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jozeff

jozeff: trying to come off of citalopram - a little help would be great

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jozeff

Hello everyone,

 

I'm a 42 year old male trying to come off of citalopram. I have been on 25 mg since oktober 2016 and find it time to trying to taper. I started about 85 days ago with a 0.1 mg decrease per day tapering method so I'm down to 25-8.5 =16.5 mg/day. I work in a  chemical laboratory so carefully preparing the solution/weight etc is no problem for me. I was doing fine with little side effects. I take small dose of benzo when I'm feeling tense or anxiety.

After hitting 16.5 mg citalopram per day however I started to feel very sad and low so I stayed at this dosage for a little over a week now. I'm feeling extremely tired and want to cry but I can't. In the morning I too scared to get out of bed. And my thoughts are all over the place. Feel very depressed iny current holiday week...

My doctor takes about 10 minutes for this problem and told me there is room for an increase to 30 mg/ day! But....I'm trying to taper down! It's like they're very willing to givee more medication but don't want to know too much about tapering or self-medicating. Their advice is always to half the dosage and see what happens. If that doesn't work go back to previous dosage and take the medication for the rest of your life.

My question is:  am I tapering too fast?. It is about 12.5 % per month which would be reasonable I thought. I'm reading a lot of things about people who taper a lot slower. Is there anyone with advice or experience on this. I have been on 16.5 mg for 8 days now to level out but that doesn't seem to be happening.

 

Any help would be greatly appreciated!!

 

Thanks

Jozeff

 

 

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Gridley

Hello, jozeff, and welcome to SA.

 

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.  12.5% is likely too fast for you.  Those extra 2.5% per day can mount up and be cumulatively too much.
 
 
 
Two factors are likely present in your increased withdrawal symptoms.  First,  it can be easier to taper off the high end of your dose but as you get lower, it becomes more difficult.  Second, the brain needs time to catch up and get used to the lower doses, and you've been decreasing every day without (until recently) a hold to allow your brain a rest period to acclimate to the new doses.
 
Eight days is not a long hold. I would continue to hold for quite a bit longer, perhaps several weeks, until you stabilize.  
 
The tapering method I've been using is the Brassmonkey Slide Method, created by one of our moderators, Brassmonkey.  You decease by four equal 2 1/2% decreases for four weeks, followed by a two-week hold before dropping again.  So the hold period is built in to the taper, allowing your brain to regularly catch up to the lowered doses.  You might want to consider this method.  It's explained in the following link.

The Brassmonkey Slide Method of Micro-tapering

As you've learned, doctors know nothing about withdrawal or tapering.

 

To help you understand the symptoms you are experiencing, here is some information on withdrawal.  drug.  
 
 

 

When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  
 
 
We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

 

 

Please research all supplements first and only add in one at a time and at a low dose in case you do experience problems.
 
Many members have found the non-drug techniques in the following links helpful in dealing with withdrawal.
 
 

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.

 
 

 

 

 

 

 
 
 
  
 
 
 

 

 

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jozeff

Wow, thanks a lot for all the great hints and tips. Much appreciated from the Netherlands!

 

I truly am thankful that there are people willing to help and have similar problems. My doctor always told me not to search online for answers..... Guess he's wrong.

 

I was wondering if there are people who tried the 10 % method without the two weeks holding time. I have been on citalopram for almost 2 years. My logical sense tells me 5 or 6 months would be long enough to completely come off of the medication. My doctors advise would be a couple of weeks I'm afraid.

 

 

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SkyBlue

Hi Jozeff,

 

3 hours ago, jozeff said:

I was wondering if there are people who tried the 10 % method without the two weeks holding time. I have been on citalopram for almost 2 years. My logical sense tells me 5 or 6 months would be long enough to completely come off of the medication. My doctors advise would be a couple of weeks I'm afraid.

 

We generally advise 10% of current dosage per month plus holding, but of course everyone is different. In general, slower is always better, and going slowly (including holding time) gives the nervous system more time to adjust. 

 

I'm glad you are going to take your time coming off -- it really will be better. 

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Gridley

Take your time.  You will be glad you did.  

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jozeff

Thank you,

 

Today I'm on 16.5 mg citalopram for the 10th day. Do not see much improvement to be honest. I can sleep for 11 hours and still feel tired. I have good moments though. I forgot to mention I have been a heavy drinker but I'm 4.5 years completely clean. After quiting drinking I was so agitated that I started effexor which worked wonderfully in the early 2000's but didn't help much this time so I switched to citalopram after a slow taper. I started at 10 mg and upped to 25 eventually. Because I was doing pretty well and my libido was zero I decided to take 20 mg for a few weeks and then 15 for a few months. In October 2017 I had a major panic attack and felt completely down afterwards which lasted a week so I decided to take 25 mg citalopram again. Libido went to zero again. I started reading a lot about tapering, food, supplements etc. Doctor wanted me on 30 mg but I decided to taper and went from 25 to 16.5 with a 0.1 mg decrease each day. After having a terrible day and a panic attack I decided to stay on 16.5 for a few weeks. Almost took 25 mg again because I felt so horrible. About 8 weeks ago I started taking 5g of elemental lithium (lithium chloride) per day. I read a lot about a small dose of Li as a mood stabilizer. I'm used to taking that now so don't want to taper 2 things at once. What do you think about small lithium dosage?

 

Thank you so much for your help!

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jozeff

Hi all, 

 

A little mistake in my previous post.... I meant 5 mg of elemental lithium each day. Not 5 grams!

I'm still on 16.5 mg citalopram and my biggest problem is when I wake up. I feel sad, no energy, don't know what to do. I'm having my last 2 days of holiday and spend the time with my wife and 6yr old son. I love them so much and just want to be happy and energetic. Not the worried, tired and scared person I'm right now and have been for so many years. I have good days but my thoughts are killing me. When I feel good the tiniest negative thought can cause me to spiral down. I have a small pool in my garden and it helps a lot to just sit in it and cool down for half an hour. My brain seems to really like the cold or something. Do you have any experience with cooling your body to relieve some tension?

 

Have a nice day!!!

 

 

 

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jozeff

Hello, edited my signature. Did not manage to add everything there so I pasted it down below if that is okay. The signature shows a shortened version of my medication history.

 

To be honest it scared me a bit how much I've been altering my citalopram in 1.5 years...

 

 

 

-Venlafaxine 150 mg 1999-2003, tapered to 75 mg.

-Venlafaxine 75 mg 2004, tapered to zero

-Venlafaxine 75 mg started in 2008 for 8 months. Tapered pretty fast to zero.

-Venlafaxine 75 mg started in  Oct 2014 after 5 years of alcoholism.

- citalopram 10 mg Oct 2016 - Nov 2016

- citalopram 20 mg Dec 2016 - Jan 2017

- citalopram 25 mg Feb 2017 - may 2017

- citalopram 20 mg for few weeks

- citalopram 15 mg Jul 2017 - Oct 2017

- citalopram 20 mg Oct 2017

- citalopram 25 mg Nov 2017- Apr 2018

- citalopram started tapering from 25 to 16.5 mg in 80 days.

- citalopram 16.5 mg Jul 11th - now, trying to stabilize.

- oxazepam occasionally.

- lithium 5 mg elemental (as lithium chloride) to stabilize mood. Self medication.

 

 

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mammaP
On 7/19/2018 at 10:58 AM, jozeff said:

I take small dose of benzo when I'm feeling tense or anxiety.

 

Hi Joseff, keep holding and things will improve, as Gridley and Skyblue said, your brain needs to adjust to the lower dose.  Can you tell us about the benzo? How often do you take it?   If you take it on a few days a week you could be getting interdose withdrawal.  It is important to include it in your signature because thay can have side effects or withdrawal effects along with the citalopram withdrawal.  We don't recommend many supplements here, the nervous system is fragile in withdrawal and they can cause more problems. We only recommend fish oil and magnesium.  Many of us find them helpful, but they need to be started seperately and at the lowest doses in case of any reactions. 

 

It will help if your list is in your signature. You can delete the old list and copy the new one in there, it is more accurate and we will see it at a glance instead of needing to scroll back to the beginning. 

 

 

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jozeff

Thanks a lot! I edited my signature, at least that's what I thought. How do I get to my signature??

 

I take about 3 tablets of 10 mg oxazepam per week. Not more. Sometimes zero tablets per week. Just for sleeping sometimes or when I'm really tense.

 

Jozeff

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jozeff

Ok I edited my signature.

 

How can I see other people's signature?

 

Tnx!!

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jozeff

Ok I edited my signature.

 

How can I see other people's signature?

 

Tnx!!

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jozeff

Hi guys, have been reading a lot on this site. Is is an amazing source of information. Wish I found it earlier in life..

Feeling pretty rubbish today. Have been tapering citalopram from 25 to 16.5 by 0.1 mg decrease each day. I'm on day 12 now taking 16.5 mg to stabilize. I feel down without reason some parts of the day having evil thoughts about my future.

 

What scares me is that I read so many negative stories about Lexapro/citalopram and withdrawal. Is there anyone who successfully came off of this drug?

 

When should I go back and taper again? Want to go a bit slower then 10% per month I think. Brass monkey tapering seems ok to me. Don't want to be tapering for three years but if that helps me staying of AD in the future and without to many WD that's the best choice. The WD symptoms are absolutely horrible btw.

 

Thank you and wish you all the best!

 

Jozef

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Kostas
58 minutes ago, jozeff said:

What scares me is that I read so many negative stories about Lexapro/citalopram and withdrawal. Is there anyone who successfully came off of this drug?

Hi Jozeff 

as a point of encouragement, I was on citalopram 20 mg on/off for 13 years. 

I had 3 failed attempts to withdraw, but always reinstated to the full dose in order to stop the physical symptoms. 

In my fourth attempt, I was able to stop it, in a very very slow process, lasting almost 7 years. 

During this time I had almost none withdrawal symptoms, and now I am off the citalopram for 6 years and 90% functional. 

Take care. 

 

P. S

During my last weaning of the drug, I was not aware of this site, and was following my instinct with big cuts of 50% but long holdings of 6-9 months, and proceeding to the next cut only if feeling absolutely stable! 

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Gridley

Google "Surviving Antidepressants Lexapro success stories" and "Surviving Antidepressants Citalopram success stories"

 

Aeroman is one member who comes to mind who successfully tapered off Lexapro.

 

 

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jozeff

Thanks for the tip Gridley!

I'll give aeromans story a go. Looks very interesting.

 

I'm looking at the brass monkey tapering method for WD relieve. I'm on 16.5 mg citalopram right now. I have to taper untill I have only 2 % citalopram =0.33 mg left.  If I will follow that tapering method (2.5% per week) and two weeks stabilizing it will take 232 weeks!

That is 4.5 years........I have been on citalopram for 20 months now.

 

Isn't 4.5 years a little too long???thanks for your opinions. Means a lot to me!

 

Jozef

 

 

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Gridley

In the beginning, it's a little hard to wrap your mind around how long it takes.  But it does take that long.  The good news is as you get lower, you feel better.  It's a safe taper that minimizes withdrawal symptoms.  

 

As you can see from my signature, I've been tapering Lexapro using the Brassmonkey taper for a year and a half now with some ways to go.  But I'm down from 20mg to 5.9.  The taper has worked well for me.  Like the originator of the taper, Brassmonkey,  I've used the Gemini-20 scale to measure my doses.  It's available for around $20 on Amazon but I don't know if you have Amazon in the Netherlands.  If not, you can taper using liquid.

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jozeff

Thanks for your response, appreciate it.

 

Ok I'll have to take this taper very seriously then. 

I dissolve 20 mg citalopram in a 50 ml volumetric flask. I take out 8.75 ml with a syringe after dissolving and shaking the liquid and drink the rest. That way I get exactly 16.5 mg of the medicine (or should I say poison...). I can taper very precisely that way. It helps that I'm a chemist and work in a laboratory 😉.

My psychologist said that 5 mg less or more does not make a difference with these medicines..... He is a great guy and has been a professional fo 35 years. Just so little knowledge about substances.

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jozeff

Hello Gridley, how can I see your or anyone's signature?

Can't even find my own signature....

Tnx!

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jozeff

Thanks bluesky, I was indeed using a phone!!!

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SkyBlue

Oh good! You're welcome. 

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jozeff

Hello everybody,

 

Thanks for all your support!

 

It's been a good week. It was very hot in the Netherlands and I have been swimming a lot in my small swimming pool with my wife and son. 

 

I used to take the heat pretty good for big part of my life but since taking celexa I am really sensitive to panicking when my heart rategies up. I get very restless and uncomfortable. I dip in the water does miracles for that! Anyone have experience with that?  

 

Have been on 16.5 mg of citalopram for 18 days now. Tapered from 25 mg to 16.5 starting in April 2018. This was a 10 % taper on average but no stable weeks in between. I tapered 0,1 mg each day and that was going pretty well until reaching about 17mg (which took me 8/0.1= 80 days) . I would not recommend doing my taper. I think brass monkeys method is better and a bit slower. It has stabilizing weeks and it tapers relative compared to previous dose. I tapered 0,1 every day which is 4 to 5 % per week @ 16 mg. This is considerably faster than brass monkeys method.

I have been studying the receptor occupancy stuff a bit and made a nice spreadsheet. I know now why I should do a relative taper and be careful around the 10 mg celexa dose. The relative receptor occupancy changes the most around that dose. 

 

Thank you guys and girls very much for explaining all this stuff. It feels really good to be concious about all this. Keepsy mood up. Much better than taking the pills day in day out and wait.....

Have a nice day!!

 

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jozeff

Dear all ,

 

Question because I'm a bit desperate. ....

 

Tapering citalopram since April. Came down from 25 mg to 16.5 in 85 days. At 16.5 mg I decided, after reading a lot on this site, to stay on that dose. Went ok but felt nervous and depressed. Last week was pretty good after being on 16.5 mg for 15 days so I thought yeah I'm stable!! But today  after 20 days on stable dose I felt horrible suddenly. Very anxious, depressed, almost panick attack, and very worried. Wanted to cry but couldn't.

 

So here is the question......

Could this be withdrawal? I mean, I felt very good last week so thought I was stable. I know about windows and waves but I'm pretty desperate right now.  Any answers or thoughts would be helpful? Tnx!

Jozeff

 

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Gridley

Withdrawal is up and down.  Your taper from 25mg to 16.5 was fast.  The timing of withdrawal symptoms is impossible to predict, and the onset of symptoms can be delayed.

 

 

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jozeff

Thank you,

 

Yes my taper was fast but was it too fast. It was faster than 10% per month that's for sure. Should I take a bit of a higher dose? I mean like a dose that I would have had if I tapered slowely like 19 mg instead of 16.5 that I'm on now.

 

Or, should I stick to the current dose 16.5 mg and see what happens?

 

Tnx!!

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Gridley

I would hold at 16.5 for a few months and let your system catch up and stabilize.

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jozeff

Ok, according to brass monkeys taper I should have been at 20mg by now. I'm however at 16.5 so that's a bit faster. I would have expected to be stable after 3 weeks at this dose but I'm feeling very vulnerable and awful right now.

I decreased 7.5 mg citalopram in 75 days. My doctor would think thats very very slow, much slower than he would recommend I guess. 

 

Why am not nearly stable after 3 weeks at the same dose?? Will I be stable after I tapered too fast maybe?

 

Tnx

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brassmonkey

Hi Jozeff-- Welcome to SA. Yes, you are in WD from doing a too fast taper. It also doesn't help that you've made a lot of very large changes in the past year.   Each change has sensitized your body to future changes and they are coming back to haunt you now.  Right now the best thing to do would be nothing.  A long hold is called for to let all those changes stabilize before trying to taper any more. 

 

The recommended taper for the site is 10% of your previous dose every four weeks. This is a baseline taper and is frequently too fast for a lot of people. The Brassmonkey Slide Method is based on this but uses smaller reductions that add up to the target reduction and an added hold period to let everything settle out before proceeding.  Unfortunately, because of the math and the physical changes to the body it takes a very long time to complete a taper.  The alternative of trying to go faster usually ends up taking a lot longer and is frequently a lot more painful.  Our taper methods are based on science and practical experience and have proven very successful if they are adhered to.  We have also found that the majority of doctors have no idea how to handle these drugs and their advise is often detrimental to the patient.

 

Finding stability after it has been upset can be a very long process that involves a lot of waiting.  In some cases three weeks is just about enough time for the drug to become steady state in the blood.  Which has to happen before the body can start to stabilize.  In general terms we like to have members hold for three to six months to stabilize, in some cases it can take quite a bit longer.  It can be a long frustrating time, but stability does eventually come.

 

If you haven't read it yet, I would suggest reading this link: 

Are We There Yet? How Long is Withdrawal Going to Take? 

Brassmonkey

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jozeff

Thank you brass monkey! Appreciate it a lot.

 

I learn and read a lot here!

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jozeff

 

I came across this guy and listening to his stories made sense to me. I hope it's allowed to share YouTube recommendatios. If not I'll notice soon enough 😉

 

 

It's a guy named Douglas Bloch and he shared some nice videos.

 

 

 

Grtz

Jozeff

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jozeff

Hello all,

 

I'm still at 16.5 mg citalopram. Have been on this dose for a month now. I can't say I'm feeling a lot better to be honest. Started taper in April and went from 24 mg to 16.5 mg @ 0.1 mg per day which seemed pretty decent to me. At 16.5 mg I started feeling very emotional, very down every morning and just awful so I stayed at that dose. Now, almost 4 weeks on I still feel emotional, I'm upset pretty quickly and I'm scared of many normal situations. The anxiety is more in the forefront so to speak. 

 

Should I still stick to 16.5 mg and let my nervous system do it's thing or should I consider a small up-taper (I'm from the Netherlands so I don't know if that's English 😙😁)?? I don't know if I tapered too fast and damaged my nervous system or whatever..

 

I know a lot of you people are in the same boat and ask themselves how long before making a change, will this ever pass etc.. a few good hints and tips would be awesome anyway! Keep up my mood and hope.

 

Thank you for your thoughts!!

 

Jozeff

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jozeff

So a bit shorter.....

My question is:

Should I still stick to 16.5 mg and let my nervous system do it's thing or should I consider a small up-taper (I'm from the Netherlands so I don't know if that's English 😙😁)??

 

Thanks!!

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jozeff

Anyone thoughts about this?

 

And one more question. In the morning when I get up everything seems to be okay. After a while a sad feeling is entering my brain and an urge to cry but I can't. Very unpleasant! This feeling can be pretty heavy and I want it to be over so bad. Sometimes it suddenly disappeares without doing anything but other times no matter what I try it just doesn't go away for hours... In the evening most of the time I'm completely calm and relaxed. 

 

Does anyone recognize this and maybe have some tricks for me??

 

Thanks a lot!

 

 

Jozeff

 

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jozeff

Hello everyone,

 

I'm still at 16.5 mg citalopram. Have been on this dose for five weeks now. I can't say I'm feeling a lot better to be honest. Started taper in April and went from 24 mg to 16.5 mg @ 0.1 mg per day which seemed pretty decent to me. At 16.5 mg I started feeling very emotional, very down every morning and just awful so I stayed at that dose.

 

Did I taper to fast? I mean 7.5 mg in 75 days isn't extremely fast I hope. I leveled at 16.5 mg to stabilize and I had hoped that 5 weeks was decent to get steady. What do you think? I'm willing to start tapering again at a slower rate but I'm hesitant to do that before I feel stable. 

i had a panic attack this morning and have had heart palpitations all day. Could that be withdrawal??

 

thanks guys! I noticed that the person replying to my messages is me mostly... Is there a way so that more people will follow my topic? I want to benefit from all the knowledge here!!

 

thanks!!

 

jozeff

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Gridley

Keep holding until you stabilize.  5 weeks is not a long hold.  Some hold for months until they stabilize.  Do not start tapering until you stabilize.

 

Panic attacks are a common withdrawal symptom.  For information on heart palpitations, Google survivingantidepressants.org heart palpitations.

Edited by Gridley

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