This post by J is about his withdrawal. He takes a different approach to the ones outlined in Side Effexor Withdrawal through to Helping H – an engineering approach rather than a therapy one. Next week we will feature a post about some of the TRP (Transient Receptor Potential) Channels he mentions.
I usually work as an Engineer in an Embedded Systems development capacity. I was prescribed 40mg Citalopram towards the end of 2004 after I was made redundant from a role in Cambridge and I felt nervous about meeting my financial obligations and finding new work.
In 1992, whilst at university I had been prescribed Seroxat, which I came off around 1996 with the usual problems of head zaps, dizziness, and unpleasant autonomic disturbances. Unpleasant but not too difficult – except I went through it whilst working at a Satellite Systems development company in Newbury and I was suddenly all over the place and got fired from that role.
After starting Citalopram in 2004 I tried twice to reduce it. The first time I just stopped taking it abruptly on beginning a new job. I was doing fine to begin with but after a month things went haywire and I was reduced to a quivering wreck, I had to give that job up. I drank quite enthusiastically to mitigate the dreadful symptoms. My GP gave me some Diazepam for a week and put me back on the full dose of Citalopram and the symptoms vanished as swiftly as they had appeared.
I found it peculiar that things hadn’t gone completely haywire until almost a month after stopping. So, some years later I tapered down gradually to 30mg Citalopram. I wanted to get off this medicine so I then tried tapering from 30mg, 15mg, 7.5mg, 3.75mg to 0mg over 4 months whilst I was unemployed. Even with this scheme I was hit by severe incapacitating symptoms – a month after stopping the 3.75mg dose. Again, my GP gave me a week’s worth of Diazepam and returned me to the full 30mg dose of Citalopram. It was clear Citalopram would be difficult to come off.
I managed to get work as a PLC Controls Engineer early in 2011. Although I wasn’t feeling on top form, I enjoyed it but the work schedule was intense. I was pleased to be made redundant from that role in April 2012 as I really was feeling very ragged and I thought a more sedate desk bound embedded systems role would suit me better. I got one in April 2012 where I worked on developing a simple marine anemometer. To begin with I was doing fine, however things started to go wrong a few months later. I carried on working but my focus was going and I was starting to feel a bit all over the place. Eventually I was so distracted and had headaches and what I now know to be akathisia, I couldn’t continue to work and in February 2013 I left. My employer was a nice fella he was as puzzled as I was by what happened with me.
I decided it was a combination of tolerance to and withdrawal from Citalopram. It left me feeling quite ragged and I couldn’t work during 2013. I went through the required motions with the Department of Work and Pensions but being forced to look for work when I knew I couldn’t honour a contract due to my iatrogenic health condition made me feel bad.
At the end of February 2014 my GP said I needed to be moved onto the alternative SSRI Sertraline as Citalopram had obviously pooped out causing me tolerance withdrawals. So he made the change to 50mg Sertraline and in April 2014 I was sent into a hellish state which I got through by drinking Brandy when I felt I needed to. That state was bizarre and frightening but it thankfully subsided in May. After doing some research I decided to taper down to 25mg over 4 months which I managed but had brain zaps, very vivid dreams and terrible night sweats.
I flew to Australia in October 2014 and spent time with family who all emigrated there in 2001. I was very burnt out, slept a lot and felt distant and like a zombie. I managed to go fishing but felt odd and dissociative like I was in a dream. I couldn’t do much about it. Some beer perked me up a bit now and then but I wasn’t properly present. So I went back to the UK in November and wondered what to do.
I wanted to feel better and get back to work as an Embedded Systems Developer on some project but I had little confidence in having consistent health so I felt it was foolish to sign a contract. More recently I decided it was no longer safe for me to drive due to my condition.
I spoke to an old work colleague about tapering off Sertraline using a successive dilution method toward the tail end of 2019 and then I found RxISK. I spoke with David Healy about my proposals for SSRI tapering systems to begin with. He was looking for an Engineer so I thought a bit about how I could design cheap QST machines or Biothesiometers for use in peripheral nerve assessment for PSSD. I was interested in coming up with Arduino Adafruit type embedded systems solutions to these requirements. If I could work from home under my own direction that would be great, I didn’t have a lot of equipment and I would need to build prototypes but I knew what to do if I had the right tools and equipment.
A New Approach
I decided I could make myself useful by looking into papers which had unearthed plant derived ion channel agonists. I began with TRPV1, TRPA1, TRPM8 and TRPC6. I went searching for agonists for all those ion channels using Google Scholar. These TRP ion channels are strongly linked to the peripheral neuropathy that crops up in PSSD so finding plant derived TRP agonists might be very helpful to the RxISK mission. I came up with lists of agonist compounds for each of those TRP ion channels. (One of J’s lists will feature in the next post – DH).
I was looking through papers for agonists which might be helpful in restoring SSRI damaged channels functionality as this might lead to possible PSSD and withdrawal cures. The more people who look into this besides me the better as there are a lot of papers and a lot of ion channels that might be restored using agonist compounds.
As the symptoms of protracted withdrawal are extremely unpleasant and make life very difficult for those afflicted, it would be nice to have some reliable supplements that could help take the edge off withdrawal symptoms. So, I went looking for those and I initially decided that anxiolytic supplements like L-Theanine, Passionflower, Lemon Balm, Valerian Root, Chamomile, Feverfew would be helpful based on the TRP research I had read.
I began ordering these supplements from Amazon and taking them each day. They did make life easier. My craving for alcohol vanished and I no longer needed to take Cocodamol to reduce my headaches.
A paper showed Feverfew helped with migraine significantly through it’s inhibitory effects on TRPA1, so I kept on searching for more supplements that might help by mitigating the symptoms of protracted withdrawal.
I was struck by the similarity of symptoms in people experiencing SSRI protracted withdrawals with those that crop up in Autism Spectrum Disorders, so I looked into supplements with solid trial data demonstrating improvements in ASD as they would probably help people in protracted withdrawal states.
I found a paper about a trial of Sulforaphane in Autism. Sulforaphane can be found in broccoli, bok choi and cabbage. Autism has common features of hyperstimulation and subjective discomfort which produces typical ASD aberrant behaviours so I thought it might help manage SSRI protracted withdrawal symptoms.
|Overall Autism||0/11 0%||0/26 0%|
|Social Interaction||0/11 0%||12/26 46%|
|Abnormal Behavior||1/11 9%||14/26 54%|
|Repetitive Behavior||0/11 0%||6/26 23%|
|Verbal Communication||0/11 0%||11/26 42%|
|Nonverbal Communication||1/11 9%||5/26 19%|
|Inattention||0/11 0%||3/26 12%|
|Anxiety||0/11 0%||2/26 8%|
|Sensory Sensitivities||0/11 0%||6/26 23%|
|Restricted Interests||0/11 0%||0/26 0%|
I also found a trial showing Vitamin B6 alleviates akathisia. The paper said 200mg-400mg but it is usually considered risky for someone of my age to take more than 100mg Vitamin B6 but if you are afflicted with akathisia it is probably worth risking taking a higher dose. Always try to look for solid trial data that shows some supplement has demonstrated utility in amelioration of a particular symptom.
I have been taking the following supplements which have at least a theoretical rationale in managing SSRI protracted withdrawals – Omega 3, Probiotics with live strains of bacteria, Choline Bitartrate, Taurine, Magnesium Glycinate, Magnesium L-Threonate, Hops Flower, Green Tea Energy Complex with Matcha Green Tea, Sage Leaf Extract which will help diminish the sweating that occurs with SSRIi induced dysautonomia, Vitamin B Complex, Vitamin B12 and Vitamin D3.
There are other supplements for which there is some evidence like L-Tyrosine, Acetyl L-Carnitine, Selenium, Zinc as well as Vitamins A, C and E but it doesn’t seem a good idea to be on too many things at the same time.
Does this work? It has made a big difference to how relaxed I feel. I typically felt rotten in the morning, took my supplements, and felt better a few hours later. I now take a dose of supplements at night also and feel much better first thing in the morning when I repeat the dose.
I now need to get liquid sertraline from my doctor and put everything to the test by reducing and hopefully finally stopping the final 25 mg. I will report back here.