Erika: Withdrawal or relapse? How long will it take?

[Erika]

Hello all,

I wanted to share with you my experience hoping that some of you might give me some good advice.

 

I've taken Citalopram for 3 months (even less than that) for some problems of possible anxiety somatization (dizziness when I was walking especially), I was taking only 8 drops per day and when I stopped (I tapered over 1 week or so) then I had the typical withdrawal symptoms like brain zaps and nausea moreover. They lasted for 2 weeks then they completely disappeared.

 

What happened 1 month after stopping instead has been the return of the previous problem + new symptoms which I didn't have before (a feeling of vertigo when I watch fast moving images like the screen of my laptop, my phone, tv, in all positions also when I'm laying down on my sofa). Before I only had a feeling of instability when I was walking instead.

 

This has been persistent for 3 months now and it won't go away: is it part of the withdrawal syndrome or is it a relapse? Definitely 3 months is not enough time to cure a problem with a SSRI so I've done a mistake when I stopped (I have to say that I was feeling good when i was on citalopram).

 

So do you think that my only option is to retake the Citalopram for a longer time in order to avoid another relapse? Or all of this will go away?

 

Please give me your thoughts

 

Thank you

[manymoretodays]

Hi Erika and welcome,

 

How much Citalopram were you taking?  If you have the old bottle, you could check the label to find out the actual dose you were taking.

And then when did you stop?  Even an approximate date would be good.

 

Did it help with the "anxiety somatization" at all?  The dizziness when walking that you describe?

 

Yes, the newer symptoms could be related to WD(withdrawal). 

Here is a good list that you can view or print out if you'd like, of a lot of the WD symptoms that can occur.

Dr. Glenmullen's withdrawal symptom checklist

 

Have you tried anything else for the dizziness when walking/ anxiety somatization? 

Any previous medications tried or non -drug coping? 

 

Please put your withdrawal history in your signature

This is the portion that you can see below others posts, unless viewing from a cell phone device.  However you can still create a signature from a phone device.

It will answer several of the questions I asked above, and make it easier to support, and try to answer some of your questions.

Just open the link above and follow the instructions.

 

On 5/21/2019 at 3:03 AM, Erika said:

So do you think that my only option is to retake the Citalopram for a longer time in order to avoid another relapse? Or all of this will go away? 

 

I'm not sure.  As I'm not sure if the citalopram actually helped your dizziness when walking/anxiety somatization.   Do you think it did?  The other symptoms may go away in time, or it's possible you might benefit from a really low dose reinstatement.  Or just some non-drug coping.

Give us a bit more information for now, if you would.  Thank you.

 

All for now.  And welcome again.

 

Love, peace, healing, and growth,

manymoretodays(mmt)

p.s.  Impressed with your multi lingual- ness.  Mine is not so good, so please forgive, if my wording is off at all.

Edited May 23, 2019 by manymoretodays
worried about how this will translate to italian

[Erika]

Hello,

 

thank you for answering my questions.

I've added my history in the signature as kindly suggested.

 

I was taking 16mg of Citalopram, I started with 4, then went to 8 until I settled at 16 for less than 3 months. (started the first week of October and ended between Christmas and New Year's Eve).

I've stopped at the end of December and apart from the usual withdrawal syndrome (brain zaps and nausea that I had for 10 days) I've started developing new symptoms which are different and separate in time from the ones said before and especially these are persistent because I've been having them since the first week of February (so let's say 1 month after the last drop taken).

 

Did it help with the "anxiety somatization" at all?  The dizziness when walking that you describe?  Yes it did I was feeling completely good after 3 months that's why I stopped, thinking I had gotten over it and not thinking that I was taking an antidepressant so a lot more attention should have been given to it.

 

The thing is that I did have withdrawal symptoms (nausea, brain zaps and fever like sensation) but they lasted for 10 days then they went away. But these new weird symptoms of vertigo, (spinning sensation when I watch tv or my phone) came out separately 2 weeks after the typical withdrawal ones went away so this makes me think it's more a relapse, don't you agree?

 

The other symptoms may go away in time, or it's possible you might benefit from a really low dose reinstatement. Do you think that I could start again with a low dose? So I was taking 16 mg, how much could I take now and how long for?

 

Thanks for your help

much appreciated

Erika

[manymoretodays]

15 hours ago, Erika said:

The thing is that I did have withdrawal symptoms (nausea, brain zaps and fever like sensation) but they lasted for 10 days then they went away. But these new weird symptoms of vertigo, (spinning sensation when I watch tv or my phone) came out separately 2 weeks after the typical withdrawal ones went away so this makes me think it's more a relapse, don't you agree?

 

Hi Erika,

 

The symptoms could be WD.  I mean what would they be a relapse of?  It you never had them before?  I had some of those same symptoms in early WD.   I was just off balance for a bit.

 

Did you get any medical work ups originally when the dizziness with walking began?

 

And then do you have any of your citalopram liquid left?  Or can you get some? 

We usually have people try a very low dose of reinstatement.  

I think generally, reinstatement works better, if done early on.  

But.....it might help relieve some of your symptoms though. 

You are about 5 months out now from your last dose of citalopram.

 

Here's the link for you to read about it:  About reinstating and stabilizing to reduce withdrawal symptoms

Read through at least the first post in ^ link

And then ask any questions that you might have right here

 

And tips for tapering off Celexa(citalopram)

^ this might be helpful if you do go back on it

 

Let us know what you think and would like to do.

L, P, H, and G,

mmt

 

[Erika]

Hello

 

and thank you for your very useful answers and links. I've read them and I think that this is a risky road (reinstatement) but I need to try, don't I? It's been too long I've not been feeling good.

 

I will try to answer some of your questions:

8 hours ago, manymoretodays said:

I mean what would they be a relapse of?  It you never had them before? 

Yes I never had them before but I read in some publications online that a relapse can occur in a more intense way from the original one, so maybe this is the case.? 

 

The fact that I've taken the antidepressant for such a short time (less than 3 months) can it have something to do with these new symptoms? Like my body getting used to it, then abruptly this medicine disappears and my brain goes in panic because I didn't give it enough time to adjust to the new situation?

8 hours ago, manymoretodays said:

Did you get any medical work ups originally when the dizziness with walking began?

 

Yes I've done all the possible tests: including MRI, all negative.

 

8 hours ago, manymoretodays said:

nd then do you have any of your citalopram liquid left?  Or can you get some? 

Yes I recently bought two new bottles of Citalopram, I use the liquid version so I can use drops instead of tablets.

You know I'm writing from Italy and here they are super cheap so it's very easy to get it: I pay only 2.5 euros per bottle ($2.80).

 

I was thinking and thinking of reinstating just trying to get some advice first.

So if I was taking 8 drops per day as my max dosage (16 mg), shall I start with 1 drop per day for the first week and see how it goes? Then I can go up with the weeks if I don't feel worse, what do you think?

 

 

Thank you so much, this forum is so useful

 

Erika

[Erika]

Sorry forgot to say:

do I have any other option than reinstate the Citalopram?

I mean either I try to reinstate or what do I do, I wait? Will these things will ever go away?

[Maca44]

You have been off for sometime I wouldn't be starting it again, just ride it out, give it time. Your other symptoms went in time so no reason these won't. 

[Gridley]

4 hours ago, Erika said:

 

 

 

I was thinking and thinking of reinstating just trying to get some advice first.

So if I was taking 8 drops per day as my max dosage (16 mg), shall I start with 1 drop per day for the first week and see how it goes? Then I can go up with the weeks if I don't feel worse, what do you think?

 

 

Erika,

To answer your most recent question, yes, the choice is between reinstating or waiting it out.  Unfortunately, there is no way to predict how long it will take for you to stabilize if you wait it out. While some recover fairly quickly, others take months or longer.  One other factor to consider is that you've been off almost six months.  Reinstatement works most predictably within 3 months of your last dose.  It can work even this far out from the last dose, though it might not.  There are so many unknowns.  It is, as you said, a risky road.

 

An important question to consider in your decision is  how are your symptoms?  Are they improving or worsening as time passes?

 

Should you decide to reinstate, is it possible for you to take 1/2 drop (1mg)?  It is best to start very low and work up if necessary.  

 

 It takes about 4 days for a dose change to get to get to full state in the blood and a bit longer for it to register in the brain.  So your one-week wait idea is good, if you decide to do this.

 

 

 

 

[manymoretodays]

Hi Erika,

 

You know I just noticed that I didn't give you much, in the way of the general links go.........as far as what WD is all about.  It's also frequently referred to an "discontinuation syndrome".  I prefer WD.   So here are a few more links that might help your understanding of what's happening now:

Brain Remodelling

What is withdrawal syndrome.

The windows and waves pattern of withdrawal and stabilization

 

The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.

Why taper by 10% of my dosage?

 

Unfortunately, sometimes even short usages of AD's, and then the discontinuation..........CAN result in WD.  I'm sorry that you have had to go through all this Erika.

 

5 hours ago, Erika said:

I was thinking and thinking of reinstating just trying to get some advice first.

So if I was taking 8 drops per day as my max dosage (16 mg), shall I start with 1 drop per day for the first week and see how it goes? Then I can go up with the weeks if I don't feel worse, what do you think?

I agree with Gridley.  1 gtt(drop) of your citalopram is equal to 2 mg. 

 

Best would be to start even lower, if you reinstate.  Then wait for 4-7 days to see how you might react to it.

 

You could add the one drop to some measured water, mix it up real well,  and then take one half of the liquid.  1/2 drop would equal 1 mg. 

As your solution already contains water, that suggests that it is water soluble.  (  See this post in the Tips for tapering off Celexa)

 

Since you have had WD symptoms for some time now, you likely do have a sensitized system, so it's best to start low(in dosage) and cautious.  That way if you have adverse reactions you can just stop the medication.  And yes......you've been off your medication for some time now.  Reinstatement tends to work best early on.

 

I think, that most of what you are having now ARE WD or discontinuation symptoms.  Rather than "relapse".  Some of the more recent literature, does give credence, to the idea that WD can last up to a year for some.  Personally, from my own experiences and understanding, and others, I think it can last longer.  And I'm not at all suggesting that it will, for you........I'm just trying to explain more about it all(WD).  Your usage was short term and you don't appear to have a history of multiple medication trials.  I don't know your age, but if you are young too, I think that there's a great chance, you might recover really well.

 

If you do decide to just go on back to full dose citalopram, it's best to do that with your doctor.

 

5 hours ago, Erika said:

do I have any other option than reinstate the Citalopram?

I mean either I try to reinstate or what do I do, I wait? Will these things will ever go away?

 

Other options would involve non-drug coping  (there's a whole indexed list of different things to try in the first post there),  and like Maca mentioned, riding it out. 

 

As far as your initial condition and "relapse" of that........the dizziness and anxiety.  Pretty much the same........non drug coping.  Or you might work with a practitioner of some sort to help teach you skills to manage your "anxiety" with somatization.

 

And thanks for answering all my questions about that.  Oh yes, these things will go away.  The when part is just hard to predict.

 

Let us know what you decide to do Erika and keep us updated.

 

L, P, H, and G,

mmt

 

 

 

Edited May 24, 2019 by manymoretodays
elaoration, additional thoughts

[manymoretodays]

47 minutes ago, Gridley said:

An important question to consider in your decision is  how are your symptoms?  Are they improving or worsening as time passes?

 

Yes!  Thanks Gridley.

[manymoretodays]

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system.   Generally though, it is best to only try one new thing at a time, and then always start low, keep records of your response, and then proceed from there.

 

Magnesium, nature's calcium channel blocker 

Omega-3 fatty acids (fish oil) 

[Erika]

2 hours ago, Gridley said:

An important question to consider in your decision is  how are your symptoms?  Are they improving or worsening as time passes?

 

Hello Gridley and thank you for your advice.

The thing is that my weird symptoms are always the same. They have started in early Feb and have been the same since then, no improvement and no worsening. That;s why I would like to take this chance because if they had improved at all I would have waited a bit longer but it's crazy I feel like I'm stuck in this weird chronic condition and I will remain like this forever.

 

I've also noticed that my symptoms are worse when I'm nervous or in a bad mood or tense for some reason. For example when I'm at work I feel quite bad because I'm going through a tough period at work and I'm desperately looking for another job so at the moment I'm going to work with the worst mood and this makes it all worse. Instead when it's the weekend and I'm off work I feel a bit better.

2 hours ago, Gridley said:

Should you decide to reinstate, is it possible for you to take 1/2 drop (1mg)?  It is best to start very low and work up if necessary.  

 

 

Yes I could take half a drop by diluting it with water right? that's for the first week maybe to see how it goes. Then second week 1 drop and decide afterwards. I've asked my doctor and he said to start it again but I think doctors don't have a clue how these medicines work, they just prescribe them as if they were water.

[Gridley]

5 minutes ago, Erika said:

Yes I could take half a drop by diluting it with water right? that's for the first week maybe to see how it goes.

 

That sounds like a good plan.  

[Erika]

2 hours ago, manymoretodays said:

I think, that most of what you are having now ARE WD or discontinuation symptoms.  Rather than "relapse".  Some of the more recent literature, does give credence, to the idea that WD can last up to a year for some.  Personally, from my own experiences and understanding, and others, I think it can last longer.  And I'm not at all suggesting that it will, for you........I'm just trying to explain more about it all(WD).  Your usage was short term and you don't appear to have a history of multiple medication trials.  I don't know your age, but if you are young too, I think that there's a great chance, you might recover really well.

 Hello,

wow thank you so much for your advises, you're making me feel better because for the first time I feel like I'm speaking to someone who really understands what I'm talking about. I'm so glad I've found this forum. Where are you from?

 

Well yes you can say that I'm quite young, I'm 32, I've never been on any kind of drugs in my life, I've always been healthy, positive, good family, no economic problems, no problems at all. I just had a bit of a stressful year 2 years ago when I decided to move back from London where I lived for 4 years and come back to Italy and I've brought with me my bf who couldn't speak a work of Italian at the beginning so the move has been very tough and he was unemployed for 6 months which made us go through a tough period. This might have been the reason why I've developed this anxiety which possibly decided to show up in my life and in my body in this weird way: with vertigo/dizziness feeling, then Citalopram and then WD and here I am.

 

I think I'll wait a couple of more weeks and then if nothing happens, I'll try to reinstate super slowly like you suggested.

 

I've also wanted to ask you: there are many people who go on and off on antidepressant, they take them for a while, they stop and then they take them again after 2 years for example. This risky situation of the reinstatement, is it risky because I'm still going through the WD syndrome? For example if I'm symptoms free and then I decide to take the Citalopram back after 1 year, will the risk be lower or once you take it and you stop it, any kind of reinstatement will be risky?

 

And last thing: the thing is that I think I didn't have the time to recover from these anxiety problems I have, and my old symptoms are also back together with the new ones so it's like I would still need maybe to be on the medication because I didn't take it long enough. Does it make sense? I mean, is it possible that my body was feeling good when I was on Citalopram and maybe it needs it again for a more consistent time? Or does the fact that I took it for such a short time have not much importance?

 

Thank you again

Erika

[manymoretodays]

On 5/24/2019 at 11:47 AM, Erika said:

 

I think I'll wait a couple of more weeks and then if nothing happens, I'll try to reinstate super slowly like you suggested.

 

I've also wanted to ask you: there are many people who go on and off on antidepressant, they take them for a while, they stop and then they take them again after 2 years for example. This risky situation of the reinstatement, is it risky because I'm still going through the WD syndrome? For example if I'm symptoms free and then I decide to take the Citalopram back after 1 year, will the risk be lower or once you take it and you stop it, any kind of reinstatement will be risky? 

 

And last thing: the thing is that I think I didn't have the time to recover from these anxiety problems I have, and my old symptoms are also back together with the new ones so it's like I would still need maybe to be on the medication because I didn't take it long enough. Does it make sense? I mean, is it possible that my body was feeling good when I was on Citalopram and maybe it needs it again for a more consistent time? Or does the fact that I took it for such a short time have not much importance?

 

Thank you again

Erika

 

Hi Erika,

I am a USA denizen.  Italy sounds nice though.  And, I, do so love Italian food.  Cannoli's come to mind!  Yum.

 

That sounds good, on the reinstatement, if you do it.  Do keep notes(for yourself) and be prepared to wait 4-7 days, unless you feel like it's made you worse.  In that case stop.  It's not a complete cure of WD symptoms, nor of your pre-existing difficulties.......but might help a bit. 

 

You have a lot of good questions.

 

Yes some do go on and off AD's.  I think that they might struggle, but know not why.   And oftentimes, if presenting to a doctor or prescriber.......may be seen as "relapses", with no consideration of WD given.  That's just how it is right now.  Some, in fact many of us here, have a very different truth now.

 

  Overall, I think the effectiveness of AD's, for much of anything, is a whole lot less than what Joe Q. Public believes. 

You might be interested in this:  Again, chemical imbalance is a myth. Stop the lies please.

I don't know for sure, on your individual situation and make-up........as far as answering your ?.   I've certainly come to learn, for myself, that these overprescribed pills are not as benign as most believe.  I don't think that your difficulties prior to medication were ever due to a deficit in citalopram, or any other SSRI.  That you felt like it worked for your symptoms, is at best, poorly understood.  If I were you, I would work on non-drug coping skills going forward.......and learning stress reduction techniques.  And general acceptance.....as far as of yourself and who you might be.

That you took it, the citalopram, for such a short time might have significance.........in that, yes, changes from the medication/drug and dependencies, might resolve more quickly.   It can be a bit variable too, depending on the individual.

 

There are a lot of links to more information, in the "What is WD" link I gave you in my 3rd post too, that might be helpful in your search for answers, for yourself.

And a wealth of information, elsewhere too, here on site.

 

Love, peace, healing, and growth,

mmt

 

 

[Erika]

21 hours ago, manymoretodays said:

I am a USA denizen.  Italy sounds nice though.  And, I, do so love Italian food.  Cannoli's come to mind!  Yum.

 

 Hello, 

oh yes, all of our food is nice. It's hard to do any diet, too many temptations

 

21 hours ago, manymoretodays said:

That sounds good, on the reinstatement, if you do it.  Do keep notes(for yourself) and be prepared to wait 4-7 days, unless you feel like it's made you worse.  In that case stop

Yes definitely. So I think I'll start with this little dosage, less than 1 drop and see how it goes. Of course, if it makes me feel worse I'll stop, but what about if I don't feel worse nor better so if I take 1 or less than 1 drop and I feel the same? Do I go up and take 1 drop and a half the 2nd week? What do you think?

 

Anyways I think a lot has to do with my stressful life: for example if I feel good and I'm in a good mood I feel a lot less the symptoms. This past weekend my dad came and visit me and I was feeling happy so my symptoms were so much reduced; then when I'm back at work, all the symptoms come back. So it's a tricky situation really, don't know what to do.

 

I think that the underlying problem (my negative mood and anxiety) is still there and will still be there until I will change my job probably but if I do in the meantime? So difficult

 

Thanks for your support

Erika