Citalopram? Worth the 5 year wait? Help!!

[daisy_a7x]

I had my appointment today, finally told the GP everything, took my mum who got all sniffly when we got to the suicidal thoughts and self harm part of the conversation although I had told her I didn't really want her in there.
The problem is this, the doctor says it's not BP because apparently my mood swings are too close together, and in her own words she says 'The symptoms suggest mostly cronic depression but you're also having these emotional highs...' what more does she need?? Ugh! So she's signed me off work for another two weeks, because I'm not really to be trusted behind the wheel of my car ever since I started driving with my eyes closed during manic episodes.. and I'm on a starting dose of Citalopram going up to 40mg in two weeks. I feel quite positive at the moment because the ADs I've used in the past had horrendous side effects for me and so far the only thing I've noticed is being drowsy, dizzy and my mind is racing a bit... although I heard that they can trigger mania so I'm keeping my fingers crossed. Also I have to see the same GP in two weeks [or before if I have any serious suicidal thoughts] and she will be referring me to a psychiatrist.

I almost dragged my mum out of the waiting room and felt like I was goin to puke ALL MORNING, but I think it was worth it even though she doesn't really know what's wrong still..

[Delusion]

Sadly in Britain if you have a rich and accomplished daddy who went to medical school you can get in even if you have the intellectual capacity of small walnut.. a lot of GP's are clever people but they are also complete morons who dont read between the lines and try and comprehend the bigger picture at hand.

As monkeyc says pdoc's are usually a lot more reliable because of their additional training :)

[monkeyc]

The second opinion is a good idea but at this point I do not see a first opinion - A GP is not qualified to make a diagnosis of a mental disease.  Sorry but that's reality - it does not matter what a GP or family doc tells you for a proper diagnosis you need a pdoc

[Crystlas]

I see no one mentioned you getting a second opinion on being bipolar.  Your doctor is incorrect about one thing.  Just because your mood swings are close together does not mean you are not bipolar.  Rapid cycling bipolar disorder is just that.  Mood swings are very close together!  I would seek additional help and hopefully your new psychiatrist will be able to give you a better diagnosis.  Best wishes, Kristen

[manicmary]

On of the things I have done is to educate the GP.  My daughter has lots of health problems adn in the past I have come prepared with clinical information from recognized medical organizations.  ie "mixed state", "SSRI inducing mania".  This may not get you the rx you need but it may get you to the Pdco sooner.  Just a thought and hang in there.

[bernie40]

ADs  need to be monitored very carefully when you are BP although not everyone will react to them it is advisable to be aware of the risk.  If your hallucinations begin to get worse or the racing thoughts - well any dramatic change in mood really - then get yourself back to the Dr.  Drs are not in a position to diagnose mental illness and your Dr should not have dismissed BP so off hand.  A referral to a psychiatrist is definitely the best thing but if you are unable to wait the agonising long time you have to on the NHS then pester your Dr or if things get too bad ring the Crisis Line number for Mental Health Services, your GP surgery should be able to give this to you.  The crisis line is manned by Psychiatric Nurses.

Don't panic about the medication but just keep a close eye on things.

All the best.

[irishwriter]

i don't have hallucinations but my moods can change minute to minute. some ads make this worst and add in agitation so just be careful. i did some cutting and burning when on effexor only and when i stopped that drug and started lithium, zyprexa and rivotril (klonopin) i can;t believe i did that to myself. make sure you get that appointment with psychiatrist. driving with eyes closed is so not good!!! take care of yourself.

[monkeyc]

Hang on dont panic !!!

There's no certainty that you would suffer from a mixed episode so dont worry about it and get worked up.

What worried me was your comments the other day and the comment now about hallucinations.  You need more than a GP.  You need a psychiatrist.  If you cannot control the hallucinations then you need to get some help OK.  

The one thing that scares me the most is the old GP "There there dear its all a little depressions have these pills" attitude that you see so often in the world - its one of the big killers of people who should be getting real help but are instead diagnosed as just depressed.  That was my diagnosis by a GP 15 years ago as he reached for the script pad.

There is a tendency to dismiss people who talk about hallucinations and the like as being over the top and the younger you are the more common the attitude is.

So take a deep breath and relax.  Mixed Episodes are not a guarantee but any bipolar on an SSRI should be warned which is why I do it.

You can read here : en.wikipedia.org/wiki/Agitated_depression

But be aware that the more rational you feel the less likely it is you are in one - sanity checking yourself is a good idea anyway but if you feel multiple symptoms and you are hallucinating dont panic, simply go to the hospital - tell them you maybe bipolar and exactly how you feel and take the drugs with you - there is no shame in getting help.

We are here, youre not alone, youre having a rough patch right now and we all have them, im just coming out of one myself so I know its hard but sit it out and ask for help if you need it.

[daisy_a7x]

Ok.. not good.. kinda panicking a bit now.

What am I supposed to be looking for in a mixed episode? I'm so up and down I rarely know what state I'm actually in. I was perky earlier... boosted by the fact I actually GOT meds and now I'm hallucinating and my head's tingling.

Buggerbugger...

[monkeyc]

You need to get a psychiatrist - the problem with GP's is they go on the books and only the books and if their knowledge is not current they fall back on the courses they took during med school.

Rapid cycling is indeed very possible and for some bipolars it can be hourly at bad times - I can cycle from hypomanic to depressed in the course of a day.

Pretty much every AD can trigger mixed episodes in some people - I cannot touch SSRI's for example.  Be VERY careful with Citalopram if you are not on an MS - make sure you know the signs of mixed episodes - the mania is not the problem its dysphoric mania (mixed episodes) that is the risk factor - I attempted suicide on SSRI's due to that state.

It does not affect every BP the same so no need to panic or anything just be aware of your moods and if so make sure the people around you are aware of the signs.

This is why i loathe GP's and their ability to prescribe AD drugs to anyone - A rapid cycling person presents and the first thing they do is reach for the script pad and prescribe an AD.

[daisy_a7x]

Definitely!
I've just been put on that one drug, although I think the GP was pretty stumped with the rapidity of my highs and lows. I'll get through the weaning process and let you know.

Jo

[vdp]

Hi,
I'm taking Citalopram to, in my case 40mg. I've also just started on Stelazine 5mg for my racing thoughts and anxiety! I'm still not convinced after 8 weeks on the Citalopram that it's the right drug for me but my doctors keep telling me to bear with it.
I've been up and down like a yo-yo so if nothing else it'll be interesting to see how you get on.
Keep in touch
Vicky