Erin9: my experience with citalopram withdrawal

[Erin9]

Hi, this site was recommended to me and I'm very grateful to have found a place where people might understand what I'm going through. 

 

My story with antidepressants starts 10 years ago, but I've only really had problems with them within the past year. 

In 2017, I was switched from fluoxetine to citalopram. The citalopram worked for me, and I was quickly upped to a dose of 30mg, which I happily stayed on for 4 years. This takes us to November(ish) 2021. In November I was really struggling with my anxiety, and physical symptoms which were new to me. I had lots of tests done to rule out any physical illness, and nothing abnormal came up so I was just really confused about what was happening. Everyone kept saying it was anxiety but I couldn't really believe it, because the symptoms were so strong and I'd been dealing with anxiety my whole life and it had never presented like this. 

My doctor suggested that I increase my citalopram to the maximum dose of 40mg. I'd never been on the maximum dose as I'd always been warned off it because I am underweight, but I did it anyway. I tapered up to 40 by January and stayed on it for about 6 weeks. It didn't help whatsoever - in fact I just felt worse, because I had some side effects from the increase that I'd never experienced previously. Skin crawling, tingling and numbness on my left side, etc. It was horrible so I decided to reduce back down to 30mg. I'd achieved this by late February. At this point, my mental and physical health has been feeling awful for about 4 months. I wasn't able to work, socialise, or do anything at all really. I'd developed extreme health anxiety from having all these new symptoms which I was convinced could be a serious medical condition, and I had now started to develop constant nausea (my worst symptom, as an emetophobe).  
 

At this point my doctor started to talk about me switching medications altogether. I was open to it, because in 2017 I'd made the switch from one SSRI to another and it went so smoothly that I just thought this would be the same. She suggested Sertraline, so I started to taper down the citalopram in preparation for that. I got down to 20mg by May and it was really difficult. The nausea, foggy headedness and tingling symptoms were constant. But, looking back, in mid May when I'd settled on 20mg I actually felt a bit better for the first time in a while. I was able to do slightly more and felt less sick every day. I think a wise decision at this point may have been to stay on 20mg and just allow my body to calm down and give myself the chance to have a life again. BUT back in April, I'd had my first appointment with a psychiatrist. After telling him everything, he suggested a medication I hadn't really thought about, Mirtazapine. He told me that when I came off citalopram completely, I should start 15mg of mirtazapine then work up to 30. I sort of took this as a better idea than sertraline, I'm not sure why really...I think because I knew that mirtazapine increased appetite, and I wanted desperately to gain weight because anxiety always takes my appetite away. So I ditched the idea of sertraline (which my doctor seemed fine with after hearing the psychiatrists new recommendation) and continued to taper down further.

I got to 15mg by the start of June, and tried to drop again to 10mg. Things were just getting awful, I felt I was worse than I was in May, and I couldn't see myself being able to get all the way to 0 without just having no life anymore and becoming a shell of a person. At this point my doctor prescribes me 7.5mg of mirtazapine to take alongside 15mg citalopram, as a sort of crossover, so that I could continue to taper down citalopram but have the mirtazapine to make me feel a bit better. I took the mirtazapine for a total of 5 days - it made me very sleepy, very groggy in the mornings, and very emotional. I did in some ways feel mentally better - my overthinking definitely reduced and I was finally hungry again which was amazing. But when I told the doctor that I'd been very groggy and tired and had felt very off kilter, she told me to stop the mirtazapine immediately and just stick to 15mg citalopram for a while.

This brings us to now. I'm at a loss - I stopped the mirtazpine last week (which has given me withdrawal symptoms too, even though I was only on it for 5 days - headaches, pulsatile tinnitus, worse brain zaps and tingling) and now I'm just sitting with being on 15mg of citalopram, half of what I've been on for 4 years and feeling pretty hopeless. The worst part of all this is the physical symptoms which just disrupt everything. After reading on here and on reddit, I think I'd describe them as brain zaps - a sort of constant tingling in my head which makes me nauseous and makes me feel like my head is fuzzy. I also feel sick at the thought of doing anything - its so hard to describe, but I literally cant picture myself doing anything without feeling spaced out and nauseous. I feel like I am just not on the same plane of existence as anybody else - my head is spaced out, I can't enjoy anything, I feel like crying, my thoughts are quite literally racing and my body is just messed up by all these medication changes. I feel such regret for ever trying to withdraw from citalopram in the first place, especially when I was in a bad place to begin with. I can't imagine how to get out of this hole that I've dug for myself. After reading about medication tapering online I realise I've done it at the wrong time, and far far too quickly, and I'm living with the consequences now. 

As for trying to settle the symptoms, I've of course tried lots of different supplements with limited success. In fact, since stopping mirtazapine, I'd say supplements make it worse. A few days ago I took a vitamin B supplement and the next day my head was pounding and I had pulsatile tinnitus, and last night I tried a magnesium supplement and today my head is pounding again. I'm very lucky that my family is able to look after me during all this, but they are constantly telling me to 'get out and do things', which I think is their reaction to the idea that all of this is just anxiety, and nothing actually physical. Its so hard to get people to understand that it feels like my body and brain are falling apart, and that withdrawing from my medication (something I chose to do which was meant to lead me on the road to recovery) has made things so so much worse, mentally and also physically. 

I hope that this will be the lowest point for me and that things will improve, but I have no idea. And I don't even know whether my next step will be more withdrawal, or reinstating the citalopram, or just staying at the dose I'm at. But I'm pretty scared for any of those directions because I've just bounced from one bad experience to another, and somehow I'm scared that it could get even worse. 

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  Is your goal here to get off of psychiatric drugs, or to tweak your drugs until you feel comfortable? I'm sorry to hear that you have been put in this position.  It sounds as if you were on too high a dose of the citalopram, and this caused the symptoms you were experiencing.  Then, when you reduced by 25%, that was too big of a drop, and so your nervous system rebelled and you felt worse.  Adding, and then stopping the mirtazapine may have further destabilized things.  I assume you reduced citalopram to 15 mg start of June? I assume you meant to say "Tapered 20 to 15 mg" instead of "tapered 30 to 15 mg".   And then, dropping citalopram (I'm assuming) to 15 mg, then 10 mg, further stressed your system.  Please put the dates of each of these dose reductions in your signature.  

 

On 6/26/2022 at 10:17 AM, Erin9 said:

I got to 15mg by the start of June, and tried to drop again to 10mg.

I assume you are talking about citalopram in the above quote?  Just checking to make sure. 

 

On 6/26/2022 at 10:17 AM, Erin9 said:

As for trying to settle the symptoms, I've of course tried lots of different supplements with limited success

It is better to be very cautious with supplements.  More on this later.  

 

Here is some important information about how these drugs actually work.  This explains why we get symptoms from going off of these medications, and why it's so important to taper slowly and carefully, and be very cautious about changing our doses: 

 

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

 

 

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 reduction becomes exponentially smaller.

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering Citalopram

 

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

 

Stability is really important when we are tapering off psych meds.  Please read the link about stability:

 

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

 

It looks like you already updosed from 10 mg back to 15 mg.  It would help a lot if I had specific dates of these various dose change.  Please add info in your signature for each time you changed your dose, up or down, with the drug name and specific dose amount.  We can better advise you this way about a possibly further updose.  Thank you. 

 

 

Edited June 30, 2022 by getofflex

[Erin9]

Hi - I think my goal is to tweak the antidepressant until I'm comfortable. Originally I planned to come off them entirely but I can't see that happening, as the withdrawal has been so difficult so far. Yes, I definitely feel that increasing and then decreasing the dose messed up my nervous system to start with, and then was made worse by my relatively fast attempts to taper down even further. I've edited my signature so it makes more sense with dates and when I started tapering. I'm definitely considering an updose from 15mg to 20mg, but obviously would need to speak to the doctor and get further information on whether this would be a good idea. 15mg is an awkward amount for me as I don't have access to the liquid solution so I'm just cutting tablets which doesn't seem very accurate in terms of dosage. 

In terms of supplements, I've tried my first Omega 3 capsule today (will update with whether it turns out to be helpful). After no success with magnesium or B vitamins I'm hoping this might help with my neurological symptoms, specifically brain zaps and a flu-like pressure in my head... they have been particularly bad since my 5 days spent on mirtazapine. Thank you for the links to all those topics, they'll be really useful.

[getofflex]

Instead of jumping from 15 mg to 20 mg, you may want to increase it more slowly, perhaps go up one mg at a time: 15-16, 16-17, etc.  Once our brains have been sensitized, increasing the dose by too much can cause our symptoms to be even worse.  You may consider staying on the 15 mg for a while, and see if things settle down.  It often takes several months for the brain to adjust to a particular dose.

 

You can easily take any dose you want by using the liquid, which should probably be available in England.  You can also make your own liquid from the tablets, or crush the tablets and weigh the powder:  

 

Dosing and Tapering Citalopram

 

And, perhaps in a few years, when your nervous system is completely stabilized, you could attempt another withdrawal.  If you do it extremely slowly and carefully, and not jumping on and off other psych meds, it will probably be much easier.  It has been shown that in the long run, antidepressants actually tend to worsen depression:

 

Robert Whitaker, author Anatomy of an Epidemic video

Edited July 1, 2022 by getofflex

[Erin9]

Thanks, yes I've definitely noticed I'm much more sensitive to drug changes since starting all this. The fact that taking one supplement recently messed with me so much (after never feeling like I was particularly affected by them) makes me feel like my nervous system is very easily 'activated' at the moment. I definitely plan to stay at 15mg until I feel more stable and the neurological symptoms have settled. Part of me worries that the symptoms won't settle...so i'm not sure how long to wait...but I guess its logical that if I just stay on my current dose my body will eventually get used to it? 

[ChessieCat]

  

18 minutes ago, Erin9 said:

Hi - reading this topic has been so interesting, I've been on citalopram for years and never really understood how it worked biologically. I've been on SSRI's since I was 14, and at that stage I was still not developed, so I've been on this type of drug since before my brain and body fully developed and matured. A decade later I've tried to reduce citalopram and its been awful, and I'm worried that because of how long I've been on SSRI's and the fact that I was on them from a young age has meant that it'll take my brain years to 'repair' or just get used to being on a lower dose. I tapered way too fast (trusted the doctors advice to just taper in a few weeks..) and even though I'm stopping all adjustments now (to let my brain heal) my brain feels zapped every day. It's so awful being in your early 20s and feeling like your brain just isn't okay, while everyone around you seems to be getting on with their lives. 

 

I often suggest to members who have been on a psychiatric drug since a young age to see a counsellor and learn general life coping skills, because if they have been numbed during their early years they have not experienced life without the drugs so have probably not learned how to deal with the normal ups and downs and stresses of living.

[Erin9]

26 minutes ago, ChessieCat said:

  

 

I often suggest to members who have been on a psychiatric drug since a young age to see a counsellor and learn general life coping skills, because if they have been numbed during their early years they have not experienced life without the drugs so have probably not learned how to deal with the normal ups and downs and stresses of living.

Thanks for this. I actually have been having therapy for around the same amount of time as I've been on antidepressants - I feel that if I didn't have any physical symptoms I'd be coping fairly well... I just cannot seem to cope with everyday living while having this myriad of symptoms. And of course that affects the mental health and it spirals... but I'm grateful that at least I know the cause of the symptoms. Before I'd realised it was withdrawal I had terrible health anxiety, thinking I had an awful illness or condition that was going undiagnosed. It's definitely been a year of struggling to realise and/or cope with body and mental health changes. Hoping that I'll come out of it stronger eventually. 

[Erin9]

Today's symptoms have me struggling. I think its the withdrawal from citalopram and also still withdrawal from mirtazapine. Today my headache is bad, I keep getting chills/shivers from my head and then down my whole body, which gives me goosebumps too. My neck and head get electric zaps, and I feel nauseous from having all these head symptoms. My scalp is also tingly. It just seems like my nerves are shot, and I'm not sure what to do about it. I've also been experiencing a runny nose which gets blocked, and the feelings in my head are similar to when I have a cold/flu and I have a pressure headache. I know that mirtazapine is a strong antihistamine so I'm wondering if stopping that has made me feel this way. Considering trying an OTC antihistamine to counteract this, but not sure if it's a good idea to add anything else into my system at the moment. 

[getofflex]

Unfortunately, there are no quick fixes for the symptoms of withdrawal.  That is why we have a plethora of non drug coping skills that are described in the link in my first post.  The only solutions to this is huge amounts of time and patience, and natural self care.  I understand this is very frustrating, and unfair, but this is the situation we are in.  An antihistamine may help with the sinus issues, but just take a small amount at first, to see how it affects you.  Here are some things that may help you cope with the symptoms: 

 

Acknowledge Accept Float

 

Meditation

 

https://www.psychologytoday.com/us/blog/pieces-mind/201207/radical-acceptance

 

For me, what helped a lot when I was in acute WD, was to distract myself by doing simple easy physical tasks, to take my mind off my symptoms.  Dwelling on the symptoms, can put you in a downward spiral, and lead into depression and anxiety.  Try a gentle walk outside if possible, coloring in adult coloring books, light house cleaning, knitting, etc.  

[savinggrace]

  

13 hours ago, Erin9 said:

Hi - reading this topic has been so interesting, I've been on citalopram for years and never really understood how it worked biologically. I've been on SSRI's since I was 14, and at that stage I was still not developed, so I've been on this type of drug since before my brain and body fully developed and matured. A decade later I've tried to reduce citalopram and its been awful, and I'm worried that because of how long I've been on SSRI's and the fact that I was on them from a young age has meant that it'll take my brain years to 'repair' or just get used to being on a lower dose. I tapered way too fast (trusted the doctors advice to just taper in a few weeks..) and even though I'm stopping all adjustments now (to let my brain heal) my brain feels zapped every day. It's so awful being in your early 20s and feeling like your brain just isn't okay, while everyone around you seems to be getting on with their lives. 

 

Erin,

 

It is indeed terrible that for whatever reason, many of us got "trapped" on these drugs too early and for too long before we figured out, for ourselves, that we needed off.

 

Your nervous system has been through a lot.  15 mg. is almost 75% less than what you were on 6 months ago.  You did the right thing by quitting the mirtazapine so quickly.  Generally not adding anything to the mix is the best way to calm your nervous system down.

 

I am wondering if it is too late for an updose to 20 mg. and stay there for a while.  It might or might not work.  Perhaps a moderator could comment on this.  It looks like you felt considerably more stable with fewer side effects at 20mg.

 

I made a HUGE mistake decades ago by beginning to taper when I was never stabilized.  By the time I understood that mistake I would have had to double my doses to stabilize and there was no guarantee I would, and then I would have more drugs to taper.

 

Time is on your side, Erin.  You have every reason to feel very hopeful.  You are young and resilient.  Give yourself positive reinforcement, be patient, and "this too shall pass"...perhaps not as quickly as you'd like it to, but it will get better.

 

Grace

 

Edited July 3, 2022 by ChessieCat
added quote before moving to member's intro

[ChessieCat]

4 hours ago, savinggrace said:

Your nervous system has been through a lot.  15 mg. is almost 75% less than what you were on 6 months ago.  You did the right thing by quitting the mirtazapine so quickly.  Generally not adding anything to the mix is the best way to calm your nervous system down.

 

I am wondering if it is too late for an updose to 20 mg. and stay there for a while.  It might or might not work.  Perhaps a moderator could comment on this.  It looks like you felt considerably more stable with fewer side effects at 20mg.

 

The above post has been moved from another topic.

 

Getofflex posted this before the above post was moved.

 

7 hours ago, getofflex said:

Unfortunately, there are no quick fixes for the symptoms of withdrawal.  That is why we have a plethora of non drug coping skills that are described in the link in my first post.  The only solutions to this is huge amounts of time and patience, and natural self care.

 

 

[ChessieCat]

4 hours ago, savinggrace said:

Your nervous system has been through a lot.  15 mg. is almost 75% less than what you were on 6 months ago.  You did the right thing by quitting the mirtazapine so quickly.  Generally not adding anything to the mix is the best way to calm your nervous system down.

 

I am wondering if it is too late for an updose to 20 mg. and stay there for a while.  It might or might not work.  Perhaps a moderator could comment on this.  It looks like you felt considerably more stable with fewer side effects at 20mg.

 

Going from 15mg to 20mg would be a 25% increase.  When a member feels that need/want to make an updose, SA generally suggests only making a small increase and then increase by small increments if needed.  In this case I do not think that making an updose is a warranted at this time.

 

ALSO Erin only very recently started and stopped mirtazapine, so Erin could possibly be experiencing fall out from that.

 

One thing that is very important to understand is that the effect of psychiatric drugs is cumulative. There are SA members who have been on/off drugs and up/down in dose multiple times with no issues, then one day they do the same thing that worked before and their nervous system cannot cope with it.

[Erin9]

4 hours ago, savinggrace said:

  

 

Erin,

 

It is indeed terrible that for whatever reason, many of us got "trapped" on these drugs too early and for too long before we figured out, for ourselves, that we needed off.

 

Your nervous system has been through a lot.  15 mg. is almost 75% less than what you were on 6 months ago.  You did the right thing by quitting the mirtazapine so quickly.  Generally not adding anything to the mix is the best way to calm your nervous system down.

 

I am wondering if it is too late for an updose to 20 mg. and stay there for a while.  It might or might not work.  Perhaps a moderator could comment on this.  It looks like you felt considerably more stable with fewer side effects at 20mg.

 

I made a HUGE mistake decades ago by beginning to taper when I was never stabilized.  By the time I understood that mistake I would have had to double my doses to stabilize and there was no guarantee I would, and then I would have more drugs to taper.

 

Time is on your side, Erin.  You have every reason to feel very hopeful.  You are young and resilient.  Give yourself positive reinforcement, be patient, and "this too shall pass"...perhaps not as quickly as you'd like it to, but it will get better.

 

Grace

 

Hi Grace, thank you so much for your response, it really made me feel supported. I'm definitely glad I didn't stay on mirtazapine, it may have helped in some ways but I also think my nervous system needs a break. I had considered going back to 20mg of citalopram, as I did feel more stable on that (and it was easier, I didnt have to cut any tablets) but as the moderator says, it feels like my nervous system is so fragile at the moment that any change could be damaging. So I might stick to 15mg until my brain feels more robust again! But maybe 20mg is where I should eventually settle.

 

I'm sorry you experienced the same issue with tapering at an unstable stage - I definitely have regrets about the speed of my tapering, and the timing I chose to do it...but I suppose I was desperate for change and too optimistic about how it would turn out. I actually went out tonight though (rare occasion) and had a few hours where I forgot about all this stuff, forgot about my symptoms and just enjoyed myself. So doing that and then reading your post makes me hopeful that things will be okay in the end x 

[savinggrace]

It's wonderful that you just left your troubles behind you and enjoyed yourself.  More good times are ahead!

 

Grace

[savinggrace]

1 hour ago, ChessieCat said:

 

Going from 15mg to 20mg would be a 25% increase.  When a member feels that need/want to make an updose, SA generally suggests only making a small increase and then increase by small increments if needed.  In this case I do not think that making an updose is a warranted at this time.

 

ALSO Erin only very recently started and stopped mirtazapine, so Erin could possibly be experiencing fall out from that.

 

One thing that is very important to understand is that the effect of psychiatric drugs is cumulative. There are SA members who have been on/off drugs and up/down in dose multiple times with no issues, then one day they do the same thing that worked before and their nervous system cannot cope with it.

Actually, I was assuming she would taper up to 20 mg. but also I referred her to a moderator, as I really don't know.  Yes, a 25% increase is definitely too much.  I try to refer members to moderators.  I should have specified tapering up, if need be, as she felt better at 20 mg.  You are right though.  She just experienced the mirtazapine addition/subtraction.  I just hate seeing people get stuck, like I did, when they are not stable.  Perhaps Erin will stabilize at 15 mg.

[getofflex]

On 7/1/2022 at 4:36 PM, Erin9 said:

I guess its logical that if I just stay on my current dose my body will eventually get used to it? 

Yes, this is generally true, unless a person has an adverse reaction to the drug at that dose.  Time will tell.  It is quite likely that it could take several months to stabilize at your 15 mg dose of citalopram, so please be patient.  I did a 5 month hold in my taper 2 years ago, and it was profoundly helpful.  

[Ariel]

Hi @Erin9

 

Welcome to SA. 

I'm sorry for what has brought you here, and glad you found us.

The mods are great and I trust you'll get the support you need.

 

I see that you started on psych drugs at a young age. Same here. 

We've got a support thread for that (I post there, too), if you're interested:

 

 

Peace and healing <3

A.

[Erin9]

On 7/3/2022 at 1:34 PM, getofflex said:

Yes, this is generally true, unless a person has an adverse reaction to the drug at that dose.  Time will tell.  It is quite likely that it could take several months to stabilize at your 15 mg dose of citalopram, so please be patient.  I did a 5 month hold in my taper 2 years ago, and it was profoundly helpful.  

I will definitely try to be patient with it - I am still experiencing the fallout from mirtazapine (numbness, tingling, brain zaps) and I can't tell how much of that is from the citalopram withdrawal too. So my plan is to just hold on where I am and hope that things stabilise. I am trying to learn to live my life while feeling like my brain is in this state of adjustment, although I'm sure everyone on SA understands how hard it is. 

[getofflex]

I'm glad.  You are taking the right approach.  Things will stabilize, if you avoid alcohol and mind altering stuff, stay away from major stress and drama, take your dose each day at the same time, don't miss a dose, avoid intense exercise, etc. 

 

These links will help you know when is the time to do another reduction. 

 

Stability

 

WD Normal

[Erin9]

So I think I've just discovered some new WD triggers, this is probably stuff that people with experience on here will know lots about, but it's all quite new to me. 

 

This weekend after months of not much physical activity I went on a cycling holiday, and definitely over-exerted myself. Funnily enough I felt great during the holiday, I didn't have many symptoms at all (or maybe I was just so distracted that I didn't notice them). The exercise was definitely exhausting but I pushed myself and managed it. I was really proud of myself and so glad to have enjoyed something. But since coming back a couple of days ago my symptoms have been really bad. It may also be the heat (we're in a heatwave in the UK at the moment), and could be that now my focus is back on my symptoms they seem worse. It also could be that I'm ovulating, and usually I'm more reactive and sensitive during ovulation and my period. So overall I'm thinking that perhaps exercise, ovulation and heat could all be triggers for my symptoms. 

 

So since coming back the symptoms that have been bad are headaches, fatigue, nausea, brain zaps, pulsatile tinnitus, paresthesia on my head and face (mostly on the left side) and achey neck and shoulders. Also cognitive difficulties and memory problems - I find I cant remember names or what I went into a room for, and also reading really makes my head feel foggy and nauseated. 

 

This is such a pain, because I feel like I take one step forward then two steps back. I also feel like it triggers my health anxiety, because even though all of these symptoms are congruent with what I experienced when I was tapering citalopram (and therefore I know it is linked to the antidepressants), part of me still thinks 'something else is wrong here and I'm not picking up on it'. Today the paresthesia in my head has been so bad that I wonder if something scary will happen, like a seizure (not that I've ever experienced that!!) - but the discomfort is so intense that it feels like something will give eventually. Just praying this will all settle soon. 

[Erin9]

Hi - just wondering if the same applies to updosing as it does for reinstating? If I am on 15mg of citalopram and I feel unstable on this dose (have been on it for 6 weeks) would a recommended updose be to maybe 16.5mg? My symptoms are intolerable and after 6 weeks of trying to wait them out I think I need to try updosing

 

(I couldn't find a specific topic on updosing but if there is one I don't mind being redirected there)

[ChessieCat]

5 hours ago, Erin9 said:

Hi - just wondering if the same applies to updosing as it does for reinstating? If I am on 15mg of citalopram and I feel unstable on this dose (have been on it for 6 weeks) would a recommended updose be to maybe 16.5mg? My symptoms are intolerable and after 6 weeks of trying to wait them out I think I need to try updosing

 

(I couldn't find a specific topic on updosing but if there is one I don't mind being redirected there)

 

Yes much of the process of reinstatement also applies to updosing.

 

When updosing it is better to increase by small increments than to risk taking too much.  There is no way of knowing how much adaptation the brain has made during the time you have been on the lower dose.  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, so keep that in mind when considering when to increase again (if you feel you need to).

 

The aim of increasing is not to get rid of withdrawal symptoms completely but to bring them to a bearable level.  Some members try to find the perfect dose and end up making things worse.  It is better to compare how you feel to have you felt at your worst, not how you felt at your best or how you want to feel.

 

If it was me, I would be cautious about the amount that I increased by.

 

To start with I would only increase by 0.5mg, so 15.5mg.  I realise that this sounds like a tiny amount but if after 1 week you have noticed some improvement then hold for another week but if no improvement you could increase by another 0.5mg to 16.00mg.

 

Because you have recently took and then stopped mirtazapine, if things worsen it will unfortunately be difficult to know if what you experience is due to the updose or taking and stopping mirtazapine.

 

Please keep notes for yourself during this time.  Even a short time of feeling some improvement will indicate that the updose is helping.

 

Remember - slow and steady.

 

 

[Erin9]

13 hours ago, ChessieCat said:

 

Yes much of the process of reinstatement also applies to updosing.

 

When updosing it is better to increase by small increments than to risk taking too much.  There is no way of knowing how much adaptation the brain has made during the time you have been on the lower dose.  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, so keep that in mind when considering when to increase again (if you feel you need to).

 

The aim of increasing is not to get rid of withdrawal symptoms completely but to bring them to a bearable level.  Some members try to find the perfect dose and end up making things worse.  It is better to compare how you feel to have you felt at your worst, not how you felt at your best or how you want to feel.

 

If it was me, I would be cautious about the amount that I increased by.

 

To start with I would only increase by 0.5mg, so 15.5mg.  I realise that this sounds like a tiny amount but if after 1 week you have noticed some improvement then hold for another week but if no improvement you could increase by another 0.5mg to 16.00mg.

 

Because you have recently took and then stopped mirtazapine, if things worsen it will unfortunately be difficult to know if what you experience is due to the updose or taking and stopping mirtazapine.

 

Please keep notes for yourself during this time.  Even a short time of feeling some improvement will indicate that the updose is helping.

 

Remember - slow and steady.

 

 

 

Thank you for your advice - I may wait a few more days and think about whether an updose will be worth it. And if I do updose I'll take your advice and do it in an even smaller increment - I don't want to risk making things worse so I'm willing to go super slow. I do think that the mirtazapine withdrawal effects are reducing ever so slightly...I still get the neuralgia, headaches and brain fog but I'm getting slightly longer windows between waves of those symptoms, eg half an hour instead of 10 minutes. So maybe (agonisingly..) I will wait. Patience is definitely not a virtue of mine but I'm learning that it has to be to get through this. I'm also now weighing out my current 15mg dose of citalopram instead of just cutting the tablets, so its more accurate and consistent, and maybe after a few more weeks of that I'll notice a difference. 

[Ariel]

Hi @Erin9,

I'm sorry things are so rough right now and the symptoms are intolerable. 

Based on your drug signature there have been a lot of major changes in the past 7-8 months, which is bound to take its toll. 

 

Healing is a slow and often harrowing process, and I assure you it is happening.

Healing is happening all the time, whether or not we consciously feel it. 

 

I find this essay useful and inspiring in imagining all the behind-the-scenes brain activity going on around the clock. 

When I feel stuck, like nothing or not enough is happening, I sometimes revisit this topic to remind myself that my body is healing 24/7. 

 

 

Hang in there, Erin. It gets better. 

 

I'm glad to see you posting around the site, reaching out to others and making connections. 

That's a great way to exchange support as well as distract from symptoms and glean information. 

It sounds like you're committed to getting through this. You have a constructive attitude that'll serve you well.

 

In solidarity and support,

A. 

[ChessieCat]

8 hours ago, Erin9 said:

I'm also now weighing out my current 15mg dose of citalopram instead of just cutting the tablets, so its more accurate and consistent

 

This could make a difference.

[Erin9]

So I had a window for a couple of days (on and off during the days but definitely some more positive moments), but once again I've been feeling the neurological symptoms again for the past 2 days. Headaches, tingling, goosebumps, and a sensitive/tight throat feeling. A big part of all this is definitely my health anxiety which really hits me when I have any symptoms. I need to tell myself its WD combined with anxiety, and not something scary or sinister. I'm building up more evidence for myself that I can function even when I'm feeling rough (have been out a few times this week even when feeling in the depths of WD symptoms, and nothing awful happened except feeling some discomfort). I've decided not to try updosing yet - maybe sitting with the uncertainty and the discomfort is better for now, after all it'll have to pass at some point. 

I had a terrible experience with a psychiatrist, who I told about my medication change symptoms, which he dismissed and offered nothing except giving me more metaphors for anxiety, which is just pointless when I've been going through it for years, and I know that my symptoms are definitely nervous system/withdrawal related. 

 

I'm just wondering whether to try a very small amount of magnesium again - I have powder filled capsules of magnesium glycinate (200mg), I'm assuming I could just open them and stir part of the powder into the liquid and consume it that way? 

[rmce72a]

  

On 7/30/2022 at 3:39 AM, Erin9 said:

Hi @Kay23 

 

I wanted to say hello because I feel I'm in a similar situation. You can see from my drug signature that basically I was stable for a long time and then one change of dose started a domino effect of symotoms, more dose changes, increases, reductions, new medication introduced, all while constantly trying different supplements all the time in a panic while trying to make myself better. I happen to be having a really bad day today so I can relate to what you've written about your experience. I feel stuck, like if I move in any direction by body will react in a negative way. My CNS feels pretty wrecked, I have tingling and burning and nausea symptoms almost every day. I dont feel good, or stable, or happy - but if I increase or decrease my dose, or take a supplement, I'm scared I will feel worse. Its such a horrible position to be in and I'm so sorry you are there too. Just know that you're not alone. I'm at the stage where I'm just trying to tell myself that it must get better at some point if I just stay where I am (with dosage) and let my brain heal itself. Its hard to believe some days, like today. But we can only try. Sending you all the healing vibes, genuinely, I really hope you feel even the tiniest bit better soon. 

 

Hell Erin, I am in a similar situation trying to reduce Effexor XR 75 mg. I have only reduced to 73.0 after 11 weeks. I am holding at 73 until I can go a few days without symptoms. I don't know what else to do but just ride out the storm and hope things improve which is what you will probably have to do. One of the saddest parts of all of this is that we are all working so hard to do all the right things, yet our bodies seem to fight us every step of the way. Let's both hang onto hope, and maybe tomorrow will be better. Best wishes and love.

 

Edited August 2, 2022 by ChessieCat
added quote for context before moving to Intro

[Erin9]

3 minutes ago, rmce72a said:

Hell Erin, I am in a similar situation trying to reduce Effexor XR 75 mg. I have only reduced to 73.0 after 11 weeks. I am holding at 73 until I can go a few days without symptoms. I don't know what else to do but just ride out the storm and hope things improve which is what you will probably have to do. One of the saddest parts of all of this is that we are all working so hard to do all the right things, yet our bodies seem to fight us every step of the way. Let's both hang onto hope, and maybe tomorrow will be better. Best wishes and love.

 

Honestly, the worst part is that all of this started because I was trying to make myself better, like all of us on here were. I feel there's definitely an element of self-blame...we are all working so hard, like you said, but sometimes it feels like there's no light at the end of the tunnel. I'm so sorry you're in the same boat. At least there's a community on here who understands. 

[Ariel]

Hi @Erin9

I was sorry to read in your comment to @Kay23 that you are having a rough day. 

 

In your most recent post here you mention that you had a window for a couple of days a while ago. Do you feel that has given you some hope? 

I know it can be hard to hang on to those window experiences as they are inevitably all too short and easily forgotten when we are hit with the next wave. 

I received an approx. 36-hour window five weeks ago, and it was incredible. That was the first window I'd had since October, probably. 

I haven't felt well since that window closed, and I'm trying to practice every day to just check in with that memory and remember that it did happen. 

The windows are real. Healing is happening. Healing is happening all the time, even when we don't consciously feel it. 

 

On 7/23/2022 at 5:28 PM, Erin9 said:

I had a terrible experience with a psychiatrist, who I told about my medication change symptoms, which he dismissed and offered nothing except giving me more metaphors for anxiety, which is just pointless when I've been going through it for years, and I know that my symptoms are definitely nervous system/withdrawal related. 

 

I am really sorry you had this experience. It's so awful to feel disbelieved and patronized and dismissed. It can be so stressful. 

I hope you never have to go back to him ever again. 

Do you have access to any good psychiatrists who know about withdrawal, or who at least are not condescending, ignorant pricks? 

 

On 7/23/2022 at 5:28 PM, Erin9 said:

I'm just wondering whether to try a very small amount of magnesium again - I have powder filled capsules of magnesium glycinate (200mg), I'm assuming I could just open them and stir part of the powder into the liquid and consume it that way? 

 

I don't know the answer to your question. 

I can share that after extensive experimentation I've found this magnesium to work best for me. 

It's mild and pure (not sure that makes scientific sense, but subjectively speaking), and it's a powder that one dissolves in water, which makes for easy dose control. 

 

On 7/23/2022 at 5:28 PM, Erin9 said:

I'm building up more evidence for myself that I can function even when I'm feeling rough (have been out a few times this week even when feeling in the depths of WD symptoms, and nothing awful happened except feeling some discomfort). I've decided not to try updosing yet - maybe sitting with the uncertainty and the discomfort is better for now, after all it'll have to pass at some point. 

 

This all sounds very brave and wise, Erin. 

Hats off to you for your courage and tenacity. 

 

Remember: this is temporary, it will pass. It gets better.

The windows are real, the windows are real. 

Healing is happening <3

 

Sending hugs and healing vibes <3

A.

[rmce72a]

I check this site every day, sometimes multiple times, because it has become my lifeline. No one, (spouses, friends, doctors, pharmacists) understand. They may be kind and sympathetic, but people who have not gone through this have no idea how much we are suffering. I try to hide how I feel and carry on if I can, so I don't make people around me feel bad for me. This is the hardest thing I have even done in my life, and I've had some pretty tough challenges. All we can do is reach out to people here who DO understand the suffering. If nothing else, it helps me to know that I am not in this alone. Wishing you healing and love. Please stay in touch.

 

[getofflex]

On 7/29/2022 at 1:07 PM, Erin9 said:

Honestly, the worst part is that all of this started because I was trying to make myself better, like all of us on here were. I feel there's definitely an element of self-blame...we are all working so hard, like you said, but sometimes it feels like there's no light at the end of the tunnel

@Erin9I'm very sorry for what you are going through.  Please hang on, it gets better eventually.  There is a light at the end of the tunnel.  Try not to blame yourself.  If you are like me, you were brought up to trust doctors and medicine, and assume that they knew best, and had our best interests at heart.  Sadly, this is often not the case, and we've had to learn it the hard way.  Please read: 

 

Shame, Guilt, Regret, Self Criticism

[getofflex]

On 7/23/2022 at 10:28 AM, Erin9 said:

I'm just wondering whether to try a very small amount of magnesium again - I have powder filled capsules of magnesium glycinate (200mg), I'm assuming I could just open them and stir part of the powder into the liquid and consume it that way? 

Yes, give this a try.  When you had the headache the last time you tried it, the headache may have been from something else.  Yes, you can mix a little of this powder with some liquid.  Let us know how it goes. 

[getofflex]

On 7/23/2022 at 10:28 AM, Erin9 said:

I've decided not to try updosing yet - maybe sitting with the uncertainty and the discomfort is better for now, after all it'll have to pass at some point. 

I agree, often toughing it out is better than changing our drug dose.  We don't want to updose just because we are in a wave.  Waves and windows are part of the healing pattern.  And, frequent drug dose changes are more likely than not to further destabilize us.  Please read this: 

 

On 5/12/2021 at 11:15 AM, Yesyes123 said:

"My withdrawal symptoms are so bad, I tried X and it didn't work, so I changed it to Y and it made me even worse, so I am now doing Z hoping to get better by the end of the week!"

 

Every time I see someone say things along these lines, I truly feel bad for them.

 

This type of behavior is like playing ping-pong with your brain and Central Nervous System, as people sometimes say around here.

And I don't mean only with psychiatric drugs - that goes for supplements, sleep patterns, food, etc.

 

"Stability" - this post by the amazing @brassmonkeyis spot on, as everything else he puts out.

 

"For some people who are very sensitive to changes in dosage, it may take two or three months for people to stabilize after such an adjustment.  Some people will take even longer."

In this quote he's referring to stabilizing after dose changes in psychiatric drugs - but similar patterns can be seen in many other things, such as supplements.

I often see people taking fish oil or other supplement for 3 days and complaining that it "didn't work" or made them more anxious...

In such short period, there is really no way to see the effect of the substance on you (unless you have a clear, strong and definite adverse reaction immediately).

 

Your body likes stability.

That's the main idea here. If you keep jumping around with supplements, doses, diets, excercise routines, etc, you will very hardly find stability.

 

You need to find something that seems to work for you and stick with it for a while in order to truly benefit from it.

You will definitely have to do some experimenting in order to find what works for you - but that does not mean you are allowed to try every single thing in 1 week hoping to get better sooner. It will take some time... for some, shorter. For others, longer. But we all get there eventually.

 

I have personally only started to see benefits in fish oil after nearly 2 months of taking the same dose daily.

 

Something to think about!

 

and, 

 

On 6/14/2021 at 2:16 PM, getofflex said:

Tough It Out

 

We live in a world where the internet and media lead us to think that we should live a life free of pain and troubles.  But, is this realistic?  Has life on earth ever been easy and fun all the time?  No.  Most of us went on psych meds to take away mental anguish.  For many of us, this worked, at first.  But then, for one reason or another, we needed or wanted to get off the drugs.  However, most of us found that getting off of these drugs was not so easy.  The medical people usually recommend a very fast taper, and most of us who try that end up with significant withdrawal symptoms.

 

Unfortunately, we then try to find a solution to take the pain of withdrawal away quickly and easily.  We jump back on the drugs, try a different drug, try a bunch of supplements, etc.  But, isn’t this what got us into trouble in the first place?  Trying to use drugs to fix the trials and tribulations of life?  Thus, we end up on a carousel of more drugs, and the problem just grows bigger.

 

What I see so much now, and it disturbs me, is that when people get uncomfortable withdrawal symptoms, they want to go right back to the drugs to take away the uncomfortable symptoms.  But in a lot of cases, this can lead to our nervous systems becoming even more sensitized and even to kindling, which causes worse pain and suffering.   It ends up just prolonging the problem and making it worse.  The drug was what caused the problem in the first place.  I think perhaps the basic underlying problem a lot of us have, is to avoid and escape pain.  Perhaps we need to take a different approach to pain and discomfort.  Pain and discomfort has been with us since the beginning of time.   And unfortunately, avoiding pain and discomfort can work in the short run, but in the long run can cause much worse pain and misery and suffering.  So, I’m calling on all of us to try and toughen up, and put up with some pain and discomfort now, in order to avoid worse pain and discomfort in the future.

 

One caveat - there are cases when a temporary reinstatement is called for, because it can reduce severe withdrawal symptoms.  I’m not talking about that.

 

I’m calling for us to get away from this notion that we need a quick fix to make our problems go away.  For me personally, there was a good reason I was anxious and depressed.  I needed to deal with that directly. The pills only masked the pain - they did not cure the problem.  It was like taking a pain killer to deal with a cancer.  I needed to deal with the cancer directly by removing it, not by just killing the pain the cancer was causing. That is why we suggest non drug coping skills.  These help us deal with the pain of living in a non drug way, and get at the root of the problem instead of just taking away the pain.

 

 

[Erin9]

On 7/29/2022 at 7:10 PM, Ariel said:

In your most recent post here you mention that you had a window for a couple of days a while ago. Do you feel that has given you some hope? 

I know it can be hard to hang on to those window experiences as they are inevitably all too short and easily forgotten when we are hit with the next wave. 

I received an approx. 36-hour window five weeks ago, and it was incredible. That was the first window I'd had since October, probably. 

I haven't felt well since that window closed, and I'm trying to practice every day to just check in with that memory and remember that it did happen. 

Thanks for your message @Ariel. I definitely find it very difficult to remember the windows during the waves - I've always been like this, forgetting that the good days even existed when in the middle of a bad day. I've started a journal to track my mood and symptom severity, so that I have something to look back on and remember the better days. I'm glad to hear you had a window, and I definitely admire your ability to hold onto that and remember it - I will try and practice this more. 
 

 

On 7/29/2022 at 7:10 PM, Ariel said:

Do you have access to any good psychiatrists who know about withdrawal, or who at least are not condescending, ignorant pricks? 

 

Unfortunately I don't on the NHS, and can't afford to pay for somebody private. I might still investigate it, although from my previous brief searches there doesn't seem to be anybody who actually has any specialism or understanding of medication withdrawal.. 


Thanks so much for your message, it's nice to feel supported on here. 

[Erin9]

Its probably a bad idea to post here during a really bad wave, because I know it'll all be negative...but here we are. My headache is back and so is the head and neck paraesthesia, the occipital neuralgia and the brain fog. I had a big cry this evening because yesterday was a good day, and so to feel unwell again today just made me more upset than ever. It just will not end. It has been 6 weeks since my run in with mirtazapine (also since the headaches/tingling restarted), around 9 weeks since being on this 15mg dose of citalopram, and around 9 months since my dose was first changed. I am so tired of feeling unwell and scared, and I am tired of constantly trying to live my life but being hampered by symptoms and negative thoughts. Today I once again seriously considered updosing, and also seriously considered a direct switch from citalopram to fluoxetine (the ssri I was on for 5 years when I was younger, aka a familiar drug that I know has worked for me in the past). It's safe to say I'm panicking, and scared. I feel stuck, at this awkward middle dose where I cant increase or decrease without it being a long haul. I still can't work, or function very well without the help of my family. Right now I can't see the light at the end of the tunnel.

 

The only saving grace at the moment is that I am still able to eat and feel hungry; over the past few months I'd been having some gut issues and was worried about that, but for now they seem have cleared up so my main concern is my headaches and tingling. (If its not one thing its another...) 

[ChessieCat]

2 hours ago, Erin9 said:

Its probably a bad idea to post here during a really bad wave, because I know it'll all be negative

 

There is no issue with posting when you are feeling bad.  However, so that you can look back and see that you have made progress it is a good idea to also post when you are feeling improvement.

 

Also each member's Introduction topic is a journal of their recovery off psychiatric drugs.  They become case studies which the medical community can use.  Part of SA's mission is to educate the medical community.  See:

 

  

On 5/15/2011 at 5:22 AM, Altostrata said:

This site is also a research project. The personal stories on this site are documentation of an iatrogenic condition -- suffering caused by medical treatment -- that is almost always ignored, misdiagnosed, or denied by the medical establishment. Given the widespread prescription of antidepressants to tens of millions of people worldwide, withdrawal syndrome probably affects hundreds of thousands if not millions -- including newborns and children.

Antidepressant withdrawal syndrome can last weeks, months, or years. It can be distressing, debilitating, or even disabling. It may be adding to an increase in what is termed disabling mental illness.

With our documentation of antidepressant withdrawal syndrome, we hope to educate the medical establishment about this problem. Case studies are essential; they are evidence understood by doctors, the psychiatric industry, and government regulatory agencies. The have already informed numerous articles in major publications and scientific papers.

Our hope is, eventually, antidepressants and other psychiatric drugs will be prescribed rarely, and only in cases of extremely severe mental illness after less invasive treatments have been tried.

 

 

 

Edited August 6, 2022 by ChessieCat