Depression Forums
General => Medication => Topic started by: Russell on July 23, 2014, 10:13:08 PM
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I have been on Citalopram 20-30mg a day for 2.5 years initially for anxiety. My anxiety has definately improved no end,but over the past 6 months my symptoms have changed and I find myself being swallowed by really black moods for 4 or 5 days when I literally don't won't to go on living and then it lifts and I feel happy,normal,just really good. This lasts for 3-6 weeks and then crash again. Went to my GP and all he was interesting in was did I drink alcohol with Citalopram. I have had 2 or 3 beers a night throughout the time I have been taking it,but these problems are nothing like my previous problem and are getting a lot worse. Over the last week I have been considering ending it all several times and don't know what to do when your GP is no help. BTW I feel loads better now so don't worry!
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Is there another doctor you can speak to at your surgery?
If there is you can request to talk to that doctor as there is nothing wrong with getting a second opinion. At our previous surgery there were several doctors so it was pot luck who we saw but we could request to see a specific doctor if we wanted to. The one we are under now we tend to see the same for consistency but again we can request to see another doctor.
With alcohol it affects people in different ways so you may be able to notice a change of mood when you don't drink alcohol and when you do. Having a change of anti depressant can help or having a combination might be another option. I hope you can see another doctor to get his or her opinion.
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Hi Pip,Thanks for the quick reply! I shall take your advice. Re-alcohol,I didn't drink alcohol for the first 14 weeks of this year and my problem was worse than ever,it really feels like some chemical imbalance and just frightened of how bad it may become. Doctor did give me a number for Solihull Healthy Minds,but they don't prescribe meds and are a group interaction therapy based organisation,which generally operate during normal working hours. As I work 36 hours pw and am not paid for appointments this is not really an option.
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Hi Russell,
I thought I would post since I was a little concerned. When you were describing your symptoms there were elements that were characteristic of cycling mood disorders. GP's do diagnose these but I feel happier when it is a specialist in mental health that does it.
These days the place to go for that is your Community Mental Health Team. You can't refer yourself so it would need your GP. The CMHT for your area should consist of the whole range of different mental health services workers.
I would visit your GP and ask for a referral. The drugs used for cycling mood disorders are different to those used in ordinary depression and anxiety. So it is important to get the diagnosis right.
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Thanks Steve and Pip. There is absolutely a cycle to my moods. I literally felt the depression come on me last Friday night,in the way a cold comes on you. By Monday I felt as if I couldn't hold a conversation. Guilt,fear,no interest in anything,including food,bathing,reading etc. By last night I felt 100% better and now I feel fantastic! Positive,lively excited. I am interested in your comments and I will seek the help you mention.
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It might be worth you Googling BiPolar 2 to get a bit of a feel for the symptoms. Bipolar can cause havoc in your life, especially the highs. I once knew a woman who suffered from BiPolar. She used to have a good job and had a whole collection of credit cards. One was empty but with a £15,000 credit limit. I watched as she managed to max out the card in an afternoon. Try and be as sensible as you can during the highs.
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Thanks for that Steve! Amazing! That is exactly how I feel,it's almost like a womans cycle. It happens roughly every 4-6 weeks,lasts for about 5 days and goes. Monday night I was planning the best way to die and 72 hours later I love my life. I now need to get some professional help before a low mood actually takes over. I honestly could see myself jumping in front of the train,clear as day,and it all made sense! Now I want to live till 100! Dude I am seriously messed up!
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I wouldn't say you were seriously messed up, your brain chemistry is somewhat screwed but treatable. Mood cycling can get very rapid. I once admitted a guy to hospital who experienced the same sort of cycle you do but with one difference. He would go through the complete cycle 3 or 4 times in a day, every day. That is seriously messed up.
If there is anything you find yourself wanting to know, just send me a message.
Love
Steve
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Hi all! After finally getting to see a helpful doctor today I have been prescribed 37.5 venlafaxine,and to replace the citalopram immediately. What are your experiences of this drug?
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Good to hear you saw a helpful dr. Some seem to understand mental health problems more than others. I am sorry but I cannot help with any info on the meds you are on now, but hopefully someone here can help.
S x x
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Venlafaxine is a bit of a problem as drugs go. Firstly its side effect profile isn't too good. Headache and Nausea are very common.
Common as in 30% of people who take it for headache I think. If you want the percentages for all side effects I could probably find it for you.
The second problem is blood pressure. It has a tendency to cause sometimes quite significant rises. The thorough protocol is to
take a persons blood pressure before they start the drug and a short time after any dose increase.
The third problem is that it is a bastard to come off. It is easily the most difficult of all the anti-depressants to come off. Its signature withdrawal symptom is the "brain zap" which is a bit like an electric shock running through the head. It has a good few other withdrawal symptoms as well.
I have taken it myself until I got fed up with numerous bad headaches.
Did your GP give you a diagnosis ? I am sure he had bipolar well to the front of his mind. Venlafaxine in bipolar is'nt that unusual
but it isn't the first line choice. That is Depakote. But venlafaxine is as good to try for a first attempt as well as any of the other
mood stabilizers.
You have a wide range of doses to try. The maximum dose is 375 mg and 37.5 mg increases are pretty standard.
I hope you get on OK, though I would recommend getting a pack of paracetamol.
Love
Steve
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Thanks for that. I take ramipril for blood pressure as is! Sounds like the cons outweigh the pros. I am waiting for CBT counselling in October. Should I stay on citalopram until then?
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Now you have the prescription for Venlafaxine I would be inclined to give it a try. The combination of Velafaxine and Ramipril is
unusual but maybe your GP thinks your blood presssure is so well controlled that he doesn't have to take it into consideration. You will discover what side effects if any you get and if you find them intolerable you can make a switch.
Citalopram does have a bit of a reputation for pushing people out of depression and into mania, but that is more therapist gossip than hard science. Citalopram has a few problems of its own though, mostly sexual ones. I decline to go anywhere near the whole group.
I'm sure other people here will have taken Velafaxine. It would be a good idea to find out what take on the drug other people have.
Take care
Steve
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One side effect of Ramipril is a cough so if you do suffer with it get back to your doctor. I take Amlopidine for blood pressure and was taking Ramipril until my husband was taking easy exercise classes with the British Heart Foundation and heart specialist nurses. There was a session on drugs and that's when I found out about Ramipril. I saw one of our GPs about it after getting advice from the nurse and he took it on board then gave me a prescription for Losartan (sp)which has stopped the cough.
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Started the new meds today. Sweating a bit, definitely heightened anxiety, but nothing unbearable. I will keep you posted over the first few days. Hopefully this should help me and others in this position.
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I wouldn't worry about Ramipril and Losartan. Pip is right about ACE Inhibitors like Ramipril and cough and the alternative group
Angiotensin II antagonists not having it.
However your only real concern is if Velafaxine is going to affect your Ramipril. The answer is pretty much No. I had a quick look at
a reference source and didn't find any interaction mentioned. Good luck.
Love
Steve
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Hello Russel,
I took Venlafaxine for about 12 years and was a good antiD for me. Unfortunetly after these quite long years it lost its effect on me and had to find something else.
I also suffer from hypertension but it remained under control with the right medication. There is quite an array of anti-hypertensives whilst with antidepressants one may have to stick with what works.
It's true that Venlafaxine is known to increase blood pressure but in my experience it didn't go as high that it went out of control. Besides as the antiD sets in the side affects tend to normalise too.
I have been on Ramipril for some time but it made me cough too much and it had to be changed.
Grace
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I have just added another post re-quitting meds all together. I don't want to be addicted to varying meds forever. Following 2 days on new meds I am going to go back to 20mg citalopram for a short time and then try one every other day. How bad do you expect the first few days will be? Don't want to put my body through too much, but the idea of disturbed sleep, dependency and worst of all no sex life has got to be worth a try!
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Bit personal, but what can be done to overcome sexual problems relating to use of ventaflaxin? The meds are making me feel better, but I (and my wife) need a healthy sex life. I still feel aroused but things aren't working.
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i'm very sorry to hear about this side-effect! You might like to taolk to your specialist before you stop taking Venlafaxine at all. There are other meds which don't have this particular side-effect. Besides you may need another kind of medication for your mood cycles.
Grace
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First day back at work and I have crashed through the floor! Had to leave the building for 30 mins because I new I was going to start crying at any moment.Is this normal? I have been doing so well.This feels worse than anything I have felt so far. I feel I can't do my job anymore,unable to teach and panicking about the future. Help!
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It sounds that you have gone through one of your cycles. A mild high followed by an almighty crash. You could persist with the Venlafaxine and hope it lifts you out of the depression but I don't think I would. I think you need to explicitly deal with the issue of Bipolar with your doctor. I think I would be saying I think I am Bipolar and need to be on a first line mood stabilizer drug like Depakote.
Fashions change in psychiatry and the present fashion with Bipolar is to treat it with a mood stabilizer alone. If you tell your doctor what has happened he is going to have to change his prescription.
I didn't want to raise it with you but there are plenty of people who would say Venlafaxine isn't much of a mood stabilizer if at all.
I used to teach difficult kids back in the 70's and with bipolar depression you are going to be struggling. You might need to go on the sick. I hope not but it is a possibility. Bipolar is a serious illness.
Sorry for not doing a longer answer but I am not doing too well myself at the moment.
Steve
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So sorry to hear you're low,this is one cruel disease. Really good of you to take the time to reply to my post,when you have problems of your own. The strange thing today was my crash was very intense, much more than previously, but lasted for 4 hours and has now almost passed.