Reaction to quitting citalopram

[ljmonkey]

Hi - I am new here - wasn't sure whether to post but...

I've recently come off Citalopram - prescribed for depression but I don't think I have depression, I have anxiety which leads to depression - and I am having some issues.

Has anyone else had extreme anxiety when coming off? I am really edgy and cannot stop crying at everything as I feel overwhelmed by the smallest thing.... How long is this likely to last? Any coping strategies - I am trying to talk myself round but not working.

I reduced over about 6 weeks and was OK until a couple of days after I stopped. I don't want to go back on it because of the side effects and because I don't think it works. Am waiting for CBT but doubt I will get thru the triage as I am not 'ill enough'.

Thanks for 'listening'

[clarisse]

Hi.You didn't say how long it's been since your last pill. But it will take a while for the withdrawals to stop unfortunately. This depends on what your dose was.as the drug has a half life of 36hrs.
6weeks is not long to come off a high dose,and it is always best to do the discontinuation very slowly.
Try to get some exercise as this will improve your mood.
Maybe if you explained to your Dr how Anxious you are, he will give you something to take the edge off for a couple of weeks like a low dose of Benzo,s.

Out of curiosity what dose were you originally taking? I ask as this is very often given for Anxiety and maybe the dose you were on wasn't working because it was not high enough.
Tc & Hope you feel better soon.

[ljmonkey]

About 5 days - was on 20mg but had gone down to one every third day before stopping. I already reduced from 40mg and felt much better after that. Sick of the doctor - they don't care and don't understand - they just want me to keep taking it. I can't deal with the side effects not least going up 4 dress sizes. :(

Need to do some research into what alternatives there are maybe so I can ask Dr outright.

Is this my life now??? It sucks :(

[MyNameIsTerry]

Clear elimination has the following:

HL.......%
0.........100
1.........50
2.........25
3.........12.50
4.........6.25
5.........3.13

When its under 5% its no longer clinically significant. It's more complicated than this when you consider how people taper as it will mean some overlap and then with some meds (e.g. Benzo's) you also have the storage outside of blood plasma which also needs elimination.

Factors involved in speed of distribution (drug starting to work) & elimination (clearance out of blood plasma) can be things like age (children differ, there are specific calculations for age that can be used for older people), speed of metabolism, weight (which will impact on metabolism), renal insufficiency conditions, etc. There are some very complicated guides on the internet for those interested such as some books on pharmacokinetics on Google Books but they are very difficult to understand without a medical background.

So, when you dropped to 1 in every 3 days, your blood plasma would be getting to 25% of the drug and then you would push it back up to 100% and it would fall sharply again. This yo-yoing effect can make withdrawal harder with some meds. When I came off my 20mg dose, I would to 10mg for 2 weeks first and then came off completely. It might have been smoother for you if you had dropped to 10mg rather than try to come straight off the minimum therapeutic dose.

Alternating days seems common with meds like Prozac but theirt half life is far longer so the amount of the drug in your blood plasma reduces at a much more steady rate.

Here are the NICE guidelines for the anxiety disorders they have covered and the one for depression. These should tell you more about what GP's should be doing and the recommended meds:

https://www.nice.org.uk/guidance/cg113/chapter/guidance
https://www.nice.org.uk/guidance/cg159/chapter/recommendations
https://www.nice.org.uk/guidance/cg113/chapter/guidance
https://www.nice.org.uk/guidance/cg31/chapter/1-guidance
https://www.nice.org.uk/guidance/cg90/chapter/1-guidance

My GP is pretty poor too. They have 10 minutes so it's fine if you have a cough or cold but anything complex and they don't have the time. Please have a read of those and know what you should be getting offered and why. GAD & Panic Disorder are covered in the first one but I didn't know which so gave you them all. The de[ression one will also tell you what they should be doing even under that diagnosis.

You can access Guided Self Help (Level 2) usually quite quickly and many services do this without a GP referral. Getting to CBT can mean a referral but it depends on your local service. So, Google your area plus CBT or anxiety with NHS in it and it should bring them up. Otherwise, you will have a NHS local trust website you can Google with your area and often the local council websites will show them.

There are other routes for help such as CCBT (computerised CBT which is accepted by the NHS & NICE as equally effective as one-to-one treatment as long as their is remote therapist support) which your GP can arrange for you or there are free ones online anyway. Your GP can also write you a book prescription that you take to your local library.

See NHS Choices here about all this:

http://www.nhs.uk/Conditions/online-mental-health-services/Pages/introduction.aspx
http://www.nhs.uk/conditions/stress-anxiety-depression/pages/self-help-therapies.aspx

I've assumed you are not in Scotland since they don't have the IAPT network and go by different rules (and NICE don't cover them).

There are even charities such as Anxiety UK that offer sliding scale therapy and some universities off free CBT (one in Manchester I think) to train up their MSC grads under supervision. Private therapists can even do free sessions. (See NHS Choices, MIND, Anxiety Uk, etc for more information as you need to be careful as it's an unregulated industry hence BACP, BABCP registers are useful to check therapists out to ensure they have a minimum professional standard).

Also, check out this thread:

http://www.nomorepanic.co.uk/showthread.php?t=169814

If you are covered by this you will have th right to choose your provider too. So, if you have more than one near you, you can opt for the best service fit for your needs or the quickest to see you, etc.

[whatisthis]

Extreme anxiety was my main symptom withdrawing from Paroxetine.

I'm still on 3.2mg and reducing using liquid. It took me 6 months to convince my gp and outpatient pysch doc it was withdrawal not an original condition.

I went on it for mild derpression and anxiety from a pain problem.

[ljmonkey]

Thanks SO much everyone, especially Terry :).

I am having a nothing day today, trying to be kind to myself :).

I have a CBT referral but not hopeful - they only seem to be interested in acute not chronic cases - although I have dark thoughts I am not actively suicidal so I expect they will tell me to go away...

Will do some reading up x

[Smurfy]

I was on 20 mls of citalopram for 8 yrs and felt ok so tryed stoping it my self big mistake went at it far to fast for the length of time I had been on it and had a massive blip anxiety went sky high all of the bad negative thoughts came back . So I'm a muppet n had to start taking ten mls again to try n level my self out again I'm getting there very slowly and feel like I'm back at square one after all these years. Guess the best advice I could give any one is to take it very slow coming off them don't push your self to hard like I did .

[elibabez]

About 5 days - was on 20mg but had gone down to one every third day before stopping. I already reduced from 40mg and felt much better after that. Sick of the doctor - they don't care and don't understand - they just want me to keep taking it. I can't deal with the side effects not least going up 4 dress sizes. :(

Need to do some research into what alternatives there are maybe so I can ask Dr outright.

Is this my life now??? It sucks :(




Hmm dress sizes up?
if i can be honest i LOOSE weight on citolopram
i was once put on sertaline for a week or so, and i was constantly hungry and put on like 10 pounds! as i was constantly eating.

The move back onto citolopram was a nightmare.

Anyway i took 10 and then 20mg of citolopram for a good 7 months and it was so and so okay, sometimes semi decent, and then at times useless

I have been taking 30mg for a week and a half now and have felt 100 times better. i would be bumping it to 40 but the doctore says i need to give a few weeks of 30 first and only then if it isnt working to bump it up to 40

long term im having therapy but for the moment citolopram is a life saver.
the smaller doses like 10/20 dont work though,
how much were you on -- and how come you came off?

---------- Post added at 10:12 ---------- Previous post was at 10:08 ----------


I was on 20 mls of citalopram for 8 yrs and felt ok so tryed stoping it my self big mistake went at it far to fast for the length of time I had been on it and had a massive blip anxiety went sky high all of the bad negative thoughts came back . So I'm a muppet n had to start taking ten mls again to try n level my self out again I'm getting there very slowly and feel like I'm back at square one after all these years. Guess the best advice I could give any one is to take it very slow coming off them don't push your self to hard like I did .

As i said above to the other person, 10 or 20 mg simply doesnt work for anxiety, it can make you feel worse overall :weep: