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Gbest: My Celexa/Citalopram & Trazodone Taper Attempts


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Hi Folks,

 

Here is my story. Hope it's not too long. Would love any feedback.

 

Background
In the Spring of 2007, at the age of 43, I started having sleep problems. In the beginning it was waking up at 3 or 4 AM and being able to go back to sleep. I was going through a stressful time but I saw this as a sleep problem, not a sign of depression. I went to my PCP to ask for Ambien. He was hesitant to give me sleeping pills. He also said that they primarily helped with getting to sleep but not with waking up in the middle of the night. He added that this was often a sign of depression. To make a long story short, I was so exhausted from lack of sleep that I accepted that I might be depressed. PCP referred me to a psychiatrist who started me on 10mg of celexa, titrating to 20mg Celexa, after 8 weeks moved up to 40mg, and added 50 mg of Trazodone to help with sleep. By late November I was a new man. I was optimistic, energetic, and I was sleeping well. Everything seemed to be going well for me.  The side effects were, weight gain (which I managed to bring under control with diet and exercise), delayed orgasms - which didn’t really bother me, and most troubling of all - rectal bleeding/blood in stool.  I had a colonoscopy and everything checked out. My doctor said it was hemorrhoids and recommended I get more fiber and he did not think it was related to the celexa - I disagree because when I have discontinued celexa in the past the rectal bleeding stopped

 

Previous tapers
By July 2008, since I was doing really well I tapered down 20, 10, 0.  Don’t recall any withdrawal. Felt pretty good. Rectal bleeding stopped. In March of 2009, I was feeling a little frazzled, had a little difficulty focusing and a few nights of not so good (but not terrible) sleep. I checked in with my psychiatrist and he said that based on my history I should reinstate the Celexa, which I did with no problem and things went well.

 

In 2012, after a few years doing really well, I decided to try again. I went a little slower in the taper but much faster than the 10% discussed on this forum. I also supplemented with 5htp and fish oil.  I don’t recall any brain zaps or other serious discontinuation symptoms, but after going off completely I started to feel a lack of motivation and focus. While it was not quite to the point of being debilitating, I was getting concerned that if I kept going that way, my business would fall apart and that I would have a downward spiral. I went back on, and this time things got worse before they got better. I would have pretty bad anxiety. Mostly in the mornings, and it would ease as the day progressed, but it was pretty bad at times. Within 5-6 months I was back to being good and I have been on 40mg Celexa and 50mg of Trazodone ever since. 

 

Current Taper:
I decided I wanted to try again because I’ve always had a goal of coming off the meds, and the rectal bleeding and gastrointestinal issues were really starting to get on my nerves.  

  • 1/14/24 - went from 40 - 35mg Celexa, 50mg Trazodone
  • 2/4/2024 - down from 35 to 32.5mg Celexa, 50mg Trazodone
  • 2/24/2024 to present - 30 mg Celexa, 50mg Trazodone

During this time, particularly the last two months, I have been very good about my diet, exercise, and hardly drink any alcohol - 1 or 2 beers on the weekend, if that.  The good news is that the rectal bleeding is happening with much less frequency. My biggest issue is that I have much more anxiety, particularly in the mornings, I am more fatigued, I have more trouble focusing, I am less motivated at work, and although I would not call my life devoid of joy, there is certainly much less of it.

 

Questions/Feedback Requested

  • At times over the last month I have felt discouraged to the point of considering updosing or going back to 40mg, which I have resisted.  While things are more difficult, I am certainly not despondent. The worst is the anxiety over work and fear of things slipping through the cracks, which is compounded by my lower motivation and difficulty focusing. However, I would hate to lose whatever progress I’ve made. Thoughts, comments?
  • I’ve always thought of Celexa as the main drug I want to be rid of. In the past I had not tapered off Trazodone until I was completely off Celxa. Should I consider a lower dose of Trazodone? Would that help with the fatigue? I would hate not being able to sleep though?
  • I think I know the answer to this, but if I feel stable at a certain dose, is there any problem with staying there for months, or longer before tapering further? My ultimate goal is to be off completely.
  • Any other thoughts or comments would be greatly appreciated.
     
Edited by Emonda
Name to title

8/2007 - Started Celexa at 10mg, 20mg a week later

10/2007 - 40mg of Celexa, 50mg of Trazodone for Sleep

6/2008 - 7/26/2008 - Tapered down to 0

3/2009 - 4/2009 - Titrated to 40mg Celexa & 50mg Trazodone

2011 - Not sure of the timeline but tapered to 0

11/2011 - Titrated to 40mg Celexa & 50mg Trazodone

January 2024 - Current attempt to Taper

1/14/2024 - 35mg Celexa 50mg Trazodone

2/4/2024 - 32.5mg Celexa 50mg Trazodone

2/25/2024 - present 30mg Celexa 50mg Trazodone

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  • Emonda changed the title to Gbest: My Celexa/Citalopram & Trazodone Taper Attempts
  • Moderator

Hello @Gbest, and welcome to SA!  We are a community of volunteers who provide peer support for the tapering of psychiatric medications, and their associated withdrawal syndromes. 

 

Thank you for completing your drug signature. Are you currently taking any supplements?   I see you took some with previous tapers.  The only supplements we recommend here are fish oil and magnesium.  When we are experiencing withdrawal symptoms, it is not at all uncommon to become hypersensitive to various things- other medications, supplements, and even foods.  Keeping a symptom diary can be helpful in figuring out if you have developed any sensitivities.  Here is a link to a Daily Checklist of Antidepressant Withdrawal Symptoms that you can use as a template, if you wish. 

 

It looks like your taper started out fairly rapid, which likely explains the increased anxiety, fatigue, brain fog and anhedonia.  You may need to hold here a bit longer before resuming tapering, even if only to establish what your 'withdrawal normal' state is going to look like.  When you resume tapering, as you already know, we do recommend tapering at a rate no faster than 10% of the current month's dose every four weeks.  This is to minimize withdrawal symptoms.  Some people have to move slower than this, and that is where your symptom diary comes in- if you are not stabilizing in four weeks, slowing down your taper is recommended. So, to answer your question, holding for longer periods is completely fine, and probably recommended for you, given that things have been more difficult, to the point where you have considering updosing.  There is absolutely no rush- slow and steady is the way to go!

 

If you are really struggling, you can absolutely try to updose a little bit at this point.  I understand the fears about things slipping through the cracks at work- I am currently on disability, but I literally felt terror when I thought about this back when I was working. If you want to try to updose to relieve some of your withdrawal symptoms, a small updose to start is fine.  You won't necessarily have to go all the way back to 40mg- sometimes, even an extra mg can make enough of a difference that you are more functional.  Increase by 1mg, and then hold!  It takes time to really establish if an updose has made a difference.  Move slowly- that is now your mantra!

 

As for your trazodone, we typically recommend fully tapering the more activating drug first, which would be your celexa.  Staying on the trazodone can help mitigate the severity of your withdrawal from the celexa.  You can read more about this here: Taking multiple psych drugs?  Which drug to taper first?

 

Again, welcome to SA, and I look forward to following your journey.  Keep posting, and engage with the community- the support here is wonderful.  We always feel better when we know we're not alone. ❤️‍🩹

1995- 2007- On and off multiple antidepressants (Prozac, Paxil, Effexor, Wellbutrin, escitalopram). Memory poor- can’t remember dates. Always tapered fast or CT.  2007- tapered Wellbutrin, zopiclone and escitalopram over one month to get pregnant.  Withdrawal hell for many years.

2009- Daughter born 🥰 Post partum depression/psychosis- no meds taken.

2016- Back on escitalopram due to job change/anxiety

2022- Severe covid infection- Diagnosed with long covid 08/22.

2023- 01/23- Long term disability approved for long covid.  Started taper under MD advice from 20mg: 11/23- 15mg. 2024- March-10mg. Started low dose naltrexone for long covid-5mg- terrible reaction, reduced to 0.5mg.  April- 10mg escitalopram, 1.0mg LDN. May 1- 9.0mg escitalopram, 1.0mg LDN. May 15- 9.0mg escitalopram, 1.5mg LDN.  June 12- 8.5mg escitalopram, 1.5mg LDN.  July 8- Brassmonkey micro taper started.  8.4mg escitalopram, 1.5mg LDN.  July 15- 8.3mg esc, 1.5mg LDN.  July 18 8.3mg esc, 2.0mg LDN

 

Supplements/other meds: Vitamin D, B12, Claritin

 

I am not a doctor.  I don't even play one on TV.  This is not medical advice, but based on personal experience.  Please consult a medical professional.

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  • Moderator

I should have also commented on the rectal bleeding- if you type 'rectal bleeding' in to the search bar at the top of the page, making sure the dropdown menu says 'Everywhere,' you will find a list of threads where others have experienced this symptom.  

 

That being said, as a former healthcare worker myself, I have to say that this is a symptom worth following up on with your doctor.  I'm not sure how long ago you had a colonoscopy, but around here, we recommend every five years.  Bloodwork would also be prudent, as we don't want you to become anemic, as I'm sure that would exacerbate your fatigue. 

1995- 2007- On and off multiple antidepressants (Prozac, Paxil, Effexor, Wellbutrin, escitalopram). Memory poor- can’t remember dates. Always tapered fast or CT.  2007- tapered Wellbutrin, zopiclone and escitalopram over one month to get pregnant.  Withdrawal hell for many years.

2009- Daughter born 🥰 Post partum depression/psychosis- no meds taken.

2016- Back on escitalopram due to job change/anxiety

2022- Severe covid infection- Diagnosed with long covid 08/22.

2023- 01/23- Long term disability approved for long covid.  Started taper under MD advice from 20mg: 11/23- 15mg. 2024- March-10mg. Started low dose naltrexone for long covid-5mg- terrible reaction, reduced to 0.5mg.  April- 10mg escitalopram, 1.0mg LDN. May 1- 9.0mg escitalopram, 1.0mg LDN. May 15- 9.0mg escitalopram, 1.5mg LDN.  June 12- 8.5mg escitalopram, 1.5mg LDN.  July 8- Brassmonkey micro taper started.  8.4mg escitalopram, 1.5mg LDN.  July 15- 8.3mg esc, 1.5mg LDN.  July 18 8.3mg esc, 2.0mg LDN

 

Supplements/other meds: Vitamin D, B12, Claritin

 

I am not a doctor.  I don't even play one on TV.  This is not medical advice, but based on personal experience.  Please consult a medical professional.

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