rowinghippy: citalopram has been terrible, need advice

[ChessieCat]

I've moved this to your Intro topic because it is about your individual situation and keeps your history, questions and responses in one place.  It also means that we can easily see what information you have already been given.

 

It's like anything else to do with these drugs, nobody knows what will happen.  What works for one may not work for another.  And as has been found by members here too is that what worked once before may not work the next time they try the same thing.

 

As you said, there are no quick fixes and changing drugs is the same as looking to drugs to fix the problem.  It is generally better to stick to the current drug because changing over may mean you experience withdrawal from the first drug combined with start up/side effects from the second drug.  You will not know what is causing what.

 

You may currently be experiencing withdrawal symptoms not side effects.  If this is the case, then reducing by a smaller amount may help.  Many members have found that they need to go slower as their dose gets lower.  See Why taper paper: dose-occupancy curves

 

Information in these links may be helpful.  I'm not sure if they have already be suggested:

 

Brass Monkey Slide

 

Micro-taper instead of 10% or 5% decreases

Rhi's "Start Small, Listen to Your Body" Taper Plan

Slowness of slow tapers

[Rain]

Hi mate, I got same situation as yours, do you feel better recently? 

 

Did you switch the meds now? 

 

Hope you are doing better!

 

Regards

 

Rain

[Eleven10]

Hi rowinghippy.

 

I just wanted to say that I wish you well. I had terrible anorexia from 16-20 I was in and out of hospital. At the time I was never given any drugs but I did suffer a lot of the symptoms you have particularly the trouble eating nausea and fatigue.im not suggesting it's not the drugs causing just saying what happened to me.

When I read your thread it brought a lot of memories back. I wish you a speedy recovery

[rowinghippy]

First update in 9 months.

 

I stopped taking meds all together. After an initial and messy taper early on, I've been sitting at 10 mg since February. I plateaued, but wasn't getting better. I kind of expected that, since I've known since very early on that so long as I'm on citalopram, my body won't be healthy. 

 

A month ago I ran out, and for a week was med free for the first time since starting. My suicidal ideation and crippling depression (both of which had be worsening over the past year and a half) were lessened. Upon going back on, they worsened again, and all motivation to taper vanished. So 2 weeks ago I decided to just quit cold turkey. Not smart, but given the current state of my life I had and have nothing to lose.

 

Withdrawal kicks in religiously a week after any sort of dose drop. It did this time, and insomnia picked up again. Mood swings are worse again, mostly anger. I'm gaining weight again (100 lbs overweight now), and growing excess hair again (an innocuous but weird side effect) all over my body (I'm asian, so I'm naturally hairless). The new symptom is 'drunkenness' - dizzy spells, lightheadedness, minor cognitive impairment, etc. - luckily it's not too intense and isn't debilitating or constant. Body aches are up a little too, although I suspect diet has long contributed to this.

 

Since stopping, my gynecomastia is ever so slightly down I think (although I doubt it'll be really noticeable unless I lose weight). Excess sweating/increased BO is also slightly down, so hopefully that continues. Suicidal ideation is down, although I'm still depressed at being obese (given what I've read of WD induced weight gain, I'm not hopeful honestly, plus I've wreaked so much havoc on my metabolism the past 2 years that I'm likely fucked permanently), dropping out of college, friends disappearing...

 

The dearth of success stories since I was last active here is furthermore demoralizing to be quite honest.

 

I still don't take that good care of myself; don't eat well or enough, dental health is poor (although for the past year I've been throwing up whilst brushing my teeth from the gag reflex), spend too much time in bed.

 

----------------

 

Symptom list:

 

From citalopram:

acne

nausea

dry heaving (occasional)

insomnia (minor)

high prolactin

     gynecomastia

     galactorrhea

edema (occasional)

increased sweating (decreasing)

heartburn

general malaise

weak gag reflex/vomiting (rare)

loose stools

 

From withdrawal:
flu symptoms

chapped lips

wired feeling - physical feeling of anxiety (occasional)

extreme fatigue

extreme hunger cues

food doesn't taste good/insatiable mind

extreme thirst

stomach capacity issues/gastroparesis

depression (insufficient nutrient intake/poor hygiene)

blood sugar problems

suicidal (not explicitly)

sibo/leaky gut

nutrient malabsorption (unsure, no recent bloodwork, but highly likely)

food intolerances (dairy, gluten, peanuts, fructose, etc.)

pssd

hard to concentrate/think clearly (minor)

anhedonia

depersonalization

neuro-emotions

headaches

hypercortisolism

     muscle pain

     weight gain - buffalo hump, mid section, face

     increased hair growth

     stretch marks

dizzy/drunkenness

 

Hope you're doing better, whoever reads this. 

[rowinghippy]

I'm so god damn ******* tired of this. I don't want to have to wake up everyday like this anymore.

[nz11]

On 01/02/2018 at 11:16 AM, rowinghippy said:

I know someone who is trying to go from 20 mg paxil to 150 mg wellbutrin. They did a week long bridge of 10 mg paxil + 150 mg wellbutrin. They hit withdrawal upon dropping to only the 150 mg wellbutrin. Going back to only paxil isn't a good option due to side effects.

 

Normally with withdrawal I'd say go back up to 10 mg then taper down more slowly, but per the Prey 2012 method found in here, it seems staying on a combo of the two meds for more than 2 weeks is not recommended. Obviously this isn't a prozac switch, but I assume the ideas are similar. 

 

Not sure whether 1) they should just try another SSRI instead of wellbutrin or 2) go back to 10 mg Paxil and slowly taper that, all while taking 150 mg wellbutrin. I suppose they could ride it out, but that doesn't seem like the best advice. 

 

 

 

Apparently wellbutrin's equivalent dose is 10x that of paxil's, evidenced from here: https://www.sciencedirect.com/science/article/pii/S0165032715001512, so perhaps the 150 mg wellbutrin is just too low?

 

Saw this post in tapering.

 

Why on earth is this persons doctor switching to Wellbutrin. I doubt very much that will cover wdl off paxil 

 

yes you are right wellbutrins equiv dose is a factor of 10 more than paxil 14.6mg paxil is equiv to 150 wellbutrin. or 20mg paxil =205 Wellbutrin.

 

Does this person want to join this site and do a drug sig?

 

When did all this happen. How long had they been on paxil for.

 

Well all these drugs have a list of side effects the length of your arm so if i were them i would go back to the paxil. 

 

Edited March 2, 2018 by ChessieCat
fixed you glitch - overlapping typing

[rowinghippy]

39 minutes ago, nz11 said:

Why on earth is this persons doctor switching to Wellbutrin. I doubt very much that will cover wdl off paxil 

yes you are right wellbutrins equiv dose is a factor of 10 more than paxil 14.6mg paxil is equiv to 150 wellbutrin. or 20mg paxil =205 Wellbutrin.

Does this person want to join this site and do a drug sig?

When did all this happen. How long had they been on paxil for.

 

Not sure if they want to join. As to why the doctor is doing this, who knows. Maybe it worked for another patient, maybe they're throwing darts at a dartboard, or maybe they're incompetent (or all of the above).

 

The person is 7 days off paxil, after the weeklong bridge. Been on paxil since April 2017.

 

I guess I'll recommend trying another SSRI instead.

[ChessieCat]

8 minutes ago, rowinghippy said:

I guess I'll recommend trying another SSRI instead.

 

You could be setting them up to continue on the drug round about (aka merry go round - which definitely isn't merry )

 

My suggestion is that if they are NOT willing to at least check out SA, then I wouldn't be making any suggestions about trying another AD.  It's dangerous ground you would be treading.

[rowinghippy]

1 minute ago, ChessieCat said:

 

My suggestion is that if they are NOT willing to at least check out SA, then I wouldn't be making any suggestions about trying another AD.  It's dangerous ground you would be treading.

 

That's fair, although passively allowing them to go through paxil withdrawal seems cruel too. But there is no win in situations like this it seems.

 

I'll link them to SA, but what is it you hope they'd get out of it that I couldn't convey to them directly?

[ChessieCat]

8 minutes ago, rowinghippy said:

what is it you hope they'd get out of it that I couldn't convey to them directly?

 

I'm thinking of it from your side.  It could be detrimental to your well being.  It is hard enough being a moderator here where we are being supported by others and can take a step back if needed.  I imagine being involved in real life with someone could end up being very draining and stressful.

 

Also, being a member here anonymously they may provide information about their drug history which they are not telling you about.

[nz11]

Do you know this persons drug history they may have already been on other ssris prior to april 2017. ?

The doctor doing a switch is it because of side effects or to bridge getting off ? 

 

 

[nz11]

3 minutes ago, ChessieCat said:

being a member here anonymously they may provide information about their drug history which they are not telling you about.

yes this is why they need to join sa.

 

They may be oblivious to their plight or not be interested in tapering off just simply switching as per doctors orders....maybe they tried to taper before and weren't able to ??

 

Theres always room for one more at sa.

 

[rowinghippy]

3 month update, * denotes changed for better, ** denotes changed for worse

 

From citalopram:

acne *

nausea

dry heaving *

insomnia **

high prolactin (doubt it's still elevated, but the breasts will require surgery at this point assuming I can lose weight)

     gynecomastia

     galactorrhea

edema (occasional)

increased sweating *

heartburn

general malaise *

weak gag reflex/vomiting *

loose stools

 

From withdrawal:
flu symptoms

chapped lips

wired feeling - physical feeling of anxiety *

extreme fatigue

extreme hunger cues

food doesn't taste good/insatiable mind **

extreme thirst

stomach capacity issues/gastroparesis

depression **

blood sugar problems

suicidal (still wish I could) *

sibo/leaky gut

nutrient malabsorption

food intolerances (dairy, gluten, peanuts, fructose, etc.)

pssd

hard to concentrate/think clearly

anhedonia

depersonalization

neuro-emotions *

headaches

hypercortisolism

     muscle pain

     weight gain - buffalo hump, mid section, face *

     increased hair growth

     stretch marks

dizzy/drunkenness *

"pins and needles"/burning bones

 

A little improvement these past 3 months, compared to the prior 6 months from when I made my first list 3 months ago. Going keto has worsened my sleep but I've finally lost a little weight (still a huge amount to go), I'm not sure how it's affecting hormones - waiting on blood work, saliva, and urine tests to come back. Most noticeable is the cessation of my gag reflex, which means I can take out the garbage without vomiting. 

 

Being obese, along with having gynecomastia and no energy to do anything, is still making me really depressed. I'm back in one class, but after these past 2 years I don't have any motivation for college, much less all the extracurriculars and networking required to actually get a job once I'm done. With my hunger cues STILL messed up (and all the crap that comes with that), I just don't really care about my life anymore beyond walking through the motions. I'm angrier than I used to be, or it's at least built up enough to notice.

 

I could deal with all the other crap if it weren't for the weight and hunger cues, but those are the two I doubt I will ever recover from long term.

[rowinghippy]

3 month update, * denotes changed for better, ** denotes changed for worse

 

From citalopram:

acne

nausea

dry heaving

insomnia

high prolactin (doubt it's still elevated, but the breasts will require surgery at this point assuming I can lose weight)

     gynecomastia

     galactorrhea

edema (very sensitive to salt and carb intake) **

increased sweating

heartburn

general malaise

weak gag reflex **

loose stools * 

 

From withdrawal:
flu symptoms

chapped lips

wired feeling - physical feeling of anxiety 

extreme fatigue *

extreme hunger cues

food doesn't taste good/insatiable mind *

extreme thirst

stomach capacity issues/gastroparesis

depression

blood sugar problems

suicidal

sibo/leaky gut

nutrient malabsorption

food intolerances (dairy, gluten, almonds, fructose, etc.) * (strict keto, so exposure has been minimal)

pssd

hard to concentrate/think clearly

anhedonia

depersonalization

neuro-emotions

headaches

hypercortisolism *

     muscle pain

     weight gain - buffalo hump, mid section, face *

     increased hair growth **

     stretch marks

dizzy/drunkenness *

"pins and needles"/burning bones

worse body odor **

rashes **

ptosis **

 

Have seen more small improvements over the past 3 months. I have continued to lose weight via keto and levothyroxine (down 55 lbs), although I'm concerned about the complications arising from the thyroid meds. I really hope that I can taper off the med down the road, as I would be remissed if I was dependent on it forever. That said, it seems withdrawal has burnt out my thyroid, because I do benefit from it (despite the med's side effects for me). Will do another whole round of hormone tests next month.

 

Taking summer class now, and will be full time (bare minimum in terms of hours) in the fall for the first time in nearly 2 years. Class now takes up most of my energy and mental faculties, although it is an improvement compared to last year. Mentally I've seen less gains compared to my physical state, as I'm still pretty rocked by withdrawal and the continued impact it has on my life/future. Sleep is still pretty bad. Gut seems better finally. Not sure if it's tied to the regimen, and will go away the moment I get off in the future, or if it's a genuine gain. Able to commute now, which is minimal but still some exercise.

 

Probably biggest is my hunger cues have mostly normalized under the regimen, thank god.

 

After a year of dedication to the forum I mod, I'm burnt out from it. Not replying or being active as much as I probably should. People's antidepressant problems never end, and I'm tired of withdrawal/ADs consuming my life..

[rowinghippy]

6 month update, * denotes changed for better, ** denotes changed for worse

 

From citalopram:

acne

nausea

dry heaving

insomnia *

high prolactin (doubt it's still elevated, but the breasts will require surgery at this point assuming I can lose weight)

     gynecomastia *

     galactorrhea

edema (very sensitive to salt and carb intake) *

increased sweating

heartburn

general malaise *

weak gag reflex *

loose stools

 

From withdrawal:
flu symptoms

chapped lips

wired feeling - physical feeling of anxiety 

extreme fatigue

extreme hunger cues

food doesn't taste good/insatiable mind

extreme thirst

stomach capacity issues/gastroparesis

depression

blood sugar problems

suicidal *

sibo/leaky gut

nutrient malabsorption *

food intolerances (dairy, gluten, almonds, fructose, etc.)

pssd

hard to concentrate/think clearly

anhedonia *

depersonalization

neuro-emotions *

headaches

hypercortisolism

     muscle pain *

     weight gain - buffalo hump, mid section, face

     increased hair growth *

     stretch marks

dizzy/drunkenness *

"pins and needles"/burning bones *

worse body odor

rashes *

ptosis

 

It's still hard to believe (as in part of me is waiting for the other shoe to drop, so to speak), but it seems like I'm actually getting there - most of my really bad withdrawal/med effects are gone. I'm still pretty messed up in the head from all this - I have admittedly been too self-indulgently angry (although the pssd really screws with me), and all my relationships are severely strained or have been destroyed.

 

I'm still existentially tired and trying to claw myself back into a life. I'm tired of being angry, and tired of being tired. I realize I'm doing better than many here (and compared to myself just a year ago), but gratitude and grace still escape me. I don't really know how to connect with anyone anymore. I guess this is what I'll have to work on for the next couple years in order to "return" to how I was before all this.

 

Best of luck to anyone on their own med/withdrawal journey.

[Altostrata]

Thanks for updating, rh. Recovery is slow and frustrating, no doubt about it, but you are seeing improvement.

 

Please let us know how you're doing.

[FarmGirlWorks]

On 12/3/2018 at 11:25 AM, rowinghippy said:

I don't really know how to connect with anyone anymore. I guess this is what I'll have to work on for the next couple years in order to "return" to how I was before all this.

Hey thanks for saying this. Even light small talk feels like it's of heavy import where you have to choose each word very carefully and it still comes out like a failed improv routine or, worse, like desperate babble. Glad you are seeing improvement. Me too, it is just mind-numbingly slow, especially the mental symptoms. Keep on truckin'. (See? I at first typed "keep on turducken'" which is kinda funny but makes absolutely no sense 🙂

[rowinghippy]

2.5 years into withdrawal, nearly 3 years total of bad ssri related stuff. Doing better than I expected when I was at my worst. Hormones are probably still a bit off, and the diet is still finicky (as are my vitamin levels/cholesterol/etc.). Two main issues are the never ending fatigue (and sleep problems) and pssd (the rest is just the new normal, honestly). The latter scares me still, but I try to put off thinking about it in light of all I've lost and regained in 2.5 years (although the notoriety around pssd's persistence is still worrying deep down). Fatigue is frustrating, and my weight loss has stalled because of it, but so it goes.

 

I'm not a positive person by any means, but I have found a level of acceptance and peace with things now. It doesn't hurt that I'm not in daily hell - I still admire those here who could find some acceptance when they were worse than where I am now.

 

I'm just exhausted and unsure about who I am/how I fit into the world and with others, given everything that's happened over these past few years. But I guess I'm getting there. I'm trying not to define myself by withdrawal anymore - it's ironic albeit not surprising that withdrawal itself became an emotional crutch when my previous identity was shattered.

 

In my worst I couldn't imagine why people wouldn't come back to write their success stories, but I think I can see why, now. I still will, eventually, even if I never make a "full" recovery, just as a promise to my old self.

 

Thanks for checking in Alto, and thanks for the smile FGW.

[rowinghippy]

Things had actually gotten somewhat decent by May. My weight was stable, and I was slowly getting physically stronger and doing body re-composition. I was doing well in school and started dating a wonderful girl. Sleep had improved to the point where I could get 8 hours sometimes. Diet was still finicky - due to my history with eating disorders, the fact that I was eating an abnormal diet (albeit slowly expanding on what I did eat) meant I was in hindsight riding the fine line between restricting and not.

 

But my stress tolerance was lower than expected, and once I began my summer internship, my health began to decrease. Stress began some slow weight gain, and sleep got bad again. Diet was more of a standard American diet which probably didn't help, but I was in the Midwest and options aren't as good as Colorado. Stress led to undereating too. By July 4, my body/brain broke - the extreme hunger cues returned, and have been around since then. It's hard to say how much of it is physiological vs psychological (anxiety vs a need to make up for the restriction). Regardless, my sleep is very bad (3 hours a night max), my cortisol has been jacked again, leading to rapid weight gain (30 lbs since June, mostly in the past 6 weeks). Seems like history is repeating itself, with the insatiable hunger and weight gain and general malaise that accompanies it. Again, it's hard to tell how much is anxiety related (and the eating disorder resurfacing), but I'm kind of at a loss of what to do; the hunger feels real, despite the fact that I am indeed overeating. It feels like all the hard work I've done has been lost so quickly, and I'm really afraid it will continue to decline. Due to the level of stress right now I'm not sure keto will work - even if it were to, it would be a really rough transition. But I may reach the point where I don't have a choice.

 

Going to be part time student this fall. Hope that I can get a handle on this before spring because I need to be full time then to graduate..

 

I don't know if this is even strictly withdrawal anymore - beyond the fact that the WD nuked my body's ability to be resilient and this is just dealing with the aftermath. God I'm tired of this. Someone here once said once sleep gets normal, you're in the home stretch. That's kind of how I felt in May, and I miss that feeling of hope. I feel hopeless again. I'm scared for my health.

[Longroadhome]

On 8/22/2019 at 5:01 AM, rowinghippy said:

insatiable hunger and weight gain and general malaise that accompanies it. Again, it's hard to tell how much is anxiety related (and the eating disorder resurfacing), but I'm kind of at a loss of what to do; the hunger feels real, despite the fact that I am indeed overeating. It feels like all the hard

 

On 8/22/2019 at 5:01 AM, rowinghippy said:

Things had actually gotten somewhat decent by May. My weight was stable, and I was slowly getting physically stronger and doing body re-composition. I was doing well in school and started dating a wonderful girl. Sleep had improved to the point where I could get 8 hours sometimes. Diet was still finicky - due to my history with eating disorders, the fact that I was eating an abnormal diet (albeit slowly expanding on what I did eat) meant I was in hindsight riding the fine line between restricting and not.

 

But my stress tolerance was lower than expected, and once I began my summer internship, my health began to decrease. Stress began some slow weight gain, and sleep got bad again. Diet was more of a standard American diet which probably didn't help, but I was in the Midwest and options aren't as good as Colorado. Stress led to undereating too. By July 4, my body/brain broke - the extreme hunger cues returned, and have been around since then. It's hard to say how much of it is physiological vs psychological (anxiety vs a need to make up for the restriction). Regardless, my sleep is very bad (3 hours a night max), my cortisol has been jacked again, leading to rapid weight gain (30 lbs since June, mostly in the past 6 weeks). Seems like history is repeating itself, with the insatiable hunger and weight gain and general malaise that accompanies it. Again, it's hard to tell how much is anxiety related (and the eating disorder resurfacing), but I'm kind of at a loss of what to do; the hunger feels real, despite the fact that I am indeed overeating. It feels like all the hard work I've done has been lost so quickly, and I'm really afraid it will continue to decline. Due to the level of stress right now I'm not sure keto will work - even if it were to, it would be a really rough transition. But I may reach the point where I don't have a choice.

 

Going to be part time student this fall. Hope that I can get a handle on this before spring because I need to be full time then to graduate..

 

I don't know if this is even strictly withdrawal anymore - beyond the fact that the WD nuked my body's ability to be resilient and this is just dealing with the aftermath. God I'm tired of this. Someone here once said once sleep gets normal, you're in the home stretch. That's kind of how I felt in May, and I miss that feeling of hope. I feel hopeless again. I'm scared for my health.

How are you now Rowinghippy? 

[Altostrata]

@rowinghippy, how are you?

[rowinghippy]

@Longroadhome @Altostrata

 

Thanks for checking in.

 

Doing better than when I last posted. As I mentioned then, it's difficult to truly figure out what's aftermath of the citalopram vs. just my own issues (e.g. the history of eating disorder, which is definitely a large part of my personal journey, unfortunately). Some things are obvious; like my restricted ability to absorb certain vitamins/minerals (which never occurred in blood work pre-citalopram). Others I see as likely, like my hypothyroidism that I picked up during withdrawal. I've discovered in the past year that I have trauma from withdrawal as well, which I only recently realized how significant it has been on my mental state. I always considered my withdrawal physical-centric, but I realize this is not entirely true.

 

Due to my devolving mental state when I last posted, I went on vyvanse/abilify/tenex, which helped. I went off them without issue and am currently on wellbutrin, which I imagine I will stay on until later this year once I graduate, move, and get situated in a new life. I'm not thrilled about meds since I obviously know the risks, but they have helped so for now I have accepted it. Having a more positive experience with antidepressants has, at least, helped me get over some of the intense anger I used to feel (assuming wellbutrin doesn't give me hell/other long lasting issues).

 

Since 2016 my gut has gone up and down, but it is probably the best it has been since before then. It is not 100% what it was pre-citalopram, and I doubt it ever will be, but I count it as a major success given how hard I worked to heal it. I can eat a more or less "normal" diet now.

 

Hormones will probably never be what it was pre-meds (besides the thyroid issues, I have dealt with low T during this whole experience), which may be reflected by my heavier set point, acne (never an issue before), lower stress tolerance, etc. My sexual function has never been 100% either.

 

Writing this out and reflecting on where I still currently am (mentally, physically), I realize I'm still not "great". But, I'm finally finishing college (after 7 years), have some leads on a career I find fulfilling, and have the energy to do some of the physical activities I used to do before all this (with a small number of people I enjoy).

 

Back then I never understood why people didn't come back here to write their success story more often, but I think I can understand it now. While I don't actively think of withdrawal anymore, I am still rebuilding my life and mental state from the cascade of events that it set off. I still plan, some day, to come back and share when I feel more fully recovered from all this.

 

I hope you all are well.

[Altostrata]

Thank you. I do hope to see your Success Story in the not-too-distant future.

[Pepms]

Hi @rowinghippy it’s been a long time since your last update, how have you been doing ?