☼ Windsor77: Celexa - it's time for peace

[Windsor77]

FYI. I took 6.5 mg an hour ago.   We’ll see what tomorrow brings. 

[ChessieCat]

Keep symptom notes.  It's easy than trying to remember and more objective.

[Windsor77]

6:30am - wake.  Hand/finger jerking.  

Walk dog. Shaky leg muscles. Shaky arms and hands.  

Jaw nerves twitching. 

I can feel this medicine in my nerves/muscles. 

I have no other way to explain it. 

 

I have read read this site pretty extensively.  I have read many instances where Alto and others have stated that reinstating any ssri after ct and withdrawal symptoms can be “too much” or too activating to the nervous system.  Considering that these symptoms presented AFTER I went back on Zoloft after 3 months of ct from lexapro, why does no one here suspect that this is what has been happening with me?  

From yesterday to today is a 180 degree turnaround. 

 

Take it from me, it’s too much.  Reread the descriptions of mild serotonin toxicity.  You’ll find that it sounds a lot like my symptoms. I have no fever, etc., but shaky, jittery, jerks weakness, numbness sensations, all more prominent and present when I dose.  

This site talks about how hyper sensitized we become.  

I spent yesterday feeling normal. This morning, it’s clear that this medicine is “activating” to my CNS.   

All of our experiences Are similar but also unique. 

 

 

[manymoretodays]

5 hours ago, Windsor77 said:

I have read read this site pretty extensively.  I have read many instances where Alto and others have stated that reinstating any ssri after ct and withdrawal symptoms can be “too much” or too activating to the nervous system.  Considering that these symptoms presented AFTER I went back on Zoloft after 3 months of ct from lexapro, why does no one here suspect that this is what has been happening with me?  

 

This is what happened to you, yes, no argument there Windsor77.

 

5 hours ago, Windsor77 said:

Take it from me, it’s too much.  Reread the descriptions of mild serotonin toxicity.  You’ll find that it sounds a lot like my symptoms. I have no fever, etc., but shaky, jittery, jerks weakness, numbness sensations, all more prominent and present when I dose.  

This site talks about how hyper sensitized we become.  

I spent yesterday feeling normal. This morning, it’s clear that this medicine is “activating” to my CNS.   

All of our experiences Are similar but also unique. 

You'd be surprised though.......I think there is more similarity,  That is IF, you could find those with the same exact medication/drug history and history of W/D......be it tapering or C/T..... and life circumstances, environments, age, health in all dimensions(mind, body, spirit), etc.    It's hard to find a control group like that.

 

So.....hopefully you will find that you start to have more windows than not soon.  With a consistent approach.

The rule of 3KIS

Maybe this will help.  More of Alto's wisdom in the first post there.

 

Attitude, non drug coping, and a nice consistent approach.  I can't wait until the next window hits for you.  Go on back.....as I see that you felt pretty good in October and then again, not long ago at all.  I'm not trying to downplay your feelings of "it's too much" Windsor..........I've been there before too.......I found lot's of coping, non-drug coping to use that pulled me through until I got to the end of my taper.  And then.......even then........I had to deal with symptoms off and on.  And I still do.......usually only when something else comes up that causes my nervous system to react.......be it an emotional event, or ch ch ch changes that I'm making........or schedule and routine changes even sometimes.  Oye.....new stuff.....still = scary a bit for me,  sometimes still.  And then some of the symptoms that I'll still call secondary to W/D syndrome or secondary to medication toxicity.  I bet I had some serotonin toxicity too in my history.  But I have all these honed skills to use now, and a whole new philosophy, if you will.

 

Do you celebrate Gratitude Day and Month?  Formerly known to me as Thanksgiving.......and oh.......same thing I suppose.  Set your sights on happy things for today.  And I'm glad you went on back to 6.5 mg.  Might I mention that many of us, me included tend to go through an angry phase or irritable discontent........for me, it was out of this world crabbiness for awhile.  And even that resolved, for the most part........I have my days or moments.

 

Do you do any meditation or walking even?  I found various things to help and now and then I switch  up my routines.......as I've never been "a real creature of habit".  I get easily bored yet do keep working on discipline and timeliness, knowing that they often pay off.  I sometimes "act as if...." even when feeling distressed.......until I can "act as I am". 

So.....yes, the notes......just so you start to see improvements even or know what does what to you.  I expect you might level off soon and I hope for the greatest window for you soon too!

 

.....and I do go on sometimes......maybe something in there will help you feel more understood.

 

Love, peace, healing, and growth,

mmt

 

 

 

[Windsor77]

Thanks MMT. I do walk and do some meditation. It helps a little.  

 

I am hopeful to find a dose that eliminates the side effects.  I’d consider myself stable if I could do that.   

I’ll stay at 6.5 for a week or so.  Then perhaps go to 6mg.  

We shall see what the next week holds!

 

Hope and Healing to all!!!

W77

[Windsor77]

No luck. As predicted. No change.  Though, I talked to my doc and I am gonna try the switch to lexapro 3.5mg on Monday to see if this reduces my symptoms.   I’ll also probably break down and see a neurologist.  After this long, I really need to rule out my fears. 

Again, I know the collective eye roll is taking place upon reading this, but we each have to go through our individual steps to acceptance. 

We will see.   Any thoughts?  I’d think I’d need to stay with same dose for a few weeks at least to get used to the new (old) drug.  

 

Thanks to Chessie and MMT for your continued support. 

 

W77

[ChessieCat]

You said that you were better taking your previous dose every second day.  It seems like you are after a quick fix.  Before changing drugs why not continue to reduce a bit more to see if getting to a daily dose of 1/2 your previous dose works.

 

Remember you are trying to balance between what you think is a drug side effect and getting withdrawal symptoms.

 

Changing drugs can cause all sorts of problems. Possibly withdrawal symptoms from old drug, start up and/or side effects and/or bad reaction to the new drug.  Because of the change you won't know what is causing what.

[Windsor77]

I hear you but I have already switched the script.    

[ChessieCat]

You've only given it one of two days.  And you aren't down to 1/2 dose yet.  As I said, you are after a quick fix.  You said that you felt better on 1/2 the dose.  It is going to take a little bit of time to do the fast taper.  My suggestion seems like a logical (possible) solution, yet you don't seem willing to give it the short amount time to find out if it will work.

 

It takes about 4 days for a dose change to get to a steady level in the blood and a bit longer for it to register in the brain.

 

On 11/16/2018 at 7:11 AM, Windsor77 said:

I’ll stay at 6.5 for a week or so.  Then perhaps go to 6mg.  

We shall see what the next week holds!

 

You haven't even stuck to what you said you were going to try.

 

2 hours ago, Windsor77 said:

No luck. As predicted. No change.

 

It's only be 1 or 2 days on the lower dose.  Seems like you had already decided that it wasn't going to work.

 

50 minutes ago, Windsor77 said:

I have already switched the script.

 

I'm assuming you still have citalopram left.  You can still try what I suggested.  If it works then you can tell the doctor you changed your mind and decided to stick with the former drug instead of trying a different drug.

 

We make suggestions but it is your decision what you decide to do.

[Altostrata]

2 hours ago, Windsor77 said:

No luck. As predicted. No change.  Though, I talked to my doc and I am gonna try the switch to lexapro 3.5mg on Monday to see if this reduces my symptoms.   I’ll also probably break down and see a neurologist.  After this long, I really need to rule out my fears. 

 

Hello, Windsor. Withdrawal symptoms are very poorly understood, even by psychiatrists and neurologists.

 

You can clearly see your symptoms are drug-related. A neurological exam is unnecessary. A genetic test will show nothing useful. Your doctor is barking up all kinds of wrong trees.

 

What we see here is going on and off psychiatric drugs often makes you hypersensitive to drugs and sometimes supplements and foods. More is not better. Yes, it's possible that when you reinstated 10mg citalpram, you overshot considerably, maybe by 100% or more.

 

Since you find relief when you take none -- some amount still being in your bloodstream from your previous dose -- It could be that 5mg citalopram or even less would be sufficient.

 

Switching to 3.5mg Lexapro, citalopram's stronger sibling, is not going to help, either. You'd be taking a dose equivalent to 7mg citalopram in a different, harsher drug.

[Windsor77]

Thanks Alto.  I will ask my doc to hold the switch.   I really appreciate everyone’s help and guidance.   

 

I value this site and everyone on it so much, that I cannot put it into words.  

Thanks

W77

[ChessieCat]

It's important not to panic and end up making hasty decisions.  Please be patient.

[JackieDecides]

On 7/16/2018 at 6:18 PM, Windsor77 said:

It then occurred to me after, so many years of wondering “why me”, that anxiety is a narcissist.   Having grown up with one, and encountered many (occasionally in the mirror), I know how they work.  They have the upper hand when you are down, they thrive on the tiny cracks in our confidence, they demand constant attention, and grow more powerful when they get it.   Maybe after all, for me this anxiety, though likely genetic, manifests due to the experiences we go through at certain points.   The deep pain we all sometime experience burns in to the mind as the most vivid of memories, in many cases more so than the happiest times.   Our brains revert to the conditioning they received......that which caused us to doubt our inner compass and fear the uncertainty of life.   When we are taught that we must be prepared for everything, or we are inferior, the uncertainty of life becomes a huge obstacle.  

 

I don't know if this is 100% true or mostly true or just sort of true ( just true for you) but I wanted to tell you, even though you aren't all the way off drugs like I am, you already write much better.  I think I would almost rather have more physical symptoms and less of the "can't think, write badly and with great effort" symptoms but maybe not. who knows.

 

anyway, in the pre-dawn darkness after yet another night of not nearly enough sleep, I wanted to say you write good* I hope you can appreciate that! 😍

 

*um, well. you write well. 

 

ps I also have GAD and I really need to re-do my signature to make it easier to read

 

and I hate it when I can't think/write!!!!!!!!!!!

[Windsor77]

7 hours ago, ChessieCat said:

It's important not to panic and end up making hasty decisions.  Please be patient.

Great summary of how I’ve been feeling/acting.

 

Thanks to you all for your help and counsel.  

[Windsor77]

46 minutes ago, JackieDecides said:

 

I don't know if this is 100% true or mostly true or just sort of true ( just true for you) but I wanted to tell you, even though you aren't all the way off drugs like I am, you already write much better.  I think I would almost rather have more physical symptoms and less of the "can't think, write badly and with great effort" symptoms but maybe not. who knows.

 

anyway, in the pre-dawn darkness after yet another night of not nearly enough sleep, I wanted to say you write good* I hope you can appreciate that! 😍

 

*um, well. you write well. 

 

ps I also have GAD and I really need to re-do my signature to make it easier to read

 

and I hate it when I can't think/write!!!!!!!!!!!

Thanks!   I used to like to write more.  I appreciate your comments.  

Hang in there. The mental fog breaks.  

Now if I can find a way to shake the physical symptoms, I’ll be ok.  We all will eventually. 

 

W77

[Windsor77]

Happy Thanksgiving to all.  I hope we can all find some happiness today. 

As for me, I’m holding at 6.2mg.  Been having touches of momentary anxiety, as happens with every reduction.   

I am growing more and more concerned though, as the random twitches and jerks have not subsided.    I know that patience is the key here, so I am holding on and hanging in.  Benadryl is my go to when it’s too much.   

Im not sure I’ve done any of this correctly, as I’ve quit caffeine and alcohol during the past three months.  I’m just about off of sugar, etc.  all of these are activating to my symptoms.   

Has anyone ever had the tremors or jerks muscle fatigue and nerve pain and had them subside?  Still worrying about being stuck like this forever.   Am I experiencing PANES?  

 

Thanks

W77

[ChessieCat]

2 hours ago, Windsor77 said:

Am I experiencing PANES?

 

What is PANES?

[ChessieCat]

Are you still taking magnesium?

[Windsor77]

https://pdfs.semanticscholar.org/286a/cdc247930f694a94dbff36c411ed77c12c74.pdf

 

not taking magnesium.  I was getting a lot of fatigue and when I stopped it, the fatigue subsided. 

[ChessieCat]

Persistent Adverse Neurological Effects Following SSRI Discontinuation (PANES)

 

[Windsor77]

Today is as bad as the shakiness and jerks have been.  Holding at 6.5mg.   Not sure what to do with the meds. Alto mentiononed a 5 mg dose.  That would be a big jump from where I was at 7mg, now 6.5mg to 5, right?  My logical side tells me that I am just now feeling the effects of the reduction to 6.5mg, and that these heightened sensations and shakiness are due to this reduction.  That said- 

I am going to make a neurologist appointment.  

I’m not concerned if they are well versed in ssri WD or tapering.   I have to know if something else is wrong with me.  

If testing shows nothing, then I know that it is the removal of this drug from my system causing these symptoms.   They are extremely unpleasant and hard to endure, and are perpetuating my anxiety, which is otherwise non-extant. 

 

 

 

[Windsor77]

Benadryl is the only thing that helps.   

[Windsor77]

Hard to believe I am only going on 5 months of posting here at SA.  Frankly, after so much mental anguish attempting to problem solve my way out over the past 13 months since I ct’d Lexapro, I am feeling that it is very unlikely that any drug switch will help make these physical symptoms go away.    

Here is what I have learned:

 

My original episode was Mild serotonin toxicity brought on by taking pantoprazole, peppermint oil, and a vitamin with grapefruit with my lexapro over a 2.5 month period.   My CYP system was a mess.

 

Caffiene became activating to my CNS, so I weaned off of it. 

 

Alcohol became activating to my CNS, so I barely consume any, after drinking moderately for the past 10 years. 

 

After I switched to 10 mg celexa from 50mg Zoloft (I halved my 100 mg dose in an effort to relieve the nervous tension and shakiness) the mental hell I went through from June-September was the worst experience I have ever dealt with.  Full on 24/7 SEVERE adrenaline filled anxiety and rumination, catastrophic thoughts, anhedionia, you name it, it was there.   I still worked and maintained my normal day to day.   But wow, was it a tough road to go.

 

Then, all of that mental fog, fear, worst case scenarios and adrenaline fatigued heart palpitations left.  It just slowly faded.  Can not explain why. 

 

Now, my brain being back to itself, I am attempting to rationally find a way to tackle the physical symptoms.   I still have what I consider rational fear of a CNS disease.   I mean, symptoms have been present in varying states since March-April.   Getting the clear from a neurologist will allow me to release the sense of “what if” which is always in the back of my mind each time these symptoms present like they did today. 

 

I still I’ll walk the fence on “going back” to the SSRI roulette game.   It’s tough when you are enduring these symptoms and feelings, remembering when they did not plague you and monopolize your thoughts.  It’s with a large dose of apprehension that I wonder if I will wake every day for the rest of my own performing the usual full body sensory assessment to rate the status of today’s menu of the symptom “wheel of misery”.    Many times as of late I almost welcome the idea of going back on,  abandoning what had always bothered me about taking a pill.   I’d think, “why do I have to take this stuff?”  I felt inferior for having to take a pill to regulate my anxiety and rumination.  Now, I don’t care about any of that.  My pride, you see, matters not any longer.   I want to live out the rest of my days feeling as far from how I physically feel today as possible.  I NEVER FELT LIKE THIS UNTIL I REINSTATED SSRI. The question is, is this scenario even possible at this point in my process?  The consensus from the group seems to think not.   And part of me agrees.   

 

I certainly believe that these nervous system symptoms are a result of the Zoloft reinstatement at 100mg being too much.  Then I  reduced myself to 50 mg and they went away for a while.   Then they came back.   Then, like I have mentioned, I switched on 5/30/18 to celexa 10mg.  Then To liquid 7/9/18.   Now I sit at a 6.5 mg crossroad.  

 

Am I feeling WD from the sertraline switch to celexa in June? Is this still from the lexapro ct last October?  The world may never know.   The uncertainty is my enemy.  Talking to a neurologist can at least eliminate some of the uncertainty.    Though, with good luck, I’ll find that I don’t have a degenerative CNS disease.   But that deep feeling of relief will be shortly overshadowed by the stark, shaky, jittery, weak-feeling, twitchy reality that I wake up to every day.   That is not such a good prognosis, as m any of our fellow members can attest.   

 

I am meditating, walking, and floating, as you can see writing helps me a little too.  Has any member had the CNS symptoms I have shared and seen them subside?  

 

W77

 

 

[Windsor77]

As I picked up my prescription today, I realized how unscientific his whole process has been.   I skipped again last night.   I feel fairly decent today.    Still feel a bit of anhedonia , but the twitches are more than 60% lessened and the “wired” hyper reflex feeling is a little bit lessened.   

I decided that I am giving celexa one more month to experiment with.  Gonna try to get low enough to feel better daily without skipping, but I’m really not sure how much that means.   There is no way to know.  Not without trial and error.    That said, I feel like trying a med for 6 months and feeling progressively worse is giving it the old college try. 

How do we not know that celexa is the cause of this pain, stiffness, twitching, etc.   how do we not know that another drug may not relieve some of these symptoms?  

[Windsor77]

As I was sitting with my wife just now, I noticed that my body and head were rocking back and forth slightly.   I am guessing but hoping that this not TD.   I am really freaking out right now.   I want to stop the meds asap.   I don’t know what to do.  I am afraid that if I continue, it will only get worse and be permanent.   

 

I am feeling really screwed right now.   Not sure what to do. 

 

 

[Windsor77]

Seems to me that the effects of lowering to 6.5 are finally here.   The anxiety and panic are back in full force.   The slight rocking motion and fear of permanent nerve damage or Parkinson’s or ALS or whatever is wrong with me has triggered a full panic session.   Yay for me.    

 

Not in a great spot right now. 

[Altostrata]

Please do not skip doses. That has a ripple effect that might shock your nervous system some time later or the next day and continue for weeks.

 

On 11/23/2018 at 6:56 AM, Windsor77 said:

Today is as bad as the shakiness and jerks have been.  Holding at 6.5mg.   Not sure what to do with the meds. Alto mentiononed a 5 mg dose.  That would be a big jump from where I was at 7mg, now 6.5mg to 5, right?  My logical side tells me that I am just now feeling the effects of the reduction to 6.5mg, and that these heightened sensations and shakiness are due to this reduction.  That said- 

I am going to make a neurologist appointment.  

I’m not concerned if they are well versed in ssri WD or tapering.   I have to know if something else is wrong with me.  

If testing shows nothing, then I know that it is the removal of this drug from my system causing these symptoms.   They are extremely unpleasant and hard to endure, and are perpetuating my anxiety, which is otherwise non-extant.

 

Since your symptoms began when you made some precipitous drug changes, it is far more likely the symptoms are drug-related rather than a neurological condition. It's not likely the neurologist will be of much help. Many of our members have gone down that route.

 

It is possible that your nervous system is in a state where you are having adverse reactions to citalopram yet you get withdrawal symptoms when you reduce it.

 

The way we ascertain if the drug is causing your symptoms is by tracking your daily symptom pattern. We want to see if symptoms are better or worse before and after you take the drug each day.

 

Since you take citalopram in the evening, I'd like to see more detail about how you feel in the hours after you take it. Does it make you sleepy? What is your sleep pattern?

 

We especially need these daily notes while you are making drug changes. (It's best if you don't drink alcohol. Any experiments should also appear in your daily notes.)

 

Another hypothesis: As Chessie implied several times, it could be that you are metabolizing citalopram unusually quickly overnight and might be in withdrawal in the morning, explaining your muscle jerks and parasthesia in the early part of the day.

 

One way to test this is by moving part of your citalopram dose earlier in the day and see if your symptom pattern changes.

 

So, one way or the other, we can identify whether the drug is causing your symptoms by your observing your symptoms and keeping notes. It's been 2 weeks since you posted your symptom notes. You need to be systematic about the way you take your drug. Are you willing to do this?

[Windsor77]

Sure.   I’ll try anything.    But my days are always the same.  Fall asleep with jerks and twitching.   Only noticeable when about to sleep,  wake the same. When up about and moving they are not noticeable. 

This med does not make me sleepy at all.  I’d say it activates. But I am willing to try splitting doses. 

Any insight on that track? Should I take three in the morning and the rest when I get home?

 

just looking for ideas. 

 

But it I do think that this particular med is the issue.   6 months of sertraline, even with a 50mg drop never made me feel like this.  

 

I think it is just the citalopram 

 

[Wellbutrinsucks]

Did you say that you took Benadryl for the jerks and twitches? If so, has that helped any? I completely understand how you feel as those have been my main symptoms since having a reaction to Wellbutrin in June 2017.

 

What you’re feeling is completely normal, especially in regards to thinking it is something worse. It’s terrrorizing but it does go in windows and waves, much like withdrawal symptoms. 

[Windsor77]

Upon falling asleep last night and awakening today, same old same old.  Every 10-30 seconds, a random limb will get a little jerk.  Usually, in the arms this runs through either the index finger or thumb.   In the feet/legs it’s usually the foot twitching upwards.   Some times my head/neck will jerk too.  

My jaw is nearly always clenched. And when my teeth are nearly together, I can feel the very microscopic chattering.  

My sleep pattern is the same too.  Fall asleep between 9:30-10pm, Sleep well until around 2:30, fall back asleep, wake up at 5:30, fall back asleep, get up at 7. Nearly the same every day.  And the jerks are there at night time too. 

Until yesterday, I was not fearing tardive dyskinesia.   But the strange swaying motion I experienced last evening has me scared.  

I am feeling nearly exactly like I did the day I called my doctor last October.  When I was most likely experiencing mild serotonin toxicity.    I feel poisoned, and I want to switch meds ASAP to prevent the potential TD from progressing any further.  

@AltostrataI am systematic about meds, the only reason I skipped is because I was out and my pharmacy was closed for holiday.  I am confused by Chessie’s referencing my metabolism speed, as when I mentioned my doc advising that I may metabolize slowly, this was dismissed as the doc barking up the wrong tree.   If anything, I would believe that I am metabolizing too slowly.  I don’t know.  All I do know is how I feel, and these symptoms are getting progressively worse with citalopram, even at this lower dose.  I believe this is possibly a form of citalopram induced Parkinsonism, judging by my fatigue, muscle tightness and kinetic tremor. 

I believe I need to find a bridge drug to stabilize on.   As it is abundantly clear that stability not happening now.  So do I updose back to 7mg as an experiment?  3.5mg in morning and 3.5 at bedtime? 

 

@Wellbutrinsucks- yes. The Benadryl calms these sensations fairly well.   But I really don’t think what I’m feeling is normal.  Tell me more about your reaction. 

 

 

[Altostrata]

Please post your daily notes in this form

 

It was I who said your doctor is barking up the wrong tree. I explained in my prior post how a fast metabolizer might experience withdrawal symptoms overnight.

 

The only way we can make an educated guess about what the drug is doing is by looking at your symptom pattern. Otherwise, switching drugs is just flailing around.

 

We need your daily symptom pattern, as explained several times so far.

[manymoretodays]

Hi Windsor,

Can you put some of the above into the drug/symptom log format like you did here:  Windsor's notes

Oh man, double post to Alto's......same idea.

 

Best,

L, P, H, and G,

mmt

[Windsor77]

 

 

Today

4am- awake with anxiety. Worrying about TD symptom. Took 12.5 mg benadryl.  

5:45am awake briefly

8:30 awake- jerking and twitching as described above. 

9:30 - 12 oz carbonated water, fish oil and magnesium citrate pills

Epsom Salt bath 

10- 12.5 mg Benadryl. 

Hot tea

Turkey for lunch 

current- mild twitching in random areas.  Fatigue. Sore knees and on muscles around hips.  Shoulders too. 

Mild palpitations. 

 

 

 

[Wellbutrinsucks]

Have you considered just not being on any drugs altogether? Honestly it doesn’t seem like any of them are working for you, and if the side effects are worse than what they are treating you for, then maybe it’s time to have a serious conversation with your doctor about stopping medications, and if they don’t support that, then find another doctor. 

 

I took hydrochlorothiazide (blood pressure), Wellbutrin, and Adderall in June 2017 and had numbness, tingling, slight tremors, and host of other symptoms for the first two months. Then in October 2017, the muscle twitches and jerks started. The jerks lasted initially for about a month then stopped. Then in December 2017, both the jerks and the twitches started again and my doctor put me on Zoloft and that helped me fall asleep as the jerks interfered with my sleep, and after about a month, I was able to sleep without Zoloft and the jerks stopped but the muscle twitches continued for another 3 months until April 2018. Then in mid-May, the muscle twitches started again and have lasted for the past 6 months, with the jerks also happening occasionally. 

[Wellbutrinsucks]

Also have you tried taking the Benadryl at night rather than the morning? 

[Windsor77]

Yeah, I take benadryl at varying times, depending on the severity.   My jerks are very very minuscule.  Similar to a brain zap.  I believe they are called hypnic jerks. Only when I am very still are they noticeable.   

I could really copy and paste my notes, as they vary only on the type of food I eat for my meals. I do the same thing the same way nearly every day.    This is why I haven’t posted my symptom notes lately.