Hi, I'm Halsyon (and this is my journey to a life without SSRIs)

[Halsyon]

Hello everyone,

 

I'm new here. I found this site two years ago when I first became aware that there were other methods of "getting off" of SSRIs besides the typical schedule suggested by primary care doctors. I was thrilled to discover a community chock full of resources to taper. I was on a dose of 10 mg of citalopram (brand name Celexa) at the time, which is below the standard therapeutic dose of 20 mg. I stayed on 10 mg because it seemed to give me enough of a mental/emotional boost with less intense side effects, and I had dealt with more troublesome side effects of other SSRIs at higher doses and was fed up. That's not to say the 10 mg had NO side effects - they were just a bit less bothersome. 

 

I have been on and off SSRIs since I was about 17 years old, and I am now in my 30's. I've had years where I wasn't taking them, but inevitably I would go through some kind of mental health crisis and desperately ask my doctor for meds again (or they would, of course, offer it after ascertaining I was depressed again). In the last two years I've come to wonder how much my mental health struggles are present in my brain without meds, and how many relapses *may* have been in fact caused by having started SSRIs in the first place? I can't know that answer for sure, but I do know - and have always known - that I am NOT ok with the idea of taking SSRIs for my entire life. To be frank, the side effects, even at lower doses, are unacceptable to me.

 

Some of the side effects I've experienced depending on the SSRI: Blurry vision, hot flashes/heat sensitivity, sexual dysfunction (every single SSRI I've taken), dry mouth, trouble sleeping, trouble waking, anxiety, daytime sleepiness and lethargy (sometimes so bad I had to drink a lot of caffeine and felt it distressingly difficult to concentrate or accomplish anything), increased/voracious appetite leading to significant weight gain that I am still struggling to lose, jitteriness/restlessness. 

 

Family have told me that these are a small price to pay for not feeling suicidal. That when it comes to sexual dysfunction vs. despair, choose the lesser of two evils. And while this seems obvious on the face of it, I'm not so sure those are the only two choices. I have been diagnosed with social anxiety disorder, generalized anxiety disorder, major depression, OCD, and I'm being evaluated for ADHD next year. OCD in particular is quite difficult to manage without medication. But difficult is not impossible, and earlier this year I was doing well off my meds for a while, until work stress triggered emotional issues in me (although it could have been a long term withdrawal effect, and I don't really know, so this time I want to monitor more closely and support myself better). 

 

This is my third attempt at tapering and this time, I am joining this community as a member to really commit but also to closely monitor my symptoms and do this the right way this time. Glad to be here, and thanks for reading.

[Onmyway]

Hi @Halsyon

Welcome to SA. Glad you found us.  It's very likely that some of your previous "relapses" were due to withdrawal.  And you're right,  the choices are not only between suicidal ideation and SSRI. In fact SSRIs cause more suicides and ideation in young adults (see FDA black box warning). OCD is tough but there are therapies for it.  I like the work of Martin Seif. 

 

Can you please create your drug signature so we can advise you better? 

 

You may also want to find your specific drug in the tapering forum and look at advice on how to taper it properly - i.e. obtain the right doses etc.  

 

Let us know how else we can help.

 

Also consider using the Brassmonkey slide method given your long term use. It is gentler.

 

@mstimc is a moderator who has successfully gotten off of SSRIs and is managing his OCD without drugs.  He also knows a lot about CBT ERP. Check out his thread. 

 

With the right sort of support this can be managed!

 

OMW

[Halsyon]

Thank you, Onmyway! I appreciate your response.

 

A couple things I'm wondering:

 

1. I changed my dose of citalopram 10 mg to 20 mg this past June because of continued low mood and OCD symptoms. I have been feeling better since on the 20 mg, but the side effects are awful and I decided to switch back to 10 mg before I had been on the 20 mg for even a month (supposedly it takes 4-6 weeks for a new dose to take full effect). 

 

My question is, should I remain at the 10mg for another month or so before starting to taper? I am eager to start again, but I know I have to be patient, and with the dose changes I wonder if it's better to give my brain time to adjust to the 10mg again before I start to change the dose again.

 

 

2. Wonder about caffeine - caffeine is a drug, and we all have different tolerance levels. I am extremely sensitive to caffeine, so I don't drink a lot of it or even drink it every day. I do enjoy it though, and I wonder if I should record when I have caffeine and note how I feel throughout the day after taking it? Or, another thought comes to mind - should I avoid caffeine for the duration of my recovery because it has such strong effects on me? It does really boost my mood, but that could make it hard to see how I'm feeling with the taper. I know you can't answer this FOR me, I have to decide, but I would welcome any opinions or input!

 

Thanks!

[Onmyway]

Hi @Halsyon

I'd wait at the lower dose for months until you get some stability before tapering again. The brain needs to adjust.  Are the side effects bearable on 10mg? How about the withdrawal effects?

 

The best thing re: caffeine is to gauge your reaction to it.  Not everyone reacts horribly to caffeine. Alcohol does set people back but caffeine either has a milder effect or it doesn't have an immediate impact. Take notes to see what happens - do it for a week. I had to drink tons of it (due to CSF leak) within the first year of withdrawal and it was ok. But others may react so do your own experiment.  

 

Are you taking magnesium? Look up the thread here and see if it helps but don't do two -'experiments' at the same time. 

 

Omw 

 

[Halsyon]

@Onmyway the side effects on 10 mg are pretty bearable, although not great. The withdrawal, from what I noticed before, can be bad in terms of mood if I taper too quickly. If I do it very gradually, it is much, much better and quite manageable. The harder part seems to be months after, when I start to struggle with anxiety afterwards and then low mood, sometimes severely low.

 

Good idea about the caffeine.

 

I do take a magnesium supplement occasionally - supposed to be every day - but haven't been consistent with it.

 

 

[Halsyon]

So it has been about 5 months since I last posted here. I had been waiting for a few months to start my 3rd tapering attempt, since I just switched from 20mg to 10mg of citalopram in June 2023. Now, it is December 2023 and I had been on 10mg of citalopram for 5 months. I began my tapering process December 19th, when I reduced my current dose by 10%, and have been taking that amount for the past 11 days.

 

So far, so good. Looking at my notes, I have had some headaches and dizziness that were possibly some mild withdrawal effects in the first few days, but seemed to improve these past five days or so (dizziness especially - headache improved right away). Hard to tell though because I also got a bad cold around this time, and that has passed and am feeling much better in that regard - headache could have been due to cold, who knows. 

 

Funny enough, my OCD symptoms were bothering me still while on the med, but now that I'm tapering, they seem to be bothering me less? But I've only just started and it hasn't been a significant reduction, so this could be just a psychological thing. Interesting to note, though. OCD symptoms also wax and wane generally, though, and are worse when I am stressed. I have been on Christmas break (I work in the education system), so I am less stressed, which is important to note as well.

 

I have been getting enough sleep and am well rested. Nutrition has been ok, but could be better - struggle with eating a lot of sugar. I also really want to push myself to exercise regularly, as this has always helped my mood tremendously.

 

[Onmyway]

I am so glad this is going well @Halsyon. Our goal is for this to be as smooth as possible. Do you have tools to manage OCD symptoms if they occur? 

 

Pls keep us updated. Happy New Year!

OMW

[Halsyon]

1 hour ago, Onmyway said:

I am so glad this is going well @Halsyon. Our goal is for this to be as smooth as possible. Do you have tools to manage OCD symptoms if they occur? 

 

Pls keep us updated. Happy New Year!

OMW

 

Hi Onmyway! I do have some tools at my disposal. I have a few different books, one of which is called an "intrusive thoughts toolkit" and it is super helpful - provides techniques for managing anxiety that comes from obsessive and intrusive thoughts that are able to be accessed and implemented quickly and easily. I have also found various other tips online from different sources, and have done some ERP so I am familiar with how to sit and monitor my anxiety and avoid engaging in compulsions. I was seeing an ERP therapist for a bit, but currently can't for financial reasons. I also felt like it was getting repetitive and becoming less helpful though, and feel like I can do it on my own maybe.

 

Thanks for the comment, and happy New Year to you too.

[Halsyon]

I just wanted to add to my post for today that since I have been poking around this site - as well as on Mad in America and listening to their podcast - I have this feeling of lightness I haven't experienced in a long time. I feel this lifting of shame - the shame that comes with thinking I have a "diseased brain" and am "mentally ill." Even family members close to me haven't known better and played into this by noting that every time I stop taking my meds I seem to relapse - but they don't seem to understand and/or accept, even though I have explained it to them, that this is most likely withdrawal from the SSRI itself. I haven't been off an SSRI for longer than a year or two at most since I was about 16. I want to know what my baseline is and who I am without it, and not have these side effects.

 

So frankly, I love my family, but I don't give a damn what they think about me stopping them again. It's my body and my mind and reading about others' experiences and seeing the complete lack of evidence for a biological basis for depression and OCD has really opened my eyes. I'm not going back.

 

And this energizes me, I feel like just a normal human being who has experienced trauma in my early life and was made to be dependent on religion as well (with all of the toxic coping mechanisms that can come with that), but always struggled with making and keeping friends and never really learned healthy coping strategies or had a community of support. My mother was not a good role model, not a single adult in my life was a good role model, and many had substance issues - it's no wonder I struggled into adulthood! But this doesn't mean my brain is flawed or diseased - I just needed to learn new ways of coping, and of being.

 

Also, re: religion, I know not everyone has a bad experience with it, and it often brings community with it, which can bolster our mental wellbeing. So it's not all bad. But I think there are some distorted ways of thinking in the religion I was raised in and for more sensitive people like me, I think it can have some harmful effects on emotional wellbeing.

[Halsyon]

It has now been 16 days of being on the 1st 10% cut dose (0.057 g, I use a scale to weigh the powder and put it in a gelatin capsule). So far, aside from some mild possible symptoms, I feel ok.

 

Some of the potential symptoms I experienced aside from the ones documented above, included the occasional feeling of sudden lightheadedness after movement, which occurred a couple of times. It wasn't too bothersome and passed quickly. I have also had some mild fleeting feelings of stomach upset, and some moments where my mood has felt a bit down. 

 

I am pretty sure that, even though the 10mg of citalopram I was on is considered a "non-therapeutic" dose, it is the cause of my feelings of tiredness, slightly blurry/less-focused vision, and a feeling of being "out of it" sometimes. These symptoms - among possible increased appetite and sexual side effects - are what made me want to go off this med and get off all SSRIs in the first place. I will say that on 10 mg, my sexual side effects are much, much better (sorry if that's TMI/awkward to read but it is important information as it is a part of bodily functioning and a significant human experience). However, an on-and-off feeling of fatigue, and the blurry vision and spaced-out feeling remains. It was obviously worse on the 20 mg, which is why I dropped back down to the 10 mg in the first place despite a psychiatrist subtly encouraging me to go to 20 (they do seem to push this stuff sometimes, don't they?). 10 mg was enough for me to manage my emotional issues (or so that was my thinking then, but now I'm against it at all), so I said 20 mg no than you, I don't need suffer with terrible dry mouth, inorgasmia, etc just to numb my difficult feelings more. 

 

Now that I've reduced my dose by 10%, I don't notice any difference in side effects. I still feel tired and spacey, still have blurry vision, etc. Remaining patient.

 

Also just wanted to say that I know everyone has their own unique reactions to SSRIs based on their own makeup, and I know a few people who stopped SSRIs cold turkey after a while of being on them and had NO symptoms that they were aware of or at least not troubling to them. I know that is possible, but frankly it amazes me. I think my own withdrawal reaction is moderate and not severe generally speaking, and tends to be more emotional, while I've noticed other people on here suffer terrible physical reactions that are very bothersome. The range is interesting, for lack of a better word.

 

[Onmyway]

Hi @Halsyon, it is great that things are not getting worse with the cut. That makes me hopeful that you may get through tapering with very few symptoms. 

 

It is true that some people can get off ADs without issues and in the future it may be possible to select those that are able to do that and those that aren't. I also think that some of these people are  experiencing withdrawal but don't realize it. 

 

Wishing a smooth sailing in the new year! Pls keep us updated

[Halsyon]

It has been 3 weeks since I reduced my dose by 10% for the first time. I plan to typically wait at least a month before cutting another 10%, but since it has been over two weeks without any significant symptoms of withdrawal, I decided to go ahead and move to the next cut. I will closely monitor myself, but I made this decision with the knowledge that it could be too soon but also that I have been doing well, and if I can reduce the amount of time I am on higher doses of this drug, I am happy with that.

 

I don't plan to be reckless - in the past I did cut down my dose too much too quickly once and my mood plummeted - had to reinstate and stabilize for a bit before trying again. My tapers didn't fail before for that reason, though - it seems like they failed because after being off of the meds for a while, I possibly returned to a state where I had to deal with obsessive thoughts and some other issues without meds. Or, it is possible that I had a delayed withdrawal reaction. That latter possibility is odd to me, though, because I had tapered 10% of each dose over a period of a year, and then jumped off. Maybe that means I should stay on each dose longer and taper over 18-24 months. I honestly don't know. I was on a low dose of 10mg citalopram to begin with, but everyone is different and I know that the lower doses can still be very tricky to get off of (I've experienced it, so here I am trying a 3rd time)!

 

My hunch is that if I am exercising regularly, practicing ACT/CBT skills, meditation, eating well, getting enough sleep, and studying Stoicism - as well as leaning on people I love for support and connecting with people regularly - I can cope with the emotional difficulties that led me to take this med in the first place. It is not clear to me if my months'-delayed emotional difficulties after stopping meds is a withdrawal reaction or a return to coping with emotions without meds, but I think it is the latter, and I have a plan to deal with it this time that is more robust than any plan I had in the past.

[Onmyway]

The reason we propose taper by 10% is because these drugs' effect is not linear.  You can look to mark horowitz's paper on his site to understand what I mean.  The jumping off point matters enormously. I'm at 0.3mg out of 30mg (at one point) and I wouldn't dare jump until 0.01. It's so ain't 10-15% occupancy of SERT receptors - those that they can measure.  At 30mg is about 85% at 5mg is over 50%

 

Omw

[Halsyon]

Since last posting I have reduced my dose for a 3rd time. This time, I am struggling more with emotional symptoms, while also noticing an improvement in the side effects I hated from the drug (so, less side effects because there's less drug in my system, but withdrawal effects from tapering). I plan to stay on this dose for longer than my last two reductions, because I have been feeling more down lately, anxious, and more obsessive. I cry more easily. It's not severe and I don't want it to get to that point, so I will wait until I feel a bit more stable to reduce again. 

[Onmyway]

Hi @Halsyonthanks got the update. Hope things improve quickly.

 

Can you pls also update your signature so we have the most recent information when giving advice? 

[Halsyon]

@Onmyway do you mean to include that I'm currently tapering? What additional information should be included?

[Arisotura]

On 1/3/2024 at 4:29 PM, Halsyon said:

despite a psychiatrist subtly encouraging me to go to 20 (they do seem to push this stuff sometimes, don't they?).

Indeed. A few months back I went to a GP to have bloodwork done, to see if the fatigue I was experiencing was a result of lacking vitamins or whatever. I was prescribed some vitamin supplements to fix what had been found. Later I went back to the same doctor, for something else, but I was still feeling tired and depressed. He wanted to take the matter into his hands, he didn't prescribe me an antidepressant because I said my psychiatrist was taking care of that, but he still wanted to prescribe me a benzo. I said I avoid these because I've had a really bad time with alprazolam, he prescribed me oxazepam instead. I tried it once and it didn't help. Kinda scary how quick people are to throw pills at you for any and every problem.

 

Atleast they're not all like that, my psychiatrist actually listens to me and works with me, so that's good.

 

Regardless, good luck with your tapering!

[Onmyway]

6 hours ago, Halsyon said:

@Onmyway do you mean to include that I'm currently tapering? What additional information should be included?

Hi @Halsyon

Pls include every drop you make and date on which you made it - pls see my signature for an example. It helps us quickly see how fast/slow you're going

 

Omw

[Halsyon]

On 2/14/2024 at 12:42 PM, Onmyway said:

Hi @Halsyon

Pls include every drop you make and date on which you made it - pls see my signature for an example. It helps us quickly see how fast/slow you're going

 

Omw

Ok, I will do this when I am home today and have access to my notebook with this information.

[Halsyon]

Quick update - I had made a 10% drop in dosage about a month ago, and 3.5 weeks after that I was feeling more emotionally stable, so I decided to go ahead and make another 10% cut. It has been a little over a week and I notice an improvement in the bothersome side effects of the meds (as I mentioned last time), notably in my energy. The difference isn't huge, but it's there. However, I am definitely struggling emotionally. Many more negative thoughts, feeling overwhelmed at work, feeling hopeless, all of the ruminating and feelings of depression - as well as some of the anxiety - that led me to take an SSRI in the first place.

 

I'm going to stick it out of course, being very careful to monitor my mood closely. I have made a deliberate effort to get enough sleep and stop work in the evening at a certain time even if I am not finished (which I would not do in the past) - so far, the world hasn't fallen apart doing this, and I feel much more rested and able to control myself emotionally. However, I think it wise to stay on this dose at least four weeks, and possibly longer, considering how low I feel at the moment. 

 

I will update my signature to reflect these changes in dose as soon as I am able to get my notebook that contains this information.

[Erimus]

9 minutes ago, Halsyon said:

Quick update - I had made a 10% drop in dosage about a month ago, and 3.5 weeks after that I was feeling more emotionally stable, so I decided to go ahead and make another 10% cut. It has been a little over a week and I notice an improvement in the bothersome side effects of the meds (as I mentioned last time), notably in my energy. The difference isn't huge, but it's there. However, I am definitely struggling emotionally. Many more negative thoughts, feeling overwhelmed at work, feeling hopeless, all of the ruminating and feelings of depression - as well as some of the anxiety - that led me to take an SSRI in the first place.

 

I'm going to stick it out of course, being very careful to monitor my mood closely. I have made a deliberate effort to get enough sleep and stop work in the evening at a certain time even if I am not finished (which I would not do in the past) - so far, the world hasn't fallen apart doing this, and I feel much more rested and able to control myself emotionally. However, I think it wise to stay on this dose at least four weeks, and possibly longer, considering how low I feel at the moment. 

 

I will update my signature to reflect these changes in dose as soon as I am able to get my notebook that contains this information.

Put your two dose changes in your signature. Edit signature. 
 

Regarding the taper, slow down! It’s a terrible cliché, but it’s a marathon, not a sprint.

 

 

[Kaylaq]

I agree with the above post, SLOW DOWN the taper, it’s at the last taper stage you have to inch by inch, every post I’ve read since joining comments on tapering too fast the last amounts as it can be so dangerous to your brain adjusting… 

 

all the best!! 😊

[Halsyon]

@Erimus and @Kaylaq I just updated my signature, and realized that I did four dose reductions between December and end of February, which, you're right, is way too fast. I thought it would be ok because I seemed to stabilize about a 3rd week into a reduction, but I think it's catching up with me now as I am really struggling and feeling super low, teary, lack motivation, feel overwhelmed by work and life in general and want to run away from everything. My thoughts are very negative and tinged with despair and anger. 

 

If I'm not mistaken, maybe I'm experiencing the windows and waves withdrawal where I feel ok for a while and then struggle and then feel ok, and that's why I thought I as doing fine enough to reduce my dosage again.

 

I've been on this new dose for almost two weeks now - would it be best to just stay on this one for a lot longer until I really do feel stable for weeks at a time before reducing again? I don't want to reinstate at higher dose if I don't have to, but if that is recommended I will. 

 

Going forward, I will give myself a minimum of four weeks even if I feel ok and then perhaps longer. Not sure how to know how long is sufficient, but 3 weeks is obviously not long enough between reductions.

 

Thank you.

[getofflex]

48 minutes ago, Halsyon said:

I've been on this new dose for almost two weeks now - would it be best to just stay on this one for a lot longer until I really do feel stable for weeks at a time before reducing again?

Yes, this is the best thing to do at this point.  Please do not rush a taper, because these things have a way of catching up with us.  I would wait at least a month or two.  Wait until you are stable for at least 2 weeks before doing another reduction.  This link explains what we mean by stability: 

 

Stability

 

49 minutes ago, Halsyon said:

Going forward, I will give myself a minimum of four weeks even if I feel ok and then perhaps longer. Not sure how to know how long is sufficient, but 3 weeks is obviously not long enough between reductions.

This is an excellent plan.  I often had to wait 6 to 8 weeks between my reductions, but I'm glad I did it that way.  The keys to getting off of these drugs are extreme patience, and time.  

 

I see you did a 50% reduction back in July of last year. It's quite possible your brain is still trying to adjust to that. 

[Halsyon]

1 hour ago, getofflex said:

I see you did a 50% reduction back in July of last year. It's quite possible your brain is still trying to adjust to that. 

 

I was only on the 20mg for a month or so, and I lowered it to 10mg because the bothersome side effects were not tolerable to me. However, even a month I realize could make a significant difference to your brain. My doctor was fine with it because I was only on the dose for a short time, but we know they often aren't aware of how much patients struggle and/or don't have them change doses slowly. 

 

Thank you for the link and the advice. I'll be more careful going forward. I should have known better because of my prior attempts at getting off an SSRI, but alas. This time I can pump the brakes before things are even more severe, and perhaps I can get to a place of stability sooner before I have a complete breakdown at work (which is what happened before).

Edited February 28 by Halsyon
fixed mistake about time on a dose

[Erimus]

5 hours ago, Halsyon said:

@Erimus and @Kaylaq I just updated my signature, and realized that I did four dose reductions between December and end of February, which, you're right, is way too fast. I thought it would be ok because I seemed to stabilize about a 3rd week into a reduction, but I think it's catching up with me now as I am really struggling and feeling super low, teary, lack motivation, feel overwhelmed by work and life in general and want to run away from everything. My thoughts are very negative and tinged with despair and anger. 

 

If I'm not mistaken, maybe I'm experiencing the windows and waves withdrawal where I feel ok for a while and then struggle and then feel ok, and that's why I thought I as doing fine enough to reduce my dosage again.

 

I've been on this new dose for almost two weeks now - would it be best to just stay on this one for a lot longer until I really do feel stable for weeks at a time before reducing again? I don't want to reinstate at higher dose if I don't have to, but if that is recommended I will. 

 

Going forward, I will give myself a minimum of four weeks even if I feel ok and then perhaps longer. Not sure how to know how long is sufficient, but 3 weeks is obviously not long enough between reductions.

 

Thank you.

In your signature you've put 0.041mg as your current dose. I'm assuming this is the reading from your scales, which is actually 0.041gpw (grams pill weight), or 41mgpw (milligrams pill weight)

 

It will be easier for us to help in the future if you put your dose of active ingredient. If your 10mgai tablet weighs 0.063g, then your current dose of 0.041gpw is 6.5mg (active ingredient).

Edited February 28 by Erimus

[Halsyon]

12 minutes ago, Erimus said:

In your signature you've put 0.041mg as your current dose. I'm assuming this is the reading from your scales, which is actually 0.041gpw (grams pill weight), or 41mgpw (milligrams pill weight)

 

It will be easier for us to help in the future if you put your dose of active ingredient. If your 10mgai tablet weighs 0.063g, then your current dose of 0.041gpw is 6.5mg (active ingredient).

 

Is there a topic on the forum that talks about how to figure this out? I have no clue, I just go by the reading on the scale after weighing (and I averaged the weight of a bottle of pills).

[Erimus]

14 hours ago, Halsyon said:

 

Is there a topic on the forum that talks about how to figure this out? I have no clue, I just go by the reading on the scale after weighing (and I averaged the weight of a bottle of pills).

It's fine to do it by weight for your records, but to anyone else on the forum the numbers mean nothing.

 

If your 10mg citalopram tablet weighs 0.063gpw (on average), then every 0.001g is equal to 0.1587mgai of citalopram.

 

So, to convert the weight to the dose of active ingredient to the dose of drug in milligrams, multiply by 0.1587 and then 1000 (x 0.1587 x 1000) OR (x 158.7).

 

Here is a simple forumla for you to follow in future calculations:

 

Dose of citalopram (in milligrams) = Weight of powder (in grams) x 158.7

 

For example: Dose of citalopram (in milligrams) = 0.041 x 158.7 = 6.5067mg = 6.51mg (2 decimal places)

Edited February 29 by Erimus

[Halsyon]

@Erimus ok thank you for the math shortcut.

[getofflex]

Here is another option for you to convert from pill weight to dosage: 

 

How to Convert Tablet weight to dosage of active ingredient

 

Most of a tablet is filler and coating. The scale weighs the total tablet weight, but we usually express our doses in milligrams of the drug (active ingredient).

 

First, weigh 10 tablets.  Divide this weight by 10 to get an average tablet weight.

 

If the scale measures in grams, multiply the average tablet weight by 1000 to find the average tablet weight in milligrams.

 

Divide the dosage amount in milligrams by the average tablet weight in milligrams of a complete tablet.  You should get a decimal number between 1 and 0.

 

Multiply your current tablet weight, in milligrams, by the number above to convert it to show what your current dosage is.

 

Example:

Citalopram tablets in 20 mg strength.

Weigh 7 tablets.  The total weight is 1.4 grams.   Divide this by 7, the answer is 0.2 grams per tablet, which is your average tablet weight.

Multiply this by 1000.  The answer is 200.  An average tablet weighs 200 milligrams.

20 (dosage of a whole tablet) divided by 200 (average weight of a whole tablet) equals 0.1.  This is the number you will use to convert from tablet weight to dosage of drug.

If your current dose of citalopram weighs, say, 150 milligrams, then to calculate what drug dosage this contains, multiply it by 0.1, and the answer is 15 mg.  You are currently on a dose of 15 mg of citalopram.

Every time you reduce your dose, you can use 0.1 as the number to convert the tablet weight to dosage amount.

 

 

[Halsyon]

As I said before, I recognize that I made dose changes too quickly, and am sticking the most recent change out for at least a month, probably longer - especially considering the symptoms I'm experiencing. I have definitely felt quite depressed recently. I'm getting emotional a lot, I feel a lack of motivation to do anything related to work (but not other things - work causes intense feelings of dread, overwhelm, and depression). I already disliked my job but it has gotten really overwhelming with some additional work I've been given and will have to do from now on going forward. Won't go into that too much. I think without my work stress I wouldn't be feeling as negative as I currently do, but significant work stress combined with tapering too quickly is definitely not a good combination.

 

I am trying to be kind to myself and make sure my basic needs are met and am able to relax. Easier said than done when I am always behind on work and feel like I have to work during all my waking hours. I have to resist that though, even if I "get in trouble" at work, because it's not sustainable.

 

I'm concerned that I have felt somewhat more suicidal lately due to feeling trapped due to job and finances combined with tapering. I'm hoping that given enough time and avoiding alcohol (don't drink much anyway) and getting enough sleep, I will stabilize within a few months. I will absolutely not make any more dose changes until I feel stable for several weeks.

[Erimus]

1 hour ago, Halsyon said:

As I said before, I recognize that I made dose changes too quickly, and am sticking the most recent change out for at least a month, probably longer - especially considering the symptoms I'm experiencing. I have definitely felt quite depressed recently. I'm getting emotional a lot, I feel a lack of motivation to do anything related to work (but not other things - work causes intense feelings of dread, overwhelm, and depression). I already disliked my job but it has gotten really overwhelming with some additional work I've been given and will have to do from now on going forward. Won't go into that too much. I think without my work stress I wouldn't be feeling as negative as I currently do, but significant work stress combined with tapering too quickly is definitely not a good combination.

 

I am trying to be kind to myself and make sure my basic needs are met and am able to relax. Easier said than done when I am always behind on work and feel like I have to work during all my waking hours. I have to resist that though, even if I "get in trouble" at work, because it's not sustainable.

 

I'm concerned that I have felt somewhat more suicidal lately due to feeling trapped due to job and finances combined with tapering. I'm hoping that given enough time and avoiding alcohol (don't drink much anyway) and getting enough sleep, I will stabilize within a few months. I will absolutely not make any more dose changes until I feel stable for several weeks.

Sensible decision. It's very difficult balancing tapering in conjunction with the unrealistic expectations of a capitalist society. If we could all abstain from work whilst getting off these drugs it would be much easier, but that is not the way the world works. You will find the right balance between tapering and work eventually.

[Halsyon]

A few thoughts I wanted to add.

 

Tangential to tapering, but: I notice that when I'm feeling what I would call depressed, I have this strong aversion to darkness. When I wake up in the morning, sitting in a dim room makes me feel awful, and I'm driven to open the blinds and let the sun in, and it makes me feel so much better. This is interesting to me because there is this stereotype of the depressive who hates the light and sits at home in the darkness, shades drawn. We are all different, so of course not everyone will be this way when depressed, but I do wonder if I feel this way because my depression seems to be very strongly tied to my anxiety (which is significant), and so when I feel depressed I often almost feel like I'm... suffocating? That's the only thing I can compare it to. Opening the blinds and making the room sunny feels instantly comforting and I don't feel trapped in a dark room with my dark thoughts, I guess.

 

Amazing the effect environment has on us. I don't think people pay enough attention to this (and just think of the sterile, fluorescent-lit environments many of us spend our days in. Sunshine and green plants and birdsong are soothing).

 

I notice that when I'm feeling really down I also find the smallest things upsetting, and by things I mean literal objects at times. If I'm feeling particularly emotional, certain objects - like a stuffed animal or a mug someone gave me - make me feel weirdly upset to look at. There's more to it than that but it's hard to explain.

 

Anyway I think this is all due to withdrawal, and too fast, so I know it will pass in time. May not be "true" depression.

 

 

 

[Erimus]

32 minutes ago, Halsyon said:

A few thoughts I wanted to add.

 

Tangential to tapering, but: I notice that when I'm feeling what I would call depressed, I have this strong aversion to darkness. When I wake up in the morning, sitting in a dim room makes me feel awful, and I'm driven to open the blinds and let the sun in, and it makes me feel so much better. This is interesting to me because there is this stereotype of the depressive who hates the light and sits at home in the darkness, shades drawn. We are all different, so of course not everyone will be this way when depressed, but I do wonder if I feel this way because my depression seems to be very strongly tied to my anxiety (which is significant), and so when I feel depressed I often almost feel like I'm... suffocating? That's the only thing I can compare it to. Opening the blinds and making the room sunny feels instantly comforting and I don't feel trapped in a dark room with my dark thoughts, I guess.

 

Amazing the effect environment has on us. I don't think people pay enough attention to this (and just think of the sterile, fluorescent-lit environments many of us spend our days in. Sunshine and green plants and birdsong are soothing).

 

I notice that when I'm feeling really down I also find the smallest things upsetting, and by things I mean literal objects at times. If I'm feeling particularly emotional, certain objects - like a stuffed animal or a mug someone gave me - make me feel weirdly upset to look at. There's more to it than that but it's hard to explain.

 

Anyway I think this is all due to withdrawal, and too fast, so I know it will pass in time. May not be "true" depression.

 

 

 

Maybe you need one of those sunrise alarm clocks to wake you up, or replace blackout blinds/curtains if you use them. I always find withdrawal is much easier in summer, when it's warmer and daylight is more plentiful.

[Halsyon]

3 minutes ago, Erimus said:

Maybe you need one of those sunrise alarm clocks to wake you up, or replace blackout blinds/curtains if you use them. I always find withdrawal is much easier in summer, when it's warmer and daylight is more plentiful.

I considered getting one of those but couldn't decide on one, haha. Maybe I'll look again. I do use blackout blinds but I really need them to sleep. If they bother me in the morning I just open them. When I go to sleep any light bugs me.

[Halsyon]

It has been 3 weeks (20 days, so minus one day, heh) since my last reduction. Some things I've noticed follow. Let's see if I can present this in an organized fashion so it's not hard to follow.

 

My mood has been leaps and bounds better this past week, BUT - this corresponds with not having to go to work because of a medical emergency I had. It could also be that I'm stabilizing, but that remains to be seen. I do think the work part is highly significant - I don't like my job and it is very stressful and eats up the majority of my time, so naturally, my mood is going to be lower sometimes being in that position. Add in the anxiety I experience anyway, and feeling socially isolated (and lacking exercise and a good diet at times), and it's a recipe for feeling low. I can definitely work harder to change some of those things, though, such as the diet and exercise. Socializing is necessary too, it's just hard when you feel you're jeopardizing your job because you are behind, if you choose to socialize instead of work. I know, it shouldn't be this way. I'm trying to figure this part out, and my ultimate goal is to change careers, but that takes time and significant work as well. 

 

So, it's funny - the medical emergency that happened you'd think may have had a depressant effect on my mood. And it did, briefly, but as I've healed from surgery, I've found that the time off work - and the required rest I need to give myself to heal - has forced me to slow down and be present. I feel so much more human. I'm not saying I'm thrilled I had to have surgery, but... it was a blessing for me, honestly. I will have to go back to work, of course, but I'm taking the time off to get some of my life things more organized and getting a system set up so hopefully I will have less overwhelm when I return.

 

Another significant thing happened - and I feel like maybe I'm providing too many identifying factors about myself here, but they're important to this tapering/wellbeing process, so I will include them anyway - I got the results of an ADHD evaluation back this week. The results were very validating in the exact opposite way you'd think - I strongly suspected I had ADHD but the psychologist doesn't think I do based on the data they collected and how I functioned in the past as a child, and what he said instead makes a lot more sense.

 

It seems my main problem isn't depression or issues with executive functioning and impulsivity, but with general anxiety. I've always known I tend to worry a lot about everything, and knew I could be said to have generalized anxiety disorder. This can mimic symptoms of ADHD at times, and can also (naturally) lead to low mood at times. That's not to say I don't struggle with depression at times, I do - but what I gathered is when I do, it is because of my anxiety (I know anxiety and depression often go hand in hand), and not that I have major depressive disorder. I kind of figured that anyway, but I had started to believe over time that I was a "depressive," and then I started to believe that I had OCD and ADHD. The OCD is still up for debate - I got diagnosed with it from an online platform, which apparently aren't always reliable when it comes to diagnoses, and the psychologist was candid with me and said he had many patients come to him with diagnoses that didn't seem to fit after he tested them. I know many of us here are skeptical of psychiatry in general, but I have to plant my flag somewhere, and I choose to trust him. He acknowledged that the OCD screener only measured my current state and that it's possible I did struggle with it in the past (and for me, I know it can flair up and die down, so I may just not be in a flair right now - I am monitoring my symptoms). He said the same about depression. 

 

I don't think anyone with ADHD or OCD of MDD or anything else should feel bad or defective, but the messaging from society about these struggles doesn't help, and although I was prepared to embrace the reality that I may have ADHD, I feel relieved to know I don't have it. I just feel like this weight has been lifted off my shoulders and I feel better about myself, and about how I think of my internal struggles. 

 

Final note, which is related to my SSRI directly - blurred vision has been a bothersome side effect for me on it, and I meant to make an appointment with an optometrist to check it out and never did, which isn't good. I noticed this morning that before taking my dose, my vision was fine and normal, as was my thinking. About 1-2 hours after taking my SSRI, my vision is back to being weird and kind of fuzzy (t's hard to describe what I mean because I can see ok to function and drive and everything else, but it looks like there's this weird mild haze around everything, and text close to my eyes is harder to read, which isn't typical for me). I also feel somewhat dizzy, which I was NOT feeling before taking my SSRI. It feels like it envelops me in this kind of dizzy, shimmering haze that I can still function in but feels a bit off, and I don't like it at all. Looking forward to being off it completely.

 

I will stay on 6.5 mg for the time being, and pay close attention to how I feel when I return to work.