How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr Basu Your Own Question

Dr Basu
Dr Basu, Experienced Specialist
Category: Medical
Satisfied Customers: 28198
Experience:  MD
23744323
Type Your Medical Question Here...
Dr Basu is online now

Hi, I was diagnosed (over the phone - nhs service) with ODC.

Customer Question

Hi,
I was diagnosed (over the phone - nhs service) with ODC. My GP prescribed me citalopram 20mg.
First two weeks it was like an nightmere(increased anxiety, intrusive thoughts etc), week 3, 4 and 5 better I was going back to normal slowly, then since Monday I feel very anxious and have some Intrusive thoughts, always waking up at 4am and in general feeling lime I am going crazy.
I contacted my gp today but my appointment is next monday.
My question is, should I change the meds or is my condition is worsening? Is it normal that this citalopram stop working after 5 weeks?
What should I do?
Thank you for any advice in advance
Monika
Submitted: 2 years ago.
Category: Medical
Expert:  Dr Basu replied 2 years ago.
Dr Basu :

Hi there, This is Dr Basu, Experienced Specialist. I am here to address your concerns and provide great service.

Dr Basu :

YOu meant OCD.

Dr Basu :

So, you have already been on 5 weeks of citalopram.

Dr Basu :

Since your symptoms returned, it is betteer to consider a dose increase by 10 mg to 30 mg daily.

Dr Basu :

Since you did feel better for past 3 weeks, the medication is working.

Dr Basu :

But your brain needs more of that effect.

Dr Basu :

Hence, increasing the dose will be appropriate.

JACUSTOMER-a32xs9j8- :

Hi,

Dr Basu :

Please do watch out for any suicidal ideation which may be seen in small number of individuals with dose increase.

Dr Basu :

hi there

Dr Basu :

did you see my replies above

JACUSTOMER-a32xs9j8- :

I spoke to my GP and she said that medicine is not working

Dr Basu :

the maximum dose of citalopram is 40 mg daily.

Dr Basu :

so, you have some scope to go up.

JACUSTOMER-a32xs9j8- :

and i should have side eefects for two weeks only

JACUSTOMER-a32xs9j8- :

can I make that decision on my own?

Dr Basu :

these are not likely side effects since you have taken for 5 weeks already

Dr Basu :

it is better to switch to a different medication like Cymbalta or Effexor.

JACUSTOMER-a32xs9j8- :

its my 7th week

Dr Basu :

No, you should not change dose on your own.

Dr Basu :

yes I calculated that.

Dr Basu :

so side effects are not likely at this stage.

Dr Basu :

so you may continue same dose if dose increase is not approved by your GP.

Dr Basu :

but she should change to a SNRI like cymbalta ( duloxetine) or Effexor ( venlafaxine)

Dr Basu :

they work better

JACUSTOMER-a32xs9j8- :

I dont know how can I help myself, the worst are the intrusive thoughts, its like I am worry all the time

Dr Basu :

yes can be very uncomfortable.

Dr Basu :

that is why we treat these symptoms right away if possible

JACUSTOMER-a32xs9j8- :

Are these medicines stronger that citalopram?

Dr Basu :

they act differently and in a sense stronger

JACUSTOMER-a32xs9j8- :

Is there anything I can take along with Citalopram for the time being..I need something to calm down, I am working and have daughter . I can not be this way.. it's very hard

Dr Basu :

There is nothing over the counter.

Dr Basu :

there areseveral prescirption medication choices:

Dr Basu :

1. Lorazepam

JACUSTOMER-a32xs9j8- :

she gave my propanolol

Dr Basu :

2. Clonidine twice daily.

Dr Basu :

Propranolol also may be helpful

JACUSTOMER-a32xs9j8- :

I am sorry, for asking so may questions but I am so disappointed I felt better for 3 weeks and now low again.And at the same time , each time I go to my gp I have to wait ages for an appointment and each time see different doctor.

Dr Basu :

I understand that.

Dr Basu :

But this is common during initial period

Dr Basu :

it is to find the right medication that will provide long lasting relief at the correct dosage.

Dr Basu :

THat is an art not science

Dr Basu :

as each individual is different

Dr Basu :

so it takes some time.

JACUSTOMER-a32xs9j8- :

Do you think is any chance that my dose is to big?

Dr Basu :

Being said that, you should also consider counseling sessions.

Dr Basu :

And consider consulting with a psychiatrist.

Dr Basu :

no your dose is average

Dr Basu :

big dose is 40 mg and above

JACUSTOMER-a32xs9j8- :

I went for CBT, but so far dont see any improvement, I read a lot about my condition and anxiety but I guess I am very impatient

Dr Basu :

it takes some time but you should see improvement over time.

JACUSTOMER-a32xs9j8- :

I just scared that with new medicine I have to go through the same hall as with citalopram

JACUSTOMER-a32xs9j8- :

sorry hell, I meant

Dr Basu :

That is unlikely.

Dr Basu :

worst is over in your case.

Dr Basu :

please do ot give up

JACUSTOMER-a32xs9j8- :

Just to summarise.. you think is no chance citalopram 20 mg will still work on me? So I should see my doctor and we should change the medicine.

Dr Basu :

i wont say no chance --but increased dosage can be tried since your dose is still considered low

Dr Basu :

Yes medication should be changed if possible.

JACUSTOMER-a32xs9j8- :

ok, thank you for you time , goodbay

Dr Basu :

very welcome

Dr Basu :

It was my pleasure to help you today.
I am Dr Basu experienced in Metabolic Diseases.
If I have answered all your questions, Please rate my response Excellent (click on the smiley faces) under this chat box only.
Please bookmark my profile for asking further questions!
This is the link to my profile:
http://www.justanswer.com/medical/expert-mysticdoc/

What Customers are Saying:

 
 
 
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me FROM a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O.
< Previous | Next >
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me FROM a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O.
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C.
  • This expert is wonderful. They truly know what they are talking about, and they actually care about you. They really helped put my nerves at ease. Thank you so much!!!! Alex
  • Thank you for all your help. It is nice to know that this service is here for people like myself, who need answers fast and are not sure who to consult. GP
  • I couldn't be more satisfied! This is the site I will always come to when I need a second opinion. Justin
  • Just let me say that this encounter has been entirely professional and most helpful. I liked that I could ask additional questions and get answered in a very short turn around. Esther
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C.
 
 
 

Meet The Experts:

 
 
 
  • Family Physician

    Family Physician

    Doctor

    Satisfied Customers:

    2418
    GP with over 27 years experience including emergency medicine
< Last | Next >
  • http://ww2.justanswer.com/uploads/FA/FamilyPhysician/2013-8-31_191624_JA550x500Photo.64x64.jpg Family Physician's Avatar

    Family Physician

    Doctor

    Satisfied Customers:

    2418
    GP with over 27 years experience including emergency medicine
  • http://ww2.justanswer.com/uploads/DO/DoctorRich/2012-9-12_72454_Doctorweb.64x64.jpg Dr. Natasha's Avatar

    Dr. Natasha

    Doctor

    Satisfied Customers:

    7887
    American Board Certified in Emergency Medicine, Ivy League trained
  • http://ww2.justanswer.com/uploads/DR/DrK99/newpic2.64x64.jpg Dr. K.'s Avatar

    Dr. K.

    Board Certified MD

    Satisfied Customers:

    255
    Board certified with experience in primary care.
  • http://ww2.justanswer.com/uploads/agketch/2008-7-14_184046_drketchresized.jpg Dr. Ketch's Avatar

    Dr. Ketch

    Board Certified Physician

    Satisfied Customers:

    76
    Medical Degree, Former Assistant Professor at School of Medicine at Yale University
  • http://ww2.justanswer.com/uploads/JA/JACUSTOMERjtu60wne/2011-2-14_183449_passportphoto2.64x64.jpg docwithheart's Avatar

    docwithheart

    Board Certified Physician

    Satisfied Customers:

    0
    Board certified pediatrician, with special experience in general pediatrics, hospital pediatrics, and pediatric cardiology
  • http://ww2.justanswer.com/uploads/DR/drappapo/2013-8-16_22576_drdavid.64x64.jpg Dr. David's Avatar

    Dr. David

    Board Certified Physician

    Satisfied Customers:

    224
    Treat children/young adults, former chief resident, multiple publications
  • http://ww2.justanswer.com/uploads/TA/tazechip/2012-6-7_135230_drpic.64x64.png Dr. Chip's Avatar

    Dr. Chip

    Board Certified Physician

    Satisfied Customers:

    12373
    20 yrs. in practice, includinge surgery, general medicine, addiction medicine and pain.