clairef: new to this site

[clairef]

Hi there, I've come across this site very recently and I'm hoping it will guide me in my tapering off citalopram which I've been taking for too many years.

I started taking daily 20mg pills after a post-natal depression bout in 2009-2010, stopping was fine, then returned to 20mgs after my next baby in 2012 and have been on citalopram since. I shifted to daily 10mgs approx in 2015, and since 2019/2020 I've skipped one dose per week, so I'm having 6 pills per week. I'm hoping to taper off 1mg at a time although I'm open to other suggestions? I'm unsure about scales- if they work for 1mg how do you measure say, 0.5mg? More sensitive scales cost a bomb!

Looking forward to hearing from the sxperienced ppl on here. 

Thanks!

[Shep]

Hi, Claire. Welcome to Surviving Antidepressants.

 

Here is some information to get you started:

 

Tips for tapering off citalopram (Celexa)

 

We recommend tapering no faster than 10% per month off the prior month's dose:

 

Why taper by 10% of my dosage?

 

A few more links: 

 

How psychiatric drugs remodel your brain

 

Healing from antidepressants. Patterns of recovery video (4 minutes)

 

The Windows and Waves Pattern of Stabilization

 

On 7/26/2021 at 5:31 PM, clairef said:

I shifted to daily 10mgs approx in 2015, and since 2019/2020 I've skipped one dose per week, so I'm having 6 pills per week.

 

We don't recommend skipping doses. Please see:

 

Never Skip Doses to Taper

 

On 7/26/2021 at 5:31 PM, clairef said:

I'm unsure about scales- if they work for 1mg how do you measure say, 0.5mg? More sensitive scales cost a bomb!

 

Please see:

Using a scale to weigh and measure doses

 

You may be able to find a scale at a reasonable price. Many people find the Gemini 20 scale to work well for tapering. You may also find these on eBay and other online venues.

 

Citalopram also comes in prescription liquid. From the "tips for tapering off citalopram" thread, please note:

 

On 4/9/2012 at 3:07 PM, Altostrata said:

It looks like citalopram liquid is available in the UK:

 

https://www.medicines.org.uk/emc/product/3349/smpc

 

EDIT BY ONMYWAY: Note that the UK liquid formulation of citalopram has different bioavailability so 

1mg of the liquid solution is equivalent to 1.25mg of the tablets, very important to remember when switching to liquid or when reinstating in liquid. Also use syringes to measure rather than drops which can be inaccurate.

 

Please continue to use this thread to document your taper and to ask questions.

 

 

[Moonpie]

Hi Clairef so happy to have you join us!  You are definitely at the right place to get help and support along your journey to being off your medication. I too found this site 4 years ago and am so thankful!  I could not have made this far with out all these wonderful people.  The compassion, knowledge and wisdom cannot be found anywhere else!  Welcome to SA! 

[Altostrata]

Welcome, @clairef

 

Please do not skip doses of citalopram! Before tapering, suggest you convert to 8.6mg citalopram per day -- the average daily dose for the 60mg you take over 7 days. You can do this by taking 8.6mg on the day you usually skip a dose, then continue with 8.6mg rather than 10mg every day after that.

 

There might be a little bump from the change, but it should smooth out in about 4 days. Please let us know how you're doing while you make this change.

 

To taper, you'd decrease by 10% from the dosage you're taking every day. If 8.6mg suits, your first reduction would be to 7.7mg.

[clairef]

Guys you've been so great at getting in touch and offering advice, thanks so much, I really appreciate it! I like your idea, Altostrata, to do 8.6mg for the first 4 weeks and then taper off to 7.7mg. Before I start, I need to get my act together and buy the bits I need. I definitely need scales (are cheaper ones than Gemini 20 less reliable with the measurements?), and then I was wondering whether I should just scrape off the 1.4mg from each tablet or actually grind the whole tablet down and then stick it in some food? I realise that the active ingredient won't be even across the tablet, but seriously, does it really matter? I'm just trying to manage tapering plus a super busy life!   I'm not sure I can be bothered to start buying gelatine capsules to fill? I will also ask my doctor whether they'd be happy to prescribe the liquid form of citalopram, as maybe that's the best option going forward?

 

[Onmyway]

Hi Claire, 

the citalopram liquid is the best option and in the UK it is easily available. If your doctor resists prescribing it saying it's more expensive (I had a serious fight with mine about this) tell him that it's still under the £9 copay and it will last you a long time. One thing to remember is that the liquid mg (not ml, the mg) are 1.25 times more potent than the pill mg. It says so on the leaflet. This is important to know when you switch. At the time you pick up your meds also ask for a 10ml and 1 ml syringe. To get precise measurements it will be necessary to dilute in water as you get to the lower doses. You can keep the solution (water + citalopram) in the fridge in an jar with a lid. To get 8.6 mg into the equivalent in liquid form you'd divide 8.6/1.25=6.88 ~ 6.9 mg liquid (liquid is more powerful so you will need less of it in mg). 

 

0.2ml (2 units of the small syringe) of the liquid contains 8mg of citalopram.  I dilute that into 80ml (8x10 ml - 8 times of the large syringe) of water and stir it well - so each ml of the water solution is 0.1mg of citalopram. That gives you a 1ml solution=0.1mg. 

 

To take 6.9mg then you could do

1) 69 ml of the water solution (6 syringes x 10 ml + 1 syringe x9 ml).

 

OR

2)  0.1 ml of the medicine directly from the bottle (for 4 mg) + 2 syringes x 10 ml of the solution + 1 syring x9 ml of the solution. 

 

I'd recommend option 1 as precise measurements of this liquid are hard so there are bigger variations when it is more concentrated. Also the liquid version is more viscous and may stick more to the syringe or its outside. Very small doses have a large impact at low doses so even though this sounds anal, it's important to get it right. Our bodies become more and more sensitive the lower we go. 

 

Your next cut will be 10% from 6.9 so about 6.1 mg in liquid but I'd suggest stabilizing and getting used to the liquid first before you make changes. Any changes in formulation impact how our body absorbs the medicine and can take time to rebalance. 

 

Let me know if you have any other question. If you tag me like this, I will get a notification. @Onmyway

 

 

[clairef]

@Onmyway you are amazing thank you so much for your advice! I'm awaiting a response from my GP and will get back to you if I struggle to work out what to do thank you v much

[clairef]

Just a quick update that I received a prescription for liquid citalopram from my GP and I am now drinking my water/citalopram concoction every day! See updated signature

I am finding it a small hassle every morning, squirting my daily millilitres into a glass, but I suppose this is the best way?

 

[clairef]

i am so utterly panicking right now because i've just worked out that i have been taking 10x the amount i'm meant to be taking (daily!!) since starting to taper of with liquid citalopram.

 

HELP!

 

i have bought a 10ml and 1ml syringe.

i've been taking 2ml per 80ml water, rather than 0.2ml!!!

please help, yikes, i don't even know what to do now... do i go staight to the correct dosage? i've had 10x too much since 27 August.

 

yiiiiiiikes

 

i feel so massively embarrassed.

 

i can't believe i haven't collapsed!!

 

someone help

 

 

 

 

[Shep]

8 hours ago, clairef said:

i have bought a 10ml and 1ml syringe.

i've been taking 2ml per 80ml water, rather than 0.2ml!!!

please help, yikes, i don't even know what to do now... do i go staight to the correct dosage? i've had 10x too much since 27 August.

 

Please don't panic, Claire. This happens more than you can imagine on these forums. It's only been about 9 days, so it's safe to go back to where you were. 

 

Are you having any upticks in symptoms? 

[clairef]

Thanks @Shep for getting in touch. More than anything, I felt unhappy that I could have made such a mistake. I ended up diluting it all correctly and now have over 3 litres (!) of meds in my fridge. I spoke to a GP (medical doctor) who said the same as you and advised to reduce 25% every 3-4 days from that super high dose until I am back to where I started. I haven't had any weird symptoms to speak of, thank G-d!

I am predicting strange symptoms over the next few weeks but who knows. I'll keep this forum posted if anything comes up.

Thanks again

[Shep]

23 hours ago, clairef said:

 I ended up diluting it all correctly and now have over 3 litres (!) of meds in my fridge.

 

I'm not sure how long this will last with your doses, but be careful you aren't using liquid doses that have gone bad. Some liquids should only be made up in advance for a few days before they expire. If you're unsure, please ask your doctor or pharmacist. 

 

I'm glad you haven't had any symptoms. It's possible you may not.

 

Please let us know how you're doing over the coming days.