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Snowyowl16

have been on citalopram since 2004 after an event that left me depressed. My dose has changed over the years, mostly because I have reduced it on my own- not really wanting to rely on medications to get by. I was down to 5 mg/day a few years ago then stopped cold turkey. I was off 4 months and felt so sick I went back on. I immediately felt better- that should have been my clue that I was withdrawing. I started back on 10 mg. Well, now due to life I have been back on 20 mg/day for about a year. I have tried, in the last few months, to taper by reducing my dose 1 day a week to 10 mg. I have since learned that can trigger withdrawal and it did trigger intense bouts of nausea and loose stools. Last I tried to reduce by 25% and have been on 15 mg/day for 10 days. Symptoms: sweating, headache 24/7, nausea, loose stools, pounding heart, feelings of dread. And I have had a hand tremor for years that I am certain is caused by this horrid medication. I am taking propranolol for that. Anyway, thank you for this forum, I cant wait to get started!

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Gridley

Hello, Snowyowl, and welcome to SA.

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.
  • Any drugs prior to 24 months ago can just be listed with start and stop years. 
  • Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago) 
  • Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016. 
  • Please leave out symptoms and diagnoses. 
  • A list is easier to understand than one or multiple paragraphs. 
  • Link to Account Settings – Create or Edit a signature.
As you have already learned, skipping doses is a bad idea and can definitely lead to withdrawal symptoms.  Your most recent decrease of 25% was too much and has triggered the withdrawal symptoms you describe.  At Surviving Antidepressants, it is recommended that a person taper by no more than 10% of their current dose with at least a four week hold in-between decreases.  The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.  Some people may have to taper at a more conservative rate as they are sensitive to even the smallest drops.
 
 
So you have a better understanding of what you are experiencing, here is some excellent information on withdrawal:

 

When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur. 
 
Reinstatement of a very small dose of the original drug is the only known way to help alleviate withdrawal syndrome.  The only other alternative is to try and wait out the symptoms and manage as best you can until your central nervous system returns to homeostasis.  Unfortunately no one can give you an exact timeline as to when you will start feeling better and while some do recover relatively easily, for others it can take many months or longer.  
 
Reinstatement isn't a guarantee of diminished symptoms for everyone but it's the best tactic available.  You're still in the time period where reinstatement predictably works.  It is best to reinstate as soon as possible after withdrawal symptoms occur. We usually suggest a much smaller reinstatement dose than your last dose.  Then, once you've stabilized on that dosage, you can begin a 10% per month taper down to zero.   
 
I suggest you read Post #1 of this topic.  About reinstating and stabilizing to reduce withdrawal symptoms
 
Since you've been been at the lower dose for 10 days, your brain has had time to adapt somewhat to the lower dose, so I wouldn't reinstate back to 20mg.  Often a very small increase is enough to ease withdrawal symptoms.  I suggest you reinstate 1mg (16mg) and see if that helps.  Keep in mind that it takes about 4 days for the dose change to get to full state in the blood and a bit longer for it to register in your brain.
 
This is your introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community. I hope you'll find the information in the SA forums helpful for your situation. I'm sorry that you are in the position that you need the information, but I am glad that you found us.
 
Edited by ChessieCat
removed white space

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Snowyowl16

Hi Gridley, thanks for responding. I actually re started at first 20 mg X 1 day, then after reading on this site went to 18 mg 1xd. I take my citalopram in the evening so this past Sunday took 20 mg, then 18 mg mon, Tues and today. I still had withdrawal Monday but felt good tuesday. Today I had nausea and headache with chest pounding this am. I always feel better later in the day. I guess I had wd so today? After reading your post maybe I should have re instated at 16 mg? I find this all so confusing. I have been reading a lot though. This site is a wealth of information.  Dr Weekes is amazing!

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Gridley

See how you do on the 18mg.  It's better to make as few changes as possible.  The brain wants stability.  Don't jump up and down in dosage.

The rule of 3KIS: Keep it simple. Keep it slow. Keep it stable. 

It's common to feel better later in the day.  Morning often brings cortisol spikes to those in withdrawal.  I have certainly experienced this.  I'm much better in the PM.

Waking with panic or anxiety - managing cortisol spikes - Symptoms ...

The important thing to remember at this point is not to over-react to symptom changes and then try to adjust your dosage up or down in a desperate effort to alleviate symptoms. Keep it stable.

 

 It is very encouraging that you felt good Tuesday.

 

 

 

 

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Snowyowl16

So I have been on 18 mg citalopram for 5 days now after restarting at 20 mg X 1 day. I am able to function as I try to push through the symptoms.  I am still having a headache today and my heart is pounding away. I am reading posts about over sensitization after re instating. What are the symptoms of over sensitization? Still trying to figure out if I am taking too much or too little.

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ChessieCat

Hi Snowyowl and welcome from me too.

 

Q:  Have any of your symptoms improved?

 

If yes, then updosing is working.

 

It takes about 4 days for a dose change to get to full state in the blood about a bit longer for it to register in the brain.  This is a time when you need to be patient.  You have gone from 20mg to 15mg to 20mg to 18mg in a less than a month.  The brain likes consistency.  Now is the time to be holding at one dose so the brain has a chance to adapt.

 

It's important to Keep Notes on Paper

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Snowyowl16

Ok, yes it is hard for me not to react to my symptoms. I am learning from the site about waves and windows. Thanks for the support. It seems the more I think/obsess about my symptoms the worse they are. I have been reading about that too. This site is a real god send for me.

And yes, actually feeling good today😊

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ChessieCat

I wrote this in response to a member asking how long I had a symptom for:

 

"Because I know about WD symptoms I don't make a big deal about them.  I just accept a symptom for what it is and it's usually when a symptom happens again or a member mentions something that I realise that a particular symptom hasn't happened for a while.

 

It was only this morning when my feet felt a bit crampy that I realised that the plantar fascia had gone.

 

I think it's just that I learn to live with something so it isn't forefront in my mind."

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Snowyowl16

Yes. Keeping busy is key for me so I don't sit and obsess about symptoms. I hope this obsessing gets better with time. I am going on vacation soon and will have to fly. Just the thought triggers intense panic and I feel so sick. I will have to take the xanax😟

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Snowyowl16

I have stopped the glutamine as I read that it can cause nausea in a high percentage of people and no nausea today! Coincidence?? Maybe, but happy still :)

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Snowyowl16

I have had the worst nausea for 2 days after 4 relatively good days. I am ready to just stop ct and take my lumps all at once. This is just prolonging the agony! This medication causes nausea and the withdrawal does as well..so hard to determine what is going on. I can barely function on these nausea days.

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ChessieCat

I've merged the new Intro topic you created with your original Intro topic.  Each member has only 1 Intro topic where they can ask questions about their own situation and journal their progress.  It keeps your history in one place.

 

Please do not create any more Intro topics.  Thank you.

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Gridley

Snowyowl,

 

Do not be tempted to CT.  You will not be "taking your lumps all at once."   Going off AD's doesn't work that way.  If you CT,  you will be increasing the severity of your withdrawal symptoms and the length of time it takes you to recover.  Please read the following link which explains why it is so important to taper slowly:

 

Brain Remodelling

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Snowyowl16

My initial goal is to get my dose down to 10 mg which I have tolerated in the past. The 20 mg is just too much for me. This nausea I think really started when I went on venlafaxine then stopped ct  and switched to citalopram. It is hard for me to tell if it is the drug itself or withdrawal as I have had the nausea all along on and off, especially in stressful situations. 

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Snowyowl16

Thanks chessiecat, I didn't realize..

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Gridley

I know you want to get down to 10mg, but do it slowly.

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Snowyowl16

Yes. Thanks, I will hold for 2 more weeks then go to 16.2 mg. I saw my Dr the other day and she suggested reducing every 2 weeks. I don't feel I am ready to reduce yet especially given my horrible weekend. I have always been super sensitive to medications responding to very small doses. This 20mg dose is way too much for me. My symptom of choice seems to be nausea.😕

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Gridley

Good plan, Snowy.

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Frogie
28 minutes ago, Snowyowl16 said:

Yes. Thanks, I will hold for 2 more weeks then go to 16.2 mg. I saw my Dr the other day and she suggested reducing every 2 weeks. I don't feel I am ready to reduce yet especially given my horrible weekend. I have always been super sensitive to medications responding to very small doses. This 20mg dose is way too much for me. My symptom of choice seems to be nausea.😕

I get a lot of nausea. It's not fun. I hope you feel better soon.

 

Take care,

Frogie xx

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Snowyowl16

Thanks frogie. It is horrible. I am having difficulty working

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Frogie
8 minutes ago, Snowyowl16 said:

Thanks frogie. It is horrible. I am having difficulty working

I don't work thank goodness. I don't think I could. There is this over the counter stuff called Nauzene that helps. You chew it. My dr has given me Phenergran and Zofran but I only take it when it's unbearable maybe 1-2 times a month if that.

 

But try the Nauzene. You can get it at Walmart. 

 

Hope it helps.

 

Take care,

Frogie xx

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Snowyowl16

I will try nauzene, thanks. I took the zofran today as I had to work. I don't like to take it either though. I am going on vacation in a couple of weeks and will have to fly. I am already in a panic about it. I will take the zofran, xanax and Zantac for that and hope I can get through it. I am determined to keep living my life though! I really appreciate the support.

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Snowyowl16

I guess my question is, by re instating at 18 mg after 2 weeks at 15 mg am I having these symptoms because I am over sensitized? Wouldn't it make sense then to decrease my dose?

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Frogie
19 minutes ago, Snowyowl16 said:

I will try nauzene, thanks. I took the zofran today as I had to work. I don't like to take it either though. I am going on vacation in a couple of weeks and will have to fly. I am already in a panic about it. I will take the zofran, xanax and Zantac for that and hope I can get through it. I am determined to keep living my life though! I really appreciate the support.

You are welcome. I have a really hard time just leaving the house right now. I couldn't fly.

 

I just tried to taper my Xanax per my dr and it was a nightmare. I made it 3 days and got really sick, so I'm back up to my normal dose.

 

Do you take Xanax regularly? I do 1mg 3 times a day.

 

Have fun on your trip!

 

Take care,

Frogie xx

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Snowyowl16

I just take the xanax if needed, rarely. I am trying not to take it too much.

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Frogie
1 minute ago, Snowyowl16 said:

I just take the xanax if needed, rarely. I am trying not to take it too much.

Lucky you. I'm addicted to it and one more thing to taper off of. Like I said the dr wanted me to start tapering off of it and I lasted 3 days and got really sick. I'm not looking forward to it at all.

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Snowyowl16

I am sorry frogie. I hope you find some relief soon. 

 

 

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Frogie
12 minutes ago, Snowyowl16 said:

I am sorry frogie. I hope you find some relief soon. 

 

 

Thanks I hope you do too.

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Snowyowl16

So I have been nauseous and anxious for 4 days now. I am in to week 3 of my citalopram taper to 18 mg. Am I sensitized because I reinstated after 2 weeks on 15 mg? When it is time for my dose it makes me feel even more nauseous.

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Gridley

Sometimes it can take a while to stabilize after a reinstatement.  Don't make any changes until you feel better.

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Snowyowl16

I am on day 4 of nausea and anxiety. I am in to my 3rd week of tapering at 18 mg of citalopram. It is worse than ever. It seems that anything slightly different from my normal routine causes this really sick feeling. Am I sensitized because I reinstated at 18 mg after a 2 week taper of 15 mg? I am at my wits end and having difficulty functioning. I have just accepted a new job. Anyone find relief from this kind of thing with CBT? My doctor has referred me.

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Snowyowl16

Thank you Chessiecat. I read that symptoms don't have to necessarily be gone to taper. I will wait the full 4 weeks then if not completely gone reduce by 5%, because I do feel this nausea is caused as much by too much drug as by withdrawal. Does that make sense?

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Snowyowl16

I feel like I am making my symptoms worse. If I don't think about my nausea, anxiety, heart beating like a drum it goes away or at least fades in to the background if I stay busy. The minute I stop and think; I actually feel ok and do a check of symptoms they come rushing back. How do I stop this cycle? I have listened to a few videos from Dr Claire Weekes which were excellent and have bought one of her books. Anyone else have this problem?

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ChessieCat
Snowyowl16

Thanks so much Chessiecat.  I spent hours on the links last night and only got through a few of them. I am working on the mindfulness meditations on the U MASS site now. Again..I am just blown away by the wealth of great information on this site. Thank thank you☺

And the great moderators and supportive members too!

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