AM08: Professional support

[AM08]

Hello,

 

After nearly 20 years of my love-hate relationship with citalopram, I would love to taper. My doctor just boosted by prescription from 30mg to 40 mg a few weeks ago - and the old subtle shakes have started up. Makes me extremely uneasy. I've tried to taper myself many times over the years, usually by chopping off larger and larger bits of my pill. Was able to get down to 15 mg or so, but was never successful -- and was DEFINTELY not a precisely measured approach. Tapering feels intimidating to me. Actually feels insurmountable, but I know it is possible. I do have 13 years of sobriety from booze, smokes, etc. so I know it's possible. Thanks for being here. 

[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.  The secret to getting off these meds successfully is to do an extremely gradual and careful taper.  It sounds as though you are now on too high a dose of citalopram, hence the shakes and uneasy feeling.  It's good that you are going to get off this drug.  Congratulations for being sober and off the smokes!  That is a huge accomplishment.  

 

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 vertical 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 helps you understand what withdrawal syndrome is: 

 

 Video on Recovery from Psych Drugs

 

What is Happening in Your Brain

 

Windows and Waves Pattern of Stabilization

 

 

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  

 

Tips for Tapering Citalopram

 

 

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

 

Keep it Simple, Slow, and Stable

 

Considerations About Stability - Stop Jumping Around

 

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

 

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

 

I've given you quite a bit of information here.  Please read through it, and mull it over, and we will take it from there. In the meantime, take care of yourself, and take heart.  We in this forum have been through this, and we understand first hand the pain and discomfort you are going through.  Please know that the brain is amazing in it's healing abilities.  It takes time, but healing can and will happen. 

[AM08]

Hello. I think one of the long term effects of my celexa use is I can’t focus. So I have trouble with routines. I feel im in a whirlwind each day. So to taper I feel like I need accountability or guidance to help me remember I am trying to taper (at first). I am stuck in fear around this little tremor I’m dealing with and all the ways the 20 yrs of citalopram makes me miserable. But if I have bad side effects or taper and start to feel bad I talk to the doctor and she drops or raises my dosage.  Most psychs say I have to be on for life.  I can’t find online how to get professional support of people who will help you taper.  The forum here is awesome but to get started I feel I need some in person support.  Anyone know where I can look? Thank you so much. I am grateful you are here.  

[Onmyway]

Dear @AM08, 

welcome back to SA. Each member has one introduction topic here so that we can keep all of your information in one place. You are welcome to post here as much as you like and on the other forums or the threads of other people but things about your specific case should be on this thread so we can keep track and advise you better.  

 

Here is a list of doctors that we consider to be doing withdrawal the right way, with minimal harm to patients. You are welcome to reach out to them.  

 

It seems like you are having adverse effects to the increased dosage of your medication. Did you tremor start before or after you dropped from 40 to 30 mg in July? Your post from September says that your doctor increased your dosage from 30 to 40 but your signature says your dosage was decreased from 40 to 30 in July? Can you update this with the correct information? 

 

As @getofflex has mentioned earlier keeping things as stable as possible is the way to get through this tapering process. That means not jumping up and down or adding new drugs but committing to tapering but holding when necessary as long as necessary to achieve stability. 

 

Why do your doctors say you need to be on these drugs for life? As long as you taper slowly you can overcome the physiological dependence. It is not an easy process but you already have experience in this area with alcohol and cigarettes as you say. The idea of a chemical imbalance is a myth, your depression/anxiety etc is not caused by chemical imbalances. Your "depression coming back" after you quit is a usually symptom of withdrawal. 

 

Hope this helps, 

OMW

[AM08]

Thank you for your response @onmyway. The docs say I need to be on for life because I have had depression return when I stop taking the citalopram. I think they are just convinced since that is the prevailing consensus among docs that if you’ve been on long term you will have to stay on. My doc is not cool about me trying to get off my medicine.  
 

I know it’s possible to wean off, but each time I have tried, I just get so irritable and then depressed when I back off — and my spouse encourages me to just keep taking it. I start being pretty mean and miserable.  As for the tremor I was at 20 for a long while then boosted up to 30 and then to 40 for depression anxiety due to hormonal changes.  then had tremors so she backed me down to 30. But on 30 I still have tremors. Like the back of my neck, head and spine.   The last few days it has freaked me out so I am back down to 20 or 25 cutting the pill in half. I know I shouldn’t jump around but am hoping to get to 20 and then start to wean off following the methods here.  Honestly I can’t keep the days straight or the doses either.  I feel I have been in a fog for years which is getting worse. I can’t even begin to think about sorting out where the issue is in my signature with the description. I feel discombobulated most of the time. Might be hormonal but I suspect the celexa makes me confused and absent-minded.  Not taking anything else but vitamins.  Thanks for you list of docs. The two from Atlanta unfortunately have websites that are inactive.  I’ll keep looking! 

[Onmyway]

Hi @AM08, 

the "you need to be on these drugs for life" mantra is not based on solid research. Most people get depressed and irritable when coming off of the ADs because these are withdrawal symptoms. Even people who were prescribed these drugs for something that was not depression (for example pain) end up getting depression and irritability and anger etc when coming off of them. It is not the return of some disorder - those are withdrawal symptoms. 

 

You seem to be having serious side effects from being on these drugs so lowering the dosage maybe a bit faster than 10% in the beginning seems necessary. Why don't you try going to 25 mg for a week, see if the tremor and fogginess gets better and update us here. From there we can see what to do next. 

 

Once the adverse effects are gone or lower you can start tapering more slowly. 

Can your spouse help measure your dosage and plan the dates and dosages? Some of our members need help with that because withdrawal or the drugs can make them so foggy. I have, myself, messed up doses on a few occasions. 

 

How are you cutting your pills? It is important to measure things correctly while tapering so you will need to either get a very precise jeweler's scale, make the right dosages through a compounding pharmacy, get a liquid formulation or make your own liquid. Have a look at tapering threads here 

 

Important topics in the Tapering forum and FAQ - Tapering - Surviving Antidepressants

 

I also want to say that you should not be discouraged by your previous unsuccessful attempts to come off of these drugs. They were just not done the right way and created unbearable withdrawal symptoms. This time you can do it the right way, with the right support, very slowly in order to not only come off but also stay off of these drugs. Do read carefully the tapering threads. You can do this and we can help you along the way. 

 

I very much hope that you feel better soon and that the tremors subside as you lower your dosage. 

Please do try to remember the right sequence of dosage changes especially in the last year so we can advise you correctly here. That part is really important. 

 

Please update us on how you are doing with the lower dosage now. 

OMW

 

 

 

[AM08]

@onmyway Thank you for helping me. I have read the threads on tapering. I ordered a jeweler's scale and a pill cutter. Before I was using a knife to cut them. My efforts before were haphazard and not measured or logged, so I definitely see why it has been so challenging. I have learned so much just reading these threads. 

 

I don't feel my spouse will be on board with me reducing my medication. She has also been taking medication for years - wellbutrin, and doesn't see it as an issue as I do. Also, life has been hell for her when I've tried to reduce my medication on my own. But I will keep a journal and follow the tapering rules.

 

The shakes have been easing up over the last couple of days since I reduced. I will stay at 25 for a week and report back. Is this forum just a bunch of folks helping each other? How does it work? I am so grateful to not be alone in this.

[ChessieCat]

34 minutes ago, AM08 said:

Is this forum just a bunch of folks helping each other? How does it work?

 

SA was started by Altostrata in 2011 after she experienced PAWS (Prolonged Antidepressant Withdrawal Syndrome) after cold turkeying in Paxil in 2004.  You can view a video and also a recent podcast as well as the post screening of the Medicating Normal panel discussion.  They are all good, but if you only have time for one then listen to the podcast.  The links are in Post #1 of this topic:  

 

about-altostrata-11-years-of-protracted-antidepressant-withdrawal-syndrome

 

The staff of SA are all unrostered, unpaid volunteers who have been through or are currently going through their own taper and/or withdrawal issues.

 

Here is the link about Surviving Antidepressants; general information in Post #1 and SA's mission in Post #2:

 

about-survivingantidepressantsorg

[AM08]

Wow.  Thank you. I feel like I was reading and listening to my own story.  A different version of the same tale.  Brain zaps and chemical sensitivity. Not feeling myself.  Apathy. Each time I tried to come off citalopram. I knew it felt different  than the depression and anxiety I had been treated for — like I was jolting out of my skin or body.  But each time they said relapse and put me back on the medicine. Many doctors! Each one.  The psychs and the general practitioners and even obgyn.  So glad to learn more about how this community and resource gained steam.  As a sober member of a 12 step program, I am always amazed at what people can do to help one another.  It’s pretty phenomenal. I have felt so alone until now.  Thank you for responding. 

[AM08]

Hello. I feel the need to check in. The information here has helped so much. I have been able to taper to 20 mg for the past month.  I am next reducing to 18 mg. Magnesium glycinate is helping and fish oil as well. I have a strange head tremor feeling when i rest my head back on a wall or pillow - apparently no one can see it - but it's still there - feel like it's from long-term use of celexa. Am glad to finally have an approach for slowly tapering! Thank you. 

[Blossom71]

Hi @AM08

 

I feel the same as you. I feel less alone and less scared having a bunch of people here to help who know what the withdrawal feels like, but also the fears around being antidepressant free.  Reading other people’s stories, reading more about the pharmaceutical industry and doctors lack of knowledge on withdrawals have really helped me start to take charge of my own destiny, and I feel much more confident about what I’m doing.

 

I hope things continue to go well for you x