SteCitalopram: tapering 20mg citalopram

[SteCitalopram]

Hey everyone,

 

i’m new to the website.I’m so glad i’ve found it now that i’m ready to taper.

I’m sorry if i’m posting in the wrong topic.

 

I’m being prescribed citalopram 20mg around 7months ago and i’m now ready to taper off as i feel theyhave already stopped working, and i want to do it with the 10% method.

 

I’m currently taking tablets of 20mg(weight 0.18 g). Would it be better/easier switching to the liquid or i can make it with the tablet?should i crash it or dilute it in water?

 

Did anyone experience bad withdrawals even using this method?
 

Thank you so much for your help🙂

Edited August 25, 2020 by Gridley

[Gridley]

Welcome to SA, SteCitalopram.  It's great you came here before starting your taper.

 

It's really a matter of individual preference whether you taper with liquid or with the tablet.  The majority view on the site seems to favor the liquid method, and it does give you more control at the lower doses. Some people, however, can't tolerate the liquid. I was more comfortable with using the tablet and the Gemini-20 digital scale (available on Amazon).

 

This link, which is specifically about tapering Prozac, gives you more information about both methods.

 

Tips for tapering off citalopram (Celexa)

 

If you do choose to taper we liquid, we recommend a gradual crossover from tablet to liquid before beginning your taper, taking your daily dose up as follows:

 

3/4 tablet, 1/4 liquid for 3 to 7 days

1/2 tablet, 1/2 liquid for 3 to 7 days

1/4 tablet, 3/4 liquid for 3 to 7 days

all liquid thereafter

 

You should wait around three weeks after completing the switchover before beginning your 10% taper to make sure everything is settled.  

 

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.

Edited August 25, 2020 by Gridley

[SteCitalopram]

Thank you so much guys for your help.

@Gridley did you find the withdrawals harsh even if you are doing at 10%?

 

I will start in the next few days and keep you updated. I will go with the tablets crushing. 🙂

[Gridley]

38 minutes ago, SteCitalopram said:

did you find the withdrawals harsh even if you are doing at 10%?

Harsh is too strong a word.  There were some symptoms with every drop but they resolved before the next drop.  You're really in a better position than I was because I had already destabilized my system with a too-fast taper of Imipramine, so some my symptoms were from that.  You're fortunate that you're only on the one drug.

 

I used a modification of the 10% taper, which is called the Brassmonkey Slide taper and consists of four weekly 2 1/2% reductions from the previous dose followed by a two-week hold.  It takes a little longer but is gentler than the straight 10% method because you spread out the drops over four weeks instead of hitting your system all at once with a single 10% drop.  This link explains the taper.  Both methods are fine.

 

The Brassmonkey Slide Method of Micro-tapering

 

If you have questions along the way about weighing doses, I'll be happy to help.

 

 

Edited August 25, 2020 by Gridley

[SteCitalopram]

@Gridley you are a star, thank you so much. 
 

I think i will go with the monkeyslide, honestly it doesn’t metter how long it takes but I don’t want to feel the withdrawals.

 

so if i understood, for me it would be like this:

 

20mg tablet(0.18g)

1 week: 0.18-2.5%= 0.1755g

2 week: 0.18-5% = 0.171g

3 week: 0.18-7.5%= 0.1665g
4 week: 0.18-10%= 0.162g

 

2 or 3 weeks hold and then start again -2.5% each week starting from 0.162 for 4 weeks and then 2/3 weeks hold again...

 

In case in a point they change the brand and tablets will weight more o less(as happened in the past), i will need to calculate the full weight of the new tablet -2.5% for each week and restart from the week i’ve left when i swap to the new one(with the new weekly weight based on the new tablet) right?

Sorry if questions might sound stupid, but i really want to make sure i’m doing right.

 

Also, does the tablet need to be crushed completely in powder or can just be broken in small pieces?

 

Thank you🙂

[Gridley]

35 minutes ago, SteCitalopram said:

 

so if i understood, for me it would be like this:

 

 It's better to calculate in mg rather than grams because you're going to be keeping track of two things, your dosage (right now, it's 20mg) written as 20mgai (active ingredient) and pill weight (mgpw) and they both need to be in the same measurement,  milligrams.  You use the ai measurement for communicating here and keeping track of your dosage and mgpw for making the reductions.  pw is always going to be more than ai because of the fillers used to bind the pill together.

 

I keep track of my taper with a piece of notebook paper with these columns:

 

DATE   mgai     mgpw        week/% reduction

 

I'm going to give you the instructions that Brassmonkey came up with for calculating reductions:

 

BRASS’ SPECIFIC MULTIPLICATION TABLES FOR BM SLIDE

The first thing you need to calculate is the average weight of one pill.  Weigh 10 random pills, add the weights together and divide the total by 10.  This is the number you will base your dose calculations off of. It is referred to as XXX mgpw (mg pill weight). A full pill ( XXX mgpw) gives you a dose of 20mgai (mg active ingredient).

You now apply the multipliers.

Slide One
   Week one: XXX times 0.975 =  YYY This is the amount you weigh out with your scales all week
   Week two: XXX times 0.95 = WWW  This is the amount you weigh out with your scales all week two
   Week three: XXX times 0.925 = VVV This is the amount you weigh out with your scales all week three
   Week four: XXX times 0.9 =  UUU This is the amount you weigh out with your scales all week four, five and six

The next time you base your calculation off of the number UUU

Slide Two
   Week one: UUU times 0.975 =  AAA This is the amount you weigh out with your scales all week
   Week two: UUU times 0.95 = BBB This is the amount you weigh out with your scales all week two
   Week three: UUU times 0.925 = CCC This is the amount you weigh out with your scales all week three
   Week four: UUU times 0.9 =  DDD This is the amount you weigh out with your scales all week four, five and six

The next time you base your calculations off of the number DDD

Slide Three
   Week one: DDD times 0.975 =  EEE This is the amount you weigh out with your scales all week
   Week two: DDD times 0.95 = FFF  This is the amount you weigh out with your scales all week two
   Week three: DDD times 0.925 = GGG This is the amount you weigh out with your scales all week three
   Week four: DDD times 0.9 =  HHH This is the amount you weigh out with your scales all week four, five and six

The next time you base your calculatons off of the number HHH.

At the same time you need to calculate the same progression starting with 20mgai instead of the XXX mgpw.  This will be the measurement you use in discussions on the forums. 

----

 

45 minutes ago, SteCitalopram said:

n case in a point they change the brand and tablets will weight more o less(as happened in the past), i will need to calculate the full weight of the new tablet -2.5% for each week and restart from the week i’ve left when i swap to the new one(with the new weekly weight based on the new tablet) right?

 

That's right. The brands all weigh different amounts. 

 

46 minutes ago, SteCitalopram said:

 

Also, does the tablet need to be crushed completely in powder or can just be broken in small pieces?

 

It'll be easier to crush into powder so you can add/subtract a bit to get the weight you want.  I crush my 20mg Lexapro pill between two spoons.  

 

 

 

[SteCitalopram]

@Gridley oh ok, i understand, thank you
 

as soon as i get the scale i will try and i will post it here so you can tell me if i’m doing ok, if that’s ok. 
 

Is there the choice for mg in the scale instead of grams(gemini-20)?

 

 

[Gridley]

31 minutes ago, SteCitalopram said:

 

Is there the choice for mg in the scale instead of grams(gemini-20)?

The scale has four places, with a decimal after the first (far left) place.  Everything to the right of the decimal is milligrams.  For example, my 20mg Lexapro weighs 170mg and it shows up as this on the scale readout.

 

0.170

 

This would be .17 grams, but you won't be working with grams.

[SteCitalopram]

@Gridley Great, thank you so much!

[SteCitalopram]

@Gridley hey, i haven’t started taparing yet but as you have been really helpful and as I don’t have much experience on antidepressants i would like to ask you something else, it’s not probably the best place to ask as people try to get help to come out from meds, but i will give a go.

 

as i was saying i only started Citalopram around 7months ago and honestly, it made me feel amazing. Now, as it’s not working anymore, If i listen what my doctor says, i should try something else or increase the dose but i am so scared as i’ve read so many stories about withdrawals.

 

There is a part of me that says i should try something else and part of me that says i can make it on my own(i’ve tried to make it on my own before -exercise, keto diet, meditation, yoga, cbt, vitamins etc. but even if they were giving me a bit of reliefs, anxiety was always there and so debilitating in so many ways until it leads to depression).

 

Now, in your experience, is it worth change and  try to find the right medication that hopefully works for bit longer? As you have taken various medications for many years, have you always found that they were working at least to take the edge away? If you went back would you take them again? I would still obviously try to taper super slow in a future in case i want to come out. Does tapering many meds make it really hard?

 

Thank you so much for your help, i just feel i need some advices🙂

[Gridley]

1 hour ago, SteCitalopram said:

If i listen what my doctor says, i should try something else or increase the dose

 

When a drug stops working, it's known as tachyphylaxis or poop-out.  If you increase the dose, it will possibly help for a short time but then will poop-out again, leaving you where you are now but with a larger dose to taper.

 

As far as changing to another drug goes, it's not something this site recommends, and personally I agree.  If a person want to change to a new drug, it's our position that the member will have to work that out with her doctor and it is not something we, as a site for going off drugs, involve ourselves in.  Switching to another drug puts you on what we call the drug-merry-go round of trying one thing, then if that doesn't work, trying another, etc.  There's no way to know if any given drug will work.  Another point to consider is that taking a new drug will not necessarily prevent withdrawal from your Celexa.  So you'd be starting a new drug (or drugs if you have to keep searching) and dealing with start-up symptoms and possible adverse reaction plus withdrawal from the new drug(s) on top of a Celexa withdrawal.   

 

Of course, whether you start another drug has to be your decision.  In my personal experience, the Lexapro helped me with what was a fairly short-term period of difficulty, but I see now that I would have been better off working through it with a therapist.  In the days before SSRIs, depression was regarded as a self-limiting phenomenon, and I believe that would have been the case with me.  I'm almost off the Lexapro and no vestige of my former depression has returned.  The Ativan does nothing for me as I've long since reached tolerance and I'm taking it only to stave off withdrawal.   Given what I know now about withdrawal and how long it takes to taper, if I could go back, I definitely would never have gone on these drugs.  I really want to be drug-free and let my mind heal and function naturally.   

 

Robert Whitaker, author of Anatomy of an Epidemic, in the course of his research for that book, found that in every class of drug (antidepressants, benzos, antipsychotics, etc.), people who went off the drugs fared better than those who stayed on them.  I highly recommend the book to help you in your decision.

 

Here's a video book trailer by the author::

 

Robert Whitaker, author Anatomy of an Epidemic video (11 minutes)

 

2 hours ago, SteCitalopram said:

Does tapering many meds make it really hard?

 

It complicates matters.  You have to taper them one at a time, which lengthens the taper.  You're in a great position with just one drug at not too high a dose and on it for a short time.  I'd encourage you to go with the taper and handle things with your own resources.

 

 

[SteCitalopram]

@Gridley thanks so much for the detailed reply.
 

I will follow your advice and try make it with my own resources and taper it off.
I think i will keep the “short term medication” option for the future in case i get in a really dark place again.

 

Realistically, even though i feel citalopram is not working anymore and anxiety and depression symptoms are coming back, they are waaay less severe(for now) that what they were 7months ago.
I think i just got used of feeling “great” for the first few months on citalopram so I don’t want to accept the fact that the symptoms are coming back, but i guess i just need to accept it and don’t let this *****ing A&D ruing my life!!💪🏽

 

Thanks again!

[Gridley]

13 minutes ago, SteCitalopram said:

they are waaay less severe(for now) that what they were 7months ago.

That is great to hear.

 

Take a look at this link, which contains several links to techniques for coping with life drug-free.  Many members use these to great advantage.  Several deal with anxiety.

 

Non-drug techniques to cope

 

My go-to technique for anxiety is this restorative yoga pose:

 

10 minute Restorative Yoga for Relaxation | Up the wall

 

 

 

 

[SteCitalopram]

@Gridley thank you🙂

[SteCitalopram]

@Gridley Hey,

I have finally started taparing on sunday with the Brassmonkey slide. I just have a few questions.

You said before i should weight the pill in mg, however in the scale there’s only the gr option. So what i’ve done is this:

 

• I weighted 10 pills and divided the total by 10(0.127 gr = 127.2 mg)

• 127.2 times 0.975= 124.02mg —>now my question is, on the scale this would be 0.124gr and that’s the unit(gr) i need to use when i weight it, right?

Also the scale sometimes jumps from for example 0.124 to 0.125 or 0.123 which it make so difficult to understand if i’m doing the right amount, have you got any tips for this?

 

One more thing, i’ve been feeling a bit dizzy and anxious, now i’m not sure if it’s the withdrawals already??To be honest i started feeling anxious and a bit dizzy again when tablet have stopped working a few weeks ago but it seems a bit worse now, not sure if i’m just making my self paranoid about the withdrawals?!😕

 

Thank you so much

[SteCitalopram]

Citalopram missed dose - Vertigo

 

Hi everyone,

 

I’m currently on 5mg Citalopram. I used to take 20mg(for around 2 years) and gradually reduced to 5mg (which i’ve been taking for the last 2 months to take a break from tapering) with no withdrawals effect at all at any time, as i’ve reduced the dose suuuper slowly with time thanks to the advices of this community❤️.

 

Around 2 weeks ago I accidentally missed a dose but got back in track the day after.
After around 2 days i’ve started getting those weird vertigo, especially when i move my head up and down or left and right, it’s like everything it’s spinning and i’m going to fall down - it’s not dizziness from anxiety, i still get that sometimes but it’s a completely different feeling, they are proper vertigo that make me loose the balance.

 

I thought they would go with time but it has now been 2 weeks and it’s starting to get a bit annoying.

 

Did it happen to anyone before? How long did it last? Can it be related to the missed dose or would more likely be something else that has got nothing to do with antidepressants?

 

Thank you 🙂

 

Edited June 12, 2022 by ChessieCat
added topic title before merging with intro topic

[ChessieCat]

Q:  Have you continued to taper whilst you have withdrawal symptoms?  If yes, then that might have caught up with you and the missed dose might have been the last straw.

 

 

Other things to consider:

 

Q:  Do you drink alcohol?  Or did you consume alcohol or a higher amount of alcohol prior to this happening?

 

Q:  Have you taken any antibiotics?  Been sick, Covid vaccination/booster?

 

Q:  Additional stress; a death, relationship breakdown, financial or work issues?

 

If there is nothing else that you can attribute to the cause of the dizziness, then missing 1 dose might have caused it.

 

Q:  Have you noticed that it is easing a bit, even if only for a short time or a bit lower intensity?

 

What we have seen with other members if there is something that has caused their symptoms to increase is that with time they generally settle.

 

Some members the lower their dose gets the slower they need to go, reducing less and/or holding for longer.  This topic helps to explain why:

 

Why taper paper: dose-occupancy curves

 

Some members find certain doses harder to get past than others.  There is no particular drug/dose; it seems to be very individual.

 

Please create your drug signature following these instructions:

 

Instructions:  Withdrawal History Signature

[SteCitalopram]

Thank you so much @ChessieCatfor your reply.

 

I’m following the Brassmonkey slide method for tapering. I’ve started around 1.5 years ago giving myself some brakes in between. 

 

When I started having these vertigo, it was while i was having a moth break from tapering, but 2 days after i missed the dose (i’ve never missed a dose in 2.5 years).

 

I don’t drink alchol on a daily basis but i sometimes do in the weekend and yes, i did drink alot 2days before missing the dose.

I’m also a really active person - gym, football etc..

 

I haven’t been taking antibiotics and i’m not vaccinated for covid.

 

No additional stess have impacted my life lately, i’m been feeling great in the last year.

 

One thing i was thinking is that, around a week ago, i started a diet cutting my kcal intake drastically, however the symptoms started 2 weeks ago.

I tried to have a refeed yesterday increasing my calories and it seems to be better today, so i will try to eat more in the next few days and see if the vertigo goes away completely🤞🏽

I’ve got the tendency to catastrophise when these things happen, which it doesn’t help as anxiety make them worse.😭

[ChessieCat]

8 minutes ago, SteCitalopram said:

i did drink alot 2days before missing the dose.

 

I think that this might be the culprit.  This is what happened to another member:

 

On 7/6/2020 at 5:50 AM, brassmonkey said:

Drinking alcohol is a major factor in excellent recoveries getting derailed.  We just had a case of a member who has been drug free for several years with an excellent recovery underway.  They had a couple of drinks over the weekend and tripped off their symptoms all over again.  Luckily, it cleared in a few days, but that is not always the case.

 

Also see:

 

alcohol-and-beer