one in three of us (IIRC) will have treatment for mental health issues at some point in our lives.

Interesting thought that. I suspect that, if the percentage is that high, the definition is pretty wide.

However, certainly from my experience as an interested third party, I am intrigued by the number of people I know who have suffered from mental health issues.

It is, in my view, of great value that these things are more out in the open.

[applauds OMITN]

😳

That's the look of embarrassment. Er, thanks. Just trying to help, and from a slightly different perspective.

Just really nicely put, sensible and honest without leaping to attack/defend any particular strategy. Could do more of that kind of thing on threads like this.

Could do more of that kind of thing on threads like this.

I think maybe objectivity is hard if you're either in the midst of something, or have a view not based on any sort of experience (i.e. prejudice).

I'm lucky, I guess, to have fallen in the middle. No idea if I'd say the same if I'd been in Mrs North's shoes, though..!

anti depressants have their place. But in my professional experience they are overprescribed

there are many reasons for this. patient expectations (ie i want something now doc), poor doctoring, lack of timely access to counselling/psychotherapy on the NHS which are just as effective as drugs and in an ideal world would always be my first choice. We also live in a pill for every ill culture- ie your feeling a bit miserable hears a pill to sort you out. the list could go on and on. However antidepressants are often indicated and as doctors are encouraged to screen for depression these days it's hardly surprising their use is rocketing.

Right personal experience, I had a shit year last year losing 2 close members of my family in tragic circumstances 3 months apart. Did i feel shit -yes, did i feel suicidal -hell no. However with time doing things i enjoyed support from family and friends and EXERCISE i got better with time. Did i take pills- hell no as i felt that they would not change the life events that had occurred and were npot the answer for me. Many doctors would disagree with my comments and i try and help patients make up their own mind regarding treatments. Obviously if they are actively suicidal or severely depressed they need treatment or urgent psychiatric assessment

so back on topic, ssris are largely safe Citalopram is frequently prescribed as safe in overdose(relatively) good for symptoms of anxiety and depression and relatively non sedating compared with other antidepressants.

It sounds to me that you feel that you have been given this script as the doctor felt he needed to do something. Obviously if you are not keen to take them you should probably return. But if i were you i'd probably try and focus on the positives in your life, don't dwell on negatives you cant change cos they only make you more frustrated, avoid drugs and alcohol and exercise- endorphins help!

you could also do an online depression screening tool like the HAD score or phq-9
also you could try online Cognitive Behavioural Therapy google moodgym- you might find it useful.

obviously if all else fails get further professional help!

Have a look on drugs.com or go on to scholar and search, loads of good information. Even try UKpatient, some patient feed back maybe on there. I don't take the drug myself but I use some of these sites when researching drugs and their contraindication, good luck.

Reading the whole thread through you can see the problem, some love citalaopram some hate it and some are indifferent. Treating depression is not like treating tonsillitis – you give drug a and it will be better in seven days- different things work for different people. I find that taking the ptaient seriously , listening and iunderstanding are often as effective as the drugs themselves. I just wish i had more time per patient to enable me to provide a better service.

I never prescribe seroxat now a nasty drug with awful withdrawal effects.

but reading the threads the genuine consensus is you need to work this out for yourself and find your own solution. I would argue that few people go through life without experiencing a depressive episode and it is largely a normal human emotion. However if your mood is consistently so low you cannot function properly in society you need professional help.

AndyP – Member
If you feel you need them, then use them. If you don't, then don't. Simple as that…only you cna make that decision.

This looks like the best and simplest piece of advice on this complex subject I have heard

bananaworld – Member

I've been an RMN

Really Mean Nutter? Right Muddy Nightcrawler? Royal Mail Nurse?

RMN = Registered Mental Health Nurse. Not sure why we lose the capital H in there.

Not at all suprised how many folk on here are/have been depressed. One in three and all that. I am suprised how many of us on here work on the other side of the thermometer, so to speak. *waves at smell_it*

FWIW, OMITN and Dr Nick both speak much sense on this thread. And I am not a big fan of seroxat either. Little else to add to their comments though.

One other little point regarding possible side efects: there is a newer version of Citalopram called Escitalopram or 'Cipralex'(brand name). As mentioned earlier, 'normal' citalopram is amongst other things, not very expensive. Escitalopram costs a lot more (still under 10 year licence) and may not be available as a prescription due to its cost to the presciber (of course you pay your flat prescription fee whatever you get). It is supposed to have the same good bits as citalopram but with fewer side effects, so if the side effects put you off Citalopram it may be worth asking for this. I have only known a couple of patients take this, so not really enough to coment on whether the obviously optimistic drug-rep blurb and heavily funded Randomised Control Trials I read about match the reality for patients though.

All the best!

I must admit that I do get a little frustrated by the "no, don't take them, put them in the bin" approach. It's certainly true that positive thinking, exercise and even diet can make a huge difference to depression, but equally some depressions can be so profound and crippling that you just can't manage this. Dealing with underlying causes is key if there are some but this isn't always the case, sometimes depression can hit out of the blue without any decernable cause, it may just be a chemical imbalance, I've had periods of cyclic depression that seemed to descend even during good times.

I do agree that anti-depressants are over prescribed but I do think that they have a place (although, as others have said, not as a long term solution), I don't see taking depressants any differently to taking paracetamol to cope with tooth ache until you can get it pulled (and some people won't take painkillers and insist that you should endure the pain).

At the end of the day it's a personal choice and more often than not a cost/benefit analysis between side-effects and improvement. As someone who's had more than their fair share of mental health issues (not just depression) I've come to a compromise between medication and therapy/learnt skills. Cycling is also a huge benefit.

Perhaps another thing to add is about side-effects. I've been reasonably lucky and never had major problems, some people have major reactions (there have been well publicsised problems with Prozac and Seroxat) so if you are going to take something I think that it's really important to start off on a low dose and increase with proper medical supervision; some GPs do seem to give the impression that they're just prescribing them to make you go away.

I am on them and have been for around 5 months though unlike most I am not suffering depression. I suffer from occasional panic attacks and anxiety which I put down to heavy cocaine use in my twenties. They have helped me a little by just leveling things off. But I cannot comment on them with regards depression as they do not (and are not required to) alter my state of mind. They do stop the 'butterflies' I get in public places though.

I will say though that the first 3 weeks they made me feel absolutely attrocious!!

I was on 20 mg of this several years ago after having what can only be described as a "breakdown " which crept up on me from I don't know where.

Result was a trip in tears to a very understanding GP who was very supporting and helpful.

First thing she did was to have a long chat then sign me off work for a month and to give me a prescription for 20mg once a day with a warning not too expect miracles and explained that it takes around 2 – 4 weeks for C to kick in.

No unpleasant side effects for me other than the slightly dry mouth which I could live with.

When it did kick in it seemed to totally compress my range of emotions, stopped the dreadful lows brought on by my breakdown , which was great , However it also prevented any highs to the extant that I found myself thinking " This should be great fun, but I am not getting that buzz today " in my case this was a small price to pay as the lows were bad, a very dark place I don't want to go back to.

After a while my GP suggested maybe some councelling may help and as my employer had a scheme which provided some free sessions I took up the suggestion, for me that also helped.

In the end I made a staged return to work after 4 months and eventually after about 9 months also came off the C in a staged managed way over a period of about 2 months, this was agreed with GP after several discussions where I made it clear I didn't like the idea of being on anything long term and she agreed that was a sensible approach not wanting me on anything long term.

I know every one is differant but my outlook now would be "Talk to your GP, Take their advice, explain your reservations BUT most of all give it chance to work "

I was very sceptical about such pills before but now I have to say I realise they have a place and job which they can dso very well given chance.

Good Luck on your journey and I hope the dark place becomes a thing of the past for you as it has ( so far ) for me

AFAIK the NICE guidelines state that first line treatment for depression should be a generic SSRI – hence the GP's use of fluoxitene (PROZAC), paroxetine (Seroxat) and Citalopram as a first drug of choice.

This would suggest that newer drugs like Escitalopram and Venlafaxine (Effexor) are seen less initially in a primary care setting. GPs prescribing guidelines for Venlafaxine (Effexor) are even tighter these days

GPs are also advised I believe to provide each patient a leaflet that describes things like they take 3-4 weeks to work; perhaps first line treatment only helps about 60% of patients rising to 80% when a second choice of AD is used. Together with the withdrawal effects and the need to taper off these drugs under medical supervision.

Curry, Friday? Damn your problems, Curry is the cure!! Maybe a couple of Pale Riders