Celexa withdrawal?

[sw8689]

Hi everyone, I'm changing from celexa to cymbalta. I'm quite excited about the change as I'm told the cymbalta will help with my nerve pain as well.

My concern is going off of celexa after being on it for many years and I'm terribly afraid of withdrawal. My doc doesn't seem to think there should be any difficulty, suggested if im concerned to take one every second for a few weeks.

But I'm thinking maybe I should cut it in half every night? Or three quarters, just like reducing topomax or the like?

Will you please share your experiences, I have no idea even what withdrawal symptoms to expect?

[Redwings]

The prescribing information for Celexa cites reports of the following adverse events upon withdrawal, especially abrupt withdrawal: dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesias such as electric shock sensations), anxiety, confusion, headache, lethargy, emotional lability, insomnia, and hypomania.

If I were in your position, I would consult a pharmacist for some technical details. And here's why. There's a difference between completely discontinuing a selective serotonin reuptake inhibitor (SSRI)/selective serotonin and norepinephrine reuptake inhibitor (SSNRI) and being on no med, versus switching from one SSRI/SSNRI to another drug of the same or similar class.

What I would want to know from the pharmacist is, is it necessary to completely withdraw from one and then start completely anew with the other, or is it possible to just change from one to the other on some schedule. It's common for patients to change antidepressants, and there's some risk involved in leaving a person unmedicated between drugs. There has to be a protocol for drug changes that doesn't leave a person at risk, and a pharmacist is a good source for telling you what that protocol is when changing from an SSRI (Celexa) to an SSNRI (Cymbalta).

In addition, there's an article on the eHow health site about changing from Lexapro (an SSRI) to Cymbalta (http://www.ehow.com/about_6574375_si...-cymbalta.html). So maybe you could read that and then talk to a pharmacist. You could also ask your doctor about it. But the fact that your doctor recommended cutting your Celexa dose first only if you're concerned leaves me unsatisfied and wanting another opinion.

[Nebbykoo]

I don't know about Celexa, but I had bad withdrawal symptoms from Effexor. I read the including wellbutrin while stopping Effexor can make it easier to come off. Maybe talk to a doc and see what he/she says about a combo like that?

You should google 'Celexa withdrawal' and read about what to expect.

Good luck. let us know what happens!

[sw8689]

Thank you so much for your replies!

Redwings, thank you for the information. Your suggestion in seeking the advice of my pharmacist is very good. In fact I just came home from the there. In the morning I had consulted with the other pharmacist on the phone and she didn't have any info to offer and said she would look it up? Well I can do that, so I told her not to worry about it.

So when I picked up the prescription tonight a different pharmacist was in and He was concerned that I was on three antidepressants and I told him I was going off celexa and reducing Wellbutrin, titrating celexa down. He had nothing to offer in terms of how to do it..

So I really appreciate your advice, and any experiential guidance I receive here.
Thank you!

[maitrimama]

I have been on both celexa and cymbalta. I wasn't on cymbalta for too long because it made me very anxious which was disappointing because many people have had success with cymbalta and nerve pain. One thing you should keep in mind with cymbalta is that withdrawal can be difficult.

I have been on celexa for several years and literally can't get off of it. The first time I tried to get off of it was in a hospital setting so it was a controlled taper but when I was down to no celexa I had a headache that lasted for weeks until they put me back on celexa. In the past 2 years we have tried increasingly slow tapers 3 times with no success. My case is rare but it does happen

I would insist on a taper.

[MarkLavelle]

In the morning I had consulted with the other pharmacist on the phone and she didn't have any info to offer and said she would look it up? Well I can do that, so I told her not to worry about it.

It's good to be "proactive,' but don't forget that professionals often have access to info that us mere patients do not....

[Redwings]

Hi sw8689:
What a bummer that your pharmacists couldn't offer you more information. I guess I'm more used to dealing with hospital-based pharmacists, who are more involved in patient care.

Maybe the doc who prescribed your antidepressants can be a little more detailed about how to decrease the Clexa and start the Cymbalta? Do you have another doctor you can ask?

Since you don't seem to be getting much help from your medical professionals, I think the gradual, systematic step-down that many (most?) professionals recommend is probably the best approach.

Here's a link to a Q&A about getting off Celexa from the viewpoint of an doctor on the Advisory Board of Harvard Women's Health Watch: http://www.denverpost.com/headlines/ci_5101467.

I hope your doc(s) will be a bit more involved in helping you and monitoring you as you decrease your Celexa dose. Even if you find you're doing most of the work yourself, I hope it all goes smoothly for you.

[sw8689]

Thank you all very much. I think I will call my Doctor early next week if I am having any problems. I have very good doctors, i feel very fortunate. however, I have managed my meds so well in the past, and I think I came across as confident with this changeover when in fact one of my biggest fears is being addicted to some of these meds we are on, and I haven't had to go right off of a big one before..


I do feel as if I'm on too many brain altering drugs. All of them are to try and rid me of this terrible fatigue, and I think combined they may be doing a number on my personality as I feel so flat sometimes. Wellbutrin, Methalphenidate/Ritalin, and and now cymbalta, titrating off celexa.. It's a bit much since adding the Methalphenidate, but it keeps me out of bed.

And I have a post concussion syndrome From a serious accident last may that is making it hard to figure out what is what..

Sorry for the ramble, I've been away from here for a long time and it's good to be back and get some experiential advice, especially as meds are changing so fast right now it's hard to keep up.

Thanks again,
Sw

[deb46]

I was on Lexapro for years and my doctor changed me to Cymbalta. I went straight from the Lexapro to the Cymbalta and did fine. After several weeks the Cymbalta made me kind of nervous so switched back to Lexapro.

[sw8689]

Thanks deb, I appreciate your responding this is important to know. The more research I do, the more frightened I get..

But some of the research I found is on psychiatric forums and I think the reactions to withdrawal and changes are likely different for folks who are taking meds with protrated depression, or anxiety disorders, for example their symptoms come back or exacerbate during the withdrawal etc. so I've decided not to look at those sites further and concentrate on folks experiences here with my disease as although we have depression often we are treating other symptoms as well.

The other thing is that I would imagine adding the cymbalta would counteract some of the withdrawal from the celexa wouldnt you think?

So far, I have had three nights at 5mgs celexa from 10, and no problems that I can detect, I'm on 30mg cymbalta so far..

Again, thanks for reply

[Redwings]

The other thing is that I would imagine adding the cymbalta would counteract some of the withdrawal from the celexa wouldnt you think?

Hi sw:
Yes, that's what I was referring to earlier when I said that there's a difference between completely discontinuing an SSRI/SSNRI and being on no med, versus switching from one SSRI/SSNRI to another drug of the same or similar class. So even though you're discontinuing Celexa, you're replacing it with another SSRI inhibitor, so you may not experience much in the way of withdrawal symptoms. It might be that any difference you feel could be coming from Cymbalta's additional neurotransmitter effects. (Or maybe you won't notice any difference. ) Glad to hear things are going well.

[sw8689]

Thanks Redwings, i need the clarification..I'm a little slow on the uptake these days

[lemstar]

In my opinion, docs often/sometimes underestimate medication side effects, and withdrawal symptoms. I agree with Redwings about seeing if you can wean off Celexa, while slowly titrating up in Cymbalta. Right now, my son is switching from one SSRI to another, doing just that.

And yeah, reading online about withdrawal can make you crazier than you need to be. It may be that you would have no withdrawal symptoms at all, especially since, as you mentioned, many time withdrawal symptoms can be mixed in wtih the symptoms a person has from not deriving the benefit of the medication they are eliminating.

So bottom line? I would ask the prescribing doc if you can wean off the Celexawhile you slowly add the Cymbalta, and yes, I think a slow wean helps. You may be worrying about nothing--this med change could just work well for you.
Good luck.

[sw8689]

Thanks Lemstar!
I think that's what my Doc may have meant by taking a celexa every other day for a week or so while I titrate up on the cymbalta if I felt I needed too.

I'm five days in now, and i am taking 5mg celexa a night instead of ten. And frankly the only symptom extra I'm feeling is a smallish headache in the latter part of the day.

I will change to five mg every other day starting this Friday and then one week later cut it into a quarter for a few days.

I think I will keep you all posted if you don't mind. Then it's recorded for anyone one else in the future, asking/searching the same or similar question.

Thank you all again,
SW

[sw8689]

Quick update

I did as I said in the last thread except I didn't bother cutting the 5mg into half, I just went from every other night to skipping it altogether. No problems at all.
All in all it was an easy transition, except my anxiety about starting the process of switching meds.!

Just wanted to update to complete the thread.