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Dworkin: citalopram discontinuation tougher than expected


Dworkin

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I've been long time ago diagnosed with Borderline disorder but then they decided to make this less radical and now its only Anxiety/Depression disorder.

Since year 1994 I have been prescribed benzodiazepines and was on them for 23 years. I managed to get off them over the period of 1,5 years some 5 years ago. It wasn't an easy one, some really horrible days were there to endure. I used dry cutting and microgram scale in my end game.

 

From year 2013 I was prescribed Citalopram 20mg and Mirtazepine 30mg. They were introduced to help manage anxiety and help me sleep.

 

I have successfully reduced both few years ago to half of that - Citalopram to 10mg and Mirtazepine to 15mg.

 

Then furthermore, I decided to wean off Citalopram, so cca 1,5 years ago successfully reduced it to a quarter a day - 2.5 mg per day.

 

Beginning of this spring I felt like I should progress further with Citalopram, but I was really lazy and underestimated possible withdrawal symptoms. I gradually over the course of 4-5 months started to space doses, so started to take 2.5mg each second day, then each third day etc, until recently each 5th day.

You will probably say this was very naive approach because of the half life of the medicine - i might have this way continually discontinued it and re-introduced it every 5 days.

 

On parallel with this, I started to have gastro issues for the first time in my life, for which I believe they are not because of withdrawal, although they coincide with it. I have for 2 months low grade fever, nausea and heartburn. I am scheduled for stomach endoscopy.

On citalopram withdrawal side, my anxiety increased greatly, panic attacks were returned full force, ocd which I also suffer from started to be more noticeable, also headache and feeling dizzy / unsteady on my legs - almost difficult to walk. Of this panic attack and dizziness are more difficult to bear.

 

I'm not able to battle on these two fronts at the same time, so I think I will just re-instantiate to 2.5mg a day, and once I'm back to normal, attempt to do a more proper taper.

My GP (Ireland) approaches this in a very shallow way, she just tracks what I do but disregards these symptoms and only accepts headache as valid withdrawal symptom. At least she is not forcing upon me some unrealistic taper.

 

I do not plan to do anything with Mirtazepine for a while, as I noticed I can't sleep without it.
I also have underactive thyroid, which sometimes generates its own symptoms, but for now I am not on medications.


Looking for any reflection or advice regarding my Citalopram experience.

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  • ChessieCat changed the title to Dworkin: citalopram discontinuation tougher than expected
  • Moderator

@Dworkin

 

Welcome to SA. We are a volunteer ran site to help people taper off psychiatric medications or have tapered off and are now healing.

 

This is your introduction page where you will receive information, ask questions and meet other members. We ask that you only have one introduction page so we can keep all your information in one place.

 

Can you please create a signature.

 

How to List Drug History in Signature

 

You don't want to skip doses as your body can't keep a steady amount of the drug in your bloodstream. 

The brain likes consistency and alternating days is not consistent.

 

NEVER SKIP DOSES TO TAPER

 

Right now you are only taking 2.5 mg every 5 days? I would not go back to 2.5 mg a day at this point. I would start off with 1 mg a day and keep it at the same time each day. It will take 7-10 days for it to reach full stability in your bloodstream. This dose can always be adjusted if needed.

 

Here is some information in reinstating. This is essentially what you would be doing going back to taking the citalopram everyday. Then you would do a nice log hold before tapering anymore.

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

 

 

Tips for tapering off citalopram (Celexa)


Dr. Joseph Glenmullen's withdrawal symptom checklist

 

Why taper by 10% of my dosage?

 

Windows and Waves Pattern of Stabilization

 

Digestive Problems

 

We don't suggest supplements on here as they can cause stimulation to the central nervous system. We do suggest 2 that have been found to be calming. If you want to try one try a small amount, wait a few days before introducing the other.

 

https://www.survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

King of supplements: Omega-3 fatty acids (fish oil) - Symptoms and self-care - Surviving Antidepressants

 

After you have read the links provided, please reach out with any questions you may have.

 

 

PREVIOUS medications and discontinuations: Have been on medications since 1996. 

 Valium, Gabapentin, Lamictal, Prilosec and Zantac from 2000 to 2015 with a fast taper by a psychiatrist.

 Liquid Lexapro Nov, 2016 to 31-March, 2019 Lexapro free!!! (total Lexapro taper was 4 years-started with pill form)

---CURRENT MEDICATIONS:Supplements:Milk Thistle, Metamucil, Magnesium Citrate, Vitamin D3, Levothyroxine 25mcg, Vitamin C, Krill oil.

Xanax 1mg 3x day June, 2000 to 19-September, 2020 Went from .150 grams (average weight of 1 Xanax) 3x day to .003 grams 3x day. April 1, 2021 went back on 1mg a day. Started tapering May 19, 2023. July 28, 2023-approximately .87mg. Dr. fast tapered me at the end and realized he messed up. Prescribe it again and I am doing "slower than a turtle" taper.

19-September, 2020 Xanax free!!! (total Xanax taper was 15-1/2 months-1-June, 2019-19-September, 2020)

I am not a medical professional.

The suggestions I make are based on personal experience.

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Hey Froggie - thanks for these useful links and tips. The article about reinstating confirmed some of my thinking as well. I planned to go to take it each second day but I agree with you i should transition to stable dose each day.
I will do some dry-cutting and go to about 1mg per day or 1.25 mg per day (to be 1/8 of the tablet). I think that will be manageable and that it will save some of my "progress".
And yes - I saw for myself now skipping the doses was a bad idea. Just I greatly underestimated citalopram dependency as we were falsely told that they are not as bad as benzos!

 

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  • Moderator

@Dworkin

 

You could get a scale and weigh and crush the tablet to get an exact dose, since just cutting the tablet you won't get an even dose everyday.

 


Using a scale to weigh and measure doses

 

You can get them on Amazon fairly inexpensive. You would also want to order some "0" or "00" gel caps to put the powder in to.

 

Unfortunately, most dr's don't know how to taper you off these medications and just tell you you will have to be on them for life. 

 

Let me know if I can help in any other way.

PREVIOUS medications and discontinuations: Have been on medications since 1996. 

 Valium, Gabapentin, Lamictal, Prilosec and Zantac from 2000 to 2015 with a fast taper by a psychiatrist.

 Liquid Lexapro Nov, 2016 to 31-March, 2019 Lexapro free!!! (total Lexapro taper was 4 years-started with pill form)

---CURRENT MEDICATIONS:Supplements:Milk Thistle, Metamucil, Magnesium Citrate, Vitamin D3, Levothyroxine 25mcg, Vitamin C, Krill oil.

Xanax 1mg 3x day June, 2000 to 19-September, 2020 Went from .150 grams (average weight of 1 Xanax) 3x day to .003 grams 3x day. April 1, 2021 went back on 1mg a day. Started tapering May 19, 2023. July 28, 2023-approximately .87mg. Dr. fast tapered me at the end and realized he messed up. Prescribe it again and I am doing "slower than a turtle" taper.

19-September, 2020 Xanax free!!! (total Xanax taper was 15-1/2 months-1-June, 2019-19-September, 2020)

I am not a medical professional.

The suggestions I make are based on personal experience.

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I already have gemini-20 Miligram scale which I used during benzo taper.

10 mg citalopram whole tablet is 0.064g. so I weighed a 1/8th which is 0.008 g, which should be 1.25mg of Citalopram.

Its tricky to measure it as even tinier of movement can change measurement, and is even more trickier to cut exactly needed part of the tablet, but usually I'm left with enough particles which I can combine to get desired amount.

20220719_205658.thumb.jpg.05bcf5b03bbee483cc1497c75db15df7.jpg

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  • 10 months later...

So it has been a year since I posted here. I was then stabilising on 1mg per day. Since then I was gradually reducing without an issue. The dose (dry cutting) became so small that my mg scale can't measure it anymore. Since two weeks ago I reduced fromy a tiny weeny fraction (prob something like 0.2mg) to an amount that is just a little dust, it is so small that its difficult to reliably say if I'm swallowing it really.

 

I have hard times since then, notably middle of the night insomnia - waking up at 4am, not able to get back to sleep, with nerve/brain zaps. Once I start my day, brain zaps subside. I also have dizziness, a feeling that somehow Im not stable on my legs. As I worry more and more, panick attacks returned.

 

My biggest dillema is whether this is caused by wirhdrawal, or the symptoms are generated by something else.

 

If I was sure its Citalopram, I would go back an up the dose tiny bit just to get back to normal.

 

But if its not, then I will be sad to ruin my end of taper.

 

I am keen to hear about your experiences/opinions.

 

Also, I am wondering, is my dose actually same as nothing for a while already - is there such a small dose after which medicine is not effectively metabolised?

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