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Citalopram or Mirtazapine for severe anxiety & depression

Dizzy

Anyone tried either Citalopram or Mirtazapine for anxiety &/or complex trauma? My 16 year old ASD transgender son struggles with almost constant severe anxiety & voices in his head and having had no luck on Sertraline, Fluoxetine, & especially not with anti-psychotics because they've realised he's not psychotic, they want him to start one of these other antidepressants. He's not convinced so we're trying to gather any evidence that these may or may not be effective so we can make an informed decision. Thanks in advance.

  • Thank you everyone, that's really helpful. Luckily our GP has offered to be on hand to help monitor how things go & answer any questions etc too, so we don't need to just rely on the CYPMHS psychiatrist, who suggested an appointment 2 months after starting a new med, which is nowhere near soon enough in my eyes!

  • in reply to Autonomistic

    I had a similar experience to Autonomistic on Citalopram - it was the most terrible experience and I’ve never dared take any other mental health medication ever since. 
    Obviously everyone is different - but if your child does take it then do take care and keep a close eye on him. It gave me a strong urge to kill myself - which I didn’t have before starting the medication (I had really bad anxiety which was why I went to my gp for help). So do be very careful to watch for any signs of suicidal ideation. 

  • I have been on Mirtazapine for approximately 5 months. The psychological impact has been quite subtle. I don’t feel “better” but I do feel slightly more in control of myself. I’m in two minds about whether it has been worthwhile.

    However I was warned that mirtazapine commonly causes weight gain and that had been the case for me. I am now permanently hungry, never feel full and have gained approximately 7kg in 5 months.

  • I tried citalopram for 3 months. My appetite worsened and I felt sleepy a lot of the time. I didn't feel any change in my mood really, and I ended up passing out at work once.

  • I was on citalopram once for depression. I’m not sure it had much effect but it didn’t have any side effects either except for perhaps slight nausea for a week or two while it was taking effect / I was getting used to it but that’s quite a common side effect. The problem with most medication is that they only work for the majority of people and not everybody so to some extent it’s a case of trial and error to see what works, normally starting with drugs which normally have the least side effects.

  • I've tried both for severe anxiety but had to discontinue due to severe and intolerable side effects.

    On Citalopram I experienced severe agitation, restlessness, massively increased anxiety and an inability to sleep without vivid nightmares. I believe it is known as SSRI induced activation syndrome 

    https://en.wikipedia.org/wiki/Activation_syndrome

    After a few months I was experiencing constant suicidal ideation, despite not having depression or suicidal thoughts prior to taking them. I believe the risk of that happening is higher in younger people but it can happen at any age.

    Mirtazapine (not an SSRI) is what I was put on next but they did not help in any way. The vivid and horrific nightmares got worse and I became extremely angry for no reason pretty much all the time. 

    Just my personal experience and not medical advice. Some people do seem to find them helpful but personally I would not take them again under any circumstances.

  • Hello, I am Autistic and am on Citalopram for anxiety and depression. I am not a doctor so this is my personal opinion, but I find Citalopram really helpful. Mirtazapine is similar medication. That group of medication sounds like a fair treatment option, alongside talking therapy. Hope this helps.