JuliusVernon: Struggling with no drugs

[JuliusVernon]

I recently weaned off of Citalopram after 14 years of use. Based on what I've read here it was an aggressive weaning. I was at 40mg, went to 20 mg for 4 weeks, 10 mg for 10 weeks, 5 mg for 8 weeks. This was under the direction of a general practice physician. I have now been off for 7 weeks. I am past physical withdrawal symptoms of head buzzing, etc. but I am really struggling emotionally. Lots of crying, everything tinged with darkness, anxiety, near panic. I want to be normal. I want to be happy again. I only got off the drugs to remove dependency, sick of buzzes if I missed a pill, felt like I had lost a mental edge I had prior to the drug.

 

I need help, I have a psychiatrist appt in 4 weeks. I see a therapist, but need expertise with these drugs.

 

Should I resume the drugs? St. John's Wort? Anything else?

 

Is there a quick fix? Do I just tough it out?

[mammaP]

Hi JuliusVernion, welcome to SA.  Sadly you are right, your taper was rather aggressive but you are niot the only oine who has arrived here in withdrawal after tapering too fast. It is how I came here too!  There is only one way to stop withdrawal and that is reinstating the drug that was stopped. Many of our members have had success by reinstating a very tiny dose of the drug. Even a dose as small as 1mg could help.  Citalopram is available in a liquid, or you can make a liquid yourself from tablets.  If 1mg does nothing to help you can titrate up gradually, but if it makes things worse stop immediately. If such a small dose helps it is less to taper later. It will still need to be tapered even though it is so small.  It takes a few days to get a steady level in the blood, so be patient for a few days and don't be tempted to jump straight up in dose. Often when someone has been off for a while they cannot tolerate the same doses and can react badly. This is harm reduction, a tiny dose is less likely to have adverse effects and can be increased if needed. If a reaction happens at a higher dose it can take quite a long time to recover. 

 

About reinstating

https://www.survivingantidepressants.org/index.php?/topic/7562-about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms/

 

About withdrawal syndrome

https://www.survivingantidepressants.org/index.php?/topic/603-what-is-withdrawal-syndrome/

 

Tapering citalopram. This will tell you how to get the low dose.

https://www.survivingantidepressants.org/index.php?/topic/2023-tips-for-tapering-off-celexa-citalopram/page__pid__19887#entry19887

 

Let us know what you decide to do and how you are. 

[JuliusVernon]

Thank you so much for the reply. So starting yesterday I began taking 300mg of St John's Wort. I would like to know if beginning a reinstatement while taking St John's Wort is advisable.

 

I will continue to check this to make sure I approach this correctly.

 

Are there concerns that I've caused permanent harm via the abrupt taper?

[ChessieCat]

Hi JV and welcome from me too.

 

Taking SJW and an AD is not a good idea. It would be better to stop taking the SJW and reinstate the original drug.  Changing drug can make it difficult to work out where your issues are coming from.  The only know way to reduce withdrawal symptoms is to take a small amount of the drug you have stopped.

 

Because you only started the SJW yesterday it should be okay to just stop that and take the citalopram.  Please note what mammaP wrote:

 

30 minutes ago, mammaP said:

If 1mg does nothing to help you can titrate up gradually, but if it makes things worse stop immediately. If such a small dose helps it is less to taper later. It will still need to be tapered even though it is so small.  It takes a few days to get a steady level in the blood, so be patient for a few days and don't be tempted to jump straight up in dose. Often when someone has been off for a while they cannot tolerate the same doses and can react badly. This is harm reduction, a tiny dose is less likely to have adverse effects and can be increased if needed. If a reaction happens at a higher dose it can take quite a long time to recover. 

 

[JuliusVernon]

How do I go about making a liquid? I have loads of pills, but I'm not sure how to get such a small dose.

 

 

[ChessieCat]

Making a Celexa solution yourself
See http://survivingantidepressants.org/index.php?/topic/2022-making-a-celexa-solution-yourself

[ChessieCat]

The second post in the above link says she changed to dissolving in water.

[JuliusVernon]

Thank you, this is very helpful. Are there any concerns of a dissolved pill not being mixed uniformly and resulting in inaccurate dosages?

 

 

[JuliusVernon]

I've dissolved 20 mg of Citalopram in 20 mL of distilled water. I will plan on taking 1mL tonight unless I receive further advice here.

 

Thank you each for your help, just your kindness and support has begun to improve my mood tremendously. This site is an answer to prayers.

[ChessieCat]

1 hour ago, JuliusVernon said:

Are there any concerns of a dissolved pill not being mixed uniformly and resulting in inaccurate dosages?

 

Other members have been using this method.  Just make sure you stir/shake just before measuring.  And always use the same method and tools.  It's a good idea to write notes about your "recipe" just in case you have a brain freeze, which everyone has occasionally.

[JuliusVernon]

Good call! Will do.

[ChessieCat]

SA recommends keeping notes on paper of when you take your drug and your symptoms throughout the day.  This can help to identify if reinstatement is working and/or if your dose needs to be increased by a small amount.

 

It takes about 4 days for the dose to get to a steady level in the blood so it is important to try and stay as calm as possible and not panic.  The brain likes consistency and jumping around in dose can cause problems.  Also remember that you took the SJW.

[JuliusVernon]

Got my notebook ready!

[JuliusVernon]

I took 1mg of Citalopram last night. I'll keep posting here over the next few days if I notice a change. 

[JuliusVernon]

I took 1mg of Citalopram on each of July 29, 30, 31. In addition, since these issues have arisen I have not been sleeping well, so I took a sleep aid on the 29th and 30th. I was feeling some relief on the 30th and 31st. Today is starting off rough, I think it could be connected to not sleeping well. I chose not to take the sleep aid last night because I'm worried about my body building up a tolerance and I won't have that option to turn to. 

 

I plan to continue with the 1mg reinstatement, but when should I consider going to 2mg or more? 

[JuliusVernon]

I've now taken the 1mg of Citalopram for 5 straight nights. I have seen some relief. (Not sure how much is attributable to better sleep or to the drug). Should I consider going to 2mg? 

 

What factors should I be watching for to make that determination?

 

 

[ChessieCat]

The fact that you have had some relief is a good sign.  Taking the sleep aid has, however, muddied the waters, and it makes it difficult to know if it was getting sleep or the reinstatement which has helped.  It is best to only make 1 change at a time.

 

It takes about 4 days for a dose to get to full level in the blood and a bit longer for it to register in the brain.  It would probably be better to wait for at least 2 weeks before considering updosing.  Please note that the idea of reinstatement isn't to get rid of withdrawal symptoms completely but to bring them to a bearable level.  The question I ask myself is:  Can I live with the symptom/s?  If I can, I stay on the dose.  If not, I have updosed by a very small amount.

 

Increasing to 2mg would by a 100% increase.  You might find that an amount as small 0.125mg might be enough IF after 2 weeks the withdrawal symptoms are unbearable.  It is better to increase by tiny amounts than to risk taking too much and causing destabilisation.