simsim: trying to get off 20mg Cilift / citalopram

[simsim]

Hi guys

 

I'm having a really rough couple of days so started googling out of desperation for some resources. 

 

I started taking Lexamil (escitalopram) shortly after my second child was born, due to anxiety and rage among other things. I was feeling really good at the beginning of 2017 and decided to come off it. I tapered over the course of about 4 months and ended up having a bit of a mental breakdown towards the end of the year with panic attacks etc. I was completely dysfunctional.

 

After about 6 months of taking nothing, GP prescribed 20mg Cilift (citalopram) (November 2017) which has worked really well except for weight gain and loss of libido. If it wasnt for these things i would continue taking it. 

 

I went down from 20 to 15mg for about three months and then down to 10mg for the last two months. This is the first real wobble I have experienced and it's making me want to go back up to full dose. My husband also wants this, he says he can see the difference.

 

I have read the guidance on tapering 10% and the info on withdrawal etc. I guess my biggest fears are the following:

 

- That all of this will be really hard work and I'll just have to go back on to meds at some point anyway

 

- That I am destined to be a depressed anxious person for the rest of my life

 

- That the longer you take the meds for the more it screws with your brain and the harder it is to ever be normal again

 

- I'm scared it's just not going to work for me. 

 

I would love to hear from people in similar situations who have managed to do this and keep their **** together and not kill anyone or lose their job etc etc.

 

Or just any advise or encouragement would be good too:)

 

Thanks

 

Edited October 23, 2018 by ChessieCat
added generic names

[Gridley]

Welcome to SA, SimSim.

 

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.

 

Account Settings – Create or Edit a signature.

 

You've been tapering faster than we recommend, which might account for your "wobble."  Also withdrawal symptoms can be delayed.

Why taper by 10% of my dosage?

 

What is withdrawal syndrome.

 

Glenmullen’s withdrawal symptom list.

 

 The Windows and Waves Pattern of Stabilization

 

Updosing all the way back to 20mg Cilift (Celexa, Citalopram) would run the danger of being too much for your brain to handle and could be quite destabilizing.  In the time that you tapered from 20 to 15 to 10mg, your brain has made adjustments to the lower doses.

 

About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic

 

Reinstatement isn’t a guarantee of diminished symptoms for everyone, but it’s the best tactic available.  You’re still in the time period where reinstatement predictably works, up to three months after last dose or dose reduction.  We usually suggest a much smaller reinstatement dose than your last dose.  These drugs are strong, and when updosing/reinstating it is better to start with a small amount and increase of symptoms remain unbearable.  If you take too much it may be too much for your brain and can cause you become unstable.  Sometimes it can be hard to regain stability after this happens.

 

I would recommend an updose of only 1mg to start.  You can always increase if you need to.  Remember it takes about 4 days for a dose change to get to full state in the blood and a bit longer for it to register in the brain.

 

The following link gives specific information on how to make nonstandard doses of Cilift.

 

 

Tips for tapering off Celexa (citalopram)

 

To answer your questions as best I can--

 

1.  It can be hard work but it is eminently doable.  Please Google "SurvivingAntidepressants Citalopram Celexa success stories"

2.  We take the approach here at SA that no one is "destined" to be anxious or depressed for the rest of their lives.  We recommend non-drug coping skills.

The Dr. Claire Weekes Method of Recovering from a Sensitized Nervous System

Non-drug techniques to cope with emotional symptoms.

3. The brain has remarkable capacities to heal itself regardless of how long you've been on the drug.  It will take time to heal but the damage is not irreversible.  Google "SurvivingAntidepressants neuroplasticity"

4.  Assume it can work for you and you will have a much better chance of it working.

 

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. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Please research all supplements first and only add in one at a time and at a low dose in case you do experience problems.

 

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.

 

 

 

 

 

[simsim]

Thanks Gridley for your comprehensive response. I am working through the links.

 

So I should add 1mg for now, go from 10mg to 11? I assume I will just stay at this until I feel a bit less wobbly and then go from there? 

 

 

[ChessieCat]

18 hours ago, Gridley said:

 

Remember it takes about 4 days for a dose change to get to full state in the blood and a bit longer for it to register in the brain.

 

 

Hi simsim and welcome from me too,

 

If you have decided that you do want to updose you can start taking more from you next dose.  So yes, 11mg.  Please keep notes on paper about your symptoms.  This can help guide you about how updosing is affecting you.  You will need to be patient and not panic.

 

The idea of reinstating/updosing isn't to get rid of the withdrawal symptoms completely but to bring them to a bearable level.

 

Please let us know how you are going.

[jozeff]

Hi simsim,

 

Welcome and I'm sorry for everything you have to go through.

 

I think Gridleys advise is the best you can do. You "played" with your dose a few times and you made quite big steps. Just as I did. I went from 15 mg to 20 to 25 and back a few times (citalopram) and it made me feel very unstable. I'm afraid that if you would updose again to 15 or 20 mg you would get the same shock effect to your brain and you may have nasty symptoms. 

 

I think it would be wise to stay around your dose of 10 mg (and maybe updose what Gridley said). It is tough right now but you have made great steps already!

 

I made an Excel sheet for myself with daily symptoms. Sometimes I feel like I've always been bad but my spreadsheet tells otherwise. This is quite motivating and makes the whole journey a bit more visible.

 

 

Good luck with your 11 mg and let us know how you are doing!

 

 

Cheers

 

Jozeff

[ChessieCat]

There are several different types (computer, printable) daily symptoms lists here:  Dr Joseph Glenmullen's Withdrawal Symptoms

 

Rate Symptoms Daily to Check Patterns and Progress

[jozeff]

Hi simsim,

 

How are you doing?

 

Jozeff

[simsim]

On 1/6/2019 at 8:49 AM, jozeff said:

Hi simsim,

 

How are you doing?

 

Jozeff

Hi Jozeff

 

Thank you for checking in on me. I do really appreciate it.

 

I did a month at 10mg, then 9 then 8.1. Reinstated at 10 about a month ago because I was feeling overwhelmed.

 

I am still on 10. I am struggling (today is particularly bad so thank you for checking in:)

 

Symptoms:

There is a very low key depression which I keep at bay by trying to keep myself busy every second of the day. It just hangs around in the background and makes me want to sleep a lot.

My anxiety is back in the last few weeks. I'm back at work today after an amazing three week holiday and work stress is pushing me over the edge today. My heart is beating out of my chest and I feel like I want to vomit. I'm trying to make it through the day until I can get home to keep myself busy again (dinner, kids etc).

I don't know that it's the dosage that's an issue. I maybe just need to work on managing the anxiety better (maybe see someone but not sure who?).

 

Most days are not this bad (I also skipped a dose two days ago because I ran out). But one does feel very hopeless on days like this. It doesnt help that it makes me super unproductive and so the work stress is just piling up.

 

Thanks for listening.

Edited January 8, 2019 by Carmie
Got rid of white space

[ChessieCat]

9 hours ago, simsim said:

I did a month at 10mg, then 9 then 8.1. Reinstated at 10 about a month ago

 

Please update your drug signature showing dates and doses.  Thank you.  Account Settings – Create or Edit a signature

[Carmie]

Hi simsim, 

 

I’m sorry to hear you had to skip a dose because you didn’t have the medication. I’m glad you had a nice holiday though. The work stress sounds tough. Are you able to chill out when you get home?

 

Please update your signature as ChessieCat mentioned. Thank you.

 

Sending hugs🤗

 

 

[simsim]

i normally have a glass of wine when I get home from work but there are two little ones and dinner and sometimes work to do. So yes and no to chilling out! I do try.

I am ADHD so struggle to let myself do nothing, always end up doing housework or something until I pass out.

 

I am truly blessed with a great hubby and kids, a beautiful home and not many other real problems. But, as we all know, that doesnt mean **** when it comes to anxiety right!?

 

 My work situation is the main stressor. I am highly intelligent ADHD and currently doing a mind numbing but very important financial role with lots of deadlines etc. I struggle with my performance (especially when I'm bored and disengaged) and that causes most of my anxiety.

Bored=unproductive=underperforming=pressure=anxiety=unproductive

 

(@ChessieCat I have updated my siggy thanks)

 

 

 

 

[Carmie]

Hi simsim, 

 

Hope you’re doing okay. I just wanted to make you aware that any amount of alcohol might affect the withdrawals.Some people have had one glass of something and it has affected them for a long time. Off course, this doesn’t happen to everyone, but it’s better to be safe than sorry. Alcohol can actually slow down withdrawals.

 

I’m so happy that your circumstances outside of withdrawals are wonderful. It’s good to have that support. Make sure you have a good rest in your breaks at work seeing it’s stressful. Anything stressful can ramp up withdrawals. Take care, sending hugs🤗

 

 

[jozeff]

Hi simsim,

 

Work as a stressor,.... sounds very familiar. There are a lot of different people with a lot of different emotions at work and I find it hard sometimes to get on the same level with some of them. That costs a lot of energy.

 

About the alcohol. I'm a recovered alcoholic and all I can say is that ad/WD and alcohol do not go together well. I've been absolutely clean for almost 5 years. I miss the sedative effect however, especially when I'm stressed out but in the long term it is way better to not be dependent on stimulants/sedatives.

 

You have a great family and that is so important. Cherish them and keep the faith!!

 

Happy healing!

 

Jozeff

[simsim]

Ah ok that is good to know, thank you. It didnt even cross my mind that alcohol consumption may affect my withdrawal. I have a pretty healthy relationship with alcohol so I'm not drinking a lot but I will consider cutting it out for a while and see how it affects me. It's going to be tough because that's my me-time, a quick glass of wine and watching a show after the kids go to bed. 

 

Last weeks wobble was definitely due to the missed dose because I was much more stable after that one day. It messes me up badly to miss a dose so I wont be doing that again!

 

Thank you all for all your support! It was great timing when I really needed it last week so thank you:)

[ChessieCat]

alcohol-and-beer

 

[Carmie]

Hi simsim, How are you doing?💚

[simsim]

On 4/3/2019 at 9:31 AM, Carmie said:

Hi simsim, How are you doing?💚

Hi Carmie

 

I am doing good actually. Mentally and emotionally I have done a lot of work on myself this year and have picked up a great mentor at work who has helped me build my confidence at work. Lack of confidence is normally one of my biggest anxiety triggers so that has been awesome.

 

BUT...

 

I have just stayed at 10mg. Im too scared to screw up the current recipe and also too lazy/anxious about doing my own measuring/mixing etc to get custom doses. 

 

My libido has come back since dropping from 20 to 10 so that's not an issue anymore. But I keep gaining weight so I guess that is one motivator to try get off it. I do hope it's the meds that are causing the weight gain and not just my age!

 

I know I need to drop at some point. Anyone have thoughts about a water solution vs weighing it out? 

[Carmie]

Hi simsim, 

 

Glad to hear you’re doing well and have stabilised on 10mg.

 

I’ve never used scales myself, I’ve been water titrating. I just crush my tablet with a mortar and pestle, and add water.

 

It would be wise to do a crossover if you decide to do that. The formula is: 

 

3/4 of the old formula.             1/4 of the liquid.

 

1/2 of the old formula.             1/2 of the liquid.

 

1/4 of the old formula.              3/4 of the liquid. 

 

Then all liquid. 

 

You do each phase for 3 to 7 days, or longer if you wish. 

 

You might need scales to weigh the dry part of the crossover to be accurate. Many people like the Gemini 20 scale. 

 

Once you’re on all liquid you won’t need to weigh anything anymore. I find water titrating really easy. 

 

Sending hugs🤗