How long should I give Celexa to work?

[gwenk]

Hi all,

I've been having major depression with big time anxiety on & off for the last 20 years. It seems to cycle about every 3-4 years. For 5 years I was on Paxil, which worked really well up until about 1 year ago. The major problem with that was weight gain, but what did I care? I was happy for once.

A few months ago, my Dr. weaned me off the Paxil & on to Celexa. Started me at 10mg. I went up to 20mg & then 30mg about 3 weeks ago. Still feeling depressed, but now I can't freakin' sleep which is making it 10X worse. Dr. said try to take 40mg, which I did for about 4-5 days. Felt like I was climbing the walls. So, basically, now I've had insomnia for about 3 weeks. I can fall asleep, but can't stay asleep for more than 3-4 hours. Waking up at 3:30AM every day & not able to go back to sleep. I've tried Tylenol PM , melatonin & Valerian. None of which are working. And if I take more than the recommended dose, I get heart palpitations.

So, my questions are: What can I take for sleeping which will help me to STAY asleep?

how much longer should I try Celexa before telling my doc I just won't take it any more? I seem to be pretty OK on the 30 mg (at least not suicidal anymore) except for not sleeping, but feel like I'm really losing it when I go higher than that. Or is there something I can take to augment the Celexa's effectiveness?

Help!!! Let me off this bus. I feel like I'm in hell.

[ConfusedCat]

It really should be doing much better on your depression by now.

If you did well on paxil, Zoloft might be worth a shot.

What type of Doc do you see? A GP or a pdoc? I just wonder about your "cycling".

I would try another one soon and if for some reason that one doesn't seem to work and you still feel anxious and cycling with insomnia after a good trial, I would consider a pdoc for possible bi-polar tendancies. I am not a Doc nor am I trying to play one, just a personal suggestion. However my short trials of other meds (Wellbutrin and lexapro) left me in a similar state as you and going back to paxil calmed me right down.

Best of luck and keep posting.

CC~

[puddicazz]

I have similar problems to yours, chronic depression and anxiety, and I've been on citalopram (not Celexa, another, more obscure brand name; my first try with meds) for nearly two months now (4 days at 10mg, 3 weeks at 20mg, and now it's been about a month at 30mg), and I actually have the opposite problem, in that it is making me sleep a lot more than I used to. At what time of day do you take it?

The first month, at 20mg, I didn't really feel any great change with regards to ether depression or anxiety, except that there would be the occasional one or two days where I would feel anxious -all- the time, and then another couple where I'd feel little to no anxiety at all.

It is only now, almost two months into it, that I've started noticing significant improvement both in my moods and anxiety.

[gwenk]

Hi Cat,

I went to see GP today & he said that I should try Prozac. After reading about it, though, I'm not sure that would be such a great idea since it apparently causes problems with blood sugar levels. I'm going to see the PDoc tomorrow, so will see what she says before I start fooling around with the Prozac.

The cycling I'm describing is that about every 3-4 years I tend to fall into a major depression. I really don't think I'm bi-polar..frankly, I'm not that happy even when I'm not depressed. 

At least the doc today gave me some Ambien, so hopefully I'll be able to get some decent sleep which will help a lot to cope. My brain just feels so fuzzy right now because of 3-4 hours of sleep per night (3 nights with no sleep at all) for the last 3 weeks or so. I know that lack of sleep makes everything worse.

I wish these GD meds didn't take so long to kick in. I thought I learned the meaning of patience when I got thyroid cancer & had to start messing around with my thyroid meds every 6 weeks. At least then I knew that I would eventually feel better.

At least the withdrawal from Celexa isn't supposed to be too bad so I won't have to go through the hell of Paxil withdrawal.

This too shall pass, though, right??

Gwen

If you did well on paxil, Zoloft might be worth a shot.

What type of Doc do you see? A GP or a pdoc? I just wonder about your "cycling".

I would try another one soon and if for some reason that one doesn't seem to work and you still feel anxious and cycling with insomnia after a good trial, I would consider a pdoc for possible bi-polar tendancies. I am not a Doc nor am I trying to play one, just a personal suggestion. However my short trials of other meds (Wellbutrin and lexapro) left me in a similar state as you and going back to paxil calmed me right down.

Best of luck and keep posting.

CC~

[ConfusedCat]

Forgive me I misunderstood and read you were cycling every 3-4(months), I do that because I speed read. Bad Cat!

Ok then you sound like you share my exact affliction. A few months ago I went wonky and didn't sleep at ALL either. Of course it makes everything much much worse. Xanax didn't help, Lunesta didn't work. Ack! Finally had to take benadryl and it would let me sleep 3 or 4 hours, then I would pop a few more.

I have constant anxiety and every so many years I hit a wall and get depressed.

Paxil has helped me the best and I don't plan on changing it though I may have to add something in the future. I never feel "great" either but I do feel stable on it.

Read up on all of the ssri's and try the one you think sounds the best for you. While the Doc may suggest Prozac, that does not mean you have to settle for it.

I am sure your pdoc will have more suggestions also.

Please let me know how it goes for you.

CC~

[Greenyflower]

gwenk,

Like other SSRIs, Celexa should give you significant improvement in your depression in about four weeks from when you start taking a therapeutic dose. So, since you've been on 30 mgs for three weeks and give it a couple more, if you're not feeling substantially better then maybe it's time to try something else.

It sucks. Sorry.

At one point in your post you say that you're still depressed, then later on you say that you're pretty OK. If there is improvement at the 30 mgs, I'd give it a couple more weeks before giving up on it.

Unfortunately, the insomnia will probably not resolve until you get the depression under control. At least, that's how it was for me. With the SSRIs, you have to deal with all the side effects first. The good stuff comes later. The insomnia was the last unacceptable symptom to go, but it finally did.

Greeny

[hollywoodfreaks]

Hi Gwen,

Are you absolutely certain your thyroid meds are optimized?  I've read that if you aren't taking the right amount of thyroid meds for hypothyroidism then antidepressants won't work.  I guess though if you were on Paxil after having thyroid cancer and it worked then that is probably not the problem.

[gwenk]

Hi guys,

Thanks for the advice. Maybe I will try doing the Celexa at 30mg for a few more weeks before I switch. I just can't bear to do the med switching thing right now..feel way too unstable.

When you say that the meds need to be at a therapeutic level for 4 weeks before they kick in, do you mean that I would need to take the 30Mg for 4 weeks before I would notice improvement? Or that as I'm ramping up on the dosage, I would be feeling better within 4 weeks?? If this is as good as it gets, I think I should switch. Because, although I'm not suicidal right now my brain is just not a good place to be living.

Yep..my thyroid meds are good right now. My Endo keeps a close watch on those because they need to be at a certain level to prevent regrowth of the cancer. Although, I wondered aloud to my GP yesterday if the thyroid meds might be causing the Celexa to metabolize differently or something. He said no.

Sort of good news is that I was able to sleep some last night. I took 7.5 mg Ambien at 10:30. Went to sleep, but woke up at 3:30 again. Took 2 xanax, but didn't feel better, so stayed awake until 6AM. Went back to sleep at 6 & slept til 7:45.

Do you guys have any tips on how I can sleep THRU the night?? Waking up at 2 or 3 every night is very very upsetting. I live alone & just lay there in bed feeling scared & paralyzed. Like if I take 1 ambien at 10:30 & another at 3:30??

Gwen

[ConfusedCat]

I have no idea if you can take another Ambien. Of course the website says not to.

When I am in an insomnia stage nothing works to KEEP me asleep. Not ambien not lunesta not xanax, not even my trusty benadryl. The reason I do like the benadryl is because I CAN take a few more in the middle of the night.

As for your dosage on celexa, what Greeny meant by 4 weeks at a therapeutic dose to feel better is, if 30 mgs is a therapeutic dose for you then in 4 weeks at THAT dose you should be having significant improvement. There is no way to know until you get to at least 4 weeks. If it is the right dose it should keep improving up to 8 weeks into it. If you get a little improvement but not enough and decide to go up, then you will not know if that is going to be the good dose until another 4 weeks into it. Make sense? I know that seems like a really long time, and if you don't feel you have had any or hardly any benefit then it may not be worth it to you to keep trying a particular one.

When I went back to paxil I felt continuous improvement ( not saying there aren't still some bad days here and there, but in general) from the second week at only 20 mgs. I am now 3 months into it and still improving. It is obviously a therapeutic dose for me. However note that 3 months later it is still improving, ssri's can take a really long time to reach full effect.

CC~

[gwenk]

Cat,

OMG..that totally sucks! Because at 30mg, I may not be on a "therapeutic dose" at all.

At least Celexa is supposed to be one of the easiest drugs to get off of once you start it. So I have that to be thankful for (unlike the Paxil). So I guess I'll just resign myself to continuing to feel shitty for the next few months.

The other thing I'm worried about now is how long does it take to become addicted to Ambien or Xanax?? I don't want to create even more problems for myself while I'm trying to make myself less depressed.

Gwen

[ConfusedCat]

Gwen I know it all does suck, please remember I am not suggesting that you have to wait so long to titrate up if you don't feel 30 is working. If you know that to be true then just go up to 60 and see what happens. (If your Doc has already agreed). Only you and he can tell how far you have come (or not).

CC~

PS on the Ambien and xanax addiction thing, unless you are taking megadoses I wouldn't worry about that right now. You don't need added anxiety. When you start feeling better you can slowly cut your use of them.

[Greenyflower]

Do you guys have any tips on how I can sleep THRU the night?? Waking up at 2 or 3 every night is very very upsetting. I live alone & just lay there in bed feeling scared & paralyzed.

There are a couple of older antidepressants that are very sedating - amitriptyline and trazodone. I had the same problem with Ambien; I would sleep for about 4 hours and wake up. Upping the dose didn't help. I never tried taking an extra dose at 2 a.m. because I have to get up early for work. The amitriptyline works like a charm, though. I can sleep through the night, it's not habit forming, and it doesn't give me rebound insomnia when I don't use it.

Good luck.

Greeny