Tapering off SSRI

[Matthew1798]

Oh well…that’s life! It’s nice that someone cared enough to help you. No one ever helped me when I had panic attacks in social situations. We all have our problems, etc.

My panic attacks were mostly induced by social situations, but I had out-of-the-blue attacks for a few years. So, I do relate all too well.

I have very odd triggers for panic attacks (socially-induced, however), even though I rarely have them these days.

You cannot fight a panic attack - that just makes them a zillion times worse. All you can do accept it as it’s happening (not sure how you do that, because you feel like you’re dying, but…).

Qigong has helped me a lot.

Take good care.

[KGB]

I’m watching football but just noted that celebrity ‘race across the world’ is on bbc1 for the final leg.

So this is from africa to the Arctic?

Tromso is where I clanged planes for my second flight when I was having the panic attacks.

Tromso is about 69 north? The arctic circle starts at 66ish so that is not the arctic.

Try getting to greenland or svalbard from south africa…

Now that’s a race across the world.

What do you think @j.p.mac ?

Or would you prefer Patagonia to Ladakh to see snow leopards?

K

[Matthew1798]

I always wanted to go to both Patagonia and to the far north of India.

[KGB]

Been to some India but not north and been to Argentina but not that far south!

Penguins?!?! Who cares

I’m an arctic guy. I’m not an ant.

[Matthew1798]

Maybe we can go together someday. We can bring JP.

[Rups]

Just thought I’d update on this topic. I’ve been a bit of a lurker lately on the forum. A recent family drama has been consuming all my mental energy and mood, as a result I have upped my Citalopram dosage, back to the 20mg I had started with. I decided so as a means of bolstering my anti-anxiety shield, it wasn’t something I had wanted to do but thought it best to batten down the hatches as best I could. Upping my dosage again has come with its own set of problems, of course, increased anxiety for a while and my brain settling back into it all. I have to admit though, I did successfully taper off 20mg, and once my brain had adjusted, I felt very well, but life circumstances will sometimes throw curve balls.

[Mrs5K]

@Rups well done on tapering off the meds. Thats a big achievement. As you say though life sometimes throws curve balls & different strategies are required for those moments. I hope the family issues settle for you. Take care x

[Matthew1798]

Take care of yourself. Sometimes we just have to do what we have to do.

I’m sincerely wishing you more serenity in your life. Things will get better somehow.

[fryingtonite]

Hi All

I’m really lucky, ever having experienced a panic attack, but from the descriptions, it sounds really, really hairy. I took a drug some time ago called aripiprazole which is a mood stabiliser, but can cause anxiety as a side effect. Ye gods it did. I was scared to drive,answer the door or phone and was anxious all day and all night so couldn’t sleep. The only thing I could do is lie stiff like a board on the sofa. Been off it for some time now, so all recovered, apart from one small thing:

As I spent so long being anxious about not sleeping (self reinforcing or what?), at bedtime I’m still off like a shot. Loo, teeth, bed quick as you can. This is just in case I can’t sleep lol. My wife and I laugh about it now, although she gets a bit irritated when I’m muscling in past her in a rush.

On the medication front, I was given Diazepam which didn’t even touch it. They also don’t like to dish it out as it’s very addictive.
On to titrating down your meds. I have no medical qualifications, but have been up and down that road many times and the theme is softly softly. It doesn’t matter even if it takes a few months. Also if you have a partner, tell them what you’re doing so they can be aware of any changes. Even better, your doctor and they can monitor you.
Ok now side effects. I’ve been told many times not to use Dr. Google, but always do. I think it’s fine to research things on the Internet, so long as you are looking at what I call a “proper authority”. Facebook, Twitter, TikTok, Reddit, it aint. NHS site is good, but very general and vague for my liking.
My goto for side effects for meds is the BNF. This is the British National Formulary’ and is here:

https://bnf.nice.org.uk/

This is the authority the medical staff use. You can search for any drug on there and read the possible side effects and how common they are.

As an example, last year I had a condition called gynecomastia which is a hormone imbalance. The consultant said I could take Tamoxifen which is very effective. On to the BNF and it told me that blood clots are “common or very common”. What? Post stroke? Are you joking? I searched for the drug using Google and came across a breast cancer web site which discussed it. The general advice was to keep an eye on swelling in your legs as it could be a blood clot. So as a stroke survivor would I take it? I’m off like a rat out of a tunnel!
Sorry, banging on, but I’ve found that medical staff don’t always know the side effects of every drug (of course) so you have to check yourself. If you tell your doc you’ve read it on the BNF, they will accept that and in any case, can look it up themselves.

My 2 pennorth…

Cheers

Steve

[Rups]

Shwmae Steve,

Yes, I agree. To a great extent, I am attentive, with other comestibles, to what I put into my system, so it should be reasonable that, with medications, it is no different. I have advised my GP on drug interactions when he has suggested prescribing me certain meds. I use the NICE site myself. We should be aware of what we are taking, what the side-effects are, and what the contraindications are. Panic attacks are harmless physically but cause great mental distress. I am going to try and taper off citalopram again, and see if mine have gone, or if I can manage them again without medication. At the moment, I pop three pills a day. I would like to get down to popping just the one. Diolch for your reply.

[fryingtonite]

Shwmae @Rups OO welsh eh? I’ve got relations in Aberystwyth and my brother went to uni there.

I completely agree with you comparing food/meds as they are both things you put in your body. I was pretty shocked when I found about Tamoxifen having blood clots as a common side effect and the consultant knew I’d had a stroke, but to be fair, I’m guessing very professional doesn’t know every side effect of every drug. That’s why I always check myself.

Best of luck reduce your dosage, but remember, it doesn’t matter if it takes a long time, softly softly

mae croeso i chi (ok, used Google Translate )

Steve

[Mollybenji]

Be care anti depressant don’t mix well will clopedogrel ( blood thinner). They stop it working and raise bp. I’d not risk the side effects

[Rups]

Aye, I am now at 5mg and next month will be embarking on the one day on, one day off for at least six weeks. I was aware of the potential risks with SRRI and anti-platelet meds when I first consulted my GP, but I suffer from severe panic attacks which combined with the early years of post-stroke symptoms would have made life unbearable, so I opted for citalopram which is one of the “safer” SRRIs to take with anti-platelet and blood thinner medication. I am looking forward but also a bit daunted by the upcoming challenges that await me in managing panic attacks again, but I feel a lot more resilient and braver in mental constitution to deal with this invasive nightmarish delirium of the brain.

[Trace57]

@Rups

I’m very interested in your post about SSRI’s. I’ve had a very long relationship with Escitalopram, which I started taking around 2007. I’ve tried to come off it 4 times, each time has been unsuccessful and ending with worse symptoms than I had to begin with. The last time I tried was a few years ago when I had been taking the minimum dose of 5mg for a few years and tapered off very slowly over 2 years until I was down to taking 5mg once a week which continued for 2 months or so. I didn’t envisage having any problems this time yet within a month of taking the last dose, again I found myself ‘crashing’. Anxiety was off the charts and I was very tearful for no reason at all. But this time, there was the added problem of not being able to sleep, no matter what I did to tire myself out. The doc said I was relapsing (I knew I wasn’t) and although I really didn’t want to take those drugs anymore, I was feeling so desperate and exhausted that I was almost begging to go back on them. So I started back on 5mg again. Within a year, I cut them back to 5mg every other day and then I found this:

How to Avoid Withdrawal When Stopping SSRI Antidepressants

Although the article is mostly addressing what can happen if SSRI’s are stopped abruptly, there are plenty of accounts online where people have had the same experience as I’ve had even if they’ve not been medicated long term.

With hindsight, if I’d stuck it out for another month or 2 after taking that last dose, I’d probably be free of them now. But I don’t want to ever go through that again, much less since having a stroke.

The last thing I want to do is to worry you - I’m sharing my experience just in case you or anyone else comes up against the same thing. Forewarned is forearmed. And if it happens, be more courageous than I was by sticking it out till the end.

[Rups]

I know, I know, such a tough ride with this kind of medication. When I first began citalopram, the first six weeks were a living nightmare. 3 am and I was wide awake with startling anxiety, the likes I had never felt before. However, on the plus side, it worked a treat with my panic disorder, and a little silver lining is that a side-effect of SRRI medication is the regeneration of hippocampus cells. I felt this latter consequence of taking the medication to be nothing but beneficial for someone who was struggling with working memory because of the stroke shock or damage. This time around, I know when to batten down the hatches and I follow my progress on a tapering off calendar, so I can see the progression visually. I don’t have anything against SRRI meds per se, and I see them as being highly effective for specific needs. My panic attacks were a horrendous burden to me but I had managed them pretty well, it’s just that I couldn’t juggle them on top of stroke damage, unless the NHS were willing to provide me with a bungalow out the back of one of their hospitals.

[cuddyhung]

come off my ssri no chance ! i have tried every couple of years with limited success, and had little or no i would go from 20mg a day down to 10 , im on escitalopram ,i started on citalopram up to 40mg and it stopped working so moved to escitalopram 20 mg and it works fine , as soon as i do anything to my dosage the Black Dog comes calling for me

[Matthew1798]

So are your panic attacks much better?

I suffered with out-of-the-blue panic attacks for about 5-7 years. Now, the only thing that triggers them is certain social situations. I know what to avoid, most of the time. I never fully overcame them, though.

Please take good care of yourself.

[Rups]

Citalopram worked a treat to suppress panics, I could feel them rising but they never followed through. I am yet to see in what shape and form they arise once I have tapered off the medication. I have Lorazepam as a back up for bad panics but I want to address these panics again. I have had them since my mid-twenties, am now in my late forties. I tried CBT, hypnotherapy et cetera. My trigger is being inside my own head, it’s when I feel trapped in life itself. This is annoying because it isn’t something I can avoid.

[DeAnn]

I don’t know how I missed this conversation until now. I am so glad I have now read through it. I take an SNRI. I was thinking of going completely off of it, but I take a fairly low dose now. My Neurologist had suggested I up the dose from 60 to 90 mg, but I never did. I was thinking of going down to 30 mg, but some recent events tell me now I should probably stay where I am awhile longer. I still get some feelings of anxiety or depression, but they are much easier to overcome than without the Duloxitine. Maybe next year I will try going to 30 mg and see how it goes.

[Matthew1798]

I relate to your panic attacks very much. I always felt alone.

Take good care.