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HardTimes

HardTimes: late onset withdrawal from long-term citalopram disaster

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HardTimes

SO... Just discovered something at once kind of terrible and absurd. The drug the doctor gave me was ESCITALOPRAM, not CITALOPRAM. Which are not the same thing (one is sold as "Celexa" and the other as "Lexapro"). I can't entirely account for how I screwed this up so badly - I think I thought the "escitalopram" was the French way of naming it (I live in France), or a french brand, or maybe a generic brand of the same drug. But it isn't. Either my doctor or the pharmacist or my language skills screwed up somewhere along the way.

 

So this means that when I decided back in august to try to reinstate, I tried to reinstate on the WRONG F%^&ing drug. I worked my way up to 5mg and felt totally crazy. Apparently from what I just started reading today, EScitalopram is also twice as strong, such that 5mg of "es" is closer to 10mg of regular citalopram. So I was actually taking way, way, way too much of the stuff back in August. 

 

Now, as I write this, I am on my seventh day of an attempted reinstatement, but again, this has been on the wrong drug! I've been taking a very, very small dose (0.25mg) with a syringe. While it has changed my symptoms somewhat, it hasn't exactly relieved them. Today, a few hours after that very small dose, I feel pretty stoned and glassy eyed, unmotivated, and with tingling sensations on the back of my head. The hot flashes have returned, though not as severe as they once were. I fall asleep much more easily than before reinstatement, but I still wake up after only four hours with a hot flash and difficulty sleeping again. I'm also still pretty depressed, though it can be hard to feel much of anything when the "stoned" sensation hits. I can feel that the impact now after 7 days is stronger than it was, that a pattern is developing, even though it is such a tiny dose and such a short time. 

 

I'm such an idiot for making a complicated situation even more complicated. It seems pretty clear to me that I should immediately stop taking this (I don't think I need/want to taper after so small a dose and after so short a time, right?). So the new strategy is to get this stuff out of my system, give myself a couple of weeks with nothing at all, and then reassess yet again. @DataGuy, you seem to be my moderator advisor on all this, so if you have a moment to confirm and console that would be great. I'm going to force myself off for some exercise now - I've had several days now where all I really want to do is stare at the TV. Not good!

 

 


20 years on small citalopram (10mg)

2019 sometime I dropped to 5mg with no problems. Stayed on that for 6 months or so

Feb 2020 went from 5mg to zero, thinking I had "tapered".

Feb - Current: occasionally using .125 or .25 benzo to treat bad symptoms

May - June 2020 - sometimes taking sleeping pills, thinking I had a sleep problem, not SSRI withdrawal

Entire month of August - Attempted reinstatement, but apparently I increased dose too fast, which ended in really horrific depression

No drugs at all since then... but now several w/d symptoms are resurfacing...

BUT TRYING HARD TO STAY POSITIVE!!!

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arbor

Oh yecchh, this certainly sounds like an easy mistake to make.  Hope you feel better soon, Hard Times--

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 - 

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DataGuy

Hi @HardTimes,

 

Sorry to hear about the mishap, but it probably is not as big of a deal as it seems. Escitalopram and Citalopram are very similar. Both have strong action on the serotonin transporter and not much else. Escitalopram is a bit stronger, and that definitely could have thrown things off during the prior reinstatement, but this time it likely did not affect things too much. You may have gotten the same reaction with Citalopram. We have reinstated people who stopped Escitalopram with Citalopram before with not terrible results. 

 

If the current dose you are on is making you feel stoned, you could always lower to 0.1mg. Just have to decide whether you feel better with a tiny amount of drug or none. It's very tough and any evaluations will be necessarily subjective. I am actually a bit skeptical of the scales they use to evaluate whether these drugs make people less depressed, like HAM-D or Montgomery-Asperg. There is an inherent problem that the person has no objective anchor for how they feel and a very imperfect memory of how they felt off-drug (or on drug, depending on when the measurement is taken). Also tough to evaluate dose changes. I feel like this is where patients run into trouble. They take the drug and feel worse, but mistake the worsened feeling as not being caused by the drug. The doctor, trained to think the drug helps, increases the dose and the patient feels even worse and thinks they are hopeless. Very insidious. 

 

I will leave the evaluation as to whether you feel worse or better to you, but I would recommend you step down to 0.1mg for awhile before stopping altogether. This may be a more appropriate dose, as ridiculously trivial as it seems. 

 

This is the difficulty of withdrawal. Symptoms can often be refractory to any treatment, especially initially. All I can tell you is that it will, very slowly, get better. Surviving and protecting your health is your priority. If you do that, you will eventually get your old self back. Please keep that in mind and be sure to enjoy any windows you get. 

Edited by DataGuy

Remeron - 2004-2005 (bad withdrawal)

Clonazepam - 2005-2018 (jumped around March)

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

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

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HardTimes

Hi @DataGuy . I completely agree about the difficulty of measuring all these subjective feelings. I'm trying to keep track of symptoms, and quantify the overall level of symtoms in the AM, PM and evening, but I can see that I'm not always in the best place to judge because the numbers are comparative to feelings I had previously that I cannot correctly remember. It really isn't easy. But it can be helpful, I guess, to be able to look back and see some general trends of some kind. Sometimes lately I've just become exhausted by the whole tedious process and I've been too depressed to be bothered to note things in a journal, and then have to try to remember a day later. 

 

Having discovered the EScitalopram vs Citalopram error, and based on your comments that maybe this wasn't a HUGE deal, I decided NOT to stop this attempt at reinstatement, but I did drop down a level to 0.125mg. So, for the record, this current reinstatement has been:

0.5mg - one day, thought it was too much.

0.25 mg 5 days, until discovering the error

0.125mg 2 days, instead of stopping entirely. 

All of this was Escitalopram, when it should have been Citalopram. 

 

However, from some of my reading, it looks to me that while the difference between EScitalopram and Citalopram isn't that huge, there IS a difference. And it makes sense to me that if I've been on something for so long I should reinstate the same thing. The dosage difference is in fact double, and some of the side effects are a little different (https://www.singlecare.com/blog/celexa-vs-lexapro/). So I've looked around and found one last pill of Citalopram that I can dilute and turn into quite a few doses if I want to.  Do you think it is safe to switch like this? Or should I stop the Escitalopram for a week first? Or, since the doses are so small, likely moving from one to the other won't be a problem? I think I'll feel more comfortable, somehow, knowing I'm taking the same stuff I was supposed to be taking, and maybe that placebo effect will help too... Advice appreciated.

 

Another bad night of sleep last night - I wish I could explain it better to you. It is not that I'm not sleepy and yet forcing myself to try to sleep. In that case I could just get up and write a novel or whatever. Instead,  I'm exhausted, and physically out of it, yet my mind is dancing around all over the place, and I get a strange nervous panicky feeling. If I turn on the light and read for a while, or maybe turn on the tube, I cool off and sometimes my brain settles to the point where my eyelids are falling and the book falls out of my hands. But then there is an unexplained rush of heat and panic and I'm "awake" again. For hours on end! I'm at the end of the rope on this. My wife has booked me acupuncture on Saturday, which I'm not all that optimistic about, but at this stage I'll try anything if it keeps me safe. 

 

Thanks again for your efforts. I really am just so sick of all this and finding it difficult to put a brave face on it all and keep making the effort. But I have to!


20 years on small citalopram (10mg)

2019 sometime I dropped to 5mg with no problems. Stayed on that for 6 months or so

Feb 2020 went from 5mg to zero, thinking I had "tapered".

Feb - Current: occasionally using .125 or .25 benzo to treat bad symptoms

May - June 2020 - sometimes taking sleeping pills, thinking I had a sleep problem, not SSRI withdrawal

Entire month of August - Attempted reinstatement, but apparently I increased dose too fast, which ended in really horrific depression

No drugs at all since then... but now several w/d symptoms are resurfacing...

BUT TRYING HARD TO STAY POSITIVE!!!

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