OhioSteph: Withdrawal with cardiac involvement

[OhioSteph]

I began this journey with a postpartum depression diagnosis in May 2013 after my 3rd baby.  Prior to that, I was healthy without any issues.  In the beginning, I started with Lexapro 10mg qd.  After about 9 months, it was not really doing the trick anymore, so my doc increased the dose to 20mg (!!).  I had an impaired gag reflex with this increased dose, and I slept all the time.  At this point, about 1.5yrs in, I tried to quit cold turkey.  That did not work.  I had all kinds of symptoms (crying all the time, irritability, brain zaps).   Because side effects were horrible I went back on antidepressants and tried to switch to a SRNI, which did not last long.  I recognize the difference of adding the norepinephrine immediately.  It made me extremely irritable.  So, after about 6 months of that, I went back on the Lexapro 10mg qd and Wellbutrin 150mg qd (to help with the s/e of the Lexapro).  I stayed on the for about 1.5 years before beginning my final taper.  

 

My final taper (the one I am on now) began April 2017. I never took the Wellbutrin every day (skipped 1day/week due to building irritability and 2-3x/week during PMS).  Because I could not cut the pill, I spaced the days, one day at a time every other month.  I quit Wellbutrin completely the 1st week of August.  I alternated decreasing the doses medications every month (1 month decreased lexapro, next decreasing Wellbutrin).   I cut the lexapro, decreasing the dose by 25% every other month (10mg one day, 7.5mg the next, then 7.5qd, then 7.5mg & 5mg alternating etc.). Once I got to 5mg, I began spacing the days with changes made every few weeks until I quit completely the first week of September.

 

Gradually over the next 3 weeks, I had increasing feelings of anxiety, panic, and racing and pounding heartbeat.  I also had an intermittent resting HR in the 90’s (like, sitting on a couch after no physical activity my HR according to my watch was high 80’s-low 90’s for 30min at a time).  This continued to become more noticeable until one night, standing in the kitchen after the kids were in bed, I had an overwhelming feeling of anxiety accompanied by the feeling my back was both burning up and freezing at the same time.  I went to check my HR on my watch, and proceeded to pass out.  Thankfully, my husband was able to catch me.  Once to the couch after about 15min, I looked at the HR log on my phone.  At the time I passed out, my HR went to 148 for 4 minutes.  I restarted Lexapro after this incidence at 2.5mg every other day.  I had the same feeling again 4 days later, again late in the evening, but this time sitting on the couch.  My heart rate was in the 120’s. I began breathing deeply, listening to my heart with my stethoscope.  I took 3 deep breaths (all w/o exhale) and held it for a second before exhaling.  Immediately before the exhale, my heart rate converted back to a rate in the 60’s (what it had been before going into the 120’s).  This lasted just a few minutes.

 

I went to the doctor, had labs drawn and an EKG done (all ok), then a halter monitor ordered.  That came back with depressed ST segment with t wave inversion, so I was referred for a stress test.  That was normal.  My physician (not believing I am withdrawing) said if it happened again, she would start me on a beta blocker.  So, here I am about a month into taking Lexapro 2.5mg qod again.  I am still committed to coming off the meds, but have decided to slow the wean. 

 

I realize there is no real data to indicate how long it takes your brain to start regulating neurotransmitters normally again, BUT, does anyone have any ideas about how long it takes?!  I am tired of yelling at my kids and feeling flat all of the time.  I do not experience joy.  I make it through each day, irritable and taking my anger out on my poor kids (aged 8yr, 6yr, 4.5yr) and husband.  I have made dietary changes (more vegetables, no processed food) and think about working out.  My motivation is extremely low, so working out has not made its way into our schedule yet.  I have read extensively, and know what I need to do, but doing any of it takes enormous effort.  Most days I feel I will never get better and have ruined my serotonin production forever.

 

Any thoughts?

[AliG]

Hi Steph.  I'm so sorry for what you have been through and I can empathize as I was also started on antidepressants after my 3rd baby. Obviously, the doctors don't seem to take into account, the sudden drop in hormone levels that occurs after delivery not to mention the sleep deprivation and stress involved with caring for a newborn baby.

 

Tapering by alternating doses is not advised. It causes the amount of the medication in your bloodstream to go up and down, battering your nervous system, and makes withdrawal worse.
Your brain likes stability, to be treated gently. The object is to gradually accommodate it to lower and lower dosages. Don't throw it off a cliff every day. Move it slowly down a ramp by gradually decreasing dosage by an amount it may hardly notice.

 

SA recommends tapering by 10% of your current dose with a hold of at least 4 weeks before your next decrease. The 10% taper method is a harm reduction approach to going off psychiatric drugs.

Why taper by 10% of my dosage?

 

To start with , can I ask you to fill out your drug history signature? This appears below each of your posts and enables us to see your situation and history easily.

Please put your withdrawal history in your signature

 

The symptoms you are experiencing, including the heart palpitations etc. are most likely withdrawal symptoms.

http://survivingantidepressants.org/topic/1868-irregular-heartbeats-palpitations-tachycardia-bradycardia/

 

You reinstated Lexapro 2.5mg? Did you start at that amount?  Has it helped to lessen symptoms at all?

 

I'm going to post some relevant links. Read through them as they will also help to answer more of your concerns and also help to explain the withdrawal process. When we have more of your history we can answer more of your questions. This is your thread to journal progress and ask questions.

 

About reinstating and stabilizing to reduce withdrawal symptoms

Brain Remodelling

 

Welcome to SA ,

Ali

Edited November 16, 2017 by AliG

[OhioSteph]

I reinstated Lexapro 2.5mg qod (mainly because I could not get the pills cut any smaller than 1/4), but my original dose was 10mg.  I began the taper in April and reduced the dose every other month to compensate for the larger wean.  The cardiac issues did resolve with reinstating the dose.  After my episode of what I assume to SVT (supraventricular tachycardia), I started looking at the HR log on my phone.  Before tapering in April, I consistently had bradycardia into the high 30’s and low 40’s, usually at night. My lowest HR’s are now in the high 40’s and low 50’s, so that has improved.  I wish there was more medical information about the cardiac effects of withdrawing from SSRI’s so I could convince my doctor of the issue.

 

I began saffron tea (1/4ish tsp qd) in July of this year, and that did help to decrease the w/d symptoms.  I drink this almost every day.  Occasionally I do forget.

 

I also just restarted Deplin 15mg qd (prescribed folic acid supplement) and turmeric 1000mg qd (for inflammation) about 2 weeks ago.

 

I am getting ready to order a full spectrum light (I live in Ohio, and it is dark and dreary here through the winter which always exacerbates my symptoms) to help with these seasonal lows.

 

My other symptoms I currently attribute to w/d are muscle tension, deep unrelenting itching in my hands and scalp, total lack of motivation, and of course disordered mood.  I get massage 3x/month to help work through some of the muscle tension.  

 

I am going to my primary MD today, and am planning to ask for her help in finding a compounding pharmacy to help me get those lower doses for more consistent administration.  I plan to decrease my dose by 1mg every 4-6 weeks.    I am also planning to start a vitamin D supplement (which I do try to take in the winter months).  I also would like her to draw a few more labs (B12, Vitamin D) to see where I am with those levels.  I have been switching to diet less in animal products and do need to supplement with B12 more consistently.  

 

Thank you for your reply, and the links.  Being new to the site, I do find navigating for information to be a bit confusing.  I realize this will improve as I use the site more.

[OhioSteph]

Today I am decreasing the Lexapro from 2mg/d to 1.8mg/d.

 

I have been feeling much more stable since changing from qod dosing to qd.  After going to the MD the day of my last entry, I switched from 2.5mg qod to 2mg qd.  I also added Vitamin D 2000U qd and Turmeric 1000mg qd.

 

Starting December 10th, I began using a CES device (I have the Fisher Wallace) for 20min/day.

[OhioSteph]

Today I am decreasing my dose of Lexapro to 1.6mg.

 

I have begun meditating and taking a course with Shefali Tsabary for the year.