Gibby's citalopram taper

[Gibby]

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

 

Thanks for the encouragement, Karen!

 

I'll get this all sorted out eventually. Part of me wants to rush because I don't want the olanzapine to do any lasting damage, though since I'm on such a low dose (and I'm only 25) I think I'm at a low risk for that. I also worry about the olanzapine permanently ruining my ability to sleep, though I've actually never heard of that happening to anybody (quite the opposite, in fact) so it's just my anxious, self-defeating personality talking!

 

I felt kinda crummy this morning, could be lack of caffeine as well as re-adjusting, but I went for a swim and a walk and now I'm gonna eat my beloved fake Old El Paso tacos and then hang with a friend. It's all I can do, really.

 

On the weekend I might try going to 40mg via the liquid and see how that goes. I'll have to get a new batch at some point since the shelf life is only two weeks. 

[KarenB]

Swimming, walking, seeing a friend - sounds like you are taking good care of yourself.  You'll get there...

[Gibby]

Swimming, walking, seeing a friend - sounds like you are taking good care of yourself.  You'll get there...

 

I know what will keep me sane : P Took me long enough to figure it out, though!

 

As an update, the re-instatement has gone well, though I have been getting headaches and dry mouth. The pharmacist says that this is likely due to re-instanting my normal dose and I am inclined to agree. I'll wait for the headaches to go away before I play around with the liquid again. 

[Gibby]

Update time:

 

I wanted to take a break from thinking about tapering, hence my silence here the past week or so. 

 

I'm going to switch over to the liquid tonight, at the same dose I'm taking now (40mg). I was going to on Friday night, but something stressful happened and I felt like that wouldn't be a good night. 

 

I'll let y'all know how it goes!

[Gibby]

Hey, here's an update.

 

So I cut my citalopram by 2.5% last night, and I definitely felt it. 

 

I felt wired up and my head felt funny, like a little motor was running in my forehead. I fell asleep for about 3 hours, but when I woke up I took a tiny crumb of zopiclone and I think I slept another few hours. Certainly doesn't feel like I slept a whole lot, though.

 

Should I take this as a sign that 2.5% is too much, or should I try to tough it out and see if tonight goes better than last night?

[Gibby]

Me again! I took the 2.5% smaller dose again last night. 

 

I slept okay, maybe slept a bit less than usual, not a big deal. 

 

My main symptoms right now are a slight jitteriness and stomach cramps. The cramps came on all of a sudden and got worse when I tried to run today (I settled for just fast walking). 

 

Research indicates that the cramps are normal. Dunno what to do to alleviate them. Oh well, as long as I'm sleeping I can handle them. I imagine they'll go away. 

[Fresh]

Good on you for sticking with it.  Are you taking all liquid now?

I get nervous after a drop because of that uncertainty factor. For the first 7-10 days I can't relax , needing to be prepared 

for whatever w/d symptom might jump out.   It passes.

 

Have you tried magnesium?   There are lots of things you can take to relax your digestive system - ginger tea ,

lemon tea , slippery elm , apple cider vinegar (in hot water with honey). Best to eat plain foods till things settle.

 

Btw , where the heck is Manitoba?

 

[Gibby]

Good on you for sticking with it.  Are you taking all liquid now?

I get nervous after a drop because of that uncertainty factor. For the first 7-10 days I can't relax , needing to be prepared 

for whatever w/d symptom might jump out.   It passes.

 

Have you tried magnesium?   There are lots of things you can take to relax your digestive system - ginger tea ,

lemon tea , slippery elm , apple cider vinegar (in hot water with honey). Best to eat plain foods till things settle.

 

Btw , where the heck is Manitoba?

 

 

I've been taking all liquid for about two weeks now. I adapted to it well, didn't notice any real difference...until the drop, of course : P

 

My stomach isn't so crampy now. I feel sort of like I just woke up from a too-long nap, that kind of fuzzy tense feeling. I imagine this will all go away. 

 

Manitoba is a province in Canada, right smack in the middle. Look it up, we have many wonderful features like the mosquitoes! And the crime! And the -50C wind chills! 

[Gibby]

Update:

 

Well, the stomach cramps went away. It was two days of feeling not great after the cut, which might be the pattern going forward.

 

The main thing I'm feeling right now is some indigestion, especially at night before I go to bed. It's annoying but not awful.

 

I've been sleeping at night just fine, but I'm not "tired" before I fall asleep, unlike before the cut where I would start to nod off before I took my meds. I'm awake and then I'm not, is the pattern for the last few days.

 

I've been out of my routine lately so I'm going to get back into that and see if it makes a difference in feeling tired. It's weird to sleep without that sleepy feeling beforehand, y'know? 

 

I was planning on making another cut Saturday night. We'll see how the next few nights go first.

[KarenB]

Hello Gibby,

 

I can't quite tell when you made your last cut, but just wanted to say maybe think about not rushing into your next cut?  Make sure you've had a good length of time feeling stable first.  

 

You seem to be handling the w/d symptoms really well.  Doing something outside and a little active in the afternoon can help with feeling more tired before sleep (or at least it does for me).  

 

Wishing another window for you soon,

KarenB 

[Gibby]

Hello Gibby,

 

I can't quite tell when you made your last cut, but just wanted to say maybe think about not rushing into your next cut?  Make sure you've had a good length of time feeling stable first.  

 

You seem to be handling the w/d symptoms really well.  Doing something outside and a little active in the afternoon can help with feeling more tired before sleep (or at least it does for me).  

 

Wishing another window for you soon,

KarenB 

 

Karen,

 

I'm doing a bit better these last few days, thanks for your reply : )

 

I think I cut about two weeks ago. I'm going to start writing all of this down, I think that's the prudent thing to do, just so I can keep track of when I'm doing what and how I'm feeling.

 

The acute withdrawal from the cut only lasted a few days, with this little wave. I felt okay today, stomach was mostly being nice. 

 

I never thought I'd say this, but thank goodness for the olanzapine. It might be mis-perscribed and generally awful, but it's helping me sleep, and hopefully keeps doing that until I'm ready to give IT the boot. 

 

I'll see how the next week goes before making another cut. Might cut faster or slower in the future depending on how the pattern develops. 

 

I might also hold for a bit longer at some point to taper down the olanzapine a step. Haven't made any firm plans on that yet. I'm going to get my olanzapine compounded as well, so I'm not wavering on the dose the way I am now with cutting the pills into quarters 

[brassmonkey]

If you've been at this dose for two week and wait another, that will only be three weeks between drops which is still really fast.  We recommend a MINIMUM of four weeks between drops and that is still too fast for many people.  The big problem is that the symptoms won't catch up with you for several drops then it becomes a big mess to try and sort things out and restabilize.

 

I keep a sheet of paper with my scales and list each new dose as I start it.  Then add a tick mark as each week passes while I'm on that dose.  Makes it real easy to see how long it's been.

[Gibby]

If you've been at this dose for two week and wait another, that will only be three weeks between drops which is still really fast.  We recommend a MINIMUM of four weeks between drops and that is still too fast for many people.  The big problem is that the symptoms won't catch up with you for several drops then it becomes a big mess to try and sort things out and restabilize.

 

I keep a sheet of paper with my scales and list each new dose as I start it.  Then add a tick mark as each week passes while I'm on that dose.  Makes it real easy to see how long it's been.

 

I was actually attempting to do your "Brassmonkey Slide" method, hence the small drop of 2.5%. Maybe that's not a good idea, though?

[brassmonkey]

That make some sense.  For me there was frequently some carryover between the drops, but it cleared up by the end of the longer hold period.  That's what the longer hold is for, to let the drops meld together and settle down.  I wouldn't suggest a shorted hold but a longer one never hurts.  We've had a bunch of people trying to do 10% every three weeks lately, so I miss read your post.

 

It would be a real good idea to keep written records of your drops, dosage, number of weeks, major symptoms, when the symptoms hit after the drop, when they started to clear up.  Anything to help establish patterns and keep everything strait in your mind. 

[KarenB]

Hey you might like to check out this:  http://survivingantidepressants.org/index.php?/topic/1779-rate-symptoms-daily-to-track-patterns-and-progress/ for ideas on rating symptoms etc. 

 

And this too:  http://survivingantidepressants.org/index.php?/topic/2390-dr-joseph-glenmullens-withdrawal-symptom-checklist/  Part way down on the 2nd page (post #60 by ChessieCat) is a file you can open with a printable checklist of symptoms so you can record a months' worth all on one page.  Sorry I don't know how to make you a more direct link to that.

[Gibby]

Thanks for the responses, guys, I will start keeping a log today.

 

Had that "wired and then fell asleep" thing happen again last night. My guts started acting up about 10pm last night, I think that did it. 

 

Woke up feeling pretty down, still not feeling great but not horrible, either. Decided to skip caffeine today, see what happens there, maybe I'll feel a bit more tired at night. 

 

This whole tapering thing isn't helping my job prospects any. I have to carefully choose what to apply for to avoid something I can't handle. Try telling that to my parents though, oy gevald, do they ever not understand. 

[KarenB]

I felt heaps better after I got rid of caffeine.  My horrible anxious-stomach feeling in the afternoon stopped.  I had caffeine-w/d headaches for about 4 days, then all good.  It was worth it to end up feeling so much better.   

[Gibby]

I felt heaps better after I got rid of caffeine.  My horrible anxious-stomach feeling in the afternoon stopped.  I had caffeine-w/d headaches for about 4 days, then all good.  It was worth it to end up feeling so much better.   

 

Well, cutting out my beloved tea didn't seem to help much. By around 1:30pm, I started feeling the flu-like symptoms. Pretty much like clockwork the past few days. 

 

Anyways, I know this is a wave, what else could it be? And waves go away. I'm going to keep at this dose awhile longer. If things get a lot worse, maybe I'll have to consider updosing. 

 

I mean, I did have that nice ten day window, and I'm still able to function and do things even though I feel kinda poopy. 

[Gibby]

Okay, today is a very bad day. I woke up with my heart racing and feeling very weird, like foggy and depressed. 

 

I had a shower and didn't feel better, and then my dad gave me a spiel about finding a purpose in life and I couldn't take it. Then mom starting yelling at me about my bed being made, and I got really agitated and we all had a big screaming match. I'm crying as I type this, it's not my fault I can't get a job even though I apply to at least five a week, why am I being blamed for things out of my control while I feel bad?

 

This is definitely a wave, I just don't know if I can stick it out. Things have gotten worse the last few days, so I dunno if it's an indication that the cut was too much or what. I've thought about updosing but I've also thought about toughing it out. But man, everything I do for self-care (going swimming, having baths, playing my favourite games) gets me screamed at.

 

Anybody have any ideas?

[Fresh]

Sorry it's turning.   Do try to stick it out without updosing . . . you know it will pass.   Your previous drops may be

catching up but that's nothing to updose over.

And when everyone around you is meshugganah , it's most important to try not to buy into it.   You can't change

someone else's behaviour , but you can protect yourself and not respond the way you're used to.

 

When things settle a bit it would be good to try and open communications with your folks.   They scream because

they care and don't know what else to do.

They probably love you.

 

[Gibby]

Sorry it's turning.   Do try to stick it out without updosing . . . you know it will pass.   Your previous drops may be

catching up but that's nothing to updose over.

And when everyone around you is meshugganah , it's most important to try not to buy into it.   You can't change

someone else's behaviour , but you can protect yourself and not respond the way you're used to.

 

When things settle a bit it would be good to try and open communications with your folks.   They scream because

they care and don't know what else to do.

They probably love you.

 

 

Thank you for the kind words, Fresh! 

 

The symptoms come and go during the day, though the flu-like feeling is there most of the time. It's weird that I fall asleep without being tired beforehand, I guess that's the olanzapine "helping". I mean, I'm sleeping, though I miss feeling sleepy. Hopefully that comes back at some point...

 

I know asking "how long will this last" is meaningless, since there is no answer...but I guess I asked it anyways!

 

I went with a friend to the pool and I feel okay afterwards, though my stomach is grouchy. Before I went to the pool I had a little moment where my heart was beating faster than usual and I felt some little jerks in my arms and chest...but those have not returned. Maybe this morning when I felt jumpy when I woke up was one of those "cortisol spikes" I've read about on here?

 

This is the longest I've been on a lower dose of a medication in a long time...for two years, at least, I think. 

[Gibby]

Update:

 

Today was better. Still got amped up last night when trying to sleep, but got 8 hours (on the couch). Kind of up and down with symptoms again, but nothing as extreme as yesterday. Still having gut issues and felt really, really tired this afternoon while in volunteer meeting. Felt halfway normal this evening but not feeling as normal now. 

 

I imagine that the relaxation before sleep will be the last thing to come back...I mean, I'm getting sleep, but being tired beforehand would be nice!

[Gibby]

Daily update:

 

Slept without having to move to the couch last night, which I guess is a good step. 

 

Definitely feeling more brain-foggy today, plus a bit of feeling antsy. My stomach didn't freak out from eating breakfast this morning, either.

 

The brain fog could be due to the fact that I'm not getting a consistent dose of the olanzapine just from cutting the pills (so I might have taken slightly more than usual last night) with my pill cutter, so I think this week I'm going to get a prescription to get 1.875mg capsules compounded. Might as well since I'm on Pharmacare and don't have to pay for meds until I get a job. 

 

I'm cautiously optimistic! I will report back later in the day since the symptoms seem to shift around a lot

[KarenB]

Even if things do swing back for a bit you'd be fully justified in remaining 'cautiously optimisitic'.  Healing is happening, and these are all good signs. 

[Gibby]

Even if things do swing back for a bit you'd be fully justified in remaining 'cautiously optimisitic'.  Healing is happening, and these are all good signs. 

 

Thanks for the encouragement, Karen, it really does help : )

 

Felt pretty clearheaded for a few hours, now feeling just wiped out like I was this morning. My stomach only got mad a bit at supper.

 

I told my pharmacist what was happening and she understood and was encouraging, which is a relief.

 

We'll see what bedtime brings in terms of being able to relax before bed. Before I was actually nodding off before taking my meds, we'll see when that comes back. 

[Gibby]

Today's update:

 

Feeling pretty lousy all day, was more depressed this morning when I woke up. Last night around 9:45 I had a bit of an anxiety spike, thong it was more mental than physical. I fell asleep that night in my bed anyways, so it's more annoying than unbearable. Still, not being able to relax at night is bothering me.

 

Today, I feel like my brain has the flu. My head is all tight and feels like somebody is drilling into my temples very slowly. No stomach cramps but general indigestion for sure. Generally feeling pretty down, though was able to get out to the YMCA for a swim which was pretty nice. 

 

I bought some magnesium citrate that I might take in a few days when I don't have anything going on, it'll be safe to experiment then. They are 150mg caplets. Maybe they'll help and maybe they won't.

 

I don't really want to updose after this length of time, but if things get worse over the next week instead of better, I might consider it. I dunno, I'm really unsure. 

[Gibby]

Update:

 

Woke up feeling pretty anxious today...well, my BODY was anxious, my brain wasn't worried about anything in particular. 

 

This passed and I just felt flu-like again until a few hours ago, when I felt pretty normal. I can feel a bit of the flu-like stuff coming back again, but I think today has been better than yesterday.

 

Evenings are still annoying, because my body still won't relax. I think it was better last night, but still. 

[Gibby]

Update:

 

The nightly anxiety continues, it's pretty annoying, really. It hits like clockwork, 9:30-9:45pm every night. I feel sleepy until then and then I can feel my heart speed up and my chest tighten. Last night it was pretty bad in the chest, my health anxiety was NOT happy. I still fell asleep and slept 7.5 hours as I always do.

 

I took 150mg of magnesium citrate this morning. No gastro issues, didn't notice much different really, but I suppose it's not hurting to take it. 

 

The days are getting better bit by bit, very little stomach issues and morning anxiety has been lessened these last few days. Still some brain fog but it's minor and might change, it has before.

 

It's just the evenings that are bad. Maybe it's inter-dose withdrawal? What do you guys think?

[Gibby]

Night anxiety again last night, though maybe not as extreme as previous nights. Wondering if in addition to interdose withdrawal, I'm sort of creating the anxiety, or amplifying it. 

 

I dunno, I'm still sleeping, I guess that's what's important.

 

Felt mostly normal today, even went Christmas shopping with my parents. 

 

I got my olanzapine compounded into 1.875 caplets by my pharmacy, so no more variation there. 

 

 

Hoping my relaxing nights will come back!

[JanCarol]

Hey Gibby - 

 

In spite of all of the difficulties, it sounds like you are doing really well:

 

You wrote:

Woke up feeling pretty anxious today...well, my BODY was anxious, my brain wasn't worried about anything in particular. 

 

This is an AWESOME insight!  I've been listening to Claire Weekes about dealing with anxiety, and she says this is the vital piece:  realizing that your body is having a reaction, and not attaching to that reaction.

 

And you - you waltz in here and do it naturally!

 

You mention:

Night anxiety again last night, though maybe not as extreme as previous nights. Wondering if in addition to interdose withdrawal, I'm sort of creating the anxiety, or amplifying it. 

 

Or, your body is creating all the signals that it is anxiety - racing pounding heart, tight chest, fight or flight reaction, cortisol/adrenaline rush - and your brain / mind interprets that as "anxiety."

 

Sometimes it's normal cycles - like I find if I don't go to bed before 2 am, I will catch the "morning cortisol spikes" before I even get to bed.  Then, tired, eyes throbbing (that's my "tired signal"), I lay in bed, waiting for the pounding to stop, and, in true cortisol fashion, it doesn't stop until around 4 am.  If I am asleep during that time, it doesn't wake me up - but - if I am awake, it makes it darned difficult to sleep.

 

I hear gratitude in your voice that you are sleeping.  That's a good way to be.  Are you sleeping regular hours? Or does your sleeping time shift from night to night?

 

And - you've got the magic magnesium, now, please consider the fabulous fish oil!  Omega-3 fish oil

 

Another link which may be helpful to you is this:  http://survivingantidepressants.org/index.php?/topic/33-waking-with-panic-or-anxiety-managing-cortisol-spikes/

 

Keep fighting the good fight, you're really doing quite well.

 

ps - from your signature - how much citalopram are you on?  Unless we know the strength of your liquid, telling us in ml's doesn't really tell us much.  I'd prefer mg's, so that I can think "apples," and see apples.    (no maths here!  )

[Gibby]

Hey Gibby - 

 

In spite of all of the difficulties, it sounds like you are doing really well:

 

You wrote:

 

 

Woke up feeling pretty anxious today...well, my BODY was anxious, my brain wasn't worried about anything in particular. 

 

This is an AWESOME insight!  I've been listening to Claire Weekes about dealing with anxiety, and she says this is the vital piece:  realizing that your body is having a reaction, and not attaching to that reaction.

 

And you - you waltz in here and do it naturally!

 

You mention:

 

 

Night anxiety again last night, though maybe not as extreme as previous nights. Wondering if in addition to interdose withdrawal, I'm sort of creating the anxiety, or amplifying it. 

 

Or, your body is creating all the signals that it is anxiety - racing pounding heart, tight chest, fight or flight reaction, cortisol/adrenaline rush - and your brain / mind interprets that as "anxiety."

 

Sometimes it's normal cycles - like I find if I don't go to bed before 2 am, I will catch the "morning cortisol spikes" before I even get to bed.  Then, tired, eyes throbbing (that's my "tired signal"), I lay in bed, waiting for the pounding to stop, and, in true cortisol fashion, it doesn't stop until around 4 am.  If I am asleep during that time, it doesn't wake me up - but - if I am awake, it makes it darned difficult to sleep.

 

I hear gratitude in your voice that you are sleeping.  That's a good way to be.  Are you sleeping regular hours? Or does your sleeping time shift from night to night?

 

And - you've got the magic magnesium, now, please consider the fabulous fish oil!  Omega-3 fish oil

 

Another link which may be helpful to you is this:  http://survivingantidepressants.org/index.php?/topic/33-waking-with-panic-or-anxiety-managing-cortisol-spikes/

 

Keep fighting the good fight, you're really doing quite well.

 

ps - from your signature - how much citalopram are you on?  Unless we know the strength of your liquid, telling us in ml's doesn't really tell us much.  I'd prefer mg's, so that I can think "apples," and see apples.    (no maths here!  )

 

 

Hi Jan Carol, sorry for my late reply, I've been avoiding SA a bit just to keep my stress levels low : P

 

I'm sleeping 6-8 hours a night right through, though today I woke up at 5:30am for some reason, but went back to sleep right away. So the olanzapine is doing something good even though I hate it! 

 

I don't feel the "anxiety" spikes anymore, though I'm not falling asleep before I take my meds still, which, well, whatever, it'll come back sometime.

 

Still working on finding a job and such, which isn't easy around here. Oh well, I've got a roof over my head.

 

My current dose of citalopram is 39mg. These cuts are smaller than I'd like them to be...this is going to take forever. I had an intake meeting with a community mental health worker and she was pretty indignant about taking years to get off of a medication. She acted like I was nuts. Granted, she'd been pretty rude on the phone earlier, and she's not the worker I'm going to have, so she can shove it, quite frankly. 

[ChessieCat]

 

... she was pretty indignant about taking years to get off of a medication. She acted like I was nuts. ... so she can shove it, quite frankly. 

 

And remember, she's not the one in the situation.  It she walked a mile in your shoes she'd probably understand much better.

 

It's great to hear you've been sleeping well.  I can imagine just that makes a big difference to how you are feeling.

 

CC

[Gibby]

Well, it's been awhile.

 

I haven't been feeling good lately. In particular, my body is not relaxing at night no matter how much I exercise during the day. The last few nights have been the worst. Normally, I've been able to fall asleep no matter how amped up I was, not not this week. 

 

I've had to take zopiclone a few times this week and I think that's a warning sign that I'm not responding well to my November cut. 

 

I start a new job on Monday and I want to be able to perform that job. 

 

So I'm thinking of updosing back to 40mg. This job is important and I need my routine back. 

 

It's frustrating that it's come to this point, but I've been working on coping skills and realize that it's not a race to get off this stuff, and that a smaller cut might be better for next time.

 

I know updosing will cause re-adjustment symptoms, I know which ones those are (I've reinstated citalopram before)

 

Thoughts? 

[KarenB]

Are you currently on 39mg citalopram?  If so, then it's not too big a step to go back up if that's what you decide.

 

Strangely, exercise can increase w/d symptoms, including that of insomnia. Finding the level of exercise which brings benefits without ramping things up too much is the key.  Perhaps you'd like to try that before deciding to increase?

 

I guess it's a matter of deciding what level of symptoms you can cope with while starting a new job.

 

Karen

PS - congrats on the job .

[Gibby]

Well, I'm back. 

 

I'm not tapering right now, but I do feel pretty unwell...had a good six months(!) there, but this might be a wave

 

Seems weird to have a wave six months after reinstating my original dose of citalopram. I have actually started seeing a new psych and I mentioned my symptoms (abdominal pain, feeling weird in the head, not great sleep, kinda restless) and he said that they came on too fast to be a med issue (he knows about withdrawal stuff) so he thinks I'm just sick. A walk-in doctor I went to about the stomach pain agreed that I'm just sick or have colic (bland diet!). My mom is sick too so maybe that's it. 

 

Looking for advice really or guidence, and to say hi and sorry I've been gone. Not planning on tapering for a bit yet, want to get my life in order. 

[KarenB]

A wave is one possibility - just a bit of adjustment happening after your last changes.  Occasionally they do occur this far out. 

 

Another possibility is that your body isn't tolerating the drug so well anymore, and so you are getting some side-effects.  I agree with you that rushing to change anything isn't a good idea.  Maybe sit with it a bit longer, record your symptom pattern each day, and see if it passes or intensifies. 

 

Had things been stable in the months prior to this?