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Mental health

Anyone know how to come of anti-dp's

12 replies

mummalish · 01/01/2010 21:00

Feel that I would like to come off mine, been on them for long enough. Spoke to my GP, who advised to start taking half a pill for a month, then stop. I had meant to start doing that. I have forgotten to take my pill for the past 3 days, and I have been sooooo ill. Having shakes, dizziness, nausea and drowsiness. Feels so bad. I took half a pill tonight just in the hopes that I would feel bette. Is this withdrawl?

Didnt think coming off would feel so bad. Help, please? xx

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tiredlady · 01/01/2010 21:06

depending what one you are on, they can be a bugger to withdraw from. Your Gp is right, you need to come off them very slowly, gradually reducing the dose over time. The symptoms you describe are most certainly "withdrawal symptoms" thought the drug companies prefer to use the phrase " discontinuation syndrome" as they think withdrawal has negative connotations. Keep reducing slowly and you will be fine. Let me guess... citalopram?

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FrayedKnotRoastingOnAnOpenFire · 01/01/2010 21:14

Hw long have you been taking them, mummalish?

I agree you must take it very, very slowly.

I was taking seroxat for 4 years (now well-known for its side effects when stopping), and the last year was cutting down the dose.

I can't remember what dose I was on but I had a pill cutter and I think I went 3/4 - 1/2 - 1/4 in the end, and it took several months.

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squashedfrogs · 01/01/2010 21:35

I forgot to take my anti-dp's for three days over Christmas and felt awful, particularly having shakes and nausea. I'm not particularly thinking of come off mine at the moment but I'm not looking forward to the time when I decide to.

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Tras · 01/01/2010 21:46

You really should ask your dr because it may be different for each type of medication and doseage. However my G.P advised me to cut mine down to one every other day for two weeks and then twice a week for another two weeks. He also said that he wouldnt advise anyone to stop at this time of year so I am gonna wait until March I think. Good Luck when you decide to stop.

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Tras · 01/01/2010 21:52

Just read ur message about Citalapram? Is it hard to come off? I have been on 10mg of it since Sept. Hate the thought of being addicted to it!

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GetDownYouWillFall · 01/01/2010 21:59

I think all ADs have "withdrawal effects" whichever one you take, although the manufacturers claim they are not addictive in a physical way.
The best thing to do it to do it very very slowly. The slower the better really.

I found I wrote on my calendar every three weeks, so I wouldn't forget and I could track my progress, to reduce the dose by a tiny amount each time.

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NanaNina · 01/01/2010 23:56

I was taking imipramine (a trycyclic anti d) for 10 years following a serious clinical depression following the sudden death of my sister. I was actually better within 6 months but was afraid to stop the meds in fear that the depression would return. The GPs were useless, just willing to let me keep taking them.

I tried several times to reduce the dose myself but each time it ended in the symptoms returning and I mistakenly thought this was the depression returning and in fact the GPs confirmed this. They encouraged me to go back on the full dose and I was Ok again. It took a good counsellor to explain to me that I had become dependent on the meds after so long and when I tried to reduce the dose I was getting classic withdrawal symptoms. At NO time did any GP tell me that I may be suffering withdrawal symptoms rather than a return of the depression. She had a particular expertise in coming off prescription drugs and I followed her advice and over a period of about 10 months finally stopped in June last year.

This is what she advised:

  1. I must be in control of the way the meds were to be reduced as only I knew how I felt.


  1. No GP (or anyone else) must give me a schedule of how/when to reduce (as in the examples given here half pill for a month and then stop or whatever)


  1. The reason that schedules don't work is because the GP (or anyone else) doesn't know how you will feel when you start reducing -only you will know that.


  1. Most GPs don't understand about withdrawing from meds - they know it has to be done slowly but just take a guess at how slowly and in what precise way.


  1. She told me that the only thing she would stop me doing was reducing too quickly.


SO what to do:

  1. She told me I could safely reduce 20mg a day for 2 weeks BUT I needed to decide if I felt comfortable with that. The important thing was to monitor how I felt after 2 weeks of this reduction and if I had any withdrawal symptoms I must not reduce any further until I felt on an even keel.


  1. I was too worried about reducing 20mg every day for 2 weeks and wanted a slower reduction, which she supported as she said it was of the utmost importance that I was in control of the reductions.


  1. I therefore reduced 10mg every day for 1 month and monitored how I felt. I was Ok with this and continued to reduce 10mg per day every month until I came off them.


She warned me that I might get some mild withdrawal symptoms but this would not overwhelm me and I must not reduce any further until the symptoms subsided. I did have a few vague symptoms but nothing to reallyworry me and I continued with the 10 mg per day reduction every month.

The thing was whereas the GP had been happy tfor me to be on repeat prescription when I was on the full dose, when I needed fewer tablets as I reduced I had to go back every month so that they could "monitor" me. This was a nonsense really as alll that happened was I told them how many tablets I needed and they asked if I was OK and I said Yes!

I am absolutely convinced the the counsellor told me the best way to come off these meds. A helpful GP had tried to give me a schedule of reduction before which was much too quick and ended in horrible withdrawl symptoms, which she said was a return of the depression, when it was no such thing. I really found it incredible that GPs don't even understand about withdrawal symptoms. When i said to one GP that I had become dependent on the meds he said "well it's not so much that, it's more that your body has just got used to taking them and can't do without them" ...............How barmy is that?

Sorry this is a long post but if I have not been clear please post again and I will try to be more clear.
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mummalish · 02/01/2010 10:30

It's not citalopram, but paroxetine, better know as Paxil. Well, I have done some reading online, and it sounds horrendous, i wish i had done some research before going on it. People suffer terribly coming off it.

The thing about some GP's, is that they just like to prescribe, and dont really care about the fine print. My GP looked in his little book when prescribing these for me, and said, "Yep, these will do".

I have only been on them for a year, but I want to come off.

So, I have now halved my daily dose, even though i feel rubbish, how long should I continue with the halved dosage?

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NanaNina · 02/01/2010 17:58

How many milligrams are you on a day. These tabs come in 20mg and 30mg strengths. So you need to add up how many mgs you are on a day. I think this thing of half a tablet is a bit like guess work at this stage. If you are on 20mg a day, half will obviously be a 10 mg reduction and this may be a safe reduction, if you are on 30mg per day, the half tablet will be a 15mg reduction and I don't know whether this is safe or not.

You say you feel "rubbish" - how bad? Can you cope or is it horrendous. If the latter I would go back on the full dose until you can get some proper advice about a safe reduction. I know that paroxetine is known for producing very severe withdrawal symptoms so you need to take care. If you can cope, I think you should stay on the half tablet until you are no longer having any withdrawal symptoms (however long that takes) this is really the ONLY way to safely reduce. As I said before it's no good the GP telling you "half a tablet for a month and then stop" because he doesn't know how you are going to feel when you start reducing, only you can know that.

You may need to get assertive with the GP and insist that you want a referral to a consultant psychiatrist in order to agree a safe reduction programme especially given paroxetine is known for producing severe withdrawal symptoms. It isn't any good the GP just making a guess about what reduction is safe for you.

Did you understand what I was saying I learned about safe med reduction from my counsellor. If not I will try to explain again.

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mummalish · 02/01/2010 19:24

I was on 20mg per day. Yes, thank you, I do understand what you are saying about safe med reduction.

Do you know if withdrawl can have any serious health consequences? Sorry, this may sound stupid, but I have been feeling so rough, that sometimes I think that I am going to have to go to A&E.

So, today is the 2nd day that I have been taking a 10mg dose, I basically feel as though I have the flu. I can muddle my way through the day I guess. I am going to get an appointment with the GP for next week. I am hoping that my body will adjust to this soon.

When i started taking the paroxetine, I felt just as rough, for 2 weeks I suffered with tiredness, nausea etc. Then it went away and i felt fine.

Do you think that GP's should try to explain the withdrawl effects before prescribing these pills? I truly don't think my GP knows anything about anti-dp's, which frightens me a bit really!

Thanks for you advice NanaNina. xx

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NanaNina · 02/01/2010 22:10

Hi mummalish - Fortunately you are on a relatively low dose. No I don't think withdrawal can have serious health consequences, it's just that paraxotine has been proven to be a difficult drug to withdraw from and can produce more severe withdrawal symptoms than some other anti ds.

I've had a look on a few sites (there are quite a few) and 2 things have been suggested by others trying to come off paraxotine. One is that the medication comes in a liquid form too, so that would enable you to reduce at a much lower level than 10mg - as low as 1mg apparently. That would of course take longer but if it lessened the withdrawal symptoms it may be worth considering that option.

The other thing is that someone on the website has said that she changed from paroxetine to Prozac (which is apparently easier to withdraw from) and this too lessened the withdrawal symptoms.

Another poster said that she ensured that while she was coming of paraxotine her GP prescribed her medication to help with nausea, dizziness and other withdrawal symptoms and this made the withdrawl easier to bear.

I absolutely agree with you that GPs should give far more information about side effects/withdrawal effects before prescribing but of course they don't as they just want you out of the surgery in the quickest possible time. I don't think it's just your GP that doesn't know much about anti ds........in my experience the vast majority of them don't know much about mental health at all as it is a very small part of their training, though I think that might be changing now. The other thing is that a lot of these newer anti ds were not available when many GPs were trained and therefore they have little knowledge of them and the withdrawal problems.

Agree it is scary though - depression is scary enough without having to worry about the GPs limited knowledge.

Someone on a website posted a link to MIND and said it gave a stepby step approach to coming off paraxotine/seroxcat but I couldn't find it when I clicked onthe link. It might be worth contacting MIND for advice.

The only other thing I can suggest is tring to find a counsellor/pschologist who is experienced in drug withdrawal - I was luck enough to find one, but it cost me £50 per session.

Gather you are going back to your GP so maybe you could talk about some of the options I have suggested.

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strawberry17 · 05/01/2010 21:13

Hi
I have a ton of experience with this over the past 10 years and in fact have a blog on the very subject of my withdrawal from prozac prozacwithdrawal.blogspot.com/
I would reiterate what the others have said and take it very slowly (unfortunately it's going to take me about three years all in to get off prozac ). Find out from your doctor or a pharmacist if you can get your medication in liquid form as you can really reduce as slow as you want with a 5ml syringe. In my experience doctors have no clue about how some people struggle to get off these medications and how slowly they need to do it.

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