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Shadowsnana: starting to taper off Celexa


Shadowsnana

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I have been taking Celexa 10mg pill for probably the last 7 years but have been on this drug since the year 2000.  My PCP just prescribed Citalopram HBR 10MG/5ML solution on June 14, 2022 to make tapering easier for me rather than cutting up the pill form.  I plan to start my taper on June 20, 2022.  I know that I must taper at 10% of my previous dose and I plan to taper down every 4 weeks.  I came here searching for help on the taper amounts specifically for my prescribed solution, and I cannot find a spreadsheet here that shows the 10% taper amounts starting at 10MG using the 10MG/5ML solution in ML syringe measurements.  Does a spreadsheet like this exist and if so can you point me in the right direction where to access it?  Also, if no spreadsheet exists can someone please help me figure this out, I am no good in Excel and trying to convert this solution into 10% reductions using ML's in syringes is blowing my mind.  I do not want to take any part of the pill form anymore, I only want to take the solution.  I have a 5ml syringe and a 1ml syringe.  My first taper should be 9MG, how do I calculate how many ML's this is using a 10MG/5ML solution?

Shadowsnana

2000 - was put on Celexa 40mg pill

2010 - reduced to Celexa 20mg pill

2015 - reduced to Celexa 10mg pill

2020 - prescribed Lunesta 2.5mg to take as needed for insomnia

June 14th, 2022 was prescribed Citalopram liquid HBR 10mg/5ML solution to start tapering

June 16th, 2022 started using 5ml of Citalopram liquid HBR 10mg/5ML solution instead of 10mg pill

June 23th, 2022 tapered 10% to 4.5ml, July 26th, 2022 tapered 10% to 4.05ml

August 19th, 2022 - Stopped taking Lunesta 2.5mg

September 4, 2022 - tapered celexa to 3.6ml

October 20, 2022 - tapered celexa to 3.25ml

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  • ChessieCat changed the title to Shadowsnana: starting to taper off Celexa
  • Moderator
3 hours ago, Shadowsnana said:

I have been taking Celexa 10mg pill for probably the last 7 years but have been on this drug since the year 2000.  My PCP just prescribed Citalopram HBR 10MG/5ML solution on June 14, 2022 to make tapering easier for me rather than cutting up the pill form.  I plan to start my taper on June 20, 2022.  I know that I must taper at 10% of my previous dose and I plan to taper down every 4 weeks.  I came here searching for help on the taper amounts specifically for my prescribed solution, and I cannot find a spreadsheet here that shows the 10% taper amounts starting at 10MG using the 10MG/5ML solution in ML syringe measurements.  Does a spreadsheet like this exist and if so can you point me in the right direction where to access it?  Also, if no spreadsheet exists can someone please help me figure this out, I am no good in Excel and trying to convert this solution into 10% reductions using ML's in syringes is blowing my mind.  I do not want to take any part of the pill form anymore, I only want to take the solution.  I have a 5ml syringe and a 1ml syringe.  My first taper should be 9MG, how do I calculate how many ML's this is using a 10MG/5ML solution?

Hi @Shadowsnana

Welcome to SA. Good for you for starting the taper the right way. If you are just switching to liquid we would suggest that you don't make any other changes in that first month - i.e. do not make a 10% cut.

 

In your drug leaflet do you see anywhere whether the liquid is compared to pills? For example the UK version says that 8mg of the liquid is the same as 10mg of the pill because of bioavailability. I don't think the US version has that but it's good to check. If it doesn't say that anywhere on the leaflet then we'll treat this as a 5ml=10mg.

 

So if you switch to the liquid on 6/20, you will take 5ml for 4 weeks (no dose reduction as you're switching to a new formulation). I also recommend that you ask for the same producer of the liquid from then on for your refills.

 

SA recommends that when you switch to liquid you start by taking 1/4 of your liquid and 3/4 of the pill for a week then half and half and then 3/4 of the liquid and 1/4 of the pill for a week and then finally all liquid. But this means that you need to be able to measure 1/4 very precisely. In the absence of a precise scale, a direct switch may be ok at this high a dose. But I wouldn't make any other changes the first month. The reason is that if some adverse event occurs then you won't know if it's the new formulation or the reduction.

 

Here is your schedule for the tapering. 

 

On July 18 you would take 0.9,*5ml= 4.5ml of the liquid

 

Then if everything goes well on 8/15

You will take 0.9*4.5= 4.05ml (you'll need a 1 ml syringe for the 0.05ml)

 

Then 4 weeks later you'd start taking 

0.9*4.05  ml= 3.65ml 

 

Basically the rule is that you multiply your previous dose by 0.9. That's because if you are reducing by 10% then you're basically taking only 90% of your previous dose hence you multiply your previous dose by 0.9 to find your new dose.

 

I'm breaking it down for clarity. 

 

Please look at the FAQ in the tapering forum if you haven't done so yet. There is also a thread dedicated to tapering citalopram. I think it can be useful.

 

Good luck to you and do let me know if you have more questions about this.

 

OMW

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

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Thank you so much for the information! I read the paperwork that came with the liquid and didn't see anything about it being compared to pill form.  The liquid is manufactured by Camber Pharmaceuticals in NJ, and on the actual liquid bottle it states "each 5ml contains citalopram hydrobromide USP equivalent to 10 mg of citalopram base". There is also a link to the same sheet that came with my prescription online at http://camberpharma.com/medication-guides Based on what you stated above this has me worried that I might experience other or more side effects using the liquid form rather than the pill form I have been on.  The medication guide lists possible side effects from the "oral solution", and I'm wondering if these are the same side effects that you get from taking the pill form? I understand what you are saying that SA recommends a taper when you switch from one form to another, but I think you also stated that moving from a 10mg pill to solution might be OK at my low dose of 10mg, correct? I do not have a scale, so switching from pill to oral solution (3-4 weeks) and then being on the oral solution for another month will put me back about 2 months before I could actually start the tapering process, correct?  Obviously I want to get off this asap so the sooner I can start tapering the better, I'm wondering now if actually staying on the pill form and tapering would be better for me and in doing so would eliminate the possibility of side effects switching from pill or oral solution.  I would have to get a scale if I stayed with the pill to taper, or if I stayed with the liquid you said I could possibly just take 5ml daily for a month before tapering without slowly converting to the liquid?  I want to eliminate as much of the side effects as possible but am not really sure which route I should go. I tried searching for tapering off pill form and cutting up the pill but haven't come across more detailed info about if you can crush the pill and just weigh the crushed amount that you need, etc. is it in here somewhere and I'm just not finding it? The citalopram pills I've always have been on have been hard pills, nothing with beads in them.  I assumed that liquid would be easier and that's why I had my Dr. prescribe the liquid form, but honestly I don't know what would be easier for me now after reading your suggestions.  As long as I have a measuring tool (either syringe or scale) I am ok with measuring but calculating using a syringe with odd amounts is going to be my biggest struggle, at least with a scale I have an excel spreadsheet from here that tells you exactly what your measurement and weight should show on the scale.  Can I ask what you would recommend to someone whose brain is fried and do you know what other peoples experiences have been, easier or whatnot, using pill compared to liquid and if later people wished they chose the other form to taper?  Thank you for your help!

Shadowsnana

2000 - was put on Celexa 40mg pill

2010 - reduced to Celexa 20mg pill

2015 - reduced to Celexa 10mg pill

2020 - prescribed Lunesta 2.5mg to take as needed for insomnia

June 14th, 2022 was prescribed Citalopram liquid HBR 10mg/5ML solution to start tapering

June 16th, 2022 started using 5ml of Citalopram liquid HBR 10mg/5ML solution instead of 10mg pill

June 23th, 2022 tapered 10% to 4.5ml, July 26th, 2022 tapered 10% to 4.05ml

August 19th, 2022 - Stopped taking Lunesta 2.5mg

September 4, 2022 - tapered celexa to 3.6ml

October 20, 2022 - tapered celexa to 3.25ml

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  • Moderator

Hi @Shadowsnana

 

Seems like you're ok to do a 1 to 1 transition to liquid where 10mg=5 ml. Please get yourself a syringe and not rely on the drops.

 

I can create a spreadsheet for you next week (don't have wifi on my computer now). I'm tapering off citalopram using liquid. I find it easier at the low doses - I'm at 0.65 and can go down by 0.0016mg every day. You can dilute the liquid by a lot to get precise measurements. I dilute it in water to get very small measurements.

 

The scales may not be very precise at the very low doses. However there are plenty of people who do choose to stay on the pill form and either dissolve the pills in water or measure using scales. However even if you're on the pills you might be switched to different formulations depending on which pill the pharmacy has. It will be up to you - there isn't a right or wrong answer there. I, personally, like the liquid.

 

The switch to liquid should not be presenting problems but we want to be cautious. It's a different formulation with different solvents and fillers so it might be absorbed differently and it's from an abundance of caution that we are suggesting to wait for a month (or at least a few weeks) for your system to get used to the liquid before you start tapering. 

 

Is there a reason why you're in a rush to start tapering? Are you having serious side effects? Trying to get pregnant? 

 

Here's the thread on tapering citalopram with more information

 

 

 

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

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Yes My cardiologist wants me off this medicine bc I’m having arrhythmias, PVC’s. I’m 59 so no to a pregnancy. Just started having these PVC’s in March. I told my Dr. about these feeling I was having, fast heart rate, pounding etc and they ordered a holter monitor. Dr got back to me with results and said it showed a very high amount of PVC’s in the 48 hours I wore the monitor and said he was referring me to cardiology. I had my first cardio appt on 6/2 and Dr said celexa can cause a heart issues but from what I’ve read it’s when it’s over 40mg, and Ive been on 10mg for many years, but she wants me to get off it anyway, and also put me on a beta blocker to help eliminate the PVC’s along with magnesium and potassium since my potassium level was at the very bottom of the normal range. When I asked her to help me taper off celexa and with dosing she said she doesn’t know how to do that and referred me back to my regular Dr, who wants me to go down to 5mg for 2 weeks with the liquid he prescribed me then stop it completely, which I don’t agree with. Thank you for offering to get me a spreadsheet for the liquid, that would help me tremendously. 

Shadowsnana

2000 - was put on Celexa 40mg pill

2010 - reduced to Celexa 20mg pill

2015 - reduced to Celexa 10mg pill

2020 - prescribed Lunesta 2.5mg to take as needed for insomnia

June 14th, 2022 was prescribed Citalopram liquid HBR 10mg/5ML solution to start tapering

June 16th, 2022 started using 5ml of Citalopram liquid HBR 10mg/5ML solution instead of 10mg pill

June 23th, 2022 tapered 10% to 4.5ml, July 26th, 2022 tapered 10% to 4.05ml

August 19th, 2022 - Stopped taking Lunesta 2.5mg

September 4, 2022 - tapered celexa to 3.6ml

October 20, 2022 - tapered celexa to 3.25ml

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  • Moderator

Hi @Shadowsnana

Then why don't you move to the liquid for a week directly and we can go from there. The full effects of this drug will usually be evident in a week so if any issues arise with the liquid (most likely they won't), we can make changes. After a week you can start tapering. It's possible that your taper might go slightly easier but let's try at 10% every 4 weeks to begin with and if things go well and you don't have symptoms you can go slightly faster. But let's plan for 10%.

 

Why do you need to wait until the 20th to switch to liquid? Can you do it now? That way you are going along faster?

 

omw

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

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@OnmywayI picked next Monday the 20th so I could get all my ducks in a row and figure out everything I needed to, like my measurements and how to convert them into the measurements in the syringes, try and make an excel spreadsheet, etc…. I just picked up the liquid last night from the pharmacy and figured Id take the weekend to try and figure this all out. I can definitely start the liquid tonight and try it for a week and see how it goes with the 5ml. Thank you so much for all your assistance!

Shadowsnana

2000 - was put on Celexa 40mg pill

2010 - reduced to Celexa 20mg pill

2015 - reduced to Celexa 10mg pill

2020 - prescribed Lunesta 2.5mg to take as needed for insomnia

June 14th, 2022 was prescribed Citalopram liquid HBR 10mg/5ML solution to start tapering

June 16th, 2022 started using 5ml of Citalopram liquid HBR 10mg/5ML solution instead of 10mg pill

June 23th, 2022 tapered 10% to 4.5ml, July 26th, 2022 tapered 10% to 4.05ml

August 19th, 2022 - Stopped taking Lunesta 2.5mg

September 4, 2022 - tapered celexa to 3.6ml

October 20, 2022 - tapered celexa to 3.25ml

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  • Moderator

Hi @Shadowsnana

That sounds good. If you start the liquid tonight then next Thursday you can start lowering to 4.5ml. By then I will get you a spreadsheet.

 

This is going to be ok! You're doing the right thing by going slowly.

 

Good luck and hope you have an uneventful taper.

 

OMW

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

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Great, sounds like a plan!! Thank you so much!!!!🙏

Shadowsnana

2000 - was put on Celexa 40mg pill

2010 - reduced to Celexa 20mg pill

2015 - reduced to Celexa 10mg pill

2020 - prescribed Lunesta 2.5mg to take as needed for insomnia

June 14th, 2022 was prescribed Citalopram liquid HBR 10mg/5ML solution to start tapering

June 16th, 2022 started using 5ml of Citalopram liquid HBR 10mg/5ML solution instead of 10mg pill

June 23th, 2022 tapered 10% to 4.5ml, July 26th, 2022 tapered 10% to 4.05ml

August 19th, 2022 - Stopped taking Lunesta 2.5mg

September 4, 2022 - tapered celexa to 3.6ml

October 20, 2022 - tapered celexa to 3.25ml

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  • 3 weeks later...

@OnmywayI started tapering on 6/16/22 and it is going OK so far.  I need to get off this med asap due to my PVC's and am wondering if at least in the beginning of my tapering it would be OK to reduce every 3 weeks instead of every 4, at least until I get down to a lower dose? I've read that as you get to smaller doses you have to taper slower, what are your thoughts on doing this?  Also, 3 weeks will be up tomorrow, if I reduce at 3 weeks from my current 4.5ml to I think it would be 4.05ml? Were you ever able to calculate a spreadsheet for me for the liquid?  How do I measure .05 in liquid ml form on a syringe? I do have a 1 ml syringe just not sure where .05 would be?

Shadowsnana

2000 - was put on Celexa 40mg pill

2010 - reduced to Celexa 20mg pill

2015 - reduced to Celexa 10mg pill

2020 - prescribed Lunesta 2.5mg to take as needed for insomnia

June 14th, 2022 was prescribed Citalopram liquid HBR 10mg/5ML solution to start tapering

June 16th, 2022 started using 5ml of Citalopram liquid HBR 10mg/5ML solution instead of 10mg pill

June 23th, 2022 tapered 10% to 4.5ml, July 26th, 2022 tapered 10% to 4.05ml

August 19th, 2022 - Stopped taking Lunesta 2.5mg

September 4, 2022 - tapered celexa to 3.6ml

October 20, 2022 - tapered celexa to 3.25ml

Link to comment
  • Moderator

Hi Shadowsnana, 

I haven't figured how to post a spreadsheet yet so I will paste it here in the text. This looks slow given your predicament but remember that at the lower doses the impact of the drug on the PVC should be low even if its impact on the nervous system in terms of WD is still high. Also, I am not suggesting that you jump at 0.75 but we can re-evaluate where you jump off after you taper the next months. If you have had no issues lowering to 4.5ml, you may try lowering again now. We don't recommend it but some people manage to get down ok faster. Did you have issues tapering down from 40mg to 10mg celexa  at all? If not, you may be a candidate for lowering every 3 wks. But I would suggest tracking your symptoms closely. I personally get physical and mental symptom increase 4-5 days after if I make a larger (5%) dose reduction but get hit by serious emotional spirals about 4 weeks after. Generally it is better to observe your symptoms carefully for a few months and find your own response cycle. 

 

If you had issues lowering from 40 to 10 mg, then I would not recommend a reduction every 3 weeks. I have looked into the literature and don't see PVC reports associated with citalopram. Celexa does cause heart issues - QT interval prolongation is a common one (can be seen on an ECG) in some people so it is possible that it is the cause of the PVC but I didn't see any other reports of this. 

 

Here is your spreadsheet. To get 4.05 ml with a 1ml syringe you would take 4 syringes worth and then the 5th syringe you would fill to the first large scored line halfway between the tip of the syringe and the 0.1 ml. In this picture it is covered by the black stopper. Basically the tip of the black stopper would be right at that heavier line between the tip of the syringe and the .1 line. Similar to the halfway line between -.4 and .5, .5 and .6 etc.  just yours would be between the tip of the syringe and the .1 line. 

MSZwaWQ9QXBp

 

original dose 5
dose after cut 1  4.5
dose after cut 2 4.05
dose after cut 3 3.65
dose after cut 4 3.28
dose after cut 5 2.95
dose after cut 6 2.66
dose after cut 7  2.39
dose after cut 8 2.15
dose after cut 9 1.94
dose after cut 10 1.74
dose after cut 11 1.57
dose after cut 12 1.41
dose after cut 13 1.27
dose after cut 14 1.14
dose after cut 15 1.03
dose after cut 16 0.93
dose after cut 17 0.83
dose after cut 18 0.75
   

You can get the 3.28 but diluting further (I can help with that) or you can simplify and take 3.3 rather than 3.28. We can decide how to do it when we get there. Pls let me know if you have any more question. How did the first dose reduction go for you? Any symptoms? 

OMW

Edited by Onmyway

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

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@OnmywayThanks so much for the reduction schedule for the liquid! It's fine that it wasn't in a spreadsheet and this is exactly what I needed, so thank you for your time in getting that info to me!! To answer your question, I've been on celexa so long, 20+ years, and I did not taper when I felt I didn't need this anymore, I just stopped it, I think I was on 40mg when I stopped, not sure though.  I remember being dizzy every now and then, like I was high, and thought hmm this is weird, but it was nothing really troublesome or constant, at least from what I remember.  The next time I went back to the Dr. I told her I quit and I had some dizzy spells and I remember her telling me that your not suppose to just stop taking the med, which of course I didn't know at the time.  I don't remember exactly when I went back on the med, and I think at that point it was 20mg, and I don't remember exactly when I went from 20 to 10.  I think I just stopped taking the 20 and started taking 10, and I don't recall ever having an issue with it. I have been on 10mg for probably 7 or more years now.

 

As far as side effects, I have been experiencing daily dizziness since April 2021 and have seen numerous Dr.'s to try to find out what is causing it.  I have seen every Dr. imaginable.  A neurologist I saw ordered a brain MRI and they found a pituitary adenoma, however the neurologist said that would not be causing my dizziness.  After I found this out I found a pituitary program near me and now see a neurosurgeon and a endocrinologist at the center who are following me for any adenoma growth.  My 6 month checkup was this past March 2022 and the adenoma had not grown at all.  The neurosurgeon said I would not require surgery unless the adenoma grows 4-5mm, and he said the dizziness could be from the adenoma but more than likely not. Cardiology was the only type of Dr. I had not seen for my dizziness, then I saw my PCP in March due to these palpitations I just started feeling and he ordered a 48 hr holter monitor which came back with a high number of PVC's, then he referred me to cardiology.  The cardiologist I saw on 6/2 said my dizziness could be from the PVC's.  We talked about the celexa, she did say that it can cause QT interval prolongation and wants me off the celexa. I'm not sure if the PVC's could be related to the celexa and have not specifically read anything that states PVC's however have seen palpitations, so IDK. So if I did experience any dizziness as an effect of tapering now I honestly wouldn't know it as I already have had dizziness since last April 2021, unless it got more severe than it already is.  My theory is that my dizziness is either from the PVC's or possibly the celexa causing it because I've been on it so long.  I have been on other medications for a long time as well, and last year in May 2021 I developed a chest rash that turned out to be from one of my meds I had never had a problem with and been on for years.  After talking to my Dr. he changed the medicine and my rash went away, but had it been caused by the celexa I don't know what I would've done.  Yet my dizziness continues...

 

So as far as switching to the liquid from pill form, I took the liquid for a week then started taking the 4.5ml.  I have been OK, I haven't noticed anything unusual other than what I have been experiencing the last year with the dizziness.  I did mess up my dates and realized I didn't start taking the 4.5ml until 6/23, so I will wait to reduce to 4.05 until 7/27 as we will be camping the third week in July and I don't want to reduce while out camping.  On a side note, I'm wondering if the liquid will be OK in the heat, obviously I won't have air conditioning to keep it cool and it will be in the mid to high 90's.   The bottle says keep at room temp, so I'm not sure what to do, I guess keeping it in the cooler is out too.  Hopefully as long as I keep it out of the sun I will be OK. And I took a pic of my 1ml syringe and marked where the .05 line is, just to confirm this is correct. Thanks again for your help, I really appreciate it, and I will stay in touch soon, when I taper again!

syring marking.jpg

Shadowsnana

2000 - was put on Celexa 40mg pill

2010 - reduced to Celexa 20mg pill

2015 - reduced to Celexa 10mg pill

2020 - prescribed Lunesta 2.5mg to take as needed for insomnia

June 14th, 2022 was prescribed Citalopram liquid HBR 10mg/5ML solution to start tapering

June 16th, 2022 started using 5ml of Citalopram liquid HBR 10mg/5ML solution instead of 10mg pill

June 23th, 2022 tapered 10% to 4.5ml, July 26th, 2022 tapered 10% to 4.05ml

August 19th, 2022 - Stopped taking Lunesta 2.5mg

September 4, 2022 - tapered celexa to 3.6ml

October 20, 2022 - tapered celexa to 3.25ml

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  • Moderator

Hi @Shadowsnana

yep, that is the right line on the picture. Good idea to wait on the tapering. It seems like you haven't had serious WD symptoms from lowering celexa so you may be ok to try every 3 weeks. However, sometimes these cuts accumulate for us and the next time might be more troublesome so pls watch your symptoms just in case. 

 

It seems reasonable to taper the drug given the dizziness and potential issue for the heart. But I am also glad that you are proceeding carefully and going slow. At 10mg citalopram has around 70% SERT occupancy (around 80-85% at 20 mg) so for the brain that dose is still very significant. 

https://www.semanticscholar.org/paper/Serotonin-transporter-occupancy-of-five-selective-Meyer-Wilson/f363bd06521ba4915761921bfca306396a4a7519

 

I think 90F might be too high for citalopram. Can you keep it in the shade in a thermos? This is what I find about it. 

https://www.drugs.com/pro/citalopram-oral-solution.html#s-34069-5
Store at 20°-25°C (68°-77°F); excursions permitted to 15°-30°C (59°-86°F). [see USP Controlled Room Temperature]

 

Have fun camping and hope you feel better and the dizziness goes away as you lower the dose :)
OMW

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

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  • 3 weeks later...

@OnmywayHi, I'm back from camping and am going to reduce my liquid celexa down to 4.05ml tonight.  I still have a little liquid left from my original bottle I got last month that I took camping with me.  I was careful to keep the bottle in a small cooler with a cold water bottle in it and out of the sun, but I have no way of knowing how warm it actually got in the cooler.  A new bottle is ready for me to pick up at the pharmacy though and I will start using the new bottle tomorrow just in case something happened to the little I had left.  I have been doing well for the last month on 4.5ml and have not noticed anything new as far as withdrawals or other symptoms go.  I am excited to go down in my dose again, so fingers crossed no new symptoms with this reduction!  As always thank you for your help and assistance!

Shadowsnana

2000 - was put on Celexa 40mg pill

2010 - reduced to Celexa 20mg pill

2015 - reduced to Celexa 10mg pill

2020 - prescribed Lunesta 2.5mg to take as needed for insomnia

June 14th, 2022 was prescribed Citalopram liquid HBR 10mg/5ML solution to start tapering

June 16th, 2022 started using 5ml of Citalopram liquid HBR 10mg/5ML solution instead of 10mg pill

June 23th, 2022 tapered 10% to 4.5ml, July 26th, 2022 tapered 10% to 4.05ml

August 19th, 2022 - Stopped taking Lunesta 2.5mg

September 4, 2022 - tapered celexa to 3.6ml

October 20, 2022 - tapered celexa to 3.25ml

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  • Moderator Emeritus
42 minutes ago, Shadowsnana said:

I will start using the new bottle tomorrow just in case something happened to the little I had left.

 

Good idea!

* 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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  • Moderator Emeritus
43 minutes ago, Shadowsnana said:

I'm back from camping and am going to reduce my liquid celexa down to 4.05ml tonight. 

 

It might be better to take the old one tonight at the same dose and reduce when you get the new bottle.  That way if the old lost some potency there is less issue if the new is a bit stronger because you are reducing the dose anyway.

* 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
  • Moderator
48 minutes ago, Shadowsnana said:

@OnmywayHi, I'm back from camping and am going to reduce my liquid celexa down to 4.05ml tonight.  I still have a little liquid left from my original bottle I got last month that I took camping with me.  I was careful to keep the bottle in a small cooler with a cold water bottle in it and out of the sun, but I have no way of knowing how warm it actually got in the cooler.  A new bottle is ready for me to pick up at the pharmacy though and I will start using the new bottle tomorrow just in case something happened to the little I had left.  I have been doing well for the last month on 4.5ml and have not noticed anything new as far as withdrawals or other symptoms go.  I am excited to go down in my dose again, so fingers crossed no new symptoms with this reduction!  As always thank you for your help and assistance!

Good news that no new symptoms have emerged! I'm cheering for you. Ok to do the old bottle tonight and start the new one when you get it!

 

OMW

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

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  • 4 weeks later...

@Onmyway hello, hope everything is well.  I am getting ready to taper down to 3.65 ml this coming Friday 8/26.  I am wondering if you could help me by maybe showing me a pic of where 3.65ml might be on a syringe? What line would this be over the 3.5ml mark?  I have had a few episodes of dizziness this past month that were more intense than my normal and I'm not sure if it attributed to this taper or not.  It is hard to tell because I think the celexa in general could be causing this dizziness I have been experiencing since April 2021, and the only way I will know for sure it to get completely off it.  My dizziness usually happens after taking my medicine before going to bed, after I lay down, before I fall asleep.  I haven't tried to skip this med for a night before bed to see if I don't experience the dizziness, nor have I tried switching to take this med in the morning.  I figured either one would mess me up.  I was also prescribed Lunesta for my insomnia about a year or so ago and at first didn't like taking that because it gave me headaches, so I took it very rarely.  I was experiencing the dizziness before I even started taking the Lunesta, so I know that was causing my dizziness last year.  The last couple of months though I had been taking the lunesta several times a week because I was still laying in bed awake at 5-6 in the morning, but I stopped taking the Lunesta all together about 2 weeks ago and do not plan to ever take that again.  I have been doing fairly well without it considering.  I started listening to audio books when I go to bed and when I'm almost falling asleep I stop the book and have been able to fall asleep fairly quickly.

Shadowsnana

2000 - was put on Celexa 40mg pill

2010 - reduced to Celexa 20mg pill

2015 - reduced to Celexa 10mg pill

2020 - prescribed Lunesta 2.5mg to take as needed for insomnia

June 14th, 2022 was prescribed Citalopram liquid HBR 10mg/5ML solution to start tapering

June 16th, 2022 started using 5ml of Citalopram liquid HBR 10mg/5ML solution instead of 10mg pill

June 23th, 2022 tapered 10% to 4.5ml, July 26th, 2022 tapered 10% to 4.05ml

August 19th, 2022 - Stopped taking Lunesta 2.5mg

September 4, 2022 - tapered celexa to 3.6ml

October 20, 2022 - tapered celexa to 3.25ml

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  • Moderator Emeritus

Q:  What size mL syringe are you using?

* 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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  • Moderator Emeritus
17 minutes ago, Shadowsnana said:

I am getting ready to taper down to 3.65 ml this coming Friday 8/26.  I am wondering if you could help me by maybe showing me a pic of where 3.65ml might be on a syringe? What line would this be over the 3.5ml mark? 

 

Q:  Are you meaning 3.65mL (liquid) or 3.65mg (dose)?

 

The syringe pictured above is only 1mL but yourCitalopram liquid HBR 10mg/5ML solution.

 

It is better to use mg in your drug signature because different liquids are different strengths.

* 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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@ChessieCat,   sorry.  I switched to the liquid citalopram, it is the HBR 10mg/5ML liquid solution.  I have tapered down from 5ml and am currently on 4.05ml liquid, and will be reducing again to the 3.65ml this week.  Here is 1 pic of the syringes I have, I will attach the other pic in a separate post.  

1ml syringe.jpeg

Shadowsnana

2000 - was put on Celexa 40mg pill

2010 - reduced to Celexa 20mg pill

2015 - reduced to Celexa 10mg pill

2020 - prescribed Lunesta 2.5mg to take as needed for insomnia

June 14th, 2022 was prescribed Citalopram liquid HBR 10mg/5ML solution to start tapering

June 16th, 2022 started using 5ml of Citalopram liquid HBR 10mg/5ML solution instead of 10mg pill

June 23th, 2022 tapered 10% to 4.5ml, July 26th, 2022 tapered 10% to 4.05ml

August 19th, 2022 - Stopped taking Lunesta 2.5mg

September 4, 2022 - tapered celexa to 3.6ml

October 20, 2022 - tapered celexa to 3.25ml

Link to comment

@ChessieCat,  this is my other syringe.

10ml syinge.jpeg

Shadowsnana

2000 - was put on Celexa 40mg pill

2010 - reduced to Celexa 20mg pill

2015 - reduced to Celexa 10mg pill

2020 - prescribed Lunesta 2.5mg to take as needed for insomnia

June 14th, 2022 was prescribed Citalopram liquid HBR 10mg/5ML solution to start tapering

June 16th, 2022 started using 5ml of Citalopram liquid HBR 10mg/5ML solution instead of 10mg pill

June 23th, 2022 tapered 10% to 4.5ml, July 26th, 2022 tapered 10% to 4.05ml

August 19th, 2022 - Stopped taking Lunesta 2.5mg

September 4, 2022 - tapered celexa to 3.6ml

October 20, 2022 - tapered celexa to 3.25ml

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  • Moderator Emeritus
46 minutes ago, Shadowsnana said:

reducing again to the 3.65ml this week

 

To get 0.65mL in the small syringe you would measure half way between the 0.6 and 0.7 mark, the line that is a bit longer with no number next to it.

 

And also take 3mL in the large syringe.

 

For a total of 3.65mL.

 

You might consider buying a 3mL syringe which will allow you to be more accurate.

* 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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  • Moderator

Hi @Shadowsnana

in the syringes above you would go to 3ml on the large one and then on the small one you would go midway between 0.6 and 0.7 (that slightly longer line in between). 

 

Stopping the Lunesta may be disruptive so it may have increased the dizziness a bit. If the dizziness doesn't get better, I'd wait an extra week before lowering your citalopram dose. Lunesta is what's called a Z-drug which are drugs that impact your nervous system (psychoactive) to help with insomnia and can cause physical dependence. The more you take and stop such drugs the more your system gets sensitized. You may be able to get away with it now but it may have increased the dizziness (even if it didn't cause it). Can you pls add the Lunesta to your signature - it is important for us to know and can change our advice. 

 

From your description though, it seems like the dizziness is a side effect of citalopram since it happens every time you take it. You could try a small experiment - for a few days observe how many minutes/hours after you take citalopram your dizziness appears. Then move the citalopram 30min or 1 hr earlier and see if the dizziness comes after the same hours/minutes. It shouldn't mess your system too much but may give you an answer. 

 

On the one hand, knowing that it is a side effect by itself is not very useful because it is not like you can get away faster from this medicine. On the other hand, if you are worried that it is a WD effect, it may reassure you that it is not and may not delay you in your taper. If it were a withdrawal effect we would advise you to hold off on it. 

 

Overall, while dizziness is unpleasant, if it is limited to just before sleep and if it is your only significant symptom, count your blessings and keep the slow taper to keep the bad symptoms away. If your symptom pattern stays the same for the next 3 months or so (time to also account for the possible Lunesta disruption) you may be able to start lowering every 25-28 days on a trial basis and then every 3 weeks. I know you were eager to come off of the meds due to health issues and the fact that you are doing well so far is good.  

 

Have you had a look at the insomnia thread? There are some tips to help with that. 

Important topics about symptoms, including sleep problems - Symptoms and self-care - Surviving Antidepressants

 

OMW

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

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  • 3 weeks later...

@Onmyway, thank you, I updated my signature with the Lunesta and have not taken the lunesta at all since.  I have been feeling pretty good after going to bed since around 8/22/22, meaning I have not been experiencing the dizziness I always have had after taking my medicine and going to bed.  I did not want to experience the dizziness again so I pushed back my next citalopram reduction which was due to happen on 8/26/22.  I kept at my current dose of 4.05ml liquid which I had been on the last 30 days since 7/27/22, and I continued with the same 4.05ml liquid dose until September 4th, 2022 which was a total of 38 days at 4.05ml, with no dizziness. On September 4, 2022 I reduced my citalopram dose to 3.65ml liquid.  I did not experience any dizziness on 9/4/22 however on 9/5/22 the same dizziness came back again shortly after taking my dose and going to bed.  I figured this had to be from the reduction of the citalopram, as I remembered the last 2 months since starting my reduction I would experience dizziness every night after a reduction of the citalopram EXCEPT for around days 22-30.  So the next day on 9/6/22 I changed my dose to only a 5% reduction of the 4.05ml and took only 3.8ml of liquid instead of the 3.65ml.  Sure enough I did not have any dizziness at all that night. I have since been taking only 3.8ml of liquid every night since 9/6/22 with no dizziness when going to bed since.

 

I'm assuming what this means is that I was having dizziness as a withdrawal effect when I reduced my dose by 10% and I would continue to have the dizziness until I was taking the reduced dose for 3 weeks, then after 3 weeks the dizziness would go away for the final week I was on that dose until I reduced again, then the dizziness would start up again, and then switching to only a 5% reduction eliminates the reduced dose dizziness.  It seems my body took 3 weeks to get use to the new dose before the dizziness symptom went away.  Does this make sense and is possible?  

 

If so, this will put me a lot farther back in getting off this drug if I only reduce 5% every 30 days so I don't experience any dizziness. Would I possibly be able to stay at 5% reductions for only 3 weeks instead of 4 weeks to speed this up? Do you think the dizziness as a side affect of my reducing will always be a symptom of mine no matter how much faster I try and reduce?  I've read that people experience more withdrawal symptoms the lower in dose they go, that doesn't seem to apply to me, unless I will experience more symptoms besides dizziness the lower I go, which I hope I don't.  I'm just happy the dizziness has gone away for now at least.

 

On a side note, I had another holter monitor done a couple weeks ago and had a follow up with my cardiologist last week.  The number of PVC's I had on this holter monitor test was significantly less compared to my previous holter monitor I had done in May which was over 8% load. My load percentage is down to almost 2% now and the cardiologist was very happy with this.  I asked her what specifically reduced my PVC's, was it a specific med, and she said it was everything she did, getting off the citalopram (my reduction), taking the prescribed magnesium, potassium and also adding the beta blocker Bystolic.  In any case I was happy with this result and I don't need to see her again for 6 months.  I only hope that as I continue to reduce the citalopram my PVC's will become even less.

 

Finally, my insomnia is through the roof.  I did review the info in here on suggestions for insomnia, and I have tried several OTC meds and nothing has helped so far.  I am thinking that the current medicine I am on is causing the insomnia.  I read that all beta blockers can cause insomnia and I am on 2 different beta blockers I was not previously on last year and think this might be where this is coming from.  I talked to my cardiologist about it and she suggested switching from magnesium oxide which she originally put me on to magnesium glycinate and to take the glycinate at bedtime, which has not helped me either. I am leery to switch out the beta blockers I am on because its taken me 5-6 different beta blockers before I found these 2 that work for me without major side affects, except possibly them causing the insomnia.  In addition to possibly the beta blockers causing the insomnia, it may very well be coming from the citalopram too, or all 3 meds, I'm not sure.  I just don't want to start another sleep medicine again after stopping the lunesta but I can't continue to not fall asleep until 6 a.m. either and only get 4 hours of sleep before waking up again. I usually am in bed by 10:30 every night and to lay there awake until 6 a.m. is horrendous. I'm just not sure what to do for this problem.

Shadowsnana

2000 - was put on Celexa 40mg pill

2010 - reduced to Celexa 20mg pill

2015 - reduced to Celexa 10mg pill

2020 - prescribed Lunesta 2.5mg to take as needed for insomnia

June 14th, 2022 was prescribed Citalopram liquid HBR 10mg/5ML solution to start tapering

June 16th, 2022 started using 5ml of Citalopram liquid HBR 10mg/5ML solution instead of 10mg pill

June 23th, 2022 tapered 10% to 4.5ml, July 26th, 2022 tapered 10% to 4.05ml

August 19th, 2022 - Stopped taking Lunesta 2.5mg

September 4, 2022 - tapered celexa to 3.6ml

October 20, 2022 - tapered celexa to 3.25ml

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  • Moderator
6 hours ago, Shadowsnana said:

@Onmyway, thank you, I updated my signature with the Lunesta and have not taken the lunesta at all since.  I have been feeling pretty good after going to bed since around 8/22/22, meaning I have not been experiencing the dizziness I always have had after taking my medicine and going to bed.  I did not want to experience the dizziness again so I pushed back my next citalopram reduction which was due to happen on 8/26/22.  I kept at my current dose of 4.05ml liquid which I had been on the last 30 days since 7/27/22, and I continued with the same 4.05ml liquid dose until September 4th, 2022 which was a total of 38 days at 4.05ml, with no dizziness. On September 4, 2022 I reduced my citalopram dose to 3.65ml liquid.  I did not experience any dizziness on 9/4/22 however on 9/5/22 the same dizziness came back again shortly after taking my dose and going to bed.  I figured this had to be from the reduction of the citalopram, as I remembered the last 2 months since starting my reduction I would experience dizziness every night after a reduction of the citalopram EXCEPT for around days 22-30.  So the next day on 9/6/22 I changed my dose to only a 5% reduction of the 4.05ml and took only 3.8ml of liquid instead of the 3.65ml.  Sure enough I did not have any dizziness at all that night. I have since been taking only 3.8ml of liquid every night since 9/6/22 with no dizziness when going to bed since.

 

I'm assuming what this means is that I was having dizziness as a withdrawal effect when I reduced my dose by 10% and I would continue to have the dizziness until I was taking the reduced dose for 3 weeks, then after 3 weeks the dizziness would go away for the final week I was on that dose until I reduced again, then the dizziness would start up again, and then switching to only a 5% reduction eliminates the reduced dose dizziness.  It seems my body took 3 weeks to get use to the new dose before the dizziness symptom went away.  Does this make sense and is possible?  

 

If so, this will put me a lot farther back in getting off this drug if I only reduce 5% every 30 days so I don't experience any dizziness. Would I possibly be able to stay at 5% reductions for only 3 weeks instead of 4 weeks to speed this up? Do you think the dizziness as a side affect of my reducing will always be a symptom of mine no matter how much faster I try and reduce?  I've read that people experience more withdrawal symptoms the lower in dose they go, that doesn't seem to apply to me, unless I will experience more symptoms besides dizziness the lower I go, which I hope I don't.  I'm just happy the dizziness has gone away for now at least.

 

On a side note, I had another holter monitor done a couple weeks ago and had a follow up with my cardiologist last week.  The number of PVC's I had on this holter monitor test was significantly less compared to my previous holter monitor I had done in May which was over 8% load. My load percentage is down to almost 2% now and the cardiologist was very happy with this.  I asked her what specifically reduced my PVC's, was it a specific med, and she said it was everything she did, getting off the citalopram (my reduction), taking the prescribed magnesium, potassium and also adding the beta blocker Bystolic.  In any case I was happy with this result and I don't need to see her again for 6 months.  I only hope that as I continue to reduce the citalopram my PVC's will become even less.

 

Finally, my insomnia is through the roof.  I did review the info in here on suggestions for insomnia, and I have tried several OTC meds and nothing has helped so far.  I am thinking that the current medicine I am on is causing the insomnia.  I read that all beta blockers can cause insomnia and I am on 2 different beta blockers I was not previously on last year and think this might be where this is coming from.  I talked to my cardiologist about it and she suggested switching from magnesium oxide which she originally put me on to magnesium glycinate and to take the glycinate at bedtime, which has not helped me either. I am leery to switch out the beta blockers I am on because its taken me 5-6 different beta blockers before I found these 2 that work for me without major side affects, except possibly them causing the insomnia.  In addition to possibly the beta blockers causing the insomnia, it may very well be coming from the citalopram too, or all 3 meds, I'm not sure.  I just don't want to start another sleep medicine again after stopping the lunesta but I can't continue to not fall asleep until 6 a.m. either and only get 4 hours of sleep before waking up again. I usually am in bed by 10:30 every night and to lay there awake until 6 a.m. is horrendous. I'm just not sure what to do for this problem.

@Shadowsnanaseems like you figured out the source of the dizziness and managed to find a solution. Excellent. I think a reduction of 5% every 3 weeks sounds like a good idea. Let's try that and see how it goes. Your 5% reduction from 3.8 would give you 3.61 for next time. I think you can just do 3.6 which would be easier to measure (slightly more than 5%).

 

Insomnia is generally a withdrawal symptoms but it seems in your case it might be from the beta blockers. I did a bit of research and it seems like the cause is that beta blockers are reducing the amount of melatonin which prevents you from falling asleep.

 

You could in principle take extra melatonin to counteract that effect BUT it seems like extra melatonin may change (lower) the effectiveness of the beta blockers for high blood pressure. I don't know if it alters their effectiveness for the indication for which they were prescribed to you. I think you should contact your cardiologist and ask about this specifically. This is in the literature so s/he would know about melatonin suppression and beta blockers. They can then advise you what to do and whether taking extra melatonin may be ok.

 

Avoiding anything with blue light a few hours before sleep (electronics, TV) will likely help as blue light suppresses melatonin even further. You could also get blue light blocking glasses if you can't completely avoid them. It likely won't solve the issue entirely but might help even if a little bit. You may also try taking your beta blockers in the morning instead of the evening. 

 

When you talk to the cardiologist mention the insomnia and that you want natural treatments rather than new sleeping drugs. Mention also that you've done some research and seen the articles on beta blockers and melatonin. I can link them if you'd like.

 

Melatonin is usually secreted in the body when it is dark. So it might help get your bedroom as dark as possible as well.

 

I'm hoping things get better.

I'm so impressed with your tapering strategy - keeping track of your symptoms, listening to your body and making changes where necessary. I wish every SA member were as dedicated and systematic in their approach as you. I'm so proud of you for taking charge of your healing and overall health!

 

I wouldn't worry about things getting worse at the low doses. You've done such a good job to not unsettle your nervous system that as long as you stay careful and vigilant like you've been you may manage to avoid serious withdrawal issues throughout your taper. Please keep us updated!

 

OMW

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

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  • 1 month later...

@Onmyway, hi, sorry I haven’t responded sooner. I did reduce to 3.6 ml on 9/4 and have been ok on that. I’ve actually been on this dose for quite a while, 46 days, and I plan to do a 10% reduction tomorrow down to 3.25ml. I completely forgot about lowering my dose at the 3 and 4 week mark bc Ive been consumed with taking care of my diverticulitis. Went to the ER on 9/19 with horrible lower left abdominal pain and was dx with diverticulitis, lucky me ☺️, not! So while dealing with this and my diet I completely forgot to reduce my dose, which is fine, I’ll just do it tomorrow. Going to try a 10% reduction and see how it goes, if I get dizzy I’ll go back up. 
 

I have been taking melatonin, only 1mg, to help with sleep and it’s been working wonders for me and I’m sleeping again! I talked to my Dr and she said it was ok to take it every night. I hate to do that - to take something every night for sleep, but my Dr said it was ok so 🤷‍♀️  I haven’t had any lunesta since August 19 so it’s been 2 months off of that, yeah! Slowly getting to where I want to be, off these drugs!!  Thanks so much for all your help, support, encouragement, and compliments, I appreciate them very much! Hope you are well, and I’ll check back in again in 3 weeks!

Shadowsnana

2000 - was put on Celexa 40mg pill

2010 - reduced to Celexa 20mg pill

2015 - reduced to Celexa 10mg pill

2020 - prescribed Lunesta 2.5mg to take as needed for insomnia

June 14th, 2022 was prescribed Citalopram liquid HBR 10mg/5ML solution to start tapering

June 16th, 2022 started using 5ml of Citalopram liquid HBR 10mg/5ML solution instead of 10mg pill

June 23th, 2022 tapered 10% to 4.5ml, July 26th, 2022 tapered 10% to 4.05ml

August 19th, 2022 - Stopped taking Lunesta 2.5mg

September 4, 2022 - tapered celexa to 3.6ml

October 20, 2022 - tapered celexa to 3.25ml

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