One week remission with an SSRI?

[Boodle]

A few months ago, I began taking Citalopram (for depression) starting on a half dose (10mg) and then after a week, moving up to a 20mg full dose. After commencing the full dose, I began to feel better and within a few days all my CFS/ME symptoms had disappeared. The whole suite of them. What a week it was!

Unfortunately, a week later, all those missing symptoms piled back on. The first night all the pain came back and then the following two days I was bed ridden (I hadn’t had a crash like that in months).

The past couple of weeks I have stabilized again but at the pre-SSRI level.

(I have read a lot of people’s views on SSRI’s on this forum and understand a lot believe they are a bad idea. And I understand that, but I did need some help and they do the trick for me.)

I wondered if anyone had any insights or suggestions on what happened in that week that took away the symptoms. Any clues would be greatly appreciated.


Thanks
Louise

 

[Mary]

bump

 

[Hip]

I had a similar 2 week remission from brain fog with Wellbutrin, but then after 2 weeks the remission mysteriously disappeared. I've ever been able to regain it, even after taking a break from the drug, and restarting a few months later. I never was able to figure out why that happened.

 

[nandixon]

@Boodle, I've recently found it helpful to look at most things in terms of their effect on the HPA axis. I started doing this after looking into Dr Nancy Klimas's hypotheses about ME/CFS and Gulf War Illness.

In this study (on rats) here:
https://www.ncbi.nlm.nih.gov/pubmed/10336728/

It was found (just from reading the abstract) that citalopram initially activated the HPA axis (which is what I believe I'm needing) but then after 14 days it had the opposite effect, desensitizing the HPA axis and presumably reducing corticosterone (the rat version of cortisol).

A few years ago I would have thought the effect you described was related more to serotonin, but the HPA axis seems a better fit to me now. Dr Klimas believes that the HPA axis is needing to be reset in ME/CFS (and GWI).

 

[Boodle]

Thanks so much @nandixon that is extremely helpful!

 

[Float]

Im not sure this is helpful, and probably far too obvious, but did you feel better and do more cognitive/physical/social tasks that triggered it? Sorry if that is unhelpful comment.

 

[Boodle]

Thanks @Float , that is a fair question.
I did end up doing more than I usually would have but it really was quite a different feeling to my usual self. It's hard to explain the sensation, but I felt energised like all my cells were no longer working at half speed and therefore wouldn't run out of energy like they do now.
And then it was if the switch flicked again and I was back to good old ME.

 

[jimmy86]

I took one Citalopram earlier today and I feel energized.

If the HPA Axis theory that @nandixon describes be correct, should I just take the drug 14 days before the effects can revert??