Gibby's citalopram taper

[Gibby]

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? 

 

 

Things were stable, yes, though I'd had a few emotional low periods and stress a few weeks before this all started. Was pretty well over that by the time the symptoms showed up. 

 

My symptoms are as follows:

 

-Abdominal pain and crazy bowel movements. Doctor thinks this is colic and I'm inclined to agree given how suddenly it came on, and the fact that my mom is having the same symptoms...we probably have the same bug. Might even be colitis which is fun

 

-Nervous feeling in chest, you know, twitchy and tight. This is the mysterious symptom that is almost like a withdrawal thing that doesn't match the gut symptoms. Gets worse when I think about it. 

 

I slept 8 hours last night so hopefully that continues. Able to fall asleep without much trouble despite the anxious feeling in my chest. 

 

The psych I saw on Friday the 24th said that the symptoms "became acute" too suddenly to be a med poop out. He seemed to believe that the gut illness is affecting my whole system, which given how I react to illness seems plausible. 

 

Took a bit of zopiclone last Saturday night because I had a midnight snack that was too large before bed. Sunday is when the gut problems started, Monday night I needed a bit of zopiclone to help me sleep, Tuesday night I had to take 5mg of the stuff to finally put me out, I was so wound up. Haven't taken any since then. Gut problems have been bad since Wednesday. 

 

The gut thing is explained but the nervous feeling in my chest isn't, which bothers me. I guess I'll see what happens. Been finding progressive muscle relaxation helpful before bed. 

[Gibby]

Last night did not go well.

 

About 9pm it felt like somebody switched a motor on in my head. Did my PMR but it didn't help much. Tossed and turned in bed for a bit, my thoughts were all over the place. Called a helpline who calmed me down a bit. Took 2.5mg of zopiclone and watched TV until I fell asleep.

 

I don't know what's wrong with me, and it's kind of scary. Thinking about going to the hospital today to talk to a doctor, I dunno. What's most annoying about all this is that I have a 9-4 job and really need to keep it so sick time is not an option. 

[Gibby]

Slept last night without zopiclone, but boy am I agitated today. 

 

If this is a bug, it's sure not like any bug I've had before. If it's a wave...well, I guess I'll ride it out. Still not sure what to make of the whole deal. 

[KarenB]

Earlier you were saying your mum was ill with the same symptoms.  Has she recovered yet?  That might provide some clues. 

 

It looks to me like taking the zoplicone on Saturday caused the gut and other issues - including anxiety.  From Tapering Z drugs:

Dose self-escalation can result in tolerance to the hypnotic and sedative effects of zolpidem. Symptoms of sweating, tachycardia, tachypnea, tremors, and severe anxiety have been reported upon discontinuation of zolpidem. Discontinuation syndrome symptoms also include fatigue, nausea, flushing, panic attacks, abdominal discomfort, uncontrolled crying, emesis, and delirium.

So that could explain your 'nervous chest' feelings, as well as the other symptoms you listed. 

 

If it were me, I'd stop using zoplicone, and let things settle down again.  Keep making symptom notes so we can see if it does improve as you get further away from that last zoplicone dose. 

 

Fingers crossed...

[Gibby]

Earlier you were saying your mum was ill with the same symptoms.  Has she recovered yet?  That might provide some clues. 

 

It looks to me like taking the zoplicone on Saturday caused the gut and other issues - including anxiety.  From Tapering Z drugs:

Dose self-escalation can result in tolerance to the hypnotic and sedative effects of zolpidem. Symptoms of sweating, tachycardia, tachypnea, tremors, and severe anxiety have been reported upon discontinuation of zolpidem. Discontinuation syndrome symptoms also include fatigue, nausea, flushing, panic attacks, abdominal discomfort, uncontrolled crying, emesis, and delirium.

So that could explain your 'nervous chest' feelings, as well as the other symptoms you listed. 

 

If it were me, I'd stop using zoplicone, and let things settle down again.  Keep making symptom notes so we can see if it does improve as you get further away from that last zoplicone dose. 

 

Fingers crossed...

 

 

Hi Karen,

 

That's a possibility, though it'd be a mighty big co-incidence given that my mom developed the same symptoms soon after me. I got some blood work done today to see if anything is making me sick. 

 

I feel quite a bit better today, if grouchy, which I can ascribe to work stress. I don't feel as zonked, but my stomach still doesn't like food very much. I haven't taken a zopiclone since the 25th of June. 

[Gibby]

Hi folks, thought I'd regale you with an update. 

 

I was doing okay, feeling not quite myself but sleeping okay at night, until last week. Had a bit of a relapse on Monday and Tuesday night and needed 1.25mg of zopiclone to get sleep each night. After that I was sleeping fine, exercising, all that, until last night. My brain was just not tired at all and I tossed and turned and eventually ended up taking 2.5mg of zopiclone.

 

Now, before you scream at me for taking the zopiclone, please understand that I have a full time 9-5 Monday to Friday job that I need to be rested for. If I didn't, I'd be more inclined to just muscle through the bad nights. Losing this job would be very bad indeed.

 

Today I feel just weird, like a little motor is running in my head. Not antsy like the weird thing back in June, but just a little wired.

 

I got my test results back and the only thing that was abnormal was I have low ferritin. Doc told me to eat more leafy greens and beans (and the occasional steak!) and that was it. I doubt that low iron would cause all this.

 

So, what could it be? Continuing wave? Med poop out? I just want to feel normal again, if if that normal isn't all that great.  

[scallywag]

Sometimes when not taking a psych-pharmaceutical, I would have insomnia for a night or two. It could be that for you it's also one of those things that happen from time to time. 
 
If it continues, you may want to check out your sleep hygiene habits.  There are some ideas here:

Tips to help sleep

If you have difficulty getting to sleep, I and others have had success with melatonin. I describe my use of it as "resetting the onset of sleepiness."

 

Melatonin for sleep

 

Keep us posted on how you're doing.
 

[Gibby]

Sometimes when not taking a psych-pharmaceutical, I would have insomnia for a night or two. It could be that for you it's also one of those things that happen from time to time. 

 

If it continues, you may want to check out your sleep hygiene habits.  There are some ideas here:

 

Tips to help sleep

 

If you have difficulty getting to sleep, I and others have had success with melatonin. I describe my use of it as "resetting the onset of sleepiness."

 

Melatonin for sleep

 

Keep us posted on how you're doing.

 

 

 

Thanks for your reply.

 

It's not just the insomnia, my whole head feels different. Like it doesn't have the weight of the pills pressing down on it. Normally that would be a good thin! But my brain just doesn't want to sleep. I have done all the sleep hygiene things and once I get into bed I'm just awake. During the day I'd usually feel sleepy from 2pm to 5pm but not for the past two days.

 

I'll give it another night and then I'll need to contact a medical professional. I talked to a pharmacist today and she said that meds don't poop out instantly like that. I wish I knew what is going on

[scallywag]

Yeah, a sudden appearance of a symptom means it's likely withdrawal -- an unpredictable CNS adaptation to the absense or decreased level of a substance.

 

Be prepared: Doctors of any variety -- GPs and psychiatrists, Psych nurse practitioners, etc. -- *often* see these symptoms as the return of the original condition and respond with either

• changes (i.e. increases) to current or previous pharma prescriptions,
  --- and/or ---
• new prescriptions for different pharmaceuticals.

[Gibby]

<p>

 

Yeah, a sudden appearance of a symptom means it's likely withdrawal -- an unpredictable CNS adaptation to the absense or decreased level of a substance.

 

Be prepared: Doctors of any variety -- GPs and psychiatrists, Psych nurse practitioners, etc. -- *often* see these symptoms as the return of the original condition and respond with either

• changes (i.e. increases) to current or previous pharma prescriptions,

  --- and/or ---

• new prescriptions for different pharmaceuticals.

Well, that would make more sense if I had changed my doses at all in the last six months, but nothing has changed at all since early January

[Altostrata]

Have you accidentally skipped a dose, or taken one off schedule?

[Gibby]

Have you accidentally skipped a dose, or taken one off schedule?

Hi Alto,

 

No, I haven't. I have one of those pill holder things to make sure I don't miss a dose. I'm kind of absent minded.

 

I slept okay last night, took awhile to fall asleep and wasn't super tired but slept through my alarm. Still feel weird today but not as weird. Avoiding caffeine and such though I miss my tea

[JanCarol]

Hey Gibby, I"m sorry it's so hard for you right now.

 

I hope you come back and keep trying.

 

Many people are helped by Claire Weekes - she's from decades ago, and talks about Nervous Illness instead of anxiety.  THis is important because she separates the physical feelings (cortisol / adrenaline) from the emotions (OMG Anxiety stuff).

 

Claire Weekes - Self Help for your Nerves

and

How to Recover from Anxiety - Dr Claire Weekes

 

There are other non-drug techniques available here:

Non Drug Techniques for Coping with Emotional Symptoms

 

You wrote about your protracted withdrawal:

 

Well, that would make more sense if I had changed my doses at all in the last six months, but nothing has changed at all since early January 

 

Well, except for the regular bounces of zopiclone you take.  This can slow your healing, and cause destabilization, as you are going into CT withdrawal the following day, each time you take zopiclone.  That's my understanding, anyway.

 

When you regularly bounce your brain with zopiclone, you are paying a price.  It would be better to take a small dose nightly than to take it intermittently, IMO.   It would be more stable, and might help your symptoms level out.

 

It's just regular enough to "bounce" your brain like a basketball, but not regularly enough to count as "dependence"

 

I hope you see the sun today!

[Gibby]

Thank you for the replies, everyone. 

 

I was doing quite a bit better, feeling normal for about 17-18 days. Last Saturday I had a stressful day and decided to take a zopiclone to avoid tossing and turning. 

 

It's been four days now, and every night I've needed a zopiclone again. Something has obviously changed in the last few months where I can't just shrug off taking a zopiclone PRN every once in awhile. I actually had to take a day off work today because I woke up so groggy. 

 

I guess the plan now is to ween off zopiclone again. It hasn't even been a week and I've done it before, but the anxiety remains. I'm frustrated because I was doing so well and then I slipped up.

[Gibby]

Update:

 

Haven't taken a zopiclone since Tuesday night. Feeling that kinda wore out, cotton-headed sort of way I get when I'm a little unstable. 

 

Just trying to take it easy. I see my counsellor tomorrow and my psych Friday so I can make some progress this week, I hope.

 

Also, I ordered a weighted blanket from an outfit in Calgary. My psych thought it would help when I'm feeling stressed out and wrote a script for it. Of course, my insurance didn't cover it (even in Canada they can shaft us!) so there's 400 bucks out of pocket, but I guess it'll be worth it in the end. 

 

I like my psych, but he seems to really have a fascination with diagnosing me with ADHD, despite the surveys me and my parents filled out saying that I didn't. 

 

Despite that, he is a believer in reducing meds and will work with me on a plan when I am ready to start that again. I'm going to be working on cognitive behavioural therapy for insomnia. Those tools will be very helpful in the future, I feel. 

[Gibby]

Don't move to BC, folks

 

http://www.cbc.ca/radio/the180/facts-vs-values-in-canadian-health-care-forced-psychiatric-care-and-urban-indigenous-people-need-a-voice-1.3764173/a-psychiatric-refugee-why-one-woman-fled-b-c-s-mental-health-laws-1.3764440

Edited September 18, 2016 by ChessieCat
Original link went nowhere. Corrected.

[Gibby]

I've been quiet, but I've been here.

 

Not tapering at the moment and don't plan to until January. I want to get through Christmas feeling 75% before plunging into tapering. Plus I'd like to hit my one year at my job so it's harder for them to fire me. 

 

I got ahold of a weighted blanket (400 bucks out of pocket despite a prescription from my psych. Thanks Canadian health insurance!) It's really great and is helping with sleep. I've had to use zopiclone exactly once since I got it the first week of September and that's because of two very rough days at work with the clients being violent and a lot of stress built up. 

 

I've been putting in some work, getting a new support network. My new psych is pretty good, my new mental health worker is amazing, and I host a support group for the local Mood Disorders organization once a month. 

 

Have to say that I still feel kind of hopeless about getting off this stuff, off and on. I'm sure we all feel that way.

[ChessieCat]

Good idea holding for the reasons you state.  Very sensible.

 

It sounds like the blanket is well worth the cost.  It would have been awful if you had paid so much for it and it didn't work.  A few winters ago I bought an absolutely beautiful king sized doona insert that felt fantastic to snuggle up under in bed.  Unfortunately it made me too hot!  Thankfully it wasn't too expensive, but it was still money I ended up wasting.

[Gibby]

Good idea holding for the reasons you state.  Very sensible.

 

It sounds like the blanket is well worth the cost.  It would have been awful if you had paid so much for it and it didn't work.  A few winters ago I bought an absolutely beautiful king sized doona insert that felt fantastic to snuggle up under in bed.  Unfortunately it made me too hot!  Thankfully it wasn't too expensive, but it was still money I ended up wasting.

 

 

It can get a little toasty under the weighted blanket, but it was never really an issue since we have powerful A/C for the hot days anyways. Now the weather is getting chilly and the toasty-ness is welcome. I like laying under it after a stressful day and listening to music or making music. 

 

The real acid test will be when withdrawal symptoms hit. It will be a good friend then

[Gibby]

Well, I only seem to post here when my life is falling apart, but here I am again.

 

Going through the whole zopiclone song and dance again. Pretty similar to what happened in the summer, actually, which gives me some hope that I can get through it, but still. Not sleeping very well. Had to take a day off work today which made some of my co-workers mad but my boss was very understanding. 

 

Not getting a lot of support from friends or my girlfriend, really. My parents have been really helpful but they are going to Mexico for two weeks so I'm on my own. Trying to get ahold of my mental health worker. 

 

Did all the right things last night (exercise, PMR, taking it easy) but I think I feel asleep for maybe an hour before waking up. 

 

I think there is a nice crummy interplay between my inherent anxiety and the semi-addictive nature of zopiclone. I don't WANT to take zopiclone, I don't seek it out or look forward to taking it, but it's a tool that I've needed and a tool I hate. At the same time, my anxiety about sleeping is feeding into the need for that tool. It's all good fun. 

[Gibby]

I'm back after a long absence.

 

I was tapering olanzapine, very slowly. Latest cut was from 1.8mg to 1.76mg, this was about ten days ago. 

 

I was managing it well but over the last few days I could feel anxiety starting to creep in, and it became harder to relax at the end of the day and fall asleep. Just felt more amped up. 

 

Last night I could not get to sleep at all. While I was awake at 4am, the news came in that my uncle died. Obviously this meant taking measures and I took some zopiclone to fall asleep, about 5mg instead of my usual 1.25 PRN. So I feel like a bag of rocks today: hungover, tired, and very sad because of my uncle. 

 

I've discussed all this with (most) of my team, and they've all said it's good to go back up to 1.8mg. I'm just concerned that it won't have any effect or make me sicker.

 

I've done all this before, and I know that going back up has always worked (after a period of adjustment) but I'm always afraid it will be permanent, as in, the "doped-up" feeling I get when I go back up from cuts. It never is and I always manage, but I'm still afraid. 

 

I'm also frustrated that this tiny cut had such an effect. I think my psych and I will have to sit down and formulate a new plan of attack. I'm fine with being stable for the next year so I can finish school. 

[Altostrata]

Gibby, there's no shame in going back to 1.8mg olanzapine and taking another pass as tapering when there's less stress in your life.

 

Clearly, you took too much zopiclone, please don't do that. Who is your team?

 

Please update your signature.

[Gibby]

2 hours ago, Altostrata said:

Gibby, there's no shame in going back to 1.8mg olanzapine and taking another pass as tapering when there's less stress in your life.

 

Clearly, you took too much zopiclone, please don't do that. Who is your team?

 

Please update your signature.

 

Hi Alto, 

 

My team is my mental health worker, my pharmacists, and my psychiatrist. They are all wonderful. Unfortunately my MHW and my Psych are on leave until next week so I guess I'm flying solo until then. 

 

I ended up in the emergency room today because my heart was racing like crazy and my left arm was numb. I'm only 28 so that was concerning. They did blood work, an X-ray, and and EKG. All were normal so obviously my body is still in withdrawal mode and is reacting with the symptoms of extreme anxiety (stomach cramps, wired-but-tired, heart racing, etc). 

 

The doctor said to give it a few days for the levels of olanzapine to stabilize in my body. I sure hope that it does, my main worry now is that I'll have to go on an even higher dose than 1.8mg in order to stabilize. I'm not sure if that'll happen or not but I guess that's anxiety for you. I'll see how the next few days go and try to play it cool. 

[Altostrata]

You probably will not have to go on a higher dose than 1.8mg olanzapine to stabilize. As your doctor said, it can take 4 days to a week for the drug change to fully register.

 

It might be a good idea for you to stay on this dose for a few months at least, let your nervous system settle down. You've had a lot of drug changes in your past.

 

How much citalopram are you taking now? At what times of day do you take each of your drugs?

[Gibby]

7 minutes ago, Altostrata said:

You probably will not have to go on a higher dose than 1.8mg olanzapine to stabilize. As your doctor said, it can take 4 days to a week for the drug change to fully register.

 

It might be a good idea for you to stay on this dose for a few months at least, let your nervous system settle down. You've had a lot of drug changes in your past.

 

How much citalopram are you taking now? At what times of day do you take each of your drugs?

 

That's what I'm thinking, too, it's just BELIEVING it that's the hard part. Anxiety does things to your sense of logic. 

 

I was on 1.8mg for 8 months and I plan to stay on 1.8, once I stabilize, for maybe a year. I want to finish school. Yeah, it sucks being on meds longer but I'm very close to having a career finally, so that takes precedence I guess. 

 

I take 40mg of citalopram. I take all my meds at night. I know you aren't supposed to take citalopram at night but the olanzapine usually "wins" and I sleep fine. The doctor I saw today recommended trazadone instead, but I don't feel like changing anything without a solid plan. 

 

I feel pretty calmed down right now, relatively,  just have a head full of rocks. I just hope I don't get a big energy spike before bed. 

[Altostrata]

Are you taking olanzapine because citalopram messes up your sleep? If that's so, maybe we should talk about reducing the citalopram rather than olanzapine. 40mg is a high dose.

[Gibby]

16 minutes ago, Altostrata said:

Are you taking olanzapine because citalopram messes up your sleep? If that's so, maybe we should talk about reducing the citalopram rather than olanzapine. 40mg is a high dose.

 

Well, I originally took olanzapine to keep me asleep all night when I was on zopiclone, since zopiclone only keeps me asleep about two or three hours. I guess I just got used to the combination since it is what's been working for fall these years. 

 

I did attempt a citalopram taper a few years ago. I made a very small taper using a liquid. Withdrawals never went away even though it was a small, small drop and I kept it there for months. So I have some work to do on that front. 

 

40mg is indeed a high dose, the highest they can prescribe. It gives me gas and heartburn, plus some sexual side effects that I've been able to work around. 

 

To be honest, thinking about it affecting me or tapering it or what have you is causing me some anxiety at the moment. I just want to be back to baseline with what I know works so I can feel "normal". I don't mean that to be brusque or rude if it comes across that way. 

[Altostrata]

I can imagine.

 

If I were you, with those side effects, I would consider tapering the citalopram. If the citalopram is activating, causing the sleep problem as well as those adverse effects, lowering the dosage could enable you to go off the olanzapine.

 

Keep that in the back of your mind, you might get more comfortable with the idea.

[Gibby]

3 hours ago, Altostrata said:

I can imagine.

 

If I were you, with those side effects, I would consider tapering the citalopram. If the citalopram is activating, causing the sleep problem as well as those adverse effects, lowering the dosage could enable you to go off the olanzapine.

 

Keep that in the back of your mind, you might get more comfortable with the idea.

 

So today was up and down. I slept last night without zopiclone, woke up feeling okay. Groggy, but okay. I was stressed most of the day, really physically stressed, just from everything. One of my cousins will be staying with us for a few days which throws me off a bit but I will try not to worry about it too much. My co-workers at my summer job gave me some going-away gifts that were really sweet and I was pretty happy. You gotta hold on to the little moments like that.

 

I agree with you that the citalopram should go first. In the current med combination it works fine, but yes, as things get moved around its activating qualities come to the forefront (I can deal with the digestive issues). Once I've been stable for a good long while, I will look at changing things. Right now, things are day-to-day and I'm trying to get as many zopiclone-free nights as possible, though I won't beat myself up too much if I need it for a night or two. 

 

I will, however, discuss the citalopram with my psych when I see him in September. The doctor at the ER suggested trazodone instead but, well, we will see.

 

Any advice for getting through the next few days? I want to be nice and ready to deal with grade 7s, haha

 

Oh and I appreciate the help and support so far!

[Altostrata]

Keep calm and carry on.

[Gibby]

4 hours ago, Altostrata said:

Keep calm and carry on.

 

Yup, will do. Today was a good day. Tomorrow I will have some tea, and it'll be good. 

[Carmie]

On 9/1/2018 at 10:31 AM, Gibby said:

 

Yup, will do. Today was a good day. Tomorrow I will have some tea, and it'll be good. 

 

Hi Gibby, 

 

Reading this made me smile. So u reckon tea helps, tea n a good book😄. 

 

Hope u continue to have some good days. 

 

Sending hugs🤗🤗

[Gibby]

Hi folks, sorry for the break. School started up again and has been quite busy.

 

Feeling pretty stressed out, frankly. Almost like I'm getting sick. Kind of antsy sometimes. Sleeping fine, though. Not sure what's causing what, though lots of stress at school is probably the culprit. 

[Gibby]

Three years later, I'm back. 

 

I've been fairly stable since my last attempt at a taper. I finished school, started teaching, basically lived life for a bit.

 

In a few days, I will begin a cross-taper from citalopram to fluoxetine, with the idea that the longer half life of the fluoxetine will make it easier to taper. I'd like to get off the SSRI first, as it's pretty activating, and the side effects from it are more embarrassing (constant gas, for one). Once I'm off the SSRI, I'll worry about the olanzapine; even reducing the dose of that by a bit would be nice, help me shed some weight.

 

At this point, it's not the fact that I'm on meds that bothers me (I've fared better on them than a lot of people), it's just that the side effects are really annoying and I'm tired of dealing with them. My cholesterol is quite poor, I've about ten to twenty pounds overweight, I have constant GI upset, heartburn at night, and gas, which makes dating or social interactions awkward when I'm having an episode. I wish I could go back to my 20-year old self and say "No, don't take that, you don't need to be on an antipsychotic for sleep, etc," but ruminating on the past is not helpful. 

 

I'm pretty nervous, frankly. I haven't successfully change a dose or a med in years. I worry about insomnia and possibly serotonin syndrome since I'll be taking 2 SSRIs at once (though the dose of c. will be lowered as the dose of f. increases). We'll see how it goes, and I'll update this thread with notes. 

 

 

 

Oh, on a positive note, I'm fully vaccinated. The 2nd dose really knocked me on my butt, but it was worth it. Maybe any pain from this new med plan will be worth it, too. Take care. 

[Gibby]

Okay, so I've done some digging. It turns outlet protocols for switching SSRI's are actually somewhat standardized. 

 

For the switch from any SSRI to fluoxetine, you're supposed to "taper and stop" before going on to fluoxetine, not cross taper like my psychiatrist set out. Tapering and stopping isn't much of an option for me since even modest cuts in my dose of citalopram leave me feeling kind of awful, hence why he suggested the cross taper. 

 

Main danger is serotonin syndrome. I'm well aware of the symptoms of that and I might delay starting the new taper until my mother is home from her cabin in case something goes wrong. 

 

What do you all think about this cross taper idea? My other idea was CTing citalopram, suffer while it washes out, then starting fluoxetine, which is...not ideal. I'll post the schedule for the cross taper when I pick up my prescription on Friday. 

 

I'm trying to be optimistic. It's been 11 years since I started these medications. They have helped me in some ways, but the side effects are just getting in the way of my life and my health. A wakeup call was in 2019, when my physician told me that my cholesterol was bad enough that I'd likely have a heart attack in my 40s. I was at a perfect weight for my height before meds (esp. olanzapine) and I really don't want to have to take cholesterol meds in my 30s. Time to take some risks, I suppose. 

 

 

[Gibby]

I got the "compliance pak" from my pharmacy for the cross taper today. They were very good, and answered my questions frankly and honestly. They've done this sort of protocol with other people before so they weren't going in blind. Of course, me being me, it likely won't be so cut and dry, but apparently this is standard operation procedure now.

 

Here is the schedule:

 

Week 1 - 10mg Fluoxetine, 30mg Citalopram 

Week 2 - 20mg Fluoxetine, 20mg Citalopram

Week 3 - 30mg Fluoxetine, 20mg Citalopram

Week 4 - 40mg Fluoxetine 

 

I start all this Monday night. 

 

Despite the somewhat upsetting name, I'm actually glad about the "compliance pak", I really would not be able to keep track of this by myself as I am a forgetful dude at times. 

 

I haven't really gotten any feedback on this so far. Chime in if you feel like it, I guess.