Yoga599- A runners with Health Anxiety

[Yoga599]

Hey everyone. I heard great things about this forum and wanted to share my experience, and receive some advice. I am a 28/M from the Midwest who has had a lifelong battle with anxiety and depression. I was on a smorgasbord of physcotropic meds from 8 years old until 14 where I decided to stop. 

 

In fall of 2020 I was diagnosed with IBS and stomach ulcers due to too much aspirin. I was immediately put on Paxil propranolol (both 20mg once a day) and famotidine 10 mg (2x/day) for panic attacks from health anxiety and acid reflux. It helped and I was on it until January of 2021, where I switched to Prozac after changing doctors.  I took Prozac 20mg from January 2021 to March 2023 when I started dating a girl and weened myself off Prozac. I felt good - only taking famotidine. My IBS got better until a break up in September of 2021 and a very hostile work environment. I ended up going back on Prozac 20 mg until December 2021. From here is where my signature picks up my health history.

 

I proceeded through this period and started experienced odd pains in my body that come and go. I have experienced referred pain from my IBS, so I chalked this up as normal. 
 

In November of 2022 I experienced a fall on both knees, and experienced plantar fasciitis in my left foot. I started thinking maybe my meds had something to do with this. I decided to wait until late December to try and taper off Mirtazipine.

 

I did a three week taper - cutting a 15mg pill into quarters. I experienced rebound insomnia and quickly reinstated Mirtazipine at 7.5 mg and was put on Celexa 5 mg to start with the intent of going up to 10mg.  (The doctor mentioned I sound like I am sensitive to these meds.) 
 

I started feeling better, my knees improved and my foot started to feel better with some annoying tight calves. I told my doctor I wanted to back off the mirtazipine to 3.75 mg - and he agreed. I stayed here for about two weeks. During this time, I was also taking Celexa 5mg

 

I decided to try and taper off mirtazipine on 19 jan 2023 again from 3.75 - and two days in I felt panicked and insomnia. I quickly reinstated to 3.75 mg.

 

I am currently taking mirtazipin 3.75 mg - 1/2 of a 7.5 hard Tablet and Celexa 10 mg. I was just upped on Celexa last from 5 mg to 10 mg Tuesday (17 Jan 2023). And here I am. 
 

I felt horrible withdrawals - mainly insomnia, fluishness, and panic attacks 
 

Now - I can feel my body get worked up when i get anxious, and feel my left leg hurt and my muscles tense up. My left leg tends to hurt in the evening - and sometimes my heel arch too. I don’t know if this is still pain from my plantar being referred up my leg, but it’s uncomfortable.
 

I have been staying at my parents this week, recognizing I was destabilized after browsing this forum. 
 

I could use some advice. My sleep has gotten better since reinstatement - although I get some night sweats from Celexa.

 

I was told to take magnesium citrate (150mg) for my plantar fasciitis and an omega 3 supplement (lemon lime 200mg)

 

I want these body pains to stop - and these panic attacks. I have health anxiety stemming back from my battle with IBS and ulcers. 
 

Meds did help me through this tough time, and I found Mirtazipine to be the only med that really has helped me feel better. But tapering off it has been a nightmare. 
 

My current coping mechanism is yoga - although it’s $100 a month, I know that it does wonders for my health and anxiety. 
 

 

Any advice is appreciated. 

 

 

 

 

 

 

[Gridley]

Welcome to SA, Yoga599.  Thanks for doing your signature and for your helpful introduction.

 

You've been through a lot with some drug changes, fast tapers, and reinstatements.  My suggestion would be that you make no changes for at least three months and possibly up to six months to allow your nervous system to rest and stabilize.  Then you can start thinking about tapering.  If your intention is to go off the Mirtazapine and the Celexa, we can help.  I want to give you some information for your future taper so you feel grounded in the path ahead.

 

We recommend tapering only one drug at a time.  Otherwise, if there is a problem, you won't know the cause.  It's best to taper the more activating (stimulating) drug first--in your case, Celexa--while leaving the more sedating drug--Mirtazapine--in place to help with sleep.

 

Taking multiple psych drugs? Which drug to taper first?

 

We recommend tapering no more than 10% of your current dose every four weeks.

 

Why taper by 10% of my dosage?

 

The Brassmonkey Slide is a way of making reductions weekly, as opposed to a larger reduction once a month.  I used this method for my Lexapro taper, and it worked very well.

 

The Brassmonkey Slide Method of Micro-tapering

 

The following link is specifically about tapering Celexa.  Celexa comes in a liquid, which is recommended because of accuracy and ease of use.

 

Tips for tapering off citalopram (Celexa)

 

These links will give you a better understanding of the withdrawal you experienced.

 

What is withdrawal syndrome.

 

The Windows and Waves Pattern of Stabilization

 

When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

We don't recommend a lot of supplements because in withdrawal our nervous system are very sensitized, but the omegas and magnesium you're taking are an exception, and many members find them helpful.

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

This is your introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community.  I hope you’ll find the information in the SA forums helpful for your situation.  I'm sorry that you are in the position that you need the information, but I am glad that you found us.

 

 

 

 

 

 

[littlebird]

Hey friend, welcome to the forum! 

 

Glad you’re reaching out for help and taking care of yourself, the mods here have some of the best advice on this that I’ve ever found. It’s also a lovely community of folks who understand the strangeness of the med journey. 

[Yoga599]

Thank you @Gridleyfor your fast reply.

 

After reading around the forum, I agree with you. I think the most recent pill cut taper attempt has left me withdrawn and stabilization is needed. I was in a dark place last week, but luckily I have family and friends that have been helpful in watching for me. 
 

i was recently told to up my citalopram about two weeks ago - from 5 mg to 10mg…is it too soon to come down from this dose back to my original 5? When the withdrawal started, I was going up to ten buy adding a 2.5mg for a total dose of 7.5 mg citalopram (I wanted to work up slowly.  I have not been taking the full 10mg. I have been on citalopram for 4 weeks. 
 

If not - I understand the need to stay on this dose to allow stability. 
 

Mirtazipine does help me sleep - and keeps me calmer, although I notice more physical anxiety symptoms on this medication - mainly muscle tension. 
 

I struggle with the physics side effects - muscle spasms & tense feelings. This most recent wave has given me some body aches & pains. 
 

I have developed some anxiety around sleeping, since I experienced rebound insomnia during taper off, and some restlessness. 

 

I saw that you do not recommend tapering with health anxiety, is this true?
 

 
 

 

 

[Onmyway]

6 hours ago, Yoga599 said:

Thank you @Gridleyfor your fast reply.

 

After reading around the forum, I agree with you. I think the most recent pill cut taper attempt has left me withdrawn and stabilization is needed. I was in a dark place last week, but luckily I have family and friends that have been helpful in watching for me. 
 

i was recently told to up my citalopram about two weeks ago - from 5 mg to 10mg…is it too soon to come down from this dose back to my original 5? When the withdrawal started, I was going up to ten buy adding a 2.5mg for a total dose of 7.5 mg citalopram (I wanted to work up slowly.  I have not been taking the full 10mg. I have been on citalopram for 4 weeks. 
 

If not - I understand the need to stay on this dose to allow stability. 
 

Mirtazipine does help me sleep - and keeps me calmer, although I notice more physical anxiety symptoms on this medication - mainly muscle tension. 
 

I struggle with the physics side effects - muscle spasms & tense feelings. This most recent wave has given me some body aches & pains. 
 

I have developed some anxiety around sleeping, since I experienced rebound insomnia during taper off, and some restlessness. 

 

I saw that you do not recommend tapering with health anxiety, is this true?
 

 
 

 

 

Hi @Yoga599

Can you please list your daily doses of the meds since you started citalopram as you took them rather than as you were prescribed, please? That will help us advise on whether to stick with it and at what dosage. 

 

It seems to take about a month for the body to develop dependence to these drugs from what we've seen here.

 

Do your heightened bad symptoms follow the citalopram introduction?

 

OMW 

[Gridley]

9 hours ago, Yoga599 said:

 

i was recently told to up my citalopram about two weeks ago - from 5 mg to 10mg…is it too soon to come down from this dose back to my original 5? When the withdrawal started, I was going up to ten buy adding a 2.5mg for a total dose of 7.5 mg citalopram (I wanted to work up slowly.  I have not been taking the full 10mg. I have been on citalopram for 4 weeks. 
 

I need a little clarification on your dosage and timeline.  

1.  When did you start 5mg?  

2.  When did you go up to 7.5mg? Your original post said Jan. 17.

3. How long have you been on 7.5mg? 

 

 

9 hours ago, Yoga599 said:

 

I saw that you do not recommend tapering with health anxiety, is this true?
 

 

Sorry, I don't understand your question.  Many of us have health anxiety and that doesn't stop us from tapering.

Edited January 29, 2023 by Gridley

[Yoga599]

@Gridley

@Onmyway

 

1. I started citalopram on Jan 3rd - 5mg. This is also when I re-introduced mirtazipine

2. I was told by my psych to hold on 5mg for about two weeks then go up to 10mg citalopram. I decided to go up to 7.5mg then hold for longer. I started 7.5mg on Jan 17th.

3. I have been on 7.5mg for a little less than two weeks.

 

Currently - I am having a few side effects to citalopram - manly the occasional panic attack or racing thought, sweating at night & some GI issues. Although I have IBS so this could have been anything - diet has been less than stellar. 

 

I hope this helps.

 

[Gridley]

@Yoga599

@Onmyway

 

Thanks for the clarification.  I've alerted the other staff about your particulars to get their input about where to go from here with the Citalopram.

[Shep]

8 hours ago, Yoga599 said:

1. I started citalopram on Jan 3rd - 5mg. This is also when I re-introduced mirtazipine

2. I was told by my psych to hold on 5mg for about two weeks then go up to 10mg citalopram. I decided to go up to 7.5mg then hold for longer. I started 7.5mg on Jan 17th.

 

Thanks for this information, Yoga. I've updated your signature to reflect the exact dates in January when you made these changes. Please double-check that this information is correct and if not, here is a direct link to your signature to make edits:

 

 Account Settings – Create or Edit a signature

 

Please note there is a MAJOR drug interaction between citalopram and mirtazapine, as you can read about here:

 

Drug Interaction Report

 

8 hours ago, Yoga599 said:

Currently - I am having a few side effects to citalopram - manly the occasional panic attack or racing thought, sweating at night & some GI issues. Although I have IBS so this could have been anything - diet has been less than stellar. 

 

This may be a side effect or it may be that drug interaction.

 

Please list the time(s) of day you take each of your drugs. Spacing them apart by at least 2 hours can help decrease the likelihood of a drug interaction.

 

I would reduce the citalopram back down to 5 mg, which is where you were on January 16. If you feel better or don't feel any worse over the next few days, you may want to reduce down to 2.5 mg. The goal will be to get off these drug before dependency sets in; HOWEVER, if you feel any withdrawal symptoms, you'll want to stay on it, stabilize, and then do a slow taper. 

 

Please post your thoughts. Also, if you're still taking famotidine (or any other drugs), please add that to your signature. 

[Shep]

On 1/27/2023 at 12:33 PM, Yoga599 said:

I am currently taking mirtazipin 3.75 mg - 1/2 of a 7.5 hard Tablet and Celexa 10 mg. I was just upped on Celexa last from 5 mg to 10 mg Tuesday (17 Jan 2023). And here I am.

 

8 hours ago, Yoga599 said:

2. I was told by my psych to hold on 5mg for about two weeks then go up to 10mg citalopram. I decided to go up to 7.5mg then hold for longer. I started 7.5mg on Jan 17th.

 

@Yoga599 I just noticed a discrepancy. Please clarify your dose change for January 17 - you have 10 mg in the first quote box and 7.5 mg in the second quote box. 

[Yoga599]

@ShepI went up to 7.5mg of citalopram with the intent of going up to 10mg per my doctor. I am only taking 7.5mg of citalopram at the moment.

 

Does your reduction recommendation hold?

[Shep]

3 minutes ago, Yoga599 said:

@ShepI went up to 7.5mg of citalopram with the intent of going up to 10mg per my doctor. I am only taking 7.5mg of citalopram at the moment.

 

Does your reduction recommendation hold?

 

Thanks for your quick clarification.

 

Yes, please go ahead and reduce down to 5 mg and let us know how you're doing over the next couple of days. 

[Yoga599]

@Shepquick update - I saw my psych from my teen years - whom I haven’t seen since I was about 13 or 14. I went through age 14 - 26 without treatment of any kind.  She was shocked. 
 

She shared some genetic markers & some details about my past treatment & reactions. She was concerned about my me having tried paxil - as it’s common to cause issues with people long term chronic anxiet. She shared some insight into withdrawal and CNS stabilization. 

She wanted me to stabilize citalopram to 10mg - from 7.5mg I was taking. I informed her I was sensitive / had greater effect being lower doses of meds, and she explained 5HTT receptor occupancy and liver metabolism. 
 

She shared with me my previous success as a younger person on Lexapro - Citaloprams sister drug.

 

I shared my failed taper off mirtazipine, and she was not surprised. She wanted me to stabilize on this dose of citalopram before coming off mirtazipine, as my previous experience and genetic marker testing shows a higher sedating effect on citalopram & mirtazipine.

 

I was hesitant - but given my past history with her and her wealth of intimate knowledge, I decided to give 10mg a shot.

 

Seemingly, it appears a few days on 10mg has had a somewhat positive effect on me. My mood is improved, and I am experiencing less muscle & body pain. I am also less anxious - and experiencing less intrusive thoughts. 
 

My foot has been bothering me less, as well. 
 

I was a bit nervous going to sleep last night, as I am currently out of town, but I slept surprisingly well. 
 

I was told to stabilize on this dose and not touch mirtazipine for a while. She was open to a long term taper down the road, but not at the moment. 

 

I will update my dose of citalopram on my signature line. 

 

[Yoga599]

@Shep

 

Just returned home from a trip. Feeling alright. More elevated mood & returning internal monologue.

 

I’m not sure if citalopram is either A. Helping me overall 

 

or B. Reinstatement of an SSRI has reduced withdrawal simptoms overall.

 

either way - planning on staying here to stabilize for a while.

 

I am getting some rather annoying muscle cramps in my legs - but not sure why. I could just be dehydrated or still recovering from a leg/ knee injury.

I was able to get out and do some hiking  🥾 it was enjoyable. 

 

[Shep]

Do you think you may be deficient in potassium, @Yoga599? That can cause leg cramps. If you don't want to do supplements, you can google to find foods that are high in potassium. Bananas are always good for that. 

 

Epsom salt baths can also help muscle cramps. 

 

Glad you were able to get a good hike in. 

[Yoga599]

@Shep I am a runner - and it is probably something that is low. 

 

I try and eat bananas at work - but only one or two weekly. Maybe I should try getting in some potassium via protein shakes.

 

I think it maybe tied to panic/anxiety. I had very few issues this week when I was out of town. Started to get tense on my return flight home.
 

I had some upsetting thoughts - legs started to tighten up & feel weak. I let it pass and feel alright now. Maybe a wave. 

 

But we can’t fight the waves- just flow with them and trust they lead us to calmer seas or the soft shore 🌊.

[Shep]

19 hours ago, Yoga599 said:

Maybe I should try getting in some potassium via protein shakes.

 

Do you make your own protein shakes? Be careful if you're using the pre-made kind - some of them may have ingredients that a hypersensitive nervous system may have trouble with. 

 

19 hours ago, Yoga599 said:

But we can’t fight the waves- just flow with them and trust they lead us to calmer seas or the soft shore 🌊.

 

Lovely metaphor. 

[Yoga599]

@Shep

 

Hey! Just a heads up - I’m still on Citalopram and Mirtazipine- but I’ve dropped to about 2mg of mirtazipine by shaving corners off of my pills since last post.

 

Most of my body symptoms of WD/Anxiety have passed. I’ve educated myself about anxiety/stress and it’s weird effects on the body. Since this, I’ve been less fearful about how body sensations/cramps. I have upped my water intake to about 2l a day, this has helped me loose weight, stay calm and feel more alert.

 

I am able to run and exercise normally now with my new shoes and insoles. 
 

I did develop some mild tinnitus, but it seems to be related to neck and jaw tension - I am usually able to stretch or roll a lacross ball around and make it go away. It’s rather annoying, but it isn’t dreadful.

 

I’ve taugh myself that while my body may feel weird or my ears may ring, that it’s not damaging or catastrophic. 
 

I’ve also started being more social - which helps me get my mind off withdrawal and anxiety. 
 

Regarding protein shakes - I use vega and have not felt any “activating” effects.

 

Currently what gets me anxious is stuff regarding my job - mainly my boss being an ass on occasion or the occasional mistake I make being called out. 

[Shep]

17 hours ago, Yoga599 said:

Hey! Just a heads up - I’m still on Citalopram and Mirtazipine- but I’ve dropped to about 2mg of mirtazipine by shaving corners off of my pills since last post.

 

Yoga, you were on 3.75 mg January 17th and now you're on 2 mg mirtazapine, which is a 53% reduction in about  2.5 months. This is much faster than the 10% per month reduction (based on the prior month's dose) that we recommend. 

 

Why taper by 10% of my dosage?

 

That being said, since you're shaving off the corners of your pill, you may not be reducing as much of the active ingredient but more of the filler. It's hard to say with that method. I would crush up the pill and weigh it so the active ingredient is distributed more evenly. That will give you a more accurate way of reducing the drug.  

 

On 1/28/2023 at 9:50 PM, Yoga599 said:

Mirtazipine does help me sleep - and keeps me calmer, although I notice more physical anxiety symptoms on this medication - mainly muscle tension. 

 

You wrote this back in January. Is the mirtazapine still helping your sleep? 

 

Please note we recommend reducing any drugs that help with sleep last because preserving sleep is a priority. Please see:

 

Taking multiple psych drugs? Which drug to taper first?

 

What time(s) of day do you take your drugs? 

 

Please update your signature with your drug changes since January 17, 2023. 

 

[Yoga599]

Update 

 

Still here. Psych convinced me to up my dose to 15mg of citalopram.

been on 15mg since feb. 

 

Holding on Mirtazipine at 3.75mg. I don’t mess with this one. I will probably come off this one last - as this helps me sleep.

 

I can’t tell if Citalopram is helping me - but I can tell it has side effects. It has increased my appetite - and now I have TMJ as a side effect.

 

I am wanting to cut back on citalopram - and try going to 13.5mg - and see how it goes. I went a week without taking citalopram back in may - due to travel & cvs messing up my refill. I felt more alert and on edge - but not panicky. I would really like to try a larger step down - to 12.5mg of citalopram and see how this goes.

 

I am wanting to get off of this due to weight gain and the TMJ it causes me. I also have Tinnitus due in part to the TMJ - which was horrifying and very scary at first- but I habituated to it via yoga and meditation. Now it’s mildly annoying.

 

Mirtazipin does help me sleep - but I don’t rely solely on it to help me fall asleep. I’ve done a lot of sleep hygiene work - so I naturally get tired when it’s time to go to bed. 
 

My psych is amazed how much I have improved. But as I have upped my meds I have also upped my work in anxiety/depression coping/mindfulness strategies.

 

I have been doing lots of yoga. I joke with her that yoga had done more to help me than meds (because it has….)

 

i will be sure to update my signature when I am on my laptop.  

 

 

[Yoga599]

Updated signature. Recently started a small taper off experiment with guidance of holistic resident doctor.  10% month. Too early to tell side effects. Currently doing CBT reading, meditation, yoga and lifting weights with said doctor. 

 

Losing a bit of weight & recomping my body mass. I think exercise & mindfulness should have been where I started to being with handling my anxiety. 

[Yoga599]

Following up-

 

I just finished my taper. I finished in April of 2024.

 

It was a slow road, with lots of life stress in the middle two, but I made it.

 

I have not taken a dose since April 14, 2024.

 

I am doing well - I have lost 22 lbs off of Mirtazapine. I went at 10% a both (not hyperbolic method) and my body reacted well. 
 

I lost 4 friends and an aunt over the last year, and at the same time moved across the country to a new city and started a new job.

 

I have been using CBD oil on occasion to help with stress, and it does help a great deal. I try to take time to exercise and lift weight, but it is often difficult due to work.

 

Needless to say, it was a long road off of anti-depressant. 
 

My final taper off symptoms were anxiety, ruminating thoughts and some psoriasis. I am managing these as I go, but these withdraws were no where near cold turkey cutoff that I had tried previously. 
 

 

[Ariel]

Hi @Yoga599

 

Thank you for this positive update!

 

1 hour ago, Yoga599 said:

Following up-

 

I just finished my taper. I finished in April of 2024.

 

It was a slow road, with lots of life stress in the middle two, but I made it.

 

I have not taken a dose since April 14, 2024.

 

Congratulations on completing your taper and being off psych drugs! 

Well done on all your hard work thus far. 

 

Could you please update your drug signature to reflect current status?

 

1 hour ago, Yoga599 said:

I lost 4 friends and an aunt over the last year, and at the same time moved across the country to a new city and started a new job.

 

 

I'm so sorry for your loss <3

It sounds like you've had a very challenging year all around. 

Amazing that you successfully pursued and completed tapers off of two psych drugs at the same time. 

How brave you are!

 

Moving forward please continue to go gently and take good care of yourself. 

The stress of coming off psych drugs, even with tapering, can be cumulative. 

Your body, brain, nervous system may be quite sensitive for the time being and require kindness, tenderness, stability. 

Healing is happening all the time, and after zero there is still a lot of healing to do. 

Now that you have given yourself the gift of being drug-free, you are paving the way for your brain, body, nervous system to proceed with profound healing. 

 

Wishing you the best of luck and sending healing vibes, please keep us posted!

In solidarity and support,

Ariel