894 replies to this topic

[invalidusername]

Just walked a mile to/from grocery store and spent 40 minutes doing a food shop with the wife on a Saturday afternoon.

 

Surely that says something for my anxiety

[invalidusername]

OK - so woke yesterday to feeling very dizzy and spaced out. Had to stay in bed all day. Managed a bath in the evening and some posting here and then got nasty headache.

 

No problem getting to sleep. Have woken this morning to the same - very dizzy, unsure on feet and having to stay in bed again.

 

5 weeks today on the 10mg Lexapro drop from 15mg.

 

2 weeks today since re-starting the 10mg Citalopram. There was 10 weeks between stopping and re-starting.

 

Any ideas what this might be? Could it be start-up effects of the Citalopram?

[fishinghat]

No idea. I gave read not to stay on two different ssri/snri for more than a few weeks but no explanation given. I am assuming they worry about serotonin syndrome.

[invalidusername]

Cannot be SS as I don't have any of the other classic symptoms.

 

As it took 2 weeks for the effects of the lexapro drop to show up, I can only assume this is a similar situation. But you are right Hat, I cannot stay on this mixed dose for any longer - 2 weeks is long enough already, but I just do not know where to go from here. 

 

This is stupid - I should have some guidance.

[fishinghat]

What a situation. Not at all funny. You need to come see my dr. You can get in to see him in about 2 or 3 days.

[invalidusername]

You say that, but what I would give to be under the guidance of someone who understands, listens and that I can get hold of. If that meant shipping off to the States. All the psy's over here are under, or have been under, the NHS. Unless you have silly money to go to Harley Street, the choices are few.

 

If you are lucky to get on a waiting list to see a psy (6-9 months) then you can wait it out, or you pay £300 and see them earlier. It is far from a joke. The next thing we'll be going to ER with a broken leg and get told to wait 3 weeks for a nurse to x-ray it.

 

Biggest reason for people taking time off work in the UK? Cold? Cough? Nope. Mental health.

[gail]

Scrat,

You know what to do. Do the switch like, yesterday. Then we'll see how goes. As you said in a post, keep it simple. The answer is often right under our nose, the thing in the middle of the face.lol!

Dizziness is one of most reported effect of withdrawal. Even after many months, it could still be a symptom of Cymbalta withdrawal.lovage to my dear Scrattage. You will make it!

[invalidusername]

I do want to - it is just the depression that came with the 5mg drop was scary. Really scary. Just think what the 10mg is going to do... O_o

 

At the very least I need to go to 7.5mg, but those tabs are such a b*stard to cut....

[invalidusername]

Quick update - yesterday turned out to be a good day. Despite the physical symptoms, I just got on with the day and ignored as best as I could.

 

Today has seen something of a worrying turnaround. I woke feeling really low. I adopted the same approach as yesterday and just got on with the day, but my mood just will not shift. Ten hours of feeling close to rock bottom. Not sure what is going on, but I sure hope it passes soon. 

 

Still have Gail's words from the "drop a word" post going round in my head. She is truly an Angel... Thanks Siddage.

[invalidusername]

Ahh.. this is stupid. I've just been out to first client for the day and got super-anxious now?! Haven't felt this anxious in weeks.

 

Given that I am still dizzy, fatigued and ringing in the ears, can only conclude it is the citalopram. 

 

This really is a medication nightmare...

[fishinghat]

Been doing a review of IUN's recent history as best I can. Please be aware that the estimates of when withdrawal symptoms from a particular situation will end is nothing more than an educated guess and should be taken with a grain of salt. Things underlined can contribute to withdrawal symptoms. More thoughts to follow.

IUN's Journey
Citalopram (taken for 13 years). During that time switched from the Citalopram twice before - once to Venlafaxine and then to Cymbalta

June 2017 - 12 week crossover to Cymbalta from Citalopram

19 Sept 2018 - Back up from 30 mg Cymbalta to 60 mg.
20 Sept 2018 - Back to 30 mg Cymbalta.
23 Sept 2018 - Changed to 20 mg Cymbalta and 20 mg Citalopram
12 Oct. - 30 Citalopram and 10 mg on Cymbalta
Weaned off rest of Cymbalta (on 30 mg of Citalopram during wean.)
24 Oct - 45 beads a day on Cymbalta, less than 10 mg.
25 Oct - 40 beads Cymbalta
27 Oct - back up to 56 beads (10 mg) Cymbalta
4 Nov. - Took 8 extra Cymbalta beads.
Nov. 9th - 60 beads
November 10th - 56 beads
Nov. 11th - 48 beads
Nov. 12th - 40 beads
3 November 2018 - Down to taking 30 beads of Cymbalta.
15 Nov 2018 - Took last dose of Cymbalta.
Note Cymbalta withdrawal effects to end by Nov. 2019

Crossover to Lexapro
30 Nov. - 5 mg Lexapro, still 30 mg Citalopram
1st Dec. - 5 mg Lexapro, No Citalopram , forgot
2nd Dec. - 5 mg lexapro, 30 mg Citalopram
Dec. 3rd - Stopped Lexapro continue with Citalopram
Dec. 5th - Started 5 mg Lexapro again, continuing with 30 mg Citalopram
Dec. 10th - Started on 5 mg Lexapro and 20 mg Citalopram
Dec. 11th - 10 mg Lexapro and No Citalopram
Dec. 12th - 15 mg Lexapro
Citalopram withdrawal to end approximately Sept 2019.

Added Pregabalin
Dec. 22nd - Started 50 mg Pregabalin as well as the Lexapro 15 mg/day went to 25 mg for second dose of pregabalin
Dec. 25th - Skipped 25 mg Pregabalin in the evening, 12.5 mg dose of Pregabalin
Dec. 26th - 12.5 mg dose of Pregabalin and continue with Lexapro 15 mg/day
Dec. 27th - Stopped Pregabalin
Any Pregabalin withdrawal should be ended by now.

Lexapro wean
Dec. 12th - 15 mg Lexapro
Feb. 4th - Did not take morning Lexapro.
Feb. 5th - Down to 10 mg on Lexapro.
March 1st - Started on 10 mg Citalopram along with supplements and 10 mg of Lexapro
March 2nd - 20 mg Citalopram, No Lexapro.
Lexapro withdrawal to end approximately Sept. 2019

Supplement history
30 Oct - Had L-theanine and Valium, got worse.
2 Nov. - Taking products with a lot of D3 as well as B Vitamins.
3 Nov. - Took Valium again, did not help.
5th Nov. Stopped vit B supplement
14 November started Omega 3 and CBD oil.
18 Nov. - 500 mg Magnesium
Dec. 17th - Started epsom salt baths.
Dec. 19th - Started Apple Cider Vinegar
Jan. 22, 2019 - Started iron supplement.
Jan. 23rd - Stopped iron.
Mid January - Kratom
Feb. 1st - Started ashwagandha and suntheanine
Feb. 16th - Stopped ashwagandha and suntheanine
Feb. 19th - Restarted Suntheanine in morning.
Feb. 28th - Started 50 mg 5htp.
Used 13 supplements during that time.

Misc.
March 6th - Started amoxicillin
March 8th - stopped amoxicillin

[invalidusername]

Wow... that is all spot on according to my notes - thank you so much for summarising my 6 month nightmare! When I look at it like that all in a list, it makes a lot of sense that I have been all over the place.

 

The only adjustments being;

 

Lexapro wean

Correct as far as March 2nd - I am still on BOTH Lexapro 10mg and Citalopram 10mg

 

Supplements

Stopped 5htp after 3 days - clearly did not help to the extent I was anticipating

 

I have today made enquiries to see a "proper" p-doc. He has had 40 years in the game, recently retired, but still working 2 days a week taking on private patients. What you have done here Hat is JUST what I wanted to prepare. Your timing is impeccable. 

 

So, what does this all spell out for everyone?? I am really interested to see what the p-doc has to say...

[fishinghat]

Absolutely fantastic. I am glad you are going to see a pdoc. I hope he/she is not an idiot.

 

Be sure and ask about the clonidine for the anxiety. Really works well. May want his opinion on the hydroxyzine but with your sensitivity to H1 agonist it may not be wise. He will know. Both help with anxiety but do nothing for depression. I am really anxious to see what he says.

[fishinghat]

We recently had a discussion on one of the threads the other day about how long to stabilize after updosing. The following research shows how fast the body responds to reinstating a ssri/snri shortly after withdrawal.

https://www.ncbi.nlm...pubmed/10958258
The SSRI discontinuation syndrome.
SSRI reinstatement leads to resolution within 48 h.

https://www.ncbi.nlm...pubmed/12008858
Selective serotonin reuptake inhibitor discontinuation syndrome: a review.
These self-limiting symptoms resolve on reintroduction of the drug and cannot be explained as a remanifestation of the original disorder.

https://www.ncbi.nlm...pubmed/11347722
Antidepressant discontinuation syndromes.
Severe cases can be treated symptomatically or the antidepressant can be reinstated before being gradually withdrawn. Reinstatement usually leads to symptom resolution within 24 hours. Some individuals require very conservative tapering schedules to prevent the re-emergence of symptoms.

[invalidusername]

Had a look at the overviews - the first is obviously a bit outdated being 20+ years old and only had Effexor as an SNRI to consider. These are papers that all p-doc's should be reading and well aware of. Unfortunately with my situation - and others - is one where I start on a replacement SSRI and then need to cross-taper back rather than taper, and then reinstate. Like it reads in first, it makes a diagnosis difficult when there is discontinuation going on, so how my situation with all the above going on is going to be diagnosed, God only knows.

 

The Lexapro clearly did a good job of masking the Citalopram withdrawal, and the 5mg drop certainly uncovered something. My psychological symptoms were at least predictable 4 weeks ago - it was just the physical symptoms that were a problem. 

 

Now having introduced the Citalopram back in the mix, this has added an unpredictable elements back to the psychological symptoms AS WELL AS all the reinstatement effects. I dare not change any doses until I have seen the p-doc. Even if he feels I am on the wrong path, I would rather wait a few days and know which way I am going.

 

The only downside to all this is the capital I have got to lay out to do this. The first appointment alone is costing a small fortune - let's hope it will be worth it.

[gail]

Fisherman, wow, what a beautiful job you did here! Bravo!

Scrat, so glad that you are seeing a doctor, stay put till you finally see him! Love

[invalidusername]

Didn't he just - right when I needed it...

 

Don't worry cupcake, I will indeed stay put until told otherwise.

[fishinghat]

When is your appointment with the pdoc IUN?

[invalidusername]

Waiting to hear back, but hopefully weds next week.

 

Got a new one today. Feeling stressful anxiety - but again no reason for it. Don't want to keep taking valium.

 

Yesterday evening was much better, and was a much welcomed rest.

[invalidusername]

Didn't end up taking valium - although it would have helped. I want to know what my system is doing without the aid of pills. I was fine through a light work day, a few glimmers of peace coming through, but anxiety is strong and repeatedly shot these down with the "what if's" and "how many times have we been here" thoughts.

 

Very much up, down and all over the place. I know it will settle, but after a week of the flu, and then this, reserves of patience run low!!

[fishinghat]

Don't worry IUN. It is all typical. Just 5 or 6 months more. Hold on!!

 

 

[invalidusername]

Well... if the p-doc thinks otherwise, then it will have been 3 weeks enduring the start-up effects of Citalopram for nothing! I can't say that I will be too happy to try yet another AD. I'd much rather get back as far as Citalopram and then augment if needed with something else. Too many unknowns...

[invalidusername]

APPLE CIDER VINEGAR

"I had two servings this morning and this is the first good day since last Friday and I even woke up with my period in full force"

 

 

There really are some fantastic anecdotes on this forum

[invalidusername]

Very strange but wonderful thing to report today.

 

Woke and feeling very unhopeful about everything, but a little after 2 hours, it was like my brain flipped my happy switch. Out of nowhere... just really happy! And has lasted all day!!

 

Made the most of it, did some work on the car, made some lovely food, but not overdoing it. Just hope the brain can remember these settings for the morning

[fishinghat]

Those good days will get more frequent and the bad days less frequent with time. I think you still over did it. We will see today how you do.

[invalidusername]

Well today was good - relative to the rest of the week. Didn't have quite the energy as yesterday, but 2 hours at my friends with 3 screaming kids running around - I didn't do too bad! Looming anxiety about the p-doc, but as long as something comes out of it, then it is a step in the right direction. If not, I will find another. Simple.

[invalidusername]

P-DOC APPOINTMENT UPDATE

 

An appointment came through for today and I have just got back, so first port of call is to update you all. I had Hats list and a drill down of stressors that have occurred which he found very useful (thanks again Hat). Essentially it was a run down of everything that had happened over the last 18 months, which took most of the hour. The usual questions of work, parents, the wife. He agreed that I have had a lot pumped into my system over the last few months, and that the lexapro should have been introduced at the end of duloxetine rather than throwing in citalopram as well. 

 

Having told him I am now on 10mg Lexapro and 10mg Citalopram he said that there is no reason why I cannot mix the two, but only having been 3 weeks on this pairing, it is too early to tell what is needed from here. He has suggested that I stay put as I am for another month - no other medication whatsoever - and to review then. There is a question over whether the shakes was from the Lexapro or something else, and although I am still not quite right, there is less big jumps from good to bad and back again. Things are within the tolerable range, but not moving. He suggested that we may need to try moving up the Lexapro again, but very very slowly given my sensitivity. I got the impression he wasn't overly keen on going back on the Citalopram given that it didn't help completely last time. I asked about the dizzy spells and he asked me what I thought - maybe this is a typical p-doc response. I said I thought it was the start-up from Citalopram. 

 

Given the anxiety build-up to it all, and the fact that I think I had a solution already expected from the fist meeting, I am feeling quite down about it all. I shouldn't, and should understand that there was not a lot the p-doc could have done at present, and was probably taking it cautious. 

 

I would very much welcome thoughts from you all please...

[fishinghat]

"He has suggested that I stay put as I am for another month - no other medication whatsoever - and to review then."

A wise dr. I fully agree. You have had enough changes recently.

[invalidusername]

I thought this would be the case. I will be going armed with plenty of questions next time. Want to get my money's worth! 

 

I think it just seemed like going over old ground - the amount of mental health workers that I have had to explain the same story - the only difference this time being that I was charged around $350 for doing it!!!

 

Thank you NHS - I want a refund on my tax please as I am paying for my own health care.... If I ever emigrate, this would be high on the list of reasons. Don't get me wrong, I am very proud of what our forefathers (and especially my grandfather) did for the country, but it's become a right mess...

[gail]

Hello Scrat,

I was going to say the same thing as Fishinghat.

The positive is that you can stay on both antidepressants without banging your head over the wall, so, that's ok.

Expensive, but I don't think that he could have done better. I agree with him about the Citalopram not doing it's job and that Lexapro would have been better.

What a day for you, lovage, Gailage