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Rocksandhardplaces: Stuck between a tapering rock and a hard place

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Rocksandhardplaces

Rocks, I merged your topics to keep your history all in one place.

 

Since you are getting withdrawal symptoms when you take citalopram irregularly, that's a very strong indication tapering faster than 10% per month is not going to work for you.

 

You may wish to try a taper of 10% per month to see how it goes. If it goes well, you might want to gradually pare down the time period, but I would not reduce any faster than every 2 weeks. You may end up with an infant and withdrawal syndrome.

 

See Why taper by 10% of my dosage?

 

Why taper? Paper demonstrates importance of gradual change in plasma concentration

 

Tips for tapering off Celexa (citalopram)

 

Many people do better with fish oil and magnesium supplements, see

http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/

 

I hope all goes well for you.

Thank you for the response

 

I'm wondering why you think I'm experiencing withdrawal symptoms whilst taking the citalopram regularly? I am experiencing withdrawal symptoms but that is to be expected three days out from the end of a benzo taper. I agree though that it does seem likely I am now sensitised to SSRI withdrawal.

 

On supplements, for some reason I can't tolerate magnesium. It is true I'm back on the 'activating' supplements. I was hitting a wall in my benzo taper in december last year and slowly building up those b vitamins turned things around. Of course I worry about whether they are always right for me at this point though.

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Rocksandhardplaces

hi 'rocksandhardplaces' you've gone about things the right way unlike myself.well done for tapering the benzo.

I wish you well

sorry you are doing badly. psych med withdrawal can be brutal and terrifying. hoping you get some relief soon

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Altostrata

Rocks, I merged your topics to keep your history all in one place.

 

Since you are getting withdrawal symptoms when you take citalopram irregularly, that's a very strong indication tapering faster than 10% per month is not going to work for you.

 

....

 

People react differently to magnesium, seems it's not for you.

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Rocksandhardplaces

 

Rocks, I merged your topics to keep your history all in one place.

 

Since you are getting withdrawal symptoms when you take citalopram irregularly, that's a very strong indication tapering faster than 10% per month is not going to work for you.

 

....

 

People react differently to magnesium, seems it's not for you.

 

 

Ah I get it.

 

Yes I fear I am now sensitised to withdrawal but I will only know once I start. And I am very keen to start. The citalopram is giving me waves of anxiety soon after I take it. There is something to withdrawing from the activating one first, but I didn't really consider the SSRI a problem when I started the benzo taper.

I'll hold out for at least two months before trying my first reduction. I'll know more then I guess.

My reaction to magnesium might change the further I get from benzo withdrawal. Magnesium has an odd relationship with benzo wd.

 

Thanks for all you do

 

Would you put my history/posts in a journal area by any chance?

 

Thanks

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Rocksandhardplaces

Hello

 

So I've just heard of crossing over from an SSRI to a tricyclic in order to cease overactivation, resulting insomnia and anxiety, for a long taper.

I was prescribed temazepam/restoril in order to sleep initially because of the SSRI. It is overly activating for me. It is even worse now that I've finished my benzo taper. Had I known any of this before I would have probably have tapered my SSRI first. Honestly at the beginning of the benzo taper I didn't know the SSRI was a problem.

 

So I'm in a situation where I need to knuckle down for a long AD taper but I dread taking my AD every day - as I get horrible anxious energy surges - and it is causing insomnia. Is it then worth considering a swap to a tricyclic? Honestly I'm very frightened by the prospect. I'm so not stable at this point with extreme chemical sensitivities so messing with AD drugs is the last thing I wanna do. But if it means this AD taper will be more tolerable then I will consider it. The other possibility is as I taper the SSRI that the overactivation is less extreme/as I go down?? 

 

Thank you

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Altostrata

Rocks, I moved your post here. Your Intro topic is the place for those "what should I do?" questions. Over time, it will be a sort of journal for you.

 

Where did you hear of switching to a tricyclic to go off an SSRI?

 

This is not a method we recommend. While tricyclics are somewhat weaker than SSRIs, drug switches always incur an additional risk. The switch may not work and you get withdrawal syndrome anyway.

 

If you feel overactivated by citalopram, this should be reduced as you taper it.

 

You are correct, you don't know how you will tolerate tapering. This is why we strongly recommend a very small decrease at first, to test the waters. Once you damage your nervous system by decreasing too fast, you might not be able to right it.

 

Restoril is not a tricyclic, it is a benzo.

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Rocksandhardplaces

Rocks, I moved your post here. Your Intro topic is the place for those "what should I do?" questions. Over time, it will be a sort of journal for you.

 

Where did you hear of switching to a tricyclic to go off an SSRI?

 

This is not a method we recommend. While tricyclics are somewhat weaker than SSRIs, drug switches always incur an additional risk. The switch may not work and you get withdrawal syndrome anyway.

 

If you feel overactivated by citalopram, this should be reduced as you taper it.

 

You are correct, you don't know how you will tolerate tapering. This is why we strongly recommend a very small decrease at first, to test the waters. Once you damage your nervous system by decreasing too fast, you might not be able to right it.

 

Restoril is not a tricyclic, it is a benzo.

 

Hey Alto

 

I heard the option of tricyclic switching on benzobuddies. Honestly it is a relief that you don't recommend it. I might have tried it but only if I felt I had to. 

 

Yes Restoril was the benzo I was prescribed 4 years ago essentially because of the SSRI overactivation. I'm now finished my benzo taper - incidentally I did sadly have to switch to valium because of interdose restoril withdrawal - and the SSRI overactivation is worse than ever. Now there is not much GABA to speak of the SSRI's hit is too much. I dread taking it daily. I get unpleasant surges of energy and anxiety (different to the benzo wd anxiety). I've stopped the activating supplements for now too to see if that helps. They helped a great deal earlier in the year but my main problem is now the SSRI again so even though I loathe to change things I figure it is best to see if things settle somewhat without it.

 

 

Such a relief to hear you say that the over activation will dimish with a taper. I can handle a painfully slow taper if I don't have the horrible overactivation.

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Altostrata

I'm sorry, you're probably sensitized by the benzo taper.

 

When did this reaction to citalopram start? What is your daily symptom pattern relative to when you take your drugs?

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Rocksandhardplaces

I'm sorry, you're probably sensitized by the benzo taper.

 

When did this reaction to citalopram start? What is your daily symptom pattern relative to when you take your drugs?

 

My reaction to citalopram has been slowly on the increase since I got lower and lower on the benzo. There isn't much in the way of GABA brakes in my brain at this point so the SSRI is too much. As you know I had the same problem with the SSRI last year. Additionally I suspect the insomnia that led to retoril use was SSRI induced.

All in all the citalopram doesn't sit so well with me.

 

My daily symptom pattern is hellish benzo withdrawal induced mornings.

Previously I was taking the citalopram then. I've now shifted the citalopram to the afternoon so it isn't making a dismal situation worse.

About half an hour to an hour after I take the citalopram I get waves of unpleasant energy and energised anxiety along with itchiness. Today is the second day without the activating B vitamins and it started later. I knew those B vitamins were activating but at the time for whatever reason they helped my benzo wd a great deal. I'll keep limiting them which will hopefully help the citalopram to settle down.

 

Thank you for your replies and attempts to help... all a bit scary being stuck between a pharma rock and hard place. I'd start tapering the citalopram straight away given the side effects I'm suffering except I'm fairly sure that wont help at this point, given how unstable I am with the benzo wd. Still, if it keeps up maybe a bit of slow tapering of it will be the lesser of two evils.

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Altostrata

Yes, those B vitamins are too activating at the current dose. Suggest you take less and not at the same time as citalopram.

 

Please keep notes on paper regarding your daily symptom pattern relative to when take your drugs, b vitamins, etc.

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Rocksandhardplaces

Hello :)

 

So I stopped taking the vitamins and that reduced the hyper reaction to the citalopram... mostly. My mornings from benzo wd had improved a lot. Symptoms from benzo wd were minimal.

 

Two days ago I did my first citalopram 10% cut. I got a compounded liquid and cut from 10mg to 9mg and yea wow not gonna lie.. that 10% cut hurts already.

some good things is I can already sleep better just from that cut two days ago. Less good things include quite a profound panic in the morning hours. It isn't an easy to calm down panic either. Also shakes, feelings of cold and nausea here too. I'll wait till the symptoms die down and then I'll know my recovery pattern. but woa... once I'm down to 5mg I'll go to a microtaper or something cause even 10% cuts hurt and I'm supposed to be able to teach students etc. Good times   :D ;D

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brassmonkey

If a 10% drop is hitting that hard, it might be a good idea to try 5% instead.  The kick up in symptoms says that it is too much.  You could adjust back up to 9.5mg and stay there for a while and see if it goes any better.

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Rocksandhardplaces

If a 10% drop is hitting that hard, it might be a good idea to try 5% instead.  The kick up in symptoms says that it is too much.  You could adjust back up to 9.5mg and stay there for a while and see if it goes any better.

 

I know it is dissappointing it hurt that much. It is annoying because in the past I was able to cut and move around the citalopram without noticing so much. Clearly I'm very sensitised from the benzo taper. I'm even semi craving taking another dose which is a terrible sign. I didn't crave a dose this much on freakin benzos. Citalopram has a relatively good half life so I thought I'd be fine. I didn't imagine I'd have an issue like that. I want to stay here now though and see how long it takes to stabilise. Then I'll have a better sense of how this all sits with me, and what my recovery rate looks like.

But yes, I may try 2.5% weekly next.

 

You may be able to help me with something though... can one stabilise during a taper from SSRI. I remember from my benzo taper it was rarely worth staying put for very long because you felt as bad staying as you did cutting. I had thought it might be a bit different on the SSRI... like it was easier to actually properly stabilise on a certain dose. But then I may be wrong, particularly if there is interdose withdrawal I guess :/

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brassmonkey

Hi Rockie--  That is an excellent question and you will probably get a variety of answers to it. From my experience yes you can stabilize during WD.  That does not, however, mean an absence of symptoms.  I refer to the stabilized state as "WDnormal" which I define as the symptoms being of an average intensity from day to day over several months.  I have found that in the days following a drop in dose the symptoms will ramp up in intensity, stay there for a few days and then decline back to the WDnormal level.  As the taper continues the WDnormal level slowly rises, showing improvement as healing progresses.  A prolonged decline in WDnormal would indicate that the taper is going too fast and a hold period is needed.

 

Tapering benzos and SSRs are two similar yet different processes.  I'm not a benzo expert but it is my impression that once the taper is started it is generally best to proceed at a slow steady rate and never backtrack.  Where as with SSRIs there is a bit more flexibility in tuning the taper to what your body is telling you.  With benzos we are dealing with an actual addiction while with SSRIs we are dealing with undoing physical changes, so the two tapers will have to be a bit different. (Skyler; if you're reading this and I'm way off base please tell me.)

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Rocksandhardplaces

Hi Rockie--  That is an excellent question and you will probably get a variety of answers to it. From my experience yes you can stabilize during WD.  That does not, however, mean an absence of symptoms.  I refer to the stabilized state as "WDnormal" which I define as the symptoms being of an average intensity from day to day over several months.  I have found that in the days following a drop in dose the symptoms will ramp up in intensity, stay there for a few days and then decline back to the WDnormal level.  As the taper continues the WDnormal level slowly rises, showing improvement as healing progresses.  A prolonged decline in WDnormal would indicate that the taper is going too fast and a hold period is needed.

 

Tapering benzos and SSRs are two similar yet different processes.  I'm not a benzo expert but it is my impression that once the taper is started it is generally best to proceed at a slow steady rate and never backtrack.  Where as with SSRIs there is a bit more flexibility in tuning the taper to what your body is telling you.  With benzos we are dealing with an actual addiction while with SSRIs we are dealing with undoing physical changes, so the two tapers will have to be a bit different. (Skyler; if you're reading this and I'm way off base please tell me.)

 

mmm benzo wd is an odd beast. I microtapered the whole way, and allowed myself updoses as needed; I essentially went with how my symptoms were going. I had hoped I'd get away easier from the citalopram but alas I will just have to do the same: steal myself for the slow plod of tapering.

 

I'll try to sit on this dose to give me a baseline sense of how hard cuts hit me and how long it takes to recover. Next time I'll try the 2.5% cuts

 

hate being stuck between a rock and a hard place... can't stay on the med, and can't readily get off it.

Ah well. One day I'll be free

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Rocksandhardplaces

starting to feel better.. maybe that means it takes a bit over a week to recover from a 10% cut

i don't feel recovered exactly but perhaps this will be my new baseline withdrawal normal. At least the horrible cortisol/adrenaline mornings have gone for the past few days (they were horribubble!)

 

Still not sure what is going on with my supp situation. I couldn't stay off the Bs for long. I got too down and anxious. I was better on them then without, and since the citalopram cut I don't have quite the same issue of that revving me up too much. Incidentally niacin really turned around my cortisol mornings.

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Altostrata

Interesting. Could be the B vitamins are doing you good.

 

Please tell us more about your experience with niacin.

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Rocksandhardplaces

Interesting. Could be the B vitamins are doing you good.

 

Please tell us more about your experience with niacin.

Niacin has been quite amazing

The cortisol and adrenaline mornings were truly unpleasant but the niacin literally stopped them. I take a 50mg niacin lozenge as needed. You can bite off what ever amount you need. 

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Rocksandhardplaces

Kinda feel like I'm at a party for one..

I get a few visitors.

I'd love to speak to other citalopram taperers but I struggle to navigate this forum, which is altogether odd because I'm not un-tech-savvy.

 

Ideally there could be a thread where people tapering the same drug could share but I don't know how that would work in this context.

 

Anyhow I may as well document how I'm going.

 

I'm doing fine really. I make 2.5% cuts now. Everytime I  make one I'm surprised how nasty the mornings/nights get. That is the kicker for me in terms of symptoms: terror in the night/morning. Trouble sleeping is another annoyance. Originally when I took off the first 10% my sleep had improved. But once I got past the bump in sleep from reducing the overactivation and got further into withdrawal sleep has been more difficult. I'm back taking teeny tiny amounts of doxylamine some nights, which doesn't please me.

 

Since the benzo wd I still can't tolerate GABA heavy sleep aids, like milk peptides or even strong magnesium. One night I took a large dose of magnesium and B6 and I was out so heavy and positively drowsy. After it wore off though withdrawal was nasty. I get these mini withdrawals from GABA heavy things, and then back to baseline after a few days. Annoying and unpleasant.

 

Still on lots of B vitamins and they still help. Whenever I miss one I can feel it (not sure if that means I'm 'dependent' on them too?).

 

I'm now sitting on 8.25mg of citalopram. Onwards and downwards

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KarenB

I'm glad you're doing okay.  You're right that contact with others is really important.

 

You could try these:

 

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

 

I usually click on people's names as they come through the http://survivingantidepressants.org/index.php?/forum/3-introductions-and-updates/

thread and see if they are also tapering my drug (Effexor).  You could try that to find other citalopram taperers. When I find them I either leave a comment on their thread (which means I get alerted if further comments are added) or press the 'follow' button at the top right.  

 

Then all the threads you're interested in are in one place to keep an eye on - just click on your own name at the top right of the page, then click 'my content' and see what's there.

 

The other thing is that drugs go by many names, so keep an eye out for anyone tapering the following:

Cipramil, Celeza, Citrol, Seropram, Talam, Citabax, Citaxin (Poland), Citalec (Slovakia), Recital (Israel), Zetalo (India), Celapram, Ciazil (Australia, New Zealand), Zentius (South America), Ciprapine (Ireland), Cilift (South Africa), Citox (Mexico), Citopam, Akarin (Denmark), Cipram (Turkey, Denmark), and Celius (Greece)

 

And because the s/a search button doesn't work too well, you can google 'Surviving Antidepressants citalopram' and you'll get a list of threads here which you can read and follow. 

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