wanderingmind: Introduction

[wanderingmind]

I’m at my wit’s end here. Earlier in 2023 I was on 20mg of Citalopram after having been on them (with a brief change to Sertraline in 2020 after upping Cit to 40mg in 2019, if I remember correctly) since 2017. I was given them alongside 20mg Omeprazole for suspected anxiety-induced gastritis, which still hasn’t been confirmed.  They helped me cope well enough, except for the dip that caused me to change to Sertraline. Sertraline wasn’t as effective and seemed to give me IBS. In January this year I was given 10mg Amitryptyline for painful IBS symptoms. it made me feel confused and limited my cognition and concentration, and didn’t seem to help my pain either.

Meanwhile, I had decided to go off antidepressants altogether as I have now been in therapy for three years and wanted to explore my emotions properly in a safe space that I didn’t have when I started. The antidepressants had made exploring my emotions very difficult and I was under the impression that coming off would give me the space to move forward. I was instructed to taper off over three months, decreasing to 10mg, then alternating between 10 and 0 before dropping altogether. After the last decrease, I started to feel odd, but decided to persevere, not knowing any better. My appetite started to decrease and my health anxiety was increased. I thought I had breast cancer and in the first week off Citalopram entirely, I was in a massive depressive state convinced that I was dying.

It gradually subsided as everything was fine health wise, so I again decided to persevere as I was desperate to feel like myself again and move forward, having felt stuck for years. I now realise that I should have reinstated at 10mg. I thought I was getting on okay, but very lethargic and my appetite was slowly decreasing, which I didn’t quite notice. Citalopram had made me voracious and almost overweight before I got that under control, so I was pleased to lose that. I was able to maintain my weight for a month or so, and thought that I was just going through the motions and must be getting better. My mood was a bit off, but there were positives coming up such as old memories and generally feeling more like myself.
But I was starting to have brand new depressive thoughts creeping in, and suicidal ideations, which have never happened for me. Making my mood worse was the mental impairment caused by the Amitriptyline. I can’t work much at the best of times and do very minimal freelance work at home, and this was just making it worse, so I was desperate to get off.
I had told the doctor about all of my symptoms (so so many, including no appetite, weight loss, heavy heartbeat, fatigue, weakness) and had a clear blood test come back, with a note of low iron that was just left at that. I had mentioned wanting to come off Ami and doctor told me to do it over a week, taking a pill every other day. I had a feeling this was a bad idea, but I was desperate and trusted that the doctors must know what they’re doing. I could get through the initial symptoms, but then I had another huge depressive episode, maybe even psychotic, where I was doubting my own mind and unsure of what to trust, my anxiety was huge and I had to drop everything I was doing because everything made me too afraid.
I had real trouble eating after this, not wanting to eat much other than carbs and fridge snacks. This regressed into being unable to eat anything without sobbing because it made me too anxious. I am still in this place. I have continued to lose weight because I simply cannot eat enough. I have had a lump in my throat (apparent globus) since July or so, which makes swallowing extra sensitive now. I’m experiencing an intense internal electricity panic sensation, and tremors, which is increased when I try to eat, hence the sobbing. I got desperate last week and asked the doctor to increase back to 10mg Citalopram because of how hungry it had made me in the past. Instead, I now just have impossible insomnia and flare up of my gastro issues, nausea, excessive burping, early fullness, catastrophic thoughts, and complete food aversion. My sense of taste has also changed, it’s oversensitive and makes eating so so difficult. I keep descending into moments of fear that I will keep wasting away and end up in hospital and inevitably be put on more medications. I’m trying to eat more, and realise that I probably got my stomach used to too little food, but it’s incredibly tough and I’m having to rely on high calorie foods and Complan. The doctor had initially wanted to give me Mirtazipan for my appetite but I really didn’t want to be on a sedative after how Ami made me feel on it. I’m at a complete loss of what to do, I realise that my central nervous system is in complete shock and I’m so scared that this has done some real permanent damage. I’ve never felt so hopeless in my life, how am I supposed to get to sleep? I just lay awake buzzing with electricity. On the off chance i get an hour or so, I jolt back awake. Some moments I feel like I can handle this and things will slowly get better but that's quickly replaced by panic. If anyone has any advice or kind words, please please leave a comment. 

[LotusRising]

Hi @wanderingmind

 

Welcome to SA. Could you please help us by summarizing your drug history How to Create a Signature.

 

We recommend a harm reduction taper, reducing no more than 10% per month of your previous dose. It sounds like you've tapered faster than that and are experiencing WD symptoms. This is to be expected from a fast taper and is not permanent. Going on and off medications can destabilize your nervous system and while it heals, you will likely experience The Windows and Waves Pattern of Stabilization.

 

You might find these links helpful as well:

 

Keep it simple, slow and stable

 

Hypersensitivity and Kindling

 

Symptoms and Self-care

 

Are you currently off all your medications at this point?

 

[wanderingmind]

Thank you so much for your reply @LotusRising

 

I did input my medication history into my signature, but perhaps it’s not showing up? Have just updated it and hopefully it shows. 

I am currently on 10mg Citalopram again after getting desperate with my symptoms 7 days ago, and 40mg Omeprazole increased on the 17th. The reintroduction has added on more symptoms, the worst being inability to sleep and increased hypersensitivity which leads to near constant panic at most stimuli and more frequent panic attacks. That said, I am able to experience very short periods of relief from the hypersensitivity, and so I have refrained from stopping the Citalopram again as I imagine it would just wreak more havoc?

And thank you for sending those links, any positive reminders of the process are always helpful in these impossible moments (I realise that my post was undoubtedly submitted within one of the much more frequent hopeless moments, but there are fleeting moments of clarity and hopefulness). I am certainly experiencing hypersensitivity in ways that I’ve never encountered before. I will give these posts a good read. 

[LotusRising]

5 hours ago, wanderingmind said:

The reintroduction has added on more symptoms, the worst being inability to sleep and increased hypersensitivity which leads to near constant panic at most stimuli and more frequent panic attacks.

 

It sounds like you reinstated 10mg and are feeling worse? Did you have these symptoms prior to the reinstatement?

 

What symptoms were you hoping would improve with reinstatement? 

 

Have you seen our topic on Reinstating and Stabilizing? Reinstatement does not guarantee that symptoms will be diminished. I suspect that you may have reinstated too high of a dose. These drugs are strong and your system has become sensitized, and if you take too high of a dose, it might be too much for your CNS.

[wanderingmind]

4 hours ago, LotusRising said:

It sounds like you reinstated 10mg and are feeling worse? Did you have these symptoms prior to the reinstatement?

I had these symptoms to an extent, but the reinstatement amplified them. I did get around 6 hours of sleep last night, though, which was very welcome, and I was able to consume 1,800 calories without too much distress yesterday, which is about twice what I can usually manage, and experienced a flutter of a craving for a food I used to enjoy. I am wary about making too many changes on my own at this particular early stage, partially because I cannot risk a scenario in which my local doctors write me off as unwilling to cooperate. Like me, they are most concerned with making sure my weight doesn’t drop further as I’m very close to becoming underweight and am likely experiencing nutritional deficiencies as my diet is so restricted. I wouldn’t know how to begin handling these on my own and am afraid of risking real physical damage. There are only a few doctors that I have access to, and it’s difficult enough getting to speak to them in a crisis. I need some form of additional support as this must be taking a massive toll on my mother, who I live with, and only seeing my therapist once a week isn’t nearly enough. I am seeing a doctor today about my stomach though and will ask about the possibility of reducing the dosage, as I am open to the idea if you think it might help. Hopefully this one is more understanding, he seemed to listen when I told him I felt as though my nervous system had been traumatised by the meds, and he was receptive to my request of finally having my stomach properly checked. 
 

4 hours ago, LotusRising said:

What symptoms were you hoping would improve with reinstatement? 

I was hoping that the reintroduction would increase my appetite as this has been my most distressing withdrawal effect, leading to feelings of complete hopelessness as I haven’t been able to eat properly for months and have been continually and rapidly losing weight that I cannot afford to lose. I was hoping to get some hunger cues back, realising that Citalopram must have completely overwritten any natural cues I once had. My sense of taste has also changed to a point where most foods taste foul or overwhelming and increased sensitivity makes keeping food down tough. I was put on them at age 20, so I’ve never really had a chance to find out what my adult, post-puberty weight/metabolism/hunger is supposed to be like and seems like my CNS has just done a complete erasure. Am realising that my full-time job for the time being is going to have to be encouraging myself to eat. Made all the more difficult by increasing nausea and unconfirmed gastritis. 
 

If anyone has any tips for dealing with nausea in a way that doesn’t further upset gastritis, I would be incredibly grateful, as it’s been a beast for most of my life. 
 

Also, apologies for the not-so-succinct replies, but I am finding that the process of writing out and sharing my experiences is quite effective for calming some of my symptoms. I appreciate any advice you might have. 

[wanderingmind]

I’m very conflicted at the moment about what is withdrawal and what is my heightened natural anxiety, though I know they will be closely related. No doubt these effects are a result of coming off the meds too quickly without giving myself proper time, but so hard to know what is withdrawal/reinstatement and what might just be my difficulties managing my anxiety and depression. I do think that the long time spent on antidepressants at a time when my brain was finishing its development must have given me a dependence, and that’s tough (but worthwhile) to learn to cope with. Really, that’s why I went off the meds in the first place, as they didn’t allow me to learn about my difficulties, just numb them. Apologies if my journey doesn’t quite fit on this site, but the site has helped me realise that I need to take much better care of my nervous system and be much kinder to myself during this period, whether my struggles are caused by withdrawal or unresolved anxiety issues (or a combination of both). Thank you @LotusRising for your valuable replies thus far.  

[LotusRising]

8 hours ago, wanderingmind said:

I did get around 6 hours of sleep last night, though, which was very welcome, and I was able to consume 1,800 calories without too much distress yesterday

 

This is a good sign!

 

8 hours ago, wanderingmind said:

My sense of taste has also changed to a point where most foods taste foul or overwhelming and increased sensitivity makes keeping food down tough.

 

Have you tried smoothies? I found this the easiest way to add calories when I was struggling with stomach issues. Personally, I drank a lot of ginger tea and also used gravol ginger chews. I was reluctant to add any medications for nausea, but others do. This topic might help:

 

 

3 hours ago, wanderingmind said:

I’m very conflicted at the moment about what is withdrawal and what is my heightened natural anxiety, though I know they will be closely related.

As you already mentioned, you have been on these drugs for quite some time, so understandably, it could be difficult to ascertain what your baseline is. You might find some useful info at this link:

 

 

3 hours ago, wanderingmind said:

Apologies if my journey doesn’t quite fit on this site,

 

I believe your journey absolutely fits on this site! I think the more you look around here, the more evident it will be that others have struggled the way you have. 

[Catina7]

9 hours ago, wanderingmind said:

If anyone has any tips for dealing with nausea in a way that doesn’t further upset gastritis, I would be incredibly grateful, as it’s been a beast for most of my life. 

 

Hi @wanderingmind!  You can try those motion sickness wrist bands; I've used them before with some success.  Also, I've rubbed peppermint essential oil outside my nostrils to breath it in.  That has helped me too.  

Edited October 20, 2023 by Catina7

[wanderingmind]

@LotusRising thank you for the kind words and advice! 
 

I haven’t yet tried any fruit smoothies as I’m still in the process of figuring out what foods work for me (new doctor thinks I have gastritis, IBS, and reflux, been referred for an endoscopy though so will find out!). But I did make an oat smoothie with a meal replacement, which helped a great deal yesterday. I’m wary of ginger as it seems to aggravate my throat, but I might see if it helps. Thank you!

 

Thank you for the link, I read this post earlier today and think it has some helpful info, but sadly doesn’t lessen the confusion. I may need to step away from the site for a short time to evaluate everything as reading nonstop has been adding to my confusion. Thank you for your support though!

[wanderingmind]

@Catina7 thank you for the great suggestions! 

[wanderingmind]

@LotusRising am feeling quite desperate again today, thinking that I should have reinstated the Amitriptyline instead of Citalopram. I have moments of feeling calm, but only when I’ve been able to calm myself by reading success stories in forums. I cannot sleep again, I must have gotten three hours last night before staying up to journal, but it didn’t feel like I had. I’m feeling more and more like I’ve got irreversible brain damage, and I’m scared I’m just making it worse but not reinstating the Ami. I get fleeting cravings at night, but am still averse to eating and experiencing nausea. The thought of eating (or not being able to) gives rise to the painful burning sensation. I’d appreciate any thoughts you have

[wanderingmind]

What might be the best course of action RE the Citalopram? Last night I experienced repeated hand and arm jerking whenever I fell asleep, waking me up. I’ve also noticed increased chest pressure. I’m only 10 days into the reinstatement and I’m worried that symptoms will get worse the longer I take the Citalopram. What might my options be? Other than my sleep and chest, other aspects are getting a little easier to deal with, especially with calming myself and self care. 

[LotusRising]

3 hours ago, wanderingmind said:

Last night I experienced repeated hand and arm jerking whenever I fell asleep, waking me up. I’ve also noticed increased chest pressure.

Are these new symptoms since the reinstatement, or have you had them before?

[wanderingmind]

@LotusRising I’m fairly sure they’re new symptoms

[Altostrata]

How do you feel after taking your citalopram dose, compared to before you take it?

 

How's your IBS?

[wanderingmind]

thank you for your reply @Altostrata

 

I’m not sure there’s a huge difference before and after taking the cit, apart from increasing nausea in the morning. That said, it may be that I am able to calm myself down into the evening, and the citalopram puts me back into high alert. 
 

My IBS symptoms fluctuate. I did get some cramping and diarrhoea yesterday, perhaps after I took the citalopram. But I had also taken an antihistamine to try to manage some postnasal drip that is making me gag. 
 

On the upside, I don’t think I experienced any jerking last night, and was able to sleep around 7 hours. I would hate to lose that progress. I did take 25mg Magnesium before bed though, and fell asleep to some brown noise, maybe that helped. Will try again tonight. 

My primary concern is appetite and nausea, as I simply have to gain weight. I reinstated 10mg because that was the last place in my (admittedly too short) taper that I remember feeling hungry. I was hoping that reinstatement would give my brain whatever it was missing that gave me an appetite on the meds. Occasionally I’ll get a glimmer of a craving, which I’ve taken to be a good sign. Sometimes I can convince myself that food tastes okay, and that I can eat more on certain days, but I keep getting derailed. 

 

I was given some metoclopramide for short-term nausea but have been wary to take it

[Altostrata]

Please add the date you reinstated 10mg citalopram. I believe it was October 12?

 

That was only 2 weeks ago. It may take you longer than that to stabilize. Your withdrawal pattern may show The Windows and Waves Pattern of Stabilization 

 

On 10/23/2023 at 11:36 PM, wanderingmind said:

On the upside, I don’t think I experienced any jerking last night, and was able to sleep around 7 hours.

 

This is a good sign. Please be patient.

 

Eat whatever appeals to you. Do you like butter? Put butter on everything.

 

 

[Onmyway]

@wanderingmind have you been tested for H-Pylori? 

 

[PortugueseSea]

On 10/24/2023 at 3:36 PM, wanderingmind said:

I was given some metoclopramide for short-term nausea but have been wary to take it

You were right to be wary, it is an old recycled anti-psychotic, you should be extremely weary.

Hope you are feeling better.