Kirstyloop Citalopram Withdrawal

[Kirstyloop]

Hi 

 

Around 15 weeks ago I stopped Citalopram. I'd been on them for 18 months and felt fine. On advise from my doctor I reduced down to 10mg a day for a week, then 10mg nothing 10mg nothing for a week, then finally 10mg nothing nothing 10mg nothing nothing. In hindsight this was a very quick tapering. 

 

I'd been put on them due to anxiety. Since 2009 I'd experienced little bits of anxiety in lecture halls, trains, cinema, large crowds. But nothing major until 2012. I'd gone on a train and felt awful and went shopping and just felt strange...just a strange unease feeling that wouldn't go away. 2 months later I was due to go away for a week to Turkey. I immediately was scared to death of sitting on a plane for 5 hours. Worked myself up. Got on the plane and felt hideous, but not majorly bad. Anyway I had a few drinks and relaxed. Whilst on holiday I had a permanent hangover, was also smoking like a chimney. I used drink to get my through the day time as my heart was racing and I felt so scared. I asked the rep to get me on an earlier flight but there was no spaces. I was trapped in a foreign country petrified, with 3 other girls who didn't have a clue. I felt humiliated, beaten, weak, tired, hopeless, like my life was over. I'd never experienced this before and I had no idea what to do. The last day was horrific I knew I had to get back home but getting on the plane in a worse state than when I came to Turkey was killing me. I made it back in one piece, fell asleep on the plane as I hadnt slept in a week. 

 

Anyway, when I arrived home I was withdrawing from a week of binge drinking, my heart was racing i couldnt keep still. I had to go to the hospital and have diazepam to calm me down. Visited the gp the next day and he put me on citalopram. Even though, I didn't really need it. As I felt "ok ish" Anyway, was on them 18 months, then as they do the GP suggests you come off them. They have no idea about tapering or withdrawal. So here I am now 15 weeks after my last tablet. And today Im having a "bad" day. 

 

I totally understand the waves and windows. Im going to 2 different counsellors (one through uni and one paid) Mum and dad want me "normal" again. In one of my window days I booked to go and see my friend in spain. Going on Monday 9th June 2014. Now Im terrified. Todays a bad day. I have an essay to write for uni and Im struggling to sit still and concentrate. I just want to sleep. I hope this nightmare ends soon because 15 weeks feels like a lifetime.

[mammaP]

Hi Kirstyloop, welcome to SA.  I am quite impressed that your doctor didn't want to keep you 

on anti depressants and attempted to get you off them, but sadly he hasn't a clue about 

how to get off them safely! I'm sorry that he had you taper too fast and that you are suffering because of it.

 As it is 15 weeks since you stopped them reinstatement might help

but it is always better to reinstate as soon as possible for the best chance of it helping. 

 

You could try a minute dose 0.5 mg to see if it helps, then hold there for a few weeks before starting

a slow taper. A tiny dose is better because you could be sensitised to it and have a reaction to a larger dose.

If it makes you feel worse then stop immediately. 

 Citalopram is available in a liquid that makes it easier to taper by using an oral syringe for measuring tiny doses. 

 

Please read the topic on reinstating here. http://survivingantidepressants.org/index.php?/topic/3079-about-reinstating-and-stabilizing-to-stop-withdrawal-symptoms/

 

About tapering citalopram here. http://survivingantidepressants.org/index.php?/topic/2023-tips-for-tapering-off-celexa-citalopram/page__pid__19887#entry19887

 

There are some excellent topics on coping with anxiety and emotional problems here. http://survivingantidepressants.org/index.php?/topic/1112-non-drug-techniques-to-cope-with-emotional-symptoms/

 

I'm glad that you found us, this is a fantastic place for peer support with tapering and withdrawal. 

[mammaP]

I just noticed from your sig ( thanks for doing that)  that you actually stopped at the end of March?  

That could mean that reinstatement will have more chance to work if  as it is only 8 or 9 weeks

actually off. 

[Rhiannon]

This method of alternating days on and off a med to taper is not supported by any literature that I know of, it's just something doctors seem to advise and I don't know why. We have found that it aggravates withdrawal symptoms, probably by causing fluctuating blood levels that make it difficult for the CNS to maintain homeostasis. 

 

We find a better taper method is to take the medication every day but at gradually decreasing doses. This is easily done with citalopram, which has a commercially available liquid formulation. I sometimes wonder if doctors even know that it can be done this way. I am daily amazed at how little physicians actually know about psych drugs.

 

Anyway, I concur with the advice to try a small reinstatement of maybe 0.5 mg, to see if that will help stabilize your withdrawal symptoms. You can stay on that dose for a while (until after your trip) and then once you're feeling more stable you can taper off of it slowly. Given the history you describe (no previous ADs and no previous attempts to taper) I would expect you to do quite well.

[Kirstyloop]

Hi

 

Thanks for the replies

If I was to 'stick it out' would it subside? I'm having days were there is anxiety and it's horrible but I cope. Today is an overwhelming sad day for me. I'm going to counselling too trying to get more connected to my emotions, as I think I ignore them. However, would my gp let me have such a small dose?

 

Thanks

[Rhiannon]

It's impossible to say what will happen if you stick it out. Some people do okay, some end up having protracted withdrawal. I wish there were some way to say with certainty who is going to have ongoing problems for a long time and who isn't. Given the fact that you're still having problems now, you're not one of the ones who is going to have an easy time of it, for sure, and given how much people can suffer due to protracted WD, I'm not going to encourage you to gamble.

 

Given your history I think a very small reinstatement would be your best approach. The sooner your CNS gets settled down and stabilized and reaches homeostasis, the better, and that small dose can be the crutch that allows that to happen. (Small doses are actually much more active than most GPs realize, and with markedly fewer side effects.) Then once you're stable you can taper off using the 10% approach, gradually, which generally gives very good results.

 

But it's up to you. 

 

If you do decide to just stick it out, please be aware that it's a common pattern for people to get through the acute part of withdrawal and think they're out of the woods, then to get hit with another phase of symptoms a few months out, anywhere from three to nine months or so. If you find yourself feeling okay for a while and then feeling worse again this isn't a "relapse", it's another stage of withdrawal. At that point a small reinstatement isn't really an option; people usually either have to ride it out again, or go back on the same med or new ones. Just be aware that if this happens your doctor is likely to tell you you're having a relapse or you have an underlying disease condition of some sort, when actually what you're having is another stage of withdrawal.

[Rhiannon]

As far as your doc giving you a small dose, some will and some won't. Yours doesn't sound very well informed about meds and withdrawal. There are several options here. One, find a new doctor who does know a bit about tapering. Two, see if he's willing to prescribe the liquid formulation at whatever dosage he thinks is appropriate, and just take it at the small dose yourself.

 

Three, and I hate to say this, but sometimes it's necessary: Usually since ADs are not considered a drug of abuse, if you tell your doctor you think you "need" one, they will prescribe it and you can taper it without necessarily telling them that's what you're doing. They're usually more than willing to believe that prolonged withdrawal symptoms are a sign of relapse or underlying disease, since that's the agenda the pharmaceutical companies have spent billions of dollars promoting and educating doctors with. 

 

I'd recommend seeing if you can get the liquid formulation. If not, it's really easy to dissolve the tablet and make your own.

[Kirstyloop]

Hi

I see, I've totally over exaggerated my weeks, I've been totally off them around 9 weeks.

So a reinstatement of 0.5mg would you suggest? Can I get that in the uk in liquid form? Tapering down using the 10% rule on 0.5mg would be difficult wouldn't it.

 

Thank you for your help it's greatly appreciated

[mammaP]

Yes you should be able to get it in the UK. I agree that tapering 0.5 would be very difficult with tablets but

easier with liquid. Here is a topic on how to make your own liquid. http://survivingantidepressants.org/index.php?/topic/2693-how-to-make-a-liquid-from-tablets-or-capsules/

[Kirstyloop]

I won't get bad side effects will I? Is 0.5mg too low a dose?

[Altostrata]

Welcome, Kirsty.

 

We are suggesting a trial run with .5mg to limit the risk of a bad reaction. Your nervous system might be sensitized to all drugs  -- and alcohol -- now. It's possible .5mg will be enough to reduce the withdrawal symptoms. If it sort-of works and you feel you need more, you can increase it.

 

Since it's been 8 weeks and you still have severe withdrawal symptoms, it's unlikely you're going to be one of those people who bounces back from quitting. Skipping doses is indeed a very bad way to taper, please let your doctor know about this if you can.

[Kirstyloop]

I had alcohol and cigarettes on Saturday and feel this made me feel even worse. I will go to the gp tomorrow and try and get him to give me a low dose. Thank you for your help

[Kirstyloop]

Been doctors she thinks I should go back on 10mg I don't agree she said there's no lower available. I don't know what to do. Cut them in quarters? 2.5mg a day? I don't know x

[Northcoastboy]

Hi Kirsty

I live in Uk too, in Norfolk.

I'm on Citalopram liquid. Its called Cipramil liquid drops. 1 drop is equivalent to 2.5mgs of Citalopram.  If you go to Boots Chemist and ask the Pharmacist for a leaflet or info you can then take it to your Doctor. 

Your Dr could easily find this on her prescription list. They obviously don't know of its existence or are fibbing!!

You can get a baby syringe and a plastic beaker from your pharmacist. The beaker has 5ml 10ml 20ml 25ml 30ml marks on it.

You would put 25mls of water in the beaker. Tip bottle up and let 1 drop fall into water, i.e. 2.5mgs. Pour this in a glass and give it a good mix. Draw off 0.5mls into the syringe to give you 0.5mgs of Citalopram. Just squirt the syringe full into your mouth.

It sounds complicated, its not, it only takes a minute.

This is a very low dose. You could always up the dose. Stay here and take their advice, they know what they are talking about about:-)

I didnt initially and had terrible withdrawals and I am now trying to stabilise on 2.5mgs.

 

Just check with Alto etc that they want you to take 0.5mgs and not 5mgs? It certainly reads as 0.5mgs.

[Kirstyloop]

What would 5mg do to me? Would it not be ok? I'm going to struggle to get a doctors appointment now before I go Gibralter on Monday and I feel hacked off that she fobbed me off

[Bellisimo]

Hey & welcome kirstyloop

 

Me too was on citalopram for around 6 years, its been now 10months ago i took my last pill, i can say that it never hit my mind again that i wud start over the medicine, like in the beginning, i feel SO much better now then i used to, it truly gets better, i could never belivei it wud and i also thought the wd would kill me on the way but here i am alive and MORE alive then ever before! I love life <3!

[Kirstyloop]

That's fabulous! I'm so glad it's worked out for you. I'm going to see how tomorrow is. Wish I would have tapered down slowly but doctors don't know their stuff xx

[Kirstyloop]

Can someone please advise if I can take 5mg?

[bubble]

Hello Kirstyloop,

 

our friends on the other side of the Atlantic are still sleeping. Can you wait a bit to get the clarification?

 

Did you get the liquid Citalopram?

 

best,

 

bubble

[mammaP]

Hi Kirsty, we suggested 0.5 because often people can become sensitised while off the drug. You may be

ok with 5mg but if you have a reaction it can take a long time to settle down again if the dose is too high. 

You don't want to be feeling worse when you go to the lovely Gibralter!  If you start with 0.5 and you are ok with it,

that is, you don't feel any worse, you can then increase to 1mg, it can take a few days to take effect  but sometimes

it is very quick. I reinstated 5 beads of effexor after a month off and felt better within hours! 

 

We are saying 0.5 to reduce the risk of reaction, if you wish you could try 1mg but I would not advise any more to

begin with after  9 weeks off. 

 

I hope that you find some relief and are able to enjoy your time away. 

[Kirstyloop]

Hi

 

No I didn't get any liquid. I woke up anxious then it settled, now it's just uneasy feeling I'm trying to think my way out of it, but it's hard. I might get a 1ml shrynge tomorrow and put a 10mg tablet in. Would I be ok to use the liquid the day after also? Or should I make up a fresh each time?

 

Thanks for the advice

 

Xxx

[Rhiannon]

Hi Kirsty--

 

I make up several doses of citalopram (dissolving my own tablets as described in the Tapering forum) and keep several days' worth in the fridge. I was actually able to find some data online about the stability of citalopram in water and it's pretty good, definitely not a problem over a few days.

 

And you can throw away the extra--it sounds like your doctor is more than willing to keep giving you 10 mg tablets.

 

I concur with what mammaP said about the size of dose. It's best to reinstate with the smallest effective dose, because taking too much can actually make you feel worse. We aren't saying withdrawal is going to go away completely; the reinstatement is just to cushion the worst of it, take the edge off of it, to make it so you can live and function, and then you can taper off slowly when the time comes. Try 0.5 mg and see if it helps at all.

[Jemima]

Also, be sure to give the .5 mg. dose a full four days to work. Often symptoms improve right away, but for some it can take longer.  If the .5 mg. isn't helping much after four days, then try upping it to 1 mg.

 

Welcome to the forum. You'll find lots of good information and friendly support here.

[Kirstyloop]

Thank you. It's one of those, the holiday is making me anxious because of my past holiday. It's hard to know whether the anxiety will go if I cancelled it. Which means it was the holiday. Don't want to go on citalopram again if it's unnecessary, if you understand what I mean

[mammaP]

I think you are having some withdrawal symptoms coupled with the anxiety about the holiday.

Withdrawal does seem to worsen anxiety for many people, and they don't always realise it is

due to withdrawal, until the reason for stress is gone but the anxiety stays, if that makes sense.

 

Reinstating is best  as soon as possible because the longer you are without the AD the less

chance there is of it working.  So many people here are suffering nightmare withdrawal symptoms

that have left them  unable to function and have left it too late to reinstate.  It's your call and 

whatever you decide to do I hope you have a good holiday. 

[Nikki]

Hi....

 

I took citalopram and I did have to go back up in dose to offset WD symptoms and for me it did help settle me down.  If the tablets only come in 10mg. doses you can get a pill cutter and crack them in half.  I always thought making a liquid solution was hard and then I did it, and it was a cinch.

 

The  Pharmacist gave me the pill cutter and syringes.  He was very helpful.

 

The people here will help you get thru this.  It's been a short time so you may really feel alot better by reinstating.

 

Best regards

[Kirstyloop]

Reinstated at 5mg

Gibralter was crap. Left yesterday, flight was perfect got there met my friend, then my heart was thudding. I drank a bit not loads, only about 5 bottles of beer. No cigarettes (stayed strong) this morning felt awful., I just had to come home. Booked another flight came home. I know I did great getting on the plane but I feel defeated, feel weird and unsure about what to do. Feel like I'm in limbo no light at the end of the tunnel. So scared I could cry

[dalsaan]

Hi Kirsty

 

We have all been scared at one point and felt defeated. Keep your chin up, you are in good, supportive company.

From here you need to see how your reinstatement goes. It will probably take 4 days at least for the 5mg to reach a steady state in your bloodstream. I usually allow two weeks at least before I assess where I am and whether I have to up dose any more to stabilise withdrawal.

 

If the 5mg is enough to address most if not all of your withdrawal symptoms, I would stay on that for at least 1month to allow your nervous system to stabilise, then plan on dropping at no more that 10 percent of your previous dose each time.

 

Although distressing to have to leave Gibraltar you have probably made a good decision for your health and I applaud you for it. From here patience is a virtue. The goal is not to come off in the quickest time, it is to come off in the best shape in terms of your health and wellbeing.

 

Dalsaan

[Kirstyloop]

Do you think I'm sensitive to alcohol. Has anyone else drank alcohol on citalopram and been in tachycardia my heart rate was 118 lying in bed. It was just freaking me out

[mammaP]

Many of us can't tolerate alcohol while in withdrawal   . Was it like this before you quit or

is it new to you after reinstating?? 

[Altostrata]

Kirsty, this is a sign not to drink alcohol, at least for a good while.

[Rhiannon]

Most people seem to have more trouble with alcohol in withdrawal. I can only have a very small amount and I'm on a very very slow taper. If I have more than one (beer, glass of wine, or drink) I feel like crap the next day, or if I have one for two days in a row same thing. I can get away with about one or two drinks a week although I feel better if I avoid it altogether.

[Rhiannon]

So you've reinstated at a full 5 mg? Let's see how that goes. I'd recommend as soon as you can get it together, finding out either how to dissolve your own tablets and make your own liquid, or arranging to get some of the prescription liquid. You may find you're too sensitized to stabilize on 5 mg, or you may do just fine on 5 mg, but either way you'll need the liquid to taper off eventually.

 

I'm sorry you're feeling so bad. Hopefully you'll be feeling better in a few days. Please keep us posted.