Jump to content

Mrs Scottly9999 : 60mg Citalopram and 200mg Tramadol HELP!


scottly9999

Recommended Posts

Hello Friendly people!

 

I just wanted to put this out there and ask for some advice on behalf of my lovely wife.

 

Very quick history of her.

SHe has suffered quite bad depression a lot of her earlier life.

She lost both parents by age of 16, and fell into deep depression.

By age 21 or so, she got herself together, got a job and started in a positive direction.

After her first marriage breakup, she went on 20mg of Citalopram, around year 2000.

I entered her life a little after this.

We moved out to Australia 2004.

I can't quite remember the situation, but she started getting depressed again, and went to a helpful doctor (ironically the same one that put me on Lexapro!!!)

She put her dose upto 40mg.

That seemed to help her.

After the birth of our daughter, she has had chronic back pain.  It's been 9 years now, and has slowly got worse and worse.

After MRI scans showed inconclusive information, but various issues, she was put on 200mg of slow release Tramadol to help manage the pain.

It does help her.

She was also put upto 60mg of Citalopram!  I beleive she was hitting "poop out" at 40mg, and was becoming more and more depressed more often.

 

I understand the maximum dose is 40mg.

She was advised to be tested for liver issues occassionally.

So far, her blood tests have been fine.

She suffers TERRIBLLY with side effects, night sweats, fatigue etc.

 

I also understand that Tramadol also acts as an SSRI!!!

So she is not only over the 40mg of Citalopram, but added 200mg Tramadol!!!

 

I fear that this situation isn't ideal and really needs to be addressed.

 

The GP's she has seen in the meantime give mixed messages about what to do.

 

If she lowers the dose to 100mg of Tramadol, she finds her back pain ALMOST unbearable.

 

She tried to lower her Citalopram to 50mg - by the 5th week she went into a VERY VERY deep depression, and immediately went back to 60mg, suffering with side effects.

She was fine for a good 4 weeks.  But 5th week hit her hard!

 

I fear that her dose is far too high.

Can she titrate to a different SSRI?

Is this something that can be done quite safely?  Can it be titrated to minimize side effects?

 

I'm very upset at the GP that put her on both Tramadol and the high level of Citalopram - she but me on Lexapro - which I'm still struggling to get off.

 

From a personal perspective, she is in a good place emotionally in her life, and recently discovered extra happiness through joining a church.

 

She feels trapped on her current medication, but the dose cannot stay that way.

She says she read something that said she can't swap SSRI's.  SHe is a bit reluctant to delve into this herself.

Even the pharmasist approached her and said that the combination she was taking, and the amount wasn't good for her heart or liver.

 

Any advise?

 

We are in Australia.

 

2008 (approx) Lexapro 10mg.  2009 attempted cold turkey 5mg for 2 weeks - crash and burn.  2009 back on 10mg.

2012 - pooped out - but didn't know.   2014 - poop-out got worse.  2014 sept 20mg, 2014 oct 15mg, 2014 nov 10mg

2014 dec 7.5mg,  2014 dec 23rd crashed.  Dec 24th 10mg - trying to stabilize

2015 Jan Stabilized as much as thought I would, 2015 Jan 9mg, 2015 Late Feb, 8mg, 2015 late Mar 7mg.  22nd May 6.3mg

2015 small "slide" down to 6mg.  19th June 5mg. 15th Aug 4.5mg - slid down to 4mg.  Sept 20th 3.8mg.

2015 gradual decrease between Oct and Nov 10th to 3mg:  Dec between 3-2mg.  2016 Jan15th 2mg  Feb: 1.8mg, somewhere got to 1.6mg.

2016 Feb 25th crashed!  Not sure if sick or WD, back to 2mg.

2016 During March - gradual decrease to 1.8mg, then 1.5mg.  April 19th 1mg

2016 June 8th 0.8mg   July 1st 0.6mg:  Sept 0.4mg (long hold)

2017 Jan 0.2mg

2017 May 0!!!!!!!!!!!!!!!  YAY

Link to comment
  • Moderator Emeritus

I put citalopram and tramadol into the drug interaction checker at www.drugs.com , and they have a serious major interaction. 

 

Some of the symptoms she is having may well be indicative of serotonin syndrome.

 

Decreasing citalopram from 60 to 50mg is almost double what this site recommends as safe.

 

I'm sure others will be along to make suggestions or comment on her best move from here.

 

:)

1987-1997 pertofran , prothiaden , Prozac 1997-2002 Zoloft 2002-2004 effexor 2004-2010 Lexapro 40mg

2010-2012Cymbalta 120mg

Sept. 2012 -decreased 90mg in 6months. Care taken over by Dr Lucire in March 2013 , decreased last 30mg at 2mg per week over 3 months. July 21 , 2013- last dose of Cymbalta

Protracted withdrawal syndrome kicked in badly Jan.2014 Unrelenting akathisia until May 2014. Voluntary hosp. admission. Cocktail of Seroquel, Ativan and mirtazapine and I was well enough to go home after 14 days. Stopped all hosp. meds in next few months.

July 2014 felt v.depressed - couldn't stop crying. Started pristiq 50mg. Felt improvement within days and continued to improve, so stayed on 50mg for 8 months.

Began taper 28 Feb. 2015. Pristiq 50mg down to 45mg. Had one month of w/d symptoms. Started CES therapy in March. No w/d symptoms down to 30mg.

October 2015 , taking 25mg Pristiq. Capsules compounded with slow-release additive.

March 2016 , 21mg

Link to comment
  • Moderator Emeritus

Hi Scottly, welcome to your wife, I'm sure she will be reading this along with you. Your wife is in the same situation as I was in, taking both effexor and tramadol which should never be prescribed together.  As your wife needs the tramadol for the pain it would be best to taper the citalopram.  If she tapers slowly and carefully she could start to feel better as the dose lowers, that is what happened for me, side effects are dose related, and depression is a side effect of anti depressants! 

 

We advise tapering no more than 10% of the current dose with 4 weeks between cuts. At 60mg that would be an initial cut of 6mg, if you are splitting pills it will be easier to cut by 5 mg for the first cut.  Citalopram is also  available in a liquid, or you can make a liquid easily from tablets. See tapering citalopram for details.....

 

http://survivingantidepressants.org/index.php?/topic/2023-tips-for-tapering-off-celexa-citalopram/page__pid__19887#entry19887it includes links to making your own solution for tapering.  Your wife may find that her pain reduces as she tapers, pain is a side effect too! 

 

We don't recommend switching drugs, it's better to taper from the one you are taking to avoid further problems. 

**I am not a medical professional, if in doubt please consult a doctor with withdrawal knowledge.

 

 

Different drugs occasionally (mostly benzos) 1976 - 1981 (no problem)

1993 - 2002 in and out of hospital. every type of drug + ECT. Staring with seroxat

2002  effexor. 

Tapered  March 2012 to March 2013, ending with 5 beads.

Withdrawal April 2013 . Reinstated 5 beads reduced to 4 beads May 2013

Restarted taper  Nov 2013  

OFF EFFEXOR Feb 2015    :D 

Tapered atenolol and omeprazole Dec 2013 - May 2014

 

Tapering tramadol, Feb 2015 100mg , March 2015 50mg  

 July 2017 30mg.  May 15 2018 25mg

Taking fish oil, magnesium, B12, folic acid, bilberry eyebright for eye pressure. 

 

My story http://survivingantidepressants.org/index.php?/topic/4199-hello-mammap-checking-in/page-33

 

Lesson learned, slow down taper at lower doses. Taper no more than 10% of CURRENT dose if possible

 

 

Link to comment

Thanks for the suggestions so far guys.

I think with my knowledge of what to expect in a taper, I get hit with EXCEPTIONALLY strong waves of fierce depression for 2-3 weeks about 4-5 weeks into my taper... but it passed.

and If I'm there for her, it'll help her to get through that nasty patch.

2008 (approx) Lexapro 10mg.  2009 attempted cold turkey 5mg for 2 weeks - crash and burn.  2009 back on 10mg.

2012 - pooped out - but didn't know.   2014 - poop-out got worse.  2014 sept 20mg, 2014 oct 15mg, 2014 nov 10mg

2014 dec 7.5mg,  2014 dec 23rd crashed.  Dec 24th 10mg - trying to stabilize

2015 Jan Stabilized as much as thought I would, 2015 Jan 9mg, 2015 Late Feb, 8mg, 2015 late Mar 7mg.  22nd May 6.3mg

2015 small "slide" down to 6mg.  19th June 5mg. 15th Aug 4.5mg - slid down to 4mg.  Sept 20th 3.8mg.

2015 gradual decrease between Oct and Nov 10th to 3mg:  Dec between 3-2mg.  2016 Jan15th 2mg  Feb: 1.8mg, somewhere got to 1.6mg.

2016 Feb 25th crashed!  Not sure if sick or WD, back to 2mg.

2016 During March - gradual decrease to 1.8mg, then 1.5mg.  April 19th 1mg

2016 June 8th 0.8mg   July 1st 0.6mg:  Sept 0.4mg (long hold)

2017 Jan 0.2mg

2017 May 0!!!!!!!!!!!!!!!  YAY

Link to comment
  • Moderator Emeritus

If she feels withdrawal it means the cuts are too big, some mild withdrawal for a few days after a cut is normal but any more means they are too big, if that happens then just make the following cuts smaller. A micro taper might be better if there are any symptoms. , it's smaller cuts but more often. I wish I had done this with my taper!  http://survivingantidepressants.org/index.php?/topic/2878-micro-taper-instead-of-10-or-5-decreases/

**I am not a medical professional, if in doubt please consult a doctor with withdrawal knowledge.

 

 

Different drugs occasionally (mostly benzos) 1976 - 1981 (no problem)

1993 - 2002 in and out of hospital. every type of drug + ECT. Staring with seroxat

2002  effexor. 

Tapered  March 2012 to March 2013, ending with 5 beads.

Withdrawal April 2013 . Reinstated 5 beads reduced to 4 beads May 2013

Restarted taper  Nov 2013  

OFF EFFEXOR Feb 2015    :D 

Tapered atenolol and omeprazole Dec 2013 - May 2014

 

Tapering tramadol, Feb 2015 100mg , March 2015 50mg  

 July 2017 30mg.  May 15 2018 25mg

Taking fish oil, magnesium, B12, folic acid, bilberry eyebright for eye pressure. 

 

My story http://survivingantidepressants.org/index.php?/topic/4199-hello-mammap-checking-in/page-33

 

Lesson learned, slow down taper at lower doses. Taper no more than 10% of CURRENT dose if possible

 

 

Link to comment

Hi Guys - thanks for the advice.

All good.

 

I was also wondering, how she could maybe transfer to another brand or similar?  

 

I'm worried about the high dose she's on and pooping out again.

I understand (having read an awful lot myself) that it's a bit of pot luck and she might end up on the "med-go-round".  She does say that being on Citalopram has definitely helped her for sure.

2008 (approx) Lexapro 10mg.  2009 attempted cold turkey 5mg for 2 weeks - crash and burn.  2009 back on 10mg.

2012 - pooped out - but didn't know.   2014 - poop-out got worse.  2014 sept 20mg, 2014 oct 15mg, 2014 nov 10mg

2014 dec 7.5mg,  2014 dec 23rd crashed.  Dec 24th 10mg - trying to stabilize

2015 Jan Stabilized as much as thought I would, 2015 Jan 9mg, 2015 Late Feb, 8mg, 2015 late Mar 7mg.  22nd May 6.3mg

2015 small "slide" down to 6mg.  19th June 5mg. 15th Aug 4.5mg - slid down to 4mg.  Sept 20th 3.8mg.

2015 gradual decrease between Oct and Nov 10th to 3mg:  Dec between 3-2mg.  2016 Jan15th 2mg  Feb: 1.8mg, somewhere got to 1.6mg.

2016 Feb 25th crashed!  Not sure if sick or WD, back to 2mg.

2016 During March - gradual decrease to 1.8mg, then 1.5mg.  April 19th 1mg

2016 June 8th 0.8mg   July 1st 0.6mg:  Sept 0.4mg (long hold)

2017 Jan 0.2mg

2017 May 0!!!!!!!!!!!!!!!  YAY

Link to comment
  • Administrator

Sorry, we can't advise on drug switches for the purpose of fine-tuning a cocktail.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Link to comment

Hi Altastrata.

 

Sorry - I didn't mean to offend or break any rules.

I guess I'm after other people's experiences of a similar situation.

2008 (approx) Lexapro 10mg.  2009 attempted cold turkey 5mg for 2 weeks - crash and burn.  2009 back on 10mg.

2012 - pooped out - but didn't know.   2014 - poop-out got worse.  2014 sept 20mg, 2014 oct 15mg, 2014 nov 10mg

2014 dec 7.5mg,  2014 dec 23rd crashed.  Dec 24th 10mg - trying to stabilize

2015 Jan Stabilized as much as thought I would, 2015 Jan 9mg, 2015 Late Feb, 8mg, 2015 late Mar 7mg.  22nd May 6.3mg

2015 small "slide" down to 6mg.  19th June 5mg. 15th Aug 4.5mg - slid down to 4mg.  Sept 20th 3.8mg.

2015 gradual decrease between Oct and Nov 10th to 3mg:  Dec between 3-2mg.  2016 Jan15th 2mg  Feb: 1.8mg, somewhere got to 1.6mg.

2016 Feb 25th crashed!  Not sure if sick or WD, back to 2mg.

2016 During March - gradual decrease to 1.8mg, then 1.5mg.  April 19th 1mg

2016 June 8th 0.8mg   July 1st 0.6mg:  Sept 0.4mg (long hold)

2017 Jan 0.2mg

2017 May 0!!!!!!!!!!!!!!!  YAY

Link to comment
  • Administrator

No offense taken. We simply can't advise on that.

 

She is in a pickle, though. It's not good to stay in a state of adverse drug reactions.

 

Please see Tips for tapering off Celexa (citalopram)

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Link to comment

Please sign in to comment

You will be able to leave a comment after signing in



Sign In Now
×
×
  • Create New...

Important Information

Terms of Use Privacy Policy