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Suggest Treatment For Withdrawal Symptoms Of Celexa

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Posted on Tue, 28 Jun 2016
Question: I am having trouble distinguishing whether my current low level of drive and social interaction is normal or depression, or maybe even related to klonopin use.

I recently discontinued taking celexa after 15 years as it may have been attributing to some kind of cyclothymia. It has been over two months since stopping and I certainly feel much less "frantic" than I did and more still overall, but I have lost interest in exercising and socializing. I watch a lot of TV and I'm more likely to avoid responsibilities and chores.

I was preparing to enroll in grad school for medicine: taking many prerequisite classes in the past two years and having a lot of enthusiasm for the training and the new career. I seem to have lost my interest and drive for this..the change in heart came quickly thoroughly after stopping Celexa. I am continuing the classes and application process out of momentum but now I can't seem to grasp why I wanted to pursue this career change at all! I am kind of enjoying sitting still instead of racing around, even though I don't enjoy my current career and I don't seem to look forward to much of anything.

I'm trying to discern if this lack of drive/desire/motivation is a symptom of returning depression OR if the strong drive I had before stopping the SSRI was a manic kind of compulsiveness. I am still taking 150 mgs of Lamictal, which helps to keep the active sadness at bay; and .25-.5 mgs of klonopin, which helps with anxiety, concentration, and sleep. I am also wondering if taking klonopin for 4 years is creating the detachment/lack of motivation. I know a lot of people who have taken it and stopped caring about anything and just getting fat :(
doctor
Answered by Dr. Chintan Solanki (26 minutes later)
Brief Answer:
more likely due to stopping celexa

Detailed Answer:
Hello,

Thanks for writing to us. I can understand your concern.

You have mentioned your details very well.

Your problem is likely due to stopping celexa. In that case two possibilities are there. It can be due to discontinuation effects or mild depression. For confirmation mental status examination as well as XXXXXXX rating scale assessment should be done by a psychiatrist in person. According to me restarting celexa or other SSRI in low dose may treat your problem.
In my opinion klonopin is not responsible for your problem rather it is helping you to at least carry out your routine.

Hope I have answered your query, I will be happy to help further.

Regards,

Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki (17 hours later)
thank you doctor:

I think I am past the wash-out period for Celexa. I recognize a lot of the feelings from before being on an antidepressant.

I'd like to steer away from Celexa as low doses of it tend to make me irritable and labile, while higher doses make me feel rather impulsive.

I've tried Wellbutrin as an adjunct med twice. Once with Serzone and I had problems focusing and getting very angry. The other with Celexa (for focus and sexual side effects) and after several days I felt weird and detatched, and then I became irritable.

Given that I had different experiences, do you think it would be worth trying Wellbutrin again but as monotherapy?
doctor
Answered by Dr. Chintan Solanki (8 hours later)
Brief Answer:
yes wellbutrin is good option

Detailed Answer:
Hi,

Thanks for follow up and clarification about celexa.

Considering your history and side effects of celexa, it is a very good option to start wellbutrin as a monotherapy for your depression. Continue lamicatal and klonopin as there is history of cyclothymia.

There is also scope of increasing dose of lamictal up to 200 mg.

Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki (13 hours later)
I am a little worried about anxiety and over stimulation (Ritalin can cause this in me)

If I get these side effects should take extra klonopin or use Latuda, which I am going to try if this fails.
doctor
Answered by Dr. Chintan Solanki (10 hours later)
Brief Answer:
klonopin can be used

Detailed Answer:
Hi,

Wellbutrin is not as much potent stimulant as ritalin. Still if you feel anxiety, extra use of klonopin for sometime is good option.

If still any query there, I will be happy to answer if not, you can close the discussion and if feasible give your feedback and rating so I can improve my service.

In future if you wish you can contact me directly on this site with following link:
http://bit.ly/drchintansolanki

by clicking on 'Ask me a question' on same page with three follow up questions.

Take care.
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Chintan Solanki (34 hours later)
please stick around for the Wellbutrin start up! My current doctor is very unreliable and cancels most of her appts.

I took Wellbutrin Sr 100 mg on the first day and 150mg XL the second day. On both days there was a lift in mood, but also a feeling of overchattiness and hyperactive, a little nervous. Not enough to stop.

I like the smoothness of the XL vs. the shorter action of the SR. It was harder to get to sleep however.

After only two days I feel like my old self again...making plans, interest in hobbies, and talking with friends. I am a little worried that I am hypomanic and/or just reacting to the start up agitation in my brain. I know that in the past the feeling was somewhat dysphoric. Would manic symptoms kick in so quick?

Anyway I know I'm only at half of the therapeutic dose. If the edginess doesn't go away, does it make sense to increase the dose? Sometimes the effect is different at higher doses, but I tend to be very med sensitive and prone to anxiety.
doctor
Answered by Dr. Chintan Solanki (11 hours later)
Brief Answer:
wait on 150 mg XL

Detailed Answer:
Hi,

Thanks for follow up.

Many patients feel initial high after antidepressant. You are right that in such cases we must suspect mania or hypomania. But in your case after 2 days you came back to normal mood, so no possibility of full hypomanic episode.

For depression XL preparation is better. You are going somewhat well on 150 mg dose. I recommend keep continuing this dose for 3 weeks. In any case if there is need of increasing dose for depressed mood, I suggest increasing lamotrigine (lamictal) dose up to 200 mg first. It also helps in depression later on if needed wellbutrin can be increased up to 300 with keeping possibility of hypomania in mind.

Wish you good health.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki (11 hours later)
Thanks. I just woke up and today will be day four on Wellbutrin. I was up until 2 am researching and buying camera equipment for an upcoming scuba trip. It seems extreme but then for a month I had very little interest in anything.

Day three I continued to have an elevated mood but my brain felt very busy and I felt a fair amount of physical anxiety, especially in my chest. Klonopin and proponalol helped a little. The first 7 hours were bad and then I felt more settled.

I am a little hesitant to take again today...I don't want to feel so hyper. should I expect this to be a regular side effect of the drug for people with anxiety, or will it pass?

It worked quickly to quell constant ruminations of suicide and persecution, which I liked, and returned motivation. I miss the feeling of stillness
doctor
Answered by Dr. Chintan Solanki (15 hours later)
Brief Answer:
it will pass

Detailed Answer:
Hi,

Initially after starting wellbutrin many other patients feel such discomfort. Usually this will pass maximum in a week.

It is good that it worked on suicidal thoughts.

You should take klonopin sos(as and when needed) for a while. I guess wellbutin will show its optimum effects in 2 weeks.

Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki (3 days later)
Ok today is day 7 and I've been feeling good mood wise, less fragile, more motivated, and the physical anxiety/speediness went away. Today however I am feeling dysphoric and extremely irritable. Angry at inanimate objects. this is what stopped my two previous trials of wellbutrin

In addition I have the sad, hopeless feeling back. Not sure if that is from adjusting to the dose or feeling hopeless because another med failed two days before I go on vacation.

I will give another day but if the anger increases I will need to stop. I can stop easily at 150mg XL? If it leaves me feeling freaked out (which will be bad for scuba diving vacation) can or should I take low dose of latuda?

between the feelings or irritability and hopelessness after a week of antidepressants, I am worried I am having a mixed episode, hence the thoughts about latuda.
doctor
Answered by Dr. Chintan Solanki (11 hours later)
Brief Answer:
two options are there, either latuda or increase wellbutrin

Detailed Answer:
Hi,

Sorry for delayed response.

In last 7 days there is some progress with wellbutrin. Feeling dysphoric and irritable can be part of depression. You are already on lamictal. In this case two possibilities are there.

One is you told that it can be mixed episode and considering that we can stop wellbutrin and start latuda.

Other possibility is these are depressive features and dose of wellbutrin is not sufficient. In that case we can increase the dose of wellbutrin.

If I were your treating doctor I would like to increase the dose of wellbutrin 300 mg if these symptoms persist for 2 days more.

Take care.
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Chintan Solanki

Psychiatrist

Practicing since :2007

Answered : 2406 Questions

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Suggest Treatment For Withdrawal Symptoms Of Celexa

Brief Answer: more likely due to stopping celexa Detailed Answer: Hello, Thanks for writing to us. I can understand your concern. You have mentioned your details very well. Your problem is likely due to stopping celexa. In that case two possibilities are there. It can be due to discontinuation effects or mild depression. For confirmation mental status examination as well as XXXXXXX rating scale assessment should be done by a psychiatrist in person. According to me restarting celexa or other SSRI in low dose may treat your problem. In my opinion klonopin is not responsible for your problem rather it is helping you to at least carry out your routine. Hope I have answered your query, I will be happy to help further. Regards, Dr.Chintan Solanki.