stevenb: need advice on tapering Zyprexa and citalopram

[stevenb]

I'll try to keep it short, I've been on zyprexa 15mg and citalopram 20mg for a little over 3 years with a few failed attempts at coming off. I've been cutting them in half for 2 and a half weeks and then I felt like that was just too fast and when to 3/4 of the normal dose.

 

Should I go back to half doses since i've been already doing that for 2 weeks or should I just stay at 3/4 to be safe? Any advice on that/how long my taper should last before going back down in dosage would be appriciated as I feel my current doctor does not have too much knowledge of tapering.

[Gridley]

Welcome to SA, steven.

 

The half doses were definitely too much and 3/4 was more than we recommend, which is no more than 10% of current dose every four weeks. As you've learned, the vast majority of doctors know nothing about safe tapering.

 

Why taper by 10% of my dosage?

 

How are you feeling now?  Do you currently have withdrawal symptoms?  What symptoms did you have when you were at 1/2 pill?  Are they improved on the current 3/4 pill dose?

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

I would hold where you are 3/4 pill and stabilize there for at least 3 months.  Let's see how you feel at that time before proceeding with further tapering.

If I understand you correctly, you are at 3/4 dose for both the zyprexa and the citalopram.  Is that correct?  We recommend tapering only one drug at a time.

Otherwise, if problems arise, you won't know the cause.  Our general recommendation is to taper the more activating (stimulating) drug, which we call accelerators, first, leaving the more sedating drug, which we call brakes, to act as a buffer to be tapered later.  SSRIs like Citalopram are accelerators, and antipsychotics like Zyprexa are brakes.  Unless you are having problems (side effects) with the Zyprexa, I'd recommend you taper the Citalopram first--but only after waiting at least three months to stabilize from your recent rapid taper of both drugs.

 

Taking multiple psych drugs? Which drug to taper first?

 

Cutting pills is not the best way to reduce your dose because often it's not possible to get a consistent dose, especially as you get lower in dose.  Other methods, such as using a liquid form of the drug or weighing doses on a digital scale, are recommended.  The following link is specifically about tapering Citalopram and include an explanation of how to get the smaller non-standard doses you'll need for your 10% taper when the time comes.

 

Tips for tapering off citalopram (Celexa)

 

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

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Add in one at a time and at a low dose in case you do experience problems.

 

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

 

 

 

 

 

 

 

[stevenb]

Thanks for the advice! Yes i'm currently tapering off both. In my situation it's more of an urgency to get off them sooner then later I felt so i'm cutting them both into 3/4. I'm feeling a lot better on 3/4 so I guess I will stick there for a while.

[composter]

Hi Steven, welcome to SA.

 

On this site we advocate for a 10% taper rate to minimize withdrawal symptoms. I encourage you to do some reading on the site into why this is: 

 

Why taper by 10% of my dosage?

 

It's good that you are willing to hold on your current dose for now and see how you feel. I would not make any reductions for at least 6 weeks, or as Gridley suggested, 3 months may be best.

 

It sounds like you are tapering using a pill cutter. This is not a method we generally endorse as it is not very precise and would cause your receptors to swing up and down due to inconsistent dosing. I would look into and incorporate a more precise method such as liquid tapering, weighing doses using a scale, or getting compounded doses from a compounding pharmacy. 

 

See: How to make a liquid from tablets or capsule  -AND- Using a digital scale to measure doses.

 

Also: Can you please add your drug history to your signature? This helps the mods see the medication changes you've made.

 

This link takes you directly to edit your signature: Account Settings – Create or Edit a signature

[stevenb]

I guess I crashed or something. I'm strongly considering just going back on the meds. I hit this same wall last time I tried to quit (about 3 weeks in). Maybe I just need to be on them?

 

Or is withdrawal suppose be this hard lol

[ChessieCat]

It is possible to get off psychiatric drugs.  When you had issues before it was because you were not aware of how slowly you need to go.

 

You have tapered two drugs at the same time and have tapered too quickly.  Even if you had only tapered one drug at the rate you have you most probably would be experiencing withdrawal symptoms.  Understanding what is happening can help:

 

how-psychiatric-drugs-remodel-your-brain

 

It takes about 4 days for a dose change to get to full level in the blood and a bit longer for it to register in the brain.  As the other mods have already suggested, a long hold is needed.  And yes, at least 3 months sounds reasonable due to the fact that you have tapered too fast and two drugs at the same time.

 

Please be aware that stabilising happens in a windows and waves pattern.  It is not linear.

 

Windows and Waves Pattern of Stabilization

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

I suggest you also check out this topic:

 

are-we-there-yet-how-long-is-withdrawal-going-to-take

 

31 minutes ago, stevenb said:

I'm strongly considering just going back on the meds.

 

If you do find that after a few more days your withdrawal symptoms are unbearable you could increase the dose of one drug at a time by a small amount.  Because you have already been off the "full" dose for a few weeks you would NOT go back to that amount.  It is better to increase by a small amount than to risk taking too much.  I suggest that you wait one week before increasing the other drug.

 

Please read Post #1 of this topic much of which also applies to updosing: 

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

These topics explain how to get small doses:

 

Tips for tapering off olanzapine (Zyprexa)

 

Tips for tapering off citalopram (Celexa)

[ChessieCat]

This is my personal experience with reducing my drug too quickly.  I've been successfully tapering since this happened and am now down to 0.75mg Pristiq.

 

I reduced my Pristiq from 100mg to 50mg and for 2 weeks I experienced severe cog fog, and even walking took my whole concentration.  I joined SA but didn't updose as suggested because I was trying, through the brain fog, to learn about what was happening.  A couple of days after joining I got to the stage that I was unable to type.  Having been a typist for 40+ years I knew that something was really wrong.  I was very thankful for SA's suggestion.  I went and took extra Pristiq.  Astoundingly after only about 4 hours (not days) I was able to type again and the brain fog was lifting.  Because I had a benchmark I knew that it was because of the drug.

[stevenb]

On 8/19/2020 at 2:17 PM, ChessieCat said:

This is my personal experience with reducing my drug too quickly.  I've been successfully tapering since this happened and am now down to 0.75mg Pristiq.

 

I reduced my Pristiq from 100mg to 50mg and for 2 weeks I experienced severe cog fog, and even walking took my whole concentration.  I joined SA but didn't updose as suggested because I was trying, through the brain fog, to learn about what was happening.  A couple of days after joining I got to the stage that I was unable to type.  Having been a typist for 40+ years I knew that something was really wrong.  I was very thankful for SA's suggestion.  I went and took extra Pristiq.  Astoundingly after only about 4 hours (not days) I was able to type again and the brain fog was lifting.  Because I had a benchmark I knew that it was because of the drug.

 

I reinstated and was about to give up but was having an even harder time on the meds then when tapering! I think it "pooped out" as they say here so back to tapering. May I ask for advice on how you gett smaller doses? I have a dr appointment soon to check up on how my taper is going but I don't think the doctor would be able to perscribe me doses of 10% decreased increments.

 

My apologies for going up and down in dose I know it's not good. Having a hard time navigating my way through this.

[ChessieCat]

I'm not sure which drug you are tapering.

 

Post #1 of this topic has a list of links to different drugs:

 

Important topics in the Tapering forum

[stevenb]

I just wanna say it's working   I had to reinstate for about a week or so but am back to successfully tapering. I'm getting headaches most mornings but nothing too bad.

[stevenb]

Having trouble with doses

 

So i've been tapering off some medications and the way I was doing was cutting the pills into 3/4s... was working fine until I started having a lot of trouble with accurate cuts, now it's near impossible for me to accurately cut 3/4s of a pill and i'm just wasting a lot of medication trying.

 

The only way I can see it working is if I cut the pill into halves since its not as hard to do. But last time I tried to take half a dose it felt like it was too big of a drop (although I did start my taper with half doses only to change to 3/4s after).

 

Is there any way that I could still taper if i'm having this much trouble with the doses? Is it possible to take half doses if I just spend more days taking complete doses? I'm lost right now lol

 

Edited September 8, 2020 by ChessieCat
added topic title

[ChessieCat]

1 hour ago, stevenb said:

 

So i've been tapering off some medications and the way I was doing was cutting the pills

 

 

We need to know drug/s you are talking about so we can give you the right information about how to get your dose/s.

[stevenb]

1 minute ago, ChessieCat said:

 

We need to know drug/s you are talking about so we can give you the right information about how to get your dose/s.

Citalopram(20mg original dose)/zyprexa(15mg original dose) both of wich i'm tapering

[ChessieCat]

On 8/19/2020 at 4:41 AM, Gridley said:

 

Cutting pills is not the best way to reduce your dose because often it's not possible to get a consistent dose, especially as you get lower in dose.  Other methods, such as using a liquid form of the drug or weighing doses on a digital scale, are recommended.  The following link is specifically about tapering Citalopram and include an explanation of how to get the smaller non-standard doses you'll need for your 10% taper when the time comes.

 

Tips for tapering off citalopram (Celexa)

 

 

[ChessieCat]

36 minutes ago, stevenb said:

both of wich i'm tapering

 

 

On 8/19/2020 at 4:41 AM, Gridley said:

 

If I understand you correctly, you are at 3/4 dose for both the zyprexa and the citalopram.  Is that correct?  We recommend tapering only one drug at a time.

 

Otherwise, if problems arise, you won't know the cause.  Our general recommendation is to taper the more activating (stimulating) drug, which we call accelerators, first, leaving the more sedating drug, which we call brakes, to act as a buffer to be tapered later.  SSRIs like Citalopram are accelerators, and antipsychotics like Zyprexa are brakes.  Unless you are having problems (side effects) with the Zyprexa, I'd recommend you taper the Citalopram first--but only after waiting at least three months to stabilize from your recent rapid taper of both drugs.

 

 

[ChessieCat]

On 8/19/2020 at 4:41 AM, Gridley said:

 

I would hold where you are 3/4 pill and stabilize there for at least 3 months.  Let's see how you feel at that time before proceeding with further tapering.

 

 

[ChessieCat]

Citalopram tablets can be made into a liquid.

 

If you are able to cut your tablets in half accurately, then I suggest that you make a liquid with 1/2 a tablet and take half of the liquid (= 1/4 tablet) as well as a 1/2 tablet to get your dose.

 

Keep the other half of the dose in a covered container in the fridge to use for the next day.

 

EDITED to add accurately

 

Edited September 8, 2020 by ChessieCat

[morgana]

g'day, i was on cipramil i think its the same as what your on..anti depressant...i quit the anti depressant before the zyprexa because whenever i came off zyprexa too fast i couldnt sleep...it was easier to put up with the depression than not being able to sleep as the less sleep i got the more psyhcotic i got...i found everytime i tried stopping zyprexa i would end up back in hospital....this time i said to myself "go slow" its taken me so far 2 years and i am still only on 2.5mg...and still tapering off zyprexa.....and i have found the first 6 months on a lower dosage was the hardest, it really takes time for my body to adapt to a lower dosage....i understand you just want to get off as soon as possible but i am sorry but it just wont work! not zyprexa...some side affects i have experienced while tapering are:  night sweats, insominia, muscle cramps in feet and hands, stomach pain - digestion problems, sores on my face, pain in all my joints including my shoulders, pain in my jaw, twitches in my shoulder, getting angry at everything (looking back, i am fine now, but boy...sometimes i remember thinking i should carry a knife....just doing my food groceries...people not walking fast enough.....lol}lucky for them and me i didnt!, so its been very difficult.  I was cutting my tablets in 1/2 so i was doing it way too fast...luckly i didnt hurt anyone or end up back in hospital as going back there would not be moving forward to where i want to go...which is drug free!

[stevenb]

I'm taking trazodone 50mg once every 8 or 9 days. For maybe about a year or so. Does this need to be tapered or can I just cold turkey it?

[ChessieCat]

Hi and welcome to SA,

 

We need to know some more information please. 

 

Why are you only taking trazodone once every 8 or 9 days?

 

Have you ever taken it every day?

 

Are you, or have you every, taken any other psychiatric drugs?

 

Please create your drug signature for ALL drugs.  Thank you.

 

Instructions:  Withdrawal History Signature

Account Settings – Create or Edit a signature

 

This is your own introduction topic where you can ask questions and journal your progress.

[stevenb]

3 minutes ago, ChessieCat said:

Hi and welcome to SA,

 

We need to know some more information please. 

 

Why are you only taking trazodone once every 8 or 9 days?

 

Have you ever taken it every day?

 

Are you, or have you every, taken any other psychiatric drugs?

 

Please create your drug signature for ALL drugs.  Thank you.

 

Instructions:  Withdrawal History Signature

Account Settings – Create or Edit a signature

 

This is your own introduction topic where you can ask questions and journal your progress.

Just trazodone now. I was on abilify at one point but not anymore I didnt like the way it made me feel. I kept taking the trazodone for sleep though as needed

[ChessieCat]

When were you taking abilify?

[stevenb]

Am I unable to taper? zyprexa/citalopram

 

Hi, so i've been on these meds for a little over 3 years. At the very beginning of August I started to taper. Went from half dose to 3/4 dose 2-3 weeks later then eventually had to reinstate. Zyprexa and Citalopram both is what I was tapering. (15mg zyprexa, 20mg citalopram). I've been tapering pretty fast up to just recently where I had to reinstate full doses for probably a little over a week now. Everytime I try to go down in dose i'm unable to. Tonight I tried 3/4, then I went a step further and cut the remaining 1/4th in half and took that (roughly 13.125mg of 15mg) and I was still unable to hold there, and had to take the full dose.

 

My question is this.. Does this mean I am just unable to taper and have to remain on them or is this a normal occurance if I taper too fast? It seems to me that I'm just not able to get off these and am gonna try switching meds if this taper doesn't work.

 

I apologize if I left anything out, i'm not very functional on the meds I take anymore =\

 

Edited September 16, 2020 by ChessieCat
added topic title

[stevenb]

On 9/8/2020 at 1:23 AM, morgana said:

this time i said to myself "go slow" its taken me so far 2 years and i am still only on 2.5mg...and still tapering off zyprexa.....and i have found the first 6 months on a lower dosage was the hardest, it really takes time for my body to adapt to a lower dosage....i understand you just want to get off as soon as possible but i am sorry but it just wont work! not zyprexa...

 

One thing i've noticed is that even though i'm only just starting to taper I haven't found yet a dose where I can just sit at. It's either all in or all out for me wich is making me doubt the possibility of a taper for me. 3/4 of a dose was closes I came and was there for a little bit but ultimately couldn't maintain it.

[morgana]

i am not doing too well either...i am not sleeping at all...my sleeping had been ok for the last 4 months i could handle it, however stressed over a full time study i am now doing...i am not eating properly, thinking alot...crying, feeling i have no support, no friends, no purpose...lonely..all i want to do is sleep....and never wake up, my eyes burn from not getting a proper sleep...i feel the same...i dont think i will ever get off this ****....

[stevenb]

I wanted to update my signature but cant remember how to.

 

I was not only able to go back to a lower dose but for the first time found myself able to be on only half a dose.

[ChessieCat]

May 2017 - started zyprexa 15mg and citalopram 20mg

August 1 2020 - cut doses in half for both pills.

August 19 2020 - crashed from tapering too fast and reinstated full dose

August 23 2020 - Felt aweful like meds weren't helping and lowered to 3/4 of normal dose

 

Please clearly state what drug/s you reinstated/reduced in your drug signature.

 

Account Settings – Create or Edit a signature

 

 

Edited September 24, 2020 by ChessieCat

[stevenb]

So i'm feeling terrible today. After taking trazodone 50mg (I take once every week for sleep) I felt HORRIBLE and realized I have to taper off this too. I didn't mention trazodone because I thought it was irrelevant/didn't need to be tapered. Did some research and found that it does need to be tapered though. Luckily i've been taking for only a year 

 

Will try and just skip it or cut in half to 25mg every week if needed

 

[ChessieCat]

21 minutes ago, stevenb said:

After taking trazodone 50mg (I take once every week for sleep)

 

Please add this to your drug signature.  As well as the Abilify that you have mentioned previously.

[ChessieCat]

January 2020 - started trazodone 50mg

 

Please include how often you take this.

[stevenb]

5 minutes ago, ChessieCat said:

January 2020 - started trazodone 50mg

 

Please include how often you take this.

I think that's everything 😃

[ChessieCat]

Please provide the following information.  You can delete the "3/4 of normal dose" (for example) and just use dose.  This makes it easier for the moderators to know what you took without having to calculate and possibly make a mistake.

 

And please make state the drug and doses separately, Zyrprexa xxmg, citalopram xxmg so that we don't get confused.

 

We need the doses:

August 1 2020 - cut doses in half for both pills. (both zyprexa and citalopram)

We need to know the dates and doses for the taper and what was the last dose you took and the date

August 19 2020 - crashed from tapering too fast and reinstated full dose (both zyprexa and citalopram)

We need the doses:

August 23 2020 - Felt aweful like meds weren't helping and lowered to 3/4 of normal dose (both zyprexa and citalopram)

We need the doses:

September 21st - Cut doses in half (both zyprexa and citalopram)

 

 

[morgana]

I have only taken cipramil and zyprexa...40 mls cipramil and 10mls Zyprexa, silly me went off ciprimil cold turkey and began reducing my zyprexa in Octobter 2017.  i reduced my medications only by what the pills came in....so 7.5mg to 5 mg and now 2.5mg every year.....i  was watching "alternatives to meds " its an holistic centre in America (NOTE: See this post about this centre) ....and he was talking about zyprexa....and he put it pretty plainly..he said "if you cannot sleep and you can not eat" you are tapering too fast"...so i guess it would be the same with any drug you are tapering from....i am eating, but unfortunately not too heathy at the moment and i am sleeping, but not the best....however its not bothering me enough that i need to adjust my dosage....i have been sitting on 2.5mg for 5 months now...and i have been feeling great, and i have been feeling like my body has been hit by a bus and i have had crying spells, suicidal thoughts and feeling i have no purpose in life.  If i was constantly adjusting my dosage to suit how i was feeling i would feel even worse....so i just sit on the same dosage, try and deal with my lifes problems, eating properly, excercise, look for work, work out how to deal with my emotions, i am always angry,...it comes in waves and i find the longer i sit on one dosage, i more time i have to work out how to deal with life....in the last 3 days i have been putting my 2.5mg into 25mls of water and dissolving it and then drinking it all, i will continue doing that every night for the next 6 months...once my body is use to getting my tablet in solution form i will than start to taper again..that will mean i would of been on 2.5mg for 1 year....i know its slow but even at that rate i am having to deal with my body unable to sleep very well, my anger, my body cramps and joint pain, stomach pains, my suicidal thoughts, my ability to communicate with people appropriately without getting annoyed with them, i need to look for work...so i take it slow.....i have only taken meletonin for a about a month in the past to help me sleep, but that didnt really work..so i stopped taken it. i have found the longer i sit on the same dosage, i start to feel i get alittle bit better sleep, enough that i can cope with.      

 

Edited September 29, 2020 by ChessieCat
added note

[ChessieCat]

1 hour ago, morgana said:

"alternatives to meds " its an holistic centre in America

 

We have a discussion topic about this centre

 

Just in case anyone reading this considers going there:

 

 

On 10/25/2014 at 7:26 AM, Altostrata said:

 

I have personal experience with that center. I do not recommend it.

 

GiaK also went there. She does not recommend it.

 

[morgana]

no worries i am in australia, thanks for letting me know! not to go there...i just saw a video of them talking about withdrawing from Zyrpexa, it only went for 5 minutes but what is said was helpful...not suggesting to anyone they should go tho!  The video talked about how when your on like 2.5mg zyprexa and that it the hardest part to be in because of the increase of dopamine going into your system and so you end up with anxiety which is basically how i feel...as i do not want to take a tablet to deal with anxiety which i think i will see a therapist about cognative behaviour thearpy, maybe that could help me work out how to deal with my strong emotions that are coming through...i remember when i was on high dosages of medication...i use to work as a disablity support worker, and the boss would ask me to deal with a certain person because i came across as "nothing bothers me", i use to say to myself yeah thats because i am medicated...lol....however looking back now....now that i have reduced my medications i can no longer say...hey nothing bothers me....as any little thing annoys me now...so i need to learn how to deal with them without medication..so i am in the process of looking into it...slow process i guess

[Altostrata]

Yep, they're still churning out the baloney.