View Full Version : Quitting Celexa after 7 weeks
Hello there
I just completed 7 weeks on Celexa. (5mg on the first 20 days and increased to 10mg for another 20 days and have been on 20 mg for the last 10 days).
I started having insomnia as a result of anxiety/depression when my father had a stroke on January 2013. I’ve tried to deal with it myself without medications abut finally decided to seek professional help so 7 weeks ago I saw my pdoc and he prescribed Celexa.
With the exception of improving my sleep unfortunately, I haven’t noticed any improvements on my mood and anxiety at all. I mean prior to taking Celexa I had some interests like watching TV, movies, take a walk in the afternoon or getting together with friend for happy hours……. I’ve noticed not only Celexa did not improve anything but it took away my joy and those few interests that I had before staring the med. Even after 7 weeks I feel awful everyday. Headaches, lack of concentration, restlessness (inability to sit or stay in one place with lots of pacing), irritability, increased anxiety (specially early morning), nervousness.
Don’t you agree I should’ve seen some small signs of improvement by now?
So I decided to taper off and currently taking 10mg for a couple of days and planning to go down to 5mg tonight and see what happens. Hopefully 7 weeks in not considered to be a long time on AD but you never know.
Sal
Sal, sorry but I don't think you've given it nearly long enough.
The usual situation is that it takes ~2 weeks at one dose just to settle down the side effects. Those side effects include many of the things you describe. Them, it takes a full 8 weeks ...at that settled dose... before many people start to feel full benefit. So, in other words, the typical guidance would be for you to go up to 20 mg and stay at that dose for 8 weeks. So you have at least 6 weeks to go at 20mg before you can really draw conclusions about its long-term efficacy.
That is the unfortunate thing about this med and many others: they just don't work very quickly, and there can be some real struggles as build up the levels you need.
If you'd like to continue with SSRIs and see whether they can help you, let me suggest one of two things: (1) stay at 20mg of cit for 8 weeks and re-evaluate every month or so; or (2) transfer to escitalopram (lexpro), which can be better for some of us (it has been for me, and I transferred to it a month or so ago).
In either case, if your jitters are extreme then I would inquire about an additional, adjunct med to help with the startup phase. One med I was given, and which has been quite helpful, is klonopin, which I take in very small doses (usually 0.125mg, twice daily). It is a longer-acting med that you can take 2x or 3x daily, and is sometimes prescribed for people undergoing major stressful life changes e.g. coping with a major loss or big job changes etc. What it has done for me is lower that baseline of anxiety and take out the wired/hypomanic jitters associated with startup on the SSRIs. The klonopin makes me drowsy but I find that a cup of coffee, some fresh air, and good exercise usually helps.
If you have less severe jitters and want to try something quickly, let me suggest diphenhydramine, the active ingredient in benadryl. As you probably know, benadryl can act as a sedative. What you may not know is that it is actually a very safe nonselective serotonin reuptake inhibitor, and for some of us it does a good job at calming us down, tamping down anxiety and lifting mood. Benadryl can make you drowsy, but again that is usually just an issue of coffee and fresh air and exercise.
Above all else, I would recommend starting a dialogue with a good therapist and also starting a regular and rigorous exercise program- something that makes you breathe deeply, dump some anxiety, and feel good about yourself. I think that is a very important when working with any of these meds. The exercise will become something to look forward to, and the dialogue can give you that added confidence that you're on the right track.
I hope this helps!
Sparkle1984
19-08-13, 17:45
I'd say to stay on the 20mg for a few more weeks unless of course your doctor says otherwise. A dose change can take several weeks to kick in fully. I also started on 10mg and moved up to 20mg and it took at least a month for the increase to kick in. 10 days isn't long enough to judge whether the increase will work.
---------- Post added at 17:45 ---------- Previous post was at 17:42 ----------
Sorry I meant to ask, did your doctor say you have to quit?
---------- Post added at 17:45 ---------- Previous post was at 17:45 ----------
Sorry I meant to ask, did your doctor say you have to quit?
Hello there
I just completed 7 weeks on Celexa. (5mg on the first 20 days and increased to 10mg for another 20 days and have been on 20 mg for the last 10 days).
With the exception of improving my sleep unfortunately, I haven’t noticed any improvements on my mood and anxiety at all. I mean prior to taking Celexa I had some interests like watching TV, movies, take a walk in the afternoon or getting together with friend for happy hours……. I’ve noticed not only Celexa did not improve anything but it took away my joy and those few interests that I had before staring the med. Even after 7 weeks I feel awful everyday. Headaches, lack of concentration, restlessness (inability to sit or stay in one place with lots of pacing), irritability, increased anxiety (specially early morning), nervousness.
Don’t you agree I should’ve seen some small signs of improvement by now?
My past experience with anti-depressants is that if they are going to do anything you can actually see some small positive effects quite early on, but the full benefits do take longer to become apparent. So I agree with you, if you aren't feeling something (I'm not talking about a cure but even just the smallest light at the end of the tunnel) after 4-6 weeks then the medication probably isn't the right one.
I was recently put on Citalopram and my doctor said I needed to give it 6 weeks. After 6 weeks I actually felt considerably worse and had many of the symptoms you describe - restlessness, agitation, anger, concentration problems, physical exhaustion, etc. Because of this my doctor decided that was enough of a trail and to put me on something different.
What concerns me is you also state you are feeling worse in some ways - Lack of enjoyment from things you were enjoying before and so on.
What I would say is see your doctor to discuss the next steps before tapering off the drugs. S/he may want to just switch you straight from one medication to another.
Hello keith
Thanks for your detail reply. I really appreciate it.
After reading your post, I have to say that I agree with you. I decided to stick a bit longer on 20mg and hopefully this will do the trick so I don’t have to go up to 30mg. I agree, I didn’t give the 20mg enough time. I tried Zoloft for a couple of days (only 7.5mg) and had a very hard time dealing with jitteriness and increased anxiety. Also tried Lex (5mg) for couple of days and my BP went through the roof something like 190/100. I believe they are both more active than Celexa.
Btw, I've heard that Celexa is really meant for depression and not so much for anxiety. Any thoughts on that?
Sal
---------- Post added at 19:57 ---------- Previous post was at 19:49 ----------
My past experience with anti-depressants is that if they are going to do anything you can actually see some small positive effects quite early on, but the full benefits do take longer to become apparent. So I agree with you, if you aren't feeling something (I'm not talking about a cure but even just the smallest light at the end of the tunnel) after 4-6 weeks then the medication probably isn't the right one.
I was recently put on Citalopram and my doctor said I needed to give it 6 weeks. After 6 weeks I actually felt considerably worse and had many of the symptoms you describe - restlessness, agitation, anger, concentration problems, physical exhaustion, etc. Because of this my doctor decided that was enough of a trail and to put me on something different.
What concerns me is you also state you are feeling worse in some ways - Lack of enjoyment from things you were enjoying before and so on.
What I would say is see your doctor to discuss the next steps before tapering off the drugs. S/he may want to just switch you straight from one medication to another.
Hello Yenoo
I had the same opinion as you but after reading Keith’s & Sparkle’s replies I decided to give 20mg a bit longer time. The only benefit I’ve noticed from Celexa (right from day one) was improvement on sleep. I really had a bad case of insomnia and with celexa I sleep fairly well. But besides this I really don’t see anything else. Hopefully it needs a little more time. (cross my fingers).
Sal
---------- Post added at 20:06 ---------- Previous post was at 19:57 ----------
I'd say to stay on the 20mg for a few more weeks unless of course your doctor says otherwise. A dose change can take several weeks to kick in fully. I also started on 10mg and moved up to 20mg and it took at least a month for the increase to kick in. 10 days isn't long enough to judge whether the increase will work.
---------- Post added at 17:45 ---------- Previous post was at 17:42 ----------
Sorry I meant to ask, did your doctor say you have to quit?
---------- Post added at 17:45 ---------- Previous post was at 17:45 ----------
Sorry I meant to ask, did your doctor say you have to quit?
Hello Sparkle
No my pdoc didn’t tell me to quit. I was so very frustrated that I decide to taper off but after two days of tapering down to 7.5 & 5mg I noticed the crying spells came back. Yesterday I was crying almost the entite day (which by the way I still don’t understand the reason why). This episode of crying is new to me and started two months ago prior to Celexa so I can’t really blame Celexa for that although it could’ve been increased by Celexa. (I’m not sure).
Sal
Hello keith
Thanks for your detail reply. I really appreciate it.
After reading your post, I have to say that I agree with you. I decided to stick a bit longer on 20mg and hopefully this will do the trick so I don’t have to go up to 30mg. I agree, I didn’t give the 20mg enough time. I tried Zoloft for a couple of days (only 7.5mg) and had a very hard time dealing with jitteriness and increased anxiety. Also tried Lex (5mg) for couple of days and my BP went through the roof something like 190/100. I believe they are both more active than Celexa.
Btw, I've heard that Celexa is really meant for depression and not so much for anxiety. Any thoughts on that?
I'm glad you'll give it some more time. It'd be a shame if you invested so much time and then pulled off it before really having a clear answer of whether it's the right med.
Celexa is prescribed off-label for anxiety, whereas lexapro (escitalopram) is prescribed on-label for it. How much should we read into that? I don't know... unless we have side-by-side pharmaceutical trials, it's hard to draw a conclusion. What we do know is that it's fairly hit or miss with all of these meds, and we just have to try to them with as much patience as possible.
If your issue is really more specifically driven by anxiety, I really wonder about using klonopin or similar as an adjunct med. And maybe once you have the depression under control then you can go for a more standard anxiolytic and depart the SSRIs altogether. In my case, the depression was gone very quickly on citalopram, and it was "just" anxiety that I was left to combat. But wow, what anxiety! I felt jittery and hypomanic for quite a while.
Sorry to hear you had the high BP reaction to lexapro. As I mentioned before, I transferred from celexa to lexapro and have been faring generally better with it. As for my BP, well it's been spectacularly improved since I started the meds and my rigorous (3x per week) gym workouts. I was borderline hypertensive before, so it's brought about quite a transformation for me. That could have more to do with my better fitness though and diet though- I really did everything I could think of to improve all 'round wellness- not just meds.
Also, it's odd that celexa is actually helping you sleep while also giving you more anxiety in the morning. Hmmm. So I really wonder about the SSRI cortisol reaction in your case. I would discuss that specific issue with your doc as soon as possible and see if an adjunct med might help. And look closely at ways to reduce cortisol.... again, exercise, music, and diet.
In my case, the depression was gone very quickly on citalopram, and it was "just" anxiety that I was left to combat. But wow, what anxiety! I felt jittery and hypomanic for quite a while.
Hi Kieth, So are you saying that your main issue was also anxiety and it wasn't quite resolved by Celexa? If that is the case, wouldn't make more sense that I also try Lex and give it one more try? Perhaps the BP issue was just a fluke and will not happen again (I hope).
Sorry to hear you had the high BP reaction to lexapro. As I mentioned before, I transferred from celexa to lexapro and have been faring generally better with it.
May I ask how did you transition from Celexa to Lex?[/QUOTE]
Also, it's odd that celexa is actually helping you sleep while also giving you more anxiety in the morning. Hmmm. So I really wonder about the SSRI cortisol reaction in your case. I would discuss that specific issue with your doc as soon as possible and see if an adjunct med might help. And look closely at ways to reduce cortisol.... again, exercise, music, and diet.
Can you please explain this a little more in detail for me?
Thanks
Sal
Hi Kieth, So are you saying that your main issue was also anxiety and it wasn't quite resolved by Celexa? If that is the case, wouldn't make more sense that I also try Lex and give it one more try? Perhaps the BP issue was just a fluke and will not happen again (I hope).
Sal, in my case there was definitely acute depression at the beginning. I felt weepy and desperate and out of energy... at the end of the road. I wanted to have that on clear record with my doc and a therapist before embarking on any meds, and that was a very good call on my part. Everybody got to see me all weepy and pathetic, which gave them a good baseline assessment.
I then began celexa (citalopram) and that was gone within a month. However... in its place were fairly extreme jitters, an overcaffeinated feeling, loss of sleep... a kind of "hypo-hypomania" might be a way to describe it. I kinda knew that was coming because I've had similar responses to SSRIs in the past, and so this time we started with 10mg cit, and progressed to 20mg only after 2 or 3 weeks, when I knew I could take it.
Note, and I think this is very important: I began a really rigorous exercise regimen when I started the SSRI. I had absolutely no intention of letting the med be the sole controller of my serotonin levels, because I do plan to come off. And besides that, I just wanted to throw everything I could at the depression.... use all available tools.
May I ask how did you transition from Celexa to Lex?
I went cold turkey, so to speak. I was at 20 mg of Celexa one day and 10mg of Lexapro the next. Done. I think I felt a little bit of dizziness and headache had maybe a bit of sleep disturbance but that was all over very quickly.
As for my BP, well it has been terrific. I don't think I've ever had better overall health stats, seriously. I chalk that up to the exercise regimen and a much better diet (minus fried foods, most breads, and sugary stuff- much more emphasis on protein). I started that better diet in the winter after a weird insect bite led to some scary rheumatoid arthritis symptoms which left me totally unable to exercise and I was about 20 lbs overweight and was thus feeling down. That's probably what the catalyst for the depressive episode really was- I had RA symptoms at age 40 and thought my life was over. Anyway, now I am in some of the best health of my life.... I just need to work on the mental health ;) My therapy has led me down a rather dark tunnel to some items at the root of all my anxiety and so that is my next task, to open some doors and let some light in. And I credit my therapy, meds, exercise, diet, spiritual thoughts... all of that for giving me enough courage to do what needs to be done.
Can you please explain this a little more in detail for me?
Yes well these meds hit certain receptors responsible for mood, sleep, diet, etc., and the result can be variable. I think most of us kind of get unsettled 'oscillatory' moods for a while, meaning ups and downs that may be more extreme than before. The med and the body are dueling over who will be in charge of serotonin and other chems about the various receptors. that can be quite a struggle. Now, on the one hand, I think you want the patient to escape without too much discomfort, and so the usual strategy is to increase slowly. But on the other hand, I suppose that might kind of prolong the struggle between the med and the body. In any case, until the mental chemistry has settled down, you will have ups and downs.
Some people get big ups and downs. The effects can look like manic-depressive episodes. This is usually described as activating bipolar disorder, or such. And I think I can imagine what that's like- it really sucks. I didn't have that, but at times I felt pretty damn close, and it was very important for me to have the therapist and doc there lending some confidence.
A lot of people first get the wired/tired feeling and then settle; some people have no such issues and just go merrily along; other people go way off track and feel suicidal or manic- opposite sides of the same bipolar coin.
In any case the thing to bear in mind is that the med and the body are dueling over the chems that affect mood, sleep, appetite etc. So the best thing you can say is that you knwo the med is "working" if you have those disturbances, and you hope that it'll settle soon.
Meanwhile, you may need an anxiolytic to get through the worst of it. People tend to go to the beta blockers. My concern is that people show up at the doc's office and they are really panicked, or describing a panicked situation. So the doc goes, wow, you need a beta blocker! And so (s)he typically prescribes something fast acting and also short acting. Mistake?! Remember what's going on in the SSRI startup phase is a kind of oscillatory mood behavior- swings between ups and downs of indefinite, unpredictable period. So then people throw another powerful mood changer into the mix and it can go any number of ways. It can relieve short-term panic but it can leave a person feeling worse in the long run. Hence my comments about going to a longer-acting adjunct like klonopin which brings down that baseline of anxiety and can be taken regularly, at lowish dose, for extended periods. '
And again, I think the pharma industry doesn't want us to know that good old diphenhydramine is a pretty fine anxiolytic for some people... it's certainly worth a try before getting into all manner of exotic combinations of dueling meds.
Long story short, if you are on celexa (citalopram) and not getting what you want after 2 months, then I'd definitely give lexapro (escitalopram) a try again. The transition should be quite easy. And you must engage in exercise and such, you do not want these meds to be the sole regulator of your serotonin! I worry about people getting on SSRIs for years and years and just kind of ceding all that control...
And cortisol well that appears to be an issue for many people on SSRIs. Just read the wikipedia article on it and you'll probably see some things that ring a bell...!
http://en.wikipedia.org/wiki/Cortisol
When you mentioned BP, I was wondering about whether you might be getting a cortisol spike from your SSRI...
I hope this helps.
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