jenster: Citalopram withdrawal

[jenster]

Hi, I could do with some support and words of advice. I've been on fluoxetine and now citalopram for 20 years. I was prescribed by a specialist for IBS and chronic fatigue. They helped with tiredness for years and then I realised the terrible anxiety I started to get was a side effect of fluoxetine, so GP suggested citalopram. 

 

I've been trying to get off the 20mg of citalopram for 5 years and keep failing as I've been tapering too fast. Each time I've failed I've ended up back on 20mg of citalopram. I've managed to reduce to 10 mg over last few months but everytime I reduce the dose I get terrible, uncontrollable anger, brain zaps and inability to concentrate or make decisions. So angry with my kids and husband over nothing.

 

I feel just terrible despair and fear that I will never be able to come off these drugs, as I can hardly bear the side effects I'm feeling. My kids are suffering and I hate myself for it. All I can think about day in and day out is how to get off these drugs. I can't concentrate on anything else.

 

I'm trying to reduce to 0.75mg but now I've found this website I think its too big a jump. I'm so scared that I'll never be off these drugs and that I won't be able to do the slow taper over several years. I feel so alone and unsupported as my doctor doesn't understand the slow tapering and I just keep jumping up and down doses. My life is on hold until I can get off these drugs, but so scared I will never function properly again as I've taken them for 20 years. Has anyone tapered off after so long on ADs? Please give me some words of reassurance as I feel so desperate to be AD free.

 

[Gridley]

Welcome to SA, jenster.  First of all, yes you can taper off this drug.  I've been on Lexapro (a much stronger drug than Citalopram) for 16 years and have tapered from 20mg down to 0.8mg over the past three years and am doing fine.  I'll be off in a few months.  Brassmonkey, one of our moderators, came off a high dose of Paxil after 24 years on the drug.  Yes, a safe taper does take a long time but you can do it.

 

Doctors know nothing about safe tapering or withdrawal, which they don't even believe exists.  That's the reason this site exists.

 

The reason why your tapers have failed in the past in that you have tapered too fast, as you said.  We recommend tapering by no more than 10% of your current dose every four weeks.  Please read this link to understand the importance of tapering slowly.

 

Why taper by 10% of my dosage?

 

A slightly slower taper, which might be a good idea for you since you've had difficulties tapering in the past, is described here:

 

The Brassmonkey Slide Method of Micro-tapering

 

This link is specifically about tapering Citalopram.

 

Tips for tapering off Celexa (citalopram)

 

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 (glycinate is a good form) and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Add in one at a time and at a low dose in case you do experience problems.

 

This is your Introduction topic, where you can ask questions and connect with other members.  We're glad you found your way here.

 

 

 

 

 

 

 

 

[jenster]

Thanks Gridley. I’m just so confused about the best method do the taper as my brain isn’t working properly. Is it best to cut up pills or dissolve them in water?

 

I’m so scared at getting this wrong and don’t know how to start the tapering. I just don’t know where to start. Tips gratefully received as there is so much information on this website it’s overwhelming. But so grateful to have found this website. Thank you.

[Gridley]

5 hours ago, jenster said:

I just don’t know where to start.

I understand.  It can be confusing.  Cutting and weighing pills vs. dissolving in water are both fine.  It really depends on which method you're more comfortable with. I was more comfortable with cutting and weighing because....it was just clearer to me, working with a solid rather than a liquid.  Other prefer the liquid.   How did you taper from 20mg to 10mg?

 

Let me try to make it more understandable and reduce the verbiage . I've taken the following from the "Tips for tapering Citalopram" thread I sent you in my first post.  Read the links and see which method makes more sense to you and that you feel more comfortable with.

 

So, method 1 is making a liquid yourself.  I've never done a liquid so I can't give you any personal experiences with it. 

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

 

You'll need to use an oral syringe to precisely measure out doses as small as .01mg  These are available at a pharmacy.

 

Tapering by cutting up tablets
The tablets are scored, which means they can be cut up.

Use a digital scale to accurately measure doses cut from tablets.

 

The first thing you do is weigh ten of your 10mg tablets to get an average weight.  Let's say, for example that the weight of your 10mg tablet is 100mg.  The reason is weighs so much more is all the fillers that make up the tablet.  We use this terminology.  The pill is 100mg pill weight (written 100mgpw).  It contains 10mg active ingredient (written 10mgai).  You're going to be working with the pill weight and keeping track of how low you're going with the active ingredient.

 

You want to reduce by 10% for your first reduction.  You multiply 100mg (remember, you're working with pill weight with the scale) by .9.  100mg X .9 = 90mg.  That's how much of the pill you want to take for your first four weeks.

 

What I do is make a powder from the tablet by crushing between two spoons.  Then I put the powder on the scale and take off enough so what remains is 90mg.  Save the extra powder for use later.  Fold a post-it in half and pour the 90mg powder into a gelatin capsule (available on Amazon or in a health food store).  Size 00 is nice and big and makes pouring easier.  You may spill a little the first few times but you'll get used to it.  Now you have a dose for one day.  Make up however many you want to, maybe a week's worth.

 

Many members, myself included, use the AWS Gemini 20 scale available on Amazon in the U.K.  Here's information abut the scale:

 

The GEMINI-20 Scale

 

The scale is accurate only to around 3mgpw.  This will be a very low dose in active ingredient.  At that point you can switch to a liquid or do what I'm going to do when I get to that point, which is eyeball the doses.  At that point you're talking about a minuscule amount of powder.  This is not something you're going to have to worry about for quite a while.

 

There's a third option, which would be very easy but might be too expensive:

 

FYI, for those in the UK:

 

   On 9/28/2018 at 7:51 AM,  Caspur said: 

Hi ButterflyHope,

If you are in the UK, then yes it should be possible for you to get a liquid form of citilopram via your GP. The problem I've seen from others reporting is the cost. Some GPs will have one eye on their budgets. The liquid preps are expensive at £100-120 a 150ml bottle. My GP prescribed liquid venlafaxine for me with me even prompting him! That said, if there's any objections just make it clear that the NHS got you onto this drug so it has a moral obligation to help you get off it, whatever the cost!

The British National Formulary shows it is available as oral drops 40mg per ml of liquid; see link here.

https://bnf.nice.org.uk/medicinal-forms/citalopram.html

I'm sure it would be possible for the NHS to get it made up at a lower concentration which is probably what you need.

Good luck with your taper.

Caspur

 

Okay, jenster, read all the links and see which method you like and get back to me if you have any questions.

[jenster]

Thanks for your advice Gridley. I've been freaking out all weekend as feel so desperately bad that I keep failing. I'm so desperate to come off the medication to feel like me again, that I keep cutting the doses too fast. I got from 20mg to 10mg but just taking 15mg and then 10mg over a few months. I feel better not having so much of the drug in  my system, but also the withdrawal side effects have been terrible for both me and my family. 

 

I know I need to stick at 10mg again until I feel better and then start the brass monkey taper. It just feels so hard to keep taking a drug everyday that I don't want to take. I'm taking comfort from reading the SA website and hoping I can be as strong as others have been. This is a scary journey with no knowing whether I'll feel better (or worse) off the drugs.

[Erell]

9 hours ago, jenster said:

I know I need to stick at 10mg again until I feel better and then start the brass monkey taper. 

Hi Jenster : I'm not sure To understand : I see in your signature that you are at 9 mg, and in your post you talk about 10mg.

What is your dose?

 

Take care ❤

[Gridley]

9 hours ago, jenster said:

It just feels so hard to keep taking a drug everyday that I don't want to take.

 

I know that feeling.  But unfortunately we do have to keep taking it and holding as long as necessary to stabilize and then taper oh so slowly and patiently.  Cutting too fast ends up taking longer if you have to updose,  That's the unfortunate nature of this particularly nasty beast.  

[jenster]

9 hours ago, jenster said:

Thanks yes I'm still at 10mg. I made a typing error, just wishful thinking that I'm at 9mg. I hope that's my next post.

 

33 minutes ago, Erell said:

Hi Jenster : I'm not sure To understand : I see in your signature that you are at 9 mg, and in your post you talk about 10mg.

What is your dose?

 

Take care ❤

 

[jenster]

Can anyone give me some tips on how to deal with the anger and rage that I feel about everything whilst withdrawing? I’m so angry at my kids and husband all the time but don’t know how to control it, apart from taking a higher dose than 10mg. 

[Gridley]

@jenster  I hope this link is helpful:

 

Dealing With Emotional Spirals - Surviving Antidepressants

[Altostrata]

Hello, @jenster, how are you doing?