Citalopram (Celexa), panic/anxiety attacks and MAV

Hi everyone. I would like some advice please from anyone who has experience with Citalopram. I had some kind of breathing problem/panic attack at work so I was given Citalopram. This seemed to exacerbate my restlessness so I was also given Diazepam to take alongside it. But I have since had another two of these episodes, plus the feeling that my breathing is not very good. I have been checked out at A&E and have also been advised that the Citalopram is safe. But?? My first question is:

  1. Do these symptoms settle down. Is Citalopram actually likely to help with anxiety or whatever this problem is or just keep making it worse?

  2. Does it help with dizziness? With all this going on my dizziness has seemed better. Except when I am lightheaded from hyperventilating.

I was offered this on top of Amitriptyline, but interestingly my neuro referred me to a psychiatrist to get it prescribed. I almost went because Iā€™ve never been to a psychiatrist and was tempted just for the experience! :smiley: However, I eventually declined because Iā€™d read that the drug has some interesting side effects, including a big impact on your libido which I wasnā€™t prepared to accept as Amitriptyline already has a slight impact on this.

Best of luck Sarah with the new med, sorry I couldnā€™t be of help (but thought Iā€™d chime in anyway to show that you are not alone being told to try this drug)

Note in the US it goes by the name Celexa.

Hi James. Thanks for replying. It was actually a GP who prescribed it to me, and not even my own one. I have never been to a psychiatrist either, though the possibility was recently mentioned by someone from occupational health at work. Knowing me I would probably do what you were going to do, go for the experience, and accidentally get myself sectioned!!

Re: Side effects: It is hard to know how much of the restlessness I was getting in the first two weeks was the Citalopram and how much was the existing problem but it got pretty bad. I had bad earache for the first week which has now all but gone, though I do have some ear fullness left. The libido thing is not an issue for me as I am single anyway.

I have yet to see if it is going to do anything to stop these ā€˜panic attacksā€™. At the moment I am still taking Diazepam and Propranolol as well and am not feeling myself at all. Hopefully I will be able to manage work next week without this happening again.

PS I have to askā€¦ I am puzzled as to how my post got edited at 4.32am. It wasnā€™t me. Is that something the moderators do to make titles more appropriate?

That was me :). I added the Celexa bit to help US members find the post.

Oh lolā€¦ fair enough. Thank you!
:slight_smile: I didnā€™t know it was even possible to edit someone elses post.

Just the title I think. Maybe more once you accrue more ā€˜trustā€™

Hi Sarah!

I was on Citalopram last year, I took it for about 4 months them came off them as I didnā€™t get on with the side effects I was experiencing. I was actually put on it for generalised anxiety, but it immediately stopped my dizziness too as it was preventing the migraines. The dizziness came back as soon as I came off it completely.

I did find it was good for my anxiety after a few weeks, but mainly because it more or less completely numbed my emotions :joy:

Tracey x

Hi tracebean, thank you for your reply, it is helpful to hear about someone elses experience. It has been almost a month since I started the Citalopram now but it hasnā€™t been easy. I am either restless to the point of trying to do things really quick to get some relief (or even scratching, hitting or pinching myself) or I am so worn out I can hardly stay awake. There doesnā€™t seem to be anything in the middle! I also have ongoing ear issues (which seems to be a problem with most medications). These are either earache, a burning sensation or a plugged ear feeling which all come and go. Does any of this sound familiar to you or were your SEā€™s different?

On the plus side, I havenā€™t been dizzy but I am not feeling myself.

I have a neurology appointment tomorrow so I am wondering whether to persevere with this or risk asking for something else.

May I ask you if you changed to another antidepressant after Citalopram and/or what you then used to control your dizziness? Many thanks.

So sorry, didnā€™t see your reply as the email went into my spam!

I didnā€™t have any ear issues no, my main problems were emotional numbing and awful nightmares. I eventually went onto Venlafaxine after I came off the Citalopram, but that was for the migraines, not anxiety. Iā€™ve just come off the Venlafaxine as the side effects became too much to bear, I was on it for ten months. Side effects were emotional numbing, again, though not as severe as I had on the Citalopram, hyperhydrosis (sweating out of places I didnā€™t know you could sweat fromā€¦ Under my eyes was a favourite :joy:), constipation, and I was starting to lose interest in eating. Iā€™ll not lie, the withdrawal was horrific (even though I came down in stages), so even though this drug was pretty effective at keeping the dizziness away (I had to increase dose every few months as it started creeping in), Iā€™d never use it again. Iā€™m horrified at how much it affected my brain. Though now, Iā€™m stuck wondering what to do, as I donā€™t really want to take head meds again! Got my first Neuro appointment in August, keen to see what they suggest.

I do feel for us! Weā€™re kinda lost at sea, and nobody really knows how to bring us back to shore lol x x

Forgot to ask how your neuro appointment went? X

Hi Tracey. Thanks for the reply and info. I did try Venlafaxine a couple of times myself around Christmas, but I couldnā€™t stay on it for longer than about 4 days at a time. It made me really nauseous (which I could have coped with as it got less as I reduced the dose) but it caused me ear problems so I had to stop. I have read how bad withdrawal from it is though, it sounds like you did well to get off it.

The restlessness seems to have settled now, I am just having trouble staying awake, it is getting really bad. I am struggling at work and keep wanting to sit down and nap. Obviously the Diazepam has served itā€™s purpose :slight_smile:

It is good that you have a neurologist appointment coming up.

The most success I ever had was with Propranolol. That was prescribed by the first neurologist I saw last June. I was dizzy free for three months last summer on that (apart from a blip in the middle when I tried reducing the dose). However then the dizziness came back and rather than increase the dose I asked my GP if I could try Topamax instead. That is when I began getting ear troubles that pretty much every med now seems to exacerbate. But donā€™t let that put you off, I do seem to be in a small minority with this SE.

I was disappointed with this one to be honest. I first met this neurologist (my 2nd one) at my last appointment when I found her really helpful and nice. She prescribed me with a med that I specifically asked for (Zonisamide) and also wrote to my GP suggesting Amitriptyline if for some reason I couldnā€™t continue with the Zonisamide.

Anyway, because of ear problems I was unable to continue with either of these and I had since tried some others with my GP.

The neurologist seemed surprised with one that my GP had given me and wasnā€™t willing to prescribe anything else that I hadnā€™t tried (which really surprised me) and seemed to think the only appropriate treatments were Sodium Valproate (which wouldnā€™t be appropriate for me), Propranolol, Amitriptyline or Topiramate. Since she had allowed me to have the Zonisamide before I had thought she would be more open to trying different things than she was.

She suggested referring me for Botox or referring me to London, so I suppose she didnā€™t just give up on me. But I know there are loads more different medications that people use for MAV. I asked about Diamox (Acetazolamide) but she said that was for increased pressure in the head??? I know it is not specifically for MAV but nor are lots of meds that are prescribed with much success. She didnā€™t suggest Verapamil, Nortriptyline, Pregabalin, Gabapentin etc.

She was also somehow in possession of a copy of a letter I had sent to my ENT consultant which I thought was a bit strange. I had written to him expressing concern over my ear reactions to medications and ototoxicity and quoted Neil Bauman (alot). And asked for a more in depth hearing check.

I already take Propranolol, though not always consistently at the same dose. She told me to take it 40mgs a dayfor 3 months. Although this is already on my prescription I donā€™t actually take that much because although I find it great for stress, to be on it consistently (when I am not stressed) does make me fatigued. So I suggested trying low dose Topiramate again with it which she said she could support. And she suggested taking Betahistine with it if it causes ear fullness which it probably will. Since I have read that Betahistine caused an increased ototoxic reaction to Amakin in rats I am not sure that is a very good idea. (I do realise the link is tenuous but there may be something in it).

Anyway, sorry for the length of this reply, I think I just wanted to talk to someone lol. My other two neurologist appointments were better than this one, and I am sure yours will be too :slight_smile:

Oddly, Iā€™ve been thinking of Betahistine recently, as one of my GPs recently suggested they could prescribe it, when I came off the Venlafaxine (I thought that was odd, but then I remembered my ENT consultant saying it had been helping with my dizziness, even though I didnā€™t have Meniereā€™s afterall).

Maybe Betahistine with your Topiramate would be worth a shotā€¦? It might help with the ears fullness, and it might also help with the dizziness as an added bonus?

I was on it for 7 months, when they thought I had Meniereā€™s, and I had no side effects (which is all I can think about now - damn side effects!). It did help with the dizziness a bit (I had a few periods where I felt absolutely fine, they probably lasted a couple of weeks each time).

Propranolol made me fatigued too, but I donā€™t feel it too much on Atenolol. On the Propranolol I definitely felt it affected my metabolism and slowed me right down. I could have also napped at my desk, every day!! And sometimes did :wink:

Itā€™s awful that you react to meds with your ears so badly, why does it have to be so difficultā€¦? Are you considering the botox?

Tracey x

(Just realised I misread that Propranolol made you tired, apologies - migraine brain lol :wink: )

I have actually been on Betahistine before, it was for about 4 months, though I am not sure how much it helped. Psychologically it did (because I was taking something rather than nothing) but I was never quite sure how much it was really helping physically. I was told to stop it when I started Amitriptyline and I didnā€™t restart it again when the Amitriptyline trial failed.

I am a bit hesitant to take it was Topiramate in case it really does increase any ototoxic response as the study I read suggested it did with a particular drug.

I didnā€™t have any notable side effects either.[quote=ā€œtracebean, post:12, topic:13904ā€]
and I had no side effects (which is all I can think about now
[/quote]

Absolutely!!! I never knew before this dizziness how many side effects from drugs it was possible to experience!

Propranolol seems to make me fatigued if I take it at regularly at 40 mg a day if I am not stressed. If I just take it (at 20mgs) when I am upset/stressed it calms me down and really helps!

I did mostly get used to it when I was on it for 3 months before, but right now I am struggling with fatigue so I want to take it less, not more.

I havenā€™t restarted Topiramate yet, my ears are not properly right from the Citalopram though I have managed over a month which is really good for me on a new med.

Someone I work with has been on Atenolol for years.

I donā€™t know about the botox, I donā€™t like the sound of it. She also suggested something called Neurostimulation which I have yet to read the article she sent me on. Tbh I donā€™t like the sound of that either but perhaps I should at least look into it. But I donā€™t want my brain zapped!

@tracebean I noticed you mentioned you are on Atenolol. My neurologist suggested it but my primary care doctor doesnā€™t want me on it, long story. But it could be a possibility for me. Are you on it for migraines/dizziness and does it help either? Thanks!

Hi Jess!

Yes, Iā€™m on it for migraines/dizziness. Itā€™s helping, but not enough on its own. I used to get palpitations a lot, and I had a high heart rate during my dizziest periods, so this (and the Propranolol before it, even though it slowed me down just a touch too much) takes away those symptoms :smiling_face:

I ended up on Venlafaxine because Propranolol on its own wasnā€™t enough, so I think with the Atenolol Iā€™ll be the same; I need something else alongside it, but Iā€™m desperate not to do head meds again :smiling_face:

Tracey x

You can try a neurostimulation device for Ā£49 for 60 daysā€¦ Interesting! It doesnā€™t look too scaryā€¦ :wink:

http://www.cefaly.co.uk/en

Tracey x

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Hi Sarah. Just wanted to let you know I have been on Citolopram for about 4 years. I was prescribed it for anxiety, not my MAV, and didnā€™t find out until years later that it is used to treat symptoms of MAV. I might have had some mild SEā€™s initially but they were mild and disappeared after taking the drug for awhile. From what I understand, it is very effective for people who have anxiety that affects you gastrointestinally such as myself so it might not be the med for you. I donā€™t think it has any effect on my MAV symptoms. I take Verapamil for MAV which I find to be somewhat effective. Like so many others, my ENT tells me this is good as it gets and doesnā€™t seem to want to be bothered by me. I also have a prescription for Diazapam which I only use for a bad dizzy spell. Iā€™m already so exhausted most of the time so I hate taking something else that makes me tired unless I absolutely have to. Bottom line is, by the sound of your anxiety/pains attacks, I think a different anxiety med would work better for you.

@tracebean Interesting. It is something to think about. Thanks for the link.

Hi JCon. Thanks for your post. Can I ask do you (or did you) have any feeling of pressure (or tingling) around your ears, earache or a plugged ear or burning sensation that coincided with your taking Citalopram? Apologies if that sounds like a weird question but I am being serious.[quote=ā€œJCon, post:18, topic:13904ā€]
Bottom line is, by the sound of your anxiety/pains attacks, I think a different anxiety med would work better for you.
[/quote]

Did you have something in particular in mind? The jury is still out for me regarding Citalopram (my ears are still not right) so I would genuinely welcome any other suggestions, especially as I am seeing my GP again tomorrow to review things.

I think my concern is that I have had so many failed med trials that the fact that I have been able to stay on this for a month is quite an achievement. Maybe this is as good as it is going get with regard to SEā€™s? But can I really put up with earache/pressure/discomfort indefinitely?? That is the question I am now asking myself. Is it worth it?

I have cut right back on the Diazepam, mainly just one at night, and cut down the Propranolol (10- 20mgs at night only) but I am still very fatigued.

I am now doing things in stages and resting in between. I havenā€™t had any more anxiety/panic/suppressed breathing attacks though.