coming off citalopram

shaki

I am on my second round of citalopram having first come off it about two years ago. I was on 20mg for about a year ,doing ok so then i was reduced to 10mg and stayed on this dose for about two months. The doctor then reduced me to 10mg every other day and then 10mg every 3rd day. Doing it this slowly and gradually meant i did not suffer any side effects at all. My doctor would not recommend missing days when on 20mg as this is too big a sudden drop for your body to take and your withdrawl symptoms could be quite bad. Having said all that i am now on my second round of citalopram and in my fourth week of treatment and very loathed to come off it at all this time, last time i was like you and wanted off asap. I hope everything goes well for you at the doctors.

Lindsay

Thanks Lindsay
I think I might ask the doctor to reduce me down to 10mg. As I said previously I feel I've identified the things that were causing my stress / depression. But I guess I don't know how much the drugs have helped until I come off. It's really quite worrying. I have a friend who has been taking anti depressants for eight years and it really worries me I'll end up the same. Would you be happy to stay on them forever?
Shaki

no,i wouldn`t,i think it`s just that after a really low point i am now starting to feel on the up again, and having been on them before and then having a really good 18 months or so i am worried about slipping again while off them. However this time i am going to cbt to try and sort out the underlying issues which do affect me so hopefully this time when off the drugs i can help myself to get out of the cycle of depression. I haven`t started going to the counselling yet so i don`t know if it will help, i hope so.

Right now, I'm at the point where you 1st started building down your dose and I've halved to 10mg. In fact I feel great! I feel that I have a little more 'zip' and more 'On' if you know what I mean.
I started thinking about dosing down when I missed a day and really felt okay and 'with it', but when I restarted the full dose the next day, it was as if I was smothered by a hot and suffocating blanket.
My wife's a little apprehensive of what this will do to my moods, but so far, so good. It helps that I'm in a great therapy program and that I've cut drinking alcohol entirely. I still have the occasional pangs of the desire to drink, but I love the clarity that sobriety brings.

What sort of therapy are you having if you don`t mind me asking, is it straightforward counselling or cognitive behaviour therapy. I am starting cbt tomorrow and am quite apprehensive, i know what my issues are but don`t quite know how they are going to be resolved by talking about them. But i have heard that long term to stay off drugs therapy is the solution (not for everybody i suppose).When i first halved my dose as i said i had no side effects at all and having been on them for 18 months or so i was pretty well balanced mentally(at the time) and so my moods pretty much stayed as they were on the citalopram, it was not until 18 months later (earlier this year) that i would say things started on a downward spiral again and i ended up really bad. I also don`t drink alcohol and i`ve got a dog so i`m out and about for about 2 hours a day which i`m sure helps.

My therapy, in which I have been for over a year by now, is a combination of traditional one-on-one counseling and group-therapy on topic of anger-management and ittitude adjustment. I have several PTSD issues (Caused by experiences in a violently abusive family of origin and later by experiences in two Middle-East deployments.) and resulting depression and behavioral problems, amongst which substance abuse (alcohol). I sincerely hope for you that these do not apply to you. Most of my fellow group members are either Court-ordered or Service-Ordered. As a voluntary participant I'm the odd-duck out who isn't any of that. I do not expect this from of therapy to align itself with your particular requirements. I'm glad that my health plan is actually covering it.
I have been on citalopram for about 1.5 years and have significantly stabilized to the point of regaining functionality in my daily life and family.
Thanks for your concern. It is appreciated and I'll keep you posted.

Hi
I went to the doctors today and she said as I was feeling so much better she was happy to let me come off drugs. As I have only been taking the drugs for 12 weeks she doesn't think I'll have much of a problem coming off. I have to take one tablet (20mg) every other day. As I forgot to take one on Saturday, I guess I have already started and haven't taken another one today. Let's just wait and see what happens eh? Doctor did also say that if I start to feel bad again I have got to start taking drugs again and must not see this as failure, it just means I need to take them for longer. I've only had one counselling session, but unfortunately I was having a good day and the counsellor did not think my need was urgent. I have however started to write a private diary and have found this to be very useful in identifying my stresses.
Thank you so much for all your comments it really helps!

Hi Shaki -- no doctor here, but I keep seeing that it's best to taper off very gradually... and that skipping days causes a "roller coaster" type of effect. You could consider tapering off, like 15mg a day, then 10mg, then 5mg.... but each day. Just my two cents worth.

Also -- keep in mind that whenever you reduce your dosage, you will probably have some withdrawal effects that can mimic returning depression. These can start as soon a day after, but usually start around day 3-6 and can sometimes last several weeks. An actual returning/relapse depression would not usually begin until about a month or more later. People often stop (or reduce) their meds and then start them again after just a few days because they think their depression is returning. It's a shock to your system, and your body has to readjust. Keep this in mind if you feel strange or moody or irritable after a couple of days.

I just stopped taking citalopram a few days ago after tapering off. Both when I reduced the dosage to half and when I stopped I experienced some irritability, a little moodiness and slight tingling in my head... I had to remember that it was the drug leavin my system and not necessarily cause to be alarmed.

So basically, once you reduce the dosage or stop, you should try to stick with it. Good luck to you!

I do agree with birdie here and the 20 mg every other day seems quite a big jump for your system to cope with. If you are able to split them maybe the 10 mg every day would be better. But likewise i am not a doctor, but skipping days when on 20mg is not good for your body or your mind. Best of luck to you reducing them however you decide to do it and let us know how you get on.

Thanks
I do feel a bit strange at the minute,(having missed my second dose yesterday) bit light headed and not quite with it,- very similar to when I first went on the drugs in the first place in fact. Thanks for your advice, without it I think I'd be thinking of going straight back on them. I'm gonna try it this way for two weeks and see how I go.

The one thing you absolutely should do not do with these drugs, is withdraw by missing out days.

The short half-life of the drugs means that the concentration levels in the body start rolling, and this can bring on waves of withdrawal effects. It destabilises.

Doctors continue to recommend it, left, right and centre. With highly predictable results. Yet do not see the anomaly with the information in your drug leaflet insert which usually clearly states you should not miss doses when taking the medicine.

Yes, some individuals manage it - they may be slow metabolisers, or just be able to hang on with the 35 hour half-life of citalopram. But is it a good idea? No. Most people end up straight back on the drugs, convinced in their doctors' explanations of 'disease' resurfacing.

One of the independent experts in this field states, from the antidepressant withdrawal FAQ (ref p.97 of Glenmullen's book on the subject 'The Antidepressant Solution'):

"Q. Can antidepressants be taken every other day as a method of tapering them?

A. None of the short acting depressants should be taken every other day as a method of tapering them. Because of their short half-lives, the every-other-day schedule can result in roller coaster levels of the drugs and roller coaster episodes of withdrawal symptoms."

The emphasis in withdrawal is usually to keep the drug levels as stable as possible within the body, by taking the same dose every day... then you wait until you stabilise, and only then drop the dose to the next withdrawal level.

If you follow the miss-a-day route, please watch yourself very carefully.

I have taken to clipping my pills and went down from 20mg to 10mg in 3 days. So far so good and I'm actually feeling nearly perfect and better than on the original dose, but it's still early, I know. I notice that I have a lot more energy without getting squirelly or fidgety like I used to. I'm amazed about the almost instant disappearance of sexual side effects (Mrs. Meerkat too.)
I think that as long things remain okay, I'll stay on 10mg.

I'm going to cut my pills up and do 10mg a day! Thanks everyone.

Shaki wrote:

I'm going to cut my pills up and do 10mg a day! Thanks everyone.

Oh, Shaki, I did talk to my GP first, and I'd advise you to do the same.

Shaki - go armed with pertinent information.

Ring up a few libraries or bookshops and get a copy of Glenmullen's 'The Antidepressant Solution'; print off a copy of David Healy's 'Halting SSRIs'

http://www.ssri-uksupport.com/files/haltingSS...

As you'll find out when you read it, this document is specifically designed to be printed out, so you can take it to you GP. It's written by an independent specialist, who has written books about the SSRIs and testified at the FDA hearings.

P.S. Given that your doctor says "if I start to feel bad again I have got to start taking drugs again," plus, your doctor has given you the miss-a-day-schedule.... make sure that YOU know about antidepressant withdrawal, because that combination makes it most likely that standard, classic and common withdrawal symptoms will be misdiagnosed as 'the original problem'(the Healy Protocol explains how to tell them apart).

Do your homework! Remember we are all strangers on the ether, so to be safe, write this off as a load of rubbish - but research it yourself, FAST. The withdrawal information IS out there, and has been put together by experts. Independent experts. And DOES tally with patient experience and drug pharmacology.

Good luck.

Shaki

Have you considered going to a different doctor within the same practice,just so you maybe get a second opinion firstly about the missed day withdrawl method and secondly about starting them again if your symptoms worsen (which is quite possible but is only a side effect not a return to the depression). As mentioned above how about researching this on the internet/books so that you go armed with knowledge yourself. I do think that the 10mg a day is the right method of withdrawl but doing it under the doctors supervision is always the best option. Then if you start having withdrawl symptoms , if he/she knows and agrees with what you are doing you will have someone to discuss the options with.

Just wanted to add here in case my previous posts weren't clear... by tapeing off, I mean that each reduction in dosage should be taken for a while. It may be different for everyone depending on you, how long you've been on it and your original/current dosage. In my case, it was my first time and I took 10mg for 6 weeks. I went down to 5mg for a week and have been off the drug for five days now. Feeling my old self again (the part I missed, not the sad-eyed one).

So if you go down, better safe than sorry. My guess is to give it (at the *very* least) a week, preferably longer, with each reduction in dose... but don't take my word for it. Do lots of research!

Well Day 4 on reduced to roughly 10Mg and all is well. A little glitch in the sleep pattern, but nothing to worry about. That's what personal days are for. For the rest feeling dandy and actually quite bright and happy. I think I'll stick with this for a while.