Long term Citalopram usage: Tapering off slowly but getting withdrawal effects

Treatment and medication
1

Hi

Many years ago (over 10 at least) I was prescribed Citalopram for anxiety and panic attacks. Initially, I believe it was a 10mg dose, then upped to 20mg and possibly reduced to 10mg at some point. I’ve never been on a dose higher than 20mg.

I have tried unsuccessfully over the years to come off the drug, by slowly reducing the dosage/frequency of taking, but each time the side effects have made me give up and go back on to the full regular dose. Headaches, head filled with cotton wool, spaced out, not with it, distant, tired, extremely irritable, mood swings, memory issues, lack of focus and concentration, did I mention extremely irritable?!

My doctor and I discussed a better plan for slowly tapering off the drug and I’d not heard of this one before and it seems neither had the chemist as they never have more than one in stock at a time - but essentially the idea is to use Citalopram drops instead of tablets to have a finer control over the reduction. As the doctor described it and I understood it: “by alternating tablets of different strengths, the amount of chemical in your body is not constant or regular, it’s up and down if you do that, like your side effects and mood”.

So I started with 6 drops daily with no rush to reduce it further. Many, many months later I’m down to 4 drops daily, which I think is the equivalent to a 10mg tablet.

The problem is I’m now getting the symptoms described above on an almost daily basis. Sometimes they feel debilitating. I’m off work today for example with a thumping headache which I’ve had for 3 days. I feel not with it, foggy, drowsy.

I have had many blood tests recently to screen for any deficiencies and also for stomach related issues, but all have (and always have) come back clear apart from a slightly raised liver function (which is always slightly raised; I don’t regularly drink either).

I’m waiting to see the doctor I discussed the withdrawal plan with about this, but ironically he has been signed off sick for weeks.

Just wondering if there were any others out there suffering in the same way with the same circumstances.

Jamie

2

I came off Citalopram after 16 years and spent a year withdrawing by 5mg reductions and waiting on each one about 1-2 months or until I felt ready to continue. Doing it that slow I didn’t have any withdrawal at all - nothing - unlike a previous time when I’d done it quicker and dropped too big a dose.

I bought a pill cutter / crusher and chopped my tablets up and the last 5mg I gad to crush. My doses were 20 - 15 - 10 - 5 - 2.5 - 1.25 - 0.

You can even reduce by 2.5mg. Your body doesn’t miss small reductions. You also need to give each reduction lots of time so your body adjusts gently.

If you get withdrawal its because you’re doing it too quick or by too big a dose.

3

i am currently on 3 drops, its hard, the problem is some people get worse side effects than others

4

Thanks for the replies.

I’d understand getting the withdrawal symptoms if I were coming off them too quickly, but a reduction from 6 drops to 4 over what must be at least a year now seems paced enough not to have any noticeable effect.

5

Hi there Jamie,
Some sites, such as Mind and Surviving Antidepressants and the Icarus Project, suggest only tapering by 10 per cent of your current dosage.
I don’t know what mg the the equivalence in drops is…how many mg is one drop?

So for example, if you are on 10mg, then ten per cent is 1mg, so you’d drop from 10mg to 9mg.

Then you hold at that dose for 4 to 6 weeks, to see if there’s any reaction and to let your system stabilise.

Then you drop by ten per cent of 9mg and hold for 4 to 6 weeks.
Etcetera.

6

ive been on 6mg over a year still not stable

7

Each drop contains 2mg of Citalopram, however drops and tablets are not equal. 8mg (4 drops) = a 10mg tablet.

Source: Citalopram 40mg/ml Oral Drops, solution - Summary of Product Characteristics (SmPC) - (emc) | 3349

8

Hello! im not on celexa now after getting off of it.
Im feeling it bad withdrawal.
Any suggestions?

9

how you doing?

10

Some days are symptom free, other times not but otherwise fine :slight_smile:

11

you where feeling bad with celexa now you are feeling bad without celexa.take your benzo thats my suggestion.

12

Hey Lois! i been crying and stuff. Its been very rough as you can see.
My family is very worried and me too.
I was pacing crying this morning .
Thanks!

13

these are the pros and cons of these meds.everything you are feeling is normal unfortunately.you did not give these meds long enough.at least you have your benzo to at least calm you down.

14

Yesh i been trying buspar. I do have klonopin. I starting to act stupid with family and getting mood swings and crying .
Seems like im all over the place.
Im not sleeping well either so yeah and not doing much daily.
This is taking over me.

15

go on a buspar chat .maybe you will get answers .because buspar is not an ssri.so most are clueless.

16

plus going cold turkey with celexa was not a good decision from you or your doctor.you are going to have discontinuation symptoms which is normal.

17

Well, doctor and I thought we’d try tapering off further. Now gone from 4 drops per day to 3. Wasn’t really expecting any negative effects as that seems like such a tiny reduction.

Fast forward a couple of days on the new dose and my head feels like I’ve been doing a head stand on it for a week. Headache/pressure in the head, feel woozy, sick, sweaty, tired, extremely irritable, (like with the stupid text editing on this forum WTF is going on with it on iOS?), can’t concentrate, off work with a migraine, eyes move and brain slowly catches up etc. etc.

I remember now why I’ve failed so many times to come off them. I’d have never started taking them all those years ago had I known the WD side effects might last indefinitely. How can anyone function as a human being coming off this stuff let alone as a father, husband and employee.

18

I have been on Citalopram for twenty years and have tried to come off it multiple times, under my doctor’s supervision. I had brain zaps, mood swings, brain fog and irritability, which I couldn’t tolerate, so am back on it and have decided I’ll have to take it forever! Hope you’re doing better!

19

I’ve come to the realization that I can’t wean myself off it due to the debilitating withdrawal affects. I’m stuck.

20

Feeling much better this week after re-instating my previous dosage. I don’t want to go through another week like last week with no obvious end in sight so like you have taken the view that I’m stuck on them.