Ange's Citlalopram Withdrawal Diary
Why I Started Citalopram: After a long period of stress and ignoring my mental and physical health, I had a breakdown that presented in the form of an absolutely devastating panic attack. The symptoms were more than I could handle, nothing like my previous anxiety, and they continued to come for days. I'd dealt with anxiety, agoraphobia, social phobia and depression for a long time prior and though I was coping well. I wasn't.
My doctor had prescribed Cit to me 6 months prior when I burst out crying in her office, but I was absolutely against SSRI's at the time. I thought "I'm not that bad that I need medication", and I had also heard all kinds of horror stories about them. After the panic developed I had no choice but to try them. Nothing could have been worse than what I was already feeling.
Length of treatment: 2 years, 6 months.
Did they work?: They did. The first 6 weeks were incredibly difficult. I had all of the side effects including increased anxiety that I thought would never end. But it did.
They have helped me learn a lot about myself and work on thought patterns that lead to depression and anxiety. I didn't actually realise how depressed I was until Cit. My internal monologue was incredibly negative.
Overall I'm positive about my Citalopram experience but it's time to move on.
Why I'm quitting: Citalopram has served me well, but lately I've been feeling like they're no longer effective for my anxiety. I've been experiencing panic attacks during specific points in my cycle, and what gets me through is CBT, friends, distraction and meditation. Not the Cit.
I also have some lingering side effects that I'm getting tired of. Including emotional blunting; feeling "trapped" in my head; obsessive existential thoughts; my spiritual side is currently non existent. Not that I was ever deeply spiritual or religious, but there's a deeper part of the life experience that I feel cut off from; I have no life goals. Nothing seems worth the effort, and I feel absolutely fine with that. But I don't want to be fine with it. I always dreamed big and would like to get back to that; I'm sleeping too much.
Starting dosage: I began on 10mg for the first 3 months of treatment, moving up to 20mg. The increase immediately worked. I felt lifted, happier. Great. I've been on 20mg since then.
Taper method: After a lot of research I believe the 10% reduction method will work best for me. I wanted to wait until winter was almost over so I have plenty of opportunity to get outside while dealing with any potential side effects. I haven't spoken to my GP about my plans yet but will mention it next time I'm there. I have lots of support around me, my GP's number, Samaritans etc. I'm prepared and ready :smile:
I'm tapering by cutting up my 20mg pill in to one half, one quarter, and an eighth. I'm aware this isn't the most accurate method but it will have to do for now. If I start to feel bad from this I'll change my method.
Here are my first 4 entries on 18mg:
Day 1: My head feels ever so slightly less foggy. I can think slightly more clearly. I had a burst of energy this evening when I usually would be knocked out by the pills.
Day 2: Weird dreams have started. Not scary, but just very active and unusual. Minor ice pick headaches. Sleeping feels really good atm, even with the crazy dreams.
Day 3: Weird active dreams again; An apple eating itself... Not sure if it's symbolic or just random :biggrin:
Colours seem richer. Twice I noticed every day items seem to pop with colour.
Day 4: A moment of strong anxiety this evening. Very brief. I felt absolutely in control though. Libido seems to be returning in nano second bursts. Overall, still feeling good.
Re: Ange's Citlalopram Withdrawal Diary
Quote:
Originally Posted by
AngeAgain
I haven't spoken to my GP about my plans yet but will mention it next time I'm there.
Ideally, s/he should have been in the loop before beginning the taper.
Quote:
Here are my first 4 entries on 18mg:
Day 1: My head feels ever so slightly less foggy. I can think slightly more clearly. I had a burst of energy this evening when I usually would be knocked out by the pills.
Day 2: Weird dreams have started. Not scary, but just very active and unusual. Minor ice pick headaches. Sleeping feels really good atm, even with the crazy dreams.
Day 3: Weird active dreams again; An apple eating itself... Not sure if it's symbolic or just random
Colours seem richer. Twice I noticed every day items seem to pop with colour.
Day 4: A moment of strong anxiety this evening. Very brief. I felt absolutely in control though. Libido seems to be returning in nano second bursts. Overall, still feeling good.
Citalopram has a fairly long half-life so it takes about 7-8 days for plasma levels to drop and stabilize to a new steady-state after a dose reduction. Most of what you've felt has probably been generated by your mind, not the dose reduction.
Most can tolerate tapering off an AD the way they got onto it, or for citalopram by decreasing the dose by 5mg every 10-14 days. Cutting back faster may increase withdrawal symptom severity, but waiting longer won't significantly reduce them no matter how long the delay.
Re: Ange's Citlalopram Withdrawal Diary
Day 5 on 18mg (approx): Tiredness starting to kick in now. Libido still on the increase which is nice. Dreams continue to be active. Had a teary moment this evening. Not even sure why I was crying, which resulted in me laughing and crying at the same time :D This could be hormonal as it's coming up to that time of the month. We shall see. Getting a slight inflating sensation in my head. This is a side effect I experienced when I first started Cit. A few more ice pick headaches. Nothing major. Overall though, still feeling good.
Re: Ange's Citlalopram Withdrawal Diary
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but waiting longer won't significantly reduce them no matter how long the delay.
I'd be interested in reading the research on this if you have it. The recent research I've read suggests tapering as slowly as possible.
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Ideally, s/he should have been in the loop before beginning the taper.
While I agree, my GP (who I actually trust and get along with), like many in the UK, is not an expert in this area and the advice I've received regarding Cit so far has been unhelpful. I've spoken to them in the past about tapering and the advice was "You can split the pill or try taking one every two days". I knew that if I waited for an appointment, which would be weeks away, I'd likely have changed my mind as discontinuing is something I've been hesitant to do due to fear of negative side effects. So while it's not ideal, I hope it's clearer why I made this choice.
[EDIT: To add additional details.]
Re: Ange's Citlalopram Withdrawal Diary
Actually, you've got me thinking now. I will make an appointment in the next few days. Of course, I'd prefer to come off them more quickly if possible so I'll see what she says.
Re: Ange's Citlalopram Withdrawal Diary
Quote:
Originally Posted by
AngeAgain
I'd be interested in reading the research on this if you have it.
Research none, there isn't much available, just anecdotal info garnered from support groups like this one over the past 25 years. Despite what you may have read here and elsewhere, most people have relatively few problems quitting ADs. It is only the minority who do that post about it.
You can always revert to your 10% method if a faster wean proves too difficult.
Quote:
The recent research I've read suggests tapering as slowly as possible.
Which may just extend the misery for longer. The thing to be aware of is that successful withdrawal depends at least as much on psychology as chemistry and biology. Become convinced that you will suffer greatly and your mind could easily deliver your worst nightmares for you.
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I've spoken to them in the past about tapering and the advice was "You can split the pill or try taking one every two days".
Not a fan of the missed dosing strategy, although the longish citalopram half-life tends to make it less of a problem than with most SSRIs which have half-lives of <=24 hours. The issue is that it can set up a yo-yo effect as plasma levels rise and fall which can be very disturbing. The only AD for which it may be required is duloxetine (Cymbalta) as it comes in only a limited range of doses and the pills can't be cut. But switching to fluoxetine (Prozac) and then weaning off it is a far better option, imho.
