Does Citalopram need to be tapered? (5+ symptoms)
By
Ivan Kahwa
Author bio
Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.
Mr Ivan Kahwa’s Highlights:
Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.
Professional Experience:
Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.
With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.
With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.
Education:
2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.
2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.
2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.
Publications:
▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7
▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60
▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.
https://ethnobotanyjournal.org/index.php/era/article/view/4683
▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.
https://doi.org/10.53388/TMRIM202307004
▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.
https://doi.org/10.1186/s43094-021-00296-2
▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.
https://doi.org/10.5799/jmid.951600
Published book Chapter
▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.
https://doi.org/10.1016/B978-0-323-91942-5.00012-4
Submitted manuscripts Under Review:
▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience
▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine
▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology
Submitted book chapters under review
1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.
2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press
You can view my works on the following professional sites:
Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa
Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en
ORCID: https://orcid.org/0000-0002-6440-3437
Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159
In this article, we will discuss whether Citalopram needs to be tapered before discontinuation. We will also discuss the best way to taper off Citalopram.
Does Citalopram need to be tapered?
Yes, Citalopram needs to be tapered off and should not be stopped abruptly. Stopping Citalopram abruptly can lead to potential side effects.
Citalopram is an antidepressant, used to treat mental health conditions such as depression and anxiety (1). This medication is prescribed at both low and high doses depending on the individual’s age and condition.
The continuous use of antidepressants can make your brain dependent on them and stopping them abruptly will result in withdrawal symptoms.
Always consult your healthcare provider before discontinuing Citalopram. They will guide you on how to gradually reduce the dose over some time to safely discontinue the medication.
What is Citalopram withdrawal syndrome?
Citalopram’s abrupt withdrawal can lead to disturbing symptoms associated with Citalopram withdrawal syndrome. This happens if you have been taking Citalopram for a long period and then suddenly stop using it one day.
Citalopram works by increasing the amount of active serotonin in your brain. Serotonin is an excitatory neurotransmitter that elevates mood, energy and motivation. When you start taking Citalopram, your serotonin levels start to go high and your body takes time to adjust to this change.
Some people may struggle with adjusting to Citalopram, as this antidepressant may cause side effects during the early course of the treatment. However, these side effects may subside within a few weeks when people finally adjust to it.
If you stop taking Citalopram abruptly, your body tries to adjust to its regular level of excitatory chemicals. Your brain starts to desire these chemicals more because the usual levels no longer feel adequate. This can lead to “discontinuation syndrome” resulting in symptoms such as (2):
- Nausea
- Vomiting
- Agitation
- Hallucination
- Excessive sweating
- Nervousness
- Tremors
- Fatigue
- Weakness
- Tinnitus
- Muscle twitching
- Dizziness
- Vertigo
These symptoms can vary from person to person and depend on factors like:
- Age of patient
- Dosage strength of medication
- Duration of treatment
- How abruptly did you stop the medication
What does research suggest?
There are several research studies explaining the effect of abrupt discontinuation of antidepressants on the mental health of individuals.
One study indicated that when changing antidepressants, stopping one too quickly can lead to withdrawal symptoms and worsen mental health. Gradually reducing the dose lowers these risks and introducing a new antidepressant too soon can lead to dangerous interactions, including serotonin syndrome (3).
The study also indicated that stopping antidepressants needs close monitoring and caution (3).
How to taper off Citalopram?
The best way to taper off Citalopram is to talk to your healthcare provider as every individual has unique chemistry in terms of symptoms for which they started taking Citalopram in the first place.
If you have recovered or want to switch to another antidepressant, it is advisable to gradually reduce the dose over 4-5 weeks. Your healthcare provider will first reduce the dose.
This reduced dose is then taken for at least a week to make your body settle on this dose. If your doctor suspects your body requires more time to adjust, you may stick to this dose for more than a week.
Once you are adjusted to this dose, that’s when your dose is further reduced for another week or so. This process helps your body adjust to a change.
Once your body starts going back to normal with the least possible dose of antidepressant, that’s when your doctor fully stops the medication. Some individuals may experience some symptoms after the last dose but these symptoms disappear on their own.
Remember a balanced diet and a good lifestyle can help you a lot to recover from antidepressant withdrawal.
Conclusion
In conclusion, Citalopram should be tapered when discontinuing the medication to minimize the risk of withdrawal symptoms and potential side effects. It’s crucial to follow your healthcare provider’s guidance and not stop Citalopram abruptly.
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