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mic576: taper, change, stay the same?


mic576

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I have a long history with depression and I have been experiencing real struggles with severe depression over the last year.  I think it is getting worse even though I eat well, sleep, exercise, in talk therapy etc.  I have had some really significant struggles lately.

The challenge is I am on 20mg of Citalopram daily for 15 or so years.  I have been reffered to a new psychiatrist to discuss updating meds.  I have no idea what they are going to say.

 

I am not sure what to do. 

1. Keep my Citalopram regimin the same - knowing that I seem to be getting worse but certainly not better

2.  Allow someone to change my SSRI

3.  Begin a taper of Citalopram

 

Any thoughts?  I feel lost.

 

2004 - 2008: Citalopram 40mg

2008 - current: Citalopram 20mg

supplements

2017- current: mutlivitimin; D3 5000 IU; Omega 3 1400mg

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  • Moderator Emeritus

Welcome to SA, mic576.  We are a site dedicated to helping people to taper off psychiatric drugs and to deal with withdrawal symptoms from going off these drugs. The decision of whether to switch your SSRI, or to stay where you, are must be yours.  If tapering off the Citalopram is what you decide to do, we can help you.  In he meantime, here is some information so you can make an informed decision. 

 

 It is very possible that you are in "poop-out" or tachyphylaxis, which means that after long use your Citalopram is no longer working but your body requires it to maintain "normal function."  This is common.  SSRI's were not tested for long-term use when they were in the approval phase, nor were they originally intended for long-term use.  This link provide a good explanation:

 

Tachyphylaxis or As It’s Lovingly Known “Poopout”

 

Does that sound like what's going with you?

 

Should you decide to taper the Citalopram, we recommend tapering by no more than 10% of current dose every four weeks.  

 

Why taper by 10% of my dosage?

 

Here is specific information about tapering Citalopram.

 

Tips for tapering off Celexa (citalopram)

 

Doctors will almost invariably advise tapering at a much faster rare than what we recommend.  This puts the patient at risk of withdrawal symptoms that can be very unpleasant and long-lasting.  

 

 
 
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.  
 
These explain it really well:

 

 

   On 8/30/2011 at 2:28 PM,  Rhiannon said: 
When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.
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This is your Introduction topic, where you can ask questions, post updates and connect with other members.  I'm glad you found your way here.

 

Gridley Introduction

 

Lexapro 20 mg since 2004.  Begin Brassmonkey Slide Taper Jan. 2017.   

End 2017 year 1 of taper at 9.25mg 

End 2018 year 2 of taper at 4.1mg

End 2019 year 3 of taper at 1.0mg  

Oct. 30, 2020  Jump to zero from 0.025mg.  Current dose: 0.000mg

3 year, 10 month taper is 100% complete.

 

Ativan 1 mg to 1.875mg 1986-2020, two CT's and reinstatements

Nov. 2020, 7-week Ativan-Valium crossover to 18.75mg Valium

Feb. 2021, begin 10%/4 week taper of 18.75mg Valium 

End 2021  year 1 of Valium taper at 6mg

End 2022 year 2 of Valium taper at 2.75mg 

End 2023 year 3 of Valium taper at 1mg

Jan. 24, 2024: Hold at 1mg and shift to Imipramine taper.

Taper is 95% complete.

 

Imipramine 75 mg daily since 1986.  Jan.-Sept. 2016 tapered to 14.4mg  

March 22, 2022: Begin 10%/4 week taper

Aug. 5, 2022: hold at 9.5mg and shift to Valium taper

Jan. 24, 2024: Resume Imipramine taper.  Current dose as of Feb. 22: 7.6mg

Taper is 90% complete.  

  

Supplements: multiple, quercetin, omega-3, vitamins C, E and D3, magnesium glycinate, probiotics, zinc, melatonin .3mg, anti-candida, iron, serrapeptase, nattokinase


I am not a medical professional and this is not medical advice but simply information based on my own experience, as well as other members who have survived these drugs.

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Thank you so much Gridley.  I read further on some of the information you provided.  I am hoping I can gain some insight to help my desicion making process.  I can see that many people here have much more experience than  I do and maybe there are some 'if I had it to do over again' type thoughts.  

 

After reading here, if I do anything trying to go off meds I will taper using the guidelines here, its all very hepful.

2004 - 2008: Citalopram 40mg

2008 - current: Citalopram 20mg

supplements

2017- current: mutlivitimin; D3 5000 IU; Omega 3 1400mg

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  • ChessieCat changed the title to mic576: taper, change, stay the same?
  • Moderator

Hi Mic, 

I am no expert in this but one thing you need to consider is to switch to a new drug you need to cut this one and usually doctors cut you rather quickly (if you take two at a time I think you risk serotonin syndrome). It is possible that that in itself might trigger withdrawal symptoms. It might  or it might not, but for many people in these boards it seems to. 

 

The therapy that you are doing - is it CBT? CBT has been shown to help as much as ADs in clinical trials. If you can't do that kind of therapy, I really like The anxiety and depression workbook for dummies by Charles Elliot and Laura Smith. 

 

As Gridley said, we can't tell you what to do but do check out the links to non-drug techniques to manage emotions. I don't know how to add links here but they are pinned under the Symptoms section. 

 

Hope you get there soon. 

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

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  • Moderator
10 minutes ago, mic576 said:

Thank you so much Gridley.  I read further on some of the information you provided.  I am hoping I can gain some insight to help my desicion making process.  I can see that many people here have much more experience than  I do and maybe there are some 'if I had it to do over again' type thoughts

Mic, if I had to do it over again I'd never have gone on antidepressants. And I am saying that not just because of withdrawal but because of the research that shows that they are no better than placebo (or minimally better) and that they create significant long term problems. I.e. even if they work in the short term, they make things worse in the long term. And if I knew what I know now, I'd have stopped them many many years ago. If you get a chance, read "Anatomy of an Epidemic" by Robert Whitaker. 



HOWEVER, I was not seriously depressed at the time, I was anxious. You are the one who knows your situation best.  And you will be the one who lives with the consequences of your decision so it would be presumtuous to say what you should do.

 

If I were depressed now, I'd find a CBT therapist. It doesn't work for everybody but it does for many. I'd try to change the situation that is making me depressed (if it is situational) - bad boss, divorce etc. etc. Not always possible of course. I'd do many other things before thinking of drugs. I'd also wait it out with enough support - i.e. plan what to do if you get suicidal, have a support system if things get really bad etc. I also like the book The Upward Spiral a lot. I am sure you are doing many of the things that they recommend but it is quite good. 

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

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  • Moderator Emeritus
2 hours ago, Onmyway said:

non-drug techniques to manage emotions

 

Here are some links that many members have found helpful:

 

 

And some links for dealing with anxiety, which is such a common symptom. 
VIDEO:  Peace from Nervous Suffering - Claire Weekes (1 hour) (http://sendvid.com/vgquc1dg)

Gridley Introduction

 

Lexapro 20 mg since 2004.  Begin Brassmonkey Slide Taper Jan. 2017.   

End 2017 year 1 of taper at 9.25mg 

End 2018 year 2 of taper at 4.1mg

End 2019 year 3 of taper at 1.0mg  

Oct. 30, 2020  Jump to zero from 0.025mg.  Current dose: 0.000mg

3 year, 10 month taper is 100% complete.

 

Ativan 1 mg to 1.875mg 1986-2020, two CT's and reinstatements

Nov. 2020, 7-week Ativan-Valium crossover to 18.75mg Valium

Feb. 2021, begin 10%/4 week taper of 18.75mg Valium 

End 2021  year 1 of Valium taper at 6mg

End 2022 year 2 of Valium taper at 2.75mg 

End 2023 year 3 of Valium taper at 1mg

Jan. 24, 2024: Hold at 1mg and shift to Imipramine taper.

Taper is 95% complete.

 

Imipramine 75 mg daily since 1986.  Jan.-Sept. 2016 tapered to 14.4mg  

March 22, 2022: Begin 10%/4 week taper

Aug. 5, 2022: hold at 9.5mg and shift to Valium taper

Jan. 24, 2024: Resume Imipramine taper.  Current dose as of Feb. 22: 7.6mg

Taper is 90% complete.  

  

Supplements: multiple, quercetin, omega-3, vitamins C, E and D3, magnesium glycinate, probiotics, zinc, melatonin .3mg, anti-candida, iron, serrapeptase, nattokinase


I am not a medical professional and this is not medical advice but simply information based on my own experience, as well as other members who have survived these drugs.

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Onmyway,

Thank you for your insight.  You identified one of my concerns with agreeing to a change in antidepressant is what is done with my current citalopram dose.  I hadn't even considered seratonin sysndrome.  I have no doubt that a new med will cause an effect, maybe positive, but what happens after that short term effect is over.   It all seems really scary to me.

 

Yes I am doing CBT and with some issues it has helped a great deal. 

 

Does anyone ever experience any level of positive effect on depression when they taper off antidepressants?

 

You have given me a lot to read and think about.  Thank you 

2004 - 2008: Citalopram 40mg

2008 - current: Citalopram 20mg

supplements

2017- current: mutlivitimin; D3 5000 IU; Omega 3 1400mg

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Gridley,

 

You mention (August 2016, discovered SA, updosed to 25 mg and holding )

What is SA if you don't mind sharing?

2004 - 2008: Citalopram 40mg

2008 - current: Citalopram 20mg

supplements

2017- current: mutlivitimin; D3 5000 IU; Omega 3 1400mg

Link to comment
  • Moderator Emeritus

SA = Surviving Antidepressants, the name of this website

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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7 minutes ago, ChessieCat said:

SA = Surviving Antidepressants, the name of this website

 

Oh gosh, do I ever feel silly missing the obvious!

2004 - 2008: Citalopram 40mg

2008 - current: Citalopram 20mg

supplements

2017- current: mutlivitimin; D3 5000 IU; Omega 3 1400mg

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