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Citalopram - Pure OCD - Second Time

Posted , 5 users are following.

bob_25326
bob_25326

Hi,

After starting Citalopram for Pure OCD, I felt great after about 3 weeks.

After about 4 months of feeling better, I decided I was ready to stop taking it.

I started to reduce my dose and went down from 20mg to 10mg a day, but after about a week or so the symptoms came back again as strong as ever.

So I went back to 20 mg, but after about 5 weeks of being back on the full dose, I'm still feeling terrible.

Has anyone had a similar experience, and does it take Citalopram take longer to kick in the second time round?

Thanks

Bob

0 likes, 13 replies

13 Replies

  • weenett
    weenett bob_25326

    Posted

    Im not sure but i hope so i think its taken me roughly a month longer this time
  • john059
    john059 bob_25326

    Posted

    Bob

    I have read in here that it does take awhile longer for it to take effect when you start up again. Stick with it!!! Its only time and as you know the benefits of these meds are worth it

  • katecogs
    katecogs bob_25326

    Posted

    I'm on these melds for the second time and it took much longer for them to kick in.  It's advisable to stay on meds for at least a year to ensure symptoms don't return.

    Recovery often comes in waves, which can last months and months, so it might be that you started feeling a low time when you were reducing, which might have been too soon?

    The meds will work for you again.

    K x

    • katecogs
      katecogs

      Posted

      Melds?  That was meant to say meds 😊
    • bob_25326
      bob_25326 katecogs

      Posted

      Thanks Kate, you're probably right that I came off them a bit too soon. Just looking forward to them kicking back in now!

      Thanks

      Bob

  • betsy0603
    betsy0603 bob_25326

    Posted

    HI Bob, 

    You came off a bit too fast, I hate to say.  When the symptoms came back stronger than ever, that was due to the imbalance caused by coming off the med too fast, not due to a relapse of your original complaint.  There is a distinction. 

    I wish I could post links here but patient won't allow it.  There's a wonderful research article that looks at the occupancy of sertoinin receptors (the reason these are called "re-uptake inhibitors") by varying dosages of these drugs.  For citalopram, at 30 mg receptors are blocked by 80% which is about the most they get blocked even if the dosage is increased from there.  At 20 mg, they are still blocked at close to 80%!  But at 10 mg, they are still blocked at about 70%, but that 10% difference means receptors are freed up which means destabilization and withdrawal symptoms, because the nervous system got itself used to operating with 80% blockage.

    Between 10 mg and 0, that's a freeing up of a whopping 70% of your receptors, so just imagine the neurotransmitter imbalance caused by that!  It is the imbalance that causes the symtoms and "relapse"!

    What no one explains to patients is that when you first take these drugs, they create an IMBALANCE of serotonin and other neurotransmitters that are inter-related.  This causes side effects, and in the case of citalopram, from what I've seen, a lot of start-up anxiety!  The nervous system doesn't like this excess serotonin in the gap between nerves and wants homeostatis, so it sets about making adjustments such as pruning back the number of receptors (down-regulation).  Eventually, side effects settle down because the body has made these adjustments.

    Now you try to come off the drug, but these compensatory adjustments are still there, so not only are receptors no longer blocked by the drug, but you also have these push-back modifications that must be reversed by the nervous system, but this takes a lot longer than most taper schedules allow.

    So, what you have gone through, Bob, is a big bounce on the brain from going to zero too fast, with another bounce on the brain from trying to reinstate.  Your system is all over the place and it will take time for it to settle out and figure what it supposed to be doing. It was freaking out trying to upregulate and then you thew the reinstatement at it and it's going "WHAT?!!!"

    It may be that your system had done some up-regulating and taking 20 mg exceededthe level of healing, so you are perhaps having side effects again (imbalance in the upward direction).

    You will see that I have encouraged many people on this forum to follow a 10% taper program.  This is because the nervous system is slower to respond to downward changes with upregulation than anyone expects.  We can't force faster healing by going faster.  As you can see, it's not about getting the drug out of your system and it will be over with faster; the problem IS getting the drug out of your system too fast, that your system can't keep up with the changes.

    The last thing you need is to be bounced all around any longer, Bob, so you may just need to sit tight with this dose and wait for your NS to get caught up with everything that it has been through.

    I'll send you a link for that article by PM.  Page four has the chart for citalopram.

    Meanwhile, for the future, see the topic "why taper by 10%" or such in the following topic:  https://patient.info/forums/discuss/depression-resources-298570

    • john059
      john059 betsy0603

      Posted

      Wow Betsy. That was an interesting read. Very insightful. Thanks for sharing this.
    • bob_25326
      bob_25326 betsy0603

      Posted

      Thanks Betsy for your helpful advice. Definitely some good words of wisdom! It makes sense and reassures me that the meds will work again, just have to stick with it!

      Thanks

      Bob

    • betsy0603
      betsy0603 bob_25326

      Posted

      I am hoping that will be the case, Bob, but ultimately these meds poop out, in which case slowly tapering off is your best bet for feeling better.

      I see it time and time again, here and on other forums, that people go on long term and find themselves still not feeling great, which is actually due to the long term negative of these drugs.  But, unaware of the connection, they believe that this is their original condition showing through, and so they must need the drugs.  It's a paradoxical situation.  It leaves people feeling that they really must need an antidepressant, so they feel that in coming off one, they will need to go onto another.  

      I have been slowly tapering off Effexor, one bead at a time, for the past year, and now on 24.5 mg (37.5 mg is the minimum pill size), and  I have to say I feel better than I have for the whole 20 years I've been on ADs!  I handle stress SOOOOO much better than ever before, don't get triggered into depression the way I used to on much higher amounts.  So, to me that is proof that the drug had a negative impact after all those years, and that it is possible to feel better and better on less and less.  Just food for thought.

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