liverstone1951: trouble with withdrawal from antidepressants

[liverstone1951]

Citalopram (Jan 2020 - June 2021) [1.5 years] : Started Citalopram in January 2020 for sleep problems caused by anxiety. Worked well for me until early 2021. Stopped therapy (as it wasn't working), my anxiety and insomnia got worse. 

 

Didn't think Citalopram was doing enough for me anymore. In June 2021 started tapering off it, starting from 40mg, until I reached one 20mg tablet every other day in September 2021. 

 

Withdrawing Citalopram (June 2021 - Sept 2021) [3 months]: Experienced worsened anxiety, insomnia and anger during withdrawal. MOST importantly, a previous minor phobia became a MAJOR OCD obsession of mine, and has completely overtaken my life since. Think about it all the time. This obsession is, and has been, my main issue for the past 6 months.

 

Sertraline (October 2021 - December 2021) [2 months]: GP directly switched me from Citalopram to Sertraline 50mg, at my request. Didn't wanna go back on Citalopram for fear it wouldn't be enough. Had heard good things about Sertraline. Ended up being a nightmare. In 7 weeks on 50mg, all I got was dizziness, numbness, brain fog, chest pain, and a panic attack. Though it did elevate my mood, did nothing for my anxiety, and I couldn't tolerate it anymore. 

 

Withdrawing Sertraline (December 2021) [1 month]: Came off Sertraline slowly over space of 4 weeks quite successfully.

 

Mirtazapine (Dec 2021 - Feb 2022) [6 weeks]: Psychiatrist in December prescribed Mirtazapine 15mg nightly. Started off ok, noticed increase in my mood. Couldn't tolerate going up to 30mg - same symptoms as Sertraline mentioned above. After 6 weeks on 15mg, I suddenly deteriorated, became suicidal, dark thoughts. The major obsession I mentioned before also got WORSE.

 

Withdrawing Mirtazapine, Re-Instating Citalopram [2 weeks]: Psychiatrist initially instructed Cold Turkey from Mirtazapine 15mg and start on Citalopram 10mg. Couldn't take the Mirtazapine withdrawal anymore so changed to slower withdrawal, 15mg every other day. Initially, over the space of 1 week, my obsession/ obsessive thoughts got better. But after a few days they got worse again. Not sure if this was the doing of Mirtazapine withdrawal, or the Re-Instating of Citalopram.

 

My current problem is this major OCD obsession, which was a minor phobia and I hardly thought about it before coming off Citalopram. Since coming off Citalopram, and especially after Mirtazapine, it's gotten 10x worse and has taken over my life. 

 

Told my psychiatrist my obsessions got out of control, he said to re-instate 15mg Mirtazapine daily and we'll come off again but more slowly. Said stay on Citalopram for now.

 

But I mentioned that in the week after withdrawing more slowly off Mirtazapine, the obsession got better. Then after another few days it got worse again. In that time I was also starting Citalopram, and had been on it for a week. I don't know which one is causing it?

 

More generally, psych thinks re-instating Citalopram is the end goal, thinks it will re-stabilise me. But I came off it 5 months ago, isn't it too late for re-instatement? Other people (Redditors from Mental Health sub) have suggested Escitalopram.

[Frogie]

@liverstone1951

 

Welcome to SA. We are a volunteer ran site with members as you going off medications.

 

This is your introduction page where you will receive information, ask questions you may have and meet other member going through what you are.

 

Thank you for creating a signature, that helps us a lot.

 

From what I see, you have taken a lot of things and then tapered off them very quickly. We don't suggest more than 10% a month taper and some members go much more slowly.

 

You say that you are reinstating Citalopram. How much are you reinstating? It is suggested not to reinstate at a high amount. To start at a very low amount and you can always increase it if necessary. It would be suggested to start out at 1 mg and see how you do. It takes approximately 4 days for it to become steady in your bloodstream and few more days for it to regulate your brain.

 

I would not suggest going on Escitalopram, as it is much stronger than Citalopram.

 

Tips for tapering off citalopram (Celexa)

 

Tips for tapering off mirtazapine (Remeron)

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

Why taper by 10% of my dosage?

 

Brain Remodelling

 

OCD Obsessive Thoughts, Compulsive Behaviours

 

We don't suggest supplements on here but 2. You might try one at a time in a small amount. Wait a few days before introducing the other one.

 

Magnesium

Omega-3 Fish Oil

 

Please reach out to us with any questions you may have. I'm glad you found us.

 

 

 

 

 

 

[liverstone1951]

Thanks for your reply. I am reinstating Citalopram at 10mg. My Psychiatrist plans to increase it up to 20mg. What are your thoughts on that?

 

How do I get 1mg Citalopram?

[Frogie]

@liverstone1951

 

Are you on tablets? You can get a scale an crush, weigh them to 1 mg.

 

If you can get liquid that would be ideal.

 

Why do you want to start on 10 mg? That is a high reinstatement amount and 20 mg is way too much to start taking again.

 

Notes on reinstatment

 

 

[liverstone1951]

Yeah I'm on tablets. I have to wait until next week at least until I can get a new prescription (in liquid form) because my psychiatrist is off on break this week. 

 

The psychiatrist was the one who put me on 10mg reinstatement. I only discovered SA afterwards but I'd already been on 10mg Citalopram for 2 weeks by that point (now 3 weeks). Had I discovered this website earlier, and read about low dose reinstatement, I would've started at a much lower dose. 

 

But now I'm in a situation where I've been on 10mg Citalopram for 3 weeks, meanwhile tapering off Mirtazapine (taking 15mg every other day).

 

I think the new obsessive thoughts associated with the sudden Mirtazapine withdrawal are mostly gone, but there are still some there. My original dose was 15mg daily, do I have to go back up to that dose and start again withdrawing in order to fully get rid of the withdrawal effects? Initially when I came off Mirtazapine, my psychiatrist Cold Turkey'd me off it, which caused all these withdrawal effects. So from Cold Turkey I've been slowly upping my dose until now, where I'm taking 15mg every other day. 

 

Do I have to go back to my original dose of 15mg every day and start withdrawing from that? If so, what taper rate do you suggest.

 

I think I've been getting the "Windows and Waves" pattern while reinstating, but I'm not sure if that's in response to reinstating Mirtazapine, Citalopram or both. As soon as I think I've stabilised, I start to feel different again.

 

What do you suggest with regards to Citalopram?

[liverstone1951]

Should I bring my Citalopram dose down from 10mg?

 

With Mirtazapine, I started with 15mg every day. When I initially attempted to withdraw, I took a tablet every other day, which worked ok. But as soon as I tried to decrease the frequency further, I got bad withdrawal effects. I went back to taking a 15mg tablet every other day. My psychiatrist instructed me to go back up to 15mg every day.

 

I know my method of withdrawal (skipping doses) is bad, and in hindsight I probably should've cut/ split the pill.

 

What do I do now regarding Mirtazapine? I've gone back up to 15mg daily as advised but I think I'm getting "kindling". 

 

With Citalopram, I seemed fine on 10mg, but 20mg is a bit intense, am I also experiencing kindling with that?

[liverstone1951]

UPDATE

 

@Frogie

 

Citalopram

 

I seem to be getting on ok with re-instating Citalopram at 10mg. When I first came to SA 5 weeks ago, I had been off Citalopram for 4 months, having previously taken it for 1.5 years. Safe to say coming off Citalopram completely de-stabilised me. My psychiatrist put me back on it on 2nd February 2022, starting me at 10mg.

 

I know 10mg is too high a re-instatement after 4 months off. However, I had already been on the 10mg for 2 weeks by the time I discovered SA (18th February), and learned about re-instating at low amounts. Not wanting to disrupt things, I elected to stay at 10mg.

 

I think the withdrawal effects are slowly un-doing themselves, I am getting a Windows and Waves Pattern.

 

I also can't seem to go above 10mg. 20mg is too "intense" for me, which matches up with the idea of being "sensitised" that SA talks about. Before coming off Citalopram I easily tolerated 40mg. 

 

However, I do recognise the importance of what SA says about "low re-instatement", so with that in mind, is it worth decreasing my dose to 5mg?

 

 

Mirtazapine

 

This drug is a ******* nightmare. I can't get off it for the life of me. I was taking 15mg every day before 2nd February 2022, when my psychiatrist stopped it - and switched me to Citalopram.

 

For reference, I had been on Mirtazapine for 2 months before we decided to come off it. Since 2nd February 2022, we've spent a further 2 months trying to wean me off Mirtazapine, with little success.

 

First, we tried going Cold Turkey. Didn't even last 4 days doing that. Terrible withdrawal.

 

Second, we tried Mirtazapine 15mg every 3 days. The withdrawal got better but didn't completely go away.

 

Third, I went up to Mirtazapine 15mg every other day, which further improved things.

 

Fourth, we tried going back to Mirtazapine 15mg every day. I started getting intense suicidal ideation, which is the reason we stopped the drug in the first place (back in February). Couldn't last more than 3 days.

 

This all happened before I came to SA. Then I read about re-instatement at low doses, and how skipping doses is not recommended.

 

With that in mind, what's the next thing I should try? It seems like I've tried everything with regards to Mirtazapine. I'm gonna assume I should re-instate at a constant dose each day, like 7.5mg, rather than skipping doses with 15mg?

 

 

Advice

 

My psychiatrist advised alternating Citalopram doses between 10 and 20mg. He thinks a higher dose of Citalopram will help me come off Mirtazapine more easily. Because I'd struggled to come off Mirtazapine for the past 6 weeks while only being on 10mg Citalopram.

 

I've tried this for 1 week and so far I only feel worse and have very vivid nightmares.

[Altostrata]

On 2/24/2022 at 11:01 AM, liverstone1951 said:

meanwhile tapering off Mirtazapine (taking 15mg every other day).

 

This is not a good way to go off any drug. NEVER SKIP DOSES TO TAPER

 

On 3/23/2022 at 6:37 AM, liverstone1951 said:

I also can't seem to go above 10mg. 20mg is too "intense" for me, which matches up with the idea of being "sensitised" that SA talks about. Before coming off Citalopram I easily tolerated 40mg. 

 

Why are you trying to increase above 10mg?

 

On 3/23/2022 at 6:37 AM, liverstone1951 said:

My psychiatrist advised alternating Citalopram doses between 10 and 20mg. He thinks a higher dose of Citalopram will help me come off Mirtazapine more easily.

 

There is no basis to either of your psychiatrist's beliefs. Do not alternate dosing of a drug or skip doses to taper!

 

Since your system is in an uproar from your inconsistent dosing of citalopram, I cannot determine what symptoms you might have from mirtazapine withdrawal. 

 

If I were you, I'd stay at 10mg, stay at that dose until your symptoms settle down to some kind of baseline. It's very important to take the same dosage of the drug at the same time each day. Even variations in schedule can cause odd symptoms.

 

You'll have to be patient. It can take weeks for symptoms to settle down from inconsistent drug dosing. Please let us know how you're doing.

[liverstone1951]

@Altostrata

 

staying at a consistent dose of Citalopram makes sense. Will try that 

 

what do you recommend regarding Mirtazapine - you said my skipping doses is unsafe. I assume I should try 7.5mg each day? 

 

When I tried 15mg Mirtazapine daily, I couldn’t last 3 days as I had strong SI. Although, I am taking citalopram 10 at the same time, maybe they’re interacting idk. Not sure what the cause of SI but I suspect Mirt

[Altostrata]

You are not taking any mirtazapine now? For what reason do you want to reinstate it?

 

When did you start consistently taking 10mg citalopram per day?

[liverstone1951]

@Altostrata

No sorry for the confusion I’m still taking Mirtazapine. My psychiatrists latest regimen is Mirtazapine 50mg every other day and Citalopram 10/20 mg alternating 

 

we’ve tried multiple times to come off Mirtazapine since 2nd Feb 2022 but each time we were unsuccessful. These are the attempts:

 

On 3/23/2022 at 1:37 PM, liverstone1951 said:

First, we tried going Cold Turkey. Didn't even last 4 days doing that. Terrible withdrawal.

 

Second, we tried Mirtazapine 15mg every 3 days. The withdrawal got better but didn't completely go away.

 

Third, I went up to Mirtazapine 15mg every other day, which further improved things.

 

Fourth, we tried going back to Mirtazapine 15mg every day. I started getting intense suicidal ideation, which is the reason we stopped the drug in the first place (back in February). Couldn't last more than 3 days.

 

I just keep getting weird obsessions with symmetry and perfection whenever I try withdrawing off Mirtazapine. I was only on it for 2 months, yet coming off it has been so difficult 

 

21 hours ago, Altostrata said:

When did you start consistently taking 10mg citalopram per day?

 

2nd Feb. Only since last week have I been alternating 10/20mg. 

 

21 hours ago, Altostrata said:

You are not taking any mirtazapine now? For what reason do you want to reinstate it?

 

To summarise:

- since 2nd Feb 2022

- we’ve tried to come off Mirtazapine 15mg (many attempts see above)

- at the same time starting Citalopram 10mg

- each new regimen of Mirtazapine/Citalopram we try I just feel worse 

- I’m finding anything above 10mg Citalopram too intense (I am “sensitised?”)

 

 

- currently we are on Mirtazapine 15 every other and Citalopram 10/20 alternating 

- feel worse than ever 

 

I want to be off Mirtazapine but we are struggling to do it

[Altostrata]

1 hour ago, liverstone1951 said:

- currently we are on Mirtazapine 15 every other and Citalopram 10/20 alternating 

 

As explained earlier, your irregular dosing is causing major problems. You need to stop doing this. If you continue to do this, we cannot help you, you are making your own problems.

 

Suggest you take 15mg citalopram per day and 7.5mg mirtazapine per day, be sure to take your drugs at the same dosage on the same schedule every day. It probably will take some weeks for your system to gradually settle down. Please let us know how you're doing.

 

If you prefer to follow your doctor's recommendations, please take your problems to your doctor.

[liverstone1951]

@Altostrata

 

The dosages I have rn are quite hard to tolerate I agree. 

 

12 minutes ago, Altostrata said:

You need to stop doing this. If you continue to do this, we cannot help you, you are making your own problems.

 

Sorry if I implied I don't trust SA. I meant to highlight that most of all these changes happened BEFORE I discovered SA. Thought making a list may be of some use.

 

The "skipping doses" idea started before I discovered SA, but I only continued it because my psychiatrist told me so, even though I am very conflicted.

 

12 minutes ago, Altostrata said:

Suggest you take 15mg citalopram per day and 7.5mg mirtazapine per day, be sure to take your drugs at the same dosage on the same schedule every day. It probably will take some weeks for your system to gradually settle down. Please let us know how you're doing.

 

Thanks. Normally it takes me only 1 week to notice a change in dosage so you'll be hearing from me soon.

[liverstone1951]

@Altostrata @Frogie I've spent a week on Mirtazapine 7.5mg and Citalopram 5mg. 

 

Question: my original dose of Mirtazapine was 15mg. Now I'm re-instating at 7.5mg. Do I have to go all the way back up to 15mg? When re-instating, do you have to go back up to the exact dose you were originally on?

 

I am slowly decreasing citalopram as it gives me headaches, I can't take more than 5mg.

 

Secondly: what do I do next? How do I know when I should change things?

[Altostrata]

4 hours ago, liverstone1951 said:

Now I'm re-instating at 7.5mg. Do I have to go all the way back up to 15mg? When re-instating, do you have to go back up to the exact dose you were originally on?

 

No, you do not need to go back to a prior level of dosage.

 

What are you taking now, at what times o'clock, and what dosages? How has your symptom pattern changed since you last posted a month ago?

[liverstone1951]

@AltostrataThanks for the quick response. Sorry for the delay, I wanted to wait a day or so for my symptoms to stabilise.

 

As a reminder, I re-instated 7.5mg Mirtazapine 1 week ago after a botched attempt by my psychiatrist to take me off it (15mg skipping doses).

Also at the same time I reduced my citalopram to 5mg.

So it's been a week with both.

 

I take 7.5mg Mirtazapine at 11pm every night 

5mg Citalopram every afternoon at 12 noon

 

 

With 7.5 Mirtazapine daily, I feel almost as if it's a bit too much. I feel like I'm on a really high dose. I feel the same way as when I took 30mg Mirtazapine daily ages ago and had a bad reaction. I'm having these new symptoms, which come on in social situations (and other triggers). I get:   chest tightness, feeling faint, legs feeling weak (verging but not quite a panic attack). This is not normal for me, so I know it's the drug doing it.

 

These symptoms are the same as when I had a bad reaction to Sertraline 50mg last year, and more recently Mirtazapine 30mg (in January).

 

Is this "kindling"?

 

However, compared to before (botched attempt by my Psych), I do feel better now. I feel like the withdrawal, insomnia, anxiety is less. But I'm getting new/ different symptoms, as described above - the ones in social situations.

Even though the Mirt withdrawal is better, it's not completely gone. I still have the weird OCD obsessions I've been having since Feb when my Psych Cold-Turkey'd be off Mirtazapine. I'm not sure if these will ever go away, if they haven't yet?

 

With my Citalopram, I've been taking 5mg daily (I split a 10mg tablet in half). I feel as if I can't take any more than that because it interacts with Mirtazapine and gives me a headache.

 

What do I do now for Mirtazapine? (My aim is to come off Mirtazapine)

1. Do I hold and push through, hoping the new Mirtazapine symptoms go away? It's a bit debilitating, because there's so many triggers for these new symptoms that I can't go outside much at all, can't go to my job. I can only do very few things, like work from home.
2. Or do I change my dose? Maybe buy liquid version.

What about Citalopram? (My aim is to come off this too)

1. Should I hold that steady? Each time I take it I get a headache but it's minor
2. Or should I decrease that further? 

[Altostrata]

On 5/3/2022 at 4:47 PM, liverstone1951 said:

With 7.5 Mirtazapine daily, I feel almost as if it's a bit too much. I feel like I'm on a really high dose. I feel the same way as when I took 30mg Mirtazapine daily ages ago and had a bad reaction. I'm having these new symptoms, which come on in social situations (and other triggers). I get:   chest tightness, feeling faint, legs feeling weak (verging but not quite a panic attack). This is not normal for me, so I know it's the drug doing it.

 

This sounds more like hypersensitivity caused by withdrawal syndrome rather than a reaction related to taking a drug.

 

After you take mirtazapine at night, how does it affect you? How do you feel in the morning?

[liverstone1951]

@Altostrata I feel quite tired in the morning, it's difficult to get up and do stuff. I fall back asleep almost immediately. I also have the new anxiety symptoms to certain triggers. Mainly physical symptoms which I don't usually get like chest pain, leg weakness, feeling faint etc. These same symptoms happened when I was taking 30mg months ago.

 

It also gives me vivid dreams, which are quite crazy but nothing scary. 

 

I also have a lot of OCD right now (purely thoughts), which I don't usually have, which I again put down to the Mirtazapine.

 

I'm worried that these OCD symptoms have continued since February, and if they'll ever go away. They get worse on a lower dose and more intrusive. So it's gotten worse lately.

 

 

[Warrior]

Hi @liverstone1951! I'm sorry you're experiencing these bad symptoms.  I know they will pass with time, as I have felt many of them and still have many.  Stand firm during this process!  I also had a lot of OCD thoughts and in stronger waves they come back but they pass with time.  I wish you get better!

[Altostrata]

Hello, @liverstone1951 How are you doing now?

[liverstone1951]

@Altostrataquite bad. I came off too quickly in May, going from 7.5 to 3.75 to nothing. 10th May was last dose of 3.75

 

ive been suffering ever since then and it’s only getting worse each day. I’m thinking of re-instating, but is 2 months too late for re-instatement? 

 

Also so I dunno whether to use homemade liquid or prescribed liquid. Homemade liquid is a lot of effort to make, and you gotta do it every 4 days. However, I can make it whatever concentration I want, if I need to slow my taper rate from 10 to 5% for example.

 

Prescription liquid is easier, but it’s a change of brand. Also, it’s more concentrated, meaning once I get to very low doses, like 1.3mg, the 10% reductions would be too small for a syringe to measure.

 

0.01ml is the smallest reduction on my syringe, so going down by less than that, say 0.009ml, is not possible

 

 

 

 

[Altostrata]

What are your current symptoms that you attribute to withdrawal? Are they better or worse at any particular times of day?

 

How has your symptom pattern changed since the end of June?

[liverstone1951]

@Altostrata Sorry for late reply, I didn't get a notification from your message for some reason

 

Shortly after coming off it, my symptoms were mainly OCD and insomnia. 

 

I then started taking 5mg citalopram. The above symptoms improved (not completely) and were replaced by the following:

 

Memory loss, brain fog, slower thinking. Feeling of discomfort or "tingling" inside my head, headaches. Feeling very "out of it" like I'm half asleep. Slightly blurred vision, pains in my neck randomly.

 

My symptoms are quite unbearable rn , i'm housebound and can't go outside for long b4 feeling unwell. Been like this for past 1.5 months. I need to change something. Overall i feel quite disabled by this.

 

I assume I had a sensitive/ bad reaction to Citalopram, but when I tried reducing it (by half), it gave me a hypomanic-like episode. Bear in mind i am not bipolar.

 

So I am still on 5mg citalopram after failing to reduce it. All the symptoms above are still there

 

I also experience weekly variation. This week, things were better, but last week I had terrible anxiety episodes, muscle twitching, flashing lights in my eyes, DPDR, hearing things, easily scared by minor things. The week before was better, and week before that was worse again.

 

My theory is that Mirtazapine withdrawal is in the background, made worse by starting taking citalopram, and reducing, then going up again. But this doesn't explain why my main symptoms of Mirt withdrawal have improved (insomnia, OCD), though are still there and not gone.

 

Also, I have taken citalopram in the past, and I never experienced these symptoms before, which is why i still think Mirtazapine WD is in the background. But it's strange how it took 3 weeks after stopping for them to appear.

 

Most ppl i've asked said don't re-instate Mirt because it's been 2.5 months, might not be good. But one doctor said he i can do it and he can monitor me.

 

An alternative idea is reducing the citalopram slowly using liquid. But i dunno how much benefit that will bring, could just be a waste of time.

 

Idk what to do as it's 2 drugs wreaking havoc not just 1. I dunno how much is down to Mirt and how much is citalopram.

 

Sorry I know ive been chopping and changing a lot, i have trust issues and act impulsively.

[Altostrata]

I want to point out that we suggested this:

On 3/26/2022 at 12:45 PM, Altostrata said:

Suggest you take 15mg citalopram per day and 7.5mg mirtazapine per day, be sure to take your drugs at the same dosage on the same schedule every day. It probably will take some weeks for your system to gradually settle down.

 

but you kept on changing your drugs despite our advice to stop changing your drugs because it would make your symptoms worse.

 

3 hours ago, liverstone1951 said:

I then started taking 5mg citalopram. The above symptoms improved (not completely)

 

3 hours ago, liverstone1951 said:

This week, things were better

 

Did you reinstate 5mg citalopram 6 weeks ago? Please add approximate dates to your signature.

 

Given your history of irregular dosing, this may be the best you can expect for now. It appears you are slowly improving, this is what we'd expect in stabilizing from withdrawal symptoms, which can take quite a while. See https://www.survivingantidepressants.org/topic/7562-about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms/

[liverstone1951]

@AltostrataI know I made mistakes many times, I’m sorry. I had a psychiatrist and GP who kept pressuring me to come off Mirtazapine as they wanted me to start Citalopram. I kept telling them I can’t tolerate Citalopram and have terrible Mirt wd but they insisted in all their years of experience it’s impossible. I’ve now cut these people off 

 

I re-instated 5mg Citalopram 6 weeks ago yes 

 

I see what you’re saying about stabilising

 

[Altostrata]

Please let us know how you're doing.

[liverstone1951]

@Altostratathank u for your kind words

 

it seems my NS is very sensitive now so shouldn't change anything. you would like me to completely stabilise from the "hypomania"episode

 

i am increasingly worrying about the re-instatement window going away, for mirtazapine, as it's been 2.5 months

 

as i came off it during a fast taper

 

i know my current symptoms are partially Mirt wd, which made me v sensitive to citalopram. i believe Mirt wd is contributing to making my NS sensitive

 

i don't want to be like this forever, if i miss the window

 

would you recommend re-instatement at any point in time in the future, and if so when? 

 

i assume you would say i should have stabilised from citalopram wd, before considering a re-instatement of Mirt. 

 

also, should there be a problem if i use a liquid to re-instate, but i was on tablets during taper

 

 

[liverstone1951]

@AltostrataI thought I’d give an update. Thanks again for being patient with me. 

 

I’ve held on Citalopram 5mg and have recovered from my “hypomania-like” episode in June when I stopped it too quickly. 

 

Problem is, it’s giving me SI and kindling. However, when I reduce it, the hypomania-like symptoms come back (extreme anxiety, agitated, trouble sleeping) 

 

So on the one hand, if I take it, I don’t have extreme anxiety and I can sleep somewhat. However it gives me SI and head pressure, presumably from kindling. 

 

I think the Mirtazapine WD happening in the background of all this is affecting things. Probably the reason why I have kindling. 

[Altostrata]

14 hours ago, liverstone1951 said:

Problem is, it’s giving me SI and kindling.

 

Please describe these symptoms.

 

This is what you reported in July: 

On 7/23/2022 at 10:38 AM, liverstone1951 said:

I then started taking 5mg citalopram. The above symptoms improved (not completely) and were replaced by the following:

 

Memory loss, brain fog, slower thinking. Feeling of discomfort or "tingling" inside my head, headaches. Feeling very "out of it" like I'm half asleep. Slightly blurred vision, pains in my neck randomly.

 

14 hours ago, liverstone1951 said:

However, when I reduce it, the hypomania-like symptoms come back (extreme anxiety, agitated, trouble sleeping) 

 

When was the last time you tried to reduce it, and by how much?

 

[liverstone1951]

@Altostrata 

17 hours ago, Altostrata said:

Please describe these symptoms.

Sure. I have memory loss, brain fog, slower thinking, pressure/ tingling inside my head, headaches. Feeling very "out of it", slightly blurred vision. I also get thoughts of S which is the main bad thing. However, I do get to sleep.

 

17 hours ago, Altostrata said:

When was the last time you tried to reduce it, and by how much?

So I reduced to 4.5mg for a few days by making a liquid by dissolving the tablet. Immediately, the trouble sleeping and terrible anxiety from the "hypomania" episode came back. However, apart from that 1 time, I've been taking 5mg, usually at 4pm.

 

Even worse, what's been happening over the past few days is that the pharmacy switched my brand to a different one, and when I've been taking it, I feel like I'm not taking citalopram at all, or a placebo, so these "hypomania-like" symptoms are now back (not sleeping much, terrible anxiety, restlessness, hyperactive). I've rung like 6 different pharmacies, but everyone seems to be out of my usual brand Noumed, so I'm stuck with a different one. Or I can split the 20mg tablet (of my usual brand) into 4.

 

 

[Altostrata]

The symptoms you have described are not those of kindling. They are the same as those you described July 23. They may be effects of the drug.

 

On 7/23/2022 at 10:38 AM, liverstone1951 said:

I then started taking 5mg citalopram. The above symptoms improved (not completely) and were replaced by the following:

 

Memory loss, brain fog, slower thinking. Feeling of discomfort or "tingling" inside my head, headaches. Feeling very "out of it" like I'm half asleep. Slightly blurred vision, pains in my neck randomly.

....

I also experience weekly variation. This week, things were better, but last week I had terrible anxiety episodes, muscle twitching, flashing lights in my eyes, DPDR, hearing things, easily scared by minor things. The week before was better, and week before that was worse again.

 

How has this symptom pattern changed since the end of July?

[liverstone1951]

@Altostrata 

1 hour ago, Altostrata said:

 

The symptoms you have described are not those of kindling. They are the same as those you described July 23. They may be effects of the drug.

 

 

yeah, I had these symptoms since June actually, when I re-started Citalopram after unsafe Mirt taper 

 

thing is, all the previous times I took Citalopram, I never had side effects like this from it. It’s only after withdrawing from Mirt did I experience these symptoms upon taking Citalopram. Before, when I wasn’t in such bad Mirt wd, I was fine taking Citalopram. 

 

This aligns with the fact that withdrawal from 1 drug makes you more sensitive to others

 

After a while, thoughts of S began to appear, alongside these symptoms 

 

1 hour ago, Altostrata said:

How has this symptom pattern changed since the end of July?

 

1 hour ago, Altostrata said:

Memory loss, brain fog, slower thinking. Feeling of discomfort or "tingling" inside my head, headaches. Feeling very "out of it" like I'm half asleep. Slightly blurred vision, pains in my neck randomly.

 

These symptoms are still there, and were for the entire time I re-started 5mg Citalopram since June. The ones which may be “sensitivity” to it

 

1 hour ago, Altostrata said:

I also experience weekly variation. This week, things were better, but last week I had terrible anxiety episodes, muscle twitching, flashing lights in my eyes, DPDR, hearing things, easily scared by minor things. The week before was better, and week before that was worse again.

 

This weekly variation has stopped after I holding on 5mg for a while. 

 

 

However, in the past few days, the hypomania-like symptoms came back, after the pharmacy switched my brand 

 

 

My theory is is that I have ongoing Mirt wd since stopping unsafely in May. Straight after that, in June, I dropped my Citalopram dose too quick too, leading to the hypomania-like symptoms. Which have mostly gone since holding re-starting and holding on 5mg in June as well

 

however while holding on 5mg, a new set of symptoms appeared, the ones I may have wrongly described as “kindling”. Which may be sensitivity to Citalopram 

 

however, any drop to my Citalopram causes those hypomania-like symptoms to reappear. 

[Altostrata]

5 minutes ago, liverstone1951 said:

However, in the past few days, the hypomania-like symptoms came back, after the pharmacy switched my brand 

 

 

Please describe these symptoms in more detail.

 

Have you taken your drugs off-schedule lately, had any alcohol, gotten overheated or overdid it in any way?

[liverstone1951]

@Altostrata 

4 hours ago, Altostrata said:

Please describe these symptoms in more detail.

Sure. So the “hypomania-like” symptoms include constant severe anxiety, not feeling the need to eat, or to sleep, feeling overly excited, being fidgety/ restless, feeling terrified at the smallest things. So right now I haven’t slept a wink 

 

These are the same symptoms I got when suddenly reducing Citalopram too fast in June

 

however, I’ve not reduced it this time. All that’s happened is I ran out, so I went to the pharmacy to get more. Didn’t have my usual brand so got a different one, and have been taking it for the last few days (3-4 days). 

 

4 hours ago, Altostrata said:

Have you taken your drugs off-schedule lately, had any alcohol, gotten overheated or overdid it in any way

 

I normally take it 4-6pm, admittedly one day I took it around 7pm but that’s about it. I did miss 1 day when I ran out but apart from that, I’ve been taking it consistently 

 

 

I’ve never gotten this type of WD from Citalopram before. This only happened after I stopped Mirt unsafely. So either Citalopram suddenly has a different effect in me, or this hypomania stuff has more to do w Mirtazapine WD 

 

don't know if you agree with this theory, but I think the Citalopram is protecting me somewhat from the Mirt wd. This may be why I can sleep when I take it, but when I even make a slight change, I cannot sleep at all and begin experiencing “hypomania”, which is a symptom of Mirt wd that has been reported 

[Altostrata]

The symptoms you describe are not of hypomania. They could be withdrawal or too high a dose of citalopram, which may also interfere with sleep.

 

How do you feel before and after taking citalopram every day?

 

15 hours ago, liverstone1951 said:

I did miss 1 day when I ran out

 

When did this happen?

 

Varying the timing of this low a dose of citalopram by 2 or 3 hours may bring on odd symptoms. Please be more consistent in your dosing. 

[liverstone1951]

 

1 hour ago, Altostrata said:

The symptoms you describe are not of hypomania. They could be withdrawal or too high a dose of citalopram, which may also interfere with sleep.

 

@Altostrata Whatever the name is for them, it's the same symptoms I had back in June when I quickly dropped my citalopram to 0, which then caused me to not feel the urge to sleep, or eat, as well as having an unusually elevated mood, hyperactiveness but also terrible anxiety at the simplest things. My symptoms now are exactly like that. 

 

Quote

How do you feel before and after taking citalopram every day?

 

Before, all my usual symptoms are there - headache, head pressure, brain fog, etc. Normally, after taking it, the headache, head pressure and neck pains get worse. So yeah I'm getting a lot of symptoms from it. 

 

I'm sorry, I know I've described so many symptom patterns. Does any of this sound confusing at all? I know I've described a whole load of different symptoms so I'll summarise them:

• Citalopram "sensitivity" - started when I re-instated citalopram. Head pressure, headache, pains in my neck, brain fog, memory loss, slower thinking, head pressure, slightly blurred vision. This has existed since I re-instated citalopram after stopping Mirtazapine unsafely in May.
• "Hypomania" / other name - when I drop or vary my citalopram dose. No urge to eat, sleep, unusually elevated mood, hyperactiveness, overreactive anxiety.
  • Other symptoms - muscle twitching/ spasms, flashing lights in my eyes, DPDR. These came on in June when I reduced citalopram too fast, but haven't gone away, even after I held my dose.

 

The day I missed happened on Monday.

 

 

One important thing to note. I never got side effects or noticeable withdrawal when I first took citalopram from 2020 to 2021. Only thing was I didn't withdraw from it safely in 2021. Even as recent as February and March 2022, when I started taking it again, I had no side effects taking it, or noticeable withdrawal.

 

It's only after bad Mirtazapine withdrawal did I notice that the citalopram is now giving me effects when I take it ("sensitivity") and I am noticing when I reduce or miss a dose (what I described as "hypomania"). This is why I'm unsure as to whether it's actually citalopram withdrawal.