PurplePaisley: tapering citalopram

[PurplePaisley]

Hello. I’m 62. I’ve taken an SSRI (primarily citalopram) since ~1997 for depression. I stopped drinking in 2011, and participated in recovery programs (through my HMO and Women for Sobriety) for several years. I began medical cannabis for anxiety and sleep problems in 2013. Over the past ~2 years, I’ve lost 50 pounds (going from obese to a “normal” weight), and have eaten better and exercised much more consistently than before. I retired in late 2020.

Now that many of my stressors are less intense, or gone altogether, and I’m taking much better care of myself (including not self-medicating with alcohol), I want to see whether I can return to being myself, without citalopram and its suppression of various emotions. I’d like to be me again before I die.

My main psychological issue is anxiety (much worse than the depression), which wasn’t recognized until a few years ago. (I’d always just thought that I had “anxious depression“.)
Knowing that the recommended dosing of citalopram is lower in people 65 and older, I tried to prepare for the future by decreasing my dose. I made very tolerable drops, from 30 mg/day to 20 mg/day, then more gradually from 20 mg/day to 10 mg/day, without severe withdrawal symptoms. 
I became overconfident, and dropped from 10 mg/day to 5 mg/day on April 15, 2021. I have developed more withdrawal symptoms, which are  increasingly severe, over the past (nearly) 3 months:

 > Anxiety — was appearing randomly during the day; in the last couple of weeks, has begun shortly after I wake up in the morning and worsened throughout the day. The anxiety is far worse than anything I’ve experienced since adolescence. I have had episodes of panic that are much worse than ever before. I’m often shaking.

> Dissociative symptoms.

> Depression — I can’t muster interest in activities that I used to enjoy, have little energy, and experience waves of traumatic memories.

> Neuro-emotions often have me by the throat: sudden, intense crying; a feeling of impending doom; feeling that I have failed in my life, failed my husband and children, failed to achieve much worthwhile in my (now ended) career.

> Memory gaps and uncertainties, and difficulty focusing.

> Physical symptoms, including odd skin sensations (electric current, over-sensitivity, and creepy-crawly feelings), occasional numb fingers, gastrointestinal issues (incl. low appetite); occasional facial pain; worsened tinnitus; chest discomfort.

 

When I was depressed in the late ‘90s (which led to my starting an SSRI), I was always able to get things done at work and at home. I might cry in the elevator on my way to my office, but I didn’t have to take more than an occasional day off for mental health. Now I don’t think that I could hold a job with my current symptoms.

Once I stabilize on 5 mg/day, I plan to taper much more slowly (10 % per month).

 

Thank you for being here.

[Gridley]

Welcome to SA, PurplePaisley.  Thank you for completing your drug signature.

 

As you know, you're experiencing withdrawal symptoms caused by the rapid decrease in your dosage, in specific from 10mg to 5mg but possibly from previous decreases coming into play after a delay.  The reason we suggest an exponential taper (cutting the dose by smaller amounts as we taper) is because there is a high rate of receptor occupancy at low doses of the drug.  That is to say, even on low doses of the drug, it is still having a major effect on the brain.  Please see this link: 

 

SERT Transporter Occupancy Studies

 

All the symptoms you're experiencing are typical of antidepressant withdrawal.  At this point you have two options:

 

1.  Hold where you are at 5mg and wait to stabilize before tapering.  There is no way to predict how long stabilization will take. 

 

2.  Updose a very small amount of Citalopram.  Updosing/reinstatement doesn't always work, but it is the only known way to alleviate withdrawal symptoms.  Please read: About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic.

If you're interested in updosing, please let us know and we can suggest an dosage to updose.  Please do not updose without letting us make a recommendation.  In the time you've been at 5mg, your system has made adjustments to the lower dose, and updosing too much can make symptoms worse.

 

So that you have a better idea of what you're experiencing, here is some information on withdrawal and the healing process.

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

The Windows and Waves Pattern of Stabilization

 

When we take psychiatric medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

These explain the healing process really well.

 

Brain Remodelling 

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

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).

 

For future reference, we recommend tapering by no more than 10% of your current dose every 4 weeks.

 

Why taper by 10% of my dosage?

 

This link is specifically about tapering Citalopram, including how to get the non-standard doses needed for a 10% taper (and for an updose, should you decide to updose).

 

 

Tips for tapering off citalopram (Celexa)

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

 

 

 

 

 

 

 

[PurplePaisley]

Thank you, Gridley.

 

I am interested in increasing my dose temporarily to ease my symptoms. What would you suggest?

 

BTW, I take magnesium and flaxseed oil. As a sleep aid, I rarely take melatonin, alone or in a product also containing 5-HTP and l-theanine. I take CBD to aid with anxiety, and CBD and a little THC to aid sleep. Should I add this info to my sig?

 

After posting, I realized that I had left out a little info re my older (pre-taper) med history, and my current symptoms in withdrawal. In the interest of having more complete info about me here, should I create a revised introductory post? I don’t see an edit option for my original post.

Thanks again.

[Gridley]

31 minutes ago, PurplePaisley said:

 

I am interested in increasing my dose temporarily to ease my symptoms. What would you suggest?

 

I'd recommend updosing from 5mg to 6mg. This may seem like a small dose but it's important not to overwhelm your system.  You could measure the dose by weighing using a digital scale, such as the Smart Weigh Gem-20 (also known as Gemini 20), available on Amazon.  An easy way to updose would be to switch to a prescription liquid.  Please read about these two methods in the link I provided earlier:

 

Tips for tapering off citalopram (Celexa)

 

Once you've decided the method you prefer to use, let us know and we can give you further instructions.  It takes a 4 days for the updose to reach full strength in your bloodstream and a few more days to register in the brain.  So be patient and give the updose time to work.  If you need to updose slightly more, it will be a simple matter to do so, especially with the liquid.  

42 minutes ago, PurplePaisley said:

 

BTW, I take magnesium and flaxseed oil. As a sleep aid, I rarely take melatonin, alone or in a product also containing 5-HTP and l-theanine. I take CBD to aid with anxiety, and CBD and a little THC to aid sleep. Should I add this info to my sig?

 

Yes, please add these.  Here's the link to edit your signature.

 

Account Settings – Create or Edit a signature

 

Regarding the melatonin, we recommend single ingredient supplements.  Otherwise, if problems arise, you won't know the cause.  We recommend starting wit a very low dose of melatonin, around 0.3mg.  Too much can result, in a system sensitized by withdrawal, in a paradoxical reaction (it keeps you awake).

 

Melatonin for sleep

 

48 minutes ago, PurplePaisley said:

my older (pre-taper) med history, and my current symptoms in withdrawal. In the interest of having more complete info about me here, should I create a revised introductory post? I don’t see an edit option for my original post.

This isn't necessary.  

 

 

 

 

 

 

[PurplePaisley]

Thank you, Gridley.

I received liquid citalopram (10 mg/5 mL) just yesterday, and increased to 6 mg/day (3 mL/day) this morning. I want to try to taper by 10 % per month, once I stabilize on 6 mg/day (5.4 mg/day, 4.86 mg/day, 4.37 mg/day, 3.94 mg/day, etc.).

 

My brain's "higher functions" aren't working as usual. Along with the problems with memory and focus, I have trouble with math (don't worry -- I'll be using Excel for my tapering schedule, so no paper and pencil for me), trouble understanding non-simple speech at times, and difficulty expressing myself at times. These additional symptoms are somewhat like some symptoms I have with migraines.

 

I updated my sig -- thanks for the link to edit it.

[Gridley]

42 minutes ago, PurplePaisley said:

I received liquid citalopram (10 mg/5 mL) just yesterday, and increased to 6 mg/day (3 mL/day) this morning. I want to try to taper by 10 % per month, once I stabilize on 6 mg/day (5.4 mg/day, 4.86 mg/day, 4.37 mg/day, 3.94 mg/day, etc.).

 

Very good.  As I said it'll take about a week or a little more for the full effects of the updose to take effect.  Please keep us updated on how you're doing.  To tag me so I'll be sure to see your posts, write @Gridley and when the rectangle appears with @Gridley in it, click on that and I'll be notified that you've posted.

 

If the updose helps, it can take a while (a few months) to stabilize before you should begin your taper.  "Stabilize" doesn't mean the absence of symptoms but rather that they're tolerable and you don't have big swings in symptoms from day to day.

 

It's a good idea to keep daily notes on your symptoms to keep track of how the updose is doing

[PurplePaisley]

@Gridley, thank you.

 

I increased from 5 mg/day to 6 mg/day on 7/9. The first 4 days were awful -- my WD symptoms kept getting worse (horrible anxiety with shaking like a leaf, deep crying, & no appetite) for the first ~3 days. I began occasional pacing and hand wringing/rubbing. My receptors hadn't yet experienced the effects of the increasing drug levels.

 

Things got a little better over the next 3 days (slightly less anxiety, with less shaking and crying, and even some interest in food).

 

Memory and focus are still strangers to me. Cognitive issues continue. Dissociative symptoms remain strong and bothersome. Pacing and hand wringing/rubbing continue. Last night, I said to my husband (my primary support in AD WD, and in life), "I don't feel like myself. Whoever's brain is in my head, it needs fixing."

This morning, I had a fit of despair, regret, and shame, and the feeling that I have failed him, our grown children, and myself. I was in such deep emotional pain that I told him that I felt like I was dying.

 

I would say that a week ago I was barely functional. Now, I'm slightly functional -- I'm taking a little better care of myself and my surroundings, and I even left the house alone for a dental appointment. I'm still very anhedonic -- I can rarely think of anything that I enjoyed previously that I could do/read/watch/listen to now. In the past day and a half, I've considered giving away my piano (which I've always wanted to take up again in retirement), my large bead collection (I was an avid amateur beadworker for about 20 years), masses of books that I now have time to read, and my other crafting materials. There doesn't seem to be a point to keeping these things around, as it feels like I'll never be able to use them again with any interest or pleasure.

 

I have an intake appointment with a psychologist in my HMO a week from today. I will push to get assigned to someone who knows about SSRI tapering/WD.

 

Question: Should I increase my dose to, say, 6.5 mg daily? Or should I hang on (I believe that I can do that) to see whether my emotional distress decreases and evens out a little more over the next week before considering another increase?

 

Thank you,

PurplePaisley

[Gridley]

13 minutes ago, PurplePaisley said:

 

I would say that a week ago I was barely functional. Now, I'm slightly functional

 

14 minutes ago, PurplePaisley said:

Question: Should I increase my dose to, say, 6.5 mg daily? Or should I hang on (I believe that I can do that) to see whether my emotional distress decreases and evens out a little more over the next week before considering another increase?

 

It seems the updose is a step in the right direction.  I'd give it a few more days to see if you even out a bit more before considering another increase, say to 6.5mg.

 

20 minutes ago, PurplePaisley said:

I can rarely think of anything that I enjoyed previously that I could do/read/watch/listen to now. In the past day and a half, I've considered giving away my piano (which I've always wanted to take up again in retirement), my large bead collection (I was an avid amateur beadworker for about 20 years), masses of books that I now have time to read, and my other crafting materials. There doesn't seem to be a point to keeping these things around, as it feels like I'll never be able to use them again with any interest or pleasure.

I'd keep them.  Anhedonia can feel like it's permanent but it isn't.  You will be able to get back into those pleasures.  

 

22 minutes ago, PurplePaisley said:

HMO a week from today. I will push to get assigned to someone who knows about SSRI tapering/WD.

I hope you have good luck with this.  Please keep in mind that the vast majority of doctors have no concept of safe tapering and don't even believe in the existence of withdrawal.  It's what they were taught and what is reinforced by the information they receive from the pharmaceutical industry.

 

 

[PurplePaisley]

Hi, @Gridley. Thank you for your response.

I've been feeling only slightly better since our exchange on 7/16. My anxiety is usually moderate rather than severe now, with internal and external shaking (but not shaking like a leaf). Crying spells are less frequent and severe.

However, I have increased urges to move repetitively, and my movements are sometimes stiff and jerky.

 

Everything else is essentially the same. I don't feel like myself, my brain and body don't work properly, and I'm suffering.

 

So I'm again thinking about increasing my dose to 6.5 mg/day, in hopes of reaching a plateau that I can tolerate better while holding for a while (maybe a few months). Then I'll start tapering slowly (possibly microtapering). Your thoughts are very welcome!

Thank you,

PurplePaisley

 

[Gridley]

3 hours ago, PurplePaisley said:

So I'm again thinking about increasing my dose to 6.5 mg/day

That sounds fine.  I hope you feel better very soon.

[Greatful]

@PurplePaisley  Sounds like you have handling you symptom pretty well.   

The neuro emotions get the best of us.  I am sure you did a great job with your children and I bet your husband will tell you the same thing. I am glad you have him there to support you through this process.  It is truly amazing the changes these  drugs do to our brains.  I have been on them for a little over 20 yrs.  Scary.  But there are many that have successfully gotten off and are doing well.

There is information and print outs you can bring to the Doctor visit.  

 

 

Have you looked around the site?  Lot's of information to go through.  Anything I can do drop me a line.

Let us know how the Doc appt goes.  

 

Click on the title and it will bring you to the thread

 

[PurplePaisley]

Thanks again, @Gridley. I increased my dose to 6.5 mg/day today. I'll report back as things improve (which I expect to happen).

 

A funny thing -- yesterday, I had some relief for a few hours -- anxiety, shaking, and brain fog were all lessened greatly. I was more interested in my surroundings, and I spent some time with a couple of books that would have been too difficult before.

 

I don't expect to feel like that most of the time as I'm trying to stabilize, but I hope that I can look forward to a few hours here and there during which I feel more like myself.

 

Thank you for your help.

PP

[PurplePaisley]

And thank you, @Greatful. I know that I'm my own worst enemy sometimes when it comes to evaluating my life. My husband has assured me that I'm not, in fact, a terrible person who's failed everyone and everything.

 

I've been spending quality time on the site, reading several of the topics in detail.

I'll report back on how things go with my healthcare professional(s).

 - PP

 

[PurplePaisley]

Hi, @Gridley.

I had meant to post mid-to-late last week, when I was feeling relatively well, and thinking that I could stabilize on my current dose of 6.5 mg/day of citalopram before any further taper. (Today is day 12 of this dose.) When I'm feeling better (as I was), I have a hard time persuading myself to come here, to try to meditate, to read helpful material, etc. I'm sure that this is not a rare situation for people who have difficulty with physical and/or mental health -- when the problems recede, even very temporarily, it's only human to feel like things are back the way they should be, perhaps for good, and then to have a big letdown when the tide of symptoms comes back in.

 

In the last few days, I've had a setback, with a return of severe anxiety, shaking inside and out, insomnia, irritability, emotional lability, and a very negative outlook over all. I think that this is due to the up-and-down, round-and-round nature of withdrawal symptoms, on top of a significant family issue that's causing both me and my husband added stress.

 

I want to curl up in bed and cry. I've done plenty of crying, but have managed to stay out of the fetal position for the most part.

 

I forced myself to do a little craft work over the weekend for a practical purpose, but I didn't enjoy the process and couldn't get any creativity flowing -- I basically reworked a small item that I'd made years ago. And I didn't do it right, so it's not usable until I rework it yet again.

 

I can't find anything to watch for distraction. Everything on the streaming services seems to focus on violence, hypersexuality that's not loving, or paranormal nonsense. I told my husband that I need the video equivalent of rice pudding.

 

I'm still hopeful that I can hang on at my current dose. Twelve days may not be long enough to feel the full effect of the latest dose increase.

 

 - PurplePaisley

[Greatful]

@PurplePaisley  Sorry you are still struggling, but you will get there.  

7 minutes ago, PurplePaisley said:

I told my husband that I need the video equivalent of rice pudding.

sounds like me.  I get to stimulated trying to follow conversation, then add in the music in the back ground, changing scenes.  UGH!  

Sending you a hug🤗

How did your appt. go?  

 

 

[Gridley]

49 minutes ago, PurplePaisley said:

it's only human to feel like things are back the way they should be, perhaps for good, and then to have a big letdown when the tide of symptoms comes back in.

This is very common and is pretty much the rule for all of us.  I know it is for me: it feels so good, so normal, to be feeling right again and you settle right ito it, thinking it's forever.  Then the symptoms return and it's an enormous let-down.  We just have to keep slogging through it until we're healed again.

 

52 minutes ago, PurplePaisley said:

due to the up-and-down, round-and-round nature of withdrawal symptoms, on top of a significant family issue that's causing both me and my husband added stress.

 

This is exactly right--and the stress is a big factor in ramping up withdrawal symptoms.  You are doing very well at understanding and dealing with WD.

 

53 minutes ago, PurplePaisley said:

couldn't get any creativity flowing

Agan, very normal.  I'm a writer, and for now there's very little if any creativity flowing. 

 

55 minutes ago, PurplePaisley said:

 

I'm still hopeful that I can hang on at my current dose. Twelve days may not be long enough to feel the full effect of the latest dose increase.

I would give it a bit longer and see how you feel.  

[PurplePaisley]

Thanks, @Greatful. I have an appointment in a couple of weeks for medication management with a psychiatrist, and a first therapy appointment late next month...

[PurplePaisley]

Thank you, @Gridley. I'll post an update in another few days. I'm hopeful that my heart will stop feeling like it's trying to pound its way out of my chest by then.

[jutland86]

Hi @PurplePaisley

 

Hi jutland!

 

Just wanted to check in and tell you that you are not alone. I started skipping doses as a way to taper as adviced by my GP, and I ended up feeling awful. It felt like I would never get better, but slowly I did after holding on a dose of 7,5 mg. It just takes time, and the fact that you have had windows is a good sign. You will get better!

 

Wish you all the best!

 

Jutland

[PurplePaisley]

Thanks for the encouragement, @jutland86. I'm having a better day today, to the point that it's difficult to remember how awful I felt yesterday. We are resilient creatures when we're allowed to be.

 

Sending good thoughts to you.

 

 - PurplePaisley

[PurplePaisley]

It's another bad day. I had a crying fit this morning on my way to have my hair trimmed. I had very bad anxiety, irritability, and crying this afternoon over problems filling out forms online, because they required information that isn't relevant to my situation, I have no access to some of that information, and there are no fields to allow me to enter explanations. It doesn't help that the form is required for a stressful reason.

 

My craziness today, and the stressful reasons for which the forms are needed, are affecting my husband. Fortunately, he can take a long drive if things get too tense, and I'm not going to do myself any harm if he has to be away for a few hours.

 

This is day 14 of the increased citalopram dose (6.5 mg/day). Hanging on. Walking when possible. I'm hopeful that I'll be able to listen to a meditation recording soon -- I have a few of them, but I somehow haven't been able to sit still to listen to any of them.

 

I find being on this site comforting as well as informative. We're all in this together.

 

All will be well, and all will be well. Just keep walking, right?

 

 - PurplePaisley

 

[Greatful]

@PurplePaisley

1 hour ago, PurplePaisley said:

I had very bad anxiety, irritability, and crying this afternoon over problems filling out forms online, because they required information that isn't relevant to my situation, I have no access to some of that information, and there are no fields to allow me to enter explanations.

A person can get anxiety filling out forms without W/D.  Be kind to yourself❤️ 

You are doing a great job holding it together.  I know it is hard for our husbands to watch someone they love in pain.  It's great that you relies  your husband may need time to process how he is doing and how he can best help you.  Great partnership♥️

 

1 hour ago, PurplePaisley said:

We're all in this together.

 

Yes we are.  We are never alone.  Hubby at home and support from people here that know what you are going through.😊

[PurplePaisley]

Thanks for your words of encouragement, @Greatful.

Today has been going better today. I'm frustrated with the swings in my mood from day to day, as is my family. If my mood were stable, though, I'd be stable, or at least "stabilized". I'm looking forward to having moods that are more predictable and reliable, so that I can decide whether I can move forward with a (slow) taper.

 

Cheers,

PurplePaisley

[PurplePaisley]

This is day 22 of citalopram 6.5 mg/day. I've seen some improvement -- I had 2-1/2 decent days in a row this week, which was a relief. Since last week, I had been alternating one okay or even good day with one low or bad day, which was frustrating and draining.

 

I did some beadwork today -- I again reworked the item that I tried to rework last week, and it works now. I also made another item from scratch, and that one also works. So even though I was shaking somewhat most of today, I crafted successfully. (That sounds funny, but coming up with clear sentences isn't my strong point lately.)

 

I've also been able to walk more regularly. I have to go fairly slowly because exercise raises my anxiety. Some weeks back, I had been walking longer and faster while listening to the "The Good Place" podcast or music, and experienced bad anxiety that I attributed to what I was listening to rather than to the exercise itself. It's nice that I can walk around the neighborhood now.

 

With good self-care support from my husband and you good people, and a little luck, I should be able to remain on this dose for a while in hopes of stabilizing.

 

Walk walk walk...

 

[Greatful]

@PurplePaisleyI am glad that things are slowly improving for you.  Sometimes it seems like time stands still.

Someone on SA said....The days go by slow but the weeks go by fast.  I find that to be true.  Somedays all you can do is make it through the day.  Before you know it, it is the weekend again.  

41 minutes ago, PurplePaisley said:

I had 2-1/2 decent days in a row this week,

That sounds wonderful.  Way to go.  

Hopefully that will grow into weeks at a time soon❤️

[PurplePaisley]

Thank you, @Greatful. Time doesn’t have the same feeling to it now, compared with pre-WD, for the most part. And I’m retired, so weekends are much like weekdays.

Unfortunately, I have gone back to being more down & negative. I look forward to better and more predictable moods.

[Greatful]

@PurplePaisley  

1 minute ago, PurplePaisley said:

Time doesn’t have the same feeling to it now, compared with pre-WD, for the most part. And I’m retired, so weekends are much like weekdays.

I can relate to the days blending together,  What is your secret to staying busy and not getting restless?  I need to learn how to relax and in  WD and all the anxiety and fatigue  that comes with it, makes it hard to think of  How am I going to past the day.

 

5 minutes ago, PurplePaisley said:

Unfortunately, I have gone back to being more down & negative. I look forward to better and more predictable moods.

I am with you on this.  

We will get through this, one day at a time😊

[PurplePaisley]

On 8/15/2021 at 2:59 PM, Greatful said:

What is your secret to staying busy and not getting restless?  I need to learn how to relax and in  WD and all the anxiety and fatigue  that comes with it, makes it hard to think of  How am I going to past the day.

Hi, @Greatful. I don’t have good insight into how to keep busy, or how to relax. I’m not even very good at distracting myself when I’m anxious, since that mood makes it very difficult for me to read anything that’s not light and humorous, I don’t like over 95 % of movies and TV available for streaming, and exercising more than a little makes me more anxious. 

 

I’m tired of reading silly stuff on the Web, rereading books by Tom Holt, etc. There’s a lot that I want to and even need to do that’s just beyond me right now. I don’t get much done, frankly.

 

I switched to washing dishes by hand a few days ago, and find it somewhat satisfying (“See? I’m doing something!”). I do my laundry and some of my husband’s laundry, and pay the few bills that aren’t already on autopay, but I can’t focus on much of anything.

On 8/15/2021 at 2:59 PM, Greatful said:

We will get through this, one day at a time😊

Yes, we will. 👍 

Take care.

[Greatful]

@PurplePaisley  I have heard of people doing paint by numbers.  I did a lot of coloring last winter, trying to think of something else🙄

I don't read much  or watch tv.  I sit outside a lot  on my computer when it's not to hot.  I use to do puzzles on my tablet not sure if I can get into that yet.  Play some games on my tablet.  Blah, Blah ,Blah  I use to do puzzles on my tablet not sure if I can get into that yet. 

It is amazing how easily  we can get over stimulated. 

Oh well time marches on no matter what😉

[PurplePaisley]

Hello, @GridleyI've been on 6.5 mg citalopram/day for 4-1/2 weeks now, and have seen some improvement, but I still don't feel comfortable in my own skin or head most of the time.

 

My appointment with a psychiatrist on Thursday, Aug. 19, went about as expected -- she said that:

slow tapering isn't recommended with Celexa [rather, tapering over 1-2 weeks(!?!) is recommended!];

my symptoms are reemergence of depression & anxiety;

she recommends that I go back up to 10 mg/day citalopram, OR SWITCH meds [to fluoxetine (for "self-tapering") and/or venlafaxine; or even to Lexapro (?!?)];

she wants me to consider gabapentin "as needed" for anxiety; I'd taken this med for a while after stopping drinking (I'll add this to my med Sig).

 

The only things she said that seems really relevant to my situation is that regular exercise will be helpful, and that therapy sounds like a good idea. My first therapy appointment isn't until late September.

 

I told her that I accept that my situation is not necessarily typical, and that my symptoms since starting my taper have been worse than I had experienced before going on an SSRI.

 

I declined her offers of other/more meds, and also said that I'm willing to continue at 6.5 mg/day for another 2 months before determining next steps (ideally, to include restarting the taper, very slowly). I don't know whether I'm going to be able to hold out for that long without updosing, but it's a goal.

 

I started taking some l-theanine recently, and have stopped CBD. My husband is concerned about the lack of research into long-term safety of CBD, and worries that I'm setting myself up for another round of withdrawal because I've been using it more regularly during the worst of SSRI WD. The l-theanine seems to help my anxiety somewhat.

 

I'd previously stopped THC, except for the very small amts in the vaped and oral CBD products. I had an unpleasant reaction to a small amount of vaped THC a few weeks ago.

 

I've been so anxious and shaky that meditation has been impossible for over a week.

 

I welcome your thoughts.

 

I wish for calm, peace, good health, and support for everyone.

 - PurplePaisley

 - - -

Hi, @Greatful. I did some paint-by-numbers a few years ago, and found that it required a lot of fine motor control. That's something that I don't have now, though I hope to eventually, maybe when I've stabilized on my current dose. I'm really hoping that I'll again be able to read material that isn't fluffy and humorous at some point in the future -- my husband and I were really enjoying reading aloud in the evenings before everything went to [bleep].

 

 - PP

[Greatful]

 

 @PurplePaisley

 

23 minutes ago, PurplePaisley said:

I've been on 6.5 mg citalopram/day for 4-1/2 weeks now, and have seen some improvement, but I still don't feel comfortable in my own skin or head most of the time.

  I can really relate to not feeling comfortable in my own skin and head.  I feel panicky quite a bit and underlining anxiety.  We won't even get into the brain malfunctioning UGH😵  I think improvement after 4- 1/2 weeks is a good sign.  That means healing is taking place and you know that more improvements are on the way☺️

36 minutes ago, PurplePaisley said:

slow tapering isn't recommended with Celexa [rather, tapering over 1-2 weeks(!?!) is recommended!];

my symptoms are reemergence of depression & anxiety;

I don't know if this makes me more sad or more angry.  I think both.  The ignorance in their lack of knowledge is so frustrating.  All they need to do is actually open their eyes and ears to their patients.  They have excess to the internet how can they not have heard or seen even a little bit of information that is circling around the internet.  Youtube. forms,  Even books on the book shelves at stores written by their peers.  This is their job, you would think they would want to be well informed  to any information that applies to their  job. 

23 minutes ago, PurplePaisley said:

The l-theanine seems to help my anxiety somewhat.

 

I take L  Theanine also.  Sometimes it really seems to help.  How much are you taking?  I take 200mg once a day.  Keep me posted on how you think it is working for you.  I am trying to decide if I  should take a higher amount or just drop it.  You get so tired of what is causing what when you don't feel good.

Do you drink tea.  I started to drink chamomile tea.  It has a calming effect too.

Do you take magnesium slowly throughout the day or take it all at once?  They  recommend you take it in small amount throughout the day.

I split up my 100mg capsules 50mg at a time in water and drink it.  I take about 4 times a day.  I may increase the amount per dose 100mg 3 times a day.  

We will try anything to help with the anxiety🙄

 

I hope things settle down soon for you❤️

[Gridley]

16 hours ago, PurplePaisley said:

slow tapering isn't recommended with Celexa [rather, tapering over 1-2 weeks(!?!) is recommended!];

I'm taking a break from moderating now, but I'll be happy to give you any thoughts on the questions you raised.  Regarding the first point about slow tapering, as you're read here on Sam doctors know nothing about tapering or withdrawal.  Slow tapering is safer and better.

 

16 hours ago, PurplePaisley said:

she recommends that I go back up to 10 mg/day citalopram, OR SWITCH meds [to fluoxetine (for "self-tapering") and/or venlafaxine; or even to Lexapro (?!?)];

These don't sound like good ideas to me.  Increasing from 6.5 to 10 is a very large increase and could overwhelm your system, making matters worse.  Fluoxetine is not self-tapering and there are many problems that can result from switching drugs.  The fact that you're seeing some improvement is a good sign, and I wouldn't experiment with increases or other drugs.  

 

16 hours ago, PurplePaisley said:

regular exercise will be helpful, and that therapy sounds like a good idea.

Therapy can be helpful, depending of coarsen the fit between you and the therapist.  Exercise is fine, but strenuous exercise is very often too much (too activating) for people in withdrawal.  Gentle exercise like a walk in nature is recommended.  See what works for you.

 

16 hours ago, PurplePaisley said:

that my symptoms since starting my taper have been worse than I had experienced before going on an SSRI.

Ys, that is typical of wthdrawal.

 

16 hours ago, PurplePaisley said:

don't know whether I'm going to be able to hold out for that long without updosing, but it's a goal.

If you do decide to updose, the updose should be very small to avoid overwhelming your system, such as an increase of .5mg.  It takes several days for an updose to reach full effect in your system.  

 

16 hours ago, PurplePaisley said:

I had an unpleasant reaction to a small amount of vaped THC a few weeks ago.

I'd stay away from it.

 

16 hours ago, PurplePaisley said:

 

I've been so anxious and shaky that meditation has been impossible for over a week.

I have a hard time too with meditation due to anxiety.  Keep at it.  You are likely getting benefits even though you're not aware of them.

 

 

 

 

[PurplePaisley]

Thank you, @Gridley.

Your suggestions and info are very consistent with my understanding and personal experience so far (unlike much of what the psychiatrist said…). I have to exercise in a moderate or even mild way, for instance. Getting my heart rate up with more intense exercise leads to worsened anxiety that lasts for hours.

Should I tag a different moderator for a while? Or, while you’re away, is another mod going to be checking on the folks whom you follow?

Thank you for your words of wisdom and support.

 — PP

[Gridley]

1 hour ago, PurplePaisley said:

Should I tag a different moderator for a while?

That would be a good idea.

[Greatful]

@PurplePaisley  Hi stopping by to see how you are doing?

[PurplePaisley]

Hi, @Greatful. Thanks for checking on my thread.

 

I'm still here, and still looking for stability. In general, my mood is moderately anxious (3 on a 5-point scale) and somewhat depressed (2 on a 5-point scale). Memory and focus problems remain worrisome. I broke my main pair of eyeglasses over 2 weeks ago, and my vision is blurry with my other (out of date) pair, so that's adding to my sense of things being uncomfortable, unreal, and weird. It's going to be over 2 weeks more until I can see an optometrist at my HMO. (Bleah.)

 

It's difficult to get to sleep, and especially difficult to stay asleep.

 

I got myself out of the house (alone! without my husband!) a couple of weeks ago, and bought a couple of books, even though I didn't think I'd be able to concentrate on them. To my surprise, I can usually read the books and get something out of them, though I may not be able to remember much of what I've read a half hour after putting the book down. One of the books is "Code Girls", about women working on code- and cipher-breaking during World War II in the U.S. I can recommend it to anyone who's interested in non-combat aspects of war, and the effects of war on people who aren't in the armed forces.

 

I'm so disheartened by the response of the psychiatrist (see my previous posts). I don't even want to read the messages that she sent through my electronic chart.

 

My husband and I are looking into food issues potentially affecting the nervous system. It looks like an elimination diet may be in our near future.

 

I hope that you are well. Thanks again.

 - PP