Citalopram/Celexa/Cipramil?

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Disclaimer: I don't practice in this particular area, so my knowledge is not as comprehensive as it is in other areas.

I have mixed feelings about prescribing psychotropes. On the one hand, if, for example, your body produces insufficient levels of serotonin, then an SSRI is going to have the beneficial effect of increasing the concentrations in your system. Much like a diabetic needs insulin, some people with chronic depressions are going to need drug therapies to make up for deficits. However, if there is a stronger link between your depression and, say, norepinephrine reuptake, then an SSRI will have limited impact, so just because you have a prescription does not mean that you and your doctor have reached a therapeutic conclusion.

But, notwithstanding the real benefits of drug therapies for people who need them, the diagnosis of depression can be slapdash, and reaching for the SSRI's a bit of a reflex action.

As far as your circumstances are concerned, it sounds to me like your use of St. John's Wort has not been effective at managing your symptoms. I suspect that a safer course of action than increasing your use of St. John's Wort is to discontinue it, start on the citalopram and monitor your response. You and your doctor can have an ongoing discussion about your response to it, and determine whether it is the correct therapy for you, and whether the dosage is appropriate.

Obviously, the drug affects everyone differently so I can only give my perspective on it. The Citalopram helped for about half a year. I felt a little less stressed, fewer mood swings and I started to leave the house again, however, without additional non-drug therapy, the positive effects wore off within the year. Despite upping the dose, I still felt low and suffered severe anxiety. Unlike other people, I have tried to come off Citalopram and suffered bad withdrawal symptoms, mainly shakiness, mood swings and nausea, although I get the impression that this is rare, and might have more to do with the time length I have been on the drug for (nearly 5 years).

Another side effect that I cannot cope with is severe gastric reflux, which has worsened since the dose was upped. Personally I can't wait to be taken off the stuff permanently!

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