My partners Citalopram withdrawal from 60mg

Treatment and medication
1

Hi All,

I'm new to the forum and have just been reading through some of the prior posts which I have found helpful and appreciate greatly.

First off this isn't about myself, but my partner. She has been on citalopram for 16years now and is slowly trying to come off it. She's currently in a rehab come ahsram type place in India and has been on and off for about 7 months, which for therapy etc is fantastic (it's also where about 9 years back I managed to get sober from my heroin addiction).

She has been a long term sufferer of depression and anxiety, all started around the time her mother passed away and her father left her to fend for herself when she was a teen.

The doc put her on 40mg back then, she got suicidal so the doc upped her dosage to 60mg (she was 16 at that point) and she had been on that dose since.

Then around 2 years back she managed to cut from 60 to 40, using a tapering method over a month using 3 day cycles, 60-60-40, repeated over 2 weeks, 60-40-60-40 etc for 2 weeks 40-60-40 over 2 weeks and then stabilised on 40. She found she could manage that cut relatively okay with mild withdrawals, she then tried to cut using a similar method of 40 to 20, got terribly panic attacks, suicidal etc so stayed on 40.

Since she's been having therapy in India she cut from 40 to 30 using again tapering method over about a month to 6 weeks. She felt fine until getting to the stabilisation on 30s, where she felt terrible for about 2 weeks, nauseaus panic attacks wherever she went, crying spells, disassociated etc. Though that only lasted for about 2 weeks. She stabilised on 30s about a month back and with the therapy has been feeling a lot better.

She came home over the last few weeks for a trip and then upon return to the rehab/ashram in India she tried to cut to 20mg, again using the aforementioned technique, but literally within the first couple of days of her 30-30-20 cycle she started having almost continuous panic attacks, suicidal, disassociated etc again. This was pretty surprising for her as she assumed it would be similar to cutting from 40 to 30 where the withdrawals would be felt most towards the end of the taper. Shes went back up to 30s and stayed on there after only 6 days of tapering (30-30-20-30-30-20) as she said she was getting scared, was unable to attend therapy, eat in groups with more than a couple of people due to her anxiety, long crying spells, nauseaus, dizzy and the suicidal thoughts were really frightening her.

I just spoke to her on the phone and as you can imagine her self esteem and confidence is completely shot. She's been doing exceptionally well in therapy and has come a huge way over the past 7 months and Im very proud of her and just trying to support any way I can.

Does anyone have any advice/support I can offer her? She desperately wants to be off these meds in the long run, but I think she feels right now like shes not capable of anything.

Thanks for any help

Nikhil (and my beautiful partner's name is Bella)

2

Hello Nikhil. I am so  sorry to hear about Bella and the problems she is having in coming off Citalopram. I can say,from personal experience, that it is a difficult drug to come off of. The approach of tapering has to be very carefully handled. I would suggest that Bella tries the format that was successful for me and see how she gets on. Take 30mg every day for seven days, then every day for 6 days, then every day for 5 days, until she gets down to one day, when she comes down to 20mg for 7 days, then 6 days etc until she gets to 10mgs for 7 days and so on until she comes down to nothing. The whole process will of course take several weeks but it should ease the process of withdrawal greatly. If it helps I did it this way myself after taking Citalopram for 3 years and I suffered no side effects.

 

3

Sorry to hear of your partners difficulty.  May I first say that here in the UK the maximum dose for Citalopram is 40mg.  This was reduced by the UK. drug regulator from 60mg in 2012.

Reducing medication is best as slow as possible.  After 15 years of anxiety and depression I was eventually out on this medication and stayed on it for 15 years - eventually I came off which took months and reduced each time from 20mg by 5mg each time.  Firstly I bought a pill cutter and cut my tablets into 1/4's making each dose 5mg.  From 20mg I went on to taking 15mg for about a month, then 10mg for a further month, then 5mg for a month and after that took 5mg every other day for a month, then every 2 days and so on until I had 1 tablet a week to take.  I had no withdrawal symptoms and have been well ever since.

You must not miss any days of taking medication as you can become very ill.  All SSRI's give the same withdrawl symptoms.

I've never heard of the withdrawal way you describe, but of course it may be different in another country.

You can stay on this medication for life if needed a it's not addictive.

Im not surprised her body feels all over the place taking it the way she is.

K x

4

I agree with Katecogs,  cutting down by 5mgs would probably be best if having symptoms.  I cut down from 20 to 10 by taking 10mg every 3rd day for 3 weeks (20-20-10-20-20-10) then every other day for 3 weeks (20-10-20-10). Then 20-10-10-20-10-10 for 3 wks. It took at least 2-3 mths to get down a level. If I didn't feel right I'd stay on a particular dose for longer. It was more difficult to get to 5 mg, but I went back a step until settled, then tried again. Basically it's taken me about 9 months to get from 20mg to 0. 

Maybe going from 30 to 25mg over about 9 wks or longer may help.  60 is such a high dose, to get to 30 is a massive achievement. 

5

Thanks everyone for your responses. It's greatly appreciated.

I think she wants to leave it a while as her body didnt take the cut too kindly and wants to just get properly balanced again before trying anything. Her confidence is pretty shot and it seems sensible to let it build up for a while before trying again.

We've found that you can also get 10mg tabs here so may look at quartering them and just cutting 2.5mg to begin with, slow and steady.

She felt completely fine on the 30s, had been down to them for a month and was doing super well.

Thanks again

N