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Ask Dr. Kaushik Your Own Question
Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4506
Experience:  MD Psychiatry
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I am trying to get off of celexa and switching to cymbalta.

Customer Question

I am trying to get off of celexa and switching to cymbalta. After 20 years on celexa. I have lower back pain. Not crippling most days, but always there. I have gone from 40 mg. celexa to 20 in 2 months and now have anxiety. I wonder when I should start cymbalta or just go back up with the celexa. My doctor doesn't understand side effects.
JA: How long have you been dealing with this? Is there anything in particular that seems to make the symptoms better or worse?
Customer: No psych problems really, just general anxiety. Now since lowering the celexa to 20 from 40, I have had a few very mild panic attacks.
JA: Anything else in your medical history you think the psychologist should know?
Customer: Not really. Pretty stable. overcame Daughter on heroin 15 years ago, but fine now....basically happy family. No real worries, just general worry.
JA: OK. Got it. I'm sending you to a secure page on JustAnswer so you can place the $5 fully-refundable deposit now. While you're filling out that form, I'll tell the Psychologist about your situation and then connect you two.
Submitted: 5 months ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 5 months ago.

Greetings.

Welcome to the site.

I am a psychiatrist and i believe i can help you with your celexa withdrawal and control over anxiety which seems to me like a celexa withdrawal symptom.

Kindly please tell me what time of the day you take celexa 20 mg -- morning or night ?

Regards

Customer: replied 5 months ago.
night
Customer: replied 5 months ago.
I was taking 40 mg for about 20 years.
Expert:  Dr. Kaushik replied 5 months ago.

Well, you see there is a method called as Cross-titration where a new drug can be introduced at low dose and slowly raised in its dose over time while on the other hand the older drug is still continued but its dose is continuously lowered over time.

So, this method can be used in your case where in you can continue to come off celexa slowly on one side, while we can introduce cymbalta on the other side and slowly increase its dose. So you do not have to wait any more for celexa to come off completely and then start cymbalta.

So i suggest that you shift celexa to morning dose and start taking it at 10 mg in the morning and while introduce cymbalta 20 mg at night.

Kindly see the below mentioned cross-titration process.

-- Start with 10 mg celexa in the morning and 20 mg cymbalta in the night and continue this for 1 week.

-- Then take half of 10 mg in the morning and 30 mg cymbalta in the night x 1 week

-- Then take half of 10 mg celexa every alternate day in the morning and 40 mg cymbalta daily at night x 10 days.

-- Then take half of 10 mg celexa once in every 3 days in the morning and 60 mg cymbalta at night daily x 15 days.

-- sTOP celexa and continue on 60 mg cymbalta and stay put on this dose.

So i reckon that with this systematic process of cross-tritation between two drugs you will not only be able to come off celexa easily but also your anxiety will evaporate into thin air during this process and you will be able to get started on cymbalta faster.

I hope this helps.

Wish you all the best and kindly discuss this with your doctor.

Please kindly leave a POSITIVE RATING if you are satisfied with the answer.

Regards

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