☼ lionboy: protracted withdrawal from citalopram

[lionboy]

Thanks sky it means a lot. I just hope and pray this is just part of the shelf and it will sort itself out. In my less desperate moments my rational says that it is.

I went down from 25mg to 11mg reasonably smoothly in 5 months and for the most part had a really good quality of life doing it.

I then hit this big patch of problems which Healy calls a shelf and he has published documents on it so it did not surprise him when I have relayed my problems.

The fact that this shelf has gone on for 5 months and that I seem to be getting the worst of it now is very disheartening.

Healy writes that people commonly hit shelfs at quite high doses such as 12 - 15mg Prozac (I'm at 11.25mg citalopram) and then have smooth sailing down to 1or 2mg before they hit another shelf.

That is reassuring if I can get past this point.

[Altostrata]

Stay calm, LB. You will get past this.

Please do share the document with everyone. Can you start a topic in Tapering?

If you click on the More Reply Options at the bottom of a post, you will see options to attach a document or image.

[lionboy]

I'm trying to stay calm but this latest development has got me really scared as I can't see the way out unless it stops very soon.

It's 12 days now of not being able to relax, struggling to eat and sleep.

Prof Healy has basically just reffered me back to my GP.

He suggested I take his document with me. The only outcome I can see from that is a course of benzos.

I couldn't sleep properly last night and was so anxious I couldn't face going to the gym.

I know if I don't go to the gym my symptoms will just get worse.

I took a 2mg diazepam this morning (which my dad gave me. He has them for very occasional use.)

I was then able to go to the gym. That started to wear off this afternoon so I took another 2mg.

The agitation has gone for the first time in 12 days.

This is the only thing that has brought me any relief, except a very small relief for the first couple of days when I tried a 1mg reduction. By day 5 it was clear the reduction was not what my body wanted and I fear if I had persevered it would have just got worse.

Healy seems to think this is part of a shelf that will pass.

I am so worried now. I can't face many more days of such agitation and I am scared by what I have read from skyler that even a week of diazepam could lead to addiction.

I really don't know what to do ?

[Skyler]

I am so worried now. I can't face many more days of such agitation and I am scared by what I have read from skyler that even a week of diazepam could lead to addiction.

I really don't know what to do ?

You would probably be okay if you took one dose a day for a week. I'd think the larger problem with doing this would be rebound symptoms. I'd hate to see you get into that.. and though I'm the last one to recommend benzos, maybe 2 or 3 doses a week, for the next couple of weeks might get you over the hump?..

 

S

[lionboy]

Thanks sky x

[btdt]

I would suggest taurine... amino acid 500mg NOW brand... take a very small amount 1/4 capsule to test. 

I have had issues with about every other supplement but this one. Maybe some others will have some thoughts about it. 

 

You can find information on this site about it or you can read this link...

http://www.rlcure.com/glutamate2.html

I cannot recommend any other supplement but this one... tho I know the article mentions others.

peace

[lionboy]

Thanks for the suggestion btdt.

[btdt]

Your welcome so far it is the only thing that has helped me that I did not react to and I have tried a LOT of things have a cupboard full of things I cannot tolerate. Still because of the reactions I have had I take a small dose as needed to treat symptoms - only when I have symptoms I up the dose by 1/4 capsule increments until I feel better... waiting after each dose.  I don't touch it again until I need to control symptoms again.  There are some here using 2 500mg capsules a day.  I would never suggest starting any supplement full dose.  A reaction can take a long time to go away... I have great respect for the power of supplements and how touchy my system is start small and move ahead slowly if you decide to try it. 

[lionboy]

Just a quick update to my situation and a shout out to skyler / alto and anyone else with benzo experience.

The Doctor prescribed me a 10 day supply of diazepam 4mg (2 x 2mg tablets) on top of the 13 x 2mg tablets my dad gave me.

I was honest with her regarding what my dad had given me.

She said I could do 2 x 2mg per day if required for 2 weeks and that I could go back for another 7 x 2mg tablets (in order to do one a day for a week) if required.

 

I have taken 26 x 2mg tablets over an 18 day period with 2 days off along the way.

To start with I was doing 2 x 2mg per day and then mostly went to 1 x 2mg per day.

I found them to be a massive help to be honest and they certainly got me out of my desperate state.

To be honest I think I took one some days when I maybe could have possibly done without.

 

I decided on Sunday that I now need to stop taking these diazepam before they become a whole new issue.

I didn't take one on Monday and felt ok ish. A bit up and down and anxious etc.

On Tuesday I started to feel panicked as if the old ssri problem was coming right back so I took a 2mg diazepam which calmed me for the day.

I didn't take any diazepam yesterday and I felt very up and down. Good in parts a bit panicked in others.

Again today I have not taken a diazepam and I have had a slightly worse day than yesterday feeling very up and down. A bit panicked at times but with it usually passing within the hour etc.

Overall I feel a bit uncomfortable etc similar to the original ssri problem but less severe.

 

Am I likely now having to deal with the original ssri problem without the support of the diazepam or would I likely also have some rebound anxiety from my diazepam use ?

Is 2 or 4 mg per day of diazepam over 2 weeks ish enough to give a bit of a rebound and if so, how many days should I expect this to last.

As always, everyone's help is greatly appreciated.

[Skyler]

Am I likely now having to deal with the original ssri problem without the support of the diazepam or would I likely also have some rebound anxiety from my diazepam use ?

Is 2 or 4 mg per day of diazepam over 2 weeks ish enough to give a bit of a rebound and if so, how many days should I expect this to last.

As always, everyone's help is greatly appreciated.

Hi Lion... Impossible to know for sure, but it's a possibility. Because of diazepam's long half life, getting symptomatic on the second day would seem to be evidence this is happening. Glad you had something of a respite though, you surely needed a break.

[lionboy]

Thanks for the response sky. If I am experiencing a bit of a rebound, likely how long would that take to pass ?

[Skyler]

Thanks for the response sky. If I am experiencing a bit of a rebound, likely how long would that take to pass ?

I'm not sure .. it's a slippery slope from rebound into taper territory. If it takes longer than you can reasonably tolerate, you may need to taper. And you may want to do that in any case.. but you could probably come off more in stages than a full taper.. Reduce by 25% for a few days and see if that takes care of the symptoms. If you are okay after that, go for another 25% reduction.

[lionboy]

It's really hard for me to tell exactly what's happening sky ?

My last diazepam was 2.30pm on Tuesday. Felt fine Tuesday then Wednesday I was up and down, same thurs and same so far today.

Possibly Thurs was a bit worse than Weds, too early to really tell today in comparison.

It's like my original panic and agitation that I experienced before the diazepam comes back but not on a constant basis.

It starts to come, sometimes stays maybe an hour then an hour later I feel relatively ok. I have had a few patches of feeling really o.k.

Sometimes I'm up and down up and down within the same hour.

I'm not suffering unbearably like I was a few weeks ago, I'm sleeping o.k and just about functioning.

If it was simply the ssri problem, how long after taking the last diazepam would they stop masking it ?

That is to say after 2 weeks of diazepam use how long after the last dose are you still getting a therapeutic effect ?

(Just to say, sky you are a great help to me).

[Northcoastboy]

hi lionboy

 

I'm down to 2.5mgs of Citalopram and suffer these same issues as you. I have resisted sleepers and benzos. They are worse or as difficult to get off as Citalopram.

 

The answer to the benzo question above was answered in your journal on Posted 28 January 2013 - 03:11 PM by starlitegirlx

 

I use mindfulness and abdominal breathing to try and control my anxiety. It works. The majority of the time anyway. It lessens the waves. Makes the whole process more managable.

 

Heres a link to Ruby Wax talking about it.

 

[Skyler]

If it was simply the ssri problem, how long after taking the last diazepam would they stop masking it ?

That is to say after 2 weeks of diazepam use how long after the last dose are you still getting a therapeutic effect ?

(Just to say, sky you are a great help to me).

The half life of diazepam (proper) is 2 days. The half life for the active metabolites kicks in at 4 days and lasts up to 200 hours. The WD Sx of benzos are often the same (or worse... does not sound so in your situation) as those you originally took the drug for. You are not having insomnia which is very big. But the way you describe symptoms kind of sputtering on and off... some of that could be benzo WD, but this does not sound major.

 

You have so much CNS sensitization it would be surprising if there was absolutely no sequella to stopping. But again, what you are describing sounds relatively minor.. as all things benzo go.

 

http://www.benzo.org.uk/ashvtaper.htm

[lionboy]

Hi Northcoastboy

Thanks for sending me that message. I have re read starlightgirlx's post from jan 13, which warns of the dangers of adding in a benzo, I am not sure how that answers my current question ?

Are you suggesting I am having benzo withdrawal after using them for 2 weeks or warning not to continue using them ?

Like you I had thus far resisted using benzos or sleepers and have managed to get from 50mg 2007 to 11.25mg today riding the waves naturally so to speak. Whatever suddenly happened to me a few weeks ago was more terrifying than anything that has happened before. I was so agitated I couldn't sleep or get any rest bite.

In desperation I decided to do diazepam for a very short time as a last resort despite understanding the dangers.

I am now nearing the end of day 3 without taking any diazepam and have only taken 1 x 2mg tablet in the last 5 days.

I am not in a good place but I am not as bad as when I started taking the diazepam. What I really want to understand is whether I am now dealing with the original ssri problem or if I'm likely having rebound problems from diazepam and if so what to expect from that really ?

 

Good luck to you mate as well in your battle !

[lionboy]

Hi Sky

Thanks again !

As mentioned, I am nearly through day 3 with no diazepam having only done 1 x 2mg in the last 5 days.

As you say I have had no insomnia since stopping the diazepam.

If I was to suffer rebound problems from the diazepam would I likely be in the thick of it by now ?

I am coping so far just not having much fun with my symptoms going up and down all the time.

It is similar to before I took the diazepam just not as bad and not as constant.

Is my best best to now tough it out and leave the diazepam alone ?

Whilst I understand what half life etc means, I don't know how that translates to the effect it has on us ?

I guess what I really fear is the problems getting worse as the diazepam leaves my body, like the worst is to come ?

Is that likely ?

[Northcoastboy]

I can only talk from experience. When I have short term use 7 days etc I had no problem stopping Valium. I was just concerned that you were swapping one problem for another and trying to give you an alternative to using them in mindfullness .

I had a massive panic attack a few nights ago that literally scared the s..t out of me. It sent me into depression. But I'm improving. Had a good day today. The ruby Wax clip really hit the spot for me. During the day I practice mindfullness.

You could also look up john kabat Zin on you tube.

Good luck to you as well. We can do this.

[lionboy]

I see. Yes, thanks for the concern.

As you say starlight girl warned me in no uncertain terms regarding benzos also Skyler had me well prepped on the dangers of benzos and I really never thought I would use them but what happened a few weeks ago was off the scale !

Hopefully now I can push on without them and leave that episode behind me.

I've never felt that out of control. Scary **** !

We can all get there in the end I hope and should certainly be better people for it !

Good luck to you mate. Thanks for the info.

[Skyler]

If I was to suffer rebound problems from the diazepam would I likely be in the thick of it by now ?

 

I am coping so far just not having much fun with my symptoms going up and down all the time.

It is similar to before I took the diazepam just not as bad and not as constant.

 

Is my best best to now tough it out and leave the diazepam alone ?

 

Whilst I understand what half life etc means, I don't know how that translates to the effect it has on us ?

I guess what I really fear is the problems getting worse as the diazepam leaves my body, like the worst is to come ? Is that likely ?

I think so.. though benzos are tricky. BUT you were not on all that long, so you should be okay.

 

Half life is no biggie in this instance, stop worrying about it. It's academic at this point in any case.

 

Sounds like the symptoms you took diazepam to quell may be waning somewhat. How about checking out some of the strategies NCBoy suggested? Even if they don't make you 'better', they are a way to refocus your energy.. so no matter what they would be a win! :-)

 

I wouldn't. It sounds like you started to become symptomatic when the dose was interrupted which does not bode well if you resume.

 

I can't answer that.. the fact your symptoms are somewhat better now than before you started taking diazepam argues against a significant benzo uptick in future. But LB, I do not have a crystal ball, nor for that matter do you. All you can do is wait, and put that considerable mind of yours to another activity/concern.

[lionboy]

Thanks Sky x

Tough times at the moment ....

[lionboy]

I have now not taken any diazepam since last Tuesday. Today is day 6 without it !

I don't seem to have suffered any ill effects from the short course I took (I don't think ?)

I think I am now dealing with the ssri shelf problems unaided.

This is not much fun still and I go up and down all the time.

I seem to be worse for the first couple of hours after I wake up (although not that significantly).

I am sleeping fine and managing to eat now. I seem to be either reasonably relaxed, or tense and irritated. At some points I feel cold and anxious.

The worst feeling is that my head is blocked and I can't feel relaxed and normal.

It's like I want to do things yet when I try they stress me out and I get really tense and aggravated.

My family seem to think I am improving however, as you guys on here will probably understand, it's hard to acknowledge feeling any better until you feel better better.

I have 7 diazepam tablets in the house and whilst I get tempted everyday to pop one and have a day off from the stress (she certainly is a temptress) I have been strong and left them in the cupboard.

I am assuming now that 6 days out the diazepam is no longer having any effect on me and that any chance of symptoms from stopping them are now behind me ? (Sky).

It's only a few weeks since I was climbing the walls in desperation so I guess I must be improving.

Like everything with ssri withdrawal it is slow going !

 

A massive thank you to everyone who replies to me and tries to help. Particularly Alto and Sky, I'd be lost without you guys x x

[Northcoastboy]

Well done Lionboy

First 2 hours are worst for me as well.

Just had a bad wave myself.

Hang in there re Valium

[lionboy]

Thanks mate.

[Rhiannon]

Sounds like you've gotten past the Valium withdrawal. I would be very careful with it in the future. We often find that people can go on and off a psych drug a few times okay and then the third or fourth time or whatever, wham, they get slammed with withdrawal. 

 

Two weeks of daily use of any benzo is enough to produce at least some dependence and withdrawal. It sounds like you came through yours fairly smoothly though. Just be careful with future use. I wouldn't take Valium more than once a week.

[Rhiannon]

By the way, have you seen these charts? 

http://survivingantidepressants.org/index.php?/topic/6036-why-taper-paper-demonstrates-importance-of-gradual-change-in-plasma-concentration/

The charts start on about page 4. 

 

You can see clearly why tapering gets more challenging as you get to lower doses. If you've been tapering by 1 mg increments, those increments are probably too large now. It's safer to taper by a percentage of your current dose, so that you actually make smaller and smaller cuts the lower your dose gets.

[lionboy]

Hi Rhi

Thank you for your comments. I am certainly very wary of the Valium and am resisting the urge to take it. Would using it once a week or less be safe ?

And by once a week do you mean one dose per week or one day per week at maybe 2 x 2mg per day ?

I really don't intend to establish any kind of regular usage pattern with it however it would be nice to have the occasional day with it, like next Sunday for instance which is my daughters birthday.

I would prefer to leave it alone completely if possible. Hopefully this bad patch I am in will not last much longer.

 

I have seen the charts and I completely accept the logic with regard to the 10% taper method.

As I have never tapered a drug to zero I don't feel as qualified as some to comment on the relevance of the graphs. Does it really get harder and harder the lower you get ?

Have people found that tapering from 10mg to 5mg is significantly harder than say 15mg to 10mg ?

I have limited experience of tapering as i went from 50mg to 25mg via a haphazard series of big cuts and reinstatements and spent a few years in total carnage.

My only tapering experience is last year going from 25mg to 11.25mg via predominantly 1mg cuts.

As I suffer serious side effects once stable on a dose I have to balance my taper with the emergence of the side effects.

My pattern was cut 1mg, have a day or two of turbulence followed by roughly 7-10 pretty decent days followed by the reemergence of the side effects and then another cut.

On three occasions I tried to cut by less than 1mg and in every case it produced up to 3 good days followed by side effect reemergence.

This meant the need to then cut again.

At 23mg I tried a half mg cut which gave 3 days ok then side effects so i did another half mg cut which produced one good day and then side effects the following day. I then did a 1mg cut which destabilised me for a week or so before the 1mg pattern resumed ?

At 16mg I tried to cut by 0.75mg which gave me 4 decent days and then side effects. I then had to cut again 1mg, meaning I had chopped off 1.75mg in 5 days and this destabilised me for nearly a month.

My experience so far is almost as if I need a 1mg cut to halt the side effects for a reasonable period of time ?

I'm really at a loss to explain it ?

If you consider it purely in terms of percentage the 0.75mg from 16mg is 4.68%. A 1mg reduction from 21mg is 4.76%.

Percentage wise these two reductions are almost identical yet behaved very differently as described above.

I can only share this as my experience ? It really has me baffled ?

Incidentally a 1% reduction from say 14.25mg to 13.25mg behaved pretty much the same as all the other 1mg cuts despite it being 7% against earlier 1mg cuts being 4%.

I agree with Alto that the SERT graphs are indicative however I think they are unlikely to provide the full picture of what is happening.

I feel that I am just trying to work it out as I go, of course with great support from this site.

Professor Healy refers to people hitting shelves during taper and this seems to tie in with what has happened to me at this stage. I went from 13.25mg to 12.25mg with minimal issue and then went from 12.25mg to 11.25mg and that caused 6 months of extreme problems so far !

I would find it very hard to attribute that to the % difference of those cuts.

[Petunia]

I agree with Alto that the SERT graphs are indicative however I think they are unlikely to provide the full picture of what is happening.

 

 

Hi Lionboy, I agree with you that its more complicated than what these graphs suggest.  The human body/mind system is such a complex entity, and each one is unique.  I don't think any theory, graph or model will ever be able to show exactly what's happening when foreign/toxic substances get added/subtracted.  The best we can do is follow what seems to have worked best for most people in the past, adjusting it to our own changing patterns and symptoms as we go.

 

I am certainly very wary of the Valium and am resisting the urge to take it. Would using it once a week or less be safe ?

And by once a week do you mean one dose per week or one day per week at maybe 2 x 2mg per day ?

I really don't intend to establish any kind of regular usage pattern with it however it would be nice to have the occasional day with it, like next Sunday for instance which is my daughters birthday.

 

 

I have some experience with xanax, another benzo, while being in withdrawal.  Before being in withdrawal (destabilized nervous system), I used to be able to take the occasional xanax, maybe one a month with no problem.  I hardly ever did, but taking one to help me get through a temporary stressful situation caused no problems.  But now, if I took one, I would experience extreme rebound anxiety, much worse than any anxiety it would relieve, so I don't even consider it.

 

I doubt there is any chance of becoming dependent on valium by taking it once per week, but you may experience the same kind of paradoxical effect from it that many do in our situation.  You might decide its worth the risk in certain circumstances.  But for me, its no longer an option because I know how bad I'm going to feel a few hours later and probably for the next few days.

 

Valium may be slightly different from xanax, because it has a longer half life. 

[lionboy]

Thank you Petu. I've certainly taken on board your cautionary words !

[lionboy]

This last couple of days I seem to be slipping back to how I was before the diazepam. Yesterday was not a good day and today seems worse.

Sunday was my best day lately (excluding days on diazepam).

I am worrying that I am now slipping back to the state I was in before.

As my last dose of diazepam was last Tuesday, surely that would not still have been propping me up on Sunday would it ?

I felt windows of improvement through Friday, Saturday and then Sunday but feel like I have slipped back since then.

 

I feel really worried.

[lionboy]

I am getting really worried now, I don't know what to do ?

The last few days feel like they are getting progressively worse. I feel almost back where I was a few weeks ago now.

I can't eat again and am feeling more and more uncomfortable and anxious.

I need to go to the gym today and I just can't get off my bed.

I have done another 2mg diazepam.

I am really scared about what is happening to me.

It's 6 weeks now since these bad symptoms took hold of me.

After I stopped taking the diazepam last Tuesday I seemed to be ok for the next 5 or 6 days. Not good, very up and down but I felt I could cope like the worst of it was behind me.

These last few days I seem to have just slipped back to how I was.

I am really scared now. I'm not sure how much longer I can take this.

[MaryKA]

Hi Lionboy, I see you are in the UK, so instead of cutting pills or skipping days to 'reduce' your dose, how about being prescribed the liquid prep? (sorry if this has been said already) The liquid comes in a pretty hefty concentration with a dripper (40 mg/ml and yuk, yuk to the dripper) so I make a 1 in 40 dilution in a separate bottle, to give 1 mg/ml, and use a 10 ml syringe to measure how many mg I want. That gives me great control on my dose level (eg I could get 5.7 mg (5.7 ml) accurately) and so I take my drug daily.

 

I am sorry you are having such a hard time. My symptoms were mild as they were the first time and somewhere from this forum I've learnt that we get sensitized to wd the more we have wd. If you haven't already got the liquid, it will help to maintain a stable dosing regime. I have never used a pill cutter and I have seen how even a sharp knife cannot do the job accurately (or even reliably inaccurately :-|) 

 

PS I got my liquid while I was in Scotland: just said to my doctor that it would be best and explained how I would manage my own dosing right down to the nitty gritty detail of what I've just said. Since then I've moved to England and have yet to see new doctor...

 

PPS I also wonder about getting down to zero. After all, x% of something is always something :-|

[lionboy]

Hi MaryKA

Thanks for your message !

I am really struggling at the moment.

With regard to dosing, I am already using liquid as I dissolve my tablets in water and dose using a syringe as per Rhi's method. I did try the actual liquid citalopram in the past but I found the doseage did not translate accurately from pills to liquid.

Rhi's method is spot on and I had good success with it last year before this problem patch / shelf that I am in now.

[lionboy]

Is this akathisia ?

I have now slipped back to how I was a few weeks ago.

This episode has now lasted nearly 6 weeks.

I am severely anxious, agitated and panicked. I can't sleep properly, I can't eat and I keep crying all the time.

I really am desperate now and just don't know what to do ?

Other than dosing with diazepam I can't get any relieve. I literally lay on my bed in a cold sweat then get restless and have to be sick / reach in the toilet then back to laying on my bed.

When I take my dose of citalopram in the morning I can literally feel the symptoms ramp up over the next hour or so.

I recently tried a 1mg reduction and that brought immediate relief, however by day 5 I was starting to feel worse with withdrawal.

I really don't know what to do.

Can anyone advise ? Alto ?

[lionboy]

Even taking diazepam today has not helped.

I feel my only option is to do another reduction in the morning.

How long do people think it can take before you can really tell if a reduction is successful ?

 

I tried a 1mg reduction a few weeks ago and these terrible symptoms immediately subsided however by day 5 I reinstated the dose as the withdrawal did not feel good. Should I try again and persevere longer this time ?

[Jemima]

I'd like very much to help, but I'm not clear on where you are now and it's difficult to piece the context together by reading back through your thread. The history in your signature ends with 11.25 mg. of Citalopram (I think) at the end of this past December.

 

Some questions:  what dosage are you on now and how long have you been at that dosage? How often do you take Valium and at what dosage?  How long have you been taking it?

 

Without knowing more, I can't even take a good guess at whether your current symptoms are antidepressant or benzo related, or just part of your own withdrawal. Sometimes the withdrawal alone can be excruciating.  Have you read this topic?  The Windows and Waves Pattern of Recovery  Most of us have experienced that sensation of being back right where we started during the withdrawal process, although just because we felt that way didn't make it true.

 

Given your past history of antidepressant and street drug use, it would probably be best if you could possibly hold where you are until we can figure things out. Changing the dosage over and over every few weeks only adds to the pain of withdrawal.