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quads: tapering off citalopram


quads

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Hi there, I'm a 29 year old male from the UK and I'm really glad to have found this site.

 

I've been taking 40mg citalopram for 8 years (since i was 21) for depression since my early teenage years (14 years old).

I've considered reducing my dosage for a long time with the goal of coming off and finally took the plunge and yesterday saw a doctor about it. His advice didn't seem particularly good and I've spent the past 16 or so hours reading as much as possible on tapering off citalopram which has led me to this site.

Reading about it makes me feel incredibly nervous but I feel like I'm ready as I haven't experienced depression in a long time and am in a good place in my life. My biggest worry about tapering off the citalopram is not so much the withdrawal effects as I'm coming off - but getting it wrong and having persisting/returning depressive symptoms after tapering off and finding the past 8 years of recovery going up in smoke. I'm determined to do this right. I accept the possibility that maybe I'll need to remain on a maintenance dose for the rest of my life, but if that is the case I don't want it to be because I screwed up the tapering process.

 

I was optimistic in seeing the doctor that I'd get the support I need to make the right decisions and do this the right way, but my meeting with him didn't go well. Despite my high dose and fairly long term use he suggested dropping to 30mg for a week, then 20mg for a week, then 10mg for a week and then stopping altogether, 40mg - 0 in one month. Based on everything I've read this sounds like a recipe for disaster. I said this sounded very fast and he told me another option was to drop 10mg at a time and stay at the new dose for a few weeks to see how I get on - so now I have a repeat prescription for 30mg which I started yesterday. Based on what I'm reading it sounds like I should take this dosage for at least 2 months. If the drop to 30mg goes well after 2 months or so I may try and see a different doctor who will hopefully be more helpful. I was told I can only drop down in 10mg increments and 10mg is the lowest available dose, but now I'm reading about people cutting their 10mg in half and I was very interested to read about the liquid solution. I'm not sure if these are available in the UK but if I see another doctor I will enquire, though I'm more interested in that for the drop from 20mg to 10mg to 0 which sounds like where it gets tricky. 

 

I'm just starting to read all the different information on this site and will spend some time today going through as much as I can but was wondering if the drop from 40mg to 30mg is too much to start? I was hoping that this drop off wouldn't be too bad to start with and once I'm stable on 30mg I can speak to a different doctor about a slower taper rather than dropping from 30-20mg in one go. I feel like I'm caught between a rock and a hard place since doctors seem to absolutely hate any sort of 'self-medication' or people doing things their own way, yet this way seems significantly safer and healthier for both my short and long term health than what's been suggested to me and the limitations that the NHS allegedly puts on the tapering process (no doses smaller than 10mg etc). It's also complicated by the fact that I rely on the NHS and doctors to prescribe me any drugs at all. 

 

I look forward to hearing any advice and thank you in advance.

 

QUAD

Edited by scallywag
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Tapering off Citalopram

January 2009 - 29th March 2017: 40mg Citalopram 

30th March 2017 - 1st November 2017: 30mg Citalopram

1st November 2017 - 1st September 2019: 20mg Citalopram tablet

2nd September - 7th October: Transition to dissolving 20mg Citalopram in liquid

7th October - 4th November: 19.5mg--->19mg--->18.5mg--->18mg

4th November 2nd December- 17.55mg--->17.1mg--->16.65mg--->16.2mg

Other drugs: 15mg lansoprazole daily,  Dymista nasal spray twice daily

Supplements: 2x omega 3 fish oils per day, 2x200mg magnesium citrates per day

 

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  • Moderator Emeritus

Hi quads, and welcome to SA.

 

I am really pleased that you realised that the doctor's suggestion was too fast and decided to do your own research.

 

SA recommends a "harm" (ie withdrawal symptom) minimisation approach to taper by no more than 10% of the previous dose followed by about a 4 week hold to allow the brain to adapt to not getting as much of the drug.

 

You have a couple of options:

 

1.  Stay at 30mg and see what happens.  However, if you find that you start experiencing withdrawal symptoms it is suggested that you reinstate (in your case, updose) to bring the withdrawal symptoms to a bearable level.  The sooner this is done, the better chance that it will work.  It will depend how long it is before you reinstate (if needed) what dose you would take.  Please read the link below.

 

2.  Because you have only been on 30mg for 1 day, start taking 36mg which would be a 10% drop as recommended by SA (40mg x 0.9)

 

If it were me, I would go with option #2.

 

Please check out the following links:

 

Before you begin tapering what you need to know


About reinstating and stabilizing to reduce withdrawal symptoms
 

Why taper by 10% of my dosage?


Dr Joseph Glenmullen's WD Symptoms Checklist

 

Tips for tapering off Celexa (citalopram)

 

Making a citalopram solution yourself

 

How do you talk to a doctor about tapering and withdrawal?


What should I expect from my doctor about withdrawal symptoms?

 

These helped me to understand SA's recommendations:

 

Brain Remodelling


Video:  Healing From Antidepressants - Patterns of Recovery

 

This is your own Intro topic where you can ask questions and journal your progress.

Please DO NOT TAG me - thank you

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • 1 month later...

Hi quad,

 

Welcome to the forums. How is your taper going?

 

Tikki

Celexa (Citalopram)    40mg  - 60mg - 40mg for 7 years          Tapered (over 3 months) drug-free Aug–Nov 2013 CRASH

40mg    Dec 2013 – Jan 2017 (7 weeks reinstatement hell then relief)

2017:    20mg    30 Jan       18mg   19 April          16mg   6 May          14mg   20 May      12mg  10 Jun

              10mg   7 July          9mg    7 Aug               8mg     16 Oct          7.5mg  27 Nov         

2018:    7mg      8 Jan          6.5mg  12 Feb          6mg  17 Mar            5.2mg  14 Apr      5mg  28 Apr

             4.8mg  4 Jun           4.6mg   23 Jun         4.4mg   24 Jul          4.2mg 13 Aug      4mg  20 Aug

             3.8mg  1 Sep           3.6mg  28 Sep          3.4mg  14 Oct          3.2mg  11 Nov     3mg  5 Dec

             5mg    26 Dec          10mg  28 Dec

Added Valdoxan 25mg   12 Dec 2018      stopped 24 Jan 2019

Wellbutrin 150mg     25 Jan

 

 

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  • 1 year later...

Hi folks

Thank you for you replies.

Sorry I haven't replied in so long - I kind of just forgot about this forum but I'm reconsidering things again. I just got so worried reading all the horror stories of the withdrawal symptoms and the logistics of tapering off properly that I kind of put it on the back burner.

With that said I did manage to 1/2 my dose from 40mg to 20mg in the past 18 months so that's great. I went from 40 to 30mg which I know is a bit of a big drop, but I did that for 6/7 months and I didn't experience any side effects. I then made another fairly large jump from 30mg to 20mg and have been on that dose for a year now - I think November 2017 was when I started taking only 20mg. I didn't get any side effects from that either, though I did notice that nowadays if i ever miss a dose for some reason the withdrawal affects come on much more quickly than they did when I forgot a dose when I was on 30mg and 40mg.

 

I missed a dose 2 weekends ago for the first time in many, many months and since then I've had a bit of an issue with restless legs. I always took my tablet at night and it was worse then and affecting me sleeping, so this morning I took my tablet early in the day instead of at night time and I had restless legs pretty bad again, but it eased off throughout the day, so it seems to be a response to me taking my medication. It's a little weird as I've experience restless legs a little over the years but now it's quite consistent. This is what's motivating me to try to properly reduce my citalopram dose again for the first time in a year.  Well, it's always been on the back of my mind if I signed up on this forum 19 months ago.

 

I've read a ton of the links Chessie Cat linked (thanks for that!) and I'll finish the rest and see where to go from here. Ideally I could go to the GP and talk to them and get good advice but I find that extremely unlikely. I'll probably give it a try anyway and if it doesn't go well then I'll look seriously at the links on here about making your own liquid solution (though initial thoughts imagine some breaking bad style chemistry and me making a mess of it and damaging my health). I think I read it's 2mg citalopram per drop of the liquid stuff, so a nice starting point would be 1x10mg tablet and a 4 drops equivalent of 2mg each straight from the GP, but as I'm in the UK I don't know how feasible that is. I'll look on some of the other subsections on the forum and see what I can find.

 

Anyway, just rambling, thanks again for the 2 replies above, anyone who wants to chime in feel free to do so (though I'm aware it was a little silly of me to drop 40-->30 and 30--->20 and I won't make those size drops going forward) and I'll try and keep you all posted on what I decide to do

Peaaaace

Tapering off Citalopram

January 2009 - 29th March 2017: 40mg Citalopram 

30th March 2017 - 1st November 2017: 30mg Citalopram

1st November 2017 - 1st September 2019: 20mg Citalopram tablet

2nd September - 7th October: Transition to dissolving 20mg Citalopram in liquid

7th October - 4th November: 19.5mg--->19mg--->18.5mg--->18mg

4th November 2nd December- 17.55mg--->17.1mg--->16.65mg--->16.2mg

Other drugs: 15mg lansoprazole daily,  Dymista nasal spray twice daily

Supplements: 2x omega 3 fish oils per day, 2x200mg magnesium citrates per day

 

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Right I've been doing all kinds of searches and bookmarking all sorts of articles and other peoples blogs and such. It seems that Magnesium Citrate can be useful for people struggling with RLS so I just bought a ton and hopefully that can at least alleviate those symptoms. It wasn't as bad last night but still kind of annoying. My sleep patterns and routine are the best they've ever been and I'm going to bed extremely tired but still finding it hard to fall asleep recently cause of the restless legs.

 

Still haven't made any decisions regarding what I'll do about my dosing. I saw that stuff on microdosing which sounded interesting, but I suppose if I've dropped from 40 to 30 and 30 to 20 seemingly without withdrawal symptoms maybe I'm not quite to sensitive as others might be and I can just start out with standard 10% taper and take it slow. Magnesium Citrate won't be here until the 19th unfortunately but I might see if I can pick some up locally. 

 

Just read an interesting article on RLS and magnesium: https://www.healthline.com/health/restless-leg-syndrome/link-between-magnesium-and-rls#alternative-remedies-for-rls

 

It sounds like I'm ok to try it, the tablets I have 200mg, so I'll start with that one a day and see how I get on. I already have a regular sleep routine, meditate 20 minutes a day, do 20k steps a day on my fitbit and avoid caffeine after about 4pm (though I really don't want to cut it out altogether). I don't really want to have to run a bath every night and can't afford too many massages, though I have considered the idea of going once a month or once a fortnight as a treat seeing as I cut out a lot of other things like junk food, drugs/drinking etc 

Tapering off Citalopram

January 2009 - 29th March 2017: 40mg Citalopram 

30th March 2017 - 1st November 2017: 30mg Citalopram

1st November 2017 - 1st September 2019: 20mg Citalopram tablet

2nd September - 7th October: Transition to dissolving 20mg Citalopram in liquid

7th October - 4th November: 19.5mg--->19mg--->18.5mg--->18mg

4th November 2nd December- 17.55mg--->17.1mg--->16.65mg--->16.2mg

Other drugs: 15mg lansoprazole daily,  Dymista nasal spray twice daily

Supplements: 2x omega 3 fish oils per day, 2x200mg magnesium citrates per day

 

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  • Moderator Emeritus

Magnesium may work better taken throughout the day.    Magnesium

 

Non-drug treatments for restless legs

 

2 hours ago, quads said:

if I've dropped from 40 to 30 and 30 to 20 seemingly without withdrawal symptoms maybe I'm not quite to sensitive as others might be and I can just start out with standard 10% taper and take it slow.

 

Even when reducing by SA's recommended no more than 10% of current dose with a 4 week hold, many members find that the lower their dose gets the slower they need to go, either by reducing less and/or holding for longer.

 

It sounds like withdrawal symptoms may be starting to appear.  This means you have reduced too much.  Because you have reduced by 33% it would be a good idea to do a long hold of 3-4 months before commencing a 10% taper.  This will give your brain a chance to catch up to the large reduction you made.  It would be better to hold now than to continue tapering and run into bigger problems further along in your taper.

 

The other option is to make an updose, eg increase to 25mg.

Please DO NOT TAG me - thank you

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Hi ChessieCat, thanks for replying again. I see you on every thread I seem to look at so massive respect for the effort you put into helping people on this forum.

 

Just to clarify I've been on 20mg for just about 1 year now. Do you still think these are delayed withdrawal symptoms and I should continue to hold this dose another few months, or did you misread and think I only recently dropped? The only withdrawal symptom I've experienced is the increase in restless leg, which started about 10 days ago to 2 weeks ago after I accidentally skipped my dose for the first time in many, many, many months. I still haven't got round to reading much on the delayed withdrawal symptoms both while tapering and once tapering is completed so I'm not really sure on this stuff. It's pretty fascinating though, I'll get round to it soon.

 

I don't think I can really updose at this point as I only get 20mg tablets so trying to go into the GP to get prescribed more because I want to updose because of advice I'm getting online probably wouldn't go down well, as you can imagine. I also doubt it's really required as symptoms are quite mild, hopefully the magnesium citrate helps a little. 

 

In fact I slept better last night, when I got into bed I had an itching on my hip which I wasn't sure if it was something do to with restless leg or just itchy :D It wasn't so irritating that I needed to scratch it though. I also had very minor feelings in my legs compared to previous nights, I basically just needed to slowly wiggle my toes a little to alleviate it. Hopefully it starts to subside more going forward...

Tapering off Citalopram

January 2009 - 29th March 2017: 40mg Citalopram 

30th March 2017 - 1st November 2017: 30mg Citalopram

1st November 2017 - 1st September 2019: 20mg Citalopram tablet

2nd September - 7th October: Transition to dissolving 20mg Citalopram in liquid

7th October - 4th November: 19.5mg--->19mg--->18.5mg--->18mg

4th November 2nd December- 17.55mg--->17.1mg--->16.65mg--->16.2mg

Other drugs: 15mg lansoprazole daily,  Dymista nasal spray twice daily

Supplements: 2x omega 3 fish oils per day, 2x200mg magnesium citrates per day

 

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  • Moderator Emeritus
11 hours ago, quads said:

Just to clarify I've been on 20mg for just about 1 year now. ... or did you misread and think I only recently dropped?

 

Thank you for clarifying.  Yes, I did misread and thought you had dropped recently.  So, no, I don't think updosing is a good idea.

 

11 hours ago, quads said:

The only withdrawal symptom I've experienced is the increase in restless leg, which started about 10 days ago to 2 weeks ago after I accidentally skipped my dose for the first time in many, many, many months.

 

So you missed a dose 14 days ago and 10 days ago the RLS started?  If that was the only thing that changed then it seems likely to be the cause.  It's interesting too because it takes about 4 days for a dose change to get to full level in the blood and a bit longer for it to register in the brain.  It would seem that the missed dose has caused a small "hiccup".

 

The best option is probably to hold.  And if you slept better last night that is a good sign.  It seems like things might be improving, even if only slowly.

 

It would be a good idea to keep notes on paper so that you can assess whether things are improving.  Rating your symptoms might be helpful.

 

This is SA's topic:  Magnesium

 

One thing you might want to consider when you start tapering is to go very slowly.  If your RLS happened because of 1 missed tablet, I think a cautious taper would be the way to go.  Check out:  the-brassmonkey-slide-method-of-micro-tapering

 

Please DO NOT TAG me - thank you

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • 9 months later...

Hi everyone.

 

I'm back and ready to continue on the next stage of my antidepressant journey. My next goal is to reduce my dose from 20mg to 10mg, and possibly take a long pause at this dose for 6 months, or if my reduction is going well keep continuing down to zero.

As an update from my last time here, I got the magnesium citrate and I take 400mg a day. I haven't really experienced many issues regarding RLS since, though I do occasionally get it from time to time it's not a major issue. 

I've done a ton of reading on the suggested links and articles on this website and I feel I'm mostly ready to begin the taper though I had a few questions first which I couldn't find answers to. For the record I've decided to go with the brass monkey slide method of tapering from 20mg to 19.5mg, to 19mg, to 18.5mg to 18mg and holddddddddd before starting reducing again at 17.55mg. I'm planning on dissolving my 20mg table in a measuring cylinder of liquid and using a syringe to remove the appropriate amount of liquid according to my tapering needs. 

Here are my questions (I thought I'd ask here first before posting elsewhere on forum as people are usually excellent with responding)

 

1. Does the volume of liquid you dissolve your tablet in matter? I see a few people using 20ml for a tablet with 20mg active ingredient, would me using 40ml liquid matter? I have no real reason for preferring 40ml to 20ml except possible increased accuracy so will do whatever is recommended.

2. When withdrawing volumes of liquid to get the required dose, is the tablet really distributed equally across the liquid so that you're always getting the right amount of active ingredient? (I'm basically wondering how/why it doesn't just sink to the bottom)

3. I read that transitioning from tablet to liquid even on the same dose can be a shock to the system. Should I do a month of my usual 20mg dissolved in water before starting to taper?  and

     b/ if I do this can I just dissolve the whole 20mg tablet and drink the solution, or would it be smoother to try and cut the 20mg in half, eat 10mg and then dissolve the other 10mg or does it not matter?

 

Whatever it takes to minimise the risk of withdrawal symptoms. Thank you all so much for your replies so far and the great work you do for this community.

Tapering off Citalopram

January 2009 - 29th March 2017: 40mg Citalopram 

30th March 2017 - 1st November 2017: 30mg Citalopram

1st November 2017 - 1st September 2019: 20mg Citalopram tablet

2nd September - 7th October: Transition to dissolving 20mg Citalopram in liquid

7th October - 4th November: 19.5mg--->19mg--->18.5mg--->18mg

4th November 2nd December- 17.55mg--->17.1mg--->16.65mg--->16.2mg

Other drugs: 15mg lansoprazole daily,  Dymista nasal spray twice daily

Supplements: 2x omega 3 fish oils per day, 2x200mg magnesium citrates per day

 

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  • Moderator Emeritus

It's best to do a cross over when changing form of a drug.  We generally suggest doing the following combinations for 3-7 days without making a reduction:  3/4 + 1/4, 1/2 + 1/2, 1/4 + 3/4.

 

No it doesn't matter what amount of water you use to make the liquid.  But you do need to understand the math of it.  Putting a 10mg tablet in 10mL of water means that each 1mL of solution = 1mg drug.  Putting a 10mg in 20mL of water will mean that the ratio will change so 2mL of solution = 1mg drug.

 

 

Tips for tapering off Celexa (citalopram)

 

On 5/2/2011 at 1:00 PM, Rhiannon said:

Originally, Rhiannon was using a small amount of ethanol to dissolve her Celexa. She later changed her method and was successfully dissolving her tablet in water only. 

 

Check the posts made by Rhiannon in this topic (she tapered Celexa): 

 

how-to-make-a-liquid-from-tablets-or-capsules

 

 

It's important to make sure that you do everything the same way each time.  Always use the same equipment and same method to measure everything.  Even use the same area on the bench or table to measure the liquid because different areas can have a different slope.

 

It might also be helpful to write down your "recipe" (equipment, quantities, method) so that if you have a brain freeze, which even "regular" people have sometimes, you will have the recipe to look at.

 

Please DO NOT TAG me - thank you

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Thanks for the tips ChessieCat
Yeah I've read that thread fairly thoroughly and just started the process today. I'm only doing a single cut as I think 2 cuts would make the pill fracture too much but I have a good marker on the tablet that I used and have cut approx 1/4 to 1/3 off each tablet for the next week. I just took my first 3/4 tablet and 1/4 is dissolving now in 20ml water so I'll see how I get on. It's been 10 minutes and it's kind of just sunk to the bottom of the container and dissolved a bit but I'll give it another 20 minutes and check it then. 

Looking forward to seeing how all this works out, it's nice to feel like I'm working towards something which will hopefully give me a better future. 

Tapering off Citalopram

January 2009 - 29th March 2017: 40mg Citalopram 

30th March 2017 - 1st November 2017: 30mg Citalopram

1st November 2017 - 1st September 2019: 20mg Citalopram tablet

2nd September - 7th October: Transition to dissolving 20mg Citalopram in liquid

7th October - 4th November: 19.5mg--->19mg--->18.5mg--->18mg

4th November 2nd December- 17.55mg--->17.1mg--->16.65mg--->16.2mg

Other drugs: 15mg lansoprazole daily,  Dymista nasal spray twice daily

Supplements: 2x omega 3 fish oils per day, 2x200mg magnesium citrates per day

 

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Ok so I just took my first liquid dose.

After about 30 minutes it didn't look much different to how it did after 5/10 minutes, it sunk to the bottom and sorta dissolved in a pile. I gave it a good stir and it was pretty well broken up at that point though I did notice there was a small amount looked to be settling near the bottom. 

I think I'll buy a bottle of distilled water and keep it at room temperature as today I just used water straight from the tap which was quite cold so probably didn't dilute as effectively as it might have done. 

 

Tapering off Citalopram

January 2009 - 29th March 2017: 40mg Citalopram 

30th March 2017 - 1st November 2017: 30mg Citalopram

1st November 2017 - 1st September 2019: 20mg Citalopram tablet

2nd September - 7th October: Transition to dissolving 20mg Citalopram in liquid

7th October - 4th November: 19.5mg--->19mg--->18.5mg--->18mg

4th November 2nd December- 17.55mg--->17.1mg--->16.65mg--->16.2mg

Other drugs: 15mg lansoprazole daily,  Dymista nasal spray twice daily

Supplements: 2x omega 3 fish oils per day, 2x200mg magnesium citrates per day

 

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Hello

I'd decided I wanted to be extra cautious and go with the Brassmonkey slide taper from the start - but starting at a dose of 20mg citalopram I'm projecting ahead and I'm in 2024 and still on a dose of 0.414mg.

I previously went from 40mg to 30mg, held for a year, 30mg to 20mg and have held for a year without problems, so I think while I'm still on a highish dose I'd be better off just following a standard 10% protocol and if i feel it's too fast I can then switch to the brassmonkey slide - or alternatively switch to the brassmonkey slide when I get to significantly lower dosages. 

If I'm going to start following a 10% taper could I still do it in 2.5% reductions per week for 4 weeks as per the brassmonkey slide method, only without the regular 2 week holds at the end? Logically I don't see why not.

Thanks

Tapering off Citalopram

January 2009 - 29th March 2017: 40mg Citalopram 

30th March 2017 - 1st November 2017: 30mg Citalopram

1st November 2017 - 1st September 2019: 20mg Citalopram tablet

2nd September - 7th October: Transition to dissolving 20mg Citalopram in liquid

7th October - 4th November: 19.5mg--->19mg--->18.5mg--->18mg

4th November 2nd December- 17.55mg--->17.1mg--->16.65mg--->16.2mg

Other drugs: 15mg lansoprazole daily,  Dymista nasal spray twice daily

Supplements: 2x omega 3 fish oils per day, 2x200mg magnesium citrates per day

 

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  • Moderator Emeritus
14 minutes ago, quads said:

could I still do it in 2.5% reductions per week for 4 weeks as per the brassmonkey slide method, only without the regular 2 week holds at the end?

 

Yes you could try doing it that way.  But you will still need to listen to your body/symptoms and hold if you start feeling withdrawal symptoms and/or during times of sickness/extra stress.

Please DO NOT TAG me - thank you

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Ok, thanks ChessieCat, I'll follow that method but like you say I will pay close to attention to how I feel and be prepared to adjust if required.

I'm working on a spreadsheet of dose reductions and I'm way into the future now at sub 1mg doses and I'm wondering to what accuracy I should be aiming for (assuming I'm on a liquid celexa solution at this point dissolved in a suspension to enable accurate dosing)

For instance at 0.35mg my next 2.5% reduction would be reduction of 0.00875. Up to this point I've been rounding to 3 decimal places, as I get closer to zero should I be looking to extend this to 4 decimal places to go 0.0088 instead of 0.009 or is that practically not possible?

I'll obviously continue to do my own research through other peoples blogs etc and further research on microdosing but I'm just putting forward my thoughts in this topic and maybe someone will offer suggestions and advice.

 

As for the transition to liquid - so far nothing to report, I've done 1 week now of 3/4 tablet, 1/4 tablet dissolved in water, and tonight I have my first dose of 1/2 tablet, 1/2 tablet dissolved in water. No changes to report, feeling good.

Tapering off Citalopram

January 2009 - 29th March 2017: 40mg Citalopram 

30th March 2017 - 1st November 2017: 30mg Citalopram

1st November 2017 - 1st September 2019: 20mg Citalopram tablet

2nd September - 7th October: Transition to dissolving 20mg Citalopram in liquid

7th October - 4th November: 19.5mg--->19mg--->18.5mg--->18mg

4th November 2nd December- 17.55mg--->17.1mg--->16.65mg--->16.2mg

Other drugs: 15mg lansoprazole daily,  Dymista nasal spray twice daily

Supplements: 2x omega 3 fish oils per day, 2x200mg magnesium citrates per day

 

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Having a mental block here. Dealing with a hypothetical of getting a liquid solution of 2mg per drop (don't see how else microdosing is possible with 10mg being the largest pill size) and assuming I can drop it into 10ml suspension that would be 0.2mg per 1ml suspension.

Looking at the 1ml syringe I can accurately get down to approx 0.01ml (though 0.05 is where I'd feel more comfortable in the accuracy) so 0.1ml would be 0.02mg and 0.05ml (the ideal maxmimum reduction) would be a 0.01mg.

So realistically I can suppose an accuracy to about 0.01mg citalopram using 10ml solution.

 

Though I could use 20ml solution for 2mg citalopram which would be 0.1mg per 1ml,  0.01mg per 0.1ml and thus 0.005mg per 0.05ml (the ideal maximum reduction)

So if I used 20ml solution per dose I could get down to a reasonable accuracy of 0.005mg. 

 

This means I could reduce down to 3 decimal points max and needing to round up/down from there

 

 

Tapering off Citalopram

January 2009 - 29th March 2017: 40mg Citalopram 

30th March 2017 - 1st November 2017: 30mg Citalopram

1st November 2017 - 1st September 2019: 20mg Citalopram tablet

2nd September - 7th October: Transition to dissolving 20mg Citalopram in liquid

7th October - 4th November: 19.5mg--->19mg--->18.5mg--->18mg

4th November 2nd December- 17.55mg--->17.1mg--->16.65mg--->16.2mg

Other drugs: 15mg lansoprazole daily,  Dymista nasal spray twice daily

Supplements: 2x omega 3 fish oils per day, 2x200mg magnesium citrates per day

 

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  • Moderator Emeritus

Diluting with more water means that you can measure with better accuracy.

 

It is possible to get 0.5mL syringes.  A vet might sell you some.

 

Remember to always use the same equipment and method each time.  Even using the same area of a bench or table.  I suggest that you write yourself a "recipe" so that you can refer back to if needed.  Everybody, even "regular people" have mental blanks at times.

 

You can see by the different ratios of tablet to water that the more water you use the easier it is to measure.

 

Examples:  10mg tablet in:    10mL, 20mL, 50mL, 100mL

 

I'm a visual person and I like to do the calculations step by step, and you have this for later reference (however please double check my calculations).

 

You can use the ratio to calculate the amount of solution to measure for your dose.  I've used 0.375mg dose in these examples.

 

 

10mg : 10mL

divide both sides by 10

1mg : 1mL

 

multiply both sides by 0.375mg

 

0.375mg : 0.375mL

 

          OR

 

10mg : 20mL

divide both sides by 10

1mg : 2mL

 

multiply both sides by 0.375mg

 

0.375mg : 0.75mL

 

          OR

 

10mg : 50mL

divide both sides by 10

1mg : 5mL

 

multiply both sides by 0.375mg

 

0.375mg : 1.875mL

 

          OR

 

10mg : 100mL

divide both sides by 10

1mg : 10mL

 

multiply both sides by 0.375mg

 

0.375mg : 3.75mL

 

 

Please DO NOT TAG me - thank you

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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That's all so helpful, thank you very much.

 

For now I'm just dissolving in water, however I remember reading somewhere on here about people who buy a liquid suspension like you get at a chemist as it's slightly more reliable. Would this be more appropriate once I get into microdosing and want to ensure perfectly even distribution of my medication throughout the liquid I'm dissolving it in? I looked about but couldn't find the thread/topic with the name of the topic. I'm thinking for when I'm down to hundreds/thousands of a milligram differences in dosages. 

 

Again getting ahead of myself but I like to plan ahead and be as informed as possible as to how my taper will look in the future.

 

First dose of 1/2 tablet, 1/2 tablet dissolved in liquid. Was a lot more cloudy than the 1/4 tablet mixed in liquid and much more like what I was expecting. Still no issues whatsoever with the transition to liquid.

Tapering off Citalopram

January 2009 - 29th March 2017: 40mg Citalopram 

30th March 2017 - 1st November 2017: 30mg Citalopram

1st November 2017 - 1st September 2019: 20mg Citalopram tablet

2nd September - 7th October: Transition to dissolving 20mg Citalopram in liquid

7th October - 4th November: 19.5mg--->19mg--->18.5mg--->18mg

4th November 2nd December- 17.55mg--->17.1mg--->16.65mg--->16.2mg

Other drugs: 15mg lansoprazole daily,  Dymista nasal spray twice daily

Supplements: 2x omega 3 fish oils per day, 2x200mg magnesium citrates per day

 

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  • Moderator

The liquid suspension material is called "OraPlus" and can be purchased on line.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Final Dose 0.016mg.     Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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  • Moderator Emeritus
5 hours ago, ShiningLight said:

 

ShiningLight posted a link to the above calculator in another member's topic.  The following is an explanation of where you need to enter which numbers.

 

D(desired) Dose:

H(have) Dose:

Q(quantity)

____________________________

X(amount)= ? milliliter

 
If you put the quantities into the fields above the line then the X(amount) will tell you the amount of the solution you need to take for the dose.
 
So using the amounts:  wanting to take 0.125mg (125 micrograms), 5mg tablet, 100mL water = 2.5mL to take.

 

 

 

 

 

 

To make sure you have the correctly converted the dose to micrograms check the amount under step one which is just below the heading

 

Step By Step Solution:

Step 1: Convert input to common units.

D(desired) Dose  = 125 microgram = 0.125 milligram

 

Please DO NOT TAG me - thank you

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • 1 month later...

Hi everyone,

Just a quick update, I started my taper on the 7th October and have now went from 20mg to 19.5mg, 19mg, 18.5mg and 18mg. Today I reset my 2.5% reduction to 0.45mg a week and begin on 17.55mg. As mentioned above I'm on a mix between standard 10% a month reduction and brassmonkey's slide micro-reductions of 2.5% a week without the 2 week holding period (to start...I will add holding period if I feel I require it)

Personally I feel amazing about the reduction, while I'm projecting my taper to end some time in 2024 even without the 2 week holding period every 4 weeks, reducing my dose each week feels great, even if it is only 2.5%. Not a single hint of a withdrawal effect either (which I was quite optimistic of anyway given I'm still on a high dose)

So yeah I'm really happy so far, I don't mean it to sound as a brag or anything since I'm just at the start of my taper, but given how helpful and important I find this community to be I thought I'd post a little update. 

Best wishes to anyone reading

Tapering off Citalopram

January 2009 - 29th March 2017: 40mg Citalopram 

30th March 2017 - 1st November 2017: 30mg Citalopram

1st November 2017 - 1st September 2019: 20mg Citalopram tablet

2nd September - 7th October: Transition to dissolving 20mg Citalopram in liquid

7th October - 4th November: 19.5mg--->19mg--->18.5mg--->18mg

4th November 2nd December- 17.55mg--->17.1mg--->16.65mg--->16.2mg

Other drugs: 15mg lansoprazole daily,  Dymista nasal spray twice daily

Supplements: 2x omega 3 fish oils per day, 2x200mg magnesium citrates per day

 

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  • Moderator

Hi Quads-- it's great to hear that your taper is going so well.  I do, however, strongly suggest that you don't skip the two week hold periods.  They are very important.  After each reduction in dose there is a spike in symptoms, as you know.  Once that spike has settled out there are still unresolved symptoms in the background.  They aren't very strong but after a number of reductions they build up to the point that they cause a crash.  That crash can be a major setback. It will take many months to resolve and calm down before it is safe to taper again. Not to mention that it is very, very unpleasant to go through. The crash is always unexpected and can happen in a matter of hours.  A person will be feeling great and wham it all goes down the drain. In the long run it's actually quicker to do the holds than to try and skip them. They make the entire process a lot more comfortable too.

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Final Dose 0.016mg.     Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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Hi brassmonkey, it's nice to have to have you contributing and helping me with my taper, thanks for the feedback.

I mentioned a few posts back that I was planning on following your taper exactly but after projecting into the future decided I would prefer to follow a more standard 10%/month protocol to start with the option of moving to the slightly more conservative brassmonkey slide method if at any stage I felt I needed to withdraw more slowly or withdrawal symptoms became noticeable. 

I asked if instead of doing 10% over 4 weeks I could try a variation of the BM slide with 2.5% a week instead of the 10% block at once and ChessieCat said I could try it that way instead of the 10% at once but to be careful. I can see why reducing small doses every week might be a little rushed even if it's the same reduction total as you don't get the same stability.

Would you recommend if I didn't wish to do the full BM slide from the start I'd be better to do the 10%/month taper in once dose reduction instead of micro-reductions due to slightly more stability? 

 

Tapering off Citalopram

January 2009 - 29th March 2017: 40mg Citalopram 

30th March 2017 - 1st November 2017: 30mg Citalopram

1st November 2017 - 1st September 2019: 20mg Citalopram tablet

2nd September - 7th October: Transition to dissolving 20mg Citalopram in liquid

7th October - 4th November: 19.5mg--->19mg--->18.5mg--->18mg

4th November 2nd December- 17.55mg--->17.1mg--->16.65mg--->16.2mg

Other drugs: 15mg lansoprazole daily,  Dymista nasal spray twice daily

Supplements: 2x omega 3 fish oils per day, 2x200mg magnesium citrates per day

 

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  • Moderator

You could do 2.5% every week instead of just taking a 10% reduction and get similar results. But there are drawbacks to both methods.  If you do a straight 10% reduction there will be a very pronounced spike in symptoms several days to several weeks after the reduction.  Many people find this spike to be quite debilitating and can take much longer than a month to resolve and stabilize.  During that time many people find that coping with life's stress and their symptom load is a very taxing experience.

 

If a person does a continuous 2.5% reduction with no holds, the unresolved symptoms build up until there is a major crash.  That crash can be extremely unpleasant and debilitating and take a very long time to resolve to the point that one can continue their taper.

 

Starting a taper with a straight 10% reduction and then switching to the Brassmonkey Slide is a very viable way to taper.  But given the heavy symptom load that the 10% taper gives and the the possibility of a buildup of symptoms and crash of a continues 2.5% taper, it is far better to take the conservative approach right from the beginning.  In the long run it will be faster and far less painful.  The choice is up to you.

 

20 years on Paxil starting at 20mg and working up to 40mg. Sept 2011 started 10% every 6 weeks taper (2.5% every week for 4 weeks then hold for 2 additional weeks), currently at 7.9mg. Oct 2011 CTed 15oz vodka a night, to only drinking 2 beers most nights, totally sober Feb 2013.

Since I wrote this I have continued to decrease my dose by 10% every 6 weeks (2.5% every week for 4 weeks and then hold for an additional 2 weeks). I added in an extra 6 week hold when I hit 10mg to let things settle out even more. When I hit 3mgpw it became hard to split the drop into 4 parts so I switched to dropping 1mgpw (pill weight) every week for 3 weeks and then holding for another 3 weeks.  The 3 + 3 schedule turned out to be too harsh so I cut back to dropping 1mgpw every 4 weeks which is working better.

Final Dose 0.016mg.     Current dose 0.000mg 04-15-2017

 

"It's also important not to become angry, no matter how difficult life is, because you can loose all hope if you can't laugh at yourself and at life in general."  Stephen Hawking

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At this point I honestly feel like I probably will just go with the full slide method. For 3/4 nights now I've felt very slightly 'off' at night time. It's not bad in anyway, in fact its possibly even a nice spaced out stoned type feeling. It doesn't feel similar to when I missed a dose in the past, it's more of a sort of feeling when you drink too much coffee and are slightly over stimulated or something. It could be unrelated to my taper and could actually just be an over stimulation from coffee by the evening time after having a few cups during the day. It's also at times felt a little like when you haven't eaten for a few hours and your blood sugar feels a little low. Again...a sort of spaced out feeling. I also haven't experienced any restless leg type symptoms which was always the most prominent thing to occur when I missed a dose or 2 of my medication in the past. Also no brain zaps or anything unpleasant like that, no anxiety or nausea (though I felt a minor headache 2 nights and a sort of high blood pressure type, warm face feeling).

 

Either way I feel something and there's a chance it's related to my taper so I'm just going to play it safe and go with the slow slide. So far I've done 19.5mg, 19mg, 18.5mg and 18mg, which was where I should have done a 2 week hold. I didn't and have since done 17.55mg for a week and am now on 17.1mg so I'm not sure how to proceed. I think I want to do a hold on this dose for 3 weeks though my next scheduled hold had I held at 18mg would have been at 16.2mg.

 

My 2 main options seem to be (taking the week I'm currently in as week 1 - which started on 11/11/19)

 

Option 1

Week 1 17.1mg

Week 2 17.1mg (hold)

Week 3 17.1mg (hold)

Week 4 16.65mg

Week 5 16.2mg

Week 6 16.2mg (hold)

Week 7 16.2mg (hold) 

Week 8 15.8mg (new cycle, drop 0.4mg each time)

 

Option 2

Week 1 17.1mg 

Week 2 17.1mg (hold)

Week 3 17.1mg (hold)

Week 4 16.65mg

Week 5 16.2mg

Week 6 15.8mg (straight onto new cycle of 0.4mg drops for 4 weeks cause I just did a hold recently at 17.1mg)

Week 7 15.4mg 

Week 8 15mg

Week 9 14.6mg

Week 10 14.6mg (hold)

Week 11 14.6mg (hold)

 

I take it the conservative approach is always considered preferable and I should follow the first schedule rather than risk 6 straight drops in the second schedule. I want to realign myself with a taper from 20mg rather than reset from 17.1mg which is an awkward number and would require me redoing all my calculations.

Tapering off Citalopram

January 2009 - 29th March 2017: 40mg Citalopram 

30th March 2017 - 1st November 2017: 30mg Citalopram

1st November 2017 - 1st September 2019: 20mg Citalopram tablet

2nd September - 7th October: Transition to dissolving 20mg Citalopram in liquid

7th October - 4th November: 19.5mg--->19mg--->18.5mg--->18mg

4th November 2nd December- 17.55mg--->17.1mg--->16.65mg--->16.2mg

Other drugs: 15mg lansoprazole daily,  Dymista nasal spray twice daily

Supplements: 2x omega 3 fish oils per day, 2x200mg magnesium citrates per day

 

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  • 3 months later...

Hey quads, how's your taper going?

2005-2009 18mg concerta on and off

2009-2013 ritalin and buproprion on and off; 2010 nortryptyline, amitriptyline for accident pain; 2014 Apr - lamictal 2 weeks until hives

2016 Mar...Sep -  st. john's wort, rhodiola, other supplements tried

2016 Nov...2017 Mar - began & increased citalopram (4 months) up to 30mg (11months)

2018 Feb - began taper, ~2.5mg/month, cutting tablets (3 months)

2018 May - 20mg, tried ~17.5mg but symptoms too strong, held at 20 (11 months)

2018 Nov - tried bupropion again, stopped within a couple months

2019 Apr - began ~5%/month taper from 20mg using dissolve in water and measure with syringe method

2020 Jan - no lorazepam for 1year; 0.5mg lorazepam average 3x/month since began citalopram; at most 3x/week

2021 June - 10mg. Race like the tortoise.

 

external-content.duckduckgo.com.jpg

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  • 5 months later...

Hi @bunchesofoats

My taper is going really good so far, sorry for no updates but I'm on my old pc and noticed this in the bookmarks so thought I'd check in.

I'm at 10.2mg now and about to drop to 10mg so I need to book an appointment with the doctor to get a 10mg tablet instead of a 20mg, and I'll continue to dissolve in 20ml water.

I'm a bit behind the schedule I had set myself, but I'm not rushing and took a few extra weeks to stabilise at around 12-13mg because I was getting really bad restless legs. I think it might have been as I had ran out of magnesium citrate and didn't bother topping up my supply. Since I reinstated the magnesium citrate I've had no problems whatsoeve so I'm going to make sure I keep taking it throughout my taper.

 

How are you getting on? I see from your sig we're about the same dosage now! I'll take a pop into your thread, I hope things are going well for you and anyone else who happens to read this

Tapering off Citalopram

January 2009 - 29th March 2017: 40mg Citalopram 

30th March 2017 - 1st November 2017: 30mg Citalopram

1st November 2017 - 1st September 2019: 20mg Citalopram tablet

2nd September - 7th October: Transition to dissolving 20mg Citalopram in liquid

7th October - 4th November: 19.5mg--->19mg--->18.5mg--->18mg

4th November 2nd December- 17.55mg--->17.1mg--->16.65mg--->16.2mg

Other drugs: 15mg lansoprazole daily,  Dymista nasal spray twice daily

Supplements: 2x omega 3 fish oils per day, 2x200mg magnesium citrates per day

 

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  • Moderator Emeritus

Thanks for updating.  Please remember to update your drug signature too.  Thanks.

 

8 hours ago, quads said:

I'm a bit behind the schedule I had set myself, but I'm not rushing and took a few extra weeks to stabilise at around 12-13mg

 

That's the best way.

 

8 hours ago, quads said:

I was getting really bad restless legs. I think it might have been as I had ran out of magnesium citrate and didn't bother topping up my supply. Since I reinstated the magnesium citrate I've had no problems whatsoeve so I'm going to make sure I keep taking it throughout my taper.

 

It's good that you made the connection.  I've had several times when I've run out of magnesium and each time I've noticed an increase in anxiety and each time I've restarted it has improved.

Please DO NOT TAG me - thank you

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions. 

  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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