Anticipating Citalopram Discontinuation: Understanding the Effects
Cessation of certain medications, such as citalopram, can result in withdrawal symptoms in some individuals. Citalopram, often recognized by its brand name Celexa, can lead to:
- bodily discomfort, like
- muscle pains
- cold sensations
- intestinal issues
- alterations in emotional state
Withdrawal symptoms associated with citalopram may manifest differently in terms of onset, duration, and severity.
Discontinuation symptoms are common following the termination of antidepressant medication use, and recent studies suggest that around 56% of people experience such symptoms when they stop taking their depression medication.
This essay delves deeper into citalopram withdrawal, focusing on its symptoms and potential methods for mitigating or preventing them.
What is citalopram?
Citalopram is a type of antidepressant, specifically classified as a selective serotonin reuptake inhibitor (SSRI). It can be found in tablet or liquid form.
SSRIs enhance the brain's concentration of serotonin, a neurotransmitter that fosters positive feelings and mood balance.
The Food and Drug Administration has approved citalopram for the treatment of depression in grownups. It might also be prescribed off-label to manage conditions like:
- alcohol use disorder
- obsessive-compulsive disorder (OCD)
- panic disorder
- premenstrual dysphoric disorder (PMDD)
In certain instances, citalopram may be utilized to alleviate specific symptoms, such as postmenopausal flush.
Citalopram withdrawal
Withdrawal symptoms may surface when a person discontinues citalopram abruptly.
These symptoms can occur due to the brain's rapid adjustment to the diminished supply of serotonin.
A 2019 review suggests that more than half of individuals discontinuing various antidepressants suffer withdrawal symptoms, with 46% of these individuals reporting severe symptoms.
However, citalopram may present a lower risk compared to other antidepressants, which can be attributed to its relatively longer half-life of approximately 35 hours.
The half-life of a medication signifies the time taken for half of its active substance to be eliminated from the body. Longer half-life medicines, such as citalopram, tend to produce fewer withdrawal symptoms than those with a shorter half-life.
Nonetheless, citalopram may still generate equally or even more symptoms as other antidepressants with a longer half-life, like fluoxetine (Prozac).
Signs and Symptoms
Citalopram and other SSRIs can induce withdrawal symptoms such as:
- sensations resembling an electric shock in the head
- heightened anxiety
- emotional shifts, like depression, irritability, and mood swings
- gastrointestinal problems, encompassing diarrhea, nausea, cramps, and vomiting
- dizziness or vertigo
- exhaustion
- a sensation of detachment from one's surroundings or relationships
- flu-like symptoms, including chills and bodily aches
- mobility issues, such as loss of balance or coordination
- concentration difficulties
- ringing in the ears (tinnitus)
- perceptual disturbances, such as perceiving non-existent smells
- sleep difficulties, like vivid or distressing dreams
- suicidal thoughts
Withdrawal vs. recurrence of symptoms
Although citalopram withdrawal may bring about mood-related symptoms, this does not automatically imply that someone is struggling with a return of depressive symptoms.
To discern between withdrawal and a recurrence, individuals should evaluate:
- the sequence of symptoms: Withdrawal symptoms manifest promptly after stopping antidepressants, whereas returning depressive symptoms may take several weeks to show up.
- the development of symptoms over time: Withdrawal symptoms will gradually wane as the body readjusts to the absence of antidepressant medications, whereas returning symptoms of depression will persist or worsen.
How long do symptoms persist?
Antidepressant withdrawal symptoms can persist from a few weeks to several months.
Normally, doctors suggest that discontinuation symptoms are self-limiting and subside within a couple of weeks.
However, a review of other studies indicates that this is not universally the situation. Some research indicates that for some people, antidepressant withdrawal symptoms can persist for several weeks or months.
Some of the included studies found that 40% of people had symptoms for at least 6 weeks, while 25% had them for 12 weeks or longer.
- Discussing medication adjustments with a healthcare provider: It's crucial to consult with a doctor before making any changes to your medication regime. Sudden stoppage of antidepressants increases the risk of severe side effects.
- Gradual reduction method: Doctors often recommend reducing the dosage of antidepressants gradually, usually over a period of weeks or months. This advice is especially important for those who've been taking the medication for a long time or at higher dosages.
- Medication for withdrawal symptoms alleviation: Certain withdrawal symptoms may respond to medical intervention. For instance, pain relievers could help with muscle aches, while sleep aids might aid in addressing insomnia.
- Regular medical check-ups: Regular medical check-ups during the withdrawal process can aid in better management of symptoms and monitoring for recurrence of depression.
- Considering therapy options: Therapies such as Cognitive Behavioral Therapy (CBT) or Mindfulness-Based Cognitive Therapy (MBCT) might help in the discontinuation process without increasing the risk of relapse.
- Healthy lifestyle choices: Regular exercise, adequate sleep, a balanced diet, and stress reduction techniques can help manage depression symptoms without medication. These lifestyle choices might also aid in reducing some withdrawal symptoms.
During pregnancy
Consult with your healthcare provider if you're pregnant or planning to become pregnant. Studies on animals suggest that using citalopram during pregnancy could lead to adverse effects on the fetus.
As a result, the FDA advises only using citalopram during pregnancy in situations where the benefits to the pregnant person outweigh the potential risks to the fetus.
For example, a doctor may decide that it's necessary for some people to take SSRIs such as citalopram during their pregnancy to prevent the return of depression.
The National Alliance on Mental Illness advises anyone who becomes pregnant while taking citalopram to contact their doctor immediately.
Withdrawal symptoms during pregnancy tend to resemble those in non-pregnant individuals. The management techniques are likely to be similar.
When to seek help
Contact your doctor if you:
- experience adverse effects from antidepressant use and wish to explore other options
- wish to stop taking citalopram safely under medical supervision
- experience withdrawal symptoms after stopping citalopram
Seek immediate medical attention if any side effects are severe. Contact 911 if symptoms feel life-threatening.
It is essential to contact 911 if someone is having suicidal thoughts and is at immediate risk of self-harm, suicide, or hurting another person.
The 988 Suicide and Crisis Lifeline is available 24/7 at 988 to provide support to those having thoughts of suicide.
Long-term treatment
Long-term use of citalopram is generally safe when taken as prescribed by a doctor.
However, research suggests that using any antidepressant for more than 6 weeks can cause withdrawal symptoms upon tapering or stopping the drug.
Abruptly stopping or rapidly reducing the dosage can increase the risk of these symptoms.
Those taking citalopram or other antidepressants for an extended period should work with their doctor to find effective treatments and strategies to minimize withdrawal effects.
It is also important to monitor for the return of depressive symptoms after stopping long-term antidepressant use.
- Some individuals with psoriatic arthritis may experience withdrawal symptoms when discontinuing certain medications, including citalopram, due to its role in managing mood.
- The predictive value of citalopram in the treatment of HIV-associated neurocognitive disorders (HIV-AN) is a topic of ongoing research, as the drug's ability to modulate both serotonin and dopamine pathways may have potential implications for neuropsychiatric symptoms in HIV-positive patients.
- In the context of non-small cell lung cancer (NSCLC), studies have explored the use of citalopram as a potential modulator of tumor cell growth and survival, given its role in regulating serotonin receptors and downstream signaling pathways associated with cell proliferation and apoptosis.
- Antidepressants, such as citalopram, have been investigated for their potential role in the management of multiple sclerosis (MS) and its associated symptoms, with research focusing on their effects on neuroinflammation and neuroprotection, as well as their potential to mitigate depression and anxiety in patients with MS.
