Evandallas8: Celexa withdrawal while on Lamictal

[Evandallas8]

I’m on 20mg of citalopram and went down to 18mg two weeks ago.  How long does it take to experience withdrawal symptoms?  I didn’t really notice anything until a week later but wasn’t sure if it was because I accidentally missed a dose of Lamictal.  I’m also taking Lamictal and haven’t started that taper.  

[ChessieCat]

Hi there and welcome to SA,

 

It's really good that you have found SA so early on in your taper.  SA recommends tapering by no more than 10% of the current dose with a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.  Your reduction from 20mg to 18mg is a 10% reduction.  Your next reduction will be calculated on 18mg so 16.2mg.  If the 10% reduction dose is difficult to measure it is better to round up, not down.  Why taper by 10% of my dosage?

 

When we reduce the drug we can experience withdrawal symptoms.  Withdrawal symptoms can generally appear anywhere up to about 3 weeks after a reduction, which is why a 4 week hold is recommended, so it isn't unusual.  Dr Joseph Glenmullen's Withdrawal Symptoms

 

It may be coincidental that your withdrawal symptoms appeared when you missed your Lamictal dose or it may have been as a result of it, or even a combination.  Because of the 2 variables and because you have only just started tapering the citalopram so you don't have any previous experience of what happens when you reduce citalopram it is difficult to know what has caused it.  It is best not to concern yourself about something which cannot be answered.  That just adds stress.  You may have a better idea after you make your next citalopram reduction.  But what's done is done and you can't change it so best not to worry about it.

 

Please note that it is best to only taper one drug at a time.

 

This topic explains how to get the dose you need:  Tips for tapering off Celexa (citalopram)

 

 

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

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

[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.

 

 

[Evandallas8]

Wow thank you for this!  So helpful.  I actually switched to the BRAND NAME Lamictal a month ago since the generics were so unreliable.  Let me get this straight. It can take two to five years EACH drug?  So it may take two years just to get off my 20mg of citalopram and then another five to get off the lamictal?  Also - do people notice positive effects after tapering down the dose even before they completely get off the drug?  I just feel so flat all the time and want to get some life back.  

I DEFINITELY. Relate to the windows and waves, before I even started tapering. 

[ChessieCat]

It can take several years to get off a drug, depending on the starting dose.  I've been tapering from 100mg Pristiq for 3 y 4 m and still have about another 2 years to go.  I'm now down to 4.5mg.  I'd rather go as slow as my brain needs me to so that I only experience mild withdrawal symptoms.

 

You haven't yet completed your drug signature so we don't know what dose of Lamictal you are taking.

 

My personal experience was that as I reduced my dose the side effects lessened.

[Evandallas8]

 Did I successfully update my drug signature? I just put it under the “about me” section. 

[ChessieCat]

No signature showing.  Click on the link provided, type in the box and click on Save at the bottom.

 

When we sign up we provide some drug info, but that is only visible to the staff.  The signature appears below each post you make.  They are not visible when using a phone.

[Evandallas8]

Ok I just created it.  So let me make sure I have this right.  I put my 20mg citalopram tablet in 20mg water and let it dissolve.  And if I want to take 16.25 ml I then shake it a little, draw up 16.25 ml and take it?   Can I use the 10ml syringe for the first 15ml and then a small 1ml syringe for the remaining 1.25?  Also there a tiny white particles still swirling around after it dissolves. Is this normal? 

[ChessieCat]

Yes your drug signature is showing now.  Please add date and dose for each change made in your drugs.  You only need to show the year for the first mention of it.  Thank you.

 

Celexa:  full date, dose; full date, dose; etc

Lamictal:  full date, dose; full date, dose; etc

 

If you don't know the exact date please state early, mid, late.

 

Yes, 20mg tablet in 20mL of water will give a 1:1 ratio.  Each mL of solution will contain 1mg of dose.

 

You might find it easier to do it the opposite way and extract and dispose of the balance and drink the remainder.  Once you get to lower doses you can swap around and measure your dose and keep the remainder covered in the fridge for the next dose.

 

The particles are fillers which don't dissolve.

 

It's important to do everything the same way each time and to use the same equipment.  Even using the same place on the bench or table to measure the liquid.  It's also a good idea to write a "recipe" in case you ever have a brain freeze, which happens to everyone, even people note trying to taper their drug.

[Evandallas8]

Thank you.  I have been recovering from chronic fatigue syndrome slowly the past few months after getting into a program. The parallels between drug withdrawal are almost identical to chronic fatigue syndrome which tells me CFS is nervous system related.  

I have OCD tendencies which haven’t helped.  I am wondering whether it’s best to fully recover from CFS before I taper.  I am very sensitive and any symptoms leave me in a state of anxiety and gloom as many articles you provided said.

[Evandallas8]

I’m just curious about something.  I was given Lamictal as a mood stabilizer and it seemed to help some.  I have also read hundred of people saying they’ve been on it decades with zero issues.  Is there any reason I should come off of it?

thanks

[Altostrata]

How long have you been taking Lamictal? Please update your signature.

 

What times of day do you take it? How does it "help"?

[Evandallas8]

Been on it about 7 years. 150mg.  I take it in the evening.  It really helped even out my moods and keeps me from going into depressive episodes.  So I’m just not sure why I’d go off of it.  It has literally helped thousands of people.  Just curious. Thanks,

evan 

[Evandallas8]

Lamictal dosage increase timeframe

 

I am going to increase my current dose of lamictal (150mg) back to the starting dose of 200mg.  I am having a very tough time on the generic because it’s less efficacious and am going to go up to the 200mg generic in order to compensate.  My insurance no longer covers the brand name.

I was doing so much better when I started this medicine and nothing but issues since I dropped the dosage slowly to 150mg. 

My question is how long can i safety “trial” this and then go back the the 150mg dose if needed before my body becomes dependent on the 200mg dose? 

Thanks 

Edited June 10, 2019 by ChessieCat
added topic title

[Altostrata]

If you like Lamictal, you can stay on it. It's up to you.

 

Your body gets used to an increased dose within a month.

[Evandallas8]

Topic title:  Going back to original dose after trying an increase...

 

I have been on 150mg of lamictal for four years (I reduced my dose from 200mg).  I recently went back up to 200mg to see if it would help with depression but it made me worse. I have been on the 200mg for about 19 days.  My question is: can I just go back to the 150 or has my body gotten used to the 200mg?

thanks

 

Edited July 27, 2019 by ChessieCat
added topic title

[ChessieCat]

On 6/12/2019 at 6:30 AM, Altostrata said:

 

If you like Lamictal, you can stay on it. It's up to you.

 

Your body gets used to an increased dose within a month.

 

 

It's already been 3/4 of 1 month.  You might find that doing a fast taper from 200mg to 150mg better than jumping straight to 150mg.

 

At least that way you would be able to hold at a dose if you find that things worsen.

[Evandallas8]

Ok here’s my delimma tho... I have been on the 150mg brand name for awhile, so I switched to the 200mg generic to cover up for it being less efficacious if that makes sense.  So should I go to 175mg of the brand name to taper down, go to 150mg of the brand plus a 25mg of the generic, or 175mg of the generic?  Im sorry this is so complicated.... my head is spinning. 

[Eastcoastgirl]

How have you been able to get a handle on your chronic fatigue syndrome? I'm dealing with it pretty bad and see no end in sight !

[ChessieCat]

We generally recommend making only one change at a time.  Keep it Simple, Slow and Stable

 

We also suggest that when changing form of a drug that you do a cross over (without making a reduction).  Each combination for 3-7 days:  3/4 + 1/4, 1/2 + 1/2, 1/4 + 3/4.

[Evandallas8]

15 minutes ago, KMart95 said:

How have you been able to get a handle on your chronic fatigue syndrome? I'm dealing with it pretty bad and see no end in sight !

When did it start for you? It has gotten better for me.  I want to cure it before I start withdrawing from drugs. 

[Eastcoastgirl]

3 minutes ago, Evandallas8 said:

When did it start for you? It has gotten better for me.  I want to cure it before I start withdrawing from drugs. 

It has started in Prozac withdrawal for me, so in the last 6 months or so. But I also went off the pill so my hormones are messed up too. Definitely do a slow taper ! I went cold turkey, now i've been stabilizing on a low dose for a while but the fatigue has not improved. It's definitely one of my worst symptoms!

[Evandallas8]

 

 

Just now, KMart95 said:

It has started in Prozac withdrawal for me, so in the last 6 months or so. But I also went off the pill so my hormones are messed up too. Definitely do a slow taper ! I went cold turkey, now i've been stabilizing on a low dose for a while but the fatigue has not improved. It's definitely one of my worst symptoms!

Oh yes I know it, it started for me when I went through some very traumatic stuff.  And I don’t want to start withdrawing until I get stable.  

[Evandallas8]

35 minutes ago, ChessieCat said:

We generally recommend making only one change at a time.  Keep it Simple, Slow and Stable

 

We also suggest that when changing form of a drug that you do a cross over (without making a reduction).  Each combination for 3-7 days:  3/4 + 1/4, 1/2 + 1/2, 1/4 + 3/4.

I wish I had realized that.  I think I’m going to go to 175mg with 150 of the brand name (much better) and 25mg of the generic for a week and then back to the 150mg of the brand name. 

[Evandallas8]

18 hours ago, Evandallas8 said:

Topic title:  Going back to original dose after trying an increase...

 

I have been on 150mg of lamictal for four years (I reduced my dose from 200mg).  I recently went back up to 200mg to see if it would help with depression but it made me worse. I have been on the 200mg for about 19 days.  My question is: can I just go back to the 150 or has my body gotten used to the 200mg?

thanks

 

I went down to 175 the past two days and haven’t noticed anything worse So I am assuming it is easier to taper since my body was used to the 150 mg and I have only been on the 200 for three weeks? I went down to 175 the past two days and haven’t noticed anything worse

[Altostrata]

It will take a few days for your body to adjust to the lower dosage, I would give it a couple of days more to make sure the dosage reduction is okay.

 

It may be that your body has not completely adapted to the 200mg and going back to 150mg will be relatively easy.

 

You can mix generic and brand name tablets if you need to. Do you feel better when taking brand-name tablets?

[Evandallas8]

17 minutes ago, Altostrata said:

It will take a few days for your body to adjust to the lower dosage, I would give it a couple of days more to make sure the dosage reduction is okay.

 

It may be that your body has not completely adapted to the 200mg and going back to 150mg will be relatively easy.

 

You can mix generic and brand name tablets if you need to. Do you feel better when taking brand-name tablets?

Yes.  When I switched over to the generic after being on brand name for months I had a bad reaction after about a week.  It took awhile for the symptoms to creep in, which is exactly what happened when I went to 200.  I felt even better at first and then I had horrrible akathisia.  Have you heard of people getting that?  It was a restless, horribly anxious, suicidal feeling. 

[Evandallas8]

2 hours ago, Altostrata said:

It will take a few days for your body to adjust to the lower dosage, I would give it a couple of days more to make sure the dosage reduction is okay.

 

It may be that your body has not completely adapted to the 200mg and going back to 150mg will be relatively easy.

 

You can mix generic and brand name tablets if you need to. Do you feel better when taking brand-name tablets?

Why do I feel okay for a week or two on the generic and then I start feeling worse?  What is the differences between them?  My pharmacist said there is none but that CANNOT be true. 

[Altostrata]

Some people feel the difference between brands. If one brand works for you and another doesn't, stick with the one that works.

 

2 hours ago, Evandallas8 said:

Why do I feel okay for a week or two on the generic and then I start feeling worse?

 

It takes about that long for many psychiatric drugs to fully take effect. The old drug is working its way out of your system while the new drug is ramping up.

[Evandallas8]

I had a horrible reaction.   Have you ever heard of akathisia? 

Can’t stop grinding my teeth!!

[Evandallas8]

On 7/27/2019 at 7:09 PM, ChessieCat said:

We generally recommend making only one change at a time.  Keep it Simple, Slow and Stable

 

We also suggest that when changing form of a drug that you do a cross over (without making a reduction).  Each combination for 3-7 days:  3/4 + 1/4, 1/2 + 1/2, 1/4 + 3/4.

So I went to 175 about four days ago.  I was okay till today where I felt abnormally sleepy and that withdrawal feeling.  Should I hold at 175, go down to 150, or go up?  My psychiatrist is basically worthless since he doesn’t understand how sensitive I am. 

[ChessieCat]

4 hours ago, Evandallas8 said:

My psychiatrist is basically worthless since he doesn’t understand how sensitive I am.

 

It's probably that your psychiatrist doesn't understand about careful tapering and withdrawal off psychiatric drugs.

 

You were taking 200mg for about 3 weeks so your brain will have made at least some adaptation to that dose., possibly fully adapted.  We don't know.

 

Please update your drug signature to include dates and doses increases/decreases - we need to be able to see this information at a glance please.  Account Settings – Edit a signature

 

On 7/29/2019 at 2:39 AM, Altostrata said:

 

It will take a few days for your body to adjust to the lower dosage, I would give it a couple of days more to make sure the dosage reduction is okay.

 

It may be that your body has not completely adapted to the 200mg and going back to 150mg will be relatively easy.

 

 

It takes about 4 days for a dose change to get to full level (aka steady state/level) in the blood and a bit longer for it to register in the brain.  If you have noticed a worsening of symptoms it may be withdrawal, which if it is then it would be better to hold and wait for the symptoms to subside before reducing again.

[Evandallas8]

51 minutes ago, ChessieCat said:

 

It's probably that your psychiatrist doesn't understand about careful tapering and withdrawal off psychiatric drugs.

 

You were taking 200mg for about 3 weeks so your brain will have made at least some adaptation to that dose., possibly fully adapted.  We don't know.

 

Please update your drug signature to include dates and doses increases/decreases - we need to be able to see this information at a glance please.  Account Settings – Edit a signature

 

 

It takes about 4 days for a dose change to get to full level (aka steady state/level) in the blood and a bit longer for it to register in the brain.  If you have noticed a worsening of symptoms it may be withdrawal, which if it is then it would be better to hold and wait for the symptoms to subside before reducing again.

Ok.  I wasn’t sure if it was the withdrawal or the results from increasing the dose three weeks ago.  So I didn’t know if decreasing to where I was would take the symptoms away. I will hold on the 175 for another week.  It’s not unbearable, but not exactly right. 

[ChessieCat]

Because you have already noticed the reduction from 200mg to 175mg it might be better, when making the next reduction, to do less than a 25mg drop.  Consider reducing by 12.5mg or less.

[Evandallas8]

2 hours ago, ChessieCat said:

Because you have already noticed the reduction from 200mg to 175mg it might be better, when making the next reduction, to do less than a 25mg drop.  Consider reducing by 12.5mg or less.

Thanks.  I actually haven’t started tapering the drug yet.  I just went up in dosage to see if it helped.  I do have a question for when I start my gradual taper. Is it possible to do it slow enough to where the withdrawal symptoms are minimal?  Like I’m thinking that I’ll do a microtaper over at least four years.