Citalopram: coming off it, the menopause, athsma and general vileness

[Ormirian]

I've been on citalopram (20) for 2 years now. Every year I try to take myself off it around sept time and every year I end up in a real mess. THis year I was OKish until christmas but now I am a real muddle. I was down to one tablet every third day - if I stuck to that I was OK but as soon as I let it go longer I got the horrible physical symptoms, even if I don't I am dog-tired, a bit ratty, I have no energy. I have put on heaps of weight and as I don't seem to have the stamina to run anymore I am getting flabby and unfit. I am trying to run but it's killing me - I can do about 200yrd before having to stop and use my inhaler and cough. I have a dreadful pain in my back that has been leading to headaches.

I don't know what to tackle first.

1. Go back to normal dosage of citalopram.
2. Go to GP and ask for 10mg tabs and take them every day.
3. Ask GP about menopause - I did before about 2 years ago and was put on citalopram because I was too young for the menopause, despite all symptoms to the contrary (hot flushes, night sweats, sleeplessness, tiredness and rare and irregular periods).
4. Speak to GP about back - i've been using a chiro but although it works really well the pain always returns and I can't afford much more treatment. I wrote off the NHS when it came to back pain years ago but wondering if it's worth trying again.

I just don't know where to start TBH.

I've stopped drinking completely now - to see if that helped my mood and my physical well-being - it hasn't so far.

I had accupunture and that helped a big lot,was nearly off but family berevement set me back. After one session I could feel the difference.

Hi there Ormirian Do you really need to come off the citalopram? Is there a specific reason you want to be off it? It's just if it's helping you, and you feel so bad when you come off it, probably isn't the right time for you.

I have lots of experience getting off psychiatric drugs. I was on 11 different drugs whilst I was admitted as an inpatient. One by one I have got off them all - and I am still well. It was a long hard slog but you have to be patient. And be prepared to up your dose again if you start feeling the side effects.

If you are weaning yourself off correctly, you won't get side effects like you describe. And don't listen to the GP re. how quickly you can get off them. They often don't have much expertise when it comes to psychiatric drugs. They will sometimes say, wean yourself off over a couple of weeks - bad news. I took 6 months to get off my AD, and did this on a schedule I designed myself. I didn't get any particularly bad side effects, except occasional insomnia, for which I temporarily upped my dose again, then tried again in a few days.

BTW the "every other day" strategy is not good, because it causes peaks and troughs of the drug in your system. You need to cut down smoothly and take the same dose each day / night so that the drug leaves your system in a smooth controlled way. When you are nearly off your AD, you can then have a small dose that you have on standby in case you need to take one every now and then, more for psychological dependence really rather than physical dependence. I also started taking a vitamin pill at the same time as my AD, so that when I finally stopped my AD, I still took a pill so the association with pill taking and feeling ok was still there.

You need to persevere with the exercise if you can. Exercise is a great tonic for mood. Find something you really enjoy. do you enjoy running? If not, do something else, do you like dancing or something sociable like that?

Hi Ormirian

I agree with GetDown about coming off your AD slowly. You get fewer withdrawal problems. Also I wondered why you chose to come off in September? It's probably the worst time of year to try to come off your ADs, due to going into Winter. You might do best to stay on them and reduce in Spring.

It sounds like you have a lot to deal with atm and I really understand how difficult it is knowing where to start.

You could start by getting your asthma under control as if it isn't controlled properly, you will feel tired and lack energy and this will effect your mood. It's also miserable having back problems and it might well be worth going back to the NHS to see if you can get some physio with them.

Exercise is a good idea but running may not be ideal for you at the moment. How about doing a Pilates class instead? It's gentle and would strengthen your tummy muscles which in turn would help your back pain.

Thanks everyone. Response much appreciated

I love running - I have run long distances for many years. I even got back to running as soon as my foot was out of plaster after a break. But I've had tendonitis and this bloody back pain which has put me off and I seemed to have lost all my fitness meanwhile.

Re the ADs - I thought I was doing it slowly . But I take the point about a smooth reduction. I don't have to stop - I just want to - I hate the feeling of being dependent on them. I already depend on athsma medication and disposable contact lens - I just feel dependent and useless. I know that sounds stupid. Perhaps just ask for a lower dose - and see how it goes.

I have to make an appointment with the athsma nurse soon - I have to go once a year - if it is still bad at that point I will ask about increasing the dose.

pilates - I might give it a go. There is a class near here but one of the reasons I started running was because I could do it when it suited me and for as long as I wanted. I work full-time and have 3 DC so fitting classes in isn't easy. I used to do yoga though and loved it. I guess there are similarities.

Many thanks again.

hi, my doctor advised me to come off my tablets straight away, which were 40mg a day after falling pregnant with my third child. i have been on them about 18 months after having eye cancer, which was sucessfully treated. i had nightmare mood wings but came out the other side, i'm now 24 weeks and having a really bad patch again, read about potential risks if i go back on the tablets so i don't want to do that, but i know i'm just getting through my day, me and my husband are ok but i know he finds it so difficult when i'm like this. i have so much coming up with my first son who has asd, we are fighting for a statement and thats just the tip of the iceberg, feeling very helpless and frutrated i can't snap myself out of this and worried when the baby is born i'm not going to be ok

Bloody hell finash You have a huge amt on your plate. I can't beleive GP said to come off them straightaway What are the potential risks?

i thought i would come off slowly but she said, there was a risk of miscarriage and birth defects in early pregnancy and the baby could become addicted in late pregnancy and cause withdrawal and i was to come off them straight away and i would be a little moody for a couple of weeks and then i would be fine.

"a little moody for a couple of weeks and then i would be fine."

Really? Why doesn't everyone do that then? I guess he felt time was of the essence but even so.

Ormirian Just wanted you to know I hate taking ADs too and got down to a very low dose just before winter set in. I've had to go up a bit though as I found I wasn't sleeping.

I also get asthma and have suffered with back problems. Very frustrating especially as like me you also enjoy running:)

I also have tried pilates and love it but like you struggle to fit it in. There never seems to be a class when I want to go! The beauty of running is you can just go out the door.

Hope you can get things sorted x

Blimey clutie, are you my clone

I loved citalopram when I first went on them - I had been feeling so bad for so long and it felt like coming into a warm room. I kept dozing off in the most inappropriate places because I was so much more relaxed. But I find it hard to accept I need to take them indefinitely. Last time I was on ads I came off after 6m with only initial withdrawal sypmtoms. I thought it would be the same this time.

Is not sleeping an expected symptom of withdrawal then? I was assuming it must be but didn't know.

Orm, I'm facing a similar problem to you in that my general fitness has plummeted a bit, to the point where I haven't the energy to run and feel like running would be doing me more harm than good: I have all sorts of joint aches and pains which are worsened by running. I take citalopram but certainly have felt in the past that excercise was a vital mood lifter, and now it seems less possible to exercise.

I think I am trudging towards the menopause. Does its proximity make us more prone tp joint difficulties. It seems that all of the wear and tear of my life has caught up with me at once, in a matter of months.

"Does its proximity make us more prone tp joint difficulties."

I don't know but I tell you what! If the GP can be convinced that I'm on my way to the menopause I would be very happy to consider HRT. I know there are downsides but I am fed up feeling like shit.

I have zero energy and zero concentration. I constantly find myself just stopping and I have to will every little stage of even simple things like getting dressed. I do wonder whether menopause if a factor, and yes -- I too would be tempted to wolf down HRT to feel differently, if I thought it would help.

Hi everyone - I am concerned about my daughter who was on Citalopram for about a year and ten days ago reduced from 40mg to 20mg. She is getting horrible withdrawal symptoms including light sensitivity which is making night driving impossible, and working is hard cos of bright office lights and computer screens, even though she is wearing dark glasses. Headaches, shakes, anxiety, nausea. Anyone like to hazard a guess at how long this goes on? And will it happen again when she drops to 10mg and eventually stops?

I don't think the not sleeping is a withdrawal problem as I had got down to 25mg (which is a low dose I take dosulepin), and was doing ok. However I had some bad news just before Christmas and found my sleep went haywire. I knew I would have to go up on my dose to sleep and to help control my anxiety. My mood was also really low.

I was on Citalapram for a while and had to come off as it didn't work for me. I found it too activating and had no appetite so couldn't eat. I do wonder though if my sleep problems are really a sign of depression or if they're hormone related as I struggle with PMT. I have noticed though that since being on ADs my PMT has improved, so what do I do? I'm having to accept I might be on them for quite a while.

Just wondered how old are you Ormirian ?
Apparently if you are starting the menopause they say it's better to start HRT earlier rather than later. It must be difficult for you though if your doctor isn't convinced.

I'm 45 and I've been having symptoms on and off for about 3 yrs. But I was too young apparently though why everyone has to fit the standard rules I don't know.

I am going to have to go to see my GP and weep and forget things and sweat at him until he accepts I AM MENOPAUSAL!

:o !

Hi when you are reducing definately try not to miss out days. the drugs have a relatively short half life (except for prozac) which means that they leave your body quite quickly. It means that you are going through a bit of a see saw. (partic when you are still taking a 20mg dose.) Taking every three days you will be basically going down to nothing then back up to 20 then back down again which will make it harder. Getting 10mg tablets would help you in that respect. Good luck.

(PS re. the menopause. Could it be peri menopause? Lots of drs dont seem to recognise it but can go on for years before the actualy menopause.)

Orange flutie - did you go back up to 50mg? Im on a trycylic too and currently on 50mg but trying to reduce to 25mg to take longer term if possible x

Thankyou kizzie - yes it could bel in fact I assumed it was. I am still getting periods but only about 4 a year.

kizzie yes I'm back up to 50mg. It got to a stage when 25mg just wasn't enough anymore. I knew it but didn't want to give in for a while. However once the sleep went I got progressively more tearful, so in the end it made sense to increase.

I do feel quite a bit better now and probably will stay on 50mg for a while now. When I was reducing though, I found it fairly easy and didn't get any nasty withdrawal symptoms so would try again in the future.