PugLife: citalopram equivalent dose to duloxetine

[PugLife]

I have been trying to find the Citalopram equivalent dose to 4mg of duloxetine. I have hit a wall with my duloxetine taper and have been pondering switching to Citalopram. I am also tired of counting tiny beads to make twice a day dosages(once a day caused too many symptoms) and would like to switch to Citalopram. I tried fluoxetine/Prozac but the side effects were worse than the duloxetine withdrawal symptoms I was experiencing. I have a health condition that involves a sensitive nervous system so I have been listening to my body and tapering at a speed I can handle but I have hit the sticking point. 
 

Any help is greatly appreciated 🙂
 

[Gridley]

Welcome to SA, PugLife.

 

I've brought your question to the attention of the other moderators.

 

 

[Altostrata]

Welcome, Puglife.

 

How long have you been taking 4mg?

 

Equivalent dosages among antidepressants are only approximate. Better to err on the low side than the high side. See

 

 

This source says to substitute 30mg duloxetine with 20mg citalopram. That would suggest about 2.7mg citalopram for 4mg duloxetine.

 

 

[PugLife]

Hi Alto, I’ve been on approx 4mg for around a month now. Since getting below 7ish mg, it’s been a slow go reduction wise. It was much easier in the beginning. I have tapered off an antidepressant before and it was neither as lengthy or as symptomatic as it is this time. 

[PugLife]

Hitting a heavy fatigue wall every afternoon

 

I’m really curious what causes this as I deal with this every afternoon. Around 1-2pm I hit this heavy fatigue wall where I can barely keep my eyes open. My brain just starts shutting off. Is this most likely due to being sensitive to changes in cortisol levels? 

Other than crps/rsd I don’t have any other health issues so it’s a withdrawal symptom but the timing is pretty spot on every day. 

 

Edited August 17, 2022 by ChessieCat
added topic title before merging with intro topic

[ChessieCat]

@PugLife

 

Before we can assess what might be causing the fatigue we need to know what drugs your are currently taking as well as any changes (start/stop drug/s, dose reductions/increases) you have made since the beginning of 2022 (this year).

 

Please list this information and include the drug name, the dose, the date as well as the time that you take the drug.

 

[Altostrata]

Hello, @PugLife, we haven't seen you in a long while. Why do you think this symptom is related to withdrawal?

 

To help us out, follow these instructions Please summarize your drug and withdrawal history in your signature You may need to use a computer to do this.

[PugLife]

I’m currently only on Pregabalin at the moment. I’ve been off the Duloxetine since last year. I’ve been tapering the Pregabalin off and on for over a year. I would taper the Duloxetine for a bit, then the Pregabalin. That seemed to work the best for me symptom wise. I found the Pregabalin much easier to taper symptom wise. 

 

I feel like it’s withdrawal because I have already been to the doctor about it and I’m ok health wise other than my crps(it’s in partial remission).  I have made several reductions in my dose since the beginning of this year and mostly tolerated it fine as long as i listened to my body. It’s just this weird heavy fatigue that hits like clockwork….always the same time of day. It usually comes with head pressure and a foggy brain.

[PugLife]

I’m debating if i should updose the Pregabalin a small amount to see if it eases the fatigue and brain fog or just keep holding my dosage until I improve and stabilize.  I have been at my current dose of 12.5mg for 2 weeks. I’m definitely much more sensitive to dose decreases during this final stretch. 
 

Any advice appreciated 🙂

[ChessieCat]

Q:  How many times a day are you taking the Pregabalin?  It has a very short half life, about 6 hours.

[PugLife]

Hi, Chessiecat,

I’m taking it twice a day. I’ve also been dissolving my capsules in water to make my daily doses. 

 

 

[ChessieCat]

22 hours ago, PugLife said:

I’m taking it twice a day.

 

I suggest that you keep daily notes for yourself.  You might be experiencing interdose withdrawal.

 

Your symptoms may worsening leading up to the second dose and then easing as the second dose takes effect.  You might need to dose more often.

 

From https://www.drugs.com/dosage/pregabalin.html

 

it says to dose 2-3 times a day.

[PugLife]

Thanks for getting back to me chessiecat.

 

I’ve been writing down when I make my reductions but I really do need to write down more in detail. I do experience my set of symptoms everyday and around the same time but I’ve also noticed that any stresses to the body will make it worse and it fill affect a longer portion of the day. This week has been especially bad as I’ve been taking a class and the material is not easy to absorb. I make myself feel Ill just trying to concentrate and remember the material. 
 

I’m going to start taking my dose 3 times a day instead of 2 to see if keeping the amount in my body more consistent will help. I’m also going to increase the dose a tiny bit as well and I’ll hold there for several weeks and see if I improve. I’ll post back In my progress in a few weeks.

 

 

[ChessieCat]

50 minutes ago, PugLife said:

I’m going to start taking my dose 3 times a day instead of 2 to see if keeping the amount in my body more consistent will help. I’m also going to increase the dose a tiny bit as well

 

Only make one change at a time.  The dose increase may not be needed.  Try the 3 x day dosing first and give it some time before considering updosing.