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Thread: Citalopram withdrawal

  1. #1
    Join Date
    Mar 2011
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    Citalopram withdrawal

    Iíve been on 20mg since December (but was on 10mg from July last year). I ran out of meds but my GP basically got me to come off cold turkey then because we just found out Iím pregnant.

    For days now I have had terrible loose stools (with cramping), tossing and turning and feeling cold. Would it be right to attribute this to the withdrawal? The hormones could be making it worse too I guess though my mood is not really low and I havenít been terribly anxious yet so thatís good!

    naomi

  2. #2
    Join Date
    Jan 2017
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    2,570

    Re: Citalopram withdrawal

    Quote Originally Posted by Hopefulmi View Post
    Iíve been on 20mg since December (but was on 10mg from July last year). I ran out of meds but my GP basically got me to come off cold turkey then because we just found out Iím pregnant.
    Sigh! Coming off any antidepressant cold-turkey is very unwise, plus it is probably not warranted because of pregnancy with SSRIs, Naomi.

    With the exception of paroxetine (Paxil) it is unclear that antidepressants significantly increase the risk of birth defects or complications. Studies have reported slightly higher incidents of defects, but there doesn't seem to be a common pattern to them which may indicate the studies aren't showing a real issue, but just reporting statistical noise. The problem is that the number of patients in each study tends to be low, the defects tend to be mostly the rare ones and the increases they report are often small.

    To complicate matters there is evidence that maternal anxiety (and/or depression) can adversely affect the fetus, both immediately, and later in life. They tend to have lower birth weights, be born prematurely and have impaired neuronal development. As children and adults they are more prone to asthma, dyslexia and to have learning difficulties. They are also much more likely to develop anxiety disorders and/or depression later in life.

    Anxiety/stress can also increase the risk of miscarriage, however, it is unclear whether SSRIs reduce the risk as at least one study has found that the risk is still high for women treated with antidepressants.

    If planning to breastfeeding then sertraline (Zoloft) may be the best bet as very little, if any sertraline is expressed in the milk (Pinheiro E, 2015).

    Unfortunately, antidepressants and pregnancy is an issue where there is no clear cut 'right' answer. I suggest you discuss this thoroughly with your GP [or maybe not given the advice to cold-turkey] and obstetrician and/or gynaecologist and follow their recommendations.

    For days now I have had terrible loose stools (with cramping), tossing and turning and feeling cold. Would it be right to attribute this to the withdrawal?
    Yes. Serotonin isn't only a brain neurotransmitter, nor is the brain the major serotonergic organ. It makes and uses less than 2% of all the serotonin in the body whereas the gut and the enteric nervous system, the mini brain which controls it, makes over 95% so will often be more effected by SSRIs when first taking them and when quitting. Serotonin is also a signal protein in the regulation of blood vessel tone, constriction and dilation, which can produce symptoms of feeling cold, or hot when the blood vessels in the skin are affected.

    Loperamide (Imodium) may help with the loose stools and cramping, but ask your pharmacist about it first especially if on other medications.
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  3. #3
    Join Date
    Mar 2011
    Posts
    328

    Re: Citalopram withdrawal

    Thank you. Yes a different GP was supportive last pregnancy though I weaned off then went on sertraline at 28 weeks.

    I see the consultant on August 4th so will be able to bring it up then if I need to. This isn’t the part of pregnancy that makes me really anxious so I’ve got a bit of wiggle room.

    Thank for for the excellent information! My consultants are brilliant and will agree with all you’ve said I think.

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