Hi, everyone,

 

I'm recovering from a combination withdrawal episode and have been experiencing symptoms for over 7 months. Was put on Citalopram and Lamotrigine when I was 13 (now 34). I'd been stable on them but me and my husband wanted to try for a baby so I came off the Citalopram over 4 months (slower than what my np recommended). Had minimal issues until the jump from 5 to 0 but then was just anger, crying, anxiety, and manageable depression. I also had a feeling that things were a bit strange and unfamiliar but not constant. I thought withdrawal was mostly over. Two months after discontinuing Citalopram I reduced my Lamotrigine dose by 25 mg (np recommendation) and immediately started experiencing increasing anxiety and dread, as well as a shaky feeling. This escalated to dissociation and a feeling of doom, as well as SI. After 3 weeks I partially updosed to 137.5 but no improvement so I restored the 150mg. There was some initial improvement and then profound worsening: extreme panic, dread, doom, SI, GI issues, inability to eat, insomnia, and derealization/depersonalization that has been persistent for 5 months. I ended up having a total crash/shutdown that I have been slowly emerging from ever since.

 

I waited in increasing misery until the end of December to stabilize on Lamotrigine (added Lithium 600 then 900 trying to stabilize). Then, I saw a neuropsychologist who saw this as obvious SSRI protracted withdrawal. I reinstated at 5mg and have been working my way up, seeing slow steady improvements. The activation syndrome has been only slightly better than the withdrawal, including one bout of akathisia and one hospitalization. I'm just one titration away from my original dose, then it's just time.

 

My goal is no longer to get off, just to recover. I'm terrified that my home doesn't feel like it used to and I feel emotionally disconnected from my memories. There's no thread between my past life and now. The emotional context is missing from my life. Head pressure has resolved and the world looks natural again, just not like it should.

 

Any encouragement about this not being permanent or sharing similar experiences would be greatly appreciated. 

Hi @sweetsally

 

Welcome to the forum!

 

This is a volunteer-run, community forum aimed at helping those who are tapering and/or experiencing difficulties with psychiatric medications and withdrawl syndrome. We are not medical professionals and cannot offer medical advice. We simply offer support and opinions which you could use as talking points with a medical provider knowledgeable in withdrawing off psychiatric medications.

 

Please familiarise yourself with the forum rules and the disclaimer located here: Guidelines

 

Please make sure your signature is kept up to date with your drug history. This will allow members to see some basic information about your drug history and situation so that they may help you best. Information on how to do this is located in the FAQs section above, but here is a direct link: Update Signature

Once this is done, future posts made by you will have this signature turned on by default. For this reason please keep it clear but condensed as possible.

I'm so sorry to read about the tough time you've had recently you will find plenty of support here for sure.

 

Unfortunately you tapered Citalopram too quickly. You seemed to 'get away' with it until you decreased your Lamotrigine and that was the final straw. Increasing your Lamotrigine would appear to have resolved some of the issues but your nervous system is likley very upset by the whole experience.

 

He is our tapering document for you to read:

 

Tapering Information

 

14 hours ago, sweetsally said:

I waited in increasing misery until the end of December to stabilize on Lamotrigine (added Lithium 600 then 900 trying to stabilize)

 

Quote

Lithium: Started 600mg Nov 2025| Started 900mg Nov 2025

Lithium Taper: Feb 2026: 750mg, 600mg | Mar 2026: 450mg

Gabapentin: started Mar 2026 300mg

Trazodone: started Feb 2026 50mg

Propanolol: started Feb 2026 30mg

Adding in additional drugs isn't reccomended. You can't treat WD injury with more drugs, if often just makes things worse. If it were me as you have not been on these long I would get off these quickly before you gain further depedance. I would stop the Gabapentin immediatley as you have not been on it long at all.

If that seems ok after 14 days I would consider tapering the other drugs with a linear 25% per month taper and see if you can get off them quickly. You might not be able to but if you can at least reduce the drug load here that would be good. I personally wouldn't want to get stuck on this much drug, it could take years to taper off.

 

14 hours ago, sweetsally said:

Then, I saw a neuropsychologist who saw this as obvious SSRI protracted withdrawal. I reinstated at 5mg and have been working my way up, seeing slow steady improvements. The activation syndrome has been only slightly better than the withdrawal, including one bout of akathisia and one hospitalization. I'm just one titration away from my original dose, then it's just time.

RI is best done straight away and at a low dose. You seem to be doing ok with it, which is good. I think you might be hoping it will 'fix' all of this and I suspect it won't. The nervous system gets injured when it experiences these kinds of events. Each additonal drug, dose shift and so on adds to the problem. We refer to this as kindling. Often/mostly it isn't a case of adding all the drug back and the issue goes away. I would personally stick with your current doses of Citalopram and Lamotrigine, and hold there and wait to stablize. More drug isn't best and can actually be too much. It might not be obvious immediately but it can take some time for the true effect to be shown.

 

Here is our document on RI for you to read:

 

 Reinstating an Antidepressant

 

Here is some information on the 'kindling'

 

Hypersensitivity and kindling

 

14 hours ago, sweetsally said:

My goal is no longer to get off, just to recover. I'm terrified that my home doesn't feel like it used to and I feel emotionally disconnected from my memories. There's no thread between my past life and now. The emotional context is missing from my life. Head pressure has resolved and the world looks natural again, just not like it should.

 

Any encouragement about this not being permanent or sharing similar experiences would be greatly appreciated.

Whether to come off the drugs is totally up to you. I would encourage you to think about it once you are stable. Long term use of these drugs has some consquesnces and you also built up tolerance, issues can arise from that too. Again this is your choice and we support what ever you choose to do. 🙂 

 

Time is the healer. The main thing to realise is that you must try not to make all this better with more and more drugs and increasing you dose, trying to get back to where you were. This isn't likley possible. The best thing you can do is to try to be on as little extra drugs as you can and hold your other doses where they are and wait for your nervous system to sort itself out. This can take some time and happens in a nonlinear way, in an up and down pattern described as windows and waves.

 

How long does it take to stabilize after reinstating or updosing?

 

The Windows and Waves Pattern of Stabilization

 

In the mean time this is what I would do if I were you:

 

-Stay Hydrated 

 

-Eat a good clean whole food diet, avoiding processed foods and sugars.

 

-Stay away from caffeine, alcohol and antihistamines and any other psychoactive substances.

 

Supplements are to be avoided initially, as they often irritate our nervous systems. Try to get your nutrition through food.

 

Down the line, you may wish to introduce Fish Oil and Magnesium. Those who can tolerate them have found them calming to the nervous system. Be careful try one at a time and start low and see how you get on should you choose to try them.

 

A daily walk is very important as much as you can manage, if you can manage it. Gets you your fresh air and Vitamin D does wonders for your mind!

 

You are very welcome here and I hope you find the site supportive.

 

Chippy

Welcome to the forum.

 

14 hours ago, sweetsally said:

Then, I saw a neuropsychologist who saw this as obvious SSRI protracted withdrawal.

 

It is good that a clinician recognised this. This is often a huge battle for many of us.

 

 

14 hours ago, sweetsally said:

Any encouragement about this not being permanent or sharing similar experiences would be greatly appreciated. 

 

Slowly and carefully working your way up with reinstating is a sensible way to do this. There is a decent chance that if you remain cautious and do it slowly like this, you will stabilise on a suitable dose.