Kay62: Citalopram and lamotrigine

[Kay62]

I’ve been on both of these meds since I was 15 years old and I am now 21. Im scared to get off due to the side effects that may occur… I had a really scary episode of phycosis where I tried to harm myself but the doctors don’t know what lead to it and I think it may be the medications im on.. I don’t really know what to do anymore im on 10mg of citalopram currently and 75 of lamotrigine… please help. Im experiencing anxiety and panic attacks at this time which I have never experienced before..   

[getofflex]

Hello, and welcome to SA.  We are a peer owned and run forum of people who have been or are getting off of psychiatric drugs.  You have come to the right place.  It's great that you are researching how to taper properly before you start your taper.  Most people come in here after a too fast taper or cold turkey.  If you taper correctly, you should be able to avoid or minimize any withdrawal effects.  

 

Can you please give us specific information about your drug history for all drugs you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise list (no symptoms), only drug names, specific dates (as best you can say for example early March if you don't recall the day) and dosages of each medication decrease or increase.  Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Drug History in Signature

 

Here is some information about how these drugs actually work.

 

How Psychiatric Drugs Remodel Your Brain

 

This link can help you decide which drug to taper first.  We suggest you only taper 1 drug at a time and do so very slowly and carefully to avoid destabilizing your nervous system, and going into withdrawal.  

 

Taking Multiple Psych Drugs, Which to Taper First

 

Tapering is best done extremely slowly, and we generally taper by 10% of the current dose no more than once every 4 weeks, so that the taper becomes exponentially smaller.

 

 Why Taper by 10% of my Dosage  

 

 

Also, as we are recovering, we suggest keeping things slow, simple, and stable. 

 

Keep it Simple, Slow, and Stable

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

 

Omega 3 Fish Oil

 

Please take your time to read the information in the links I gave you.  Congratulations for choosing to come off psychiatric drugs.  Feel free to ask any questions.  This is your intro topic where you will keep us up to date on how you are doing, and discuss anything with us that may come up.  Keep us posted.  

[getofflex]

I'm sorry you are experiencing panic and anxiety.  My suggestion would be to start tapering the citalopram first, as that tends to be activating, and could be causing or contributing to this.  How long has the panic and anxiety been going on?  Has there been anything happen in your life that could have started this?  Are you on any other drugs besides citalopram and lamotrigine? 

 

I would suggest switching over to liquid citalopram. In the USA, commercial citalopram liquid is 2 mg/ml, so to take 10 mg, you would take 5 ml in a syringe. Please double check this with your pharmacy.  

 

First, you want to cross over to liquid gradually, using this schedule:  

 

week 1.  7.5 mg citalopram tablet (3/4 tablet) and  2.5 mg (1.25 ml) liquid citalopram. 

week 2.  5 mg citalopram tablet (1/2 tablet) and  5 mg (2.5 ml) liquid citalopram. 

week 3.  2.5 mg citalopram tablet (1/4 tablet) and  7.5 mg ( 3.75 ml) liquid citalopram. 

week 4 10 mg liquid citalopram. Take 5 ml.  

 

Stay on the 10 mg liquid for a couple of weeks to allow your system to settle, then start the taper.  You first reduction would be 9 mg, which is a 10% reduction of 10 mg.  That would be 4.5 ml.  Let's see how it goes, and take it from there.  

 

The liquid will make it much easier to measure the doses as you taper.  

 

 

Edited September 15, 2021 by getofflex

[Altostrata]

Welcome, @Kay62

 

On 9/14/2021 at 2:26 PM, Kay62 said:

Im experiencing anxiety and panic attacks at this time which I have never experienced before..   

 

Let's figure out where these symptoms come from. When did they start? Had you just made a drug change?

 

What times of day do you take your drugs, with their dosages?

[Kay62]

I started both lamotrigine and citalopram when I was 15 years old. I’ve never had any issues until recently I had an episode of phycosis is what the doctors said it was. I tried to harm myself but I did not want to die… I’m trying to figure out what to do or if I should go off medication.. the anxiety and my depression have been terrible lately… I’m not sure what’s going on.. 

[getofflex]

Do you or the doctor have any idea what may have caused the psychotic episode?  What were your symptoms during the psychotic episode?  What times of day do you take the 10 mg of citalopram, and the 75 mg of lamotrigine?  

 

There is a moderate drug interaction between these 2 drugs.  According to drugs.com, 

Interactions between your drugs

Moderate

lamoTRIgine  citalopram

Applies to: lamotrigine, citalopram

Treatment with citalopram may occasionally cause blood sodium levels to get too low, a condition known as hyponatremia, and using it with lamoTRIgine can increase that risk. In addition, citalopram can cause seizures in susceptible patients, which may reduce the effectiveness of medications that are used to control seizures such as lamoTRIgine. Talk to your doctor if you have any questions or concerns. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications. You should seek medical attention if you experience nausea, vomiting, headache, lethargy, irritability, difficulty concentrating, memory impairment, confusion, muscle spasm, weakness or unsteadiness, as these may be symptoms of hyponatremia. More severe cases may lead to hallucination, fainting, seizure, coma, and even death. Also let your doctor know if you develop seizures or experience an increase in seizures during treatment with citalopram. Additionally, because these medications may cause dizziness, drowsiness, and impairment in judgment, reaction speed and motor coordination, you should avoid driving or operating hazardous machinery until you know how they affect you. It is important to tell your doctor about all other medications you use, including vitamins and herbs.

[Altostrata]

On 9/16/2021 at 12:28 AM, Kay62 said:

I started both lamotrigine and citalopram when I was 15 years old. I’ve never had any issues until recently I had an episode of phycosis is what the doctors said it was. I tried to harm myself but I did not want to die… I’m trying to figure out what to do or if I should go off medication.. the anxiety and my depression have been terrible lately… I’m not sure what’s going on.. 

 

Which doctors think this?

 

What times o'clock do you take your drugs, with their dosages? Have you ever accidentally forgotten to take a dose? How often does this happen? Had you been taking your drugs inconsistently prior to this episode? When did this episode happen?