I’ve been on the citalopram for almost seven weeks now. My psychiatrist likes to give things eight weeks, which is fair enough, but I think this may be as good as it gets. Which leaves me with a bit of a dilemma.
I am not ‘right’. Things have improved, undoubtedly, and I’m managing to be back at work, but I don’t feel well. I’m incredibly low on energy. I work from bed in my pyjamas a lot. I’m struggling with housework (the wonderful Mental Political Parent has drawn a cartoon that’s a pretty accurate depiction of my bedroom and attire). I can just about keep my head above water when life is straightforward, but if any kind of problem or minor crisis hits I’m floundering. This is not sustainable in the long term.
I’m not sure whether this tiredness is still the depression, or if it’s a meds side effect, but in a way it doesn’t matter because I couldn’t tolerate 20 mg citalopram before. I don’t think increasing the dose is an option, especially when I’m also already on enough mirtazapine to knock out an elephant. My psychiatrist and I discussed coming off both meds and switching me to another antidepressant entirely, but I’m not seeing her until 12 September, possibly even later if my partner and I manage to book a holiday. Can I muddle on until then?
The alternative is to go to my GP and ask her to change my meds, but this is not without its drawbacks. I don’t think she’d be happy to just put me on a tricyclic behind my psychiatrist’s back. She’d probably want to ring my psychiatrist for advice on what to prescribe, which is absolutely reasonable, but then my psychiatrist is likely to say duloxetine and I don’t get to have the discussion about why I really don’t think that’s a good idea given my previous experiences on SNRIs.
I suppose I could just be a very awkward patient. 
Hey, thats a hard one – and starting therapy as well and partner’s job stress – loads of strands, and hard to unravel med impact. The psychiatrist who runs my service always say ‘suck it and see’ – she also says ‘lets get you off all of those tablets’ but she’s kinda crazy and I’m under the care of my doctor, who is more savvy then her on meds. I think you can ask your doctor for a change – I don’t think it would be seen as going behind psych’s back, everyone knows how long it can take for a psych appt. – your doc could say no or do phone/fax/email advice from psych. I think that’s all fair play and not awkward. If she says give it another week – are you ok with that, or knowing how long switches can take, do you want to try something different now?
I’m happy to give it another week, and I’m not seeing my GP till next week anyway. I think I feel torn because I don’t want to wait almost two months until September, but I’m worried if my GP rings my psychiatrist, my psychiatrist will suggest something I don’t want to take (i.e. duloxetine, which she mentioned before) and then it will be difficult for me to have a proper discussion about that. I’m going to give it my best shot though.
hmm I think if your GP is a decent option – if they’re not happy changing things about, it’s not difficult for either them, or you, to give your psychiatrist a ring and ask for input. I don’t know what happened with the duloxetine – but maybe that’s something to bring up, as if you reacted badly to it, they can avoid giving you something that cross reacts etc? And for what it’s worth, well done for sticking with meds – I just stopped taking mine when I got fed up of the whole not working/taking ages to get apts/side effects carousel – and fortunately, I was lucky enough to get away with it, this time. I really commend people who stick it out. It’s not easy. xx
I haven’t taken duloxetine before, but I had a very bad experience on venlafaxine which is why I’m wary of another AD from the same class. My psychiatrist mentioned duloxetine as an option the last time I saw her and I really wish I’d spoken up then! I will bring it up with my GP.
I have gone to my GP for med changes when I had to wait ages for a psychiatrist appointment. The psych didn’t always like it very much but did recognise the failings of the system in that respect. If we have to wait so long for appointments we’re bound to go to our GPs. Not that you have to do this, just that I did.
I can’t advise on how long to stick with the current regime or what else to try, because it’s all so individual. I could only say what worked/didn’t work for me, etc. and I doubt that would be helpful. For what it’s worth, I think you’re doing really well to keep going and be patient with the meds and decisions like you are, it’s so hard when recovery takes so long!
Thanks. I think my psychiatrist will understand me going to my GP, but it gets complicated if I then refuse to take what my psychiatrist recommends! That’s really what I’m concerned about.