Ben92: To up-dose of not, due to chronic intrusive thoughts ...

[BenViv]

Hello all,

I am writing as a supporter for my son Ben, who has been on citalopram since 2011.  He has had some success, if not easy, at tapering and had been on 20mg since the end of 2016. 

In May last year, he started tapering 10% every 5 weeks, until Sept when he had reached approx. 13.3mg.  All ok during the taper, but in December he started feeling off, and down. Fast forward to Feb, he was feeling quite a bit worse, with unwanted thoughts popping up.    By the beginning of March, which coincided with having Covid, he had developed very upsetting intrusive thoughts, which are now almost constant. He is struggling at work, as the thoughts now involve workmates, or anyone at all it seems, but happier to be there than at home. Very tearful, loss of appetite, panic attacks, avoiding friends in case it triggers more thoughts. Has lost interest in all the things he usually loves, and very difficult to encourage any positive behaviours, although he has started meditating/mindfulness and does get out and walks...

He never had any OCD type compulsions/intrusive thoughts prior to going on the meds, so we assume it is related to the taper.   Going for a full blood test tomorrow to see if anything significant. Was diagnosed with Gilberts syndrome, 8-10 years ago, if that has any bearing on his taper..?

The question please is - should he go back up to his 20mg (or less..) as he is keen to do, or try to wait it out; he knows it will not be a quick fix.b Is it possible that doing so could make things worse - the last thing he/we want are worse symptoms. 

Any advice please, and thank you!

Viv

[getofflex]

Hello, and welcome to SA.  It is great that you are supporting your son Ben in tapering off of citalopram.  I'm sorry to hear that he is struggling with these symptoms.  Because of the difficulties in assisting a person through an intermediary, SA only does this in rare circumstances.  

 

Could you please have him create an account and make an introductory post so that we can help him directly?  We would be more than happy to help him, and it sounds like he would be in the right place here.  We look forward to hearing from Ben soon.  

[SumGy]

Hi BenViv. I'm sorry your son is feeling this way, I feel like I can relate to him pretty well. I'm 33 now and have been on Citalopram for 20 years pretty consistently, to treat intrusive thoughts/OCD. I was originally treated with Paxil, starting when I was 8 years old, but was switched over to Celexa as a teen. I temporarily tapered off of my Celexa over the course of a year, around 5 years ago, assuming that I didn't need the medication anymore. After a super stressfull time on a solo trip in Europe I had a panic attack for the first time in my life (had no idea what it was at the time), and because I didn't have my meds it was associated with extremely intrusive thoughts, about self-harm, violence, etc. I basically associated panic attacks with those thoughts, and thus made me afraid of having panic attacks. Once you fear them, this starts to cause the develpment of a panic disorder. To make a long story short, I eventually ended up back on 40mg Celexa, which is when I realized that on Celexa, my panic attacks were not associated with intrusive thoughts like they had been before. Which seemed like a win at the time, but I feel like I've been experience cognitive issues from SSRI use, so at the start of the month I decided to start tapering off again. I've decided that I need to learn how to deal with the intrusive thoughts without medication. As I know from my prior experience, that it is only during intense stress that they are likely to arise. One of the things that I will be relying on when/if the intrusive thoughts come back is the book "Dare: The New Way to End Anxiety and Stop Panic Attacks", this helped me overcome the panic disorder I was developing. It also has a section on dealing with intrusive thoughts, which I think he might find very helpful. The methodology for dealing with panic and intrusive thoughts is basically the same, and is very simple, DARE is the acronym for this process.

 

In terms of intrusive thoughts, the key is to realize that you are not your thoughts, and that once you lose your fear of them, they lose their power, and tend to disappear. It isn't about stopping the thoughts, as that just makes them stronger, but being ok with them, and occupying yourself with something else until they go away.

 

I highly recommend picking up that book. I'm also available for a chat whenever if he'd find that helpful.

[Ben92]

Can I increase dose back to original since reducing..?

 

Hello all,

 

My name is Ben, and I have been on citalopram since 2011. I have been tapering on and off over the years, and had been on 20mg since the end of 2016. 

 

Last May I decided to begin tapering again, as I had been feeling very good for the last few years, with the very occasional, very minor dip in mood in between.

 

I reduced 10% every 5 weeks, until Sept when I was on roughly 13.3mg. I was completely fine during the taper, but in December last year, I didn’t feel quite right, and began to develop some minor, yet fairly distressing intrusive thoughts. Fast forward to late Jan/early Feb, and I started feeling quite a bit worse, with unwanted thoughts popping up at all times of the day, but just being able to function ok. By the end of February, which coincided with me having Covid (and having to isolate at home for 10 days, which were the rules here at the time), I had developed incredibly upsetting, OCD-like disturbing intrusive thoughts, mostly sexual, which are now almost constant. I am struggling to function at work, as the thoughts have now developed to involve workmates, or anyone at all it seems that I feel close to, or care for, which is most distressing of all. Compulsions and checking rituals have now gotten to a point where I can barely focus on anything else, which I now know only make things worse, but can’t seem to help myself.

 

There is a lot of crying, a big loss of appetite, panic attacks (or close to it), avoiding friends or anyone that can triggers more thoughts. I have lost interest in virtually all the things that I love doing. I have always been a bit of a pessimist, but positive behaviours and thoughts seem to have disappeared completely. I had started doing some meditating/mindfulness and I do get out and walk every now and then, but even then, the thoughts are always there.

 

I don’t recall ever having any OCD type compulsions or intrusive thoughts before going on the meds, so I assume it is related to the taper. I had a full blood test today to see if there is anything of significance. I was diagnosed with Gilberts syndrome 10 years ago or so, if that has any bearing on the taper..?

 

The question I’m really asking is can/should I be going back up to 20mg (or less?) as I am willing to try anything to improve my current situation, or should I be trying to wait it out?

 

I know it won’t fix everything right away, and perhaps might not change anything, but is it possible that doing so could make things worse?

 

Any advice would be greatly appreciated. Thanks!

 

Ben

 

Edited March 30, 2022 by ChessieCat
added topic title before merging with intro topic and spacing

[ChessieCat]

Hi Ben92 and welcome to SA,

 

To help us out please create your drug signature following these instructions:

 

Instructions:  Withdrawal History Signature

 

This is your own Introduction topic which is the place to ask questions about your own situation and journal your progress.  This will keep your history in once place and mean you won't have to repeat your story.

 

I will ask getofflex, the mod who responded to your parent, to respond to your post

 

@getofflex Ben92 has posted above.  I have merged the topic he created with the topic his parent created.  Could you please follow up on this one?  Thanks.

[getofflex]

Hello Ben, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  It sounds as though you are dealing with withdrawal from psychiatric drugs.  What was the reason you were put on the drug in 2011 if you don't mind my asking?  I will need more specifics about your drugs, and about your taper before I can give you suggestions about updosing.  I'm sorry that you are going through this.  

 

Can you please give us specific information in your signature about your drug history for all drugs you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise vertical list (no symptoms), only drug names, specific dates (as best you can say for example early March if you don't recall the day) and dosages of each medication decrease or increase.  Use this format:

 

Drug name: date, dose, date, dose, date, dose…

Drug name: date, dose, date, dose, date, dose…

Etcetera

 

Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Drug History in Signature

 

Here is some information about how these drugs actually work.   This explains why we get symptoms from going off of these medications, and why it's so important to taper slowly and carefully, and be very cautious about changing our doses: 

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

Video on Recovery from Psych Drugs

 

Windows and Waves Pattern of Stabilization

 

 

Tapering is best done extremely slowly, and we generally taper by 10% of the current dose no more than once every 4 weeks, so that the reduction becomes exponentially smaller.  It sounds like you were doing that, but I don't know if the 10% was based on the original dose of 20 mg, or the current dose.  

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering Citalopram

 

Here is a link with checklists of common WD symptoms: 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

Stability is really important when we are tapering off psych meds.  Please read the link about stability:

 

Keep It Simple, Slow, and Stable

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

Omega 3 Fish Oil

 

When I know more specifics about your tapering schedule, I can make a suggestion as to what to do.  Hang in there, this gets better!  

[nick1990]

Bump @getofflex, I have noticed that Ben92 has updated his signature and is now seeking advise as to where to go from here. 

 

Thanks  

[getofflex]

On 3/30/2022 at 3:01 AM, Ben92 said:

The question I’m really asking is can/should I be going back up to 20mg (or less?) as I am willing to try anything to improve my current situation, or should I be trying to wait it out?

If it were me, I would try doing a small updose.  You are currently on 13.3 mg citalorpram, right?  Try updosing to 14.0 mg.  See if that helps. Give it at least a week, which is how long it will take to get into your system and make a difference.  Let us know how it affects you.  If you do OK on this, we can always increase it a little bit.  I would not suggest going back up to the full dose of 20 mg, as this puts you at risk of kindling, which is discussed here: 

 

Kindling

 

Intrusive thoughts can also be managed using non drug techniques.  

 

Withdrawal Causing Intrusive Thoughts

[Ben92]

  

On 3/30/2022 at 9:34 AM, SumGy said:

One of the things that I will be relying on when/if the intrusive thoughts come back is the book "Dare: The New Way to End Anxiety and Stop Panic Attacks", this helped me overcome the panic disorder I was developing. It also has a section on dealing with intrusive thoughts, which I think he might find very helpful. The methodology for dealing with panic and intrusive thoughts is basically the same, and is very simple, DARE is the acronym for this process.

 

In terms of intrusive thoughts, the key is to realize that you are not your thoughts, and that once you lose your fear of them, they lose their power, and tend to disappear. It isn't about stopping the thoughts, as that just makes them stronger, but being ok with them, and occupying yourself with something else until they go away.

 

I highly recommend picking up that book. I'm also available for a chat whenever if he'd find that helpful.

 

Thank you so much for your response, and we will be searching out the book. What you say about intrusive thoughts is so true and I think as time progresses, he will be able to see and do this; but it takes practice and time..

 

Edited April 2, 2022 by ChessieCat
added quote for context

[AbelRiver]

@ben92 Hi Ben! Intrsuive thoughts were my worst symptom... I had them prior to taking meds, too... they were the number 1 reason I started taking SSRIs nearly 10 years ago. (and spolier alert, tapering/stopping brings them alllll back :). I think it's mainly an offshoot of anxiety. While they are disturbing, there's nothing to fear. This book is pivotal in understanding them https://www.amazon.com/Overcoming-Unwanted-Intrusive-Thoughts-Frightening/dp/1626254346

 

We must remember our thoughts do not control us. Check out the book (I have it downloadedon the kindle app on my phone so I can access it any time) and remember  you are NOT alone in intrusive thougts. Rose here wrote a whole book on her sexual intrusive thoughts https://www.theguardian.com/society/2013/aug/31/pure-ocd-the-naked-truth