Coming off citalopram- is it worth it?

[Pastnowfuture]

Hi everyone.

I have been on 20mg of citalopram for over 2.5 years. I started taking it after untreated anxiety spiralled into depression- I basically cried for 5 days straight and believed the whole world would be a happier place if I disappeared.

The medication worked great for me and once i stopped crying could engage with therapy to address the underlying anxiety. After a year of being stable and happy I decided to start coming off it ready to ttc next year. Over about 6 weeks I reduced from 20 to 10mg without any side effects. I felt great and 4 weeks later I reduced from 10 to 5mg.

Within a week I felt a bit low. I have been on 5mg for 3 months now but managing my anxiety is a daily struggle. Luckily this time I can spot the symptoms and use the techniques I learnt in therapy. I understand that anxiety is a side effect of withdrawl but surely after 3 months this is just 'me' now?

If this is how it's always going to feel I will go back to the 10mg but wondered if anyone had their own experience to share?

Also, I'm beginning to wonder whether weaning off my tablets is a pointless task as I anticipate feeling anxious in pregnancy. Does anyone know of any increased risk/difference between starting citalopram during pregnancy as oppose to taking it before conception? In some ways I think maybe if I'm on it when I get pregnant the foetus will always be used to it?

I will be seeing my gp to chat things through before making any changes but can't get an appointment a couple of weeks so any comments/advice would be helpful.

I can't comment on whether there's a difference in risk between starting citalopram during pregnancy versus already being on it at conception, but I know that while there is some evidence of a slight increase in birth defects with SSRIs (of which citalopram is one), they're considered one of the safer antidepressants in pregnancy. You and your GP will have to weigh up the risk to the baby with the citalopram versus the risk to the baby if you're too depressed to look after it and/or yourself.

FWIW, I take desvenlafaxine (SNRI) 250mg, reboxetine (NRI) 8mg and lithium 900mg daily for depression. It's been a long hard road (and 3 failed attempts to stop lithium, relapsed each time) to accept that I will be taking these drugs while I'm pregnant (I'm 4 weeks... eeeep!) and probably for the rest of my life, but the reality is with them I'm a productive and stable person but without them I'm so unwell that getting out of bed/getting dressed/leaving the house are mammoth tasks... nevermind looking after a baby.

Thank you so much @bgdino and congratulations. At first I was determined I was coming off them but feeling this way again has made realise 'being drug free' is not the most important thing.

I was on citalopram for post natal anxiety, and couldn’t wait to get off it, and back to my ‘normal’ self. I accepted being on it, only because I’d convinced myself it was temporary, and I wasn’t one of THOSE people. Once the therapy and exercise and anxiety strategies kicked in, I was going drug free forever.

Turns out I may need to be on a low dose forever. Took me a long time to come to terms with it. It was far harder than going on it in the first place. There was real grief in coming to terms with it.

Now, two years on, I’ve made my peace with it. I decided that every 3 years I am going to try going off it (under go supervision) but not beat myself up if I need to go back on. Best of both worlds.

You’ll need good medical knowledge to establish whether there are added risks in taking it when preggers, but if it comes down to your choice I hope my experience helps you.

Nowadays I’m just deeply grateful that I have access to these medications, so many people in the world need them but can’t have them. I’m a far better mum for taking them, and it would be so counterproductive to buy into some stupid stigma rather than accept help.

I would also advise you not to ignore those other therapies & strategies that go hand-in-hand with the meds. I know it is all to easy to lose sight of self-care with pregnancy and a newborn. But the meds aren’t a substitute for all those other important things. That’s a far more dangerous trap to fall into, for mine. Keep track of your ‘red flags’ and manage them, so you don’t end up needing more meds.

All the best with TTC, sounds like you’ll be a careful and conscious mum!

I came off to ttc, and lasted the 1st trimester without it. Then started to struggle with too many dark days so went back to gp and got prescribed sertraline instead. I don't think its as good for my mood as citalopram was but it is enough to keep me ticking over, when combined with some of the techniques from therapy. I'm glad I managed to be off meds for the conception and early stages of pregnancy, and am very much in a 'let's just see what happens' state of mind for the near future.

Thanks @bosswitch. Was there a reason why sertaline was prescribed rather than citralopram?

Thank you @skittlesandbeer it's encouraging to know I'm not the only one who has struggled to accept that I'm simply a better version of me when taking the meds.

The gp I saw said it was a gentler one - which is probably why I'm on 50mg as opposed to the 20mg dose of citalopram. It's the same 'group' as citalopram though.

Thanks for reply @bosswitch

Op I really honestly and genuinely wouldn't stay off it just for the sake of pregnancy. Research is sparse anyway, and the research that does exist shows that the chance of a low dose (

Thanks @grumpasaurus I'm definately leaning towards going back up to the 10mg and staying on it. Will chat it over with my GP but having read all the comments I no longer feel 'I've failed'.

You definitely haven't failed. Anxiety and depression are, at their most basic level, imbalances of brain chemistry and the drugs help rebalance those.

With so much else going on with your body during pregnancy, i genuinely think giving yourself the advantage of a calm mind is just a healthy, sensible decision.

PS 10mg is a very low dose. I take 20mg and my GP and midwife and mental health midwife (there is a special name for her but I can't remember) all agreed it was far better to stay on.

Hi everyone...just thought I would give an update. My mental health dipped further so I visited GP and went back up to 10mg. I felt sad at first but looked back at these posts and it really helped. I'm now emotionally stable and plan to come off my pill this month. Feeling very positive about choosing to stay on the medication and just wanted say thank you to everyone who replied.