Frankthecat: Coming off Citalopram after long-term use?

[Frankthecat]

Hi,

 

I know I am a bit late to contribute to this discussion but I wondered if anyone had any advice? Plus I don't think I have the energy to read through all of the thread at the moment. Basically, I am a 32 year old female and have been on 20mg Citalopram for 9 years roughly. I have recently been to see my GP about reducing with a view to coming off them completely because my partner and I are trying for a baby and I would just rather not have anything in my system unless I absolutely have to. Anyway, surprise surprise, the GP didn't have a clue about this stuff and suggested I go straight from 20mgs to 10mgs over night and then grandually reducing to be off them completely in about 6-8 weeks I think. I thought this would be ok for some reason, despite the fact that I tried to reduce once before in a similar way, which involved taking one 20mg every other day and increasing the gap between days.. and I felt awful, but not as uwful as this. I feel so depressed, lethargic, irritable, I can't concentrate, I just feel lonely and sad and hopeless - it's like having full on depression again. Today is Wednesday 28th May and I started on 10 mgs excatly a week ago today.

Anyway, a friend of mine who is also on Citalopram suggested that I try taking 20mgs again and then 1 day per week taking 10mg, then 2 days per week 10mg and so on for 7 weeks until I am on 10mgs every day and then reduce further from there.

I am interested that someone has written that they heard you have to reduce over a month for each year you have been taking meds. This is so hard! Anyway, I hope someone hears this and can give me some advice!

Thanks - Im glad I found this site. 

[Frankthecat]

Hi,

 

I am new to this site and wondered if anyone is able to help? I am a 32 year old female from the UK and have been on 20mg Citalopram for 9 years roughly. I have recently been to see my GP about reducing with a view to coming off them completely because my partner and I are trying for a baby and I would just rather not have anything in my system unless I absolutely have to. Anyway, surprise surprise, the GP didn't have a clue about this stuff and suggested I go straight from 20mgs to 10mgs over night and then gradually reduce to be off them completely in about 6-8 weeks I think. I thought this would be ok for some reason, despite the fact that I tried to reduce once before in a similar way, which involved taking one 20mg every other day and increasing the gap between days.. and I felt awful, but not as uwful as this. I feel so depressed, lethargic, irritable, I can't concentrate, I just feel lonely and sad and hopeless - it's like having full on depression again. Today is Wednesday 28th May and I started on 10 mgs excatly a week ago today.

Anyway, a friend of mine who is also on Citalopram suggested that I try taking 20mgs again and then 1 day per week taking 10mg, then 2 days per week 10mg and so on for 7 weeks until I am on 10mgs every day and then reduce further from there.

I am interested that someone has written that they heard you have to reduce over a month for each year you have been taking meds. This is so hard! Anyway, I hope someone hears this and can give me some advice!

Thanks - Im glad I found this site.

[Jemima]

Hello Frankthecat,

 

I'm glad you found us before taking your friend's advice.  Changing doses like that is very hard on your nervous system.

 

I'd suggest trying 15 mg. a day, every day, and see if that gets you back on keel. Give it four days and let us know how you're doing. If that doesn't work so well, then going back to 20 mg. will probably fix things. Once stabilized, which may take a month or so, you can start a slow, safe taper. Here's our topic on tapering Citalopram: Tips for tapering Celexa (citalopram)  The rule of thumb is that a person should cut no more than 10% of the current dose at a time (not the original total), hold for about a month, and then proceed with another 10% cut and so on.  There is no hard and fast rule about reducing a month for each year you've been taking meds; in fact, this is the first I've ever heard of that, and I've been on this forum since early December of 2011.

 

If you find it difficult to cut up pills accurately, here's how to make your own liquid: How To Make A Liquid From Tablets Or Capsules  You may also be able to get Citalopram in liquid form by prescription, and certainly a compounding pharmacy could make it up for you if you're shaky about making your own liquid. Accuracy is important, especially when you get to lower doses.

 

Please take your time and browse the forum.  There's lots of good information and friendly support available here.

 

Welcome!

[Rhiannon]

Hi FTC! I've only got a minute here but I want to confirm that your feeling you need to be off your SSRI before pregnancy is right on. SSRI use during pregnancy is associated with a higher risk of autism and developmental delay, especially in boys. See this: http://www.sciencedaily.com/releases/2014/04/140415153735.htm

 

It turns out that doctors don't know much about tapering and withdrawal from psych meds. (It's not an accident--if you want to know more about why it is, the best resource for the history of how this situation came about is the book Anatomy of an Epidemic by Robert Whitaker.) Unless you're very fortunate, you're probably not going to get very good advice from your doctor.

 

Cutting your dose by 50% after long term use is drastic and unlikely to produce good results for anyone. We recommend cutting by no more than 10% of your current dose.

 

After nine years of use, nine months (a month per year) would be a fairly quick taper (personally I'd plan more like a year), but it could be do-able, especially since it sounds like you haven't had a lot of attempts to get off in the past, or lots of drug changes, or been on multiple meds. (All of those things make withdrawal worse.) And you're young, so your brain can adapt faster than an old fogy like me.

 

I would recommend you go back up to the 20 mg and stabilize for a couple-three weeks, and use that time to learn here about your options for a more realistic and reasonable taper. If you do a 10% taper, your first reduction would be to 18 mg. You can learn here about getting a liquid formulation or making your own so you can make those sensible reductions.

 

Welcome! It sounds to me like you have every chance of being successful, and we have the information you need to make that possible.

[Rhiannon]

Jemima's advice to go to 15 mg is also not bad--you may have already adapted to a slightly lower dose than 20 mg, so the full dose might be too stimulating, and 15 gives you less to taper down from. (She was posting at the same time that I was, so we overlapped.)

 

But if you find it too daunting to figure out how to get 15 mg from what you have now, you can try just going back up to 20 until you can get it sorted out. It's only been a week on the 10 mg, so 20 is probably still ok, and 15 will still involve some withdrawal symptoms for you.

 

If you have 10's, you can get a pill cutter at your pharmacy and do one and a half. 

 

At this point it's important to pick a dose and take it every day at the same time and get nice and stable, then you can look at reducing at a reasonable taper rate.

[areyouthere]

Hi Frankthecat.. welcome. 

 

You have some excellent questions and will get very good help here but first please start a new topic here explaining what you just did & someone will be along shortly.

 

I'm sorry that you are having trouble, it sounds as if both your Dr. & friend have given your poor advice.

 

You are very early in this process, just a week out , so you have an excellent chance of reinstating and tapering more slowly from there. After you post in the Introductions section and while you wait you might want to read up on self care & symptoms here 

 

Again, welcome!! Oh. In case you aren't sure of and want to read up on reinstatement… go here.

 

RU