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What Causes Persistent Depression Despite Taking Medication?
Question: Good morning,
I am curently taking 20 mg of citalipram.
Story:
During the last 1.5 months I increaed
my dose from 10 mg to the 20mg. I have felt a lot a benifits but been having ups and downs the last few days and feel like the medication is slowly starting not to work. Why do the benifits wear off?
My ORIGINAL symptoms were:
Anxiety
Waves if depression
Unable to concentrait (brain fog)
Day dreaming
I have been taking this medication for 9 years. I feel like my anxiety level is slowly going up again and i have had some waves of depression over the last week. It seems overthing and stress at work may seem to trigger something. Also, my concentrasion is bad again.
Questions
1. Why does this happen?
2. Is it recommeded i increase my dose or should i wait a bit longer.
3. Should i switch medication?
I would prefer not to increase my dose as i am not a fan of the weight gain, dry mouth, increaed sweating and low sex drive.
Thanks for your help.
XXXX
I am curently taking 20 mg of citalipram.
Story:
During the last 1.5 months I increaed
my dose from 10 mg to the 20mg. I have felt a lot a benifits but been having ups and downs the last few days and feel like the medication is slowly starting not to work. Why do the benifits wear off?
My ORIGINAL symptoms were:
Anxiety
Waves if depression
Unable to concentrait (brain fog)
Day dreaming
I have been taking this medication for 9 years. I feel like my anxiety level is slowly going up again and i have had some waves of depression over the last week. It seems overthing and stress at work may seem to trigger something. Also, my concentrasion is bad again.
Questions
1. Why does this happen?
2. Is it recommeded i increase my dose or should i wait a bit longer.
3. Should i switch medication?
I would prefer not to increase my dose as i am not a fan of the weight gain, dry mouth, increaed sweating and low sex drive.
Thanks for your help.
XXXX
Brief Answer:
Augmentation can be dose with Bupropion if you don't want to increase dose
Detailed Answer:
Hello thanks for asking from HCM for your health related doubts
I can understand your concern. Citalopram 10 mg is a low dose and if that dose worked then that is a good thing. You felt benefit after increasing the dose to 20 mg and then symptoms worsened. This probably happened due to relapse of symptoms of depression. Dose of 20 mg might not be sufficient for this relapse and this is the reason you are seeing worsening.
About one and half month passed with 20 mg dose and if the symptoms persisting then dose can be increased to 30 to 40 mg per day. Don't go to doses more than 40 mg per day.
Wait for at least 2 more months and increase the dose to 30 and then 40 if needed. If symptoms persist then switching the medicine can become an option.
Dose increase to 30 mg per day would not add to weight gain and other side effects. But if you don't want to increase the dose then addition of some other drugs for augmentation can be thought. Bupropion can be added to prescription and this will supplement the actions of Citalopram. The drug doesn't cause much weight gain and is safe to use. The drug has no sexual side effects and is better tolerated.
You can talk with your doctor for this drug.
Thanks. Take care
Augmentation can be dose with Bupropion if you don't want to increase dose
Detailed Answer:
Hello thanks for asking from HCM for your health related doubts
I can understand your concern. Citalopram 10 mg is a low dose and if that dose worked then that is a good thing. You felt benefit after increasing the dose to 20 mg and then symptoms worsened. This probably happened due to relapse of symptoms of depression. Dose of 20 mg might not be sufficient for this relapse and this is the reason you are seeing worsening.
About one and half month passed with 20 mg dose and if the symptoms persisting then dose can be increased to 30 to 40 mg per day. Don't go to doses more than 40 mg per day.
Wait for at least 2 more months and increase the dose to 30 and then 40 if needed. If symptoms persist then switching the medicine can become an option.
Dose increase to 30 mg per day would not add to weight gain and other side effects. But if you don't want to increase the dose then addition of some other drugs for augmentation can be thought. Bupropion can be added to prescription and this will supplement the actions of Citalopram. The drug doesn't cause much weight gain and is safe to use. The drug has no sexual side effects and is better tolerated.
You can talk with your doctor for this drug.
Thanks. Take care
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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