emerik: SSRIs error, withdrawal and back on it!

[emerik]

Hello guys!
ive been on celexa for a year or 2, 20mg, for general anxiety, nothing crazy, mainly some little phobia that i could get under control. never had any side effects on it. i was always taking it on and off
a 30 days tube could last me 2 months sometime and i felt fine,.

ive recently moved country, and decided to drop my celexa cold turkey.
i dont know why , i didnt know it was bad tbh i was just a stupid clueless dude
i just had completely forgotten this was a bad thing that no one should do, im learning from my biggest mistake..

Fast forward to 3 months now, 2 first months were totally fine no worry didnt even think about it.
3 months everything went downhill, became cripple with anxiety.

i went on a anxiety week with 3 days of no sleep
(so this all started when i was med free)
talked to my gp to go back on the meds.i started celexa again 10mg 2 weeks then 20mg for 3 weeks. i had some good days on week 3. like feeling totally normal and barely anxious

now on week 5
but then the last 2 weeks have been bad, constant anxiety 24/7, like im in a stress of panic
stomach knot mostly all the time from stress, also insomnia , like sometime go 2-3 days without sleep at all till my body get too tired, abandon the stress and let me somewhat sleep. im now mainly scare and anxious of sleep, nightime because of all of those. think about it back in my mind all the time, and i have thoughts about never healing etc all the time.

ive been doing my best and excercices even when sleepless, doing stuff i like, i have an amazing partner, but it is very hard to focus on the present moment.

now it has put my life on hold for now as this is too much to deal with, im a freelance tattoo artist so i can just take a break anyway.

anyway, i know this is all my fault but my biggest wonder is;
am i going through withdrawals effects or celexa side effects hitting me hard this time?
or both at the same time?
like i said, i had some good days, early 3 weeks with no worry and good sleep.
bright note; im seeing a psychotherapist now and that feel good.

NOW
do i stay on celexa? or do i taper down to nothing again.
i dont know what my brain is trying to tell me.

 

Edited February 7, 2020 by manymoretodays
moved to introductions from S and S care

[Gridley]

Welcome to SA, emerik.

 

It is very common for withdrawal symptoms to hit at the 3-month point.  What you are suffering now is likely a combination of withdrawal from the cold turkey plus your brain having to deal with the reinstatement of a large dose of Celexa after having been off the drug for three months.  

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

Healing is not linear.  There will be ups and downs.

 

The Windows and Waves Pattern of Stabilization

 

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.  

 

You should make no further changes.  I strongly advise you not to add any more psychiatric drugs to what you're already taking. 

Your system has been destabilized by all the changes and now needs to regain stability.  This will take several months.  Stay on your current dose of 20mg and take it every day around the same time.  Skipping doses is very destabilizing.  Once you have stabilized, you will be able to taper.  We recommend tapering by no more than 10% of current dose every four weeks.

 

Why taper by 10% of my dosage?

 

This link is specifically about tapering Citalopram.  Again, you will need to wait several months before tapering, but here is the information for that future time.

 

Tips for tapering off Celexa (citalopram)

 

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 (glycerinate is a good form) 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.

 

Regarding exercise, some do all right with strenuous exercise, but for many in withdrawal strenuous exercise is too stimulating.  You might do better with gentler exercise.

 

Insomnia is one of the most common withdrawal symptoms.

 

Tips to help sleep - so many of us have that awful withdrawal insomnia

 

Relaxation exercises, guided meditations, calming videos, sleep hypnosis

 

Tricks and tips to fall asleep faster

 

http://articles.mercola.com/sites/articles/archive/2017/02/16/tips-tricks-fall-asleep-faster.aspx?utm_source=dnl&utm_medium=email&utm_content=art1&utm_campaign=20170216Z1&et_cid=DM133787&et_rid=1889748952

 

This link contains helpful information, including insomnia and also non-drug coping skills.  

 

Important topics about symptoms, including sleep problems

 

Some members have found Melatonin helpful with insomnia.   

 

Melatonin for sleep   

 

It's best to start at a very low dosage, such as .25mg, and gradually increase if needed to the lowest effective dose. 

 

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

 

 

 

 

 

 

 

[emerik]

what do you advice for sleeping?
its making me worst, theres day i had 0 sleep,

it make the anxiety so much worse.

i was thinking of tapering down to 5mg in a span of a month but i guess that would be a big mistake like you said?

[Gridley]

2 minutes ago, emerik said:

what do you advice for sleeping?
its making me worst, theres day i had 0 sleep,

it make the anxiety so much worse.

i was thinking of tapering down to 5mg in a span of a month but i guess that would be a big mistake like you said?

 

Please read what I wrote about sleeping in my previous post.  Is Melatonin available in Germany?

 

As I said, you need to hold where you are for several months.  Tapering down  to 5mg would be a big mistake.  You need to be patient and make no changes.

[emerik]

melatonin never did much for me, but then i took 3 or 6mg.
 

[Gridley]

9 minutes ago, emerik said:

but then i took 3 or 6mg.

Melatonin at too high a dose can have a paradoxical effect (keep you awake).  You might try -.25mg.  I take a 1mg tablet and cut it into 1/4s.  It's been helping with my sleep.

[emerik]

make sense, the reason of my insomnia is anxiety induced by the shock,
heart palpitation, breath, i focus too much on the overall as its too new for me. i think i have to let it go.

[emerik]

would you advise on anything benzos small dose for sleeping for the time being while i heal in due time? or ride it out

the not sleeping has been going for a month at least with a lot of day of being awake all night.
i did use zopiclone for a few days for one week with mixed effects ( make me sleep, sometime great, sometime i wake up a lot)
i did need more than one. one just make me drowsy a bit.
and zolpidem on another week with even less effects.

both for 3-4 days with some day breaks.

[Armorall]

Emerik- I don't know if it's my place to say this, but the site usually recommends to use only .3 melatonin at first. If you go over that, it could be too energizing. When my CNS was still stable, I would use 3mg of melatonin (and felt like it was a bit overpowering) but now that I'm in withdrawal, I only use .3 melatonin or else I get energized instead of sleepy. 

 

[mstimc]

Hi Emerik

 

I've had insomnia for most of my life, even pre-anxiety and especially during withdrawal.  What worked for me was adopting a nightly "ritual".  I prepared  for bed at the same time every night.  I'd make myself some chamomile tea and try something calming and diverting to slow my thoughts.  I also read the Daily Office from the Book of Common Prayer (I'm Anglican--Episcopalian in States).  In the US, there's a website called The Great Courses that offers half-hour lectures on many subjects.  I subscribed to that service and watched many courses on subjects like history and philosophy.  This helped by focusing my attention on a subject instead of my anxious feelings.  I often listened to a relaxation routine that encouraged me to psychically relax by focusing on a body part, starting at my toes and ending at the top of my head.  I won't say it worked every time, but it did make me musch less anxious about sleeping.  I still try to keep a regular night-time practice and it really helps me sleep. 

[Gridley]

45 minutes ago, emerik said:

would you advise on anything benzos small dose for sleeping for the time being

We wouldn't recommend benzos.  You can become dependent even with intermittent use and once you're dependent, it's not doing any good and you're only taking it to stave off withdrawal.  And there you are with another drug to taper off.  

[Gridley]

30 minutes ago, Armorall said:

.3 melatonin

You can order 0.3mg melatonin from Amazon at this link.  I just ordered some.

 

(available on Amazon) is exactly 0.3 mg.

[emerik]

what  do you guys do when you cant sleep at all?
i mean laying in bed with relaxation music for 2-3 hours or more and tossing and turning.
i never know if i should get up and read  and try that trick or stay in bed,
especially when i start panicking not sleeping in the middle of the night. i feel like this is still new to me so i have trouble dealing with it.
 

[mstimc]

1 hour ago, emerik said:

what  do you guys do when you cant sleep at all?
i mean laying in bed with relaxation music for 2-3 hours or more and tossing and turning.
i never know if i should get up and read  and try that trick or stay in bed,
especially when i start panicking not sleeping in the middle of the night. i feel like this is still new to me so i have trouble dealing with it.
 

If you choose to read, pick something that isn't suspenseful but interests you.  You don't want to increase your anxiety by reading something with an exciting climax.  I used to read American history or theology books when I couldn't sleep.

[emerik]

ive tried 2 times yesterday night to read for 20 mins and go back to bed after but no success
i know im still in super early recovery and hopefully time will help.
no point in staying in bed if your panicking right?

[mstimc]

2 minutes ago, emerik said:

ive tried 2 times yesterday night to read for 20 mins and go back to bed after but no success
i know im still in super early recovery and hopefully time will help.
no point in staying in bed if your panicking right?

I agree.  Getting up and doing something, even if its just watching TV or doing light cleaning burns mental energy and may help calm you.  Just lying there thinking about not sleeping won't do you any good.

 

BTW, my wife and I will be visiting Berlin in early December! 😊

[emerik]

1 hour ago, mstimc said:

BTW, my wife and I will be visiting Berlin in early December! 😊

Glad to hear , its a nice city ! that i cant really enjoy atm but im trying to!

one thing you guys mention is stabilizing.
does stabilizing mean when my anxiety gonna be back to normal level? and my brain feel like before ?
I have to mention i still had anxiety back in the days  even on celexa 20mg, especially phobia, agarophobia and toilet phobia(fear of not being near a toilet lol)
but my everyday life was totally manageable and i was a fairly happy person.

i guess right now what im experiencing the most is my thoughts (not healing, not sleeping, bad stuff, breathing badly) 
are all over the place, every 30 seconds they come and go. one moment im positive, and then im back.
i can never concentrate on the present moment. like never. same for sleeping.
 

[Gridley]

6 minutes ago, emerik said:

stabilizing mean when my anxiety gonna be back to normal level?

Stabilizing means your symptoms are pretty much the same every day without big swings or changes.  It doesn't necessarily mean the absence of symptoms but rather that they are tolerable and you are functional.  

[mstimc]

Just now, emerik said:

does stabilizing mean when my anxiety gonna be back to normal level? and my brain feel like before ?

 

Great question--it shows a lot of insight.

 

In a separate post, I said to truly deal with withdrawal and meds, you also need to address the root cause of anxiety, OCD or depression.  I did that by finding a therapist who understood withdrawal and who taught me CBT tools to deal with my anxiety and OCD.  If you don't address the anxiety, you run the risk of going back to where you started.  So the answer is, to me, recovery means getting off the meds and managing your anxiety.

[emerik]

thank for your answers so fast !
make sense, my symptoms are manageable some moments and some other moment i feel like im dying,
so i get what you mean by stabilizing, its when the roller coaster start being steady and your not all over the place every 30 min.

i guess i am expecting the return of celexa to 'make me normal' again and to diminish my anxiety about normal life stuff.

[Gridley]

1 minute ago, emerik said:

ts when the roller coaster start being steady and your not all over the place every 30 min.

Exactly.

[emerik]

am i wrong in expecting that the reinstation of celexa will in time go back to what i was before ( when i was on celexa)
 i dont mind staying on the medication.

[Gridley]

25 minutes ago, emerik said:

am i wrong in expecting that the reinstation of celexa will in time go back to what i was before ( when i was on celexa)

There is no way to tell.   Your CNS (central nervous system) has been through a shock and after trying to adjust to not having the drug, it is now working very hard to adjust to having the drug again.

 

You're going to have to be gentle with yourself, make no changes in drug doses and allow yourself to heal.  

[emerik]

2 minutes ago, Gridley said:

You're going to have to be gentle with yourself, make no changes in drug doses and allow yourself to heal.  

make sense.
is there a particular reason , normal, that i had really good days in the early days of getting back on the medication?
 i was in london for work on jan 13-19th, and worked everyday on 4 day 0 sleep or maybe 1 hour?
 i was a zombie but functional, weirdly didnt feel stressed. 
came back home and was fine for a while, no anxiety, sleep ok, even good for a few days
and now since then,  jan 27th i think, downhill, with the insomnia and fear of sleeping.

im just wondering in a way if those good really normal day
( i remember saying, wow i dont feel anxious)
were just part of me rationalizing : ok im back from work, it was horrible, now theres nothing no stress im home
or are just totally random to my brain being wired.

[Gridley]

2 minutes ago, emerik said:

im just wondering in a way if those good really normal day
( i remember saying, wow i dont feel anxious)
were just part of me rationalizing : ok im back from work, it was horrible, now theres nothing no stress im home
or are just totally random to my brain being wired.

There's so much we don't know about these drugs, there's no way to tell.  Very possibly all three.

[lxjuice]

While you wait to stabilize you might want to try CBT-I or other things to help your insomnia. It doesn't sound entirely like a withdrawal reaction so you could make some easy improvements there. Sleeping better temporarily when you move is classic insomnia.

[emerik]

1 minute ago, lxjuice said:

While you wait to stabilize you might want to try CBT-I or other things to help your insomnia. It doesn't sound entirely like a withdrawal reaction so you could make some easy improvements there. Sleeping better temporarily when you move is classic insomnia.

yes i am seeing a psychotherapist who do cbt and hypnosis, it was our initial meeting last week.

i think my sleep problem is not a withdrawal issue. but it is in a way,
its just related to me being super anxious because of the brain change about normal everyday stuff, in this case, sleeping or thinking about my condition all the time.
my brain is anxious and stressed, i think about, im not gonna sleep again all the time, but also even when relaxed, music and all and not thinking, i can feel myself falling asleep but then i twitch or move and back to square one.

hopefully the CBT and hypnosis will help ease the anxiety about sleeping , its pretty deep as nothing helped up to date, tea, meditation everyday, calm night, nightly routine, good sleep hygiene,

i def didnt help myself when ive used zopiclone for a week as i was thinking about the pill when i couldnt sleep. ditched that.

[lxjuice]

6 minutes ago, emerik said:

yes i am seeing a psychotherapist who do cbt and hypnosis, it was our initial meeting last week.

i think my sleep problem is not a withdrawal issue. but it is in a way,
its just related to me being super anxious because of the brain change about normal everyday stuff, in this case, sleeping or thinking about my condition all the time.
my brain is anxious and stressed, i think about, im not gonna sleep again all the time, but also even when relaxed, music and all and not thinking, i can feel myself falling asleep but then i twitch or move and back to square one.

hopefully the CBT and hypnosis will help ease the anxiety about sleeping , its pretty deep as nothing helped up to date, tea, meditation everyday, calm night, nightly routine, good sleep hygiene,

i def didnt help myself when ive used zopiclone for a week as i was thinking about the pill when i couldnt sleep. ditched that.

That's good but make sure she is specifically doing CBT for insomnia, it's different to regular CBT. It's usually a mix of withdrawals, rebound symptoms and amplification of any other existing symptoms. It's not very helpful to try and figure out exactly what is happening, mainly because you can't (even recurrence of the original problem aka "rebound symptoms" may actually be a withdrawal effect), so the point is if you have a symptom that can be treated by something else you can always do that too. And the type of insomnia you've described can be.

[emerik]

4 minutes ago, lxjuice said:

That's good but make sure she is specifically doing CBT for insomnia, it's different to regular CBT. It's usually a mix of withdrawals, rebound symptoms and amplification of any other existing symptoms. It's not very helpful to try and figure out exactly what is happening, mainly because you can't (even recurrence of the original problem aka "rebound symptoms" may actually be a withdrawal effect), so the point is if you have a symptom that can be treated by something else you can always do that too. And the type of insomnia you've described can be.

i dont think she specialize in insomnia but mostly anxiety, depression and those problems,
would you say to seek a sleep cbt therapist? , yeah my type of insomnia is purely anxiety related as i never had insomnia in my life before,
i didnt even know you could keep yourself awake this long. its my biggest source of anxiety at the moment as i think about it constantly.

[lxjuice]

Just now, emerik said:

i dont think she specialize in insomnia but mostly anxiety, depression and those problems,
would you say to seek a sleep cbt therapist, yeah my type of insomnia is purely anxiety related as i never had insomnia in my life before,
i didnt even know you could keep yourself awake this long.

You can do it yourself, it's not too complicated. The VA offer a free online program, https://www.veterantraining.va.gov/insomnia/index.asp there are others which are more polished that you have to pay for like sleepio but I haven't used them and can't vouch for them. You can do it while you're seeing a therapist too.

[emerik]

21 minutes ago, lxjuice said:

You can do it yourself, it's not too complicated. The VA offer a free online program, https://www.veterantraining.va.gov/insomnia/index.asp there are others which are more polished that you have to pay for like sleepio but I haven't used them and can't vouch for them. You can do it while you're seeing a therapist too.

ill check that out right now,
i think my case is also a like, omg im having withdrawals, and attributing all my problems to it and focusing on it too much. i have to let go

[emerik]

34 minutes ago, lxjuice said:

You can do it yourself, it's not too complicated. The VA offer a free online program, https://www.veterantraining.va.gov/insomnia/index.asp there are others which are more polished that you have to pay for like sleepio but I haven't used them and can't vouch for them. You can do it while you're seeing a therapist too.

im gonna do the program but i think my insomnia is really problematic as i can several days without sleep and dont even know what is feeling sleepy anymore.
my brain getting all ***** up of the cold turkey and back on meds too fast make it hard to even focus on task such as reading, watching tv, walking, without my mind wandering about negative thoughs every 15 seconds.

[lxjuice]

Just now, emerik said:

im gonna do the program but i think my insomnia is really problematic as i can several days without sleep and dont even know what is feeling sleepy anymore.
my brain getting all ***** up of the cold turkey and back on meds too fast make it hard to even focus on task such as reading, watching tv, walking, without my mind wandering about negative thoughs every 15 seconds.

I would make an adjustment to the program then - when you get to sleep restriction don't reduce your time in bed below 6.5 hours. This is one of the adjustments made for people with bipolar but is also a good idea for really severe insomnia.

[emerik]

15 minutes ago, lxjuice said:

I would make an adjustment to the program then - when you get to sleep restriction don't reduce your time in bed below 6.5 hours. This is one of the adjustments made for people with bipolar but is also a good idea for really severe insomnia.

thanks for all your quick answers, my insomnia is very recent so there is hope, i just have to modify my thoughts behaviours even with all the effects of the withdrawal and medication.
some day i feel not that much stress about sleeping or not sleeping.

i think a big set back was the fact that i resorted to sleep meds,
ambien for a week and then lunesta for a week, it was always playing in the back of my mind even the first day of use
' if you cant sleep, just pop the pill' even if i told myself it was a last resort

[emerik]

another thing always in the back of my mind
is going back home, canada  (just moved to germany with my partner for oct-june, so im going back june anyway)
to my parents house while i recuperate, but this does seem like giving up on life to me and a step backward maybe?
what are your thoughts?

[mstimc]

5 minutes ago, emerik said:

another thing always in the back of my mind
is going back home, canada  (just moved to germany with my partner for oct-june, so im going back june anyway)
to my parents house while i recuperate, but this does seem like giving up on life to me and a step backward maybe?
what are your thoughts?

 

I think anything that helps you recover is worth it.  If you spend a few months at your parents' house to successfully recover, what's that compared to the rest of your life?