Citalopram advice to a worried mum

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My dd18 has struggled with crippling anxiety for a few years. It has ramped up this year (yr13 a-levels) to the point where she has stopped attending school and will not be sitting her exams this year.

we are just focussing on her health. It is breaking my heart. She is an amazing young woman who has just crumbled before my eyes. I didn’t realise that she was struggling before the last couple of years as she hid it so well. I feel I’ve failed her so badly.

She was on sertraline for around 8 months but having gone up to the maximum dose, the psychiatrist and we decided it was time to try a different medication. The sertraline helped somewhat with day to day anxiety but she was still having daily panic attacks.

she has been on citalopram now for just over 2.5 weeks. She’s went up from 20 to 40mg quite rapidly as she had no side effects and was struggling so badly.

so day 10 of 40mg and she’s still not good. She’s very tired. I think that might be a side effect? She’s very low mood wise. She stays in her room most of the day. She used to go to the gym 4-5 x a week but she barely goes now. Maybe once a fortnight if ger bf can cajole her. She sees her bf several days of the week and she looks forward to this. He’s really kind. She just seems lower than ever.

my question is, is it possible that she will turn around and start to feel positive on citalopram or would you have expected to see something positive by now if it was the right medication?

how long before you felt better? Or at least could feel the tide was turning?

when did you stop feeling tired? Please could I hear your journey?

please give me hope. I’m in despair. She’s my precious girl and I just want her to be happy again. She used to be so social. Threw big parties, had loads of friends.

Citalopram normally takes 2-3 weeks to settle, and by then she should start feeling a lot better. She’ll still be right in the middle of the side effect period at 10 days, so give it a bit more time.

Just saw you said she went up as well - that will lengthen the adjustment time a bit. It can be tough increasing the dose on citalopram, so I’d add 2-3 weeks for each dose increase.

I'd also recommend taking it last thing at night, if she doesn't already.

Thank you. 🙏 really. Thank you for replying. I feel so lost. So low and so guilty. I gave her these genes. I struggle also and I just don’t want her to feel this way. She is amazing. Has brought joy every day.

does the improvement happen all of a sudden or gradually?

and do improvements coincide with the cessation of side effects or can side effects continue even as you are feeling better?

We did speak with the psychiatrist about time of day and he said most patients take in the morning. Some take in the evening. And we would see what was best over time. Some people apparently can’t sleep if they take it at night. Others are tired all day if they take it in the morning.

why did you find nights better?

If I recall correctly the improvement is noticeable over a few days around 3 weeks in with mood stabilising and lifting, I found side effects settled then as well. 40mg is quite a big step up, so she may want to just take it easy for a few weeks while she adjusts and be as patient as possible!

It’s not your fault, OP! 💐

It made me sleepy and nauseous to start with. Taking it at night meant I slept well, slept through the side effects, and wasn't tired in the day.

It works brilliantly for me, although it does take a while to build up in your system. I'm also on 40mg btw.

I didn't enjoy my time on it but was given it after my dad passed away so it wasn't to treat any kind of long term anxiety. I felt like once I started taking it I was stuck on it. It did numb my emotions but also dulled my brightness and happy times too. I came off it when I found out I was pregnant as they didn't recommend I continue taking it. See a therapist helped me a lot more once I came off it.

Do you mean by this that each increased dose starts the side effects process again? So 2-3 weeks from the increase?
I’m just desperate for this medication to work as she is SO despondent and feels so disappointed in herself. She’s never a disappointment. I wish she could see what the rest of the world sees in her 😞
I keep fretting ‘what if this med doesn’t work?’

@Azandmedid ALL your anxiety go? Did you have panic attacks before? Did they completely cease?

She sees a therapist for cbt abd emdr and has seen this therapist for about 8 months now. She likes her a lot. She says it helps. Both the psychologist (therapist) and psychiatrist are really lovely. They both say she struggling with very very severe anxiety

Hopefully it will settle down and all the threapy will help. I can't imagine having such extreme anxiety at that age and I think overall the meds will help as I didn't worry about anything when I was on it. Try not to blame yourself OP, it sounds like your doing everything you can to support her!

It’s hugely genetic. I didn’t even know what anxiety was but looking back I realise I was struggling. I just quit situations that triggered my anxiety. So I didn’t suffer this way but I also didn’t realise what was going on. Then later it reared up again after childbirth, during perimenopause. Times and things I could no longer quit or run away from. I recognise now my late dm also struggled. But being of that generation she just repressed it. I feel so bad that I didn’t know more about it. I wish my dm had more inner peace. Both my older dc struggled in their late teens/early 20s also. But it’s been far more dramatic and crippling with my dd

It took a full two weeks to have an impact on me and it never fully got rid of the anxiety but it took me from not functioning at all to being able to cope and then therapy helped hugely. I'm off it now, stopped after 9 months. It was a bit of a slow process recovering but I'm incomparably better now, just over 2 years from the bottom.

Some mild anxiety in certain situations is normal - and I wouldn't want medication that reduced me to feeling nothing.

I feel normal. And what I mean by that is a healthy normal. Generally happy, sad when sad things happen, a little anxious when it would be normal to be a little anxious - but no extremes, and nothing that lingers.

I enjoy my life.

Thank you for replying. It really helps me to hear stories of people thriving

i do tend to internally catastrophise things. I have to do my best to not pass this on to my dd so it’s so good to have a place here where I can release honestly 🙏

May I ask people how the change felt? Was it just day after day you felt slightly less panicked and anxious? Or did you come to a realisation that you hadn’t felt bad for a few days and realised something had changed

I been on it 13 weeks. Week 10. 11 I felt amazing. Now week 13 I feel awful again. I think these meds gives you ups and downs. I been trying to find a forum where I can get advice. On side effects. I some some bad side effects going on. It’s very Scarey