Good! To many feel great after a course of antidepressants and decide to quit without having any tools to handle the occasional bad day, or days when they occur and then begin to relapse.Originally Posted by happybunny13
No. I see what he is trying to do, use the relatively long citalopram half-life to affect a small dose decrease via skipping doses, but the interval back at 20mg is too long. Anyway, I've never been convinced this is the best method anyway. Roller-coasting the dose eventually ends up in roller-coasting anxiety. The only time it could be necessary is for ADs only made in slow-release formulations and even then there are other options for all except duloxetine.He suggested 20mg for 3 nights then 10mg for one night then 20mg for 3 nights and so on. Do you think this sounds sensible?
The trick with weaning off is to do it by small steps at intervals of no earlier than 5 times the half-life of the med, which for citalopram is 8 days. It takes that long for plasma levels to stabilize to a steady-state after a dose decrease (or increase). Cutting back the dose faster may increase the severity of any withdrawal symptoms, but delaying the drop won't significantly reduce them no matter how long the wait. However, there is more to this than chemistry and biology. Psychology is at least as important, some would argue even more important because an anxious mind is very capable of producing far worse symptoms than mere biology, so I suggest waiting a few extra days to build confidence ahead of the next reduction.
Imho, the best option for citalopram is to drop the dose by 5mg every 10-14 days. This means you will probably need a prescription for either 10mg tablets to cut in half (pill cutters sold by all good pharmacies are more accurate than breaking tablets and much less bloody, ime, than knives), or for citalopram in liquid form, as the shape of many 20mg tablets makes quartering them accurately difficult even with pill cutters.
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