Taking Citalopram to treat depression: Rachel's story

My Experience of Taking Citalopram

I was prescribed Citalopram by my GP for major depression at the age of 24. I was already an outpatient at the local adult eating disorders service and finally my weight was healthy and stable and I was able to eat more normally than I had for years but I had noticed that my mood was getting much worse. I was feeling exhausted and hopeless, sleeping only a couple of hours per night, very anxious and jittery and unable to concentrate on reading or even holding a conversation with someone because I couldn’t focus. I had started self-harming a lot, which I hadn’t done regularly for a few years and I had constant thoughts about self-harm or suicide. I also had no appetite and was terrified at the thought of relapsing with bulimia. I told the psychiatrist all of this and she told me to go to my GP and ask to try an SSRI. I made an appointment with a GP at the surgery and told him the same things and what the psychiatrist had recommended and he said he could give me a prescription if I was sure that I wanted to try medication. He explained that it was not a short-term treatment and I would probably have to be on medication for at least six months if I wanted to try it.

I was really unsure about whether going on medication was the right thing to do, because I know a lot of people are very against it and disagree that there’s good evidence to support it, but I was so distressed most of the time that I didn’t know what else I could do. I was worried about taking too much time off work or losing my job because of behaving erratically at work and then not being able to pay my rent. My doctor gave me a prescription for 20mg of Citalopram.

The first day of taking the pills I was just nauseous but the few days after that got much worse and I was very tired and too dizzy to stand up. I had to call in sick to work and just lay on my sofa (crying a lot because I felt so awful). The doctor had warned me I might feel sick or tired but I hadn’t expected to feel so bad or I would have organised time off. The physical side-effects mostly disappeared within the first week. I still have a few, like yawning a lot, feeling like my jaw is stiff and needing to use the loo more often. Though I sleep much better now, I always wake up a few times in the night and am not sure if this is because of the meds or just because I’ve always had sleeping problems.

The first couple of weeks of taking Citalopram I was even more anxious, I would shake and fidget more and any loud noise would make me burst into tears, feel my heart palpitating or feel like I was going to pass out. A couple of times, walking down the street and hearing a loud car horn made me collapse on the pavement and kneel there with my arms round my head until I could breathe again. That really did make me feel like I was going crazy. The extra anxiety gradually went away though and after about four weeks I noticed that I wasn’t obsessing about hurting myself nearly so much. I still felt very down but it was much easier to go on with things anyway and my appetite also came back. Another few weeks later my mood had improved a lot and I started feeling like I could be around people and could enjoy things again.

Since then (about nine months ago) I’ve needed to increase the dosage twice (now I take 40mg/day). When I’ve gone to a higher dosage it’s been because of a very sudden dip back to the worst I felt before. This is really upsetting because after feeling so much better it is such a shock. I can get irrational and hopeless so quickly. I’m trying not to be overwhelmed by feelings like that because now that I’ve seen how much relief I can have by taking meds it’s easier to see it as a symptom of an illness. The times when they stopped working I often planned to go off the pills and save them up to overdose on. Though I did go back to the doctor, I also kept a packet of unopened pills for a while ‘just in case’ and I think my doctor should have been more careful of how many pills I had and asked me to hand them back to the surgery or something.

At the moment I feel better than I have for years, I’m still taking Citalopram and not even thinking of when I will come off it (I know I will sometime). It doesn’t make me feel sedated, I just feel like myself. I do worry about whether it will suddenly stop helping me again. I know that I need to use this time to practise looking after myself and plan for what I will do if I feel myself getting depressed again. I keep track of my mood and days when I am more anxious I know I need to give myself time to be calm and not get over-tired. I have many more ways to manage my mental health that I couldn’t even think about when I was really ill.