MusicMan23: off Effexor, now on citalopram

[MusicMan23]

Oh, and experiencing dizziness lately as well.

[scallywag]

Hi MusicMan - welcome back!

 

A 25% reduction could knock many people back into symptoms, and apparently the 20 mg to 10 mg decrease in November did just that. Some people experience citalopram as quite stimulating so effects on energy - fatigue continuum aren't surprising.

 

I hope that you'll continue to hold at 15 mg until your symptoms have lightened somewhat and stabilized.

 

Just a reminder, slower is safer. You may remember this topic:

Why taper by 10% of my dosage?.

Also, 3KIS: Keep it slow. Keep it simple. Keep it stable.

 

Let us know how you're doing.

[MusicMan23]

Thanks, scallywag - I intend to hold. Though I don;t think the fatigue has ever completely abated . . . I'm ready to have energy again, especially after I've slept a sold 8hrs!

 

What about the dizziness . . . is it likely that the dizziness is part of it too? It comes and goes, but has been more present over just the past couple weeks, kinda out of nowhere.

[scallywag]

Yup, dizziness is a withdrawal symptom. You may find it helpful to download and keep a copy of this list of common symptoms. It's not a complete list but it covers a lot of ground:

Glenmullen’s withdrawal symptom list.

[LexAnger]

Hi hopeful,

Just read your entire thread. I have a feeling the fatigue you got are more from the side effects of citalopram, like alto mentioned several times before.

 

Was the fatigue worse since the start of 15mg?

 

Updosing sometime can cause bad reactions with symptoms including fatigue. I hope you try not to change dose dramatically up or down, and reduce gradually to ensure no more updose is needed.

 

Hope you feel better,

Lex

[MusicMan23]

Well, here I am again, checking in to update and glean some wisdom from Y'all. Its been just over 2 years since I last posted, and I am at and have been at, 10mg citalopram for about a year now. I STILL experience fatigue from time to time, often times it is almost incapacitating (in this form it usually lasts from a couple weeks to a month or so).  The fatigue is especially prevalent after times of prolonged stress ... I had to fire someone at work (Nov. 2018), and I think I hit a wall of fatigue a month or so after that ... still fatigued daily to a certain degree daily right now.

 

I really want to be done with this medicine, but I am terrified that I will make things worse. I have been on citalopram consistently since 2004 and was originally prescribed it in 1998. I cannot imagine this stuff is doing anything but accumulate toxins in my liver, etc. and at 10mg I don't think there is much therapeutic benefit. Also, I have aged and matured considerably, being able to handle more that life throws at me (usually, lol). I guess I'm wondering if I'm in (and have been in, since 2013) protracted withdrawal. 

 

I don't have a problem taking my time with getting off this stuff (obviously, lol) but I want to be actively taking steps toward getting off, not just being stalled-out. I have a few questions if you guys are willing (thanks in advance):

• I am on 10 mg pills. Do I need to transition to liquid at this point? What is the best / easiest way to get a hold of the medicine in this form?
• Do I need to take certain supplements while tapering?
• How slow should I attempt to go so that I don't worsen the fatigue or get any other symptoms?
• Is adrenal fatigue a common result from withdrawal?
• Any thoughts on glutathione and N-Acetyl Cysteine?
• Are adaptogenic herbs (Ashwagandha, Shatavari, etc.) helpful or harmful? My experience has been that they are relatively helpful, but I've gotten limited results this time around.
• I'm about to have an Organic Acids Test (OAT) performed to help identify other sources of fatigue. Any thoughts on this?
• Any other tips for beating this?

Man, I really appreciate you folks for being here - you have given me such tremendous peace over the years as I have sought your advice and know that I'm not the only one dealing with this.

 

I pray that you are all doing well and that God would provide healing for us all in time.

 

God bless and kind regards, 

[MusicMan23]

I failed to mention that I used chlorella / spirulina daily for about 3 weeks in an attempt to do some internal cleansing ... do not know what effect, if any, this has had on my symptoms ... thoughts?

 

Y'all are awesome. Thanks.

[ChessieCat]

Welcome back.

 

I'll provide you with some information and if you still have questions please ask them here in your Intro topic.

 

Please simplify your drug signature using the following format.   Keep it simple.  NO diagnoses or symptoms please - thank you.

• details for last 2 years - dates, ALL drugs, doses
• summary for older than 2 years - just years and drug/s

Account Settings – Create or Edit a signature

 

 

SA recommends tapering by no more than 10% of the current dose followed by a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.  Why taper by 10% of my dosage?

 

Brass Monkey Slide     a slower method of tapering - BrassMonkey is now 1+ years Paxil free after tapering using his method

 

Tapering Calculator - Online

 

When the drug is taken away too quickly we can get withdrawal symptoms:  Dr Joseph Glenmullen's Withdrawal Symptoms

 

Before you begin tapering what you need to know

 

The only supplements which SA recommends are  Magnesium and  Omega-3 Fish Oil.  Try a small amount, one at a time.  Keep it Simple, Slow and Stable

 

This topic explains how to get the dose you need:  Tips for tapering off Celexa (citalopram)

 

I will provided some additional information in the next 2 posts.  This is your own introductions topic where your can ask questions about your own situation and journal your progress.

[ChessieCat]

Here's some additional information which might help you to understand what is happening:

 

Recovery isn't linear it happens in a Windows and Waves Pattern

 

Withdrawal Normal Description

When we take a psychiatric drug, we are adding chemical/s to the brain.  The brain then has to change to adapt to getting the chemical/s.  It might have to change something to do with A and then once that change has been made it affects B so another change has to be made and so on down the line.  It is a chain reaction, a domino effect.

 

The same thing happens when we take the drug away.  That's why it's possible to experience such a vast array of withdrawal symptoms, and they can change, and be of different intensity.

 

are-we-there-yet-how-long-is-withdrawal-going-to-take

 

These explain it really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

On 8/31/2011 at 5:28 AM, Rhiannon said:

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.

 

AND

 

On 12/4/2015 at 2:41 AM, apace41 said:

Basically- you have a building where the MAJOR steel structures are trying to be rebuilt at different times - ALL while people are coming and going in the building and attempting to work.

It would be like if the World Trade Center Towers hadn't completely fallen - but had crumbled inside in different places.. Imagine if you were trying to rebuild the tower - WHILE people were coming and going and trying to work in the building!  You'd have to set up a temporary elevator - but when you needed to fix part of that area, you'd have to tear down that elevator and set up a temporary elevator somewhere else. And so on. You'd have to build, work around, then tear down, then build again, then work around, then build... ALL while people are coming and going, ALL while the furniture is being replaced, ALL while the walls are getting repainted... ALL while life is going on INSIDE the building. No doubt it would be chaotic. That is EXACTLY what is happening with windows and waves.  The windows are where the body has "got it right" for a day or so - but then the building shifts and the brain works on something else - and it's chaos again while another temporary pathway is set up to reroute function until repairs are made.  

 

[ChessieCat]

During any taper, there will be times of discomfort.  We strongly encourage members to learn and use non drug coping techniques to help get through tough times.

 

Understanding what is happening helps us to not get caught up with the second fear, or fear of the fear.  This happens when we experience sensations in our body and because we don't understand them we are scared of them and then start to panic.

 

This document has a diagram of the body explaining what happens in the body when we become anxious:

 

https://www.getselfhelp.co.uk/docs/AnxietySelfHelp.pdf

 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help ...

 

Audio FEMALE VOICE:  First Aid for Panic (4 minutes)

 

Audio MALE VOICE:  First Aid for Panic (4 minutes)

 

Non-drug techniques to cope

 

dealing-with-emotional-spirals

 

Dr Claire Weekes suffered from anxiety and learned and taught ways of coping.  There are videos available on YouTube.

 

Claire Weekes' Method of Recovering from a Sensitized Nervous System

 

Audio:  How to Recover from Anxiety - Dr Claire Weekes

 

CBT Course:  An Introductory Self-Help Course in Cognitive Behaviour Therapy

 

Resources:  Centre for Clinical Interventions (PDF modules that you can work through, eg:  Depression, Distress Intolerance, Health Anxiety, Low Self-Esteem, Panic Attacks, Perfectionism, Procrastination, Social Anxiety, Worrying)

 

On 4/28/2017 at 4:03 AM, brassmonkey said:

 

AAF: Acknowledge, Accept, Float.  It's what you have to do when nothing else works, and can be a very powerful tool in coping with anxiety.  The neuroemotional anxiety many of us feel during WD is directly caused by the drugs and their chemical reactions in the brain.  Making it so there is nothing we can do about them.  They won't respond to other drugs, relaxation techniques and the like.  They do, however, react very well to being ignored.  That's the concept behind AAF.  Acknowledge, get to know the feeling involved, explore them.  Accept, These feelings are a part of you and they aren't going anywhere fast. Float, let the feeling float off as you get on with your life as best as you can.  It's a well documented fact that the more you feed in to anxiety the worse it gets.  What starts as generalized neuroemotinal anxiety can be easily blown into a full fledged panic attack just by thinking about it.

 

I often liken it to an unwanted house guest.  At first you talk to them, have conversations, communicate with them.  After a while you figure out that they aren't leaving and there is nothing you can do to get rid of them.  So you go on about your day, working around them until they get bored and leave.

 

It can take some practice, but AAF really does work.  I hope you give it a try.

 

 

[ChessieCat]

There are many existing topics on this site.  I like to use google and add survivingantidepressants.org to my search term.

 

Please research on SA to read other members' experiences before trying anything.

[MusicMan23]

Topic title: Functional medicine & organic acids test

 

I've searched the SA forum for information on functional medicine and the diagnostic testing associated with it, but find little.

 

I've been working with a naturopath, and have taken the Organic Acids Test (OAT), among others. Based on my discussions with the ND and my own interpretation and research, my results are pretty good / normal, but my 5-HIAA is at the very bottom end, at 0.09. 5-HIAA is the metabolite of serotonin, and is supposedly an indicator of the volume of serotonin in the body.

 

I am currently awaiting my genetic testing to see if there may be some more insight into the low level of serotonin represented by the 5-HIAA metabolite; i.e., that is , whether I'm a fast / slow metabolizer of serotonin, etc. But, taken at face value, it certainly makes sense to me that my body is not producing the level of serotonin that others are, and it would be quite the coincidence if the SSRI's that I've been off and on since 1999 haven't altered the way in which my body produces and metabolizes serotonin.

 

Now I know that there is no empirical evidence that clearly points to imbalance of neurotransmitters being a cause of depression or mental disorder, so understand straight off that I'm not contesting this. And in fact, I wouldn't say that I'm depressed ... however, what I do have is bouts of extreme fatigue and less than restful sleep on the regular. - symptoms associated (from what I can tell) with low serotonin. I do occasionally have great nights of sleep, and magnesium glycinate is likely to credit for this, in my opinion, but I am 'tired of being tired'. 

 

Now, all of that being said, my ND has recommended a combination of 25mg 5-HTP combined with B6 and 250mg L-tyrosine to attempt to boost the level. Of note, I tried 5-HTP about 15 years ago, and experienced anxiousness, but I was taking much higher doses, was on 4 times the dose of citalopram at the time (40mg), and was also not taking B6 and tyrosine concurrently.

 

In any event, I intend to give this a go, and will report back, but am interested in the interim by anyone's past experience with functional medicine, OAT, Dutch hormone testing and genetic testing providing answers and symptom relief by the adhering to any particular protocol.

 

For your reference, I have provided my OAT, with all of my identifying information redacted.

 

God bless, many thanks in advance for your information and opinions -

REDACTED - Small - OAT_ENG.pdf

 

Edited March 15, 2019 by ChessieCat
added topic title

[ChessieCat]

 

[MusicMan23]

Thanks for the information. I guess my follow up questions and comments would be:

 

Is there no range of neurotransmitter quantity (serotonin, dopamine, etc.) that has been accepted as the 'range to shoot for', that are 'healthier'? Or are values of these chemicals simply as individual (genetic) and person specific as blue eyes, detached ear lobes and blue eyes? 

 

Because, again, I'm not experiencing depression,  but rather fatigue and less than refreshing sleep ... I've read that these are associated with lower serotonin values. Is that also untrue? I'm looking to 'fix' things, if possible, and the logic of raising the serotonin value to this end at least seems inescapable.

 

Again, much appreciated for your time and input.

[MusicMan23]

Last question -

 

Obviously we are all here because of issues associated with these drugs. Have the changes to our brains (thatcause all these symptoms) NOT resulted from alterations in the neurotransmitters? And is there NOT a path on which to discover what affect these drugs may have had on these chemicals? Are we to just sit by, wait out the withdrawal and hope that any alterations effected in our brain chemistry will be corrected all on their own, without any intervention from us?

 

This truly is just an honest inquiry, not meant to be incendiary... I need to know whether to do something or not. And if not, where is the evidence to support that brain chemistry will return to its previous (pre drug) state all without intervention. And even if it will, is there NO benefit to speeding the process along, if possible to do so?

 

Thanks so much for your time - it is very much appreciated! 

[ChessieCat]

This site was started back in 2011.  If Altostrata, this site's founder, knew of anything that was going to "fix" things she would be freely telling us all about it and closing down the website.

 

Time is the healer.  The brain has been given chemicals to which it has adapted.  When those chemicals are taken away, whether by a tiny amount or in one go, the brain immediately tries to regain homeostatis (level things out) which is why we experience withdrawal symptoms.

 

It is not simply a case of how much of this or how much of that.  As posted previously, when one thing is changed then something else has to be changed and when that thing is changed it affects something else and so on down the line.  Even if the drug is taken away slowly, by tapering, there is tweaking that the brain/nervous system/body has to do.

 

The only supplements which SA recommends  Magnesium and Omega-3 Fish Oil .  Try a small amount one at a time to see how it affects you.

[MusicMan23]

Hi, thanks again for the info. I've decided not to do 5HTP, and instead just stick with my magnesium and do a little bit more exercise to help the fatigue - hopefully it works.

 

Question - I'm trying to get my courage up to begin tapering down again. Going to see the doc soon and request citalopram liquid, so that I can more precisely measure out the dosage. 

 

Can you tell me, does the liquid have to be refrigerated? I wouldn't think so, but I can't seem to find anywhere that discusses that. 

 

Also,  I travel a lot for work ... is leaving the liquid in a hot car (while I'm at appointments) for a few hours a problem?

 

Thanks -

[Carmie]

Hi MusicMan, 

 

Yes, it’s best to store liquids in the fridge. If you have to leave the liquid in a hot car while out and about, put it in a cooler. If it gets too hot it may lose some of its potency. 

 

You may wish to do a crossover, because changing formulas without a crossover can put you into waves. It’s happened to me. I changed from my tablet to a compounding formula without a crossover and ended up in waves for three months. When I changed back to the tablet, with a crossover, it went really well.

 

A crossover looks like this:

 

3/4 of old formula                    1/4 of the new liquid formula.

 

1/2 of old formula                     1/2 of the new liquid formula.

 

1/4 of old formula.                    3/4 of the new liquid formula.

 

Then all liquid.

 

You do each phase for 3 to 7 days. I did mine a bit longer. 

 

Wishing you all the best with your tapering💚

[MusicMan23]

I took Ultimate Omega fish oil by Nordic Naturals for the better part of a month, and then stopped. Now I seem to be having dizziness and an increase in tinnitus. I previously hadn't taken fish oil for a number of years, 5, I think. Does this make sense? Is it getting off the fish oil that has irritated things again?

 

Thanks