HomeAnswersInternal MedicinehypochondriasisCan Citalopram cause side effects like cold hands and feet?

I am a hypochondriac, and I feel my hands and feet are always cold. Please help.

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Lochana .k

Published At October 29, 2020
Reviewed AtMay 27, 2021

Patient's Query

Hi doctor,

I am a 35-year-old male. My weight is 190 lbs. Due to the nature of my job I get little to no exercise. My hands and feet are always so cold. I have to take regular showers for them to feel right. For about three days half of one of my big toes is going numb with a pins and needles feel occasionally. Only medications I take are Citalopram (Celexa) for anxiety and depression. I am also an extreme hypochondriac. Please help.

Hi,

Welcome to icliniq.com.

I am sorry to learn about your situation and the worries you are experiencing. Your description is consistent with two issues.

1) Cold hands and feet are often seen in patients with a state of chronic panic. Chronic panic is not a common medical term as we speak rather than anxiety. However, in real life, we do see a difference. Patients with chronic anxiety have other psychosomatic reactions than those in chronic panic.

2) The half-numb toe and the other nervous sensations are consistent with an irritated nerve. As long as you do not have a disk prolapse, most cases are self-limiting or treatable with physiotherapy. I understand how important this is for someone who lives in constant fear about his health. Stay strong.

The Probable causes

1. Panic disorder. 2. Hypochondria. 3. Irritated nerve.

Investigations to be done

Neurological test (if the symptoms are not self-limiting or getting worse).

Differential diagnosis

1. Disc prolapse (toe).
2. Thyroid dysfunction (cold extremities).
3. Various others.

Probable diagnosis

1. Hyperadrenergic state due to a severe psychiatric condition (chronic panic, also may be an obsessive-compulsive disorder spectrum disorder). 2. Irritated nerve, most likely due to lack of movement.

Treatment plan

1. The psychiatric condition needs to be treated much more effectively. 2. At least 20 minutes walking (speed does not matter) three times a day outside the house while keeping your lower spine region warm. 3. Physiotherapy for the lower spine region.

Preventive measures

See a neurologist if the nerve issue worsens or is not self-limiting within the next few days.

Regarding follow up

Any time you want.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Alexander Davis
Dr. Alexander Davis

General Practitioner

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