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Re: SSRI Withdrawal-Does tapering help? » Daveman

Posted by Cam W. on October 14, 2001, at 0:48:27

In reply to SSRI Withdrawal-Does tapering help?, posted by Daveman on October 13, 2001, at 23:27:07

Dave - While I have heard of a few people who have seemingly gone through SSRI withdrawl while stopping Celexa™ (citalopram), the numbers have been nowhere near that seen with Paxil™ (paroxetine) or Zoloft™ (sertraline). Effexor™ (venlafaxine) regular (not XR) is by far the worst offender. Still, it best to taper down any SSRI fairly slowly. SSRI withdrawl affects those who have a polymorphism for the cytochrome P450-2D6 (many repeating copies of the gene in their DNA) metabolizing enzyme. This polymorphism seems to affect about 5% of those of European descent.

Tapering of the dose of an SSRI allows the body to adjust to lower levels, and allow the body to adjust to slightly lower levels of this neurotransmitter. More serotonin is being forced to be produced than at pretreatment time (ie. when you were depressed). SSRI therapy does force the body to produce more serotonin because the mechanism conservation of serotonin, via the reuptake pump, is blocked. It is hoped that by forcing the body to produce more serotonin, the body will naturally keep producing serotonin at a higher once the SSRI is withdrawn (ie. stopped). The body does need to adjust to the slightly lower level of serotonin in the gap (ie. the synaptic cleft - the space between neurons) because the reuptake pump is again drawing back into the presynaptic nerve ending from which it is released. The slower the block is taken off the reuptake pump, the more time the body has to adjust.

In your case, I believe dropping the dose of Celexa by 10mg per week is more than slow enough. Do confirm this with your doctor (or show him this post. In any case, your doc will probably only want you to decrease your dose to 30mg (possibly 20mg), so you could, in reality, drop directly to 30mg (or even directly to 20mg) without any problem. Usually, any drug that is taken once daily, and has a half-life of longer than 24 hours can be tapered fairly quickly.

I hope that this post will assuage (cool word, huh?) any fears that you may have. - Cam




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