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TikkiTikki: Going slow off Celexa to avoid "relapse"

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TikkiTikki

Hi everyone,

 

I'm wanting advice on how to taper if my withdrawal symptoms are delayed - ie they occur several months after the taper is completely finished.

 

If I have no symptoms during taper, should I proceed to the 'Fast Taper' guidelines (4 weeks x2, then 3weeks x2, then 2 weeks x2, then weekly until done)?

 

In the past I have thought I was relapsing, and resumed the medication. Now I understand it was probably WD from too fast a taper (4 months).

 

Any thoughts?

 

Tikki Tikki

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ChessieCat

Welcome to SA.

 

Thank you for completing your drug signature.

 

SA recommends tapering at no more than 10% of the previous dose followed by a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.  I can see from your signature that you are tapering at a faster rate than we suggest.  If you are experiencing withdrawal symptoms it would be better to reduce the % you taper by.

 

If you try and go too fast it is possible you could get hit with bad withdrawal symptoms several months down the track.  There are members who have had this happen and some of them have been unable to stabilise because their CNS has been sensitised.

 

Why taper by 10% of my dosage?

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

Tapering Calculator - Online

 

Tips for tapering off Celexa (citalopram)

 

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


What should I expect from my doctor about withdrawal symptoms?

 

Many members have found that the lower their dose gets the slower they need to go:

 

Why taper paper: dose-occupancy curves
 

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 about your own situation and journal your progress.  Click "Follow" top right and you will be notified when someone responds.

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TikkiTikki

I feel like a slow taper is a miraculous approach.

 

I feel awakened in lots of small, subtle ways - more energetic, more interested, more playful. I feel a lot of delight in small things that I think I've been missing. I haven't lost weight but I don't feel compelled by carbs anymore. 

 

I want to connect with people more than before, and so I feel lonely at the state my social life is in, but I know I can do something about. Small steps. Everything is small steps now, and manageable.

 

This sound strange, but I feel like there is more beauty and interest in the people around me. My family - I used to be more annoyed and preoccupied and overwhelmed, but now they seem lovely and interesting to me. I suppose I feel more engaged, and not just getting through with the least possibe fuss.

 

I get edgy in the morning, with jolts when I'm half asleep either drifting to sleep or waking up, but I know what it is and it doesn't frighten me yet.

 

I am total convert to the slow taper.

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TikkiTikki

Very few side effects this past week. Very mild cortisol feeling yesterday morning, but I think I only felt it because I was checking for it!

 

I think I felt more edgy/ blah/ empty some months ago, when I had dropped to 20mg (admittedly a big drop. Hadn't found this site then.)

 

Now, I'm working, keeping all my commitments without fuss, no physical side-effects at all.

 

And I'm doing a pretty fast taper (10% every two weeks for last three drops).

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TikkiTikki

Hi everyone,

 

I've been posting but never wrote a proper introduction.

 

I've been on Citalopram for 10 year's with three attempts at stopping. The last was 4 years ago, and I tapered over 3 months but crashed 3 months later.

 

I've gained a heap of weight and was lacking in motivation.

 

So basically I'm trying to taper slowly to avoid the delayed withdrawal symptoms. I tend to have few symptoms while tapering, it's just that kicker 3-4 months down the track when it's too late to go slow or hold.

 

WOuld love to hear from anyone who did a slow taper and avoided the delayed symptoms.

 

Best,

Tikki

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TikkiTikki

Haven't had any symptoms for a while now. Maybe slight irritability?

Been sick this week and even took cold and flu tablets with no adverse effects.

Taking magnesium has helped the RLS.

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TikkiTikki

I think I've hit my first wave of symptoms?

 

I have been extremely irritable at home with kids the last two days, like 0 to HAD ENOUGH in seconds.

Also have a strange pressure/ache in the top half of my head - not strong but persistent. A bit like when dehydrated.

Much more tired than usual.

Spasm/ache in my left calf.

Lowish mood - not feeling very buoyant at all.

 

I am getting over a cold, and have had a very busy few weeks with starting a new job and other commitments, so I think it's partly due to that.

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TikkiTikki

In the morning I take the Celexa, b12 and 300mg magnesium citrate and gee I feel great afterward! (not sure which one it is!)

I've been waking very groggy with a dry mouth and puffy face.

Still mild flu aches, head pressure, light-headedness. (Lingering head cold.)

Feeling flat, but not too bad.

Had a few days with more time at home with seems to help a lot - my schedule has been very frantic lately.

Been reading plenty of stories on SA and I'm going to hold longer at 14mg, then reduce to 13mg (7%).

 

Funny thing - barely notice the taste of the citalopram liquid now. I nearly gagged the first time I took it.

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Madeleine

When we get stressed that causes irritability too. Starting a new job is always hectic to some extent. Sounds like you're doing pretty well overall, which is good to hear.

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LexAnger

Good for you going smoothly with the fast taper!

Pressure on head/body is my sure WD symptom so I think your idea is good to hold now.

 

Some people are able to taper rather fast, please check lexFree in the forum.

 

Lex

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TikkiTikki

HI guys, Thanks for dropping by!

 

I checked LexFree's thread - wouldn't that be the dream! My problem in the past has been delayed withdrawal about 3-4 months down the track, with few symptoms through the taper, so I'll need to go slower. I just worked out a schedule today that keeps me tapering for another 2.5 years!

 

But I'll play it by ear - if I'm feeling good in 6 months maybe I can try some quick cuts like I've been doing. How are you feeling LexAnger? You're getting low now.

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TikkiTikki

ten0275

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Posted 08 February 2015 - 11:08 AM

Frustrated, hey.

 

My guess is that despite the suffering you endure bravely and the shortcomings you perceive in your parenting/grandparenting, in their eyes, mom/nana not only loves, but actually is love. You ARE love to them.

 

We are our toughest critics. I think loving our little ones amidst our own fragility is at once brave and necessary. If you can lie your head down each night and say "I loved them today," Then you have more than survived the day, you've contributed your essential heart to it.

 

Hang in there.

 

Dave 

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TikkiTikki

Felt better today. Certainly the fatigue of the past week has lifted and I didn't wake up so groggy this morning. Perhaps it was just the effects of the cold?

No headaches today either. And I have more spark and enthusiasm, even though I've been working all day.

Holding another week anyway.

 

(The date and time on this post is out. It's 10.03pm on June 4th.)

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TikkiTikki

Full of energy and high spirits this week.

A little irritable still at home, I think it is impatience with housework on top of working now - kids and hubby need to pull their weight!

Had a strange night on Tuesday when I couldn't sleep until about 2am. Spent the time very happily reading and researching, but it was odd. Had a coffee at midday, which would never normally affect me like that, but maybe?

Felt slightly fragile last night but practised mindful observance of the feeling, and made plans to address the content of my unease.

 

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Madeleine

Nice to read your update. Tikki. Glad to hear you are in good spirits. :-)

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Happy2Heal

hi Tikki

good for you, slowing down your taper and doing ok!

I hope you continue to do well.

I'm on my 3rd try to get off lexapro- one thing that may help you decide on how fast or slow to go, is knowing that, for those of us who have tried to get off the drug in the past, it's *usually* best to go slow.

It's because we already kinda bounced our brains around with the going off and going back on the drug, so we want to be a bit kinder to our brains and give them more time.

 

at least that's the theory as I understand it.

 

 

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TikkiTikki

Hi Madeleine, Happy2Heal.

 

Feeling good, had a lovely afternoon horseriding with friends and my kids. away on holiday at the moment. I'm short-tempered and impatient, but only with nearest and dearest! No other symptoms to speak of. Oh - actually, I had tinnitus 2 nights ago. That was a symptom out of the blue. It was like I had been at a rock concert - you know that ringing sound? Just when I was getting to sleep. ANd some reflux/heartburn which I haven't had since my last pregnancy nearly a decade ago. WD related? Couldn't find any other cause.

 

Happy2Heal - I hear you! I've been going reasonably quickly (dropped to 12mg 2 days ago), but I'm planning a longer hold - maybe months - when I get to 10mg because it's a pill and not liquid. ANd to let this taper catch up with me. I really have no symptoms, other than being irritable (but I'm also sleeping less, more energetic, more sociable and just more awake, motivated and engaged in general). But my fear is the crash 3-4 months after finishing, when I become depressed and anxious again. I need to reassure myself that I don't need the Celexa by staying on a really low dose and giving my system time to adjust. I imagine the last 3-5mg will take me longer than getting from 40mg to 5mg.

 

TIme will tell. Healing wishes to all.

 

 

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DaveB
On 2017-05-09 at 11:21 PM, TikkiTikki said:

HI,

 

My reinstatement experience:

 

Tapered off 40mg Celexa over 3 months. Over the next 3 months, felt increasing symptoms of irritability, self-consciousness, vulnerability to stress, low mood and anxiety, intrusive thoughts, emptiness and hopelessness. Was taking small amounts of Valium and Oxazepam for anxiety.

 

On reinstatement, anxiety went through the roof, extreme nausea and vomiting, waking really early with cortisol/ adrenalin spikes, felt desperate, didn't think meds would work again. Taking Lorazepam, valium, oxazepam to get though the day and sleep. Panic attacks.

Went up slowly 10mg for 2 weeks, 20mg for 1 week, 30mg for 3 1/2 weeks. Lost 4kg. Vomited a lot in the morning.

 

After 7 weeks, clouds parted and the sun came out and I felt safe again. 

 

SO: 3 months taper, 3 months off, nearly 2 months of HELL to get well again on ADs

 

This sounds exactly like what I am currently going through! So eventually your body desensitized to the meds again? 

Edited by DaveB
split from reinstatement topic

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TikkiTikki

Still on 12mg, no changes. Sleeping fine ( less than at 40mg), bit short-tempered, but no other symptoms to speak of. Death in the family last week, quite emotional, but hasn't provoked anything WD related. Don't feel any sense of despondency or anxiety. Things I am less than happy with feel just like things in my life I need to change. Still have a bit of that 'waking up' feeling, looking around and thinking 'how did I put up with this for so long?'

More ambition, more drive, but also willing to go slow with changes.

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TikkiTikki

Still on 12mg, nearly 4 weeks now.

I had three or four days when I felt quite bleak so i decided to stick with this dose longer. I felt irritable and tired and anxious about my life, sometimes waking in the night and finding it hard to get back to sleep. I've been fine about a week now, so I think I was actually tired and run down. It's winter here in Australia so its very cold and dark, which does affect me. 

Feeling good at present. Calmer, no early morning cortisol spikes, better mood. 

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TikkiTikki
On 6/20/2017 at 9:51 AM, Utah49er said:

 

This sounds exactly like what I am currently going through! So eventually your body desensitized to the meds again? 

 

Hi Utah,

Yes. I mean, all the negative symptoms vanished and I felt profound relief. It felt like a switch, at the seven week mark, though I had had glimmers of better mood before that, and I kept feeling better and better afterwards. But there was definitely a feeling that I had reached some threshold around the 7 week mark, like a light switch going on.

 

You're using Paxil, after withdrawing from Lexapro? How are you feeling now?

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TikkiTikki

Down to 10mg, and feeling awesome actually.

I've been initiating some social gatherings and I feel really good about it, like I'm finding myself again. No fear or anxiety.

I'm loving work, even though it can be a bit boring.

ANd I feel like exercising, despite it being the dead of winter here and freezing cold.

Sugar/ carb craving pretty well dormant, except a few days before my period.

Despite eating less, and less carbs, I've gained a few kgs. Think I might be one of those paradoxical weight gainers with tapering. Dang. I don't mind that much though, because I feel confident that eventually everything will even out. It would just be a physical manifestation of the changes I can feel in myself, you know, but oh well.

 

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TikkiTikki

Still stable.

Busy week, very social, working, and kids on holiday from school. 

I feel so much more able to connect with people now. My self-conscious preoccupation and distant feeling have disappeared, and I just feel interested in people, eager to connect, and don't waste time worrying whether i'm interesting or not. I feel confident, I suppose, in a way that I haven't for years and years, and it has to do with removing that distance, like a streaky window pane, between me and the world, and even between me and myself.

Eating a lot less. Just don't think about eating treats anymore, or soothing with a big pile of toast etc. 87kg today - still my top weight! 

Taking a pill rather than liquid is so easy i might stay on 10mg longer than a month.

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Happy2Heal

glad to hear you're doing so well!

:)

 

 

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joy2730

Hi Tikki Tikki

 

Likewise glad you are doing well at 10 mg.  You probably have a little bit of paradoxical weight gain, so have I, I definitely have it and can almost feel it as a withdrawal symptom now, it feels different from the weight gain when I have eaten too much and the wrong things.

 

A quiet word of warning, it seems to be general that things are harder from 10 mg to nothing than 20 mg to 10 mg.  It may not be for you of course.  How lovely that you are well at 10 mg, I am well at 18 mg and feel all the alertness and benefits that you do.

 

Joy

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TikkiTikki

Thanks Joy and Happy.

Yes, I realise that so far has been the easy part. After my experiences the last time, I'm quite apprehensive about being off altogether, so I'm planning to take it very slowly. 

Anyway, 10mg feels good for now.

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DaveB
On 7/12/2017 at 7:19 AM, TikkiTikki said:

 

Hi Utah,

Yes. I mean, all the negative symptoms vanished and I felt profound relief. It felt like a switch, at the seven week mark, though I had had glimmers of better mood before that, and I kept feeling better and better afterwards. But there was definitely a feeling that I had reached some threshold around the 7 week mark, like a light switch going on.

 

You're using Paxil, after withdrawing from Lexapro? How are you feeling now?

 

Still struggling pretty bad after 5 weeks on Paxil. Really I am "withdrawing" from Zoloft that I was on for 7 years, Lexapro trial "failed" according to doctor after 6 weeks. Found this site and realized if I had just stayed with my reinstatement of Zoloft that also "failed" I would most likely have stabilized and started to taper. Listening to doctors has earned me 6 months of absolute unstable hell. Worried the pregabalin is only confusing things at this point as well. Your story gives me some hope though that stabilization will come.

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StarJ

Thats great news.

 

I'm also on 10mg and feeling pretty good now.

 

No anxiety or depression.  Was a little grouchy and spacey after the initial cut, but seemingly more stable now.

 

I plan to stay here for a while, im not suffering from the dysphoria I had at the higher dose, which was my nain reason for going down..

 

 Libido is better too. Weight has not been affected tho. Other side effects are negligible 

 

Good luck

 

 

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TikkiTikki
On 19/07/2017 at 10:51 AM, Utah49er said:

 

Still struggling pretty bad after 5 weeks on Paxil. Really I am "withdrawing" from Zoloft that I was on for 7 years, Lexapro trial "failed" according to doctor after 6 weeks. Found this site and realized if I had just stayed with my reinstatement of Zoloft that also "failed" I would most likely have stabilized and started to taper. Listening to doctors has earned me 6 months of absolute unstable hell. Worried the pregabalin is only confusing things at this point as well. Your story gives me some hope though that stabilization will come.

 

Yes, don't lose hope. I remember feeling like I would never feel better, and anxiously scouring various depression forums for 'the answer' about how long it would take. I thought maybe the Cipramil wouldn't work again, despite working fine other times. But it kicked in, and I very quickly forgot I'd ever doubted!

 

On your Zoloft reinstatement - I actually tried to reinstate Zoloft once, 11 years ago, and the nausea was so extreme I refused it and pdoc gave me Citalopram, which I've used since. I had used Zoloft 2 or 3 times in the 4 years before, usually about 3-4 months at a time I think. I don't recall any trouble going on or off, and I wouldn't have tapered properly. Prescribed by my GP, with little follow up, so I just made my own decisions. When I tried to go on again in early stages of pregnancy I became extremely sick, as well as anxiety etc. I wish I could remember better what went on then with the knowledge I now have of "discontinuation syndrome" - I just remember that I couldn't tolerate the Zoloft, no matter how low we started, and eventually begged them for something else. I'm sure they thought it was all in my head. 

I just assumed that the pregnancy had changed something, like pregnancy nausea + SSRI start-up nausea = extreme vomiting. I had to go to the hospital for drips I was so dehydrated. But maybe Zoloft can cause havoc once you're sensitised to it? It's possible.

 

Fingers crossed the Paxil does what it should soon.

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TikkiTikki
18 hours ago, StarJ said:

Thats great news.

 

I'm also on 10mg and feeling pretty good now.

 

No anxiety or depression.  Was a little grouchy and spacey after the initial cut, but seemingly more stable now.

 

I plan to stay here for a while, im not suffering from the dysphoria I had at the higher dose, which was my nain reason for going down..

 

 Libido is better too. Weight has not been affected tho. Other side effects are negligible 

 

Good luck

 

 

StarJ - that's great.

I seem to notice a little dip in mood premenstrually/menstrually, more than I notice it in relation to cuts in dose. I think the Citalopram had me feeling more even, perhaps, and masked hormonal changes? But I still felt crappy a lot of the time, 'stuck' in my life and frustrated and even anxious.

I've felt much, much better since reducing my dose.

I'm thinking of sitting on this dose for a while too, because I'm feeling good. I'm still scared of crashing again, I'll admit, when I get to lower doses.

 

Let's hope we both keep going like this for a while!

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StarJ

I hear what you are saying about the crash. I am also terrified of that.

 

Perhaps holding at this lower dose for a lengthy time to ensure we are not in a honeymoon period is not a bad idea. Say 6 months. Once that dose is tried and tested we can take the plunge to slowly reduce further? I think this is a good approach.

 

 

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joy2730

Staying at 10 mg for a while sounds like a good plan to me.  10 mg downwards to 0 seems to be harder than 20 to 10 from what I have read.  My own GP thinks I will never get passed 10 mg.  'Never' is a lot time and is a sad concept to me.

 

However, I would rather take 10 mg than 20 mg, and the 18 mg I am currently taking feels much healthier than the 30 mg I used to take.

The main antidepressive effect (if there is one, as many say it is a placebo response), seems to be between 0 and 10 mg, and then some more between 10 and 20.  I think the benefits of going from 20 to 30 are not so marked, I have never tried 30 to 40, and in UK citalopram is not recommended above 40 mg anyway because of QT syndrome (heart problems).  I do think side effects increase with dosage, I feel a lot more lethargic at 30 than at 20 and feel less lethargic at 18 than 20.

 

If I ever reduced successfully to 10 mg I might become really productive in life!  I know I am productive now, but if I hadn't spent my life full of drugs I could have really done something with it.  However, it is silly to look back with regrets.

I think if I was at 10 mg I would be so grateful I had got there, I would be tempted to stay there for ages, not wanting to rock the boat in any way.

 

Take care

 

Joy

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DaveB
8 hours ago, TikkiTikki said:

 

Yes, don't lose hope. I remember feeling like I would never feel better, and anxiously scouring various depression forums for 'the answer' about how long it would take. I thought maybe the Cipramil wouldn't work again, despite working fine other times. But it kicked in, and I very quickly forgot I'd ever doubted!

 

On your Zoloft reinstatement - I actually tried to reinstate Zoloft once, 11 years ago, and the nausea was so extreme I refused it and pdoc gave me Citalopram, which I've used since. I had used Zoloft 2 or 3 times in the 4 years before, usually about 3-4 months at a time I think. I don't recall any trouble going on or off, and I wouldn't have tapered properly. Prescribed by my GP, with little follow up, so I just made my own decisions. When I tried to go on again in early stages of pregnancy I became extremely sick, as well as anxiety etc. I wish I could remember better what went on then with the knowledge I now have of "discontinuation syndrome" - I just remember that I couldn't tolerate the Zoloft, no matter how low we started, and eventually begged them for something else. I'm sure they thought it was all in my head. 

I just assumed that the pregnancy had changed something, like pregnancy nausea + SSRI start-up nausea = extreme vomiting. I had to go to the hospital for drips I was so dehydrated. But maybe Zoloft can cause havoc once you're sensitised to it? It's possible.

 

Fingers crossed the Paxil does what it should soon.

 

Thanks, I appreciate your concern and encouragement. I know it will be fine eventually, who knows when that will be though. Unfortunately, I am now also faced with an essential cold turkey off of the lyrica I was taking for a couple of months due to insurance rejecting my petition. How did you do getting off the benzos you took during your bad time?

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TikkiTikki
12 hours ago, Utah49er said:

 

Thanks, I appreciate your concern and encouragement. I know it will be fine eventually, who knows when that will be though. Unfortunately, I am now also faced with an essential cold turkey off of the lyrica I was taking for a couple of months due to insurance rejecting my petition. How did you do getting off the benzos you took during your bad time?

 

No problem. I've read about the struggle others have with them, and I would worry about taking so much at the time, but honestly, once the Citalopram kicked in I just ceased any benzos with no problem at all. And I've taken the odd half a tab during this taper with seemingly no issues, but I am much more wary now after all I've read.

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TikkiTikki
On 7/21/2017 at 0:38 AM, StarJ said:

I hear what you are saying about the crash. I am also terrified of that.

 

Perhaps holding at this lower dose for a lengthy time to ensure we are not in a honeymoon period is not a bad idea. Say 6 months. Once that dose is tried and tested we can take the plunge to slowly reduce further? I think this is a good approach.

 

 

 

I've been thinking something similar ... I just said to my partner yesterday that I could stay on this dose indefinitely because I feel so good. 

But then there's the weight gain :-(  Though I'm eating so much less lately, nothing has budged, so I may need to get completely off the Citalopram to be able to lose weight. I've got 30kgs to lose! Well, 20 at least. 

But I'm still more scared of crashing than anything else. Life is too good now to get derailed.

I think I could do 2 months on 10mg? And if no withdrawal effects, I think I'd be tempted to make a cut. 6 months is a great idea, but I think I would get impatient. 

Best

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TikkiTikki
On 7/21/2017 at 1:26 AM, joy2730 said:

Staying at 10 mg for a while sounds like a good plan to me.  10 mg downwards to 0 seems to be harder than 20 to 10 from what I have read.  My own GP thinks I will never get passed 10 mg.  'Never' is a lot time and is a sad concept to me.

 

However, I would rather take 10 mg than 20 mg, and the 18 mg I am currently taking feels much healthier than the 30 mg I used to take.

The main antidepressive effect (if there is one, as many say it is a placebo response), seems to be between 0 and 10 mg, and then some more between 10 and 20.  I think the benefits of going from 20 to 30 are not so marked, I have never tried 30 to 40, and in UK citalopram is not recommended above 40 mg anyway because of QT syndrome (heart problems).  I do think side effects increase with dosage, I feel a lot more lethargic at 30 than at 20 and feel less lethargic at 18 than 20.

 

If I ever reduced successfully to 10 mg I might become really productive in life!  I know I am productive now, but if I hadn't spent my life full of drugs I could have really done something with it.  However, it is silly to look back with regrets.

I think if I was at 10 mg I would be so grateful I had got there, I would be tempted to stay there for ages, not wanting to rock the boat in any way.

 

Take care

 

Joy

 

HI Joy,

 

Yes, I realise how lucky I am to have gotten down so far with no withdrawal effects. I wish it could be the same for you.

I am much more apprehensive about the next 10mg then I have been so far.  And if what you say is correct about therapeutic dose, then 10mg is still providing an antidepressant benefit. And i am already feeling so much more awake and engaged with life, that I should be satisfied for a while with this.

 

Take care, Tikki

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