StarfishMila: Tapering Citalopram, would like advice

[StarfishMila]

I have been on Citalopram for 14 years. I tried to come of 20 mg 5-6 years ago, crashed terribly, and ended up on 40 mg, where I stayed until the beginning of May this year. I have felt stable and happy for a long time, and decided it was time to try again. My GP told me i could cut 25% every month. On May 3 I cut to 35 mg and stayed there for a week. I felt OK, so I went down to 30 mg. Big mistake... I stayed at 30 mg for 12 days, and then went back to 35, as I was getting horrible side effects. Tremors, tingling feeling in face, hands and feet, and a feeling of eletricity going through my upper body. The side effects improved, but it has now been 6 days, and today they seem to be getting worse again. Would like some advice on whether I should stay on 35 mg, or if there is still time for me to go back on 40mg. Have realised that I must do a much slower taper if I am to succeed.

[scallywag]

Hi Starfish and welcome!  Sorry to hear that your recent dose reduction left you with withdrawal symptoms.

 

Going back up to 40 would be an additional change in only a few weeks. You've already made 3 changes: 40-35-30-35.  Given 2 things:  (1) what I've seen recommended for others and (2) that your withdrawal symptoms have improved with the updose to 35 mg,if I were you I would stay at 35 mg for at least a month to let your central nervous system (CNS) stabilize.

 

Surviving Antidepressants (SA), like many peer support groups, recommends a much slower taper that most doctors, including yours.  The harm reduction approach is to reduce 10% of current dose once a month. For more information about that, read Why taper 10% of my dosage?

 

Have you read this topic? About reinstating

 

A moderator will be along to provide more information and guidance.  It will assist them if you put your drug history and taper history in your signature so that it shows below every one of your posts. Withdrawal History in Signature

[StarfishMila]

Thank you for quick reply. Read about the 10% approach a little too late, unfortunately. Thought I was being really careful... Am worried I have messed up my tapering process already. Am hoping I went back on 35 mg in time so it won,t get any worse!

[SquirrellyGirl]

Welcome to SA, StarfishMila!

 

It is never too late to start the 10% taper if you are still on the med!

 

Thank you for filling out your signature block with your history - that helps us know your history at a glance under each of your posts.  

 

You've hit the dosage range where your nervous system is rebelling against losing the drug it has built itself around:

 

Introduction to AD Withdrawal Syndrome

 

Right now your nervous system is in a big wobble over the recent dosage changes, down and then up again, and it will take some time for that wobble to settle.  Changing the dosage again at this time will not help but only confuse your system more.  When you went to 35 and were ok for week, then cut again, your nervous system was still adjusting to the cut to 35, though happily without major withdrawal symptoms.  That next cut exaggerated the imbalance of neurotransmitters caused by the first cut even more, and voia, symptoms!  So, going back to 35 was fine; just taking time to settle out.  You are likely going through the Windows and Waves Pattern of Stabilization. 

 

This video explains things really nicely:  Video:  Healing From Antidepressants - Patterns of Recovery

 

This applies for people going through what you are while still on the meds as well as for people who have come off entirely, too fast.

 

So, is it possible for you to hang tight with what you are feeling and wait for the reverberations to settle?  It helps to understand that this is caused by the imbalance set forth by changing the dosage of your meds, forwards and backwards.  The main thing is to not get worked up with fear about it.  Right now what you need is some self care.  This link is about emotional symptoms but is pertinent for all the symptoms of withdrawal:

 

Non-drug techniques to cope with emotional symptoms

 

I would like to emphasize that going back up to 40 is not necessary nor desireable - going that high could trigger an adverse reaction and cause further sensitization to the medication.

 

It may take a month to 6 weeks at 35 mg to settle out and truly allow your nervous system to adapt back to that level, since it was still trying to deal with that 12.5% cut you did from 40 mg.  That was not a horrifically huge cut, just a bit over the 10% we recommend.  Probably why you felt ok for that week, because it wasn't that extreme.  Thankfully you didn't do the 25% up front!

 

Here's some tips about tapering citalopram:

 

Tips for tapering off Celexa (citalopram)

 

Give all those links a read and then come back here with questions!  Your Intro is your place to document your journey, give updates, ask questions about your situation, express concerns, etc.  By clicking Follow above, you will be notified of responses on your thread.

 

We're glad you found SA!

SG

[AliG]

Hello Mila.   You have been through a period of destabilization , but hopefully if you stay stable now at 35 mg, your symptoms can improve slowly. I think if you can hold at this dose , as it's what you have been on for the longest time recently, you can possibly stabilize. 

How are you tapering? Are you dry cutting/ liquid or using scales ?

Thanks for adding your drug history signature. As you have already realized, a slow taper is key in coming off these drugs safely. 

I would keep notes / journal over the next few weeks, and then check in to let us know how you are going.

 

Rate symptoms daily to track patterns and progress

 

Welcome to S.A.

Ali

Edited May 26, 2016 by AliG
posted at the same time as S.G.

[StarfishMila]

Thank you for taking the time to answer me. I thought I was being very clever doing the reductions slower than my GP recommended, and felt quite panicky realising it was still too fast. I will definitely wait a good while before attempting further cuts as I am terrified of crashing like i did a few years ago. At that time, my doctor consulted with a psychiatrist and was told there was no way symptoms of withdrawal would last more than 2-3 weeks, so for a while there I thought I was just going crazy...

I am using a tablet cutter for now, but will ask my GP for liquid before next taper. Today has been pretty awful, but reading your posts has helped a lot. I'm very grateful for finding S.A. and getting advice so quickly. Guess I'll just prepare for a few wobbly weeks and wait for it to get better

[AliG]

Mila.   Doctor's are essentially clueless. That's how we got here. I wouldn't rely on them .You are here now and therefore have the best information available, anywhere.

Yes, you might be a bit up & down for a while as your CNS adjusts to new circumstances, but if you can just stay steady with your dose, then when you're stable you can slowly taper off. 

Ali

[LexAnger]

Hi Mila,

Just want to welcome you and say sorry from another lexapro victim!

Those symptoms are horrible indeed, worse than anything from hell. But I'm glad you had the realization early after the first hit. I believe your future tapering will be much smoother and less painful with all the great information and support from here.

 

Lexapro is a much stronger Ssri than all others and can cause it's unique set of most evil physical symptoms including the electrical, needling, strange pain sensations.going slow and steady is the key and try to avoid further need of up dose in future ( saw many strucked by that).

 

Good luck!

 

Lex

[scallywag]

I am using a tablet cutter for now, but will ask my GP for liquid before next taper. Today has been pretty awful, but reading your posts has helped a lot. I'm very grateful for finding S.A. and getting advice so quickly. Guess I'll just prepare for a few wobbly weeks and wait for it to get better

 

StarfishMila: Withdrawal symptoms aren't fun.  It's surprising to me how much getting educated, e.g. reading the forums, can help.

 

Citalopram may be available as a liquid in your country or it may not.  Many people have tapered off drugs by making their own liquid from their capsules and tablets.  Here are some threads in the Tapering forum that explain:

Making a liquid from a tablet or capsules

 

Using an oral syringe

 

Making a Celexa (citalopram) solution

 

 

[StarfishMila]

Thank you all for posting. Symptoms still there today, but not as bad as yesterday. I'll take that as good sign

Mila

[JanCarol]

Welcome Starfish!

 

I'm so glad you found us when you did, before it got too far.  

 

Think of it like this - going off psych drugs is like jumping off a cliff.  Cold turkey is just flying through the air, and waiting for the landing (sometimes it takes over 6 months to hit the ground, and it's very dramatic).  Tapering too fast is like descending out of control, but if you hold, you can catch your breath and stabilize before you start a much slower, more careful descent.

 

So it looks like the majority here think that just holding on for a month, 6 weeks more.  Better yet:  hold until you feel better, and then wait another 2 weeks before trying another taper.  

 

If you land and shatter into a zillion pieces it is awfully hard to put them back together again.  But you haven't "landed" yet - so it's awesome that you got in here in time to slow down, and stay whole while you get off these drugs.

 

If you want to tell us more about you - we can tailor more of our Non Drug Techniques for Coping with Emotional Symptoms (HINT: they are good for physical symptoms too).  SA is huge, and I was overwhelmed when I came here - with all the information available.  If you need help with sleep, or anxiety, or panic, or brain zaps, or (insert symptom here) we can help point you to what others have experienced and possible solutions for that as well.

 

Just a little warning - we're not big on supplements.  A lot of naturopaths and holistic doctors like to load you up with supplements, but when you are in withdrawal, you can become hypersensitive.  The best ones to support withdrawal seem to be Magnesium and Omega-3 fish oil - to help nourish your neurotransmitters (mag) and coat your nerve endings (fish oil).  But please only start them one at a time, after reading those forums, in case you have a reaction to one of them.  And, in fact, consider only taking part of a tablet/capsule for the first few days  just to make sure you don't have a reaction - like a test dose.

 

So - welcome to SA!