SeekingAnswers: Struggling after completed tapering off Celexa

[SeekingAnswers]

I have been off Lexapro since the end of April. Most of the time I have been doing pretty well. But lately I am having so much trouble getting sleep because just as I am about to drift off, weird thoughts come into my mind out of nowhere and wake me up. Then as I come back to full consciousness I get a horrible feeling a dread and panic that comes into my stomach and hurts. Anyone else having these problems during withdrawal, and any advice? I really need to be sleeping a full night but I've never taken sleeping pills and don't want to even start them. Thank you in advance. @Altostrata 

[Altostrata]

Welcome, @SeekingAnswers

 

Sleep disruption is common in withdrawal syndrome, and it occurs exactly as you've described. 

 

As with your son, reinstatement of a small amount of Celexa might help. I suggest you get a prescription for Celexa liquid and take 1mg per day. This small amount can stop withdrawal symptoms. You'd stabilize on that for some weeks and then taper off by minuscule amounts.

[getofflex]

Hello @SeekingAnswershow are you doing these days?  How are your symptoms?  Thinking and praying for you.  

[SeekingAnswers]

Thank you so much @getofflex, I really appreciate you thinking of me and praying for me. I am doing better today, less anxiety about my son's situation today even though I am very concerned, at least I am calm and my heart is not racing or anything like that. I am taking all of this one day at a time and hoping for the best. I had two nights of only sleeping 2 hours each night, but last night I was able to get about 6 hours sleep and that's helping me. How are you doing? I hope you're doing well, too.

[KenA]

@SeekingAnswersI remember having those sleepless nights and the cortisol / adrenaline bursts right I was drifting off to sleep! It sure did set the tone for the rest of the night. I would be lucky if I was able to drift back off to sleep at all for the rest of the night! You def have the right mindset of just taking things one day at a time!! That is the best way to get through this!! I can promise that normal sleep will return at some point. I had the insomnia for probably a good 6 months or so, but I made it through and so will you I found when I would have a sleepless night,  I would just turn it around and think of it as just having some free time to do the things I wanted to do. So I would work on a craft, or turn on a movie and just make a night of it. That way I wasn't worrying about not sleeping, and honestly towards the later part of it, I would actually end up falling asleep because I had stopped trying to fall asleep. Wishing you the best!

 

 

[SeekingAnswers]

Thank you for the encouragement @KenA ! I'm glad you're sleeping better now! 

[getofflex]

6 hours ago, SeekingAnswers said:

I am doing better today, less anxiety about my son's situation today even though I am very concerned, at least I am calm and my heart is not racing or anything like that.

This is very good!  I'm glad you are doing better today.  🌻

 

I'm doing well myself, for which I'm very grateful.  My sleep has improved quite a bit and that helps a lot.  My husband and I got to go for a short hike today, because the weather is milder today in the midwest.  We have very hot humid summers here.  

[SeekingAnswers]

I'm glad you're doing well. So nice that your weather is cooler today and you got to go hiking. I'm in southern CA and it's hot all summer here, even through Fall. It always seems like it's hot until Halloween, and then it starts cooling off. I like cooler weather much better. I'm hoping we'll get some rain this "winter" because we sure need it! 

[getofflex]

I’m envious of your Southern California Mediterranean weather. We get very hot and humid summers here and pretty cold in the winter.

[SeekingAnswers]

Took one 10mg Celexa, is it too late to switch to 1mg liquid Celexa?

 

Hi, my son who has been off Celexa for about 9 weeks has been having some really bad depression, along with other WD symptoms as well. Although he is an adult, he has Autism (high-functioning) and very much looks to me for guidance and advice in this matter of his Celexa discontinuation. He also won't make an account on this site, unfortunately, and also doesn't want to see a therapist. People will Autism can be stubborn about things sometimes. Anyway, because of the depression which was getting bad, and the other WD symptoms, he (we) decided it would be best for him to go back on Celexa for now and then start a VERY slow taper once he's stabilized. So he took one of the 10mg Celexa tablets last night. Now I'm wondering if it is too late for him to switch to 1mg Celexa in liquid form or will that cause worse WD symptoms now that he took one of the 10mg? Thank you so much for your help. I'm sorry if I seem confused, I am just 6 months off Lexapro and while I thought I was doing fine, with all the stress of seeing my son suffering from WD symptoms lately, I am now super stressed and having so much anxiety along with not being able to sleep more than 4 hours per night. 

 

 

Edited October 12, 2021 by ChessieCat
added topic title before merging with intro topic

[SeekingAnswers]

21 hours ago, brassmonkey said:

The Brassmonkey Slide calculates the reduction in both ways. The overall 10% reduction is calculated off of the previous dose to provide the hyperbolic taper. While the 2.5% reductions are calculated off of the current dose.

Hi Brass Monkey, I hope you're doing well! I just posted a question but wanted to make sure you see it because you're so knowledgeable about reinstating, tapering and so much more. You can read my whole post to see the specifics of the situation, but basically here's my question:

If someone (my son) has been off Celexa for 9 weeks and then reinstated by taking one 10mg Celexa pill, is it OK to switch to 1mg liquid Celexa? Or is is too late because more WD symptoms can start up from switching to 1mg so quickly? Thank you so much! 

[brassmonkey]

10mg is way, way too much. Even 1mg is a lot for an RI after 9 weeks. I would start with 0.5mg for several weeks to see how he reacts. There may be some ups and downs caused by the 10mg, but they should only last a few days.

[SeekingAnswers]

Thank you so much for your help brassmonkey! I really appreciate you responding so quickly. It has been so difficult seeing him suffering with the WD symptoms, especially in the last few days. I will look up how to make a 0.5mg dose and proceed from there. I'm hoping the 0.5mg will help him stabilize, even if it takes a few days.   

[ChessieCat]

5 hours ago, SeekingAnswers said:

Took one 10mg Celexa, is it too late to switch to 1mg liquid Celexa?

 

Hi, my son who has been off Celexa for about 9 weeks has been having some really bad depression, along with other WD symptoms as well. Although he is an adult, he has Autism (high-functioning) and very much looks to me for guidance and advice in this matter of his Celexa discontinuation. He also won't make an account on this site, unfortunately, and also doesn't want to see a therapist. People will Autism can be stubborn about things sometimes. Anyway, because of the depression which was getting bad, and the other WD symptoms, he (we) decided it would be best for him to go back on Celexa for now and then start a VERY slow taper once he's stabilized. So he took one of the 10mg Celexa tablets last night. Now I'm wondering if it is too late for him to switch to 1mg Celexa in liquid form or will that cause worse WD symptoms now that he took one of the 10mg? Thank you so much for your help. I'm sorry if I seem confused, I am just 6 months off Lexapro and while I thought I was doing fine, with all the stress of seeing my son suffering from WD symptoms lately, I am now super stressed and having so much anxiety along with not being able to sleep more than 4 hours per night. 

 

 

 

I've moved several posts to your Intro topic to keep history in one place.

 

BrassMonkey has suggested a 0.5mg reinstatement of Celexa for your son.

 

It takes about 4 days for a dose to get to full level in the blood and a bit longer for it to register in the brain.  That being the case, changing to 0.5mg liquid Celexa after only 1 dose of 10mg Celexa tablet will probably not cause much of an issue.  If there is any issues, I think they would be minor and that they will most likely resolve during the first week.

[SeekingAnswers]

Thank you @ChessieCat. That's good news.

[SeekingAnswers]

On 10/12/2021 at 2:29 PM, ChessieCat said:

It takes about 4 days for a dose to get to full level in the blood and a bit longer for it to register in the brain.  That being the case, changing to 0.5mg liquid Celexa after only 1 dose of 10mg Celexa tablet will probably not cause much of an issue.  If there is any issues, I think they would be minor and that they will most likely resolve during the first week.

Hi @ChessieCat, It's been 2-1/2 weeks since my son reinstated Celexa at 1mg per day. He has some days where he seems to be doing pretty well (as far as I can tell) but has had a couple of days here and there where he struggles and gets upset that the symptoms are still persisting, mainly the intrusive thoughts. Tonight he came downstairs and said he thinks his Celexa dose needs to be increased. I reminded him that it takes a while for the reinstatement to be fully working. He's angry about it taking so long. My husband and I are kind and understanding when he gets angry about the symptoms, but it's so emotionally difficult. When he was completely off Celexa (for about 9 weeks) his personality was so sweet and kind, but now that he's back on it his personality is just like it was before he went off which is basically pretty selfish and rude a lot of the time. (Another person on this site mentioned that his personality changed while on Celexa and he wasn't his usual nice self during that time, so maybe that just happens to some people.) Anyway, my husband and I really don't want him to increase the dosage because then it will take even longer for him to wean back off, but if he is suffering so much, then maybe it should be increased? I guess I'm just needing encouragement and support at this point. Do you think we should encourage him to stay at 1mg, or just let him increase his dose? If he stays at 1mg how long do you suppose it will take for the symptoms to go away? Or maybe they really won't go away at that dose and he really does need a higher dose, like 2mg or 5 mg? It's so hard to know what to do. Because he has autism and is somewhat childlike (although very intelligent at the same time) he looks to us to advise him but he's frustrated with us at this point. Not sure what to do and it's so hard to see him suffering. Thank you for any suggestions or insight you have. 

[SeekingAnswers]

On 8/30/2021 at 4:39 PM, Altostrata said:

As with your son, reinstatement of a small amount of Celexa might help. I suggest you get a prescription for Celexa liquid and take 1mg per day. This small amount can stop withdrawal symptoms. You'd stabilize on that for some weeks and then taper off by minuscule amounts.

Hi Altostrata, Thank you so much for your help. You help so many of us and it is so appreciated. After being completely off Celexa since the end of July, my son reinstated Celexa 18 days ago. The first day he took a 10mg pill, then after rethinking it he went to 1mg liquid Celexa the next day and has been taking that every day since. He is still struggling so much with the WD symptoms. It's really hard to get him to tell me about it because he hates even talking about it . . . says it makes him even more upset. But anyway, he is wanting to increase his dose because he is so upset about all of the WD stuff right now. I am trying to reassure him that he will stabilize and that it just takes time. Do you have any idea of how long it might take to stabilize at the 1mg per day dose? I know every person is different, just wondering if you have any advice about whether to increase the dose, or keep waiting. Do some people just not stabilize at all until they go to a higher dose? Thank you so much.

[Altostrata]

Did the 1mg Celexa help? What was its effect? Did he feel a little better or no effect? Knowing his is crucial before deciding next steps.

[SeekingAnswers]

Thank you, Altostrata. He is still having intrusive thoughts even since reinstating, and that's the thing that's really upsetting to him. Some days he doesn't have them much but other days he has them a lot. I'm not sure if he should hold where he is since it's been only about 18 days since the 1mg reinstatement. Once he can get to a point where he has been stabilized for a few months he will then start the Brass Monkey Slide Method of tapering VERY slowly. We know that will take a long time, but hopefully the symptoms won't be as bad as they have been for the past few weeks. If he increases his dose, it will take even longer to taper, but we're wondering if it will lessen his intrusive thoughts for now. 

[SeekingAnswers]

13 hours ago, SeekingAnswers said:

If he increases his dose, it will take even longer to taper, but we're wondering if it will lessen his intrusive thoughts for now. 

Also, Altostrata, would it be better to switch him to Prozac because of it having a longer half life, or would that just potentially cause more problems?

[SeekingAnswers]

On 10/30/2021 at 2:45 PM, Altostrata said:

Did the 1mg Celexa help? What was its effect? Did he feel a little better or no effect? Knowing his is crucial before deciding next steps.

Hi Altostrata, He was on the 1mg for 3 weeks. The intrusive thoughts are still a problem and he has said several times over the last few days that he just wants to go back on Celexa to get them to go away. I told him it's only been a couple weeks since being on the 1mg and I think he should give it a longer chance to work. Then, yesterday we (husband, son, and I) had our scheduled zoom appt with his psychiatrist. He told her in no uncertain terms that he wants to increase the dosage back to 40mg which is where he was when he started tapering back in the summer. He was very angry and rude and wants these intrusive thoughts to go away immediately, but of course it takes time as I have found out from this website. Very difficult situation and I am wrought with anxiety about all of it, not knowing if we are doing the right thing or not. Anyway, after he had stormed out of the room, I told her maybe he should go up to 2mg which would hopefully help a little more and also give him hope. When he came back in she suggested to him that go up to 2mg and also take micronutrients which she says will amplify the effect of the Celexa. He was not thrilled about this solution, but he agreed. So as of last night he is now on 2mg liquid Celexa per day. I wish he could give all of this time but because of his Asperger's he often sees things in black or white, and is extremely stubborn. What are your thoughts? Do you think the 2mg will eventually make the intrusive thoughts go away? He never had them before going on Celexa or while on it. Thank you again!

[Altostrata]

It's good you're trying to help your son, @SeekingAnswers I understand it might be difficult to get answers out of him. But it's very important to find out how he feels after a dose increase. 

 

If he had bad withdrawal, he may react badly if he puts the dose too high. Think of it as his nervous system is bruised from withdrawal symptoms before. It's been sensitized. Too much drug can hit it too hard. A little can go a long way.

 

40mg citalopram is a hefty dose.

 

Perhaps you can explain it to him as slowly titrating up to his minimum effective dose -- not too much or too little. He does an experiment when he increases the dose by 1mg, then he gives it 2 weeks to see the results. (Citalopram ramps up over a week.) If he feels better, that might be a good place to stay. 

 

We're not after treating intrusive thoughts here, we're after reducing withdrawal symptoms with reinstatement. Since he didn't have them before, it looks like those intrusive thoughts are from withdrawal. We see that often here. They will go away in time. A little reinstatement is a crutch that can make this easier. 

 

If he's finds the minimum effective dose for his withdrawal-induced intrusive thoughts, he'll have less to taper later if he chooses to go off.

[SeekingAnswers]

11 hours ago, Altostrata said:

Perhaps you can explain it to him as slowly titrating up to his minimum effective dose -- not too much or too little. He does an experiment when he increases the dose by 1mg, then he gives it 2 weeks to see the results. (Citalopram ramps up over a week.) If he feels better, that might be a good place to stay. 

Thank you so much Altostrata, I appreciate your advice and help so much. I'm encouraged that you think the intrusive thoughts will go away in time. I was beginning to wonder if this would be a permanent thing. It's so hard to see a loved one suffering like this. Although yesterday I asked him if he was having the intrusive thoughts and he said, "Not as much today." So maybe the Citalopram is starting to help. 

 

I completely agree with you about keeping the dose low so he has less to taper off eventually. Thank you again for all your help.  

[SeekingAnswers]

On 11/2/2021 at 8:17 PM, Altostrata said:

If he's finds the minimum effective dose for his withdrawal-induced intrusive thoughts, he'll have less to taper later if he chooses to go off.

Hi Altostrata, As you know, on Oct 12 my son reinstated 1mg liquid Celexa per day, and then on Nov 1 went to 2mg liquid Celexa per day. He's still having intrusive thoughts, which are causing him quite a bit of distress. (Just to remind you, he didn't have them before going on Celexa, so we do believe they are a WD symptom). My question for you is, do you think he should hold at 2mg for a few more weeks and see if that helps, or go up to 3mg or even 5mg? I don't want to increase his dosage because it will take longer to taper off later, but how long do you suppose it might take for the 2mg dose to stop the intrusive thoughts? I'm wondering if it could be a few weeks, or if it would take a few months. I know that no one really knows the answer to that because each person is different, and I don't mean to put you on the spot, I'm just wondering what your thoughts are on this. Thank you again.  

[ChessieCat]

There are many existing topics on SA.  Before creating a new topic, please do a search to see if one already exists.  You can use the site search function or use an internet search engine and add site:survivingantidepressants.org to the search term.

 

I've merged your new topic with an existing topic which you can find here:

 

inositol

 

[SeekingAnswers]

5 minutes ago, ChessieCat said:

I've merged your new topic with an existing topic which you can find here:

Thank you, ChessieCat!

[Altostrata]

Hello, @SeekingAnswers Did the increase have any effect on his symptoms? He can go up by 1mg at a time, give each increase a couple of weeks to see what happens. A moderate improvement is a good sign and probably will get better, don't expect to eliminate the withdrawal symptoms immediately.

 

If he gets surges of anxiety after taking a dose or finds his sleep deteriorates, he's probably taking too much. Sometimes you have to balance the adverse effects against symptom reduction.

[SeekingAnswers]

 

4 hours ago, Altostrata said:

A moderate improvement is a good sign and probably will get better, don't expect to eliminate the withdrawal symptoms immediately.

Hi @Altostrata. The intrusive thoughts are the only things that are bothering him, and they are still prevalent, so he is still distressed, but at a more tolerable level now. At least he isn't talking about drowning himself in the pool, and he isn't lying on the floor crying like he was before he reinstated. So in that sense, I think the reinstatement probably IS helping somewhat. I guess I was expecting (or hoping for) the symptoms to magically disappear a few days after reinstating, so thank you for reminding me that it doesn't happen immediately. I will keep that in mind and I'll watch for anxiety or sleep problems if he goes up another 1mg. Thank you again so much, I appreciate your expertise and wisdom! 

[SeekingAnswers]

On 11/14/2021 at 2:40 PM, Altostrata said:

Did the increase have any effect on his symptoms? He can go up by 1mg at a time, give each increase a couple of weeks to see what happens.

Hi Altostrata, just wanted to update you on my son. During our zoom meeting with his psychiatrist on Monday, he told her he is feeling quite a bit better now than he was a couple months ago. I was glad I heard him say it, because when I ask him he says he isn't feeling any better. Anyway, just wanted to let you know and to thank you so much for your advice regarding the small dose reinstatement, which seems to be helping. He reinstated at 0.5 ml, and 2 weeks later got his psychiatrist's "permission" to increase to 1.0 ml. 17 days later I noticed he was only taking 0.1 ml instead of 1.0 ml! This is a really good example of what WD brain fog does to us because he is normally very good at math and would not have made this mistake. Anyway, since then he has been on 1.0 ml and is finally starting to feel better. I'm hoping the intrusive thoughts will go away soon, as this is the problem that distresses him so much. Thank you again for your help.

[Altostrata]

Good to hear. Please be aware the psychiatrist might think 1.0mg is a placebo and might urge your son to take closer to a "normal" dose of 5mg or more.

 

If your son intends to live without an antidepressant, taking a dose higher than necessary will mean tapering will take longer when he wants to go off.

 

It is very possible that 1mg is enough of a crutch to enable his nervous system to settle down from withdrawal, and if he stays at this level, the withdrawal-related symptoms will gradually go away. This may take months. When they do go away, he might taper again, by minuscule amounts.

[SeekingAnswers]

1 hour ago, Altostrata said:

Good to hear. Please be aware the psychiatrist might think 1.0mg is a placebo and might urge your son to take closer to a "normal" dose of 5mg or more.

Thank you, Altostrata. We're fortunate that his psychiatrist is actually wanting him to stay at the dose he's at, rather than going up. She's been really good so far, unlike his original psych who tapered him too quickly. My son is the one who keeps wanting to up the dose. The intrusive thoughts are really torturing him and he just wants them to stop, so he wants a quick fix. We know there is no quick fix. So far we're able to keep the dose low by reminding him that it takes several weeks for the Citalopram to start working. I don't know what will happen going forward but for now he is willing to stay at the low dose. The psychiatrist wants him to get therapy for the intrusive thoughts but he won't do it. He doesn't want to talk about them or even think about them, even though they are ongoing all the time. I'm trying to get him to read the book Overcoming Unwanted Intrusive Thoughts by Mary Winston and Marty Seif, which a lot of people have said really helped them. Thank you again.  

[Altostrata]

23 hours ago, SeekingAnswers said:

I'm trying to get him to read the book Overcoming Unwanted Intrusive Thoughts by Mary Winston and Marty Seif, which a lot of people have said really helped them.

 

Good idea. 

 

Your son may need to realize those are just thoughts, he can push them away and not be afraid of them.

[SeekingAnswers]

I agree with you. 

[SeekingAnswers]

On 11/2/2021 at 8:17 PM, Altostrata said:

We're not after treating intrusive thoughts here, we're after reducing withdrawal symptoms with reinstatement. Since he didn't have them before, it looks like those intrusive thoughts are from withdrawal. We see that often here. They will go away in time. A little reinstatement is a crutch that can make this easier. 

 

If he's finds the minimum effective dose for his withdrawal-induced intrusive thoughts, he'll have less to taper later if he chooses to go off.

Altostrata, I'm not sure what to do at this point, and hoping you can guide me a bit. As you know, my son has Asperger's so his brain isn't neurotypical. He's been having these intrusive thoughts ever since coming completely off Celexa in late July, but I never heard him talk about them before that. Then he reinstated at 1mg in November, then a couple of weeks later went up to 2mg. Two days ago he started taking 3mg (unbeknownst to me). My hope was that reinstating at a low dose would make the intrusive thoughts go away, but they are still plaguing him, which is why he went to 3mg. My husband and I are starting to wonder if they will ever go away without a higher dose of Celexa. We were really hoping he could get off of it, but maybe he just needs to be on it for the rest of his life? I have read that antidepressants stop working after a few years. Do you know if this always happens, or are there people who can be on them for a long time and they don't quit working? We really don't want him to be on them for the rest of his life. For one thing, after we have passed on, he will be on his own and if Celexa quits working for him after that, I'm not sure what will happen for him. I'm thinking a psychiatrist will just put him on a different one and that may not work and then withdrawal symptoms could get really bad for him, but we won't be around to help him though it.  

 

So, I guess my question is do you think we should keep him at 3mg and see if the thoughts go away after a few weeks? Also, if the lack of serotonin is causing these intrusive thoughts, would some other means of increasing serotonin help? I'm wondering about 5-HTP. Do you think it would be worth trying that before going back to a higher dose of Celexa? 

 

Thank you so much, again, for your help.

 

 

 

 

 

[Altostrata]

14 hours ago, SeekingAnswers said:

So, I guess my question is do you think we should keep him at 3mg and see if the thoughts go away after a few weeks? Also, if the lack of serotonin is causing these intrusive thoughts, would some other means of increasing serotonin help? I'm wondering about 5-HTP. Do you think it would be worth trying that before going back to a higher dose of Celexa? 

 

Please disregard any theories based on serotonin balance, that has been thoroughly debunked. 

 

The intrusive thoughts may be a habit of mind that does not require drug treatment to be interrupted. The content of the intrusive thoughts may be significant, in that they may have a psychological trigger that your son can learn to manage with the help of a therapist. For example, he may be worrying about having withdrawal symptoms again. Have you looked into this?

 

We advise reinstatement to reduce withdrawal symptoms, not to treat psychiatric symptoms. The drugs are psychotropics that tend to dull emotions. It may be that his Asperger's causes him to have repetitive thoughts, and that higher doses of citalopram may interrupt this.You and your son would have to balance adverse effects of higher doses vs suppression of these thoughts.

 

Is there a minimally effective dose that suppresses these thoughts without lower adverse effects? I cannot say what dosage that might be. It may be less than 5mg, or more. You'd have to find out by trial and error, very gradually increasing the dose until you get the desired results.

 

Then you'd have to decide whether the drug benefits are worth the effects on quality of life. Each individual has to decide this for themselves, not just people with Asperger's. The drugs themselves are not guaranteed miracles, they're just drugs with effects, sometimes good, sometimes bad, sometimes both.

[SeekingAnswers]

Alstostrata, thank you for the great insight and advice (as always).  I believe the intrusive thoughts are a symptom of his Celexa withdrawal because he never had them before he went on it, or when he was on it. At least I hope so. It's possible that because he went on at age 13 these thoughts may have come up eventually anyway as he got older (without Celexa). I wish I'd never let him be put on it, but all I can do is deal with the here and now and hope the future will be better. 

 

He's now on 3mg and maybe that will help, or like you said maybe he will need to go to a higher dose. I have been trying to get him to stay at a lower dose because I'm hoping that time will make the intrusive thoughts go away, like it seems to for so many on this site. He is impatient though, understandably so. Hopefully the thoughts will go away soon since it's been 5 months since he quit Celexa and the thoughts (they are actually images) started.

 

Thank you again for your answer and for all you do for everyone on this site. I really appreciate your help.