Gurgle: 18 years of SSRIs - citalopram, sertraline withdrawal advice please

[ChessieCat]

On 1/9/2019 at 1:06 AM, Gurgle said:

Should I increase to 2 mg seeing as my symptoms are still unbearable at times

 

Yes you could try increasing.  You could try go to 1.5mg or 2mg. 

 

When changing form of a drug we generally suggest doing a cross taper each of these combos for 3 to 7 days each:  3/4 + 1/4, 1/2 + 1/2, 1/4 + 3/4.

 

EDITED TO ADD:  Only one change should be made at a time.  Please see this post for clarification.

 

If you are going to use the prescription liquid and not do a cross taper it might be better to start with 1.5mg and give it a week before going up to 2mg if needed.  Or you could do 1mg for a few days before increasing to 1.5mg.

 

On 1/9/2019 at 1:06 AM, Gurgle said:

Also, can you dilute the liquid and use a syringe to be more specific when tapering etc? 

 

Yes you can dilute the prescription liquid.

 

Edited January 18, 2019 by ChessieCat

[Gurgle]

Thank you so very much for your reply. I greatly appreciate it. I haven't had one of those seizure episodes yet, today, like yesterday, which is a relief. I am going to consider going onto the liquid as I think it will be a lot easier to be more accurate. Thank you, again for your answer.

[ChessieCat]

1 minute ago, Gurgle said:

seizure episodes

 

Do you mean brain zaps?

[Gurgle]

Sorry - cants see the other replies on main site- can see in email. With regards to the seizures:

 

 

I mean weird episodes where my brain feels like it's being sick?! I  feel agitated befote feelhand and sometimes my stomach feels empty, I feel dead behind the eyes and start making weird noises like moaning and grunting and start retching and coughing up phlegm. I feel confused and agitated, sometimes walking around, wrapping myself in my top and then coughing on all fours I then cry and feel really suicidal and have to convince myself I need to stay alive, and then it calms down , sometimes slowly, sometimes quickly and I revert back to more normal feelings and behaviour (within reason bearing in mind I am still in wd). It feels like some kind of seizure to me. The first month of withdrawal these episodes could last hours ( one time it was 16 hrs). It's not a panic attack ( I am well versed in those). I also develop some tics after for a few minutes ( clicking fingers and tongue). 

[Altostrata]

If these weird episodes started after you cold-turkeyed from sertraline 3 months ago, they are withdrawal symptoms.

 

As Chessie suggested, reinstatement of a small amount might help. Do not overdo it -- your nervous system is likely hypersensitive now.

[Gurgle]

Thank you. I have reinstated 1mg a month ago. Had moments of being not so bad but still having very dire dire times. I am considering upping the reinstatement. 

DOSING?

If I want to transfer to liquid, for the liquid part, could I put, for instance, 1 drop of liquid ( 2mg) Citalopram into 10 ml water , stir and the syringe out 5ml to get 1mg? Should it all distribute evenly in the water? Or should I put into more water than that. Advice would be appreciated. Thank you

[ChessieCat]

Please update your drug signature.  Account Settings – Create or Edit a signature

 

5 minutes ago, Gurgle said:

1 drop of liquid ( 2mg) Citalopram into 10 ml water , stir and the syringe out 5ml to get 1mg?

 

Yes that is okay to do.  You should be able to keep the remainder for the next dose in the fridge..  Just remember to do everything the same way each time using the same equipment.  And even the part of the bench where you measure the water because some benches/tables aren't precisely level.  And you will need to measure the 2nd dose with the syringe as well.  Don't just drink the remainder assuming it is the same amount.  It important to be as consistent as possible.  Especially with the small doses.

 

If you would feel more comfortable measuring larger amounts you could increase the amount of water you use.

[Gurgle]

Thank you. I have to try to transfer to liquid. It's got to be more accurate. Think I shall increase reinstatement to 1.5 mg too. I had a god aweful night last night. Still very ropey. 

 

Orgasms!

 

Sorry about this but has anyone else had this. When my hub and I had been 'together' since wd, orgasms have been ridiculously more intense than usual ( sounds good-  it's not). It's disturbing and followed but overwhelm of emotion ( anger fear crying shaking) for a while. Hence no more hanky panky. Well last night, I think I had an orgasm in my dream and in my sleep!! ?? Woke up in a mess, retching, coughing, feeling suicidal and scared for hours. Feel like a turd today. Sorry about tmi.

[Gurgle]

Oh my gosh. I've been reading Gia's posts on histamine intolerance/ mast cell. This is most definitely one of my issues! Maybe my main issue! I am having reactions to foods and chemicals and stress etc.  It seems worse during ovulation Be before period ( high estrogen means high histamine). I am literally having episodes where my gut, brain chest and skin react. 

 

Does anyone know if I'd be able to take ketotifen alongside my 1mg citalopram reinstatement? I wonder if the reinstatement has made it worse ( it was happening before but I've had a really bad week of it). Or maybe I need to increase to increase the antihistamine effect. I have tried some vitamin c today - not sure if it helped really. 

[Altostrata]

Citalopram comes in a prescription liquid, you may wish to use that rather than make your own.

 

Ketotifen is a rather drastic treatment for food intolerance. Highly recommend you try the exclusion diet first, it's much safer to simply avoid the foods to which you react. See

 

Food sensitivities
 
Histamine food intolerance

 

Elimination or exclusion diets for reactions to food (food intolerance)

[Gurgle]

Thank you for your reply. I have begun a low histamine diet. We shall see. However, I think I may be having a reaction to swapping from tablet to liquid Citalopram too. 

 

Reading up on mast cell activation and histamine intolerance ( maybe low Dao), I now believe this is what has affected me all my life, including junior arthritis, cold uticaria, bleeding during pregnancy ( can be caused by high histamine/ low DaO), my sensitivity to SSRIs, other meds and anaesthesia. Much exploring to do! 

 

Is it early stage anaphylaxis? I wonder if the fits I have talked about previously and current symptoms after having switched to liquid Citalopram ( and experience d during withdrawal) are anaphylaxis. I have tingling all over. My tongue and face feel tingly and numb. I have weird sensations in my stomach and am reacting to all sorts of food. I even went off on a coughing spree after breathing in some acetone that was being used in the house. I intermittently have episodes of impending doom followed by coughing fits where I cough up excessive mucous, retching, shakiness, heart palpitations and breathlessness etc. I really reckon histamine has a massive part to play in withdrawal, maybe even akathisia/pgad/ insomnia and much more. SSRIs can a activate mast cells, from I have read, and reduce Dao. 

Please excuse the mindless ramblings - for myself more than anything.

[Gurgle]

Oh bloody hell. URGENT reply if possible please. Okay, I am now positive I am having a horrid reaction swapping from 1 mg tablet citalopram to 1mg liquid ( was thinking of updosing too but didn't). I thought it was ok the first couple of days ( I hadn't actually stabilised on the reinstatement so things were still hellish but had taken the reinstatement for over a month.) 

 

Chestercat suggested I could taper across from tablet to liquid in increments across the two forms or go to liquid but updosing only on small amount. I decided I would go from 1mg tablet to 1 mg liquid ( being aware this may act as a small updosing due to the approx additional 20% bioavailability of liquid.

 

But now I realise I am getting older withdrawal issues more frequently and signs of allergic / anaphylaxis type reaction / histamine intolerance. More tingly tongue, neck and lower face, including nose. Insomnia return ( this may be histamine related?), Shaky, juddery, episode of impending doom and suicidal ideation along with foggy head, louder tinnitus, stomach pain, coughs, coughing up copious amounts of phlegm, agitation, rumination, tourettes type tics ( which I had in early withdrawal a few months ago ( again I think this is histamine related), return of palpitations and some breathlessness , stiff neck and intermittent pain in lower back ( also more prevalent in early withdrawal). And more.. I did seem to have changes in withdrawal symptoms when reinstating tablet form ( some worse like agitation, increased vaginal discharge (I think  this is excess estrogen maybe due to liver issues not processing histamine  and estrogen well - my liver blood tests showed a slightly  higher than normal upper threshold for bilirubin)).but going onto liquid has been worse;only just figured it out after 7 days.

 

Do I swap straight back to 1mg tablet? Advice please. I take it at 9.30. 

 

Sorry guys ( barely slept, feel like my body is on fire and my son was sick in the night)

 

Looking back on my life, I think I may have mast cell activation syndrome and this is why I am reacting.

 

 

[ChessieCat]

Is there anything else you have taken/started that may be the cause of the issues.

 

14 minutes ago, Gurgle said:

Do I swap straight back to 1mg tablet? Advice please. I take it at 9.30. 

 

Yes, I think swapping straight back might be the best thing.

[Gurgle]

Hi. I think looking at my diary, I may be taking more magnesium. From 50 mg to 75 mg. I'm also mid cycle.

[Gurgle]

I tried some vitamin c yesterday as well as I was feeling so bad. But not before that. Don't think vit c helped actually. Looks like I increased magnesium a week before changing to liquid actually - don't think it had an effect. Still taking 1omega 3 at lunch 

[ChessieCat]

I just want to clarify something regarding this post:

 

On 1/9/2019 at 8:23 PM, ChessieCat said:

 

Yes you could try increasing.  You could try go to 1.5mg or 2mg. 

 

When changing form of a drug we generally suggest doing a cross taper each of these combos for 3 to 7 days each:  3/4 + 1/4, 1/2 + 1/2, 1/4 + 3/4.

 

If you are going to use the prescription liquid and not do a cross taper it might be better to start with 1.5mg and give it a week before going up to 2mg if needed.  Or you could do 1mg for a few days before increasing to 1.5mg.

 

 

When changing form of a drug we generally suggest doing a cross taper as described above.

 

Only one change should be made at a time.  So you do not  change your dose at the same time as doing the cross over.

 

The same thing applies if changing from tablet/powder to prescription liquid, even if you don't do the cross over.  You would not change the dose at the same time as changing form.

[Gurgle]

Iforgot to say thank you for your reply. X I am doing 1mg of liquid (was doing 1 mg of tablet). I didn't updosing as such but I didn't cater in the liquid form for the fact that 1mg of tablet Is equivalent to 0.8 mg liquid. Maybe this is my issue? 

[Gurgle]

Maybe that and I'm having a reaction the different ingredients in the liquid. I think there is ethanol in there. Is that a type of alcohol? I seem to have an allergic reaction to alcohol; have done for a long time.

[ChessieCat]

Yes, ethanol is alcohol.

[ChessieCat]

How much did you take?  The Zoloft prescription liquid is a concentration.  What is the concentration of your liquid? 

 

From tips-for-tapering-off-zoloft-sertraline          US order code for Zoloft 20mg/ml Concentrate Solution NDC 000494940

 

[Gurgle]

I actually reinstated citalopram even though I CT d Zoloft due to bad reaction for a year on it. So I do 1 drop (2mg) of cital in 10 ml water and take 5 ml to get 1 mg

 

Do you think it would be ok to go back to 1mg tablet after 7 days?

[ChessieCat]

5 minutes ago, Gurgle said:

I actually reinstated citalopram even though I CT d Zoloft due to bad reaction for a year on it.

 

Okay, thanks for clarifying that.  I saw sertraline which is the last line your drug signature.  Your current citalopram usage has not been added.

 

Please update your drug signature so that we can see your drug history at a glance and not have to read back through your posts to get the information.  Thank you.  Account Settings – Create or Edit a signature

 

9 minutes ago, Gurgle said:

Do you think it would be ok to go back to 1mg tablet after 7 days?

 

Yes, I think this might be the best thing to do because you think you may be reacting to the prescription liquid.

[Gurgle]

Thank you. X and thanks for reminding me about the signature.

[Gurgle]

Has anyone been allergic to ads on reinstating? I wonder if I'm developing an allergic reaction/ histamine reaction to citalopram. Took 1mg at 9.45. increasing buzzy feeling all over followed by an intense coughing retching episode, bringing up phlegm at 11.40-12.10. 😒

 

 

[Gurgle]

This had been happening after food and stress sometimes too.

[Gurgle]

I presume ct ing a reinstatement after 5 or 6 weeks won't go down well. Feel trapped. Think my body is rejecting medicine now.

[Gurgle]

I am reacting to everything. I even cough with loud noises. Feel like I have had a reaction after going to the loo as well. 

[Rachellynn]

Have you tried taking H1 and H2 blockers for Mast Cell issues? Zyrtec/Zantac? ❤️

[Gurgle]

Hi all. It all went **** up for me. Got type A flu; it drove me bonkers; attempted to commit suicide- it failed, obviously. Still doing 1 mg of citalopram. I have also been diagnosed with ME/ CFS which would explain my issues over the last 5 years ( before sertraline cold turkey). 

 

 

 

Now still struggling severely. Not resting enough and crashing regularly. Hyper and agitated in between crashing. I have identified that I hold a lot of guilt ( about anything and everything ) and need to deal with this otherwise I'll never heal. So very ill 

 

I know we say no other meds but feel I won't get through this. Could a low dose antipsychotic or mood stabilizer be good? Trazodone for sleep?

[ChessieCat]

Hi Gurgle,

 

I'm sorry to read that you are struggling at this time.

 

4 minutes ago, Gurgle said:

I know we say no other meds but feel I won't get through this. Could a low dose antipsychotic or mood stabilizer be good? Trazodone for sleep?

 

Before trying a new drug, you might want to consider reinstating a very small dose of sertraline.  You could try a dose as small as 1mg.  It is better to start with a small amount and increase by a small bit more than risking taking too much.  You might find that a little bit of sertraline will help with the withdrawal symptoms from your cold turkey.

 

If it was me, I'd be trying reinstatement before starting a new drug.  If you start a new drug you might still have withdrawal from the sertraline and/or start up/side effects/adverse reaction to the new drug.  You won't know what is causing any issues.

 

Please read Post #1 of this topic:  About reinstating and stabilizing to reduce withdrawal symptoms

 

You will need to keep daily notes on paper to see how the reinstatement is affecting your symptoms.

 

I would also encourage you to seek counselling to help deal with the diagnosis that you have recently been given.

[Gurgle]

Hi Cheesiecat. Thank you. I did reinstate 1 mg of citalopram after 3 months off sertraline. Reason I didn't reinstate sertraline was because I had horrendous side effects from it and it never helped me but was on it for a year. 

[ChessieCat]

14 minutes ago, Gurgle said:

I did reinstate 1 mg of citalopram after 3 months off sertraline.

 

I can't see this in your drug signature.  Please add it if is not already included, and include how long you were on it.

 

Q:  Why did you stop the citalopram reinstatement?

 

15 minutes ago, Gurgle said:

Reason I didn't reinstate sertraline was because I had horrendous side effects from it and it never helped me but was on it for a year. 

 

Side effects are generally dose related.  Being on it for 1 year your brain would have adapted to the drug.

 

You might find that a very small dose will help to relieve the withdrawal symptoms but not cause bad side effects.

[Gurgle]

I didn't stop the 1mg citalopram. Still on it. Hadn't helped yet and it's been 3 months. So bloomin desperate now. I think im really struggling as it's hard being physically shot and mentally while trying to pretend to be ok to my children. Do some people do well on a mood stabilizer? 

[ChessieCat]

2 hours ago, Gurgle said:

I didn't stop the 1mg citalopram. Still on it. Hadn't helped yet and it's been 3 months.

 

Please add this information to your drug signature so we don't have to read back through your posts to get the information.  Thank you.

 

Q:  Did you notice an improvement when you first started on 1mg citalopram?

 

Q:  Did things improve after you changed back from liquid to tablet?

 

Q:  Have you taken any other drugs during the last few months?  If yes, what and when?

 

Q:  Have you missed any doses of citalopram in the last month?

[Carmie]

Hi Gurgle, 

 

I’m really sorry you’re struggling so much. It must be hard trying to act like everything is fine when you have kids. We will all eventually heal, everyone does, it’s just a matter of coping with the withdrawals while we are going through them. I have a million distractions that help me to keep going. It doesn’t get rid of the withdrawals, off course, but it helps me to stop focusing on them so much. 

 

Can you please answer Chessiecat’s questions. Thank you.

 

Sending hugs🤗

 

 

[Altostrata]

Hi, Gurgle. What time of day do you take citalopram? How do you feel afterward?

 

Please keep daily notes on paper with times of day for when you take your drugs, their dosages, and your symptoms. You can post them in this topic with a simple list format with time of day on the left and notation (symptom, drug and dosage) on the right. Post your notes here in your Intro topic.