Ask a doctor on the topic of Neurology

Antidepressants

March 7, 2012 | 20,00 EUR | answered by Dr. med. Ralf Berg

Dear Sir or Madam,

During a skull CT examination, I suffered from great anxiety until I received the results. My doctor prescribed lorazepam for temporary relief. Unfortunately, I misused the medication afterwards. During a rehab program I underwent at a psychosomatic clinic at the end of last year, the lorazepam was supposed to be tapered off. At the same time, I was supposed to start taking antidepressants. After having to discontinue the intake of Cyprilax and Venlafaxine due to severe side effects after a week each, my primary care physician prescribed me Citalopram. I took this medication in increasing doses up to 20mg/day for 5 weeks. The side effects (nausea, vomiting, dizziness, drowsiness, insomnia, diarrhea) were persistent and did not improve. There was no positive effect.

Two weeks ago, my primary care physician and I decided not to take any more antidepressants. The psychotherapy specialist, with whom I finally managed to get an appointment, believes that I do not suffer from depression, but rather from anxiety disorders.

My question: Even though I have not taken the relatively low dose of Citalopram for 2 weeks now, symptoms such as nausea, dizziness, drowsiness, and diarrhea are still present. Could these still be withdrawal symptoms? And what can I do to alleviate them?

Thank you and kind regards.

Dr. med. Ralf Berg

Dear patient,

In individual cases, it can take 4-6 weeks for the effects and side effects of a psychopharmacotherapy to subside. However, considering the overall overview of your problems, I also believe that some of the symptoms related to your anxiety disorder could be psychosomatically triggered. If you haven't already done so, you should also discuss these symptoms with your therapist.

So what can you do: Firstly, wait with the certainty that nothing in this world lasts forever, and that the part of your symptoms triggered by Citalopram decreases every day. Secondly, realize that the fears you may have had, perhaps unconsciously, about the side effects of psychopharmacotherapy can now be overcome. Thirdly, take action to counteract dizziness, nausea, and drowsiness. This varies from person to person, but in general, many find that following certain rules helps. These rules include getting fresh air, engaging in short ball games of all kinds, and getting regular and sufficient sleep.

Try to incorporate all of these actions into your daily routine, or at least two of them. Every day. No excuses. If necessary, do them before going to bed.

Best wishes, warmly, Dr. R. Berg