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MaryKA

MaryKA Withdrawal without tapering scary and unsuccessful

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MaryKA

Today is day 22 since I stopped citalopram, and I've had the worst time of my life in these last three weeks.

 

I started taking citalopram about 11 months ago in preparation to stop smoking. The only adverse effect I had was about 4 days after starting on 10 mg/day, which was physical shaking.

 

Over 3 months my dose was increased from 10 to 40 mg/day.

 

I stopped smoking about 3 months ago. I went cold turkey and the worst side effect was feeling cold and tired so that I spent half of days 4-7 in bed

 

A month ago, I saw my doctor and said I wanted to stop citalopram. Although she had already talked about taking 3 months to come off it, this time she suggested that I could take 2 weeks. So I did: 20 mg for 6 days with no withdrawal symptoms; then 10 mg for 6 days with no withdrawal symptoms, then 0 mg.

 

I define my first day of first withdrawal of 0 mg as day 1, and I count thereafter in this email (how I define second withdrawal to be decided). This intro email is written on day 22.

 

Days 0-4: no withdrawal symptoms

Days 5-6: heightened awareness, euphoria

Day 7: inability to coordinate driving, drowsiness, persistent genital arousal, loose tongue, could cease inappropriate behaviour

Days 8-9: normal functioning requiring additional concentration [a]

Days 10-11, heightened awareness, euphoria [a]

Day 12: normal functioning [a]

Days 13-15: normal functioning [a,b]

Days 16-21: persistent genital arousal, increasing in intensity to the point of extreme distress on day 21 [c,d]

Day 21 onwards: reinstated 10 mg citalopram

Day 22: persistent genital arousal symptoms reduced by about half to that on day 20

 

Notes

a: These days were contact time with my children, who live with their father. Could it be that after day 10 when our contact started, my being able to focus on them may have somehow reduced my vulnerability/the harm to withdrawal?

b: Day 13, I decided to divorce my husband

c: Contact with children ended on day 16

d: Day 21, trigger event with estranged husband leading to distressing persistent genital arousal

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lexicon

Hi Katie,

I am sorry for your not feeling good ..

But you are not forgotten, someone with knowledge will come along to help you.

You are in a good, caring place.

Just hang in there strong ..

Sending you thoughts of healing,

Lexi

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Altostrata

Welcome, katiemt.

 

Reinstatement of citalopram at a low dose as soon as possible can relieve withdrawal symptoms. If I were you, I'd try 5mg first to see if it helps.

 

You might be able to get a prescription for liquid citalopram so you can measure small amounts accurately, or you can make your own liquid, see http://survivingantidepressants.org/index.php?/topic/2023-tips-for-tapering-off-celexa-citalopram/

 

What a shame your doctor changed her mind about tapering over 3 months.

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MaryKA

Thank you Lexi and Altostrata. My doctor wanted me to reinstate on 20 mg/day but I managed to get 10 mg tablets and I can always double up. Today the arousal symptoms have all but gone away but I'm still feeling jittery and have a heavy head.

 

Altostrata, why do you suggest 5 mg? Is reinstating too much not good either. I was on zero for three weeks.

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Altostrata

Correct, reinstating too much can cause a bad reaction.

 

Over the 3 weeks, your nervous system may have adjusted somewhat, though still complaining, and may not need a full dose of citalopram to stabilize. If 5mg does the trick, why go higher? You'll have less to taper after you stabilize.

 

You can always increase, judiciously, if that seems to be what you need to do.

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MaryKA

Altostrata

 

My referee pointed me to this forum saying, among other things, that there could be issues with reinstating at a higher dose than necessary... which made sense to me cos I had to take 1 month on upping the dose on starting  this wretched drug...But does anyone know the dose to reinstate? after what length of time, on what dose?. I expect nobody can answer that question, because if they could, I suspect it would be up in this forum... I'll keep looking

 

Unfortunately, things happens quicker than we can research. So I'm on my second day of double the 10mg/day that I started again after being zero for 21 days. So no 5 mg/day for me yet. |)

 

But still, after a Saturday working and shaking and feeling half-times aroused all day after an early morning encounter with my estranged husband, I feel most better for eating, talking with friends, and getting out to the sandy beach, yeaahhh

 

Katiemtwho will do her signature soon

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MaryKA

To continue previous post:

 

Day 22: up to 20 mg/day, in two 12-hour doses

Day 23: feeling better than when on 10 mg/day

Day 26: feeling very few WDs, none distressing

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Altostrata

Hi, katie. Please bookmark this topic and add your updates to it. Only one topic to a customer in the Intro forum.

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MaryKA

An update now I'm 3 weeks into reinstating a half dose of citalopram (20mg) after being at zero for 3 weeks from 40mg cit for 10 months.

 

I felt immediate relief starting back on 10mg, but it was only partial so after a couple of days I went up to 20 mg. The first week of that was still difficult, but there was massive relief when I started my period a week later. I've seen on this forum some discussion about hormones and PMT: I haven't previously suffered from PMT but I did big time that week.

 

I'm still having reflexive intakes and out-takes of breath, mild internal shaking, and chronic tiredness. Going on what I''ve read here and knowing myself (like I'm not as I used to be), I am not considering tapering down for the foreseeable future. I don't want any more shocks to my system. And me and my husband need to mend things after me nearly insisting on divorce (still not easy but we can see a future together) and I don't think it would be fair if I wasn't as careful as possible with reducing my dose.

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Karma

Hi Katie

 

I think your instincts to continue holding are good.  We recommend holding until you feel stable ... that may mean some minor symptoms, but as an example, the internal shaking should have subsided.  Once you are stable then you can consider a slow taper.  And if your personal life is in upheaval wait until life is a little less stressful.

 

Karma

 

 

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MaryKA

Thank you Karma! I think I've learnt the lesson. I am going to be soooo patient amd take my own time. Good news is my GP isn't going to say no to a liquid preparation so I can dilute and measure with a syringe. He's not convinced but I get the impression that I will not have to fight my corner too much on this. I'm expecting 6 months before I can decide whether I feel confident to change anything.

 

I am so glad I was told about this forum. I'm suffering mildly but it's made a big different. I just hope I can give back some of the warmth and hope and comfort I've had from it in just 3 weeks.

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tezza

Hi Katie,

 

Welcome to the group! I'm glad your doc is being cooperative, so many are not. Thankfully, my GP has been cooperative but not until I SHOWED him my 1mL syringe. The med I needed in liquid is 1mg per 1mL and he didn't think I could measure such a small dose.

 

I've since begun making a liquid, myself of other meds. Liquid makes for a much smoother taper.

 

Wish the best for you

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Azgirl

welcome to the forum..periods can certainly complicate things !

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MaryKA

Hi Katie,Welcome to the group! I'm glad your doc is being cooperative, so many are not. Thankfully, my GP has been cooperative but not until I SHOWED him my 1mL syringe. The med I needed in liquid is 1mg per 1mL and he didn't think I could measure such a small dose.I've since begun making a liquid, myself of other meds. Liquid makes for a much smoother taper.Wish the best for you

Hi Tezza! From what my GP said, the liquid prep for Cit in the UK is 10 mg a ml! If that's the case, I'm definitely diluting it 1 in 10 before I begin to put my syringe in! How else did your GP think you'd be measuring? Even, for instance to get 20 mgs, needing 20ml, how else would anyone measure it as conveniently as by syringe?*?!!?* Not even digital microscales would be so accurate ... But OK, so you proved the point. If push comes to shove at this end, I can say I worked in a lab with stock solutions and pipetting into mixtures to a final concentration. Ha ha, but I won't have a pipette to show him!!

 

When the time comes, I'll report. But I want him to prescribe my syringe, my stock solution, my bottle to dilute into, even maybe a measuring cylinder. Or prescribe so the pharmacist does the dilution and then I get that plus syringe.... Until then, I'm just biding my time :mellow:

 

Cheers!

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MaryKA

periods can certainly complicate things !

No kidding there! I thought it was just the w/d, but it was only the day I came on I realised there'd been some sort of 'syngeristic' reaction. I've never had PMT like that...

 

Thanks Azgirl

 

Katie, managing not to stay on tenterhooks until her next period :o

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MaryKA

Update after 4 weeks into reinstating a half dose of citalopram.

 

I'm not so terribly tired every day: waves of tiredness 2 days rather than 3 or 4 days a week. Still have the deep in- and out-breathing from  time to time.

 

Getting better still.

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Karma

Good to hear you continue to get better. 

 

Karma

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Rhiannon

Yes, it's good to hear you're stabilizing on the updose. Please don't be in a rush to start tapering again, especially given that it sounds like your personal life is pretty stressful right now. 

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Nikki

Hi Katie

 

Just read your thread and so glad you are having relief.  I take Celexa/Citalopram too.  I was on 40mgs. which is a high dose.  I actually felt better on lower doses.

 

Maybe you can hang out at the 20mgs. and see how it goes.  It may take a few weeks, but it may be worth it.  You can only try.

 

As for tapering...when things are stressful, tapering can be more difficult.  You never have to taper again if you don't want to.

I learned a while back that I needed to be my own best advocate.

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MaryKA

Thank Q to Nikki and Rhi and Karma and everyone who's here.. . It's gonna be a long haul -- I'm still so tired I can hardly work unless I gee myself up... I'll keep in touch

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MaryKA
Snip...
I was on 40mgs. which is a high dose.  I actually felt better on lower doses.

 

Maybe you can hang out at the 20mgs. and see how it goes.

Snip

I actually do not know why I was taken up to 40 mg/day! Maybe in anticipation of an acute condition like stopping smoking... In which case, yeah alright but OK but I wish they'd told me to get on with the quitting ... I'm not moving from 20 mg/day for the foreseeable future !!**?*!?*

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MaryKA
You never have to taper again if you don't want to.

 

Well, in principle, emotionally and idealistically from an Orwellian's novel's point of view, I can agree with this sentiment ... But now with my own wd, I do have to taper as quickly as possible (please do understand that I'm not defining the time scale, but as you will see there is some urgency; I'll probably take a year....)

 

First and foremost for me, cos I'm a late 1960s child so I have maybe a mid-1980s apocalyptic point of view but which could nowadays be extrapolated to the economic view.... what if I can't get my meds? like they are not in supply? I'd be up the proverbial creek without my paddle. I do believe my pharmacist nodded her head when I said that I felt vulnerable being on my drug (and bless her, she called up my surgery so that in the end I got my drug by the end of the day)

 

And second, the adverse effects .... like I had/have night sweats and insomnia (both of which could have been (could be) connected with an adverse hormonal effect (and I've only just turned 45 and have no (maternal) family history of hormonal imbalances), and goodness what else (do forgive, I don't yet know what was reasonable disengagement from my husband and what was drug induced: I'd say the former; he'd say the latter ...).

 

All to say, if I'd realised the above before taking my first pill, I'd have avoided the first pill, like I'd have realised that it was a medication really unnecessary to me getting over smoking and life's stresses and ... and ... not very much at all, relatively ....

 

You know Nikki, I'm sorry and we're all doing our best, But I had someone close to me a year or so ago saying 'why not take it?' cos they'd had had it for 4 months .... I was jealous ... cos I hadn't taken it. Ha! so what about when I want to come off it? :angry: not to blame that someone, or my doctor, but somehow not much was said on the downside (could it have been said in the circumstances?)

 

So am I saying: one message for us who've already started on the drug; and another one for those who've never taken it?

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MaryKA

update now I'm 7 weeks after reinstating a half dose citalopram.

I feel much the same as I did 3 weeks ago, and in some ways possibly worse, which is a bit alarming

 

What's the same: So I still have the breathlessness and internal shaking. I don't think these have abated much, or if pushed I'd say about 10% less now than 3 weeks ago.

 

What's different: I am hungry. I haven't mentioned this before. When I was starting the drug I became extremely hungry once in the day, But since a sudden w/d and half reinstatement, these 'sugar lows' are worse now than before. I have been eating a low to zero carb diet for 8 years now (well since before I starting taken this SSRI) and I know a sugar low. I think I've read something on this forum about this sort of thing, so I'm going with the flow on this, I knew already that eating carbs can give a big pendulum to one's metabolism, so I'll keep my carb intake down or expect to feel some differences a few hours down the line ...

 

What else is different is my legs are feeling really tense. ,, I'm not sure if that is the whole story, because I started with stiff achilles tendons over a month ago. I thought it was my broad-backed sandals that was causing it (maybe it was, I stopped wearing them and the problem has still persisted) but now I think something else is going on, as I last had achilles heel 30 years ago when I was walking too much and it was asymmetical between the two heels; this time, both heels are equally sore. And in the two weeks, I"ve got stiff knees. And in the last week, twinges in my hips. I don't know what all this is. But I've worked six weeks 7/7 to make up my inefficiency while getting over w/d symptoms, been watching the Tour of France and then getting ready for my sons to visit, so I've not gone walking/paddling for three weeks. Either it's the drug or my lack of exercise.

 

Finally, I am going to try a day journal. Yesterday was really hard. My sons were coming in the afternoon and I'd worked the day before right up to the bell at 6pm. So I had lots to do in the morning, which I did do, just left the house too late to properly shop in Aberdeen before meeting sons on their flight (that bit is understandable as I had lots to do...) But I couldn't drive yesterday, my coordination was all over the place, and I felt quite vulnerable

 

Today was much better. A bit less breathless, able to accomplish household tasks with minimum fuss, and I've driven, and I'm told I drove well!

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mammaP

I'm sorry you are feeling so bad Katie and hope you feel better soon and are able to enjoy your time with the boys.

You deserve some relaxing time and some fun with them. 

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basildev

Hi Katie,

 

It can take a while to stabilize. I reinstated 20mg citalopram in Feb this year and I'm still not where I want to be.

 

That's not to say it will take that long for you, but I just wanted to reassure you that some people take months, as opposed to weeks to stabilise.

 

I hope you feel better very soon.

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Rhiannon

Hi Katie,

 

It can take a while to stabilize. I reinstated 20mg citalopram in Feb this year and I'm still not where I want to be.

 

That's not to say it will take that long for you, but I just wanted to reassure you that some people take months, as opposed to weeks to stabilise.

 

I hope you feel better very soon.

 

Ditto this.

 

Also, after a bad withdrawal event, even with reinstatement, "stabilized" doesn't necessarily mean "feeling great." I think most folks shoot for "feeling well enough to function." Not that I'm saying you're there yet; the autonomic symptoms (breathlessness, shaking, appetite changes) would, to me, indicate the need to continue to hold for a while yet before you begin tapering.

 

I just wanted to mention that it's not strange or unusual for people to never really feel completely well after a reinstatement. Once the CNS is destabilized by a CT or too-fast discontinuation, even going back on the med doesn't necessarily seem to "fix" things for everyone. And frankly these meds (well for me anyway) can make us feel pretty crappy when we're on them too.

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MaryKA

My day journal for the last two days:

 

Yesterday and today was OK. Hardly there were the breathlessness, the sighing, the day-time fatigue. The first two is fantastic to me, but maybe the lack of fatigue is cos I have my teenage boys visiting, which would keep anyone awake? (But 2 days in and a a walk along the bay as I crashed at 10 pm...

 

Like I said, yesterday we walked along (and in) the bay to the nearest town and back, and I could feel both my Achilles pulling, so maybe the tendons are reacting to cold water, resistance, ...

 

Today it rained all day, the heavy summer rain that would lead to a thunderstorm if it didn't starting falling overnight and keep on going until the next evening. So me and hubby have been settling into being ourselves with the boys, and vice versa -- haha, the boys argues between themselves and me and hubby did not -- and I kept going altering some large curtains.

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MaryKA

I'm sorry you are feeling so bad Katie and hope you feel better soon and are able to enjoy your time with the boys.

You deserve some relaxing time and some fun with them. 

Gosh, mammaP,  I hope the change of routine, the energy, the responsibility, whatever, helps me to have some respite. I do try to get out and have a less reclusive life, but I'm a freelance worker so 'getting out' has to be during the evening (and thank goodness it is summer at the mo!). But not working right now is a very good thing!!

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MaryKA

Hi Katie,

 

It can take a while to stabilize. I reinstated 20mg citalopram in Feb this year and I'm still not where I want to be.

 

That's not to say it will take that long for you, but I just wanted to reassure you that some people take months, as opposed to weeks to stabilise.

 

I hope you feel better very soon.

 

TQ Basildev, it's good to hear from someone else what I was suspecting, that things can carry on ping ponging for quite a bit.

 

Sorry to hear you're 'waiting still', even after you took it more slowly than me ....

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MaryKA
 .... after a bad withdrawal event, even with reinstatement, "stabilized" doesn't necessarily mean "feeling great." I think most folks shoot for "feeling well enough to function." Not that I'm saying you're there yet; the autonomic symptoms (breathlessness, shaking, appetite changes) would, to me, indicate the need to continue to hold for a while yet before you begin tapering.

 

I just wanted to mention that it's not strange or unusual for people to never really feel completely well after a reinstatement. Once the CNS is destabilized by a CT or too-fast discontinuation, even going back on the med doesn't necessarily seem to "fix" things for everyone. And frankly these meds (well for me anyway) can make us feel pretty crappy when we're on them too.

 

 

Rhi, thank you for this. I think I understand, and still ponder, what could be happening to me: continuing wobble after w/d and reinstatement? too much reinstatement? too little reinstatement?

 

Your post does really highlight the dilemma: when is one ready to down the dose a bit? and when should one hold?

 

I'm really glad of the change of routine this week, which will keep on for the next 3 weeks or so. Then I can try to partition my reactions to drugs from changes in social interactions/exercise/daily routines.

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MaryKA

Today has been interesting. I had to work for 3 hours in the middle of the day so my sons and their stepdad went out to do their own thing. And so I sat at my desk and all the autonomic breathing and shakiness started again: i.e. when I'm active and Doing Stuff I'm ok and when I'm doing my freelance computer stuff I'm not ok. I think I've said this before.

 

Apart from that and the unusual hunger at lunchtime, today has been reasonably ok.

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Altostrata

Perhaps it's the sitting? Can you adjust your desk so you can stand and work on your computer?

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MaryKA

Perhaps it's the sitting? Can you adjust your desk so you can stand and work on your computer?

 

I looked into an adjustable desk some time ago, for posture reasons. Some have a desk with hydraulics to adjust the height up and down... Or maybe it would be cheaper to have two computers at different heights ... Anyway, good thinking Alto. I'll see how it goes and decide if I really need something so elaborate!!!

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MaryKA

The last three days have been much the same, the mild breathing and shakiness. Although I said earlier this week that I don't have these things when I'm being active, I think I do, but I just don't notice them unless I think about it, which is more likely when I'm in a quieter situation.

 

I am also vulnerable to my emotions. Last night I boo hoo'd into the small hours because I'm facing a £400 bill to repair someone else's car to high standards after my elder son fell off his bike into one of the car's doors ... I woke up feeling like crying too. This one thing may be understandable -- what else could that money buy? how many hours to work for that much? -- but it's not the only thing that can set me off. My hairdresser says she has a fiercer temper than me, but I think it is more likely that I have generalised anxiety disorder. I'm trying to keep in touch with my hubby about what we are feeling and I'm glad that it has only been one night in seven so far into my sons' visit. And I do think they appreciate the stress of the enormous cost of this bike accident.

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MaryKA

Update, now 10 weeks after reinstating a half dose of citalopram (20 mg/day)

 

Change of routine with holiday meant I  felt much less acute w/d symptoms and then I needed to get a new prescription so I had to see my doctor. I didn't see much reason to not start tapering so asked and got a liquid preparation as well as smaller tablets.

 

So now I have been prescribed 10 mg tablets and and 40 mg/ml liquid in a dropper bottle.

 

Reason for success? I'm not sure, it could be that I see two doctors in the same practice according to their availability -- so I'm not saying I play one off the other, I think there is mutual respect all round -- so (i) I'd had a practice about talking about liquid with the first doctor, and (ii) the second doctor was the one who suggested I could go to zero in a fortnight and then also was contacted by the pharmacist when the Really Bad WD kicked in and who I told off relatively mildly on the phone so was primed at least ... , or even (iii) there was a student doctor observing the second consultation.

 

How much am I tapering? I'm going for a 5% taper, which is very cautious but because of extreme w/d symptoms after 3 weeks. So I am now on 19 mg/day, which I take as a 10 mg tablet and 9 mg liquid.

 

How do I measure my dose? Having worked in a research laboratory dealing with fractions of millilitres, I do not trust the dropper system at all. The bottle I was given is supposed to give 20 drops/ml, or 50 microlitres per drop, and if I ever had to measure 50 microml in the lab, I used a burette, not a dropper bottle :o So my first step was to take part of my prescribed 'stock solution' of 40 mg/ml and dilute it 1 in 40 to make a working solution of 1 mg/ml. Thereafter, measuring 9 mg liquid is very easy (i.e. 9 ml).

 

How many days ago did I start my taper? Five days.

 

How am I feeling? The second day after 5% reduction, the autonomic breathing and increased internal emotion started again. This was even while I was on holiday. Although this has continued till now, it is not so severe now. So I'm hoping that this is the pattern of mild w/d effects that gradually fade until the next taper.

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Altostrata

I wouldn't trust the dropper, either. Good for you, for negotiating all of this.

 

It may be you're not quite ready to taper. You may wish to hold for a bit, again.

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