Tuesday, September 29, 2009

Quitting SSRIs safely and patiently

After taking citalopram (Celexa) for just over six years I have finally succeeded in quitting. I'd tried before, even managing to get down from 40mg to 20mg before I accidentally missed a single dose and spent a week going out of my mind. After bumping it up to 30mg I seemed to regain my sanity but a visit with the doctor left me saddened - she told me I would probably never be able to get off the meds.

This past winter I read the book, "Biology of Belief" by Bruce Lipton. It was interesting and inspiring, even if the science is dubious at best. It talked of mind over matter, our ability to heal ourselves, and it made me think of trying to quit the drugs again. Remembering my past experiences I did some research, and found out that one resource among others seemed to help a lot of people - a book by Joseph Glenmullen, "The Antidepressant Solution".

The message of the book boiled down to one thing: the doctors don't know the safe way of going off SSRIs (selective serotonin reuptake inhibitors). I had been following my doctors advice of taking a full dose one day, then a half dose the next, then a full dose again. After a week I was supposed to switch to doing just the half dose. Repeat. What I did this time (for reason well illustrated in the book), was to lower my dose by the smallest fraction possible, which in my case was 5mg, and try to stay on that dose for at least a month. This gives your brain time to adjust and kick in it's own serotonin production. After a month I would lower the dose again by 5mg and so forth. I was also supplementing with an excellent B vitamin complex, which provides choline and lecithin, needed for acetocholine production (that is advice not from the book but this site.)

It took me 5 months, six if you count the number of withdrawal periods. It wasn't pleasant, but it was far less painful than my previous attempts. Among physical symptoms I had dizziness, which would usually come on three days after I lowered the dose, and last a few days. Psychologically, I had some pretty bizarre obsessive thoughts. I didn't recognize them as symptoms until I saw a pattern emerge. I still had the occasional panic or anxiety attack, but no more so then when I was on the drugs.

So now I have been drug free for two months. I am still on the look out for signs that I am slipping back into the anxiety state I was in pre-meds, but so far so good. I should mention that I do not regret the decision to start the medicine in the first place. It was at a time in my life when they were the help I needed to become a person again (perhaps more on that another day?) Still, it feels great to know that I am not a dependent, that if I accidentally miss taking that one little pill I will not have to spend the next few days suffering crazy withdrawal symptoms.

I shall now allow myself a "Yiiiiiiiiiiiiiiiiippeeeeeeeeeeeee!" :)

1 comment:

Spatula said...

Congratulations! I have gone on and off antidepressants too, and I don't like the idea of being on meds for the rest of my life, so I try to limit my "stay" and go off them when I feel more steady.

Of course, now I've gone off them for financial reasons, and I went from 75mg/day to 0mg/day because I am impatient and also a bit of a dolt. It was a very weird two weeks, but thankfully I did not have to work during that time and could actually get through the resulting "soul flu".

I hear you on the dependency - I call it the chemical leash. I don't like the onset of crazy withdrawal symptoms within 48 hours of missing a dose! I don't know if it's built in on purpose, or if the pill makers simply don't know how to control the side effects better, but it feels very nasty to be that dependent on a substance.