Flowers: tapering citalopram

[Flowers]

Moderator note - link to benzo thread - Flowers: Xanax - spacing of doses

 

Hi Everyone!

 

it's been great to find this site and know their are others in the same boat as me.

 

I am British but live in Spain but it looks like a lot of you are from USA. Well, regardless of our geography the drugs and effects are still the same I guess.

 

My story goes like this........

 

I have been on antidepressants since my thirties and nothing ever seems to trigger off the depression. I am however quite an anxious, nervy person!

 

The last 15 years I have taken Citalopram after my Dr told me I would probably need it for the rest of my life. All was fine - Citalopram helped me immensely initially and has kept me on an even keel since. I think it just made me feel normal - no highs or lows. 

 

Then in March this year I got a severe allergy to pollen that gave me sinusitis and an asthma flare up. My Dr gave me some antibiotics and oral steroids to help. I had a very bad reaction to the meds and ended up with increased anxiety, shaking etc. He suggested that I might like to increase the Citalopram from 30mgs to 40mgs. All was well until early September when I started to get extreme nightmares and heart palpitations. The nightmares were so bad I was screaming out loud. My mood was good but I was very tired. 

 

So the Dr suggested that either 40mgs was too high or the drug wasn't agreeing with me at all. His advice was to try to reduce or come off the drugs  so he could see if I was OK without them or he would need to give me something else. He also advised taking 20mg for 4 weeks then 10mg for 4 weeks etc until I was off them.

 

So, I started end of September and reduced to 20mgs straight away for 4 weeks. I didn't feel that bad over those weeks just maybe a little extra anxiety that could be managed. The trouble started when I went down to 10mgs just over 4 weeks ago. I got all the withdrawal symptoms full on. This wasn't helped by getting a lung infection which set off asthma again. I was getting even more anxious not being able to breath and was given antibiotics again and a nebulizer. Both meds can effect anxiety and I think they did because I ended up really ill. One of the worst withdrawal symptoms was not being able to control my legs and the weakness in them. I collapsed and ended up in the Emergencies with my Blood Pressure 207/117.They eventually stabilised me and sent me home where I am now watching my BP at home. The depression has set in and I can barely get out of bed each day and can't stop crying. I have seen a different  Dr.  who  has given me Lexatin  to take 3mg up to 3 times a day to ease the anxiety. I have only taken one today and it has calmed me down, but am conscious of the dependency issues. He has also suggested increasing the dose of Citalopram back up to 30mgs. I think the first Dr maybe have recommended a far too quick withdrawal for me as I haven't been able to cope with the severe effects.

 

I am going to increase to 20mgs to see what happens but I am so scared of what is going to happen. I can't even contemplate coming off these drugs now. I just want to get back to normal and live again.

When will I get any benefit from the increase and should I go on up to 30mgs? 

 

Any help or advice anyone can give would be so welcome - you all seem to have a wealth of experience out there.

Edited November 26, 2018 by Shep
drug tags (ChessieCat), added link to benzo thread (Shep)

[tgirl]

Hello Flowers,

I just wanted to say hello and Welcome to SA.

I'm sorry you are not feeling well.

Someone with more experience should be along shortly to help you.

Good Lucky

[Reflex]

Hi flowers

I just wanted to say that I understand how you are feeling. I am not an expert but know that there are some knowledgeable people on this site who will be along to speak to you soon.

 

If you read my signature you will see that I was on citalapram for about eight years and I too felt the same . When I took the doctors advice in how to come off I became Ill. I am now on Prozac and I have been stable for about six weeks. I am still determined to come off A.D but realize that it will take much longer than anticipated.

I now plan to start in the new year micro tapering.

 

Good luck and have hope that you will feel better.

[Flowers]

Thank you Reflex and tgirl.

 

Just hearing from you and your kindness has reduced me to tears.

 

Damn this awful drug!

[Flowers]

Gosh Reflex you have been through it too havn't you?

 

So glad that you have been stable for a few weeks and are feeling better.

 

Hopefully, I will see how you progress.

 

I wish you well. 

[Rhiannon]

Welcome Flowers!

 

It sounds to me like your problem is that you cut your doses down too much too fast. What you're describing are pretty typical withdrawal symptoms for someone who comes off their meds too fast. Most doctors don't know anything about slow tapering; this is probably the most common reason we see people arrive in this forum.

 

We suggest reducing by no more than 10% of the current dose every 4 weeks. Please read through this link:

 

Why taper by 10% of my dosage?  (The general philosophy of gradual tapering)

 

I agree with you, it sounds like the best idea for you now is reinstating your dose, and 20 mg is probably a good choice since it means you won't have to cut pills. Since you've been off that dose for four weeks now though it could be too high. If you find you feel too overstimulated by 20 mg you might try 15 mg.  But if it were me I'd probably give the 20 a try first.

 

You won't feel better instantly or overnight. It may take some weeks for you to stabilize, maybe longer, it's hard to predict because everyone is so different and you've been on the drugs for a pretty long time, and you've been kind of unstable since March, sounds like.

 

If you do decide to try to come off the citalopram all the way (as your doctor suggested), given how long you've been on it you'll need to plan to taper off over many months, maybe a year. (Like I say, docs have no clue about this.)

 

Keep us posted and let us know how you do.

[simon]

Hi Flowers

Ive taken Citalopram for about 7 years (with 2 others) and in the summer my GP suggested that sort of taper (they must just read the pharmaceutical leaflets). It hit me about  6 weeks after I had come off it completely and I was back to square one.

Its just far to fast when weve been on it for any length of time.

Im just beginning a very slow taper now and would recommend it to you; and I reckon it requires a lot of patience. Im thinking in terms of a few years now. But then I have got a lot more chemicals to get rid of!

I wish you well

 

Simon

[mammaP]

Hi Flowers, welcome to SA. I agree with all that Rhi said and feel that 20mg might be best for you as 

you were stable on that dose before all the changes.     Doctors really don't know anything about 

tapering as they are educated by the drug reps who don't want you to come off their drugs! 

 

I am sorry you have been through so much and hope that you start to feel better very soon.

[Flowers]

Thanks for the encouragement and advice which is really helping me. My Dr suggested going straight back up to 30mgs but I am so glad I found this site and didn't.  You are so right that they haven't got a clue about this sort of thing.

 

Am struggling a little bit today wondering if I have done the right thing. I have slept better these past 3 nights since upping to 20mgs but am aware in the night of being giddy through a sleepy haze - if you know what I mean.  I'm also experiencing heart palpitations again but monitoring with a home BP/heart rate machine. Is this due to increasing the dose and when will these symptoms settle?  Am very unsteady on my feet which has been a problem since getting down to 10mgs.  so husband has helped me get up, wash and dress this morning. My mood seems better as I am not crying so much. Can't really get off the sofa  but will try to have a wander around our garden this afternoon.

 

Rhi  - I don't really understand your comment about being overstimulated at 20mgs. What would this feel like? I have had so many withdrawal symptoms I am finding it hard to recognise any different ones!

 

Thanks to everyone on this site who has replied to me. I don't feel so alone now trying to battle through this awful time.

[Flowers]

Hi Simon

 

Thanks for replying to me and I take on board your recommendations for a very slow taper. I will try and get stable on the increased dose I have just started and then see what I will do. If I do want to get off the Cit it will definitely be over a long long time - like you say - years. After all what is the rush? 

 

I can see you have a lot of meds going on and can why you have come to this decision to take a slow taper.

 

I really hope this works for you - let me know how you are doing.

[mammaP]

The palpitations and feeling giddy through the night, have they started since going up to 20mg? 

Are you feeling worse since increasing Flowers?

[Flowers]

Hi Mamma P  - Sorry I am a bit confused with all that's happening to me so may not be very clear with the current symptoms.

I have had the palpitations since  reducing the dose so it is difficult to say whether they are worse or not. 

 

However, I have not had these new symptoms which started after increasing up to 20mg 3 nights ago.   I will do my best to describe them to you as follows: being asleep but awakening  to  turn over or whatever like you do  and feeling giddy and whoozy like you are coming around from an anaesthetic or something. I am feeling quite drugged for a couple of hours after getting up in the morning also.

 

Do you have any experience of this? I sure would appreciate some guidance.  

[simon]

I reckon  that taking small amounts of lexatin (equivalent in dose to diazepam that I have had prescribed following my problems coming off Cit too fast) wont do any harm in the short run.

I was extremely nervous a few weeks ago when I was advised to take 12mg per day and thought the doctor mad to suggest it. But im down to 6 now with no apparent problems, though I was addicted for a short while.

If youre careful and don't take them too regularly you can get off them when symptoms fall away. (although I know its not the policy of this forum to go adding new drugs)

In the meantime I guess its good to research all the other anti-anxiety methods (for me this means meditation) that are available. And not addictive!

Simon

[Flowers]

Thanks Simon.

 

I must admit that I am a bit concerned to take another drug to get rid of the withdrawal effects of another one! I forget in all the turmoil I have been in to include in my signature that I had been given Lormetazepam (Noctamid) to help with the withdrawal process. I only took a little as I when I needed it and probably had on average 2mgs per day for a couple of months. I don't think I got addicted.It just made me too drowsy as I believe it is primarily a sleeping tablet.

 

I am hoping that the increase in Cit will kick in soon and help with the anxiety problem - if I am desperate I will have to take the lexatin.   As you say, though,  I should be finding other ways to help with anxiety. Maybe when this episode is over I will go and seek professional advise to help me eventually get off this stuff for good. I am willing to try anything.

 

It's good to hear about your experiences and you have done so well - it really gives me hope. Thank you.

 

 

[Flowers]

I have had an unsettled time since Spring this year when I was prescribed Clarithromycin and Prednisone for a chest infection - I am asthmatic. I had increased anxiety/depression, shaking and heart palpitations as a result which took a while to go away. I assumed it was the steroids.

In Autumn I reduced my dose of Citalopram from 40mgs to 10mgs in 8 weeks on my Dr's advice. I have since found out from this site that this was far too quick. Whilst I was struggling with withdrawal symptoms

 on 10mgs 2 weeks ago I got another chest infection for which Clarithromycin was prescribed.

The withdrawal symptoms got so much worse that I am wondering if it is infact the Clarithromycin that has heightened the withdrawal symptoms and knocked my nervous system for 6.

4 days ago  once I had finished the course of Clarithromycin I increased the Cit to 20mgs. I am just waiting to see what happens with upping the dose and hope it helps.

I am really struggling as not only have increased anxiety/depression but have weakness in my legs and loss  of balance. I can't walk unaided as I feel I am going to fall over. 

Has anyone else had problems with this type of antibiotic?   

 

[Petunia]

Hi Flowers,

I joined this post with your original introduction thread, its one intro topic per member.  You can use this thread as your ongoing journal to track progress and communicate with the community, add to it whenever you want.

 

Many people have problems with taking antibiotics while in withdrawal, we have a thread about it here:

 

http://survivingantidepressants.org/index.php?/topic/1126-taking-antibiotics/page-3#entry107444

 

Petu.

[Flowers]

I am so sorry Petu - I am new to this computer stuff and didn't realise I had to put everything under my intro thread.

 

Thanks for the link - I will read it with interest as am really struggling with all this.

 

Best Wishes

[Flowers]

Well, my days seem to be following a pattern after increasing my dose of Cit from 10mgs to 20mgs 5 nights ago. I am going to keep a journal going just so I have some record or reference to what is going on.

 

Sleep is OK but feeling very fugged in the morning so force myself to get up, wash dress, eat breakfast .My husband helps me as I am so exhausted and am off balance. Mornings are the worse time for the anxiety and waves of depression come over me making me cry for a while without knowing why. Mainly sit on the sofa reading or on the computer.  Have been out for a drive in the car with my husband to get me out of the house but have no energy to walk - keep feeling as though I am going to fall over. Any interaction with anybody makes me feel so ill and just want to get home. Back on the sofa feeling exhausted, physical symptoms like muscles twitching in my legs, involuntary leg movements, palpitations worry me. Tearful and feeling guilty that my husband is having to do everything and I can't help him. Just being very irritable to him.  Eat a little dinner and watch TV if it is not on too loud. Start to feel a little better as the evening goes on leading up to when I have to take my next Cit pill just before bed. Go to bed hoping that the increase in dosage will start to make me feel better soon.

[Altostrata]

Welcome, Flowers.

 

It may take a bit for your citalopram reinstatement to settle.

 

How are the palpitations?

 

Please keep notes on paper about your daily symptom patterns. This can help determine whether 20mg is too high for you now.

 

Lormetazepam is a benzodiazepine. You were taking it every day for how long? When did you stop it? How did you go off it?

 

(Simon, please do not recommend people take benzos. They are powerful drugs that can cause more problems than they help.)

[simon]

Yes , sorry about that (Alto) , i'll stick to describing what Im doing rather than suggesting things to others. I guess theres a subtle difference.

Simon

[Flowers]

Hi Alto

 

Thanks for your help.  I will make notes regarding symptoms - am I permitted to keep a journal on here as to how I am feeling too?

 

I still have palpitations but am not feeling so drugged throughout the night - just waking up a lot

.

My Dr gave me the lormazepam to help with the withdrawal effects when I first started reducing Cit at the end of Sept/beg October. He gave me several suggestions of  combinations of using them with a 1 mg dose ranging from taking 1mg up to  2 1/2 mg daily as and when needed. Over the following 8 weeks while I was reducing  the Cit, I probably had each day  1mg  sometimes 2mg and sometimes nothing. I was hardly taking any these past couple of weeks.

 

 I am asthmatic and felt they were not helping with my breathing so last Tuesday  my Dr prescribed me with Bromazepam instead -  up to 3 x 3mgs daily.  Since last Tuesday there have been two occasions when  I have taken 1 dose of 3 mgs when the anxiety has been intolerable. I did not realise until joining this forum that these drugs are so powerful. I am struggling with anxiety this morning and keep looking at the pill packet thinking shall I take one? Help! 

[Petunia]

  I will make notes regarding symptoms - am I permitted to keep a journal on here as to how I am feeling too?.....

 

 

.......... I am struggling with anxiety this morning and keep looking at the pill packet thinking shall I take one? Help! 

 

Hi Flowers,

You can use your thread in any way you feel helps, using it as a feelings journal is a good idea.

 

Have a look through this topic for some ideas about how to manage anxiety without drugs:

Non-drug techniques to cope with emotional symptoms

[Flowers]

Well, I managed to get through the worst day I have had so far on Dec 7. I was alone at home crying all day and worrying about everything. We live by the sea and I was looking at it thinking shall I just go in there and never come out. Quite scary. Since then I seem to be having some improvement with my mood although the anxiety is hard to control. I think maybe the updose is kicking in at last. The worst bit is still this feeling of weakness and instability on my feet. 4 weeks ago I was practically running marathons! Now I am having to use a crutch to get around to stop me falling over. Legs are so weak and have muscles twitching all over them. I have a Dr's appointment on Mon 15 so will see what happens then. All the blood tests etc I have had over the last couple of weeks have ruled out any underlying illness causing these symptoms. I am not surprised as I know it is the stress on my body caused by too fast withdrawal. If only I had come on this site before I started it.

[tgirl]

Hello flowers,

Sorry to hear your not doing well!

It's criminal what these meds do to us!

Hope things begin to get better for you.

[Flowers]

Thanks tgirl - how are you doing?

 

What's making it worse is that it's Christmastime  and we are  supposed to be travelling to Scotland tomorrow to see our family. I am just not well enough to go. Everyone is so disappointed. Just have to keep trying to be positive and hope that this will pass...........

At least I saw dolphins in our bay today - truly spectacular.

 

Take care now. 

[Flowers]

Just writing an update of the weeks events. I went to see a new Dr yesterday within the Health System here. He was lovely and very shocked to see the state I was in. He agreed that the quick withdrawal my previous Dr had suggested was just too much for my system. He has organised a load of blood tests tomorrow and a 24/48 hr ECG test next week to check on the heart palpitations. He has also referred me to a psychiatrist to try to sort out this damage to my body. I have never seen a psychiatrist before and will find that quite scary. I have now reached the level of citalopram I was taking earlier in the year when I felt OK. I only upped to 30 mgs last week though so may not feel any pros or cons yet. I am only taking the benzo in extreme moments and haven't had any for the last couple of days. Each day I feel a little better mentally but physically I am still very weak and need to use a walking stick as my balance is so bad. I am hoping the physical side of things will improve gradually. Don't know what else I can do really except take each day as it comes.

[Rhiannon]

Flower, I'm sorry to hear how rough it is for you right now. :-(

 

I am hesitant to make any suggestions since it sounds like you're getting advice from doctors and going to be seeing a psychiatrist soon too. However I am quite concerned about the erratic use of benzos. They're quite powerful drugs and you've been taking them long enough and regularly enough to have developed some dependence (it only takes a couple of weeks), which means that when you go up and down on dose or skip doses you're going to get various effects which can contribute to the symptoms you're having. Benzo withdrawal is awful.

 

Maybe you can work with your docs to get onto a regular schedule with those or else to taper off them. We find that when people are in withdrawal from ADs, their response to other meds can be unpredictable and even paradoxical (the opposite of what's expected).

 

Good luck with the docs.

[Flowers]

Hi Rhi -Yes, I can see where you are coming from with the erratic use of benzos which could be messing me up even more. I was telling the Doc yesterday that the effects of the bromazepam wear off after a few hours but I do feel better when I take them. He  gave me a prescription for Diazepam 5mgs to be taken once a day. I haven't been to the chemist to pick them up yet and am so scared to take any benzos now let alone new ones! I was thinking I maybe would give them a try but  am in a bit of a dilemma as what to do for the best. 

 

I would appreciate any suggestions or guidance.

[Petunia]

Hi Flowers,

I don't really have anything to add beyond what Rhi has written.  If you are going to take a benzo while in withdrawal, it should be regularly.  I made the mistake of trying to take Xanax to manage withdrawal symptoms and it made me much worse and probably added a year onto my recovery time.  If you start taking the Diazepam, you will need to taper off it carefully when you decide to stop.  Stopping a benzo after regular use can be just as difficult, if not worse than coming off an antidepressant.

 

Please be aware that if you see a psychiatrist he/she is likely to want to prescribe more/different drugs.  Its what they do.  You might find a good one, who is willing to help you come off the drugs, but most of them seem to prefer increasing drugs.

 

Do let us know how things go, and what you decide.

[Altostrata]

Hello, Flowers.

 

It sounds like the reinstatement of citalopram is working at last.

 

I would be very, very stingy with diazepam use (or any other benzo); doctors think it's less addictive, but it is not. You can take a fragment of a tablet, that may be enough to get you through the roughest times.

 

Rather, please give the citalopram reinstatement time to work -- this can take several weeks or longer -- remind yourself that this, too, shall pass when you're in a bad spot.

 

Be sure to take citalopram at the same time each day, and keep notes on paper of your daily symptom pattern.

[Flowers]

Hi Rhi/ Petu - Thanks for replying. Well, from the experts advice here, which I really appreciate, it seems I have to make a decision regarding the benzos. I am a bit of a mess at the moment and my decision making is hampered so have written it down here how I see the current situation and the way forward.

 

From what I can gather because I took the benzos for 2 months I may have a dependency.  Stopping them or taking them irregularly may be giving me withdrawal symptoms that is making me feel worse. This wasn't mentioned by my Dr at the recent appointment.  He just seemed to want me to see the Psychiatrist to sort it all out!

 

So, should I be considering tapering them off in a manageable way to hopefully control any withdrawal symptoms? I am very relunctant to take a daily dose of diazepam 5 mgs. Not sure what a good taper dose would be. Think I would prefer to go down this route.  

 

My appointment with the Psychiatrist won't be for a while and I was really hoping that they may be able to refer me to someone within the mental health system here that would be able to help me without the use of drugs - maybe some sort of  therapy. I am in a foreign country to me and not familiar with the way things work here but have to start somewhere.

[Flowers]

Hi Alto

 

I had just hit the send key to my recent post when your post came through! It was just what I needed to hear as I have been worrying about what to do about the benzos/diazepam.

 

I will try to ride this out without taking a regular dose of benzos regardless of whether I am having withdrawal symptoms from them. If I need something if things get too bad I will take a fraction of a diazepam - but will try my best not to.

 

Thanks for your guidance - I prefer to listen to what you have to say as your have a wealth of experience.

 

Thank you for being there.

[Altostrata]

You're welcome.

 

Please be aware that even a psychiatrist may not have a clue about withdrawal and drug damage, and try to fake it when giving you advice. Listen to your body, don't make any dramatic drug changes.

[Flowers]

Another update for the past week after updosing Citalopram to 30 mgs 2 weeks ago (after a too rapid taper) and hoping that things stabilise eventually .........have tried to get involved in the lead up to Christmas and all the things that need to be done. I have undertaken a small task every day - even done some light housework. My mood is much happier and have wanted to go out for short walks each day. My balance has improved and legs are a little stronger. Managed to go out to friends for Christmas dinner yesterday - it was nice to see everyone but  found interacting with others (there were 8 of us) quite hard mentally and everything seemed so noisy. I felt really disappointed with myself when I had to bale  out after 5 hours as just mentally exhausted. BUT got home and thought that I couldn't have done this 2 weeks ago. So, progress is slow but IT IS progress, so I shouldn't feel too despondent. I haven't had any benzos for nearly 2 weeks now - seem to be managing the anxiety OK without them. Am feeling tired today and that could be down to the excitement of  yesterday. Every day is different in how I am feeling so maybe tomorrow I will feel more energized.........

[Altostrata]

Good news, Flowers. Please don't be impatient, give your system time to stabilize.

[chicken]

 

Then in March this year I got a severe allergy to pollen that gave me sinusitis and an asthma flare up. My Dr gave me some antibiotics and oral steroids to help. I had a very bad reaction to the meds and ended up with increased anxiety, shaking etc.

Flowers,

May I ask just what antibiotic you were given? I wasn't by any chance, Cipro, Levequin or Avelox?

 

My meds got messed up big time after taking the antibiotic Cipro.

 

Good to hear you are getting better and less reliant on the benzos.