Posted by ed_uk2010 on May 6, 2018, at 13:38:43
In reply to Re: More research: Celexa versus Lexapro, posted by Mtom on May 6, 2018, at 12:41:29
Hi there,
Citalopram undoubtedly has the potential to be useful in multiple forms of anxiety disorder. Approval in individual countries mainly depends on what was submitted to the relevant regulatory authorities in that country. As an example, in the UK, it was submitted and approved for panic disorder.
Given your previous sensitivity to SSRI adverse effects, you're doing exactly the right thing to start with a really low dose. This should reduce the risk of side effects a great deal. You can then increase gradually if tolerated.
Aggravated initial anxiety due to SSRIs certainly isn't inevitable, but it is common.... and usually occurs very early during treatment, or after large dose increases. Most commonly, it will occur during the first two weeks of treatment, or within the first two weeks after changing the dose.
People who experience this initial worsening can still benefit from SSRIs. Just monitor it over time. If citalopram is likely to help, anxiety should start to reduce below baseline after the first month or so. If your anxiety is worse than it was before starting citalopram even after a few weeks of treatment, I would suggest that you ask for a different medication instead.
The starting dose of citalopram recommended by the manufacturer for people prone to panic is 10mg per day. Given your response to sertraline, 5mg per day might be a good starting dose. You could then increase gradually up to 20mg over a period of a few weeks.
Personally, citalopram doesn't make me anxious, even at first. But that's just me. After a few weeks, it starts to help.
poster:ed_uk2010
thread:1098520
URL: http://www.dr-bob.org/babble/20180331/msgs/1098568.html