long term use

[arfasc]

Other people here on long term use?
I am on citalopram.. for... 10 years!!!
I do not suffer of depression... or maybe some short periods because I Was not able to manage my anxiety..
They gave it to me for anxiety and panic.
Related to serious issues I had, when I was 22.
I was on 20mg... then after one year went on 10mg.. 20 ... 10 during all these years, I was always trying to reduce with the idea to stop... but something was happening and my panic coming back again.
In the past 2 years I have been to 40mg.. back to 20mg... then 40mg again..
always something happen..
Now I was trying again to "quit".
1 month on 30mg
1 month on 20mg
on 10 I had the crisis and went back to 20mg after 1 week.
Maybe I should have waited?
The effects would have gone away?
I m so scared by my anxiety that I didn't want to risk
I didn't even thought to take the risk to fall down in a black period.

I've tried a lot, but I cannot accept to take it all my entire life.
Maybe I will.. because when I am feeling very bad I just want a solution.

I've tried many ways and now I am happy with some CBT/mindfulness.
But still not able to cope with this anxiety that came from the witdrawal and now from the new dosis side effects.

It's stressfull to think I have to take all my life.
Because I am not able to stop.
Because I don't work anymore without it.

I am asking myself why they didn't try to stop my physical anxiety with a bit of anti-anxiety pills (short term use)... or beta blocant.
I am starting reading on that... I want to find my way out or if I have to live with the citalopram, to know that there is no other option for me.

Sorry for too many threads and long ones.
But I need a bit of understanding and this forum seems rich of nice people that knows the matter!!
My family (living abroad) is very nice helping me, listening to me.
Obviously they say: if you need it, take it and don't worry.
If they would say nOO stop it would have been worse.
But people with real experience I think can understand more..

Thanks!

[steveo]

I was on Citalopram for 11 years. I tried to come off after feeling good for years.... and I probably shouldn't tell you what's happened to me as it might scare you.

I was on 20mg of Citalopram for those 11 years. I weaned off over a 6 month period. Coming off the meds was fairly simple for me. It was what happened 3 months later than I wasn't expecting to happen....

If you want any advice or help or are interested in hearing my story then drop me a message. x

[arfasc]

Hi thanks for your answer.
I've read something on the forum, maybe is your story... is not a good one.
That's also why I am asking myself this question.
It's difficult to know, I don't want to destroy my life because I cannot accept to need a medicine.
It's also difficult to know if we need it until we discover...
But yes, it's a risk.
It's a very delicate and difficult matter.
I don't know what to do. For sure I will stay on 20mg now... and for a while!
Then I will start thinking about that again.
I would maybe switch to another ssri, because this one interact with medicine I will need. Don't know.
I hope you feel better anyway, with or without the tablets!

[steveo]

My advice would be not to stop taking it if things are OK. 'If it aint broke, don't fix it' as they say.

For me, it was a life changing mistake to come off the medication, something that 5 months down the line, I've lost everything I ever had and have been bed bound for 3 months.

But that's just me. That won't happen and doesn't happen to everyone. No one is willing to recognise that long term SSRI use can be damaging either. I was fine on the meds.

I don't understand what you mean by switching to another SSRI because that one will interact with medicine you will need? All SSRI's are near enough the same so what will interact with Citalopram is 99% likely to interact with ALL SSRI's. Luckily, very few medications interact with SSRI's.

Why do you want to come off the medication? Why go through the potential problems?

[arfasc]

Well no, I am not 100% sure I want to come off.
Obviously I hate to have to take forever.
There are no studies and so on.
But I am happy if I am fine.
The problem is that it seems to be always increasing, second time going on 40mg.
At least I want to be able to be on a minimum dosis.

I have problems with my stomach (and it all almost started with citalopram.. as far as I remember).
I've taken for one month esameprazole and it interact with citalopram and it's not nice.
I've read that setraline for example doesn't have this interaction because it affects another CY don't know..

Let's see how is going.
I am also wondering why there are no drops or people don't use that to reduce very few drops at time?

My sister has been on haldol for 11 years, just told me, and she quit very slowly with no problems.

I agree that we are all different.
For sure I don't want the risk to have your experience.. so thanks a lot for sharing.
I will think a lot about that before doing anything.
Would be really helpful to have studies on that.. how many people have problems and how many can come off.. which problems they have and they had before starting.

Obviously not judging at all you or your experience.
I am really sorry about what you are living and obviously it "scares" me the idea to go through the same sufference.

Sometimes I just wish I never started... but then again, who knows if I could have been worse?

[keithwms]

So, obviously this is a very personal thing, there is no single prescription that suits everyone.

My own feeling is that SSRIs should only be used long term if necessary, and it takes some work to determine if that is the case. That requires good consultation with a doc (at least one knowledgeable doc) and a good therapist, etc... and some patient experimentation. Most of us become afraid to experiment with dose, for obvious reasons- rather adverse side-effects after just slight dose changes.

I do not like the thought of dependency one bit- not on any medication. And I particularly do not like the idea of being dependent on anything that affects my thinking. Thus my own goal is to use the meds only as long as I need to, to sort a few issues and identify the underlying catalysts for A/D, and meanwhile work to do everything I can to lessen my need for them. This includes rigorous exercise- physical and mental- and continued research on 'natural' ways to address my condition. In fact, I started the exercise and therapy before the med, because I wanted to be absolutely sure that I was in the right place to do what I needed to do.

I do not like the idea of being on the meds long term. If it is necessary, then it is necessary. But I am hopeful that won't be the case, and committed to do the hard work to make it possible to wean off.

What I won't do is make the same mistake I did last time with venlafaxine, which was go on the meds without also doing therapy and taking other steps to address the A/D. Last time, I was on a med for 6 months and just got to a comfort zone and then came off, without really making an earnest attempt to address the real issues. I did so because I started to read about long-term side effects and it really freaked me out, and my few missed doses confirmed some really nasty side-effects could be ahead. So basically I was on the wrong med for the wrong period, and I had a lousy doc and a bad therapist too. That was a bad experience! But this time, I plan to be more proactive with supplemental therapy and exercise etc. and I don't plan to come off until I really feel confident that I have thoroughly tilled the soil, so to speak. So far so good.

[steveo]

I could be moving on to Venlafaxine soon.

Could you tell me more about your experience on it?

[KeeKee]

Hi Guys,

What would you say is long-term? Just as I have now been on SSRI's for 5 years and will not be coming off them anytime soon. I also don't want to become reliant on meds forever :-(
Why can't depression/anxiety be cured!!

[keithwms]

I could be moving on to Venlafaxine soon.

Could you tell me more about your experience on it?

Sure Steve. So... venlafaxine is a long story. I'll try to provide the highlights and lowlights in condensed form

First of all, as you know, it's a combo SSRI/SNRI, so it acts in a rather different way than straight SSRIs. Whether you need the SNRI component... apparently one just has to experiment. But because of what I am about to say next, I would make sure that the straight SSRIs aren't cutting it for you before going to venlafaxine.

Starting venlafaxine is probably not as bad as cit, at least what I remember. I had belly upset and loss of sleep etc., but it really wasn't so bad. As you know, citalopram really makes you question it for the first few weeks. With venlafaxine, I was good to go pretty quickly- maybe two weeks in.

My idiot (former) doc put me on the standard release form of venlafaxine, and wow, not good! I guess he did it to save money for me or something. Anyway, one missed dose, and boy oh boy do you feel it. Some people get brain zaps; I didn't really, I just some tingling and disorientation. The stuff has a short half life. The positive thing about that, which people often mention, is that you should clear it out of your system quickly when you quit i.e. the withdrawal won;t last long... but it can also be very acute.

During the 6 month treatment period, I felt very good. I wasn't jittery or nauseated or whatever.. I felt normal and rather energetic. I felt creative. I didn't have brain zaps. The venlafaxine really worked, no question about it. but then I figured I was 'well' again and began to taper. But since I was at the lowest dose, there wasn't anything lower to taper too, and I didn't have a good doc at the time so I wound up doing what nobody should every do... I tapered without any additional help. Now I know that prozac and other things in single doses can make a big difference... wish I knew that when I was coming off venlafaxine!!!

So yeah, about quitting....

Quitting venlafaxine was awful, awful. I had indescribable nightmares, the worst images I'd ever seen in my life... and I literally grew up in a war zone, if that helps you calibrate. I will spare you the details, but I swear the med stored up every awful thought for months and then unleashed them full fury. I told my parents what i was going through and they stayed with me a few days. It was quick withdrawal but very acute. I honestly think I still have some PTSD from that horrid experience; it was truly awful and I wouldn't wish it on anybody. BUT... again, bear in mind that I didn't do it the right way and was not appropriately counseled or helped.

Now here's the thing to watch with venla... some people have to keep adding dose to see good maintenance effects, and the dose can get very high. I recall some people starting at 37.5 and going up well past 200 over a year or two. The thing is, when you taper off that, you have to go very slowly, so it could take a very long time to come off. Whether that worries you... it's individual. For me, with my tendency not to want to be on any med for the long term, so I was very anxious about increasing dose. And 37.5 served me well for those six months.

What I should have done is stayed on for a full year, and then tapered another half year and transitioned to fluoxetine or such.

So all in all, velnafaxine was good while I was on it, but whoa, coming off... serious business. You have to do it right, And bear in mind that most of the horror stories you do hear about it are from people who didn't do it right, and were at the mercy, like me, of a GP who didn't know his stuff. Honestly, I wonder if venlafaxine shouldn't be the domain of psychiatrists, and not GPs.

Sorry for the treatise. I'm happy to discuss further if you wish. You can do it and it can work for you, but know the risks and make a good plan and stick to it. Don't do what I did!

By the way, my insight from citalopram, after only 3 or 4 weeks in, is that anxiety is what has been driving my A/D. So maybe I have found my right med. I hope so.

---------- Post added at 19:10 ---------- Previous post was at 18:59 ----------

Hi Guys,

What would you say is long-term?

I would say longer than a year or two but it is all very individual to the med and to the person and his/her circumstances. And bear in mind that the effects some of these meds famously 'peter out' and you either have to increase dose or go to something else, so then I wonder if placebo effect rises with time with some of these...

Please don't misunderstand me, I would be the last person to tell someone to come off just because they've been on something for a long time. You have to make that determination very carefully, with doc and therapist and with a lot of consideration of risks vs. returns. If you need the med, you need the med. And nobody should feel ashamed or anxious about needing a med to help. But obviously it's best to do the other things, alongside the med, that can reduce dependence in the long term.

Why can't depression/anxiety be cured!!

Maybe it can. Who's to say that it can't? Many people have depressive phases and then recover. I think we need to distinguish between the depressive tendency and the depression itself. The later can probably be addressed and corrected in most cases; the former is something we might just have to live with- something we're prone to. But that's okay as long as we know how to prevent it form taking hold of our lives.

I think we just have to be grateful for the many good tools now available to us. Can you imagine suffering through this ailment a hundred years ago?! Goodness gracious, we now have so many different therapy routes, including meds, and much more information via the web. Just things like this forum can make such a difference in helping people find the right route to recovery...

[arfasc]

Yep you are right with the information we have especially.
I was feeling guilty and ashamed to have had another "crisis".. didn't think was the reduction and again increase.
I thought that increasing would suddenly stop the symptoms, so if I was still feeling bad it was "my fault".

It's very difficult matter, it is right that we can only try and see how is going.
The bad thing of internet is that we have much more negative stories than positive.
So it is difficult to have a statistic.

For sure I am planning to stay back on this 20mg for a long while now before thinking to attempt again. At least 3/4/6 months let's see.
And yes, keeping with the CBT / counseling, started yoga, trying to be serious with mindfulness... etc..