Jump to content
SurvivingAntidepressants.org is temporarily closed to new registrations until 1 April ×

JoeB: Citalopram, PSSD & Where to go from here


JoeB

Recommended Posts

Hello all, 

 

I have been browsing the site and thought i would now try introducing myself and asking the community here for any advice on next steps.

 

About me - My name is Joe, i live in the UK just outside London. My mental health Journey started in February 2020, when i suffered Panic Attacks, followed by severe general anxiety and depression. I was initially given 40mg of Propranolol to help with the Panic Attack episodes. Then 50mg Sertraline for anxiety and depression. These medications helped me stabilize but not improve. i Also had 10 sessions of CBT, which included EMDR Therapy to help my deal with previous Trauma and to disassociate certain situations with Panic Attacks etc.  After my dosage was increased twice up to 150mg with little to no effect, i was switched to 20mg of Citalopram in December 2020.

 

I can honestly say Citalopram changed me for the better, i had almost no side effects. I gradually improved to a point where i was enjoying life again, my sex life improved to a point where it was better than i could remember. I had almost no re-occurrence of Panic like symptoms, plus my general anxiety and depression had improved dramatically. I even got Married while taking this mediation (Oct 2021). Previously i was petrified about my Anxiety ruining the day, but i had no problems on the day and couldn't believe how calm and collected i was.

 

Now on to the issue - Because i felt so confident and was in such a good place, On December 1st i dropped to 10mg, and on 1st January i stopped altogether. I soon after experienced Post SSRI Sexual Dis-function (Premature Ejaculation, Loss of Libido and attraction) this quickly expanded to general emotional numbness. I felt disconnected from life, work and my Wife. i was still able to function correctly (go to work etc) but was not enjoying anything like i was before. 

 

Around 10 days ago, quickly and suddenly Anxiety/Panic symptoms stated again, i started obsessing about my breathing again (problem i had after my initial panic attacks). I have had to leave work multiple times, i feel overwhelmed and panicky when i feel either trapped or isolated (at work, stuck in traffic, in public). I experience chest pains and stiffness all over. I am also full of regret and negative thoughts, i feel scared and im obsessively worrying about this downward spiral and the impact its having on my health and my relationship with my Wife. I have gone from such a high, to a massive low.  I'm seeing a psychiatrist next Tuesday. 

 

After much reading on here i feel like i have screwed myself over by trying to do something which i thought was good, stopping the medication!! 

 

My initial questions for anybody, although any input at all is appreciated 

 

 - Given the fact that i tolerated Citalopram very well, Should i start taking it again? in the hope it will help like it did before, and then attempt to taper much much more slowly (my GP has already suggested starting a 10mg dose again). However i am concerned this may compound the problems of PSSD even further. 

 

- Any thoughts on whether this may be a relapse of symptoms or simply SSRI withdrawal?

 

- Does anybody have experience with PSSD after stopping Citalopram, and how they dealt with this?

 

Thank you all so much.

 

 

 

Jan 2020 - Series of Panic Attacks trigger Anxiety and Depression

Jan 2020 - Sertraline 50mg

May 2020 - Upped to 100mg

August 2020 - Upped to 150mg 

December 2020 - Switched to Citalopram 20mg 

Dec 2020 - Dec 2021 - Life is good 

Dec 6th 2021 - Self Taper to 10mg

Jan 1st 2022 - Stopped Citalopram 

Feb 20th 2022 - Anxiety and Panic symptoms have crashed back into my life 

Link to comment
  • ChessieCat changed the title to JoeB: Citalopram, PSSD & Where to go from here
  • Moderator Emeritus

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  I'm sorry to hear you are dealing with this, especially when things had been going so well.  It sounds like you are having symptoms because you got off the citalopram so quickly, and your brain didn't have a chance to adjust to being without the drug.  What you describe all sound like classic symptoms of withdrawal from psychiatric drugs.  

 

Can you please give us specific information in your signature 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.  Use this format:

 

Drug name: date, dose, date, dose, date, dose…

Drug name: date, dose, date, dose, date, dose…

Etcetera

 

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.   This explains why we get symptoms from tapering off of these medications quickly.  

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

Video on Recovery from Psych Drugs

 

Windows and Waves Pattern of Stabilization

 

 

Here is a link with checklists of common WD symptoms: 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

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

 

You may consider reinstating to a small dose of your drug to help reduce your withdrawal symptoms.  This is best done very carefully.  This is temporary, and after stabilizing you would then taper gradually off of this.  There is some risk involved, and we need more specifics about your drug history before we can suggest a good dose at which to reinstate.  Here is some information about reinstatement.  

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

I would not suggest going back to a 10 mg dose, as your doctor wants to do.  This puts you at risk of making your situation worse.  We see so many cases of doctors putting people on a drug merry go round, and they just go from bad to worse. 

 

I don't have experience with PSSD.  Here is a thread about that: 

 

PSSD

 

I've given you quite a bit of information here.  Take your time to look it over, and feel free to ask questions.  

Edited by getofflex

Please do not private message me.  Only tag me for urgent questions about tapering and reinstating - thank you.  

 

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

 

Lexapro   Started Apr 15 2010 - 10 mg;  started taper August 2017, recent taper info: Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08 Aug 16 - 0.07, Oct 6 - 0.06, Nov 21 0.05, Dec. 17 0.04, Jan 14 '22 0.03, Feb 19 0.02, Apr 18 0.01, May 15 0.005,  Jul 8, 0.00.  Psych Drug Free as of July 8, 2022!!  Woohoo!!!

other meds: Levothyroxine 75 mg

magnesium in small amounts at 4 AM, before bed

suppl AM: fish oil, flax oil, vit C, vit E, multivitamin, zinc

suppl 8 PM: magnesium 350 mg, extended release vitamin C, melatonin 2 mg

 

Paxil 2002 - 2010, switched to Lexapro 2010 

Trazodone 50 mg. 2002 - 2019, fast tapered in 2019 

Xanax 0.5 mg as needed 2002 - 2019, up to 3x weekly 

Link to comment

Hi @JoeB! I can relate to a lot of your symptoms & overall experiences. Lots o

panic & similar here.

 

I’ll share my experience: I tried reducing sertraline on the too-fast timeline offered by my doctor. I went on again within 6 months because i really couldn’t function.   
 

No regrets with reinstatement. I am now in a better place & reducing slowly.

 

If you started back up, you might find relief starting at a lower dose than you had previously been on …as the link @getofflex provided explains.

Zoloft 50 mg since 2019.   

2023. January 33.75 mg  February 32.5 mg March 30.0 mg April 27.5 mg June 50 mg August 40 mg September-December 37.5 mg December 33.75 mg 

2022. January 50mg February 45 mg March 40.5 April-November 37.5  December 33.75 mg

 

Prior to discontinuation:  20 years of a variety of antidepressants & anti-anxiety meds from months to  years at a time (fluoxetine, nefazodone, venlafaxine, clonazepam, hydroxyzine).  I was unknowingly experiencing discontinuation and was frequently diagnosed with anxiety/exacerbations of previous illness as opposed to discontinuation. 

 

Supplements: Fish oil, Vitamin D3, magnesium,  B complex, l-theanine

 

Link to comment

@getofflexWow! thanks for all of the information and helpful links, a lot to read and digest but all very interesting. Based on what i have read and what you have said, if my Psychiatrist agrees with my GP and tries to reinstate me on 10mg i may choose to half this and start at 5mg, as i am very much afraid of compounding the problems i currently have by starting back on a too higher dosage. 

 

My Psychiatrist appt is tomorrow afternoon so i will report back with what is said or suggested. 

 

@CeruleanSea Thanks for sharing! its strangely comforting to know that other people have had a similar experience, even when its not a nice one. i do currently think reinstatement will need to happen to stabilize me, so thanks for further highlighting the need to carefully consider the dosage amount. 

 

As a side note I see that you both have taken/take Fish Oil and Magnesium, which are mentioned on here a lot, so i think ill take a deeper look at this and consider adding them to my current D3 and B12.

Jan 2020 - Series of Panic Attacks trigger Anxiety and Depression

Jan 2020 - Sertraline 50mg

May 2020 - Upped to 100mg

August 2020 - Upped to 150mg 

December 2020 - Switched to Citalopram 20mg 

Dec 2020 - Dec 2021 - Life is good 

Dec 6th 2021 - Self Taper to 10mg

Jan 1st 2022 - Stopped Citalopram 

Feb 20th 2022 - Anxiety and Panic symptoms have crashed back into my life 

Link to comment
  • Moderator Emeritus

Please be really careful and reinstate very low. If it were me, I would reinstate at 1 or 2 mg citalopram.  It often only takes a very low dose to reduce WD symptoms. Reinstating too high puts you at risk of kindling. You can always increase the reinstatement dose if needed.   

Please do not private message me.  Only tag me for urgent questions about tapering and reinstating - thank you.  

 

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

 

Lexapro   Started Apr 15 2010 - 10 mg;  started taper August 2017, recent taper info: Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08 Aug 16 - 0.07, Oct 6 - 0.06, Nov 21 0.05, Dec. 17 0.04, Jan 14 '22 0.03, Feb 19 0.02, Apr 18 0.01, May 15 0.005,  Jul 8, 0.00.  Psych Drug Free as of July 8, 2022!!  Woohoo!!!

other meds: Levothyroxine 75 mg

magnesium in small amounts at 4 AM, before bed

suppl AM: fish oil, flax oil, vit C, vit E, multivitamin, zinc

suppl 8 PM: magnesium 350 mg, extended release vitamin C, melatonin 2 mg

 

Paxil 2002 - 2010, switched to Lexapro 2010 

Trazodone 50 mg. 2002 - 2019, fast tapered in 2019 

Xanax 0.5 mg as needed 2002 - 2019, up to 3x weekly 

Link to comment

Update - 

 

On Monday Night, after reading info on here i practiced making a compounded solution by dissolving my 20mg Citalopram in 20ml of water. For some reason I decided to 'taste it' , and probably gave myself about 1mg of it. (it tastes like ****, as if that wasnt obvious) I had Insomnia that night, may or may not be related. Shortly after waking Tuesday, I crashed hard not wanting to do anything other than nap until about 3pm. 

 

Tuesday afternoon I had my Psychiatrist appt. Didn't enjoy it one bit. Didn't get a good vibe from the outset, I was told my PSSD symptoms were just anxiety 🙄 and quite frankly I'm not sure she had even ever heard of PSSD before. Her recommendations were to seek more CBT sessions, use Propanolol to manage Panic Symptoms (I have been anyway) and re-instate Citalopram at, you  guessed it, 10mg!

 

She told me with absolute certainty that there is no issues with drug sensitivity or that what I was experiencing was indeed withdrawel, and was likely a relapse of my Panic Disorder. 

 

I feel very confused and frustrated. 

 

Today I woke up and took 20mg Propanolol before any symptoms arose, felt quite good. About 11:30am I then decided to administer 4mg of Citalopram using my solution. All good until about 3pm, when again I crashed hard (stiff, cold, anxious, breathless) again resorting to going to sleep. 

 

I don't know if that was my body reacting to the Citalopram, or withdrawel or just a new wave of anxiety. To be quite honest I'm more confused now than I was at the start of the week. Do I continue with small dose of Citalopram or not... 

 

(sorry for the long message, feels good to rant and write it all down) 

Jan 2020 - Series of Panic Attacks trigger Anxiety and Depression

Jan 2020 - Sertraline 50mg

May 2020 - Upped to 100mg

August 2020 - Upped to 150mg 

December 2020 - Switched to Citalopram 20mg 

Dec 2020 - Dec 2021 - Life is good 

Dec 6th 2021 - Self Taper to 10mg

Jan 1st 2022 - Stopped Citalopram 

Feb 20th 2022 - Anxiety and Panic symptoms have crashed back into my life 

Link to comment
  • Moderator Emeritus
On 3/9/2022 at 12:27 PM, JoeB said:

Tuesday afternoon I had my Psychiatrist appt. Didn't enjoy it one bit. Didn't get a good vibe from the outset, I was told my PSSD symptoms were just anxiety 🙄 and quite frankly I'm not sure she had even ever heard of PSSD before. Her recommendations were to seek more CBT sessions, use Propanolol to manage Panic Symptoms (I have been anyway) and re-instate Citalopram at, you  guessed it, 10mg!

Unfortunately, we hear stuff like this all the time here in this forum.  These doctors are trained and brainwashed into prescribing drugs.  We at this forum suggest a very low reinstatement, to reduce the risk of kindling.  This link discusses kindling:  

 

Post Withdrawal Nervous System Hypersensitivity/Kindling

 

On 3/9/2022 at 12:27 PM, JoeB said:

She told me with absolute certainty that there is no issues with drug sensitivity or that what I was experiencing was indeed withdrawel, and was likely a relapse of my Panic Disorder.

This, too, we hear quite a bit.  Big drug companies, who make billions of dollars selling their drugs, have convinced doctors that withdrawal and dependency are not major issues, and that patients do not experience symptoms from getting off psych meds for more than a few weeks.  We know this is incorrect - just look at all the people on this forum.  She is also wrong in saying there is no such thing as drug sensitivity.  

 

On 3/9/2022 at 12:27 PM, JoeB said:

I feel very confused and frustrated. 

I can certainly understand why you would be.  I'm sorry for this.  

 

On 3/9/2022 at 12:27 PM, JoeB said:

To be quite honest I'm more confused now than I was at the start of the week. Do I continue with small dose of Citalopram or not... 

As I said previously, if it were me, I would try a very small reinstatement.  I suggest you do not jump on and off your dosages.  In other words, don't "try" 4 mg of Citalopram one day, then decided the next day not to take it because you felt bad yesterday, then try taking 1 mg the subsequent day, etc.  This will just screw up your nervous system even more, because it is getting inconsistent amounts of the drug, and you are at high risk of even worse symptoms.  Remember, these drugs are not like taking an Ibuprofen or Tylenol.  They are very powerful, and they affect the nervous system in profound ways.  Be respectful of this.  Please carefully read the following link: 

 

Keep It Simple, Slow, and Stable

 

If it were me, I would take 1 mg of the citalopram each and every day, at the same time of the day.  Give it at least a week, which is how long it takes for a reinstatement to get into your system.  Reinstatement is meant to reduce your symptoms, it probably won't eliminate them entirely.  If 1 mg isn't enough, we can always increase the dose.  But it's best to be very cautious and measured about changing our drug dose.  Please let us know how you are doing, and what you decide to do.  

Please do not private message me.  Only tag me for urgent questions about tapering and reinstating - thank you.  

 

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

 

Lexapro   Started Apr 15 2010 - 10 mg;  started taper August 2017, recent taper info: Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08 Aug 16 - 0.07, Oct 6 - 0.06, Nov 21 0.05, Dec. 17 0.04, Jan 14 '22 0.03, Feb 19 0.02, Apr 18 0.01, May 15 0.005,  Jul 8, 0.00.  Psych Drug Free as of July 8, 2022!!  Woohoo!!!

other meds: Levothyroxine 75 mg

magnesium in small amounts at 4 AM, before bed

suppl AM: fish oil, flax oil, vit C, vit E, multivitamin, zinc

suppl 8 PM: magnesium 350 mg, extended release vitamin C, melatonin 2 mg

 

Paxil 2002 - 2010, switched to Lexapro 2010 

Trazodone 50 mg. 2002 - 2019, fast tapered in 2019 

Xanax 0.5 mg as needed 2002 - 2019, up to 3x weekly 

Link to comment
  • 2 weeks later...

Hi I too took the same treatment as you at 10mg for a little less than two years and I also had premature ejaculation stopped for 3 months I still have it.  My penis has also shrunk.  I don't know if it will return to normal, it's hard enough to live with, I feel disconnected from reality.  Before I had no sexual problems and during the treatment I could last 1 hour or even not ejaculate at all.  I think it takes a lot of time and sport helps.  At least I personally hope the doctors I stopped.  They do not understand

Hello everyone, I was on seroplex 10mg in October 2019 for over a year and then on brintellix from March to September for maybe 8 months. I made several attempts to stop abruptly then I resumed the treatment of brintellix recently for a few weeks because it was too difficult to stop.

Symptom when stopped: premature ejaculation, ejaculation with less orgasm. Severe insomnia, transient headaches, sensitivity to noise and light.

Last intake of brintellix 5mg: Saturday, September 11, 2021

Link to comment

Please sign in to comment

You will be able to leave a comment after signing in



Sign In Now
×
×
  • Create New...

Important Information

Terms of Use Privacy Policy