ChanceLucky: Antidepressant withdrawal, social anxiety, & pessimism

[ChanceLucky]

Actually, if I am experiencing a Celexa - Benadryl interaction, I wonder if I can lower the Celexa dose and the interaction would decrease or go away. I wonder if I should lower the Celexa dose from 0.5 ml to 0.4 or 0.3 ml. Or would making yet another change be the worst thing to do? It's puzzling that I didn't have any of these issues before May when I was taking Benadryl and the same Celexa dose. But it might mean that if I just leave things alone eventually my brain will adjust and get back to how it was before. Can a drug interaction just go away after the body adjusts?

[DMV64]

Hello ChanceLucky!

I used to take benedryl at night and it did seem to exaggerate the effects of my other meds at night. I was very sluggish in the morning. Not sure if it would do that with Celexa....

[ChanceLucky]

3 minutes ago, DMV64 said:

Hello ChanceLucky!

I used to take benedryl at night and it did seem to exaggerate the effects of my other meds at night. I was very sluggish in the morning. Not sure if it would do that with Celexa....

Yeah, that may be what's happening now. I once tried to taper the Benadryl and the results were bad. I've been on it a long time and I'd need to taper it slowly. Gosh, I think I'm having a bad Benadryl - Celexa interaction but I don't think I can just stop or quickly taper either one. I'm happy I'm at least functioning adequately but I don't really know what to do in this situation.

 

And I'm pretty sure the hand tremor is unrelated to the Benadryl. That's a separate issue. It's still worrisome but right now I'm more concerned with my attention, concentration, and energy. I want to be able to drive again.

[ChanceLucky]

Actually I wonder if it's not a Celexa/Benadryl interaction. I'm taking the Benadryl at around 9 PM and the Celexa around 6 AM. I'm seeing all sorts of conflicting information about Benadryl's half life but I think at least half and probably more of it must be out of my system by the time I wake up. I've actually never felt drowsy in the morning. I've always felt as though the Benadryl was entirely out of my body by then. Still if there's a small amount of it left and Benadryl in my body, maybe they are interacting.

[apace41]

Chance,

 

Any or all of these are possible.  It is very hard to say what is causing what which is why we try to keep members to switching one variable at a time in the hopes of measuring their reaction to the changes.  It's not perfect but it's better than any other method we know of.  Not to scare you but the Benadryl alone can be a very potent and dependency-forming medication.  See the following:

 

https://drugabuse.com/hooked-on-benadryl-its-much-more-than-a-harmless-dependency/

 

So, it is hard to know what is the cause of your recent slipping.  It could be Celexa, it could be Benadryl or it could be their interaction.  Or, to be honest, it could be just about anything else in your life (food, stress, exercise) that has recently changed or otherwise pressured your overall body systems.  

 

The best bet for now in my view is to try not to overreact and feel the need to make a "change for the sake of change."  Give it several days and see if this simply settles down and returns to baseline.  If by middle of next week you are still struggling, or if you see a noticeable decline, we can discuss making a change, but since things were basically working I'd be inclined to do less rather than more.  

 

And put a note in your "taper file" that you will need to take a slow and careful taper at some point to get off the Benadryl at night wagon.  That is not something that you should think is okay just because it is sold OTC.  The Celexa is a bigger fish to fry but I'd want the smaller fish downstream (see what I did there? ) as well.

 

Best,

 

Andy

[ChanceLucky]

49 minutes ago, apace41 said:

Chance,

 

Any or all of these are possible.  It is very hard to say what is causing what which is why we try to keep members to switching one variable at a time in the hopes of measuring their reaction to the changes.  It's not perfect but it's better than any other method we know of.  Not to scare you but the Benadryl alone can be a very potent and dependency-forming medication.  See the following:

 

https://drugabuse.com/hooked-on-benadryl-its-much-more-than-a-harmless-dependency/

 

So, it is hard to know what is the cause of your recent slipping.  It could be Celexa, it could be Benadryl or it could be their interaction.  Or, to be honest, it could be just about anything else in your life (food, stress, exercise) that has recently changed or otherwise pressured your overall body systems.  

 

The best bet for now in my view is to try not to overreact and feel the need to make a "change for the sake of change."  Give it several days and see if this simply settles down and returns to baseline.  If by middle of next week you are still struggling, or if you see a noticeable decline, we can discuss making a change, but since things were basically working I'd be inclined to do less rather than more.  

 

And put a note in your "taper file" that you will need to take a slow and careful taper at some point to get off the Benadryl at night wagon.  That is not something that you should think is okay just because it is sold OTC.  The Celexa is a bigger fish to fry but I'd want the smaller fish downstream (see what I did there? ) as well.

 

Best,

 

Andy

Thanks, Andy. Yeah, I'm well aware of the dangers of Benadryl. That's scary too. I got on all this stuff like 20 years ago when doctors just told me to take a pill for everything, and getting off is remarkably hard. I tried once with the Benadryl. It's a powerful drug even if it's OTC. I think any drug that's intended to make you drowsy must be doing powerful stuff to the brain.

 

I think you're right about not changing the dose right now. Do you think I should not change the time of day either for the Celexa? Maybe just leave everything alone for a while and hope for the best?

[DMV64]

I also am surprised or was blissfully unaware of how powerful benedryl is

[apace41]

49 minutes ago, ChanceLucky said:

I think you're right about not changing the dose right now. Do you think I should not change the time of day either for the Celexa? Maybe just leave everything alone for a while and hope for the best?

 

Yes.  That would be my plan.  Hold where you are for a minimum of a week to see if thing sort out.  As I said:

 

1 hour ago, apace41 said:

Give it several days and see if this simply settles down and returns to baseline.  If by middle of next week you are still struggling, or if you see a noticeable decline, we can discuss making a change, but since things were basically working I'd be inclined to do less rather than more.

 

Best,

 

Andy

[ChanceLucky]

My anxiety is better and I'm not having the balance/unsteadiness feeling. But my attention impairment is really concerning. I briefly tried driving but it was like I was staring and my mind was blank or zoned out. I made a small driving mistake that I normally wouldn't have also. So no driving for a while. When I watch TV, I'm zoned out too. My attention just isn't right. My hand tremor is about the same. I'm getting a ride into work but work is going well. Getting rides is humiliating though. It makes me feel like I'm not a fully functioning adult.

 

I talked with Dr. Ira Steinman, a psychiatrist in California who is on this forum's list of recommended doctors. On the one hand, he was helpful in pointing out that my Wellbutrin may be contributing to my anxiety. He did suggest getting off it eventually. Alto pointed this out to me when I first joined in 2012 but I wasn't thinking about it. On the other hand, Dr. Steinman suggested that I *increase* the Celexa dose. He felt it would help me with my anxiety and felt the side effects I'm experiencing now might go away. I definitely don't plan to increase any psychiatric drugs, though. I guess my plan is to just keep everything the same for at least a little while longer and then reassess things. 

 

Dr.. Steinman explained that he believes in getting people off anti-psychotic drugs but is not worried about antidepressants. I might add this info. in the thread on recommended doctors so that other people know this.

[ChessieCat]

23 minutes ago, ChanceLucky said:

Dr.. Steinman explained that he believes in getting people off anti-psychotic drugs but is not worried about antidepressants. I might add this info. in the thread on recommended doctors so that other people know this.

 

Yes good idea.

 

24 minutes ago, ChanceLucky said:

I definitely don't plan to increase any psychiatric drugs, though

 

Pleased to read this.

[ChanceLucky]

Well, I'm definitely not getting better. I want to give an update and ask a few questions. I see now that the unbalance/disequilibrium issue I wrote about a while ago seems to happen if I jog on the treadmill. I still have the tremor and attention and concentration difficulties. I also at times have a very mild head or leg twitch. It's very mild and not even enough to really worry me though. The attention issues and unbalance are the most concerning.

I talked with Dr. Stuart Shipko in California - a psychiatrist who is well known for writing about the toxicity and problems of SSRIs. He basically thinks I need to get off and he thinks I'm on a low enough dose that I don't need to taper. (And he usually recommends a 5 or 10% a month taper from what I've read.) I told him that scared me and I'd feel more comfortable tapering, and he said that was fine. He also said that for someone with 20 years of SSRI exposure, my symptoms are pretty mild and I have a resilient body. It was really nice to hear that.

 

My questions:

Do you guys think I should taper or still give it more time to try to stabilize at the 0.5 ml? Dr. Shipko was very positive towards this website and said I should take seriously the advice posters here give me. There is a big part of me that doesn't think I'm going to adjust to the 0.5 and just wants to start the long road of getting off the Celexa and dealing with withdrawal and then eventually hopefully getting better. But if I could get back to where I was in May on 0.5 ml and stabilize and then gradually taper (slowly enough that I don't have any withdrawal symptoms), that would be better. But it's starting to feel far-fetched. If I do taper, I'm wondering if I can do something like 0.33 ml for a month than 0.16 for a month and then either lower or just zero? He seemed to think the 10% a month rule didn't apply since I'm down to such a low dose. Thanks for any help you guys can give me.

[ChessieCat]

"Aug 13, 2017 I did a low dose reinstatement of 0.5 ml a day and am currently still taking that. "

 

It only been just over 5 weeks since you reinstated.  You stopping Celexa in July.  It may take 2 or 3 months before you stablise.  Withdrawal Normal Description

 

Are you keeping notes on paper?  It would help the mods if you could provide 3 or 4 consecutive days  of your dose times of all drugs and symptoms as per this example:  Keep Notes on Paper

 

As far as your dose reductions, you will need to listen to your body, not a calendar.  Instead of going from 0.5mg to 0.33mg you might want to consider being conservative and going from 0.5mg to 0.4mg.  However that is still a 20% decrease.  If it were me I would be going to 0.45mg.  It is better to reduce by a smaller amount than to try and reduce by too much, experience issues and have to updose.  The thing to realise is that if you do it cautiously you know will get off.  If you try to go too quickly and have to updose and/or hold for more than 4 weeks to stabilise after a bigger reduction it can end up taking longer to get off than if you made smaller reductions from the beginning.

[ChanceLucky]

15 minutes ago, ChessieCat said:

"Aug 13, 2017 I did a low dose reinstatement of 0.5 ml a day and am currently still taking that. "

 

It only been just over 5 weeks since you reinstated.  You stopping Celexa in July.  It may take 2 or 3 months before you stablise.  Withdrawal Normal Description

 

Are you keeping notes on paper?  It would help the mods if you could provide 3 or 4 consecutive days  of your dose times of all drugs and symptoms as per this example:  Keep Notes on Paper

 

As far as your dose reductions, you will need to listen to your body, not a calendar.  Instead of going from 0.5mg to 0.33mg you might want to consider being conservative and going from 0.5mg to 0.4mg.  However that is still a 20% decrease.  If it were me I would be going to 0.45mg.  It is better to reduce by a smaller amount than to try and reduce by too much, experience issues and have to updose.  The thing to realise is that if you do it cautiously you know will get off.  If you try to go too quickly and have to updose and/or hold for more than 4 weeks to stabilise after a bigger reduction it can end up taking longer to get off than if you made smaller reductions from the beginning.

 

True, although the attention difficulties and unbalance seem to be a reaction to the reinstatement, not necessarily withdrawal. I didn't have them when I was off though I was only off for about 4 weeks. (I did have bad anxiety and a hand tremor while off.) I guess I've lost optimism about it getting better while I'm on Celexa but it might be premature to begin tapering too. I really don't know what to do. I hear what you're saying. I'd like to get more opinions and then reflect on all of them.

[ChanceLucky]

54 minutes ago, ChessieCat said:

"Aug 13, 2017 I did a low dose reinstatement of 0.5 ml a day and am currently still taking that. "

 

It only been just over 5 weeks since you reinstated.  You stopping Celexa in July.  It may take 2 or 3 months before you stablise.  Withdrawal Normal Description

 

Are you keeping notes on paper?  It would help the mods if you could provide 3 or 4 consecutive days  of your dose times of all drugs and symptoms as per this example:  Keep Notes on Paper

 

As far as your dose reductions, you will need to listen to your body, not a calendar.  Instead of going from 0.5mg to 0.33mg you might want to consider being conservative and going from 0.5mg to 0.4mg.  However that is still a 20% decrease.  If it were me I would be going to 0.45mg.  It is better to reduce by a smaller amount than to try and reduce by too much, experience issues and have to updose.  The thing to realise is that if you do it cautiously you know will get off.  If you try to go too quickly and have to updose and/or hold for more than 4 weeks to stabilise after a bigger reduction it can end up taking longer to get off than if you made smaller reductions from the beginning.

 

I looked at the Keeping Notes on Paper link. I can do that. Good idea.

[ChessieCat]

 

I've just noticed that I am talking in mg and you are talking in ml.  And 0.5ml = 1mg.  However, my percentages were still applicable.

 

23 minutes ago, ChanceLucky said:

True, although the attention difficulties and unbalance seem to be a reaction to the reinstatement, not necessarily withdrawal

 

You stopped taking 1.5ml = 3mg about the end of July this year.  You have reinstated 0.5ml = 1mg.  It could very well be delayed withdrawal from going off and the reinstatement dose isn't quite enough.  If it is that, and you are able to tolerate the symptoms, I would be staying on your current dose.  But as previously mentioned I think a good long hold is in order, 3 months at the least.

 

On 12/09/2017 at 10:26 PM, ChanceLucky said:

It's puzzling that I didn't have any of these issues before May when I was taking Benadryl and the same Celexa dose.

 

If you weren't experiencing any issues then I doubt that it is causing problems now.  See my thoughts above.

[ChanceLucky]

I was ready to give it more time and in fact I was thinking my attention was a bit better yesterday and today. However, I realize now my sexual functioning has been slightly off for a few weeks and it got worse yesterday. This is awkward to talk about but basically ejaculation doesn't feel normal. This was minimal until yesterday when I didn't even finish masturbating because I didn't think it would feel good. It almost feels like my body hasn't fully "shut off the urine valve" when I'm ready to ejaculate although I don't think urine is actually coming out. (I never looked closely though.) Sometimes, it might be more accurate to just say that there's a slight stinging sensation rather than the urination sensation. I'll try to monitor this closer and see how to describe it although now I think I'm putting to much pressure on myself to function sexually. I hope this isn't too much detail to give. I'm mentioning it in detail because I'm worried and hoping people can give advice. 

 

I'm just by myself - not with a partner. Is this separate from SSRIs? Should I see a urologist? I've read now about how some people have permanent sexual dysfunction from SSRIs and also read about PSSD (though I'm still on the Celexa - so that might not be relevant). Ugh this is scary. I have to try to stop thinking about worse case scenarios.

 

I just want to add that I bought a notebook and am recording my experiences like you suggested Chessie.

[ChanceLucky]

I thought about this some more. I have a mild stinging sensation when urinating and I think that was the same feeling during ejaculation. As of yesterday, I did have sexual sensation and the ability to attain an erection. I haven't had one today but haven't really tried either. Gosh, I just don't know what to do now.

[ChanceLucky]

If you do a low dose reinstatement and are experiencing distressing side effects (in my case sexual), do you still need to do a 10% per month taper? In my case I believe these are probably side effects rather than withdrawal effects though I guess it's impossible to know for sure. I have more info. in my thread but wanted to ask this here.

[ChanceLucky]

Just wanted to give a little more update. I have some good news and not good news.

The good news: My attention and concentration seem better, and this morning I didn't have the stinging feeling from urinating.

The bad news: Yesterday and so far today, I haven't been able to get an erection. (I did try after that previous post.) I wonder if the good news part above means my symptoms are still transitory and my body is adapting. Part of me wants to get off the Celexa because I want an immediate fix but now I'm leaning more towards thinking that I need to be patient. I guess I'm scared that the Celexa is damaging my sexual functioning and each dose I take could make the damage worse. I've been reading about long-term/permanent sexual side effects and that scares me.

Gosh, it's so hard not to beat myself up over increasing my Celexa dose back last May. That's when I messed everything up. I wasn't even doing terribly. My anxiety was bad and I was greedy - I wanted to feel better. I guess that's not criminal but I feel I should have known better. I had read the stories here but I felt it was a small enough increase that nothing bad would happen. Ugh. I wish I could go back in time. I think these thoughts all the time.

 

I'm keeping the notes like ChessieCat suggested. I know I've probably been posting too much in response to every symptom. I'll try to just give it a few days of recording things before posting again.

[ChessieCat]

It might be the Wellbutrin causing the problems.  From:  http://www.rxlist.com/wellbutrin-side-effects-drug-center.htm

 

Common side effects of Wellbutrin include:

• agitation,
• dry mouth,
• insomnia,
• headache,
• nausea,
• vomiting,
• constipation,
• stomach pain,
• dizziness,
• ringing in the ears,
• vision problems or blurred vision,
• loss of interest in sex,
• sore throat,
• muscle pain,
• itching or skin rash,
• increased sweating,
• increased urination,
• tremor,
• changes in appetite,
• weight loss or gain,
• joint aches,
• strange taste in the mouth,
• diarrhea, and
• seizures (especially at higher doses).

[ChanceLucky]

Hmmm. It could be that my body is processing Wellbutrin differently now. My anxiety (and maybe hand tremor) might be traceable to the Wellbutrin. That seems possible.

Based on what I've read about Wellbutrin, I think it's less likely that the sexual issues (it's not loss of interest) and concentration difficulties (which I think are improving) are due to Wellbutrin. Is your main point though that I shouldn't assume getting off Celexa will solve my issues? That's a reasonable point that I need to consider.

 

One other question: I used to take fish oil and a glucosamine/chondroitin/msm supplement but I stopped about a month ago (or maybe less - not sure) when they ran out. I had been taking both for a while but didn't bother getting new bottles. My joints seem OK. So maybe I should skip the GCM. I'm wondering if I should go back to using fish oil though or is it a bad idea to change anything right now?

[ChanceLucky]

Today will be my third day of taking notes like ChessieCat recommended. After either today or tomorrow, I'll post everything. But I wanted to update everyone on a few things.

I just realized that for the past 9 days I've been taking 0.4 ml (0.8 mg) rather than 0.5 (1.0 mg) of Celexa. I got a new syringe and didn't realize that each interval was 0.2 ml. I thought it was 0.25. (Oops!) Before 9 days ago, I had been using a syringe that went by 1 ml intervals. I had been trying to do a half ml but I don't know how precise my measuring was. I got the new syringe to try to be more precise, though I messed up with my measuring.

Over the past few days, there have been the following changes (which may correspond to the Celexa reduction).

A - My attention and concentration are better. I'm driving again and I feel alert! This is very nice.

B - I haven't had any unbalance/disequilibrium. I haven't gone back on the treadmill yet, though. That will be the real test. I'll probably try that tomorrow and be cautious.

C - My hand tremor has been worse. I'm pretty sure this is not anxiety-driven. My anxiety ironically feels under control pretty well.

D - My sexual functioning has been worse. The main issue is I get a stinging/unpleasant sensation at the tip of penis (sorry to give this much detail) at times when peeing or erect. The last couple of days I've had almost no ability to get erect though. I don't know how much of this is related to the Celexa dose change vs. the fact that Dr. Shipko mentioned sexual functioning in our consultation and I've been closely monitoring it a lot since then. I definitely did have the stinging sensation (though not erection difficulty) before talking to him last Thurs. Just to give a little info.: I know this isn't STD related. I get tested just to be extra cautious once a year and haven't been active since the last time I was tested. I went to my primary care physician yesterday. She did a urine analysis which came back normal and she suggested that I see a urologist. I'm very concerned about this sexual functioning issue. The thought that it could be permanent is horrible. It tempts me to just stop the Celexa. I'm worrying that each dose I take might be damaging my sexual functioning. That said, you could also argue that I should try to go back up to 0.5 ml and maybe the tremor and sexual functioning would improve (though the concentration and disequilibrium might get worse again) since that's what was happening at 0.5 ml. I'm tempted to just take an in-between approach and stay at 0.4 ml for a while.

 

Overall, when I'm not thinking about the sexual functioning, things are going pretty well. Work is going well and I'm enjoying photography (my biggest hobby). The hand tremor slightly impacts my photography but I've learned ways to compensate for it and can keep doing that as long as it doesn't get a lot worse.

[ChanceLucky]

Well, I guess I can still achieve an erection and climax! It took a lot longer and there's still a strange stinging sensation but it was still a pleasurable experience. I feel a lot better now! I'm still going to see a urologist I think but I've managed to spend less time thinking about worst case scenarios. I guess for the time being I'll just leave the Celexa dose alone.

[ChanceLucky]

I'm very relieved to say that that stinging sensation appears to have been an allergic reaction to the new type of boxers I'd been wearing. I switched back a few days ago and the stinging sensation is gone. I'm very happy about this though I'm also a bit embarrassed by everything I shared in the past few posts. All of my other symptoms seem to have significantly improved except for the hand tremor. Hopefully that just needs more time but overall I can't complain. I feel I'm doing pretty well now.

[ChanceLucky]

Things have been going pretty well. All of the symptoms I was worried about have resolved except I still have a mild hand tremor at times. I always have but I think it's slightly worse than it was before last summer. I'm just going to keep all medication the same for now. In a month or two, I might begin a very gradual taper of the Celexa (like .03 ml a month).

The only frustrating thing in my life is that I've had a shoulder issue on and off for a little over a year. It was doing well until recently when I overdid it one day doing exercising, photography, and a lot of driving. And now it's been pretty sore and I'm back to physical therapy. But overall I can't complain about how life is going.