Citalapram discontinuation

Fish oil and magnesium are very helpful when healing.  Magnesium glycinate is absorbed better than some cheaper forms; you can start with 200 mg AM/PM, helps with sleep and anxiety.  You can also take epsom salt baths; magnesium is absorbed through the skin.

You were on Cit for a very long time and may have come off too fast.  Your nervous system will be slow to recover to your "factory default."  It will also be sensitized to stressors.  Withdrawal recovery occurs in a waves and windows pattern, the waves being the bad symptoms and the windows being periods where you feel better.  Just know that if you do have a window, it may be followed by a wave again, but that is the normal pattern, so knowing this can help you endure.  Experiencing stress during windows can throw you into a wave, so it is important to try to protect yourself from undue stress.

I would recommend joining the forum at survivingantidepressants.  There, you can create an intro for yourself, describing your history with meds and explaining your symptoms.  The moderators are very helpful and knowledgeable and many people who are on Cit will chime in with their experience.  It's a very supportive community, as is this one.  Someone will be able to advise you with regards to what actions to take to ease your suffering (beyond what I have already written).

Mindfulness/meditation can be very helpful as well.  Try to be kind and gentle with yourself during this time since your nervous system is in upheaval.  

I hope that this helps.

When I was off medication I took a natural SSRI called 5-HTP which needs to be taken with l-tyrosine.  Both can be bought from Holland & Barrett (if you're in the UK) and you need to take them both.  Read a book called 5-HTP The Natural Way to Overcome Depression, Obesity by Michael T Murray ........ it's a really interesting read.

You need to be off SSRI's completely before starting 5-HTP as they must not be taken together. 

You jumped off from too high a dose which you were on for a very long time, which is why you are having such withdrawal symptoms.  Citalopram has 80% receptor occupancy at the minimum dose of 20 mg which is saying that you went from 80% to 0%, a huge leap and a huge adjustment for your nervous system to make, basically equivalent to doing a cold turkey.  Receptor remodeling does not happen quickly, and unfortunately going cold turkey can cause protracted withdrawal that can last anywhere from several months to two years or more; no hard, fast rule because everyone is different.

Reinstatement to 10 or even fewer mg would be advised to ease symptoms, followed by doing a 10% taper per month of the previous dose from there on out. People often exclaim that they want to be rid of the drug forever and will just tough it out, but most of them end up reinstating because the suffering is just too much to take.  

I am not trying to frighten you, but just want you to know what your options are.  Many on surviving antidepressants have tried alternatives such as 5-htp, but nothing will speed withdrawal recovery since it is about your nervous system having to make huge adaptations back to the factory default, if you will, and nothing speeds that process.  The fact that no one on the site discusses 5-htp or tryptophan as being beneficial says a lot.

From one of the administrators:

What is known about reinstatement

from my reading and from patient experience as posted on online support sites:

According to medical knowledge, reinstatement is the only way to alleviate withdrawal symptoms.

Reinstatement is best done immediately upon appearance of withdrawal symptoms. The more time that passes, the less likely it is to work.

The length of this window of opportunity varies according to the individual. Sometimes people can reinstate successfully months after quitting. Others cannot.

Some find a partial dose will relieve withdrawal symptoms. If, for example, you were taking 20mg Paxil and quit rapidly only a few days ago, 5mg or 10mg may be enough. Others find they need a higher dose.

Start low to see what you need. You can always increase if necessary. If you've been off the drug for a month or more, many people can find relief from antidepressant withdrawal symptoms by reinstating as little as 1mg-5mg.

Additional reasons to reinstate only a partial dose

Reinstating at a low dose reduces the risk of severe adverse reactions in case reinstatement does not work.

Experiencing withdrawal may have sensitized you to drugs and a larger dose will cause an adverse reaction.

These drugs are vastly more powerful than they need to be and you want to be taking only the lowest EFFECTIVE dose.

Your receptors may have adjusted somewhat (upregulated) during the time you had withdrawal symptoms.

If you can stabilize on a lower dose, you have less to taper when you finally do go off.

If you had adverse reactions while you were taking the drug, a low dose may not trigger the adverse reactions but still reduce withdrawal symptoms. Adverse reactions tend to be dosage-related: The higher the dose, the worse the reaction.

You can always adjust the dosage upward if you find you need to.

How long should you give reinstatement?

It takes at least 4 days for your body to fully register the addition of a neuroactive drug. Unless you have an immediate bad reaction, observe your symptom pattern for about a week to see if the reinstatement is helping. If you have an immediate bad reaction, reduce or stop taking the drug.

After reinstatement, the amount of time needed to alleviate withdrawal symptoms (stabilizing) varies according to the individual. Relief can be felt immediately, after some weeks, or after some months.

Once you feel withdrawal symptoms are reduced after reinstatement, give your nervous system time to stabilize before attempting dosage reduction.Think in terms of months, not days.

Be patient after you reinstate. Reinstatement may not immediately eliminate all withdrawal symptoms. You may still experience waves of symptoms, which usually lessen as time goes on.

The dose needed for effective reinstatement varies according to the individual.

When to discontinue reinstatement

If, upon reinstatement, you very soon feel worse, most likely you are sensitized to the drug and need to take a smaller dosage or, possibly, none at all.

Sometimes reinstatement does not work. The nervous system has taken such a hard hit from withdrawal, it's destabilized beyond whatever effect the drug might have had.

Sometimes reinstatement not only does not work, it causes an adverse reaction from a nervous system sensitized by withdrawal.

If you have an immediate bad reaction, reduce or stop taking the drug.

Reinstate at what dosage?

Sometimes reinstatement not only doesn't work but makes symptoms worse. That is why we often suggest very, very low doses -- to reduce this risk. Higher doses can go wrong in much bigger ways. A very low dose is a way to explore the option with less risk.

The dosage is always going to be a guess. Here are some factors that might influence the dosage of reinstatement:

How the person quit the drug and how long he or she's been off it. If you've just cold-turkeyed 20mg Celexa a few days ago, you might reinstate at closer to your original dosage, such as 10mg. (It may not be necessary to go back to 20mg, standard dosages tend to be overly powerful.)

If you've had withdrawal symptoms for a month or more, it's likely your system is somewhat sensitized to drugs. You might wish to try reinstating at a lower dosage, such as 2mg-5mg (if you had been taking 20mg Celexa).

Your present condition. If you have symptoms of hyper-reactivity, alerting (anxiety, panic, sleeplessness), you may be too sensitive for reinstatement. If you want to try it anyway, you might wish to try reinstating at a very low dosage, such as 1mg (if you had been taking 20mg Celexa).

How long you've been off the drug. If you've been off the drug for many months, reinstatement is less likely to work. If you want to try it anyway, you might wish to try reinstating at a very low dosage, such as 1mg (if you had been taking 20mg Celexa).

Other drugs you're taking. Be very careful adding a drug to other drugs. Use the Drug Interactions Checker before even considering this. (Your symptoms may be due to drug-drug interactions.)

None of the above are hard-and-fast rules. There are reports of people with prolonged post-withdrawal syndrome who did better taking a drug at full dosage 2 years later. If you want to do this, please consult a doctor, we cannot advise you on it.

End quote

As you can imagine, tyring for such small doses means getting a liquid version of the drug that can be measured with a syringe, or weighing dry dosages with a jeweler's scale, obtained for around $22 on Amazone for folks in the US.  Pretty sure there's a source in the UK.

I strongly urge you to join SA for better guidance by the moderators who are very experienced in the matters of withdrawal from antidepressants and other psych drugs.