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[pinkmarshmallow]

Hi.  I’ve been advised to up my AD Citalopram from 20mg to 40mg as my anxiety is awful especially through the nights and mornings.   But I’m scared of the side effects and going backwards with my depression and more anxiety.  I’m also on HRT Serena 2mg gel and 2 weeks of progesterone tablets each cycle. 
Advice with getting through this awful time would be much appreciated as life is going on around me and I don’t feel part of it.  x

[CLKD]

Morning.   MayB add an extra dose at night - but not every night initially? 


R the tablets 20mg?  When do you take it?  I would take the extra amount at night so that I can sleep through.  How about tonight then again on Tuesday night ?

Is it actually helping the anxiety which is common in peri-menopause?  MayB a dedicated anti-anxiety medication would be more appropriate? 

[pinkmarshmallow]

Thanks CLKD.  I had changed from evening to morning to take the 20mg as I thought it wasn’t helping me sleep along with the sweats etc.  I’ve just taken 2x20mg early today and apprehensive of how I’m going to feel.  I am getting a headache - could be a migraine.  I’ll try your advice of taking 20mg tomorrow then 40mg Monday.  I’m also waiting for ITP therapy - another 10 weeks away.  It’s tough on my family the way I am at the moment. 

[CLKD]

It's tough for them so delegate? ;-)

You could do what I have done in the past: 20mg in the morning then 20mg at night.  Then 20mg the next day mid-morning to spread it out until the following morning.  To see how you feel?

Do you think your symptoms are menstrual or hormonal?  I could never tell the difference.

[pinkmarshmallow]

I know, my family are helpful, just me feeling guilty. 

I think mainly hormonal but who knows?! 
Will try the added dosage like you advise and hopefully it won’t be as bad as the past 4 weeks have been when I first started with 20mg Citalopram.   

Thanks

[Gilla999]

I also have to take my dose in the morning or it causes problems with my sleep, especially when just starting or increasing a dose.

Could an option be for you to increase to that dose slowly rather than double it in one hit? It will massively reduce side effects which can be unpleasant (for some). In general I have found that side effects from increasing last for approx two weeks, depending on how much you've increased by. But I always have to increase in smaller amounts than they advice because otherwise I really struggle with side effects. Some people are more sensitive than others. Good luck xx

[CLKD]

Same here Gilla999.  Little steps!

Get rid of the guilt.  Do you view your regime as a mental health issue?  Then stop.  If you had your appendix removed or a broken leg they would offer to help. 

[CLKD]

Also the brain has to accept take up of appropriate medication.  The longer that I was depressed, the longer the drug took to work. 

[Suzysheep]

Jumping from 20 to 40 is a bit much I would think. Could you do 30 for a couple of weeks and see if you’re any better? Just cut one of the 20s in half? If you are still no better up to 40 then…. Less chances of any side effects then.

[pinkmarshmallow]

Thanks all.  Even with 20mg x 2 a day I’ve been still getting awful anxiety surges an hour after taking them for about 3 hours after.  Just spoken with a Dr and she’s prescribed me Propranalol 40mg to help purely for the anxiety (although I used to take this as a preventative for my migraines).  She really wants me to keep taking 40mg Citalopram a day and told me in another 2 weeks when I’m speaking to another Dr, they’ll assess how things are going with me.  I’m hoping.  Good to know you’re all there for me x

[CLKD]

Propranolol helped ease the early morning anxiety surges - 80mg 3 times a day followed by 40mg twice a day for several years, then 40mg and 20mg.  Worked well.

Let us know how you get on.

[pinkmarshmallow]

Getting more anxiety again these past 2 days so now taking Propranalol 40g twice a day as needed.  CLKD - were you told to space out your 3 doses over the day?
The way I’m feeling I’ll be going to 3 times a day very soon. 

It’s all coinciding with starting a new cycle of Sandrena gel 2mg and stopping progesterone tabs for the next 15 days.  Had a really bad night with heat last night  and awaiting if I get a bleed as I didn’t last month (should have) and wondering if I need more/different estrogen.   

It’s my uncle’s funeral this Friday and I really can’t go as my anxiety is too high for me to be with lots of people.  I feel dreadful not going. 

[CLKD]

Stop feeling guilty!  In these days of C-19 people still don't want or need to mix with others.  I have avoided many cremations: I tell the others that I will light a candle at the time of the service and sit quietly.  If I've been unable to go into the Service I take photos of the flowers with the messages for people who can't attend.

Anxiety levels rise and fall.  How is your diet overall?  I took the 80mg Propranolol 3 times a day; the 40mg at breakfast and bed-time.  Bedtime when I took the 20mg.  From 2002 until 2020.   

How long have you been using 'sandrena?'