Tapering down Citalopram after 10 years?

[lollilou2]

So I’ve been on Citalopram 20mg for 10 years for anxiety. Then my life just seemed to be one trauma after the other, so it never seemed the right time to wean off.

now my GP wants me to wean down to 10 mg for 2 month, gradually reducing until I’m off.

Im absolutely terrified to be honest. I have 5 kids who are neurodivergent, one who’s home educated, and I really can’t afford to have down days and need all my energy and patience to get through the day.

Anyone have any tips to help the withdrawal? I would like to come off them, but not at the expense of losing it with my children.

Why does your GP want you to come off them? I've been on citalopram for 22 years and my GP just keeps prescribing it on repeat every month 🤣

I'm not sure, to be honest! Probably the cost- those pennies add up i suppose!

I tapered down from 30mg to zero over about 2 months but had bad withdrawal symptoms and ended up in a pysch
hospital. I’m now on 40mg plus an anti-psychotic drug as well.

Everyone is different but I’d say do it very very slowly OP to reduce the risk of withdrawal.

I'd push back. 20mg is a low dose, the pills are cheap as chips, and the potential cost is way too high. They're literally £1.50 for a month's supply.

Hi OP I'm in the same situation in that I am currently tapering down from 20 to 10 mg mainly because I feel Citalopram is making no difference to my depression. I've been on it for a number of years.
I also take 20 mg of mirtazapine at night and that has helped relieve my anxiety so I no longer suffer panic attacks.
I feel fine on my reduced dosage of Citalopram (20 days in) and see my GP for an update in 10 days time to talk about an alternative AD should I need it.
Good luck 🤞

Ask for his rationale. Don't be pressurised if you don't want to. It can be difficult, the slower the better. Whatever his reasoning, the guidance is clear that this should only been done with the patient's full agreement.

Ask what help he will be providing if his plan triggered severe or protracted SSRI discontinuation syndrome.

He wants you to halve it straight away? This is not in line with NHS, NICE or RCP guidelines.

Dropping by 25 or 50% is suggested if you have been on them for just weeks.

https://www.rcpsych.ac.uk/docs/default-source/mental-health/treatments-and-wellbeing/print-outs/stopping-antidepressant-printable.pdf

I would actually simply say that yes, you'd like to come off them eventually, but now is not the right time for you.

He doesn't have any grounds to argue with that, given all the official guidance (unless you were having serious side-effects/drug interactions, which presumably you're not.)

Any problem, ask him to record your concerns in your notes. If that doesn't work then email the practice manager, mentioning the guidance documents mentioned in previous post.

Do you want to?
I've been on it for 15 years. A doctor once wanted me to come off them, I just said no I wasn't comfortable with that. Other doctors have told me some people need them for life. If they work well for you I would rethink coming off them

The guidelines have been updated as so many people struggle Coming off these. Current guidance is 5%-10% reduction each time, and wait at least a month to stabilise before the next reduction.
I started on the old guidelines (reduce to half dose, then quarter) and it was a DISASTER. Had to go back to full dose, and now make a tiny reduction every 2-3 months. I am coming off them for a separate health issue. Also be aware that some meds affect how these are absorbed, in effect changing your dosage. Omaprazole does this.

Thank you all for your advice, the GP seemed more concerned about getting me down to 10mg than anything (said that’s the normal dosage for anxiety). Feel like she maybe didn’t take me serious as I take them for anxiety, not depression, but I do have a history of depression.

I hate being put on the spot so when she mentioned tapering them I just agreed, as I hate arguing my point 😅

Also be aware that some meds affect how these are absorbed, in effect changing your dosage. Omaprazole does this.

I am on a high dosage of emoprazole and had no idea that it affected the intake of Citalopram. Thanks for pointing it out AllTheChaos. It helps explain why I feel Citalopram has not alleviated my depression for some time.

20mg is the typical dose for anxiety, 30mg for depression. 10mg isn't going to do much for most people.

I only found out because a close friend who is a medical doctor mentioned it - my gp then confirmed when I asked them but hadn’t thought to mention it!

I'm on 40mg for anxiety! Although it's the highest dose so not sure what I will do if it stops working for me (I seem to get used to the dose I'm on after a few years and need it increased) 20mg isn't a high dose. 10mg is usually a starting dose to get used to it, then increased to 20mg