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Thread: Coming off Cital after 2 years on 20mg

  1. #181
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    Jan 2008
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    Re: Coming off Cital after 2 years on 20mg

    Well I managed to get to 52 days on 5mg with no real negative effects.

    Unfortunately three days ago I had a real bad day, I felt worthless and anxious all day at work. It continued into the next day.

    I have been back on 10mg for the past two days and I feel better already, my anxiety has greatly reduced.

    I'll stay on 10mg for the time being.

  2. #182
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    Jan 2017
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    Re: Coming off Cital after 2 years on 20mg

    Quote Originally Posted by UrbanMark View Post
    Well I managed to get to 52 days on 5mg with no real negative effects.
    Why such a long time? There is little to be gained biologically from weaning off this slowly, although there may be some psychological benefits.

    I have been back on 10mg for the past two days and I feel better already, my anxiety has greatly reduced.
    This is most likely to be either the placebo effect, or that the bad day was just that, a bad day, which all of us experience from time to time and now you're back to normal. Antidepressants have no direct affect on anxiety or depression in the way, say, aspirin has on headaches, or benzodiazepines do. They work by making physical brain changes which takes much longer than 24-48 hours.

    I'll stay on 10mg for the time being.
    Not a good idea, imho. Antidepressants work by stimulating the growth of new brain cells (neurogenesis) to replace cells killed, or prevented from growing by high brain stress hormone levels (PDF). The therapeutic response is produced by these new cells and the stronger interconnections they forge, not the meds directly and this requires a minimum level of the med in the system to initiate and sustain.

    The problem with taking sub/borderline therapeutic doses is neurogenesis may be interrupted whenever antidepressant plasma levels drop below the amount needed to sustain it which could lead to the second issue, the growing evidence antidepressants become progressively less effective every time they are stopped and restarted. Two studies, Amsterdam JD, 2016 and Amsterdam, 2009 found the likelihood of antidepressants working after each restart drops by between 19-25% (see also: Bosman RC 2018; Amsterdam JD, 2009; Leykin Y, 2007); Paholpak S, 2002).

    Taking a low dose for months may create a similar situation as stopping and restarting it. While the neurogenesis interruptions may only be of short duration, they will occur much more frequently.

  3. #183
    Join Date
    Jan 2008
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    257

    Re: Coming off Cital after 2 years on 20mg

    I can only tell you I feel better on 10mg than I did on 5mg.

  4. #184
    Join Date
    May 2010
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    239

    Re: Coming off Cital after 2 years on 20mg

    I came off Citalopram nearly 2 years ago sort of going cold turkey but I kept forgetting to take it towards the end was in 10mg.
    After that I had a good 3 months of emotional ups & downs , mainly bursting in to tears a lot, possibly hormones as I m woman. But anxiety was at bay until 2 months ago , now I m back at rock bottom considering going back on medication.
    so don’t rush it if you don’t feel ready. I wish I stayed on 10 mg as it kept the anxiety at bay and I felt ok.

  5. #185
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    1,564

    Re: Coming off Cital after 2 years on 20mg

    Quote Originally Posted by keta View Post
    but I kept forgetting to take it towards the end was in 10mg.

    I wish I stayed on 10 mg as it kept the anxiety at bay and I felt ok.
    Taking sub therapeutic doses, or often missing doses may be very unwise.

    Antidepressants have no direct effect on anxiety, or depression in the way say aspirin has on a headache. They work by stimulating the growth of new brain cells (neurogenesis) to replace cells killed, or prevented from growing by high brain stress hormone levels. The therapeutic response is produced by these new cells and the stronger interconnections they forge, not the meds directly and this requires a minimum level of the med in the system to initiate and sustain.

    The problem with missing, or taking sub/borderline therapeutic doses is neurogenesis may be interrupted whenever the antidepressant plasma levels drop below the amount needed to sustain it which could lead to the second issue, the growing evidence antidepressants become progressively less effective every time they are stopped and restarted. Two studies, Amsterdam JD, 2016 and Amsterdam, 2009 found the likelihood of antidepressants working after each restart drops by between 19-25% (see also: Bosman RC 2018; Amsterdam JD, 2009; Leykin Y, 2007); Paholpak S, 2002). Taking a low dose for months, or often missing doses may create a similar situation as stopping and restarting it. While the neurogenesis interruptions may only be of short duration, they will probably occur much more frequently.

  6. #186
    Join Date
    May 2010
    Posts
    239

    Re: Coming off Cital after 2 years on 20mg

    Blimey have you got a PhD in Antidepressants, not that I m disputing what you quoting here, but from what I ve read in this forum , everyone reacts differently to medication and for some therapeutic dose could be totally different dosage to others. Perhaps 10mg is enough for some but not enough for others.

  7. #187
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    Re: Coming off Cital after 2 years on 20mg

    Quote Originally Posted by keta View Post
    Perhaps 10mg is enough for some but not enough for others.
    In the absence of a readily available tests to determine SSRI/SNRIs plasma levels, as there are for TCAs, there is no way of easily determining whether a dose is inside the therapeutic range so given the issues I cited, imho, it is best to stick to the recommended doses. It is still 20mg for the elderly who tend to be slow metabolisers. SSRI poop-out is not rare and low doses seem to be a significant factor from what I've observed.

  8. #188
    Join Date
    May 2010
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    239

    Re: Coming off Cital after 2 years on 20mg

    Interesting , but just from my own experience I felt better on 10mg than 20mg as had less tiredness and was more with it and felt like that dose was keeping my anxiety at bay. I actually managed to do several flights and travel to Gatwick & back as my mum was dying at that time without any major panic attacks.
    while now I m s***ing myself from anxiety just to drive to work.

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