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Fluoxetine then Citalopram

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    Hi,

    I am just curious to know people's views on these anti-depressants....experiences (good/bad).

    I was initially prescribed 20mg Prozac for depression and was on this for exactly 2 months. Then seeing my GP who I've known for 10+ years she was devastated that I had been prescribed this and changed me to Citalopram. I am alcohol dependant and suffer from severe anxiety (which I take propanolol and occasionally Diazepam for)

    I argued that I wanted to know the difference (ie, addictive etc.) she assured my mum and myself all SSRI's are not addictive but SHE WOULD NOT HAVE PRESCRIBED PROZAC TO ME. Why is this? They're both SSRI's (I've not really got a clue, but I know that much...)

    After being on Citalopram 20mg for a month there was no change at all, if anything things were worse....so the dose has been doubled to 40mg daily. This was just the other day so I am still playing "the waiting game" I am due to under-go councelling etc. which should be beneficial aswell. I am also still in my teens approaching 20, so is this sort of prescribing "normal"?

    I just want opinions, experiences, views, etc.etc. and all welcome to post

    Many thanks
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    A lot of GPs prefer to prescribe citalopram, I'm not entirely sure why. I think it comes down to some NHS areas saying prescribe fluoxetine first and some saying prescribe citalopram first. Citalopram was the first thing I was given and a lot of people on here have posted that too. I suspect they may just be told they HAVE to prescribe citalopram first which is why she was pushing it so hard.

    They're slightly different in how they work, citalopram is sort of purer in that it only really does serotonin reuptake inhibition while fluoxetine hits some other receptors in your brain.
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    Why didn't you question this? With all medicines that you're taking you should ask as many question as you need to understand what your taking, but more importantly - why you're taking it.

    As said, Citalopram is generally the first port of call for SSRI's. I have no idea why you'd get such a harsh response... Prozac is fine, as said, very similar to Citalopram so I don't know... You'll have to ask your doctor.

    Also in case you are not aware, 40mg Citalopram is now the highest therapeutic dose prescribed so if it's not kicking in after 2 months (you really must give it time) then you wont be able to go any higher.

    I used to be on 60mg Citalopram before it was discovered that 40mg should be the directed therapeutic dose prescribed, it worked okay for 6 months but then I changed to Venlafaxine which is a SNRI. Personally, for me, Venlafaxine was much better than Citalopram. It's much more effective at targeting anxiety than citalopram is, which is what I suffer from (mixed with depression so seems similar to you). Again I use Diazepam PRN which helps massively.

    I used to use Propranolol, 4x40mg but I just didn't find it did anything. I could feel it slow my heart rate down, sometimes by half from 80BPM to mid 30's... which I guess is a sign it's doing something but for the actual anxious trembles/thoughts, it didn't help.

    All I can suggest is to do a little bit of research and don't be afraid to book another appt with your doctor just to go through it again, mental health is a serious subject and some medications have serious consequences. Any reasonable GP will be happy to make time for an appt to talk you through what you've been prescribed and why. It's so so so so SO important that you understand what you're taking, why you're taking it, and what you can expect from it.

    Sorry if this is a bit long-winded but it's a general over view of my experiences which I think I can relate quite closely to you. Feel free to ask me anything if it may help you!
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    Reason citalopram is used as first line defense is its high selectiveness for serotonin re-uptake receptors its a clean SSRI, so it has less sideffects.

    Also the fact its cheap in its generic form.

    I was put first on citalopram and it didn't work for me then i was put on prozac, I have just switched from them lot to mirtazapine and it seems alot better touch wood.
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    My current GP told me that citalopram is the most frequently supplied and works well for most people. I was put on 20mg prozac two years ago and it worked well until recentlym My GP switched me to citalopram..and it had horrible side effects for me.. Insomnia, Anxiety and TERRIBLE interaction with alcohol (passing out after 1 drink) Ive now switched back to prozac,40mg.. and so far so good.
    I think it really is totally different for different people.
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    I was on citalopram but stopped taking it cause I hated the idea that I was being controlled emotionally by something. Warning - don't reduce/go off without talking to your GP. Some of the most awful weeks of my life followed when I slowly decided to cut down...

    I was on 40mg Citalopram btw. It just made me feel numb really....I don't have a high opinion of antidepressants but thats because they havent helped me
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    I was on Citalopram for a while but it didn't help so I was upped to 40mg, but it still didn't help so I was switched to Fluoxetine. I abused the Fluoxetine so I was moved onto Mirtazipine. I couldn't deal with the side effects of them so now I'm on Sertraline, which is the best one I've been on

    Needless to say, definitely don't take yourself off it. I took myself off both Fluoxetine and Mirtazipine and it was probably the worst I've ever felt.
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    (Original post by posterchild)
    I was on Citalopram for a while but it didn't help so I was upped to 40mg, but it still didn't help so I was switched to Fluoxetine. I abused the Fluoxetine so I was moved onto Mirtazipine. I couldn't deal with the side effects of them so now I'm on Sertraline, which is the best one I've been on

    Needless to say, definitely don't take yourself off it. I took myself off both Fluoxetine and Mirtazipine and it was probably the worst I've ever felt.
    Same story as me, I did them in that order and now the Mirtazapine is making me knackered all the time and it feels like my hands weigh a ton and I can eat for ever and ever and not feel full. I give up and I am done with anti-depressants. I got one or 2 Fluoxetine's left for weaning off.
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    I was given fluoxetine back in 1994 when it was relatively new in the UK. It was sensationally good for me for quite a long time. In later years, I had more problems with depression and then neither fluoxetine nor any of the other modern antidepressants did much for me. The combination of fluoxetine and olanzapine works well for some but it causes significant weight gain.

    Over a long period of time, I have found very careful use of lorazapam very helpful for controlling anxiety, and that in turns helps with my depression. Unfortunately, all the benzodiazapines were massively and carelessly prescribed by GP's for years and got a bad reputation, so now most GP's are reluctant to use them.

    Re antidepressant in general; what works for one person may be dreadful for another; I've heard people say that fluoxetine was really bad for them. Consequently the only thing to do is try them and ignore whatever you hear or read.

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Updated: July 11, 2012
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