yaya: withdrawal from celexa 20mg after 12 years

[yaya]

Hi. First of all, god bless you for this forum. I've been reading stuff on it for almost 2 months now and getting a lot of strength from it. 
English is not my mother tong, so please bare with me and my typos, thanks  

I'm a 43 year old woman, single, unemployed for a year. I've been loosing my job as a freelance a year ago, i had here and there a few projects but nothing too long.
A few months ago, I stopped taking celexa completely, after, i thought, having tapered gradually. Oh boy how wrong i was. 'Gradually' for me meant taking the drug alternatively (1 day with, 2-3 days without) for almost a year and maybe more, I can't even remember when was the time i took it every day. 

I think I took the celexa for almost 12 years, before that i had 2 years approximately on prozac and one year on paxil. so more or less 15 years with drugs. All this time I got them from a GP and not a psychiatrist. I might have saw a psychiatrist once for this matter, but it's been a long time. 

And now, it's been almost 3 months since my last celexa. When I tappered "my way", i wasn't even aware of the consequences, i wish i've read this forum then. I really thought it was slow enough. but then I started to take one celexa a week and then started to feel bad, headaches, pins and needles etc. and went urgently to a psychiatrist that told me that if i made the decision to stop, and now i'm only taking half a celexa twice a week, so i might as well stop completely as it doesn't help anymore. Her words. Basically she said that the problem was that i wasn't completely 100% with my decision to stop. So she said to throw them away once and for all. 

At that time it made a lot of sense, I thought i've found a great psychiatrist. And now, 3 months after the last one, only now i realize that the "tapper" was way too fast and that it's almost CT, as I did stop brutally after reducing the dose. Now i feel SO bad, i thought the 1st month was hell, and that it will improve with time, but now it's been 3 months and i feel exhausted, i have extremely dry eyes, joints pain, headaches (a bit), bad hair loss. I feel like a sad zombie in another world. And i'm so afraid that the way i stopped may have compromised my healing. 

I have obsessive thoughts all day long about why did i stop, why now, and why this way and what the heck was i thinking to not be aware of the consequences? 
I'm starting therapy this week, i was on therapy for years and years before, and now i feel like it's time for support. I'm also taking care of myself with better eating, acupuncture and want to start exercising. But i'm afraid, i'm so afraid that this mess i'm in will go on and on, i don't know how long it will take and i need to work but it's very very difficult for me now. 

I'm thinking about reinstating (but isn't it too late now?) or going on very low dose of prozac to taper again very slowly, I don't know anymore. I'm just so afraid and confused. If i reinstate celexa, at what dose should i do it? 5 mg? 

 Im gonna see a psychiatrist soon, another one, not the one i've seen before and that told me to just throw the drugs in the basket. 

I'm taking omega 3 and started with mag citrate yesterday. 

Thanks for reading, thanks for being here.  

[baroquep]

Hi yaya, Welcome to Surviving Antidepressants (SA).  Am happy to hear that you have been doing your own research, found this site and have the opportunity to get back on track.   What you are experiencing right now is very typical when a person tapers too quickly so don't be alarmed.  Surviving Antidepressants recommends tapering 10% of your current dose with at least four weeks in-between decreases.  Alternating doses or skipping days is never recommended as this further destabilizes your central nervous system.   

 

We ask all of our members to complete a withdrawal history signature to get a better understanding of of what brought you to this site.  I’m attaching a link below that will provide you with the instructions.

 

Instructions:  Withdrawal History Signature

 

In the meantime, to give you an understanding of the protocols recommended by SA, I am attaching a few links to get you started.  A lot of people do very well after reinstating a very small dose but as you have been off of Celexa for three months now, it does come with risks and it’s best to be aware of both the benefits and potential risks.  Please also note that not too many people have had much success switching or bridging to Prozac to help with withdrawal symptoms and it is not something I would recommend (I have included a link on this topic below).

 

I would encourage you to have a look around to familiarize yourself with the options available at this time so that you can make an informed choice as to what you would like to do.  

 

What is Withdrawal Syndrome?

What is Happening in Your Brain?

The Prozac Switch or Bridging with Prozac

About reinstating and stabilizing to reduce withdrawal symptoms

What to Expect in Reinstatement (James Heaney article)

 

It would also be a very good idea to keep track of your symptoms so that you are better able to track your progress.  Good to hear that you are taking Omega 3 and magnesium as they are very beneficial when tapering off of anti-depressants.  

 

Dr Joseph Glenmullen's WD Symptoms Checklist
Dr Joseph Glenmullen's Withdrawal Symptoms

 

Best,

BaroqueP

[Dan998]

Hello Yaya,

 

Welcome to Surviving Antidepressants (SA). We're glad that you have found the site helpful and decided to start your introductory thread.

 

GP's often don't have much experience dealing with mental health. They all too quickly reach for the prescription pad and send you on your way. The exact same thing happened to me. I was also put on celexa by my GP and was on them for about 15 years.

 

Reducing your dose by skipping doses will have caused fluctuating amounts of celexa in your brain. We recommend keeping doses nice and steady to prevent this sort of instability. You may have unknowingly been suffering from withdrawal symptoms for longer than 3 months. 

 

You mentioned you were considering trying a reinstatement. At 3 months it is still possible that a reinstatement will provide some relief. If you were to give it a go you would probably want to try a small amount of celexa, perhaps 1 mg. The reason we suggest such a small amount is because your brain will have done a lot of readjustment since you quit the medication and you may also have become sensitive to antidepressants. A smaller dose will mean less intense side effects and hopefully prevent any adverse reactions. You can always adjust this dose later if it isn't effective.

 

I think you should stick with celexa rather than switching to prozac. Your brain is accustomed to celexa. There is no way of telling how you will tolerate a different SSRI. You might find you tolerate it better, but there is no way of telling and it will be a bit of a gamble.

 

Baroquep has provided some useful links for you to read. Please feel free to come back and ask any questions you might have.

 

Kind regards,

 

Dan.

 

[yaya]

 

Thanks so much baroquep and Dan998 for your fast answers and your help, I really appreciate it. BaroqueP, the link The Prozac Switch or Bridging with Prozac  

leads to the apple.com site  and the Instructions:  Withdrawal History Signature  is unclickable. Can you please repost it? thanks 

 The withdrawal symptoms I've been experiencing lately is a flu-like one, exhaustion and joints pain which have been lasting for more than 2 weeks now and of course i'm all freacked out that this gonna last forever. 
 

And you're right Dan, i've been feeling not so good during the last year while skipping days and didn't even understand what was the reason (again, totally unaware of how the whole AD stuff work even while taking them for so damn long.) 
It's good to have this forum really, although sometimes I read stories here and i'm scared to death that all those symptoms are gonna last forever. 
I so want my life back and being healthy and functional again.

Thanks again for being here

[Dan998]

Hi Yaya,

 

Here are those links again; 

The Prozac switch or "bridging" with Prozac

Please put your withdrawal history in your signature

 

5 hours ago, yaya said:

 The withdrawal symptoms I've been experiencing lately is a flu-like one, exhaustion and joints pain which have been lasting for more than 2 weeks now and of course i'm all freacked out that this gonna last forever. 

 

Please don't be frightened. Your symptoms won't last forever. It is very common to think they will be never ending, but it's just a part of the windows and waves pattern of recovery. Symptoms will come and go, some will last longer than others but they all eventually recede into the distance.

The Windows and Waves Pattern of Stabilization

 

Why not head on over to the success stories where you'll find lots of encouragement that things can and do improve.

Success stories: Recovery from withdrawal

 

[baroquep]

Sorry yaya and thank you for reattaching the correct links Dan998 I will have to update my bookmarks!!!  Sorry about that!!!

[yaya]

Thanks a lot to both of you. I've been also advised to take spirulina. I'm already taking silexan, which is lavender oil against anxiety (it's called calm aid in usa and lasea in europe, do you know it?), omega 3, vit e, vit d (sometimes), magnesium and a bit of iron.

Is it too much? 

[baroquep]

Hi yaya, people in withdrawal tend to find they are extra sensitive to supplements, in particular to most B vitamins, and would advise you to proceed carefully.  The general rule is to start low and then titrate up if you don't find they aggravate your symptoms.  Know that I had to discontinue just about all of the supplements I had been taking for years, with the exception of omega 3, magnesium and iron.  Not sure why supplements seem to give people so much trouble, so be cautious.   If I were you, I'd wait until your current symptoms settle down and introduce a very small dose and see how things go, you obviously don't want to make things more difficult for yourself.  

 

I'm attaching a link that discusses sensitivities to various supplements and other OTC medications for you to take a look and maybe even ask the community in that forum whether or not they've experienced issues with spiritulana.  

 

Sensitivity to medications and supplements
Sensitivity to neuroactive substances

 

For your reference, if ever in doubt about interactions between medications and/or supplements, it's always a good idea to check for possible interactions at the link below:

 

Use the free Drug Interactions Checker here http://www.drugs.com/drug_interactions.html if you are taking more than one prescription or over-the-counter medication -- the drugs (and supplements) you take may conflict with each other. 

 

 

 

[yaya]

Hi. I'm going to a psychiatrist tomorrow to talk about a probable reinstatement, as I've feeling horrible during the last weeks. 

I'm going there with a heavy heart, as after 3 months i was quite sure the worst was behind me, but obviously it's not. 

I'm suffering so much, phisically and mentally. I take some xanax from time to time, and now it's almost every day, but as i'm very scared to get use to it, i take only half a pill when things get really really hard only (half of 0.25 mg).  

So i'm going to see the psy tomorrow, and i would like to know what dose should i ask for, and if celexa exists in a liquid way? 

thanks 

[baroquep]

Hi yaya, it is very difficult to provide accurate information without seeing your detailed drug/tapering history.  To give you an idea of why it is recommended to reinstate at a very small dose, I am reattaching the reinstatement topic below.  As you have been off of these drugs for almost three months, I would suggest trying a dose of 1mg to see if that helps to resolve your withdrawal symptoms and then titrate up after a week or two and only if necessary.  It's important that you read the information regarding reinstatement so that you can familiarize yourself with the recommendstions before you visit your psychiatrist tomorrow.  Oftentimes doctors/psychiatrists will put the patient back on the full dose, which because of your already sensitized CNS, could end up making a lot things worse and that it why it is recommended to start at a very low dose.  One more thing, as far as I know, Celexa is available in a liquid, but best to contact your pharmacist for more details.

 

You are very wise to be concerned about the use of Xanax as it provides temporary relief of the withdrawal symptoms but causes rebound anxiety as the drug leaves your system after about six hours and why people end up addicted to them.  

 

I've reattached the links below.  If after providing your withdrawal history signature and having a good look at the reinstatement link, you still have questions, please don't hesitate to post again.

 

 

Edited September 4, 2017 by baroquep

[yaya]

thanks baroquep, It's just that I totally lost count of my so called tapering of this last year and also the year before, I didn't write how much i took and when. It's like I was forgetting to take it for 2 days and then remember and took it. But I'll try to update my signature as accurately as possible, thanks!

[yaya]

Question: how do you cut the pill to get 1mg and how to taper from 1mg? Tx

[baroquep]

If you have a compounding pharmacist in your area, I would suggest having them prepare it, that way, you won't have to deal with the stress of either weighing or turning the Celexa it into a liquid.  Just ask your psychiatrist/doctor to write a prescription for the 1mg.  I'm fortunate enough to have a compounding pharmacist right down the street from me and it has been very helpful to get precise doses and not have to worry about measurements myself.

 

I'm attaching a few links so that you can get an idea of how to do it yourself if you are not able to use a compounding pharmacy.  If you decide to turn the tablet into a liquid, you have to be extra cautious as the drug will be absorbed a lot faster than a tablet.  There are instructions on how to do this in the links below.  I've also attached a tapering calculator where you can plug your numbers in to ensure you are tapering at the recommended rate.  Like I said, a compounding pharmacy will be able to take care of all the details for you, so if you have access to a compounding pharmacy, it is the way to go.  

 

Using an oral syringe and other tapering techniques
Using a digital scale to measure doses

 

Tablets or Liquid

Tapering Calculator - Online
Tapering Calculator - Download
 

 

Edited August 30, 2017 by baroquep

[yaya]

Thank you Baroquep! 

I'm hoping to get this 1mg prescription, I understand it's not easy convincing the doc to give such a small dose. 

I'll keep you updated later today, thanks again.

[baroquep]

This might help ... 

 

 

[LexAnger]

13 hours ago, yaya said:

Thank you Baroquep! 

I'm hoping to get this 1mg prescription, I understand it's not easy convincing the doc to give such a small dose. 

I'll keep you updated later today, thanks again.

Hi Yaya, giving many bad experience from others trying to get a low dose or different script with total deny from doctors, I suggest you just ask for a regular script unless you plan to use compounding pharmacy. Celexa liquid is available so hopefully you can get that instead of the pill. Whatever the concentration is fine as it's very easy to dilute at home. It's crucial for future micro taper.

 

best luck,

lex

[yaya]

32 minutes ago, LexAnger said:

Hi Yaya, giving many bad experience from others trying to get a low dose or different script with total deny from doctors, I suggest you just ask for a regular script unless you plan to use compounding pharmacy. Celexa liquid is available so hopefully you can get that instead of the pill. Whatever the concentration is fine as it's very easy to dilute at home. It's crucial for future micro taper.

 

best luck,

lex

Thanks Lex. I'm seeing the psychiatrist on sunday. I really hope there's liquid citalopram here (Israel). Not sure, i was searching on the net but didn't find we have it here. 
How do you dilute it? As I understood, one drop of citalopram=2.5 mg. Am I right? 
If there isn't any liquid here, i don't know how to cut and dilute pills to such a small quantity. It seems complicated to me. I'm thinking about starting on 2.5 (easier to cut) although folks here are saying 1mg, but i'm not sure. I'm also not sure i have a compound pharmacy around. If there is, should i ask the physician to cut the pill for me? how's it working?

[LexAnger]

The links baroquep provided above should have information as how to dry cut, measure the pills. Many ppl here do that quite successfully. As for liquid, depends on the concentration you will get, you can just add water to it to make the desired concentration. Once you have the script, we can figure out the exact way of diluting.

 

in my opinion, it's safer to start at low doses even it's not convinent. These drugs works in a mysterious way especially when reinstating, you don't want to risk for reaction by taking higher doses after 3 months off. In case you are ok with the low dose and feel the need to go up higher,my ou can always do so gradually ( for the same reason to prevent reaction). That's another spread on to get a script of the normal dose ( 5 mg or 10 mg for Celexa ) in this experimental stage.

 

[LexAnger]

Here is the link for making liquid from pill.

 

 

 

 

 

[yaya]

Thanks Lex, much clearer now. As I understand I just have to dilute a celexa pill (20mg) in 20 ml of water, and then mesure 1ml with a seringe. Am I correct? 

Can the container stay 20 days in the fridge? Thanks in advance for taking the time to answer. I'm so grateful to all of you for your precious help. 

[LexAnger]

Hmm, I'm not sure about how long the self made solution can be good. I only used liquid myself.

i hope others with experience  can chime in.

 

you are correct with the dilution part. In the future if you want to get even smaller dose,my ou can dilute to a even less concentrated solution. For example, by adding 40 ml water to the 20 mg pill, etc.

[yaya]

Yeah, I think not such a good idea to prepare 20 ml. I'll start with a quarter of a pill, 5 mg, and dilute it in 5 ml water. 
It's just difficult for me to believe that 1 ml will make a difference after the 20 mg i took while on celexa. But i'm willing to give it a try as it makes sense to start with the lowest dose. 
Are they any successful stories with reinstating celexa 1ml after a few months? How many days before seeing a change approximately? 

[Dan998]

Accuracy is vital when making a solution. It will be very difficult to accurately split a 20mg pill into quarters of exactly 5mg without a set of scales. 

 

Bacteria will get into the solution and degrade the active ingredients. I would play it safe and throw away any unused liquid after a week at the most.

 

1 mg does seem like a tiny dose, but these drugs a very powerful. You should start to notice a difference within a week or two. We recommend such a low starting dose to protect you from any adverse reactions. You can always updose later on if you feel it's not enough to quell your symptoms. It's better to be safe than sorry.

[ChessieCat]

I saw your post in another topic saying that you will be seeing a psychiatrist:

 

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

What should I expect from my doctor about withdrawal symptoms?

[yaya]

Thanks a lot ChessieCat. 

 

If I do get a liquid form of celexa, what is the dose of liquid for 1mg?

 

I feel like this whole WD and reinstatement is all i can think about those last days/weeks/months, as if it has became my whole life. Horrible.

[LexAnger]

It depends on the concentration of the liquid. If it's 5mg/ 5ml then yes, there will be 1 mg in 1 ml.

you will have to look at the concentration on the label before knowing the # of ML that contains 1 MG.

 

 

[yaya]

Ok. Thanks Lex. I'm just so panicked at the idea that reinstatement is not gonna change a thing and stay with this flu-like symptom and panic all my life. I'm saying to myself: what if it isn't WD after 3 months, what if something else is wrong with me? Although i had done blood tests, and all is ok. What blood tests did you guys have done to check on other stuff that might cause all those symptoms?

I'm really really anxious about the idea that reinstatement is not gonna help. I know I have to stay positive and believe it's gonna be a relief, but i'm so messed up i'm thinking only about the worst case scenario. 

[baroquep]

Hi yaya, Your fears and apprehension are very normal under the circumstances and want to assure you that reinstatement is the only known protocol for easing withdrawal symptoms.  There are no blood tests or medical procedures that would be able to determine whether or not you are in withdrawal.  The information below might help you to make that determination with a little more confidence.

 

How do I know it's withdrawal and not relapse?

 

Typically, in withdrawal symptoms such as melancholia, anxiety, and disorientation come in intense waves, sometimes only a few minutes long, which differentiates them from relapse of a psychological condition.

In withdrawal, symptoms are much more intense than the original psychological condition. People suffering from withdrawal often say things like

- "This doesn't feel like my depression."
- "I've never had symptoms like this before."
- "I feel very weird and not like myself."
- "I can't feel my feelings."

It's up to you to decide whether your body and brain are behaving "normally" as they did before you tried medication, or if you are feeling differently. No one else, not even a doctor, can determine this.

 

Please also take a look at the link below to get a better idea of what you are experiencing right now.

 

What is Withdrawal Syndrome?

 

Edited September 1, 2017 by baroquep

[yaya]

Hi Baroquep, what you wrote is exactly how i feel, and this i'm sure is a WD symptom. But I have been feeling physically ill for close than 3 weeks now (exhaustion, very dry eyes, flu-like symptoms and mysterious and sudden rushes on my skin etc) has gotten me freakin out about maybe being sick, although my blood tests are showing all is ok. 
 

Yesterday I came back home and didn't feel it was my home anymore, and it just felt heartbreaking. I couldn't feel at home in my own house. 

During the week I was feeling "out of myself", and not really living, which I know by now by reading the posts here is a typical WD symptom. 

 

All of this are comforting me in the decision of reinstate, with hope that I'll soon feel better. 

Thanks for the reassurance Baroquep, it's just I've been reading posts here and there that reinstatement did not do the job, hence the panic.

[baroquep]

Yes, I can understand your panic and empathize.  The symptoms that you describe are classic withdrawal symptoms and it's not surprising that you feel the way that you do.  Your central nervous system has been put through a lot since June and can't cope with all of the changes.  

 

Granted reinstatement doesn't always work, but it's best to keep an open mind and at least try rather than put yourself through unnecessary suffering.  It's easy to get panicked when you read stories about it not working for others, but we are all different, have differing histories and what works for one unfortunately won't work for another BUT it could work for you and calm your nervous system and it is work taking the risk.  

Until you speak with your doctor, try not to focus on posts that weren't successful, concentrate on the posts that have been successful.  While I do think it is important for us to have as much information as possible and be aware of the risks, we also have a responsibility to take care of ourselves and take the steps to ease our suffering.

 

I had symptoms exactly as you are describing "out of myself" and it is frightening, but what I found helped was to realize that it was a withdrawal symptom caused by tapering too quickly and not to entertain the panic.  You are still in early days, and understand that it takes a little time to digest what is going on and why it is happening.  The links below might give you more reassurance that what you are feeling is completely normal under the circumstances and while it can't hurt you physically, I do know that it can be difficult to deal with emotionally ... I understand.

 

Derealization or depersonalization 

Neuro Emotions
Non-drug techniques to cope with emotional symptoms

As you haven't been off of Celexa for too long, I think you have a good chance of it being successful.  Right now the most important thing for you to do is take care of yourself and treat yourself with loving kindness and try and remain as positive as you can until you can see your doctor.

Things do and will get better for you.  Sending healing thoughts and wishes.

Best,

BaroqueP   

Edited September 1, 2017 by baroquep

[yaya]

Thank you so much Baroquep for reassuring me. 

It's weird but I feel all those wds mostly during the day and much better in the evening. 

[yaya]

Hi. So I went to see this psychiatrist who was quite ok and said that all the symptoms might still be withdrawal, that it sounds like it, although "WDS 3 months after stopping are not very common". Oh well. I was very nervous when i got there to be honest.

We agreed to reinstate at 5mg, although she said 10 mg at the beginning. So i'm now back on 5mg. Hope it will work and that I'll feel better soon. 

She said to wait a few days and if I don't see any changes, to take 10 mg. For the moment I really want to stay on 5 mg and see how it's workin, wish me luck. 

 

Good news is I found a compound pharmacy near my house, so that really really might help for a future tapering. 

 

I'll update about the reinstatement in a few days, hope i'll come back with good news. 

 

Thanks again for your support, your patience and kindness <3

[baroquep]

Hi yaya, glad to hear that your doctor is open-minded enough to accept that the symptoms you are experiencing are withdrawal despite their scepticism.  It is my experience that medical professionals have little knowledge of just how powerful these drugs are even in small doses and glad that you were able to start at 5mg rather than 10mg.  Please be aware that you are likely going to feel worse before you feel better and am hoping that you will be able to settle on 5mg without too much difficulty.  While I would have liked to see you start at 1mg and titrate up as necessary, 5mg is certainly better than 10mg.  

You are lucky to have a compounding pharmacy close by and it will definitely be a lot easier for you to tapering off of Celexa down the road.  I use a compounding pharmacy and it has made things quite a bit easier during this process.   

 

I'm reattaching the links regarding reinstatement so that you'll know what to expect over the next couple of weeks.  Please report back if you have any adverse reactions and most importantly keep track of your symptoms so that you have an idea of the progress you are making and just in case you run into trouble.  Please be prepared to hold at this dose for a minimum of two months (unless there are problems) so that your central nervous system has a chance to heal and settle.  It can four days or longer for a steady percentage of Celexa to build up in your system, so try not to panic if you don't start feeling better right away. 

 

Try and limit your use of Xanax as it can cause rebound anxiety and interfere with you stabilizing on Celexa.  The fewer changes/additions your CNS has to deal with the better and you don't want to end up addicted to Xanax.  The best thing you can do for yourself right now is to practise extreme self-care, learn non-drug techniques for dealing with withdrawal symptoms and to treat yourself with tender-loving care.

 

About reinstating and stabilizing to reduce withdrawal symptoms

What to Expect in Reinstatement (James Heaney article)

The Windows and Waves Pattern of Stabilization

Dr Joseph Glenmullen's WD Symptoms Checklist
Dr Joseph Glenmullen's Withdrawal Symptoms

Non-drug techniques to cope with emotional symptoms

 

Hope things go well over the next little while and please do let us know how you are doing over the next few days.  

 

Best,

BarqoqueP

[yaya]

Thank you so much BaroqueP.

 

Regarding that:

Please be prepared to hold at this dose for a minimum of two months (unless there are problems) so that your central nervous system has a chance to heal and settle.

 

I'm planning to hold for more than 2 months, I definitely need to rest now after this wd exhaustion. I might start to taper again in 5-6 months maybe, or maybe a bit less, not unless I feel much much better (with help of sport, meditation and healthy food). But I won't hurry now, that's for sure. That is of course if reinstatement works, hopefully. 

 

I plan to keep on taking omega 3 supplement, but might take less than what i'm taking now (3.6 mg). What do you think regarding the quantity?

[ChessieCat]

Here's the SA topic on Omega-3 Fish Oil

[baroquep]

Hi yaya, so happy to hear that you are going to do a good long hold, the longer the better.   Sounds like you have all your ducks in a row and a nice rest from the withdrawal exhaustion is in order.  Keeping you in my thoughts and hoping the reinstatement is uneventful and that you start feeling much better soon.

 

Best,

BaroqueP