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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Rockets on June 14, 2000, at 17:31:45
Well, it's been an interesting three months on Celexa. I had lots of anxiety at first and had to use Ativan for three weeks straight (of course I started having anxiety attacks three months ago which is why I'm on it to begin with). Most of the symptoms went away after a couple weeks.
They tried to up me to 30mg two days ago. It was quite unpleasant. Let us just say beware of big metal spiders bearing sunflowers. I think I'm ready to begin tapering off Celexa and returning to real life using relaxation techniques and a much healthier, relaxed lifestyle.
Anyone find that this worked for them?
Posted by danf on June 15, 2000, at 7:46:56
In reply to I feel a desire to taper off Celexa finally , posted by Rockets on June 14, 2000, at 17:31:45
I would venture that you are headed for a major problem.
3 months & you can do it on your own with no meds. doubt that seriously.
If you can do it now, you did not need the med. About the only time there is a chance of that is when you have a specific phobia that is linked to something that you can avoid easily.
Please give consideration to what you are suggesting. Look at some of the folks that have done this cycle many times. each on /off med cycle gets worse & more difficult, with the chance of sucessful longtime remission less.
Have you been in psychotherapy ? If you have the sucess rate is low. If not even lower.
Posted by Rockets on June 15, 2000, at 10:52:44
In reply to I feel a desire to taper off Celexa finally , posted by Rockets on June 14, 2000, at 17:31:45
I have been in counseling at that is going well. I actually am quite functional on 20mg its just that trying to send me to 30mg brought on a lot of anxiety. It was distressful. I'm back on 20mg and going thru the pain of restabalizing. But I don't know about this low success rate. I've read in some very distinguished journals that 90% of panic and anxiety sufferers have a full recovery within 2 months to 2 years. So I have to disagree with you on that point.
Posted by danf on June 15, 2000, at 14:30:36
In reply to Re: I feel a desire to taper off Celexa finally , posted by Rockets on June 15, 2000, at 10:52:44
Having gone thru one cycle of the "I am well on the meds & I want to get off & I know I will do Ok" myself, urge great caution.
Pushing can get you where you don't want to be. Restarting same med doesn't work as well 2nd time around. Then you have to try other meds & the side effects are worse & they don't work as well either. I don't know how many times I have seen it, a lot.
I thought I was tough & could do it too. Didn't work.
Probably one of the biggest mistakes we make is stopping meds too soon. While journal articles do report short time spans, a yr is probably more the norm.
One of the perplexing things about your post is if you are doing well, why was the med dose increased ? That is not done for no reason.
Anxiety attacks or panic attacks do not respond as well as most of us would like. They often return with a vengance & are worse each cycle.
If you are stable on the med & the side effects are tolerable, think about a bit longer time. Discuss your plan in depth with both ptherp & pdoc before making the final decision.
Good luck with whatever choice you make.
Posted by Rockets on June 15, 2000, at 14:57:53
In reply to Re: I feel a desire to taper off Celexa finally , posted by danf on June 15, 2000, at 14:30:36
Very well said danf. I am planning to continue on the 20mg of Celexa. My pdoc just wanted to raise because I had a little depression. I was functioning just fine on 20mg. So in the end, my desire to get off early was borne out of the pain of a failed attempt to get to 30mg to make my life "better." If it works, I'm with it. I agree with you that a year makes sense. Peace.
Posted by Cam W. on June 15, 2000, at 21:50:30
In reply to Re: I feel a desire to taper off Celexa finally , posted by Rockets on June 15, 2000, at 14:57:53
Rocket - I have to agree with danf & you, that a year taking an SSRI is probably a good idea. Adding serotonin to your system will correct the symptoms, and retraining the body to produce a proper amount, does take time (books say at least 6 months, I tend to say at least 9 months, but a year is better).You also have to adjust the levels of other neurotransmitters that have been altered while trying to compensate for the lack of serotonin in your body. Along with this, neurotransmitter receptor concentrations also must adjusted. The trick is to keep these readjustments at a "normal" level. The body always wants to take the path of least resistance. If you stop an SSRI too soon, the body will revert back to pre-SSRI neurotransmitter/receptor concentrations because the body "remembers" (still are higher concentrations of proteins and secondary messengers that are involved in gene expression due to receptor stimulation that must also be altered) how it was working pre-SSRI This remembering may be how relapse happens (no real proof, but an educated guess). All this changing takes time.
You may feel better now, but the SSRI is acting as a bandage as the wound (anxiety circuit breakdown) is being healed.
I hope this makes some sense. If not, tell me and I will try to rephrase it (my brain isn't firing on all cylinders, tonight). - Cam
Posted by danf on June 16, 2000, at 5:42:43
In reply to Re: I feel a desire to taper off Celexa finally » Rockets, posted by Cam W. on June 15, 2000, at 21:50:30
Thanks Cam. I do not want someone else to be as bullheaded as I was & suffer the same consequences.
My take from the books is stay on meds 6 months after a person is in stable remission. The getting to a stable remission taks varying times. That may be 3 months, maybe more. So we still come up with about the same times.
I am going on bits & pieces of other Rockets posts. My guess is that If one has full blown panic attacks warrantig tx, then depression is a significant part of the picture. We may not have admitted the depression. Even so, it is still there.
Along with this the difficulty associated with upping the Celexa dose seems to point to a baseline problem with neurotransmitter balance that has not yet stabilized. To stop now would just be asking for trouble.
A minor suggestion. Perhaps try adding 1/4 tab for 8 days then up it to 1/2 tab for 8 days, then 3/4 tab for 8 days. This will get you to 30mg in a little over 3 wks. Perhaps the gradual increase will be tolerated better.
Posted by Rockets on June 16, 2000, at 10:08:37
In reply to Re: I feel a desire to taper off Celexa finally , posted by danf on June 16, 2000, at 5:42:43
Once in a while on psycho babble, I am awed by the experience and wisdom of the people here. Not all the time mind you but once in a while. Cam and danf, your posts are insightful, wise, and positive. I plan on taking your advice. Despite the feelings and sufferings I sometimes experience.. 12-14 months it is. Thank you.
p.s. I still may whine about it from time to time though. :0. Peace :).
This is the end of the thread.
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