jimbo55: Starting Lexapro taper

[jimbo55]

Hi all.  Here's my story and question.

 

I've suffered from GAD my whole life.  The worst episode was when I was 12 (I'm 47 now).  I was put on Imipramine for about a year, then got off of it no problem.  I went back on Imipramine for about 6 months before I went to college.  Since about a 1 1/2 years ago, I was not on anything and would manage my anxiety through therapy.  

 

About 1 1/2 years ago my anxiety was really bad and therapy was just not enough.  So...I decided to try Lexapro (Escitalopram).  I found a good psychiatrist who was supportive of my request to only use a low dose (5 mgs).  I was really anxious to go on any medicine and really wanted to keep the dosage low.

 

Starting Lexapro was rough.  I gave up once, but then tried again.  The second time slower and at a smaller starting dose.  That helped (as did .25mg of Xanax as needed), and about 6 weeks after starting, I noticed a positive difference on my GAD and the side effects were almost nonexistent.  1 1/2 years later, my GAD is still pretty well managed with Lexapro.  I also take .25mg of Xanax or Klonopin on average about once a week.

 

While my GAD is under control, apathy has set in.  I also don't like the idea of being on Lexapro for life.  So, I decided to taper.  About 3 months ago, I went down to 3/4 of my 5mg tablet.  On the 4th or 5th day at that dose, I woke up in the middle of the night with a huge panic attack (while I have GAD, I don't normally get a full blown panic attack) as well as "dry heaves".  That scared me, so the next day I took a full pill and decided to try again later.

 

This time, I decided to use a lemon zester and shave a little off each pill.  While not as accurate as liquid, the amount of the shaving looks pretty consistent.  The amount shaved off is much less than 25%, and looks close to the recommended 10%.  This is day 4 and I think I'm having mild withdrawal symptoms.  I feel a little "spacey", my anxiety is slightly higher, and I feel a little nauseous.  It could also be the placebo effect!  The symptoms are manageable (I haven't even taken an Xanax)....for now.

 

So, now my question...Should I stay at this dose until I feel 100% normal?  Should I go back up to 5mgs and ask for the liquid?  How long do the withdrawal symptoms last at each drop in dosage?

 

Thanks!!!!

[ChessieCat]

Hi jimbo and welcome to SA.

 

I'm really pleased that you have found SA.  There is a wealth of information and lots of support here.

 

Accuracy is very important when tapering these drugs.  It is possible to get more accurate doses, see Tips for tapering off Lexapro (escitalopram)

 

It takes about 4 days for the drug to get to a steady state in the blood and a bit longer for it to register in the brain.

 

Would you please provide some additional details in your drug signature.  Dates for when you reduced and increased your doses.  We will then be able to see this information at a glance.  Please also inclde the Xanax.

 

Here are some links which you might find interesting and/or helpful:

 

Why taper by 10% of my dosage?

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

Windows and Waves Pattern of Stabilization

 

Stabilising After a Reduction - What Does That Mean?

 

How Psychiatric Drugs Remodel Your Brain

 

The really helped me to understand SA's recommendations:

 

How do you talk to a doctor about tapering and withdrawal?

What should I expect from my doctor about withdrawal symptoms?

 

 

 

 

 

[jimbo55]

Thanks for your response.  I updated my signature.  I guess my main question, is how severe and for how long should I tolerate withdrawal symptoms before considering going back up?  How long do symptoms usually last after a drop in dose?

 

I decided to buy a nail file and shave even less off and I took that yesterday.  I feel a lot better.  But, I don't know if I should have stuck it out since my symptoms were mild.

 

Also, how much does a 5mg Lexapro pill weigh?  Seems like that's a dumb question, but the pill also has filler in it.  How much?  I ask because if it is really only 5mg, I'd have to get a really expensive scale if I wanted to weigh it.  .001g would not be sensitive enough as that's 1mg (20% of my starting dose).  I'd have to buy a .0001g scale.

 

Thanks.

[mammaP]

Hi Jimbo, welcome from me too. As Chessie said accuracy is very important in withdrawal. The nail file method has been used by many but is problematic as the dose lowers. It is far better if you can get the liquid. YOu can then dilute it as necessary as the dose lowers. It is important to make reductions that are consistent so that there are no big jumps and liquid is perfect for that. If you can't get liquid from your doctor it is possible to make your own liquid. 

 

http://survivingantidepressants.org/index.php?/topic/2693-how-to-make-a-liquid-from-tablets-or-capsules/