bunchesofoats: starting 2nd citalopram taper

[bunchesofoats]

Hi everyone. I've been reading this site for the past few months ever since I gratefully stumbled upon it and finally made an account. In early 2018 I successfully tapered from 30mg citalopram down to 20mg by cutting a 10mg tablet. I went down about 2.5mg/month. I tried a couple of times to go down to 17.5mg but the symptoms were intense and I realized it was too difficult to get a consistent amount with cutting the tablets so I decided to stick with 20mg until I found a more consistent way to taper.

 

I read about the dissolve method working successfully on a post on this site and decided that would be my route. I bought some 10cc syringes with .2mL gradations. Last night I tried my first dose at an 8% taper - 18.4mg. I'm feeling worse than i'd expected/hoped considering it was such a small difference, but I have historically had a rather sensitive system. I'm starting to question whether I'm really meant to go down, if this is a sign I should keep my current dose. My life certainly isn't in a particularly solid place (though it's relatively stable). But I know it will only become more difficult the longer I'm on it, and I've seen only marginal if any benefit from taking it. Looking to document my process and experience here and contribute to this supportive community as well as find guidance about how to approach my own path.

[bunchesofoats]

Decided to post a bit more detailed info about myself.

 

Supplements:

multivitamin

1000iu Vitamin D

1000mg Vitamin C

methylfolate

 

ZMA (zinc magnesium asparate b6) at bedtime with citalopram

sometimes take 1/4 25mg doxylamine succinate to help with sleep. leaves me groggy in the morning but haven't noticed any ill effects in the ~2 years I've been taking it on and off.

 

I've done 23andme testing and found I have a 5-mthfr and COMT variations, that's why I take methylfolate separately.

 

I do my best to keep a pretty regular sleep schedule, ~10:30p-7a, though it fluctuates an hour here and there and I don't always sleep through the night. Sometimes I need a nap. I don't do any recreational drugs and drink almost no alcohol. I find I'm super sensitive to alcohol on citalopram so I stay away other than one drink every few months at a special occasion. I don't drink coffee either, but I do drink a special hot cocoa every morning - I mix up raw cacao with coconut milk and add in other things like ashwagandha, maca, turmeric, black pepper, himalayan salt, cinnamon, protein powder. I practice and teach yoga and meditation. I also tutor kids in math. I haven't had a real full time job in 5 years. I had a really stressful and traumatizing job that I quit to give myself time to heal and explore other endeavors. I've definitely found myself stuck while I work through my lifelong anxiety and depression. I have a super supportive partner and that has made all the difference in the world. I'm still trying to get more income while building up my programming skills to eventually build up a career. I'm broke and finances are a huge stressor, along with not having had full time employment in so long and being a perfectionist (in the paralyzing way). I've been doing CBT since a I began citalopram, and this therapist has helped me see through things (like that my parents despite being well intended and caring were/are a lot more abusive that I've ever wanted to admit). Working on acceptance has made a huge impact for me, though it's incredibly challenging.

 

I don't know if anyone will read this, but I'm curious what supplements/activities if any have made differences, positive or negative, in others' journeys. I've searched around and there seems to be a consensus that vitamin d and omega 3 (high quality) help. Exercise of course. NAC maybe.

 

I used to take NAC regularly. I've tried reintroducing it a couple of times and I find myself getting very anxious/ruminative when I take 600mg. I've seen others post that lower doses can sometimes paradoxically ignite more anxiety while higher doses can calm it. I actually have a bachelors in biochemistry but it was so long ago and there are so many factors at play I can drive myself nuts trying to understand all the possible interactions and effects.

 

Taking my 2nd dose of the 8% taper tonight (18.4mg). Hoping the symptoms subside in a few days.

[bunchesofoats]

My current specific symptoms today were:

 

• Woke up around 5am with feelings of body rushes and intense worries
• Felt body rushes in and out throughout the day
• Felt body anxiety, feelings of dread, irritation
• Intestine gurgles (have only felt this from serotonin related experiences)

 

Became very difficult to do anything. Had to take a nap. Not wanting to leave the comfort and safety of my own bed. Every normal worry/anger thought spirals into extreme.

 

My personal record of my symptoms:

 

feeling pretty frickin bad. really anxious. almost even suicidal, which I don't think I've every felt before, like I'd do anything to end feeling like this. good god. didn't get the brain zaps this time, but have been having the rush through my body since 5:30am. managed to get through my day. but now I'm feeling pretty panicked. it doesn't matter much that I'm aware, I'm still getting caught up in it. how can such a small amount make such a big difference? WTF?? I mean, it's not even within the realm of feeling difficult, it's catapulted me into a completely different and awful state of being. It's not even the same world anymore. And I was struggling quite a bit before. So how could I possibly keep up now? ****. I feel like I can't do anything, like I'm paralyzed. I've felt like this before - it's anxiety. But now it's hit me like a ******* brick. Is it the anxiety that's been masked under the drug, or is it withdrawal from the drug? This is so ***** up. I can't believe this legal. Will I ever heal? Do the symptoms mean I'm not ready to go off? Will it only get worse the longer I wait? Is there a better time to do this? Gastro gurgling too, like I felt when I first started and other time I've tapered down. Headache. Hot. Oh and worse tinnitus than usual.

 

FYI not actually suicidal, just weird momentary feelings.

[Altostrata]

Welcome, bunches.

 

If you're going from a table to liquid, it can be easier to take a few 20mg doses in a combination of tablet and liquid rather than going directly to a reduced dose in liquid. See

 

Tips for tapering off Celexa (citalopram)

[bunchesofoats]

Hey Alto, thanks for the tip! This actually crossed my mind since I was thinking the speed of the metabolism likely changes when taking in the dissolved state. I'll do that tonight. Do you have any recommendations on how long to continue taking 20mg in liquid form before decreasing the dose?

[bunchesofoats]

Day 2 update:

 

Was thinking to take Alto's advice and go back to 20mg but with 10mg dissolved. Didn't want to go back since I'm already 2 days in though. Decided instead to cut 10mg carefully in half (still approximate though, of course). Tonight will take 15mg by table and the remaining 3.4mg from my dissolved mixture (6.8mL). Boy does this require a lot of careful attention to detail and record keeping.

 

Here are my personal notes in case it helps anyone to see my raw thoughts:

 

doing ok. hard to concentrate, harder than usual, hard to do anything. sensitive to noise. irritated. it takes energy to "keep it together," basically to act normal and not like a jerk. I only have so much energy, though. I'm feeling tired now. might need another nap. couldn't nap, but was good to meditate. system so sensitive now, makes the stakes higher for keeping my thoughts in order. good learning method. silver lining. still getting body rushes, maybe less than yesterday. no intestinal gurgling. woke up dizzy. I'm ok. can't keep track of everything, have to let some of it go, but must use skillful means or will face the consequences later. I didn't shower. I didn't change my sheets. I didn't prep for my class. I did half hour of watching programming videos. It's not going well. oh bugger. took an ativan in the afternoon finally which helped tremendously. changing tactic: cut tablet in approximate half, take 15mg by tablet, rest by liquid.

 

Happy Passover/Easter/weekend everybody!

[bunchesofoats]

Day 3 - 20mg 8% taper diary:

 

Groggy and dizzy in the morning. Had a meditation retreat. Went late. Meditated for 1h20m. Definitely helped. Then listened to a dharma talk and had lunch. Had to pass out after lunch. It wasn't like just sleepiness, it was like everything was closing in on me and I just had to shut down. I woke for a moment here and there but kept going back down into the sleep. I slept for about two hours. When I woke up I didn't necessarily feel rested, but at least I felt like I could stay awake. I talked to my meditation teachers about my tapering process and that helped. Then went to visit a friend in the hospital who was suddenly diagnosed with pancreatic cancer. Then went and had delicious seder leftovers. Overall was feeling much better, much more stable at this point. I'm lucky I had the opportunity to shut down when I needed to so I could still be there for others. That wasn't always the case and I know it isn't for others. Last night I did the 15mg tablet + 3.4mg liquid again. Woke a lot during the night but overall slept ok. Woke up early. Trying to clear my head to get some stuff done today and stay somewhat balanced. Haven't had the intestinal gurgles since that first day. No more obvious body rushes. I did notice I'm having more lucid dreams which I used to have intensely all the time, and then I noticed I hadn't had any lucid dreams in months. I had no idea what that meant, but now I'm realizing that probably the entire time I was taking 30mg, which involved cutting a 20mg in half, I was sensitive to the daily fluctuations because of the imperfect cut of the tablet. My god that entire time I felt awful and I thought it was me. I'm glad I had the instinct to take myself down to 20mg. My doctor doesn't believe there's any way anyone can be that sensitive, and if there is then it's just proof the medication helps me. There's a part of me that's definitely angry with myself for letting myself get into this place. But I know that won't help, and I know how that kind of thinking can spiral.

[bunchesofoats]

Day 4 - 20mg 8% taper = 18.4mg diary

 

Really tough to do much again. Got by. A lot of old emotional pain I thought I'd gotten a handle on coming back. Head feels weirdly empty but also like there is someone screaming inside of it. I feel so angry and often hopeless. I have to just keep telling myself I can get through it and try my best to move on to the next thing. But of course some things just need to be let go. Flinching with every loud sound. Trying to act normal so no one puts me down for my vulnerabilities. It's happened before in this family, many times. I need to get out, but I need to feel better to get out, but I need to get out to feel better. When will this cycle end. I hope I can get myself out. I've done it before. I know I have it in me. I just don't feel that way right now. Intestinal gurgles back tonight for some reason. Didn't have them the past couple days. Headache all last night and throughout some of the day.

 

Reading about others' struggles with withdrawal is heartbreaking and overwhelming. Of course I never thought I'd end up in this boat. I'm ashamed of myself that I have, like I should've known better. I tread carefully and yet I still ended up here. I was lost. That's how I ended up here. I trusted someone else more than myself, over and over again. Try not to do that again.

[brassmonkey]

32 minutes ago, bunchesofoats said:

A lot of old emotional pain I thought I'd gotten a handle on coming back

 

This is a hallmark of ADWD.  It has a habit of digging up old memories and making you relive them again and again and again. The best thing to do is not give in to it's game.  If the memory is over and done with and the emotions handled then tell it that every time it starts to come up. "I've been through this already and have resolved it, there is no need to get into it again."  Saying this in your mind or out loud will acknowledge the thought and put it in it's place.  With some repetition and practice these thoughts will subside and bother you less and less.

 

Another hallmark of ADWD is self-loathing. Anger at ones self for getting into a situation that was beyond your control and by trusting someone we have been taught all our lives to trust. Acceptance of the situation and understanding that's it's "not your fault" are the keys.  They are hard to reach but once there you will feel a whole lot better about things and it really will help you to heal faster.

[bunchesofoats]

Thanks @brassmonkey. I saw your comment before I went to bed last night and it gave me tremendous comfort, actually brought tears to my eyes with some relief. Everything you said completely resonated and it was really helpful hearing an external voice of support. It's such a bizarre experience having those thoughts tumble back and even more bizarre that other people experience the exact same thing.

 

Day 5 - 20mg 8% taper = 18.4mg diary

 

Today was significantly better! I think backing off from the liquid and increasing the tablet dose eased things, and the participation in this community is incredibly helpful for me. I know that probably seems obvious, but I've often kept things, especially troubles with mental health, completely to myself for one reason or another. 

 

I woke up worried about not feeling my best, but as the day progressed I realized I actually felt ok. I was much calmer and more productive and I could tell I was able to see things more clearly and come up with more solutions. At night fall, nearing my next dose I started to feel more discomfort, mainly in the way of that weird hotness and increased tinnitus (which I've had ever since I was on wellbutrin 10 years ago). It's so tempting to think all the pain is over and now I should just feel great, but of course that's never been the case, not on medication, not off. 

 

Tonight I'm increasing the liquid to tablet ratio, now 5.9mg liquid, 12.5mg tablet. We'll see how tomorrow goes. I'm trying to get to the 10mg tablet point since that will be a more stable dose without all the rough pill cutting.

 

Attached a graph of my dosage of citalopram over time in the past and predicted future tapering (may go faster or slower of course). The red bar is where I am currently. The dip in the middle is when I tried to go down to 17.5mg but gave up after intense WD and waited to taper down again until I found a more reliable way to go down by less than 2.5mg than cutting tablets.

[bunchesofoats]

Day 6 - 20mg 8% taper = 18.4mg diary

 

Yeah, today was harder. I woke up at 5am with body rushes. I almost laughed when symptoms returned, like "ahh, of course, hello." I still felt decent all morning, but the lack of sleep and the additional change to liquid in my last dose caught up to me. Been having trouble eating and today was no exception. Feeling dizzy, intestinal cramps, nausea, hot flushes (though to be fair today was a hot day). Self-loathing thoughts about how much I've lost due to this path,. Anger at others for not providing better help to those vulnerable. Anger again at myself for not doing a better job protecting myself, even though that's the entire point of my anxiety (or so it thinks). 

 

I remembered today about how in 2011ish my dr prescribed my citalopram. I was on a double dose of prilosec at the time and had been for years. He didn't think to ask about my other medications, and he didn't know these two interacted when I told him. I went to work with crazy hot flushes and chills, thinking maybe I was sick, until I saw my pupils dilating and contracting wildly in the bathroom mirror. That to me signaled serotonin and from there I realized it was the citalopram. I had SSRIs pushed on me so many times, and I didn't want to give in because it didn't seem worth the negatives (which I didn't even know the extent of at the time). I finally gave in, and now my mind just keeps repeating, "why couldn't you get it together enough to not be so broken?" 

 

My entire career/current lack there of hinged entirely on my poor mental health. Why wasn't there more support? Why didn't the help I did seek pan out?

Enough feeling sorry for myself. Nothing to do now but try to make it work (hearing that in Tim Gunn's voice). But man am I scared I'll never make it work. Today was not productive. I did quite a bit more than what my bare minimum was in the past, though. Still, though, when do I get to "really start living"?

[bunchesofoats]

I'm learning to program and I just noticed there's no space between the word "Location" and the person's location. The code has

print("Location" + userlocation)

when it should have

print("Location " + userlocation)

Needs a space before the end quote. Or something like that, depending on what language this is in.

Yay I'm learning something 😁. Maybe.

[bunchesofoats]

Day 7 - 20mg 8% taper = 18.4mg diary

 

Mostly ok today, though by no means great. Had a really, really hard time eating, but luckily actually managed ok without it. Had a lot of body anxiety but was able to stay in observer mode and just watch it and my thoughts without getting too caught up in it. Still it was hard to do too much (like many days). 

 

Some of my physical symptoms remind me of the summer of 2016 when I was taking St. Johns Wort and Garcinia and realized they might interact to increase serotonin too much. And before that I tried Sam-E which really didn't work with my system. Too tired atm to expand but wanted to make a note while I remember. Some of those experiences were probably what let to me trying citalopram in the first place.

 

Tonight I switched to 10mg tablet and all liquid for the rest. I'm expecting tomorrow to be h***, and I've got a lot I need to do. I took a 0.5mg ativan preventatively. I know it'll probably be horrible tomorrow, and maybe not great over the weekend, which sucks since we're going out of town and visiting old friends and family, but I feel reasonably confident that I'll stabilize after some days. And then I'll hold at this dose for the next 3 weeks. At that point my plan is to drop down another 8%, which I'm guessing will be much smoother than the transition from 20mg because I'll already be adjusted to the liquid.

 

One more note before I forget - I started tapering 2nd week of my menstrual cycle. The first time I tried to taper down was during my last week and holy heck was that unreasonable.

[jozeff]

Hi bunch,

 

Good to read your topic. I recognize a lot in your story.

 

You can read my topic if you want. There is some info you might find useful.

 

I think you should stay on the 8 % reduction for quite some time. 

 

You can absolutely go down in dose but take it slow.

 

 

Cheers

 

Jozeff

 

 

 

 

 

[bunchesofoats]

Day 85 - 20mg, 8% taper: 15.5mg

 

Meant to keep updating more regularly but alas got caught up in a busy time (not that that's really an excuse). It just seemed hard for me to post for whatever reason. Sometimes I don't want to slow down enough to do certain things I guess? Not quite sure if that's an accurate description. 

 

Today is day 85 of my taper. I've been following ~8%/month. I didn't feel much in the way of obvious withdrawal symptoms this past month other than the first few days. The symptoms I had were mild tingles, fever, weird appetite. I've had these symptoms each time I've reduced. I'll post more details soon but for tonight I just want to write a quick update. 

 

I wanted to drop dosage again a week ago, which was 3 weeks after the previous drop (according to the 4 week, 4 week, 3 week etc schedule), but it didn't feel right. My partner and I just moved in to a new place together and it was the pms part of my cycle and I was fighting a cold. Those are the explanations I came up with. Tonight I'm dropping the dose 4 weeks after the previous drop. This time I'm planning to drop after two weeks so I don't coincide with the pms part of my cycle. We'll see if I'm up for it. For the most part I'm not having obvious withdrawal symptoms anymore, but I am still struggling with anxiety and depression. I was never really not struggling even at higher medication dose, but some part of me still starts to wonder if I'm doing the right thing by dropping. I still entertain the idea that maybe there's a medicine out there that can "cure" me of basically being me (well all the stuff I didn't like I guess that I thought I'd grow out of, all the stuff that's "holding me back from my potential"), but I think I've tried enough medications and doctors. I'm trying to accept that on some level I will always have anxiety and depression and that's ok, I get better and better at dealing with it. Everyone's got something.

 

I'm really grateful to have read about the "windows and waves" description of withdrawal and healing on this site because it gave me a lot of reassurance that what I was feeling made sense.

 

Thanks @jozeff for the note. I'll check out your posts.

[bunchesofoats]

Day 92 - 20mg, 8% taper: 14mg

 

This last dose drop didn't come with any overwhelming WD symptoms and I'm a week in! No tingles this time. I don't know if I'm doing great, though. It's been really hot and I am terrible in the heat, despite doing my best to keep up with hydration etc. I feel really foggy and sluggish, mildly dizzy, and somewhat down. At times I've felt triggered into sadness or anxiety like I have so many times in the past. I start to question whether I should really be taking myself off the citalopram, but then I remember what I felt like at 20mg and 30mg, and I don't remember it ever being consistently better. Still, the self-doubt continuously arises. I still want to improve my mental health substantially. I of course wish a medication could do that, but it just doesn't seem to work that way for me. I'm envious of those that started taking pills and then suddenly felt all better and were able to be on top of things and enjoy their lives. What am I doing wrong? The heat really makes it extra hard to cope. But I guess bit by bit I just keep trying to improve myself and my situation every day.

 

My plan is to drop after another week, for a total of 2 weeks at this dose. I don't want to do 3 weeks because that puts me at the worst week of my hormonal cycle. If that goes well, then I'll keep dropping 8% every two weeks for 4 rounds until I get to 10mg. Then I'll hang out there for a month or so while I take a break from having to dissolve pills and syringe myself a dose. Once I start decreasing again, I'll first switch to 10mg in liquid, and then work my way down. That is if I even feel up for dropping again in 2 weeks. I'm really feeling more easily triggered. I don't know if that's withdrawal or missing the effect of the medicine. I feel like poop.

 

Attached a table of dates, dosages, and % changes since the beginning of this 2nd taper. Will attach symptom table once updated.

 

Wanted also to mention that I'm still taking 0.5mg ativan about 3x/month when I get desperate. My pharmacy started getting a different generic manufacturer and this one doesn't seem to help nearly as much and it seems to give me really bad rebound anxiety about a day and a half after I take it. I'm hesitant to take it, but when I get so paralyzed with anxiety I still find myself reaching for it so I can give myself the chance to feel better even for a little bit. I've looked into other ways to improve GABA levels and haven't managed to find anything reliable. I'm a practicing meditator and yogi so I really feel like a failure. 

[bunchesofoats]

Day 97 - 20mg, 8% taper: 14mg

 

Hey I've actually been feeling pretty decent, and my sexuality is coming back woohoo! Going slow is really the way to go. I still feel somewhat down more often than not, but that's not a change from any point while I've been on citalopram. I went out of town for the weekend and actually felt genuinely comfortable and present much of the time! That's a very rare occurrence really for my entire life but especially the past 10 years. Learning to accept how I feel has helped me tremendously. It hasn't been easy, obviously, but slowly I am seeing progress. I was so desperate to "fix" myself before with supplements and at times medications, convinced that I was so lacking that I needed to immediately get myself working as I thought I should be. It's been a really long process, but with the help of therapy, Buddhism, and my partner, I've slowly changed that toxic world view (or at least have begun to).

 

I think the experimenting with supplements threw my nervous system around a lot more than anyone would've expected. Though I've stayed away from recreational drugs and even alcohol for years, I still feel like I'm "sobering" up by limiting my medication and supplements, as well as practicing seeing things more clearly through meditation and CBT. I've also flipped from listening to others and my monkey mind to instead listening to my body and inner self. Trusting in my own experience has been a HUG E shift for me that did not come easy and took its sweet time, but now that I'm starting to actually live it, it feels good, it feels right. It's still not how I live most of the time, with doubt and anger and fear and sadness often crashing in, but now I know that's a normal part of the process and that it will eventually pass.

 

Here's a graph of where I am in my citalopram path. 

[ChessieCat]

On 7/18/2019 at 3:33 PM, bunchesofoats said:

I'll keep dropping 8% every two weeks for 4 rounds until I get to 10mg.

 

Reducing by 8% every 2 weeks is equal to 16% reduction in a month (4 week period).  SA recommends tapering by no more than 10% of current dose with a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.

 

If you continue to taper at the stated rate, it is more likely for the faster taper to catch up with you and you may end up with withdrawal symptoms.  It is better to go slow enough so that you don't get bad withdrawal symptoms.  If you get bad withdrawal symptoms you will need to hold, which could end up taking longer than if you had done SA's tapering rate to begin with.  We have members here who this has happened to, some of whom haven't been able to stabilise completely and have had to either continue to hold for a long time or reduce anyway.

 

On 7/18/2019 at 3:33 PM, bunchesofoats said:

I'm envious of those that started taking pills and then suddenly felt all better and were able to be on top of things and enjoy their lives

 

I had been taking citalopram for a long time and seemed to be doing okay.  Until I had short period of time when I had 3 major life stressors occur.  I literally had a major breakdown at my daughter's wedding reception.  I realise know from what I have learned here on SA, that is was most likely that the drug reached tolerance/poop out.

[bunchesofoats]

Hey @ ChessieCat, thanks for the input! I was making my plan based on this outline:

 

• Initially, make a 10% reduction and hold there for a MONTH. It can take several weeks for withdrawal symptoms to emerge. Do that again the second month.
• If you have very minor or no symptoms from these 2 reductions, you can try reducing by 10% (calculated on the last dosage, the amount of decrease keeps getting smaller) every 3 weeks. Do that twice. If no problems, reduce by 10% every 2 weeks. Do that twice.
• If no problems after 4.5 months of very gradual reduction, you may be able to reduce by 10% every week.

Not a good idea?

 

[ChessieCat]

Where did you get that from?

[ChessieCat]

Generally we need to slow down as we get lower.  Please see:  Why taper paper: dose-occupancy curves

[bunchesofoats]

@ChessieCat, I got it from this post by @Altostrata made in August 2011. Nearer to the end of the post. I read this long before I even began tapering so I assumed this was a normal route.

 

[ChessieCat]

If it was me, I'd be sticking with the no more than 10% per month tapering method.

 

I'm down to 2.5mg Pristiq.  I've already been tapering for more than 3 years, started at 100mg Pristiq.  It's going to take me about another 2 years, or maybe a bit longer, to get off the last little bit.  However, I have decided that I have already invested a lot of time to get to where I am and even though I have had times in the last 6 months that I have considered just stopping, I have decided that it is just not worth it.  If I try to go faster or stop now, there is a possibility that I could destabilise my nervous system.  I'd rather err on the side of caution and stick it out to the end.

 

BrassMonkey took about 7 years to get off his Paxil (doing the BrassMonkey slide - 10% every 6 weeks).

 

The way I look at it is that my brain still needs the drug, it is nothing that I have any control over and has nothing to do with how strong or determined I am as a person, and as I've tapered I'm reducing my dose so why not go as slow as I need to and get off with as little discomfort as possible.

 

The important thing to note is that going on and off over the years has a cumulative effect.

[bunchesofoats]

Thanks a lot for your input, @ChessieCat. I'll reconsider my plan. My reasons for wanting to go as fast as possible are mainly so I no longer have to worry about taking the medication, especially now that I have to have a bottle and syringe wherever I go; to reduce side effects especially sexual and vertigo; to be able to more safely take aspirin and tylenol etc and to drink some wine again.

[ChessieCat]

It doesn’t end at “0”

[bunchesofoats]

Thanks @ChessieCat. Reading about these patterns gets me thinking about previous stints with other psychiatric drugs, namely concerta, ritalin, and wellbutrin. I went on and off those over many years and struggled to accommodate even the lowest doses of any of those drugs from the very beginning. I wonder how much of my struggles have been a result of my nervous system being thrown around by those (in addition to life, traumatic experiences, supplements, drinking alcohol etc), because I've felt the "windows and waves" before I even began citalopram. I've just had more pronounced symptoms with the citalopram. 

[bunchesofoats]

Summary of my experience with citalopram:

 

The red is getting on the medication and ramp up to my max dose of 30mg. The yellow is 30mg (20mg tablet + 20mg tablet broken in half). Green is 1st taper by cutting pills, getting down to 20mg, and then stabilizing there. 20mg was a whole tablet so a nice place to stop. Breaking pills to further reduce the dosage wasn't cutting it. Waited around 20mg until I found out on this site I could dissolve a pill in water myself. Blue is current taper.

 

The dates in white boxes indicate days with vertigo. When there are two side by side those are start and stop dates. I never connected the vertigo to the medication until it luckily completely stopped when I dropped the dosage. These are the only dates I've ever experienced vertigo in my entire life and I'm really, really glad I haven't experienced it in a year and a half. It was one of the most unsettling things. Of course walking around was hard and I was often too afraid to drive, but even lying in bed I would at times have to grip on to the mattress or my boyfriend because the spinning was so strong. I'm young so there wasn't a great explanation for it except maybe calcium crystals. NSAIDs helped.

 

Overall the symptoms in my 2nd taper have been usually milder than the first, but they last about 9 days after each drop.

 

The first drop of my 2nd taper was more intense than expected for the percentage because it was also a switch from tablet to liquid. When I drop below 10mg I will hold at 10mg tablet, then 10mg liquid before moving on to dropping the dosage.

 

I think part of why I struggled so much while I was on citalopram at 30mg was because I was breaking in half a 20mg tablet which gave me inconsistent dosages. I always made sure to take sequential halves so at least it would overall even out, but still, there was some powder lost in the breakage, and sometimes the difference in the halves was bigger than others. I think these "minor" inconsistencies really messed with my system. My doctor has been shocked at my experience and has disagreed the whole way, which is part of why it took me so long to take things into my own hands. When I brought up this website she made a remark about how I'm listening to the internet instead of her. I'm doing my best to inform myself and ultimately listen to myself. What I've read on this site has resonated to an astonishing level, has helped experimentally, and I haven't been able to get the same level of information or support from medical professionals.

[Altostrata]

If you get withdrawal symptoms AT ANY TIME, you're tapering too fast.

 

You were already getting withdrawal symptoms in March 2018, why would you think you could taper faster?

[Altostrata]

I removed the reference to tapering weekly from

 

You have to allow at least a couple of weeks for withdrawal symptoms to appear and not taper in the meantime. Generally, we recommend the observation period be a month for safer tapering.

[bunchesofoats]

Hey @Altostrata, that was actually a different taper cycle. I'm tapering slower than I did then and with much more precision. March 2018 I was breaking pills (into 8ths!) so my dosages were highly inconsistent. This tapering cycle my drops have been between 7.6% and 9.7% and done with a syringe that has 0.2mL precision (that's why the different percentages).

 

I didn't have any WD symptoms this last drop (9.7%). According to information I got from your own post, if you have no withdrawal symptoms, it's ok to start tapering down by 10% with less time in between drops. I don't want to do 3 weeks because that puts me exactly in my PMS week which in and of itself feels like a drop. So my plan was to time the drop strategically in my cycle, about 2 weeks after the last drop, and to do 8%. 

 

I see you just removed the information I was following. You may want to make an announcement about that. There may be people who used that information without joining the website (I was one of them...).

 

To be completely blunt, I felt hostility in your response, "...why do you think you could taper faster?", especially considering it wasn't citing my current experiences. I understand and appreciate all you've done. That kind of tone is exactly the same that I've gotten from doctors who've bullied me into taking medications I knew didn't make sense for my body. 

[bunchesofoats]

"Why do you think you know better what to do with yourself than I do?" I've been hearing this all my life, and now I'm hearing it here. It doesn't matter who it comes from. It's the same sentiment. The place where I kept a highly intimate record of a very private part of my life has now become a trigger, just like that.

[Altostrata]

Sorry, we see a lot of people doing foolish things with their tapers.

 

After years of experience, I do not feel a weekly taper is safe enough.

 

See Why taper? SERT transporter occupancy studies show importance of gradual change in plasma concentration

 

This shows that you might be able to get away with a faster taper at the beginning because the dosage you're taking might be an oversaturation. But when you get down to lower dosages, you might be at the point where partial saturation throws you into withdrawal.

 

We cannot predict where this drop-off point might be for any individual, so we advise continuing to taper cautiously.

 

The only way to find out if you can tolerate faster reduction is to try it and see. If you've had prior difficulty tapering, though, I would not take this risk, your nervous system might have been made vulnerable by earlier mishaps.

[ChessieCat]

2 hours ago, bunchesofoats said:

I didn't have any WD symptoms this last drop (9.7%). According to information I got from your own post, if you have no withdrawal symptoms, it's ok to start tapering down by 10% with less time in between drops. I don't want to do 3 weeks because that puts me exactly in my PMS week which in and of itself feels like a drop. So my plan was to time the drop strategically in my cycle, about 2 weeks after the last drop, and to do 8%. 

 

Instead of doing 8% reductions each time it might be better to do 5%.  That way you will not be exceeding the 10% per month rate.

 

So reduce by 5% of current dose then one week later a 5% reduction then hold for 2 weeks.  However, this will mean that you are only holding for 3 weeks after the 2nd reduction.

 

So:

 

Week 1:  5% reduction

Week 2:  5% reduction

Week 3:  hold

Week 4:  hold

 

The other option would to just do the "regular" SA tapering amount of 10% reduction and hold for 4 weeks.

[bunchesofoats]

Thanks @Altostrata for the info about occupancy and oversaturation. Definitely an interesting model. I started reading and will certainly read more, especially since a lot of papers seem to have come out in the last few months. It's nuts how these medications are so widely and nonchalantly prescribed when we know so little about how they work in general and even less how they affect an individual.

[bunchesofoats]

Wanted to note another thing that's been really helping that my psychiatrist recommended: a SAD light. Even though it's summer I've started using it again, and I really notice the difference. I use it for 10-15min in the morning. I got a really sleek looking one that looks like an apple product and sit directly in front of it while read or using my computer and drinking my morning hot chocolate. I measure the luminosity with an app on my phone, so it's probably not super accurate, but I found that it puts out 10,000 lux one foot (12inches) away from the light.

[bunchesofoats]

Day 101 -

 

Updated plan, sticking to ~10%/4wks for now. May push faster or slow down depending on how it feels. Planning on spending 2 months @ 10mg, first month to get to the dosage of only 10mg, 2nd month to get used to liquid form of 10mg because likely metabolic differences between tablet and dissolved forms.