Citalopram 20mg and Irritability

Evenin' all,

As mentioned in my pretty lengthy intro post, I've been taking Citalopram 20mg for coming up to three years this year. After the passing of my mother back in December '17, and failing to cry at her funeral, I decided that enough was enough and stopped taking them.

I'd like to reiterate that coming off of medication by yourself is a dumb idea, that I am dumb for doing it by myself, and that ideally you should gradually lower your dosage even if it's already small particularly if you've been taking the same medication for a length of time. You should always do this with help from a qualified professional, probably your doctor.

Issue is, my GP practice became part of a partnership around six-or-so months ago. I can no longer physically go to the GP to ask for an appointment, and they no longer take advanced bookings; you have to go on the day. Given that I was hoping to book some booster injections and such for a trip to the US later in the year, that's a bit of a ballache.

Anyway, now y' get why I didn't fight trying to see my GP regularly about this issue.

Dizziness was the main problem for a good week or so after having gone cold turkey. It still is, particularly if I'm outside walking around, but somehow I'm okay to drive. Makes sense, right?

This week in particular, I'm having very strong feelings of apathy which tend to go away near entirely as long as I've slept or rested for a bit. Apathy is the thing I was trying to get rid of in the first place, but then came the random bouts of irritability.

I've never spoken to my partner in such an abusive and disgraceful way in all our seven-and-a-half years of being together. Obviously, it'd be nice if we could find a solution.

Now and then I'll be able to catch myself and go off and do something else; remove myself from the issue, so to speak. Most of the time, it starts off as a mild niggle and turns into frustrated outbursts directed mostly at him. Again, this settles if I can sleep or rest for a while, but I can't be expected to take a nap every time something riles me. Trust me, a lot is riling me at present, and I can't figure out why or how to stop it.

This also begs the question 'is this a relapse into depression?', which obviously I can't answer with any degree of accuracy.

It probably wasn't a good idea to come off of antidepressants right on top of Mom's death, but I want to be able to feel the emotions of mourning as fully as I can, otherwise it almost feels like cheating. Next to that, I don't want to go off on one at somebody I love for asking me a question about how I'm doing or what's upsetting me.

If anyone has any info they might be able to share (I'm going to keep mooching around Google and the forums), it'd be hugely appreciated.

Love and good health to all.

Interesting!

Citalopram is often prescribed for irritability, reactivity, etc.

Your withdrawal from this med may just be uncovering an underlying agitated/irritable depression.

It's so hard to tell.


WC

I think your questions--ie, whether you are experiencing a relapse, whether the medication or the depression (or both) causes apathy--are good ones. I have a few thoughts.

First, you mentioned that you were unable to cry at your mother's funeral. In order to know whether the medication blunted your emotions, you would need to know whether you had experienced any emotional blunting before your mother's death while on the meds. If not, then it's possible that the medication was not the reason; perhaps, for example, the grief was too intense and you suppressed it and/or you began to fall into a depression. Either of those things could have made you feel apathetic. In that case, you may have actually needed to increase your dose instead of taper off, or get into therapy, or both.

Similarly, in trying to figure out whether you are experiencing medication withdrawal or a relapse of your depression, you should think back to prior depressive episodes and see if the symptoms were similar to what you're experiencing now.

It's possible that you are experiencing both withdrawal from the meds and relapse. When I tapered off of sertraline a few years back, I experienced both withdrawal and relapse. I'm sure that part of it was withdrawal because I experienced symptoms such as dizziness and nausea that I had never experienced before during episodes of depression or intense anxiety. And I'm sure that part of it was relapse because once those symptoms passed, I experienced symptoms that I was very familiar with from prior episodes of depression, and those symptoms lasted a very long time. Also, I was dealing with a series of stressful situations that were very similar to the ones that had triggered depressive episodes in the past.

If I were you, I would get into therapy and then discuss the possibility of restarting meds. I would also let the therapist know about my concerns with emotional blunting. Perhaps a different SSRI would work better, or perhaps the dose needs to be adjusted. Or maybe you're just going through a depression and need to work through it with the therapist.

Hope this is helpful.