Mamgu: reducing citalopram

[Mamgu]

On 10/28/2021 at 9:23 PM, Jolene said:

Hi Mamgu,

 

How's it going? Did the settling of your withdrawal symptoms continue? I hope so!

 

I was just going over the timeline of drops I made, and was indeed surprised with how much I was able to go down in 2020. I went from 10 mg to 1.92 mg! Sounds crazy looking back on it. My progress in 2021 has been a lot less, from 2.2 (I updosed) to 1.4 mg. My rate at the moment is 5% per month, I'm taking it slow. I indeed seem to fare somewhat better than many others on this forum, but I don't think I'll be AD-free for at least a year, possibly two. But indeed, we're getting there.

 

Hi Jolene, sorry for the delay in responding, it's great to see you're getting the dose down - well done 🙂 . When I think that I've got another year or so of this it can get me down but I remind myself how far I've come.  You're doing so well and it's an inspiration to me when I feel despondent, so thank you for that 🙂 xx

 

Good news!!  The last drop went well so I thought I'd go with another 10% so am now down to 2.55mg.  The symptoms went all squiffy for a few days but settled down and despite the ups and downs, the general direction is in the right direction.  

 

I've started yoga again which is so good, I'm no where near as strong or flexible as I used to be when I did yoga before but these are early days.  I also think I'm getting through the menopause as I'm experiencing fewer hot flushes and I even think...sometimes....just sometimes....that the brain fog is lifting!  It's difficult to unpick whether some of my symptoms are withdrawal or menopausal but I guess with time they'll both settle.

 

 

[Momiki]

Hi Mamgu,

 

That's good advice, looking at how far you've come already. As you've read in my topic, I'm having a tough time now. Heeding that advice cheered me up. It's good that we can cheer each other up; we're in this together!

 

Great to hear the last drop went well! Combining tapering with menopause sounds tough.. I found normal hormonal fluctuations already too difficult (made me feel terribly sick when my period arrived, so I went back on birth control), so menopause doesn't sound appealing at all. There is a topic about menopause in the Symptoms and Self-care section, perhaps it's interesting to you:

 

 

Yoga, perhaps I should pick that up again... I did a 30-day YouTube yoga challenge once, and have been thinking about doing some sessions lately, but haven't gotten myself to the mat yet. I can very much relate to the nowhere near as flexible as before. I used to stretch daily several years ago, I was doing a form of martial arts at the time. My muscles seem to have shrunk back to their default state. Let's hope our brains will do the same!

 

[Mamgu]

Hahaha, yes, our brains will return to default like our muscles!  Thanks for the menopause link, I'll definitely take a look 🙂

 

[Mamgu]

Happy New Year, may 2022 be our year of solid progress.

 

Since I was feeling fairly settled I thought it's time for another drop, now on 2.3mg which when I look at this it's actually pretty good 🙂.  I'm about 2 years in and have times where I wonder if it will ever end, the length of the process can be demoralising but to quote the old adage, if you have move a mountain, pick up one stone at a time.

 

I never really feel symptom-free but instead make my dose drops when the symptoms are settled and more a background buzz rather than when they are yelling and jumping up and down for attention.  I wonder if I can continue with this approach as the dose gets lower and lower....

[ChessieCat]

10 minutes ago, Mamgu said:

I never really feel symptom-free but instead make my dose drops when the symptoms are settled and more a background buzz rather than when they are yelling and jumping up and down for attention.

 

That's what is know as WDnormal - withdrawal normal.

 

WDnormal

 

Moderator brassmonkey has written more about WDnormal in his Success Story:

 

tao-of-the-brassmonkey

 

11 minutes ago, Mamgu said:

I wonder if I can continue with this approach as the dose gets lower and lower....

 

If you start finding that it takes longer to get to WDnormal, then you might find it better to reduce by a smaller percentage.  Some members find that the lower their dose gets the slower they need to go, holding longer and/or reducing less.

 

The rate at which we taper has nothing to do with how strong or determined we are as a person.  It is the brain that dictates the speed of the taper.  And the aim is to get off the drug with the least amount of discomfort as possible and being able to live our life as normally as possible.

 

Some members have tried to taper faster and it has ended up taking them longer than if they had kept tapering at a steady rate according to their symptoms.

 

The end will come.  It took me 6 years.  Yes it was a long time but I got there.

 

Any reduction is getting you closer to being off the drug.

 

I sometimes felt impatient when I was taking what seemed a ridiculously small amount of Pristiq.  I had started at 100mg.  But I would remind that I didn't need the drug but my brain needed it.

[Mamgu]

Hi ChessieCat, thanks for the advice and massive congratulations to you, you've done amazingly 🙂

 

WD normal is interesting and reading that link has helped me understand that things are actually OK, I certainly feel better today than I did a year or so ago.  Like a lot of other folks here I have times where I wonder if I'll ever be off the drug and if I'll ever be OK again, it's so difficult to reason with the brain when we feel despondent.  This is where this forum is priceless, helps me through those questioning times.

[Mamgu]

So, the WD symptoms have settled down, I mean really settled down.  So much so I've just dropped my dose again making it the third drop in as many months, never managed that before.  No idea why things are going so well but long may it continue.  

 

It's heartening to know that with patience we can reach our aim of being AD-Free.  Still a way to go and I'm sure there'll be tough times again but I'm enjoying this open window 🙂

 

 

[Momiki]

That's great news, Mamgu! I hope the rest of your journey will be smooth sailing!

[Mamgu]

Still going well, I decided to take a little break from the 4 weekly drops as I had a lot on lately and felt it wise to allow a bit of stability.  Earlier today I thought I'm ready for the next drop then a matter of hours later I felt unwell, took a covid test and yup, it was positive!  Not the best timing but it's done now.

[Momiki]

Hey Mamgu,

 

How is the covid infection progressing? I hope it's a mild one. Did you stay at the lower dosis, or did you go back, as only one day had passed?

[Mamgu]

I decided to stay at the lower dose, mainly because the covid symptoms are much worse than WD but also I'd made up 5 doses and felt too ill to bother making up a new batch!  I honestly can't say I've noticed any WD symptoms the last week or so but I am having a horrid time with covid.  I'm just so tired, struggling to take the dog for even the shortest of walks.  I hope I perk up soon as I want to meet my new grandson, who was born on the 5th.

[Mamgu]

I had to have a longer hold than I hoped for this time, it's been a tough summer with covid, horrible pressure at work and the heatwave. I'm really not a fan of the heat!  Anyway, things have settled and I'm feeling better. Even so, I decided to try 5% drops and see how I get on with that.  I don't seem to be able to sustain regular 10% drops, after a few consecutive monthly dose drops it feels as though it catches up with me.  I've been experiencing different symptoms as well, the feelings of not-being-here and walking on cushions are lessening but I'm now getting a churning stomach, not indigestion, that's fairly settled but rather it's strong nervous butterflies which can come with nausea.  At least they've settled now but I still think switching to 5% drops is the sensible way forwards at this time.

[ChessieCat]

You might consider doing a slightly different taper method which gives you more control over your taper.

 

Brass Monkey Slide

[Mamgu]

Taking ChessieCat's advice and commenced the Brass Monkey approach; I'd been avoiding it because it's more maths and more faffing about; but I have a trusty spreadsheet and a positive attitude 🙂

 

It feels as though the closer I'm getting to the end of all this, the further away it slips 😂. Withdrawal symptoms are ramping up in intensity and I've stopped thinking "how much longer will this go on for", it'll take as long as it takes.  It's tough at times, I doubt myself for starting this in the first place and think I should have stayed on the drug.  But those thoughts come when I'm at my worse and are usually accompanied by a hefty bout of depression.  It all passes and knowing this is a process of convoluted cycles helps; "been there/done that" sort of thing.  The windows always open up again.

[ChessieCat]

You can hold for longer at any time during a reduction cycle.  You don't have to wait until you get to the last of the 4 reductions.

[Mamgu]

Yes, I'll certainly bear that in mind.  I'm interested to see if this will be better.

[Momiki]

On 11/14/2022 at 9:36 PM, Mamgu said:

It feels as though the closer I'm getting to the end of all this, the further away it slips 😂.

 

I can very much relate to this. This last stretch is hard! I've gone from thinking "I'll take it slow, even if it will take 2 more years" to "Perhaps I should just do 2 reductions a year. I'll be done in 15 years". 

 

Good luck with the Brassmonkey Slide method! Hopefully it will makes things easier for you.

[Mamgu]

13 hours ago, Momiki said:

I've gone from thinking "I'll take it slow, even if it will take 2 more years" to "Perhaps I should just do 2 reductions a year. I'll be done in 15 years"

 

Hi Momiki, it's gutting to think it'll take longer than we'd originally hoped but I suppose every step down is to be celebrated.  I guess you and I are at the business end of this process, every molecule seems to have a huuuge impact on our systems.  I recall when I first visited this forum thinking to myself "I'm lucky, I seem to be getting away lightly compared to others".  But as time goes by, I do seem to be experiencing the whole gamut of symptoms!

[Momiki]

I once found a comment from brassmonkey, saying the following:

 

On 8/23/2021 at 9:11 PM, brassmonkey said:

With Paxil things frequently can start to get tricky between 5 and 3mg and stays that way the rest of the way down. Often there will be s sweet spot around 2mg that is a nice relief and then again as you get below 1. There are a whole lot of factors involved that  no one really understands, but I've seen it happen on many people who are tapering paxil.

 

The only thing I seen that helps is to take it slow and easy and practice all your self care tricks, and believe that it will end. Which it does. The Endgame with Paxil is one of the hardest parts because it is so unpredictable. It is a very powerful drug and at the end very small changes in dose can make very large changes in SERT occupancy, so smaller reductions are often called for.

 

I was all over the place between 6 and 1.5. Then it broke and really settled down. I wasn't symptom free but they got milder the further I reduced.

 

Paxil was my original drugs. I switched to citalopram more than 2 years ago for tapering (suggested by GP, citalopram is available in liquid form), so I guess the two are similar. Ever since I've read brassmonkey's post I've been hoping that once I get below 1 mg I'll have an easier time. Now to just reach that 1 mg...

 

Change the "running" to "tapering", and this shirt would be perfect. 😛

[Mamgu]

1.25 mg achieved!  Think I'll take a break for a little bit, definitely going to hold off any more reductions until well into the new year.

 

At the moment the worse symptoms are insomnia, depression, churning stomach in the mornings, brain fog and fatigue.  Oh and constant tinnitus, that's been persistent since the summer. No respite but I can cope with that.  The low mood/depression is a bit of a problem at work as I'm continually doubting myself and am very sensitive to the point of being in tears on occasions.  Not a good look for a HR Advisor 😂 but so far I've kept it together when talking with employees.  I'm going to see if I can find a counsellor who understands AD withdrawal, see if I can get some tips to cope with the negative thoughts and imposter syndrome.

 

My goodness this is exhausting.  I don't know how I'd have coped without this community, I'm sure I'd have given up by now without the advice and support to be found here 😊  

 

 

[Mamgu]

On 11/18/2022 at 8:02 PM, Momiki said:

Ever since I've read brassmonkey's post I've been hoping that once I get below 1 mg I'll have an easier time. Now to just reach that 1 mg...

 

 

We're getting there 😊

[Mamgu]

After a few weeks of WD normal I took the next step and it's all gone haywire again, overriding WD symptoms are:

• Insomnia
• Tinnitus
• Brain Fog
• Fatigue
• Depressive moods
• Ramped up anxiety
• Self doubt
• Self loathing
• Anger/frustration

That last one is a surprise, I haven't felt persistent anger since post-baby blues and my children are well into their 30s so it's been quite a while.  The anger is directed inwards not at others which is good I guess.  

 

I'm still doing the Brass Monkey approach but wonder if it protracts the WD symptoms over 4 weeks instead of a couple of weeks.  It's impossible to know of course as I don't know how the 10%-at-once reduction will impact me at this stage.  I'm clinging onto the hope that when I get under 1mg I'll find it easier again. 

 

I'm aware this is a huge focus for me, it's borderline obsessional; it's soooo difficult to not be drawn into the drama that is my WD soap opera.  So, I've started to contact old friends which helps and am spending more time with my partner.  I've spent too long with my just my dog for company and my own thoughts 😂

 

It was taking too long to find a counsellor via the NHS so I've signed up to the PMI we have through work and within a matter of hours I was sent a list of local available CBT counsellors.  I'll set something up over the next week or so.  I need to stop the self doubt, it's impacting on work-relationships and that feeds the anxiety as I'm scared I'll lose my job.  Then, when I've had a week of hyper-alert terror I come down to a state of numbness, I'm certain I'm difficult to be around.  Luckily we predominantly work from home so my melt-downs are private and in a safe place, but the knock-on effects are difficult to mask.

 

I'm exhausted.

x

 

[Mamgu]

Oh bugger!  Just read this on someone else's thread:

 

"Some people find that they have to slow down a great deal as doses get below 1 mg. This seems to happen with a few specific drugs, escitalopram (Lexapro) being one of them."   Since Citalopram is the direct cousin (descendant, really) of Lexapro, the previous comment is likely applicable.

 

Well, that's scuppered my thoughts about it getting easier below 1mg.

 

That's a really depressing thought.

 

😞

[Momiki]

Hi Mamgu,

 

I'm sorry to hear withdrawal has ramped up again. You are very very close to the 1 mg, though! It would suck it you indeed have to slow down more below the 1 mg, but it's still a great milestone! Do you have a link to that particular thread? I'm curious to read more. I was also very much hoping things would get easier below 1 mg. I based it on a post by BrassMonkey (https://www.survivingantidepressants.org/topic/19831-longroadhome-think-i-may-be-tapering-seroxat-paxil-too-fast/page/24/?tab=comments#comment-547880), but now looking back on it this was about Paxil. I've been on paroxetine for most of my AD journey, and switched to citalopram at 10 mg for easier tapering, so I figured the two are similar. There are success stories from people who have been on escitalopram and citalopram, though, so it still can be done!

 

It also sounds like you are taking good care of yourself, contacting old friends and finding a CBT counsellor. That's also something to be proud of.

 

Wishing you well!

 

[Mamgu]

On 2/9/2023 at 6:21 PM, Momiki said:

Hi Mamgu,

 

I'm sorry to hear withdrawal has ramped up again. You are very very close to the 1 mg, though! It would suck it you indeed have to slow down more below the 1 mg, but it's still a great milestone! Do you have a link to that particular thread? I'm curious to read more. I was also very much hoping things would get easier below 1 mg. I based it on a post by BrassMonkey (https://www.survivingantidepressants.org/topic/19831-longroadhome-think-i-may-be-tapering-seroxat-paxil-too-fast/page/24/?tab=comments#comment-547880), but now looking back on it this was about Paxil. I've been on paroxetine for most of my AD journey, and switched to citalopram at 10 mg for easier tapering, so I figured the two are similar. There are success stories from people who have been on escitalopram and citalopram, though, so it still can be done!

 

It also sounds like you are taking good care of yourself, contacting old friends and finding a CBT counsellor. That's also something to be proud of.

 

Wishing you well!

 

 

Hi Momiki

 

I can't recall whose thread that quote was from, but to be fair what I quoted was the whole (relevant) reference from that particular post.  Whatever the reality is, I'll work with what I have thrown at me.  At least things are a little more manageable as I'm on a hold right now.  It's still rotten but not as rotten as it has been....I'll take that 🙂

[Mamgu]

I'm ready for the next round of the BM reduction method, so started a 2.5% drop today.  I want to see how things go this time in comparison to earlier reductions; will I have the 4+ weeks of full-force grotty withdrawals? Or will it be less intense?  

 

On another point, I usually order Citalopram using my GP surgery's on-line repeat prescription service. I don't order it every month (I only need 2 tablets a week) and when I went to request  it last time, the GP had removed it from my list!  EEEEKKK, have to say I had a bit of a meltdown at the time.  My propensity to catastrophise led me to thoughts of having to CT and all the horrors that might follow.  Luckily I had enough to last as it took a full 6 weeks before I could get an appointment to request they reinstate the drug.  There was no drama, the doctor was happy to add it back onto my list of repeat orders.  Also I was pleased with his response when I explained how I'm reducing my dose and projected timeframe (I think I'm looking at another couple of years) he was supportive and encouraging, told me I was doing the right thing. Wow, first time a GP has spoken like that to me regarding coming off antidepressants!  I'm used to being met with disbelief at best and patronising 'I know better than you do' comments.  Are we finally getting through to the medical profession?  

[Mamgu]

The night after my latest 2.5% reduction I experienced what I suspect is a full-force cortisol spike.  I've never had anything like that before and really hope I never do again.  I woke up about 2am, nothing new there, my usual pattern is to wake up at 2 or 3, I usually get up and read or play card games, nothing too stimulating.  After a couple of hours I'll go back to bed and get a bit more sleep.

 

But, the other night, I went back to bed at about 4am, and as soon as I closed my eyes I could feel a kind of clicking in my head.  That's the only way I can explain it, it was like my brain was trying to make connections but the wires are rusty and corroded so couldn't quite make those connections.  I'm sure I heard the clicking. Then it spread to my stomach, this was closely followed by a very strong anxiety attack, like I've never experienced before.  I was terrified.  Next thing I had stomach convulsions, I wonder if that was my diaphragm suddenly contracting? I've had that before after a dose reduction but again, nothing as intense.  This was accompanied by the strongest palpitations I've ever had and the icing on the cake was hallucinations!  I 'saw' swirling lights form into a face which bore down on me.  At this I jumped out of bed emphatically stating I wasn't going to be terrorised by a stupid face of light.

 

But I was.

 

I had an upset stomach all of the following day and felt at odds.  I felt fearful going to bed last night but had a word with myself.  I can't let the fear of fear take over.  Ended up having a pretty decent sleep and things are more settled now.

 

Surely this is related to withdrawals.  Lawks I hope so because if it isn't I'm going mad.

[Momiki]

Hi Mamgu,

 

I share your anxiety regarding medications becoming unavailable! A while ago someone else on this forum from the same country as me told me that their liquid medication would no longer be produced. Manufacturer stopped making it. I'm on a different AD, I hope the manufacturer doesn't follow the same route!

 

Great that the doctor was understanding and supportive! I would be really nice if it indeed becomes common knowledge amongst doctors that AD withdrawal can be very problematic.

 

The cortisol spike sounds horrible. I've only experienced one myself (though different physical symptoms than you had, but the same "Am I going mad" feeling), many months ago. I've never had one since, so here's hoping it will be the same for you.

[Mamgu]

On 3/9/2023 at 6:31 PM, Momiki said:

I share your anxiety regarding medications becoming unavailable! A while ago someone else on this forum from the same country as me told me that their liquid medication would no longer be produced. Manufacturer stopped making it. I'm on a different AD, I hope the manufacturer doesn't follow the same route!

 

 

That's dreadful, as if this process isn't difficult enough 🙄

 

 

 

On 3/9/2023 at 6:31 PM, Momiki said:

The cortisol spike sounds horrible. I've only experienced one myself (though different physical symptoms than you had, but the same "Am I going mad" feeling), many months ago. I've never had one since, so here's hoping it will be the same for you.

 

So far so good!  In fact, I seem to have had fairly settled sleep since.  Sorry you went through that too and thank goodness it was only the once!  I'm constantly bewildered at how severely this drug affects us. Just when I think I've experienced it all, there's a new symptom chucked into the mix.  At some point the symptoms will fade and this will all be history.  

 

[Mamgu]

I decided to record another win, albeit a small win in the grand scheme of things.  I'm 3/4 way through my latest BM round and so far it's been so much easier than the last few dose drops, whether BM or straight 10%-at-once reductions.  I'm still experiencing WD symptoms but they are milder than before, WooHoo!  The biggest improvement is the insomnia has totally had a word with itself and buggered off.  Good riddance 😛.  I'm expecting a return but I'm really enjoying the break while it lasts.

 

The windows might not be open but they've been cleaned and I can see out 🙂

x

[Fifree]

Hi Mamgu  Thanks for stopping by my thread and giving me a high five! Encouragement is always welcome. I’ve read your thread too and it’s very inspiring to me. The stories on this site of making cuts and then stabilising are far less less common than I’d like! Plus Citalopram and Escitalopram are siblings. 

 

Very glad you’re current BM cut is going well. You’re nearly there! Although of course I know that even once we get down to that last 1 mg we still have at least a year to go, it just feels so significant! Especially from where I’m sitting at 10 mg!

 

 

 

 

[Momiki]

That's great to hear, Mamgu! Perhaps you've reached the 1 mg breaking point and you turn out to not be among the people who have to slow down even more below 1 mg, and things will be smooth sailing from now on! I know it'll probably still be tough, but one can hope, right?

[Mamgu]

On 3/24/2023 at 5:52 AM, Fifree said:

Hi Mamgu  Thanks for stopping by my thread and giving me a high five! Encouragement is always welcome. 

 

 

You're welcome 🙂

 

On 3/24/2023 at 5:52 AM, Fifree said:

The stories on this site of making cuts and then stabilising are far less less common than I’d like! Plus Citalopram and Escitalopram are siblings. 

 

I suspect the smoother moments occur far more often than are documented; perhaps most folks post on here when things are tough and are in need of support or advice?  Just a thought?  I have to say when I look for the positive stories I struggle to find them but I need the reassurance that it's not always doom and gloom.  I've had plenty of moments where I've doubted I'm doing the right thing and I should just pack it in and reinstate at 10mg.  I'm only saying this to emphasise the fact it's a roller coaster - windows and waves.  Things aren't perfect right now in terms of my WD process, but I can see it's much, much, MUCH better than it has been 🙂

 

The sagacious Chessiecat mentioned at the beginning of my process that we need to listen to our bodies and take things slowly...patience, patience, patience!!  This advice has helped me massively, knowing that it's 'normal' and not everyone can manage the cautious regime of 10% drops + 4 weeks hold, even that can be too much for some.  I was gutted at the very beginning when it was advised I increase the dose and hold until I stabilise.  We've made a choice to move on with our lives and to be told to wait isn't what we want to hear.

 

*Rambling musing warning!*   I often wonder if it's unrealistic pressures advocated by Western societies that probably led to some of us taking the drugs in the first place....got to do more....improve....be more productive.....don't be a burden......be your best self........experience everything.  At once.  All the time........we forget/aren't permitted to factor in the self care and time to just be.  It can be ridiculed or sneered at as self-indulgence.  Perhaps I could take that thought onto the next stage and say to myself, in this process I need to step back, take a breath and accept it for what it is.  So, in that spirit, I'm off to sow some seeds for my veggie garden!

 

On 3/24/2023 at 8:41 AM, Momiki said:

That's great to hear, Mamgu! Perhaps you've reached the 1 mg breaking point and you turn out to not be among the people who have to slow down even more below 1 mg, and things will be smooth sailing from now on! I know it'll probably still be tough, but one can hope, right?

 

Oh please please please!!!  But it will be what it will be.

 

 

 

[Mamgu]

WooHoo!!  Made it to under 1mg today.  This is EPIC 😎. Yes, it's only under 1mg by dint of decimal point roundings but I'm gonna take that as a major win.

 

I've no idea why this feels like a huge milestone but it does and I'm going to dance a little internal jig of joy, take a deep breath and gather my energies for what is to come.

[Momiki]

Yaaaaaaaay! Congratulations, Mamgu! That's great!

[Mamgu]

Thanks Momiki  😊  

 

How are you doing?  Hope you're feeling better xx