Taper, Celexa, The journey begins

Hi, if you're considering tapering I strongly advise you to visit the Surviving Antidepressants website for their advice. They are taking new registrations this month I believe, no charge, their advice in invaluable. Good luck!

Hello. I've read your post and wish to make comment as a retired medical professional.

With your Thyroid removed you've been provided with synthetic levothyroxine, correct? And I would assume that prior to surgery that you had at some point been evaluated with hyperthyroidism that was somehow being misinterpreted as anxiety, followed by treatment with the Celexa. Would this be a correct assumption? Initially, I'd be interested to know whether early clinical lab studies were performed regarding TSH, T3 & T4 levels at any point in time to determine thyroid function.

My primary point to the above comments is that you'll be dealing with two factors simultaneously, one being a taper of the Celexa while simultaneously maintaining the most stable dose of levothyroxine. It's important to understand that a synergistic effect of these medications may arise as you begin to taper from the Celexa and since you no longer have a thyroid gland, the stability of mood regulation is to some extent being influenced by the level of synthetic hormone levothyroxine that is keeping thyroid function within the normal range. Lastly, in this context, the use of Celexa to target anxiety is what is known as an off-label use of the drug, which is more commonly designed to treat clinical depression. So mood regulation may not necessarily produce the expected effect and could potentially result in potential bouts of clinical depression. The reason for this is because Celexa is designed to up-regulate serotonin.

I point out the above scenario because the actual reaction by your brain to gradual reductions in Celexa is that the brain must begin to produce stable and proper levels of the neurotransmitter serotonin. The brain is very unique in that if artificial neurotransmitters are introduced via medications, the brain responds by down-regulation of its own production of the natural neurotransmitters. When the artificial neurotransmitters are diminished by taper to the extent of termination, the brain is responding by way of reconstituting manufacture of ample levels of the natural form in order for homeostasis, or normal regulation and function, to be achieved. While this can be accomplished largely through the effects of careful tapering of such drugs, it's merely important to remember that a secondary influence is at hand in the way of levothyroxine and its impact upon mood regulation.

While the SSRI Paroxetine imparts a more serious interaction with levothyroxine levels, it merely warrants concern with respect to the SSRI Celexa because tricyclic antidepressants are more often the drug of choice to be used in combination with levothyroxine. As you proceed with tapering from Celexa, it may simply be wise to ask your physician whether close monitoring of thyroid function would be wise until the taper is complete.

I simply want to point out this issue since your taper from Celexa is not one being performed in isolation from other circumstances that may or may not play a role.

Best regards