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NextStep: about to start tapering off Citalopram 20mg - with a twist


NextStep

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Hello. First of all, apologies for not strictly following the signature guidelines, but since it was going to be longer that 12 lines I thought my approach would work. Can update if requested.

 

I've been o one SSRI or another for 21 years. In 2001 I was diagnosed with GAD, and depression that came along with it. Paxil was my first SSRI, it worked great, but the side affects were a problem. From there it was trial & error with all of the meds listed in my signature. The 3 times I came off meds (between 2002 - 2011) the tapers were too fast - guided by a psychiatrist who either wasn't well informed, or was just irresponsible. From what I recall it wasn't necessarily side effects that made me return to the meds, but rather the anxiety and/or depression coming back with force.

 

Currently I'm on Citalopram 20mg and have been on it for approximately the last 8 years. If it's doing anything, it's not doing enough. I just kept taking it cause it was easier than having to deal with tapering. There's also one sexual side-effect (delayed ejaculation - I'm a male by the way) that I frequently found to be a positive thing, as I had suffered from pre-mature ejaculation prior to going on SSRIs.

I'm not looking to come off the meds because I'm "doing great". But instead of looking to increase the dosage, or change medications, I want to taper off to truly see what my baseline state is, and then I want to try psychedelic assisted therapy (with proper guidance). It's time for bigger changes and I'm tired of just trying to mask things over with these meds (I'm in my mid 50s and want to take more control over my mental health for the rest of my life).

 

Here's where I would love some input from the group:

 

I'm currently out of the US and liquid Citalopram is not available. I found a psychiatrist where I am who suggested that instead of having a compound pharmacy prepare liquid Citalopram, or trying to do it myself, that I switch to Lexapro for the taper, since it's available here in liquid form. The doctor feels that they're similar enough to not cause a problem by making this abrupt change from one medication to another. Her tapering plan seems a bit more aggressive (3.5 months) than some articles I've read about slow tapering, but she seems confident that it's not too fast. Here it is:

 

Citalopram 20mg = Lexapro 10mg (10mg of Lexapro liquid form = .5ml, measured out as 10 drops)

  • Week 1: 10 drops
  • Week 2: 9 drops
  • Week 3: 8 drops
  • Week 4: 7 drops
  • Week 5: 6 drops
  • Week 6: 5 drops
  • Week 7 - 10 (1 month): stay at 5 drops (equivalent to 5mg of Lexapro, or 10mg of Citalopram). Evaluate how I'm feeling. If ok, continue:
  • Week 11: 4 drops
  • Week 12: 3 drops
  • Week 13: 2 drops
  • Week 14: 1 drop
  • Week 15: off meds

 

This psychiatrist also works with both micro & macro dosing of psilocybin. We discussed having me try micro-dosing about 1 month into the tapering if everything is going ok.

 

She also suggested taking a supplement during the tapering process that's geared towards brain function. I can't find the equivalent brand name in the US, but the ingredients are: phosphatidylserine, tryptophan, arginine, choline, niacin, vit B12, vit B6, l-methylfolate of calcium and magnesium.

 

I have some concerns about this plan being to fast, but on the other hand I'm very eager be off the meds and more onto the psychedelic therapies I've been reading a lot about. I've been in a rut for a while now and waiting a year or more would be frustrating. The idea is to try to the psilocybin micro-dosing until I'm fully off the SSRI and then try a guided macro ("hero") dose session. Possibly try Ayahuasca at some point as well. Please don't be concerned though - I won't be doing any of these things without proper research and guidance.

 

So, does this tapering plan seem ok? The doctor said we can always slow it down if there's a problem. I'm just a bit concerned about the medication switch at the beginning. The doctor has almost 30 years of experience and said she's worked with a lot of patients tapering off meds. She seems serious. I was just surprised by 3.5 months after reading some many recommendation to do this over a year, or more. 

 

Thanks in advance for helping a stranger.

  • Aug - Oct 2022: Completed tapering (with various percentage drops from 10mg to 0.5mg which was my jumpoff on Nov 3, 2022). Felt ok.
  • July 2022: Held at 10mg for 4 weeks (no issues)
  • May 25, 2022: Began tapering, using 10% approach (weekly, except for first reduction which was 2 weeks)
  • 2014 - May 2022: Citalopram 20mg
  • 2001 - 2014: Tried various SSRIs: Paxil; Zoloft; Effexor; Lexapro; Prozac; Lovox; Remeron 
    • During these 13 years I was off meds 3 times, but never for more than 6 months
    • The 3 times I was off meds, in retrospect the tapers were much too fast - anxiety had to be controlled with Xanax, etc
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  • ChessieCat changed the title to NextStep: About to start tapering off Citalopram 20mg - with a twist
  • Moderator Emeritus

Hi NextStep and welcome to SA,

 

Thank you for creating your drug signature.

 

3 hours ago, NextStep said:

This psychiatrist also works with both micro & macro dosing of psilocybin. We discussed having me try micro-dosing about 1 month into the tapering if everything is going ok.

 

The only supplements which SA recommends are magnesium and omega 3 fish oil.  The goal of tapering is to reduce the drug slowly enough so that the brain adapts to not getting as much of the drug and only reducing when you are stable.  The idea is to get off your drug with minimal discomfort and be able to live your life as normally as possible.  Adding in an unproven supplement can be risky.  It is much better to do a careful taper by listening to your body/symptoms.

 

Why taper by 10% of my dosage?


Dr Joseph Glenmullen's WD Symptoms Checklist

 

Magnesium

Omega-3 Fish Oil

 

3 hours ago, NextStep said:

Currently I'm on Citalopram 20mg and have been on it for approximately the last 8 years. If it's doing anything, it's not doing enough.

 

It could be that the drug has reached tolerance, tachyphylaxis, poop out.

 

tolerance-or-poop-out-or-tachyphylaxis

 

3 hours ago, NextStep said:

I'm currently out of the US and liquid Citalopram is not available.

 

Lexapro is a very strong drug and we have many SA members who are having difficulties getting off it.  If it was me I would NOT be changing to Lexapro.

 

It is possible to make your own liquid using citalopram tablets and I think that this would be the best option.

 

See Post #1 of this topic about how to get non standard doses including how to make your own liquid:

 

Tips for tapering off citalopram (Celexa)

 

There are many existing topics on SA where members discuss their experience with various supplements.  Please do a search for the ones you are considering.  Use the site search function OR use an internet search engine and add site:survivingantidepressants.org to the search term.

 

This is your own Introduction topic and is the best place to ask questions about your own situation and journal your progress.  This keeps your history in one place and means that you don't have to repeat your story.

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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1 hour ago, ChessieCat said:

It is possible to make your own liquid using citalopram tablets and I think that this would be the best option.

 

See Post #1 of this topic about how to get non standard doses including how to make your own liquid:

 

Tips for tapering off citalopram (Celexa)

 

Thanks for your thoughtful reply ChessieCat. Your recommendation to NOT switch from Citalopram to Lexapro just because I can't get Citalopram in liquid form here in Brazil definitely resonated with me. It seems like it would add another variable to an already delicate process. It kind of makes me question how much I should trust the doctor that gave me this advice. Between this, and the doctor's advice to be done with the taper in 3.5 months I wonder if she's the right professional to be guiding me through this.

That said, I feel a bit hesitant about making my own liquid Citalopram. I went to the link you provided, but it seems I think I had to visit this page for further into: https://www.survivingantidepressants.org/topic/2693-how-to-make-a-liquid-from-tablets-or-capsules/

 

 

There was a lot of updated information in the thread, as well as some things Rhiannon wrote that made me feel like this isn't exactly a perfect science. I'd like to know:

  • Is this a widely accepted/used method? Rhiannon's post sounds very personal
  • How many mL of water should be used for a 20mg pill? And for 10mg? And for 5mg? 
  • How long can the solution be saved? Does it need to be refrigerated? 

I'd like to have a process that would be easy for travel. 

 

Also, just so you're aware, the link you provided for "Dr Joseph Glenmullen's WD Symptoms Checklist" doesn't seem to be working. 

 

Again, many thanks for your attention and help.

 

 

  • Aug - Oct 2022: Completed tapering (with various percentage drops from 10mg to 0.5mg which was my jumpoff on Nov 3, 2022). Felt ok.
  • July 2022: Held at 10mg for 4 weeks (no issues)
  • May 25, 2022: Began tapering, using 10% approach (weekly, except for first reduction which was 2 weeks)
  • 2014 - May 2022: Citalopram 20mg
  • 2001 - 2014: Tried various SSRIs: Paxil; Zoloft; Effexor; Lexapro; Prozac; Lovox; Remeron 
    • During these 13 years I was off meds 3 times, but never for more than 6 months
    • The 3 times I was off meds, in retrospect the tapers were much too fast - anxiety had to be controlled with Xanax, etc
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  • Moderator Emeritus
46 minutes ago, NextStep said:

Also, just so you're aware, the link you provided for "Dr Joseph Glenmullen's WD Symptoms Checklist" doesn't seem to be working. 

 

I've just checked it and it goes to a PDF in my browser, so it looks like your device / browser is not set up to access it this way.

 

There is a link to the PDF here in Post #1 of this topic.  You might need to Save As and then open the downloaded document.

 

Dr Joseph Glenmullen's Withdrawal Symptoms

 

49 minutes ago, NextStep said:

I feel a bit hesitant about making my own liquid Citalopram.

 

We have many members making their own liquid from tablets.  Originally Rhiannon was using alcohol but then changed to only using water.  See this post.

 

If you put (for example) a 10mg tablet in 10mL of water then each 1mL of liquid will equal 1mL of the drug.

 

One of the members bought an adjustable volume pipette.  See this post.  (and there is another post further down the page)

 

50 minutes ago, NextStep said:

It kind of makes me question how much I should trust the doctor that gave me this advice. Between this, and the doctor's advice to be done with the taper in 3.5 months I wonder if she's the right professional to be guiding me through this.

 

We have some members who do not tell their doctor that they are tapering and let them think that they have decided to stay on their drug.  To do an SA style taper rate it is important to be able to continue getting your prescription.  In many countries you can see a general doctor to get the prescription.

 

In your situation you might decide to tell the doctor that you are not going to taper at this time and want to stay on your AD but want to change to tablet because it will be more convenient.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Hi ChessieCat,

 

Thanks so much for the continued support. I read through Rhi's post about making liquid Citalopram, but need to give it a closer look. Am I now approved on the forum to be able to reply to other people's topics? Perhaps my questions around making one's own liquid should be added to that thread you shared? 

 

Also, in the current depressed state I'm in (while still taking the Citalopram 20mg daily) I'm finding myself a bit overwhelmed while going through SA. It's an amazing resource, but at times I find myself going down a rabbit hole reading people's personal horror stories and it just adds extra anxiety and gloom. I'd love to find a therapist (or combo psychiatrist/therapist) who has a LOT of experience with tapering and providing support. Someone who also has experience with using supplements properly, etc. And who could talk about the underlying long-term problems I struggle with, to try to make change. They would have to be willing to have online sessions.

 

Does SA have any recommendations based on members' experiences? 

 

Again, many thanks.

  • Aug - Oct 2022: Completed tapering (with various percentage drops from 10mg to 0.5mg which was my jumpoff on Nov 3, 2022). Felt ok.
  • July 2022: Held at 10mg for 4 weeks (no issues)
  • May 25, 2022: Began tapering, using 10% approach (weekly, except for first reduction which was 2 weeks)
  • 2014 - May 2022: Citalopram 20mg
  • 2001 - 2014: Tried various SSRIs: Paxil; Zoloft; Effexor; Lexapro; Prozac; Lovox; Remeron 
    • During these 13 years I was off meds 3 times, but never for more than 6 months
    • The 3 times I was off meds, in retrospect the tapers were much too fast - anxiety had to be controlled with Xanax, etc
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  • Moderator Emeritus

There is a lot of information in this post.  I have added a quote for each comment to give you context.

 

So that you don't feel overwhelmed, just work your way through it from the top BUT please make sure you have read through the whole post before making any changes.

 

8 hours ago, NextStep said:

Am I now approved on the forum to be able to reply to other people's topics?

 

You should be able to reply in other topics now.  If you cannot do this please let us know.  Occasionally a member will experience and issue with this.

 

8 hours ago, NextStep said:

Perhaps my questions around making one's own liquid should be added to that thread you shared? 

 

Yes you can ask general questions in that topic.  However any questions specific to your own situation are better asked here in your Introduction topic, which keeps your history in one place.  Staff regularly check the Introduction forum for new posts but posts made elsewhere may not get seen.

 

8 hours ago, NextStep said:

I'm finding myself a bit overwhelmed while going through SA.

 

This is understandable and happens to many members, me included.  I arrived here experienced extreme brain fog from having reduced my Pristiq from 100mg to 50mg so I do understand how hard can be.

 

My suggestion would be to just try to work through it bit by bit, because there is a lot of new information that we are trying to learn about and absorb.

 

8 hours ago, NextStep said:

at times I find myself going down a rabbit hole reading people's personal horror stories and it just adds extra anxiety and gloom.

 

I suggest that you try to stick to the information topics.  You do not need the added stress of other members' bad experiences.

 

On 5/1/2022 at 11:39 AM, NextStep said:

liquid Citalopram

 

Please read this topic before changing to liquid:

 

cross-over-changing-form-eg-tablet-to-liquid-of-drug-or-changing-brand-of-same-drug

 

8 hours ago, NextStep said:

I'd love to find a therapist (or combo psychiatrist/therapist) who has a LOT of experience with tapering and providing support.

 

There are not many medical professionals who understand psychiatric drugs and how to get off them.  They get their information about drugs from the pharmaceutical companies.  That is the reason why SA, which started in 2011, and many others like it, exist. 

 

how-to-talk-to-a-doctor-about-tapering-and-withdrawal-what-to-expect

 

recommended-doctors-therapists-and-clinics

 

You could also ask in the relevant topic (see Post #1):

 

check-in-topics-survivingantidepressantorg-members-near-you

 

 

8 hours ago, NextStep said:

Someone who also has experience with using supplements properly, etc.

 

If you do a careful taper then you may not need to try supplements, other what SA recommends, magnesium and omega 3 fish oil.  If you do ever try anything new I suggest that you do a search for it here on SA to see other members' experiences, start with a small amount and only try one thing at a time, ie not a complex.  And you only make one change at a time, so you would not make a citalopram reduction and start a new supplement at the same time.

 

Keep it Simple, Slow and Stable

 

8 hours ago, NextStep said:

And who could talk about the underlying long-term problems I struggle with, to try to make change.

 

Having a good, supportive therapist (even if they are not able to support you with your taper) can be very helpful.  I often suggest to members that they find a therapist who can teach them general life coping skills which in itself can be helpful for handling tapering/withdrawal.

 

SA strongly encourages members to learn and use:

 

Non-drug techniques to cope

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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On 5/3/2022 at 7:40 PM, ChessieCat said:

If you do a careful taper then you may not need to try supplements, other what SA recommends, magnesium and omega 3 fish oil.  If you do ever try anything new I suggest that you do a search for it here on SA to see other members' experiences, start with a small amount and only try one thing at a time, ie not a complex.  And you only make one change at a time, so you would not make a citalopram reduction and start a new supplement at the same time.

 

Thanks for this important reminder about making one change at a time - this is an approach I like to take in general when it comes to anything health-related. Since at the moment I haven't started tapering and am not feeling great, I'm thinking that it might not be a bad idea to flip the approach around. Meaning, instead of starting with the taper and seeing how I do, instead start with supplements (one at a time), along with diet, therapy, and other lifestyle changes, and once I'm feeling a bit better begin the tapering. 

 

With regards to magnesium and omega 3 fish oil. If I'm going to start with one, is there a recommendation as to which one? From what I've read I'm leaning towards starting with fish oil, but curious to hear your thoughts based on what you've heard from other members. 

 

I should also mention that I'm currently taking L-Tryptophan and Spirulina (both at 500mg 2x/day) . This was started a couple of months ago when I found out I was mildly pre-diabetic and a doctor suggested the Spirulina to help with blood sugar level, and L-Tryptophan to try to help with my anxiety (which they say can affect blood-sugar).

 

Thanks again for your continued support. 

 

 

 

  • Aug - Oct 2022: Completed tapering (with various percentage drops from 10mg to 0.5mg which was my jumpoff on Nov 3, 2022). Felt ok.
  • July 2022: Held at 10mg for 4 weeks (no issues)
  • May 25, 2022: Began tapering, using 10% approach (weekly, except for first reduction which was 2 weeks)
  • 2014 - May 2022: Citalopram 20mg
  • 2001 - 2014: Tried various SSRIs: Paxil; Zoloft; Effexor; Lexapro; Prozac; Lovox; Remeron 
    • During these 13 years I was off meds 3 times, but never for more than 6 months
    • The 3 times I was off meds, in retrospect the tapers were much too fast - anxiety had to be controlled with Xanax, etc
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  • Moderator Emeritus
36 minutes ago, NextStep said:

I found out I was mildly pre-diabetic

 

I won't go into it here but you can read what I have posted elsewhere.  I have reversed/remitted my diabetes by diet alone by cutting out sugar and a lot of/most carbs in only 3 months:

 

chessiecat-so-im-not-the-only-one-pristiq-desvenlafaxine

 

And we have this topic too where I have posted links to some helpful videos:

 

diabetes

 

38 minutes ago, NextStep said:

With regards to magnesium and omega 3 fish oil. If I'm going to start with one, is there a recommendation as to which one? From what I've read I'm leaning towards starting with fish oil, but curious to hear your thoughts based on what you've heard from other members. 

 

I don't think it matters which one you start first.  However you state this:

 

39 minutes ago, NextStep said:

L-Tryptophan to try to help with my anxiety

 

Magnesium can help with this.  Some members find that some supplements can actually turn paradoxical after they have used them for a while.  There are many existing topics on SA.  To find them you can use the site search function or a search engine and add site:survivingantidepressants.org to the search term.

 

40 minutes ago, NextStep said:

help with my anxiety (which they say can affect blood-sugar).

 

Stress/anxiety increases cortisol and when the cortisol increases the body uses more glucose from the blood, which is possibly why people "stress eat" (crave) sugar and high carb foods at this time.  I've always been an emotional eater.  It doesn't seem to be as bad on the low carb diet but it is still there but may be more of a habit response than a craving for carbs.  When this happens I find low carb foods to eat instead of what I used to eat, and during the first 3 months of my change over to low carb I still had biscuits and lollies/candy/sweets (a large variety) in the house and didn't even feel like eating them.

 

46 minutes ago, NextStep said:

Since at the moment I haven't started tapering and am not feeling great, I'm thinking that it might not be a bad idea to flip the approach around. Meaning, instead of starting with the taper and seeing how I do, instead start with supplements (one at a time), along with diet, therapy, and other lifestyle changes, and once I'm feeling a bit better begin the tapering. 

 

This might be a good way to do it.  If you are changing your diet, it is also generally better to do that gradually.  I didn't suddenly stop sugar and carbs.  I did it gradually by cutting out the obvious things (in fact a had a second blood test done only a few days after cutting out the obvious and my a1c had already gone down a bit) and then gradually changing over.  Some things I did end up throwing out (pizza bases) but others weren't too bad and I used then up and replaced them with better options.

 

I encourage you to look into low carb / keto diet for your diabetes; and you can keep it simple, you don't have to go high fat and buy "keto" products.  I decided to try it for 3 months to see if it worked because there was really nothing to lose by doing it, and it worked for me.  I get the results of my 2nd post low carb eating this week.

 

Check out the links in the Diabetes topic and if you want some more information on low carb / keto (there is a lot out there and some of it complicated when it doesn't need to be) please contact my by PM.

 

Please post psychiatric drug related questions here in your Introduction topic.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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22 hours ago, ChessieCat said:

Please post psychiatric drug related questions here in your Introduction topic.

 

Hi. I didn't mean to de-rail the conversation when I mentioned the pre-diabetes. That was only meant to give context to being prescribed the L-Tryptophan. I've actually already gotten myself out of the pre-diabetes zone a few years ago through diet, so I'm familiar with it. But thank you for the info you shared, and the offer to PM you for more. Very kind of you.

 

Anyway, at the moment I'm feeling like the depression is more of an issue than the anxiety, so I think the Omega-3 Fish Oil would be a good thing to try. Then the question will be whether to continue with the L-Tryptophan or swap it out for Magnesium. I realize it's not an exact science and just need to experiment. 

  • Aug - Oct 2022: Completed tapering (with various percentage drops from 10mg to 0.5mg which was my jumpoff on Nov 3, 2022). Felt ok.
  • July 2022: Held at 10mg for 4 weeks (no issues)
  • May 25, 2022: Began tapering, using 10% approach (weekly, except for first reduction which was 2 weeks)
  • 2014 - May 2022: Citalopram 20mg
  • 2001 - 2014: Tried various SSRIs: Paxil; Zoloft; Effexor; Lexapro; Prozac; Lovox; Remeron 
    • During these 13 years I was off meds 3 times, but never for more than 6 months
    • The 3 times I was off meds, in retrospect the tapers were much too fast - anxiety had to be controlled with Xanax, etc
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  • Moderator Emeritus
1 hour ago, NextStep said:

I didn't mean to de-rail the conversation when I mentioned the pre-diabetes.

 

No, that wasn't what I meant.  Sorry if I confused you.  What I meant was that I am happy to discuss diet via PM, but that I do not counsel members about their psychiatric drugs via PM.  There is no issue with you posting about your diet etc here in your Intro topic.  In fact it can be helpful because it gives us information about what other things might be causing/contributing to any issues you have.  I have posted about my change of diet and also my back/knee issues in my topic.

 

What I do is make sure that I separate psychiatric drug from other non drug issues so that members can easily see my AD updates but not have to read through other stuff they may not be interested in to get the information they are wanting.

 

I hope that clears up any confusion.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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On 5/9/2022 at 9:46 PM, ChessieCat said:

I hope that clears up any confusion.


Yes it does... thanks! 

 

 

On 4/30/2022 at 8:31 PM, ChessieCat said:

Lexapro is a very strong drug and we have many SA members who are having difficulties getting off it.  If it was me I would NOT be changing to Lexapro.

 

I was thinking about this statement again. I definitely don't like the idea of making a switch just for the tapering, but I'm curious ... are you saying that Lexapro appears to be more difficult to taper than Citalopram? 

 

 

On 4/30/2022 at 8:31 PM, ChessieCat said:

It is possible to make your own liquid using citalopram tablets and I think that this would be the best option.


I'm going to post a few questions over in Rhi's post that you linked to above. The questions aren't specific to my situation - they're more general, so I guess they should go there.


As always, thank you.

  • Aug - Oct 2022: Completed tapering (with various percentage drops from 10mg to 0.5mg which was my jumpoff on Nov 3, 2022). Felt ok.
  • July 2022: Held at 10mg for 4 weeks (no issues)
  • May 25, 2022: Began tapering, using 10% approach (weekly, except for first reduction which was 2 weeks)
  • 2014 - May 2022: Citalopram 20mg
  • 2001 - 2014: Tried various SSRIs: Paxil; Zoloft; Effexor; Lexapro; Prozac; Lovox; Remeron 
    • During these 13 years I was off meds 3 times, but never for more than 6 months
    • The 3 times I was off meds, in retrospect the tapers were much too fast - anxiety had to be controlled with Xanax, etc
Link to comment
  • Moderator Emeritus
8 minutes ago, NextStep said:

I was thinking about this statement again. I definitely don't like the idea of making a switch just for the tapering, but I'm curious ... are you saying that Lexapro appears to be more difficult to taper than Citalopram? 

 

Some members have difficulties getting off Lexapro.  It might be because they don't realise that Lexapro is a lot stronger than most other psychiatric drugs. 

 

For you, changing now to citalopram would probably not be a good idea.  But please remember the following from Post #1 of the Tips for Tapering Lexapro topic:

 

  

On 5/27/2011 at 12:16 PM, Altostrata said:

 

Consequently, when you taper off escitalopram, you should be careful to decrease by small amounts, as each drop is magnified by escitalopram's extra potency. If you find withdrawal symptoms from a 10% decrease to be too difficult, after 3-4 weeks decrease by a smaller amount.

 

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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58 minutes ago, ChessieCat said:

For you, changing now to citalopram would probably not be a good idea.  But please remember the following from Post #1 of the Tips for Tapering Lexapro topic:

 

You meant changing to Lexapro, right? I'm currently taking Citalopram.

 

1 hour ago, ChessieCat said:

Some members have difficulties getting off Lexapro.  It might be because they don't realise that Lexapro is a lot stronger than most other psychiatric drugs. 

 

What the psychiatrist told me is that 10mg of Lexapro = 10mg of Citalopram. So it's just a matter of adjusting accordingly (according to her, not me). 

 

  • Aug - Oct 2022: Completed tapering (with various percentage drops from 10mg to 0.5mg which was my jumpoff on Nov 3, 2022). Felt ok.
  • July 2022: Held at 10mg for 4 weeks (no issues)
  • May 25, 2022: Began tapering, using 10% approach (weekly, except for first reduction which was 2 weeks)
  • 2014 - May 2022: Citalopram 20mg
  • 2001 - 2014: Tried various SSRIs: Paxil; Zoloft; Effexor; Lexapro; Prozac; Lovox; Remeron 
    • During these 13 years I was off meds 3 times, but never for more than 6 months
    • The 3 times I was off meds, in retrospect the tapers were much too fast - anxiety had to be controlled with Xanax, etc
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31 minutes ago, NextStep said:

You meant changing to Lexapro, right? I'm currently taking Citalopram.

 

Sorry I got confused.  In your first post you said:

 

On 5/1/2022 at 5:36 AM, NextStep said:

that I switch to Lexapro for the taper,

 

AND I've also been discussing Lexapro with another member today.  So it's understandable that I've cross my wires along the way.

 

My statement that you quoted was because I thought you were currently on Lexapro and I was saying that if you were having no issues that it didn't make sense to switch to citalopram to taper off.  But you are already on citalopram. 

 

37 minutes ago, NextStep said:

What the psychiatrist told me is that 10mg of Lexapro = 10mg of Citalopram. So it's just a matter of adjusting accordingly (according to her, not me). 

 

No, escitalopram is much stronger than citalopram.  Just a quick internet search will show that they are not equal.  Search escitalopram citalopram equivalency.

 

Just to clarify, if it was me I would not be changing from citalopram to escitalopram.

 

I found these:

 

https://ipswichandeastsuffolkccg.nhs.uk/LinkClick.aspx?fileticket=6JoKJA8nPsg%3D

 

https://ahpnetwork.com/wp-content/uploads/2017/09/Switching-Scenarios.pdf

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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42 minutes ago, NextStep said:

What the psychiatrist told me is that 10mg of Lexapro = 10mg of Citalopram. So it's just a matter of adjusting accordingly (according to her, not me). 

 

I would be very concerned if this was my psychiatrist.  The information is readily available on the internet, so why doesn't this psychiatrist know that the two drugs are not the same strength.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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6 minutes ago, ChessieCat said:

I would be very concerned if this was my psychiatrist.  The information is readily available on the internet, so why doesn't this psychiatrist know that the two drugs are not the same strength.

 

Sorry, that was a BIG typo on my part (it's late here). What I meant to write was 10mg Lexapro = 20mg Citalopram. So she was saying that I could switch to the Lexapro liquid as long at this is kept in mind while dosing and doing the taper

  • Aug - Oct 2022: Completed tapering (with various percentage drops from 10mg to 0.5mg which was my jumpoff on Nov 3, 2022). Felt ok.
  • July 2022: Held at 10mg for 4 weeks (no issues)
  • May 25, 2022: Began tapering, using 10% approach (weekly, except for first reduction which was 2 weeks)
  • 2014 - May 2022: Citalopram 20mg
  • 2001 - 2014: Tried various SSRIs: Paxil; Zoloft; Effexor; Lexapro; Prozac; Lovox; Remeron 
    • During these 13 years I was off meds 3 times, but never for more than 6 months
    • The 3 times I was off meds, in retrospect the tapers were much too fast - anxiety had to be controlled with Xanax, etc
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Thank you for correcting that error.

 

It's up to you to decide on which drug to take.  I just provided you with the information and my thoughts.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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During my taper generic desvenlafaxine became available and the pharmacist didn't ask before filling my prescription but the lady told me that it was now generic and I said no, I want the brand Pristiq.  I've seen too many members have issues with what seems like a minor change and decided that I wanted to stick with what I was already taking.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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1 minute ago, ChessieCat said:

It's up to you to decide on which drug to take.  I just provided you with the information and my thoughts.

 

And it's much appreciated. To be honest I'm a bit at a loss as to which approach to take. I was just trying to better understand the statement about Lexapro being more difficult to get off of compared to Citalopram.

  • Aug - Oct 2022: Completed tapering (with various percentage drops from 10mg to 0.5mg which was my jumpoff on Nov 3, 2022). Felt ok.
  • July 2022: Held at 10mg for 4 weeks (no issues)
  • May 25, 2022: Began tapering, using 10% approach (weekly, except for first reduction which was 2 weeks)
  • 2014 - May 2022: Citalopram 20mg
  • 2001 - 2014: Tried various SSRIs: Paxil; Zoloft; Effexor; Lexapro; Prozac; Lovox; Remeron 
    • During these 13 years I was off meds 3 times, but never for more than 6 months
    • The 3 times I was off meds, in retrospect the tapers were much too fast - anxiety had to be controlled with Xanax, etc
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  • Moderator Emeritus

It's possible, and I stress possible, that the reason why people have difficulty getting off Lexapro is simply because it is such a strong drug and they are not aware of this fact.

 

See this warning in the Tips for Tapering Lexapro topic Post #1:

 

  

On 5/27/2011 at 12:16 PM, Altostrata said:

 

If you are taking 5mg of Lexapro, it's not tiny, it's equivalent to 10-20mg Paxil or Celexa.

Consequently, when you taper off escitalopram, you should be careful to decrease by small amounts, as each drop is magnified by escitalopram's extra potency. If you find withdrawal symptoms from a 10% decrease to be too difficult, after 3-4 weeks decrease by a smaller amount.

 

 

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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2 minutes ago, ChessieCat said:

During my taper generic desvenlafaxine became available and the pharmacist didn't ask before filling my prescription but the lady told me that it was now generic and I said no, I want the brand Pristiq.  I've seen too many members have issues with what seems like a minor change and decided that I wanted to stick with what I was already taking.

 

Yeah, my gut tells me to stick with what I'm taking as well. For some reason I'm just hesitant about making my own liquid. That's really the only issue at the moment. I posted over at the below thread with my questions around this... 

 

  • Aug - Oct 2022: Completed tapering (with various percentage drops from 10mg to 0.5mg which was my jumpoff on Nov 3, 2022). Felt ok.
  • July 2022: Held at 10mg for 4 weeks (no issues)
  • May 25, 2022: Began tapering, using 10% approach (weekly, except for first reduction which was 2 weeks)
  • 2014 - May 2022: Citalopram 20mg
  • 2001 - 2014: Tried various SSRIs: Paxil; Zoloft; Effexor; Lexapro; Prozac; Lovox; Remeron 
    • During these 13 years I was off meds 3 times, but never for more than 6 months
    • The 3 times I was off meds, in retrospect the tapers were much too fast - anxiety had to be controlled with Xanax, etc
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1 hour ago, NextStep said:

For some reason I'm just hesitant about making my own liquid.

 

Q:  What specifically are you hesitant about?

 

Doing anything new can be scary.  In this case we have been brought up to believe that doctors know what they are doing and the pharmaceutical companies tell us that we shouldn't tamper with our drug.  My drug patient information says not to cut the tablet BUT they also say not to stop the drug suddenly.  They make 25mg, 50mg and 100mg Pristiq doses but in Australia you cannot get 25mg.  I was very thankful that previous members had provided information on how they got off; and I ended up adding to that information when I made the discovery that it is possible to make a liquid from the compounded capsules, which meant that I could get small doses.

 

From what I can see, citalopram is an easy drug to make a liquid with.  The tools (graduated cylinder and syringes; I also purchased a medicine dropper to make it easier when measuring the water using the cylinder) are easy to obtain and cheap to purchase.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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7 hours ago, ChessieCat said:

Q:  What specifically are you hesitant about?

 

Mainly it's what I mentioned in the other thread that you replied to - about the liquid maintaining its potency. In all honesty, my nature is to question and to worry ... so it's not just around this. I also tend to not make decisions in general because I always look for the "perfect solution" ... and then wind up doing nothing (and depression sure doesn't help with that). Also, the fact that I had bad withdrawal experiences in the past are probably playing a part in my fear. That said I know it's time to get off these meds - not because I'm "doing great", but I just really need to see what my true baseline is. 
 

7 hours ago, ChessieCat said:

From what I can see, citalopram is an easy drug to make a liquid with.  The tools (graduated cylinder and syringes; I also purchased a medicine dropper to make it easier when measuring the water using the cylinder) are easy to obtain and cheap to purchase.


Yeah, I need to get my little "kit" together. When you say you used a medicine dropper ... was that to add water *to* the cylinder? 
 

  • Aug - Oct 2022: Completed tapering (with various percentage drops from 10mg to 0.5mg which was my jumpoff on Nov 3, 2022). Felt ok.
  • July 2022: Held at 10mg for 4 weeks (no issues)
  • May 25, 2022: Began tapering, using 10% approach (weekly, except for first reduction which was 2 weeks)
  • 2014 - May 2022: Citalopram 20mg
  • 2001 - 2014: Tried various SSRIs: Paxil; Zoloft; Effexor; Lexapro; Prozac; Lovox; Remeron 
    • During these 13 years I was off meds 3 times, but never for more than 6 months
    • The 3 times I was off meds, in retrospect the tapers were much too fast - anxiety had to be controlled with Xanax, etc
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19 hours ago, NextStep said:

my nature is to question

 

That is normal, especially for many of us here at SA and I think it is very understandable.  We trusted the medical professionals who we are lead to believe know what they are doing.  And it can be hard to know what to trust that we find on the internet.  Altostrata, SA's founder, started SA in 2011 and has assisted many members during that time.  She has done a lot investigation about how to get non standard doses of psychiatric drugs.  It is Alto who has said that the homemade liquid is generally okay for 3-4 days covered and refrigerated.  There is at least one drug or form of a particular drug that it is noted in the Tips for tapering that drug that the dose needs to be made up every day because it cannot be stored.  I'm telling you this to try to help you realise that it is not information that someone has just plucked out of the thin air, but that this method has been used by many members over the years.  For myself I was making liquid from the contents of my compounded Pristiq and I was using it for about 2 weeks at time, BUT I was taking a very low dose and I would not suggest that other members do that.

 

19 hours ago, NextStep said:

When you say you used a medicine dropper ... was that to add water *to* the cylinder? 

 

I have a 100mL graduated cylinder and found it difficult to get the exact amount.  If I overfilled it and then tipped some out it would be under the 100mL then if I topped it up a bit it would be over.  So I filled it with water and "finalised" the amount but using the dropped to add/remove water as needed; I was able to add to it by drops of water until it was at the line measure.  It isn't necessary to have one but it helped to make the process easier.

 

Here is the link to show you what I mean (no affiliation):  medicine dropper

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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On 5/13/2022 at 5:19 AM, ChessieCat said:

That is normal, especially for many of us here at SA and I think it is very understandable.  We trusted the medical professionals who we are lead to believe know what they are doing.  And it can be hard to know what to trust that we find on the internet.  Altostrata, SA's founder, started SA in 2011 and has assisted many members during that time.  She has done a lot investigation about how to get non standard doses of psychiatric drugs.  It is Alto who has said that the homemade liquid is generally okay for 3-4 days covered and refrigerated.  There is at least one drug or form of a particular drug that it is noted in the Tips for tapering that drug that the dose needs to be made up every day because it cannot be stored.  I'm telling you this to try to help you realise that it is not information that someone has just plucked out of the thin air, but that this method has been used by many members over the years.  For myself I was making liquid from the contents of my compounded Pristiq and I was using it for about 2 weeks at time, BUT I was taking a very low dose and I would not suggest that other members do that.

 

Thank you for your understanding and sharing. Very much appreciated and helpful. 

 

 

On 5/13/2022 at 5:19 AM, ChessieCat said:

I have a 100mL graduated cylinder and found it difficult to get the exact amount.  If I overfilled it and then tipped some out it would be under the 100mL then if I topped it up a bit it would be over.  So I filled it with water and "finalised" the amount but using the dropped to add/remove water as needed; I was able to add to it by drops of water until it was at the line measure.  It isn't necessary to have one but it helped to make the process easier.

 

Makes sense. When putting together one's own "kit", besides your dropper tip, do you think it's an either/or decision for graduated cylinder vs oral syringe? Or is there a case where it's helpful to have both? 

  • Aug - Oct 2022: Completed tapering (with various percentage drops from 10mg to 0.5mg which was my jumpoff on Nov 3, 2022). Felt ok.
  • July 2022: Held at 10mg for 4 weeks (no issues)
  • May 25, 2022: Began tapering, using 10% approach (weekly, except for first reduction which was 2 weeks)
  • 2014 - May 2022: Citalopram 20mg
  • 2001 - 2014: Tried various SSRIs: Paxil; Zoloft; Effexor; Lexapro; Prozac; Lovox; Remeron 
    • During these 13 years I was off meds 3 times, but never for more than 6 months
    • The 3 times I was off meds, in retrospect the tapers were much too fast - anxiety had to be controlled with Xanax, etc
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1 hour ago, NextStep said:

Makes sense. When putting together one's own "kit", besides your dropper tip, do you think it's an either/or decision for graduated cylinder vs oral syringe? Or is there a case where it's helpful to have both? 

 

You need a graduated cylinder for measuring the water; mine was a 100mL capacity.  See this link for an example.  The oral syringes or Adjustable volume pipette (the syringes work out a lot cheaper - perhaps try these first - but if you are concerned about measuring your dose it might be worth getting the pipette) are needed to measure out the dose you take.  So you need both.  I found it helpful to have different sized syringes:  1mL, 3mL, 5mL and 10mL.

 

The syringes that I bought have what is called "slip tip".  You can see pictures of the different types on the page that I bought mine from (in Australia)

 

www.ebay.com.au/itm/Syringes-1ml-3ml-5ml-10ml-20ml-30ml-50ml-Nipro-Suit-Luer-Slip-Lock-Syringe

 

And because it is very easy to forget what to do or we can question whether we are getting it right, it is also a good idea to write down your formula/recipe for your reduction (ie amount of water used and the tablet size you use).  You might like to include the equipment you use and the order of the process, and also note down where you measure your liquid (my kitchen bench top is not level so I made sure to always put the cylinder on the same spot).  Because I was using different strengths/dilutions and using different compounded capsule doses, I found it essential to write down my "recipe" so I didn't get confused.  It helps reduce the stress and anxiety.

 

If you need to buy new syringes and you cannot get the same type, my suggestion is to make sure that you don't change the type during a reduction cycle but wait until you start a new dose.


The suggestion has been made to paint the barrel of the syringe with clear nail polish to stop the numbers wearing off but I don't know if that works (I think you might have to be careful that the nail polish doesn't "melt" the painted numbers - you could try it on an area that doesn't matter if it does); apparently this tip was posted on Amazon under syringes.  This is what I did:

  

On 12/4/2021 at 9:48 AM, ChessieCat said:

Put a good quality tape around the cylinder.  It definitely helps to stop the numbers wearing off.  But don't leave it in liquid too longer and dry the outside after use.

 

On 8/22/2021 at 4:30 PM, ChessieCat said:

Another tip:

 

I almost made a mistake when measuring my dose, thinking that I needed to measure 10mL which I needed 9mL.  What I now do is place an elastic band around the barrel of the syringe just above the dose that I am measuring.

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

Link to comment
  • 2 weeks later...
On 5/15/2022 at 9:56 PM, ChessieCat said:

 

You need a graduated cylinder for measuring the water; mine was a 100mL capacity.  See this link for an example.  The oral syringes or Adjustable volume pipette (the syringes work out a lot cheaper - perhaps try these first - but if you are concerned about measuring your dose it might be worth getting the pipette) are needed to measure out the dose you take.  So you need both.  I found it helpful to have different sized syringes:  1mL, 3mL, 5mL and 10mL.

 

The syringes that I bought have what is called "slip tip".  You can see pictures of the different types on the page that I bought mine from (in Australia)

 

www.ebay.com.au/itm/Syringes-1ml-3ml-5ml-10ml-20ml-30ml-50ml-Nipro-Suit-Luer-Slip-Lock-Syringe

 

And because it is very easy to forget what to do or we can question whether we are getting it right, it is also a good idea to write down your formula/recipe for your reduction (ie amount of water used and the tablet size you use).  You might like to include the equipment you use and the order of the process, and also note down where you measure your liquid (my kitchen bench top is not level so I made sure to always put the cylinder on the same spot).  Because I was using different strengths/dilutions and using different compounded capsule doses, I found it essential to write down my "recipe" so I didn't get confused.  It helps reduce the stress and anxiety.

 

If you need to buy new syringes and you cannot get the same type, my suggestion is to make sure that you don't change the type during a reduction cycle but wait until you start a new dose.


The suggestion has been made to paint the barrel of the syringe with clear nail polish to stop the numbers wearing off but I don't know if that works (I think you might have to be careful that the nail polish doesn't "melt" the painted numbers - you could try it on an area that doesn't matter if it does); apparently this tip was posted on Amazon under syringes.  This is what I did:

  

 

 

 

Thanks for all of the tips. Another tip that I read somewhere is to use a mortal & pestle to crush the pills into a powder to speed up the dissolving process. I realize that in this case I would just need to be careful to be sure all of the powder comes off the tools and winds up in the water.

  • Aug - Oct 2022: Completed tapering (with various percentage drops from 10mg to 0.5mg which was my jumpoff on Nov 3, 2022). Felt ok.
  • July 2022: Held at 10mg for 4 weeks (no issues)
  • May 25, 2022: Began tapering, using 10% approach (weekly, except for first reduction which was 2 weeks)
  • 2014 - May 2022: Citalopram 20mg
  • 2001 - 2014: Tried various SSRIs: Paxil; Zoloft; Effexor; Lexapro; Prozac; Lovox; Remeron 
    • During these 13 years I was off meds 3 times, but never for more than 6 months
    • The 3 times I was off meds, in retrospect the tapers were much too fast - anxiety had to be controlled with Xanax, etc
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  • Moderator Emeritus
4 hours ago, NextStep said:

 

Thanks for all of the tips. Another tip that I read somewhere is to use a mortal & pestle to crush the pills into a powder to speed up the dissolving process. I realize that in this case I would just need to be careful to be sure all of the powder comes off the tools and winds up in the water.

 

If you work from a stock pile / stockpile (search for both terms, space and no space, in the weighing topic) of crushed tablets then you don't have to worry about the residual amount.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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15 hours ago, ChessieCat said:

 

If you work from a stock pile / stockpile (search for both terms, space and no space, in the weighing topic) of crushed tablets then you don't have to worry about the residual amount.

 

Thanks, I'll take a look. In the meantime I have some big news ... I finally got started TODAY. Cut my 20mg pill in half with a pill cutter. Crushed one half and diluted in 100ml of water and then poured out 20ml of the solution leaving me with 80ml (2mg). Drank that, and swallowed the other half of the pill. Leaving me with 18mg for my first 10% reduction. I'll stick with this mix of pill & liquid, as per one of the posts you shared with me, for at least this first 10% taper. Then perhaps just move to all liquid to simplify things.

 

Having mixed feelings - of the excitement of taking charge mixed with fear of the unknown. I plan to get some blood work done soon to make sure any/all mood related things (magnesium, etc) are looking good before getting ahold of either Fish Oil, Magnesium, or both. Also going to start therapy, investigate some more intense breathing techniques for anxiety, and address as many other lifestyle changes I can. 

  • Aug - Oct 2022: Completed tapering (with various percentage drops from 10mg to 0.5mg which was my jumpoff on Nov 3, 2022). Felt ok.
  • July 2022: Held at 10mg for 4 weeks (no issues)
  • May 25, 2022: Began tapering, using 10% approach (weekly, except for first reduction which was 2 weeks)
  • 2014 - May 2022: Citalopram 20mg
  • 2001 - 2014: Tried various SSRIs: Paxil; Zoloft; Effexor; Lexapro; Prozac; Lovox; Remeron 
    • During these 13 years I was off meds 3 times, but never for more than 6 months
    • The 3 times I was off meds, in retrospect the tapers were much too fast - anxiety had to be controlled with Xanax, etc
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Hi welcome to the forum :)

 

I just came across your thread and caught up… Just quickly want to say, I can totally understand the apprehension, not knowing what’s best. Like you said though, we’re making change where we’re hoping for a positive impact on ourselves, so hats off for taking the first step 👏🏾
 

What I would say, as someone who has tried multiple times to come off AD, is that having tools in place while you’re tapering (and for after you’ve stopped) I feel is essential to getting by. There will be days we struggle and there will be days we celebrate feeling good. So it’s important to recognise that these days come and go

; accept them and use the tools to help you get through. This change of mindset has really helped me on my tapering journey. I feel more “in control” and compassionate to myself understanding that my brain is actively healing.

 

I wish you all the best on your journey :)

Click for My Journey :)

2015-2020 - on and off sertraline 100mg and fluoxetine 40mg. Tapered/restarted many times too fast/cold turkey.

 

July21 - Stopped 40mg fluoxetine cold turkey > Aug21 - reinstated 20mg fluoxetine > Dec21 - 20mg tablet every other day (didn’t know skipping days was bad news)

 

07/2/22 - 8.4mg liquid fluoxetine >

07/3/22 - 8mg > 01/06/22 - 7.6mg > 21/9/22 - 7.2mg > 20/10/22 - 6.8mg > 05/01/23 - 6.4mg > 02/02/23 - 6mg > 25/03/23 - 5.6mg > 03/06/23 - 5.2mg > 01/07/23 - 4.8mg > 11/07/23 - 4.0mg > 12/09/23 - 3.6mg > 02/10/23 - 3.2mg > 31/10/23 - 2.8mg > 14/11/23 - 2.4mg > 27/11/23 - 2mg > 15/12/23 - 1.6mg > 30/12/23 - 1.2mg > 19/01/24 - 1mg > 12/03/24 - 0.7mg >

29/03/24 - 0.6mg > 02/05/24 - 0.5mg *current dose*


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  • Moderator Emeritus

Generally we suggest only making one change at a time.  You have changed to liquid AND made a reduction.  The Cross Over from tablet to liquid topic mentions this.  The link to this topic was provided above.

 

Edited by ChessieCat

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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On 5/25/2022 at 12:47 PM, Patient2022 said:

Hi welcome to the forum :)

 

I just came across your thread and caught up… Just quickly want to say, I can totally understand the apprehension, not knowing what’s best. Like you said though, we’re making change where we’re hoping for a positive impact on ourselves, so hats off for taking the first step 👏🏾
 

What I would say, as someone who has tried multiple times to come off AD, is that having tools in place while you’re tapering (and for after you’ve stopped) I feel is essential to getting by. There will be days we struggle and there will be days we celebrate feeling good. So it’s important to recognise that these days come and go

; accept them and use the tools to help you get through. This change of mindset has really helped me on my tapering journey. I feel more “in control” and compassionate to myself understanding that my brain is actively healing.

 

I wish you all the best on your journey :)

 

Thanks for taking the time to show your support! 

  • Aug - Oct 2022: Completed tapering (with various percentage drops from 10mg to 0.5mg which was my jumpoff on Nov 3, 2022). Felt ok.
  • July 2022: Held at 10mg for 4 weeks (no issues)
  • May 25, 2022: Began tapering, using 10% approach (weekly, except for first reduction which was 2 weeks)
  • 2014 - May 2022: Citalopram 20mg
  • 2001 - 2014: Tried various SSRIs: Paxil; Zoloft; Effexor; Lexapro; Prozac; Lovox; Remeron 
    • During these 13 years I was off meds 3 times, but never for more than 6 months
    • The 3 times I was off meds, in retrospect the tapers were much too fast - anxiety had to be controlled with Xanax, etc
Link to comment

@ChessieCat I was speaking with a local pharmacist about my tapering and it turned out that he has some first hand experience with slow tapering, as he helped his wife come off an AD. It turned into a really good conversation and he showed so much care and desire to help.

 

When I mentioned to him that mornings have always been the hardest for me in terms of mood, he raised the "possibility" of changing when I take the medication. That said, he acknowledged that it's best to make only one change at a time. I'm curious if you've come across this topic here on SA and if it might make any sense to change to taking my medication at night. Thoughts?

 

That said, a couple of things to keep in mind.

1. For the many years I've taken ADs I've always taken them in the morning.

2. There's more of a chance of me missing a dose if it's before bed, although not likely to be frequent. Taking it in the morning, sometimes I might take it a few hours later than usual, but not likely to miss a dose

  • Aug - Oct 2022: Completed tapering (with various percentage drops from 10mg to 0.5mg which was my jumpoff on Nov 3, 2022). Felt ok.
  • July 2022: Held at 10mg for 4 weeks (no issues)
  • May 25, 2022: Began tapering, using 10% approach (weekly, except for first reduction which was 2 weeks)
  • 2014 - May 2022: Citalopram 20mg
  • 2001 - 2014: Tried various SSRIs: Paxil; Zoloft; Effexor; Lexapro; Prozac; Lovox; Remeron 
    • During these 13 years I was off meds 3 times, but never for more than 6 months
    • The 3 times I was off meds, in retrospect the tapers were much too fast - anxiety had to be controlled with Xanax, etc
Link to comment
  • Moderator Emeritus
3 hours ago, NextStep said:

When I mentioned to him that mornings have always been the hardest for me in terms of mood

 

Q1:  Do you take your dose every day at about the same time?

 

Q2:  Are you getting a consistently accurate dose?

 

Q3:  How long has this been happening; does it happen after making a reduction and then gradually improves before the next reduction; does it happen every morning?

 

Q4:  Please describe what you mean by "mood"; what does it feel like?

 

Q5:  How long does it take for your "mood" to improve?

 

Generally antidepressants are an activating drug which is why they are usually taken in the morning.  For some people if they are taken too late in the day it might affect sleep.  Getting good sleep (or at least as good as you are able to) is very important.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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1 hour ago, ChessieCat said:

Q1:  Do you take your dose every day at about the same time?

 

Yes, normally around 8am or so. Occasionally it's a few hours later.
 

1 hour ago, ChessieCat said:

Q2:  Are you getting a consistently accurate dose?

 

I only started tapering a few days ago, and yes, I'm taking care to keep it accurate. . The "morning issue" mentioned has existed for a long time. 
 

1 hour ago, ChessieCat said:

Q3:  How long has this been happening; does it happen after making a reduction and then gradually improves before the next reduction; does it happen every morning?

 

See Q2. This is unrelated to the tapering.
 

1 hour ago, ChessieCat said:

Q4:  Please describe what you mean by "mood"; what does it feel like?


Anxiety & depression. Racing brain/worry mixed with not wanting to get out of bed. Able to get going, but remain in a "funk" for several hours after getting up. Getting outside for a quick walk immediately tends to help.

 

1 hour ago, ChessieCat said:

Q5:  How long does it take for your "mood" to improve?

 

Several hours. Maybe 4 or so. Depends on the day. Even though the anxiety & depression soften towards the afternoon I often get tired and sometimes just want/need to curl up for a nap.
 

1 hour ago, ChessieCat said:

Generally antidepressants are an activating drug which is why they are usually taken in the morning.  For some people if they are taken too late in the day it might affect sleep.  Getting good sleep (or at least as good as you are able to) is very important.


In general I'm getting around 7 hours of sleep. Sometimes 8. But I should mention that even so I tend to wake up tired & groggy. 

  • Aug - Oct 2022: Completed tapering (with various percentage drops from 10mg to 0.5mg which was my jumpoff on Nov 3, 2022). Felt ok.
  • July 2022: Held at 10mg for 4 weeks (no issues)
  • May 25, 2022: Began tapering, using 10% approach (weekly, except for first reduction which was 2 weeks)
  • 2014 - May 2022: Citalopram 20mg
  • 2001 - 2014: Tried various SSRIs: Paxil; Zoloft; Effexor; Lexapro; Prozac; Lovox; Remeron 
    • During these 13 years I was off meds 3 times, but never for more than 6 months
    • The 3 times I was off meds, in retrospect the tapers were much too fast - anxiety had to be controlled with Xanax, etc
Link to comment
  • Moderator Emeritus

Thank you for answering my questions.

 

1 hour ago, NextStep said:

Yes, normally around 8am or so. Occasionally it's a few hours later.

 

Generally the closer you can keep to a time daily the better.

 

It might be cortisol.  If it is then changing your dose time probably won't make any difference.

 

early-morning-waking-managing-the-morning-cortisol-spike

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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