Lolabella: Severe debilitating headache when withdrawing

[Lolabella]

Hi, I am 6 weeks into withdrawing from citalopram 20mg. I have taken it for 20 years. I initially halved the dose to 10mg for 4 weeks then 10mg every other day for 3 weeks now.  I am experiencing severe, debilitating headache on an almost permanent basis. I think I've reduced the dose too quickly. After reading this site, I am thinking about reinstating 10mg daily. I see my doctor tomorrow. Any advice gratefully received. I feel terrible.

[ChessieCat]

Hi Lolabella and welcome to SA,

 

I am really pleased that you joined SA before seeing your doctor.

 

SA recommends tapering by no more than 10% of the previous dose followed by a hold at that dose for about 4 weeks to allow the brain to adapt to not getting as much of the drug.  This is because psychiatric drugs create a physiological dependence, not physical like caffeine or nicotine.

 

Skipping days is NOT recommended.  The brain likes consistency.  Skipping Days vs Every Day Dosing Graph  It is important to take the same dose at about the same time EVERY DAY.  Tips for tapering off Celexa (citalopram) explains how you can get the dose you need.

 

The headaches may be being caused because of the inconsistent dosing which means you are experiencing interdose withdrawal.    Instead of increasing your dose you could try taking 3.5mg EVERY DAY and see if things improve.  If after 1.5-2 weeks you find that things are still unbearable we could suggest a small increase amount.  Please DO NOT start taking 10mg every day because this will probably be too much for the brain.

 

Before you see your doctor please read these:

 

How do you talk to a doctor about tapering and withdrawal?

What should I expect from my doctor about withdrawal symptoms?

 

I wanted to give you the important information first.  Please see my next post for further information.

 

Edited February 27, 2018 by ChessieCat

[ChessieCat]

We ask all members to create a drug signature.  This appears below every post you make.  Please update it whenever you make a change.  This is the preferred format which makes it easier for us to see your drug history at a glance:

 

A request: Would you summarize your history in a signature - ALL drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly?

• Please leave out symptoms and diagnoses.
• A list is easier to understand than one or multiple paragraphs. 

• 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.
• Link to Account Settings – Create or Edit a signature.

 

And here is some more information which you can read when you have time.  I know it can be a bit overwhelming but just go through them one at a time as you are able.

 

Why taper by 10% of my dosage?

 

Dr Joseph Glenmullen's Withdrawal Symptoms

 

Windows and Waves Pattern of Stabilization

 

Brain Remodelling

Video:  Healing From Antidepressants - Patterns of Recovery

 

Keep it Simple, Slow and Stable

Keep Notes on Paper

 

Rate Symptoms Daily to Check Patterns and Progress

 

It is best to make only 1 change at a time.  It is also better not to start taking a complex vitamin because if you experience issues you will not know what exactly is causing it.  B vitamins can be stimulating especially B6.  hypersensitive-to-b-vitamin-or-b-vitamin-complex  If trying anything new, start with a small amount to see how you react and build up to the recommended amount.  The only supplements which SA recommends are Magnesium and Omega-3 Fish Oil.  Try a small amount one at a time to see how you react.

 

Even with a careful and slow taper you will most likely experience times of discomfort.  It is best to learn and use Non-drug techniques to cope

 

As a word of encouragement, I had been on an AD for 25 years and joined SA 2.5 years ago, after experiencing 3 weeks of bad cog fog when I reduced from 100mg Pristiq to 50mg.  I have following SA's tapering protocol and have managed to reduce from 100mg Pristiq to 12mg in that time.  I have only suffered minor withdrawal symptoms.  I am working 3 days per week.

 

There are many existing topics and discussions on this site.  You can use the site search function at the top right, or use a search engine and include survivingantidepressants.org in your search string.

 

As I said, lots of information, but I really want you to have what you need so you can have a successful taper.

 

This is your own Intro topic where you can ask questions and journal your progress.  We suggest that members visit each others Intro topics so that can support and encourage each other.

[Lolabella]

Thank you very much for your reply. I feel much more informed now and I know I really underestimated how reducing Citalopram would feel. 

I saw my Dr yesterday and he confirmed that I had reduced too quickly and by too much. He gave me a management plan to follow. 

My head has improved today. Its certainly not as debilitating when is great after trying to cope with it for 3 weeks.

This site really helped me understand the importance of tapering slowly.

Thank you

[ChessieCat]

3 hours ago, Lolabella said:

I saw my Dr yesterday and he confirmed that I had reduced too quickly and by too much. He gave me a management plan to follow. 

 

You are very fortunate that you doctor recognises your too quick discontinuation.

 

Please tell us what his management plan is so that we can assess it.  He may still be wanting you to reduce too quickly.

[ChessieCat]

Are you started taking your dose EVERY DAY?

[Lolabella]

I am indeed. I cant believe how much my symptoms have reduced in 2 days. I feel so much better and now know how to taper safely. 

Thanks for your support 

[Lolabella]

The management plan that he suggested was 10mg daily for at least 1 month (I'm thinking 2 months personally). When I feel that I want to reduce further after that reduce to 7.5mg for at least another month. Then reduce by 2.5 each time until I finish. He wants me to see him when I feel I'm ready to reduce each time.

Thanks for your support x

[ChessieCat]

On 28/02/2018 at 10:08 AM, ChessieCat said:

Instead of increasing your dose you could try taking 3.5mg EVERY DAY and see if things improve.

 

This was what I suggested.  Taking 10mg every day may be too much.

 

1 minute ago, Lolabella said:

reduce to 7.5mg

 

This is a 25% decrease.  SA recommends reducing by no more than 10% of the previous dose.  This would be 9mg.

 

Tapering by 10% of the previous dose means that the doses get smaller each reduction.  So the next reduction would be 8.1mg.  Many members find that the lower their dose gets the slower they need to go, either by reducing the amount they reduce by or by holding for longer, or both.  Why taper paper: dose-occupancy curves

 

I am currently on 12mg Pristiq and following the 10% reduction of previous dose every four weeks will see me at a 1mg at the end of 2019.  I am very concerned that about the advice your doctor has given you.

 

I suggest before you follow your doctor's tapering plan that you read the information that has been provided in the above post so that you can make an informed decision.