Calmseeker: citalopram withdrawal plan

[Calmseeker]

Hi all, 

 

I am new here so I hope I am posting correctly. 

 

I recently tapered (quite quickly) from Temazepan. Whilst I was only taking it "as required" and short term (around 6 weeks), I noticed I was having interdose withdrawals so I tapered down over four weeks and jumped off 32 days ago. Thankfully any symptoms so far have been mild and manageable however in and around the interdose withdrawals, my psych put me on to Citalopram as one of my interdose withdrawal symptoms was a middle of the night panic attack so my psych insisted that I needed to medicate for my anxiety. 

 

I started Citalopram around 9 weeks ago and for the past 4 weeks I have been tapering off. Whist on them I developed akathisia and my heart rate went quite low (below 60). I went to my psych to explain that I wanted to get off the Citalopram and whilst he was reluctant, he gave me a very short tapering plan of reducing over a few days. I asked about a slow taper however he indicated it wasn't necessary so I decided to do my own taper based on how my body was feeling. Week one I dropped from 20mg to 15mg. Week two I dropped to 10mg, week three I dropped to 5mg and week four I dropped to 2.5mg then I stopped. 

 

During the taper I have felt fine. If anything, I have actually felt better as I lowered the dose, I was sleeping well and quite happy on 10mg and 5mg. At 2.5mg I did notice an increase in anxiety and a little less sleep quality however this issue has also been playing on my mind. 

 

When I stopped completely, on day two my anxiety levels increased and I had a night of not sleeping and I had a headache (that day I had also taken a neurocalm tablet which may have triggered some symptoms - its a natural supplement with a few ingredients including passionflower). For the past two nights I've had muscle jerks when falling asleep. They are quite full on but last night I was able to get some sleep by relaxing and not worrying about them. 

 

I had two nights with no pills and then I took 2.5mg and then I took 5mg last night as I'm feeling confused about whether to push on through withdrawal or whether to stabilise and do a slow taper. I possibly anticipate what the advice will be (reinstate, stabilise over a number of months and then slowly reduce) however I am so driven to get off the drugs all together and start the healing process for my body, especially since I've been on them a reasonably short amount of time. 

 

I want to get off these pills as soon as possible but my health is obviously my number one priority along with caring for my two young children and maintaining my job. I have a lot of support from my employer and from my family. I've had many friends and family who have gone on and off similar ADs with no issues at all which makes it confusing as I'm tempted to give it a go and see if I can have some success also. 

 

I often wonder if at times, taking a slow approach is dragging out the process and whether at this stage in time given my relatively low current dose and the fact that I have not been on them for more than 3 months total (including tapering) whether I should go faster and see what the withdrawals are like over a month and if its unbearable then reinstate? What would be your thoughts on this approach. 

 

I currently take a probiotic, fish oil each day, vitamin c and ginko biloba. I dont have any caffeine, alcohol or any other drugs and I eat very clean with low gluten and low dairy. I have a naturopath appointment in two weeks time to get a diet plan and potentially suppements. 

 

I thank you in advance for any guidance you are able to offer me. 

 

 

Edited November 4, 2020 by Gridley

[Gridley]

Welcome to SA, Calmseeker.

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.

 

Account Settings – Create or Edit a signature.

 

1 hour ago, Calmseeker said:

 

I often wonder if at times, taking a slow approach is dragging out the process and whether at this stage in time given my relatively low current dose and the fact that I have not been on them for more than 3 months total (including tapering) whether I should go faster and see what the withdrawals are like over a month and if its unbearable then reinstate? What would be your thoughts on this approach. 

 

To address some of your questions  regarding reinstating if withdrawal symptoms are unbearable, the following is from the thread About reinstating and stabilizing to reduce withdrawal symptoms. 

 

Don't suddenly go off a psychiatric drug assuming that reinstatement is a safety net

This is one of the reasons we advocate gradual tapering to minimize withdrawal symptoms. Once the nervous system is destabilized by withdrawal, all bets are off. Humpty Dumpty the egg has fallen off the wall.

--

I would add that reinstatement doesn't always work.  Though it's to your advantage that you've been on the drug a short time, occurrence and severity of withdrawal symptoms are not linked absolutely to time on the drug, a person is at risk of withdrawal symptoms after only one month.  Anxiety, insomnia and the muscle jerks you describe (known as hypnic jerks) are all common signs of withdrawal.

 

The reasoning behind a slow taper is set out in the following link.  I'd urge you to read the link before making any decisions about taper rate.  

 

Why taper by 10% of my dosage?

 

1 hour ago, Calmseeker said:

 I've had many friends and family who have gone on and off similar ADs with no issues at all which makes it confusing as I'm tempted to give it a go and see if I can have some success also. 

 

Some don't have issues, some do.  Altostrata, the founder of this site, recently gave an interview (link below; well worth listening to) in which she said that the percentage of people who suffer withdrawal (the length and severity of which can never be predicted) vs. those who don't is close to 50/50.  That's why we advocate a harm reduction approach, of which a slow taper is central.

 

Mad in America - Surviving Antidepressants: An Interview with Alto

 

As you anticipated, I recommend you reinstate, hold for several months until you stabilize, then begin a 10% taper to zero. I would reinstate 2.5mg and remain at that dose, taking it at the same time every day and never skipping doses.   Reinstatement of a very small dose of the original drug is the only known way to help alleviate withdrawal syndrome.  The only alternative is to try and wait out the symptoms and manage as best you can until your central nervous system returns to homeostasis.  Unfortunately no one can give you an exact timeline as to when you will start feeling better and while some do recover relatively easily, for others it can take many months or longer.  I know you are eager to get off the drug (we all are) and the decision is, of course, yours, but the information in this post can help you make an informed decision.

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Add in one at a time and at a low dose in case you do experience problems. Get supplements that are single ingredient (not mixed with other types of supplements).  

 

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

 

 

 

 

 

 

 

 

 

[Calmseeker]

Thank you for your response. 

 

I was on 2.5mg for five days, had two days off, took 2.5mg then last night I took 5mg. Would you go back to 2.5mg or stay on 5mg? I'd love to go to 2.5mg but also don't want to yoyo.

 

It's such a difficult situation for everyone as I understand everyone just wants to be off the medication. It would be great to have some medical advice but there is nobody that I've been to that I trust truly understands withdrawals. 

 

The thing I don't understand is that 2.5mg is well below the therapeutic dose so I didn't really think it would be doing anything.  

 

I feel OK but I dont feel great. Although I am better than what I was a few month ago when this whole psych drug nightmare began. Whilst all evidence points to a slow taper, I fear in my situation it may just prolong my suffering and there is a part of me that thinks I'm not going to get out of this easy either way. 

[Gridley]

36 minutes ago, Calmseeker said:

2.5mg is well below the therapeutic dose so I didn't really think it would be doing anything.  

These low doses have a definite effect on withdrawal (ask anyone on this forum who jumped to zero from 1mg--well below "therapeutic dose"--and went into withdrawal).  Stabilizing on 2.5mg will definitely have an effect. 

 

36 minutes ago, Calmseeker said:

Would you go back to 2.5mg or stay on 5mg? I'd love to go to 2.5mg but also don't want to yoyo.

 

Based on your history I'd go to 2.5mg and hold there and make no changes for several months.  At that time, once you've stabilized, you can begin a 10% taper to zero.

 

 

 

 

 

 

 

 

 

 

 

Edited November 4, 2020 by Gridley

[ChessieCat]

Gridley replied just before I had finished typing this post.

 

28 minutes ago, Calmseeker said:

I was on 2.5mg for five days, had two days off, took 2.5mg then last night I took 5mg. Would you go back to 2.5mg or stay on 5mg? I'd love to go to 2.5mg but also don't want to yoyo.

 

If you've only taken one dose of 5mg, then it should be okay to go back to 2.5mg.  But yes, you do need to decide what dose you are going to continue on and stick to it and you need to take it every day.  never-skip-doses-to-taper  The brain likes consistency.

 

It takes about 4 days for a dose to get to full level the blood and a bit longer for it to register in the brain.  It is better to increase by small amounts than to risk taking too much.  If after one week some of your symptoms have eased then stay on that dose for another week.  If after one week your symptoms are still unbearable then you might be able to make a small increase but not back to 5mg.  It might be as low as a tiny 0.25mg.  But we can suggest a dose at that time if needed.

 

30 minutes ago, Calmseeker said:

The thing I don't understand is that 2.5mg is well below the therapeutic dose so I didn't really think it would be doing anything.  

 

Therapeutic dose is an arbitrary term which the pharmaceutical companies decide on.  SA prefers to use the term "lowest effective dose".

 

Please continue to let us know how you are doing.

 

It is a good idea to keep notes of your symptoms and what is improving.  This can help you to be objective and pick up tiny improvements which you might not feel.

[Calmseeker]

Thank you ever so much. I am incredibly grateful to have your guidance on this. 

 

I will stabilise on 2.5 mg. At the moment i'm cutting a 10mg tablet into quarters using a pill cutter however unfortunately I can never guarantee that they are absolutely accurate. I have found a compounding chemist so I will request they make me some 2.5mg capsules for more accuracy. 

 

 

[Gridley]

40 minutes ago, Calmseeker said:

will request they make me some 2.5mg capsules for more accuracy. 

 

That's a very good idea.

[Calmseeker]

I have two questions. 

 

Firstly, I took a blood test this week. All of my levels were fine except I'm a little low on iron and the Dr has suggested I take an Iron supplement. Have you heard of iron interacting with antidepressants or benzodiazapines? I am very cautious to add anything into the mix moving forward. 

 

Secondly, I've noticed a few symptoms that have the potential to get scary. I wear a fitbit and my heart rate has gone from 59 beats per minute to 68 beats per minute in the space of a week (no surprises my anxiety has increased also). As I have made a commitment to coming off all psych drugs as safely as possible. My plan is to only use the medical professionals for scripts as necessary. I have told my husband that I request no medications if i'm ever admitted to the emergency room or otherwise. I have read way too many stories of people having additional medications added in and it seems to be never ending. Is there any guidance around when to see a Dr or hospital for symptoms? I want to discuss my plan with my husband and ensure that even when it gets really hard, that I stay on the path to recovery without additional medications. 

[Calmseeker]

Sorry, one last question, I'm 32 days off Temazepan. Is there any way to distinguish between some of the symptoms as being benzo related or AD related? For example I've had akasthia at various points in time which seems to relate to changes in Citalopram but I also know its a symptom of Benzo withdrawal. The jerks I experienced after stopping citalopram seem to be related to the AD but again it could be the benzo. I guess at this point in time it does not matter but I am so scared. 

[manymoretodays]

Hi Calmseeker and welcome,

You can always check for interactions right here:  Drugs Interactions Checker

Drugs.com is also a good place to check out any drug BEFORE you consider taking it.  At the top of that same link, you'll see where you can put in a drug/medication by name.

I'm not seeing any interactions with the citalopram and Iron.

 

We do have a topic too on Iron supplementation:  Ferritin too low? Iron supplements? Anemia

 

Did you have anxiety prior to taking the Temazepan?  And how much, dose wise did you take of that?  I am seeing that it is generally prescribed just for use at bedtime, so I don't know if it was interdose WD you experienced, or with the prolonged usage, had just developed a dependency on it.

In anycase I am glad you are off of it now.

 

37 minutes ago, Calmseeker said:

Sorry, one last question, I'm 32 days off Temazepan. Is there any way to distinguish between some of the symptoms as being benzo related or AD related? For example I've had akasthia at various points in time which seems to relate to changes in Citalopram but I also know its a symptom of Benzo withdrawal. The jerks I experienced after stopping citalopram seem to be related to the AD but again it could be the benzo. I guess at this point in time it does not matter but I am so scared. 

 

Symptoms are pretty similar with benzo WD and AD withdrawal, from what I have observed and learned here.

 

And so, I think one of your best options now may be to begin to learn and practice some non-drug coping skills, while staying steady on that 2.5 mg dose of citalopram.  You may even find that after a good week or two, without adding anything, or skipping doses altogether, that you reach some improved stability. 

 

We've got a whole Symptoms and Self Care forum, where you'll see many topics covered as far as coping with symptoms.  I'll give you a few links to look at now, from that forum:

The Windows and Waves Pattern of Stabilization

 

Non-drug techniques to cope with emotional symptoms

^ this one is great and in the first post you'll find another whole indexed list of topics with coping tips and ideas

 

And then, do consider giving a try to using either the magnesium or Omega 3's.  Gridley gave you those links in his first post to you.  I have always found the Magnesium to be especially calming myself.

 

Oh and here's the link to: Tips for tapering off Celexa(citalopram)  The different options for getting smaller dosages are in that too.

 

I hope I got to most of your concerns.  Try and spend time focused now on healing, and don't get lost in any horror stories now.  Go on back to the Main Page and find the Success Stories, and focus on continued healing and hope.  Maybe you've gotten overwhelmed by over reading a bit.  I don't know.  I hope not, but it happens a lot to newbies here.

 

Best, Love, peace, healing, and growth,

mmt

 

 

[Calmseeker]

25 minutes ago, manymoretodays said:

You can always check for interactions right here:  Drugs Interactions Checker

Drugs.com is also a good place to check out any drug BEFORE you consider taking it.  At the top of that same link, you'll see where you can put in a drug/medication by name.

I'm not seeing any interactions with the citalopram and Iron.

 

We do have a topic too on Iron supplementation:  Ferritin too low? Iron supplements? Anemia

Thank you! 

 

25 minutes ago, manymoretodays said:

Did you have anxiety prior to taking the Temazepan?  And how much, dose wise did you take of that?  I am seeing that it is generally prescribed just for use at bedtime, so I don't know if it was interdose WD you experienced, or with the prolonged usage, had just developed a dependency on it.

In anycase I am glad you are off of it now.

Yes I've always had a tad bit of anxiety which I've managed through diet and exercise and have been able to keep it at bay mostly. Some of my current symptoms are from my anxiety I am quite certain so I absolutely need to find ways to manage that. The temazepan was prescribed for insomnia unfortunately (I wish they had recommended yoga and lifestyle changes). My usual dose of temazepan was 10mg. I took 20mg for a couple of nights but what I noticed was that it stopped working for me. Interdose withdrawals was increased anxiety (which may have been my usual anxiety but it felt stronger) and I also had two panic attacks shortly after falling asleep. It only happened twice but they were the reason that citalopram was prescribed. I am very glad to be off it but in the back of my mind I'm absolutely terrified of being slammed by a double whammy of benzo withdrawals and AD withdrawals as I've withdrawn from them so closely together. 

 

32 minutes ago, manymoretodays said:

And then, do consider giving a try to using either the magnesium or Omega 3's.  Gridley gave you those links in his first post to you.  I have always found the Magnesium to be especially calming myself.

I use fish oil at the moment and I include salmon in my diet which I think is the Omega 3s. I am scared of magnesium because I read on another forum (about benzos) that it works on the gaba receptors and can send you into a massive wave so I'm terrified to try it at this stage but I may work up the courage to try it in a few months time. I took a neurocalm tablet (which has passionflower and a few other natural supplements in it) and that night I got a headache and the jerks started (also two days after stopping citalopram (Its so difficult to pin point what is what which is why i'm desperately trying to eliminate everything!). 

 

34 minutes ago, manymoretodays said:

I hope I got to most of your concerns.  Try and spend time focused now on healing, and don't get lost in any horror stories now.  Go on back to the Main Page and find the Success Stories, and focus on continued healing and hope.  Maybe you've gotten overwhelmed by over reading a bit.  I don't know.  I hope not, but it happens a lot to newbies here.

You are amazing. Thank you so much for your advice, I really appreciate it so much. 

[Calmseeker]

One more thing that scares me... when I read people's signatures on here, there are often multiple drugs listed. Have you seen other people successfully get off one AD (and previously one Benzo) without having to add more drugs into the mix? I don't want to get so bad in withdrawal that I get desperate and go back to medication. Has the 10% tapering been effective for other members? I search for success stories or similar stories to me and I cant find them (which worries me that they dont exist). I am terrified of getting really sick from withdrawals, i'm terrified of losing my family and my life that I love. 

[manymoretodays]

22 minutes ago, Calmseeker said:

I am scared of magnesium because I read on another forum (about benzos) that it works on the gaba receptors and can send you into a massive wave so I'm terrified to try it at this stage but I may work up the courage to try it in a few months time. I took a neurocalm tablet (which has passionflower and a few other natural supplements in it) and that night I got a headache and the jerks started (also two days after stopping citalopram (Its so difficult to pin point what is what which is why i'm desperately trying to eliminate everything!). 

 

I'd take a read through the magnesium topic(it's long but you may learn more).  I've never heard that about the gaba receptors.  And then when you try some, start real low at first.  It might be a good idea to just settle into one change at a time, so good to wait, while we see how you do with a steady consistent dose of the citalopram now.

The rule of 3KI's: Keep it simple, slow, and stable

 

We tend to be really sensitive in WD.

 

6 minutes ago, Calmseeker said:

Have you seen other people successfully get off one AD (and previously one Benzo) without having to add more drugs into the mix? I don't want to get so bad in withdrawal that I get desperate and go back to medication. Has the 10% tapering been effective for other members? I search for success stories or similar stories to me and I cant find them (which worries me that they dont exist). I am terrified of getting really sick from withdrawals, i'm terrified of losing my family and my life that I love. 

 

Yes.  Like you said, you wished they would have just offered you non-drug coping from the start.  So be looking into practices now, that will help.  And try not to jump too far ahead.   Citalopram isn't really a antidote to benzo WD, but as you had over 2 months on it, I really think that up the road, a taper will be in order.  Even from the 2.5 mg.   And yes, 10% tapering is a very harm reduction model to go by.  That's another good link to read up on a bit more, when you can.

 

For the immediate future, just the next 4-7 days, just stay put with the 2.5 mg citalopram, and take it at the same time every day.  It takes that long to get to a nice steady state.   And keep us updated.  I think a lot of your recent distress may be from the erratic dosing you had been doing and possibly the sensitivity to the supplements.  Your CNS is craving stability right now. 

 

L, P, H, and G,

mmt

 

 

[Calmseeker]

Hi there, I just thought I'd provide an update. I've continued to take 2.5mg of citalopram. I picked up a prescription of 30 x 2.5mg capsules from the compounding chemist yesterday to ensure that I have accurate dosage. I've taken 2.5mg for two weeks now (with the exception of one day when I tried to jump off and one day where I took 5mg). I feel reasonably stable now. For a few days last week I had night time jerks, nightmares, sweating, numb leg, insomnia (not all at once thank goodness). I've now taken citalopram for 12 weeks in total and for 5 of those 12 weeks I have been tapering. My goal is to be off the citalopram as quickly as possible whilst being kind to myself and allowing my nervous system to heal. I'm looking for some guidance on where to from here. I will continue to use the compounding chemist for accuracy and they can make any dosage I specify but it is not cheap at all, however my health is my biggest priority not the cost of course. I was thinking of making a tapering schedule dropping every 3 weeks by 10% of the previous dose. I'd love to be off the drug in six months. Is this realistic? Of course I will be guided by my symptoms. I am so appreciative of any guidance you can provide. 

[ChessieCat]

21 minutes ago, Calmseeker said:

I've now taken citalopram for 12 weeks in total

 

Citalopram (for panic/anxiety which I suspect was due to the other drugs) - 17th September 2020 - have been tapering since 8th October (20mg>15mg (one week)>10mg(one week)>5mg(one week)>2.5mg (one week). Jumped 1st November - 2 days later had anxiety, insomnia, meloncolic jerks. Reinstated 2.5mg then went up to 5mg (one night)

 

I think you've got one of these wrong.  Did you start on citalopram 17th September?  If yes, then it's only been 8 weeks in total not 12.

 

If the drug signature date is incorrect please edit it accordingly.  Thank you.

[ChessieCat]

24 minutes ago, Calmseeker said:

I was thinking of making a tapering schedule dropping every 3 weeks by 10% of the previous dose. I'd love to be off the drug in six months. Is this realistic? Of course I will be guided by my symptoms.

 

Nobody can predict whether you will be able to taper at your planned rate.  Listening to your body/symptoms and holding for longer if symptoms arise is the only way.  Please note that it is better to hold for longer than to risk going too quickly.  If you get bad withdrawal symptoms and have to updose or hold for a long time, it can end up taking longer than if you had just steadily tapered at a cautious rate.

 

It's important to try to maintain your sleep.  Once your sleep is affected it can make tapering a whole lot harder.

[Calmseeker]

23 minutes ago, ChessieCat said:

 

I think you've got one of these wrong.  Did you start on citalopram 17th September?  If yes, then it's only been 8 weeks in total not 12.

 

Apologies, I'll fix that up now. I've been on it 11 weeks in total, I started on 26th August - I had my dates wrong. 

[Calmseeker]

25 minutes ago, ChessieCat said:

 

Nobody can predict whether you will be able to taper at your planned rate.  Listening to your body/symptoms and holding for longer if symptoms arise is the only way.  Please note that it is better to hold for longer than to risk going too quickly.  If you get bad withdrawal symptoms and have to updose or hold for a long time, it can end up taking longer than if you had just steadily tapered at a cautious rate.

 

It's important to try to maintain your sleep.  Once your sleep is affected it can make tapering a whole lot harder.

Thank you! Once the symptoms have passed, how long should you wait before making another drop? At the moment, I feel quite good so I would be tempted to make another drop but I will hold on 2.5mg for another week. Its a tricky situation to navigate! 

 

Do you have any idea what the best dose would be to 'jump off'?  

[ChessieCat]

You will need to listen to your body/symptoms and taper according to those.  You are the best judge of that.  All we do is provide the guidelines, general suggestions, not the set plan.  The main thing is to keep your sleep intact.

 

As for the jump off dose, it will depend on how you feel when you get to the low doses.  Some members jump off at a very low dose and find that they need to dip a toothpick in their liquid or take a tiny crumb of their drug.  They are people who have been on the drug for longer.

 

It is possible to make a liquid from citalopram tablets and the more water you use the more accurate and the smaller the doses you can get.  See Post #1 of this topic: 

 

Tips for tapering off Celexa(citalopram) 

[Calmseeker]

Thank you so much. You have been so incredibly helpful. I really just want to get this right. 

[Calmseeker]

On 11/5/2020 at 8:56 AM, Gridley said:

Based on your history I'd go to 2.5mg and hold there and make no changes for several months.  At that time, once you've stabilized, you can begin a 10% taper to zero.

Hi Gridley, I have a question. I know you can't offer specific tapering advice soI hope this doesn't cross the boundary, I guess I am just scared and looking for reassurance. I reinstated the 2.5mg of Citalopram and I feel like I have stabilised. I've now been on a dosage of 2.5mg for 22 days (with the exception of 1.5 days where I tried to jump then quickly re-instated). I have around 2 weeks worth of my prescription at 2.5mg which would take me to over a month at this dosage. I feel reasonably stable at the moment and I'm about to pick up my next prescription for 2.25mg (a 10% drop). You mentioned in your previous comment to hold and make no changes for several months. If I'm feeling stable in a few weeks time (when I finish my current prescription of 2.5mg) is it too soon to make an attempt to go to 2.25mg? Again, please let me know if this question isn't appropriate. 

[manymoretodays]

1 hour ago, Calmseeker said:

You mentioned in your previous comment to hold and make no changes for several months. If I'm feeling stable in a few weeks time (when I finish my current prescription of 2.5mg) is it too soon to make an attempt to go to 2.25mg? Again, please let me know if this question isn't appropriate. 

 

Hi Calmseeker,

It's just that your nervous system is currently craving some stability. 

The rule of 3KI's: Keep it simple, slow, and stable

What is your stable like now?

Any symptoms of WD?

How are you doing with non-drug coping skills, are you building some?   Especially around the anxiety/fears.  This is an excellent time to do that.

 

Just my 2 cents.  You could start deciding on how you are going to taper now(liquid or weighing).  That might be a better option.  Rather than start tapering again, with just a month of so, WD stability.

Be a snail or a turtle......go slowly.

Sometimes we get fooled by having a nice window too.  And think it will last forever. 

 

Best, L, P, H, and G,

mmt

 

[Calmseeker]

Thank you MMT, I really appreciate your calm and logical advice. 

 

34 minutes ago, manymoretodays said:

What is your stable like now?

Any symptoms of WD?

I am not noticing any withdrawal symptoms. I get a few twitches every now and again however I got those before the drugs (ironically it is what first drove me to drugs as I was so panicked by a couple of small twitches!). I also get increased anxiety every now and again however it is mainly when I think about this and start to freak out that I am stuck on a drug that I dont want to be on. So I thin the anxiety might be just my normal anxiety. I've noticed my anxiety is greater at certain times of the month (female hormones). I am sleeping quite well most nights. 

 

40 minutes ago, manymoretodays said:

How are you doing with non-drug coping skills, are you building some?   Especially around the anxiety/fears.  This is an excellent time to do that.

 I love that you remind me to do this. Thank you! I have completely changed my life through this experience. I walk my dogs every morning for at least half an hour. I go to the gym most evenings (I know gym can stress the nervous system so I am conscious of this but the gym/exercise is something that I really love and I find it helps me). I am seeing a psychologist fortnightly to help me with some strategies. I have mostly cut out gluten, dairy, caffeine, alcohol from my diet. I must admit I did have a beer a few weeks ago and I felt OK. I am about to start yoga once per week. I do think I need to start doing daily meditation and mindfulness. I have health anxiety, its my main anxiety issue. The fact that I know these drugs are bad for my health and that I am stuck on them sends my anxiety through the roof - this is the crux of what I am trying to deal with at the moment. 

 

47 minutes ago, manymoretodays said:

You could start deciding on how you are going to taper now(liquid or weighing)

Well I do have a plan in place. I have got a compounding chemist to make my prescriptions at the necessary dose. It is VERY expensive but I feel peace of mind that it is accurate. I have a few weeks left of 2.5mg capsules. I'm about to pick up 100 x 0.75 capsules. My plan is to take 3 x capsules (2.25mg) for say 3 weeks and keep the rest so that when I get down to my dose of 1.5mg then I will take two capsules and then when I get to 0.75 I take one capsule. This is the most economical way I have thought of to get my prescriptions compounded. I've attached a spreadsheet where I've worked it out. At the current plan I would have to purchase four more scripts of 100 pills and make do with them. Once I get down to 0.48mg I will move to a liquid taper (I will order 100 x 1mg capsules and mix the 1mg capsule in 100ml of water drawing out the desired dose over 100 days). 

 

54 minutes ago, manymoretodays said:

Sometimes we get fooled by having a nice window too.  And think it will last forever. 

Thank you for your sound advice. 

Dose Reduction Scale.xlsx

[Gridley]

11 hours ago, Calmseeker said:

If I'm feeling stable in a few weeks time (when I finish my current prescription of 2.5mg) is it too soon to make an attempt to go to 2.25mg? Again, please let me know if this question isn't appropriate. 

It's an appropriate question.  I woiuld stay at your current dose of 2.5 longer.

[Calmseeker]

10 hours ago, Gridley said:

I woiuld stay at your current dose of 2.5 longer.

Thanks again @Gridley and @manymoretodays. I am learning patience through this process. 

[Calmseeker]

Hi guys, I've decided to take your advice and hold longer at 2.5mg. I've read through the link you provided about tapering from citalopram and I understand that I can do a liquid titration method. At the moment I am taking compounded capsules, the benefit to this is that they are an accurate dosage. The down side is that it is expensive ($50 for 30 capsules) and I have to keep going to the doctor to get prescriptions.

 

I am deciding whether to refill my script for 10mg citalopram and start taking quarters (not 100% accurate but easy enough and very cost effective). Once I'm ready to take a drop I would move to a liquid (dissolving the 10mg in water and reducing accordingly - I know its best to do a gradual switch to liquid). 

 

The alternative would be to get another compounding script for 2.5mg. Then when I am ready to drop to 2.25mg I would use a compounded capsule of .75 and take three (although my concern with this approach is whether taking 3 capsules is safe as I know they use quite a lot of filler and Im not 100% sure what the filler is made with. They told me it was like a vitamin B). I've worked out my dosages so that I can get the lower mg compounded and then take 3 x tablets and save the rest for when I'm ready for the lower dosages. 

 

I understand that precision is more important than accuracy (i.e. doing the same method every time). I want to pick a method and stick with it. 

 

If I take the compounding option, I was going to use compounded capsules to get down to .5mg then I was going to get say 100 x 1mg of compounded capsule made and then make a liquid titration by pouring the 1mg capsule into the water and reducing from there (i'm thinking a smaller dose would be more precise when getting to the lower amount)

 

I guess the third option would be to buy a jewelers scales and shave the pills. However I haven't read too much about this option on here so I'm not sure how easy/accurate/effective it is. 

 

I would really welcome your opinion on what would be the safest way to come off these pills based on your experience or perhaps the methods you have used. 

[ChessieCat]

  

On 4/10/2012 at 5:07 AM, Altostrata said:

 

Making a Celexa solution yourself

See  how-to-make-a-liquid-from-tablets-or-capsules

 

 

 

Making a liquid is more accurate/consistent than weighing.

 

See the above topic and:

 

using-an-oral-syringe-and-other-tapering-techniques

 

Edited November 29, 2020 by ChessieCat

[ccfb]

1 hour ago, ChessieCat said:

  

 

 

Making a liquid is more accurate/consistent than weighing.

 

See the above topic and:

 

using-an-oral-syringe-and-other-tapering-techniques

 

 

Liquid is far more accurate than cutting and weighing tablets.  But you may be able to just ask your doctor to Rx a solution for you.

 

For escitalopram, a liquid Rx was available in most pharmacies.  The same may be true of citalopram.  According to the U.S. FDA label, citalopram is also available as an oral solution: https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/020822s037,021046s015lbl.pdf

 

If liquid citalopram is not available near you, you might be able to special-order it from a compounding pharmacy.  These are pharmacies that custom-prepare oral solutions of Rx medications special-order.  It may be more expensive, but possibly worth it.

[Calmseeker]

49 minutes ago, CCFB said:

If liquid citalopram is not available near you, you might be able to special-order it from a compounding pharmacy.  These are pharmacies that custom-prepare oral solutions of Rx medications special-order.  It may be more expensive, but possibly worth it.

Thank you. Unfortunately Citalopram isn't available in liquid to my knowledge in Australia. I have decided I am going to stick with using the compounding chemist. I'll continue using capsules for a while and then I'll get them to make me a liquid solution when the time comes. 

[Calmseeker]

2 hours ago, ChessieCat said:

Making a liquid is more accurate/consistent than weighing.

 

Thank you. I'll continue to use a compounding chemist for capsules then I'll switch to liquid down the track. It will be more expensive and more trips to the doctor for prescriptions but overall I think its the best way for me. 

[ChessieCat]

3 hours ago, Calmseeker said:

The down side is that it is expensive ($50 for 30 capsules) and I have to keep going to the doctor to get prescriptions.

 

In NSW I can take my tablets to the compounder and get them done.  Only script I need is for the tablets, not the compounding.

 

$50 for 30 capsules is ridiculously expensive.  I suggest you do some research because I'm sure you could find them a lot cheaper than that.

 

Here's the search page.  You will need to select Australia from the drop down list.  It's the 7th once down on the list (ie it is not in alphabetical order).

 

https://www.pccarx.com/Resources/FindACompounder

 

And if you cannot find one close by, some of them will mail them.

 

 

 

Edited November 30, 2020 by ChessieCat

[Calmseeker]

1 hour ago, ChessieCat said:

In NSW I can take my tablets to the compounder and get them done.  Only script I need is for the tablets, not the compounding.

 

$50 for 30 capsules is ridiculously expensive.  I suggest you do some research because I'm sure you could find them a lot cheaper than that.

 

Here's the search page.  You will need to select Australia from the drop down list.  It's the 7th once down on the list (ie it is not in alphabetical order).

I've just called nearly every number on the list within Brisbane and they all quoted me around between $50 to $70 for 2.5mg compounded capsules. I would love to find somewhere cheaper. Perhaps I could look at getting it posted. 

 

I've just placed an order with the chemist i've used, its $75 for 100 capsules. This is going to be very expensive for me! 

[Calmseeker]

I had some real trouble sleeping last night and I had a nightmare when I did sleep. I also think I got a few body jerks. Its got me really rattled today and I feel quite panicked. I know these are typical withdrawal symptoms (and they are manageable) but they really have got me on edge and I am feeling really scared today. I'm feeling scared because I havent made any changes recently and I was feeling quite good for a while. Now I am incredibly anxious today and I cant concentrate. Before I went to bed last night I was up until late on this forum researching to try to decide what my next move for the taper would be (as I'm down to my last week of capsules). I dont think it helped. I realise when I research into withdrawal etc. I get very anxious and I think it might have flared up my withdrawal symptoms. I dont know, just feeling really down. 

 

Can someone reassure me that I'm normal? That this will pass. 

Edited November 30, 2020 by Calmseeker
added a question

[ccfb]

13 hours ago, Calmseeker said:

I had some real trouble sleeping last night and I had a nightmare when I did sleep. I also think I got a few body jerks. Its got me really rattled today and I feel quite panicked. I know these are typical withdrawal symptoms (and they are manageable) but they really have got me on edge and I am feeling really scared today. I'm feeling scared because I havent made any changes recently and I was feeling quite good for a while. Now I am incredibly anxious today and I cant concentrate. Before I went to bed last night I was up until late on this forum researching to try to decide what my next move for the taper would be (as I'm down to my last week of capsules). I dont think it helped. I realise when I research into withdrawal etc. I get very anxious and I think it might have flared up my withdrawal symptoms. I dont know, just feeling really down. 

 

Can someone reassure me that I'm normal? That this will pass. 

 

Really sorry to hear that.  

 

For what it's worth, keep in mind that these are really difficult times for everyone.  Remember to show yourself some compassion.  You're doing a difficult thing, during a difficult time.  I also had a nightmare last night; I often find myself rattled by what's going on in the world.  And I'm not even in withdrawal.  

 

As far as symptoms go, here are some of the same things that help me deal with stress and anxiety. They might help you too:

 

--

 

1) 10 minutes' daily meditation

 

People laugh at this because they don't try it consistently for a few days and don't notice the effects.  The benefit is cumulative.  It adds up.  You have to do a little bit every day to notice the impact on mood.

 

I'd recommend Jeff Warren's meditation courses.  His 10-minute sessions make a world of difference for me.  You can find these on YouTube or Calm.  YT has the benefit of being free, but Calm has slightly better production value.

 

2) 4,400-10k steps daily walk among nature

 

If you can get out every day among green trees, this is a big help.  I've found it calms me down and centers me.

 

3) Good bedtime routines

 

Chamomile tea and a bedtime alarm (45 minutes before sleep) helps me get psychologically ready for bedtime.  I also take melatonin before bed, but SA doesn't recommend supplements.

 

4) Soft music in the background

 

Whatever you're doing during the day, have some soft soothing music playing.  It helps more than you might realize.

 

5) Timers to keep focus

 

I've found when you're focused on something, it's harder to be anxious.  I use a 25-minute timer to keep focus on work (no using phone during timers), with alternating short and long breaks in between.

 

6) TEDx Talks instead of news

 

Learning new things helps me stay curious and focused on interesting things.  I try to limit my access to the news, which is largely negative and can cause distracted thought patterns.  Instead, I'll watch TEDx talks on YouTube.  Learning is good for the brain, and it's inconsistent with rumination and anxiety. 

 

--

 

Hope this helps!

[Calmseeker]

Hi @CCFB, 

 

Thank you so much for your response. This is one of the things I really love about this forum. There have been a few times where I've been rattled by this process and someone has been able to provide some reassurance. I really appreciate it. I am quite sensitive to what is happening in the world and around me. 

 

I do most of the things on your list however there are a few things in there I need to do consistently. Meditation is one of them! I have an app called Insight Timer and I just found a few of Jeff Warren's meditations on there. I'll check those out this afternoon. Strange question but where do you meditate? Do you meditate at home or do you meditate outdoors? I feel if I can be consistent with this it will really help to calm my mind. I am an over-thinker but it is often not helpful lately. 

 

I've been listening to ted talks lately and I really like your comment that learning is good for the brain and that it is inconsistent with rumination and anxiety. I've thought about going back to study because when I am busy with study it helps me to focus on something that is beneficial and positive. 

 

I also like your idea of using a timer. I will definitely try that and soft music is helpful - I'll try that too. 

 

I find myself doubting myself more than usual these days and I think it is because of the medication. I am trying to re-build myself one step at a time one day at a time. 

 

Thanks again. It really did help. 

 

 

[Calmseeker]

Hello, its me again. Firstly, I want to say thank you in advance for anyone who takes the time to respond to me. I really value your time and advice. 

 

Firstly, I have read through all of the thread on tapering citalopram and making your own liquid solution and I've decided to go in this direction rather than having my pills compounded. There is soo much information on here that I just want to check and make sure that I've interpreted all of the information correctly and that the next steps in my tapering plan are OK. 

Step 1. convert over to liquid suspension slowly over one week. Taking half dose in tablet and half dose in water for a few days followed by whole dose in water for a few days. 

Step 2. stabilise on current dose of 2.5mg taken in home made liquid form for one week 

Step 3. Attempt a 10% reduction by doing the following: 

- Dissolve 1/4 of a a 10mg capsule in 100ml of water (1ml = 0.025). 

- Withdraw 10ml of water using a syringe (0.25) 

- Drink the rest of the solution (2.25mg) 

**side note - I would not worry about any of the tablet that gets stuck to the side of the glass etc. as that is OK and to be expected from what I have read. Also, precision is the key - I'll use the same method each time to ensure consistency. 

Step 4. Once stabilised on the new dose of 2.25, after 4 weeks attempt another reduction. 

 

Can you please let me know if all of this sounds OK? I am a little concerned using 1/4 of a tablet as there is risk for the dosages to fluctuate however i'd ensure i used the four quarters of the same pill over four days so it all evens out if that makes sense. I'd prefer to use quarters as its more ecconomical and less waste and it means less prescription refills. 

 

On a side note, I've been feeling fairly stable. The only thing that stresses me out at the moment is this situation of being stuck on these pills. My sleep is mostly good however I do have a few nights where I dont sleep much however that is directly related to my stress levels (mostly about how I am going to taper off the last part of this) and its consistent with my sleep cycles prior to taking any medication. 

 

I would love to know your thoughts. I would love to start to decrease. 

 

Thanks so much for anyone who responds.