Depression Forums
General => Medication => Topic started by: bookletters on October 13, 2012, 01:12:51 PM
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Hello all,
I have always responded really well and fairly quickly to antidepressants in the past (I was on Mianserin for a few years, then venlafaxin for another few years).
7 months ago, venlafaxin stopped working so the gp I saw at the time suggested a cross over to citalopram.
7 months on and despite telling the doc MANY times "this is helping my anxiety but not my depression", I get a rigid answer "okay we'll up the dose to 40" then "give it more time", "citalopram is very effective", "we'll try CBT at the same time", "it's not to going to happen overnight", "add trazadone for sleeping"....
Situation now: I am better (after having got worse for probably two months) BUT on average I get two okay days a week and the rest is tough. I am still not sleeping very well (despite taking trazadone 50 at night), some days I can't eat before night time. I haven't been able to go back to work. Some days just out to the local shops is a struggle. I have not much pleasure in doing things apart from a little bit here and there on my okay days. My mood tends to lift at night but the mornings are tough. Some days I cry my eyes out and feel I am going to be stuck like this forever!
CBT is helping a little bit but sometimes I can barely do my homework which is a shame as CBT had worked really well for me in the past!!!
My husband thinks (like I do) that because I saw a lot of junior doctors and various GPs maybe there isn't a structured plan for my recovery and no particular reason why I am being kept on citalopram. He is going to come with me to see a senior GP at the practice next week.
Has anybody been in that situation before? Do you think it's me being in a particular bad state or just sounds like citalopram is not helping? Will I ever be able to be back to my happy self? Will a change of medication made me really bad again?
Thanks for any advice and reassurance.
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Ive been on 40mg citralopram for about 15 months now and it really only started to help me feel consistently better a couple of months ago, this was also in combination with counselling and lifestyle changes.
ADs do stop working sometimes, Fluroxetine stopped working for me a few years ago. Seeing a senior GP sounds a good idea, even if he doesnt feel it appropriate to change your meds he should be able to explain why.
Z xxx
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Thanks for the answer Zaf!
Can you confirm that you were having the same sort of ups and down as me?
Why did the doc say you should stick with it?
In the past, I responded so quickly to AD that seeing citalopram do this is making me despair!!
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Zaf your answer has cheered me up no end!
I now feel like having lunch!
The pharmacist told me yesterday my mood should have stabilised by now so since yesterday I have been feeling very down but your answer has given me hope again! Pfew thank God for people like you!!
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I'm glad I could help =+-
Yes I had lots of ups and downs but gradually the good days started increasing and the bad days mostly only happened if something out of my control upset me or I got overtired.
I find citralopram takes longer to kick in than fluorexetine used to and that I have to be on it longer to stay stable, its possible you are the same.
Z xxx
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Thanks Zaf!!
Did your GP say why you had to stay on it?
I keep thinking citalopram isn't working.... did you feel like that too? xxx
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Yes, I started taking it in July last year and sometime during this summer I told my GP it didnt seem to be working and asked to change but he said to keep taking it for another 3-4 months then go back if there was no improvement but I feel I'm on the mend despite having a very stressful situation to cope with 3-4 weeks ago so am going to stick with it. He didnt say why but I dont think I asked!
Z xxx
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Okay dok thanks!
How long did it take for the good days to outnumber the bad ones? After 7 months I am starting to despair as I get 2 good days for 5 bad at the moment!!!
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I'd say about 9-10 months then I'd still have the occasional blip.
I used to keep a depression diary and write down how I felt every day, I found it helped a lot.
Z xxx
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Thanks, I keep a depression diary too.
Going to try to see what the GP is saying then probs try to stick with it!!
Thank you for sharing Zaf xx
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Its definitely worth talking to him about it
Z xxx
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Thanks Zaf, will see what the doc say...
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If I can add.... I recently went through a medication change and it was one of the worst experiences. It does take sometime to find the best dose for you and for the meds to settle. I think your husband has a point about there being no structure to a recovery plan. Is there a Community Mental Health Team where you are? They usually have a wide range of professionals who can offer guidance and support. Maybe an appointment to see a Psychiatrist might help discuss options.
Good luck with the GP next week
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I don't know about the Community Mental Health Team. Do you get referred to them by your GP?
I would love to discuss things with a psychiatrist but GP never seemed keen to refer me "we're not at that stage yet", "it's for more complicated cases".... I am like "ermmm!!!"
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I can see that you can self refer to Mental Health Social Work Service in my town but what exactly do they do?
Change of meds is hell, that's for sure!!!!
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I wouldn't listen to the GP about it being too soon for a Psychiatrist. I'd say it's overdue. The Psychiatrist will be part of the Mental Health Team. They are usually made up of social workers, Nurses, counselors, and Doctors. Look up what services are in your area. Don't ask, tell the GP you want a referral. Tell him it's important for your recovery. If there are no specific mental health team, ask to see the Consultant Psychiatrist for an assessment. They are also better placed to talk about mental health meds and explore your options
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I had an assessment with someone from the Mental Health Team.
I told them I was having CBT. At time I was having a good day so didn't seem to think I needed to have anything done about the meds, it's when I have dips like today, yesterday and the day before that I start questioning whether the meds are working etc etc etc
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And this is why they say it is always important to tell them you are having a particularly good day. I know what you mean, sometimes I've gone there feeling like a fraud. However, it's about setting something up for the future, when things aren't so good. Once you get your feet in the door of a CMHT and openly ask for all sorts of help, they will hopefully rally round. You will be able to work with someone in structuring a recovery plan. That might involve changing meds, seeing a CPN weekly/monthly, or it might mean referring you on somewhere else for specific psycho-therapy. It really depends on where you live to what's available, but it did sounds like there is something you can wrap yourself around. Just be more definite with the GP. He'll be only too pleased to see you doing something positive to get better.
Good luck and keep us posted
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Thanks Cath!
I really need to see a different GP as I feel she rigidly wants to stick to citalopram and it's making me despair!
I don't understand why I get the odd good days then it drops again, it is so inconsistent and unlike the AD (which worked) that I have taken in the past.