Cita: Citalopram free for 6 months (after 19 years treatment).

[nz11]

I am rather disapointed that the psychiatrist does not know anything about changes in brain after long-term use of ssri.

Maybe you can give him  a copy of this.

http://www.ncbi.nlm.nih.gov/pubmed/8561194

 

explained here:

http://survivingantidepressants.org/index.php?/topic/4098-hyman-1996-initiation-and-adaptation-a-paradigm-for-understanding-psychotropic-drug-action/

[Cita]

No have reinstated 4 days ago and my mood is stabilzing. First day had a serotonin euforia just like take benzo or a glass of vine. the next day was normal and the thrid day yester I was back in hell with obsessive thoughts about killing myself. Today my mood seems to have stabilazed. Hopefully for good. I feel accately the same why as when I used maximum dose 80 mg. So know we will so how I tapper. In my contry you kan buy 10 mg pill that can be shared in 4 parts with a nife. Maybe that is the best way since we don't have citalopram liquid form av non it seems to take a lot of time to do own mixutres.

 

Now 10 mg. I will have it for a month for my mood to stabilze but then. for howmany months shall i tapper. If I use the 10 % rull. How long will it take?

[nz11]

No have reinstated 4 days ago and my mood is stabilzing. First day had a serotonin euforia just like take benzo or a glass of vine. the next day was normal and the thrid day yester I was back in hell with obsessive thoughts about killing myself. Today my mood seems to have stabilazed. Hopefully for good. I feel accately the same why as when I used maximum dose 80 mg. So know we will so how I tapper. In my contry you kan buy 10 mg pill that can be shared in 4 parts with a nife. Maybe that is the best way since we don't have citalopram liquid form av non it seems to take a lot of time to do own mixutres.

 

Now 10 mg. I will have it for a month for my mood to stabilze but then. for howmany months shall i tapper. If I use the 10 % rull. How long will it take?

I'd consider buying a scale and weighing the doses. It wont be accurate enough to cut it into pieces . Maybe you can order one online.

https://www.amazon.com/American-Weigh-GEMINI-20-Portable-MilliGram/dp/B0012TDNAM

 

You may well have to put aside several months to stabilize maybe more before you consider tapering.

 

If you taper off 10mg at 10% of previous dose per every 4 weeks it will take 2.3 calender years to get to 0.5mg (1.8yrs to get to 1mg)

If you taper off 10mg at 5% of previous dose per every 4 weeks it will take 4.6 calender yrs to get to 0.5mg  (3.5yrs to get to 1mg)

 

If i were you i'd consider  the 5% taper.

[Cita]

Hi Nz11,

 

I will definitely follow your advise. A 1 1/2 to 2 year tapper seems ok. At least I know understand that I am not crazy and there are a way out. I feel as good with 10 mg as I did with 80 mg. First I thought my depression was back but since I function with just 10 mg this indicates it was the long-term change of using ssri that caused the symptoms. As I told you, I am myself working in healthcare and I feel rather surprized that there are no knowledge about this symptoms. I was sure from the begining that I felt something else than a normal depression and anxiety. Sort of had electrical burst and shivering in my body for months. It is not the same as having anxiety.

 

On question, I have just used 10 mg for 5 days. Shall I see if 5 mg is enough? It is easy to divide the 10 mg in halfs. Anyway. If I can manage on 5 or 10 mg I will be happy for that and accept that dose for years.

[nz11]

In the absence of other voices then i will comment.

 

Unless a person has experienced withdrawal its next to impossible to imagine its debilitating and inescapable horror.

As such its easy to  think the advice here is for everyone else except me.

 

When you joined it was suggested that if you have to ri do so at a low dose. Especially since you had banked 7 months drug free time.

I even know someone on this forum who would suggest at 7 months drug free fight to stay the drug free course.

No doubt you read the links on reinstatement (maybe it wasn't easy cos its not your language?) and  YOU decided to ri at 10mg. These are not jelly beans we are swallowing.

 

Chopping and changing doses is not the way to go.

My feeling is having decided to stick with 10 then stick with 10.

It makes it a tricky maneuver  when a person takes the car down the  interstate off-ramp and then decides to back it up and get back on the motorway.

 

Wishing you stability.

nz11

[Cita]

Hi Nz11,

 

I will follow your advice. You seem to be one of the more reasonable people here on the forum. I really regret I stopped using the pills. Probably the most stupid thing in my life. There is no reason at all to put ones health and life in danger just for being pharma free.

[scallywag]

Cita, nz's suggestion of staying with 10 mg now that you've started it is a good one. Stability of dosing is the most promising path to stability of symptoms.

[Cita]

Hi again,

 

the problem now is that I have gotten such a severe anxiety that I cannot controll. Reinstated 7 days ago. First day I got a "serotonin kick" from citalopram. The second day severe anxiety. The third day fine again. Now for 4 days anxiety. Today totally uncontrollable. Have had to take benzo for the first time in 4 months. Don't even want to say the dose because it is high. I read her that reinstating can make things worse. Is this temporary. I think I can use benzo for 2-4 weeks without any dependency and then tapper but longer I don't want to use them. The anxiety I have is so extreme it is not understandable for people that has not had it.

 

What are your experiences. Will reinstatement work in some weeks? I am so angry and frustrated that psychiatrists don't seem to have a clue about this phenomena. Since I am myself a medical professional I totally convinced I don't imaging anything and this was not the way I felt as a teenager when starting the pharma.

[Cita]

If I can manage with 10 mg in some weeks I will definitely stay with that dose for years. It is very low and I don't see in which way it can be harmful or affect my mood in any severe. My psychotherapist wanted me to med pharma free but after 20 years with citalopram 80. I consider 10 mg as free as one can be from the drug. If I just have such a low dose for 2-3 years. I se no reason why I then can stopp it in just some months after that.

[scallywag]

You've been on 10mg citalopram for 4 days and have had increasing anxiety.  I'm going to ask other moderators for suggestions about next steps.

[Shep]

Have had to take benzo for the first time in 4 months. Don't even want to say the dose because it is high. I read her that reinstating can make things worse. Is this temporary. I think I can use benzo for 2-4 weeks without any dependency and then tapper but longer I don't want to use them. The anxiety I have is so extreme it is not understandable for people that has not had it.

 

 

Hi, Cita.

 

I'm sorry you're suffering so much right now, but I do want to give you some background information on benzos. Please note:

 

• Dependency can occur in only 10 days with benzos. As mammaP mentioned earlier in your thread, dependency isn't about cravings. The drug changes the way your brain works. Benzo withdrawal destabilizes your central nervous system and can last for quite awhile after you come off. 
• Since you were previously on  lorazepam for 2 - 3 months, it's very likely you are dealing with both benzo withdrawal and antidepressant withdrawal now. Both benzo and antidepressant withdrawal are extremely similar. 
• You are setting yourself up for kindling. Please note that many people are able to come off of benzos the first time without as many withdrawal symptoms, but each time they come off after that, the withdrawal is much worse. This was also my own experience, and it's explained here in this thread on kindling:  Limbic Kindling -- Hardwiring the brain for hypersensitivity
• Reinstating a benzo after 2 weeks is not recommended. There is about a 2-week window after coming off a benzo that reinstatement may work. However, after that, reinstatements can cause all sorts of problems for many people. 

 

I would caution you against using any more lorazepam for these reasons. You can find more information in the benzo area of the forum:

 

 

Members-only benzo forum

 

 

As Scally said, the moderators are reading through your thread and will give more feedback on your antidepressant reinstatement.

 

Hang in there. This will get better. 

[Cita]

Today I feel much better. Maybe I just needed one big dose benzo to calm down. I am not at all interested in using benzos. But it was necassary to survive yesterday. Since I reinstated citalopram 1 week ago my mood has shifted from day to day. One day perfect the next day unimaginable anxiety. Sooo strange. My plan i just to let my mood stabilize with citalopram for a month or two. Just in case I will keep the benzos at home. When my mood is stabilzed I will thtrough them away.

[Shep]

I hear what you're saying, Cita, but please read over the information provided in the members-only benzo area which I just linked in my previous post. It's best to be informed before continuing to use this drug, as benzo withdrawal is a complete nightmare for many of us and you already have 4 months of being off this drug. If I were you, I would consider that one dose you took last night as a "rescue dose" and try some non-drug ways of coping. I would really hate to see your AD reinstatement complicated by benzos. 

 

There are non-drug ways of handling anxiety and insomnia. Please take a look at the information in these links:

 

Non-drug techniques to cope with emotional symptoms

 

Sleep problems - That Awful Withdrawal Insomnia

 

 

Some people find that fish oil and magnesium can be helpful:

 

 

King of Supplements: Omega 3 Fatty Acids (Fish Oil)

 

Magnesium, Nature's Calcium Channel Blocker

 

Epsom Salts - Another Way to Relax with Magnesium

 

 

I know this part of the journey is extremely hard, but many of us long term users find that as we add in these non-drug coping skills and make other changes to diet and exercise, we come out of this so much stronger than we came in. The recovery off these drugs can be a gateway into a completely new and better life. 

 

Sending healing vibes your way. 

[Cita]

Hi Shep,

 

I am of the same opinion. I just needed to take it ones. "A rescue dose" was a good name. Just to calm down and be able to function so I can start using the other technics I was afraid of leaving the house. If I had when to the gym thought I would have become agressive after having the adrenalin-kick after training. So it was just nesessarcy. I live alone with no family. So did not have any support.  I will try meditation. Listen to music. Take long walk. Going to the see with friends. That is relaxing. The best thing I have done was putting myself in a mood where I could cry. After crying everythin feel better.

[Altostrata]

Cita, please let us know how you are doing. It could be that 10mg citalopram is too much for you. It is not that small a dose. You might do better on 9mg or less.

[Cita]

Very hard to get the exact dose when I don't have it i liquid form. I think I got som initial anxiety after starting it. getting better every day.

[Cita]

I feel much better now. Tappered diapam 40 mg to 30 mg to 20 mg until today. Tomorrow I take 10 and 5 mg in two days. That is 5 days use will tappering. can't be so terrible. then I through the package away and went to citalopram to work. I have just have then for 8 days so 6 more days and the initial problems should be soled.

[Vigor]

Hey Cita,

 

I recently reinstated after the same amount of time off as you. I am currently on 5mg and reinstated at 10mg in February. I am doing a hold at the moment but I am 100% better than my cold turkey that transpired. I hope you are feeling good, but I would listen to nz11 just stick to one dosage. I am putting my hold up to 5 months at this current time, to let my body catch up. Stability is the most important thing and you want to maintain that the best you can.

[nz11]

I am sorry you are in this most difficult position at no fault of your own.

 

You mentioned you thought it was a wrong decision to get of this drug.

I don’t think it was a wrong decision to get off this drug in fact it was a great decision. Unfortunately due to pharma fraud and doctor ignorance, you got off in an unsafe manner.  You are not to blame the medical profession have been negligent. These drugs are so potent and brain altering it can take years for many people to taper off. But people are getting off and getting their lives back they are doing so at such a slow rate giving the brain a chance to adjust to the change.

 

I share Shep's benzo concern and reading your latest valium intake post i cant help but feel you are or your doctor is playing with fire.

It appears that you are planning to take it for 14 days only.

I assume you are referring to valium here:

just have then for 8 days so 6 more days and the initial problems should be solved.

Where are you getting this from ? the doctor?

ssri withdrawal symptoms can last for months

 

can't be so terrible

That's what snow white said in respect of a rosy red apple.

Don't you believe it.

 

One of several things that i think helped to protect me in withdrawal was an on purpose decision to exercise the 'discipline of refusal.'

When doctors spoke nonsense I refused to agree with them on it.  And when they tried to push a benzo or propanolol on me i refused it.

In my opinion you are far better off to hold or adjust the dose of the existing drug to find relief from the trauma of withdrawal than to seek relief by exposing yourself to or adding  more drugs.

 

wishing you strength and stability.

nz11

[Cita]

Hi,

 

I feel better now. Have noticed I did not even spell correctly here at the forum some days ago. I had to take Valium 40 mg for a day just to survive. Then I tapperted to 30 mg the next day and 20 mg the day after. Today I will try with 10 mg and tomorrow just 5 mg and then nothing. I am fortunate to have a psychiatrist and also a psychologist that want me to be pharma free. They don't think my problem is so severe that psychotherapy can't help me. I have been functioning professional in a demanding job for years so basically I should be able to handle my psychological problem and be pharma free one day.

 

I agree Nz11 opinion that I tappered to fast. It was my own decision and my own fault. I hade citalopram 80 mg which is a very high dose for 20 years. So when I tried to tapper from 30 mg to zero in just 30 days, I just went "mad". Now 7 months later I hope my system has adapted so much that I can survive with 10 mg. Now I have been on citalopram 10 mg for a week. I will wait for my mood to stabilze and then wait until I will good. When I haven't had any mental problem for a while. Maybe 6 months I will start to tapper with under controll of a psychoterapist that I can meet some days a week. I don't think it is good to tapper pharma without any objective person that supervise you.

[Cita]

Hi,

 

it seems as reinstating 10 mg was the right thing to do. Now 9 days later my mood is fluctating much less. I hade 5 days of a nightmare som days ago but now it is slowly getting better. If had not taken the valium 40 mg for one day I think I would have gone mad. Then I went down to 30 mg the next day and 20 mg the day after. To day I have taken 10 mg and tomorrow I will just take 5. That means 5 days of benzos just to survive. I don't consider that extreme. In some day when I feel my mood has been stable for some days I will even through the benzos away.

 

I tried to quite citalopram totally also a year ago. I had the same problem. As long as I stayed on 10 mg I could sort of manage and felt ok, even if I had had 60 mg just 5 month earlier. But when I tried to go from 10 mg to zero I went "mad". It seems as the last tappering is the most difficult for me. Does anyone else have the same experience, i.e. that the last mg are the most difficult to stop?

[Cita]

Hi,

 

it seems as reinstating 10 mg was the right thing to do. Now 9 days later my mood is fluctating much less. I hade 5 days of a nightmare som days ago but now it is slowly getting better. If had not taken the valium 40 mg for one day I think I would have gone mad. Then I went down to 30 mg the next day and 20 mg the day after. To day I have taken 10 mg and tomorrow I will just take 5. That means 5 days of benzos just to survive. I don't consider that extreme. In some day when I feel my mood has been stable for some days I will even through the benzos away.

 

I tried to quite citalopram totally also a year ago. I had the same problem. As long as I stayed on 10 mg I could sort of manage and felt ok, even if I had had 60 mg just 5 month earlier. But when I tried to go from 10 mg to zero I went "mad". It seems as the last tappering is the most difficult for me. Does anyone else have the same experience, i.e. that the last mg are the most difficult to stop?

[Vigor]

Hey Cita,

 

I think these drugs are really potent. And we take them at dosages that are probably overkill. So being on a smaller dosage still gives the brain enough to actlike the normal "therapeutic" dosage. It is the norm I think that the last few mg's around like 2 or 3 is when things really start to come into focus. If you got there too fast it will hit you with withdrawal. But I have read that people feel things coming back on those dosages that they forgot for a long time. Just take it slow, and you will be OK. In my opinion I got to 5mg a little faster than I would have liked. I am doing fine, but that is why I am holding here for awhile. Holds are important for lessening the impact on your nervous system. Just take it slow and listen to your body. Everyone is different, this is just my perspective though. I am sure a mod will come in here and let you know more. Wishing you the best.

[SquirrellyGirl]

If you look at the first graph in this paper, it is for citalopram (pg.4):  https://ils.unc.edu/bmh/neoref/this.dir.unneeded/schizophrenia/review/tmp/352.pdf

 

Note that at 10 mg, the receptor occupancy (the percentage of your serotonin receptors blocked by the drug) is still way up there, nearly as high as at much higher doses.  Below 10, you still have about 70% blocked!  That's a long way to go to get to zero!  That is why it is so tough.  Those graphs demonstrate very dramatically the fact that receptor occupancy only begins to fall off precipitously below the "minimum effective dosage" of many of these drugs (I'd hazard they all behave the same way).  So, when a doctor tells a patient she can just stop c/t off the MED because it is so low as to not be doing much, you can see how very untrue that is!

 

SG

[Cita]

In the dissucion parat of the article, it is said that citalopram need to be administred at 20 mg for any signifcant effect and that this dose gives a 80 % blocked of this receptors. Anyway, I have had 10 mg now for a week and I feel much better. I will stay on this dose for 6 months at least and hope my mood will stabilize. Then will see if I can lower the dose. Anyway, ssri are given to 10 % of the population in many Western countries and I do not believe 10 % of the population is born with a wrong balance of serotonin so sooner or later I will try to get ride of the pharma. Psychotherapy has been proven to work as well as pharma in many studies. They are equal in effect as long as you don't have a severe/major depression. Then pharma is definitely needed.

[scallywag]

Cita -- I'm glad that your reinstatement has settled your withdrawal symptoms. It's a good plan to stay at the dose for at least 6 months.

 

Comparing the curves in that paper, it seems that what's defined by pharma manufacturers as therapeutic effect seems to occur at 80% 5HTT occupancy.  That doesn't mean that lower doses that produce lower 5HTT occupancy have no effect on a person's emotions, cognition and physiology.

[Cita]

Hi again,

 

I want to thank everyone in this forum how has given me advice. I reinstated about 9 days ago and actually my mood is slowly stabilizing though it shiftes very fast. I has been given 6 month sick-leave by my doctor now and will continue psychotherapy. At least I now just have 10 mg instead of 80 mg as I had 2 years ago. It seems to be an adequate dose for me right now.  It was an extremely stupid think to tapper from 30 mg to zero in one month. Especially since I have some other problems in life right now.

[scallywag]

Cita - thanks for posting the good news that you're noticing an improvement, however slowly it's coming.

 

Be sure to hold at 10 mg until you're good and stable. 

 

30 to 0 mg in one month is a big jump.  You didn't know that then.  Be gentle with yourself.

[Cita]

Anyway, I had the same problem a year ago. The last 10 mg is definitely the most difficult.

[Cita]

Hi,

 

now almost 3 weeks after instating citalopram my mood is better and stabilizing. There are some other problem in my life that has made everything hard and are now solved. Anyway, I don't have the shifts in mood as when I started the treatment. I will continue on this dose for 6 months and see what happens. If I feel better I will try to lower to dose. If not I will continue for some years on this dose. Very interesting how such a low dose can make all the difference. I had severe obsessive thoughts about suicid for the first time in my life this spring and summer being without citalopram for the first time in 20 years.

[Cita]

Now 45 days sinced I reinstated 10 mg. It works perfectly. According to the literature it should not even be a therapeutic dose (20 mg minimum). Still the strange feeling of not being myself and shivering and uncontrollable anxiety is gone. Even if I have hade the worst month in my life with a close relative passing away I have been able to handle it with just this small dose. The psychiatrist does not seem to have a clue about why I felt like I felt. Now I am back and functioning. It was the same last year. I went from 60 mg to 0 i 4 month. Everything was controllable (even if I felt bad) until I went from 10 mg to zero. I had read the literature and official sites recommended discontinuation during about 2-6 months. I really disapointed with the scientific establishment. This drugs are so common with 100 millions all around the world using them. Still almost no research on withdrawal after long term use.

 

Thanks for all the help here. In 4 month; If I feel better I will start to tapper again.

[scallywag]

Holding your reinstated 10 mg for 4 more months (a total of 5.5) is an excellent plan.

[Cita]

Thanks, the problem is then to get citalopram in solution form. It does not exist in my country. Would you recommend that I divide a pill in two parts and then try with 5 mg i januari? Or is that a to fast decrease? Maybe 5 mg every second or third day and then 10 mg?

 

Best

[scallywag]

Cita, Reducing your dose that quickly has a high risk of putting your right back into withdrawal symptoms.

 

Please read these topics:

Why taper by 10% of my dosage?

Tips for tapering off Celexa (citalopram)

Making a liquid from a tablet or capsules

[Cita]

Is there anyway to notice the difference between long term withdrawal symptoms and recurrent depression/anxiety? One thing I noticed is that 10 mg really works well even if it is not considered a therapeutic dose.

[scallywag]

Here's a discussion topic on exactly that: is it withdrawal or relapse?