stating medication, and finding it hard to stay asleep

[Rich A]

Hey guys,, im 22 i just started taking citalopram,,, ive never taken medication before so dont know what to expect ,, been on it for 5 days now started with 10mg now after 4 daqs taking 20ng... well im always tired and its hard falling alsleep ,, anyone have the same side affects and can u telll me if this medication is good? Doctor says i have social and general anxiety,, also have panic attacks.

[cagekickr]

I recently switched from Paxil to Lexapro, which is an escitalopram and chemically very similar to Citalopram. I had a week of sleeplessness, vivid dreams, nausea, dizziness, and an increase in anxiety. At around 2 weeks, all of the side effects cleared up and it seems to be working very well. I am on 10 mgs for OCD and panic disorder. I switched from Paxil to Lexapro because Paxil had seemed to lose its efficacy after being on it for 10 years. Plus it has the unpleasant side effect of destroying your sex drive, which is always great for a maariage. There is a really great clinical study out of the UK that compares the SSRIs for anxiety. depression, and OCD. Lexapro was deemed to be the most effective one on the market with the fewest side effects. It also reaches theraputic levels in about 2 weeks as opposed to 4-6 weeks with other SSRIs. Get thru the initial adjustment period and I'll guess it will be good for you. It has been for me. Feel free to PM me if you want. I'm 31 and clearly remember what it was like struggling with a diagnosis and trying meds for the first time when I was 20.

[tigremycat]

I find it STILL hard to believe that docs will still (despite what I tell them) prescribe meds at high doses. I am very small mind you, 100lbs and 5' but, my doc still goes and puts on the prescription start at this dose, and I never even get to that dose because to me, there's no point in having unecessary side effects. I been on lots of stuff. Mostly, I get along well with only 10mg of ssri's. My advice to you is go back to that 10 mg if the side effects are too bothersome or don't subside. I can start meds at a low enough dose to a lot of times bypass the side effects all together and if they are too bothersome, (like remeron for me just this past month) then I know it's not gonna work for me. Sadly, yes the side effect of ssri being sexual dysfunction and loss of drive totally sucks but I find right now I have to be back on celexa more than I have to get laid. :lol:

[tigremycat]

Oh yeah, I forgot to tell you that a long time ago when I first started taking the SSRI's that's exactly the side effects I had too. Tired all the time and hard to get to sleep (funny how it is) and also found I woke up a lot. Then, after they wore off it was hard to even wake me up after that. Another interesting point I'd like to mention is that I found after ORIGINALLY taking an SSRI (meaning for the very first time ever) that was the ONLY time I'd experienced the side effects you're experiencing. It's like my body created a memory for it so that any time I start an SSRI again (even after years of being off them) I can resume where I left off (sort of). NO initial side effects just the usual ones that come with the territory.(sexual) Anyway, I find this interesting to point out. I wonder if anyone reading this can relate. I am glad I don't have to deal with initial side effects.

[Rich A]

thanks to both of you who replied,, its helped me alot and made me feel better,, but dont u htink i should keep taking the dose the doctor gave me, 20 mg...and see if the side effects go away,,,until i see the doc again...and how did u deal with waking up alot ,,what could i do to stay asleep...?

[tigremycat]

I am going to be honest with you. THIS IS JUST MY OPINION. I feel that doctor's are to be respected and I am greatful for them, however, they are just people who studied and passed finals like everyone else. I don't depend entirely on my doctor's say on my dosage. I know myself better than he. And the reality is I have never done anything detrimental to myself in regards to my own medication dosage. If anything, doctors' have indeed done stupid things regarding my meds. For example, what do you think about this?
My shrink gave me a rx 30 day supply of 20mg celexa on Friday. He expects or wants me to take 1 a day. Then he books my follow up appointment for January 31. What day are you reading this?
I rest my case.
Not to say he's an idiot or incompetent. Mistakes happen but if I depended on his say entirely and not paid any attention to what I felt, I can gaurantee you I WOULD BE PRETTY SICK BY MID JAN. I'd have to call him to help. That would suck. THey are hard enough to get ahold of. *sigh* anyway, my opinion is you don't have to depend on your doctors decisions like it's life or death. I mean, don't be an idiot and suddenly stop a med after being on it a week or whatever, but use your best judgement (if you have any haha) and do what you feel's right for YOU. For me, I would cut down my med in half again for a few more days or whatever it takes for me to feel better. By the way, what I did with those side affects originally when I started SSRI's for the first time, honestly, it went away within a couple days, I certainly didn't up the dose for at least 2 weeks. IN fact, that just happened to be my family doc's directions at that time. Hope this helps.
ANother example, my girlfriend was telling me the hard time she was having with weening herself off of Effexor. How she felt sick and depressed blah blah, I asked her what she did and it was basically weening except a little fast. Like a few days went down half the dose, then few days later a quarter less of that, then not anything. WHOA!!! I thought do that in weeks not days and she'd be laughing. NO WITHDRAWL at all! I almost gaurantee that from my own experience of being on Prozac and Paxil, Zololoft and Celexa. And I've tried the likes of Remeron, Risperidol, Effexor, Seroquil, Mellaril, Haldol........... all of these I've taken lose doses and literally if i can cut that thing in quarters to ween off i will. It's as easy on your body as possible under the circumstances.

[cagekickr]

I have to disagree with tigremycat on this one. 20 mgs is a very middle of the road dose for Citalopram. Most studies cite this as the dose used for clinical purposes. The more you fool around with dosing, the longer it takes to reach optimal efficacy. Side effects generally disappear in a month to six weeks, tops. If you change the dosing, you then have to deal with not only side effects, but possible discontinuation syndrome on top of it. Give it an honest chance to work. Take the prescribed dose at 24 hour intervals, and if in a month you are still having trouble, talk to the doc about other options. As you already know, those of us with panic, anxiety, depression. OCD, etc. aren't exactly the most med compliant people in the world. Give it a disciplined go and see what happens.

[tigremycat]

hey cage, i was wondering if you could tell me what discontinuation syndrome is. I've never heard of it myself and keep in mind that yes we are all entitled to our opinions and I respect yours, but my opinion is based a lot on the fact that I am 5 foot 2 and only a hundred pounds so taking as little as 10mg even of celexa or generic, can work for me. Thanks

[cagekickr]

Sorry, tigremycat. No disrespect intended. I know most of the dosing is set for "average" people, supposedly 5'10" and 175 lbs. SSRI Discontinuation Syndrome, particularly Paxil, is getting more and more acknowledgement these days. The theory is that since certain SSRIs have such short half lives, it throws the body into a mess when they are discontinued. I have tried to get off Paxil 3 times and failed due to the withdrawal problems. It consists of "zaps" which feels like an electrical current shooting through the body, vision problems, like the brain is a second slower than the eyes, hallucinations, anxiety, confusion and disorientation, and flu-like symptoms. Even when I have tried to taper off slowly, it just prolongs the pain. Do a google on paxil discontinuation syndrome and you could be better informed than I can explain it. A lawsuit was recently won against GSK because they knew about the withdrawal before releasing it to the market. Some people just have 4 or 5 days of sickness, others have more than 6 mos. Like all meds, it all depends on the person taking it. I am one of the unfortunate ones.

[cagekickr]

Rich, I was re-reading your post about falling asleep and staying asleep. A non-drug sleep aid that has worked well for me is melatonin. You can get it at any drug store or supermarket in the vitamin aisle. It's a natural supplement that puts me to sleep in about 30 mins and keeps me asleep with no "hangover" in the morning like some other stuff. Be careful with it, though, because prolonged excessive use is thought to make depression worse. It comes in 1 or 3 mgs. usually. 1 mg works well for me. It's a nice alternative to xanax or sleeping pills.

[tigremycat]

I always wanted to know what you would call that side affect, the zaps. Totally, those are the worst withdrawal symptom ever! I am one of the fortunate ones, as I was on Paxil for years and years but I was only taking a max of 20mg per day and although side affects were a bit troublesome, I took my time weening off (for me, I found when I had the symptoms of withdrawal, I would take a small dose of paxil and they'd go away and I continued to do that for as long as it took). I am lucky I haven't had any more trouble than that.

[Rich A]

thanks cagekickr , ive tried something similar valerian root ,,didnt help much so i stopped and ive been sleeping a little better now,, but if i continue to have problems ill give it a try...