success LaylaJuneBug: Tapering from Citalopram

[LaylaJuneBug]

Hi all,

 

I'm looking for some assistance in getting off of Citalpram. Here's my story:

 

I have been on an SSRI for 10+ years. Started Zoloft to deal with panic attacks brought on by a stressful boss and marijuana use. The zoloft helped with panic attacks, and then helped me get through two pregnancies (one with postpartum depression) but in the last year or so the side effects have outweighed the benefits. I have felt pretty emotionally numb, gained weight, had no libido and had a sweating problem, all attributed to the antidepressant. My doctor suggested that I switch from Zoloft to Citalopram in the last year or two, and I tried that. I didn't see much difference in side effects, in fact, I almost feel like they got worse. I also went on Welbutrin to see if that would curb the sexual side effects. It did, but very little. I could not get up to a therapeutic dose of Welbutrin because I got so angry when I took 300 mg I thought I was going to kill my children. Anyway, I was on like 150 mg Welbutrin and 20 mg Citalopram until a month or so ago, when I started trying to wean from the Citalopram. I took my GPs advice and went from 20 mg t0 10 mg, waited several weeks, then to 5, waited a couple weeks, then to 5 every other day, and pretty quickly after that stopped taking the Citalopram this last week. I had another mom say something like "2.5 mg, that's nothing! You shouldn't even be on it anymore!" and of course I felt embarrassed and decided she was probably right, so I took myself off of it altogether. I had horrible withdrawal symptoms last week. It began with just the brain shocks, but progressed to severe irritability, and emotional sensitivity and instability, and then by this weekend I was yelling at my 4 and 6 year old (of course my husband was out of town on business) for no real reason, and feeling like physically abusing them. This isn't normal behavior for me. I'm normally a mom who is wound pretty tight, but I have patience reserves - and by this Friday they were GONE. I felt like the worst person/mom in the world for screaming at them and getting physically aggressive. I felt completely out of control emotionally. One minute I was screaming and the next I was sobbing. So I made the hard decision to not "tough it out" anymore, and went back on 5 mg of Citalopram a day for the last two days to try and get rid of some of the symptoms. I am trying to get help in weaning the rest of the way off. I've been reading a lot of James Heaney's site, and feeling like weaning 10% a month might be the safest route since I seem so sensitive to the loss of serotonin in my body. I asked my GP today to prescribe Citalopram in a liquid form so I could do this, and she didn't really "hear" me the first time I asked. She sent back a recommendation that I continue on 5 mg every other day for a month, then go down to taking 5 mg for 3 days a week, give it a couple weeks, then go down to 2 days a week of 5 mg, give it two weeks, then go down to 1 day a week of 5 mg, and then give it two weeks, and then take none.

I'm concerned about her schedule because I had been reading that it probably wasn't the best idea to skip doses...does anyone know if this is accurate? And I'm wondering if anyone else has had the liquid Citalopram prescribed to them? Does this seem to be a good plan going forward? Do I need to talk to a psychiatrist? I don't feel like I trust my GP to know what's best for my body anymore. She said today that I seem to be more sensitive to this than others. It pissed me off. I see a lot of people online who are having trouble coming off antidepressants, and I don't understand why she doesn't recognize this.

 

Anyway, thanks for any advice.

 

P.S. I also went off the Welbutrin this last week. It doesn't seem to have had any affect one way or another. But who knows, maybe it's wrapped up in this too.

[Barbarannamated]

Hi Sarah. I'm VERY glad you found this site.

 

You are definitely experiencing pronounced withdrawal symptoms. Anger/irritability/rage outbursts are classic, especially if you never experienced them before, either before or on meds.

 

One of the moderators will be checking in to advise on a custom taper schedule for you. As you mentioned, skipping doses is never advised. The goal of a gradual taper is to keep a steady amount of drug in your body to not throw your central nervous system into chaos.

 

Until a moderator checks in, my advice is to NOT skip any more doses of citalopram. They will likely advise reinstating a small dose of Wellbutrin to taper carefully, but stay tuned for specifics.

 

Very few doctors know the full range of effects of these drugs on the body and fewer still comprehend the complexities of withdrawal. It is NOT like stopping opiates/pain meds, smoking, etc.

 

I tapered over several months and even that was too fast. I'm experiencing severe protracted withdrawal. I didn't find this group in time.

[Nadia]

Layla,

 

Don't listen to your GP!!! Don't skip doses! And after how long you've been on antidepressants, you need to taper reeeeallly slowly! I'm talking years, even, not months and certainly not weeks! A psychiatrist MIGHT be better informed, but many aren't.

 

Don't let other people bully you with their opinions about if you're too sensitive or not. This is YOUR mental health, and everyone is different. Plus, just about anybody on antidepressants for that long is going to have trouble going off them. You need to listen to your body and go at a pace that is just right for YOU.

 

Also, the recommendation is to taper one drug at a time.

 

There are other people on the forum that know way more about tapering than I do that I'm sure will chime in with specific recommendations.

 

Have you stabilized on the 5mg yet?

[Barbarannamated]

Sarah,

 

This recent publication by researchers in antidepressant withdrawal utilized data from our site. Most doctors have no idea of the information contained on this peer group and usually dismiss (or mock) information found online. I'm sharing this to emphasize how new this emerging field is.

 

http://survivingantidepressants.org/index.php?/topic/3132-belaise-2012-patient-online-report-of-selective-serotonin-reuptake-inhibitor-induced-persistent-postwithdrawal-anxiety-and-mood-disorders/page__fromsearch__1

[LaylaJuneBug]

Thanks for your interest and responses. I feel much more under control emotionally. More numb, but that's sort of expected and welcome after the last week. My emotional responses still seem a bit sensitive and are maybe more on the sad side than angry side. But I'm so relieved to not be feeling rage that I feel calm in comparison. The brain shocks are not as frequent or noticeable. And my sense of humor is returning, as well as feelings of strong love for my kids. So I think that probably means I've stabilized. Sound right to you?

 

For now, I'm on 5 mg a day of Ciralopram. I feel like I'm recovering from a big illness. Not pushing myself real hard. Took a nap today.

[LaylaJuneBug]

What does severe protracted withdrawal entail? I'm so sorry!

 

Hi Sarah. I'm VERY glad you found this site.

 

You are definitely experiencing pronounced withdrawal symptoms. Anger/irritability/rage outbursts are classic, especially if you never experienced them before, either before or on meds.

 

One of the moderators will be checking in to advise on a custom taper schedule for you. As you mentioned, skipping doses is never advised. The goal of a gradual taper is to keep a steady amount of drug in your body to not throw your central nervous system into chaos.

 

Until a moderator checks in, my advice is to NOT skip any more doses of citalopram. They will likely advise reinstating a small dose of Wellbutrin to taper carefully, but stay tuned for specifics.

 

Very few doctors know the full range of effects of these drugs on the body and fewer still comprehend the complexities of withdrawal. It is NOT like stopping opiates/pain meds, smoking, etc.

 

I tapered over several months and even that was too fast. I'm experiencing severe protracted withdrawal. I didn't find this group in time.

 

[Barbarannamated]

"Protracted" refers to "persistent, long term, extended, chronic" as opposed to acute or shorter term symptoms. Most references in medical literature and prescribing info acknowledge a short term, acute "discontinuation syndrome" of brain zaps, nausea, flu-like symptoms but deny the long term, protracted effects of a too-rapid taper (or stopping cold turkey) that can be disabling. My way of saying "don't do what i did." Sorry for the confusion!

 

You'll be fine. Sounds like you are already stabilizing.

[Altostrata]

Sarah, welcome to our site.

 

I'm glad that 5mg citalopram seems to be alleviating your withdrawal symptoms. You did finally get the liquid?

 

Yes, you went off too quickly and very irregularly. Skipping doses is a terrible, terrible way to taper! It causes levels of the drug to go up and down in your nervous system. The nervous system thrives on stability; this puts a lot of stress on it. Your doctor doesn't know what she's doing when it comes to tapering.

 

If I were you, I'd stay at 5mg citalopram (or more, if you need it) for at least a month to let your nervous system stabilize. When you feel ready, you will want to use the liquid to decrease by very, very small amounts, no more than 10% per month, which would be .5mg.

 

See these topics about tapering http://survivingantidepressants.org/index.php?/topic/300-important-topics-in-the-tapering-forum/ and how to taper citalopram http://survivingantidepressants.org/index.php?/topic/2023-tips-for-tapering-off-celexa-citalopram/

[LaylaJuneBug]

Thanks for the responses. I am not sure why I wasn't being alerted to them via email. Weird. Anyway, I did finally get my doctor to prescribe the liquid form. Since I wrote in I've been on 5 mg (2.5 mL) a day. I feel ok, definitely not as impatient or rageful, but I also feel very unmotivated. Like, I don't want to do anything around the house (cleaning, etc..), don't want to work out, just sort of want to relax and sleep. This scares me a bit, because I worry about depresssion, but I don't feel apathy or dissociation from the rest of the world. Just tired. I hate being unmotivated. I wonder if this is just my body trying to recover, or if the Citalopram is making me tired? And did I screw myself by going off Welbutrin cold turkey? Maybe I'm used to that Welbutrin "Kick" and missing that. It made me angry at high doses, but I also think it made me a little more energetic. Any thoughts are appreciated. I haven't received a return call from a psychiatrist that was recommended. That kind of bums me out. I'd like to find a doctor that "gets it" to help me through this. Am I preaching to the choir?

[Nikki]

Give yourself a needed rest from tapering. Stay put and give yourself a chance to unwind, sleep and get on with life...

 

These tapers can really knock the stuffing out of us.

 

Glad your feeling better...

[Altostrata]

Sarah, that's good that you're more or less stable.

 

Your body may be telling you it needs sleep and rest to fix itself after all the changes. Being sleepy is a heck of a lot better than not being able to sleep in withdrawal!

 

So try not to worry, keep regular hours if you can, and take care of yourself.

 

Was it a doctor recommended on this site?

[peggy]

so many people have anxiety and insomnia during withdrawal - if you are able to sleep, that is great - make the most of it as it will help your brain to recover. I am not trying to sound flippant here, i understand you not wanting to feel unmotivated, but it's ok sometimes to sit back and let our bodies get better - housework and everything else will still be there.

[LaylaJuneBug]

I also posted this on James Heaney's site, but would like to get feedback here as well.

I’m having some interesting symptoms. Not sure how I would characterize them, but maybe some of you can help me do that. I reinstated 5 mg of Citalopram(Celexa) almost a month ago after trying to taper off unsuccessfully. I’m sure my nervous system was going through a very scary time, and when I reinstated I started feeling better almost immediately, like within the same day that I took a dose. Since then I’ve kind of wanted to put the episode behind me. I think this is pretty typical for me – go through something traumatic, and then move on, as far away from it as possible. I have been watching this board, and trying to relate, but I almost feel like the alcoholic that has been “cured” – even though I know this isn’t possible. I don’t want to chime in because I want to think that I’m all solved and better and resolved. I have a spouse who is as supportive as he can be, but he comes from a family that doesn’t really know how to support people who are in pain, whether emotional or physical. When I get a cold, I’d rather be left alone than have him around – he’s a “buck up and pull yourself up by your bootstraps” kind of guy. We’re working on it. Anyway, having him around makes me want to pretend even more that things are fine. But I keep having symptoms, on a much smaller scale, but they are there, and they are frustrating. For example, (and I’m really glad you posted about the Paxil alarm clock, because this may be what’s happening) I am responsible for getting my 4 and 6 year old up and out of bed, lunches made, and off to school in a timely fashion every morning. I’m a stay at home mom, so I signed up for this. But I’m the farthest from “morning person” that you can imagine. I stay up til midnight on a regular basis, and then struggle to get up at 7:30 which is sort of the absolute latest that I can and still get close to making it to school at 8:45. I don’t know what the hell is broken about our morning routine and it probably doesn’t factor in here. But this morning I felt so angry again – it was almost close to what I felt when I went off the Citalopram entirely a month ago. This anger hasn’t been as bad in the last month, at least not on a regular basis. This morning I just felt so deflated and angry with myself, and with my son, for being late to school again. It’s a small issue in the scheme of life, but it sets me off. I start feeling bad about myself for pushing him physically into the school, and then when he was embarassed for being late, I just kept pushing him into the classroom, trying to get him to sit down and “be normal” like all the other kids. I am afraid I’m harming him emotionally with my anger/anxiety. As I drove home, I thought about coping mechanisms. I know that this is probably going to continue as I continue weaning off the Citalopram. I have it in my calendar to drop my dosage by 10% at the beginning of December. How do you know when it’s the right time to do this? Do you want until you aren’t having Waves? Or do you just do it and see how it goes, and go back up in dosage if necessary?

 

Oh, and I’m sorry for the long post, but there are some other things going on. It’s dreary here in Portland right now. And my motivation is just sunk. For awhile before I started tapering, I was in a manic “fix my house” mode. I lost weight this summer, and did projects around here. Now I feel like that time is gone. At least for awhile. I have been eating to deal with anxiety and stress. I gained 8 lbs in the last little while. Ugh. Aren’t the rest of you reporting that you are losing weight? I feel like I’m beating my body up – trying to manage emotions through eating because it calms me down and gives me endorphins or whatever. As I write this, I feel tremendous pressure to starve myself back into a smaller form – and I feel once again let down by myself that I’ve let this happen. Yesterday and the day before I felt like I had to nap during the day, instead of being productive and doing laundry/dishes/projects around my house, and instead of working out. I’m letting myself down and feeling bad about it, but I’m not stopping it. Does anyone else do this? How do you get yourself out of it?

 

Here’s what I’m trying:

– Making an appt with a naturopath who works with people on weight issues, supposedly from a spiritual level

– Making an appt with an acupuncturist who works with emotional issues like stress and anxiety. My friend has gone to her and says that when she hits certain spots it just makes her sob. I’m not looking forward to that, but the release would probably be helpful.

– Trying meditation. I’m hoping this will help on many levels. Someone recommended Deepak Chopra. Any other suggestions would be appreciated.

– Trying to journal, and use CBT to fight back against the negative messages I’m sending myself. Trying to talk through some of the anxiety/panic/self recrimination.

 

Anyway, love to hear any of your thoughts, and thanks for listening.

 

Sarah[/size][/size]

[Jemima]

Hi Layla,

 

I moved your post here because it's part of the ongoing saga of your withdrawal from antidepressants, and that's part of your Intro topic. Only one Intro topic per member allowed.

 

In the future, please locate this thread and click on "Add Reply" to write a post. (I took the liberty of adding your Intro post location to your signature. You can just locate any of your posts or your profile to find the link). When finished, scroll down to just below your new post, preview if you wish, then click on "Add Reply" again. Thanks.

[areyouthere]

But I’m the farthest from “morning person” that you can imagine. I stay up til midnight on a regular basis, and then struggle to get up at 7:30 which is sort of the absolute latest that I can and still get close to making it to school at 8:45.

 

I understand that people's inner clocks are set differently. Have you always been a night owl? Sleep is so important in so many ways especially when trying to heal.

 

Do you think that if you COULD get to sleep earlier it would make your morning routine work the way that you want? Does your son have an internal clock set like yours... tend to have a harder time to get to bed and asleep?

 

Maybe if everyone could work together to get the sleep routine on a better schedule would be a good idea?

 

I remember that awful morning stress of getting kids off to school can be major suckage... just trying to help you out... what ideas have you used before to make it go more smoothly?

[strawberry17]

Not sure I can help with the mornings and bed time issues as I am the opposite, I'm a natural lark, early to bed, but then I was brought up on a farm so that may have something to do with it, however I do struggle with the early morning feeling of dread/anxiety that seems to go with withdrawal and sometimes suffer with insomnia.

 

One thing though, please don't make that 10% reduction next week, hang on until you're feeling more at the top of your game, you have to forget calendars and schedules, making a reduction now could compound the issues you're currently having.

[Altostrata]

First of all, hurray that the low-dose reinstatement is working. Phew! Dodged that bullet.

 

Even though reinstatement seems to be what your nervous system needed, it's still showing signs that it needs to heal more. I agree with strawberry that you should not rock the boat with a dosage decrease in the near future.

 

If symptoms get worse, you might consider going up a bit, maybe to 6mg.

 

Also, I agree you might change your sleep schedule a bit. Go to bed earlier and get up earlier. This more closely matches our innate sleep cycle, to bed at nightfall and up at dawn. This could help your nervous system hold out against withdrawal symptoms.

 

PS Please put paragraph breaks in your posts, they make long posts easier to read.

[peggy]

Thanks for the update Sarah.

 

Meditation will be really good for you. I use breathing meditation from Jon Kabat Zinn - he has written a great book with a couple of other psychologists called 'the mindful way through depression' It has a CD in the back that takes you through several different meditations. It has been a great resource for me and i have leant it to lots of people. He has a really good soothing voice that carries me away.

 

I also concur with Strawberry and Alto. Leave your dose where it is for the moment.

 

I have finally discovered that change is intentional. If you want to change something you need to action it. Slowly moving your sleep schedule half an hour a week will get you in a better place. You need to get to bed by 10 so you can get 8 hours sleep. Starting the day rushing like that sets you up for feelings of frustration and anger that escalate when you feel bad for how you behave. If you can get more sleep at night you probably won't feel the need to nap in the day and that will help you getting things done around the house.

[LaylaJuneBug]

Hi all, this is my second time trying to come off an SSRI, it's been awhile since I've been here. The last time I tried I started having panic attacks again and reinstated. Anyway, this situation has been much different and better. I'm coming off Pristiq this time, and I have read through the tips on how to taper from it. There are some good ideas. What I have been doing has worked but I'm getting into super low doses now and I'm a little stuck. I got the 25 mg dose prescribed, and then cut that in half at first. I did experience some dose dumping symptoms so I cut the 12.5 mg in half and took one in the morning and one at noon. Then I started taking one quarter of the 25 mg tab, so 6.25 mg for quite awhile, over a month. Now that I'm wanting to go lower than 1/4 of a tablet, things are getting tricky. I've tried crushing the 1/4 tablet in a mortar and pestle but there are still chunks of the outer coating. I then very unscientifically (eyeball) split that into two piles. My husband bought me some empty gel caplets and I try to transfer half of the powder into those. I feel like there has to be a better way though. Do I need a scale? What can I scoop the powder with? What kind of tiny funnel will get the powder into the gel caplets? How do I correctly split the pile into two? I've had a couple days where I didn't take the 3.125 mg and I STILL get brain zaps. I also have been feeling very vulnerable and alternately rageful. Such a rough time emotionally. Any suggestions would be great!!

[ChessieCat]

Hi Layla,

 

Welcome back to SA.  The mods will probably move this post and join it to your original Intro Topic.  Once that has been done you can click Follow at top right and will be notified when someone replies.  Your original topic link is in your signature.  The reason for moving it is because it is your on-going history.

 

Also, it would be helpful if you could update your signature.  Please include drug/s, dates, doses and decreases/increases (ie how you went off or reinstated).  This will allow the mods to give you their best suggestions.  How to  put your Withdrawal History in Signature

 

I'm also tapering Pristiq.  Here is the link for Tips for Tapering Pristiq.

 

These are a couple of things that you might not have seen.  They helped me to understand why 10% (or less) taper is recommended here at SA.

 

Video: Healing from Antidepressants: Patterns of Recovery

 

Brain Remodelling

[Fresh]

Hi Layla , please see the link Chessie gave you on "Tips for Tapering Pristiq" for suggestions and ideas.

 

Some of us are having are capsules with small doses compounded.

You should definitely be using a scale if you're cutting pills up.

 

We NEVER recommend alternating days to taper.

 

Best wishes , Fresh

[LaylaJuneBug]

Hi everyone,
 
I've been absent for an extended period, but have again weaned myself off my meds, as of November 2016. I did a very extended taper of Pristiq. I can't remember the exact amounts, but it took me over a year to get off of it. In the end I was cutting 25 mg pills into quarters, then crushing the quarter, and splitting that up into gel caps. Other than some mild brain zaps, when I first went off the Pristiq entirely, I didn't feel that bad. Since then, things have been difficult.

 

In December I started noticing that I would get very irritable with my family (which is interesting when I look back at my above posts). The irritability turned into extreme anxiety of a physical nature - heart pounding, not quite full panic, but often felt like it was heading into panic attacks. Mostly I lived with that heart pounding feeling of way too much adrenaline for a lot of December. Other symptoms were feeling like everyone was too loud (went to a TransSiberian Orchestra show in there, and it was excruciating), and that I was a turtle without a shell - completely vulnerable emotionally. All my emotions were just super easily accessible and fear seemed to be the main one in the first months without meds. Fear and vulnerability, and feeling alone in this. I honestly don't know why I didn't think to come and visit this forum again for help and support.

 

As the months have gone on, some things seem to have helped with my withdrawal or whatever it is I'm going through now. When I have gotten acupuncture, my emotions and adrenaline seem to calm down temporarily. I've also been seeing a psychiatrist (but for counseling which is a bit weird) to talk about how I don't want to go back on meds.

 

And I've been seeing a psychologist about the nitty gritty emotional stuff. The psychiatrist seems more pragmatic, not as emotions oriented. I have been counseled to try deep breathing, and I will admit that I haven't been successful in making that a practice that I use every day. I'm not sure what my emotional block is, other than it is uncomfortable for me to be alone with my "monkey mind" when I try to do deep breathing and meditation. I play a lot of tennis, which does help with the anxiety when I make sure I do it. And I try to take pretty good care of myself - eating decently, getting enough sleep. 
 
It seems like when I am busy with life (I'm a stay at home mom and PTA President), I can sometimes forget the emotions that can take over - but when things slow down, and I don't have a plan for the day or any project I'm working on, I can get into rumination and high levels of anxiety and sometimes veer toward depression. Sometimes my symptoms feel very physical, like the pounding heart, waking up sweating, auditory sensitivity, huge waves of emotional sensitivity. I feel like the anxiety doesn't really allow me to think clearly enough to articulate what exactly is going on with me sometimes. I've been trying a couple different mood trackers to see which one will produce charting results that make sense - so I can see how many days a month I am "struggling" - because I'm honestly toying with the idea of going back on SSRIs again. I feel really tired of dealing with all of this - there's a shift that happens within me where I go from glass half full to glass half empty, and I feel like more lately it's been on the glass half empty side a lot. I long for just feeling a sense of contentment - doesn't have to be happiness, but just feeling that things are ok in the world - ok with me. And I don't know how much I've had that feeling in the last four months. 
 
The naturopath I've been going to for years is kind of anti-meds - and she believes that within six months or so, my body will "right" itself again, and that some of these symptoms will dissipate. I guess I've been holding out for that. My psychiatrist, on the other hand, isn't so sure, and suspects that with my family history of alcoholism, abuse, parents and sibling who all struggle with anxiety and panic, that this is biologically probably something I'll be dealing with for a lifetime. But she isn't saying that for sure. I'm at a crossroads - I am really scared of going back on the meds roller coaster - I don't know what to try, and I don't know what side effects I'll be facing. But It's not like I'm not on a roller coaster without them! I have to ask myself if the side effects of not being on them are worse than the side effects of being on them. I want to be a present and positive role model for my kids, and with so much of my time seeming to go internally - to my emotional struggle, I feel like I'm failing at that in many ways. 
 
If anyone out there has stayed off the meds for longer than four months and has seen a decrease in symptoms over time, or has suggestions on other things I can try to calm down my central nervous system, calm my erratic moods, I'm all for hearing about them and trying them. I'd love to make this work - just in a spot where I'm not sure what to do. 
 
Thanks for reading!

Edited April 4, 2017 by scallywag
a few more paragraph breaks

[ChessieCat]

I've got to get ready to go out but my first thought is, if it were me, I would be working on doing everything I could to not go back on an AD.  These should get you started for now:

 

Non-drug techniques to cope with emotional symptoms

 

Claire Weekes' Method of Recovering from a Sensitized Nervous System

[Altostrata]

LaylaJuneBug has posted a success story here:

 

 

As is our custom, I'm closing this topic now. Please congratulate LJB in her success story topic.