Chalkey: Introducing myself - taking Citalopram

[Chalkey]

Hi!

 

I am taking Citalopram 20mg and am concerned that it may be affecting my sleep. I understand it degrades some of the sleep cycle. I am just so tired. I have other sleep issues - sleep apnea, which is treated well using CPAP, and Periodic Limb Movement.

 

Clonazepam was prescribed to help the PLM but was ineffective and I am in a very slow taper (now down to about 1mg. from 2mg). I suffered horrible s/x when I made a big cut to the Clonazepam.

 

I have however had a much better time tapering off a-ds - both SSRIs and tricyclics - in the past.

 

I really want to get off Citalopram if it is part of what is making me extra tired. I was speaking to a friend yesterday who said how much extra tiredness she felt on SSRis. She is nearly through her taper. Can SSRIs (and particularly Citalopram) cause so mic fatigue.

 

The only thing that is holding me back from tapering is that I may have to go to the police to deal with a cyberstalker and don't want drug s/x while I am in that position.

 

I am considering cutting the Citalopram to 10 mg. 

 

What are your thought on the above?

[Gridley]

Hello, Chalkey, and welcome to SA.

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.

 

• Any drugs prior to 24 months ago can just be listed with start and stop years. 
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago) 
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016. 
• Please leave out symptoms and diagnoses. 
• A list is easier to understand than one or multiple paragraphs. 
• Link to Account Settings – Create or Edit a signature.
•  

Please do not go from 20mg Citalopram to 10.  That is a 50% cut and is way too fast.  You could end up with severe withdrawal symptoms that will make the fatigue seem like nothing.

 

At Surviving Antidepressants, it is recommended that a person taper by no more than 10% of their current dose with at least a four week hold in-between decreases.  The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.  Some people may have to taper at a more conservative rate as they are sensitive to even the smallest drops.

 

If you decide to taper the Citalopram, you would cut from 20mg to 18mg, hold for four weeks and, if you are feeling stable, cut another 10% of the current dose of 18, bringing you down to 16.2, etc.  You make the lower doses either by making a liquid or cutting pills and weighing them, as explained in this link:

 

Tips for tapering off Celexa (citalopram)

  
To get you started, and familiarized with the protocols followed by SA, I am linking a few topics so that you have a better understanding of what is recommended here. 

 

Before you begin tapering what you need to know
Why taper by 10% of my dosage?

Brain Remodelling

What is Withdrawal Syndrome?

Glenmullen’s withdrawal symptom list.

 

The same 10%/4-week rule also applies to the benzo, Clonazepam.  

 

We generally do not recommend tapering more than one drug at a time because it is difficult to attribute the cause if problems ensue.  We recommend tapering the more activating drug first (most antidepressants, such as Citalopram), leaving the more sedating drug to act as a buffer and to be tapered later.  This link gives more information:

 

Taking multiple psych drugs? Which drug to taper first?

 

To answer your other question, yes, Cutaopram can cause fatigue.  However, given the stressful situation you are in, this might not be the best time to begin a new taper.

 

Common citalopram side effects may include:  sleep problems (insomnia), feeling tired

 

This is your introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community. I hope you'll find the information in the SA forums helpful for your situation. I'm sorry that you are in the position that you need the information, but I am glad that you found us.

 

Edited February 18, 2018 by ChessieCat
added spacing

[Chalkey]

Thanks Gridley for all the info. I have inserted a signature.

[Chalkey]

I am now down to 18mg Citalopram, since 22 March.

 

I am also tapering Clonazepam and made a 2.5% cut >0.975mg one day earlier. So I have been in dual sw/d.

 

I am wondering whether I have been over ambitious and need to decide what to do with my a-ds.

 

My rationale for tapering a-ds now is for relieving fatigue, which is crushing, in the belief that a-ds may be adding to it. The primary cause of fatigue is a sleep disorder.  I am not aiming to come right off Citalopram for a long while yet because I think there is still some depression.

 

My options are obviously reinstating, holding or cutting further. However, I wonder whether it is worth persevering with cutting as my aims are so limited. Will getting down to 15mg Citalopram (my new target)  really make that much difference to my fatigue? I want to stop at a point where I can avoid having to grind up the a-ds as it is not only a PITA but also I am concerned about a mix up with the benzos on a bad day. Further a-d cuts will mean a delay in tapering benzos as I do not want to do two at once any more.

 

I have experienced some subtle s/x from even th8is small cut in Citalopram, a slight return of depression symptoms really.

 

So to sum up it's quite a simple question really. Is the 25% overall a-ds cut I am aiming for going to benefit me very much in terms of fatigue reduction, to the point that it's worth the negatives mentioned above?

 

Any thoughts?

 

[ChessieCat]

I've merged your new topic with your Intro topic because it is about your own situation.  This keeps your history in one place.

 

5 hours ago, Chalkey said:

My options are obviously reinstating, holding or cutting further.

 

If you are experiencing withdrawal symptoms it generally means that you are tapering too quickly.  Along hold sounds like it is in order.

[ChessieCat]

Keep notes on paper about your drug dosages and daily symptom pattern

 

A symptom pattern that occurs regularly over several days could mean the symptoms are from withdrawal, other adverse effects of drugs, or something else you do on a daily schedule.

 

In the course of discussion in your Introductions forum topic, you may be asked to keep notes on paper of your daily symptom pattern, including when you take your drugs, their dosages, and any symptoms.

 

What we need to see for every individual day over several days is:

- Time and dosage for drugs taken in morning
- Time and description of any symptoms in the morning
 
- Time and dosage for drugs taken in afternoon
- Time and description of any symptoms in the afternoon
 
- Time and dosage for drugs taken in evening
- Time and description of any symptoms in the evening
 
- Time and dosage for drugs taken in middle of the night
- Time and description of any symptoms in the middle of the night (such as waking)
 
And so forth. A diary, in chronological order, such as:
 
6 a.m. Woke and vomited
8 a.m. Took 2.5mg Lexapro
10 a.m. Had diarrhea
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Stomachache
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Headache got worse
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke with headache

 

An appointments diary is perfect for this and can be bought at stationery stores. 

They have a page for each day with times for appointments which can be filled in with doses, symptoms etc as shown by Alto.

[Chalkey]

I have just read the above and it mentions not tapering two meds at once.

 

I have decided to get my Clonazepam dose to one pill (0.975 atm >0.5 mg) before I taper any more Citalopram.

 

I am reluctantly going to reinstate to 20mg of the a-d as I don't want the hassle of cutting up two meds every day.

 

Then I will hold the benzo at a nice round figure while I taper the a-d to maybe half the current dose. 

 

Long hard slog ahead. 

[ChessieCat]

Please simplify your drug signature as per the following instructions.  Thank you.

 

We ask all members to create a drug signature.  Please update it whenever you make a change.  Please keep it nice and simple.  We only need details for the last 2 years.  Date, drug and dose only, no symptoms or diagnoses.  The other years can just be an overview.  

 

This is the preferred format which is helpful for the mods.  Thank you.

 

A request: Would you summarize your history in a signature - ALL drugs, doses, dates, and discontinuations & reinstatements, in the last 2 years particularly?

• Please leave out symptoms and diagnoses.
• A list is easier to understand than one or multiple paragraphs. 

• Any drugs prior to 2 years ago can just be listed with start and stop years.
• Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)
• Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016.
• Link to Account Settings – Create or Edit a signature.Before you begin tapering what you need to know

[Chalkey]

Done.