citalopram withdrawal

[simbacooper]

Hi Im a new member. my husband and I are having IVF in a few weeks as a result I am trying to come of my citalopram, GP says I need to reduce it slowly then change it to something thats safe in pregnancy. I have been on it for a few years for depression and Im really scared of coming of it. I have gone from 60mg to 40mg this week and I fell awful. All I want to do is sleep and cry, I have a terrible headache all the time. I really want to do this so we can have a baby but I already have a son who needs me. I guess I want some advice from anyone who has come off these. I dont know if this is withdrawal or the depression coming back? How do I cope with these symptoms so I can get on with everyday life? do the symptoms get worse as the dose goes lower? Id be so grateful for any advice.

You will need to be realistic: If you've been on a dose as high as 60mg you will not be off it in a few weeks and feel ok. I assume you are changing to sertraline? (could well be wrong of course!) - if so citalopram and sertraline can be tapered, ie you start taking the sertraline while still taking the citalopram and increase one while decreasing the other.

I am concerned how you will feel once you are taking the hormones for IVF while changing/reducing ADs. Please make sure your specialist/obst knows what is going on, because it is potentially a very heady cocktail due to the emotional and physical effect of IVF drugs.

I wish I could suggest anything more helpful. Something in me says postpone the IVF until you're settled on new meds, but for all I know the massive pain of infertility is a cause of your depression...

Hi hon

I came off citalopram a couple of years ago and for me the physical symptoms of withdrawal were exactly like how I felt when I started taking them. It was like I was developing a cold but never got to the green-snotty stage, bizarrely enough; I felt bunged up and it was hard to think clearly, but that resolved itself after a week.

As for the emotional side: when I went on citalopram, I didn't feel much difference for a few weeks and then it gradually got a bit easier to cope. I did notice, though, that I had to make an effort to change my ways of thinking (e.g stop having arguments with people in my head, try and apply CBT rules rather than assuming everyone thinks the worst of me, try to identify trains of thought that leave me feeling crap and deliberately not pursue them). If I didn't impose that mental discipline, the pills didn't help much. IMO, pills give you a bit of mental breathing space when you're feeling terrible - they give you time to develop coping strategies and let you keep your head above water. However, they don't solve the whole issue by themselves.

To me it sounds like you're experiencing some purely physical withdrawal symptoms (headache) and some physical ones which translate into emotional ones (hormonal upheaval making you feel weepy). I wouldn't think of it as the depression coming back, more of a temporary physical state that you're anxious about (that anxiety is prob making you feel worse)!

My advice would be to SLOWLY taper your dose of citalopram, as coming off it is not always a smooth ride, but also to really try and work out some mental coping strategies too. Easier said than done I know. I bought a book on CBT, some of the techniques really helped me.

Sorry it's an essay but I do hope some of that helps. Hugs and good luck xx

That sounds like to high a jump to me.

Just for the record I took 60mg of citalopram all through my pregnancy with dd and she's fine.

Hi. Thanks so much for your replies. Im not sure what Im changing to yet, going back to GP this week. Im worried about the effect of the IVF drugs too, though I will be having a very low dose Im told. I have thought about postponing, it is a factor in my depression but not the whole reason.

I will def look into CBT, I do think I need to find some coping strategies, I have battled with depression for a very long time now. Im def anxious about being anxious.

I do feel like 60 to 40 is a big drop, Im going to talk to GP again about this. What advice were you given EdnaClouds? My GP didnt give me an option of staying on it, they said I have to come off, but in my own research I have seen that some consider it safe. I just want to do the best thing for my baby and my family.

When I first went to see my GP after discovering I was pregnant we briefly discussed the citalopram and he said it was perfectly safe for me to keep taking it. It wasn't an issue at all.

Talked to my GP again yesterday and shes wants me to drop 20mg every 2 weeks, then if I cant manage with nothing, start on Fluoxetine. This seems like big drops on dose to me, I expected to be dropping down 5mg at a time. Still on the 40mg at the mo, had a rough week but not too bad last couple of days. Anxious about dropping to 20 next week.

Simba - I would definitely see if you could seek a second opinion, maybe if there's another GP in your practise you could speak to? My GP was very hardline, and told me to stop taking my Citalopram the moment I found out I was pregnant (only 20mg) which I wasn't comfortable with. As others have said, there is little research that proves any significant risk to the baby from continuing to take it throughout pregnancy, and this has to be balanced with your mental health. (and would have thought IVF success could be affected by being depressed when you do it?) And from reading quite a lot when I was facing a similar situation, I read that you shouldn't reduce by more than 10% a week. I cut down by 10mg a week, and by that I mean 10mg spread over a whole week. (so, I started on 140mg a week effectively, then 130mg the week after, and took just under 14 weeks to come off it). I am no expert, but think a second opinion might be good.