AuntieBea: tapering Celexa and Wellbutrin

[AuntieBea]

No, I am not taking anything else on a regular basis. Just the Wellbutrin and Celexa. The other drugs I referred to were isolated instances of being exposed to different drugs. In all there were three different antibiotics on five occasions, an antifungal, eye drops and dyes for repeated eye examinations, morphine, and anesthesia for surgery (a mix of several things). Also many IV solutions related to the low sodium situation. Not sure what’s in them. Also the COVID vaccine.

i will all these individually if that is needed. 

 

[AuntieBea]

Day 1 Daily Symptom Chart 1/9/2022 (Starts previous night)

 

8:00 PM. Bed. Headache, loud ear ringing, tongue hot and

                tingly.

10:00 PM. Woke up. Palpitations, other symptoms continue.

2:00 AM. Woke up. Symptoms continue plus anxiety, agitation,

                 Intrusive thoughts, and then panic.

7:30 AM. Breakfast. Same symptoms continue. Severe.

9”30AM. Wellbutrin 29.7mg. Symptoms continue. Very intense.

                Cannot think or function.

10:30 AM. Snack.

2:00 PM. Lunch.

2:30 PM. Starting to feel some relief from symptoms.

3:30 PM. 5.2mg Celexa. Symptoms continue to diminish.

4:30 PM. Cleared my icy car and driveway. Over exerted

                 myself. Strong palpitations but otherwise symptoms 

                 continue to be diminished.

6:00 PM. Dinner.

7:30 PM. Sleep. Symptoms still diminished. Not gone, but in 

                the background.

                

7:30 PM. Sleep. 

 

[AuntieBea]

Hello@Kiasofia

I just posted my first daily symptom notes but forgot to send them to your attention...so I’m doing that now😋

I’m sorry about the terrible way it is formatted. I don’t know how that happened. It was all nicely lined up when I typed it out. Ugh. I’m on an iPad and sometimes odd things like that happen for me.

 

Also, I am starting to remember some things I did not include in my post on Jan 6. These are major things that have occurred in the last 4-5 weeks which I think may be significantly affecting how I am feeling. Amazing I overlooked them before. My brains are really out to lunch.

On Dec 7 and again on Dec 14 I had a subcutaneous injection of Mistletoe (alternative cancer treatment). I began to notice a significant increase in symptoms, most notably panic attacks which are something new for me, so I stopped the treatments. This is when an overall increase in symptoms really began.

 

I saw a nephrologist regarding my low sodium issue right around the same time. He told me I needed to get of the Celexa ASAP and so I began what I thought was a very cautious taper. I dropped down from 5.4mg to 5.3mg, then to 5.2mg, then to 5.1mg over three weeks, at which time my symptoms really intensified so I backed it up to 5.2mg and have been staying steady there.

 

In the midst of all this, and consistent with my post on Jan 6, I also reduced my Wellbutrin from 30mg to 29.4mg (2%), and then back up to 29.7mg (1%) when symptoms got so terrible.

At that time the symptoms were such that it seemed clearly to be related to an adverse reaction to the Wellbutrin itself (possibly after holding at that dose for so long...is that possible?)  So based on my past experience with that I began to taper.

 

I wish I had exact dates for these occurrences but I do not. All I know is that they were all happening around the same time. All in the last 4-5 weeks. I think this is a big part of the problem, I have too many things going on at once. I can’t tell anymore what is affecting what. I also have radiation treatments in the mix now and am still wondering if that in any way could be affecting my symptoms.

 

Anyway, that’s my report for today😋

Thank you for being there for me Kia. 

 

[Kiasofia]

15 hours ago, AuntieBea said:

I’m sorry about the terrible way it is formatted. I don’t know how that happened.

No worries! We will probably need a week of notes at least in order to see if there is a pattern and what the next steps should be.

[AuntieBea]

Hi @Kiasofia

Here’s my symptom chart for yesterday. I will keep at it with the notes. It actually helps me to assess my own situation more clearly. Wish I had been doing more of that in the last couple of months.

After a rough start I did get some welcome relief yesterday afternoon!

Day 2 Daily Symptom Chart 1/10/2022 (Starts previous night)

 

7:30PM. Sleep. Diminished symptoms.

11:30PM. Woke up. Intense palpitations. Whole body throbbing and pulsing.

Woke up every 2-3 hours the rest of the night with continued palpitations, throbbing and pulsing, hot feet/legs/face, headache.

6:00AM. Got up. Symptoms continue.
7:30AM. Breakfast. Symptoms continue. 
8:00AM. Agitation and anxiety starting to ramp up. 
10:00AM. Radiation, day 6.

10:30AM. Wellbutrin 29.7mg (an hour late, totally forgot☹️).

10:30AM. Snack. Headache, anxiety, agitation (medium intensity).

1:30PM. Lunch. Symptoms begin to diminish.

2:00PM. Therapy session.

4:00PM. Celexa 5.2mg. Snack. Minimal symptoms.

6:30PM. Dinner. 
8:00PM. Pulsing and throbbing, headache starting slightly.

9:00PM. Sleep.
 

 

 

[Altostrata]

You're currently getting radiation?

 

While you were being treated, were there any days you did not take Wellbutrin and Celexa? How about before, during, and after surgery?

 

@AuntieBea, you've had many strong drugs recently, all of which are known to sometimes cause adverse effects such as you've described. Unfortunately, some people who have had cancer treatment also say they have post-treatment effects that have a lot of symptoms in common with the fluctuating autonomic upset of drug withdrawal syndromes (as does long covid).

 

Even if you did skip doses of Wellbutrin and Celexa at times in treatment, I don't think we can distinguish withdrawal symptoms from those from adverse effects of your cancer treatment. Since you went back on Wellbutrin and Celexa, it's very possible any withdrawal symptoms from them have gone away.

 

You don't need to post daily notes here for now.

 

You're going through a rough patch. I think you will have to get through cancer treatment, one day at a time, before addressing the antidepressants again. Hang in there.

[AuntieBea]

Hello@Altostrata

Thanks for getting back to me.

That validates what I suspected was going on...that I have too many things happening all at once to narrow the symptoms down to any one cause. In general I have been very much in touch with my body throughout tapering and could trace the cause and effect of symptoms pretty accurately, but I am in over my head now trying to figure out what’s causing what. I will take your suggestion to heart and just take it a day at a time while I get through the remaining radiation treatments and recovery. I will not be doing any further cancer treatments after that.  

Just for the record, I have not skipped any doses of Celexa or Wellbutrin during any of my health related treatments in the last six months. That has been consistent throughout.

 

I am guessing then that your advice would be to hold at the current dose of Celexa and Wellbutrin until I stabilize?

Meanwhile, can you please advise me about this  current dilemma...I suspect that I recently weighed out my Wellbutrin dose incorrectly and have been taking as much as 38mg as opposed to 29.7mg for the last 6-7 days. I think this may actually account for some of the most recent intense increase in symptoms. 

My question is what do I do now? Go straight back to the correct dose of 29.7mg, or should I slowly bring the dose back down? I don’t actually know for a fact that this mishap occurred, but I strongly suspect it. 
 

Also wondering...are you aware of any effect that radiation treatments have on drug metabolism that could ultimately affect withdrawal?

Thanks again Alto!

 

 

[Altostrata]

8 hours ago, AuntieBea said:

I suspect that I recently weighed out my Wellbutrin dose incorrectly and have been taking as much as 38mg as opposed to 29.7mg for the last 6-7 days. I think this may actually account for some of the most recent intense increase in symptoms. 

 

Have these symptoms increased, decreased, or stayed the same over the 7 days?

 

Sorry, I am not very knowledgeable about the effects of radiation, other than it can be difficult to get through. Please join a specialized support group for your condition.

[AuntieBea]

Hi @Altostrata

 

The most noticeable change  in symptoms in the last 6-7 days has to do with feeling flushed and hot throughout my body, but especially feet, face and legs. It flares up with strong palpitations in the middle of the night, goes on through the morning, and then intermittently throughout the day. I do not have a fever.

Otherwise, symptoms have remained the same. 

 

 

 

[Altostrata]

Yes, taking more Wellbutrin than usual might do that.

 

Many people find fish oil and magnesium supplements helpful, see

 

https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

 

https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

You might try a little bit of one at a time to see how it affects you. Please let us know how you’re doing.

[AuntieBea]

Thank you @Altostrata

Thats very helpful!

[AuntieBea]

@Altostrata

@Kiasofia

Hello again,

 

Would you please validate for me (or not) that I have done the right thing by straight away dropping my Wellbutrin dose back down to normal (29.7mg) rather than bringing it back down slowly. This is after my 6-7 day mishap of taking an increased dose of probably 38mg. This is my third day of taking a normal dose.

As of today, the flushing/hot symptoms I mentioned yesterday have again intensified together with increased headache, eye pain, vision loss, palpitations and sleep loss.

I anticipated that all this might happen and know I’ll get through it OK, but it would be reassuring to know that I did the right thing by dropping straight down to normal dose and have not created yet another problem for myself.

 

Thank you both!
 

 

 

 

[Altostrata]

Yes, you diid the right thing. It may take some days for those symptoms to go away.

[AuntieBea]

@Altostrata

OK. Thanks!

[AuntieBea]

Hello @Altostrata

@Kiasofia

 

I need to ask for some help once again.

Day 6 of my reduced Wellbutrin dose (29.7mg). The last 2 nights I have been experiencing extreme agitation throughout the night which prevents me from being able to sleep or even rest throughout the night. It’s quite scary. The intensity and duration of it is different from anything else I’ve been experiencing.recently.

The agitation starts slowly 3-4 hours after my Celexa dose in the afternoon, ramps up at bedtime and goes on through the night and throughout the following morning. Yesterday I had a few normal hours in the afternoon until the symptoms.started  up again some time after the Celexa dose.

Other symptoms continue as before such as palpitations, throbbing and pulsing sensation, hot, flushed face, feet, arms and legs. 

Hoping for some help with this. Wondering if the Celexa is involved somehow and if I should be doing something differently. I found the following  quote from back in my history...not sure if it’s relevant.

 

On 4/20/2018 at 9:45 PM, Altostrata said:

It's also possible that as you reduced Wellbutrin, it caused the Celexa to be metabolized faster, giving the effect of a larger decrease in Celexa.

 

Thanks so much!

[Altostrata]

What is your daily drug schedule? Please keep daily notes of times o’clock you take your drugs, their dosages, and your symptoms throughout the day. We need to know how you feel before and after taking each drug, and your symptoms in between. Post 24 hours of notes at a time in this topic, in a simple list format with time o’clock on the left and notation (symptom or drug and dosage) on the right. This can show if your symptoms are adverse effects from one of your drugs.

[AuntieBea]

@Altostrata

OK. Will start that now. Thank you!

 

 

 

[AuntieBea]

@Altostrata

Hello!

 

Day 1 Daily Symptom Chart 1/17/22 (starts previous night)

 

10:00PM thru next day at 6:00PM. Intense agitation (can’t sit or lie still), palpitations, pulsing and throbbing, hot/flushing arms, legs, face, feet. Did not sleep at all. 

8:00AM. Breakfast.

9:30AM. 5.2mg Wellbutrin. Snack.

10:00AM. Day 11 radiation therapy.

2.00PM. Lunch.

4:00PM. 5.2mg Celexa (1/2 hour later than usual). Snack.

6:00PM. Palpitations, throbbing/pulsing, hot/flushing, headache, loud ear ringing, lightheadedness. Agitation is diminishing.

7:00PM. Dinner.

8:00PM.  Agitation continues to diminish. Other symptoms continue. 
 

A look ahead...next day when this was posted.

I’m actually feeling quite well today. Some symptoms as always, but completely manageable. Appreciating it, enjoying it, and knowing that things could flare up again tomorrow....

This is all so challenging. Grueling actually. 

As always, thank you Alto.

Will post again tomorrow.

8:30PM. Sleep.
 

 

 

 

 

 

[Altostrata]

42 minutes ago, AuntieBea said:

6:00PM. Palpitations, throbbing/pulsing, hot/flushing, headache, loud ear ringing, lightheadedness. Agitation is diminishing.

 

Please explain more what this is like. Are the palpitations, etc. sudden? Do they last though agitation diminishes? Does the agitation start before you take Celexa?

[AuntieBea]

17 hours ago, Altostrata said:

 

Please explain more what this is like. Are the palpitations, etc. sudden? Do they last though agitation diminishes? Does the agitation start before you take Celexa?

@Altostrata

What I am calling palpitations is that I am super aware of my heart thumping. I can’t actually hear it but it feels intense. My actual heart rate has never been abnormal. It is as though it is a sensation in my body but not the actual activity of my heart. It is more or less an ongoing WD symptom. I am more aware of it though when it is accompanied by what I am calling agitation. So yes, the palpitations continue in the background even when the agitation diminishes. They are part of what I call my “WD Normal”.

 

The pulsing/thumping I mention as a symptom is similar, but it is a sense of motion throughout my body. Like pulsing waves.

 

The agitation includes all these sensations together with feeling  like I am going to “climb out of my skin”. Can hardly sit or lie still. It’s like the drug induced anxiety I experienced when Ativan backfired on me many years ago. 

 

In the last few days the agitation has not started immediately but several hours after taking the Celexa. It has then gone on through the night and well into the next day. If it is present before taking the Celexa, it’s because it’s still lingering from the night before. 
Hope I’m making myself clear. The duration of this recent agitation is different than usual, and is what makes me suspect it has to do with the recent accidental updose of Wellbutrin.
 

I will further clarify if necessary. 
 

PS. To further complicate this, yesterday I felt quite normal with none of these intense symptoms. Now last night they hit me like a wave all over again, following the pattern I have described. 

 

 

[AuntieBea]

@Altostrata

Day 2 Daily Symptom Chart 1/18/22 (starts previous night).

 

1:00AM. Wake up. Palpitations, hot/flushing. No agitation.

4:00AM. Wake up. Same symptoms.

6:00AM. Get up. Fewer symptoms. 1/2 c coffee.

8:00AM. Breakfast. 
9:00AM. 2.7mg Wellbutrin. Snack. Mild agitation starting up.

10:00AM. 12th day radiation. Agitation diminished. Mild headache, ears ringing, palpitations.

11:30AM. Snack.

2:00PM. Lunch.

3:00PM. 5.2mg Celexa. Mild symptoms continue.
3:30PM. Walk. 
6:00PM. Dinner. 
8:00PM. Symptoms increasing. Palpitations, pulsing/throbbing, headache.

8:30PM. Sleep.

Felt surprisingly well on this day. 
By next day (today) I am feeling very intense symptoms again. 
Here is the beginning of today’s chart.

 

11:00PM. Wake up. Intense heat/flushing, pulsing/throbbing, agitation, palpitations, slight dizziness (did not last).

2:00AM. Wake up. Same symptoms. No more sleep.

8:00AM. Breakfast.

9:00AM. 29.7mg Wellbutrin. Symptoms continue.

10:00AM. 13th day radiation.

11:00AM. Symptoms continue.
 

 

[Altostrata]

6 hours ago, AuntieBea said:

9:00AM. 2.7mg Wellbutrin. Snack. Mild agitation starting up.

 

What does the agitation feel like?

 

What is your usual intake of coffee?

[AuntieBea]

@Altostrata

 

I usually drink 1/2 cup of coffee in the morning. 
 

Agitation feels like I can’t stand being in my body, like I’m going to climb out of my skin. If I lie down I can’t rest because my physical body is activated, edgy. I feel like I have to stay in motion, on my feet doing things because I can’t stand to be still. Was out shoveling snow at 3:00AM two nights ago for that reason. My physical body feels overly activated. Can’t sleep or rest. 
 

Hope that helps. I realize  it’s hard to describe.

 

 

 

 

[Altostrata]

How soon after you take Wellbutrin does this agitation start up? Why are you taking 2.7mg Wellbutrin, again?

[AuntieBea]

@Altostrata

 

That was a typo. The amount of Wellbutrin I take is 29.7mg. 

The agitation is already going on before I take the Wellbutrin. 
It ramps up 5-6 hours after taking the Celexa in the afternoon and goes on all night. 

[AuntieBea]

@Altostrata

 

It’s 10:00PM. I just slept 2 hours and woke up with agitation and other symptoms significantly worse. Exytemely intense.  It is 6 hours after taking 5.2mg Celexa.
 

[Altostrata]

How did you get from 100mg Wellbutrin at the beginning of November to 29.7mg now?

 

What effect does the coffee have on the agitation? It's not unusual for caffeine to have an outsized effect in people who are otherwise iatrogenically sensitized. Strongly suggest you taper off caffeinated coffee by gradually substituting decaffeinated.

 

Does the agitation get worse at any particular times of day? Please indicate this in your daily notes, post at least 24 hours at a time.

 

I cannot interpret any symptoms in isolation. You are also getting radiation treatment, that has adverse effects as well. Are you taking drugs related to your cancer treatment?

 

 

 

 

Edited January 20, 2022 by Altostrata
UNusual

[AuntieBea]

@Altostrata

7 hours ago, Altostrata said:

How did you get from 100mg Wellbutrin at the beginning of November to 29.7mg now?

I started tapering Wellbutrin in November,2019, over two years ago. Not just this last November, 2021.

 

7 hours ago, Altostrata said:

What effect does the coffee have on the agitation?

The agitation and other symptoms are so intense It is hard to isolate whether the coffee is making it worse or not.

I will taper it down to be sure. 

 

7 hours ago, Altostrata said:

Are you taking drugs related to your cancer treatment?

No, I am not taking any cancer related drugs.

[AuntieBea]

@Altostrata

 

Day 3 Daily Symptom Chart 1/19/22 (starts previous night)

8:30PM. Go to bed. No agitation or other symptoms. 
11:00PM. Woke up after 2 1/2hrs sleep. Intense palpitations, pulsing/throbbing, heat/flushing, agitation, headache, dizziness. Went back to sleep.

2:00AM. Wake up. Intense symptoms continue. No more sleep.

5:00AM. Awake. Intense symptoms continue.

7:00AM. Get up. 
8:00AM. Breakfast. Intense agitation continues.

9:00AM. 29.7mg Wellbutrin. Agitation and other symptoms continue at the same intensity.

10:00AM. 13th day radiation.

11:00AM. Snack. Symptoms the same.

2:30PM. Lunch. Agitation and other symptoms remain the same. 

3:00PM. 5.2mg Celexa. Symptoms remain constant. They are intense. 

5:00PM. Symptoms the same. No increase after taking Celexa.

6:00PM. Agitation starting to diminish slightly.
7:00PM. Dinner. Agitation still there but lower than it’s been all day. 

8:30PM. Sleep.

10:00PM. Wake up. Intense agitation, palpitations, hot/flushing.

Very intense. Slept briefly on and off the rest of the night with continuing intense symptoms.

 

[Altostrata]

Are you taking immediate-release Wellbutrin?

[AuntieBea]

@Altostrata

5 hours ago, Altostrata said:

Are you taking immediate-release Wellbutrin?

I take Bupropion HCL I believe that’s immediate release.

 

 

 

[AuntieBea]

@Altostrata

 

Day 4 Daily Symptom Chart 1/20/22 (starts previous night)

 

8:30PM. Sleep.

10:00PM. Wake up. Intense agitation, palpitations, hot/flushing.

Very intense. Sleep briefly on and off the rest of the night with continuing intense symptoms.

7:00AM. Intense agitation, palpitations, hot/flushing continue.

8:30AM. Breakfast.

9:00AM. 29.7mg Wellbutrin. Agitation and other symptoms are still present but slightly diminished. 
10:00AM. 14th day radiation. Agitation and other symptoms are moderate.

11:30AM. Snack. Agitation and palpitations ramping up.

2:00PM. Lunch.  Agitation and palpitations are moderate.

3:30PM. 5.2mg Celexa. Agitation and palpitations are diminishing. 
5:00PM. Agitation is absent, low level palpitations.

7:00PM. Dinner.  No agitation, low level palpitations.

9:00PM. Sleep. No agitation. Palpitations increasing.

11:00PM. Wake up. Intense palpitations, hot/flushing, headache, pulsing/throbbing, agitation.

2:00AM. Wake up. Intense symptoms continue. Light sleep on and off for the rest of the night with continuing intense symptoms.

 

 

[Altostrata]

According to what you know about the chemotherapy you're getting -- perhaps from participating in peer support groups for cancer treatment -- what are the adverse symptoms it may cause?

[AuntieBea]

@Altostrata

 

7 hours ago, Altostrata said:

According to what you know about the chemotherapy you're getting -- perhaps from participating in peer support groups for cancer treatment -- what are the adverse symptoms it may cause?

I am not getting chemotherapy. I do not need to have chemotherapy for my particular situation. I had surgery and am now getting radiation treatments. 
I have not taken cancer related drugs of any kind.

[AuntieBea]

@Altostrata

 

Day 5 Daily Symptom Chart 1/21/22 (starts previous night)

 

9:00PM. Sleep. No agitation. Palpitations starting to increase.

11:00PM. Wake up. Intense palpitations, hot/flushing, headache, throbbing/pulsing, agitation.

2:00AM. Wake up. Intense symptoms continue. Light sleep on and off the rest of the night with continuing intense symptoms.

6:00AM. Get up. Symptoms continue to be intense.

8:00AM. Symptoms begin to diminish. 
9:00AM. Breakfast. Moderate symptoms.

9:30AM. 29.7mg Wellbutrin.

10:00AM. 15th day radiation. Moderate symptoms.

11:00AM. Agitation, hot/flushing, headache, palpitations ramping up.

12:00 PM. Snack.

2:30PM. Lunch. Agitation diminished. Strong palpitations, hot/flushing, headache.

4:00PM. 5.2mg Celexa. No agitation. Terrible headache, strong palpitations, hot/flushing.

5:30PM. No agitation. Headache continues. No other symptoms.

6:30PM. Dinner. Headache continues. No other symptoms.

8:00PM. Headache diminishing.

10:00PM. Sleep. Mild palpitations. No other symptoms.

 

 

[Altostrata]

I misspoke, I meant your radiation treatments. Have you looked into the adverse effects of your particular treatment? See https://www.cancer.gov/about-cancer/treatment/types/radiation-therapy/side-effects

 

As explained before, I cannot tell what might be your reactions to your radiation treatments and what might be psychiatric drug effects. To do this, you need to become the expert on your radiation treatments. I cannot do this for you.

 

You need to find out when adverse effects from radiation show up, how long they last, do they affect your sleep, etc. -- see if they explain your symptom pattern. Please let us know what you find.