Noblewarrior: Need help with Celexa!

[Noblewarrior]

Hello all,

 

I’m glad I found this site, and knowing there is people like me. I’ve been looking on this site to read and gather as much information as I can. 
 

Let me start from the beginning. I’m typing this with intense brain fog. In junior high school I was diagnosed with ADD, depression and social anxiety, was put on the drug merry go round. I honestly don’t remember the dates of being on these dugs or the dosage. I do remember being on Lexapro, Paxil, Zoloft, Remeron, Tarzodone, Strattera. I’m not sure when I stopped these drugs  with help from the psychiatrist. The next part my memory is better.

In 2007 I  was having bad anxiety from my job and my up to date drugs then was Klonpin .5 mg tablet 2x a day, Celexa hbr 20 mg tablet  1x in the evening, Concerta 36 mg tablet  1x in the morning. I wasn’t my real self on those drugs. In 2014 I had a back injury, I needed to work without being in so much pain. I think around 2015 I was put on Flexeril 10mg tablet up to 3x a day, Hydrocodone-acetaminophen 5mg-300mg tablet every six hours, Tramadol 50 mg tablet 3x a day, Mobic 7.5 mg tablet 1x a day, Prednisone 20mg tablet 1x a day. All while still taking Celexa, Concerta, and Klonpin. I was a walking zombie. I couldn’t function, simple tasks for me became the most complex to do. I know I wasn’t functioning at “normal” level, but I didn’t know what else to do with being in so much back pain. In 2016 the pain from my back was going into my feet, I was put on Gapapentin 600mg tablet 3x a day. At this time, I was put on more Klonpin cause I reached a tolerance, 1mg tablet 3x a day. During this time I had a surgery scheduled for my back, I told this to my gp, and he literally cut me off from Klonpin. Dr said tapper 2 weeks off Klonpin and your fine, but I knew better. My dad is a drug and alcohol counselor, and brought home papers on Dr. Ashton for benzodiazepines withdrawal. I knew it was going to be tough. This part is a bit hazy to me, I do remember Tapering off of K for months, maybe  4 to 6 months. I forget the exact dosage I did. That was a nightmare, I’m glad I didn’t do it in 2 weeks.  I had the brain zaps, hot, rage, restlessness, feeling like jumping out of skin, depression. Definitely, one of the most difficult things I have gone through in my life. The lack of sleep I feel like was the worst part of it all. I decided not go through with the back surgery. For whatever reason I  starting to taper off the other drugs. I tapered one at time with a good amount of space before I started my next taper. I forget the dates, but I tapered off of Tramadol, Flexeril, Gabapentin, and Hydrocodone. It was not easy but I did it. I would just go to my room blackout the window and stay there.  I was also put on medical marijuana around this time. In 2019 is when I feel like I was coming out of the withdrawals. The only way to describe me before and after the drugs is night and day. I could process information, think clearly. I could feel emotions to a point. I felt really good. I was still on Celexa hbr 20mg 1x in the evening and Concerta 36mg 1x in the morning. At the end of April in 2022 I went on medical leave from my work because of my back, it hurt to stand. So 13 days ago I saw my gp told him I was feeling sedated from the Celexa, he said to take it in the morning. I tried that, and couldn’t sleep, so decided to take it at night to sleep. Last Thursday, I picked up my rx for Celexa. I told the pharmacist the same thing, he said take it in the morning, and let your body get used to it. I did as he said, and I took Celexa 20 hbr 20mg at 7am. I noticed a change and how I was feeling. At exactly 4pm this intense drowsy, dizzy, brain fog hit me. Also, noticed my breathing at this time is slow and shallow. 4pm is when I would normally take Celexa. This intense drowsy, dizzy feeling was only happening at 4pm. I wanted this to go away, so two days ago I decided to take my Celexa at the normal time 4pm. Today at 7am I started feeling that intense drowsy, dizzy, hot, almost feeling shaky, brain fog. It is so difficult to do simple things. I’m having back surgery next month, don’t want to be in this condition when that happens if possible. What do I do? Need help? I’m going to a cvs minute clinic soon, so they can check me out, but I don’t think they will be much help. Any thoughts or advice would be greatly appreciated. Every single one of you guys on here are amazing, don’t ever forget that! If people really knew the struggle we go through, I think they would have more respect for us. Much Love to you all!

[Frogie]

@Noblewarrior

 

Welcome to SA. We are a volunteer ran site helping people taper off psychiatric medications or have tapered off and are now healing.

 

This is your introduction page where you will receive information, ask questions and meet other members. We ask that you only have one introduction page so we can keep all your information in one place.

 

I guess my first question to you would be, are you going to taper off of Celexa, or do you just want help with the symptoms? 

 

I can tell you, you don't want to switch times taking the Celexa all at once. If you want to take it (example) at 7pm and you are currently taking it at 1pm, you would move it to 2pm the first day, then 3pm the second day and so on until you reach the time you want to take it.

 

Dr. Joseph Glenmullen's withdrawal symptom checklist

 

Non-drug techniques to cope with emotional symptoms - Symptoms and self-care - Surviving Antidepressants

 

You could try some magnesium and omega as they calm the nervous system with some members. If you want to try them try one in a small amount and wait a few days before introducing the other.

 

https://www.survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

King of supplements: Omega-3 fatty acids (fish oil) - Symptoms and self-care - Surviving Antidepressants

 

After reading the links provided please reach out with any questions you may have.

 

 

 

 

[Noblewarrior]

@FrogieThank you! I would like help with the symptoms, and eventually taper off of Celexa. 
 

I do have a concern with tapering off of Celexa. My goal would be a 10% taper, or even micro taper, so I’m trying to work in job position with emergency medical services. Do you think it’s possible to have the mental capacity during the taper to do that job? I’ve experienced Wds from Klonpin and that was horrible. 
 

That makes sense with when to take Celexa, an hour later each day. I wish I would have seen that earlier. I switched taking Celexa right to my normal time at 4pm. I do take omega 3s and magnesium on regular basis. I did bump up taking 2 pills of the omega 3s (500mg of dha and epa in 2 pills), in the morning and 2 at night, I noticed a slight decrease in symptoms, but more like it would come in go throughout the day. 
I guess I just have to wait for the Celexa to readjust in my system? It just feels weird, and difficult to function.

 

[Frogie]

@Noblewarrior

 

Unfortunately, you'll just have to ride out the symptoms since you made the switch back to the normal time. Hopefully it won't last long. Just don't make any other changes with it now so you can heal.

 

Did you taper off the Klonopin or did you just stop it? Benzo's are very difficult to taper off of because they control the central nervous system.

 

I think if you did a smart, very slow taper of the Celexa you could taper off of it while working. There are lots of people on here that carry full time, stressful jobs and are tapering off. But don't do it until you CNS has settled and you are stable.

 

 

[Noblewarrior]

@Frogie

 

I’m not going make any more changes to Celexa and I’ll  just ride it out. 
 

My doctor wanted me to take two weeks to taper off of Klonpin, but I knew better. I forget the exact time span and dosage, but I think it was over months, which looking back was still too quick. 
 

I was just curious, because my previous experience with Klonpin wds and working a retail job was horrible, I think it’s a miracle I was able to hold a job in that condition. 
 

 

[Frogie]

@Noblewarrior

 

If you tapered off Klonopin in a few months and held a job, you did really well. Just as an antidepressant, we don't ever suggest more than 10% on a benzo and usually much slower.

 

I'm glad you are going to hold on the Celexa for a while. Let your body rest and stabilize before doing anything else to it.

 

Keep me posted and reach out with any other questions you may have.

 

 

[Noblewarrior]

@Frogie

 

Thank you, I appreciate the advice.

In August I see my gp was going to ask to switch to a liquid of Celexa. 
 

[Frogie]

@Noblewarrior

 

When you get ready to switch to liquid let me know as there is a process to do it. You can't just stop the tablets and move to liquid.

[Noblewarrior]

@Frogie

 

Gotcha, thank you.

[Noblewarrior]

@FrogieHey, What is a safe way to taper off of Concerta? I take 36mg pill once a day. 

[Noblewarrior]

Hello,

 

I have been on Concerta for years at 36mg. 7 weeks ago my dr. dropped the dose to 18mg. Doctor says to take Concerta 4 days a week to help with the levels in my system, and then stop completely.  Is this good to do? any advice would be appreciated.

[Altostrata]

Hello, @Noblewarrior How did you feel after reducing to 18mg?

 

What exactly are you taking now, at what times o'clock and dosages?

[Noblewarrior]

@AltostrataI felt more anxious and depressed when I reduce to 18mg. I feel like the side effects from reducing to 18mg have been minimal. Currently I'm taking 18mg once a day between 6-7:30am. Today was my first day not taking Concerta, after doctors advice to take Concerta 4 days a week, and then stop completely.   

[Altostrata]

10 hours ago, Noblewarrior said:

@AltostrataI felt more anxious and depressed when I reduce to 18mg. I feel like the side effects from reducing to 18mg have been minimal. Currently I'm taking 18mg once a day between 6-7:30am. Today was my first day not taking Concerta, after doctors advice to take Concerta 4 days a week, and then stop completely.   

 

Are the withdrawal symptoms minimal or did you feel more anxious and depressed when you reduced to 18mg?

 

Good luck with the taper your doctor advised. If you get more "anxious and depressed", this may be withdrawal that will go away in some weeks or months.

[Noblewarrior]

@Altostratathe withdrawal symptoms were minimal when I reduce to 18mg. 
 

Thank you for reaching out. I appreciate that. 
 

I know this is a loaded question but in your opinion how long of a time should I wait to start tapering off of Celexa? 

[Altostrata]

What have been your drug change in the last month and how do you feel now?

 

Please update your signature with the dates you stopped a drug, such as Concerta.

[Noblewarrior]

@Altostrata drug charges in the last month have been just the Concerta to a lower dose of 18mg. 1/12/23 and 1/14/23 were my first days not taking Concerta.  The first day I didn’t take Concerta I felt calmer and not as on edge. The second day I didn’t take Concerta I felt so irritable and on edge, but I know my body is healing from this. My last dose of Concerta will be on 1/18/23. 

[Altostrata]

You are experiencing withdrawal symptoms from quitting Concerta. Your doctor's advice is not working for you.

 

When you were taking 18mg Concerta, how were you taking your dose? Was it half a tablet?

[Noblewarrior]

I was taking the whole tablet every time. 
 

 

[Noblewarrior]

I plan on buying a pill cutter and going that route. 

[Altostrata]

36 minutes ago, Noblewarrior said:

I plan on buying a pill cutter and going that route. 

 

Good idea. 

 

In exchange for the free peer support you get here, please tell your doctor that the advice he or she gave you resulted in withdrawal symptoms and a more gradual taper should be advised.

[Noblewarrior]

So I can’t use a pill cutter because it’s an extended release pill. I talked to a pharmacist and they recommended I take Ritalin at 10mg because it has the same ingredient as Concerta. Also, 18mg is the lowest dose of Concerta. 
 

I called my doctor to see if he would give me Ritalin he said no. His plan is to have have me take Concerta 6 days a week for a month, then the next month take it 5 days a week and so on. 
 

do have any suggestions/advice? 

[Altostrata]

This appears beyond your doctor's capabilities. Suggest you have a candid talk with your doctor about the failure of his earlier advice and consider finding one who will take a reasonable approach to tapering. Obviously, skipping doses of daily Concerta is not recommended.

How do you talk to a doctor about tapering and withdrawal?

 

Official FDA information about Concerta

Quote

The most common adverse reactions associated with discontinuation (≥1%) from either pediatric or adult clinical trials were anxiety, irritability, insomnia, and blood pressure increased. (6.3)

 

 

What Happens When You Stop Taking Concerta?

Quote

 

Getting off Concerta will cause different things to happen depending on how you stop. One thing that will happen no matter how you quit is the Concerta crash.

 

The Concerta crash is a daily side effect that happens as the amounts of the medication in your bloodstream decrease throughout the day. This regular experience is like a mini Concerta withdrawal period in which you start to experience withdrawal symptoms. Once the medication is taken again, as prescribed, the medication levels increase and the crash ends.

 

During Concerta withdrawal, the amount of stimulants in your system drops but isn’t replenished fully. Concerta withdrawal symptoms include:

• Anxiety
• Depression
• Suicidal thoughts
• Decreased ability to focus
• Irritability
• Lack of energy
• Nausea
• Vomiting
• Increased heart rate

Quitting Concerta cold turkey intensifies these effects. The crash is severe, creating more withdrawal symptoms as well as symptoms that are harder to manage. Abruptly stopping this stimulant medication causes intense cravings and increases the risk of resuming Concerta.

 

A cold-turkey approach to quitting Concerta also significantly increases the risk of depression and suicide. (Tackett, 2016).

 

To avoid these extreme Concerta withdrawal symptoms, misery, and risk of harm, it’s imperative to taper off this medication under medical supervision rather than just stopping on your own.

 

How to Properly Taper Off Concerta

....

When quitting Concerta, you’ll go through a period of gradual tapering according to the schedule your doctor has made for you. Tapering has to be done systematically to control the amount of medication in your body as well as to let your brain adjust to the decreased levels of dopamine and norepinephrine.

 

Getting off Concerta is a process that takes time. Once you start to wean off the drug, withdrawal symptoms will set in anywhere from within the first day to a few days after your dose decreases. The entire process can take anywhere from two weeks to several months, depending on the length of time you were taking it as well as the strength of the dose.

Under a doctor’s supervision and with gradual tapering, the Concerta crash won’t be as severe. And throughout the process, your withdrawal symptoms will be much milder and more manageable.

....

 

 

Ritalin may be substituted for Concerta but it needs to be taken at least twice a day. Here are the dosage equivalents https://www.clevelandclinicmeded.com/medicalpubs/pharmacy/novdec2000/concerta.htm

 

When you have substituted immediate-release methylphenidate tablets (5mg, 10mg, or 20mg), they can be split, or you can use the prescription liquid form, possibly in combination with a tablet, which will be easier to titrate.

 

Quote

 

How is Methylphenidate Oral Solution Supplied

Methylphenidate hydrochloride oral solution 5 mg per 5 mL is available as a clear colorless liquid.

Bottles of 250 mL . . . . . . . . NDC 43602-177-25

Bottles of 500 mL . . . . . . . . NDC 43602-177-05

Methylphenidate hydrochloride oral solution 10 mg per 5 mL is available as a clear colorless liquid.

Bottles of 250 mL . . . . . . . . NDC 43602-178-25

Bottles of 500 mL . . . . . . . . NDC 43602-178-05

Dispense in tight container with child-resistant closure.

Storage: Store at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature].

Manufactured by:

Ascent Pharmaceuticals, Inc.

Central Islip, NY 11722

 

 

[Noblewarrior]

Thank you that was very helpful. I will have a talk with my doctor. If he doesn’t write a script for Ritalin then I will go to another doctor. 

[Noblewarrior]

@Altostrata How long should one wait till they taper off another drug? I finished tapering off of Ritalin, and was going to wait about 6 months before I taper off of Celexa. I have mild withdrawal symptoms of Ritalin. 

[Altostrata]

What are your current withdrawal symptoms? How have they changed in the last 2 months?

[Noblewarrior]

Fatigued in the morning, takes a while to get going. Withdrawals have been mild. 

[Altostrata]

What were the withdrawal symptoms? How have they changed in the last 2 months?

[Noblewarrior]

Withdrawals symptoms were fatigue, intrusive thoughts, and that’s about it. 
 

My energy is starting to come back, and some of the intrusive thoughts have gone away. 

[Altostrata]

Good to hear. I would not make any drug changes until you are free of any withdrawal symptoms for at least a month. I would assume your nervous system has already been sensitized from your coming off Concerta and Ritalin.

[Noblewarrior]

@Altostrata

@getofflex

I have a liquid form of Celexa and will be starting my taper soon. My question is 1.) When I measure the liquid with a syringe it gets bubbles in the syringe and difficult to get out? 2.) I was thinking of using a scale to weigh the liquid in grams?