Does decrease

[carolf]

I was on 20mg for years and then upped to 30mg 2 months ago as was struggling to deal with life and have dropped down to 20mg again 4 days ago and have worse anxiety. How long will this last? Should I ride it out or maybe go up to 25mg for a month and then down to 20mg?

[panic_down_under]

I was on 20mg for years and then upped to 30mg 2 months ago as was struggling to deal with life and have dropped down to 20mg again 4 days ago and have worse anxiety. How long will this last?

It takes 7-8 days for plasma levels to stabilize after a dose adjustment after which any symptoms usually begin to ease, but as with everything about antidepressants YMMV.

Should I ride it out or maybe go up to 25mg for a month and then down to 20mg?

If the anxiety is severe then by all means see if taking 25mg makes a difference. You probably won't need to take the higher dose for a month. The rule of thumb is to allow 5 times the half-life of a med between dose adjustments as it takes about that long for doses to stabilize. Increasing/decreasing doses at shorter intervals may significantly increase any side or withdrawal effects, but delaying changes won't significantly reduce potential effects no matter how long the delay. Citalopram has a half-life of about 35 hours, so you could drop back to 20mg after 7-8 days, however, take longer if you wish as confidence in the process is at least as important as chemistry. Anxious minds are very capable of delivering our worst nightmares if given the chance.

Also, while you may do okay back on 20mg, there is a small chance that it wasn't a blip but a longer term change and you may now need 30mg to maintain a good response.

[carolf]

HI, thank you for your reply. im on day 7 and anziety is awful. I just dont know what to do, wait a couple of days or go up to 25mg today? im miserable and panicking.

[panic_down_under]

HI, thank you for your reply. im on day 7 and anziety is awful. I just dont know what to do, wait a couple of days or go up to 25mg today? im miserable and panicking.

Going up to 25mg is probably your best option. You may even need to go back to 30mg for a while.

[carolf]

Won’t I get bad side effects again then from increasing the dose? What is harder, the side effects of decrease or the side effects of Increase?

[panic_down_under]

Won’t I get bad side effects again then from increasing the dose?

Probably minimal after only 7-8 days at the lower dose.

What is harder, the side effects of decrease or the side effects of Increase?

Impossible to say as everyone reacts differently.