Been off citalopram for 10 days...need to go back on?

[eaamesnyc]

Hi,

It's been a long time since I've posted here....

Last year I went on citalopram after I noticed that I seemingly lost the ability to sleep and developed extreme anxiety after that.

I started out at 20mg and after a few months, went up to 40mgs for 3 months. I finally was able to sleep again and it actually made me too sleepy so I dropped back down to 20mg. At 20mg, I was still able to get restful sleep for the most part. My anxiety symptoms went away almost immediately after starting citalopram and I felt great and like my normal self.

This summer, I decided that after 9 months and I was feeling great, I should ween off completely as I was under the impression that I didn't want to be dependent on meds for the rest of my life. Doctor said it was OK and the summer was a great time to try to come off.

I dropped from 20mg to 15mg after about 8 days, then 15mg to 10mg after another 8. I did 10mg for 8 days, 5mg for 4 and it's been 10 days since my last one.

At 10mg, I noticed that I started getting sleep problems again but I chalked it all to part of the withdrawal process so I started taking a low dose (maybe 1/4 of the recommended dosage) of benadryl in the form of Zzzquil.

Since then, my sleep has gotten progressively worse to the point where it's almost as bad as what it was before I started citalopram. (I slept what seemed like just 3-4 hours last night). I also had the 'brain zaps' that people tend to complain about and while they were uncomfortable, they weren't debilitating. (I didn't run any marathons or anything but I still was able to go to work, see friends, etc..)

This past weekend, the zaps have lessened to a huge degree but the sleep problems are there and it's making me unhappy.

Should I stick it out and wait to see if my sleep problems get better? Or should I go back on it? And if I do, should I go back on the 20mg dose and wait until next year, or go back on 20mg for a few months and try to ween off slowly? I guess my fear is that after 10 days of being AD-free, I'm worried that I'm going to go through this several months process of getting adjusted to it and sleeping normal.

Wondering if anyone out there has been in my shoes and any advice would be extremely appreciated. Thanks.

[keithwms]

Sorry that you're having these difficulties. The good news is that they are fairly common discontinuation issues and there are some things you can do.

Interesting that you used benadryl for sleep, because that also happens to be a pretty good aid for brain zaps and other SSRI withdrawal symptoms. I learned this when coming of venlafaxine. Diphenhydramine, the active ingredient in benadryl- can be quite helpful in tamping down anxiety and dealing with the other withdrawal effects. Turns out that it is a nonselective serotonin reuptake inhibitor... a precursor to the modern SSRIs. So my suggestion is to try partial doses of diphenhydramine and see if that helps you, and also try to avoid any strong stimulants e.g. caffeinated tea/coffee, sugary substances etc. You just need to avoid anything that 'unlevels' your moods or energy level for a while.

I understand that liquid prozac (and perhaps also liquid citalopram?) are useful for tapering down; you can take smaller and smaller doses. If you need to go back on something like that for a while, don't be discouraged- it happens. There is no tremendous rush to get to zero dosage. One of the biggest mistakes people make with these meds is to become impatient and quit cold turkey. I did that with the venlafaxine and.. bad move! We have to be very patient with ourselves and let things re-equilibrate.

I also find that adding a rigorous exercise regimen is very helpful.

I recently stopped cit while starting escitalopram, so... I can't say I know exactly what it's like to stop completely the way you did, but I have stopped many other SSRIs in the past and yep, it can be a bumpy ride for a while. The best thing you can do is taper very slowly.

[eaamesnyc]

Sorry that you're having these difficulties. The good news is that they are fairly common discontinuation issues and there are some things you can do.

Interesting that you used benadryl for sleep, because that also happens to be a pretty good aid for brain zaps and other SSRI withdrawal symptoms. I learned this when coming of venlafaxine. Diphenhydramine, the active ingredient in benadryl- can be quite helpful in tamping down anxiety and dealing with the other withdrawal effects. Turns out that it is a nonselective serotonin reuptake inhibitor... a precursor to the modern SSRIs. So my suggestion is to try partial doses of diphenhydramine and see if that helps you, and also try to avoid any strong stimulants e.g. caffeinated tea/coffee, sugary substances etc. You just need to avoid anything that 'unlevels' your moods or energy level for a while.

I understand that liquid prozac (and perhaps also liquid citalopram?) are useful for tapering down; you can take smaller and smaller doses. If you need to go back on something like that for a while, don't be discouraged- it happens. There is no tremendous rush to get to zero dosage. One of the biggest mistakes people make with these meds is to become impatient and quit cold turkey. I did that with the venlafaxine and.. bad move! We have to be very patient with ourselves and let things re-equilibrate.

I also find that adding a rigorous exercise regimen is very helpful.

I recently stopped cit while starting escitalopram, so... I can't say I know exactly what it's like to stop completely the way you did, but I have stopped many other SSRIs in the past and yep, it can be a bumpy ride for a while. The best thing you can do is taper very slowly.

Thanks. The truth is that the brain zaps don't bother me too much. They're unpleasant, don't get me wrong, but I am fine going through them knowing there will be better days.

What I can't stand however is not being able to sleep. It ruins my mood during the day and affects my work performance, my happiness, etc..

The inability to sleep again is what's freaking me out the most.

I emailed my doctor today and he told me to stick it out for a few more weeks , taking Benadryl to help go to sleep and then see if my symptoms get better. If my mood doesn't improve though, I can go back on.

[martin222]

i read this all the time and its so frustrating,the reason people feel better is because the citilapram is doing its job, ie making you feel normal. cit isnt healing you, its just stopping you having anxiety. its obvious when you stop cit the anxiety and old problems will return, unless your the one percent who is dead lucky and dont go back to old ways! i look at it this way, and iv suffered anxiety for years, and as most on here know isnt nice at all. even if cit is addictive, SO WHAT!!, id sooner be addicted to cit then live a life under a dark cloud, feeling shite with awful mind chatter that drove me nuts, for the first time in years a ton weight has been taken from my shoulders, i will fight tooth and nail to stay on cit, cos its a damn sight better then the alternative. the moral of the story is if you feel better on cit, STAY ON THEM!! and have a life!

[eaamesnyc]

i read this all the time and its so frustrating,the reason people feel better is because the citilapram is doing its job, ie making you feel normal. cit isnt healing you, its just stopping you having anxiety. its obvious when you stop cit the anxiety and old problems will return, unless your the one percent who is dead lucky and dont go back to old ways! i look at it this way, and iv suffered anxiety for years, and as most on here know isnt nice at all. even if cit is addictive, SO WHAT!!, id sooner be addicted to cit then live a life under a dark cloud, feeling shite with awful mind chatter that drove me nuts, for the first time in years a ton weight has been taken from my shoulders, i will fight tooth and nail to stay on cit, cos its a damn sight better then the alternative. the moral of the story is if you feel better on cit, STAY ON THEM!! and have a life!

Well to be clear, my anxiety isn't back - my insomnia is however, which as I understand it is part of the withdrawal process. I just don't know why I have it again (whether it's withdrawal or part of the anxiety)

To give some background, I'm 31 years old and I never had a case of anxiety problems until last year where it seemingly crept up from nowhere. Because of my age and manifestation, my doctor thought that it would be temporary.

I'm hoping what I went through was a one-time deal but I guess we shall see. I'm going to give myself another 2-4 weeks to see if my sleep gets better and the brain zaps go away and then make a decision from there. Doctor says he's fine with me going back on them if need be.

[keithwms]

Well, other than restarting cit, one thing you might try is a single dose of fluoxetine (prozac). I have read that this can be helpful with ending the withdrawal symptoms of venlafaxine, which is something that metabolizes much quicker than fluoxetine. The basic idea is to introduce a longer half life / metabolite SSRI that will taper down more slowly in your system.

Now, cit has a half life of 35 hours, according to wikipedia. Fluoxetine has a half life of 1-3 days... so it could do the trick of providing you a longer natural taper.