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joy2730: withdrawing from citalopram

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joy2730   
joy2730

just wanted to tell everyone that I have found this easier than anticipated but have been taking ibuprofen and paracetamol regularly to help with the symptoms, especially headaches and have found this really helps, also exercise.  I used this method when withdrawing from diazepam several yrs ago and it worked well then.  I am now down to 7.5 mg citalopram in the morning and am going to do this very slowly because from previous experience this is the only way. 

 

By the way, after every psychiatric drug I have stopped using I have discovered it never helped anyway.

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Petunia   
Petunia

Hi joy2730,

Welcome to SA and thank you for posting. It sounds like you are doing well by taking it very slowly, this is what we find works best and usually recommend tapering by 10% every month.  What method are you using?

 

How long have you been taking citalopram for and what dose did you start with?

 

Here are our tips for tapering off citalopram if you are looking for any help:

 

http://survivingantidepressants.org/index.php?/topic/2023-tips-for-tapering-off-celexa-citalopram/

 

You will find a lot of friendly help and support here.

 

Petu.

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joy2730   
joy2730

I have taken citalopram for 4 yrs, prior to that I took dothiepin for over 30 yrs and found that very difficult to withdraw from.  I got down from 225mg dothiepin to 50mg over a few yrs but never got any further; eventually the GP decided that dothiepin had a heart risk and so everyone had to change to something else, which is how I got citalopram.

 

I started on 20mg but it didn't touch the depression, but 30mg did.

 

Recently I have felt much better in myself and have taken quite a responsible job and want to manage without psychiatric pills altogether.  I cut down from 30 mg to 25 mg in about 2 weeks, then 25 to 20, then 15, 12.5 etc down to 7.5 mg.  I have been using a few millilitres of liquid Prozac as a cushion now and then but am not going to do that anymore as I have been reading that Prozac is quite a different drug in some respects.

 

Withdrawal from dothiepin was HORRIBLE, I felt ice cold and wore thermal underwear for a long time, a very runny nose and severe mood swings, so far my withdrawal from citalopram has been much easier.

 

Dothiepin is a tricyclic antidepressant, a bit similar to amitriptyline, these newer antidepressants are much better drugs, in my opinion.

 

I feel the doctors and to a large extent, my family, have encouraged me to stay on meds needlessly without any thought to how they might be affecting my quality of life.

 

I think the latter stages of withdrawal are always tougher and will keep this site posted as patients are empowered by knowledge.  The internet is the best thing that ever happened to me, without it I would probably still be taking lithium, diazepam and epilim.  How sad is that.

 

 

 

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mammaP   
mammaP

Hi Joy, I would hold at the 7.5 of citalopram for a while to allow your brain and nervous system to settle

down.  Sadly withdrawal from SSRIs can be every bit as bad as from tricyclics and even worse because 

weeks or even months after quitting , either cold turkey or tapering too fast , withdrawal can hit  when you

think you are over it and feeling great! Petu has given you a link to tapering citalopram, here is one on

why we advise tapering at 10% reductions.   http://survivingantidepressants.org/index.php?/topic/1024-why-taper-by-10-of-my-dosage/

 

You are right to taper but I feel that because you have had a few psych meds in the past you could be

affected quite badly by withdrawal from tapering too fast.  Tapering the last few mgs slowly you can avoid

horrific withdrawal symptoms.  Many of us are here because we tapered too fast while believing we were doing

it right! Sadly doctors don't have a clue and often advise tapers that lead patients going back on because of 'relapse'

that is actually withdrawal.

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Skylarblue75   
Skylarblue75

Hi joy, wanted to say hi and welcome

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joy2730   
joy2730

Just want everyone to know I have been taking only 5 mg citalopram for about a week now and have suffered no withdrawal symptoms whatsoever, I really can't believe this.  I am going to hold at this for a few more days, and then cut the 5 mg into 2.5 mg, I really don't know what is going on but it is very good.  Perhaps the citalopram was never doing anything in me at all.

 

 

 

Take care everyone, and nobody be afraid to taper, because you might have a pleasant surprise.

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Karma   
Karma

Joy

 

I am happy to hear that you are feeling well during your taper, but I want to caution you that what you are doing is considered a rapid taper by our standards.  We recommend no more than a 10% reduction of your previous dose and to hold that for at least month to allow your brain time to remodel.

 

If I understand correctly you've only been on the site 8 days and you have already decremented by 33%.  The trouble with these drugs is that withdrawals may not show up immediately.  They often show up after a few months.  If you taper too rapidly and get into withdrawals after a few months, then it can be difficult to recover from.that.

 

Some people can discontinue these drugs rapidly and appear to do fine, but the trouble is that you don't know if you are that lucky person when you start out.  By the time you find out you are not that lucky person you may be at a point where there is nothing anyone can recommend except to give it time and ride it out.  We don't want to see you in that situation. 

 

Given your past difficulty with tapering off of a different class of drug, my best advise is to slow down your taper.  Give your current dose at least 30 days and monitor your symptoms.  If you find that you start to experience anxiety, insomnia, tinnitus, or depression you may need to up-dose.  If you do ok, then decrement by just 10% of your current dose.

 

Slow and steady wins the race.

 

Karma

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Rhiannon   
Rhiannon

Agree with Karma and others--you're going too fast for someone with your history. Please stop and hold for a while and then take the rest of the taper at 10% cuts. 

 

You haven't had time for withdrawal to even catch up with you, going this fast. It will.

 

We're not making this stuff up, we've worked with hundreds of people. I personally have never seen anyone with a complicated med history like yours and a previous history of withdrawal syndrome off another psych med be successful with this kind of really rapid taper at low doses. Those low doses are deceptive, you actually need to go slower at the lowest doses rather than faster.

 

The charts with this paper (starting page 4) show you why: http://survivingantidepressants.org/index.php?/topic/6036-why-taper-paper-demonstrates-importance-of-gradual-change-in-plasma-concentration/

 

Really not trying to rain on your parade, I just don't want to see you three to six months down the road coming back here in agony saying "I should have listened to you guys!" (It happens all the time and we get NO satisfaction from it.)

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joy2730   
joy2730

Thank you everyone for your concerns, I am sure you are all correct, I, too, am exceedingly surprised at this outcome, so I will slow down and let you all know how I am getting on.  This is the first time I have tried to taper citalopram and have no experience of it, so I welcome all your comments. 

 

I am grateful for all the input, after all, I must have concerns otherwise I wouldn't be on this site.

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Rhiannon   
Rhiannon

I'd say hold for about a month and see if any delayed withdrawal shows up. If you're still feeling just fine after a month then you may be able to go faster, keeping in mind that at lower doses you have to make smaller cuts. (Your cuts need to be based on a percentage of your current dose.)

 

I'd say if you're still feeling fine and not having withdrawal symptoms after a month, try a 0.5 mg cut (10%) and wait two weeks and if you still have no symptoms you can probably go down at a faster pace than we usually recommend. I'd say still make the 10% cuts but you might be able to make a cut every two weeks instead of four, if you continue to enjoy a smooth course.

 

But given how we've seen the "lag time" effect catch up with people tapering rapidly, I'd highly recommend just holding right where you are for a month to make sure you're okay. You've come a really long way and there's no point in rushing things only to crash and burn! 

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joy2730   
joy2730

Just replying to everyone's advice.  I have had a few hrs of anxiety two days ago, so shaved a bit extra off a spare pill and that smoothed things over, but still doing really well.  So grateful to people for bothering to post, the is a really good place for support.

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joy2730   
joy2730

Update

 

I have, as other members have been suggesting, been tapering too quickly and feel absolutely rotten by now.  Splitting headaches, tight throat, loss of appetite, sick and just wanting to go to bed for ever. 

 

So I am now trying to re instate some citalopram and then stabilise and then try again.

 

Slow and steady I should have done.

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dalsaan   
dalsaan

Sorry to hear about the wd symptoms. What dose are you reinstating to Joy? And how are you measuring it? Our systems like consistency and stability

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joy2730   
joy2730

I have gone back to 5mg citalopram, instead of 2.5 and the symptoms have eased straight away, I got a reasonable night's sleep last night.  This morning at work the sweat just ran off my back, but the headaches have eased and I don't feel as sick.

 

I am cutting my 10 mg tablets in half using either a veg knife or a pill cutter.  To be honest the veg knife is more accurate.

 

I think I am going to be alright on the 5 mg for ages now, but will keep posting because it is important that others see how going too fast can cause symptoms and then going back up can help. 

 

I really appreciate the help given here, it gives me the confidence to carry on.  The withdrawal symptoms were like a really bad flu, but my mood is far from depressed, in fact I feel happier!

 

Thanks everyone!

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joy2730   
joy2730

A further update this morning, back on 5mg citalopram and slept really well last night, and my really bad headache has gone and my appetite has returned.  So by increasing from 2.5 mg back up to 5mg I have stopped the withdrawal symptoms successfully and am go now going to stabilise.

 

Just posting this to show going back up has worked for me, to gives others encouragement.

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mammaP   
mammaP

Hi Joy, thank you for updating us. I'm so glad that updosing has worked for you. :) 

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Rhiannon   
Rhiannon

Joy, glad to hear the reinstatement is working for you.

 

Since you're going to be hanging out at that dose for a while, you have some time to figure out how you want to approach the rest of your taper. I'd recommend either getting the prescription liquid or making your own liquid. It's really easier than it sounds, and I think the Tapering section has all the info you need about how to do either of those things.

 

If you don't want to use liquid, you can work with a milligram scale. One or the other; just "eyeballing" cuts lower than half a tablet produces too much variation in dosage.

 

I'm so glad you stopped at 2.5 and were able to catch it in time and go back up, and get relief! And thanks for continuing to post, because you're right, people do read these threads and learn from them. And we are all still learning here.

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Altostrata   
Altostrata

Good to hear, joy.

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joy2730   
joy2730

Further update, still doing well on 5mg citalopram daily which I am going to stick at for ages now to make sure that I have caught up with any previous dose reductions, which I somehow managed to do quite rapidly.

 

I feel really well, except for one thing, I feel really sweaty and at times the sweat actually runs down my back.  This is the direct opposite of when I withdrew from a tricyclic, dothiepin, when my back was ice cold all the time.

 

I once read somewhere that withdrawal symptoms should be viewed as welcome, because they are proof the drug is coming out of your body and mind!

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Altostrata   
Altostrata

Temperature dysregulation and sweating are very common withdrawal symptoms. This should gradually go away.

 

Withdrawal symptoms are a red flag that your nervous system is feeling a lot of stress. Their fading is a good sign.

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joy2730   
joy2730

Thank you Altostrata for your reply to my sweating issues.  It is just such a comfort to see it in print that it is a recognised withdrawal symptom.  A trip to the GP for reassurance would no doubt result in a reinstatement of the prescription, which  is  so sad when you realise that all that is needed is a little knowledge and reassurance that it is common.

 

I will keep posting to say when the overheating starts to fade (currently holding at 5 mg), so that others can have a rough guideline from my experience. 

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Altostrata   
Altostrata

Thank you, joy. That kind of information is very important for others in the same situation.

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joy2730   
joy2730

Just need a bit of advice, before reducing from 5mg to 4mg in about a months time I need to consider how to do it, is making a water liquid easier and more accurate than scales, Amazon are reporting some of the cheaper scales may be inaccurate, also I will have no use of the scales once I am off citalopram, but does the citalopram dissolve fully in the water and presumably u must have to shake theliquid before using oral syringe, and use the syringe to draw solution IMMEDIATELY.

 

Got to go to work, any advice most welcome!

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bubble   
bubble
Hi Joy,
 
I was actually concerned about what you wrote on Missindy's thread below since it seemed as if you were again going to cut down from 5 to 2.5 mg. 

To answer your question re tapering, I just cut tablets up with a veg knife until I got to 2.5 mg, ie quarter of a 10mg pill, however I am now back on 5 mg due to withdrawal symptoms.

 

~When I next reduce, I will still cut to 2.5 mg, but then will have a go at making a water liquid solution. 

 

 

So I'm glad you are only planning a much smaller cut but not sooner than in 30 days (and possibly even after that time). Still, going from 5 to 4 mg is more than 10 % that we recommend. But you still have time for that.

 

Here is our thread on tapering citalopram. Citalopram comes in liquid form and the posts there explain the dosing: http://survivingantidepressants.org/index.php?/topic/2023-tips-for-tapering-off-celexa-citalopram/

 

So it means you don't have to make your own solution but if you decide to do that there are also tips on how to make your own solution from tablets. 

 

What would be very helpful for us when giving advice and for you when you look back at your tapering is to enter more detail in your drug history in your signature. In that way we will see where you are every time you post without having to go back in your thread. At the moment I can't see from your signature what dose of Citalopram you are taking at the moment, what was your original dose, when you made a cut and how much, when you reinstated...

 

so when you find the time, this information will be very helpful.

 

take care,

bubble

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joy2730   
joy2730

IMPORTANT POST FROM MY BED  Yesterday I got ill all of a sudden, GI distress, anxiety attacks, dizziness, headaches,the lot, I only just managed to get to my GP, and he was brilliant.  I hadn't told my doctors I was giving up antidepressants as they have criticised me a lot for wanting to give my lithium and valproate up.  Anything he diagnosed withdrawal immediately and gave me an emergency supply of diazepam to help.  24 hrs later and I am feeling a lot better.  He said I had done it much too quickly and to go back to my original dose and when it had all settled in about 2 or 3 weeks to get back in touch so they can supervise another taper.

 

#So I am now taking 30 mg citalopram again, and things are settling, but should I be actually taking 25 or 20?  I actually said to my GP I have made a balls up of this haven't I and he said that withdrawal symptoms are delayed and now I was getting them all at once. 

Any ideas anyone on what dose I should take now.  A least GP was up to speed.  I feel such a fool, but my mood is still really good.

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Altostrata   
Altostrata

Since you've been taking a low dose, I would see if perhaps 10mg would do the trick.

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Petunia   
Petunia
...he diagnosed withdrawal immediately and gave me an emergency supply of diazepam to help.  24 hrs later and I am feeling a lot better.

 

Did you take the diazepam?  Its not a good idea to use a benzo to relieve the symptoms of antidepressant withdrawal.  If you take it irregularly, it can cause rebound anxiety, leading to further destabilization.  If you take it regularly, dependance may occur and then it will also need to be tapered.

 

Its better if you can ride out the withdrawal symptoms until the reinstatement starts to work.  Here is some information about reinstatement so you can read about what to expect:

 

http://survivinganti...rawal-symptoms/

 

Here is the link to our symptoms and self care section, you may find some useful non-drug ideas to help manage symptoms in the mean time.  Especially read the topics pinned at the top.

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joy2730   
joy2730

Thank you for my replies.  Today I only took 20mg citalopram because I have realised I must try to come out of this as best as I can.  I only took the diazepam very briefly, because I once did a diazepam taper myself that was quite difficult.  Tomorrow I am going to do 10 mg citalopram as I had been doing very well on low doses.

 

I will keep everyone informed.  Thks so much.

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Petunia   
Petunia

As Alto wrote, you will probably do better on 10mg.  For most drugs, it takes about 4 days for the change to fully register in your system, so don't keep changing your dose.

 

2.b. Do not expect to feel better immediately. There are no silver bullets for withdrawal syndrome. There is no pill of any kind that will immediately put you back to normal. If you make a good change, the effect is likely to be slight at first. Be patient. Read this: What is withdrawal syndrome?
 
2.c. Do not jump around in dosage. For most drugs, it takes about 4 days for the change to fully register in your system. Unless you have an IMMEDIATE bad reaction, wait at least 4-7 days to see how the change affects you. (If you have an immediate bad reaction, go back to the dosage you were taking before.)

 

Keep it simple. Keep it slow. Keep it stable

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joy2730   
joy2730

I have taken your advice and am now taking 10 mg of citalopram, all my previous horrible sudden withdrawal symptoms have gone and I feel fine.  They were so severe they confined me to my bed for 2 days, I have learnt so much from this site, thanks so much, I will keep you all posted.

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joy2730   
joy2730

Just to let anyone following my story know that for the last few days I have been taking 20mg citalopram, rather than 10mg because I was getting some sweating and nausea, especially first thing in the morning, and didn't want to start the diazepam, knowing where that can lead, but I am feeling more drugged on the 20mg.

 

GPs say these drugs do not cause cognition difficulties, but I disagree.

 

Anyway, it is one week since my severe withdrawal symptoms and have survived and now have a lot more experience and knowledge, although I resent having had 2 days off work which were not really due to ill health in the true sense.

 

Take care all

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Altostrata   
Altostrata

joy, please drop by occasionally and let us know how you're doing.

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joy2730   
joy2730

Update on 14/9/14

I have tried to stabilise on 10mg but still felt nauseous and sweaty and as I don't want any more days off work I decided to stabilise at 20mg.  My GP wanted me to go back to the full 30mg, but thankfully I have not had to do that. 

 

My work involves me caring for people with severe dementia on a 24 hr live in basis for 3 days at a time, so I need to be fit both mentally and physically.

 

I have now bought some digital milligram scales, but they are showing .002 out in accuracy and I am a bit confused how to use them. 

 

When I have recovered from the shock of withdrawal symptoms I am going to start again, but much more cautiously this time, no big drops in dosage and longer gaps between reductions.  I HAVE LIVED AND LEARNT.

 

Interestingly I had no mood problems withdrawal, just physical ones, in fact I even felt reasonably well through the withdrawal symptoms.

 

I am so glad I have got rid of my lithium and epilim, and have reduced citalopram from 30 mg to 20 mg, if I wasn't working I would be considering reducing again now, but we all have to live in the real world and maintaining my employment, which I really enjoy, and is in a way, like an antidepressant to me in itself, is very important.

 

I will keep u all informed.

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joy2730   
joy2730

Updating, I tried to take 15mg citalopram but was getting some withdrawal symptoms back, so have now gone back to 20mg, which is still not the original dose of 30mg and think I will have to make do with that for the time being.

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