Gibby's citalopram taper

[Gibby]

Feeling okay today, still a bit floaty, slept for about 8 hours with quite a lot of dreams.

 

Will take the citalopram tonight to see if that still works for me. Bit nervous about that but what can you do?

[Gibby]

As an update, feeling pretty down in the dumps right now. Probably because of not taking a citalopram since yesterday morning, eh? I'm doing my best to roll with it, maybe get out of the house and do some stuff that I enjoy. 

[Gibby]

Alright, took the citalopram last night and slept well, so no issues there.

 

In the interest of not spamming this thread, I won't post any updates until I talk to my psychiatrist on Friday or something drastically changes.

 

I'll still be reading posts on here, though! Thanks for all your support so far and for your future support!

[brassmonkey]

You can't spam your own thread.  This is your journal for your WD, it is where you record your progress, thoughts, reactions and ask questions.  Having a written record will prove very useful in the future for finding patterns and seeing how you reacted to different things.

[Gibby]

Good point, Brassmonkey!

 

Today I felt pretty good! Not a lot of brain fog, did things that I enjoy doing (it was a holiday here so I couldn't book any appointments or anything).

 

I wonder if the lack of fog is due to not having the olanzapine built up in my system yet or if it's because I'm out of a rut I was in and have new energy to change my life and a new perspective on things.

 

I hope it is the latter, but I guess we'll see! The fog is usually not too bad, only slightly noticeable. 

 

I've been thinking about what my chances are for getting off all of this completely. I'm on a low dose of olanzapine, but a high one of citalopram. I'm young (25), have a good immune system, and have a lot of chances to get support. On the other hand, I tend to freak out if things change for the worst so a day or two of bad symptoms might make me panic.

 

I guess the power to not do that comes with age and experience. 

[Gibby]

Hey, just checking in

 

I went to a therapy session yesterday and got some really good work done on my attitudes and things like that. The therapist said that I focus on the past too much, so in my worry book he told me to write "how would I like to be" instead of what I've been worrying about for decades now. This plays into the med thing because I'm trying to let go of the anger and hopelessness of being put on this medication without being told what it was or how it would affect me and focus on how to get better. 

 

I also got a massage a few days ago that really helped. Self care!

 

I see my psychiatrist tomorrow. Should I bring a tapering plan to her, with a chart and everything? Or should I just discuss the idea first and then next time come in with the plan? I dunno how supportive she'll be of tapering off the citalopram but I'll try to convince her, I can be assertive when I want to be.

 

Also, how long do citalopram tapers usually take? I know it's different for everybody, but some general idea would be nice. I'm thinking about a year?

[Fresh]

Hi Gibby ,  I'd be inclined to discuss the idea and see how she reacts.  

It's not possible for you to do a tapering plan , because it will be guided by how your body reacts as you decrease each time.  You might be

fine with 10% cuts every 4-5 weeks , or you may choose to do 5% cuts more often.  You might choose to do a long hold every now and then (I've waited 2 months at times).  It's a bit of a wait and see game.

 

Are you still keen to stop the citalopram after reinstating it this week?   Take all the time you need to make a plan . . . this will hopefully be your last taper ever.

 

Best wishes ,  Fresh

[Gibby]

Hi Gibby ,  I'd be inclined to discuss the idea and see how she reacts.  

It's not possible for you to do a tapering plan , because it will be guided by how your body reacts as you decrease each time.  You might be

fine with 10% cuts every 4-5 weeks , or you may choose to do 5% cuts more often.  You might choose to do a long hold every now and then (I've waited 2 months at times).  It's a bit of a wait and see game.

 

Are you still keen to stop the citalopram after reinstating it this week?   Take all the time you need to make a plan . . . this will hopefully be your last taper ever.

 

Best wishes ,  Fresh

 

Hi Fresh,

 

I was actually off the olanzapine, not the citalopram. The citalopram will be the first to go though, I think, it causes more noticeable and annoying side effects (the weight gain from olanzapine hasn't affected me that badly since I was underweight when I started it)

 

I talked with my psych yesterday, she is open to the idea of a taper and seems to understand that withdrawal is a thing that affects some people pretty hard. She suggested a citalopram taper that's pretty fast but I managed to convince her that a really slow one is more preferable. She is also aware that Effexor and Paxil are the really nasty ones, and she told me that citalopram should be less difficult in comparison (thought it's different for everybody).

 

I see her on October 8th and by then I should be ready to start a taper. 

[Petunia]

Hi Gibby,

If you are going to be tapering the Citalopram now, you will need this:

 

Tips for tapering off Celexa (citalopram)

[Gibby]

Hi Gibby,

If you are going to be tapering the Citalopram now, you will need this:

 

Tips for tapering off Celexa (citalopram)

 

Thanks for the link, Petunia!

 

Also, is there a way to change the name of this thread to reflect that I'll be withdrawing from the citalopram first and that the olanzapine isn't the main focus anymore?

[Gibby]

I've had a bit of a slide back these last couple days. Tuesday night I had to take a zopiclone due to messing up my bedtime routine, and then last night I kept waking up in the middle of the night and feel pretty worn out and anxious today.

 

I was doing so well, too, I felt good and motivated. Today I feel like I couldn't hold it together. I dunno, I know I sound so defeatist but these little hiccups really bother me. Hopefully bedtime goes okay tonight.

[Gibby]

Last night was also a bad night.

 

I did everything right (lots of exercise, calming bedtime routine) but when I went to bed at my usual time and took my medicine, it was like the anxiety surged all at once when I tried closing my eyes after my usual bedtime reading. I slept about an hour hour before waking up and I took 2.5mg of zopicone just so I could get some rest.

 

I'm really frustrated and upset. I was doing so well, and now I'm all mixed up. I really don't know what to do besides keep trying every night to fall asleep with the regular routine.

 

What do you guys think the problem is? Is it just bedtime anxiety? 

[Petunia]

Hi Gibby, I changed the title of this thread for you.

 

I was looking at your signature, please would you add the date you last tried to withdraw from Olanzapine, its hard to know if you are still experiencing some instability from that.

 

My guess is that you are having sleep issues because of your irregular use of Zopiclone. Using drugs for sleep can be tricky, its easy to become dependent on them if you use them more then once or twice a month. It sounds like you are using them several times a week and not sleeping well on the nights you don't use them, this sounds to me like a dependency is starting to build.

 

You have two choices, you can take them every night and then eventually you will need to taper off them, or not take them at all, or only very occasionally. See :  Important topics about symptoms, including sleep problems

[Gibby]

Hi Gibby, I changed the title of this thread for you.

 

I was looking at your signature, please would you add the date you last tried to withdraw from Olanzapine, its hard to know if you are still experiencing some instability from that.

 

My guess is that you are having sleep issues because of your irregular use of Zopiclone. Using drugs for sleep can be tricky, its easy to become dependent on them if you use them more then once or twice a month. It sounds like you are using them several times a week and not sleeping well on the nights you don't use them, this sounds to me like a dependency is starting to build.

 

You have two choices, you can take them every night and then eventually you will need to taper off them, or not take them at all, or only very occasionally. See :  Important topics about symptoms, including sleep problems

 

Thanks for changing the title for me! I've also updated my signature to be less vague.

 

I should clarify that using zopiclone more than once a week is a rarity for me. Taking it once a week is usually the most often I would take it, and that's only if I've been having lots of stress. When I can better manage stress, I can go ten days to a month without taking it. 

 

I took it every night for 2 1/2 years, so I know all about how dependant once can be on them. I can actually thank the olanzapine for giving me enough mental stability to allow me to wean off the zopiclone without withdrawal effects. I used to see zopiclone as something as a nice crutch to take during stressful periods, but now I see it as a punishment for not doing the things I need to do to help me sleep better since the hangovers are usually pretty annoying. I can manage taking it as often as once a week without any rebound effects the next night, and I have never taken it recreationally or taken more than my prescribed dose.

 

Anyways, my sleep has been a lot better these last few days. I've been going swimming almost every day (even ponied up for a Y membership) and doing other exercise on the days I don't swim. I've been keeping a good schedule (going to bed by 11:30 or midnight, waking up at 7:30-8:30 depending) and trying to stay busy even though I'm unemployed. I don't feel as weirdly spacey and wiped out as I was a few days ago, which makes me wonder if I went through a "bad batch" thing where I messed up a dose of olanzapine or something interfered with the absorption and I had a mini-withdrawal and readjustment. 

 

I see my psychiatrist on October 8th and we're going to discuss the citalopram taper. I've been doing some math and the 10% per month seems like it will be worth the time it will take. The main concern with the slow taper of citalopram is that it gives more time for the really bad side effects of olanzapine to show up, but I'm in a low-risk group to get tardive dyskinesia (low dose, young, no psychotic symptoms ever, no major updosing) so I'm trying not to worry too much. 

[Gibby]

Hey, quick update.

 

I had some bloodwork done last week (I get it done every six months or so to keep tabs on blood sugar and stuff) and the doctor is concerned that my cholesterol is elevated. "It'll be a problem in 20 years" he said, which, considering that my paternal grandfather died of a heart attack when he was 59 (granted, he smoked and didn't eat well) and my paternal uncle had a heart attack in his 40s (granted, he's a stress monkey with Crohn's disease) is making me pretty worried.

 

I'm assuming that my elevated cholesterol is due in part to the olanzapine, though my diet could be better. I can only imagine how much worse it would be if I was on an actual dose and not the crumbs I take now (1.8mg is very low).

 

What this means in terms of tapering is that being drug free by the time I'm 30-ish is even more imperative. I see my psychiatrist in a week and that's probably when I'll start the citalopram taper. 40mg @ 10% per month means it'll take almost two years by my reckoning. Hopefully it won't be too late by then.

[brassmonkey]

Hi Gibby--  need to check your math.  A taper of 10% a month will take you from 40mg to 1mg in 36 months, and that is still too large a dose to jump off at.

[Gibby]

Hi Gibby--  need to check your math.  A taper of 10% a month will take you from 40mg to 1mg in 36 months, and that is still too large a dose to jump off at.

 

Whoops, yeah, messed up that math. 3 years is a long time, that means that I will have been on medication for 8 years, which I guess isn't that long when compared to some others on here. Still, a little long for comfort but what else can be done, really? Hopefully the olanzapine doesn't do too much damage in the meantime. 

 

Where does one jump off, usually?

 

Given that I'm on such a low dose of olanzapine, it would probably be best to start that one with smaller cuts, I assume? I know that's far in the future, but I kinda like to have things sorted out. Olanzapine is the one that has the most potential for awful things happening but I guess it has to go last because it's calming and not activating.

[brassmonkey]

It's surprising just how fast the time goes on a taper.  If you've visited my journal then you know I just celebrated my fourth year of tapering and still have a good six months to go before I make the jump.  But it sure doesn't feel like it's been that long.  The important thing is to do it right the first time, because it can be a lot harder to do a second, and you will have taken twice as long.

 

As far as jumping off goes, the lower the better.  From what I have seen the people who get down to the .3 to .5mg range have a better time of it than the ones who go off higher. I know a bunch of people who jumped at 1 to 1.5mgs and they are having  trouble now.    A lot of it has to do with listening to your body and how it reacts to things the further down you go.

 

I wouldn't worry too much about the possible bad things the drugs could do.  Take the best care of yourself that you can, given your circumstances, rest as much as possible, eat right, exercise if you can.  We're all kinda stuck with it, so we sort it out as it comes, and do the best that we can in the meantime.

[Gibby]

It's surprising just how fast the time goes on a taper.  If you've visited my journal then you know I just celebrated my fourth year of tapering and still have a good six months to go before I make the jump.  But it sure doesn't feel like it's been that long.  The important thing is to do it right the first time, because it can be a lot harder to do a second, and you will have taken twice as long.

 

As far as jumping off goes, the lower the better.  From what I have seen the people who get down to the .3 to .5mg range have a better time of it than the ones who go off higher. I know a bunch of people who jumped at 1 to 1.5mgs and they are having  trouble now.    A lot of it has to do with listening to your body and how it reacts to things the further down you go.

 

I wouldn't worry too much about the possible bad things the drugs could do.  Take the best care of yourself that you can, given your circumstances, rest as much as possible, eat right, exercise if you can.  We're all kinda stuck with it, so we sort it out as it comes, and do the best that we can in the meantime.

 

Thanks for all the positive encouragement. Even if it does take awhile, I have lots of life left (I hope!) to enjoy after it's all done. Being 25 does have its advantages (except in finding a job, it seems). Well, granted, I don't think my life is awful right now, I can function well, and my creativity and personality are really good, but it will all be better drug-free, if only easier on my wallet and body.

 

A had a bit of a stomach bug hit and that screwed up my sleep last night, ended up taking a zopiclone. Not super worried about it, I know why it happened and I'll just deal with the hangover. 

 

Does anyone here find that tapering makes it difficult to travel? There are places I'd like to visit in the next few years and I wonder if taking along a liquid drug and dropper will be a lot of trouble. 

[apace41]

I had some bloodwork done last week (I get it done every six months or so to keep tabs on blood sugar and stuff) and the doctor is concerned that my cholesterol is elevated. "It'll be a problem in 20 years" he said, which, considering that my paternal grandfather died of a heart attack when he was 59 (granted, he smoked and didn't eat well) and my paternal uncle had a heart attack in his 40s (granted, he's a stress monkey with Crohn's disease) is making me pretty worried.

 

 

Gibby,

 

Cholesterol needs to be "unpacked" in order to determine what the numbers really mean.  If you simply got LDL, HDL and total numbers they are pretty close to meaningless unless they are totally off the charts.  For someone with a high level of concern and some issues in the family history, I would suggest getting advanced lipid profiling at an early stage so you have a baseline.  https://www.lipid.org/sites/default/files/advanced-lipid-testing-tear-sheet_0.pdf

 

If the numbers that exist "under" the numbers you have been given are good, there is a low probability of CVD.  Since you seem to have a fair level of health anxiety (I know because I fit into that category), I don't want to cause you to obsess, however, I would at least do the research on advanced profiling so you can consider it as an option.

 

Andy

[Gibby]

 

I had some bloodwork done last week (I get it done every six months or so to keep tabs on blood sugar and stuff) and the doctor is concerned that my cholesterol is elevated. "It'll be a problem in 20 years" he said, which, considering that my paternal grandfather died of a heart attack when he was 59 (granted, he smoked and didn't eat well) and my paternal uncle had a heart attack in his 40s (granted, he's a stress monkey with Crohn's disease) is making me pretty worried.

 

 

Gibby,

 

Cholesterol needs to be "unpacked" in order to determine what the numbers really mean.  If you simply got LDL, HDL and total numbers they are pretty close to meaningless unless they are totally off the charts.  For someone with a high level of concern and some issues in the family history, I would suggest getting advanced lipid profiling at an early stage so you have a baseline.  https://www.lipid.org/sites/default/files/advanced-lipid-testing-tear-sheet_0.pdf

 

If the numbers that exist "under" the numbers you have been given are good, there is a low probability of CVD.  Since you seem to have a fair level of health anxiety (I know because I fit into that category), I don't want to cause you to obsess, however, I would at least do the research on advanced profiling so you can consider it as an option.

 

Andy

 

 

Thanks for the advice, Andy! 

 

I'll go back to the doctor in awhile to get that done, I've seen him a lot already in the last month and I think we both need a break : P

 

Also, advice to everyone: Don't do intense exercise close to bedtime, or even moderate exercise, within a few hours of bed time, even like four hours. I did a pretty brisk walk on the treadmill that ended at about 8:30, and by my usual bedtime of 11ish I was still wired from it and had to take a tiny bit of zopiclone (1.25mg). Lesson learned!

[Gibby]

Hey guys and gals, update time

 

So my psychiatrist gave me a scrip for the liquid form of citalopram. She said "I'll write the script, you take care of the drops" which I guess is okay by me.

 

I went to the compounding pharmacy and they are pretty willing to work with me as far as how concentrated to make the solution and all that. Each refill only has a two-week shelf life in the fridge but I'm willing to work around that and the quite considerable expense (good thing Pharmacare will kick in since I have zero income right now).

 

However, I'm going on a trip at the end of the month, so rather than lug a bottle of this stuff on the plane and try to keep it cold in a hotel fridge, I'm going to wait until I get back to fill the scrip and start the drops. 

 

So, it looks like November is when this whole journey begins!

 

Also, I'm one of those guys who buys natural peanut butter now. Gotta cut out those fats and sugars!

[Gibby]

Hey everybody, sorry for the gap.

 

I went on vacation last week (Victoria, BC is really great) so I had to delay starting my citalopram taper, but I filled the liquid prescription yesterday and I'll get it sometime this week. The pharmacist is pretty great and answered a lot of my questions and seems happy to be working with me on this.

 

I went a whole 3 1/2 weeks without taking zopiclone, though due to a really stressful event while I was on vacation (and also needing to get up at 0430 to catch a plane) I had to take a little bit, and I also had to take a little bit last night due being tired and then turning off my light and then being wide awake.

 

Sometimes I feel like the citalopram and the olanzapine fight over my brain at night, and if the olanzapine wins (most of the time it does), I fall asleep, and if the citalopram wins, I'm awake. Hopefully as the taper progresses, the citalopram will lose more often. 

 

I've definitely been stressed out lately and have been dealing with jaw tension leading to headaches, so I'm taking steps to take care of all that.

 

I'll be back to report when I've taken the lower liquid dose for a bit to see what happens. Since I am unemployed, Manitoba Pharmacare will be covering the cost of the (expensive!) two-week supplies I get. 

[Altostrata]

Good to hear you've gotten clear of the zopiclone.

 

Do you take citalopram in the morning or evening? You're taking olanzapine in the evening?

 

You may find a bite guard helps the jaw tension and protects your teeth. Jaw tension is very common in withdrawal.

[Gibby]

Good to hear you've gotten clear of the zopiclone.

 

Do you take citalopram in the morning or evening? You're taking olanzapine in the evening?

 

You may find a bite guard helps the jaw tension and protects your teeth. Jaw tension is very common in withdrawal.

 

Hi Alto,

 

The zopiclone is an occasional ally. I used to take it every night but now I take it if I really can't sleep, which isn't very often nowadays if I take care of myself. 

 

I take both the citalopram and the olanzapine at night before I go to bed. Usually one takes citalopram in the morning, but it really makes me feel awful if I take it then so I've been taking at bedtime for years now. It "competes" with the olanzapine, viz keeping me awake versus letting me sleep. Usually the olanzapine wins, and maybe it will win more now that the citalopram will be slowly going away. 

 

The jaw tension comes from a semi-failed attempt to correct my overbite when I was a teenager, I've had it since long before I started meds. My jaw "floats" and has no natural resting position. 

 

Also, the pharmacy just called and said I can pick up the liquid tomorrow! 

[Gibby]

Okay, I got the liquid. Will take my first 4.5ml tonight for 36mg total, 10% of the 40mg I'm on now. 

 

 

The pharmacists have been super helpful this whole time, I can even pick the flavour they'll put in it (I chose mint)

 

 

 

Trying not to have any expectations or anything. Whatever happens will happen.

[Gibby]

Brief update:

 

I took my first dose of the liquid, and holy cow does it taste awful. Oh well, we gotta suffer through, right?

[KarenB]

Can you choose a different flavour each time?  Something else might be nicer...

 

KarenB

[ChessieCat]

Hi Gibby,

 

Something to keep in mind, make sure you have your next lot of liquid made up in time for when the 1st lot runs out.  If the chemist already has that planned, don't forget to contact them to ask for a different flavour!!!    You don't want any unnecessary hiccups.

 

Good luck.

 

CC

[Gibby]

Thanks for the replies, guys

 

Definitely felt the effects of the drop last night. 

 

I felt the symptoms of anxiety and couldn't sleep well. I took a tiny bit of zopiclone which helped me sleep, but only for about four hours. 

 

This morning I feel pretty jumpy and such, my typical withdrawal symptoms, though not as bad as when I CT'd olanzapine.

 

I find it odd that a 10% drop could be causing symptoms, considering that I've skipped doses of the citalopram before.

 

We shall see if symptoms improve over the next few days...how long should I tough it out before up-dosing and trying a small taper?

[Gibby]

Noon update, because I like typing this stuff out even if nobody replies right away.

 

I did a walk on the treadmill and ate some nuts and had a glass of milk. I almost cried in the shower. Mostly I feel like a rubber band is wrapped around my head and I also feel kinda weepy.

 

It's only been one day. I'm going to give it a few more days and if it doesn't get better (or gets worse), I'll go back up to 40mg, stabilize, and then try to come off more slowly. 

 

This has all be super frustrating, as all of you probably know. I'm tackling this without a whole lot of family support and I just ended a relationship with a girl that really enriched my life, so it's awful lonely out here. 

 

I can accept that this is all the meds and that I'm not weak and it's not my fault. 

 

 

How common is it that the first days after a cut are bad, but then they get better?

[brassmonkey]

Hi Gibby--  I'm sorry to hear that the drop hit you so hard, They do that sometimes.  It's the shock of having less drug that does it.  You might want to try a Brassmonkey Slide.  I came up with it to get around the problem of the initial shock.  I do 2.5% a week for four weeks and the hold an additional two weeks before doing it all again.  That way I get a 10% reduction every six weeks but the symptoms don't hit nearly as hard.  I know several others who are using the method and are having good results.

[Gibby]

Hi Gibby--  I'm sorry to hear that the drop hit you so hard, They do that sometimes.  It's the shock of having less drug that does it.  You might want to try a Brassmonkey Slide.  I came up with it to get around the problem of the initial shock.  I do 2.5% a week for four weeks and the hold an additional two weeks before doing it all again.  That way I get a 10% reduction every six weeks but the symptoms don't hit nearly as hard.  I know several others who are using the method and are having good results.

 

Brass,

 

Sounds like a good plan if this drop proves to be too much. Right now it is tolerable, just feels like I have the flu (including the poop issues), but man, the pharmacist is going to be surprised when I tell her that a 10% drop affected me enough to be noticeable. 

 

I guess I'll see how tonight goes. I feel pretty sad and alone right now.

 

 

I went to the compounding pharmacy to get a different syringe and the pharmacist I spoke to was a girl I went to high school and university with. She said she understands how quite a few of us have a lot of trouble getting off of medication and she said "Go slow, listen to your body". I tell you, these pharmacists are way helpful than a lot of the other medical professionals I've dealt with are. 

Edited November 7, 2015 by Gibby

[Fresh]

Hi Gibby ,   many people have had similar problems switching between tablets and liquid , or between brands.

You can't really know if your reaction is to the drop or to the change of form.

You might consider:

- going back to your 40mg tablet until you get stable again

- then change to 40mg liquid and see how you do

- when you've transferred successfully to the liquid , begin your taper.

 

Others have gone to liquid by doing half the dose of each (liquid , tablets) until things are stable.

[Gibby]

Hi Gibby ,   many people have had similar problems switching between tablets and liquid , or between brands.

You can't really know if your reaction is to the drop or to the change of form.

You might consider:

- going back to your 40mg tablet until you get stable again

- then change to 40mg liquid and see how you do

- when you've transferred successfully to the liquid , begin your taper.

 

Others have gone to liquid by doing half the dose of each (liquid , tablets) until things are stable.

 

Fresh,

 

I think I'll do just that, get a little stable and then go to 40mg of the liquid for a while.

 

Might try the Brassmonkey Slide, too, and just focus on listening to my body. If I have to go really slow, so be it, that's just how my body is.

 

I must admit that it is frustrating, though, to be so sensitive and for this to take so long. I think about the large group of people who have no trouble going off these meds and I get really angry and upset. It passes, and I guess it's just being human to get impatient. I worry about the future a lot and how these meds and tapers are going to affect the things I want to do, like travel. 

[KarenB]

Hi Gibby,

 

Just wanted to reassure you about tapering slowly.  I was really sensitive too, and I'm now experimenting with tapering by only 0.4%, using a Brassmonkey slide method.  It is very slow, but the up-side is I am actually feeling really good, and only having very minimal w/d symptoms.  In fact yesterday I was able to leave my small town for the first time in about 7 months and go to the city to watch my daughter play soccer.  I'd been missing so many family things.

 

It differs for everyone, but you might find you are able to do all those things you want to do - like travel - once you get settled and onto an appropriate tapering rate for you. 

 

Hugs,

KarenB