@grandmar Thank you so much for your support. I had a similar incident where my psychiatric nurse suddenly left the practice when I was in mid-crisis. The only thing the practice could tell me was to find a new clinic (which I had to have a referral to). It was so disheartening. Congratulations on lowering your dosage!!!! I recently reviewed my medical records to get a clear idea of all my medication changes. When I first switched to Efferox I was told to continue to take Celexa at 10mgs and the Efferox at 37.5. I do not recall having as many side effects that time as I have had now. I think this is because I had not been on Celexa very long and both were low dosages. I am definitely not going cold turkey and switch back to Celexa this time around (like my PCP suggests). I am going to follow up with my doctor about a tampering method.