Citalapram discontinuation

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After being on Citalapram for 15 years  ( 60 mg finally ) it stopped working X so I tapered off x had my last dose two months ago. I feel awful although my husband says I am " more real. ". I get sad, occasionally suicidal, very stress- sensitive, fatigued , have difficulty  with sleep, lack appetite, X I obsess over things. I try to eat well X I exercise daily X I take vitamins. I need help to sleep better.

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  • Posted

    I am sorry you are feeling so badly.  You are in withdrawal from Cit.  The symptoms you listed are very common AD withdrawal symptoms.  What was your taper schedule and what was the dose before you quit?  Sometimes reinstating the last dosage will give you relief from your symptoms.  Just know that this is withdrawal and not YOU.  From there, you can do a much slower taper.

    Fish oil and magnesium are very helpful when healing.  Magnesium glycinate is absorbed better than some cheaper forms; you can start with 200 mg AM/PM, helps with sleep and anxiety.  You can also take epsom salt baths; magnesium is absorbed through the skin.

    You were on Cit for a very long time and may have come off too fast.  Your nervous system will be slow to recover to your "factory default."  It will also be sensitized to stressors.  Withdrawal recovery occurs in a waves and windows pattern, the waves being the bad symptoms and the windows being periods where you feel better.  Just know that if you do have a window, it may be followed by a wave again, but that is the normal pattern, so knowing this can help you endure.  Experiencing stress during windows can throw you into a wave, so it is important to try to protect yourself from undue stress.

    I would recommend joining the forum at survivingantidepressants.  There, you can create an intro for yourself, describing your history with meds and explaining your symptoms.  The moderators are very helpful and knowledgeable and many people who are on Cit will chime in with their experience.  It's a very supportive community, as is this one.  Someone will be able to advise you with regards to what actions to take to ease your suffering (beyond what I have already written).

    Mindfulness/meditation can be very helpful as well.  Try to be kind and gentle with yourself during this time since your nervous system is in upheaval.  

    I hope that this helps.

     

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    • Posted

      Thanks betsy0603.  My dose was 60 mg X I started tapering last May. My last doseage was 20 mg. which I finally finished sept 16th. I feel overwhelmed with stress symptoms at night X mindfulness X breathing exercises cease to have affect. 5htp X l- tyrosine has been recommended ,has anyone found these helpful.?  

      I am reluctant to go back on Cit

      Daytime, I can distract myself with varied interests. What could help me is is hearing from others their success stories X how long it has taken them. Is there a nighttime remedy ? I have tried an antihistamine to no affect last night. Thanks for your help. I feel pretty desperate X would rather be dead

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  • Posted

    Hi Paddy

    When I was off medication I took a natural SSRI called 5-HTP which needs to be taken with l-tyrosine.  Both can be bought from Holland & Barrett (if you're in the UK) and you need to take them both.  Read a book called 5-HTP The Natural Way to Overcome Depression, Obesity by Michael T Murray ........ it's a really interesting read.

    You need to be off SSRI's completely before starting 5-HTP as they must not be taken together. 

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    • Posted

      Oops, pressed REPLY before I'd finished.

      5-HTP and l-tyrosine has no known side effects and you can start/stop them when you like, unlike Citalopram etc.  They really worked for me and took them a year.  Sadly a major trauma made me restart Citalopram a year ago, and now all is settled again I've again reduced my meds and am now on 5mg and will stop next year to go back on 5-HTP etc.

      The book is really very good.

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    • Posted

      Thanks katecogs. When you went back on Citalapram did they take long to work again X did you find they worked as well as before?

      i,m sorry about your major trauma . Good for you reducing  again.

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    • Posted

      Hi Paddy

      When I restarted the meds again I did notice the side effects more this time around, but think that's because the first time I ever took the. I was so ill with anxiety depression I maybe didn't notice any extra anxiety as I had it so high anyway.  I started them last September and reckon it took until around February/March when I started feeling better, and because I'd been so well for years I really felt the anxiety this time around.  I think it took a wee bit longer too.  But ..... the meds have worked just as well as before.  Soon as they kicked in I felt back up on top.

      K x

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    • Posted

      Oops, spelling really off. I took something that helps me a little to sleep last night called Restavit that I can get in Australia. It,s a 25 mg tab of Doxylamine succinate that is commonly used for people for hay fever problems.
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  • Posted

    Hi Paddy, 

    You jumped off from too high a dose which you were on for a very long time, which is why you are having such withdrawal symptoms.  Citalopram has 80% receptor occupancy at the minimum dose of 20 mg which is saying that you went from 80% to 0%, a huge leap and a huge adjustment for your nervous system to make, basically equivalent to doing a cold turkey.  Receptor remodeling does not happen quickly, and unfortunately going cold turkey can cause protracted withdrawal that can last anywhere from several months to two years or more; no hard, fast rule because everyone is different.

    Reinstatement to 10 or even fewer mg would be advised to ease symptoms, followed by doing a 10% taper per month of the previous dose from there on out. People often exclaim that they want to be rid of the drug forever and will just tough it out, but most of them end up reinstating because the suffering is just too much to take.  

    I am not trying to frighten you, but just want you to know what your options are.  Many on surviving antidepressants have tried alternatives such as 5-htp, but nothing will speed withdrawal recovery since it is about your nervous system having to make huge adaptations back to the factory default, if you will, and nothing speeds that process.  The fact that no one on the site discusses 5-htp or tryptophan as being beneficial says a lot.

    From one of the administrators:

    What is known about reinstatement

    from my reading and from patient experience as posted on online support sites:

    According to medical knowledge, reinstatement is the only way to alleviate withdrawal symptoms.

    Reinstatement is best done immediately upon appearance of withdrawal symptoms. The more time that passes, the less likely it is to work.

    The length of this window of opportunity varies according to the individual. Sometimes people can reinstate successfully months after quitting. Others cannot.

    Some find a partial dose will relieve withdrawal symptoms. If, for example, you were taking 20mg Paxil and quit rapidly only a few days ago, 5mg or 10mg may be enough. Others find they need a higher dose.

    Start low to see what you need. You can always increase if necessary. If you've been off the drug for a month or more, many people can find relief from antidepressant withdrawal symptoms by reinstating as little as 1mg-5mg.

    Additional reasons to reinstate only a partial dose

    Reinstating at a low dose reduces the risk of severe adverse reactions in case reinstatement does not work.

    Experiencing withdrawal may have sensitized you to drugs and a larger dose will cause an adverse reaction.

    These drugs are vastly more powerful than they need to be and you want to be taking only the lowest EFFECTIVE dose.

    Your receptors may have adjusted somewhat (upregulated) during the time you had withdrawal symptoms.

    If you can stabilize on a lower dose, you have less to taper when you finally do go off.

    If you had adverse reactions while you were taking the drug, a low dose may not trigger the adverse reactions but still reduce withdrawal symptoms. Adverse reactions tend to be dosage-related: The higher the dose, the worse the reaction.

    You can always adjust the dosage upward if you find you need to.

    How long should you give reinstatement?

    It takes at least 4 days for your body to fully register the addition of a neuroactive drug. Unless you have an immediate bad reaction, observe your symptom pattern for about a week to see if the reinstatement is helping. If you have an immediate bad reaction, reduce or stop taking the drug.

    After reinstatement, the amount of time needed to alleviate withdrawal symptoms (stabilizing) varies according to the individual. Relief can be felt immediately, after some weeks, or after some months.

    Once you feel withdrawal symptoms are reduced after reinstatement, give your nervous system time to stabilize before attempting dosage reduction.Think in terms of months, not days.

    Be patient after you reinstate. Reinstatement may not immediately eliminate all withdrawal symptoms. You may still experience waves of symptoms, which usually lessen as time goes on.

    The dose needed for effective reinstatement varies according to the individual.

    When to discontinue reinstatement

    If, upon reinstatement, you very soon feel worse, most likely you are sensitized to the drug and need to take a smaller dosage or, possibly, none at all.

    Sometimes reinstatement does not work. The nervous system has taken such a hard hit from withdrawal, it's destabilized beyond whatever effect the drug might have had.

    Sometimes reinstatement not only does not work, it causes an adverse reaction from a nervous system sensitized by withdrawal.

    If you have an immediate bad reaction, reduce or stop taking the drug.

    Reinstate at what dosage?

    Sometimes reinstatement not only doesn't work but makes symptoms worse. That is why we often suggest very, very low doses -- to reduce this risk. Higher doses can go wrong in much bigger ways. A very low dose is a way to explore the option with less risk.

     

    The dosage is always going to be a guess. Here are some factors that might influence the dosage of reinstatement:

    How the person quit the drug and how long he or she's been off it. If you've just cold-turkeyed 20mg Celexa a few days ago, you might reinstate at closer to your original dosage, such as 10mg. (It may not be necessary to go back to 20mg, standard dosages tend to be overly powerful.)

    If you've had withdrawal symptoms for a month or more, it's likely your system is somewhat sensitized to drugs. You might wish to try reinstating at a lower dosage, such as 2mg-5mg (if you had been taking 20mg Celexa).

    Your present condition. If you have symptoms of hyper-reactivity, alerting (anxiety, panic, sleeplessness), you may be too sensitive for reinstatement. If you want to try it anyway, you might wish to try reinstating at a very low dosage, such as 1mg (if you had been taking 20mg Celexa).

    How long you've been off the drug. If you've been off the drug for many months, reinstatement is less likely to work. If you want to try it anyway, you might wish to try reinstating at a very low dosage, such as 1mg (if you had been taking 20mg Celexa).

    Other drugs you're taking. Be very careful adding a drug to other drugs. Use the Drug Interactions Checker before even considering this. (Your symptoms may be due to drug-drug interactions.)

    None of the above are hard-and-fast rules. There are reports of people with prolonged post-withdrawal syndrome who did better taking a drug at full dosage 2 years later. If you want to do this, please consult a doctor, we cannot advise you on it.

    End quote

    As you can imagine, tyring for such small doses means getting a liquid version of the drug that can be measured with a syringe, or weighing dry dosages with a jeweler's scale, obtained for around $22 on Amazone for folks in the US.  Pretty sure there's a source in the UK.

    I strongly urge you to join SA for better guidance by the moderators who are very experienced in the matters of withdrawal from antidepressants and other psych drugs.

     

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    • Posted

      Wow, I simply had no idea X I sit on my couch still shaking my head as I write this , with the information you,VE so kindly given me. I appreciated being on Anti- depressants when I did need them X I was happy enough to continue while the Citalapram worked for me as I was into the " you have a missing chemical" line of thought.

      I have a happy, settled life now X thought I could vacate these drugs with a slow- enough tapering off. It has been horrific. Last night I managed to sleep for a period or two X I feel so grateful but I will ponder your info X act on it.

      i am between two countries at the moment ( Australia X New Zealand) X my GP in Australia showed disinterest in any withdrawal symptoms I was getting, although he was good with referring to a gastroenterologist as constipation reared it,s head with the drop in seretonin. I went on a pro- biotic X fish oil etc. X who knows whether it,s helped.

      What is SA X how do I contact?

      again, many thanks.

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    • Posted

      My husband , a Pharmacist, managed to cut a 20 mg.tab of Citalapram to 2.5 mg, the lowest he could get. I had a crying session before I took it because I,VE had so much invested in being drug free.

      So here,s hoping it works ok so that I can look forward it being a longer term plan.

      Thanks for all your help, BETSY x the commentator.

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    • Posted

      I talk about 5-HTP a lot as have used it along with l-tyrosine (both are needed together).  Sadly having to have restarted Cit a year ago I'm currently down to 5mg Cit ready to quit next year in order to restart 5-HTP etc.

      K x

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    • Posted

      SA is survivingantidepressants org and there are people there from all over the world.  People who have been in the withdrawal trenches and come out the other side stick around to offer up support and guidance.  Tons of good information there.  
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    • Posted

      I read a book called The Mood Cure that discusses all the serotonergic supplements and how/when to use them depending on what you are addressing, anxiety or depression, etc., and I do think that 5-htp and tryptophan can be very useful for those who want to avoid psych drugs, but when a person is in protracted withdrawal, it is a whole other matter, and such supplements can actually cause a worsening of WD symptoms.

      Last year I went off of Effexor too fast after a 12 year stint with it, and started taking tryptophan and Sam-E instead.  I was having physical withdrawal symptoms I thought were due to menopause, which I was also entering:  horrible sweats day and night (drenching!), mental fog, confusion, inability to reach for words in conversation, unable to construct an articulate sentence, heart palps, raised heart rare and BP, burning skin sensations on my torso, etc. and the supplements did nothing to change that.  But, since I wasn't yet feeling depressed or anxious, I thought it was menopause.  Then, about six months out, I started having waves of anxiety I had never had before, terrible insomnia with repetitive, anxious thoughts, and depression.  The supplements did nothing to stave that off.  I now know it was protracted wd from Effexor, but at the time thought I was relapsing, though I had never had such severe symptoms before or during drugs.  And that is how it is with WD; they call them neuro emotions.  They feel real but are beyond anything you've ever dealt with before, totally irrational.   Plus, I developed agoraphobia which I never had before, and horrible cortisol rushes in the night that would startle me awake, as well as a sense of pending doom.

      Admittedly, I didn't use tyrosine with those supplements, but it wasn't discussed in the book.  It turns out that Sam-E can CAUSE anxiety, so I wasn't helping myself with that one!

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    • Posted

      Can he look into getting a liquid version?  Some compounding pharmacies can make it, or you can make your own if the tablet is water soluble.  
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    • Posted

      I feel almost tearful reading your account betsy0603 cos my symptoms have been so like yours , the cognitive ones X the hot torso, almost a burning sensation, the cortisol etc. I am post menopausal at 69 years.

      i went to buy the 5-htp yesterday but the three pharmacies I went to didn,t have any X the health shop was closed since it was a Sunday.

      Today, however , I,VE reinstated Cit to 2.5 mg X will now pursue this instead.

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    • Posted

      Michael was talking of getting a mortar X pestle to help me reduce in liquids form for the future, so yes.
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    • Posted

      I'm talking after the event ..... after Paddy has got through this withdrawal and completely off meds.  Something to consider for the future...
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    • Posted

      I used to use a pill crusher to powder the tablet, but then I would weigh the amount I needed with a jeweler's scale that weighs milligrams and mix it in juice.  Since the stuff doesn't disolve well, I'd fill the glass with water after taking the juice and drink that as well so that I was sure to get all the powder.

      Your husband can figure this stuff out, but you need to take into account the displacement the tablet volume displaces in a volume of water so that you know your final volume and can calculate what percentage of that volume you need to consume.  And then shake very well before measuring that amount since the stuff won't stay suspended in the water long!  You can PM me for more details if you like.

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    • Posted

      Ooops, I was confusing you forgetting that this was Cit and not Remeron, which is insoluble.  Hopefully Cit is soluble in water.  You might want to experiment with placing a tablet in water and seeing how quickly it disolves on its own.  What would be great is if you could place the tablet inside the barrel of a syringe, suck up a known volume of water and then wait for the tablet to disolve.  Suck up a bit of air so there is room in the barrel to shake the water/tablet to mix, and then push the air portion out again.  You will probably have to toss the amount you aren't taking since it isn't known how long it will last once mixed.
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    • Posted

      You know, you mentioning tryptophan reminds me of many years ago before I was taking SSRI's, I was invited for a drugs trial (or I probably volunteered).  Can't remember exactly what I did, but they were testing tryptophan on various people for about 6 weeks whilst they did various mental exercises ie memory etc.  I always remember one particular day I was there doing some computer test and during the day I was given tryptophan ........ soon after I felt very elated, the depression and anxiety had gone.  Only lasted for the afternoon, and of course didn't realise it was actually the tryptophan at the time.

      An interesting time.

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    • Posted

      Wow, that is cool!  When I am finally off the meds after a slow taper, I will go back to adding tryptophan. When I was a teenager, we would take it at bedtime to help sleep.  That gets me wondering about why my sleep wasn't good back then, can't remember!  Milk helps me at night, likely due to the natural tryptophan in milk, plus the milk suger probably ups serotonin as well, but not in such large amounts as to be dangerous with SSRI/SNRIs.
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    • Posted

      That's interesting 😊  Are you in America btw?  I read tryptophan was used as a sleep enhancer but in time the FDA took it off the health food market ... strangely a few months after that Prozac was introduced.  Tryptophan has since been reintroduced.

      How great to have that to help.  Yes milk is meant to have it in it naturally.  I always hated milk on its own (used to avoid drinking it at school - gave it to friends instead lol).  My mum used to make us milky cocoa at bedtime though mmmmm.  

      😊☕️

       

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    • Posted

      Yes, I'm in America. The FDA removed it due to a link to illness and death, which ended up being due to contamination of tryptophan made in Japan.  That is an interesting observation about Prozac! 

      It took 12 years before tryptophan was allowed back on the market!  5-htp is another supplement that is a precursor to serotonin.  Unfortunately, neither has been found helpful to curb protracted withdrawal :-(  They certainly didn't make a difference for me!  But I do think for people who aren't in withdrawal who want to avoid psych meds, they are a viable option.

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