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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Meri-Tuuli on July 17, 2005, at 8:54:52
Hey folks I need some help and advice - right I have been taking celexa (cipramil) for a just over a year now, 20mg. But yesterday I didn't take a dose and neither did I today because I am meant to be starting reboxetine 4mg or is that 8mg? A day. But thing is, I feel completely COMPLETELY nuts, which I realise is withdrawal, I get electtric shocks like when I was on venlafaxine and I am very very disoriented! I feel drunk. I don't trust myself to have the coordination to use the stove to make something for tea!
Will taking the reboxetine lessen the withdrawal of celexa? And celexa = seretonin and reboxetine = noradrenaline (you folks in the us call it noriprine - hey I can't spell that!)
so do I need to taper down the celexa and taper up the reboxetine at the same time? The pharmacist and my doc just said to switch straight from one to the other, but intuitively because they target different neurotransmitters, surely I'll need to taper off the celexa first!?
Posted by Tom Twilight on July 17, 2005, at 9:17:58
In reply to celexa withdrawal + reboxetine taking - HELP!, posted by Meri-Tuuli on July 17, 2005, at 8:54:52
pharmacist and my doc just said to switch straight from one to the other, but intuitively because they target different neurotransmitters, surely I'll need to taper off the celexa first!?
>Hey Meri
There's no reason why Reboxetine should not be taken with Celexa/Citalopram (as far as I know)I remeber seeing a study on Pubmed were Rebox was used to orgment SSRIs and Mirtazapine
If I were you I would ween yourself off the Celexa slowly, while starting yourself on a low dose of Reboxetine and working up.
I would see how things go, you could always raise the Celexa dose again if you felt that you needed to.
Posted by Sarah T. on July 17, 2005, at 9:35:20
In reply to celexa withdrawal + reboxetine taking - HELP!, posted by Meri-Tuuli on July 17, 2005, at 8:54:52
Meri, I agree with Tom. I suggest starting Reboxetine at a MUCH lower dose than the recommended, "therapeutic" dose. Cut the pills as small as you can. Start at one or two milligrams. Many people are scared away by Reboxetine because they start at that high dose of four or eight mg. Those noradrenergic side effects can be intolerable. You may even find that you can do well on a lower dose.
Posted by Meri-Tuuli on July 17, 2005, at 10:02:33
In reply to Re: celexa withdrawal + reboxetine taking - HELP! » Meri-Tuuli, posted by Sarah T. on July 17, 2005, at 9:35:20
Hey guys, thanks for the info. I think I will start on 1mg reboxetine this evening (thats a 1/4 of a pill!) then tomorrow morning, take half a pill of celexa 20 mg and also the reboxetine 1mg.
So thats
am 10mg celexa + 1mg reboxetine
pm 1mg reboxetineAnd do this for a week, and then see how it goes.
At the moment, I am still really spaced out, but I am less freaked out by it.
I still can't believe the pharmacists and GPs advice of switching straight from one to the other.... I bet they've never had withdrawal from a ssri! To be fair, the GP did say I should start at a low dose of reboxetine like 1mg and then taper up. Didn't mention anything about the celexa withdrawal! Although I think I did switch straight from prozac to venlafaxine a while back without too may problems, but they both target serotonin so I guess it wasn't that much of a switch.
Posted by ed_uk on July 17, 2005, at 13:42:29
In reply to Re: celexa withdrawal + reboxetine taking - HELP!, posted by Meri-Tuuli on July 17, 2005, at 10:02:33
>So thats
am 10mg celexa + 1mg reboxetine
pm 1mg reboxetineTake 10mg Celexa later in the day if you feel bad. You don't want to confuse Celexa's withdrawal symptoms with the side effects of reboxetine.
If I were you, I'd go back on 20mg Celexa and attempt to withdraw from it (very gradually) only after I'd adjusted to the start-up side effects of reboxetine.
Don't tell your GP that you're taking citalopram and reboxetine together. He won't be happy because the manufacturer of reboxetine recommends that reboxetine shouldn't be taken with SSRIs. Don't worry, there isn't any good science behind this - it's just the manufacturer covering their back.
~Ed
PS. I'm not sure what your symptoms are. Reboxetine is likely to be more effective for depressive symptoms such as lethargy than it is for anxiety.
Posted by Meri-Tuuli on July 17, 2005, at 14:46:40
In reply to Re: celexa withdrawal + reboxetine taking - HELP! » Meri-Tuuli, posted by ed_uk on July 17, 2005, at 13:42:29
> If I were you, I'd go back on 20mg Celexa and attempt to withdraw from it (very gradually) only after I'd adjusted to the start-up side effects of reboxetine.That sounds like good advice, except that I only have about two weeks (at 20mg) of celexa left...
> Don't tell your GP that you're taking citalopram and reboxetine together. He won't be happy because the manufacturer of reboxetine recommends that reboxetine shouldn't be taken with SSRIs. Don't worry, there isn't any good science behind this - it's just the manufacturer covering their back.
Can't really do this because of not having enough celexa. If I go back to the doctor, he might not like the celexa and reboxetine together, although, he is pretty amenable and seems to listen to what i say.
> PS. I'm not sure what your symptoms are. Reboxetine is likely to be more effective for depressive symptoms such as lethargy than it is for anxiety.
LETHARGY is me personified. I can't do anything, and sleep regualary for like 12 hours. I have no energy/motivation whatsoever. I just about manage to get into my naff admin job for 9.30am. Which is why I'm very keen to try reboxetine. I do suffer from aniexty/panic attacks, but I read that reboxetine is also helpful for this. However, i realise that celexa is very good for this, but at this point in my life, I can't cope with the lethargy and the no motivation. If I get some of my aniexty back, then I'll deal with it, maybe if I keep taking a low dose of celexa?
I have taken my first 1mg of reboxetine a few hours ago, and so far, I seem to be okay. Obviously its early early days yet.
I'll take the 10mg tomorrow morning, just out of habit really with the morning dose of 1mg reboxeine. If the celexa withdrawal gets bad, I guess i'll have to go back to the GP because I don't have enough celexa anymore to keep up the 20mg dose.
I'll let you know how its going! : )
Posted by ed_uk on July 17, 2005, at 15:53:22
In reply to Re: celexa withdrawal + reboxetine taking - HELP!, posted by Meri-Tuuli on July 17, 2005, at 14:46:40
Hi!
>That sounds like good advice, except that I only have about two weeks (at 20mg) of celexa left....
OK...well. I can taper off citalopram 60mg in a week! .....but I'm not very susceptible to SSRI withdrawal symptoms. I've never had a brain zap or anything like that, even when I came off venlafaxine without tapering. The problem is, most people seem to be a lot more sensitive to withdrawal symptoms than I am.......and a slow taper is therefore necessary.
>LETHARGY is me personified. I can't do anything, and sleep regualary for like 12 hours. I have no energy/motivation whatsoever.
Sounds more like a side effect of citalopram than a symptom of your underlying condition!
>I do suffer from aniexty/panic attacks, but I read that reboxetine is also helpful for this.
It might be, although probably not as much as citalopram. Noradrenergic drugs are sometimes effective in preventing panic attacks. Other people find than reboxetine makes their anxiety worse. We'll see :-) I hope it helps.
The thing that worries me about reboxetine is that I've come across quite a few people whose depression got much worse after starting reboxetine, despite the fact that they were able to tolerate or even benefit from other noradrenergic drugs.
I really hope the reboxetine is helpful :-)
~Ed
Posted by Meri-Tuuli on July 17, 2005, at 18:15:25
In reply to Re: celexa withdrawal + reboxetine taking - HELP! » Meri-Tuuli, posted by ed_uk on July 17, 2005, at 15:53:22
Its such a double edged sword - celexa totally relives the aniexty and panic attacks, although gives me no energy/motivation. I'm not too sure it really helps with my depression though. Which is worse? Well I'm completely sick of the no energy thing and I just want to get on with my life. To be honest, I don't think my aniexty/panic is anything severe from what I have been reading from other people's posts, so maybe it will be tolerable on reboxetine.
Well I guess I am hoping that reboxetine will work for me, but we'll see. I'm willing to give it a proper go, i.e. stay on it for at least four weeks.
At the moment, I feel fine - ever so slightly spaced out, but hey I did drink alot yesterday (I was at a festival).
We'll see how it goes. I realise it might be rough (hell, all ADs seem to be rough when you first go on them) but I'll gonna give it a go.
:o)
Posted by Phillipa on July 17, 2005, at 18:27:40
In reply to Re: celexa withdrawal + reboxetine taking - HELP!, posted by Meri-Tuuli on July 17, 2005, at 18:15:25
What's reboxetine? A European med? Fondly, Phillipa
Posted by Meri-Tuuli on July 17, 2005, at 18:39:58
In reply to Re: celexa withdrawal + reboxetine taking - HELP!, posted by Phillipa on July 17, 2005, at 18:27:40
> What's reboxetine? A European med? Fondly, Phillipa
Hello Fondly Phillipa -
I got this of wikipedia:
Reboxetine is an antidepressant drug used in the treatment of clinical depression, panic disorder and ADD/ADHD. Its mesilate (i.e. methanesulfonate) salt is sold under tradenames including Edronax®, Norebox®, Prolift®, Solvex® or Vestra®.
Unlike most antidepressants on the market, Reboxetine is a noradrenaline reuptake inhibitors (NARI); it does not inhibit the reuptake of serotonin, though it can be safely combined with an SSRI. Reboxetine is currently marketed by Pharmacia & Upjohn.
By mid-2001, reboxetine was licensed worldwide in over 50 countries, including Italy, Germany and the UK. In May 2001, however, the FDA declined Pharmacia's license application for the American market. As such it is yet to be available in the US.
Common side effects of reboxetine include: dry mouth, constipation, headache, drowsiness, dizziness, excessive sweating and insomnia.
Reboxetine has a relatively short elimination half life of 12.5 hours and therefore is often given twice daily.
Posted by Phillipa on July 17, 2005, at 20:21:03
In reply to Re: celexa withdrawal + reboxetine taking - HELP!, posted by Meri-Tuuli on July 17, 2005, at 18:39:58
Thanks but I'll forget in a day! Fondly, Phillipa
Posted by ed_uk on July 18, 2005, at 13:55:42
In reply to Re: celexa withdrawal + reboxetine taking - HELP!, posted by Meri-Tuuli on July 17, 2005, at 18:15:25
Hi!
>Its such a double edged sword - celexa totally relives the aniexty and panic attacks, although gives me no energy/motivation.
LOL, that is my personal experience!
>At the moment, I feel fine....
Tell us how it goes :-)
~Ed
This is the end of the thread.
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