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Switching from one ssri to another cross taper


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So I'm days away from begging a cross taper from citalopram to Prozac.

 

Citalopram worked for the past 4 years but my doctor wants to switch because I'm on the max dose and it stopped working.

 

So I have 2 questions

1. has anybody felt there ssri stopped working and switched to another ssri and had success.

2. Has anybody done a cross taper with Ssris? My doctor thinks this is the best way to switch to avoid withdrawals from citalopram and ease onto fluxotine. I'm kind of worried about the interactions. Though if I'm lowering the citalopram I wouldn't think serotin syndrome would be a huge issue.

But if anybody has any experience let me know please.

 

 

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1. Citalopram is the only SSRI that works for me, and I've tried them all. I doubt I would find another.

2. A cross taper is fine, and it works, but I found that even if I just switched from one SSRI to another even without tapering the withdrawal was not bad. It was only when I switched from an SSRI to a completely different type of med or just went off my SSRI that I had problems. You should be fine going from SSRI to SSRI.

I'm not a doctor to judge, but I think, in my non-medical way,  your doctor is doing things right.

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2 weeks ago I switched from escitalopram after 5 years to paroxetene and it's been a smooth transition. I have the famous Paxil dry mouth, but apart from that, no problems and I actually changed the bed clothes today.

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44 minutes ago, Kain said:

So I'm days away from begging a cross taper from citalopram to Prozac.

 

Citalopram worked for the past 4 years but my doctor wants to switch because I'm on the max dose and it stopped working.

 

So I have 2 questions

1. has anybody felt there ssri stopped working and switched to another ssri and had success.

2. Has anybody done a cross taper with Ssris? My doctor thinks this is the best way to switch to avoid withdrawals from citalopram and ease onto fluxotine. I'm kind of worried about the interactions. Though if I'm lowering the citalopram I wouldn't think serotin syndrome would be a huge issue.

But if anybody has any experience let me know please.

1.) Citalopram was for me the only SSRI I stayed on longterm (like jt, others did not agree with me)

2. ) My pdoc has used Fluoxetine as a "bridge med" to avoid the worst withdrawal from SNRI or other SSRI's and yes, it made things much more smooth. I believe using Prozac as a cross taper is common because Prozac has a longer half-life that most antidepressants.

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9 minutes ago, Kain said:

Thanks for your replies guys so I'm assuming the rest of you who never found relief with another ssri went to a snri?

still searching for the magic combo here - good luck to you! And yes, often you try the snri's after if no improvement.

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I've typically just "hot swapped" antidepressants at equivalent doses and had no problem (like Celexa 40 mg directly to Prozac 20 mg—rough equivalent). The only time I ever had a problem was when I had to down-titrate off Viibryd and didn't have enough to properly down-titrate and had to rush the down-titration and switched to I think 10 mg Prozac... worst withdrawal ever, probably worse than Effexor withdrawal, honestly! Felt like a car battery was hooked up to my brain.

If I were going to do a cross taper, I imagine it'd go something like this...

Week 1: Celexa 20 mg + Prozac 10 mg
Week 2: Celexa 10 mg + Prozac 20 mg
Week 3: D/C Celexa + Prozac 20 mg

That's just my idea anyway, take it with a grain of salt! I'm not a psychiatrist.

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35 minutes ago, Dphxa said:

That sounds really awful.  I hope that didn't last too long.

Nah, just a few days to a week was all. Why my pdoc switched me from Viibryd 40 mg to Prozac 10 mg I'll never know though... lol. That's the only time she's ever done something like that.

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3 hours ago, mikl_pls said:

I've typically just "hot swapped" antidepressants at equivalent doses and had no problem (like Celexa 40 mg directly to Prozac 20 mg—rough equivalent). The only time I ever had a problem was when I had to down-titrate off Viibryd and didn't have enough to properly down-titrate and had to rush the down-titration and switched to I think 10 mg Prozac... worst withdrawal ever, probably worse than Effexor withdrawal, honestly! Felt like a car battery was hooked up to my brain.

If I were going to do a cross taper, I imagine it'd go something like this...

Week 1: Celexa 20 mg + Prozac 10 mg
Week 2: Celexa 10 mg + Prozac 20 mg
Week 3: D/C Celexa + Prozac 20 mg

That's just my idea anyway, take it with a grain of salt! I'm not a psychiatrist.

So wait the Prozac made you feel like your brain was wired to car battery or withdrawing from viibryd?

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I've switched from Luvox to Lexapro without any problems. No withdrawal from the fluvoxamine at all and escitalopram kicked in after 3 weeks.
Don't think that swapping between SSRI's is a common issue, but there's not a guarantee that the new SSRI will have the same effect or will help you like the old one did.
So if the new one doesn't work, don't hesitate to tell your doctor and try another SSRI or even SNRI. 

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21 minutes ago, Catwoman said:

I've switched from Luvox to Lexapro without any problems. No withdrawal from the fluvoxamine at all and escitalopram kicked in after 3 weeks.
Don't think that swapping between SSRI's is a common issue, but there's not a guarantee that the new SSRI will have the same effect or will help you like the old one did.
So if the new one doesn't work, don't hesitate to tell your doctor and try another SSRI or even SNRI. 

 

Indeed. Each SSRI has their own unique pharmacology in addition to serotonin reuptake inhibition.

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Alright thanks for all your advice guys. I'm willing to give it a try I'm kind of nervous but tomorrow is the day. 

My doctor thinks I get caught on what she calls "the hamster wheel" were I keep asking and wondering the same things so she thinks I'm a little OCD and since citalopram doesn't work on my anxiety anymore she thinks Prozac will help anxiety and OCD so fingers crossed.

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