Citalopram overdose. Could it have caused brain damage?

[addick]

I took an overdose of 53, 20mg citalopram, four months ago. The hospital ran test's on my heart and blood pressure and I was perfectly healthy.

I have since felt really blank and emotionless. I feel a constant sense of confusion, low concentration demotivation. All of these have made my start to university very difficult. I haven't made any friends, and I may need to take a gap year. I may just be suffering from post traumatic stress disorder. Is it at all possible that the overdose could have messed up my brain chemistry or caused brain damage?

To give a back story, I struggled with anxiety, stress and depression in my A-levels, but still got the grades. I then took a year out on citalopram and OD'd 8 months in.

I have lost my creativity. Before I took SSRI's, I used to draw and write outside of studies. I don't anymore.

Once again, is it at all possible that the overdose could have messed up my brain chemistry or caused brain damage?

[bobbin]

I took an overdose of 53, 20mg citalopram, four months ago. The hospital ran test's on my heart and blood pressure and I was perfectly healthy.

I have since felt really blank and emotionless. I feel a constant sense of confusion, low concentration demotivation. All of these have made my start to university very difficult. I haven't made any friends, and I may need to take a gap year. I may just be suffering from post traumatic stress disorder. Is it at all possible that the overdose could have messed up my brain chemistry or caused brain damage?

To give a back story, I struggled with anxiety, stress and depression in my A-levels, but still got the grades. I then took a year out on citalopram and OD'd 8 months in.

I have lost my creativity. Before I took SSRI's, I used to draw and write outside of studies. I don't anymore.

Once again, is it at all possible that the overdose could have messed up my brain chemistry or caused brain damage?

Do you take any medication at the moment?

[addick]

No, none at the moment. Apologies if I rambled and raved in the OP. I am concerned though.

[bobbin]

No, none at the moment. Apologies if I rambled and raved in the OP. I am concerned though.

I do not think the overdose has damaged your brain. There is some risk of abnormal heart rhythms occurring shortly after a citalopram overdose. Symptoms such as sweating, vomiting and tremor are common and large overdoses sometimes cause seizures. It doesn't appear that you had any serious symptoms however, and most symptoms after a citalopram overdose improve fairly quickly as the drug is eliminated. I very much doubt that you have suffered any permanent damage. If the drug was not restarted after the overdose, some withdrawal symptoms (especially dizziness) may be a problem for the next few weeks. Your overdose was 4 months ago though.

It sounds like you are experiencing some depressive symptoms at the moment. I think it would be helpful to go back to your doctor and see what they recommend. They may suggest a different type of antidepressant, or refer you to a specialist. Also, I know it's a cliche but regular exercise and spending time outdoors in the natural sunlight can also help to improve your mood.

[addick]

Thanks. Is it even possible that a citalopram overdose could cause brain damage? I know it has never been reported.

[bobbin]

Is it even possible that a citalopram overdose could cause brain damage?

No one can tell you it's impossible, it just doesn't seem a likely cause of your current symptoms. If the overdose had caused a seizure and you'd fallen and injured your head, your brain might have been damaged. But this didn't happen. It doesn't sound like you had any serious toxic symptoms from the overdose.

Some people report feeling numb or less creative on certain psych meds, but not really as a result of an overdose. Do you believe you are depressed at the moment?

[addick]

Yes, I have seen a doctor recently about mental health. The feeling of being blank, no personality, low concentration, demotivation were not there before antidepressants, and I was highly depressed, stressed & anxious before I took them. That's what concerns me. It leads me to believe I have brain damage. Of course, I may just be more depressed then ever.

I thought that a pharmacist might be the best equipped person to tackle this grim topic.

Many thanks

[bobbin]

Yes, I have seen a doctor recently about mental health. The feeling of being blank, no personality, low concentration, demotivation were not there before antidepressants, and I was highly depressed, stressed & anxious before I took them. That's what concerns me. It leads me to believe I have brain damage. Of course, I may just be more depressed then ever.

I thought that a pharmacist might be the best equipped person to tackle this grim topic.

Many thanks

SSRIs have been reported to induce an apathy syndrome in some patients. It is an occasional adverse reaction to prolonged SSRI use. I doubt that your current symptoms are specifically due to your overdose four months ago.

Here is a brief summary from the Journal of Psychiatric Practice:

SSRI-induced apathy syndrome: a clinical r... [J Psychiatr Pract. 2004] - PubMed - NCBI

Apathy and lack of motivation can be symptoms of depression, as well as a side effect of SSRI treatment. Apathy symptoms have been reported to be reversible after stopping the SSRI, although improvement may not be immediate.

If citalopram was the sole cause of your apathy, I would expect you to have noticed more improvement within four months after stopping, unless a worsening of your depression has prevented you from getting better. I don't know your full situation and it's not my place to say. Of course, it's quite possible that your apathy has more than one cause. Psychiatry is rarely simple. You need to see an expert to discuss your problems in person.

If you need an antidepressant in future, it might be best to avoid citalopram and closely related SSRIs. Since you overdosed on citalopram after taking it for several months, I can only assume that it was not working well for your depression. An antidepressant with a different mechanism of action could be more suitable, although I do not know whether you are willing to take any medication right now. I would understand if you are not. An example of a non-serotonergic antidepressant used in the UK is lofepramine. It is a non-sedating tricyclic antidepressant which acts mainly on the neurotransmitter noradrenaline. In the US, bupropion (Wellbutrin) is very widely prescribed for depression with apathy symptoms. (I do not know what country you are in). Anyway, it doesn't really matter because nothing can be prescribed online. A psychiatrist would choose a suitable treatment. There are many options available.

If you have recently felt very 'down', irritable and you are no longer enjoying things which used to interest you, this is typical of depression, and a different antidepressant may be helpful. I think it would be useful to see an experienced psychiatrist who is sympathetic to your situation. You want a doctor who is willing to work with you, not someone who just dismisses your concerns.

There are treatments available for depression apart from medication, but I'm not sure how well they work on apathy symptoms. A clinical psychologist would be the right person to advise you on this.

[bobbin]

I thought that a pharmacist might be the best equipped person to tackle this grim topic.

Pharmacists can tell you about medication, but you can't get an online diagnosis of your mental health problems. You are obviously still worried, so you need to go back to your doctor and speak to someone in person. It's not possible to see the full picture online.

[addick]

Thanks for all your help. I will see a doctor.