☼ lionboy: protracted withdrawal from citalopram

[lionboy]

* just re read this whole thread and thought I should say a thank you to Angie 007 who correctly diagnosed my predicament a year ago.

At that time I was not ready to accept that, plain and simply, the drugs are the problem.

[Altostrata]

This is unknowable. All you can do is take your best guess and see what happens.

[lionboy]

Yes, I think you are right !

I think I am starting to feel slightly better again now. I intend to wait now until the side effects return and then try another 1mg reduction.

I will not rush into the next reduction, I will hold on until it is 100% clear that the side effects have returned.

If the next 1mg reduction is seem less, I can put this last experience down to either reducing too early or a knock on effect of my double dose reduction destabilising me.

 

If the next 1mg drop gives rise to similar or even worse problems than this last one then I think I seriously need to consider whether 1mg ,or 8.8% as it now represents, is too large a reduction for me now.

 

I'll report back !

[lionboy]

Advice needed PLEASE !

Since my last 1mg reduction I have been in a bad state for 5 weeks and 1 day. I thought I had established an agreeable rate of taper ?

I reduce by 1mg my body has a bit of a reaction, ranging from a derealised day to 3 quite iffy days, followed by a good 7-10 days and then the side effects return and I go again with another 1mg reduction.

This has worked well for me over the last 6-7 months and I have surprised myself how quickly and comparatively easily I have dropped from 25mg to 11mg.

I have been mindful of people's advice, particularly regarding the % drop of each reduction.

Of course the lower my dosage gets the greater % a 1mg drop represents. With this in mind I have twice reduced by less than I mg. I tried once by 0.5mg and once by 0.75mg. Both times proved unsuccessful will only 2 or 3 days relief and then a return of side effects. It was as if the reduction was not sufficient to jolt my system into the required response. When the side effects return I then have to reduce again. I say "have to" meaning that the side effects of being stable at a dose are themselves debilitating, so not really and option to sit and wait. Both times this has happened I have then reduced again after 3 days and suffered destabilisation, resulting in classic withdrawal problems.

Given this experience I am quite reluctant to try another reduction of less than 1mg.

 

Can people please advise on what they think is happening ?

 

Is it that my last reduction meant I had chalked off 3mg or 20% in just over 3 weeks ?

This is not the first time I have reduced 3mg in just over 3 weeks and last time was fine. My body tells me when to reduce.

Of course this time the % is higher, however a 0.75mg drop from 16mg represented the same % drop as a 1mg drop from 24mg. The latter was fine, the former not ?

Is it normal to find a nice pattern of reduction and then for no apparent reason just hit a wall?

I seem to recall reading someone's thread who tapered down o.k and then got stuck at 8mg.

 

All ideas and advice are welcome as always please.

[Altostrata]

As usual, it's very hard to figure out exactly what this pattern means for you, lionboy.

 

Personally, I find it hard to believe your nervous system is calibrated for 1mg cuts. That's simply not logical.

 

Perhaps you might think in terms of micro-tapering at this point, with decreases of less than 0.5mg.

[lionboy]

Hi alto, thanks for your reply. Feel very confused as to what is happening now ?

I totally get your point re: 1mg reductions. The confusing thing is that, whilst I agree with your logic, it has so far worked !

Well it had up to now !

Both times I tried to reduce less, I ended up reducing more (if that makes sense).

 

Maybe my body is now ready for smaller mg reductions ? I really can't see why this latest 1mg drop has caused such a problem ?

I guess it may be an indicator for me to slow down ?

[Altostrata]

Yes, as you noted, 1mg is a larger proportion of your entire dosage and it's probably too much of a decrease now.

[bubble]

there is also a cumulative effect of decreases and the possibility that a too fast taper which you don't feel immediately catches up with you later on...

[lionboy]

Hi Bubble, yes that is a valid point.

[bubble]

Hi, lionboy!

 

Rhi is frequently warning members about this...

 

best of luck!

[lionboy]

Thanks for letting me know, I hadn't read that.

[Nikki]

there is also a cumulative effect of decreases and the possibility that a too fast taper which you don't feel immediately catches up with you later on...

 

 

This really does happen - the cumulative effect of decreases....this may be what has happened.  There is also the 10mg. mark which if a slippery slope, sadly that happens too.

[bubble]

something little on this topic: 

 

Areyouthere?:GO SLOWER THAN YOU THINK YOU CAN…. you know, like safe sex…it's just a little inconvenience that could save a lifetime of headaches..

 

Rhi, on 21 Jan 2014 - 9:06 PM, said:

It seems to me that drug half lives are only a small part of the picture.  The problem is that our brains remodel and rewire themselves to adapt to the presence of the drug. These changes take place gradually and cannot be undone quickly. There is usually a certain amount of resilience built into our amazing nervous systems, but as Alto says they're not made of rubber.

 

We remove some of the drug and the body begins to try to remodel the nervous connections to rebalance.  It manages to get a partial balance, not robust but adequate. Then we remove more of the drug when in this state, and the body/brain continues to try to remodel; the adaptation is enough that we can function, but still not really strong because there hasn't been enough time. If we keep removing faster than our brains can adapt, our balance becomes more fragile and precarious.

 

Then we remove even more, and even more, and I think eventually we get so far ahead of our ability to heal and remodel the brain that people experience a "crash" or just go into a state of ongoing unstable withdrawal that doesn't seem to ever settle down.

 

I suspect that we can get into a state of withdrawal where the brain just can't rebalance itself because the chaos caused by the withdrawal is interfering with the chemical processes required to heal and rebalance.

 

That's the mechanism that I speculate is behind this "lag time" phenomenon, and this is why I am such a strong proponent of just holding and not changing anything when you get unstable. (And of course of slow tapers with long holds, so we don't get ahead of our brain's ability to adapt in the first place.)

 

I could be wrong of course, but it does seem to work for people most of the time.

 

 

[lionboy]

Hi Bubble / Nikki

Thank you for your posts.

Nikki what exactly do you mean when you refer to the 10mg mark ? Is it common for people during taper to hit a brick wall around 10mg and if so how does this usually resolve itself ?

 

Thanks to Bubble (and Rhi) for re posting Rhi's information.

Rhi's suggestion that a series of reductions undertaken without a sufficient hold in between each can have a cumulative effect and cause almost a delayed onset of problems does seem intuitively sensible to me. I also subscribe to the fact that what we go through is due to the brain remodelling itself after the stressor of the ssri is removed.

I believe that when you regularly subject your brain to the ssri it switches off certain functions or stops producing certain chemicals etc.

This I believe is why ssri's take a period of weeks to provide therapeutic effect and why people often feel a lot worse before they feel better when first prescribed them. I believe this first period of weeks is your brain fighting the effect of the stressor before the brain finally becomes overwhelmed and does whatever it does i.e switch of receptors etc.

When the drug is later removed, the brain has to then try and remodel itself. Of course the smaller the amount of the drug you reduce by and the longer the time you take to taper the better chance the brain has of coping. This suggests to me why large dose reductions or trying to go cold turkey causes such carnage. It also seems to suggest that the higher the dose you have been on of the ssri and the longer you have been on it then the greater the chance of problems withdrawing.

 

If I were to ever advise someone else how to withdraw from an ssri, I would advocate a very slow taper with very small % reductions (Alto has more than covered this, in her various tapering advice.)

I find my own situation slightly different to some in that I remained stable at 25mg for a number of years and it would appear that it was being stable at a dose that was actually causing me problems.

I found this concept hard to grasp at first and it was other members such as Angie and Skyler etc that really made me realise that after a prolonged period on an ssri the drug can quite simply cause you problems or side effects and you need to get off it. I mention in an earlier post that alcohol and heroin are similar in this regard.

Skyler suggested to me that I would start to feel better as I tapered and she was right !

I dropped 4% from 25mg to 24mg and had a rocky few days and then felt good for a weeks or 10 days and then started to feel the same as I had when stable at 25mg.

I reduced again by 1mg to 23mg and again it was successful and followed basically the same pattern.

It is as if a small reduction of 1mg gives me a bit of discomfort then I feel great for a while and the I return to the side effects of being stable at a dose. This pattern then has really dictated to me when I should make my next reduction. I have not decided, I'll do it a week on Tuesday, my body has guided me. This has seemed to work very well with very few hiccups. I have gone from 25mg to 11.25mg in 5 months.

It has been suggested to me and Alto firmly believes that as your dose gets lower so should the amount you reduce by, thus keeping the % reduction similar.

In theory this seems correct to me, I would expect the reduction against time line to be exponential as appose linear.

I.e I would expect it to take longer for the body to adjust to reducing 3mg to 2mg than I would expect it to adjust to reducing 25mg to 24mg as the former is a much significant decrease.

I have tried to reduce by a smaller amount twice. I tried 0.5mg from 23 to 22.5mg and I tried to reduce 0.75mg from 16mg to 15.25mg.

Both of these attempts proved unsuccessful.

The first time I had sort of 3 ok days before the side effects returned and I then dropped another 0.5mg and had one ok day before the side effects returned and I then had to do a 1mg reduction and thus had reduced 2mg in a 5 day period which caused me some destabilisation.

The same basically occurred on my second attempt also.

It seemed to me that less than 1mg was not enough to shake of the side effects and almost jolt my body down the next step (if that makes sense).

The fact is now I have been in a bad way and away from work for the last 6 weeks, so I am by far in the worst place I have been since I started my taper from 25mg.

I am not sure that what I am experiencing is a delayed onset of problems from my taper overall as to manifest itself 5-6 months and 14mg later seems unlikely to me. Preceding this bad period I had reduced 3mg in just over 3 weeks, which I have done successfully before, however this time it represented over 20% of my overall dose.

It seems obvious to point to this as being the cause of this latest problem however if % is the key then I find myself unable to explain why a 1mg 4% reduction from 25mg to 24mg was successful as was a 5.5% reduction from 18mg to 17mg yet a 0.75mg reduction, 4.6 %, from 16mg to 15.25mg was not ?

 

I am very interested to hear from Nikki regarding this 10mg theory as I'm sure I read elsewhere of someone successfully tapering before hitting a wall at 8mg.

 

Good luck to everyone !

The lion.

[Petunia]

Hi Lionboy,

 

After reading through your thread, I wrote out a long response, but before posting it, decided to read back through your latest posts again in case I had missed anything.  I had.

 

You write about side effects from the drug and also symptoms from being destabilized from tapering.

 

What are the side effects you get from the drug after your have stabilized?

 

What are the symptoms you get right after cutting?

 

Which ones are you getting now?

 

Petu.

[lionboy]

Hi Petu

Thanks for responding. This is a difficult question to answer succinctly !

I suppose the most exacting answer is that they are not clearly distinguishable.

If you remember I was off work for 5 months last year with what I thought was a withdrawal problem and it was only when Alto, Skyler, Angie etc all seemed to be suggesting the same thing that I started to accept that the problem was not a withdrawal issue but was in fact side effects.

They encouraged me to taper which I did and that made me feel much better and got me back to work.

Intuitively I feel that I reduce the dose, destabilise slightly, feel fine for a period and then the side effects return. I visualise it as going down steps of varying lengths.

In general I would say that withdrawal problems are magnified, exasperated and made instantly much worse by trying a further reduction whereas side effects are generally alleviated by a further reduction.

As previously detailed, the whole step down process has worked very well for me over the last months save the two times I tried to reduce by less than 1mg and the side effects came straight back leading to a double reduction and destabilisation.

 

The only exception being this last 1mg reduction that has given rise to over 6 weeks of problems.

Despite not having the expected good period before the return of side effects, I started to question whether I had somehow bypassed it and drifted back to side effects at the moment as my current situation feels just like that. With this in mind I just tried another 1mg reduction a couple of weeks ago and it felt so terrible I reinstated my dose a couple of hours later.

This led me to conclude that the current problem is destabilisation as appose side effects from stabilisation.

 

It is a complex and confusing picture which I don't seem to be able to decode as of yet ?

[Altostrata]

What is your daily symptom pattern relative to when you take citalopram?

[Petunia]

It is a complex and confusing picture which I don't seem to be able to decode as of yet ?

 

........ you may have to accept the fact that you will never be able to accurately decode it.

 

I just read through your entire thread again, its a very confusing picture and the fact that you experienced relief after making cuts several times, after being in a wave would make anyone think that you may have been experiencing side effects, rather than withdrawal.  But what about if the wave was naturally coming to the end anyway and the fact that you had started cutting again was just a coincidence?

 

Another thing which makes me think this is more about withdrawal and general destabilization is that it seems you get the same symptoms after holding for a long time or cutting.

 

Because of your history, of long term antidepressant use, combined with other drugs, also long term, I think you may have developed an extremely sensitive nervous system.

 

i have been on citalopram 50mg for 12 years for anxiety. for most of that time i also abused recreational drugs including cocaine, codeine, canabis etc etc.

 

From my understanding, this means you would be sensitive to all drugs, but also withdrawal from drugs.  Your nervous system is capable of healing, and its obvious it has been, but its vulnerable.

 

If you could answer Alto's question above, and map out your daily symptom pattern in relation to when you take citalopram, that would be helpful.

 

Earlier in your thread, Tezza suggested you start a daily log of symptoms, rating their severity, that might be a good option at this point, if you haven't already started it.

 

What I'm going write next is just my opinion, and its not going to be very helpful, but it may explain what's been going on.

 

Its obvious that citalopram pooped out on you a long time ago (tolerance), it stopped providing wanted effects because your brain and nervous system adapted to the new condition.  At times in your withdrawal process the drug may have been providing unwanted effects (side effects). But because you have the same symptoms, just at different times, its hard to know the exact cause.  Your nervous system has also been causing unwanted effects because of the stress of its having to adapt to a constantly changing environment of drug withdrawal, combined with life in general.  Its been a long time since your nervous system (and entire body) has encountered life in a completely un-medicated state, and the closer you get to that state, the harder its going to have to work to 'remember' how to do it.

 

I don't think people realize just how complex the human brain, nervous system and entire body is, or realize the serious implications of throwing random weird substances in there, just to see what they will do.  There is very little science behind putting these chemicals into us, so its not surprising that there is no available science to safely get them out..... at the moment its more of an art, which is driven by instinct.  (see Alto's signature for more details)

[lionboy]

Hi Alto / Petu

In terms of a daily pattern of symptoms, that is very hard to answer.

Since I started to taper in July I would say that I am in one of two states:

1. Being almost totally fine.

2. Being destabilised.

I have had the odd bit of destabilisation throughout however there have really been three distinct periods of destabilisation as detailed before, one after each double reduction and this current one.

When I am almost totally fine, I am working, enjoying life, been away fishing, on holiday with my family etc. I have felt overstimulated, a bit of tremor, a bit derealised in patches etc but generally fine and positive and I would certainly take that all the way down to zero if you could offer that to me.

When I am destabilised I am unable to work. I stay at home and don't go out. I feel a mix of symptoms that don't seem to follow a pattern and don't seem to be associated with a particular time of day. I tend to sleep in longer than I would if I was fine and thus end up going to bed later. My symptoms normally seem at their least severe in the early to late evening. That is really the only telling observation I can make. I always take my citalopram in the morning / when I first get up. During bad periods this is anywhere from 9am - 12 noon with no noticeable difference if I take it a few hours late. The fact that my symptoms seem at their best in the evening I think is simply due to the fact that this is the period of least stress. I have a wife and two young children and I try and work from home during these times. With my wife around worrying, work issues cropping up and the kids going to school and coming home, tea time, bath time etc I think this all just raises my stress level and makes the symptoms worse. Once the kids are in bed and quite often my wife as well my only hassle is what to watch on tv !

I have a variety of symptoms from feeling uncomfortable in my skin, tremor, aggression, short temper, unable to cope, akathesia, feeling desperate, anxiety etc

In terms of a daily pattern there really isn't one ?

Sorry that this doesn't give you much to go on ?

 

Petu, I read your response with interest and I think you make some great points. In terms of unlocking the code I fear you may be right and I also agree that there is very little science behind the chemicals the drug companies feed to us ! Some good marketing though !

I think you are also correct that citalopram pooped out, I became tolerant, developed side effects etc

Something happened at the end of 2006 and the drug has caused me distinct problems ever since. I take your point regarding my body / brain etc needing to re calibrate itself for life without medication and I do feel this is happening. I certainly never wish I was back on 30, 40 or 50mg. The days of being heavily numbed to the world are behind me and I welcome this new version of myself.

As detailed, I have beaten many chronic abuses in the past such as a smoking habit, a chronic pot smoking habit, alcohol abuse and drug abuse. When I leave these things behind I become a stronger version of myself and hopefully that will be the same with citalopram.

In terms of your observation that my problems could be solely withdrawal and that my taper coincided with the natural end of a wave ?

I would have to discount that theory.

I was off work in a fixed state for 5 months. I did a reduction and 4 days later I was back at work. A week after that I slipped back to how I was feeling when I was off, I did another reduction and bingo o.k again.

I can't accept coincidence.

 

It terms of my bad patches then after each double reduction I would explain them as obvious destabilisation from removing too much drug too soon. The pattern that followed, in my mind at least, gives credence to this.

This latest problem, who knows ?

As discussed, I may never unlock the code.

I would hazzard a guess that Alto is right and it is too much too soon and also as suggested by Bubble, Rhi, Nikki etc the cumulative effect of my rapid reductions has caught up with me and destabilised me. Maybe my body just needs a bit of time. Hopefully it will snap back into action as it has always done before and I can go again on the path of reduction and get another significant % of this **** out of my system before I have any more problems.

[lionboy]

Hi everyone

I am still suffering ill effects since my last decrease on the 20th dec.

As it is quite clear that citalopram causes me problems both when stable on a dose and when trying to reduce I wondered if it might be worth trying to convert to another ssri ?

I have read before that people convert to fluoxetine (Prozac) and the taper down on that as it has a longer half life.

I am thinking that if I converted, my body may not react badly to a stable dose of fluoxetine in the way it now does to citalopram.

If that was the case, I could then taper down at a much much slower rate and avoid further significant problems.

 

Does this seem like a good idea ? Or am I going to open up a whole new can of worms ?

Any advice is welcome ?

[Altostrata]

Hard to tell what that would do, lionboy. It is a last resort, you have to decide if you want to take that chance.

Please read http://survivingantidepressants.org/index.php?/topic/1463-the-prozac-switch-or-bridging-with-prozac/

[lionboy]

Thanks for that info Alto. I have read the whole thread and not really sure what to make of it ? Most people seem to be able to switch to Prozac without issue, although they mostly seem to come from a place of being stable / comfortable on the current dose of their ssri although unable to reduce. I am in a slightly different position and not sure how that would translate ?

I understand that some cannot just switch and that for some it may cause further issues.

My citalopram taper was going well until end dec and I have been off work again since. As previously discussed this is most probably a cumulative reaction to dropping 14mg or 55% in 5 months. This period will no doubt pass and I would hope that I can then carry on tapering down to zero and be fine.

Of course we don't know what further problems I will face trying to taper and I feel that I quite clearly can't stay put on a dose of citalopram.

If I'm honest I also wonder what I'll be left with if I do get to zero ?

 

If I did switch to Prozac successfully and it didn't cause me side effects I would then be sorted. Of course I would be on 12mg of Prozac but I could live with that and I could then taper very slowly as and when.

 

You term the Prozac switch as a last resort. Do you think for me it would be a risk worth taking or would you persevere with the citalopram withdrawal ?

[Petunia]

My citalopram taper was going well until end dec and I have been off work again since. As previously discussed this is most probably a cumulative reaction to dropping 14mg or 55% in 5 months. This period will no doubt pass and I would hope that I can then carry on tapering down to zero and be fine.....

 

 

..You term the Prozac switch as a last resort. Do you think for me it would be a risk worth taking or would you persevere with the citalopram withdrawal ?

 

If it were me, I would stay with the citalopram. I've been reading about too many prozac bridges that didn't work out well.  As you mentioned, the only time it goes smoothly is when someone is already stable and doing well.  Any major change like this seems to exacerbate an already difficult situation.

 

It can take a long time time for our NS to heal once it become unbalanced, there really are no quick fixes.

[lionboy]

Thanks Petu. I guess you are right. I could end up in a right pickle if I tried to bridge.

[lionboy]

Does anyone else have a view on this either way ?

I have had a good look on the internet about this and the feeling I get is that, whilst some people get lucky with it, the majority of people with real experience of the issues say no. Many consider it to be unsuccessful in the vast majority of cases.

[Skyler]

Ditto Alto. She's our expert and knows more about ADs than anyone else I've come across on the net or off. The accounts I've read on this site support this. I'm kind of curious as to why you are still thinking of taking the chance. It's very unlikely Prozac will stop the WD Sx you already have acquired. I know it's hard to have patience and give your body the time it needs to heal, but doing otherwise will likely cause a whole overlay of other issues on top of what you have now.

[lionboy]

Thanks Sky. I take it that is a resounding NO from Alto and yourself then ?

I like to always consider all options and I guess I am really looking for a quick fix. Losing my job is really my main concern. I have worked my way up through the same company for 18 years and only ever worked for them. I have a wife, kids and a mortgage etc.

I was off for 5 months last year until yourself, Alto and others helped me realise that I was suffering side effects and needed to taper. I have now been off over 2 months with this latest withdrawal issue / destabilisation etc.

my work have been very supportive with full pay etc and everyone just wants me back and sorted.

I worry that I could be off several more weeks and then when I am ok and back that this will happen again when I start tapering once more.

If I could switch drugs and lose the side effects then it is a very appealing option.

[Altostrata]

Mine was not a resounding no.

 

I don't know what will happen. I don't know if switching to Prozac would make you feel better or worse. It could go either way.

 

You need to talk to someone like David Healy to evaluate the risk-benefit of a switch. Even so, no one can predict the future.

[lionboy]

Right, thanks Alto. What would you do in my position ?

[Altostrata]

I honestly don't know. Any chance of your conferring with David Healy?

[bubble]

some of us believe that not changing anything and thus giving our CNS a chance to stabilise, regrow and heal itself is our safest bet.

 

I had this experience of symptoms abating just through waiting and not reacting to them hence I became a proponent of that 'school of thought'. And I manage to clench my teeth and work...

 

just my 2 pence to help you in the decision making process.

 

This will be my third time tonight that I post Rhi's text that explains my 'creed'

 

A lot of people, including healthcare practitioners; in fact, I guess, most people-- are operating from entirely the wrong paradigm, or way of thinking, about these meds. They're thinking of them like aspirin--as something that has an effect when it's in your system, and then when it gets out of your system the effect goes away.

That's not what happens with medications that alter neurotransmitter function, we are learning.

What happens when you change the chemistry of the brain is, the brain adjusts its chemistry and structure to try to return to homeostasis, or biochemical and functional balance. It tries to restabilize the chemistry. 

For example: SSRI antidepressants work as "serotonin reuptake inhibitors." That is, they cause serotonin to remain in the space between neurons, rather than being taken back up into the cells to be re-used, like it would be in a normal healthy nondrugged brain.

So the brain, which wants to re-establish normal signaling and function, adapts to the higher level of serotonin between neurons (in the "synapse", the space between neurons where signals get passed along). It does this by removing serotonin receptors, so that the signal is reduced and changed to something closer to normal. It also decreases the amount of serotonin it produces overall. 

To do that, genes have to be turned on and off; new proteins have to be made; whole cascades of chemical reactions have to be changed, which means turning on and off OTHER genes; cells are destroyed, new cells are made; in other words, a complex physiologic remodeling takes place. This takes place over time. The brain does not grow and change rapidly. 

This is a vast oversimplification of the amount of adaptation that takes place in the brain when we change its normal chemistry, but that's the principle.

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. 

With multiple drugs and a history of drug changes and cold turkeys, all of this becomes even more complicated. And if a person is started on these kinds of drugs at an early age before the brain has ever completely established normal mature functioning--well, it can't be good. (All of which is why I recommend an extremely slow taper particularly to anyone with a multiple drug history, a history of many years on meds, a history of past cold turkeys or frequent med changes, and a history of being put on drugs at a young age.)

This isn't intended to scare people, but hopefully to give you some idea of what's happening, and to help you respect and understand the process so you can work with it; ALSO, because you are likely to encounter many, many people who still believe these drugs work kind of like aspirin, or a glass of wine, and all you need to do is stop and get it out of your system. 

Now you can explain to them that no, getting it out of your system is not the issue; the issue is, you need to regrow or at least remodel your brain. This is a long, slow, very poorly understood process, and it needs to be respected. 

[lionboy]

Alto I'll contact Healy and see what he thinks. Bubble, thanks for your post. I totally agree that the brain needs time and that just waiting does prevail. I've been in some pretty dark places and they always come to an end in time. I also subscribe totally to Rhi's post.

I've been off work now for nearly 3 months again and I'm fairly sure the position I am in at the moment is as a result of tapering too fast. Because citalopram causes me side effects now when stable at a dose I can't really control the rate of taper. As soon as I am stable I have a good week or 10 days then the side effects return and it's time to reduce again. I took 14mg off in 5 months and I guess I am paying for that progress now.

I worry that when I start tapering again I might not get far before this happens again and so on.

I think my work will only have so much patience.

 

If I could switch over to Prozac successfully then I might not have the same side effect issues and the rush to taper would be gone. I think in my heart that whatever anyone says no one really knows what would happen.

I could feel totally better tomorrow, start tapering again in the next couple of weeks and get the remaining 11mg done successfully in 5 months time. Who knows?

 

I will see what David Healy thinks. I saw Dr. Healy last year when at 25mg and whilst he is a cool guy and extremely clever even he had to admit that the more you know about these problems the more you realise there are no clear cut answers.

He termed my problem as tolerance however he couldn't advise a course of action. It was alto, skyler, Angie etc that correctly showed me the path forward I feel.

[btdt]

I would say no to prozac too...and not just because I have had a severe adverse reaction from it but because the fallout of that reaction lasted for years and was the reason I was given further drugs. 

 

When I was in tolerance the confusion my symptoms caused a break down in communications between a neurologist who said get off Effexor and a phsychiatrist who said don't get off Effexor... while they were debating I was stuck... I tried some of the things the neurologist said to do... stopped E and took some other drugs he gave me... ALL those drugs ever one of them made me worse... I tried to go back on a low dose of E and that too made me worse. 

 

There after I found most drugs some foods and supplements that did not bother me in the past now caused symptoms to get worse. 

 

I think there are things going on inside our bodies that are not understood or my experience stated above has lead me to believe this.  Had I found the information here early enough before I quit E and celexa ...yes for years I was on both at the same time... maybe I would not have been so long healing but it is hard to say.

 

Until some true studies are done on withdrawal ...and perhaps some new ways on studying what is actually going on inside the brain during withdrawal... this all we have... best guesses. 

 

I would not try prozac.  I know you think this is as bad as it can get I have thought that too in the past... I was wrong.  

I would stick with the devil you body knows. 

[lionboy]

Hi btdt (not sure that works as a name lol) but wise words I guess !

Prozac could be the worst thing I could do. I realise that, I just get down and frustrated. A quick fix always sounds good ....

I know this destabilisation won't last forever and then who knows ? I could get 11mg done in 5 months and be free ! I did 14mg in 5 months last year.

I think I will wait for this period of destabilisation to end and then see how my tapering goes. If I only down a mg or two and then get in a pickle again I may consider my options. If I get a significant chunk off again before a period of destabilisation then I guess that shows the way.

[btdt]

What what I have seen the lower you get the smaller the drops for some drugs ... read long ago this was a good idea as the drug changes how you liver works and the less you take the better it can work the more drug your getting into you system.. think that is how it goes...

old name from other sites means been there done that... was at the time looking for what was next had been drugged for 18 years thought I had done it all... was 8 months into cold turkey when I made that name up at my first withdrawal website years ago... it stuck.

[Altostrata]

Yes, any course of action is a gamble.

 

Perhaps you can ask Dr. Healy if he can recommend any colleagues nearer to you so you can partner with a doctor instead of taking the risk by yourself.