puthappinessfirst: starting the fight

[puthappinessfirst]

Hello! I live in California and am a 27 year old female. 

 

I had been on Celexa 10mg since I was around 15 years old for anxiety. I quite cold turkey (stupid me, I know, but I never heard or knew about the side effects of withdrawal/detox) in June or July of 2018. I actually had no symptoms for 4 months, I felt really good. I got more active and outgoing. On Thanksgiving I had a panic attack that I managed to get over after a full couple days, so I decided to re-start my Celexa. 2 weeks back on my Celexa... December came and I was sitting at my desk, doing some work, I felt a wave of depression wash over me like nothing I have ever experienced before. I felt impending doom, hopelessness, sadness. It felt like I was being sucked into a black hole. I couldn't function. I stayed home from work for 2 weeks.

 

During that time I went crawling in hopelessness to my general doctor and she said that maybe Celexa just wasn't working for me anymore. Which, in hindsight, doesn't make sense since I had only been back on for 2 weeks. So she switched me to Lexapro at 10mg. I took my dose diligently and for the first couple weeks I felt my mood lift, but the body jolts and insomnia and dilated pupils were scary. Then come the most recent few weeks. My anxiety has spiked to unimaginable levels which has spiked hyper-vigilance (is that shadow a shadow? did you hear that?), terrible bouts of OCD, akathisia, and the insomnia has persisted. After about 5 weeks at 10mg of Lexapro I thought, wow, screw this, and messaged my doc. She told me to start cutting my pills in half and taper for a week. I cut my pills in half for a couple days then switched back to my 10mg of Celexa because Lexapro is obviously messing up my CNS and my overall health. 

 

So here I am, on Celexa 10mg after some back and forth but I am determined to taper, but it is intimidating. I have been on this med for SO LONG, I don't know how long I should taper. I see the doctor next week and am going to ask for liquid Celexa so I can taper. I will also be asking for taper advice, but this forum has been a great insight. Anyone have any insight on tapering after years and years of use? 

[ChessieCat]

Hi puthappinessfirst and welcome to SA,

 

Not many medical professionals understand taping and withdrawal from psychiatric drugs, which is why this site exists.

 

Withdrawal symptoms can be delayed:  Withdrawal Symptoms - Delayed Onset

 

You will need to stabilise before you start tapering.  Once we have more details about your drug history we will be better able to offer suggestions about how long you should stay on your current dose.

 

SA recommends tapering by no more than 10% of the current dose followed by a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.  Why taper by 10% of my dosage?

 

When the drug is taken away too quickly we can get withdrawal symptoms:  Dr Joseph Glenmullen's Withdrawal Symptoms

 

Tips for tapering off Celexa (citalopram)

 

You might find it helpful to write a script and rehearse what you are going to say.  Be calm, gentle but assertive.  You are the customer, it is your body.  Use words like I'd like to try this.  If a suggestion is made that you don't want to follow, say I'd like to think about it before making a decision.

 

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

What should I expect from my doctor about withdrawal symptoms?

 

Please create your drug signature using the following format.   Keep it simple.  NO diagnoses or symptoms please - thank you.

• details for last 2 years - dates, ALL drugs, doses
• summary for older than 2 years - just years and drug/s

Account Settings – Create or Edit a signature

 

 

This is your own introductions topic where your can ask questions about your own situation and journal your progress.

 

 

Edited January 24, 2019 by ChessieCat

[ChessieCat]

Here's some additional information which might help you to understand what is happening:

 

Recovery isn't linear it happens in a Windows and Waves Pattern

 

Withdrawal Normal Description

When we take a psychiatric drug, we are adding chemical/s to the brain.  The brain then has to change to adapt to getting the chemical/s.  It might have to change something to do with A and then once that change has been made it affects B so another change has to be made and so on down the line.  It is a chain reaction, a domino effect.

 

The same thing happens when we take the drug away.  That's why it's possible to experience such a vast array of withdrawal symptoms, and they can change, and be of different intensity.

 

are-we-there-yet-how-long-is-withdrawal-going-to-take

 

These explain it really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

 

On 8/31/2011 at 5:28 AM, Rhiannon said:

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.

 

AND

 

On 12/4/2015 at 2:41 AM, apace41 said:

Basically- you have a building where the MAJOR steel structures are trying to be rebuilt at different times - ALL while people are coming and going in the building and attempting to work.

It would be like if the World Trade Center Towers hadn't completely fallen - but had crumbled inside in different places.. Imagine if you were trying to rebuild the tower - WHILE people were coming and going and trying to work in the building!  You'd have to set up a temporary elevator - but when you needed to fix part of that area, you'd have to tear down that elevator and set up a temporary elevator somewhere else. And so on. You'd have to build, work around, then tear down, then build again, then work around, then build... ALL while people are coming and going, ALL while the furniture is being replaced, ALL while the walls are getting repainted... ALL while life is going on INSIDE the building. No doubt it would be chaotic. That is EXACTLY what is happening with windows and waves.  The windows are where the body has "got it right" for a day or so - but then the building shifts and the brain works on something else - and it's chaos again while another temporary pathway is set up to reroute function until repairs are made.  

 

[ChessieCat]

During any taper, there will be times of discomfort.  We strongly encourage members to learn and use non drug coping techniques to help get through tough times.

 

Understanding what is happening helps us to not get caught up with the second fear, or fear of the fear.  This happens when we experience sensations in our body and because we don't understand them we are scared of them and then start to panic.

 

This document has a diagram of the body explaining what happens in the body when we become anxious:

 

https://www.getselfhelp.co.uk/docs/AnxietySelfHelp.pdf

 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help ...

 

Audio FEMALE VOICE:  First Aid for Panic (4 minutes)

 

Audio MALE VOICE:  First Aid for Panic (4 minutes)

 

Non-drug techniques to cope

 

dealing-with-emotional-spirals

 

Dr Claire Weekes suffered from anxiety and learned and taught ways of coping.  There are videos available on YouTube.

 

Claire Weekes' Method of Recovering from a Sensitized Nervous System

 

Audio:  How to Recover from Anxiety - Dr Claire Weekes

 

CBT Course:  An Introductory Self-Help Course in Cognitive Behaviour Therapy

 

Resources:  Centre for Clinical Interventions (PDF modules that you can work through, eg:  Depression, Distress Intolerance, Health Anxiety, Low Self-Esteem, Panic Attacks, Perfectionism, Procrastination, Social Anxiety, Worrying)

 

On 4/28/2017 at 4:03 AM, brassmonkey said:

 

AAF: Acknowledge, Accept, Float.  It's what you have to do when nothing else works, and can be a very powerful tool in coping with anxiety.  The neuroemotional anxiety many of us feel during WD is directly caused by the drugs and their chemical reactions in the brain.  Making it so there is nothing we can do about them.  They won't respond to other drugs, relaxation techniques and the like.  They do, however, react very well to being ignored.  That's the concept behind AAF.  Acknowledge, get to know the feeling involved, explore them.  Accept, These feelings are a part of you and they aren't going anywhere fast. Float, let the feeling float off as you get on with your life as best as you can.  It's a well documented fact that the more you feed in to anxiety the worse it gets.  What starts as generalized neuroemotinal anxiety can be easily blown into a full fledged panic attack just by thinking about it.

 

I often liken it to an unwanted house guest.  At first you talk to them, have conversations, communicate with them.  After a while you figure out that they aren't leaving and there is nothing you can do to get rid of them.  So you go on about your day, working around them until they get bored and leave.

 

It can take some practice, but AAF really does work.  I hope you give it a try.

 

 

[Gridley]

Welcome to SA, puthappinessfirst.  

 

ChessieCat has just responded to you.  I'm going to go ahead and post this for you for any additional information it may contain.

 

I have been on Lexapro for 15 years and have tapered from 20mg to 3.9 over a 2-year period (and have also tapered my Imipramine dose by 2/3 after 32 years' use.  So tapering off an antidepressant after long-term use is very do-able.  By the way Lexapro is a very strong drug, perhaps the strongest antidepressant, and it sounds as if you had an adverse reaction to the Lexapro; Celexa is its weaker cousin.  You are wise to ask for liquid Celexa for your taper.  How are you doing on Celexa?  Do you still have the symptoms you wrote about?  You will need to stabilize before beginning your taper.

 

We recommend tapering by no more that 10% of your current dose every four weeks. Some members have to go more slowly, such as at 5% of current dose every four weeks.  You will need to monitor your symptoms as you taper and see how much your body can tolerate.  There will be some withdrawal symptoms as you taper, and the goal is not to go too fast so they remain tolerable and you remain functional.

 

Preparing to taper

 

Why taper by 10% of my dosage?

 

Tips for tapering off Celexa (citalopram)

 

These links explain the importance of slow tapering.

 

Brain Remodelling 

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

Here is some information on withdrawal.  The symptoms of an adverse reaction are very similar to those of withdrawal.

 

What is withdrawal syndrome.

 

Glenmullen’s withdrawal symptom list.

 

 The Windows and Waves Pattern of Stabilization

 

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.  

 

Youtube video, 4 minutes: Healing from antidepressants

 

 

 

 

 

 

[Gridley]

xxx

 

 

 

Edited January 24, 2019 by Gridley

[puthappinessfirst]

Hi Gridley, thank you, that's encouraging. I have been back on Celexa for not very long, since Sunday evening. I still am getting bursts of panic throughout the day and I do not experience the akathesia all day, but it comes in waves, usually when I am waking up. (It usually wakes me up an hour or two before I'd like to actually wake up). Hopefully the 10mg of Lexapro I had been on for a month+ will all clear my system soon. I take CBD oil, magnesium, and benedryl just to sleep (mostly) through the night right now. 

 

Lexapro has traumatized me, and I know that sounds silly, but I've never had intrusive, scary OCD before and definitely not akathesia before. I know I am strong and can get through this rough patch, but rough patches are rough. I am glad to have found this forum though.

[ChessieCat]

We need more information about your drug history please.  If you cold turkeyed the drug please state that.  Thank you.

 

Celexa:  date, dose; date, dose; date, dose;

Lexapro:  date, dose; date, dose; date, dose;

 

And these can be on one line:

 

Supplements:  Probiotics, Vitamin D, B complex, Iron, Magnesium

 

[puthappinessfirst]

Hi Chessie, 

 

Ok, hope I formatted correctly. Thank you for all your helpful tips/tricks/links!

[ChessieCat]

That's much better, thank you. 

 

Please add the date to January 2019 for Celexa.

 

Please add the dates for Lexapro.

[Carmie]

Hi puthappinessfirst,

 

Wanted to welcome you to SA too. I’m so sorry to hear what you’ve been through. Yes, please taper slowly as Gridley said, no more than 10% a month. I can only do around 5% or so now. 

 

You can use your thread here like a journal, it helps to know that others understand what you’re going through. 

 

All the best with your tapering💚

[puthappinessfirst]

Hi Carmie,

 

Thank you for welcoming me. I see in your signature that you've experienced akathisia as well. Isn't it torture? I never knew such a pain and irritability could exist. Hopefully you don't experience it anymore. 

[Carmie]

5 minutes ago, puthappinessfirst said:

Hi Carmie,

 

Thank you for welcoming me. I see in your signature that you've experienced akathisia as well. Isn't it torture? I never knew such a pain and irritability could exist. Hopefully you don't experience it anymore. 

 

I certainly agree with you puthapinessfirst,

 

I can’t think of anything worse than akathisia. It is torture, it’s something that you can’t even put into words. How on earth would you describe it to anyone that hasn’t experienced it? I’m really sorry you’ve had to endure it too. I don’t have it as this moment, if I taper too quickly though or don’t hold long enough I get it. 

 

Sending hugs🤗

 

[puthappinessfirst]

I have a question that someone may be able to answer. Since I've reinstated my ADs, (Lexapro 10mg for 5ish weeks to Celexa 10mg for the past several days) how long should I hold my Celexa at 10mg until I start to taper? 

[Carmie]

2 minutes ago, puthappinessfirst said:

I have a question that someone may be able to answer. Since I've reinstated my ADs, (Lexapro 10mg for 5ish weeks to Celexa 10mg for the past several days) how long should I hold my Celexa at 10mg until I start to taper? 

 

Hi again PHF, 

 

I wouldn’t taper for a while yet as you’ve made so many changes. Please give your body some time to adjust to all the changes. If you taper too soon you will probably pay for it down the track. Please stay safe.

 

I see you’re taking B vitamins too. Probably not a good idea, as it can ramp up your nervous system. 

 

I live in Australia, but I was watching videos on YouTube the other day on California n Florida. I love the beach, I heard the water at the Florida beaches is nice and warm. California looks lovely. I’m too sick to travel and I don’t have the finances so I travel on my iPad.😄 It’s a good distraction too when going through withdrawals. Take care.💚

[Gridley]

14 minutes ago, puthappinessfirst said:

I have a question that someone may be able to answer. Since I've reinstated my ADs, (Lexapro 10mg for 5ish weeks to Celexa 10mg for the past several days) how long should I hold my Celexa at 10mg until I start to taper? 

 

As Carmie said, you've made a lot of changes. I would wait at least three months then assess how you're stabilizing.  Stabilizing doesn't mean you're without symptoms but your symptoms are tolerable and pretty much the same from day to day without large swings.

[puthappinessfirst]

Ok, thank you! I figured a few months might be the answer. When I was doing my own research several weeks ago about the similarities of Celexa/Lexapro, it now astounds me that people think they are the same drug. They are not. I actually function pretty well on Celexa. Lexapro was like being dosed with meth and emotional numbness at the same time. 

[puthappinessfirst]

Carmie, good to know about the B Vitamins. I read a steady that they help with akathisia which is why I started taking them, but I don't find that I miss them much. Also, I hope you'll be able to come to CA soon. The beach is beautiful for sure!

[Carmie]

Hi again, 

 

Yes, three months really sounds like a good plan. I’ve held that long, or longer, many a time. Your brain really has to adjust to all the changes you’ve made, and also best to stay away from the B vitamins. 

 

As Gridley said, after the three months reevaluate and see how your symptoms are. We will always have symptoms in withdrawals, but we need them to be minimal and not ramping up before we taper again. It’s “withdrawal normal” we want, though there’s nothing normal about withdrawals. Take care💚

 

 

 

 

 

[puthappinessfirst]

Just updating...

 

I saw a psychiatric nurse for the first time yesterday.

 

Good news: 

She knows what akathisia is

 

Bad news:

She doesn't believe I have it

Doesn't believe SSRI can cause it

Wanted to up my dose of Celexa

Wanted to add Gabapentin for sleep

 

None of the "bad news" really surprised me. It was expected. I couldn't ask her for liquid Celexa to taper, because she was obviously on a mission to med me up some more. I am continuing to hold at 10mg Celexa since it has only been 1 week+ and I am hoping the akathisia fades away soon. 

[ChessieCat]

From  Tips for tapering off Celexa (citalopram)

 

Making a Celexa solution yourself
See making-a-celexa-solution-yourself and how-to-make-a-liquid-from-tablets-or-capsules

 

[withhopeinmyheart]

Hi Happiness, 

 

ah well, the typical clueless behavior of people in the psychiatric field... 

 

Thank you for saying hi in my thread. 

 

I can tell you that I have been holding my dose for nine weeks and the akathisia has gone. 

I don't even remember when exactly it happened but it has been gone for a while. 

[Carmie]

Hi Happiness, 

 

Well it’s no surprise that the nurse doesn’t know anything about withdrawals from psych meds. What would be a surprise is if she did know.😃

 

The links above show that you can make your own formulation from the Celexa. I water titrate my Quetiapine tablet, I just use a mortar n pestle to crush it and add the water. Don’t make any changes yet though as you’ve already made too many. Let your body stabilise for a few months. 

 

Sending hugs🤗

[puthappinessfirst]

Thanks, Chessie. I've seen that and will be utilizing that material when I am ready to taper. I thought I would be ready to taper today, but I realize that is probably not the smartest, since I was on Lexapro (bad reaction) for a month and then switched to the Celexa right after. The akathisia is bad but I am managing throughout the day and hope to stabilize in the coming weeks. 

[puthappinessfirst]

Thank you for the hope, Hope. Akathisia is the worst thing I have ever experienced IN MY LIFE!

[puthappinessfirst]

Carmie, I was even surprised she knew what akathisia was, honestly. But yeah, when we discussed tapering, she was clueless. Also, when I complained about the akathisia, she tried to prescribe Remeron so I could get some sleep! Uhhh... NO!

[Carmie]

Yes that’s just typical Happiness, 

 

You complain of a symptom and they just give you more meds, which in turn causes more symptoms.🙄 I’ve been on the medication rollercoaster myself, I don’t even remember all the stuff they gave me.

 

For now, just focus on finding some good distractions while dealing with the symptoms until you stabilise.💚

[puthappinessfirst]

Thank you, Carmie. I find myself guilt-tripping myself a lot. "Why didn't you just stay off the meds when you CTd last year? Then you wouldn't be in this mess and could just focus on withdrawal!" I feel sad that I did that... Stopped my Celexa and hopped over to Lexapro then had to hop back over to Celexa. But as most of us, I just wasn't educated, especially not by my Dr. I know there are people in the same boat as me. 

[Carmie]

It’s best to leave the past in the past Happiness, 

 

I too have been through such torture because of what the doctors have done to me, and I’ve made mistakes myself along the way. We can’t change the past, and focusing on what we should or shouldn’t have done doesn’t change a thing. Focusing on what the doctors n pharmaceutical companies have done also doesn’t change a thing. I think it’s best just to focus on what we can do for ourselves each and every day. It’s time to be kind to ourselves from this day forth. 

 

It’s best just to start afresh from this very moment and look forward. Open a new chapter in your book and make it a forward moving one with lots of self care thrown in. We can do this! Just take a day at a time.💚

[Gracee]

Hello Happiness:  Welcome to SA.  I am a newby here too and slowly tapering.   It's too bad you felt  that you couldn't ask for liquid Celexa in light of your medical professional trying to overmedicate you.  Remember, you are in charge of your own body.  With doctors and medical practitioners, I have found it's helpful to say:  "I would like to try.........."  and then be firm about it.   Just my opinion.   Sending best wishes.

[puthappinessfirst]

Hello all. Been a minute and been surviving. I am thinking about my soon to be taper. I want to dissolve my pills in water so I can start my taper from 10mg to 9mg. If I put my 10mg pill in 20ml of water, how many ml do I need for a 9mg dose. My brain feels fried! Would I need to take 18ml of solution?

[brassmonkey]

Yes you would take 18ml of that solution. For reference the solution would have a strength of .5mg/ml. Remembering this will help with future calculations. I've only skimmed your thread but it seems you should be waiting another month or so before you start a taper. It's not a good idea to rush things especially after a rocky start. I've seen too many people try to jump ahead only to have to spend several unplanned months restabilizing. Trying to go too fast is a sure way to make things take a lot longer and is usually much more unpleasant. 

[ChessieCat]

6 hours ago, brassmonkey said:

it seems you should be waiting another month or so before you start a taper. It's not a good idea to rush things especially after a rocky start.

 

I agree that you should be waiting longer.  It's better to hold for longer than to risk tapering too soon.

 

BrassMonkey has also bee a member of another, now closed, website and is familiar with a large number of member experiences.

 

You might also consider, that when make your first reduction, that you do a reduction of <10%, perhaps try 5%, as a test to see how it affects you.

[puthappinessfirst]

Thank you both. I have not started a taper, still at 10mg of celexa. I am just getting materials together for a taper and realized I had a 20ml cough syrup cap that might work perfectly. And thank you for confirming my calculation. Makes more sense to me that each ml would have .5 mg of medication. I have always been bad at math, a stressed brain has made it worse. 

[puthappinessfirst]

Also, I think I will do a 5% taper first. Seems safest. Might even try smaller according to the BM slide scale. 

[Carmie]

Hi PHF, 

 

Glad to hear you’re holding and will be going by down by a small percentage when you do your next drop. Well planned!! I can only go down by small amounts myself now too. 

 

Wishing you all the best with your tapering💚