Jump to content
SurvivingAntidepressants.org is temporarily closed to new registrations until 1 April ×

HardTimes: late onset withdrawal from long-term citalopram disaster


HardTimes

Recommended Posts

Before describing my situation, I want to start by thanking all those who have posted here, particularly those few who keep it updated and try to organize it. Even though today I'm in at a really low point, the information I've found here has been extremely valuable. I hope that I can not only continue getting good information, but that maybe my story might help somebody else sometime.

 

Apologies in advance if I am too long-winded or detailed.

 

CASE HISTORY AND WD SYMPTOMS:

I'll skip the ancient history. In short I started taking citalopram in my twenties for depression., and I'm now 46, so it has been around 20 years.  I can't recall dosages, but for the last few years I've been on only 10mg. Finally feeling like I was in a fairly stable place in my life, I thought I'd see if I could go off them. I knew this had to be done "slowly", but what this meant exactly was pretty vague. I dropped down to 5mg, and stayed like that for a long time (6 mo?), with no ill effect. I had the impression that this was the lowest medically effective dose, so I could do no more tapering. I may have done a couple weeks of every-other-day, but in February 2020 I stopped altogether. I thought (wrongly, it seems) that was tapering enough.

 

I recall having a couple of weird initial weeks, but I'd describe the withdrawal symptoms as manageable (no depression, just dizziness, lightheadedness, nausea and what I now know to be "brain zaps"). My doctor had given me 0.25mg tablets of Alprazolam (Xanax, "benzo") and I was instructed to take 1/2 a tablet only when feeling sufficiently bad, but I tried to take that as little as possible. These symptoms mostly lifted, and, if I recall correctly, I proceeded to have a couple of quite decent months. It was a lovely spring in spite of Covid, I was focused on my work and quite happy overall. But there were some odd things: I was irrationally irritable and easy to anger. Idiotic things (the sound of food being chewed, etc.) were extremely irritating to me. Then, at the end of April, I had a really horribly depressed day out of nowhere, and my sleep started to fall apart. I would wake up every night at almost exactly the same time, around 5am, and I'd be extremely hot (night sweats). I also started experiencing serious pain in the back of my neck, which I attributed to sleeping funny and a fall I had while skiing several months prior.  At this point I had made no connection between these symptoms and coming off the SSRI, as I had never heard of SSRI withdrawal syndrome.  But something wasn't right, and even the zopiclone I was given for temporary help sleeping didn't prevent the 5am wake up. I started keeping a journal, charting my sleep, exercise, sleeping-pill intake and so on. My strong feeling was that I didn't have a "mental" problem (not depression, not anxiety), I had a hormone problem causing sleeplessness. My mind might race a bit, but my symptoms all felt more physical than emotional. I recall forcing myself to get exercise (short runs) and eat healthy (lots of smoothies, etc).

 

At this point I googled something about irritability and SSRIs, and made my way to this site. Here I learned (from "Altostrata" - thanks) that my nervous system was likely hypersensitized, and the 5am wake-up was caused by an over-reaction to the hormone cortisol, which is naturally released around dawn to start the wake-up process. This made a lot of sense, and explained my situation perfectly. (Thank you again!)

 

THE IMPORTANT PART FOR ME NOW:

 

I experienced several "windows" (term used on this site and elsewhere to indicate a period of mostly clear, good days, in contrast with "waves" of heavy symptoms), but by the end of July I began to think I needed to go back on something. My goal, then and now, is quality of life, and if that meant I did indeed need some small quantity of drug, so be it. (Just MY point of view, not a judgement of anyone else!). I read on this site about the dangers of going back on at a "normal" dose, like the 5mg recommended by the doctor. My particular situation was at high risk for "kindling", since by this point I'd been off the citalopram for around 6 months, and citalopram has a short half-life. (All this learned from this site!). I tried a 5mg tablet cut in 4 (about 1.25mg), but on day two felt like I was freaking out. After a few days, I tried again, an 1/8th of a pill, smaller than a grain of rice. I ordered a scale to weigh the dose, as suggested. By the second day I was experiencing GREATLY REDUCED WD SYMPTOMS, and felt like I was out of the woods. I wanted to create an account and tell everybody about my success story, to help others. But by a few days later, things started going downhill again. Was that just a window? The hot flashes and brain zaps were gone, but a general lethargy combined somehow with nervousness persisted. I thought perhaps I had adapted to the miniscule dose, and went up to 1/4 tablet. To cut this long story a bit shorter, I slowly progressed over the course of a few weeks up to 1/2 a tablet. I felt I was in the extremely difficult situation (for which I'm seeking the community's help) - Is my situation caused by too much drug (kindling) or not enough?? How to distinguish WD symptoms and symptoms caused by going back on the drug? I saw my doctor, who feels that anything less than 5mg is just not going to help. She suggested taking 5mg and warned me that the first two weeks were likely going to be difficult, so I should take .25mg of xanax as well for the first two weeks. I've tried this for the last few days, and indeed they have been difficult. But I'm not convinced that they'll get better in two weeks! Now, seeing all this in black and white, I think likely I've increased my dosage too quickly, and I'll do better to go back down to maybe 1/4 tab. I'm just so disappointed that there doesn't seem to be an obvious right answer that makes me feel better more quickly! So many other sites say "SSRI withdrawal syndrome can be cured in a couple days by going back on the drug" - but this doesn't seem to be the case. I feel totally lost and unsure of how to proceed. I'm so exhausted by trying to figure this all out, I just want to get checked into some magic rehab hospital where they knock me out and I wake up four months later feeling fine.

 

Looking back I can also see that my symptoms have shifted very much from "purely physical" (like hot flashes) to the emotional. I've had whole days lost in front of the TV, or, like this morning, terrified to get out of bed or check my email. The insomnia is AWFUL - after 4am I can neither wake up nor fall asleep. If I try to wake I'm exhausted, when I try to sleep I can only seem to get to the brink, when some sort of nervous reaction zaps me awake again. Feelings of total despair, a strong sense that there is no way out of this (I seem to be damned if I take the stuff or not), and recently, hints of some very dark thoughts indeed, as I cannot imagine having to face mornings like this one for the rest of my life!

 

On the plus side, I do have a very loving wife who is very supportive and understanding. I'm totally ashamed of all this, of who I am right now, and would give anything, everything to simply go back to that day when I decided to go off. Things were fine, or as fine as can be expected for me. But regret gets one nowhere, and we all have to remember that there ARE good days ahead, somehow.

 

CONCRETE QUESTIONS for anyone who is able to chip in:

1) On the one hand it seems pretty clearly I've tried to reinstate too fast. Likely best to go back down, but not to zero? Try to stay at 1.25mg for at least two weeks?

2) How does the Alprazolam (xanax) fit into this? I read something about how it helps temporarily, but then you can go into a "benzo hangover", which is worse?

3) Am I just bailing out of the full 5mg dose too soon? My doctor said it would be a hard two weeks, maybe I should just try to tough it out? She's lovely, but I don't think this sort of thing is her specialization.

4) Should I find a psychiatrist (even though where I live it will likely be a month or more before I can get in)? Or will they just start saying I'm bipolar and pumping me full of other things?

 

Anyway this is getting pretty rambly now so I'll stop. Thanks to anybody who reads this and has any thoughts. Anyone else going through hard times right now, just keep hanging in there - the only thing that is sure is that things will change.

 

 

 

Edited by Gridley
Insert user name in title

15+ years Citalopram 10mg (sometimes 20?)

2019 Citalopram 5mg. No problem reduction.

2020 Citalopram 5mg to zero. (Feb)

2020 (Feb - mid Oct): Very rare use of 0.125 or .25mg Xanax for really bad symptoms

2020 (Feb - Nov): Occasional use of "Nytol" sleep aid (an antihistamine). 

2020 Failed reinstatement: Escitalopram by accident (not Citalopram).  

 -- using a scale, started July 27 0.5mg, doubled every week or so to reach 5mg by Aug 30. Too fast - terrible depression, quit.

2020 (Oct-current): Supplements:

 -- Morning: Magnesium 300mg, Omega 3(483 EPA, 360 DHA +Vit E) Night: Liquid Valerian/Passiflore/Escholtzia - French organic herbal sleep aid, 1.9mg LD Melatonin 

2020 Current - new Citalopram reinstatement. (Accidentally started with Escitalopram before realizing and switching to Citalopram Oct. 30)

 -- using pipette method: Oct 30, 0.25mg; Nov. 4th, 0.375; Dec. 1st 0.5mg, Dec. 21st 0.75mg Jan 19: Decide reinstatement fail: Jan 21 0.625mg, Jan 28: 0.5mg Feb 8 0mg

Link to comment
  • Moderator

Hello @HardTimes, welcome to SA. Glad you found the site : )

 

First things first, I think you will definitely improve. It is a bit of a dilemma as to why reinstating does not necessarily help, but it seems like you have done a bit of reading on it already. If you hadn't seen our thread on this topic, here is the link: Reinstating or stabilizing to reduce withdrawal symptoms. Your initial instinct to only partially reinstate was correct. Even the dosage after your initial reinstatement may have been too high, however (1/8 pill, or 0.625mg if I am calculating correctly). It isn't an exact science. The way you would check to see whether it is too high or too low would simply be trial and error. If you increase the dose and feel worse, it was too high. If you decrease the dosage and feel better, then that is the path you should follow until you've hit whatever your imperfect optimal dose is. However, it usually takes around 5-7 days for blood levels to stabilize and for the nervous system to fully register the effects of the drug, so after each dose change you should pause to allow it to take effect (unless of course it is immediately intolerable). 

 

Before we go further, we'd appreciate it if you filled out your drug signature (drug history with dosages and dates, going two years back, and any other drug or supplement usage before that with approximate dates). Here are instructions on how to fill it out and here is a link to your personal signature.

 

To briefly address your questions: 

1) The answer to this will depend on how your react. But yes, dropping down to a dose you find more tolerable would be a good start. How long have you been on 5mg now? What is the time period between when you reinstated at 1.25mg and steadily got up to 5mg?

2) Xanax has a similar mechanism of action to alcohol and is a very powerful sedative / anxiolytic. How long have you been taking this? We may need to taper this as well and if you haven't been on it long, I'd suggest getting rid of it first before you become more dependent on it. 

3) No, you don't want to take a higher dosage if it makes you feel worse right away

4) Not necessarily. Most psychiatrists are pretty ignorant about these medications as well. If you can find one who has extensive experience with tapering and understands something about the topic (for example, they are familiar with this article in the Lancet by Horowitz and Taylor.) then they might be worth consulting. 

Edited by DataGuy

Remeron - 2004-2005 (bad withdrawal)

Clonazepam - 2005-2018 (jumped around March)

Olanzapine - 2014- late 2017

Domperidone - 2008-2018

Many drugs in between including Lexapro, other benzos and z-drugs.

Still suffering post-withdrawal from Clonazepam (Klonopin), Olanzapine and Domperidone. 

Link to comment
  • Moderator

In addition, some important links that might help you on your journey:

 

Explanation of the tapering process and why it is important to go slowly.

 

Some non-drug coping techniques which may help you in your withdrawal and post-withdrawal. 

 

 

These are tips for tapering off citalopram specifically. 

 

This last link has links to many topics you may find helpful, including tips on dealing with insomnia, which is extremely common in withdrawal: 

 

Remeron - 2004-2005 (bad withdrawal)

Clonazepam - 2005-2018 (jumped around March)

Olanzapine - 2014- late 2017

Domperidone - 2008-2018

Many drugs in between including Lexapro, other benzos and z-drugs.

Still suffering post-withdrawal from Clonazepam (Klonopin), Olanzapine and Domperidone. 

Link to comment

Hi, 

I was taking citalopram 20 mg on /off, for 10 years. 

Tried many times to come off, since I was feeling well, but few months after, terrible physical symptoms were starting and had to reinstate, gradually being OK again. 

 

Finally, following very very slow cuts, managed to be off after a period lasting almost 6 years! 

 

Now the tricky thing, is that for almost 4 years without any drug 

2012 _2016) and feeling almost fine, gradually in Jun 2016 unexplained physical symptoms start resurfing again (insomnia, tremors, muscle pains, exhaustion, agitation and others) lasting on off till end 2017!

 

All this time didn't restart the drug , since when I tried it again, felt much worse. 

 

Finally, all symptoms gradually faded away, and now almost for  3 years I am without any symptoms, and doing fine. 

Let's hope for good! 

 

This is my personal experience, everybody reacts differently to these drugs, they do not stop to surprise you, but seems to be some light in the end...! 

Best wishes 

 

 

 

Citalopram 20 mg

Mid June 1994- end March 1995 Then tapering 3 months 

Mid August 1995-end August 1996 Tapering 6 months 

Mid January 2000-end September 2001 Tapering 6 months

Mid October 2003-end October 2005 Tapering 7 years. 

More detailed drug history is here - ☼-kostas

Off any drug from October 2012 

Link to comment
  • Moderator Emeritus
7 hours ago, HardTimes said:

I feel totally lost and unsure of how to proceed.

 

Hi HardTimes,

 

I'm so sorry you're having to go through this.  I feel the same way--in my own situation.  From what I've been reading here at SA, my sense is that you will recover given time.  I wish all of us stamina--

Arbor

Zoloft: 1995 - 2015

Prozac: 2015 - 2018 (tapered from 40mg x day on July 31 to 30mg on August 31 to 20mg on September 31 to 10mg October 31 to 0mg on  December 15, 2018

Gabapentin: 2016 to 2019  (tapered from 300mg x day to 150mg on August 31, 2019 to 75mg on September 15 to 50mg on September 31 to 25ishmg on October 15 to 0mg on December 1, 2019

Enalapril: 2010 - 2019

Lipitor: 2017 -2017

Metformin: 2000 - 2020

Liothyronine: 2007 - 2019

Levothyroxine: 2000 - 2022

Link to comment
  • ChessieCat changed the title to HardTimes: late onset withdrawal from long-term citalopram disaster
  • Moderator

Hi @HardTimes. I've had a different tapering path from you on citalopram, but your symptoms are all very familiar. I don't have the expertise to answer your questions other than I do agree that if you can refrain/taper down from the benzo it is best. In the citalopram tapering topic linked in a previous post, you will see instructions for dissolving your tablet in liquid so that you can get a more accurate lower dose. I found that the fluctuations in dosage when I was cutting tablets was problematic and have had a better time on the liquid (plus it's easier than using a scale in my opinion). Note that there will be a drop in effective dosage if you dissolve a tablet in water.

 

Quote

I just want to get checked into some magic rehab hospital where they knock me out and I wake up four months later feeling fine.

So many times I've wished for this exact thing...

 

It seems like you've already begun to inform yourself about what you're experiencing and been caring for yourself with exercise and diet. These actions will help you greatly.

 

I hope you get some relief soon. You will at some point feel better. This isn't forever.

 

peace,

bunches

2005 - 2016 on & off methylphenidate and bupropion; short terms trials of other medications; tried many supplements

2016 Nov - 2017 Mar citalopram ramp up 0-->30mg (4 months)

2017 Mar - 2018 Jan held at 30mg (11months); taking 1.5x 20mg tablets, cutting 20mg tablets in half. inconsistency in split tablet led to extreme side effects.

2018 Feb - 2018 May taper 30mg-->20mg (3months), ~2.5mg/month, cutting tablets; at 20mg side effects (vertigo, headache, etc) disappeared

2018 May - 2019 Apr held at 20mg (11months); attempted taper from 20mg; tried ~17.5mg cutting tablets but symptoms too strong

2019 Apr - 2021 Jun tapered 20mg-->10mg (26months); ~5%/month dissolving tablets in water and pipetting with syringe; min lorazepam 2-3x/mo to mitigate symptoms

2021 Jun - 2023 Nov held at 10mg (29months)

2023 Nov - Nov 7 10mg solid to liquid; Dec 7 liquid 10mg; Dec 14 9.9mg; Dec 21 9.8mg; Dec 28 9.75mg; Jan 27 9.65mg; Feb 3 9.53mg; Feb 18 9.45mg

 

external-content.duckduckgo.com.jpg

Link to comment

Thanks to those who responded. I'm still working out how to use the site and read about your situations - I guess I search for your own "introduction" posts? But from some of the things I've read so far, it looks like I'm getting off lightly compared with some people (Arbor - I have to say that I admire your courage! Your strength is remarkable!). How can all this be possible?

 

I think what I find so difficult is that I put myself in this situation. It seemed like a reasonable decision to attempt to go off them, but I just had absolutely no idea of the risk I was taking. Then, when all the sleeplessness appeared a couple months later, it seemed too far removed from stopping the drug that I just didn't put the two things together. When I finally did find out about this site, I learned that it might be too late for me to reinstate... SO MUCH REGRET. For no good reason I just gave myself a crazy disease that takes years and years to cure.

 

I think for me at least the feelings of despair (while partly just chemically caused), are also due to a sense of not having a clear strategy for moving forward. If we can sense that the steps we are taking will eventually achieve results, even if in the very long term, there is reason for hope and determination. But having no idea what to do, how to respond to changes in one's condition from day to day, that is what is so hard and creates the sense of hopelessness. Is it not enough xanax? too much citalopram? Not enough magnesium? Or just sleep deprivation? Or maybe just lack of will power? Or bad diet? It feels impossible to form a plan with so many variables, and the time it seems to take to see a change. It is like trying to play chess through the mail - you make a move and then have to wait a week to see the results, even though it feels like the pieces are all still moving around!

 

Anyway, thanks for reading and the pointers. I think in my case it is pretty clear that I tried to reinstate too fast, so now the question is what to take instead, if anything. And I'm getting a sense that it is likely good to avoid benzos if possible. I think I've been pretty careful on that score - only taking half a tablet here and there when the symptoms seemed really bad. Is that really a bad thing to do? Like taking a painkiller for a headache?

 

Kostas - how did you go about reinstating? Or does anybody have any further links or stories? Somehow reading about other people helps a bit.

15+ years Citalopram 10mg (sometimes 20?)

2019 Citalopram 5mg. No problem reduction.

2020 Citalopram 5mg to zero. (Feb)

2020 (Feb - mid Oct): Very rare use of 0.125 or .25mg Xanax for really bad symptoms

2020 (Feb - Nov): Occasional use of "Nytol" sleep aid (an antihistamine). 

2020 Failed reinstatement: Escitalopram by accident (not Citalopram).  

 -- using a scale, started July 27 0.5mg, doubled every week or so to reach 5mg by Aug 30. Too fast - terrible depression, quit.

2020 (Oct-current): Supplements:

 -- Morning: Magnesium 300mg, Omega 3(483 EPA, 360 DHA +Vit E) Night: Liquid Valerian/Passiflore/Escholtzia - French organic herbal sleep aid, 1.9mg LD Melatonin 

2020 Current - new Citalopram reinstatement. (Accidentally started with Escitalopram before realizing and switching to Citalopram Oct. 30)

 -- using pipette method: Oct 30, 0.25mg; Nov. 4th, 0.375; Dec. 1st 0.5mg, Dec. 21st 0.75mg Jan 19: Decide reinstatement fail: Jan 21 0.625mg, Jan 28: 0.5mg Feb 8 0mg

Link to comment
  • Moderator
11 hours ago, HardTimes said:

Thanks to those who responded. I'm still working out how to use the site and read about your situations - I guess I search for your own "introduction" posts? But from some of the things I've read so far, it looks like I'm getting off lightly compared with some people (Arbor - I have to say that I admire your courage! Your strength is remarkable!). How can all this be possible?

 

Yes, starting with introduction posts is a good idea. You can click on users' names and then click on "see all activity". If you then click on topics (on the left), you will see their introduction topic listed somewhere there. You can also use the search function to search for reinstatement. Topics are usually tagged or at the very least will contain "reinstate" or "reinstatement" as a key word. 

 

I would advise to go back to the reinstatement dose you felt most comfortable on, then hold there for week and adjust as needed. Once you stabilize you can think about tapering.

 

I wouldn't beat yourself up about ending up in this situation. Many people have fallen down in their responsibilities for people to end up here: prescribers, regulators, researchers, politicians. You could not have been expected to know what would happen. It's quite difficult to find good information about withdrawal from prescribed drugs, including from doctors. 

Remeron - 2004-2005 (bad withdrawal)

Clonazepam - 2005-2018 (jumped around March)

Olanzapine - 2014- late 2017

Domperidone - 2008-2018

Many drugs in between including Lexapro, other benzos and z-drugs.

Still suffering post-withdrawal from Clonazepam (Klonopin), Olanzapine and Domperidone. 

Link to comment

Hi again, 

When symtoms was becoming intolerable, few months after stopping the drug, simply was restarting it again, 5 mg for one week, 10 mg for two weeks and then 20 mg onwards. 

 

Within 2 - 3 months at 20 mg, I, was stabilized again.

 

That happened 4times I think! 

 

However it seems that I was from the lucky ones, since I was able to reinstate so many times without major problems. 

Most of the people here, from what I see, had severe problems! 

That shows how surprisingly different everybody reacts to these drugs. 

Best regards 

Citalopram 20 mg

Mid June 1994- end March 1995 Then tapering 3 months 

Mid August 1995-end August 1996 Tapering 6 months 

Mid January 2000-end September 2001 Tapering 6 months

Mid October 2003-end October 2005 Tapering 7 years. 

More detailed drug history is here - ☼-kostas

Off any drug from October 2012 

Link to comment

Thanks again, everybody. Today I'm having a hard time making a decision, which I realize is only mine to make. But articulating it in writing itself might be helpful. 

 

My signature lists the events of august: Basically I decided to try to reinstate, and I started a very low dose (0.6 - 1/8 of a tablet), and then pretty much ended up doubling that every week. I was seduced by the idea that somehow I had to get to 5mg to really have a meaningful effect, and when I didn't necessarily feel better when I went up a level I assumed it was because it still wasn't enough. But when I reached 5mg (still very low, really) and took that for 3-4 days, I really felt totally awful. @DataGuy and others wisely suggested going back down to a lower reinstatement dose, but when it came time I just couldn't bring myself to take any at all. 

 

So now I am on day four of nothing at all. I could feel the stuff leaving my system and feeling more clear-headed somehow during the first 36 hours, and yesterday afternoon qualified as a genuine "window". Except for crippling insomnia! And today is really pretty terrible. 

 

So I'm inclined to think that my initial impulse to reinstate made sense, I just went up too fast. If that's right, I should just go back to a tiny dose and stick with it for a good solid 10 days or so before maybe going up again, or off if it totally doesn't work. 

 

But on the other hand, I'm inclined to think that my attempt at reinstating simply failed, and I should just "tough it out" and plow through the coming days and weeks at zero and wait for my brain to heal. I'm not sure "tough it out" is a recommended strategy, but it raises the difficult problem we've all likely faced of deciding what exactly is "intolerable". That is to say, when are the symptoms bad enough to require a change? Basically I've been at zero since february, except for this last month of attempted reinstatement. Going back on makes me think I have to start all over, which makes me want to just tough it out now.

 

It feels like quite a tough call, but likely I'm overthinking. Any thoughts? Tough it out? Tiny dose to reinstate? The only thing I know is that it really isn't good to keep going on/off, up/down all the time as I'll never stabilize, so I need to decide. 

15+ years Citalopram 10mg (sometimes 20?)

2019 Citalopram 5mg. No problem reduction.

2020 Citalopram 5mg to zero. (Feb)

2020 (Feb - mid Oct): Very rare use of 0.125 or .25mg Xanax for really bad symptoms

2020 (Feb - Nov): Occasional use of "Nytol" sleep aid (an antihistamine). 

2020 Failed reinstatement: Escitalopram by accident (not Citalopram).  

 -- using a scale, started July 27 0.5mg, doubled every week or so to reach 5mg by Aug 30. Too fast - terrible depression, quit.

2020 (Oct-current): Supplements:

 -- Morning: Magnesium 300mg, Omega 3(483 EPA, 360 DHA +Vit E) Night: Liquid Valerian/Passiflore/Escholtzia - French organic herbal sleep aid, 1.9mg LD Melatonin 

2020 Current - new Citalopram reinstatement. (Accidentally started with Escitalopram before realizing and switching to Citalopram Oct. 30)

 -- using pipette method: Oct 30, 0.25mg; Nov. 4th, 0.375; Dec. 1st 0.5mg, Dec. 21st 0.75mg Jan 19: Decide reinstatement fail: Jan 21 0.625mg, Jan 28: 0.5mg Feb 8 0mg

Link to comment
  • Moderator
2 hours ago, HardTimes said:

what exactly is "intolerable"

What helped me was to quantify how I felt.

 

I started with this checklist for withdrawal symptoms:

On 7/27/2020 at 4:20 PM, ChessieCat said:

Dr Joseph Glenmullen's Withdrawal Symptom List is available here:  Dr Joseph Glenmullen's WD Symptoms Checklist

 

I customized it, added some things I wanted to track, and subtracted symptoms I never experienced. I put it in a spreadsheet. Each day is a new column. I assign each symptom a value 0-5, and then sum it up at the bottom. I started to be able to equate a sum to a general feeling (and functional ability). I also calculate averages over different time periods (ie 3days, 1wk, 2wks, 1mo). When I was wondering if/when I should "tough it out," I knew that if I'd had let's say several days with sums over 45 or a 2wk average of greater than 35, it probably wasn't a good time to push forward and it would benefit me to focus on stabilizing. The main reason for this is that you may feel like you can thrust forward and tough it out, but it may get even worse, and you want to be in a good enough position to handle that.

 

Diligent tracking also helped me to nail down which symptoms I experienced the most, which ones correlated the most with changes in dosage, and what symptoms come and go as part of my life. I also was able to see that even if it felt like every day was the same, it wasn't necessarily. Let me know if you have any questions about this or if there's anything I can clarify.

 

I don't what's the right reinstatement dose or whether you should just stay off at this point. I do think whatever you choose, stick with it for a while and find some techniques to really give your body a lot of stability. I do think benzos will cause more problems in the long run. You can take a look around this site and the web to see what others have experienced. There are a lot of great non-drug coping skills worth exploring to manage the feelings you take benzos for. Sleeping issues and anxiety are really common in withdrawal, and as uncomfortable as those experiences are, it's worth exploring non-drug ways of caring for yourself.

2005 - 2016 on & off methylphenidate and bupropion; short terms trials of other medications; tried many supplements

2016 Nov - 2017 Mar citalopram ramp up 0-->30mg (4 months)

2017 Mar - 2018 Jan held at 30mg (11months); taking 1.5x 20mg tablets, cutting 20mg tablets in half. inconsistency in split tablet led to extreme side effects.

2018 Feb - 2018 May taper 30mg-->20mg (3months), ~2.5mg/month, cutting tablets; at 20mg side effects (vertigo, headache, etc) disappeared

2018 May - 2019 Apr held at 20mg (11months); attempted taper from 20mg; tried ~17.5mg cutting tablets but symptoms too strong

2019 Apr - 2021 Jun tapered 20mg-->10mg (26months); ~5%/month dissolving tablets in water and pipetting with syringe; min lorazepam 2-3x/mo to mitigate symptoms

2021 Jun - 2023 Nov held at 10mg (29months)

2023 Nov - Nov 7 10mg solid to liquid; Dec 7 liquid 10mg; Dec 14 9.9mg; Dec 21 9.8mg; Dec 28 9.75mg; Jan 27 9.65mg; Feb 3 9.53mg; Feb 18 9.45mg

 

external-content.duckduckgo.com.jpg

Link to comment
  • Moderator
6 hours ago, HardTimes said:

It feels like quite a tough call, but likely I'm overthinking. Any thoughts? Tough it out? Tiny dose to reinstate? The only thing I know is that it really isn't good to keep going on/off, up/down all the time as I'll never stabilize, so I need to decide. 

 

Hi @HardTimes,

 

IMO, if withdrawal symptoms like insomnia get bad enough that you describe them as "crippling", then you should reinstate a small amount of the drug. You do not want to mess with your nervous system like that, because as many on this site can attest, it can be difficult to put back together. Withdrawal symptoms can get out of control even after being off the drug for some time, and you don't want to have to experience that. There is no benefit and it may result in you taking longer to get better (and suffering more intensely). 

 

On 8/30/2020 at 9:05 AM, HardTimes said:

I experienced several "windows" (term used on this site and elsewhere to indicate a period of mostly clear, good days, in contrast with "waves" of heavy symptoms), but by the end of July I began to think I needed to go back on something. My goal, then and now, is quality of life, and if that meant I did indeed need some small quantity of drug, so be it. (Just MY point of view, not a judgement of anyone else!). I read on this site about the dangers of going back on at a "normal" dose, like the 5mg recommended by the doctor. My particular situation was at high risk for "kindling", since by this point I'd been off the citalopram for around 6 months, and citalopram has a short half-life. (All this learned from this site!). I tried a 5mg tablet cut in 4 (about 1.25mg), but on day two felt like I was freaking out. After a few days, I tried again, an 1/8th of a pill, smaller than a grain of rice. I ordered a scale to weigh the dose, as suggested. By the second day I was experiencing GREATLY REDUCED WD SYMPTOMS, and felt like I was out of the woods. I wanted to create an account and tell everybody about my success story, to help others. But by a few days later, things started going downhill again. Was that just a window? The hot flashes and brain zaps were gone, but a general lethargy combined somehow with nervousness persisted. I thought perhaps I had adapted to the miniscule dose, and went up to 1/4 tablet. To cut this long story a bit shorter, I slowly progressed over the course of a few weeks up to 1/2 a tablet. I felt I was in the extremely difficult situation (for which I'm seeking the community's help) - Is my situation caused by too much drug (kindling) or not enough?? How to distinguish WD symptoms and symptoms caused by going back on the drug? I saw my doctor, who feels that anything less than 5mg is just not going to help. She suggested taking 5mg and warned me that the first two weeks were likely going to be difficult, so I should take .25mg of xanax as well for the first two weeks. I've tried this for the last few days, and indeed they have been difficult. But I'm not convinced that they'll get better in two weeks! Now, seeing all this in black and white, I think likely I've increased my dosage too quickly, and I'll do better to go back down to maybe 1/4 tab. I'm just so disappointed that there doesn't seem to be an obvious right answer that makes me feel better more quickly! So many other sites say "SSRI withdrawal syndrome can be cured in a couple days by going back on the drug" - but this doesn't seem to be the case. I feel totally lost and unsure of how to proceed. I'm so exhausted by trying to figure this all out, I just want to get checked into some magic rehab hospital where they knock me out and I wake up four months later feeling fine.

 

Reading your initial reaction to the 0.625mg, it seems like that provided quite a bit of relief, but then your description reads like you had an adverse reaction once it started building up in your system. So I would probably try a dose half that size or even 1/4 that size to start. As long as you have an objective way to measure how much you are taking. Perhaps another mod can weigh in on the exact recommended amount @Gridley, @brassmonkey, @Shep or @Altostrata? Any comment?


In any case, I think there is no danger in reinstating "too low" of a dose, but you definitely do not want to go too high (due to the kindling you mentioned). You'll hold this dose for around a week (it takes around 4 days to reach a steady level in your blood, but it can be longer for the nervous system to register the full effect of the drug).  You can always increase the dose until you reach whatever dose is the optimum for minimizing symptoms. Then you will want to hold that dose, likely for months, until you are stable for quite some time. After that you can begin a slow taper. I know you probably want to be rid of the drug at this point, but this is likely the best option to remain as stable and functional as possible.

 

Edited by DataGuy

Remeron - 2004-2005 (bad withdrawal)

Clonazepam - 2005-2018 (jumped around March)

Olanzapine - 2014- late 2017

Domperidone - 2008-2018

Many drugs in between including Lexapro, other benzos and z-drugs.

Still suffering post-withdrawal from Clonazepam (Klonopin), Olanzapine and Domperidone. 

Link to comment
  • Administrator
On 8/30/2020 at 6:05 AM, HardTimes said:

After a few days, I tried again, an 1/8th of a pill, smaller than a grain of rice. I ordered a scale to weigh the dose, as suggested. By the second day I was experiencing GREATLY REDUCED WD SYMPTOMS, and felt like I was out of the woods. I wanted to create an account and tell everybody about my success story, to help others. But by a few days later, things started going downhill again. Was that just a window? The hot flashes and brain zaps were gone, but a general lethargy combined somehow with nervousness persisted. I thought perhaps I had adapted to the miniscule dose, and went up to 1/4 tablet. To cut this long story a bit shorter, I slowly progressed over the course of a few weeks up to 1/2 a tablet. I felt I was in the extremely difficult situation (for which I'm seeking the community's help) - Is my situation caused by too much drug (kindling) or not enough?? How to distinguish WD symptoms and symptoms caused by going back on the drug? I saw my doctor, who feels that anything less than 5mg is just not going to help. She suggested taking 5mg and warned me that the first two weeks were likely going to be difficult, so I should take .25mg of xanax as well for the first two weeks. I've tried this for the last few days, and indeed they have been difficult. But I'm not convinced that they'll get better in two weeks! ....

 

This stuff drives me a little bit nuts. Your doctor tried to fix something that wasn't broken. That 5mg would be an effective dosage is based on a religious belief that smaller doses don't do anything, when we know they do. See

 
Shapiro, B. B. (2018). Subtherapeutic doses of SSRI antidepressants demonstrate considerable serotonin transporter occupancy: Implications for tapering SSRIs. Psychopharmacology, 235(9), 2779–2781. https://doi.org/10.1007/s00213-018-4995-4

 

Good for you for gradually going from 1/4 to 1/2 tablet and watching your symptoms. I would have interpreted the general lethargy and residual nervousness as temporary symptoms while you get used to the drug again. But then you increased too much, and added Xanax, which confuses the picture considerably. Your reinstatement got messed up.

 

7 hours ago, HardTimes said:

So I'm inclined to think that my initial impulse to reinstate made sense, I just went up too fast. If that's right, I should just go back to a tiny dose and stick with it for a good solid 10 days or so before maybe going up again, or off if it totally doesn't work. 

 

Please stop making dramatic changes. If I were you, I'd try 1/4 tablet again and expect to stay there for at least 10 days, depending on how you feel. Take your drugs at the same times and dosages each day. Please let us know how you're doing (referring to the dosage amount rather than 1/4 tablet, please).

 

Are you still taking Xanax? Please list the days and dosages you've taken it over the last 10 days. If you've been taking it every day, you've got a tiger by the tail.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Link to comment

@Altostrata, @DataGuy, @bunchesofoats:

 

First off I have to use up quite a few words to express my sincere thanks for your efforts. The idea that there are a bunch of total strangers out there willing to give up their time and energy to help me is really encouraging. I don't know if you guys are all just volunteers or if this is some sort of job for you, but either way just knowing that you're all there is extremely comforting to me. The fact that you're actively soliciting more information from me also indicates that you all actually care about what happens to me next! I'm very impressed and grateful and hope that at some point I'll be able to make a contribution to others somehow too.

 

Tiny update since yesterday: I SLEPT LAST NIGHT! I actually slept for something like 8 hours with only a very short wake-up. This was awesome! I had dreams! (Not sure if you guys know how important and helpful REM sleep can be to emotional health, but it is!). So I'm pleased as punch about at least getting one good night under my belt.

 

BunchesOfOats: You were reading my mind. I found that excel file a few days ago and made a customization of it myself to track symptoms. Mine is even broken down into AM, PM, EVE, and NIGHT, because I was getting the impression that my symptoms had a pattern throughout the day. But I think your numerical system is likely better and something I will have to incorporate. It seems this malady is very tricky to find patterns with though - and it is very difficult to predictably discover cause and effect relations because everything is so overdetermined!

 

DataGuy and AltoStrata: Excellent advice, and likey re-instating at a low dose is probably wise. However, I'm not quite sure what you meant by "half that" as a recommendation: Did you mean half the 5mg that was freaking me out? Or even half the dose I originally started with (0.625)? AltoStrata suggested 1.25, I think. I'm still inclined to take as tiny an amount as possible, if any. I don't want to screw up my nervous system any more by staying off, but I'm not keen to put any more of this poison into me than is absolutely necessary. At any rate,  I've ordered a syringe system and can commence diluting so I can get to those tiny doses more easily. I have not, however, initiated a new reinstatement, and will likely wait until the syringes arrive. (I hate to go against your very helpful advice, but as I'm feeling so rested and symptom free and positive today I just don't want to yet!)

 

And so my record is clear about the Alprazolam... whatever it is called, the Xanax: I was only ever taking it sporadically in small doses (0.125mg) on an as-needed basis since february. Specifically, this meant not every day, just here and there, and only half a tablet (0.125mg). I took more (.25mg or more daily) during my short reinstatement attempt at 5mg on the advise of my doctor (Her idea is that the first two weeks of going on SSRIs are often actually worse, so the benzo kicks in to help during those weeks, and then should be dropped). However, all you guys are making it pretty clear that these benzos should be avoided if at all possible, and I've heeded that advice. I did take another 0.125 in the middle of the night a few nights ago, but that's my only use in the last week or so. So, thankfully, I don't believe I've developed a dependency on them. Is it really a terrible idea to take them on occasion if there is a particularly intense nervous/anxious/mind-racing/insomniac situation?

 

YOU PEOPLE ARE FREAKING AMAZING AND THANK YOU SO MUCH. I'm going to spend an hour scouting around the site to see if I can encourage anyone and pay it forward a bit. I think by comparison with most people on this site I'm actually pretty well off, but I know that feeling that things will never improve, and it helps to be told by a stranger that it will.

 

PS: Are any researchers using these files to collect data or as case-studies in any serious way? You'd think this site would be a tremendous resource if one were to go through and boil it all down to the raw numbers somehow.

15+ years Citalopram 10mg (sometimes 20?)

2019 Citalopram 5mg. No problem reduction.

2020 Citalopram 5mg to zero. (Feb)

2020 (Feb - mid Oct): Very rare use of 0.125 or .25mg Xanax for really bad symptoms

2020 (Feb - Nov): Occasional use of "Nytol" sleep aid (an antihistamine). 

2020 Failed reinstatement: Escitalopram by accident (not Citalopram).  

 -- using a scale, started July 27 0.5mg, doubled every week or so to reach 5mg by Aug 30. Too fast - terrible depression, quit.

2020 (Oct-current): Supplements:

 -- Morning: Magnesium 300mg, Omega 3(483 EPA, 360 DHA +Vit E) Night: Liquid Valerian/Passiflore/Escholtzia - French organic herbal sleep aid, 1.9mg LD Melatonin 

2020 Current - new Citalopram reinstatement. (Accidentally started with Escitalopram before realizing and switching to Citalopram Oct. 30)

 -- using pipette method: Oct 30, 0.25mg; Nov. 4th, 0.375; Dec. 1st 0.5mg, Dec. 21st 0.75mg Jan 19: Decide reinstatement fail: Jan 21 0.625mg, Jan 28: 0.5mg Feb 8 0mg

Link to comment
  • Moderator Emeritus
11 minutes ago, HardTimes said:

PS: Are any researchers using these files to collect data or as case-studies in any serious way? You'd think this site would be a tremendous resource if one were to go through and boil it all down to the raw numbers somehow.

 

  

On 5/15/2011 at 5:22 AM, Altostrata said:

 

This site is also a research project. The personal stories on this site are documentation of an iatrogenic condition -- suffering caused by medical treatment -- that is almost always ignored, misdiagnosed, or denied by the medical establishment. Given the widespread prescription of antidepressants to tens of millions of people worldwide, withdrawal syndrome probably affects hundreds of thousands if not millions -- including newborns and children.

...

With our documentation of antidepressant withdrawal syndrome, we hope to educate the medical establishment about this problem. Case studies are essential; they are evidence understood by doctors, the psychiatric industry, and government regulatory agencies. The have already informed numerous articles in major publications and scientific papers.

Our hope is, eventually, antidepressants and other psychiatric drugs will be prescribed rarely, and only in cases of extremely severe mental illness after less invasive treatments have been tried.

Please join Surviving Antidepressants in its mission to support, document, and educate about psychiatric drug withdrawal syndrome.

 

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

Link to comment
  • Moderator Emeritus

 

survivingantidepressantsorg-mentions-and-honors

 

Edited by ChessieCat

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

Link to comment
  • Moderator

@HardTimes great news that you slept. I have been sleeping better lately too : )

 

The dose I meant was half of 0.625mg or 0.3125mg. I think Altostrata and I interpreted your symptoms differently. She has much more experience than I do, though. However, if you are afraid of having an adverse reaction, there is not much harm in starting with a small dose. The worst that can happen with a dose that is too small is you will still have the same withdrawal symptoms. Alto is right that you should be methodical and patient, avoiding going up and down, on and off, as much as possible. 

 

If you can record in careful detail your dosages and your reactions to them, that would be very useful, both for you and other people trying to help. As Chessie pointed out, researchers do indeed use this website to try and understand the withdrawal syndrome, reinstatement and how best to treat the condition. Doing a large study on something like that would be difficult, since everyone would be on different drugs at different doses, having discontinued at different paces. And you cannot deliberately induce withdrawal, as that would not pass any ethics board's approval process. So best to learn from those who experienced it by unfortunate accident. 

 

See SA cited in this article, as well: https://www.bmj.com/content/365/bmj.l2238

Edited by DataGuy

Remeron - 2004-2005 (bad withdrawal)

Clonazepam - 2005-2018 (jumped around March)

Olanzapine - 2014- late 2017

Domperidone - 2008-2018

Many drugs in between including Lexapro, other benzos and z-drugs.

Still suffering post-withdrawal from Clonazepam (Klonopin), Olanzapine and Domperidone. 

Link to comment
  • Administrator

Sleeping is good. For what remaining symptoms would you want to attempt reinstatement?

 

There are several research projects going on right now based on the narratives on this site.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Link to comment
  • Moderator Emeritus
9 hours ago, HardTimes said:

 I don't know if you guys are all just volunteers or if this is some sort of job for you

This site is run entirely by volunteer Administrators and Moderators, all have been through or going through withdrawal.

There are no commercial interests or influences  involved .

 

Welcome 🤗

2006 : 20mg Paxil+Bromazepam. 2008 : cold turkey of both. 2010 : Reinstatement 20mg Paxil + Bromazepam.

2014-June2017 : Switch from Bromazepam to Prazepam, slow taper to 0mg.

2018 to August 2019 : Paxil 20mg taper (3% every 15 days). 22 Aug 2019 updose to 10mg (was at 8.4mg).

25th Sept 2019 To April 2020 : found SA, holding at 10mg Paxil. 

April 2020 : Paxil 10mg to Prozac 7mg bridge. Details topic/21457

 

Current Supplements : magnesium citrate + fish oil

Current medication :

* 7pm Diazepam  : 0.85mg (15 Aug 2022) / 0.95 mg (24 April 2022) / 1mg Diazepam (since 29 Aug 2020)

* 8am Prozac : 6.16mg (25 oct 2022, feel awful, slight updose) / 6.08 mg (9 oct 2022) / 6.24mg (11 July 22) / 6.44mg (22 May 22) / 6.64mg (4 Nov 21) / 6.72mg (8 oct 21) / 6.8 mg (15 Sept 21)6.88mg (14 Aug 21)/ 6.92mg (23 Jun 21)

 

I am not a professional, I don't give medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

Link to comment
  • Administrator

It's a job, but an unpaid job.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Link to comment

I haven't been posting anything because a) I don't want to take any attention from anybody that is having a more severe time than I am, and b) I've been doing really well (until very recently). But I thought I should post an update, if for no other reason than to keep my record complete.

 

Quick recap: I decided I needed to re-initiate at the start of August. I tried to start with the tiniest dose I could manage to cut (about 0.625mg), and then doubled my dose every week or ten days, thinking I was not yet taking enough to relieve symptoms. This turned out to be WAY TOO FAST, and I spent 4 days at 5mg and became really, really bad - not the same physical symptoms, but much, much worse mentally/emotionally. I made my first post here then, wondering if I should take a smaller dose or what. Since that time I have taken nothing. I could feel the drug leaving my body over the first couple days, and slowly felt much better. I even had one day that was possibly a little too great (perhaps mildly manic?). Then, with no warning, my sleeping problems completely improved and I suddenly started getting solid 8 hour nights, many, in a row. I felt GREAT - healthy, not manic, like I had my life back. But in the back of my mind I worried that this might just be an extended "window", rather than the end of my troubles.

 

Then a couple days ago, on (wednesday sept. 9) I somehow managed to get myself pretty wound up and depressed about issues surrounding my career and life ambitions. I was still not exhibiting any of the physical symptoms I've described before - I had almost a week or so of zero or only very mild symptoms. Perhaps because I was feeling "normal" again, I was able to start looking at more big-picture issues. I started to worry about the sustainability of my situation, and was beating myself up for not having accomplished more with my life. I ended up having a very bad night of sleep. Yesterday some of the physical symptoms returned, but still tolerable, and I was distracted from my life-questions by various things. Not a good night of sleep last night - I think it is the cortisol spike thing happening again, where I wake up hot and grumpy (yet very sleepy) and toss and turn in a very unhappy, uncomfortable state from 4am on. Unable to sleep, but unable to really wake up, and feeling really tired. Still feeling pretty grumpy now as I write this, but it does get better as the day goes on.

 

So I'm disappointed that those symptom-free days were not the end of my story, but I'm still hoping (and willing) that my current state is a speed-bump rather than falling back down into where I was before. It is still pretty mild, compared to what it was, and I'm going to do everything I can to keep it that way.

 

This episode is interesting and revealing of the complex relationship between the "physical" and the "mental/emotional". Either I (as described) managed to get myself all emotionally wound up and self-loathing, which then lead to the onset of physical symptoms - I was the one who closed the window.  Alternatively, the window began to close of its own mysterious accord, which affected my chemistry, which made me come to see my whole situation in a negative light. It is a bit of a chicken-and-egg question, though likely the two reinforce one another and create a downward spiral of doom. Which is why it is SO important to remain as positive as possible, (much easier than it sounds, I know), and to do lots of mental homework so as to prevent "catastrophizing" and seeing everything in a totally negative light. 

 

Still not planning on reinstating at any dosage unless symptoms start re-appearing at the kinds of levels I was experiencing before. I think that's the right strategy - if symptoms are bearable, do nothing. Right? At the moment, my symptoms are still pretty mild, and limited to insomnia, neck pain/tingles/fizzy sensation, and mornings of agitation, unwillingness to  start the day, fatigue, and general anxiety. I'm able to have relatively productive afternoons, and, as I said, I've had several days in a row of feeling really pretty much fine. This reminds me that I CAN have fine days, and WILL have fine days down the road.

 

Hoping the best for all you others going through all this right now...

15+ years Citalopram 10mg (sometimes 20?)

2019 Citalopram 5mg. No problem reduction.

2020 Citalopram 5mg to zero. (Feb)

2020 (Feb - mid Oct): Very rare use of 0.125 or .25mg Xanax for really bad symptoms

2020 (Feb - Nov): Occasional use of "Nytol" sleep aid (an antihistamine). 

2020 Failed reinstatement: Escitalopram by accident (not Citalopram).  

 -- using a scale, started July 27 0.5mg, doubled every week or so to reach 5mg by Aug 30. Too fast - terrible depression, quit.

2020 (Oct-current): Supplements:

 -- Morning: Magnesium 300mg, Omega 3(483 EPA, 360 DHA +Vit E) Night: Liquid Valerian/Passiflore/Escholtzia - French organic herbal sleep aid, 1.9mg LD Melatonin 

2020 Current - new Citalopram reinstatement. (Accidentally started with Escitalopram before realizing and switching to Citalopram Oct. 30)

 -- using pipette method: Oct 30, 0.25mg; Nov. 4th, 0.375; Dec. 1st 0.5mg, Dec. 21st 0.75mg Jan 19: Decide reinstatement fail: Jan 21 0.625mg, Jan 28: 0.5mg Feb 8 0mg

Link to comment
  • Mentor

Hi @HardTimes

1 hour ago, HardTimes said:

This reminds me that I CAN have fine days, and WILL have fine days down the road.

Yes that’s the attitude that will get you to your destination.

You are so aware of your thoughts and that’s a great quality to have during the healing process.

Dont beat yourself up, you are doing everything you can. We have bad and good days in life, everyone has it. 
You will become stronger and more resilient after this. 
This journey is like a double edged sword. On one side there is the unknown road with all the challenges, and on the other there is the huge benefit that we will receive through out our hard work.

You will do great, never give up on your hopes and dream.

All the best to you🙏

 

 


1999-2020  20 mg Paxil

Bridged with Fluoxetine to help me get off Paxil.

2022 Fluoxetine 15 mg 12/12 14mg 27/12  13mg jan 12mg feb 11mg mars 10mg, 9 mg 8,5 mg 7.6mg 7.0 mg 6,3 mg 5,6 mg 5,0 mg 4,5 mg 4,0 mg 3.6mg 3,2 mg 2,9 mg 2,6 mg 2,3 mg 2,0 mg

 


I am not a medical professional nor is this a medical advice. I only talk from my own experience.

Link to comment
  • 5 weeks later...
  • Moderator

How are you doing @HardTimes? Yes, I think it's best to avoid reinstatement since you're so far out and symptoms are bearable, but if they do become too troublesome there is no sense in suffering needlessly. The best thing you can do for yourself is practice self-care, exercise, eat well, and do your best to sleep. Have you found anything that helps you sleep better? 

 

BTW, every time I see your name it makes me want to read Dickens. I may just grab that one from the library....

Remeron - 2004-2005 (bad withdrawal)

Clonazepam - 2005-2018 (jumped around March)

Olanzapine - 2014- late 2017

Domperidone - 2008-2018

Many drugs in between including Lexapro, other benzos and z-drugs.

Still suffering post-withdrawal from Clonazepam (Klonopin), Olanzapine and Domperidone. 

Link to comment

Hi there @DataGuy.

 

Very good of you to check in on me! And very good timing, as today is not a particularly good day. 

 

However, I am happy to report that I have been much improved overall. I've been keeping much more careful track of symptoms than when this whole mess began, and looking back over the last month I have had a lot of "1"s and even "0"s of very low symptoms to report. A few weird flare-ups, but overall the picture is much better than it was a few months ago. Even reading my last posting here shows some significant progress. Something similar to my last post happened the day before yesterday, some unknown cause triggered something and I somehow fell down the tubes again. But I don't think it is as bad as last time, and I can easily see from my notes that I have every reason to think it won't last too long. 

 

It is strange to see how the symptoms seem to have changed over the last 8 months. The horrible hot-flashes are gone, for example. But I'm finding I've got more psychological problems, more bouts of depression, more of a tendency to suddenly view the world through very dark glasses and blame myself for all sorts of things, and worry about things I never worried about before. There is a kind of raging narcissism that can take hold - everything seems to be about me, everything I see an opportunity to further ruminate on various anxieties or regrets. Even the pain/tingling sensation in my neck has changed - now, though milder, it spreads further, and even my lips tingle strangely from time to time. And even though last night was not great, for quite a while there my sleep was much improved, without any drugs.

 

One thing that I think might have helped was that I started taking chelated magnesium. I had been taking some sort of supermarket magnesium from time to time, but noticed no effect. When I started the chelated stuff I got from a pharmacist at a regular dosage I had an immediate and quite radical improvement! I think, however, that this might have just been coincidence (or placebo?), as it obviously hasn't lasted or been a cure-all. But I'm going to try to stick with with regularly again. I had started to slack off it, and maybe that's partly why I'm in rough shape again today. I woke up hot, restless, and grumpy, and tossed and turned before finally getting up to vegetate on the couch, where I started freezing and shivering, unable to really wake up but unable to sleep. A really nasty feeling! But now I'm up and in front of the computer, which is a good sign! 

 

I haven't been on this site much lately. When I first found it (at that time account creation was frozen) it was really helpful, as my symptoms were very acute and mysterious and I wanted to learn as much as I could about what the hell was happening to me. Since things have improved after my failed reinstatement I've been less inclined to be here as it can sometimes feel like I'm wallowing in the problem somehow. I think it can be a bit counter-productive in large doses, if, for example one gets stuck reading about people's difficult situations for hours on end... Better to just take a walk in the fresh air, sometimes. Does that make sense? A little bit of "fake it til you make it"? But today particularly it was really nice to get a notification that somebody out there is inclined to check in on me, and I really appreciate that. As my recovery continues and I get a better perspective on things I hope I can find a way to pay it forward somehow, maybe help out people just discovering the site themselves. 

 

Time to get out for a walk in the fresh air! I get so sick of feeling like this I sometimes am inclined to just put on a stiff upper lip and get out and punish my body a little with some good old fashioned exercise... My inner British Matron eventually turns up, telling me sternly "Enough of this foolishness"!

 

How about you, DataGuy? I'll have to go check out your posts again to see how you've been keeping. Well, I hope!

 

BTW: There is a great Irish song called "Hard Times", sung by Mary Black. The chorus is "Hard times come again no more..."

 

15+ years Citalopram 10mg (sometimes 20?)

2019 Citalopram 5mg. No problem reduction.

2020 Citalopram 5mg to zero. (Feb)

2020 (Feb - mid Oct): Very rare use of 0.125 or .25mg Xanax for really bad symptoms

2020 (Feb - Nov): Occasional use of "Nytol" sleep aid (an antihistamine). 

2020 Failed reinstatement: Escitalopram by accident (not Citalopram).  

 -- using a scale, started July 27 0.5mg, doubled every week or so to reach 5mg by Aug 30. Too fast - terrible depression, quit.

2020 (Oct-current): Supplements:

 -- Morning: Magnesium 300mg, Omega 3(483 EPA, 360 DHA +Vit E) Night: Liquid Valerian/Passiflore/Escholtzia - French organic herbal sleep aid, 1.9mg LD Melatonin 

2020 Current - new Citalopram reinstatement. (Accidentally started with Escitalopram before realizing and switching to Citalopram Oct. 30)

 -- using pipette method: Oct 30, 0.25mg; Nov. 4th, 0.375; Dec. 1st 0.5mg, Dec. 21st 0.75mg Jan 19: Decide reinstatement fail: Jan 21 0.625mg, Jan 28: 0.5mg Feb 8 0mg

Link to comment
  • Moderator

Thanks for the update @HardTimes. I have been bumbling along. I haven't been on the site too much lately myself. Have been trying to get some real world stuff done, although not terribly successfully. 

 

I'm glad you're able to recognize progress. That is very important when you are feeling low with symptoms. Sometimes we can get symptoms so intense that we can easily convince ourselves that we haven't made any progress at all.

 

Excellent that you are able to get out in the fresh air. For me, exercise has been a panacea. It almost always makes me feel better now. 

 

I like the way you think, HardTimes. Paying it forward is a great idea. There isn't too much help out there in the medical community for people with our problems, so anytime someone with experience wants to help out it is much appreciated. It can be difficult to find people sometimes. 

 

Hope your Hardest Times are behind you and look forward to your next update : )

 

PS: Nice song!

Remeron - 2004-2005 (bad withdrawal)

Clonazepam - 2005-2018 (jumped around March)

Olanzapine - 2014- late 2017

Domperidone - 2008-2018

Many drugs in between including Lexapro, other benzos and z-drugs.

Still suffering post-withdrawal from Clonazepam (Klonopin), Olanzapine and Domperidone. 

Link to comment

Unfortunately it seems I have gone off a bit of a cliff somehow. No apparent reason I can think of, but the past few days have been suddenly pretty rough, and it feels like I'm almost back where I started from. The sleeping problems are bad again, the temperature regulation all over the place. But most of all, which is actually quite different, is the psychological impact. Before, when this all first started, I would have described my symptoms as primarily physical - insomnia, hot flashes, neck pain and tingling, etc. It felt bad, but it was easier to mentally pull myself together and try to push through. Now I'm feeling just very depressed and nervous and totally devoid of self confidence. I feel like SUCH a loser, and find it difficult to stop these very negative self thoughts. I'm totally narcissistic, and can't help comparing myself (unfavourably) with everybody. I am full of regret for career/life choices, have no idea what to do with the rest of my life, and often now just feel like a pathetic waste of space. So. Not good. 

 

I realize this is all very melodramatic and self-pitying, and I can even partly see that these feelings are irrational and somehow symptoms of my situation, not to be taken seriously. But it is so easy just to say "Don't give in to self pity and depression" - it is much harder to actually do so. Rationally I can see that self-loathing is a vicious circle - moaning about yourself is a very unattractive quality, which just makes you even more unattractive, and so it goes. The solution is to just shut up and concentrate on something else, but it is increasingly difficult to do so. 

 

I'm tempted to try another reinstatement at a very very low dose. But every time I've come close to reinstating in the almost 2 months since my last attempt, I somehow hang in there and then, miraculously, seem to recover into a "window". Then I am glad I didn't reinstate, as it just means I've succeeded in going for even longer without the stuff in my system. Besides, my last attempt at reinstatement went very badly (likely because I increased my dosages too fast), and ended up making me feel suicidally bad. So I don't much want to try reinstating, as it feels like I'd be giving up the "progress" I thought made, and I don't want to make things worse. But I have to admit that yesterday was really pretty close to that same point, just total self loathing, and I'm longing for a solution of some kind. Sheer will power is wearing thin.  

 

It is all so confusing. I feel like for the last few weeks, until recently, I've been having lots (and lots) of days of mild symptoms, sometimes no symptoms, and been able to take pleasure in all sorts of things. It felt like the worst was over, and that even though these mildly fluctuating symptoms were a pain, I could deal with them and get on with more and more things. It felt like it might take a while, but things were definitely getting slowly better and better. Now it is like I hit a landmine and my limbs have been blown off all over again.

 

Yet, because it has happened before, I'm trying to hang on to the fact that tomorrow, for no reason whatsoever, I might feel a great deal better and forget about these bad days. So I just have no idea what to do. 

 

I guess just get through the day? And stop writing now. Even this activity I seem to see from two perspectives: On the one hand I'm reaching out for help to some sort of community of peers, which is surely a good, rational, intelligent thing to do. But on the other hand it just confirms my impression that I'm a self-absorbed loser who can't stop moaning about his personal bullsh*t. 

 

Anyway. I guess it helps to pour this stuff out somewhere. 

15+ years Citalopram 10mg (sometimes 20?)

2019 Citalopram 5mg. No problem reduction.

2020 Citalopram 5mg to zero. (Feb)

2020 (Feb - mid Oct): Very rare use of 0.125 or .25mg Xanax for really bad symptoms

2020 (Feb - Nov): Occasional use of "Nytol" sleep aid (an antihistamine). 

2020 Failed reinstatement: Escitalopram by accident (not Citalopram).  

 -- using a scale, started July 27 0.5mg, doubled every week or so to reach 5mg by Aug 30. Too fast - terrible depression, quit.

2020 (Oct-current): Supplements:

 -- Morning: Magnesium 300mg, Omega 3(483 EPA, 360 DHA +Vit E) Night: Liquid Valerian/Passiflore/Escholtzia - French organic herbal sleep aid, 1.9mg LD Melatonin 

2020 Current - new Citalopram reinstatement. (Accidentally started with Escitalopram before realizing and switching to Citalopram Oct. 30)

 -- using pipette method: Oct 30, 0.25mg; Nov. 4th, 0.375; Dec. 1st 0.5mg, Dec. 21st 0.75mg Jan 19: Decide reinstatement fail: Jan 21 0.625mg, Jan 28: 0.5mg Feb 8 0mg

Link to comment
  • Moderator

Hi @HardTimes,

 

Sorry you are feeling bad again. Is there any particular thing you think may have set this wave off? How did it start? Did you sleep poorly? How has your self-care regime been? Are you getting enough exercise? I have found that exercising to the point of exhaustion (literally until I start to lose strength and energy) has been very useful. Although I have been sleeping very little for a couple years (around 4-5 hours and less before that), I find I still need plenty of exercise. I also find that if I sleep poorly and skip my regularly scheduled exercise, my symptoms can often worsen and things can spiral. It is pretty important to keep a regular routine. I have also found that my nervous system can send me the wrong signals, like sometimes I will feel nauseous when I am actually hungry, or I will feel tired and heavy when I actually need exercise. Often if I begin to do something, it can help clarify things. If I try to eat something and it makes me feel worse, I'm able to figure I wasn't hungry. If I exercise and feel better, I can say I had an excess of energy I need to burn off. I don't know what your exact schedule is, but I've been exercising for a couple of years, starting from a very low point and have gotten up to this schedule: around 2 hours of walking per day minimum, either a 7km run or a 1 hour workout every other day (this can replace 1 hour of walking), walking or something like it every 4 hours regardless. This really helps keep me stabilized. I think when you are in withdrawal, your system is going a bit haywire with excess activity, and exercise can help burn off the excitatory neurotransmitters like glutamate, dopamine and noradrenaline floating around in your body. Regardless of what has happened, I've always at minimum found that exercising to exhaustion has left me feeling no worse and often much better and more relaxed. It is very possible your persistent rumination on things may just be your overactive nervous system doing something with that excess energy, and then tending towards the negative because you feel so bad. I had this too in early withdrawal and generally felt better going for a walk. 

 

There is also the option of reinstating. If you'd like to do that we can discuss a plan to do it at a very low dose. Either way, we have plenty of options. Sometimes it just takes awhile to recognize you are entering a negative state and then figuring out what to do about it to stabilize and slowly pull yourself back up. 

 

Hope you are feeling better today : )

 

DG

Remeron - 2004-2005 (bad withdrawal)

Clonazepam - 2005-2018 (jumped around March)

Olanzapine - 2014- late 2017

Domperidone - 2008-2018

Many drugs in between including Lexapro, other benzos and z-drugs.

Still suffering post-withdrawal from Clonazepam (Klonopin), Olanzapine and Domperidone. 

Link to comment

HI @DataGuy.

Thanks so much for the reply. I think I need help! I appreciate all you've said about getting more regular exercise and maybe just expecting less sleep (maybe 4-5 hours is fine). I guess my question would be (to you and anyone else - maybe I should look for a longer insomnia thread or start a new one): What kind of insomnia do you experience? For me there are two kinds: The first and most common (for me) is where I wake up at 4:30 or 5, and I'm almost always way too hot (in spite of sleeping with no covers). I know this is common (a cortisol spike). Either I am able to cool off and go back to sleep (a good night), or I fall into a kind of horrible in-between world where I'm too tired too wake up but too hot and awake to sleep. The other kind is simply not being able to fall asleep in the first place. This is less common for me, but the last week has been bad. I try to get into bed at a reasonable hour, read for a while, but then, just as I'm falling asleep (stage 1, with the strange, fleeting imagery) I somehow "bounce" back awake, and then can't sleep without chemical intervention. I almost always have some version of the first type, which I can (mostly, almost) live with, but the second type is really hard. The last several nights have been like that: If I'm not asleep by midnight, I take "Nytol" (canadian non-prescription sleep aid), or, if I'm still really freaking out I'll take some of the dreaded Xanax (Alprazolam?). I had three nights in a row where I took the "xanax", and based on the general comments on this site I am wary of taking it unless I really feel I need it, so last night I just decided to have no drugs no matter what. Result: I simply didn't sleep at all. Zero. I started out with a positive attitude last night, not too depressed, but now, at 11am, I'm a bit of a quivering wreck both mentally and physically (I'm even doing that thing where you rock back and forth unless you force yourself not to...).

 

Exercise is a fine idea, and when I'm feeling mentally "brave" enough to fight I often get myself out for a run, and in the summer I did lots of hiking. And when I'm feeling "up" I generally exercise without much trouble. But when the depression has descended, I think the level of exercise you are proposing is likely a bit unrealistic for me (I might be miscalculating, but it sounds like you are out there for many hours every day.) But I'll try to get out at it some more.

 

I think likely I just need to try reinstating again. I'm going to share a simplified chart of my month and a half since ending my last attempt at reinstatement (described in earlier posts). Red indicates a block of not very good to bad days, while green indicates only mild or no symptoms at all. As you will see - there is a lot of green! This gives me hope that those green days will return. Compared to what I've read here, these long green windows so close together are pretty rare, and I should count myself lucky! When I look at this I think I'd be foolish to try reinstating, as it looks like I'm doing so well. It is just that this current red patch is feeling pretty horrible and I wonder if, as you put it, I'm just suffering needlessly at this point. 

 

To finally answer allostrata's question from so many weeks ago (What symptoms are you thinking about reinstating to relieve?): My primary symptoms are: insomnia (currently severe), neck problems (which my doctor has recently diagnosed as occipital neuralgia), depression (recently severe), and a total inability to regulate my temperature. I have other symptoms that appear and disappear, but these have been quite consistent. With a good attitude I think I can mostly deal with physical symptoms. The trouble is that they seem to eventually affect my mental health, which means my capacity to have a good attitude is seriously compromised (see previous posts). 

 

It seems I can either:

a) Keep trying non-chemical solutions (more magnesium, exercise, some sort of talk-therapy, acupuncture, straight up tough-it-out, etc.)

b) Re-instate at a very low dose (I'm thinking a tenth of 5mg, 0.5mg to start with, or maybe .625). I now have the gear to make a liquid solution.

c) Try some other SSRI - not sure quite why this is a good idea, but maybe if the citalopram wasn't working I should try something else?

d) Use the "xanax" to treat severe symptoms during bad waves, but only on a very temporary basis and never more than, say, 4-5 days in a row and only 0.25mg max at a time. 

 

Anyone out there with advice on my situation is appreciated - I'm panicking a bit and could use a second opinion to my own.

Simplified summary.PNG

15+ years Citalopram 10mg (sometimes 20?)

2019 Citalopram 5mg. No problem reduction.

2020 Citalopram 5mg to zero. (Feb)

2020 (Feb - mid Oct): Very rare use of 0.125 or .25mg Xanax for really bad symptoms

2020 (Feb - Nov): Occasional use of "Nytol" sleep aid (an antihistamine). 

2020 Failed reinstatement: Escitalopram by accident (not Citalopram).  

 -- using a scale, started July 27 0.5mg, doubled every week or so to reach 5mg by Aug 30. Too fast - terrible depression, quit.

2020 (Oct-current): Supplements:

 -- Morning: Magnesium 300mg, Omega 3(483 EPA, 360 DHA +Vit E) Night: Liquid Valerian/Passiflore/Escholtzia - French organic herbal sleep aid, 1.9mg LD Melatonin 

2020 Current - new Citalopram reinstatement. (Accidentally started with Escitalopram before realizing and switching to Citalopram Oct. 30)

 -- using pipette method: Oct 30, 0.25mg; Nov. 4th, 0.375; Dec. 1st 0.5mg, Dec. 21st 0.75mg Jan 19: Decide reinstatement fail: Jan 21 0.625mg, Jan 28: 0.5mg Feb 8 0mg

Link to comment
  • Moderator Emeritus

Dear Hard Times, I'm SO sorry you're experiencing my own problems with sleep.  I took your #1 course of action.  If it's useful, I'll share my "progress". 

I can remember feeling almost furious when I couldn't get to sleep at all.  After reading the advice to be ok with total insomnia, and reading somewhere that it won't cause all the long term terrible side effects popularized on the Web (for instance, my mother had years and years of insomnia, but never got dementia, and lived to 93), I relaxed some.  While serious reading, or even light, seems difficult for me right now, I can read various buddhist books.  I'm not necessarily recommending buddhism, but I find the teachings soothing and directive and applicable--if only for a moment.  Occasionally a moment would arise, and I'd be able to slip into sleep.  All my sleep seems fitful still, but in spite of up's and down's I feel  better about it.

I've never taken Xanax, but I was for some time, taking Gabapentin.  Then I found out my sleep was being interrupted not only by the temperature fluctuations, but by sleep apnea.  It turned out there were articles connecting meds like Zanax and Gabapentin with sleep apnea, so I tapered off Gabapentin, and now sleep nearly sitting up.  Some people recommend sleeping on one's side, but because my hips were initially "blown out" by too quick a w/d, I prefer my back.  Basically, this works for me for the apnea.

The other things I do for insomnia are breathing exercises, meditation following my breath--just lying there (feeling wretched) in bed, or even resorting to the Butterfly Hug (an EMDR technique) which for some reason tends to make me spontaneously sigh.

And since I'm in an utter OCD state of w/d, I also take supplements as recommended here, and also (for better or worse) a lot more...I can't tell if they work in me as placebos, or if in fact, they help on their own, but I'm usually able (not always) able to patch together something like sleep.  If it's useful, I can share what I take and the info I use to support taking them.

My sleep right now almost always breaks after the first 3 hours.  I take some supplements, pat my cat, maybe read, breathe, usually (sometimes after a long time) go back to sleep.  The reading is helpful for me because my brain is often hijacked, especially at that time, with thoughts of Horror--worthlessness, hopelessness, blame, disgust, impatience, anger, alienation, sorrow.  My brain wants to talk suicide; the reading interrupts it.  (And of course, my cat!)

How long I can continue this regime--I don't know.  My fridge is plastered with encouragements from survivors here.  I hear in them, and in comments here in general, the deepest kindness.

I'm grateful to you, and so want for you recovery and health, and happiness.

Warm virtual hug,

Arbor

 

Zoloft: 1995 - 2015

Prozac: 2015 - 2018 (tapered from 40mg x day on July 31 to 30mg on August 31 to 20mg on September 31 to 10mg October 31 to 0mg on  December 15, 2018

Gabapentin: 2016 to 2019  (tapered from 300mg x day to 150mg on August 31, 2019 to 75mg on September 15 to 50mg on September 31 to 25ishmg on October 15 to 0mg on December 1, 2019

Enalapril: 2010 - 2019

Lipitor: 2017 -2017

Metformin: 2000 - 2020

Liothyronine: 2007 - 2019

Levothyroxine: 2000 - 2022

Link to comment

Very quick update:

@Arbor: Thank you so much for your kind and encouraging words -I'm going to reply to you on your own site about some of the points you made.

 

Last night, having had zero sleep the night before, I finally managed to get to sleep and slept mostly very soundly all night with only one short wake-up. Strangely, I haven't always been able to discern a clear connection between a good night of sleep and a good day the following day, nor a connection between a good day and a good night of sleep. But I am feeling MUCH better today, minimal symptoms and the really absurd, self-loathing depression seems to have lifted. I guess I just somehow needed to get completely exhausted or something.

 

So the moment of "crisis" I was in last week seems to have passed, at least for today, and I hope it will mark another stretch of "green days". However, I'm still considering re-instating, as what I want to find is some measure of stability where I don't end up in those really dark places. And maybe it is better to think about reinstating now, when I'm more clear headed and not so desperate. But for now I'm going to get some more exercise as it is very nice out for once!

15+ years Citalopram 10mg (sometimes 20?)

2019 Citalopram 5mg. No problem reduction.

2020 Citalopram 5mg to zero. (Feb)

2020 (Feb - mid Oct): Very rare use of 0.125 or .25mg Xanax for really bad symptoms

2020 (Feb - Nov): Occasional use of "Nytol" sleep aid (an antihistamine). 

2020 Failed reinstatement: Escitalopram by accident (not Citalopram).  

 -- using a scale, started July 27 0.5mg, doubled every week or so to reach 5mg by Aug 30. Too fast - terrible depression, quit.

2020 (Oct-current): Supplements:

 -- Morning: Magnesium 300mg, Omega 3(483 EPA, 360 DHA +Vit E) Night: Liquid Valerian/Passiflore/Escholtzia - French organic herbal sleep aid, 1.9mg LD Melatonin 

2020 Current - new Citalopram reinstatement. (Accidentally started with Escitalopram before realizing and switching to Citalopram Oct. 30)

 -- using pipette method: Oct 30, 0.25mg; Nov. 4th, 0.375; Dec. 1st 0.5mg, Dec. 21st 0.75mg Jan 19: Decide reinstatement fail: Jan 21 0.625mg, Jan 28: 0.5mg Feb 8 0mg

Link to comment
  • Moderator Emeritus

I'm so happy to hear that you slept well last night.  I'm sure whatever course you take re reinstating will be a wise one.  Thank you for your thoughtful reply on my intro site.  I'll answer you further there.

Warm wishes,

Arbor

Zoloft: 1995 - 2015

Prozac: 2015 - 2018 (tapered from 40mg x day on July 31 to 30mg on August 31 to 20mg on September 31 to 10mg October 31 to 0mg on  December 15, 2018

Gabapentin: 2016 to 2019  (tapered from 300mg x day to 150mg on August 31, 2019 to 75mg on September 15 to 50mg on September 31 to 25ishmg on October 15 to 0mg on December 1, 2019

Enalapril: 2010 - 2019

Lipitor: 2017 -2017

Metformin: 2000 - 2020

Liothyronine: 2007 - 2019

Levothyroxine: 2000 - 2022

Link to comment
  • Moderator

Ok @HardTimes,

 

I had forgotten you were taking Xanax. I don't think I was quite clear enough in the my first comment on it. Xanax is not good for you and will not help you heal. It is bad for brain health. Specifically, it is neurotoxic, damaging neurons and causing them to undergo programmed cell death (apoptosis). If you are going to use a med, you may as well reinstate a small dose of citalopram rather than continuing to use the Xanax. It would more appropriately treat your symptoms and would likely be less harmful. 

 

Glad you slept well, but I think we can probably stabilize things a bit more with a reinstatement. We can start with a very low dose that you may hardly notice and then very slowly increase to whatever level is optimal. Then, once you are stable for a good while, we can start a slow taper. I think I would suggest something like 0.25mg or 0.5mg to start out. Here are tips for tapering citalopram. On that page, you will find a link on how to make a liquid from capsules or tablets. This may be the best way forward, as I have heard the actual pharmacologically active compound can be unevenly distributed in the pill, which can pose an accuracy problem when taking such small doses. (Any other moderator can jump in if there is no truth to this). 

 

Withdrawal is tough, regardless of what you do, so no sense making it tougher by trying to brave acute waves that are so intolerable you need to take Xanax just to get through it. I think it is safe to say that Xanax is much less safe than a tiny dose of citalopram. Very possible that even taking Xanax intermittently while spurning citalopram may even be a slower route to healing (unfortunately we don't know this, but I might bet money on it if we conducted a trial). 

 

Hope you continue sleeping ok, @HardTimes. Just remember when you sleep poorly that even if you do not sleep well tonight or tomorrow night, eventually you will get tired enough to sleep, even if it seems impossible. I have been awake for 3 days straight before and thought I'd never sleep again, and I did. Your body will eventually shut down. And @arbor is right, insomnia is not dangerous. There are plenty of myths perpetuated by the likes of Dr. Matthew Walker, for example, that lack of sleep is dangerous. I like to think of sleep doctors who treat insomnia with drugs as grifty peddlers. Very questionable whether they are improving 1) the person's health and 2) the person's quality of life. Neither has been proven. 

 

Here is a post I wrote on the trivial effects of insomnia on health on another member's thread. You can see the risk to health is truly laughable. Mostly you will just feel bad, and that will resolve when you sleep again. Much of the horrible feeling is also simply the withdrawal rearing its ugly head. I've gone 40 hours without sleep a couple months off vs 10 months off and compared to 2 months off, 10 months off was a walk in the park. 

 

PS Thank you @arbor for those warm posts of encouragement. You're one of those benevolent souls you speak of who express the deepest kindness : )

Remeron - 2004-2005 (bad withdrawal)

Clonazepam - 2005-2018 (jumped around March)

Olanzapine - 2014- late 2017

Domperidone - 2008-2018

Many drugs in between including Lexapro, other benzos and z-drugs.

Still suffering post-withdrawal from Clonazepam (Klonopin), Olanzapine and Domperidone. 

Link to comment
  • Moderator

@HardTimes, I am also going to need you to estimate how much Xanax and Nytol you have been taking (how many nights per week?). Also, have you used them more in the last few weeks? Dependence on something like Xanax can happen very quickly. You may need to taper this if you have been taking it too often. (Note also that Xanax is a central nervous system depressant, and although it may not be on the label, depression can be a side effect. I believe benzodiazepines in general are associated with an increased risk of suicidality, see here: https://www.researchgate.net/publication/314174822_Prescribed_Benzodiazepines_and_Suicide_Risk_A_Review_of_the_Literature

Remeron - 2004-2005 (bad withdrawal)

Clonazepam - 2005-2018 (jumped around March)

Olanzapine - 2014- late 2017

Domperidone - 2008-2018

Many drugs in between including Lexapro, other benzos and z-drugs.

Still suffering post-withdrawal from Clonazepam (Klonopin), Olanzapine and Domperidone. 

Link to comment

Thanks again, @DataGuy. I had come to the same conclusion that, even though I'm feeling better than I was, a low reinstatement might just stabilize me. Frankly I don't much care if I'm on this stuff or not - my goal is stability and quality of life, not a t-shirt saying "100% drug free!!", if you see what I mean! I'm going to start with 0.5mg today. I've mixed it all up and am just giving it a little more time to dissolve (I know it won't form a perfect solution - I'll shake it well before using the syringe). I'm a bit disappointed that I have to do this, but at the same time hopeful that this will make a lasting change. 

 

As for your comments about Xanax: First off, I've been taking "Alprazolam". I don't know if that is just another brand name for the same drug, or another type of benzo, or what, but my impression from my doctor's comments is that it is the same stuff. I have 0.25mg tablets, but often only have taken half. I have a record of every time I've taken some in the last six weeks - the total amounts to 5.5 tablets in 6 weeks, so not very much at all.  I did take some here and there before this recent six week period, but don't have records. From comments I've read here I've been cautious about it, but not so cautious that I wouldn't touch the stuff. I attach a screenshot - you'll see that it was only recently that I took one each night for three nights in a row. So they certainly haven't been causing my bouts of depression, which preceded taking them, and the drug does successfully reduce whatever nervous anxiety is making me feel so crazy at night. You will also see that I've been taking quite a bit of Nytol - likely too much - but this is, to my knowledge, an anithystemene and perhaps one of the least-worst things to take. I've also been taking herbal supplement things (a liquid shot with a mixture, mostly valerian). 

 

As for insomnia in general: I think our vocabulary in this area isn't great. It strikes me that there is a big difference between someone who can get four hours of sleep and then go off to work, work well with others, happily engage in recreational activities and generally function in a healthy way, and someone who gets four hours of sleep but then feels so exhausted or "out of it" that they can't really function at work or complete whatever tasks they take on. The first person isn't really an insomniac, they just don't need much sleep. The second person, however, seems to have a problem whereby sleep is indeed compromising their quality of life. Which is NOT necessarily to say that they should take drugs for it, nor that the situation has long term physical health repercussions. But it can be extremely disruptive for some of us. It would be one thing if I simply didn't feel sleepy, and stayed up working away happily on my various projects, or just woke up early and could happily start my day at 4am. Unfortunately, for me the insomnia has been  one of the most disruptive symptoms, where I'm exhausted but can't sleep, or I fall into a state I'm calling "Lucid Sleeping". In this state it is as though I can feel my body is asleep, and part of my mind/brain as well, yet another part of me is still racing away from thought to thought - very, very uncomfortable. In this state I also experience very strong "ear worm" sensations: a fragment of music seems to loop endlessly through my mind without any ability to control it. So it isn't just that I'm upset that I'm not getting the full eight hours I think I ought to be. Its that, for example of one pattern,  I wake up exhausted but too hot to sleep, and in a terrible mood and cannot face the thought of doing anything. So maybe I stare at the TV for an hour or two, sleepy but not asleep, feeling kind of ashamed and nervous, and usually by noon I'm able to start facing things. I've lost a LOT of mornings that way, which for me is difficult to take and contributes to the feelings of depression. 

 

But at any rate, I'm hoping this reinstatement will even things out a bit. I'm also pleased that I've at least got a name for the strange neck sensations I've had, which I thought were just weird withdrawal symptoms. Turns out to be occipital neuralgia, and there are at least some ways of treating it. Interestingly, one treatment is apparently "antidepressants"! Yikes. I'm also receptive to your comments about increased exercise - the idea that I have an excess of nervous energy that maybe needs burning off does seem to fit several symptoms - restless anxiety and excessive heat for example.

 

I'll keep you posted, and thanks again.

 

Sleep and drugs.PNG

15+ years Citalopram 10mg (sometimes 20?)

2019 Citalopram 5mg. No problem reduction.

2020 Citalopram 5mg to zero. (Feb)

2020 (Feb - mid Oct): Very rare use of 0.125 or .25mg Xanax for really bad symptoms

2020 (Feb - Nov): Occasional use of "Nytol" sleep aid (an antihistamine). 

2020 Failed reinstatement: Escitalopram by accident (not Citalopram).  

 -- using a scale, started July 27 0.5mg, doubled every week or so to reach 5mg by Aug 30. Too fast - terrible depression, quit.

2020 (Oct-current): Supplements:

 -- Morning: Magnesium 300mg, Omega 3(483 EPA, 360 DHA +Vit E) Night: Liquid Valerian/Passiflore/Escholtzia - French organic herbal sleep aid, 1.9mg LD Melatonin 

2020 Current - new Citalopram reinstatement. (Accidentally started with Escitalopram before realizing and switching to Citalopram Oct. 30)

 -- using pipette method: Oct 30, 0.25mg; Nov. 4th, 0.375; Dec. 1st 0.5mg, Dec. 21st 0.75mg Jan 19: Decide reinstatement fail: Jan 21 0.625mg, Jan 28: 0.5mg Feb 8 0mg

Link to comment

Quick update: after taking 0.5mg yesterday I felt a significant reaction after only a couple of hours. I felt kind of high, staring into space, but also started to feel panic or anxiety. I remembered how this had made me feel in August. I became a bit scared of it, and decided that 0.25 might have been an even better place to begin, which is what I took today and will stay on for the next week at a minimum.

 

Also: By last night, after only this tiny dose, I was feeling a kind of "normal" tiredness, and had none of the heat problems I've been experiencing, so I was hoping for a good night of sleep. Unfortunately, this didn't happen and I had pretty rough night, followed by a terrible morning (psychologically) this morning. Hoping this stuff will provide some stability over a week or so. This morning was pretty bad, and now isn't that much better.

 

Also, I've just done some reading about the use of "Nytol" or other antihistamines for treating sleep and (surprise surprise) they're not very good for you in anything other than very occasional use. They can lead to their own side-effects that one might confuse with with SSRI withdrawal symptoms, and thus muddy the waters. So I guess the lesson here is that there are no good sleep aids, and we just have to take our bad nights as they come and wait for our bodies to sleep naturally. 

 

"Trying hard to stay positive". 

15+ years Citalopram 10mg (sometimes 20?)

2019 Citalopram 5mg. No problem reduction.

2020 Citalopram 5mg to zero. (Feb)

2020 (Feb - mid Oct): Very rare use of 0.125 or .25mg Xanax for really bad symptoms

2020 (Feb - Nov): Occasional use of "Nytol" sleep aid (an antihistamine). 

2020 Failed reinstatement: Escitalopram by accident (not Citalopram).  

 -- using a scale, started July 27 0.5mg, doubled every week or so to reach 5mg by Aug 30. Too fast - terrible depression, quit.

2020 (Oct-current): Supplements:

 -- Morning: Magnesium 300mg, Omega 3(483 EPA, 360 DHA +Vit E) Night: Liquid Valerian/Passiflore/Escholtzia - French organic herbal sleep aid, 1.9mg LD Melatonin 

2020 Current - new Citalopram reinstatement. (Accidentally started with Escitalopram before realizing and switching to Citalopram Oct. 30)

 -- using pipette method: Oct 30, 0.25mg; Nov. 4th, 0.375; Dec. 1st 0.5mg, Dec. 21st 0.75mg Jan 19: Decide reinstatement fail: Jan 21 0.625mg, Jan 28: 0.5mg Feb 8 0mg

Link to comment
  • Moderator

Thanks @HardTimes. Hope you slept a bit better last night with the 0.25mg dose. Your nervous system seems to be quite sensitized from withdrawal. Not abnormal at all. It'd be great to not have to worry about the reinstatement question and simply take a tiny dose daily. 

 

If you are still feeling odd anxiety from it, next stop is 0.1mg. And you're right about Nytol and sleep aides in general. Seems there aren't any safe ones, so best to avoid them. Natural sleep is best, regardless of how much you get. Hope you are feeling better today. Things are always pretty unstable for people as they get accustomed to "withdrawal normal". 

Remeron - 2004-2005 (bad withdrawal)

Clonazepam - 2005-2018 (jumped around March)

Olanzapine - 2014- late 2017

Domperidone - 2008-2018

Many drugs in between including Lexapro, other benzos and z-drugs.

Still suffering post-withdrawal from Clonazepam (Klonopin), Olanzapine and Domperidone. 

Link to comment

Please sign in to comment

You will be able to leave a comment after signing in



Sign In Now
×
×
  • Create New...

Important Information

Terms of Use Privacy Policy