Gwhizzle: Reinstatement advice

[Gwhizzle]

Hi, 

 

I wondered if I could get some advice as to whether reinstatement might be wise in my situation. 

 

I stopped taking 20mg Citalopram around the end of October 2023, following quite a quick and seemingly unadvisable taper (I believe full details should be in my signature - apologies I'm not totally sure on exact dates). Initially, things felt okay - I noticed some withdrawal symptoms during the taper (e.g. depersonalisation, vertigo, brain zaps), but thought this was to be expected so continued. In terms of mental symptoms, I was struggling a lot prior to and following the withdrawal, however at the time I thought this was related to an emotionally abusive relationship that I had come out of in July. Looking back, my difficulties did get a lot worse after coming off my medication thought - at the time I thought I was experiencing symptoms of PTSD (e.g. intrusive thoughts, intense anger, 'flashbacks' of sorts, obsessive behaviour). Luckily I started therapy, and my difficulties surrounding this seemed to have improved. However, I've noticed ongoing difficulties - intrusive and obsessive thoughts, feelings of hopelessness/loneliness, rapid mood swings, anger, brain fog, inability to focus on tasks for long, feeling very disconnected and trapped in my own mind, difficulties sleeping (sometimes jolting awake frequently in the night, over night struggling to sleep and waking early). Over the last few weeks, I also seem to be experiencing some sexual difficulties - but I'm not sure if these are perhaps partly due to my obsessive thinking and anxiety, as they have become the focus of this to some extent. I'm also noticing palpitations, and increased pressure in my teeth, head and eyes... but again, I'm not sure if I've become quite obsessive after discovering protracted withdrawal and have in some ways worried these into existence. 

 

These difficulties are having a big impact on my functioning - I'm currently a trainee therapist, and have had to take some time off work. I simply don't feel able to do this job efficiently when feeling so disconnected from the world and people around me. Whenever I try to work on assignments, I feel paralysed... almost unable to think and crippled by a sense of dread and inability to string a sentence together. 

 

I was hoping to get some advice around reinstatement... I wasn't sure if this would be ill advised since I stopped taking medication around 2-3 months ago? I'm also incredibly anxious about doing this and potentially worsening my difficulties and sexual side effects potentially permanently. I just feel quite lost and so unsure about what to do... part of me isn't even sure if I'm experiencing withdrawal, or have just become so fixated on it that I've willed it into existence. I feel like I can't really trust my own mind anymore...

 

Thanks you so much. 

Edited January 2 by Emonda
Name to title

[KenA]

Welcome to SA @Gwhizzle. We are glad that you have found your way here. Here is some information for you concerning withdrawal symptoms and also some information about reinstating.  Please take your time and read through the following information as it may help to answer some of your questions. If you have any further questions after reading, please respond in this intro topic and we will do our best to assist you!

 

WITHDRAWAL

What is withdrawal syndrome.

Brain Remodelling

Video: Healing From Antidepressants - Patterns of Recovery

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

The Windows and Waves Pattern of Stabilization

 

REINSTATEMENT

Reinstatement of a very small dose of the original drug is the only known way to help alleviate withdrawal syndrome.  It isn’t a guarantee of diminished symptoms but it’s the best tactic available. The only alternative is to try and wait out the symptoms and manage as best you can until your central nervous system returns to homeostasis.  Unfortunately no one can give you an exact timeline as to when you will start feeling better and while some do recover relatively easily, for others it can take many months or longer.  

  Reinstatement predictably works up to 3 months after last dose.  It is best to reinstate as soon as possible after withdrawal symptoms occur. We usually suggest a much smaller reinstatement dose than your last dose.  These drugs are strong, and when reinstating it is better to start with a small amount and increase if symptoms remain unbearable. Your system has become sensitized and If you take too much it may be too much for your brain and can cause you become unstable.  Sometimes it can be hard to regain stability after this happens.  Then, once you've stabilized on that dosage, which can take several months,  you can begin a 10% per month taper down to zero.   Please read:

 

About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic

 

 It takes about 4 days for a dose change to get to get to full state in the blood and a bit longer for it to register in the brain.    

SUPPLEMENTS

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium (glycinate is a good form) and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

Magnesium, nature's calcium channel blocker 

Omega-3 fatty acids (fish oil) 

Add in one at a time and at a low dose in case you do experience problems.

 

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.

 

Best wishes

KenA

[Gwhizzle]

Hi, 

 

Thank you so much for your reply. After careful consideration, I believe I'm going to try reinstating a small dose of 1mg Citalopram. I'm a little nervous about discussing this with my GP, due to their lack of knowledge in this area, but think I might ask for the liquid prescription in order to taper up to avoid any possible adverse effects (although I will likely not taper up!). 

 

I just wanted to check, it may seem obvious, but just to be sure - are we advised to take the reinstated dose daily?

 

Thanks again for your help and support.

[KenA]

6 hours ago, Gwhizzle said:

I just wanted to check, it may seem obvious, but just to be sure - are we advised to take the reinstated dose daily?

Yes, as close as possible to the same time each day. Our CNS craves stability and the more we can help it the better.

[Gwhizzle]

Hi,

 

Thanks @KenA again for your help.

 

I’ve now received the prescription for liquid citalopram. 
 

Before I start it, I was hoping to get some advice. Unfortunately my obsessive thinking has now turned strongly to the process of withdrawal, and potentially making things worse by reinstating. I’m highly anxious that by having taken propanalol, cialis and some other supplements and alcohol over the last few weeks before finding out about withdrawal, I may have primed myself for kindling. I am no longer taking any of these. 
 

However, I’m currently really struggling and unable to barely function, so feel I need to give reinstatement a go. However, I’m very cautious about keeping a daily log of my symptoms as I believe this will only fuel my obsessive thinking and potentially lead to psychologically induced feelings of panic and despair. 
 

I’m leaning towards reinstating a small dose and just sticking with this, unless things get noticeably worse, but without hyper-fixating on my symptoms every minute of the day and consequently self inducing panic … I’m hoping it should be obvious if things get worse, is this correct?

 

i just wanted to check if you’d advise I reinstate at 0.5 or 1mg if I did decide to do so? I’m very cautious of trying a dose and then seeing how it affects me and tapering accordingly, as I think this will just lead me to spiral further and further. 
 

I feel like I’m in a place right now where I just need to make a decision and stick with it… reinstate a small amount, or don’t (but obviously then very stressed about things getting progressively worse).

 

I guess I’m just hoping for any advice or guidance in this situation… it’s so hard right now to determine what actually are symptoms of withdrawal and what are self induced by my obsessive thinking about withdrawal and whether to reinstate, it’s almost impossible to tease these apart. I’m wondering if other members have been in a similar situation and what you would advise? It seems to be a toss up between reinstating and possibly worsening my psychologically induced panic by hyperfixating even more, or not reinstating and risking things getting progressively worse and worse. This isn’t helped by the fact I’m now about 2.5 months since my last dose, so time is ticking.

 

thanks so much for your help again 

[Gwhizzle]

Hi,

 

I was wondering if I could get some advice.

 

I’ve now reinstated 0.5mg daily, for approximately 2 weeks. Generally, I think things are feeling slightly better. I’m seeing moments where I feel more human and like my old self, those these do seem quite few and far between. I think my sleep has improved slightly and I’ve noticed I seem to be dreaming more. 

 

I’m finding a pattern of finding the morning and day quite difficult, I often wake up with a real sense of dread and despair, with really intensive obsessive thinking which often leads to me feeling very overwhelmed and borderline suicidal at times. However, I’ve noticed this generally improves towards the evening, and I have rare moments of clarity when the obsessive thinking seems so silly and I’m able to put it aside. But when I’m in it it feels so all consuming and real, so hopeless and terrifying.
 

I’m taking my dose at about 5pm everyday. I’m noticing after this I feel quite anhedonic/emotionally numb, my inner voice feels quiet and distant, and I do notice some vibration sensations in my legs/feet, as well as a pulsing sensation in my head and teeth. I do think these physical sensations have improved slightly overall since reinstating though.  The anhedonia/numbness is slightly odd though as I didn’t experience this before the reinstatement as far as I can remember, is this is a bad sign? 

 

i just wanted to see if this sounded as expected, and there aren’t any signs of potential kindling? I also wonder how I might know whether I need to increase my reinstated dose at all? I’m very apprehensive about becoming obsessive over this and possible making things worse, but obviously want to do all I can to stabilise ASAP.

 

thanks so much.

[Gwhizzle]

Hi,

 

I’m so sorry for the repeated posts, but I’m a little worried and would really appreciate any help or guidance.

 

Since reinstatement, I think things have felt a little better. However it seems this feeling of numbness/anhedonia is increasing, it previously seemed to be in the evenings but it’s now happening more in the day. It’s very strange, I can’t really feel any emotions, positive or negative. I’m still having some obsessive thoughts but these are less, but it’s almost like I’m having no thoughts really, very cloudy mind, finding myself wondering and not sure what I’m doing etc. my thoughts feel very distant and quiet.

 

This feels more bearable than the intense obsessive thoughts and panic/dread I was experiencing previously. But I am just concerned whether this is a good or bad sign, as I don’t believe I experienced this prior to reinstatement, and am terrified of making things worse in the long run. 
 

other symptoms (e.g. tingling in legs/feet/hands, head/tooth pressure) are still present, but I think slightly better since reinstatement. 
 

thanks you so much, any guidance would be so appreciated as I’d be keen to stop the reinstatement asap if this is a bad sign.

[Sonia009]

@GwhizzleHi, hope you don't mind butting in but I'm in a similar situation, reinstated 0.5mg Citalopram one month ago and not seeing real improvements, someday I actually feel worse. I'm looking for the answer to your question too which is should I stop reinstating in case it causes more damage than good. I hope a moderator responds to your question.

[Sonia009]

Hi, I was wondering how it was going with you reinstating 0.5mgs Citalopram, have you noticed any improvements yet? I was hoping a moderator would have got back to you to answer your questions but I realise they are very busy.

[Gwhizzle]

Hi @Sonia009

 

im honestly not sure if I’m doing better or worse. Better in the sense that my anxiety/panic and other physical sensations (e.g. paraesthesia, tooth/head pressure, possibly tinnitus) seem to have improved for sure. My sleep also seems better. However, I’m now feeling very numb and detached. I’ve even noticed a sense of physical numbness in my hands, lips and feet, that wasn’t there before. I think I’m noticing some increased pelvic floor/groin pain/tightness/numbness, but this was there prior to reinstatement and very up and down. Previously, I felt in a constant state of panic and fear over lots of things, sometimes feeling quite manic as well. Now, these things still occupy my brain, and at times I can get caught in obsessively thinking about them, but there’s just no emotion behind it. No anxiety, no dread, no fear. Also no real positive emotions. Just an emptiness really. I never felt this way when taking citalopram previously, or before in my life. I’ve always been quite an anxious, tightly wound person, so this feels very strange. In some ways it feels better, at least I can actually switch off and not exist in constant dread, but there is that thought that keeping cropping up… is this a good sign? Though no real feelings behind that thought.
 

I really hope to hear from the moderators soon. I’ve tried reading other posts to see if this is a good or bad sign, but can’t seem to find out. I just want to know whether to carry on this dose or stop, and then just let destiny take its course and allow my body to heal. I’m just sick of thinking about all of this. I wish I’d never came off my medication in the first place, if only if just googled and not blindly had faith in my GP, for my life to quite literally feel like it’s now crumbling around me. But here we are, just got to keep going I guess. 

how are you doing? 

[Sonia009]

6 hours ago, Gwhizzle said:

Hi @Sonia009

 

im honestly not sure if I’m doing better or worse. Better in the sense that my anxiety/panic and other physical sensations (e.g. paraesthesia, tooth/head pressure, possibly tinnitus) seem to have improved for sure. My sleep also seems better. However, I’m now feeling very numb and detached. I’ve even noticed a sense of physical numbness in my hands, lips and feet, that wasn’t there before. I think I’m noticing some increased pelvic floor/groin pain/tightness/numbness, but this was there prior to reinstatement and very up and down. Previously, I felt in a constant state of panic and fear over lots of things, sometimes feeling quite manic as well. Now, these things still occupy my brain, and at times I can get caught in obsessively thinking about them, but there’s just no emotion behind it. No anxiety, no dread, no fear. Also no real positive emotions. Just an emptiness really. I never felt this way when taking citalopram previously, or before in my life. I’ve always been quite an anxious, tightly wound person, so this feels very strange. In some ways it feels better, at least I can actually switch off and not exist in constant dread, but there is that thought that keeping cropping up… is this a good sign? Though no real feelings behind that thought.
 

I really hope to hear from the moderators soon. I’ve tried reading other posts to see if this is a good or bad sign, but can’t seem to find out. I just want to know whether to carry on this dose or stop, and then just let destiny take its course and allow my body to heal. I’m just sick of thinking about all of this. I wish I’d never came off my medication in the first place, if only if just googled and not blindly had faith in my GP, for my life to quite literally feel like it’s now crumbling around me. But here we are, just got to keep going I guess. 

how are you doing

@Gwhizzle Hi, your symptoms seem very similar to many others that I've read on here, I share some of them but dizziness is my main problem. weird dreams and obsessive thinking are others. mornings are horrible, waking up in fear of what the day will bring. Some of your symptoms could also be anxiety related too like the numbness, tingling, weird aches and pains etc. I notice after stopping Citalopram you went on propranolol for a month, so did I around the same time as you and I wonder if we had some sort of adverse reaction to it or maybe there was an interaction, particularly after such a fast withdrawal from citalopram. Perhaps a moderator could comment on this. Like you, I feel unsure if continuing with the small dose of Citalopram is the right way to go but I'm going to give it more time I guess and hope for the best. Like you I was hoping a moderator would step in and comment. I need the reassurance such as you do. I came across some great anxiety videos on youtube recently that describes many of your symptoms and mine by Trey Jones who speaks from experience. If you do a search on Trey Jones anxiety videos youtube there are lots of them, I find them very reassuring. I mention this because you said you were an anxious person, so am I. You seem to be making some progress such as sleeping, relaxing so that is a good sign. I do hope a moderator will step in an answer your questions and give you the reassurance you need. 🙏

[Gwhizzle]

Hi @Sonia009 thanks for your message and thoughts, and I’m so sorry to hear you’re struggling with too.

 

I really hope I get a response from moderators soon. I’m now feeling completely emotionally numb, and this sounds strange but also physically numb across my whole body. Not totally numb, but significantly reduced sensation and little pain etc.

 

If any moderators see this, I just need any advice or guidance based on your experience, please. I am feeling more stable… but much less like myself. Before I felt very unstable but still like myself, the paraesthesia etc. was unsettling, but in some ways this emotional and physical numbness is even more unsettling. I’ve read this can be common in PSSD, and am really worried reinstating may have caused this and doomed me, as PSSD seems to last for a long time. Any thoughts as to whether to stop the reinstatement would be so massively appreciated, please.

 

thank you so much again for everything you guys do on here.

[Sonia009]

20 minutes ago, Gwhizzle said:

Hi @Sonia009 thanks for your message and thoughts, and I’m so sorry to hear you’re struggling with too.

 

I really hope I get a response from moderators soon. I’m now feeling completely emotionally numb, and this sounds strange but also physically numb across my whole body. Not totally numb, but significantly reduced sensation and little pain etc.

 

If any moderators see this, I just need any advice or guidance based on your experience, please. I am feeling more stable… but much less like myself. Before I felt very unstable but still like myself, the paraesthesia etc. was unsettling, but in some ways this emotional and physical numbness is even more unsettling. I’ve read this can be common in PSSD, and am really worried reinstating may have caused this and doomed me, as PSSD seems to last for a long time. Any thoughts as to whether to stop the reinstatement would be so massively appreciated, please.

 

thank you so much again for everything you guys do on here.

@GwhizzleHi, sorry to hear you are suffering from your symptoms still. I am in the same boat as you regarding whether to remain on current dose, increase or come off all together. I have asked this question but waiting for a definitive response. I do hope a moderator will get back to you to give you the reassurance you need because I know you have been waiting patiently for this. I agree, the work these moderators, mentors, administrators and all others who participate do is truly invaluable. Hope you get answers soon.

[Gwhizzle]

Hi,

 

Sorry to tag you @getofflex, but I noticed in your signature it said you were happy to be tagged for emergency questions regarding reinstatement and tapering.

 

I was wondering if I could get any advice. I basically reinstated 0.5mg Citalopram about a month ago. I’ve noticed my panic and anxiety has reduced but replaced by a sense of emotional anaesthesia, which initially began in the evenings and now feels 24/7. I’m also starting to experience increasing head pressure and periods of confusion where I simply can’t think or focus on anything, it’s quite scary. I’ve also noticed a new symptom of nausea, as well as a constant full body numbness/reduced sensation and much worse genital numbness.
 

To complicate things, I’ve recently discovered I was previously taking a supplement that may cause post finasteride syndrome (PFS), which seems to mimic much of the symptoms of withdrawal/PSSD. I’m aware you won’t be able to comment on this at all, but I have read that SSRIs may make PFS worse and are not recommended at all. 
 

I’ve thought about it a lot, and feel it might be best to stop this reinstatement due to not really knowing what’s going on in my body, and not wanting to make anything worse. I feel so lost since finding out about possible PFS and not knowing what to do… I’m aware you guys will probably recommend continuing the reinstatement, but people on the PFS forum would likely recommend stopping, and ultimately there’s no way at all to know which is the best choice.
 

I know there’s no clear answer here, and either choice could possibly make things worse, but I feel completely lost with nowhere to turn, and just any other thoughts from someone else would be so appreciated, as I’m feeling very alone.

 

I’ve attempted a 25% reduction in my reinstatement today, with a plan to hold this and see how things go… if they feel much worse then this is maybe a sign to hold the reinstatement. But again, any thoughts would be so helpful, if you think this is a particularly bad idea. Feeling very lost and not knowing which way to turn.

 

thank you so much 

[getofflex]

5 hours ago, Gwhizzle said:

I basically reinstated 0.5mg Citalopram about a month ago.

Please update your signature with this info - include the specific date - thank you.  

 

I realize that some symptoms have improved, while new ones have started.  But, overall, in just one word, would you say you feel better, worse, or the same since you reinstated a month ago?  The new symptoms you describe are typical WD symptoms.  It is very good that your anxiety has reduced.  

 

5 hours ago, Gwhizzle said:

SSRIs may make PFS worse and are not recommended at all. 

However, 0.5 mg citalopram is such a low dose, that I think the likelihood of this is minimal.  Is the supplement you are talking about Pygeu?  I'm completely unfamiliar with this supplement, and with PFS.  However, google says PFS is very rare.  But in light of the fact that you are on such a low dose of citalopram, and it's unlikely this is worsening any possible PFS, I would suggest continuing with the reinstatement.  Is PFS something a doctor can diagnose?  I would start with seeing a doctor about it, if so.  

 

I will also say, it is very common for WD symptoms to morph and change, and for us to have windows and waves.  I'm assuming you are familiar with this.  I think it is more likely what is going on with you.  

 

The last thing we want to do it jump on and off our drugs, and change our dose, based on symptoms that come and go, unless we are having a serious adverse reaction.  Personally, if it were me, I would stick with the 0.5 mg citalopram for a while, unless you are having a serious adverse reaction to it.  You did an extremely fast taper last year, and a reinstatement is likely to help to reduce your symptoms.  It often takes up to 2-3 months for a reinstatement to be fully effective. 

 

[Gwhizzle]

Thank you so much for your response @getofflex. I’m really sorry but I can’t work out how to update my signature - is there any guidelines on how to do this?

 

It’s tricky to say whether I feel better, as things feel qualitatively different. I’m noticing more unusual physical sensations, and feel more unwell physically (e.g. fatigued/nausea/feeling flu-ey) but I would say mentally I feel better, purely in the sense that feeling numb is more tolerable than intense anxiety and dread. I’m feeling much less like myself though… anxiety was a familiar experience, but this numbness/anhedonia is totally novel and something I’ve never felt before and in some ways feels a more hopeless place.

 

Yes the supplement was Pygeum, unfortunately PFS seems to be as allusive as antidepressant withdrawals with doctors knowing nothing about it. I certainly think it’s likely I’m experiencing some issues related to withdrawal, as things felt off before I took the supplement, but looking back things appeared to become really difficult after taking it… although this was also when I found out about antidepressant withdrawals, so this crash may have been more psychological. But yes, I need to accept that ultimately there’s no way to know. It’s been driving me insane trying to figure out what to do, given either choice may lead to possibly more permanent difficulties, but I think this is something I just need to accept the possibility of, as fighting this and working out the ‘right’ choice has sent me to a really dark place. 
 

I think a balance may be remaining on the reinstatement for maybe a month or two longer and see how things go, and then think about tapering off. I would be very hesitant to raise the dose any further, so wonder whether the best option is to hold at this dose a little longer, and then come off and allow destiny to take its course. I think psychologically this is possibly the best option, I think changing my doses and carefully monitoring my symptoms will ultimately lead me down a lifelong path of obsessing and trying to figure out the ‘right’ thing to do, if this makes any sense. 

 

Could I just ask, when reducing the reinstatement, what would be a reasonable taper plan and timeframe? I’m aware you’d usually recommend 10% and then monitoring symptoms etc., but I genuinely feel psychologically this will not be healthy for me and will send me into a very dark place. But at the same time I would not want to just completely stop with no taper.

 

I’m so sorry, I completely understand this is all outside the realms of your guys experience given the complications and possible confounding factors, and that ultimately the responsibility is on me to decide how to proceed, but any thoughts or suggestions from another human being would be so appreciated, this is such an isolating experience.

 

Thank you so much again.

 

 

[getofflex]

To update your sig, click on your name in the upper right hand corner, click on account settings, then click on signature.  You will see the signature text box.  Edit this, and be sure to click "save" when you are done.  You may need a computer to do this.  

 

It sounds like the Pygeum probably shook up your nervous system.  This is why the only 2 supplements we suggest are magnesium, and omega-3.  Other supplements tend to have unpredictable results in those of us with nervous systems sensitized by WD.  Give yourself time, and this will gradually subside.  

 

23 hours ago, Gwhizzle said:

purely in the sense that feeling numb is more tolerable than intense anxiety and dread.

In my opinion, and that of many others, this numbness is how these antidepressants "work".  I agree, I would rather feel numb, than have severe anxiety.  You may have to keep reminding yourself that this is typical for being on the drug, and this will go away as you gradually taper in the future.  

 

23 hours ago, Gwhizzle said:

I think a balance may be remaining on the reinstatement for maybe a month or two longer and see how things go, and then think about tapering off. I would be very hesitant to raise the dose any further, so wonder whether the best option is to hold at this dose a little longer, and then come off and allow destiny to take its course.

My suggestion, as stated previously, would be to stay on the 0.5 mg dose until you stabilize, then gradually taper off this in the future using the suggested 10% exponential taper.  I assume you are familiar with that.  

 

23 hours ago, Gwhizzle said:

I’m aware you’d usually recommend 10% and then monitoring symptoms etc., but I genuinely feel psychologically this will not be healthy for me and will send me into a very dark place.

Yes, I would suggest this.  However, you don't have to obsess over your symptoms in order to monitor yourself.  When I was tapering, I developed a sixth sense about when I was stable, and when it was a good time to do a reduction.  It's called listening to our bodies.  This link will explain more.  It is suggested to be stable for 2 weeks, before doing a reduction.  You could spend 5 minutes each day assessing how you felt that day, and try to distract yourself the rest of the day with other thoughts and activities.  

 

Stability

Edited February 16 by getofflex

[Gwhizzle]

Thank you so much for your reply @getofflex, I will follow your advice. Especially your guidance around determining when we are feeling stable, that’s really helpful. I’ll update my signature asap.

 

The emotional numbness is strange as I didn’t feel this when taking the medication before on my full dose, but it does seem withdrawals are a mystery and very random! 
 

I think I’m realising that I’m just desperately searching for a way to feel ‘better’, which has just been further complicated by finding out about potential PFS. I’m realising I need to accept this is where I’m at right now, do what I can and take things slow… easier said than done when I’m not able to work or be the type of person I usually am, but hopefully this will come with time. I think I’m just really struggling with this whole process, as I previously used work as a coping mechanism and had recently got back into dating after an awful break up, which felt exciting and what I needed, but this has all been stripped away for the time being, and it’s hard not to get caught up in the feelings of it maybe lasting a long time. 
 

I would  say things are feeling more stable since reinstating, I’m not feeling ‘good’ by any means, very low and quite hopeless, but this is a consistent ‘lowness’, and certainly more stable than how I felt before. 

 

Could I just ask a couple of questions:

1) with regards to stability, would this refer to symptom changes throughout the day, as well as across days? I’m finding I feel better in the evenings, but this pattern is very consistent across days. Would this constitute stability, or would I be looking for a consistency throughout the day as well?

2) is skin numbness typically seen in withdrawal? This is very odd, but definitely present over my whole body.

 

Thank you again, I promise no more obsessive questions after these! ☺️ 
 

[getofflex]

15 hours ago, Gwhizzle said:

withdrawals are a mystery and very random! 

Yes, symptoms tend to morph and change.  

 

15 hours ago, Gwhizzle said:

I think I’m realising that I’m just desperately searching for a way to feel ‘better’,

 

15 hours ago, Gwhizzle said:

I’m realising I need to accept this is where I’m at right now,

Excellent!  Acceptance will absolutely make WD easier.  Please read this quote by one of our elders Brassmonkey: 

 

To answer question 1, stability means the pattern is somewhat consistent across days, with no major ups and downs.  It is normal to feel symptom changes throughout the day, even when we are stable. 

 

For skin numbness and other symptom questions, please use our search feature to find information on the forum: How to Do a. Site Search

 

[Sonia009]

@GwhizzleHi, just wondering how you are doing, are you still on 0.5mg Citalopram?

[Gwhizzle]

Hi @Sonia009, unfortunately I’ve just realised I’ve made a mistake with my dosage other the last week, so hard to say how I’m doing! How are you?

 

@getofflex sorry to tag you again, thank you again for your previous advice. As I’ve just stated to Sonia, unfortunately I’ve just realised I made a mistake in my dosage over the last week and 2 days so have been taking 50% of my previous dose. What spurred me to find this out is I noticed my anxiety/emotions were returning, so I thought something was up. Funnily enough I noticed the head pressure sensation had gone and joint pain seemed to improve. I’ve taken my full dose again tonight after realising this, and am now experiencing the head pressure sensation again, so not sure if this indicative of an adverse reaction, and just wondered what might be advised here, so sorry again for all of this. 

[getofflex]

My suggestion is to go back to your previous dose, which according to your drug signature would be 0.5 mg citalopram.  Stay on this for a while, until you stabilize, to allow your nervous system to rest and restabilize before making any other dose changes.  It may take several weeks, or even several months.  Please be patient, and let it take as long as it takes.  Rushing a taper is never good, especially at the lower doses.   Don't make another reduction until you have been stable for at least a couple of weeks.  

 

7 minutes ago, Gwhizzle said:

I’ve taken my full dose again tonight after realising this, and am now experiencing the head pressure sensation again, so not sure if this indicative of an adverse reaction, and just wondered what might be advised here, so sorry again for all of this. 

I doubt that the head pressure sensation is an adverse reaction to returning to 0.5 mg citalopram, as this is a very low dose.  It is very likely to be that your system has been jarred by doing the 50% reduction recently.  Withdrawal symptoms are often delayed.  

 

Please be very careful to stick with this dose precisely, each and every day, at the same time of day, not varying or skipping any doses.  

 

Please do add this to your drug signature.  We work with lots of people, and I'm still having cognitive issues and memory issues myself, so we need this information at out fingertips.  Thank you.  

[Farm24]

On 2/14/2024 at 1:35 PM, Gwhizzle said:

Hi,

 

Sorry to tag you @getofflex, but I noticed in your signature it said you were happy to be tagged for emergency questions regarding reinstatement and tapering.

 

I was wondering if I could get any advice. I basically reinstated 0.5mg Citalopram about a month ago. I’ve noticed my panic and anxiety has reduced but replaced by a sense of emotional anaesthesia, which initially began in the evenings and now feels 24/7. I’m also starting to experience increasing head pressure and periods of confusion where I simply can’t think or focus on anything, it’s quite scary. I’ve also noticed a new symptom of nausea, as well as a constant full body numbness/reduced sensation and much worse genital numbness.
 

To complicate things, I’ve recently discovered I was previously taking a supplement that may cause post finasteride syndrome (PFS), which seems to mimic much of the symptoms of withdrawal/PSSD. I’m aware you won’t be able to comment on this at all, but I have read that SSRIs may make PFS worse and are not recommended at all. 
 

I’ve thought about it a lot, and feel it might be best to stop this reinstatement due to not really knowing what’s going on in my body, and not wanting to make anything worse. I feel so lost since finding out about possible PFS and not knowing what to do… I’m aware you guys will probably recommend continuing the reinstatement, but people on the PFS forum would likely recommend stopping, and ultimately there’s no way at all to know which is the best choice.
 

I know there’s no clear answer here, and either choice could possibly make things worse, but I feel completely lost with nowhere to turn, and just any other thoughts from someone else would be so appreciated, as I’m feeling very alone.

 

I’ve attempted a 25% reduction in my reinstatement today, with a plan to hold this and see how things go… if they feel much worse then this is maybe a sign to hold the reinstatement. But again, any thoughts would be so helpful, if you think this is a particularly bad idea. Feeling very lost and not knowing which way to turn.

 

thank you so much 

I also got the full body loss of sensation. Some days it is getting better but today it is all back. 

[Gwhizzle]

Hi, 

 

Hope everyone is keeping as well as they can be. 

 

I was just hoping if I could get some advice regarding my taper. 

 

Following my previous posts, I am now fairly certain I unfortunately have Post Finasteride Syndrome (PFS), as since reinstatement I have developed various symptoms which match the syndrome - I am now experiencing bad muscle and bone pain, which becomes severe after exercise, body wide muscle and collagen loss, thinning skin, receding nails and severe sexual dysfunction and genital deformity.

 

I completely understand PFS is not within anybody's expertise here, however I am very concerned continuing my reinstatement as the pains and skin/muscle and sexual changes seem to be worsening, and were not present prior to reinstatement. SSRIs are highly likely to worsen PFS, which appears permanent and can be incredibly severe and life altering on a physical level.

 

I'm now feeling at a loss on how best to proceed forward, as can be seen in my signature, I have attempted to reduce my reinstatement quicker but did notice increased awful feelings, confusion and paraesthesia returning. I am holding at my current dose for now, as unfortunately I am having to move back to my family home due to not being able to work in my current state, so want to be as stable as I can be during the move. 

 

Either way, I think I'm in for a very rough road ahead, but am hoping for any advice on how to do minimal 'damage' in stopping the reinstatement. I am certainly not comfortable stopping it outright, but also cannot risk continuing on a slow and gradual taper that may last months, if not years, and potentially risk causing more permanent and life altering PFS related damage. 

 

Apologies if no advice can be given here, I just certainly trust the expertise of you guys more than my GP in how I might stop the reinstatement in a way that might a least minimise the damage done. I now wish I had not reinstated and had considered all possible causes of my difficulties, but here I am!

 

Any thoughts or personal reflections on this really tricky situation would be so massively appreciated. 

 

Thank you so much.