From 30 to 10mg of Citalopram - is it likely to be a bumpy ride?

[Pamplemousse]

As if the sewer terror isn't enough for me, today I noticed (as I was counting out my tablets for the week) that my GP has reduced my dose from 30mg to 10mg. We'd agreed that at some point this was going to happen - either to see if I can manage without them or going on to something different - but I'm a bit worried about the magnitude of the change and considering I've been on this for over a decade, what can I expect?

[nomorepanic]

In my opinion it is too big a drop

[BikerMatt]

Agree with Nicola. You should really of gone to 20mg first.

[pulisa]

It has to be an error surely? Can you check with your GP tomorrow?

[Pamplemousse]

It has to be an error surely? Can you check with your GP tomorrow?

I might drop him a line.

[panic_down_under]

As if the sewer terror isn't enough for me, today I noticed (as I was counting out my tablets for the week) that my GP has reduced my dose from 30mg to 10mg. We'd agreed that at some point this was going to happen - either to see if I can manage without them

If this isn't a mistake your GP should have discussed it with you first!

or going on to something different -

Is citalopram working well? If so, why go onto something different if you need to remain medicated?

but I'm a bit worried about the magnitude of the change and considering I've been on this for over a decade, what can I expect?

You have a right to be worried, both by the way it has apparently been done without any warning, or guidance and by the magnitude of the change. Ideally, the dose should be reduced to 20mg for a couple of weeks and if that goes well then, and only then, down to 10mg for another couple of weeks.

[Pamplemousse]

Hi there,

thanks for your reply - I'll deal with the points you raised in turn.

If this isn't a mistake your GP should have discussed it with you first!

We have discussed this, at length during a ten-minute telephone slot that went on for 45 minutes so I shouldn't complain - what started off as a request for some zopiclone turned into a full review, including removing a blood pressure medication that apparently makes diabetes worse but increasing the dose of another to compensate.

Is citalopram working well? If so, why go onto something different if you need to remain medicated?

Herein lies the problem. I don't think the Citalopram is actually working for me any more. I still have deep bouts of depression, I still have anxiety issues. I hate to say this, but I think I am beginning to accept that this is the way I am and nothing is going to alter that: "you're a proper Wednesday's Child", as my late mother would say (and I am a Wednesday's Child too)

You have a right to be worried, both by the way it has apparently been done without any warning, or guidance and by the magnitude of the change. Ideally, the dose should be reduced to 20mg for a couple of weeks and if that goes well then, and only then, down to 10mg for another couple of weeks.

We did discuss this at length, as I have had a previous attempt at coming off it. In that instance the idea was two days on and miss a day for two weeks (when I was on 20mg), then one day on and miss two days for two weeks and then stop. At the time, I had some pretty unpleasant but occasional nightmares when this happened, much as I did when I went "cold turkey" by accident once.

This is part of a plan we discussed where I may go on to a different treatment - it just came as a surprise but if it means I'm taking less tablets and I am none the worse for it, it's something I can live with.

[panic_down_under]

Herein lies the problem. I don't think the Citalopram is actually working for me any more. I still have deep bouts of depression, I still have anxiety issues.

Then wouldn't it be better to switch directly to another AD instead of coming off citalopram and starting from scratch on another med? It may significantly lessen the time it takes for the new AD to kick-in. Mostly people can do an overnight switch from one SSRI to an equivalent dose of another with only minor issues. Switching to a different AD class is best done via a short cross taper, but again is usually straight forward.

[Pamplemousse]

Quite frankly, the ideal medication for me would leave me catatonic except when I needed to go to work.

Unless I'm imagining it, the weird dreams started last night which seems a bit quick?

[panic_down_under]

Quite frankly, the ideal medication for me would leave me catatonic except when I needed to go to work.

There is, or at least should be imho, more to life than work. It should be a means to an end, not the end itself.

Unless I'm imagining it, the weird dreams started last night which seems a bit quick?

I don't believe weird dreams are caused by ADs, but are fairly common all the time. ADs just expose them to consciousness sometimes. I used to have some fantastic ones while on high doses of imipramine. Great vivid blockbusters that would have made Cecil B. DeMille jealous.