greymatter Trying to come off Citalopram after 10+ years

[greymatter]

I am a 49 year old female. I'm not sure how many years I've been taking anti depressants - I started with Prozac around 1996 and was on and off that and another one (can't recall its name at the moment) for a few years. I was first prescribed Citalopram 10mg around 1999 I think, soon increasing to 20mg. I then came off them (suiddenly) for a year or two until in 2002 I was in a bad way. Not sleeping, anorexia, depression, anxiety. At the same time I left a long term abusive relationship so it is hard to know if my symptoms were a 'normal' reaction to difficult circumstances or part of a mental illness I've always assumed I had since a suicide attempt in my teens (1982).

 

Since 2002 I have been on Citalopram almost constantly, for the past couple of years on 40mg. On 3 occasions over the last 10 years I decided to stop taking them. I thought I'd done it sensibly, but with hindsight I probably rushed the tapering off. Pretty soon after completely finishing the drug I began to get the same symptoms that led me to taking it in the first place. My GP said I would probably need to be on them for the rest of my life. I assumed he was right and that I was experiences the original 'illness' every time I came off the drug.

 

At the end of last year I heard about the link between Citalopram and heart problems. This worried me. I thought I could reduce my dose but not come off it completely as I 'obviously needed it'. Now though I am seeing things differently. I've only recently been aware of SSRI Discontinuation Syndrome and am now wondering if that has been the problem every time I've tried to come off the drug, rather than the depressive illness I always thought was part of me.

 

As I say, I was on 40mg for a long time (in the form of 2x 20mg tablets per day). Back in January I cut down to 30mg a day. I stayed at that dose for 2 months and noticed no difference in how I felt. Three weeks ago I cut down to 20mg. Initially I had insomnia and when I was able to sleep some very unpleasant, vivid dreams. The insomnia and vivid dreams have now stopped but I'm left with a vague anxiety feeling, like there is a physical weight in my chest and throat. It's not terrible, I can manage it, but I am very aware of it.

 

So.... how long should I stay at 20mg before reducing again? I've bought a pill cutter and had thought to cut down to 10mg next week (that will be after 4 weeks at 20mg). Should I stay at 20mg until the anxiety levels return to 'normal' instead?

 

I'm very pleased to have found this site. Hopefully this time I will finally free myself of this drug.

[Altostrata]

Welcome, greymatter.

 

I'm worried about that uneasy feeling, which sounds like it's from tapering too fast. You could either wait until it goes away or (my preference) updose slightly, perhaps to 22mg-25mg.

 

You can make a liquid from your tablets for more precise dosing. See http://survivingantidepressants.org/index.php?/topic/2023-tips-for-tapering-off-celexa-citalopram/

 

Also see Why taper by 10% of my dosage?

[greymatter]

Thank you for replying Altostrata

 

I am going to increase the dose to 25mg and see if that helps with the anxiety feelings.

 

By the way, back in January when I decided to come off them I mentioned it to my GP (not the same one who told me I'd have to stay on them forever). It seems he is blissfully unaware of how difficult it can be to discontinue, as all he said was "reduce them gradually over a couple of weeks". !!

[Jemima]

 

By the way, back in January when I decided to come off them I mentioned it to my GP (not the same one who told me I'd have to stay on them forever). It seems he is blissfully unaware of how difficult it can be to discontinue, as all he said was "reduce them gradually over a couple of weeks". !!

 

I'm sorry to say that this is typical of doctors, whether GPs or psychiatrists. They are just clueless about antidepressant withdrawal, largely because they get most of their information from drug company "detail" people, aka sales reps. As you can imagine, the physical dependency that develops from antidepressants is downplayed at best and many times just outright covered up.

 

Welcome to the forum. I'm glad you found us.

[greymatter]

I said the anxiety was 'not terrible'. Actually it has been increasing alarmingly in the past 24 hours. Just had my second updose of 25mg. I hope it makes a difference soon.

 

Incidentally, around the same time I dropped to 20mg Citalopram I also started taking Biotin every day. This was because I heard it could increase the rate of hair growth (I had a short cut recently that I'm wanting to hurry up and grow out). Is it possible that Biotin could cause anxiety or is this from tapering the Citalopram too fast.

[Rhiannon]

My guess is it's the citalopram. Given your history I think you need a much, much slower taper. See if you can hang in there with the 25 mg for a few weeks, the anxiety should gradually reduce. I would not consider tapering again until you've had a couple of good months.

 

Given your long history of use and your prior experiences when you've quit the drugs, it's just going to take some time for your brain to remodel itself, repopulate the receptors, etc. to get back to normal functioning so as not to have another post-withdrawal crash.

 

You have to grow a new brain. That is not something that can be done quickly.

[greymatter]

'Grow a new brain', yes, I like that. I'm sure you are right. Hopefully the 25mg will do the trick soon. The anxiety seems to be building rapidly at the moment. I will stick with it and do it properly this time. It seems there are no short cuts with this.

[Jemima]

I agree with what Rhi said, but I'd also suggest avoiding supplements other than high quality fish oil and magnesium. In antidepressant withdrawal, our bodies are hypersensitive and often react badly to supplements and even some foods that we used to be able to tolerate quite well.

 

Hang in there. It takes at least four days for an updose to take effect and some forum members have said that it's taken up to six weeks for them to feel any relief. Whatever you do, don't change your dose every time you have some discomfort.

[peggy]

for me an updose always takes 4 -5 weeks. I had times of intense anxiety during that period and then times of less anxiety - not a slow upward trajectory at all.

 

Neuroplasticity is slow, but possible. Look at people who have a stroke or significant brain injury - their rehabilitation can take years - they are needing to completely remodel their brain - so we shouldn't expect overnight success.

 

Going off psych drugs after long term use is difficult, but there are many people who have managed. I have been on effexor for over 13 years now and trying to get off for many. I managed to get down to a tiny dose, but after a few hiccups had to increase to half of my regular dose - i am taking a break from tapering at the moment. Yes, I am concerned about the long term effects of the drug - these were only tested for short term use. But I have decided for the moment anyway, that i have to live now and let the future take care of itself.

 

I read somewhere that you should take AT LEAST one month for every year of use.. i think that is even too fast for many and for higher doses.

[greymatter]

Is it recommended to take fish oils and magnesium during tapering?

 

I think I will stop the Biotin for now. Getting my hair long is not high in my list of priorities at the moment!

 

A month for each year on the drug puts it into perspective. Previously when trying to stop I did it in about 6 to 8 weeks.

 

The anxiety has been pretty bad today, also developed a new symptom, a high pitched ringing in my ears.

[Nikki]

HI GM

 

Welcome. I took Lexapro (citalopram) for two years and then got off of it. Getting off of it took two years. I was on 40mgs.

 

Maybe you should stay put for a good amount of time, give yourself a rest and then begin a taper. It is so important to stabilize and feel better.

 

It can take two weeks or so for the anxiety to subside after updosing.

 

Nikki

[greymatter]

I had been expecting the anxiety to lift much more rapidly than that. I need to be more realistic. Because I dropped from 40mg to 30mg successfully I rushed on and dropped all the way to 20mg. Obviously that was a mistake. Anxiety pretty bad again today but only 3rd day of updosing to 25mg.

 

What is helping is reminding myself that my brain is going to take time to recover so I must go gently.

[Francis]

Im also tapering off of citalopram (have been going through this process for around 18 months now). I had severe magnesium deficiency in the beginning, which was incorrectly diagnosed as panic attacks. I also had awful insomnia and tormented sleep. Ive had a lot of ups and downs, but right now am down to 0.6 mg of citalopram and finally have some lifting of most of the unpleasant symptoms (depression was something I NEVER felt prior to taking citalopram but has been a huge issue during withdrawal and now it has lifted almost completely). Insomnia, unfortunately, persists. I definitely have learned my lesson, that I have to be patient and allow my body to adjust for many weeks after each reduction and I have to listen to my body and not just a fixed reduction plan. I can only speak to my personal experience, since Im no medical expert, but I do feel like I can say that it can get better!

 

Patience is always so difficult for me to find and as wild as it sounds, I may come out of this awful withdrawal ordeal a better person that when it started.

 

I hope you can find some peace in this ordeal.

[greymatter]

Thanks for sharing your experiences Francis. The tight feeling in the chest is still bad. Also had palpitations for several hours. I think I need to get some magnesium. I won't have a chance to get them until after the weekend. I'm hanging in there.

[greymatter]

My symptoms seem to be worsening quite badly.

[greymatter]

What sort of magnesium? There seem to be different kinds. I've seen magnesium citrate, magnesium sulfate and something else.

[greymatter]

Ah, I've seen the information on here about supplements. Magnesium citrate is the one.

[Francis]

For a quick magnesium fix, you can do an epsom salt foot soak. Im no dr, but thats what I was told to do first by my naturopath (because I had it in the house) and it helped my tight chest, muscle cramping, shooting pains in my arms/hands pretty quickly.

[Altostrata]

Agree about the soak, take a bath. You can even ingest Epsom salts. It's mag sulfate.

[greymatter]

Update.

 

Haven't had a chance to get the Magnesium or the fish oils yet. However, after reaching a real peak of awfulness about 48 hours ago I do feel the anxiety has started to reduce over the last 2 days. I'll see how it is tomorrow before making a decision about trying any supplements. It may be that the updosing to 25mg is beginning to take effect.

[Francis]

Why not just get some epsom salt to have on hand just in case?

[flower]

Greymatter good luck with the Celexa.I'm in that boat too. Seems Celexa is popular with the Dos for some reason.

[greymatter]

It's been one week since I updosed and the anxiety has reduced considerably, I feel a good deal better than I did. I'm going to stick at 25mg for a couple of months then decide if I feel ready to taper some more. Thank you for the help everyone.

[Jemima]

Thanks for letting us know that the advice was helpful! That's encouraging for the administrators and mods and also helps to drive the point about slow tapering home to new people who don't understand that getting off the drugs as fast as possible is not the way to go.

 

Now that you're stable, you might want to browse the forum for information on tapering and the non-drug sorts of things people have found helpful while getting off antidepressants.

 

Great to hear that you're doing so much better!!!

[Rhiannon]

Thanks for letting us know that the advice was helpful! That's encouraging for the administrators and mods and also helps to drive the point about slow tapering home to new people who don't understand that getting off the drugs as fast as possible is not the way to go.

 

Now that you're stable, you might want to browse the forum for information on tapering and the non-drug sorts of things people have found helpful while getting off antidepressants.

 

Great to hear that you're doing so much better!!!

 

Ditto, good to hear!

[greymatter]

Update:

 

Still doing ok after updosing to 25mg about a month ago. Feeling quite stable. I think I'll give it another few weeks then taper down again.

[Altostrata]

Excellent! Please keep in touch.

[greymatter]

Haven't been on for a while. I'm still tapering and all is going well at the moment. Currently at 15mg. 

[basildev]

Good to hear greymatter.

 

I'm on citalopram as well. Felt fine during my taper then all of a sudden 'crashed' at 11mg.

 

Whatever you do, go slowly and even if you're feeling okay I'd suggest some long holds in the mix there.

[flower]

I crashed too at 10mgs..That was in Dec. I will wait a little longer..Take time..goig 5 mgs at a time is a good pace. Good luck.

[greymatter]

Crashed at 5mg which I dropped to just a few weeks ago. Too big a drop. To make matters worse the past 2 days I haven't taken it at all. Why? Can't really answer that except to say because I'm bloody stupid. I was doing so well for ages, then within days of dropping to 5mg I felt anxious.  I felt bad enough on the 5mg so why stop altogether? Feeling somewhat self destructive about it. Have been tearful today, also irritable and this evening getting electric shock sensations in the chest. Very low mood.  I know I need to updose again but part of me wants to just feel like **** and get it over with. 

 

If I fail to updose (and particularly if I now just stay off it completely) will these symptoms eventually stop? I can put up with all the horrors of it if I know it will stop eventually. 

 

I just want to be off this drug once and for all.

[Nikki]

Hi....honestly - updose.  It's not failure, it's not giving up.  It is simply giving yourself the time it needs to readjust and settle down.

 

5mgs. or even 10 if you need to.  Try not to wait too long to do it.  There seems to be a window of time that it will work for you.

 

After you updose, give yourself a much needed rest.

 

Hope you feel better. 

[greymatter]

Thanks for replying Nikki.  I have this stubborn thought that I'm sick of tapering and just want this drug out of my system. You are right of course. After 8 and a half months of tapering it would be foolish of me to sabotage it now. I'm going to updose to 5mg. Probably 10mg would be better but I can't face that.

[Petunia]

Hi Greymatter,

Now that your dose is much lower, you may need to slow your taper and consider the 10% reductions in order to minimize withdrawal symptoms as you continue to taper.

 

10% reduction from 10mg would have you on 9mg.  You reduced by 50%, its not surprising you are feeling so awful.

 

I made the mistake of tapering much to fast and then CT off what I thought was a small amount of Lexapro, I've been suffering for almost 2 years now, I wish I could go back in time with what I have learned here.

 

I understand wanting to get off these pills fast and be finished with all the messing around, but some people seem to be more sensitive and need to take it very slowly.

 

Tapering off Citalopram:

 

http://survivingantidepressants.org/index.php?/topic/2023-tips-for-tapering-off-celexa-citalopram/

 

Why taper by 10%:

 

http://survivingantidepressants.org/index.php?/topic/1024-why-taper-by-10-of-my-dosage/

 

 

[greymatter]

Thanks Petu. I still have the old 20mg tablets which I've been cutting up and that was ok when I was tapering from 40mg  and gradually reducing to 10mg. It's hard to cut a 20mg tablet into more than 4 pieces (each 5mg) hence the big jump. I think I need to see my doctor and get some 10mg tablets which I could easily cut into 4 x 2.5mg doses. Maybe even the liquid form if she will prescribe that. I've just taken 5mg after 3 days of taking nothing. The electric shock sensations were pretty bad last night and this morning.

[Altostrata]

Please read the links Petu posted. You can make citalopram into a liquid with the tablets.