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Conflicting advice on coming off Citalopram and moving to Venlafaxine

(25 Posts)
WigWamBam Fri 24-Jun-05 14:18:42

My GP had to refer me to a psychiatrist to get the Venlafaxine prescribed, and the psychiatrist said that I should half the dose of Citalopram for 5 days, then stop completely and start taking the Venlafaxine. I saw the GP today to get a prescription for the Venlafaxine, and he is horrified at the withdrawal advice I've had. He says I should drop down from 40mg to 30mg for 5 days, then down to 20mg for a week, then 20mg every other day for a week before I start the new tablets. He tells me that the withdrawal effects will be far worse if I do what the psychiatrist says.

I'm confused. Has anyone else done this, and how did you make the change?

WigWamBam Fri 24-Jun-05 14:33:50


kcemum Fri 24-Jun-05 14:37:03

Don't have any advise but I personally would speak to the pharmacists as I'm sure they would be more "genned" up IYKWIM

WigWamBam Fri 24-Jun-05 14:45:55

Thanks, kcemum. I would have thought that the psychiatrist would have been well clued-up on them, but what the GP has said has made me uneasy about her advice.

WigWamBam Fri 24-Jun-05 15:00:59


starlover Fri 24-Jun-05 15:02:40

i think as a rule you are advised to take a while over stopping. but i think the max dose of citalopram is something like 100mg and as you are currently under half that then the withdrawal shouldn't be too bad.

i stopped abruptly when i was taking 20mg of it and had no probs!

Sax Fri 24-Jun-05 15:21:42

I have just been increased from 20mg to 40mg of Citalopram so can't help with withdrawal. Except as a nurse from what I can remember my advice would be more to go with the Gp who said to withdraw slowly. Your body is now use to taking this amount (which my gp said I was only on half the amount on 20mg so my impression is 40mg is max but I may be wrong) but I would decrease with caution. You know the side affects of this drug are potentially strong therefore the type of drug it is I would advise a slow withdrawal to minimise any adverse reaction!!! this is just my opinion.

madmarchhare Fri 24-Jun-05 15:31:04

I'd go with the GP. I didnt change, but came off Citalopram recently. Was on 40, went down to 20 for a week, then 20 every other day for a week on the advice of my excellent GP. Didnt have any problems.

Sax Fri 24-Jun-05 15:33:24

madmarchhare - how long did you take them for if you don't mind saying?

madmarchhare Fri 24-Jun-05 15:35:05

2 years

Sax Fri 24-Jun-05 15:36:11

And who decided to take you off them - you or Gp (if I'm being too intrusive please say)

madmarchhare Fri 24-Jun-05 15:38:43

Its OK - I decided to give it a go, so went for advice on coming off. Had a bit of a chat about reasons for going on them in the first place, she was happy and agreed we should give it a go. That was 4 months ago.

Sax Fri 24-Jun-05 15:42:05

I dread being reliant on them - feel very vulnerable atm therefore you do feel reliant don't you? I hope you don't feel this is a hijack WWB, I was just interested in Madmarchhares experience becasue it takes a while to sink in that anti Ds are needed - but its how long for which worries me! nO one ever mentions how long they see you on them when you start - I am full of admiration that you have managed so soon to come off them MMH - well done for being so strong!!!!!!

madmarchhare Fri 24-Jun-05 15:43:07

Will chat later Sax, but have to go

WigWamBam Fri 24-Jun-05 15:56:34

No worries, Sax - hijack away, I don't mind!

Thank you ladies, I think I'll go with the GP this time.

Sax Fri 24-Jun-05 15:57:08

Sorry if I'm bending your ear - take care and hopefully chat again!!!!!!! MMH

WigWamBam - hows things now? how do you feel about the advice people have given? Definatley don't just stop them will you - that would not be wise even if you are anxious to start the other ones - please please please just try to follow your heart and listen to various advice and do what you think is right. I send you my thoughts!!!!! I'm here for you if you want to talk.

Sax Fri 24-Jun-05 15:58:28

Messages overlapped - glad you are going with Gp - feels more sensible to me!!!!!!

WigWamBam Fri 24-Jun-05 15:59:51

No, I won't just stop them. The side effects when I first started taking them were pretty nasty, so I have some idea of what to expect if I come off them too quickly. Impatient I may be; daft I'm not ! I was leaning towards the GP's suggestion anyway, because I know that the withdrawal symptoms can be pretty strong sometimes, but didn't want to leave it so long if I didn't have to.

madmarchhare Fri 24-Jun-05 16:03:45

Back for a brief sec, really do want to chat later Sax, but somethings come up and cant hang around, sorry for abrupt ending earlier! Back over weekend sometime Im sure.

Sax Fri 24-Jun-05 16:11:13

If you around later mmh then I would appreciate it but if you are doing something then over the weekend is fine. I was just interested!!!!! I'm in an uncertain position so have lots of questions at the mo and just ask when I think of them. Don't worry if you are busy, I know other people have lives even if mine is in limbo LOL.

erinsmom Fri 24-Jun-05 16:12:06

just like to say i have first hand experience of citalopram ,i suffer with s.a.d,i start taking it in september and finish in april and do it every year,have done for the past 5 years i take 60mg which im told is the max,and i can honestly say the withdrawl symptoms from 60 to 20 to nothing are awfull,so go didnt say if you'd tried the maximum dose i found the difference between 40 mg and 60 mg so great it was like being in a bubble to being above normal or feeling really good,so much so now i try to stay on 60mg for most of the winter

reddevil Fri 24-Jun-05 16:22:28

I think the GP is right if you were stopping medication altogether but since you're starting another antidepressant which affects serotonin levels that the psychiatrist is probably right in this instance.They must surely deal with this sort of situation all the time?Hope you're OK whatever you decide to do

Sax Fri 24-Jun-05 16:37:43

I understand what you are saying reddevil but surely if you have a quick change around your body can't cope with the withdrawal/new drug the same as if you withdraw slowly and start a new!!!!! I am really keen for WWB to get onto her new drug and feel better asap but noone wants the feelings in the mean time to be too severe to cope with!!!!! Any more thoughts on this I'm sure WWB would appreciate!

madmarchhare Mon 27-Jun-05 10:08:17

Where were we?, Yes Sax it does make you feel crap having to rely on something else to help make you feel better. Sods law though isnt it?, the very nature of the whole thing makes you feel like that about everything IYKWIM, which doesnt really help.

I think its important to not dwell on this though, always easier said than done I know, but accepting that you need a bit of a hand it part of the healing process. Anyway, that was the second stint of ADs for me and because I had been through the 'shall I, should I' scenario the first time round it did make it easier. Although I did then have the whole 'OMG, I am never going to be 'normal' thing to deal with!

Sax Mon 27-Jun-05 10:46:24

Thank you for that MMH, much appreciated!

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