Patient: I have been taking the anti depressant drug citalopram for a couple of months now but haven’t been feeling myself on them so I want to come off my tablets but I’m worried about the side effects of stopping them,,I know you have to come off them slowly which I am going to do but I was just wondering what the best way would be? I once had a seizure when I stopped them suddenly a few years ago but that was when I didn’t know that you had to come off them gradually,,so now I want to come off them slowly but was just wondering what the best way would be? I’m 30 years old an not suffering any other health issues,,I have been taking citalopram one 10mg tablet a day for two months
Doctor: Hello,Thanks for writing to us.If citalopram is not making you feel “yourself” or not suiting you, You should id eally be switched over to other antidepressant. This process will be less uncomfortable as on one side your doctor can start tapering Citalopram and side by side another antidepressant like Sertraline , Fluoxetine, etc. can be added.Usually on stopping or discontinuing antidepressant, set of symptoms appear in body commonly called as Discontinuation syndrome :1) nausea, vomiting, cramps, diarrhea, or loss of appetite2) Hot flushes3) sleep disturbances4) Restlessness, tremors, agitation,etc.As you mentioned you had seizure on stopping citalopram, it would be better to switch on to another antidepressant that would suit you. This way your depression would also be handled.Ideally an antidepressant should be taken for 6 to 8 months before stopping and this duration goes up to 2 years if person had more than 1 episode of depression.Going off an antidepressant usually involves reducing your dose in increments, allowing two to six weeks between dose reductions.Psychotherapy should be started side by side to aid in easier tapering without relapse of depression.Exercise and regular sleep are must while tapering an antidepressant.Most importantly this process of tapering drug or switching other antidepressant should be done under care of your doctor and should never be attempted alone.It is advisable for you to see your doctor who will be able to help you in process of tapering/ switching antidepressant.Hope this helps.Feel free to write back.