Argh conflicting advice - how to taper off citalopram?

[lior]

I've been on citalopram for maybe 2 years (from the first dose) and I'm coming off it now. Until recently I have been on 20mg for a couple of months.

I can't remember exactly what the last doctor said, so I'm doubting myself now. He gave me packs of 10mg, so I could take 20mg and reduce over time. My psychotherapist said it's normal to taper off slowly, in a 20mg 20mg 10mg cycle then 20mg 10mg cycle for example. I remember doing something similar when I was on citalopram a few years ago. I thought that the last doctor I saw said the same thing...

But just now on the phone, another doctor freaked out, and said it was against her professional advice to take alternate doses because it can cause mood swings. She had her freak out before asking me what my symptoms were, and before asking why I was doing this - I didn't even get the chance to say 'I'm tapering off'. I suggested taking 15mg, which she immediately rejected because they don't come in that dose. Can't I cut the tablets in half though?

I mentioned that I'd had a couple of moments of suicidal thoughts, which she got agitated about - I had to reassure her twice that they were fleeting and I'm not worried about myself. I know this is because I'm coming down off the dose, but surely if I stick to it, I'll stabilise? I don't want to go up to 20mg.

This is the first time I have wanted to act against a doctor's advice. I want to cut the tablets in half so I can have 15mg a day. If I go up to 20mg again, that would be taking a step back - I've weaned myself off pretty well, so slowly, with care. This doctor didn't even take a minute to listen to me, she just freaked out.

I find it patronising now when a doctor reminds me I can go to A&E if I have suicidal thoughts. I know how to look after myself. I've heard the schpiel so many times now. This doctor has never met me before and doesn't know basic things about me which would be in my notes on their computers, surely - like me being in therapy for the last year and a half. To make an informed decision about what to say to me, they should read the bloody notes.

I think I'm so upset by this because, apart from the possibility of taking the dose wrong, and apart from the possibility of undoing my careful work by going back up to 20mg, and apart from not being able to be fully heard, I had to deal with the doctor's anxiety about her patient. I shouldn't have to manage the feelings of the doctor. She should not freak out about me, to me. If anything, patients coming in with mental health issues should be treated more gently and kindly. Though, everyone should be treated gently and kindly.

She got me to book in another appointment with her, but I'm going to change it for an appointment with someone else. I don't want to see her again. She and I are not suited.

Story over.

If you've come off citalopram, did you taper between 20mg and 10mg or did you jump down to 10mg?
How did you taper off?

Would really appreciate hearing about how other people did it.

[Elen]

Your psychotherapist's advice sounds ok to me, but bear in mind that I am only a lay person.

I have had to come off SSRI's quite a few times and have never had any problems.

Cit has quite a long half life so I don't see how alternating doses is going to cause fluctuations and that is how I normally taper off. Higher dose one day, then a lower dose the next day down to alternating taking doses at all.

It sounds as though you do not have a lot of faith in this latest doctor and tbh I don't blame you at all.

[Mummytofour]

Hi, I have tapered off before. I was on 30mg and just went down to 20mg waited a good few months then down to 10mg for another few months then 10mg alternating days a few months and then stopped. I did this with no problems. Absolutely no withdrawal effects which I was surprised about too. Just a shame I am now going back on them again. As long as you do it slowly you should be fine. X

[lior]

Thanks both.

I changed the appointment to be with another doctor, so that's good.

I asked the pharmacist's opinion, and he said to do 20mg 10mg cycles. I've got 20mg tablets prescribed so I can't get a 5mg to make a 15mg dose - can't cut it into quarters.

So I'm going to stay on this 20mg 10mg cycle for the next 2 weeks til I see the doctor again.

Now I'm wondering, though, if me being so knocked out with the flu really is the flu, and not the citalopram dose change. I'm just going to stabilise on this dose, and see what happens.