JP904 - My Intro and Question

[JP904]

Hi, 

 

I have been taking Celexa for about 8 years now and am currently tapering at 10% every 3 - 4 weeks. I have usually slept well but recently found myself taking hours to fall asleep. I have always taken my dose before bed and have recently found out that Celexa can disrupt sleep, especially in those that are suffering from protractive benzo withdrawal (something I am also dealing with after a successful taper 10 months ago and has actually gotten a lot better). On the other hand, I am on my 3rd week of my first 10% reduction of Celexa. 

 

Could it be the reduction in Celexa that is impacting my sleep or could it be that I should start trying to take my dose in the morning? 

 

I don't know much about the implications of SSRIs so any help would be much appreciated. 

 

warm regards, 

 

James

[Hudgens]

Hi, If you're noticing some sleep problems after starting your tapper, it's your taper. Ockham's razor.

The 10% is good, but don't make the mistake of making a drop by the calendar-make your drop and then wait

until you feel stabilized at that dose, then make the next drop. Basing your drops on how you're actually doing, works;  basing your drops on artificial, regular time intervals, leads to bad withdrawal symptoms.

That said, I took my time at each drop over a 4 yr period, and still had bad insomnia for the last 2 years.

So I'm not saying you won't have any withdrawal symptoms if you take my advice, in fact there's no way to get off an antidepressant without some withdrawal, except possibly in the case of a very very few (and I'm not sure these even exist). But there's a big difference between manageable and unbearable withdrawal.

By the way, I just ended my taper 2 days ago. Also my insomnia only just started to improve during the last few months. Now getting 4-6 hours per night. As a matter of fact, I think I got 7 last night.

Glad to hear you got off the Xanax OK. You'll do the same with the Celexa, I sure.

[dalsaan]

Hi JP,

 

welcome to the forum.  I agree with Hudgens, its probably withdrawal from your taper.

 

We have a thread on insomnia in the symptoms forum which you can access here - http://survivingantidepressants.org/index.php?/topic/555-tips-to-help-sleep-so-many-of-us-have-withdrawal-insomnia/

 

Could I also ask you to put your drug history in your signature so that it's easy to see with every post you make.  This makes it much easier to respond to questions etc down the track.   Details on how to do that are available here - http://survivingantidepressants.org/index.php?/topic/893-please-put-your-withdrawal-history-in-your-signature/

 

Dalsaan

[JP904]

Hello everyone, today I decided to start taking my dose of Celexa (Citalopram) in the morning instead of before bed. I took a dose this morning and I feel like I have been doing cocaine or adderol all day. I have never taken a dose during the day before and it is scaring me that I am feeling like this. I don't like this feeling at all. Like when I have tried Adderol for studying in the past or when I tried cocaine, I hated the feeling. It makes me feel kind of depressed. I am so confused because I have been taking 40 MG doses of Celexa for 5 years now.

 

Why when I take this during the day do I feel like this? 

Also, if I continue to take during the day will the strength of this feeling subside? 

 

I am thinking about moving back to taking my dose in the evening, but if it will just take a few days to get used to this I will probably stick to AM doses. 

 

Help please.

 

warm regards,

 

James 

[JP904]

thanks guys. Dalsaan- I added my history into my signature. Thank you! 

[Wildflower0214]

Possibly, because if you are tapering you may have a cortisol rush in the AM.

 

There is a topic on cortisol mornings here. They are uncomfortable. And adding a morning dose to the mix may be like pouring gasoline on a fire.

[JP904]

Thank you for your reply. The thing is though, that I didn't feel this way in the morning. I took my dose at 11 am and didn't start feeling this way till about 5 pm and then it continued till about 12 am before it started to settle down.

[Wildflower0214]

Hmm. Well, your body is different in terms of hormone fluctuation in the morning than in the eve.

 

I would just hold it in the morning, maybe take it earlier if it activating, and not move it again. Wait it out. Many times, I have reactions to food etc... Or I think I do, and the best thing is to just keep it as stable as possible.

 

I'm no expert, just speaking from my own experience. I know the feeling of cocaine while dealing with these drugs. I have a topic in symptoms and self care about feeling "high" during WD. I felt like I was on a speedball several times. Totally bizarre.

 

I'm sorry ur suffering and for your confusion. Please do let me know how it goes the next few days. I will be thinking of you, ok? ????

[Rhiannon]

I don't think it would hurt to try changing your dose to earlier in the day. Seems like I recall finding Celexa sort of stimulating at some point. If you do, though, please don't change it all at once. Move it up by a couple of hours each day or every few days. And keep notes each day of the timing of your symptoms, that might make it easier to see what difference, if any, the change is making for you.

 

We generally find that people who have had a previous withdrawal experience from any kind of med, like the benzo in your case, don't have quite as much slack with later tapers. (Well, in general, with continued use of psych meds and especially with multiple changes and stops and starts, everyone runs out of slack sooner or later.)

 

So anyway, you may need to be more cautious with this AD taper than somebody with a different history. You may find that 10% cuts are too big, or that 3-4 weeks isn't quite long enough to wait between them. The 10%/3-4 is just a basic suggestion of where to start. Your body is the only expert. Listen to your body, it will tell you how fast to taper. In this case I would not make another cut until your sleep has improved and you've had some time to enjoy that and catch up on your rest a bit.

[Wildflower0214]

Hey there,

 

Just found your thread after our convo in symptoms and self care. Let us know how you are doing.

[Altostrata]

If you've just made this switch, from p.m. to a.m. dosing, you're overlapping the dose. Because of the p.m. dose, when you add the a.m. dose, the blood level of the drug is pushed higher than usual.

 

Over about 4 days, if you take the drug at the same time in the a.m., this will even out.

 

When people want to change the timing of a dose, we recommend moving it an hour or two each day rather than all at once to avoid blood level irregularity like the one you're experiencing.

[JP904]

thanks guys. I moved back to PM doses. That freaked me out too much. Alto, I actually waited 36 hours from my last PM dose to switch over so that I wasn't overlapping. I guess it must have been just an irregular occurrence. 

 

I really appreciate your responses. Thank you!!!!

 

Take care, 

 

James 

[JP904]

Okay, I am new to this so I have a few questions. Thank you so much in advance. I would be lost without you guys

 

I am on 40 MG, have been on it for 6 years, and plan to start a LT. I am thinking about using 80 ML and extracting 4 ML every 2 weeks so that I am reducing 2 MG every 2 weeks. Is my math correct there and does this seem like a slow enough taper? Also, would it be better to reduce 2 ML every week instead of 4 ML every 2 weeks?

 

I tried a hard cut of 2.5 MG and held it for 2 weeks and it felt like too big of a cut (so reinstated), even though I know this is only a 6% reduction, which I think is pretty small.  I felt anxious and it was pretty tough to get to sleep. I was sleeping well and I started to feel raw and it took hours to fall asleep. 

 

I also think it might be a bit more challenging because I am still healing from benzos. I hit tolerance, did a long LT, and have been off it for a year. I thought I was 80% healed, but now I think some of what I am feeling is due to hitting tolerance from Celexa. I think I hit tolerance with Celexa because I now feel like I did after I made that 2.5 MG cut. I was aware till just today that you can even hit tolerance with an SSRI. 

 

so, am I picking a reasonable LT schedule, is my math correct, should I cut every week or 2 weeks, and does anyone know how my experience with benzos effects my new journey with Celexa? 

 

Thank you!! 

[cymbaltawithdrawal5600]

JP,

 

I moved your latest post from the tapering topic to your thread because it is specific to your journey. Keeping everything in one place is the best way for us to advise you. I am also moving another group of posts from the symptoms forum too.

 

What is an 'LT'?

 

What strength is your '80 ml' solution? How many mg of celexa in 1 ml? If you then decide to reduce by '4 ml' every 2 weeks, is that really 2mg? Without knowing the strength of your solution it is not possible to double check your math.

 

The recommended reduction rate is no more than 10% of your CURRENT dose every 4-6 weeks as long as you are stable. We don't recommend cutting if you are not feeling well.

 

What was the dose of klonopin you were on, what date did you start to decrease and how large (and how often) were your cuts?

 

Your signature gives no real idea of your medication situation. This post from Nov 2, 2014 says:

 

 

I have been taking Celexa for about 8 years now and am currently tapering at 10% every 3 - 4 weeks.

 

Could you adjust your signature a bit with the information on the doses of K and celexa? It is entirely possible you tapered the K far too fast and are still feeling the effects of that and cutting even a small bit of the celexa you have taken for 8 years is upsetting your system.

 

Why are you trying to cut the celexa?

[JP904]

Thank you for doing that for me. I really appreciate it. 

 

LT is liquid titration, so basically where you dissolve the medication in water and then extract small amounts every few weeks. I think we're talking about the same thing. 

 

I'm not sure what you mean by the strength of the solution. I have a 40 MG pill in which I am going to dissolve in 80 ML if water. Doesn't that tell you the strength? Since I have 2 ML of water for every MG I was assuming that by extracting 4 ML I am removing 2 MG of celexa. 

 

As far as Klonopin, I was on 2 MG and I tapered over a period of about 10 months. I reduced 10% every 2 or more weeks. I started that taper about Feb 2013 and ended Dec 2013. After a year of being off I have come a long way and most of my symptoms have disappeared. That is why I didn't expect by anxiety from working out and sleep problems to be coming from it, especially because anxiety and sleep problems weren't symptoms I have really had trouble with throughout my klonopin taper. 

 

I want to come off Celexa because I don't need to be on it and I think I might have hit tolerance, which for me it means I either need to increase dose or start to ween off. 

[cymbaltawithdrawal5600]

Because "LT" was not a clear concept, I did not make the jump from 40 mg pill to 40 mg pill in 80 ml h₂0. So yes, your math is right.

 

Ok, so you went faster than 10% every 4 weeks. My math would have had you still on 0.63 mg of K 12 months later. You went from 2.0 to zero in 10 months, a bit fast but you said you were ok with that. Is it possible that a year later that has caught up with you? I am not sure that you really want to be continuing by cutting the celexa while you are having symptoms from something. Usually it is recommended that one tapers the antidepressant first as the benzo seems to provide a bit of cushioning while the AD is being tapered. But you have no K to fall back on.

 

I will let someone else weigh in on this, perhaps I am not seeing the whole picture because I would not recommend you cut anything yet until you figure out what has caused you to have an increase in symptoms. You have not reduced your celexa yet, right?

 

Thank you for making all of this clearer in your signature.

[JP904]

I haven't started tapering Celexa yet. What triggered this thought was just the increase symptoms. It is possible its from the Klonopin, but I have a stronger suspicion that it's from the Celexa. Well actually, let me ask you, is it common to hit tolerance with Celexa and to just randomly start feeling symptoms as a result? Until just a few days ago I thought this only happened with benzos. 

 

What I want to weigh is will a taper from celexa in conjunction with some lagging benzo symptoms (let's say it is from the benzos) be worse or better than staying on Celexa after I have hit tolerance (let's say it is the celexa)? 

 

I do agree that I shouldn't be hasty and should continue to hear from others and make a more informed opinion. 

 

Thank you CymboltaWithdrawal5600 and you're welcome on the signature- Thanks for advising me to update it. 

[JP904]

I am tried reading a lot of intros to see if I could get my question answered, but am not finding my insight. Can anyone help me to answer my last question above? The symptoms that I feel are from tolerance haven't been as bad in the last few days. It seems to travel in waives. Every few days or sometimes weeks I feel symptoms that feel different from the benzos. Its like I'm slowly starting to hit tolerance with Celexa. Can someone please help me to weigh out my options? If I need to start a slow taper from Celexa I want to start right away. I already have my gear. 

[cymbaltawithdrawal5600]

It is impossible to tell what your symptoms are from. Some people never get symptoms when they cold turkey or taper off a drug too quickly until a great deal of time has passed and then they have no idea what has hit them. If you want to rush to a celexa taper while you are having symptoms of something that is entirely up to you.

 

You are there the only one who can tell which is which and probably not even that. There is no medical test for 'benzo symptoms' or 'celexa tolerance' symptoms. Just because you think you got off K successfully does not mean your body thinks so too, after all you were on a pretty high dose of it for 5 years. That takes time to recover from. If you start tapering celexa and you get into trouble you won't be able to do much about it. Usually we recommend tapering the antidepressant first and then the benzo as the benzo often offers somewhat of a cushioning effect in that it is sedating and not activation. I said that above and I repeated it here. You have no cushion and your body is trying to tell you something if you are saying you are only "80% healed from your klonopin taper". That 20 % is significant.

 

You have to listen to your body and let it be the judge and not be so quick to label something as "celexa tolerance" when it is an overall situation of "my body got used to having 40 mg of celexa and 2 mg K in it for five years and now I don't want either one of it in there anymore" and just how it is going to cope with that and the daily stresses and strains of living and the fact that your body is also moving through time? Everyone is in such a rush to get off the drugs and do not give much thought as to the real ramifications of this. They affect every body system, every nook and cranny and do not leave that easily. Your body has to remake every cell and it does that on its own timetable, not according to our calendars.

 

Your body now has to get used to being a "40 mg celexa without 2mg K" body now and it will definitely take more than a year to do that.

[Altostrata]

Okay, I am new to this so I have a few questions. Thank you so much in advance. I would be lost without you guys

 

I am on 40 MG, have been on it for 6 years, and plan to start a LT. I am thinking about using 80 ML and extracting 4 ML every 2 weeks so that I am reducing 2 MG every 2 weeks. Is my math correct there and does this seem like a slow enough taper? Also, would it be better to reduce 2 ML every week instead of 4 ML every 2 weeks?

 

I tried a hard cut of 2.5 MG and held it for 2 weeks and it felt like too big of a cut (so reinstated), even though I know this is only a 6% reduction, which I think is pretty small.  I felt anxious and it was pretty tough to get to sleep. I was sleeping well and I started to feel raw and it took hours to fall asleep. 

 

I also think it might be a bit more challenging because I am still healing from benzos. I hit tolerance, did a long LT, and have been off it for a year. I thought I was 80% healed, but now I think some of what I am feeling is due to hitting tolerance from Celexa. I think I hit tolerance with Celexa because I now feel like I did after I made that 2.5 MG cut. I was aware till just today that you can even hit tolerance with an SSRI. 

 

so, am I picking a reasonable LT schedule, is my math correct, should I cut every week or 2 weeks, and does anyone know how my experience with benzos effects my new journey with Celexa? 

 

Thank you!! 

 

This is a reasonable way to taper off Celexa.

 

As you say you are about 80% healed from Klonopin withdrawal, it's your judgment call about whether you want to rock the boat with Celexa withdrawal.

 

Do your symptoms have any daily pattern relative to when you take your drugs?

[JP904]

Thanks Alto. I haven't noticed a pattern relative to taking it. It's really hard to tell and confusing because I know I still have waives from Klonopin. I think I better wait a few months before tapering. If these symptoms turn out to just be a bad waive from Klonopin and I taper from Celexa it could be bad. 

 

For when I do start, do you think its best to taper every 4 weeks or taper half the amount every 2 weeks? 

[Altostrata]

You could taper either way. The smaller reductions every 2 weeks might be easier on you.

 

Please keep notes on paper about your daily symptom pattern.

[JP904]

k thank you Alto. I will. Thanks! 

[JP904]

okay, so I started my taper. I put my 40 MG of celexa into 120 ml of water and have been extracting 5 ml every 3 weeks. I'm a week into my second taper (10 m taken out) and I can't sleep. I didn't fall asleep till 10 am. After my first taper of taking out the 5 ml I experienced some challenges around week 2 where it was hard to sleep, I was getting headaches, and some other pains. I didn't expect such significant withdrawal symptoms when I'm withdrawing at such a slow pace. At this rate I will be going through withdrawals and taper for 1 1/2 - 2 years. 

 

I still only feel about 80% healed from my benzo taper. Could this be why I'm having such a hard time with the taper? If so, should I stop tapering for a few months until I'm completely healed from benzos? 

[JP904]

Okay, I'm pretty sure I'm going to stop my taper and wait till I feel 100% healed from Benzos. I'm disolving my tablets in 120 ML of water and have got 25 ML out so far. I plan on just going back to taking the tablets the normal way. Could there be any risks to going straight back to tablets, or should when it comes time for my next dose should I just take the tablets? 

 

Thanks in advance!  

[JP904]

Any thoughts? Is it okay to go straight back to taking 40 MG in tablet form or do I need to reverse taper or something? I've never had to do this before. 

[Altostrata]

okay, so I started my taper. I put my 40 MG of celexa into 120 ml of water and have been extracting 5 ml every 3 weeks. I'm a week into my second taper (10 m taken out) and I can't sleep. I didn't fall asleep till 10 am. After my first taper of taking out the 5 ml I experienced some challenges around week 2 where it was hard to sleep, I was getting headaches, and some other pains. I didn't expect such significant withdrawal symptoms when I'm withdrawing at such a slow pace. At this rate I will be going through withdrawals and taper for 1 1/2 - 2 years. 

 

I still only feel about 80% healed from my benzo taper. Could this be why I'm having such a hard time with the taper? If so, should I stop tapering for a few months until I'm completely healed from benzos? 

 

It helps to communicate your dosage in terms of milligrams rather than milliiters. Are you tapering by 1.67mg every 3 weeks? You're now down to taking 31.67mg Celexa?

 

Your suspension has .3333mg Celexa in 1mL, is that correct?

 

If that is so, you are very sensitive to dosage changes. You might want to try a long hold now and see if your nervous system can stabilize.

 

If you want to try an updose, you might increase a milligram or two, to about 33mg or 34mg Celexa.

[JP904]

I'm tapering .83 mg every 3 weeks. 1ML has 1.67 mg of Celexa in it. I'm currently taking 36.25 MG of Celexa. 

 

Yeah, my system is very sensitive. I think it's because my body is still healing from benzos. That or I've hit tolerance with Celexa. 

 

Either way, I'm thinking it best to just stop the taper and go back to my full 40 mg for the next few months so I can give my body more time to heal. My only concern is that if I've hit tolerance, then it's not going to get any better and then it's just going to take longer to get through all the pain. 

 

If I am to go back to just taking the 40 mg pills, is it typically okay to updose to 40 mg immediately? I'm thinking of just taking it tonight. 

[JP904]

Question please- so the only withdrawals I seem to be feeling while tapering is an inability to fall asleep at a reasonable time. I take my citalopram when I go to bed. I have heard that the medication loses it's strength around the 24 hour mark. If this is true, if I started taking it when I wake up, would it help me to fall asleep? 

[JP904]

Does anyone have some advise on my question just above this? Thanks!

[Petunia]

Hi JP,

 

I'm not sure if changing the time you take your dose will help you sleep or not. Some people find antidepressants to be activating, so this might help. Have you always taken it at night?  What dose are you on now?

[JP904]

I have always taken it at night. I'm at 34 MG. You know, I've managed to get sleeping in order. It's so strange. If I have a nap even for 5 min during the day it throws me sleep off for not only that night, but for the next few nights. Also, if I sleep 8 1/2 hours or more it does the same thing. It's so odd. I get that a nap or sleeping too much could make it a bit more challenging to fall asleep, but making it take hours and especially for back to back nights is strange to me. Oh well, I believe I've figured it out. 

[JP904]

New question please- I am having surgery on Tuesday. Is there anything that I need to make sure to avoid due to being messed up from the withdrawal. I am also in protracted benzo withrawal and know that I need to avoid certain things due to this, but should I be aware of anything as related to ssirs? 

[scallywag]

JP -- If you haven't already, you should discuss your current medications with the anesthesiologist and also let him/her know that you previously took benzodiazepenes. That may affect what is prescribed for post-surgical pain. They may also require (or have recommendations about) stopping Celexa. Please check.

[JP904]

okay so I'm on 5.6 MG of Celexa right now. I was once on 40 mg and have been tapering since October 2014. I've been doing a liquid taper for the last year. It's crazy to me that it's taken 2 years of constant tapering and I'm still not off. I was wondering if others have had to taper this slowly. I'm reducing by about 2% at a time right now and it still seems like too much., because I'm experiencing bad headaches, head fog, anxiety, body pain, fatigue, etc. (this is nothing new, but it's getting worse the closer I get to the end) I've added more water to my solution to dilute it and that didn't seem to do anything. 

 

There is probably nothing I can do right? I Just need to hold it until I feel better and then continue to taper at my 2% rate. This is so rough. I really wish there were SSRI anonymous groups in my area! I had to taper off of Benzos for a year and that was horrific as well.....I'm now on 5 years of this **** between benzos and ssri withdrawal. We need a program like AA! ha 

 

Any thoughts or encouragement would be so very much appreciated  

[scallywag]

Some people find that the last few mg are tough and require smaller dose reductions.  I've seen folks tapering Paxil and Lexapro report this. Given Celexa's close relationship to Lexapro, it's not surprising that someone might need to make very small decreases and have w/d symptoms anyway. 

 

How long are you holding at a dose after a reduction?