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Mic323: Having problems reinstating on citalopram after withdrawal

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Mic323

Hi there,

 

So I have been tapering off citlopram after taking 20mg every other day for 5 years. Just to note I have felt great in that time and thought my time on it has been successful. In 12mths I managed to successfully get down to 0.25mgs. After 4 weeks I noticed when I got to that dose a lot crazy physical symptoms started occurring tight chest, body tremors, nausea obvs the withdrawal symptoms. I tried to see if i could beat it but unfortunately I wasn’t strong enough. I remember it got to the worst physical symptoms stage after 6 weeks and I sat down and cried with my GF  and I said I can’t do it anymore and that when one evening I reinstated 0.5mg and couldn’t believe it with in 2hrs all symptoms were gone 80% (just like a heroin addict getting their next hit after cold turkey). 
 

So my issue is now is it’s been about 4 weeks In that time the first week I felt 80% good then 8th day I notice i have my old symptoms back anxiety tight chest and start panicking so I start taking 5mgs every day rather then every other and it works ok for another week then I feel really anxious again so I take 10mg 2 days straight. Yes I know way to much and I paid the price my CNS was all over the place for 2 days. Now I am on 0.5 every day for past 4 days sleeping well but feeling on edge and anxiety is high can’t shake it off don’t want to go back to old symptoms when I started. 
 

My question is to anyone what dose is best? should go to my original every other day dose?? Or stick to every day? Finding it hard to experiment as don’t want to mess about with my CNS as it’s sensitive I have put it thro. 
 

thanks 

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Mic323

Hi,

Was on citlopram for 5 years taking every other day and decided to taper off through out 12 months due to it being a success. I got to 0.25 and was taking it every other day then after 4 weeks noticed severe tight chest and tremors anxiety ect so one eve I went bk on 0.5 and within 2hours felt fine. 
 

Through out the last 4 weeks I have been up and down some days ok and others really anxious and bad. I feel my old symptoms returning. I have tried upping my dose to 10mg every day week ago and that really didn’t work felt really bad for the time I took it so I stuck to 0.5mg every day but still feel really poor.
 

it’s week 4 and last 2 days days it’s been hell started to have bad chest pain and stomach cramps, tremors like similar to withdrawal symptoms!? 
 

so my questions are why am I having these up and down days after I reinstated? 
 

should I stick to my usual every other day dose of 0.5mg or take it everyday? 
 

feel like I am getting worse help. 

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Gridley

Welcome to SA, Mic323.

 

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.  Please be sure to include your original dosesbefore you began your 12-month taper and the rate at which you tapered.  Please use this link:

 

Account Settings – Create or Edit a signature

. 

We strongly counsel against every other day dosing..Skipping doses is equivalent to reducing your dose by 50%.  I t causes the medication in your bloodstream to go up and down, battering your nervous system, and makes withdrawal worse.  I can't say for sure until I see your drug signature with your taper rate, but my guess is that you tapered too  fast and are now suffering from withdrawal.  The instability caused by every-other-day dosing is likely also contributing to your symptoms, as well as the large dose change up to 10mg.  Your brain likes stability, to be treated gently.

 

The rule of 3KIS: Keep it simple. Keep it slow. Keep it stable.

 

We recommend tapering by no more than 10% of current dose every four weeks.

 

Why taper by 10% of my dosage?

 

Your symptoms are recognized withdrawal symptoms.

 

What is withdrawal syndrome.

 

Glenmullen’s withdrawal symptom list.

 

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.  

 

For now, I suggest you take 0.5mg every day at approximately the same time.  Once we've seen your drug signature, we'll be able to advise you further.

 

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) 

 

Add in one at a time and at a low dose in case you do experience problems.

 

This is your Introduction topic, where you can ask questions and connect with other members.  We're glad you found your way here.

 

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Mic323

HELP- So since I dropped from 10mg to 5mg I noticed with on 3rd day severe Akathisia (withdrawal symptoms) can’t stop shaking, wanting to throw up, burning sensation, and worst part can’t sleep a single peep the second night took diazepam 4mg seems to help for a little while when really bad but only take at night. I upped the dose to today in morning 8mg of citlopram  and it didn’t work at all noticed the Akathisia creep back in! 

 

should I stick it out to one dose say 5mg and see what happens? 
 

Up dose to 10mg note that was to high and hence why had bad sleep and anxiety. 
 

Has anyone tried beta blockers for rhe akethsia? 
 

thanks 

 

 

 

 

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Gridley
10 hours ago, Mic323 said:

 

should I stick it out to one dose say 5mg and see what happens? 

Yes.  I would try this for around 10 days.  It takes a bit more than a week for the full effects of the dose change to be felt.  Keep daily notes on paper of your symptoms to track how the reinstatement is working.  Please keep us updated on how you're doing.

 

Be careful with the Diazepam.  You can become dependent in as little as 2 weeks of daily use and it is possible to become dependent even with intermittent use.

 

Doctors sometime prescribe the beta blocker propranolol for akathisia, but I haven't found any information on its being used for akathisia in the context of withdrawal.  Because our systems are so sensitive during withdrawal, I would lean against it.  Below is the experience of one member:

 

"I had a relapse when I had to stop taking propranolol it for a test after only taking it for about a week and I was very ill with shakes and stuff for about 2-3 months and probably took six months to get back to where I had been before taking it. Might be better, if you really need a beta blocker, to talk to your doctor about one that doesn't cross the blood brain barrier, maybe start with a low dose and always taper off more slowly than they tell you to. Everyone's different. "

 

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Mic323

Thanks Gridly appreciate the feedback. If you know any moderaters that have suffered with withdrawal symptoms or akathesia please let me know. 

 

so this my current reinstatement after withdrawals 4 weeks ago after I got down to 2.5mg..

 

went to 5mgs and helped ok every other day for 2 weeks ( because was on 20mg originally every other day for 4.5 years) then panicked as I had a mild bad wave. 
 

so I upped it every day to 7mgs for a week 

(side effects was minimal)

10mgs 3 days was tad to high had insomnia night sweats 

dropped it to 5mgs to start slower updose

then... second day into the 5mg has the akathesia come in? since then I have gone bk upto 10mg more so wanting to see if its

the dose that needs stablzing throw up tremors wanting to walk around all the time akathesia is still here 🤷🏻‍♂️
 

Is my body rejecting the drug and saying no? 

 

am I messing about with the doses and will the withdrawal symptoms stop after i stabilise? 
 

 

Sorry to be a pain 

 

 

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Gridley
7 minutes ago, Mic323 said:

 

am I messing about with the doses and will the withdrawal symptoms stop after i stabilise? 

 

You have to stop changing doses.  It is very destabilizing to your system.  My advice was to stay at 5mg for around 10 day to see how that works.  You can't change doses every time a symptom appears.  

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Mic323

Yeh true I am just looking or quick result. Going to bk to 5 tomorrow and work from there. 10mgs wasn’t to bad today tho but had bad akathesia yeh maybe the system needs to start on smaller dose still

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Mic323

Was good for a week on 5mg then had bad sleeping patterns followed by chest pains seem to have full blown anxiety at the moment for last 3 days. Help horrible dread and nausea. Is this stabilisation with waves? 

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Mic323

@Altostrata just reaching out what your thoughts are on my situation been on citlopram 5mg for a while now after knocking my CNS system 3 weeks ago. Having waves of anxiety then panic attacks after a good week also depression is creeping in. Sleep has been poor last 2 weeks aswell. Every time I have a bad sleep the intrusive and mild depression follows next day. Seems like I am getting worse more constantly.
Is time to up dose? 
Is my dose cutting a few mgs out as I am cutting a very small pill 2mill in dimension. 

really confused why I can’t stabilise properly. 

 Thanks 
 

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Mic323
On 12/17/2019 at 4:06 PM, Mic323 said:

Hi there,

 

So I have been tapering off citlopram after taking 20mg every other day for 5 years. Just to note I have felt great in that time and thought my time on it has been successful. In 12mths I managed to successfully get down to 2mgs. After 4 weeks I noticed when I got to that dose a lot crazy physical symptoms started occurring tight chest, body tremors, nausea obvs the withdrawal symptoms. I tried to see if i could beat it but unfortunately I wasn’t strong enough. I remember it got to the worst physical symptoms stage after 6 weeks and I sat down and cried with my GF  and I said I can’t do it anymore and that when one evening I reinstated 5mg and couldn’t believe it with in 2hrs all symptoms were gone 80% (just like a heroin addict getting their next hit after cold turkey). 
 

So my issue is now is it’s been about 4 weeks In that time the first week I felt 80% good then 8th day I notice i have my old symptoms back anxiety tight chest and start panicking so I start taking 5mgs every day rather then every other and it works ok for another week then I feel really anxious again so I take 10mg 2 days straight. Yes I know way to much and I paid the price my CNS was all over the place for 2 days. Now I am on 0.5 every day for past 4 days sleeping well but feeling on edge and anxiety is high can’t shake it off don’t want to go back to old symptoms when I started. 
 

My question is to anyone what dose is best? should go to my original every other day dose?? Or stick to every day? Finding it hard to experiment as don’t want to mess about with my CNS as it’s sensitive I have put it thro. 
 

thanks 

 

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Altostrata
18 hours ago, Mic323 said:

@Altostrata just reaching out what your thoughts are on my situation been on citlopram 5mg for a while now after knocking my CNS system 3 weeks ago. Having waves of anxiety then panic attacks after a good week also depression is creeping in. Sleep has been poor last 2 weeks aswell. Every time I have a bad sleep the intrusive and mild depression follows next day. Seems like I am getting worse more constantly.
Is time to up dose? 
Is my dose cutting a few mgs out as I am cutting a very small pill 2mill in dimension. 

really confused why I can’t stabilise properly. 

 Thanks 
 

 

Do you feel better or worse after taking your dose each day?

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Mic323

Thanks for replying 🙂 i take my 5mgs shaved pill at 1pm and this week have been feeling mild anxiety in mornings and mid day are ok but I take pill at 1pm with food by 5pm anxiety creeps in followed by panic attacks/ horrible intrusive thoughts in the evening then usually settles before bed with now on and off sleep. ( that’s this week) is it worth bumping it up to find out? 
 

For some reason the last 2 weeks my sleeping pattern has changed and i the anxiety and depression is getting worse and currently at this time I am having a massive bad time at the moment. Tight chest/can’t eat/memory problems/intrusive thoughts worst then before I started pills

Since I reinstated successfully 7 weeks ago I have been progressively getting worse looking at my diary a lot more unstable days

especially last 2 weeks.  
 

i heard with cutting pills escpecaiy tiny ones they have a lot of filler so you may not always get a accurate dose. Currently doing it by eye but could get scale or liquid. 
 

Is this maybe protracted withdrawal??


is my body now having adverse reactions to it what would be causing these fluctuations over the last 7 weeks. I know I dropped massively from 10-5mg and caused delayed akathesia adrenaline but can’t understand why getting the depression now or intrusive thoughts on top of the anxiety. 
 

just want to move on had a good career going and want badly to propose to my long term partner but no way can do it in this state.

 

 

 

@Altostrata

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Altostrata

How do you feel before you take citalopram at 1p.m.?

 

Have you taken any antibiotics, additional drugs, or had an alcoholic drink in the last 2 months? Did you skip any doses?

 

Please, NEVER skip doses of a psychiatric drug.

 

Can you request the prescription liquid from your doctor? Cutting up a small tablet can be imprecise. Don't worry about distribution of drug in the tablet, it's all mixed together well.

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wantrelief

Hi Mic,

 

I saw your message to me on Rosetta's thread and thought I'd answer you here.

 

I am so sorry you are having a such rough time.  In reading your last post, it sounds like you aren't sure if you are getting an accurate dose.  It is important to make sure you know what amount of drug you are taking each day so I would encourage you to get a scale or liquid for accuracy.

 

You asked how long it took me to stabilize.  I have been trying to taper citalopram (and prior to that sertraline) for many years.  I would start having withdrawal symptoms, usually provoked by some sort of stress in my life, and updose.  This happened several times.  Usually it would take a number of months to stabilize after updosing (when I first started tapering it would be less time but over the years it took longer to stabilize).  However, the last time I updosed, I wasn't stabilizing after ~ 6 months and was told I might be in tolerance to the drug.  So I started a very slow taper down and have been tapering now for almost 2 years.  So I am never "stable" in the sense of feeling anywhere near normal but my symptoms have remained fairly consistent throughout the tapering process thus far.  

 

I didn't have any trouble switching to liquid citalopram, fortunately. 

 

In my experience, it can take quite awhile to stabilize and usually staying at the same dose over a period of time (months) will do the trick so I am hopeful if you stay put you will find improvements.  


I hope this helps.  

 

 

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Mic323

@Altostrata it’s fluctuates, yesterday I felt ok before my 1pm dose had a wobble of anxiety (tight chest) at 5pm but it settled. Today I have mild anxiety in morning. Just shows the inconsistent patterns I am having so as far as being on the 5mg. Only slept 2 hours last night, got very panicky  as it thought i would struggle today but not as bad as I thought. 3 days ago I was having crazy intrusive thoughts, anxiety, fear, nausea, tight chest. So hard to book up work as I can’t predict how I am going to feel day to day at the moment being a builder ☹️.

 

when I had the last good spell 2.5 weeks ago just before it turned nasty i had a very small glass of wine maybe 7 sips didn’t get drunk. 
never skipped dose 

no anti biotics
 

the sleeping issue is defiantly not me I wake up sweating still, never had that before unless updosing . Had it before years ago when each time I upped the dose. 
 

what’s annoying me is my old symptoms of agoraphobia coming in to play for all the panic and anxiety last week. 
 

Ordered Gemini jewellery scale. Would I need to crush pills or is it ok to just shave pill?

 

thankyou 
 

 

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Gridley
2 hours ago, Mic323 said:

Would I need to crush pills or is it ok to just shave pill?

Either is fine.  The crushed pill is easier to handle for weighing.

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Altostrata

You're going to have to avoid all alcohol for a good long while. That could have caused this downturn, sorry to say.

 

When was the last time you took diazepam?

 

You'll have to let your nervous system settle down.

 

 

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Mic323

@Altostrata yeh defiantly been off the any liquor since then. 
 

been feeling good last 3 days but still not sleeping great. Get 1hr then wake up (not always super anxious) so been taking 3mg ziplicone last 3 nights. Took last diazepam 4 days ago. 
 

Can’t describe how grateful it feels to feel almost normal but just always curious how long it lasts as been here multiple times over the last 2 months. Only issue is the pill cutting. Bought Ascher scales but not sure which mode to have it on? Grams,  Oz, Gn...? 

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Altostrata

As I read your Intro topic, it seems you have been taking 5mg citalopram consistently only since December 20.

 

Since then, you've drunk alcohol and taken occasional benzodiazepines.

 

Quite often, it takes a while for people to stabilize after an upset from the drugs -- months rather than weeks. Any drug change or alcoholic beverage can upset your system again.

 

It seems to me your reinstatement worked fairly well. You can expect waves and windows as your nervous system corrects itself, moreso with occasional drug or alcohol blips. See

 

What is withdrawal syndrome?
 
About reinstating and stabilizing to reduce withdrawal symptoms
 
The Windows and Waves Pattern of Stabilization

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Mic323

Seem to have had a good window the last week. Occasional anxiety attacks but manageable. For some reason getting withdrawal symptoms of not sleeping & having night sweats maybe averaging 2hrs a night if I don’t take sleeping aid. Wake up drenched not always anxious but feel like a charge is plugged to my brain, I take ziplicone 3.5mg every other night and it works well but don’t want to get dependent. Has anyone got any other better alternatives for sleep? 
 


 

Take magnesium/fish oil. thanks 

 

@Altostrata @Gridley

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