JoshyLaze: Citalopram 20mg withdrawal

[JoshyLaze]

Hi all,

 

I have been browsing this form for a while with a sense of anxiety around sharing my story. However, I’ve plucked up the courage (even behind a keyboard, I need it!) and realised that I would very much benefit from some advice; advice from others in the same boat as me.

 

My story - I am a 33 year old male from Birmingham, England. I have essentially been on Citalopram for about 7 years. I went through a terrible break up with my ex which led me onto this antidepressant. However, after meeting my fiancée (we have been together 3 years now), my life is much better than it has ever been.

 

The next step for me is to withdraw from Citalopram. I tried to do this from about March of last year, but I was naive in how I proceeded. I went from 20mg -> 15mg -> 10mg -> 5mg -> 0mg over a couple of months and thought this would be a suitable withdrawal time frame. How wrong I was - and how wrong the GP was! Within 3 weeks of being off the drug, I had to reinstate. The withdrawal symptoms were just too much.
 

Even now, I’m getting on and off headaches. I had a MRI scan for peace of mind which came back completely normal. I’ve also been suffering with some other odd symptoms too - the most frustrating of which is eye floaters. These were triggered during the time frame after I had completely stopped the Citalopram.

 

Anyway, I am back up to 20mg now but this time I am determined to taper properly. I have been studying many topics on this forum and my knowledge has improved. I now appreciate that this may be a process that takes years rather than months.

 

Ultimately, my main concern is overcoming the 5mg -> 0mg step. I now know that I can be prescribed liquid Citalopram in the UK but that the lowest mg I can administer from a single drop is 2mg.

 

My worry is how to consume a lower dosage of the drug. I have read here about dissolving a 10mg tablet in 10ml of water to achieve a 1mg to 1ml ratio. Is this true with Citalopram? My main anxiety is now centred around how I will reduce my dosage at such a low increment.

 

I hope to hear back from someone in response to my above concern, and thank you all for reading.

 

With best wishes,

Joshua

Edited January 30, 2023 by manymoretodays
: in title is all

[manymoretodays]

Hi there JoshyLaze and welcome aboard!

I think you've come to the right place.

 

Sounds like you may have gone a bit fast for you, and then suffered WD(withdrawal).

Did you reinstate the 20 mg all at once or start lower and titrate upwards?

 

This will be real helpful to us to have you do ASAP.

How to Summarize Your Drug History in Your Signature

Are you on any other drugs?  If so, please put them in your signature too.  Thank you.

 

And it sounds like you may still be suffering some WD symptoms too.

You'll find a PDF list of common WD symptoms in this topic:

Dr. Joseph Glenmullen's withdrawal symptom list

 

And then I just want to make sure you are aware of the 10% or less taper from each previous dose too now, and so more topics for you:

 The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.

Why taper by 10% of my dosage?

 

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.  The CNS likes stability. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.

Brain Remodelling

What is withdrawal syndrome.

 

The Windows and Waves Pattern of Stabilization

And I am hoping that you do experience some symptom free periods too.  We call those windows.

 

and:

Tips for tapering off Celexa(citalopram)

If you go with the prescription liquid, then one way to get doses less than 2 mg, would be to further dilute your liquid with each dose, so that you could measure smaller increments of dosage.  You will see some of the various tapering methods suggested in the ^ link, and then we could go from there.  And yes, you can make your own liquid too, with citalopram.  Just follow the links in this topic ^ to read more and help you decide how you will proceed.  And then ask too, right here when you do have questions.

 

Do you feel ready to begin again?  Let us take a look too, at your signature when you get that done, and help you to know when you do feel stable enough to resume a taper.

 

And here are a couple topics for you too, to peruse, to help guide you and understand too:

Stability  From brassmonkey's essay:  Are We There Yet?  How Long is Withdrawal Going to Take

And:

Stabilizing, what does that mean? ;How long does it take after reinstating and updosing?

Considerations about "Stability"- Stop jumping around!

 

This is your introduction/journal page where you have now introduced yourself to the community, you can ask questions here regarding your tapering, give updates, keep a record of your journey.

And I am happy that you feel in a good place right now with your fiancee'.  Sorry for the previous life struggles.  You'll be amazed at what you can cope with, as you begin to learn more, without drugs.  We are big on non-drug coping here.  When you get oriented do have a look at the Symptoms and Self Care forum too, found from the Home page.

Welcome again. 

Love, peace, healing, and growth,

moderator manymoretodays(mmt)

 

 

 

Edited January 30, 2023 by manymoretodays
more :-)

[possum]

Hi, there — I’m not a moderator, but just saw you are in pretty much the same place I am, beginning this journey and I wanted to say hello. I have been on 20 mg Paroxetine for decades and have decided it’s time to taper off. I chanced upon SA about a month ago and have been reading all of the information. I started a 10% taper about 9 days ago. I, too, was concerned about how to deal with very small doses, but learned here that I could make my own liquid by simply adding water. I believe the mod already sent you a helpful link. At present, I’m taking half of a 20 mg pill and 8 ml of liquid, which seems to be working. As I proceed on my taper, I’ll end up just using the liquid. It tastes horrible but if I dilute it in apple juice, it’s okay. Since it will be quite some time before we have to deal with those minute dosages, I guess we can cross that bridge when we come to it. I’m using syringes (stole them from the cat) and diluting 10 mg Paroxetine in 10 ml of water, using 8 mg from the bottle and tossing the rest. Anyway, it’s good to see you here and I look forward to following your detox.

 

[JoshyLaze]

10 hours ago, manymoretodays said:

Hi there JoshyLaze and welcome aboard!

I think you've come to the right place.

 

Sounds like you may have gone a bit fast for you, and then suffered WD(withdrawal).

Did you reinstate the 20 mg all at once or start lower and titrate upwards?

 

This will be real helpful to us to have you do ASAP.

How to Summarize Your Drug History in Your Signature

Are you on any other drugs?  If so, please put them in your signature too.  Thank you.

 

And it sounds like you may still be suffering some WD symptoms too.

You'll find a PDF list of common WD symptoms in this topic:

Dr. Joseph Glenmullen's withdrawal symptom list

 

And then I just want to make sure you are aware of the 10% or less taper from each previous dose too now, and so more topics for you:

 The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.

Why taper by 10% of my dosage?

 

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.  The CNS likes stability. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.

Brain Remodelling

What is withdrawal syndrome.

 

The Windows and Waves Pattern of Stabilization

And I am hoping that you do experience some symptom free periods too.  We call those windows.

 

and:

Tips for tapering off Celexa(citalopram)

If you go with the prescription liquid, then one way to get doses less than 2 mg, would be to further dilute your liquid with each dose, so that you could measure smaller increments of dosage.  You will see some of the various tapering methods suggested in the ^ link, and then we could go from there.  And yes, you can make your own liquid too, with citalopram.  Just follow the links in this topic ^ to read more and help you decide how you will proceed.  And then ask too, right here when you do have questions.

 

Do you feel ready to begin again?  Let us take a look too, at your signature when you get that done, and help you to know when you do feel stable enough to resume a taper.

 

And here are a couple topics for you too, to peruse, to help guide you and understand too:

Stability  From brassmonkey's essay:  Are We There Yet?  How Long is Withdrawal Going to Take

And:

Stabilizing, what does that mean? ;How long does it take after reinstating and updosing?

Considerations about "Stability"- Stop jumping around!

 

This is your introduction/journal page where you have now introduced yourself to the community, you can ask questions here regarding your tapering, give updates, keep a record of your journey.

And I am happy that you feel in a good place right now with your fiancee'.  Sorry for the previous life struggles.  You'll be amazed at what you can cope with, as you begin to learn more, without drugs.  We are big on non-drug coping here.  When you get oriented do have a look at the Symptoms and Self Care forum too, found from the Home page.

Welcome again. 

Love, peace, healing, and growth,

moderator manymoretodays(mmt)

 

 

 

Thank you for your reply 😀

 

You have pretty much hit the nail on the head with everything you have said.

 

My only sense of confusion with the 10% method is that the dosages will start becoming decimal numbers. For example, 10% of 18mg is 16.2mg. How would you propose precisely finding that 0.2mg? Would it be a case of using a syringe to take 0.2ml from a 10ml solution (or 2ml from a 100ml solution).

 

I was thinking of something like this:

 

18mg (10mg tablet plus 8mg liquid - 4 weeks)

16mg (10mg tablet plus 6mg liquid - 4 weeks)

14mg (10mg tablet plus 4mg liquid - 4 weeks)

12mg (10mg tablet plus 2mg liquid - 4 weeks)

10mg (10mg tablet - 4 weeks)

8mg (8mg liquid - 4 weeks)

6mg (6mg liquid - 4 weeks)

5mg (5mg tablet - 4 weeks)

4mg (4mg liquid - 4 weeks)

3mg (10mg tablet dissolved in 10ml water - drink 3ml - 4 weeks)

BUY PILL CRUSHER

2mg (2mg liquid - 4 weeks)

 

(The below dosages could be administered by dissolving the tablet into 100ml instead of 10ml?)

 

1mg (10mg tablet dissolved in 10ml water - drink 1ml - 4 weeks)

0.75mg (10mg tablet dissolved in 10ml water - drink 0.75ml - 4 weeks)

0.5mg (10mg tablet dissolved in 10ml water - drink 0.5ml - 4 weeks)

0.25mg (10mg tablet dissolved in 10ml water - drink 0.25ml - 4 weeks)

 

It’s not exactly 10%, but it’s a lot easier to measure.

 

Thank you again.

Josh

 

EDIT - After reading the thread about creating a liquid solution I have realised that those decimal points are achievable.

 

For example, to take 16.2mg of Citalopram I could either:

 

Dissolve a 20mg tablet in 20ml of water and consume 16.2ml with the help of a syringe.

 

Or

 

Dissolve a 10mg tablet in 10ml of water and consume a 10mg tablet plus 6.2ml of the solution.

 

Sorry for the double post but is my understanding correct?

 

Thanks.

 

 

Edited January 31, 2023 by JoshyLaze
Improved knowledge of tapering!

[JoshyLaze]

8 hours ago, possum said:

Hi, there — I’m not a moderator, but just saw you are in pretty much the same place I am, beginning this journey and I wanted to say hello. I have been on 20 mg Paroxetine for decades and have decided it’s time to taper off. I chanced upon SA about a month ago and have been reading all of the information. I started a 10% taper about 9 days ago. I, too, was concerned about how to deal with very small doses, but learned here that I could make my own liquid by simply adding water. I believe the mod already sent you a helpful link. At present, I’m taking half of a 20 mg pill and 8 ml of liquid, which seems to be working. As I proceed on my taper, I’ll end up just using the liquid. It tastes horrible but if I dilute it in apple juice, it’s okay. Since it will be quite some time before we have to deal with those minute dosages, I guess we can cross that bridge when we come to it. I’m using syringes (stole them from the cat) and diluting 10 mg Paroxetine in 10 ml of water, using 8 mg from the bottle and tossing the rest. Anyway, it’s good to see you here and I look forward to following your detox.

 

So you are essentially on 18mg at the moment? 10mg tablet plus 8ml liquid?

 

You seem to have the same issue as me, in so much that when we get to below 1mg, the ml we need to consume will be very, very small. I don’t know if it’s worth dissolving the tablet in 100ml of water rather than 10ml at that point, or whether this would affect the potency.

[manymoretodays]

On 1/31/2023 at 12:34 AM, JoshyLaze said:

Sorry for the double post but is my understanding correct?

 

Hi there.  And yes, this sounds good what you had concluded.

You want to pick a method and they stay with that too, be consistent with your method of measuring your dose.

I think a one to one solution or suspension is good for ease of measurement. 

When you get to the lower doses, below 1 mg or before you might want to increase your dilution.  I myself wouldn't increase it from 10 mL all the way to 100 mL of water........and yes, would have the same worry as you, that it might be too big of a change and felt.

 

You could change it by just 10 mL and then have a 2/1 concentration, which wouldn't be so much.

 

Also, whenever in doubt when tapering.......just round up with the mg amount to be safe.  Like say if you came up with a new taper dose that was 12.68 or something......round up to 12.7 mg.  Hope that makes sense.

 

Good that you are thinking ahead......way ahead I might add, but good for you. 

Pick a dilution ratio that might work for you best for the whole taper.

 

Remember you are just getting started again too, and you'll gain confidence too as you get going.

And get your signature done too JL.  I'm wondering when you got back to 20 mg of the Citalopram, the date.  And of course that can go in your signature.  Use the link I gave you.

 

Welcome again and hey, you've already got a fellow citalopram taper friend!  Awesome.

 

L, P, H, and G,

mmt

[possum]

Yes, I'm at 18 mg, 10 mg pill, 8 mg liquid. I have 2 syringes — one that tops off at 10 ml and a very small syringe  that goes from 0.8 to 0.1 and below. Once we get really low, I’m sure we can figure out a dilution ratio so,we aren’t dealing in such tiny quantities. My brain is too fried to think about that now!

[JoshyLaze]

On 2/1/2023 at 8:53 PM, possum said:

Yes, I'm at 18 mg, 10 mg pill, 8 mg liquid. I have 2 syringes — one that tops off at 10 ml and a very small syringe  that goes from 0.8 to 0.1 and below. Once we get really low, I’m sure we can figure out a dilution ratio so,we aren’t dealing in such tiny quantities. My brain is too fried to think about that now!

Keep at it my friend. I am going to start my taper this weekend. 18mg is the first step. Exactly like you, 10mg tablet plus 8mg liquid is the plan. I’ve purchased some syringes, a pill crusher and some small jars to get me started.