Coming off Citalopram

Some time ago, I wrote about my experiences with anti-depressants.

The time eventually came for me to come off them entirely. Here's how it went.

Background

I started taking Citalopram from August 2019. Citalopram was very effective for me and let me adjust the circumstances of my life that had caused me problems.

In May 2020, I decided that I'd been feeling stable and happy for long enough that I probably didn't need to still take the Citalopram and it was time to try coming off it.

Withdrawal

To begin with, I tried alternating a full dose (20mg) with half a dose in order to gradually reduce the amount in my system. This turned out to be unrealistic, and after about four days of this I was having mood swings and generally feeling pretty bad.

It's important to distinguish between relapse (i.e. you feel bad because this is the state of your body, and it needs to be treated) and withdrawal (i.e. you feel bad because of withdrawal symptoms, which should be temporary). Relapse takes more than a few days to appear, so this was definitely withdrawal.

Lesson learned: take it slower.

So I bumped it back up to a full dose for a week or so to regain my stability, and after that I started reducing the dose much slower.

I alternated a full dose with a three quarter dose, so in effect I was averaging 17.5mg. After a week or two on that, I went down to a three quarter dose daily, so I was averaging 15mg over two days.

I repeated this process for quite a while, going from a two day average of 20, to 17.5, to 15, to 12.5, to 10, to 7.5, to 5, to 2.5.

That's quite a long process. It took about 6 weeks as I was sticking at each interval for between one and two weeks.

But it worked really well. The transition was gradual enough that I didn't notice any withdrawal effects. I was probably overly cautious and could have gone down a lot quicker.

The final hurdle was going from a small dose (2.5mg) down to zero. Surprisingly (to me, at least), this was a bit rough. I had thought that 2.5mg was so low as to be effectively zero already, but apparently not. I had a few days of feeling a bit unwell physically - nausea and stomach issues (similar to the effects I experienced when starting Citalopram) and some strange minor dizziness (not enough to affect me in any practical way), but that settled quickly, and after which I was fine.

Summary

Citalopram for me has been a wholly great experience. It helped me get out of a bad situation and into a better one to the point that I didn't need it anymore.

Withdrawal was a bit slower than I expected, but by taking it slow I was able to come off it without any serious problems.