climbing down the ladder called citalopram

[fuz]

Hi,

I'm currently weening off Citalopram and looking for some advice. I was on 30mg for one year before I started to wean off in July this year. I alternated 30/20 for a few months and eventually got down to 20 before alternating the same way with 20/10. I was on 10 for the last two months before I started alternating 10/5 on the 8th January. I've previously had no withdrawal effect from dose reduction but now I feel it hitting me, especially since the weekend just gone: low mood, more anxious, sore head. Is this normal and should I expect it to subside anytime soon?

I'm concerned to go back to pre-Citalopram days when there was a funeral in my brain every day. My current symptoms feel like I'm on the edge of having a panic attack without actually having one, if that makes sense.

Be grateful to hear from other user who've had a similar experience and come out the other side.

Thanks in advance,

Debbie

[Hry]

I was on citalopram 20mg daily on and off for about 10 years. I could always reduce it gradually and then stop it as long as I was mentally stable (no private stress and no issues at work). I remember I discontinued citalopram in 2015 twice while having a lot of stress at work. I immediately felt very bad again (low mood, very nervous, insomnia, lack of concentration) so that I had to restart the medication. I did not learn from that experience and stop taking citalopram again in 2016 and summer last year - both times I was having stress at work. So if you are going through private stress or having too much load at work, I would recommend you gradually increase the citalopram again. I am telling you this because I discontinued citalopram so many times when I shouldn’t have done it so that the drug does not work for me anymore. I do not mean this has be your case since we all react so differently to psychoactive medications. Just wanted to let you know my experience.

[Wess2121]

I was on citalopram 20mg daily on and off for about 10 years. I could always reduce it gradually and then stop it as long as I was mentally stable (no private stress and no issues at work). I remember I discontinued citalopram in 2015 twice while having a lot of stress at work. I immediately felt very bad again (low mood, very nervous, insomnia, lack of concentration) so that I had to restart the medication. I did not learn from that experience and stop taking citalopram again in 2016 and summer last year - both times I was having stress at work. So if you are going through private stress or having too much load at work, I would recommend you gradually increase the citalopram again. I am telling you this because I discontinued citalopram so many times when I shouldn’t have done it so that the drug does not work for me anymore. I do not mean this has be your case since we all react so differently to psychoactive medications. Just wanted to let you know my experience.

Totally agree with this post. Weening off is much easier if you are in the right frame of mind. If you worry about withdrawal effects constantly while trying to ween off, it will most likely be worse for you.

I always see people recommend coming down 5mg at a time. I do see people doing the higher dose lower dose reg amine, but they tend to have more side effects doing it that way from what i've seen.

[fuz]

Hey,

Thanks for your replies.

I have no private stress or work stress, I'm just wondering whether these were normal side effects of withdrawal at this stage. As I said, I barely had any symptoms going down to 10mg from 30mg and now I'm feeling those start-up effects which I'm sure come as you go down. I certainly don't want to increase the citalopram again. The point is to be off it.

Debs

[epitaxial]

You want avoid alternating doses as that just puts your brain in a yo-yo state. Typically withdrawals will show at about 2-3 days after a dose decrease, peak at about day 6-8, then start to subside until about day 12-14.

What I would suggest is the following:

Stop alternating doses 10/5 and take 5mg. If the withdrawals are annoying/tolerable for a week - keep with the 5mg for ~3 weeks to let your brain stabilize at that dose. If you feel ok after 3 weeks, drop down to 2.5mg and repeat.

If at anytime the withdrawals are too severe/debilitating [you'll know by day 7-9], go back up to the previous dose, stabilize, and then drop down by a smaller amount.

what you want to do is setup a pattern that your brain/body is used to.

[fuz]

I hear what you're saying but I had no concerns alternating the doses coming down from 30. It's just the way I did things to avoid discontinuation effects. I'm now on day 9 of alternating 10/5 and from your calculations I should start leveling out by the weekend. I'm terrified now to do a jump to 5 like you suggested given the concrete head I've got coupled with the "someone punched me a lot" body effects. Surely, my body is now getting used to a pattern of 10/5 as it has done for any other dose reduction/alternation?

Debs

[epitaxial]

I hear what you're saying but I had no concerns alternating the doses coming down from 30. It's just the way I did things to avoid discontinuation effects. I'm now on day 9 of alternating 10/5 and from your calculations I should start leveling out by the weekend. I'm terrified now to do a jump to 5 like you suggested given the concrete head I've got coupled with the "someone punched me a lot" body effects. Surely, my body is now getting used to a pattern of 10/5 as it has done for any other dose reduction/alternation?

Debs

From what I've researched - dosage reductions below 10mg are more significant as the occupancy level of the SSRI in your brain decreases significantly and your brain doesn't like the reduction:

https://ils.unc.edu/bmh/neoref/nrschizophrenia/jsp/review/tmp/352.pdf

This is why some people have problems when decreasing below the minimum dose of a med. The drop is a lot more significant and thus why withdrawals are more significant.

You may want to instead try 10/7.5 for a week, then see how 7.5 feels and stay there for a month. Repeat with 7.5/5 and 5/2.5. When you get to the end of 2.5 - you may want to try jumping off to 0 and see how that goes.

Another option is to make a liquid version of Citalopram where you can drop by a smaller amount with more accuracy:

http://survivingantidepressants.org/topic/2022-making-a-celexa-solution-yourself/

I tested that a few times [took 10mg in liquid form] a few times and felt fine. It's a lot more accurate than using a pill cutter. :)

Good luck - hopefully you find a dose reduction that minimizes withdrawals.

[fuz]

Thanks for all your suggestions. I've decided to go back up to 10 for a bit (got a holiday looming and don't want to feel like this for that period). I really believe that reducing gradually is the way to go, especially when coming down from 10mg.

Thoughts?