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Dr. Andrew Rynne

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Suggest treatment for severe anxiety and depression

Answered by
Dr. Alexander H. Sheppe


Practicing since :2014

Answered : 2243 Questions

Posted on Wed, 5 Apr 2017 in Mental Health
Question: I suffer from anxiety, I stress easily, I have off and on very mild depression, and was told I have ADD when I was younger. I am 30 years old and have been very successful financially. I find it very difficult to concentrate and my mind never stops. I also day dream a lot. I don't think I am capable of sitting down and watching a movie at home more than once a week. I also get irritated very easy from people that I shouldn't.

I have been on Citalipram for 10 years and on 10mg to this day.

I am wondering how I can rule out other things prior to upping my dose of antidepressants. What else could be causing this? I don't sleep the greatest and have been working shift work got 8 years (stopped 2 months ago). I am always tired and my peak performance is when I have the right amount of coffee. When I drink Greek coffee my mood improves, I can concentrate, I have energy, and I am not moody.

Is my ADD causing this?
Do I have some sort of Bi polar
Should I get my sleep tested?

I don't want to stay on meds forever, the side effects are horrible and I would like to rule everything out first.

Answered by Dr. Alexander H. Sheppe 1 hour later
Brief Answer:

Detailed Answer:
Hello, and thanks for your question.

What you are describing is a classic mixture of anxiety and depression. This is not ADHD or bipolar disorder. A sleep study would be a good idea, but I would not expect it to show anything neurological based on your description. I really believe your dose of citalopram is much too low. I would work with a local doctor on increasing the dose of citalopram, as you are on a very low dose. I would increase 10mg per week to a maximum of 40mg daily. This will almost certainly help you with anxiety, fatigue, irritability, and depression.

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States ( For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address:
Above answer was peer-reviewed by : Dr. Raju A.T

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