"i started this medication exactly 4 weeks ago.  i started citalopram 20 mg and noticed something the very first day.  i stopped taking it at night as at first, i couldn&#039;t sleep.  it helped the irratability and i didn&#039;t feel depressed, however, i felt like my head was under water a bit. in the third week i noticed a major amount of fatigue and my depression again, into the fourth week as well.  right now i am still very tired and considering taking it before bed again.  i know i should talk to my doctor because the fatigue is just too much, i could sleep another 4-5 hours during the day if i could. i wonder if the dose needs to go higher now or if there is something to help the fatigue. i&#039;ll probably stick with 20 mg for another 2 weeks."