Re: Fourth attempt at coming off citalopram
Originally Posted by
Meewah
Since 2017 I have each year reduced my dosage down to one 20mg every alternate day, after about 2/3 months I stopped taking them and all in all I felt fine for about another 2/3 months. Then suddenly I noticed I was waking at 5am.
...I was unaware how difficult it is to get off Ssri’s only recently have I read about the side effects. I thought that after 5 months I would be free of the drug but it seems that your head takes a lot longer in some instances, to re adjust to the Seratonin after the chemical has gone.
If the symptoms only reappear 2-5 months after last taking citalopram then this almost certainly isn't withdrawal, but a return of the underlying disorder. Unfortunately, for some of us these are chronic disorders which wax and wane, but don't completely go away although longish remissions do occur.
ADs (also therapy) work by stimulating the growth of new brain cells (neurogenesis) in the hippocampal regions of the brain to replace those killed, or prevented from growing by high brain stress hormone levels. The AD/therapy promoted brain changes may begin to unravel when the treatments are stopped.
I would then continue for 6/8months on citalopram 20mg. They have eroded my teeth
Are the teeth eroding because you grind them when on citalopram? If so, talk to your doctor about switching to escitalopram (Lexapro). They are nearly identical meds. Citalopram (Celexa) is made up of two isomers, the 'S' form of citalopram, which is the active component, and a 'R' mirror image form which is a poorer fit biologically and so is mostly inactive. Escitalopram only contains the 'S' isomer. The side-effects of each can be different because of the small differences in chemistry and while there's no guarantee, there is a chance that the teeth grinding won't occur on escitalopram. Switching between the two meds doesn't usually trigger and side-effects.
Exercise has been proven to initiate the same brain changes as ADs and therapy, albeit to a less degree. It should help with the weight gain too. You don't need to run daily marathons, a 30 minute walk 4-5 times a week can do wonders for both anxiety and the waistline.
While it's written for doctors, you may also find this useful: How to control weight gain when prescribing antidepressants [PDF].
killed my sex drive"]killed my sex drive
You may find one of my previous posts about AD induced sexual dysfunction useful. BTW - the buspirone (Buspar) mentioned in that post may not only ease SSRI sexual dysfunction, but teeth grinding (bruxism) too.
does anyone have any advice for the insomnia symptoms while withdrawing?
Ask your GP to prescribe a small dose of either mirtazapine, or immediate release trazodone. They are ADs which act as very sedating antihistamines at low doses. Imo, trazodone is the better med for this, but most UK GPs seem to prefer mirtazapine.
I reduced to 10mg daily for the last 2 months. I candefinately feel side effects of coming off but nothing too bad until tonight when this is my first night where I am unable to sleep due to feeling hot and a racing mind.
I don't think this is withdrawal, but the disorder reasserting itself as 10mg is a sub therapeutic dose for most. The dose needs to be high enough to saturate about 80% of the serotonin transporter molecules to initiate and sustain neurogenesis and 10mg citalopram is likely not to be high enough.
I am going to stay on 10mg for some months and then fingers crossed I will reduce to one 10mg every alternate day.
Remaining on sub therapeutic doses for extended period can increase the risk of the med pooping-out. As per above, if symptoms only begin months after an AD is taken then it is unlikely to be withdrawal.
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The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.