Citalopram nighttime panic

[Eric8199]

I've been dealing with anxiety really bad now for about six months. Mostly it's health anxiety, worrying that something is horribly wrong with me that is life threatening. My dad died at 34 of a heart attack, and I'm 31, so it's been really stressing me out.

My doctor recently prescribed citalopram which I believe is the generic for Celexa. I've been on it now for two weeks tomorrow. Overall during the day I've noticed a little improvement. I am no longer as impatient and irritable. When I'm feeling panic coming on, it seems easier for me to shut it off.

But nighttime has been a problem. I take 10mg before I go to bed. First of all, when I try to go to sleep, it feels like I've had a ton of caffeine and I can't sit still. It takes forever to fall asleep.

Four times since I've started taking it I've woken up at 3:30 am in a panic. I'll have muscle twitching in my legs especially and some in my arms. I feel really panicky and my heart beats fast and feels like its pounding out of my chest. Two nights ago my heart rate was 112 and my blood pressure was 184/110 so I ended up in the ER thinking I was having a heart attack. Everything was fine.

My doctor is encouraging me to stick with it and is prescribing Xanax to use when I have one of those attacks.

What do you guys think? Will this get better? I feel a benefit during the day, but when I get these attacks at night, they suck.

Any help/advice is appreciated.

[Jules1963]

It can take a few weeks for the meds to kick in but it sounds like its helping you already during the daytime. Just try to stick with it also maybe try and see a therapist to help you figure out how to deal with the panic .

[insights]

But nighttime has been a problem. I take 10mg before I go to bed. First of all, when I try to go to sleep, it feels like I've had a ton of caffeine and I can't sit still. It takes forever to fall asleep.

Weird things happen in the brain while we're sleeping with massive changes in neurotransmitter levels, and sometimes their function. All entirely normal, but antidepressants can interrupt these changes causing insomnia, vivid dreams, and sometime nocturnal panic attacks which is what I think you experienced. This should settle down in a few weeks (although it may return with future dose increases). Taking the citalopram in the morning may help.

Ian

[Sharpshooter1911]

Hello,
I'm so sorry you are dealing with this. Anxiety really sucks! I personally have really bad health anxiety. It may make you feel better to know that last time I went to the hospital with a panic attack, my heart rate was at 183 and I was completely fine after I calmed down. I thought I was going to have a heart attack too, but it was once again merely anxiety.
I have most panic attacks at night also. Sometimes I even wake up at 2am already in the middle of one. My advice to you would be to break the cycle of worry. For example, you are having anxiety at night so your brain associates night time with panic. You probably do the same thing I used to do. Night fall comes and you start thinking, crap I'm not going to be able to sleep or I'm going to have a panic attack and it is scary and I'm afraid of heart attacks..ECT... So by thinking all these things you are unintentionally causing yourself to have these panic attacks. Instead think about how wonderful sleep feels, and try to relax all your thoughts and, not distract yourself from your thoughts but accept them. When the thought comes just think, okay so my heart rate feels funny..so what? Just accept it. Don't fight it. Just know that you're going to be fine. You will see yourself becoming less anxious.

[Eric8199]

Thank you for the advice. I've been doing that and mostly it has been working. It's hard sometimes to stop the thoughts Though, as I'm sure you know.

I've found the Celexa has really kicked in during the day, but if I wake up suddenly, I'm still twitchy and panicky. As a matter of fact, had the issue this morning. Woke up and heart rate was 121. It's back down now though, after I just calmed myself down.

The muscle twitches from this medicine drive me crazy. But so far I guess the benefits are outweighing the negatives.

And I have an appointment with an electrophysiologist Monday to see if the increased heart rate is anything we should be concerned with.

[Smize18]

I have been taking Citalopram for a week now and I feel the same way about it working during the day and then at night I get insomnia. I am trying to stick it out because like you said the positives are out weighting the negatives but it is frustrating! Do you experience any of the symptoms that comes along with Citalopram? I've been getting sweaty palms and headaches like crazy! Anyways at least we're in this together, hope you feel better

[insights]

I have been taking Citalopram for a week now and I feel the same way about it working during the day and then at night I get insomnia.

While some find SSRIs sedating, many experience insomnia at the beginning. So much so that doctors often also prescribe small doses of the sedating antidepressant trazodone (Desyrel) as a sleep aid. In fact this has become the main reason it is prescribed these days. Trazodone may also counteract some of the other side-effects, particularly sexual dysfunction. So ask your doctor for a prescription if insomnia is an issue as lack of sleep can delay recovery.

Ian

[Eric8199]

I was really sick to my stomach the first few days. I had insomnia for about two weeks. I had the muscle twitches sporadically the first couple weeks. I had I think four nighttime panic attacks since I started it three and a half weeks ago. Last one I had Xanax I could take which calmed me right down.

I'm still on 10mg of the citalopram, and debating whether I should go to 20 or not. Been doing pretty well on it, but still having some anxiety during the day at times. No panic attacks, just edginess.

I say tough it out for three to four weeks. If you're still having problems, or if they're overwhelming before that, then try something else. The first week or two suck. Then suddenly you'll realize its working.

[insights]

I'm still on 10mg of the citalopram, and debating whether I should go to 20 or not.

Given what is being leaned about antidepressant poop-out, I think taking them at sub therapeutic doses may be counterproductive, even if they work at the lower dose. It may hasten the onset of tolerance. However, this is my opinion, not medical fact, yet.

Ian