unsuccessfully, with GP approval 2 years ago. I'll remain on Citalopram for the foreseeable future, it's my little wonder drug.

Me too @Warmhandscoldheart 20mgs is the right level for me, I've tried reducing to 10 but the anxiety creeps back in, although I hope to give it another go in the future now I'm menopausal and on hrt. Hormones also have a lot to answer for!

Did you both notice any improvement on 10mg or only once you'd gone up to 20mg?

I’m on 40mg citalopram and propranolol morning and night, I found very little effect with 20mg unfortunately - I hope it’s different for your daughter.

Been on citalopram for years and it's honestly changed my life, I know antidepressants don't work for everyone but it's done wonders for me. Stick with it for a least a bit longer.

I was on 20mg years ago and only take 10mg now x

It was quite a while ago for me when I started but I think there was only very mild improvement on 10mg, much better on 20 but not straight away. I think it's worth giving a go for a couple of weeks.

@Marmora
20mg gives me the balance I need, on 10mg I struggled.

@Byjimminy
I personally found after finishing HRT, I was more out of sync with my body and mind. Hormones are devils in chemical form 😈

I take 20mg, but have been on prescriptions for 30 and 40 previously.

10 is very low, I would try all the dosage options offered before giving up as it's been life changing for me.

I've been on 10mg for about 3 years now and it suits me just fine.

This is very off thread but has she had her vitamin D tested? Most people are low and it can really trigger/not help with depression and anxiety. 4000IU daily is what I take now

Also on 20mg citalopram and fine on it, I had to increase from 10mg

I took 10mg for depression and it worked within days. I felt back to my normal self and was able to come off it quite easily after a few months.

Thank you all. Yes she takes vit d supplements but I'm sure would benefit from proper testing. I'm certain there is a deficiency.

Yes good advice. I'll encourage her to try the full range of dose options. There's no point going through all the side effects if you're not going to try it enough of a chance to see if it will work. I guess I was just keen to understand if it could still work at a higher dose when it has shown no hint of doing so at a lower dose.

Yes that's a hard call. But you say it's helped with her low mood a bit? That's what gives me the confidence to try a bit of a higher dose...

I think in days gone by, people would just be started straightaway on 20 or even 30 mgs. Is just that the side effects of going on/coming off quickly are more extreme, and for some who are more sensitive, 10mgs is enough. So it might be worth trying to get your dd to see the gradual increase as a loading time?

Thank you. Yes agree it's definitely worth a try.