Unusual Agitation in Final Year Student

Author: Cathy Wield, Mark Horowitz / Editor: Sarah Edwards / Codes: MHC8, MHP1, SLO1 / Published: 10/09/2025

Final year student Kevin is brought to the Emergency Department (ED) by his father. He is very distressed, agitated, pacing up and down in the waiting room. He describes ‘pure terror’ and feels like killing himself. He was well until he stopped citalopram – he thought it made him feel sluggish and was interfering with his concentration while revising for his final exams. He is not on any other medication and has not taken any illicit substances or OTC drugs.

Kevin asks his father to explain further. His father starts by expressing his concern that his son is not going to do as well as expected in his finals because he stopped taking his antidepressants too soon.

Kevin had started citalopram when he became stressed during his first set of university exams three years earlier. But he’s never seen Kevin like this before, constantly pacing up and down, unable to sleep and only eating small amounts while still moving. Kevin seems unable to stay still enough to sit down and eat a meal. His father confirms that he’s never been suicidal before either. He is behaving completely out of character

Kevin had seen his GP and they discussed the plan to stop his antidepressants. The GP told Kevin to reduce the dose by half for two weeks and then half it again for the next two weeks by taking half a tablet every second day.

Kevin says his symptoms started a few days after stopping the citalopram, but he has become worse.