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Citalopram and sleep problems

19681989

Hi
My adult son has fragile x and has been suffering with anxiety for a long time. We've tried low dose anti psycotics but had to stop due to side effects.
He's taking 10mg citalopram for 4 weeks.
Bizzarely he has had a reverse sleep cycle . He typically will go to sleep between 3.4am and sleeps the next day until 3pm.
Of cause this is really hard for me to cope with.
I called the special needs Phyciatrist but no one returned my call 2 weeks ago.
Obviously also with Coronavirus he is very worried, bored, low and I've continued it because I don't know what to do

Any ideas anyone please.

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thespiceman

Hello @19681989 Pleased to meet you.

Sorry to hear about your son I do understand.

Please if I can suggest and advise some links for you to look at.

Does you son have support workers ?

Please consider using these organisations.

Mental health charities. Offer floating support advice health and welfare might not be in all areas.

https://www.richmondfellowship.org.uk

https://www.mind.org.uk

https://www.rethink.org

There is also the Fragile X charity have this for you to contact.

https://www.fragilex.org.uk

Helpline 01371 875 100

Mentioned sleep problems talk to them see what they can advise.

I do know myself get tired a lot and fine much of it is due to medication side effects. Which means as well as insomnia get tired but can not sleep.

If I do often limited length of time, sleep can vary. As with age or conditions or with illness.

I use a lot of my own knowledge and expertise on diet, nutrition to help me.

My own mental health I can suggest advise offer guidance on diet, nutrition.

Avoid caffeine in tea, coffee, cola, chocolate, energy drinks.

Alcohol and smoking. If he ever does .

Whole grains, Pasta, Rice, Bread, Beans, Pulses.

Plenty of Fruit and Vegetables.

Lean Meat Eggs Leafy Greens, Nuts if allergy avoid. Milk yoghurt helps stomach bowels antibacterial.

With any sleep issues always important to consult GP. With the difficulties right now please may I advise thinking about looking at websites.

NHS one .

https://www.nhs.uk

Or this is The Sleep Council

https://www.sleepcouncil.org.uk.

Please if you have any questions please get in touch.

Happy to be supportive and offer compassion.

Please take care, keep safe.

@thespiceman

Adrian_Scope

Hello @19681989. Can I ask what time of day your son is taking Citalopram?
Tiredness and feeling sleepy seems to be a common side effect according to the NHS and is supposed to get better after a few weeks. They recommend if you have trouble sleeping while taking it that it's best to take it in the morning.

If you can't get in touch with his special needs psychiatrist it may be worth you contacting your local GP for a bit of support.

EmmaB

Hi @19681989

I know it's common for doctors/psychiatrists to resort to drugs to try and change behaviour but as a counsellor my emphasis is always on trying to find out the root cause of a problem and find strategies that can help resolve or address that as drugs often don't target this root cause...

You don't say how your son is affected by Fragile X and I believe the learning difficulties associated can be from mild to moderate, but however it affects him I'm wondering if you might find some support from this charity which coincidently I came across yesterday when reading an article about counselling people with 'intellectual disability': http://www.respond.org.uk there is also mention of another organisation - the Institute of Psychotherapy and Disability: https://instpd.org.uk/

In the meanwhile when counselling clients with sleep issues I suggest doing things like - developing a 'going to bed' routine, create a positive/nice environment for sleep eg clean linen, tidy room etc, no screen time for at least an hour before sleeping [or at the very least changing the screen colour to orange], ideally stopping caffeine at midday [as it hangs around in our system for hours...], eating properly [so not going to bed hungry], some form of relaxation, writing a to do list for the next day, and/or parking worries by writing them down.

There are lots of strategies and techniques for anxiety too and I'm wondering if the above organisations might be able to help you and your son explore and try/test these out.

I hope that helps.

Best wishes.

Emma

19681989

Thankyou all for your suggestions and replys.
Lots of advice, helplines so I will crack on and get ringing ?

I don't no how to individually reply sorry.
Best wishes

EmmaB

Good luck with getting some good support @19681989 and if you get stuck or need moral support come back! To alert someone just put the @ symbol before their name. Best wishes. Emma

charlie79

I take citalopram 40 mg and find the same. It affected my sleep patterns tremendously, But I also take zopiclone for PTSD which helps me with my sleep. I was scheduled for an apt with my doctor to change my antidepressants and try to lower my dose of Zopiclone, but the coronavirus outbreak has delayed this at present. There is an antidepressant that my CPN recommended apparently its makes you feel drowsy and is taken at night. The antidepressant works through your system as you sleep, I can't remember the name.
Even though help may be delayed by coronavirus maybe you could ask your GP. Taking a tablet before he goes to sleep may help get into a routine. One thing to remember though when you stop taking citalopram it takes 2 weeks to come out of your system So if he does change meds the effects of any new meds wonts be visible at first. I don't know if this helps, but I hope things improve.

19681989

Thank you Charlie for your advise and I wish you well.
Do you think it's possible that it could reverse his sleep pattern?

thespiceman

Hello @19681989 As along time taker of medications always been wary of changing to higher or lower dosages.

With any medications the side effects can be numerous also the one thing your son has to do is get into a routine of needed to take medications times at the necessary time of day.

It is like this all medication has a time factor because need to get in to the blood stream and in to the areas to start working.

One reason added the suggestion nutrition and diet aspects of food.

Also the links regarding sleep council plus the charities.

Because the charities offer in house courses on medications and sleep clinics in a supported groups.

Learnt a lot often bring in some from NHS services sleep clinics or bring in Doctors or Therapists or even Pharmacy teams talk about medications.

College called Recovery College do a course on how to take your medication learn a lot.

Do not know if your area, also one other Wellbeing service funded by health units your County council have one.

Where did my qualifications learnt a lot of knowledge expertise to members here, as you see bottom of the page.

I used to take meds before bedtime sorry not good to do that, usually two hours when having a meal if prescribed night time.

Breakfast take them with water or food starts if he needs to take a look at any medication leaflets or if you need to.

Another aspect of medication certain foods can interact with medications.

Understand a lot of those foods should be on the leaflets can be and should be removed.

One other reason my medication do not take any thing Grapefruit effects absorption and interaction of drug I am taking.

Consider doing a food diary for your son see what foods cause him to interact more make him sleepy , lots of sugary stuff junk food can have that effect one example if he taking that.

I would add if you do consult any of the links provided give moral support and lots of guidance, advice.

As a community we are here to be supportive anytime.

Please ask any questions.

One further thing you need to know can be a difficult road ahead I suffer a lot insomnia need to add some days good some days bad but used a lot of my knowledge from mental health charities.

Went to sleep school and clinics to reverse my sleep life cycle.

Was an alcoholic so my days were nights and my nights were days so became difficult to ever sleep again once coming off.

Took a while to adjust.

One other I forget to add if you think this is meds he is on not working. Support workers or outreach workers attend with you and your son Doctors.

Advocate charity Rethink good at this, I used them as problems with GP meds and used both Rethink and Richmond Fellowship intervened Doctors relented.

Good to know.

Wish you well and your son.

@thespiceman

EmmaB

I think it's important to bear in mind that psychiatric drugs don't help everyone nor are they appropriate for everyone... Indeed there is actually a campaign regarding the over medication of people with learning difficulties: https://www.vodg.org.uk/campaigns/stomp-campaign/

Psychiatric drugs [I don't call it medication as medication targets specific organic problems...] also have iatrogenic effects and withdrawal effects [which can both be mistaken for the 'condition' they are being prescribed for].

Indeed Public Health England has recognised there are major flaws in the way such drugs have been prescribed and is reviewing this problem:

https://www.gov.uk/government/publications/prescribed-medicines-review-report/prescribed-medicines-review-summary

I suppose what I'm saying here is don't feel compelled to keep taking something that isn't helping [but consult with your doctor as to how to come off drugs because there can be significant withdrawal effects...]. If a drug causes a problem then it's not really helping, it could be it needs time to work its way into your system but it's important to consider the fact that psychiatric drugs are psychoactive/neurotoxic drugs and if you can avoid taking them then you potentially avoid a lot of problems!

Psychiatric drugs might seem like a great quick fix [when they 'work' - this is mainly due to a placebo or sedating effect] but the tide is turning on the idea of prescribing such drugs long term which means alternative means of managing problems need to be unearthed and committed to.

19681989

Thankyou for your replies.

19681989

Glad to hear it. He only takes 10mg but not a regular user of antidepressants that's the reason I feel it has caused a sleep reversal.
It must be the cause.
Sorry can't go into In depth replies and support other people, very busy with him.
Best wishes

richp90

19681989 said:

Hi
My adult son has fragile x and has been suffering with anxiety for a long time. We've tried low dose anti psycotics but had to stop due to side effects.
He's taking 10mg citalopram for 4 weeks.
Bizzarely he has had a reverse sleep cycle . He typically will go to sleep between 3.4am and sleeps the next day until 3pm.
Of cause this is really hard for me to cope with.
I called the special needs Phyciatrist but no one returned my call 2 weeks ago.
Obviously also with Coronavirus he is very worried, bored, low and I've continued it because I don't know what to do

Any ideas anyone please.

19681989
I have had a similar issue but it is me who has the sleeping problem from medication. i moved onto venlafaxine which i take first thing in the mornings, not evenings because they are stimulates and can make sleeping patterns poor and unpredictable. my advice would be to get a urgent review. i know that one call doesn't always get a response, keep calling every single day until you get there. i hope it things improve for you and your son over the upcoming days.

19681989

Hi thankyou for your reply.
I finally did get through and the advice was to either up it or stop.
So he's stopped he's was only taking it a few weeks and won't taper it unfortunately.
Sorry to hear of your troubles it's hard isn't it.
I had terrible sleep problems and nightmares on venaflaxine. Hated it.
I got off it eventually took a while and then tried sertraline 100mg. Its been the best one so far. And I've had 30 years of antidepressants.

EmmaB

Hi @19681989 - 30 years on antidepressants. I get very frustrated when I hear how people get stuck on antidepressants particularly if they have been fed inaccurate information about them ie that they fix biochemical imbalance (they don't - their main effect is sedation and/or a placebo effect). I wonder whether you are taking them nowadays because you've always taken them and if you've ever considered talking to your GP about coming off them and/or alternative 'treatment' which address the actual cause of why you are taking them? There is increasing awareness that people shouldn't be left on repeat prescriptions for antidepressants so if your doctor is not interested in talking through this issue I would seriously consider finding a new GP. If you do decide to come off then it's important not to misinterpret withdrawal symptoms with the 'problem' coming back. Your body will have to make a readjustment to coming off which is best done by tapering... this could take years such are the effects of these these drugs...but it's worth considering as taking these drugs long term can cause iatrogenic problems which GPs should really be talking to patients about. I know the prospect of coming off drugs you have taken for decades may be daunting but it's worth considering for the sake of your long term health?
I'm hope you son can get some alternative support that directly addresses any issues he has.
All the best.
Emma

19681989

Thankyou for your message.

thespiceman

Hello @19681989 Please if I can just confirm what my friend @EmmaB has stipulated.

Understand hoe meds and especially antidepressants effect you it is best to find some support from the charities I mentioned before.

I have been on antidepressants a long time but just know the side effects the ways they work.

Little education and knowledge can be a good thing.

Most mental health charities often have support meetings where your introduced to a way of coping.

Includes bringing some one in for consultations for sleep, medication.

I also know a College funded by the NHS. Might not be in all areas.

Recovery College offer one day courses on a range of mental health issues.

I used to go them all on meds sleep and coping methods.

Also one other piece of advice I can give you is support workers if you enrolled will evaluate your health and everything.

Under their guidance went to GP and advised me to with their support to look at switching meds.

I actually have a reviews every three months meds and any thing health.
Doctors agreed with me, any Doctor who does that knows there patients and any problems can discuss.

I have since gone on Sertraline. Researched it side effects and every I need to know.

One other is your diet and nutrition if you consider looking at that as well.

In combination worth meds does help.

I have mentioned a lot of this before and please if you do look at any of the links and support can only be beneficial to your wellbeing your son, family.

Please if you have any questions please ask.

Please take care and safe.

@thespiceman

19681989

Thankyou spiceman.
I hope you are well. I will look into local charity's. I also take sertraline.
Just a question,
1. Sertraline, what information is essential to know.
2.Do you have links to the information.
Take care.

thespiceman

Hello @19681989 All meds have side effects Sertraline has a number.

Should be on the leaflet that comes with medication you have from GP.

I want to reassure you need to always do this. Read any literature with any meds at all times.

For many reasons . One is the meds you are on sometimes certain diet nutritional foods can interact and prevent meds working.

This one Grapefruit Juice which can cause problems, you need to be aware of any underlying health problems or allergies when taking meds.

Certainly look at the leaflet or if you wish to look on line. Always a good source of information.

Type in the drug your using comes up with a lot of information.

Make some notes.

Also Sertraline is a common drug is that suitable for you.

The Doctor should have explained to you if he or she did not then you need to ask.

Used for the following.

1. Depression and prevention of depression.

2. Social Anxiety in Adults

3. PTSD /OCD in Adults.

There are others such as Mirtazapine, Amitriptyline need to add been on those were causing issues so reason stopped switched to one am on now.

Other depression meds. Nortriptyline, Nefazodone, Fluoxetine, Fluvoxamine.

All are at Doctors discretion which one to give you.

Please I hope that helps.

Please ask me anything.

Please take care and safe.

@thespiceman

19681989

Thankyou spiceman.take care.

emmarenshaw

Hello @19681989 a warm.welcome to the community. Please let me know if I can help you with anything.