Meds review next week, feeling much better, am I ready to come off yet?

[Sparkle1984]

I've been on citalopram 10mg since August last year. I have a review with my doctor every 3 months, and my next review is due in a week's time. I started to feel better within a few weeks, and I've also been learning a lot of coping techniques. I've been working really hard to change my negative ways of thinking and I successfully completed a CBT course last year. I regularly listen to relaxation MP3s and I make sure I allow myself more personal time to chill out. :)

I feel like I can cope a lot better now. I hardly ever get anxious feelings nowadays, and even when I do, I can rationalise them more easily so they disappear fairly quickly. So now I'm wondering when I'll be able to start coming off the meds. I was thinking about mentioning this at my doctor's appointment next week. Does anyone think that 5 months is too soon to think about coming off them? Obviously the last thing I'd want is for my anxiety to return.

When I had my previous review at the end of October, the doctor was very pleased with my progress but she pretty much said I could stay on the meds for as long as I wanted, or that I could possibly try coming off them at some point in the future if I felt confident enough to do so.

Ideally I'd like to be completely off them by June/July time as I've got a couple of holidays coming up this summer. Does that sound like a reasonable goal to aim for?

If I do ever find that my anxiety becomes unbearable in the future, I can always ask to go back on the meds can't I? I'll ask my doctor to confirm that's the case. I'd feel happier about coming off them if I knew I'd be able to go back on them if I ever needed to in the future.

Has anyone got any advice about this?

[Oosh]

It may be useful to you to see how you are when you're not on them.

You could, with your holiday in mind around June, taper off meds between now and end of feb. Give yourself whole of march to monitor yourself and see if you have any bad reactions or not. If you conclude that you feel less than you want to feel you can use April and May to get the meds back in your system thoroughly by your June hols.

It's a good goal to want to try to come off the meds that are helping you. But this way you give yourself a big safety net in case it's not ideal and you don't want your holiday ruined :-)

[cmc46]

Hi Sparkle,

Sorry I can't help you with your query but I am in a similar situation, I started Cit last July, the last time saw my GP was in November and he said he would like me to stay on them till March, like you I still feel the anxiety occasionaly but feel I can now cope with it and it doesn't last long, I would be veery interested to see how you get on at your review and if you have to start cutting down how it goes, in one way I want to come off of them and in another I am a bit scared to.

Good luck , Christine xx

[Dazza123]

One thing I would be weary of is if you come off them now, and need them again in the future, they may not have the same effect on you. I used to take fluoxetine about 7 years ago which worked wonders for me, tried them a few years later and I couldnt tolerate them at all. I know your break in between would be a lot less if you had to retake them, but just thought id mention it. Good luck if you decide to come off them, only you will know if its right, and I hope it is and that you are able to live without them :yesyes:

[Sparkle1984]

Thanks for your comments. I'm still not entirely sure what to do. My anxiety is a bit different compared to a lot of other people's, in that it comes on in "episodes" instead of being there all the time. My episodes come on very suddenly and they can last for weeks or even months. Eventually they fizzle out and I can go for months or years until the next episode starts. Between episodes, I feel happy and relaxed nearly all the time. Nearly every time I have an episode, the anxiety is about a different topic - it always plays on my worst fear at that particular time.

My latest episode, which began in July last year, was focussed around the fear of death and dying (not just about myself but about my loved ones too). It was very intrusive and it was on my mind pretty much all the time, and I had many physical symptoms too. It was actually the first time I'd ever sought medical help for my anxiety, as my previous episodes weren't so severe and I was able to deal with them by myself.

I consider my current episode to be over. As my anxiety is intermittent instead of being permanent, I'm just not sure if it's worthwhile to stay on meds forever. What does everyone think about this? I was thinking that I'd just be able to go back on them if I have another bad episode in the future.

Dazza - I have heard some people say that a particular medication might not be so effective second time around, or that you might not be able to tolerate them again. What I've heard is that this can be due to coming off them too quickly the first time round. How quickly did you come off fluoxetine the first time you were on them? How did you manage when you couldn't tolerate them the second time around - did they put you on a different type of medication instead, or did you find another way of coping?

[Sparkle1984]

I had my review this morning and the doctor said that I was ready to come off the tablets if I wanted to. I explained that I feel a lot more confident now, particularly in my job (which was one of my big worries back in August as I'd just been promoted to a new role and it was a steep learning curve). I said that I still regularly use the techniques I learnt in my CBT stress control course last year.

She then asked me if I felt confident enough to come off the tablets. There was no pressure as she said I could stay on them for years if I wanted to! I said that I would like to come off them this year. She then said that I could start the withdrawal process straight away - she said to cut the pills in half for the next 4 weeks so that I would be on 5mg a day. I asked if I would be able to go back on them if I ever did have another bad episode in the future, and she said "absolutely". That made me feel more reassured about coming off them, as at least I know I'd be able to go back on them if I ever needed to.

So I bought a pill cutter from the chemist and I had my first 5mg dose today. Even after 4 weeks I will still have some tablets left over, so I was thinking should I then drop down to 2.5mg a day (by quartering them) or would that be overkill?

It was only a couple of hours ago that I took the 5mg dose, so I don't feel any different yet. However, I do plan to start a withdrawal diary on this forum, in the same way that I wrote a diary to track my day to day progress when I first started citalopram.

I'm excited about coming off them, but also a little nervous too.

[kittikat]

Good luck with your withdrawal Sparkle. Take it slow, don't rush :winks: I think it's amazing how far you have come, well done.

You should be so proud of yourself xx :hugs: Kitti x

[Laura1989]

I am exactly the same as you, i could have written this post myself!!

I dropped from 20 to 10 in December, and then down to 5mg after Christmas, and am now at the stage of taking 5mg every other day. I have done it really slowly, and ONLY when i have felt comfortable enough to, which i think is the key to this whole thing really!

In the next couple of weeks i am going to stop altogether and ride out the last few withdrawl symptoms. I am seeing my Doc on the 11th Feb so will hopefully be off or almost off when i see her!

I know what you mean about being reassured about going back on them...in an ideal world I wont need them again, but its nice to know that they are there if things ever get that bad again!

Hope things go ok, please keep us posted with how you are doing and feel free to PM me if you want to chat to someone going through a very similar thing!!

Laura xx

[Sparkle1984]

Thanks for your support Kitti and Laura. :) Things seem to be going fine so far. I'll start a new thread today for my withdrawal diary.

[Sparkle1984]

I never actually bothered to start a new thread like I said I would, because I haven't really had many withdrawal symptoms up until now. Most of my symptoms seem to be sleep-related at the moment.

On Saturday night, I kept having scary dreams and nightmares, so when I woke up on Sunday morning I felt a bit anxious until my memory of the dreams started to fade. I kept myself busy to take my mind off the nightmares.

On Sunday night, it took me ages to get to sleep (at least an hour) even though I felt rather tired after the disrupted sleep I'd had on Saturday night. But once I managed to get off to sleep I was OK and slept pretty much through the night.

On Monday night I got to sleep much more quickly, but again I kept having unpleasant dreams and nightmares. In these nightmares, my loved ones (including members of my family) are angry with me and I'm scared of them. I've had these sorts of dreams in the past, particularly when I'm under a lot of stress. I'm not sure what causes my dreams to have this particular theme, as I get on really well with my family in real life.

Yesterday evening I felt irritable and tearful. This wasn't helped by the fact that my period started - my hormones always make me feel awful at that time of the month anyway.

Last night was really scary - I actually harmed myself in my sleep! :scared15: (Something I've never done before). I woke up in the early hours of the morning as I felt a pain in my right hand. It seemed that I had been digging my left thumbnail into the back of my right hand. It was stinging quite a bit, but I managed to get back to sleep again very quickly. When my alarm went off this morning, I suddenly remembered the thumbnail digging incident and I wondered whether it had been real or just a dream. But I knew it must have been real, as I could see a scab had formed where I'd been digging my nail in, and it was surrounded by an angry red area. I've never done anything like that before so I felt really scared and upset about it. I started to worry - what if it happens again and what if it escalates? I couldn't remember exactly what I was dreaming about when I did it, but it was obviously something very unpleasant if it stressed me out enough to do something like that.

At breakfast time this morning I was very tearful, but I managed to get myself into work and my mood improved as the day went on.

I spoke to my mum, my step-dad and my sister about it and although I was worried about how they'd react, they said it was nothing to be concerned about. They said it could have been due to me having a weird dream, or that maybe I was acting out my dream. I'm going to try to go to bed a bit earlier tonight to see if I can get more sleep.

Apart from this, I have occasionally noticed some weird sensations in my head, but only if I'm really concentrating on it. I haven't really felt any serious pain.

[Laura1989]

Glad to hear your doing ok! I have done the harming thing in my sleep before, and it's almost always to do with a dream I had! Citalopram gives you very weird and realistic dreams! Lol

Hormones are horrible lol, I have been really ratty this week, and I know I can't blame it all on the withrawal of citalopram! It's deffo partly hormones for me too!

Keep going, sounds like you are doing ok so far!! :) x

[southey]

Just to reassure that you will be able to go back on them if you need to. I have been on the Cit 3 times now and it has worked splendidly for the anxiety every time.

The first 2 times I came off I was on 20 mg and I came off cold turkey. I don't remember any withdrawal problems? I am now on 30 mg and went cold turkey for a week a month or two ago when I ran out of pills and it was not nice this time but not the end of the world!

As to the stepped down dosage just go with the flow and see how you respond. From 5mg a day go every other day. Then nothing wrong with 2.5 mg every other day if you feel ok. After that I would just stick with 2.5 mg and lengthen the days without taking it. Pretty much after a week between the 2.5 mg dose you could come off.

My plan as I have just started to taper down is to have 20 mg a day for several weeks then every other day for several more. Then do the same on 10mg and will come off at the end of the alternate dosing regimen if I feel OK. I am looking at somewhere June/July to quit partly to get winter over with which can be depressing at the best of times!

Steve:)

[Sparkle1984]

Just a quick update to say I'm feeling a lot better today compared to yesterday. I don't recall having any bad dreams last night and I had a restful night's sleep. Plus I'm happy today because a major website I've been working on at work went live this morning. I'm so pleased I managed to complete this project, and on time too. :D We've been getting good feedback from people in the local area about the new website and my manager is very happy with what the team has achieved. We've been working on this project since November and it's the biggest task I've been involved with since I started my job in July (which is when my anxiety episode started). :)

[cmc46]

Well done,you seem to be doing so well with your withdrawal, it is making me feel better about coming off the cit, which will probably be in March when I next see my GP.:)

[little scientist]

Well Done Sparkle!!! One day I want to be free of meds, but I also realise that there is the possibility I could be on them for life. I think I've never done my withdrawals that well, as I have always done them the way the doctor says (dropping a pill a week) and I think thats never worked for me, as the anxiety has always come right back. I think next time I would like to take a really really long term approach to coming off it so that its much more gradual for my body and my head

But next time I think I am much better armed to deal with it from my CBT

[Sparkle1984]

Thanks for your support cmc and Little Scientist. :)

So, I've been on 5mg a day for 2 weeks now. This week hasn't been too bad, although I've noticed that sometimes I get irritated more easily than I used to, and feel more emotional. Other people (such as my colleagues at work) probably don't notice it that much when I'm feeling irritable, as I don't take it out on others or show that I'm moody, it's probably just that I don't smile as much! :roflmao:

However, I've also felt fatigued and lethargic for much of the week. I work full time 5 days a week so it can be difficult at times. :wacko: When I first wake up, I feel really tired but this tends to wear off after an hour or two. However, on Wednesday and Friday afternoon, just after I'd got back to my desk after having lunch, a really horrible feeling of lethargy came over me and I also began to feel a bit spaced out and irritable. On the Wednesday afternoon just after lunch, it felt as though all my energy had been sapped away. I remember thinking to myself "How on earth am I going to get through the next 3 hours if I'm feeling like this?". I simply reminded myself that if it got too unbearable, I could always ask to go home. Thankfully the feeling passed after about half an hour and I made it through the rest of the day! Yesterday afternoon, I felt irritated and emotional, but I think that's partly because I'd been given a really difficult task to do, and I just felt like I didn't have the energy to do it! I managed to get part of it done, but it took longer because of how I was feeling.
I don't usually feel that way in the afternoons. I think it might be because I take my half tablet in the early evening, so maybe by the following afternoon it has already begun to wear off?

I've got another 2 weeks to go on the 5mg a day dose, and I'm glad about that as I don't feel that I've fully adjusted to the reduced dose yet.

I haven't been on No More Panic much in the last few days - I think that's partly because I'm feeling a bit fragile due to the withdrawal and I feel the need to focus more on my own recovery now, and partly because I don't want to read anything that might scare me about the withdrawal process. Some of the withdrawal stories I've read on this site are pretty horrific, for example people feeling physically sick, and I don't want to scare myself into thinking that those things could happen to me.

I do think there needs to be more medical research into SSRI withdrawals. From reading people's experiences on this site, different doctors are wildly inconsistent in how much time they allow their patients to withdraw from these medications. I've been given 4 weeks to taper down by 5mg and I think that's quite generous, especially when I see that some people have only been given 1 week per 10mg interval! I think there needs to be more consistency on this, and all doctors in the UK should follow the same guidelines. Hopefully that would help put a stop to many of the withdrawal horror stories I read on sites like this! :winks:

[Sparkle1984]

For the past few nights I've been waking up about once an hour! I do get back to sleep again fairly quickly, but it's still annoying to wake up so many times in the night. I wonder how long this will go on for? I'm aware that serotonin levels can affect sleep as well as mood. Another thing - when I kept waking up last night, I felt really hungry and kept getting the munchies! I always keep a glass of squash and some crisp breads beside my bed, but I've never felt so hungry during the night!

[little scientist]

I haven't been on No More Panic much in the last few days - I think that's partly because I'm feeling a bit fragile due to the withdrawal and I feel the need to focus more on my own recovery now, and partly because I don't want to read anything that might scare me about the withdrawal process. Some of the withdrawal stories I've read on this site are pretty horrific, for example people feeling physically sick, and I don't want to scare myself into thinking that those things could happen to me.



I think at times that is a good idea - in your withdrawal you don't want to be questioning every little thing you feel and wondering if it is physical or in your mind. I think its important for us to monitor how we feel but at the same time not focus on it if you get me? It's a hard one to explain! I think these forums can be great for some people and not so good for others :) I have found the forums to be a great support during my hard times - a bit like a crutch or a walking stick when I need that extra little bit of support.

[Sparkle1984]

For the last few days I've been feeling better. My sleep has improved and I don't feel quite so lethargic during the day.

It was my birthday yesterday so I had the day off work. I went on a snowdrop walk in the afternoon and in the evening I had a meal at one of my favourite restaurants. My main present was a Toshiba tablet computer. I really enjoyed the day. :D

[Sparkle1984]

Tonight will be my last 5mg dose. Then from tomorrow I drop down to 2.5mg, probably for a week. For the last few days I've been feeling on edge and uneasy - I'm not sure if this could be withdrawal effects (although it has been 4 weeks since I dropped down to 5mg), or whether it's just because it's on my mind that I'll be coming off completely within the next few days. Most of the time I feel positive, but there are times when I think to myself "I hope I've made the right decision. I hope this is going to be worth it."

Once I've been completely off for a month, the doctor wants me to go back for another review, to see how I'm getting on.

What I'm wondering is, how do you know if the anxiety is a withdrawal effect or whether its your own underlying anxiety?