missindy: Tapering off Citalopram- Help

[missindy]

Hi all. I hope this message finds you well. I've never done anything like this in my life- so here goes.

Anxiety has always been a problem for me. I had my first panic attack at 15, and started Paxil soon after. My parents wouldn't let me see a therapist to talk about my anxiety, so the medication did the trick. I became emotionally numb. My relationship with my family was volatile to nonexistent, I couldn't wait to get out of the house and never come back.

I don't remember quitting Paxil as causing any issues with me. I was probably 18 or 19 at the time.

My senior year of college I started experiences heart palpitations all the time, went back to the doctor and given a script for citalopram. The palps went away, but I honestly feel like the effectiveness of the medication has worn off years ago. I still had major anxiety on the medication, but it would get 100 times worse when I tried to quit the pills. So the doctors kept refilling the script, never asking questions, telling me that withdrawals wouldn't cause the symptoms I was experiencing- that it must be the anxiety coming back. 

Finally I'm at a point in my life where life is settling down and I want to make the change to taper all the way off the Citalopram. I made a choice (probably a poor one) to go from 20mg to 10mg two weeks ago. My biggest issue right now is dizziness. It gets especially terrible before meal times, and I have to make a conscious effort to tell myself that it is a withdrawal symptom of the medication and not something actually wrong with me.

Health anxiety is something that I suffer from daily. I feel like the amount of mucus in my throat has increased dramatically since tapering Citalopram, which is stressful and causes my anxiety to spike.

After reading this site, which I came across way too late in life, I feel like the jump from 20 to 10 was about 40% too great. I should've gone 20-18-16-14-12-10 instead of all at once. Now- the question is- what do I do? Do I stay at 10 and gut it out for however long it takes- or do I go back up to a higher dosage and ween myself off slowly?

Everyone on this site has such wonderful advice and wisdom. Thank you for taking the time to read my post, and to give me your wisdom. It is much appreciated. 

 

Be well,

Indy

 

 

 

[mammaP]

Hi Indy, welcome to SA.  You are right that going from 20 to 10 was too big a drop

and resulted in withdrawal symptoms. 

 

I always get so annoyed when doctors tell people that it isn't withdrawal, they cause so

much distress and harm without even realising it! I wish they would all keep themselves up 

to date with things so they are aware, and look at research that is NOT connected to the

pharmaceutical companies.  . Sorry, rant over! 

 

You might do well to go back up in dose a little, maybe 15mg and see if it helps. If not you

can always increase again gradually until you feel better.  Doing it this way means there is

less to taper later.   Citalopram is available in a liquid and is quite cheap too so would be 

much easier than splitting tablets.

 

You've obviously done your research here, well done for that! 

 

It would be helpful if you could put your drug history in your signature so it can be seen at a

glance on the bottom of your posts and update it as you go.  You'll find a link to the instructions

on how to do that in my signature  .

 

A link to the 3 KIS's , the foundation of a successful taper. http://survivingantidepressants.org/index.php?/topic/6632-the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable/

[missindy]

Thanks MammaP, you're the only one to write back to me so I have a few questions for you. How long do you think I should hold on 10mgs? A month? Until I feel stable?

Also, I'm trying to get pregnant. My doctor told me I would be able to quit easily during the first trimester of pregnancy but I didn't believe that. Is it going to be terrible for a baby if I'm tapering off citalopram while I'm pregnant?

I have zero support at home. No one understands what I'm going through because they are either content on their medication or have no experience with anxiety. Thank you so much for your love and support. It means the world to me. 

[Altostrata]

Welcome, missindy.

 

Yes, you might hold on 10mg for a month.

 

I'm sorry to say, antidepressants have their greatest effect on a developing baby's nervous system in the first trimester. The best possible situation would be to go entirely off the drug before becoming pregnant.

 

If you are taking an antidepressant throughout your pregnancy, the baby may suffer withdrawal symptoms after it is born.

 

It may take 6 months or more for you to taper gradually off citalopram. Please consider this in your plans.

[missindy]

Thank you Altostrata, this site is so helpful and informative. I have a hard time expressing my emotions into words, but I'm grateful that there are people like you that put it together.

After my month (or so) on 10mgs, would you recommend that I buy a scale so I can measure smaller doses? I will follow the 10% taper, I think since I've been on the medicine for 7 years that seems a reasonable pace.

I used to be so fearless. I want to be that person again. 

[joy2730]

Can I ask how you are getting on?

[Altostrata]

missindy, citalopram comes in a liquid for easy tapering. See http://survivingantidepressants.org/index.php?/topic/2023-tips-for-tapering-off-celexa-citalopram/

[missindy]

Hi Joy! Thanks for checking in. Right now my anxiety is greater than it has been in a long time, but I've had some major life changes in the past three months

(Left my job, moved in with my fiance in a new town, planned a wedding with 300 guests, bought a house, got married, went on a honeymoon, moved into our new house and started a new job.) My now husband has not a damn clue what anxiety is or how I could feel anything except excited over everything. I am excited, I'm also terrified because there has been no routine and a routine is how I function best. 

It'll be 2 weeks tomorrow since I dropped to 10 mgs. In hind site I wish I would've found this site first, but the side effects aren't really much different than how I normally feel on the pills. Anxious. My vision gets blurry easily. Heart palpitations. Can't focus. Really exhausted.

I woke up and had a panic attack a few nights ago but I calmed myself down with meditation and somehow went back to sleep. A few years ago I would've been up all night long but I've really gotten into meditation and self healing in the past few years and it's really helped with my anxiety. 

I turned 30 on Friday, so I have officially been suffering from anxiety for half my life. I'm a middle school teacher (ages 10-14) and I've found that having anxiety/panic attacks has helped me to help kids in the same situation. When they have issues I am able to help them because I've been there and can relate. 

I'm all over the place tonight. Writing isn't my strong suit, I'm much better face to face (unfortunately I don't have any adults that I can confide in so you'll have to put up with my random trains of thought instead). 

Thanks for checking in, it makes my day. 

[joy2730]

As a complete outsider, perhaps you have too many anxiety provoking things happening in your life at the moment and any further reductions would be unwise? 

 

I have only started to reduce all psychiatric pills since my life has become very easy, I am in a job I love, my kids have grown up, I have managed to boss my husband, and I have enough money to make ends meet for the rest of my life.

 

I can't help but feel you should not push yourself too hard, after all, in my experience all this married/moving house/moving jobs etc is very stressful.

 

Take care and let me know how u r getting on.  I took psychiatric pills in both my pregnancies and my GP said in an ideal world you wouldn't, but it is not an ideal world.  Pregnancy is not too bad with them, I have known quite a few women take them while pregnant, but breast feeding is a no no.  My children were born fine, but both prematurely, and I couldn't breast feed which broke my heart.

 

Difficult times for you, but not insurmountable.

 

Take care

[missindy]

Hi Joy,

 

I totally agree with you that I'm not going to further reduce until I feel really comfortable. We have no kids yet, and I'm hoping I can taper this last 10 mgs before I would be giving birth/breastfeeding. I assume the medication is in the breast milk and would negativity affect the baby. 

 

When you tapered did you follow the 10% reduction rate? I am thinking about doing that from now on and buying a milligram scale to weigh out my pills if the liquid isn't available.  I'm in no real hurry to be done completely, I want to do it right and not completely destroy my CNS in the process. 

 

Thanks for your support. Enjoy your week!

[Rhiannon]

Hi missindy--

 

Sounds like you're on track with your plans. Definitely recommend you hold on the 10 mg until things have settled down--I'd plan at least a month, but listen to your body, you may need to go longer. You started meds while your brain was still not fully developed, which seems to be a risk factor for needing to taper cautiously, at least at first until you really see how your body's going to deal with it.

 

Start keeping a brief daily journal of symptoms, ranking them daily on a numerical scale, say 1 to 5 or something. This may seem silly now but trust me, it will be useful to you in the future, for getting a sense of how your own withdrawal process goes and seeing patterns that are otherwise not very clear.

 

If you're not going to use liquid you will definitely need a milligram scale. But I've tapered from 10 mg of citalopram down to less than 1 mg just by dissolving the tablets in water, and it's worked fine. I started out using a scale and dry cutting but I find that the liquid is so much easier to measure and just generally to deal with. 

 

Since you have some time, you can experiment with liquid, and explore your options.

 

Please do consider coming completely off meds before getting pregnant. There have NOT been extensive studies of these meds in pregnant women versus outcomes for the children born. I think they did some studies with rats showing not too much in the way of actual obvious visible birth defects--well, not too reassuring, given that these drugs work on the nervous system, so a missing limb isn't really the only concern. I would be much more concerned about the effect of drugs that alter nervous system function on a fetus whose nervous system is actually just forming, out of nothing, for the first time ever.

 

http://www.sciencedaily.com/releases/2014/04/140415153735.htm

 

And like I say, this is just one study, and autism is a fairly extreme outcome. How about the kids who don't actually develop autism? What other kinds of effects could there be? How are they socially, emotionally, intellectually at two, four, ten, twenty years of age? Nobody has done any studies of this. 

[joy2730]

Hi, breast milk, from my basic understanding, is your own blood minus the red blood cells, how basic is that for knowledge so anything that is in your blood will be passed on in the breast milk to your baby.  I have known a hospital doctor's wife take antidepressants and breast feed but there was a lot of monitoring.

 

You could always take the view that if you are still really struggling with anxiety after your pregnancy and a few weeks of breast feeding then you could move on to bottle feeding and resume a dose of citalopram.  Pregnancy and breast feeding is only for a very short time in your life, and a few weeks of breast feeding would benefit your baby enormously and you would benefit enormously in terms of emotional and physical satisfaction.

 

Having that personal satisfaction might help to alleviate anxiety and when breast feeding your body naturally produces extra tranquillisers, I think it is called prolactin.

[joy2730]

To answer your question re tapering, I just cut tablets up with a veg knife until I got to 2.5 mg, ie quarter of a 10mg pill, however I am now back on 5 mg due to withdrawal symptoms.

 

~When I next reduce, I will still cut to 2.5 mg, but then will have a go at making a water liquid solution. 

[Jemima]

Hello missindy,

 

As you can see from  joy's post above, cutting more than 10% at a time can give your CNS a very hard time.  There is science behind this, and I suggest you both read this paper: Why Taper?

 

I would definitely hold off on getting pregnant until you're off the Citalopram and possibly for several months afterward. It would not only be good for your child, it would give you and your husband time to adjust to all the changes you've been through.  Slow and steady really does win the race.

[joy2730]

Just want to update you that the next reduction I am going to make is from 5mg to 4mg following the advice of everyone here, as I have a very demanding job, but an easy home life.  I have decided that to go from 5 mg to 2.5 mg is a 50% drop, even from 5 mg to 5mg is a 20% drop, do some people do 4.5 mg?  Maths has never been my strong point!

[missindy]

Hey Joy, 10% of 5mg is .5 so yes, 4.5 would be your next drop.

I read all the articles posted above, some really mind blowing stuff. I wonder if doctors are aware of these things before prescribing these drugs like candy as well as telling patients to "take one pill every other day" or "switch to prozac because it has a longer half life". I've been told both those things. It totally messed with me when I took 20 mgs every other day. I never switched to prozac because I'm anxious no matter what, so I might as well be medication free and anxious. 

Rhi- I have read all of your intro and you are an inspiration to so many people on this site. It scares me so much to think of all of these kids born while their mothers were on these medications, and who knows what kind of longterm effects will happen to them. I read that doctors tell patients that if the benefits outweigh the risks that they should stay on their pills throughout their pregnancies. In my case, if I already suffer from anxiety, and I have a kid that is a mess because of my choice to stay on medication then I will have even more anxiety. 

Going on over 2 weeks of down to 10mgs. Which in hindsite was wayyyyyy too big of a drop, but the stress in my life is getting to be more routine so I'm coping alright. 

[joy2730]

I am now working out whether to take 15mg or 20mg per day, as I had some pretty bad withdrawal effects, how are you doing, I am really interested.

 

I feel u r in a very difficult position, but u can still have a family even if u stay on the citalopram