reachingforthestars: Citalopram WD

[reachingforthestars]

Hi,

 

Everything was ok for a while but now i have developed new symptom. I have constant feeling that i need to pee even tough my bladder is empty. I guess this is PGAD? My periods should start tomorrow maybe that makes this feeling worse? Does this get better too??? Anyone who has experienced this can you tell me how long did it take for you to PGAD to go away?

[Fresh]

Hi reaching , urinary urgency is a common symptom during withdrawal.  This happens independently of how full

our bladder is.

It is not the same as persistent genital arousal disorder (PGAD).

Like other symptoms , urinary urgency or frequency may come and go as you heal.

See Urination and Bladder Issues (Male and Female)

[reachingforthestars]

Fresh tank you again I have the urge to pee like 24/7 and it hurts too(it does not hurt to pee), is this still a common WD symptom too?

[Fresh]

Perhaps others will chip in here , I understand it's delicate to be specific about where the pain is.

It may be a urinary tract infection , though this is often accompanied by pain when peeing.

Have you read the thread on PGAD?   See   Persistent Genital Arousal Disorder (PGAD)

(I just saw you've posted there)  Like all the other symptoms , this isn't permanent and it varies how 

long it lasts for.

 

How long ago was your most recent drop?  

If it started after that , you may be better updosing to where you were before it started.

[reachingforthestars]

Thanks Fresh, Yes i have made a drop like a week ago...  It must be the reason for this symptom. :/

 

The day before yesterday my buttocks felt weird, i had an urge to do some exercise and stretching and also i felt like my uterus was contracting and my stomach hurt. Then the next day i started to feel some pressure against my bladder and in hole genital area and little bit in anal area too. And i have had this feeling 24/7 since yesterday.

[reachingforthestars]

I have still PGAD. Past five days PGAD was very mild and at times almost nonexistent but today it's getting worse again.

[reachingforthestars]

The next day after i updated last time the PGAD alleviated again and has been very mild since. 

 

I have noticed that my upper lip on the right side is numb and my lips don't move symmetrically when i speak due to numbness... Does these kind of symptoms go away over time?

[LexAnger]

hi,

 

Does this happen to you too? in the mornings about one hour after i have taken my AD(4mg) i start feeling little shaky, my arms and legs jelly and my tongue feels numb. Evenings are much better. Does this happen to you too?  Could this be due to uneven amounts of ADs  in my body during the day? I have been tapering way too fast and don't know should i updose a bit. Sorry, my English is so clumsy.

I feel the same pattern after I developed drug tolerance. My body sip imply can't take any dose in the morning anymore so I gradually shifted to evening. I still feel the difficulties for each drop but I don't feel dying from taking each drop. Also, I spread my dosing entire day drop by drop which helps a lot with immediate severe reaction

[reachingforthestars]

My current dose is 1.78mg. 

 

Sleeping is pretty good, pgad almost nonexisting but sometimes it comes and goes, bladder issues are gone, the numbness in my face has alleviated so I look like me again and muscle strength is better too so i can walk long walks.

[LexAnger]

Hi Reachingforstar,

 

Thanks for stopping by my thread.

I just read your entire thread. I'm sorry you also were hit badly by the poison but happy you are healpimh nicely tapering down to this low dose.

 

How are you feeling now and what are your main symptoms and tapering schedule? Do you find much better at lower doses? Are you back to work now?

 

Would you like to update your signature to reflect the tapering since 4mg?

 

Looking forward to hearing more great update!

Lex

[reachingforthestars]

Hi Lex!

 

I updated my signature but it does not reflect my taper after last June because after that I started to taper more gradual and started to make lower drops but faster(only 0,01mg drop every 2-6 day). I try to taper as fast as it is possible for me but looks like it's going to take at least another year with this pace. But who knows if it will get easier and easier on the lower doses maybe it is possible to get rid of this poison even faster.

 

I don't get big reaction after taking my dose in the morning anymore. Maybe because the dose is so much smaller now? I do feel like one hour after I'm little "high" but nothing bigger. 

 

I'm not ready to work yet but I can walk every day for one hour and brain fog has alleviated so I can read more. Sleeping is OK and I don't have anxiety but there's some andehonia still in the background even though there has been a lot of gradual progress. I can enjoy the walks in the woods and many little things but I miss feeling big emotions good and bad. It would be very comforting to hear a success story where someones ability to feel deep feelings has healed completely... Just like when I had PGAD I really needed to hear some peer support to give me hope that PGAD is not going to be permanent symptom. 

 

I guess my main symptoms are andehonia and hypothyroid symptoms that I get after every drop but things are way better than they were like six months ago. 

 

R

[bubble]

Hello Reaching and glad to hear you are doing so well.

 

I can't think of members who reported the ability to feel more deeply off the top of my head but there sure are such reports.

 

You were on the drug for 12 years so taking 3 or 4 years (or more) to get off is not such a big time. However thinking it will take this long can be very frustrating so I rather choose to focus on how much ground I have already covered (you are taking so little compared to your initial dose). I also focus on feeling well and the things I can do and enjoy like you do.

 

Unfortunately I have to warn you that reductions at low doses cause even more disruption than those at higher so we have to go slower.

 

This graph and thread explain why this is so:

 

http://survivingantidepressants.org/index.php?/topic/6036-why-taper-paper-demonstrates-importance-of-gradual-change-in-plasma-concentration/page-1

​

Bubble

[reachingforthestars]

Bubble thank you for your reply

 

I don't think that in my case anhedonia is due to withdrawal, it's due to updosing my dose last autumn. I had bad reaction to reinstatement and something broke inside of me. Before that I had a lot of withdrawal symptoms but no andehonia on the contrary I was too emotional crying a lot and everything broke my heart because I loved everyone and everything so much. 

[bubble]

I often see anhedonia as a kind of safety switch which our brain sometimes uses to ensure more energy for itself. If this makes sense. It comes in particular after periods of excessive excitement (great use of energy). As unpleasant it is it is just a protective mechanism of our brain. Once the brain has had enough energy it will turn on the flow of emotional energy again.

[reachingforthestars]

Bubble, I know that one can get anhedonia after some kind of stressful and shocking experiences for some time, but what i'm experiencing is different. My sensitized receptors were flooded with ssri due to updosing and this is the result. But luckily there has been a lot of healing after that incident. 

[reachingforthestars]

Bubble, I know that one can get anhedonia after some kind of stressful and shocking experiences for some time, but what i'm experiencing is different. My sensitized receptors were flooded with ssri due to updosing and this is the result. But luckily there has been a lot of healing after that incident. 

 

Actually I think I had adverse reaction to that reinstatement so a success story of someone healing after adverse reaction would be comforting.

[reachingforthestars]

My current dose is 1.78mg. 

 

Sleeping is pretty good, pgad almost nonexisting but sometimes it comes and goes, bladder issues are gone, the numbness in my face has alleviated so I look like me again and muscle strength is better too so i can walk long walks.

My current dose is 1.85mg not 1.78mg. I made an error in my calculations. 

 

I haven't noticed WD symptoms from 1.88mg to 1.85mg only some numbness in my face and mild brainfog. I'm going to try to drop 0.01mg daily and will hold if the symptoms are too bad. Emotionally I'm still broken (anhedonia)(even though there has been improvement) after the bad reaction from reinstatement(only 1mg) ten months ago.

[scallywag]

RFS: Is there a reason you're thinking about daily dose reductions, even though they're less than 1% of your current dose?

[reachingforthestars]

RFS: Is there a reason you're thinking about daily dose reductions, even though they're less than 1% of your current dose?

 

I just think since I have become so sensitized to citalopram  that I don't want to be on them any longer than I have to. I'm afraid that too long taper could do me more harm. I want to come off them as fast it is possible for me. In my case I usually notice the WD symptoms the same night I make the drop. For some time I made drops(0.01mg) every third day and had some symptoms for two days and the third day I felt I was stabilized. Then WD symptoms got so much milder that i decided to try to drop every second day and that was easy too so now I'm dropping every day 0.01mg and so far only mild symptoms. 0.01mg drop every day is only 13% drop in a month at this point. 

[LexAnger]

Wow, I'm glad to find you are doing this as I'm doing it too.

I have been dropping 0.02 mg every 3 days ( currently at 1.7 mg) but now I have to drop faster due to bad drug reaction even I wanted to hold longer. I do have a similar pattern with WD symptoms (pressure, numb, pain on left side of whole me from head to toe) showing up a few hours after the drop but last only for 3-4 days. I had to drop 1-2 days now to lesson the severe drug reaction ( brain dead, left side paralyzed, severe DR, extreme dry mouth, severe sedation).

I just started the faster taper so hope the WD won't be too bad or the drug reaction lessons enough to hold longer.

 

Hope your schedule works fine for a long while.

Lex

[reachingforthestars]

Hi Lex!

 

Yes, I think that we have to trust our inner intuition when we decide what is the best pace to taper for ourselves. i don't think that the super slow taper is the best for everyone like maybe for example in those cases fast taper can be less harmful when someone gets adverse reactions and becomes sensitized to the drug. CT and fast taper is Russian roulette but so is reinstatement and updosing and I think that very slow taper(5% and less) can be more harmful than fast taper in some cases. 

 

Lex, I'm happy you are so close to 0 and I really hope your schedule works fine too!!

[LexAnger]

Thanks RFS!

Like I said before, I'm dancing between the two evils. I don't have the luxury to hold long ever since the updosing. I have been trying all my best to avoid CT but the drug reaction caused by the updose keeps outpacing the WD. I read so many who were hurt badly ( at a much greater scale) from reinstating. I also tried to voice the harm of it and suspected the effect of long hold for those cases. But giving the extreme complications and uniqueness, it's hard to be sure so only each individual can make the call with profound analyses and observation.

 

Wish both of us good luck in this guessing game.

[LexAnger]

Here is an article talking about how the drug works after reinstate. I found most failed cases are lex users

 

http://survivingantidepressants.org/index.php?/topic/12764-james-heaney-article-on-what-to-expect-in-restatement/

[reachingforthestars]

Lex, I think there are so many reasons why others react badly to reinstatements. Others have poor metabolism and their liver cannot get rid of ssri as fast as others and they and up having more ssri circulating.  Others make very big reinstatements and for longer periods than we did. You and I should concentrate to the success stories and not read so much of the terrible cases. I know personally one woman who was tapering ssri and one morning just bite a piece of her tablet and it was way too big bite bc she had been on a lower dose for so long and after that she had bad reaction. She became anhedonic ect. but after finnishing her taper she started to feel more and she is now normal. This all happened to her many years ago. Brassmonkey also mentioned one success story in which someone had adverse reaction but is now doing very well. It was in Daisy1's thread.

 

Wish you fast healing!!

[reachingforthestars]

Lex, I think there are so many reasons why others react badly to reinstatements. Others have poor metabolism and their liver cannot get rid of ssri as fast as others and they and up having more ssri circulating.  Others make very big reinstatements and for longer periods than we did. You and I should concentrate to the success stories and not read so much of the terrible cases. I know personally one woman who was tapering ssri and one morning just bite a piece of her tablet and it was way too big bite bc she had been on a lower dose for so long and after that she had bad reaction. She became anhedonic ect. but after finnishing her taper she started to feel more and she is now normal. This all happened to her many years ago. Brassmonkey also mentioned one success story in which someone had adverse reaction but is now doing very well. It was in Daisy1's thread.

 

Wish you fast healing!!

 

Lex, in this success story  Lightatendoftunnel is anhedonic due to Lexapro and many months after stopping it but the anhedonia eventually went away

 

http://survivingantidepressants.org/index.php?/topic/7871-lightatendoftunnel1-me-again/

 

In Irishwill's success story he was also made zombielike by drug cocktail while he was suffering withdrawal from Paxil and he got his feelings back. 

 

I know you must have read all those stories before but I just wanted to remind you (and myself) that there are also success stories among "failed cases". And I don't know is there less "failed cases" than success stories bc life is long and we cannot possible know the rest of the story.

[LexAnger]

Thank you RFS for the kind thought, encouragement and the success stories!

I do have faith we will eventually all heal only that this process of suffering seems a must before that day.

 

I also try to tell myself when I feel the pain is totally intolerable that it will pass, and it always did.

 

I just did couple cut in the past few days and was hit badly today with severe pains various type ( needling pain , deep bone pain) so I know I have to slow down a bit. My symptoms from the drug toxicity are severe sedation, DR, coma like, brain dead but not as touturing as the pain.

 

What are your symptoms from WD and drug reaction respectively?

 

Hope you are having a good day!

Lex

[reachingforthestars]

Hi Lex!

 

After passing 1.9mg there really haven't  been many WD symptoms or they have been very mild. I wake up around 4:00 but can go back to sleep pretty easily and I'm somewhat brainfoggy and that's about it. Numbness has alleviated too. I don't get anymore daily drug reaction that I can notice, but I just know somehow that the longer I stay on this poison the longer it will take for the rest of the anhedonia to go away since it is citalopram induced anhedonia. I'm not going to CT but I try to go as fast as it is possible for me. 

[LexAnger]

That's great news!!!!

1.9mg Celexa is about 1mg lexapro. I hope once I'm down to 1mg, things will be much better.

 

You reminded me of the numb and pressure that I have most of days.

I read others similar experience feeling a lot better below 1 mg Paxil which is equivalent to 1 mg Celexa.

 

So happy for you getting over the worst. The rest journey should be much much easier!

 

Xoxoxo

Lex

[scallywag]

Thanks for posting your thinking about tiny near-daily dose cuts. I hope you're considering some time holding at a dose along the way. Your CNS is having to deal with the daily changes and has little time to adjust/catch-up to dose changes.

[scallywag]

your post in Tamarino's intro topic:

Why do you want to reinstate? Are you bedridden and suicidal ect.? Reinstatement is Roussian roulette and can make you ten times worse and I have read here more bad reactions to reinstaments than good ones when reinstament is done after long time.

Some people respond well to reinstatement -- their symptoms ease a bit within 10-14 days and then continue improving. For a small number of people, their central nervous systems (CNS) have been sensitized by neuroactive/psychiatric medications and reinstatement makes them worse.

It does seem that the more time that has passed since the last dose the greater the risk of the reinstatement being ineffective or causing problems. We suggest addressing that risk by reinstating a very small dose to test one's response.

 

It's beyond regrettable that you've had a bad reaction to reinstatement. Unfortunately, given the state of current knowledge about these drugs it's the best and only option to ease withdrawal symptoms. 

 

It's important that new members understand the risks posed by reinstatement before undertaking it. Once a person has been at a reinstated dose for 3 weeks -- even if it's their original "maintenance" dose -- I hope you understand that it's more helpful to guide someone for a safe landing than question a decision that can't be remade.

[reachingforthestars]

Thanks for posting your thinking about tiny near-daily dose cuts. I hope you're considering some time holding at a dose along the way. Your CNS is having to deal with the daily changes and has little time to adjust/catch-up to dose changes.

 

Thank you for your respond! I will hold at a dose for a while if WD gets too rough. My body seems to adapt very fast new doses and that's why there is no going back for me. Along the way I have had few milder bad reaction due to elevated amount of the circulating ssri. Once(in December 2015) I had bad reaction to my dose even though I was holding at a dose steadily but just took it two hours earlier than I usually did.  Also not so long ago I went to the dentist and dental anesthesia elevated the amount of the circulating ssri bc my liver couldn't detoxify ssri as fast as usual and I had bad reaction the next day after taking my ssri dose. I have became so sensitized to citalopram. 

 

Citalopram absorbs faster than most of AD's so I guess there will be anyway fluctuation every day especially the lower I go.

"Following oral administration, citalopram is rapidly absorbed, with peak plasma levels observed approximately after 1- 4 hours and a plasma half-life of approximately 35 hours after administration [Articles:729609, 6939299, 17722014]."

 

Also long holds are not for me bc for some reason I start feeling worse(agitated, tense) if I hold longer than a week or two. 

 

There is no one rule that works for everyone bc we are all different and holding a dose or super slow taper can be dangerous to someone and to other it can be lifesaver. We can read individual experiences but we don't have statistic information and there aren't so many success stories either. But I do think that this site offers much more safer advice than any shrink can offer! The 10% taper makes sense to me too and does sound safest but i don't think that is the only and best way to everyone. 

 

"Several publications show that the plasma concentration of citalopram is affected by CYP2C19 variants. Poor metabolizers of CYP2C19 had a reduced clearance of citalopram [Articles:16418702, 17625515, 12968986, 8451774, 12975335, 16855453]. Patients with ultrarapid CYP2C19 alleles had a lower serum concentration of S-citalopram [Article:17625515]. There is evidence that the CYP2D6 poor metabolizer genotype in combination with CYP2C19 poor metabolizer genotype can increase citalopram’s half-life; in one patient, this resulted in severe adverse effects [Article:2968986]. In another study, 6 out of 7 non-responders to citalopram were genotyped as extensive metabolizers for CYP2D6 and CYP2C19 [Article:8986013]. As these studies clearly indicate, the pharmacokinetics of citalopram is affected by CYP2D6 and , but the clinically relevant effect greatly varies between studies [Articles:16855453, 18382661]."

[LexAnger]

It is tricky while reinstating is given as the common advice to help with WD as everyone is different. For reasons we don't know, some ppl do well with reinstate while others can be hurt real bad. I read many who got severe reaction to reinstate, and myself included hit badly from 1 day dose increase of 1 mg. when ppl are experiencing bad WD, they tend to think its the worst only after they would realize it can be a lot worse if they have a reaction. Personally I feel it's important to make the risk be aware of at the time suggesting reinstate. This is also true to the belief of the benefit of long hold which for the cases of drug reaction, can actually cause more damage.

 

Even with statistics, it won't help with individual case, a total try and error game is what we are playing unfortunately.

[reachingforthestars]

Hi Lex!!

 

Yes, there are so many unknown factors! For some reason I was able to reinstate few times during my taper but the third time my body didn't like it anymore. Have you noticed many others who have reacted badly to only 1mg? 

 

R

[scallywag]

Lex -- I agree that almost everything related to psychiatric medications is trial-and-error. The best way to deal with all our individual "n=1" experiments is to evaluate the evidence and risks and then if taking action, be cautious.

[LexAnger]

Hi Lex!!

 

Yes, there are so many unknown factors! For some reason I was able to reinstate few times during my taper but the third time my body didn't like it anymore. Have you noticed many others who have reacted badly to only 1mg? 

 

R

HI RFTS,

 

Yes, I followed almost all lex users here in forum, so far I read most if not all reacted badly to reinstate ( amount various, most are low doses ranging from 1-2.5mg, one success reinstated to the original full dose at 10 mg, interestingly). The initial reaction to reinstate typically show significant improvement with WD symptoms for couple weeks or so, the followed by massive new severe symptoms different from the original problems and ppl describe it much more disabiling and terrifying.

 

The first couple dose increase worked well too for me (both writhin 1 week) and thr last couple did great harm to me. It seems I m getting more and more sensitive to dose increase now, even 0.02 mg would cause bad reaction.even it seems the reaction to reinstate usually occur only to those whose system is over sensitized and would work for the first couple times, I also saw ppl got severe reaction to the first ever reinstate ( assuming they reported theirs meds history accurately). This is especially difficult for anyone to even think of BEFORE they experience it first hand. Even worse, many still don't realize the real cause of the problem AFTER such experience still thinking it's pure WD. This whole ordeal makes it almost impossible to learn without try, the true try and error scenario.

 

How are you doing lately?

My strategy is to hold as long as possible while drug reaction symptoms allows as I have to handle WD at the same time. It sounds Drug reaction is not a big issue for you since 1.9mg. Are you considering longer holds if drug reaction is in check continuously?

 

Lex

[reachingforthestars]

Hi Lex!!

 

Luckily i didn't try to "stabilize" and hold the dose after my bad reaction to it and dropped it back to previous dose the next day! I have been too scared to search how others are coping after bad reaction... I guess most of those cases you have noticed tried to hold their dose since the new symptoms came after couple of weeks?  Did you decrease immediately after failed reinstament? 

 

Since 1.9mg I don't have much WD symptoms I even did couple of 0,02mg drops. The worst symptoms are those old ones which I got from reinstament (anhedonia mainly). I'm going to taper to 0 in three months and jump off when I reach 0.4mg. I don't want to go lower bc I'm afraid of the daily fluctuation on lower doses.

 

R