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keogh08: adverse reaction to citalopram - akathisia?

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I started with anxiety and panic attacks almost a month ago, I had been under stress at work and had lost my appetite and considerable amount of weight, and was not sleeping. My GP prescribed Citalopram 20mg, and within a few hours of taking this I was almost crazy, pacing up and down the house, feeling I needed to get out of my own body and on day 3 started with horrible dark thoughts and images of me killing myself. Mainly the images were around knives. I must stress that prior to taking this medication I  had never had a dark or suicidal thought.On day 7 of taking this drug I stopped due to the awful side affects which I now believe was Akathisia. I seen a private pysicatrist who put this down to a bad reaction with the citalopram and recommended sertraline, I waited almost two weeks before taking the sertraline as the dark thoughts still persisted, the majority of the other symptoms seems to subside. Earlier this week I started on the sertraline 25mg, once again the same symptoms have returned as in the beginning when taking the citalopram, this is only on day 2 of the sertraline. I have only recently learned about this condition but I am now going to discontinue with the sertraline given that Akathisia can last longer than the time the medication was taken. Has anyone experienced this due to the combination of these SSRI's? My GP is absolutely no help at the minute hence me having to seek help privately. 

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Welcome, @keogh08


I moved your post here, to start your own Introductions topic, where you can post questions about your situation and track your progress.


You may have had a severe adverse reaction to citalopram. As sertraline is another SSRI, it is possible that you and SSRIs do not get along.


Did you take citalopram and sertraline in combination? What drugs are you taking now, at what times of day?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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Sorry for the late reply, I have been trying to get over the side affects brought on by the short term use of both SSRI's but now I have a feeling they have affected my brain badly. 


In response to your previous question, no I did not take the citalopram and the sertraline together. I took citalopram from 7 days when I have extreme side affects and then left it a period of two weeks before starting the sertraline.


I am now left with awful ruminating and some dark thoughts, along with brain fog and cannot concentrate on even the basic of tasks. 


Have you ever known short term use of these drugs to affect someone so badly after stopping abruptly? 


I have read many withdrawal stories on this site and I feel I have been affected by long term use, I see no end of this and really do not want to start any anti-depressants ever again.


Do you think I am best to ride this out a bit longer?


I have been exercising most days, taking omega 3 and magnesium as suggested but my brain fog and ruminating is severe.


I am really angry with myself as prior to starting the AD's I only had mild anxiety and a pain in my chest none of the symptoms I have listed above which really worried me.


Thank you

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@keogh08 Hi there and welcome to SA. I am so sorry about the adverse reaction to only a few doses, if I understand your post correctly. I ! Too, had an adverse reaction to a SSRI. The recovery time can take longer than expected. This site is very useful and offers a lot of support. I hope your recovery time is quick. 



2002 - 2014, 500mg Keppra 2x’s/day (anti-seizure med)

2003 thru 2004 - 10 mg Remeron

2005ish - Adverse reactions to single doses of Zoloft, Wellbutrin, and Lexapro (no long-lasting problems)

2012 - Buspar (overly energized, stopped immediately, no long-lasting problems)

2014 - 1 month taper off of 500mg Keppra (Leviteracitam) - seizure free for 12 years 

2017 - 500mg Leviteracitam (generic keppra) 

2017 - Mid-Dec experienced adverse reaction to Leviteracitam due to different manufacturer. Stopped on Dec 20.

2018 - Jan 1st, 10 mg Fluoxetine (generic prozac) experienced severe adverse reaction after 3 doses and continue to experience issues today. 

2003 - 2018 Ativan, occasionally/rarely

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Thank you for your reply. I am now 4 months in recovery, I have good days and bad days. My main symptoms I have remaining  are anxiety, Corsitol spikes and quite strange mental anxiety, to put Frankly I am in my own head far too much of the time. Lots of overthinking etc. The pain in my chest has finally passed, along with nightmares so recovery is happening but at a very slow pace. It is absolutely crazy to think mediciation can give you so many symptoms. I am really looking forward to the day I can enjoy a some drinks with friends. I was really sociable before all of this happened, but after trying a few drinks back in November it totally intensified my symptoms. The best thing I have found so far is magneisum I take 375mg x2 a day and this really relaxes me, along with yoga and clean eating. 

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Hi Keogh,  It certainly sounds like you have had a nasty adverse reaction to the SSRIs.  It can be brutal when it happens.  What you describe sounds very similar to my experience and others who have been on here.  The good news is that you might not see as much of us on the site as our recovery tends to be a bit shorter after the initial crisis period and we are, thankfully, able to put the experience behind us.  


Most of the advice you see for managing withdrawal symptoms will apply equally to self care after an adverse reaction.  It is good that you are being proactive with yoga and clean eating.  Mindfulness really is the key to managing both the adverse reaction symptoms and the underlying anxiety that made you seek help in the first place.  Try not to be angry with yourself - you weren't to know.  None of us were.  


I notice that you are taking fish oils.  I found them far too activating initially.  A lot of people do well with them but I didn't.  


March 2003 took two sartroline tablets after a traumatic incident and had a reaction so stopped.  I am not sure now whether what I had for the next 18 months was WD after the reaction or the emotional fallout from the traumatic event.  Some of it was very similar to WD in hindsight.  


February 2014 - Took five pristiq (50mg) tablets and three Ativan and had a severe reaction.
Extreme withdrawal symptoms for three weeks compounded by visit to naturopath -

One week later took 900mg St John's Wort x 3 daily for six weeks - more negative effects and suspected serotonin syndrome - before tapering over three weeks. Last tablet late May 2014.

Waves and windows cycle of recovery with longer windows and manageable waves.

May 2015 - already in a mild wave, following a usual pattern, I took clarithromicin and amoxicillin for two weeks for a sinus infection which I also seem to have had quite a reaction to.


February 2016 - Feeling much better.  I still have waves and windows but they are manageable.  I'm largely enjoying life again.

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It has been a while since I have posted under my own area, so I thought I would provide an update. Mainly for any other adverse reaction people as I know how disheartening it can be to find lack of success stories and timelines etc. 


So it has been almost 9 months since I suffered a severe adverse reaction to Citalopram 20mg for almost 6 days. I had never suffered with any mental illnesses but I had a reaction to an asthma inhaler which set of a bout of panic attacks most likely due to increased adrenalin, and a very poor diet where I would mostly live of coffee and sugary drinks. 


The initial 3/4 months were by far the worst, I still had the all of the symptoms I had started with on day two of the medication along with depression.


I was not sleeping, eating very much or enjoying life. I was tormented with horrible thoughts, auditory and visual disturbances and horrific nightmares that would take most of the morning for me to come around. I used to wake with bursts of cortisol and panic and my arms and legs would feel extremely weak. Once this would settle around dinner time I would be left to fatigued to do anything.


I returned to work in the January 2020 after 12 weeks of sickness and although I was still struggling  I needed some normality, and not to be focusing on my symptoms and delayed recovery. The first month in work was terrible, I remember walking into the large open plan office and all of the noise of phones ringing and conversations vibrated through me. I also had depersonalization pretty bad so felt as though I was in a dream and not in the workplace. This made interactions very difficult but I pushed on and in time my cognitive skills improved. 


In March me and my partner flew to Jamaica for a break, it was supposed to be a trip of a lifetime planned before my reaction. Although it was good it was not what I had imagined. The first few days I suffered terribly with fatigue from the time difference and I didn't feel as happy as I should to be in such a beautiful country.


In April is where I seen the most improvement, my panic and anxiety left me physically, although I was still ruminating frequently and days consisted of many intrusive thoughts, but I was now able to sleep for 12 hours uninterrupted. I was exercising daily although I decided to stop as the fatigue would hit me worse for a few days later. I now opt for short walks or bike rides. 


In May improvements continued. My remaining symptoms are now free floating depression, lack of motivation. It takes me quite a while to wake up but I no longer have the cortisol or the morning panic. My thinking is still pretty messed up I often find myself imagining the most surreal of situations which would never happen. Sometimes I have quiet vivid dreams but nothing like the initial phase.


Last week I had a bout of Migraines so I decided to introduce Omega 3, these have now thankfully subsided. I am now left with a handful of symptoms which is still pretty frustrating but if I look back at the last 8 months I know I have come a very long way.


I just need my brain to settle down and for normal thinking to resume along with my love for life.


I will keep you updated on my progress as I am determined to turn this into a success story so all people who suffer after taking the meds for a short period of time can come here for hope and understand it does get better. And not necessarily 7 years later as I have read frequently on here. 

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Hi Keogh,

i am so happy to hear that you have recovered. may you continue to feel better and better and completely recover.

you went through the worse and now it is behind you.

june 2014 to feb  2015- on xanax 0.25 to 1mg/day- then CT - jan 2016 - panic attack, went on 3.75mg remeron to sleep march 2016- CT remeron (because it caused me tinnitus)- deep depression, couldn't sleep because of  intrusive Tinnitus

april to june 2016- valium 4mg, xanax as needed, lunesta 3mg

june 2016 - valium 4mg, lexapro 10mg

oct 2016- valium 2mg, lexapro 10mg- hold

march 2017- started daily micro liquid taper of valium and lex- -taper speed 0.0033mg valium daily and 0.033mg lex daily

may 2018- valium 1mg, lexapro 2.4mg - i had to slow down the rate of my daily micro taper considerably

LAST dose of Lexapro: 0.05mg on 05/17/19

LAST dose of valium: 0.04mg on 08/18/19

April 26th 2020- intense panic attack that lasted 4 days, akatisia, 0 sleep- suicidal, almost hospitalized- took rescue doses over 2 days- total: 1.5mg xanax, 18mg valium, 2x5mg lexapro




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Thank you @xyz, I am not fully recovered but almost there!

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Just thought I would post another update.


It has been 10 1/2 months since my reaction  to citalopram. I have seen some more minor improvements since June.


Symptoms that still remain are infrequent leg twitches in the left leg, mild tinnitus occasionaly. Lack of motivation some days and it also takes me a few hours to wake up each morning, although sleep is great now I can sleep 12 hours if allowed!


Strange thoughts and some over dramatic thoughts which are by far still the worst symptoms. Slight anhedonia. I also have songs repeating in my head constantly which can be really annoying. Considering they are mostly nursery rhymes as I have a toddler. 


 Some days I have no symptoms what so ever, this usually happens when I am keeping busy.


Once the strange thoughts pass and the leg twitches go along with tinnitus I will consider myself recovered. 


I will then work on excercise which has been a struggle, I am fine walking and doing chores etc. But any time I do cardio I end up with a week of intense headaches!


I wondered does anyone know of a rough timeline for the normal thought process returning?


I would have expected a better improvement in this area considering my anxiety, depression and sleep has been improved massivley.

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Does anyone have any advise regarding headaches?


It has been almost 12 months since my adverse reaction and healing is speeding right up now.


Leg twitches have subsided as has many other symptoms, one thing that persists now is headaches daily that usually start when I first wake up and can last until afternoon. 


I have tried pain killers that dont touch it now asprin isnt doing much either. 



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