is this normal - increasing citalopram dose

[peanutbrittle]

I was diagnosed with depression and started on 10mg about 20 months ago , wasn't enough so went up to 20mg, then 30 and now about a month ago up to 40mg. Each time I feel better for a couple of weeks but then gradually the bad feelings come back. I am worried i will just be constantly upping the doses forever...

I was feeling very well the past couple of weeks but now starting to feel down again. I did drink quite a lot at the weekend so that didn't help - is drinking a bad thing with citalopram? I am guessing it is but is it so bad that you shouldn't do it at all?

Hi Peanut - drinking on any antidepressants isn't advisable, and you should have read in the leaflet with your tablets to avoid alcohol when taking citalopram. This medication can be used up to 40mg, but if you feel that they are not controlling your bad feelings then I strongly suggest you speak with your GP, or prescribing Doctor, as another antidepressant may be more suitable.

thanks divedaisy

I think they are helping a lot, I just seem to have dips still. Is that not normal? I think I do need to drink less, or maybe cut it out for a while. I am normally quite good but have had lots of parties lately so fallen into some bad habits again. I was feeling very low today, which would make sense after getting hammered on Saturday night as yesterday I was feeling way too hungover to notice anything else. I will wait another while and cut out the booze, see if that helps.

Thanks for your message.

Peanut - maybe you need to speak to your GP about alcohol if you feel it is a problem. you say you have 'fallen into some bad habits again' - is alcohol one of them? And if so how bad is BAD? Being on antidepressants isn't a prescription for being happy - you need to work on what's causing the depression. have you been to councelling over the past 20 months whilst on the tablets? If not then I strongly suggest you ask for a referral or find out about suitable therapy in your area. No manner of tablets is going to miraculously cure you and take away all the problems - only you can do this by working your way systematically through them. If you feel you're not getting better, this can be a cause for your depression worsening. You need to feel you are getting somewhere.

Some charitable organisations offer councelling - it doens't have to be via the NHS.

I didn't drink alchohol at all whilst on citalopram - I would say it is factor in you feeling up and down. Also are you taking your tablets at the same time each day and not missing any?

CT - I've missed one or two (normally due to booze or tiredness) and sometimes do take at erratic times as I often end up going to bed really early when am exhausted so sometimes take about 8pm sometimes about 12pm...hmmm, now I write it down I realise that might not be great

Divedaisy - I don't have major alcohol issues (I don't think) - however I have been a major binge drinker throughout my 20s and altho' I tend to stay off it these days when I go to a party or something I can find it drifficult. I had two parties (on fri, one sat) this weekend and am afraid I totally overdid it - to extent I don't remember getting hom eon saturday night. My DH is a very big drinker so it is had to stay on straight and narrow with him about. although as I say day to day I do manage quite well.

I know I can't just rely on the meds, I have been going to relationship counselling the past 8 mths but she has decided we are now at an impasseuntil I decide what I actually want myself and so we, (me, counsellor and GP) have decided I will go for some psychodynamic therapy. I am currently filling in the forms for that, which I am finding very difficult so am sort of dreading process itself. I know I have to do soemthing though. I am also trying to help myself through meditation and various mindful techniques.

thanks for listening

I know if you are a social drinker to stay away from alcohol on a night out but I think it would be worth it for a month or so and see if that makes a difference.

Also if you can try to stick to a regular time to take to your meds then I really think that would help.

good luck

thanks CT - am going to try to stick to mineral water for a while. Am out on Friday night with two friends so may be tricky but I know them well and may even explain why to them. I think giving up alcohol full stop would be a very good thing for me to do, but then am not sure what would ever do with my DH

will think about taking the meds in the morning instead - could probably be more regular then, although not sure whether they will make me drowsy or what

ended up calling in sick today as just couldn't face going to work, first time in ages this has happened

I had the psychotherapy questionaire to fill in and it was really weighing heavily on my mind. Have just sat down with some lavender oil (for calming effect!) and filled it in and stuck it in the envelope. Is a weight off my mind. Imagine what I will be like during the therapy if this is what the questionaire does to me

It says not to drink on the info sheet but I had before I realised that. I don't generally now as I don't enjoy it.

I am on 40 atm and went 20, 30, 40. Doctor was expecting me to go back down at 20 after Xmas but ended up putting me up again.

hi nabster

I think alcohol effects me much more severely now I am on 40mg. It would do me the world of good not to drink for a while (think I poisoned myself so badly on Saturday I won't want to for some time anyway) so am going to stay off it for a month or two, hopefully

do you still get up and down feelings on 40mg? (if you don't mind me asking)

I don't feel that the 40 helps me more than the 20 but right now I am really bad tbh.

awh, am sorry to hear that nabster - maybe you need different sort of drug? someone suggested that to me - have you been back to GP?

Seeing GP a lot.

Got beyond that tbh.

Hope you feel better very soon.

peanut you're being very honest here. You need to do what is right for yourself regarding your drinking. If your dh can't reduce his usage you shouldn't drink just because he does. The obvious problem with drinking is that it creates a vicious circle - you go out to have a 'few drinks' to enjoy yourself, and maybe even tell yourself to go easy before you leave the house, but then you really start to enjoy your night out... and then before you know it you're out of it...and you think you can cope with it. Hopefully the psychotherapy will help you address these problems and give you coping techniques to deal with them effectively.
Keep being honest with yourself. You only live this life once, so please make the best of it.

I personally found that taking the tablets at either dinner time or bedtime was the best. It gave me about 8-12 hours for my body to 'dose up' again and I generally felt less sleepy during the day. I kept them beside my toothbrush.

Is your DH going to relationship therapy with you?? When I read your post I understood you are attending this yourself...??? You said: "I have been going to relationship counselling the past 8 mths but she has decided we are now at an impasseuntil I decide what I actually want myself and so we, (me, counsellor and GP) have decided I will go for some psychodynamic therapy."

Hi Divedaisy

you sound very wise, thanks for sharing that with me. You are right on the drinking. I am trying to handle it myself - went out last night and had an orange juice - was lovely. My concern though is that the "sensibler" I am on day to day the worse I get when I do let my hair down. ANyway, decision for the moment is not to drink at all, just tell myself I can't due to meds and leave it at that. WIll do me the world of good. I am nervous about the psychotherapy to be honest, it's as though it is really admitting I have a problem, which for soem reason I still seem to be denying. My DH yesterday when I couldn't go to work said to me "that does seem like depression doesn't it" so I think I kind of share his sort of vague sense that there is nothing really wrong with me, even though I've been on increasing doses of ADs for the past 20 months. It's as though agreeing to teh therapy gives it a sense of validity, and I worry that will be bad for me, will give me permission to wallow or smething. That said, taking a "mental health" day yesterday and just deciding not to try to do work from home etc did me teh world of good. I felt renewed and able to face things again today. Thankfully.

My DH did go to the relship therapy with me, although we ended up going separately mostly. In the end he didn't think it was doing much good and stopped going. We had a horrible period at the start where he wasmn't sure he wanted to stay with me, but after considering for a couple of months he decided he did. Then it was as though it wasn't necessary anymore for him, and he says he found it more of a hindrance than a help. I kept going but the therapist said in the end I needed help getting my own head straight and working our whether I wanted to stay with him, or what I wanted for my future. She said she couldn't do that with me as her remit was the couples side of things. Hence the psychotherapy.

I honestly don't know whether our problems are caused by my depression or it has its roots in my unhappiness in the relationship. Sometimes I think we don't actually HAVE any problems but that I am making them all up.

aaaaargh!

thanks for listening.

Nabster, hope you are ok

Hi Peanut - I can only talk about my own experiences! And if that makes me wise, then so be it!! Thanks.

Don't be scared of psycotherapy, cognitive councelling or whatever term is used to describe your treatment. I had very bad post natal depression and post traumatic stress disorder caused by the birth of my son 6 years ago and also the disappearance of my dad 23 years ago now. The problem I found with depression is that often you don't believe you have it. Why?? Well because you think how you feel is normal! And after feeling a certain way for long enough it does become normal for you, but it is not normal or healthy. Does that make sense?? Eg my sister has a weird blood disorder which makes her chronically tired, on top of other things. Over the years her tiredness has become part of her and she sees it as normal. Now if I told you that a 37 year old single, no kids woman NEEDED to go to bed between 6:30pm-8pm in order to try to get up for work the next morning you'd agree with me that it isnt either normal or healthy. It seams to me that you are in a similar situation, and are only now acknowledging and accepting there is a problem. That is a fantastic first step in addressing the problem.

Psychotherapy is a talking therapy which I had and found you work at your own pace - you talk about things you are aware of that bother you, and your therapist guides you through a thought process and sometimes you'll discover other deeper problems which you didn't recognise before. The therapy session I found always ended on a positive note in that I found my on answer or coping mechanism for that particular problem. It also is extremely draining and can be very emotional! I found I was so mentally tired after an hours therapy, so if you can plan to take it easy for at least an hour or 2 afterwards, especially in the early days. I had therapy for nearly 2 years and it did me good - so good luck with it!

thanks again divedaisy

I am nervous about the feelings the psychotherapy might drag out of me, but I need to get a grip on myself and the thought processes I seem to have. My eldest DD is exhibiting similar signs and I need to be strong to help her get through stuff

I know, the first time I realised not everyone felt like this I couldn't believe it - think I have had low grade chronic depression all my life, it's just gone a bit more obvious since I've had kids as I can't retreat into my shell (wallow without consequence) so much

I know how you feel cos I think I also suffered from depression throughout my life too, but thought it was normal, so never did anything about it until it really became a monster in the living room! And even then I think I didn't recognise it - it was my dh, hv & gp - and then I thought they were all conspiring against me! My thought processes were totally paranoid and obscure - to be honest I couldn't think anything through properly. Not a nice way to be.

As for being nervous - totally natural... but think of it as an exciting journey discovering yourself. Yes there will be obstacles etc in the road, but believe me there will be amazing things to discover too. Rain and sun - you'll be fine cos your therapist will be there with you and to ensure you are safe. And you are also doing this for your daughter.

So come on - time to ditch your shell/cacoon and find and stretch your butterfly wings! Fly high peanut! Life is amazing when you find your wings! xxx

no, it's not nice is it...and I think if you have always had it in one form or another you do end up just thinking it is normal...my DD is at risk of this I think - she is only 6 now but she has already been diagnosed by GP as suffering stress and we had to keep her off school - she can be very dark, irritible and me-centred, flies off the handle at the smallest thing, and often for no reason at all will be sobbing but not know why. Aaargh. I really want to change my own attitudes so that she will have a more positive role model in me...the therapy may well help, but really I should probably try to work less and be at hoem more, it's often the stress of tring to keep all the balls in the air that knockes me out of equilibrium in the end...old story though, London, house, mortgage, need to work...

I hope I can break out of my cocoon and find my wings, I fid the prospect quite scary though...what if I get the courage to actually do all the things I would love to...give up work, change career, spend more time with the kids...could be lethal (and impoverishing!)

thanks divedaisy

I had an appointment with a community mental health nurse today.

My baby is due in 7 weeks and ever since I found out I was pregnant I have been telling all health care pros abouot my history and fears of it coming back. I had spoken to my GP in the early days and she referred me back to see my consultant psychotherapist, whom I saw in November. He spoke to the consultant psychiatrist and between them they have 'a plan' in that if it comes back I'll get seen urgently. But also the psychiatrist referred me to this nurse!

So I had a chance to speak to him (the nurse) today about my history and he believes I actually didn't have 'just' PND but a worse form of it - some type that involves horrific visions and hallucinations etc.

Anyhow, I thought this appt would be a one-off and he'd tell me to phone him if I needed him. But how wrong was I??? He is going to keep an eye on me over the coming months, and has arranged a home visit on 20th April.

It was quite emotional speaking about my experiences today, which threw me a bit!! You know peanut, you will never forget what makes you depressed and like me you may find going over it in the future is emotional; but you know what?? - even though I was crying and upset, it really didn't affect me the same way! It was just a sad event that had happened, rather than a nasty horror I still had to get over. I understood today that I had learned to deal with it.

So, I am feeling supported, secure and safe knowing the help is there now for me.

Have you got your appointment yet? I would suggest you even phone them up and see if you can get a cancellation - no harm in trying!!

Working and being a mum is extremely hard to do. I did it for about 5 years and then through a series of events have been medically retired from my job last August. So I am now a FT mum. It has it's own benefits and problems too - remember the grass isn't always greener... I do love the time I have with my son, and I now often wonder how the hell I coped with a full time job also! But I also miss the adult contact and buzz from the job I did.. and the FT money too! But you manange and find a way! Having a suppoortive DH helps enormously too.
xx

Look hun, i know how you feel - yes REALLY FEEL!

I too have this drink "problem" with aniexty and clinical depression.

You need help for both, and as we know they are two differnt things, despite what anybody might say.

Put into the mix all the pregnancy hormones that will send anyone doolally!! & then some!!

Yes alcohol and antidis are bad news, they trigger each other off, cause major anxiety ( worse than what you have already) Take it from someone who knows the egg came before the chicken!

I felt talking to someone was like just a weight off my back, even though i thought i wasnt "normal" what i felt was SO common!

You should seek help chick, christ yr not a saint & neither should you be, your human, you need a bit of help, as lots of us do so please seek it hun x x x x

Good luck & feel free to mail me x x x x

just read update, so glad you are doing the right thing, best of luck.

thanks mizz - I think I am getting on top of teh drinking now - but have realised I need to be EXTREMELY careful about it - it really isn't good for me to drink more than about one drink , and particularly bad to have a couple of big drinking nights in a row. I have't had a drink in 3 weeks now and am REALLy feeling the benefit. Hav ebeen very careful about not missing any meds too and the combination is really made me feel better.

Divedaisy - glad to hear they are keeping an eye out for you. That must be quite unnerving - not quite knowing how you will be after the birth. Sounds like a very traumatic time you had last time. I hope it'll be easier this tme, at least you know what to look out for I guess.

There are times I would lov eto be signed off work, I tell you. But I know I'd probably go a bit doolally st home 24/7 too. Not that we could ever afford it. My dream is to quit my office bound, stiflingly boring job and support myself doing something more creative. I think deep down this is forming more and more of the root of my problems, as I grow older and try to reconcile it all with only having one chance at this thing called life. (mid life crisis anyone?) Hopefully the therapy will help me get to teh bottom of whether that is teh root cause of my disatisfaction, in which case I will chane things, or whether it is merely a case of grass being greener. I just don't seem to have any real confidence in my own thoughts or intuitions and I need to build that up if I do nothing else. I have an appointment now, the initial one after which I assume I go on a waiting list if tehy decide the therapy is the thing for me. The appt is in early May. Maybe I will ring and see if any cancellations, it would be good to get started soon. Although now that I have normalised things with teh meds and the not drinking (And this mindfulness program I am doing myself) I am not feeling too bad.

thanks for all your support DD. I hope you are doing ok. 7 weeks to go eh? how exciting. I was cuddling a ten week old baby at lunch today and it get my broody hormones going. New babies are wonderful. I wish you all the luck with it. And I still think you are very wise

Hi Peanut. Well done for holding off on the drink and for taking your meds at regular times. It's great that it seems to be helping you.

I've just started taking citalopram again this week so am also giving up alchohol for a while. I don't remember feeling this tired on citalopram last time so am hoping it's a tempory side effect.

Hi CT

yes, I remember feeling EXHAUSTED when I started taking them first, it took about two weeks and I felt much better so hopefully won't be too long for you

what dose are you on? that might have an effect too - I started on 10 which is very low, but I still felt it

good luck, I hope it gets better soon

and thanks for your words about the booze and the regular times to take ealier in the thread, it really has helped. My DH is worried I am about to become teetotal, might be the best thing for me as I am a big binge drinker...I can go months being fairly sensible but when I blow out it is major, and thenit can become a habit for a while until I REALLY rein it in...is that alcoholism of a sort I wonder...hmmm

anyway, good luck

I've started on 20mg. Atleast the nausea has gone!

I'm not sure what constitutes alcholism but I guess any form of drinking that impacts negatively on your life in some way is a problem. Maybe it's something you can explore in therapy?