Kaz26: Finally off antidepressants

[Kaz26]

I was prescribed citolopram 23 years ago after the death of my husband. I found they helped greatly with pre-menstrual syndrome so I remained on them for many, many years. Now as I am nearing 60, I thought I and not depressed so why do I need these pills any more?  My GP give me the following tapering schedule:

2 weeks alternate 40mg and 30mg per day

2 weeks 30mg every day

2 weeks alternate 30mg and 20mg per day

2 weeks 20 mg per day

2 weeks alternate 20mg and 10mg per day 

2 weeks 10mg per day

2 weeks alternate 10mg and 0mg per day 

Then stop

 

The side effects during this time were mostly lightedness and fatigue. Then after stopping completely I started to feel alot worse and have had the following side effects:

 

disrupted sleep, weird dreams

extreme hot flushes

headaches

anxiety

extreme irratibility

fatigue

flu like symtoms, body aches

 

It has now been 2 weeks since I have stopped, so I hope I will start to feel better from now on.

 

 

 

[ChessieCat]

Hi kaz and welcome to SA,

 

What you are experiencing are withdrawal symptoms.  This happens when the drug is stopped too quickly.

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

I can see that you have attempted to taper, however you have tapered much faster that what SA recommends.  SA's recommended taper rate is no more than 10% of the current dose followed by a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.

 

Why taper by 10% of my dosage?

 

Also, please note that alternating doses is not recommended because the brain likes consistency.  It's like playing ping pong with your brain.

 

The only known way to treat withdrawal syndrome is to reinstate some of the drug you have stopped.  The sooner reinstatement is made the more chance there is of it being successful.  Please read Post #1 of this topic:

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

You could try reinstating 5mg.  Please note that it takes about 4 days for a dose to get to full strength in the blood and a bit longer for it to register in the brain.  However, you might start to feel some easing of the symptoms in the first couple of days.  If after 1 week the withdrawal symptoms are unbearable you could increase by a small amount.  In your case, increasing your dose by 1mg to 6mg.  It is better to increase by small amounts (and allowing time for the new dose to take effect) than to risk increasing by too much.  This is because your nervous system has become sensitised by the withdrawal.  You will need to be patient and try not to panic.  Please note that reinstating is done to get rid of the withdrawal symptoms completely but to bring them to a bearable level.  you will need to listen to your body.  After settling on a dose, you will need to hold on that same dose for probably 3-4 months, possibly longer.  Then after you have stabilised you can commence tapering at recommended rate.

 

This topic explains how to get the dose you need:

 

tips-for-tapering-off-celexa-citalopram

 

This is your own Introduction topic where you can ask questions, journal your progress and connect with the community.

[Kaz26]

Thanks for the info but there is no way after 2 weeks of being anti-depressant free, would I go back on them and taper down again. Absolutely no way. 

[Altostrata]

Welcome, Kaz.

 

You have withdrawal symptoms. If they continue to get worse, you may want to reinstate 1mg citalopram and see if it helps. We often see that small amount does help. You'd stabilize on that for a while, then taper off by miniscule amounts. It's a way to do over the last part of your taper. Irregular dosing is not a good way to taper, no matter what your doctor said or what you may have heard.

 

Please let us know how you're doing.

[ChessieCat]

Hi Kaz,

 

I can understand your reluctance to start taking the drug again.  However what you are experiencing has nothing to do with how strong and determined you are as a person.  This explains it simply:

 

When we take psychiatric drugs, 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.

 

The Windows and Waves Pattern of Stabilization 

 

These explain the healing process really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

Brain Remodelling 

 

I will tell you about my own experience which might help you to understand how powerful psychiatric drugs are:

 

Just before discovering SA I had reduced my Pristiq 100mg to 50mg for 2 weeks and experienced extreme cog fog (walking took my whole concentration) and I got to the stage where I was unable to type.  Having been a professional typist for 40+ years I knew that something was truly wrong.  Thankfully I had joined SA a few days before I couldn't type and they suggested increasing my dose.  I did this and about 4 hours later I could type again and the cog fog was lifting.  There was no way in the world that it was placebo.

 

Edited June 12, 2020 by ChessieCat

[Kaz26]

Its day 15 and I am starting to feel better. Only one hot flush which woke me during the night. Otherwise slept well. Went back to the gym today which definitely made me feel better. I will see how withdrawal symptoms go. I am going to look after myself, keep life simple and do lots of healing activities.

 

A thought about tapering - if you still get withdrawal symptoms when tapering (I did) aren't you just prolonging the agony? At some point you have to bite the bullet and stop. It seems so depressing that you have to withdraw over many months, even years. I think we need more positivity and hope for a life without antidepressants.

 

A thought about reinstating a low dose of AD - I find it interesting to compare giving up alcohol to giving up AD. There is no way after being alcohol free for 2 weeks would you even consider having just a small drink everyday just to cope with withdrawals. You Just have to ride through the withdrawals and remain drug free. Otherwise you are back in the alcohol trap again. Why can't we do this with ADs?

[ChessieCat]

The decision to reinstate is entirely up to you.  We provide information so that you can make an informed decision. 

 

This site was started by Altostrata, who posted above, in 2011 and is an extremely busy site due to the fact that most medical professionals do not know how to get people off their psychiatric drugs with the least discomfort.  This is the reason that this site exists.  This site has been so busy since the start of 2020 that we have had to temporarily close new registrations.  You were one of the very last members to join before the closure.

 

I've been tapering since October 2015 and I've still got another year to go.  However, excluding the very start of trying to reduce my Pristiq, my withdrawal symptoms during this time have been minimal.  I would rather go slowly and be able to function than to risk going too quickly and suffer unnecessarily.

 

This gives a really good, simple explanation of withdrawal and tapering:

 

  

On 8/31/2011 at 5:28 AM, Rhiannon said:

This is something I posted somewhere else and then saved. I know it's all stuff I've said before, but it bears repeating and further discussion. A lot of people, including healthcare practitioners; in fact, I guess, most people-- are operating from entirely the wrong paradigm, or way of thinking, about these meds. They're thinking of them like aspirin--as something that has an effect when it's in your system, and then when it gets out of your system the effect goes away.

 

That's not what happens with medications that alter neurotransmitter function, we are learning. What happens when you change the chemistry of the brain is, the brain adjusts its chemistry and structure to try to return to homeostasis, or biochemical and functional balance. It tries to restabilize the chemistry. For example: SSRI antidepressants work as "serotonin reuptake inhibitors." That is, they cause serotonin to remain in the space between neurons, rather than being taken back up into the cells to be re-used, like it would be in a normal healthy nondrugged brain. So the brain, which wants to re-establish normal signaling and function, adapts to the higher level of serotonin between neurons (in the "synapse", the space between neurons where signals get passed along).

 

It does this by removing serotonin receptors, so that the signal is reduced and changed to something closer to normal. It also decreases the amount of serotonin it produces overall. To do that, genes have to be turned on and off; new proteins have to be made; whole cascades of chemical reactions have to be changed, which means turning on and off OTHER genes; cells are destroyed, new cells are made; in other words, a complex physiologic remodeling takes place. This takes place over time. The brain does not grow and change rapidly. This is a vast oversimplification of the amount of adaptation that takes place in the brain when we change its normal chemistry, but that's the principle.

 

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.

 

With multiple drugs and a history of drug changes and cold turkeys, all of this becomes even more complicated. And if a person is started on these kinds of drugs at an early age before the brain has ever completely established normal mature functioning--well, it can't be good. (All of which is why I recommend an extremely slow taper particularly to anyone with a multiple drug history, a history of many years on meds, a history of past cold turkeys or frequent med changes, and a history of being put on drugs at a young age.)

 

This isn't intended to scare people, but hopefully to give you some idea of what's happening, and to help you respect and understand the process so you can work with it; ALSO, because you are likely to encounter many, many people who still believe these drugs work kind of like aspirin, or a glass of wine, and all you need to do is stop and get it out of your system. Now you can explain to them that no, getting it out of your system is not the issue; the issue is, you need to regrow or at least remodel your brain. This is a long, slow, very poorly understood process, and it needs to be respected.

 

[Kaz26]

Thanks for the information Chessie Cat. There definitely needs to be more research into how ADs affect the brain and more information for GP's helping people to come off them. People need to ask when being prescribed an AD how long will I need to take this medication and what are the side effects of stopping? I wish I had known this 23 years ago.

 

[ChessieCat]

1 hour ago, Kaz26 said:

I wish I had known this 23 years ago.

 

Yes.  You and me both.  Because my depression was from life circumstances (my husband was sick and at home for about 5 years before he died at the beginning of 1999), if I had received appropriate counselling, support and been taught non drug coping techniques I might not have ended up on antidepressants.

[ChessieCat]

The one thing that I really want to make sure that you understand is this.  If you do decide to reinstate please do not panic and take a high dose.  We have members here who have done that and ended up in a worse state, even if they reduced the dose after a few dose.

 

Another example of the strength of these drugs.  I can't remember which drug it was, but a member did a careful taper and went down to a really tiny dose and jumped off.  However they still were getting some symptoms.  For a little while they were dipping the end of a toothpick into their liquid each day.

[Kaz26]

Thanks ChessieCat, that is good advice. I will just see how I go.