Annadee: escitalopram withdrawal

[annadee]

My name is Anna, and I'm 35 years old. I was first prescribed an ssri in 2000, when I was 17 years old, for panic attacks and agoraphobia. At the time, I was given paroxetine. I can't remember my exact dosages over the years, but I remember I was on 40 mg for a long time, before going down to 20 mg. In 2008, I was switched to Lexapro because the side effects of paroxetine were very annoying for me (weight gain, flattened emotions, inhibited libido). They definitely outweighed any benefits I experienced from taking the drug... I was still having panic attacks, still agoraphobic, and now also experiencing periods of depression. Lexapro gave me less side effects, but the benefits were the same (pretty much non-existent). The reason I stayed on them for so long regardless? Fear, because psychiatrists had always told me I needed these drugs. That I had a chemical imbalance. And even as I became more and more convinced that the pills weren't helping, I was terrified of what would happen when I went off them, for fear of what they'd done to my brain in the meantime.

 

But I didn't want to stay on them forever, and therapy and positive experiences in my life had finally brought me to a point where I had enough confidence to try to live without them. I'd been on a 20 mg dose for years, first of brand name Lexapro, then generic escitalopram. Early 2017, I went down to 10 mg. After gathering more courage, I went down to 5 mg late July 2018, and after consulting a psychiatrist I quit taking it entirely on October 1st, 2018. 

 

The situation with the psychiatrist is a bit complicated. I'm currently seeing a psychologist for cognitive behavioral therapy focusing on my phobias. The psychiatrist is the person ultimately in charge of my case, but she'd never seen me before we met that single time to discuss my medication (when I'd previously tapered Lexapro I'd done so under supervision of my GP, because I wasn't seeing a specialist at the time). She was against me going off ssri, but told me she'd "give me a chance". When I told her I'd never really experienced much benefit from the pills and that I'd only started feeling better as I'd tapered them, she didn't really seem to listen. She told me I could just go from 5 mg to nothing if I was so set on quitting, so I did.

 

That was two and a half months ago, and it's been... bad. I immediately fell into a depression. I started experiencing the world differently... everything feels "off". I don't feel like myself a lot of the time. I feel like I'm regressing, years and years of repressed feelings and emotions seem to keep coming up. Not so much traumatic memories as just... so many images from my childhood and teens. Sometimes I suddenly feel as though I'm seeing the world through the eyes of my teenage self again. There have been brief moments where I've felt like myself again, but every time I start to feel better, I fall back down again. Sometimes I feel like I'm losing my mind. I'm terrified I'll lose my will to live, though thank God it hasn't happened yet. But I don't know how much longer I can go on like this, I don't know how to cope. I'm trying to stay active, but I get overstimulated so easily... but being alone with my thoughts can send me down a spiral. I've tried staying with my parents for a while, but it made me feel helpless and drained my confidence. Being at home feels better, but I live alone and I don't have a big social network, so it gets lonely very quickly. It's like nothing I do seems to help. The psychiatrist had warned me against a relapse, but she never said a word about withdrawal... when she said relapse, I imagined maybe having more panic attacks for a while. I never imagined the hell I'm currently going through.

 

I don't want to go back on ssri, but I'm terrified for what lies ahead. The things I usually do to cope, like practicing yoga and mindfulness, barely seem to do anything anymore. I'm losing confidence in myself and in my healing process. I know there are no quick fixes, but if anyone has any tips on how to stay afloat during this time, they'd be very welcome. Thank you for reading my story.

[Gridley]

Hello, Annadee, and welcome to SA.  The vast majority of psychiatrists know little or nothing about tapering or withdrawal.  Jumping to zero from 5mg was bad advice and is the cause of the 

withdrawal symptoms you are now experiencing.   

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.  Please include your taper rate and dates and the date you jumped to zero.

 

Account Settings – Create or Edit a signature.

 

To help you understand the symptoms you are experiencing, here is some information on withdrawal.   Your brain will heal but the time necessary to return to homeostasis is, unfortunately, impossible to predict.  

 

What is withdrawal syndrome.

 

Glenmullen’s withdrawal symptom list.

 

 The Windows and Waves Pattern of Stabilization

 

When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

Youtube video, 4 minutes: Healing from antidepressants

 

Reinstatement of a very small dose of the original drug is the only known way to help alleviate withdrawal syndrome.  The only other alternative is to try and wait out the symptoms and manage as best you can until your central nervous system returns to homeostasis.  Unfortunately no one can give you an exact timeline as to when you will start feeling better and while some do recover relatively easily, for others it can take many months or longer.  

 

Reinstatement isn't a guarantee of diminished symptoms for everyone but it's the best tactic available.  You're still in the time period where reinstatement predictably works, up to 3 months after last dose.  It is best to reinstate as soon as possible after withdrawal symptoms occur. We usually suggest a much smaller reinstatement dose than your last dose.  These drugs are strong, and when reinstating it is better to start with a small amount and increase if symptoms remain unbearable. Your system has become sensitized and If you take too much it may be too much for your brain and can cause you become unstable.  Sometimes it can be hard to regain stability after this happens.  Then, once you've stabilized on that dosage, you can begin a 10% per month taper down to zero.   Please read:

 

About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic

 

I would recommend a reinstatement of 0.5mg (1/2mg).  It takes about 4 days for a dose change to get to get to full state in the blood and a bit longer for it to register in the brain.  If symptoms remain unendurable after around 7-10 days of reinstatement, it may be advisable to increase by another 0.5mg.  But let's try the first 0.5mg first.  It may well be enough to reduce your symptoms to a tolerable level.

 

The information in the following link will tell you how to make nonstandard doses of Escitalopram, either by making a liquid or by cutting and weighing tablets.

 

Tips for tapering off Lexapro (escitalopram)  

 

Then, once you have stabilized, which can take several months, you can begin a slow 10% every four weeks taper.  

Why taper by 10% of my dosage?

 

This is your Introduction topic where you can ask questions and post updates.  Please keep us apprised how you're doing.

 

 

 

 

 

[annadee]

Hello Gridley, 

 

Thank you so much for your advice, I feel like I've been handed a lifeline. If only I'd known this before I... I blame myself for not doing more research before I started tapering, though I can't deny I'm also furious with the psychiatrist for putting me through this hell. I'm going to see about getting liquid Lexapro as soon as possible so I can start reinstatement. 

 

I've added my dates to my signature, I couldn't figure out where to do that, so thank you for the direct link.

 

You've given me new hope that this will be okay... I'm going to educate myself as much as possible on withdrawal symptoms and reinstatement, and I'll keep this thread updated with my experiences.

[annadee]

Update: I've started reinstatement today, I cut up a 5mg tablet into pieces that I estimate approximate 0.5 mg and I've taken my first dose. I know it will take about a week before I'll start seeing results, but I feel slightly better already just knowing I have a course of action now. 

[Gridley]

Annadee,

 

Sounds good.  Are you going to get the Lexapro liquid?  It's important that your doses be accurate.

 

If you are going to continue cutting the tablets, I suggest you order a Gemini-20 scale from Amazon.com.  It's not expensive.  That's what I use to weigh my Lexapro doses.  Is Amazon.com available in the Netherlands?  

 

Gridley

[annadee]

Hi Gridley, 

 

I consulted my GP today and she thought cutting the pills would be easier than correctly measuring such a low dose of liquid Lexapro. I'm not sure if she was right, but I had to make a decision on the spot so I went with the pills, especially since she'd have to order the liquid version and I didn't want to wait even a day to start my reinstatement, since I'm pretty desperate. 

 

Thank you for the tip, I ordered the Gemini-20 scale but unfortunately since I'm not in the US it will be a few days before it gets here. I searched for an alternative that would be faster to obtain, but unfortunately couldn't find anything that could measure with the same level of precision. 

[Gridley]

Good work, Annadee.  The Gemini-20 is a good scale, and I'm glad it's available in the Netherlands.  And thanks for updating your signature.

[annadee]

Update for today: took my second reinstatement dose, still waiting for my precision scale to arrive. Being able to be more precise with it will set my mind at ease, but for now this will have to do. Yesterday I made the decision to stay with my parents for the foreseeable future, and I'm truly grateful for their love and support. I've also started taking supplements, namely vitamin D3, vitamin B12 and magnesium. I'm hoping they will help support my nervous system while it heals. 

 

I know it's unlikely that I'm feeling the effects of reinstatement yet, but  while today was still hard, it was definitely better than the previous few days. I'm slowly starting to feel a little more myself again, as well as being able to feel emotions other than abject terror. I'm glad I found this site when I was at my most desperate, and thank you so much Gridley for your advice.

[Gridley]

It's completely possible for you to feel some benefits from the reinstatement already.  Some people feel the benefits very soon after reinstatement.

[annadee]

12 minutes ago, Gridley said:

It's completely possible for you to feel some benefits from the reinstatement already.  Some people feel the benefits very soon after reinstatement.

 

If that's the case, it's a relief to know it's working

[annadee]

2.30 a.m. update: I've been intermittently queasy throughout the day, but so far it wasn't that bad... it's getting worse now, though, and it's making me scared. It's just a minor thing, but I keep thinking, what if it's the Lexapro? What if I have a bad reaction to it? I don't want to have to stop reinstatement, it's my hope for an end to this withdrawal hell... 

 

Of course queasiness could have a million other causes, including tension and the fact that I made myself eat more than usual today because I'm trying to put on weight, since I've been losing it quite drastically lately. Still, I'm scared because I need this reinstatement to work... I don't want to think that I've become so sensitized to Lexapro that my nervous system balks at 0.5 mg of it. But my mental state is still relatively okay compared to yesterday and the day before, so I have hope.

 

If it is the Lexapro causing it and keeps getting worse, does that mean I'd have to stop reinstatement, or is it something that will fade if I push through? 

[Gridley]

 

14 hours ago, annadee said:

What if I have a bad reaction to it? I don't want to have to stop reinstatement, it's my hope for an end to this withdrawal hell... 

 

I would just hold on and see what happens and not think about worst-case-scenarios.  It's important not to panic and worry about every symptom  Stress is not good for you during withdrawal.  It's better to assume that the reinstatement is going to work.  It's a good sign that your mental state is relatively okay.

 

Distraction is also important. Whatever you can do that helps take your mind off the situation.   A gentle walk in nature , reading, pleasant videos, music.  You could check these links:

 

Non-drug techniques to cope

 

Audio:  First Aid for Panic (4 minutes)
 

CBT Course:  An Introductory Self-Help Course in Cognitive Behaviour Therapy
 

Audio:  How to Recover from Anxiety - Dr Claire Weekes
 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help ...

 

Edited December 20, 2018 by Gridley

[annadee]

Thank you, Gridley. You're right, it's important not to freak out too much. I'm definitely going to check out those links. 

 

I'm still queasy, but my mental state is better. I'm experiencing a lot less moments of derealization and I'm starting to feel somewhat myself again, just still terrified to slide back into that dark mental state. 

 

My scale arrived today, so I'm able to measure precise doses now. My tablets are 5mg, so I'm taking 1/10th. It's just a tiny crumb, slightly smaller than what I've taken for the past two days when I was eyeballing it.

[Gridley]

Great that your scale arrived.  Things sound to me like they're going well.  It's a very good sign that your mental state is better with less derealization.

[jozeff]

Hi Anna!

 

Welcome! Too bad you were in such shape you  posted here but fortunately you did because there's good advice here.

 

I live in Nijmegen area so we are both Dutch. My doctor prescribed me citalopram two years ago which is similar but less potent than your medication I believe. Well, it's tough to get off of this stuff. I've been struggling for months to taper and to stabilize again. 

 

Started a citalopram taper in April 2018 and decreased 0.1 mg every day after being on it for 2 years.
After 85 days of tapering I crashed so I stayed on 16.5 mg for a couple of weeks. I felt so bad that I updosed to 18 mg to feel better. That didn't really help because my body had to get used to that dose also. I'm on 18 mg citalopram now since August 14th 2018.  Some good days, some bad ones. Symptoms are always different.

But enough about my story...

 

You went from 20 to 10 in about a year which sounds reasonable. Later on you speeded things too fast. I don't know much about reinstatement but since you came off of your meds in October 2018 I think you have a good chance to stabilize on a small dose (from what I've read...I have no experience myself).

 

Does your scale work for you? Good decision because crumbling your pills is very inaccurate.

 

What Gridley said is, unfortunately, true. I never ever heard a doctor or psychologist talk about withdrawal. They will tell you that your original symptoms return and that you should updose or switch medication. 

 

Try to get stable on a small dose and don't play around with dosage! I know you want to do something when you feel anxious or depressed but going up and down in meds will probably make things worse. It's tempting to take higher dose or try some other stuff.

 

I did just that and I wish I never did!

 

Your brain doesn't like these fluctuations in pharmaceuticals. I've learned the hard way but there are people here who are in a lot worse shape. 

 

Read and learn and try to be calm about your situation. Time is what it takes!

 

If you want to pm me or chat a bit that's ok. We are here to help and understand.

 

Cheers

 

Jozeff

 

 

[annadee]

Hi Jozeff, thank you for sharing your story, it's nice to meet another Dutch person here. I'm a bit shocked to hear that you crashed even though you were tapering carefully. To be honest, I never had any idea that ssri needed to be tapered so slowly and carefully... I went from 20mg to 15mg and then down to 10 mg within a relatively short period of time (I can't remember exactly how long I was on 15mg). Those were the steps my GP recommended at the time, and I have to say, I never had any severe effects lowering my dose of escitalopram (paroxetine,  however, was an entirely different story back in the day). Going from 10mg to 5mg was pretty much painless for me, which is why I never really thought twice about going from 5mg to nothing. It just didn't occur to me that there might be such severe withdrawal effects... clearly, I was wrong, as was the psychiatrist who told me I could safely make this jump in dosage. 

 

My plan now is to get stable on 0.5 mg and stay there until I feel stable enough to try tapering down from there. I would prefer not to updose from here unless it proves absolutely necessary. Right now I'm picturing myself staying on 0.5 mg for at least a few months, until I'm absolutely sure I'm stable, and then attempt to taper gradually. I do wonder how I'm going to manage tapering in such small increments, though... cutting a 0,5 mg piece out of a 5 mg tablet is already quite fiddly. Would I have to grind the pill to powder and then weigh it out? The scale is working well for me, though I have to admit I'm still a little insecure about whether I'm doing everything correctly. 

 

This experience has made me even more disillusioned about psychiatrists and psychologists... they seem know so little about these medications, and yet they act so sure of themselves. I believed the "chemical imbalance" theory for a long time, because they keep presenting it as fact and I didn't know enough to question them. Now I know the only chemical imbalance in my brain is because of these pills.

 

I don't know how long the road ahead of me will be, but I'll be patient. I'm very glad I found these forums, because now I know what's going on with my brain, and I know I'm not alone.

 

[ChessieCat]

23 hours ago, annadee said:

I've been intermittently queasy throughout the day, but so far it wasn't that bad... it's getting worse now, though, and it's making me scared. It's just a minor thing, but I keep thinking, what if it's the Lexapro?

 

On 12/20/2018 at 9:49 AM, annadee said:

I've also started taking supplements, namely vitamin D3, vitamin B12 and magnesium.

 

The trouble with starting new things at the same time as reinstating is that you won't know what is causing any issues.

 

If you have only just started taking the D3 and B12, I think it would be better to stop these now, and wait for about 2 weeks after you start to know how the reinstatement is affecting you.  If you continue to take them and still feel queasy we won't know whether it is the AD causing it and whether you need to increase your dose a bit more.  When you do take them again, only take 1 and see how you go and if you are okay then you can start the other one.   Keep it Simple, Slow and Stable

[annadee]

Thank you, ChessieCat. I thought about that as well last night, so I didn't take any B12 or magnesium. I've been taking D3 a bit longer, so I knew it wasn't that. 

 

I'm no longer feeling queasy, but I'll wait a while to introduce anything else and just keep taking the escitalopram and D3 for now. 

[annadee]

Update: Things are going okay. I took my fifth reinstatement dose today, and my mood has been pretty stable today and yesterday. Which isn't to say that things are suddenly great... I still don't feel like my usual self, my thoughts are often depressing, I still have moments of derealization and flashes of memory. But they're less intense than they have been, and I haven't had any crisis moments where I felt like I just couldn't go on or that I'd go insane. I just kind of feel like I'm living in a fog, or that parts of me are "on hold" while my brain recovers from all the stress it's been under. 

 

I'm trying to take things one moment at a time, taking care to do what I can to heal, and finding distractions to take my mind off of things. Even if it takes a long time... I'll get better. I'm holding on to that. 

[Gridley]

It sounds like the reinstatement is going very well.  The purpose of reinstatement isn't to totally eliminate symptoms but rather to make them tolerable.  Then, once you've stabilized (which can take a several months) you can begin a slow safe 10% (or less) taper off the 0.5mg.  

[annadee]

Thank you, Gridley. Forgive me if this is a dumb question, but does "stabilized" mean feeling completely back to my pre-withdrawal self? 

 

I don't mind taking the reinstatement dose for months or even a year if it means never having to go through this again. My ultimate goal is still to be rid of Lexapro entirely, but I'm really in no rush anymore. 

[Gridley]

"Stabilized" definitely does not mean back to your pre-withdrawal self.  "Stabilized" means your day-to-day symptoms are both tolerable and more-or-less consistent, without wild swings in mood or symptoms.  

 

Your patience is a very useful attribute  that will help you a great deal.  

[jozeff]

Hi Anna,

 

Thanks for your reply!

 

Well, dutch people have great insurance and a lot of access to any medication they want unfortunately. Once I had 6 years of venlafaxine in a row without seeing my doctor once! Just year after year I got this prescription 6 months each..

 

I didnt literally crash my medication but I tapered a bit too fast. It must be noted that I had been fluctuating A LOT in 2017 with my citalopram. From 15 mg to 25 and back a few times. You did not do that so you probably will not be that destabilized. 

It's not that I didnt want to live anymore or anything. Just that I developed a lot of anxiety and felt off a lot of days. Then these symptoms started like depersonalisation, nausea, anxiety about nothing etc.. There is a lot of placebo effect involved with me. I get worried very quickly and my family takes a lot of effort to calm me. I have been on same dose since august 14th 2018. Im not stable by any means and I don't know if I ever will be on this dose. Sometimes I think I am but then next day I'm super sad and don't feel well at all.

 

Thing is that I've learned how it feels to feel this bad. Previously I didn't know much about anxiety but now that I do I get Anxious very quickly. Just scared to get a panic attack. Before I didn't know what a panic attack was so I wasn't affraid of it eather... Kind of self fullfilling prophecy.

 

You didn't actually CT from a high dose but you jumped of from 5 mg Escitalopram which is very strong stuff.  Personally I think that a small dose will do you a lot of good. No guarantees of course but from what I've read here the last few months I think it is not too late for you to take some action.

 

Sounds like you are doing ok! That's great news! (just read your latest post now and see that you are doing very good...)

 

When you stay on this dose for a while and then very slowly taper I think you will be fine.  No taper yet for you but once you get there  I should try very small steps. Lets say you take 0.5 mg. Your first tapering step should be something like taking 0.48 or 0.49 instead of 0.5.... These small steps sound ridiculous. I once told my psychologist about this and he laughed about these very tiny dose changes. I am on 18 mg citalopram right now and my first tapering dose will be 17.8 mg for a week or so. Doctors dont believe in these tiny steps. Once you get back to them they prescribe something different.

 

I tapered venlafaxine once a bit too fast and went to the doctor, I felt down again and anxious. He typed in my story and knotted a few times and gave me  a prescription for citalopram right away. The rest is history. My doctor didn't ask me about sleep, diet, relations etc. Just gave me the prescription.

 

Anna, the trick is not to fight your symptoms too much. I did this all summer and I kept focusing so much I started to loose my mind. Take it a day at a time. Or an hour at a time if that't too long. 

I wish you all the best!

 

If you have question about tiny dose changes and how to prepare them just pm or post it here. I'm a chemist so preparing a solution or doing some calculations shouldn't be too much a problem.

 

 

cheers

 

Jozeff

 

 

 

[JackieDecides]

On 12/17/2018 at 8:45 AM, annadee said:

When I told her I'd never really experienced much benefit from the pills and that I'd only started feeling better as I'd tapered them, she didn't really seem to listen.

 

that sums up doctors nicely 😡

 

 

On 12/20/2018 at 12:25 PM, annadee said:

This experience has made me even more disillusioned about psychiatrists and psychologists... they seem know so little about these medications, and yet they act so sure of themselves. I believed the "chemical imbalance" theory for a long time, because they keep presenting it as fact and I didn't know enough to question them. Now I know the only chemical imbalance in my brain is because of these pills.

 

very well said.

 

I'm glad things are going better and you found this place - so much good information, just what a doctor should know about and doesn't. 

 

I took myself off of 5 mg every other day last May and felt pretty bad, so I can only imagine how bad you felt. 

 

sounds like the reinstatement was exactly what you needed and you are now in the right place to be prepared for going off again in a taper that makes sense and with all the new coping skills you can learn.

 

big hugs to you! 

[annadee]

On 12/23/2018 at 12:59 AM, Gridley said:

"Stabilized" definitely does not mean back to your pre-withdrawal self.  "Stabilized" means your day-to-day symptoms are both tolerable and more-or-less consistent, without wild swings in mood or symptoms.  

 

Thank you for the clarification, Gridley. Today and yesterday have been hard for me, a lot of anxiety, depressive feelings and desperation... I'm wondering whether I should updose to 1 mg, though I'm not eager to do so. Do you think I should give it a little bit longer?

 

On 12/23/2018 at 10:52 AM, jozeff said:

Once I had 6 years of venlafaxine in a row without seeing my doctor once! Just year after year I got this prescription 6 months each..

 

Jozeff, that's exactly how it was with me... I just kept getting my prescription refilled without any medical professional ever checking up on me. And whenever I asked them about it, I was just told to stay on them for my own good.

 

I understand the fear of panic attacks completely. I was prescribed ssri because of a panic disorder, so I already knew what they were like... I know that self-fulfilling prophecy very well. Though I have to say that what I've experienced during this withdrawal has been so much worse than "normal" panic attacks that the thought of having one of my regular old panic attacks again would seem like a relief. 

 

I was doing better, but the last two days have been worse again... I may have to increase my reinstatement dose, but I'm not sure yet. 

 

Doctors seem to know so little... but at least my GP was very cooperative when I went to her last week asking her to prescribe me Lexapro for reinstatement. She accepted that I knew what I was doing, and even helped me think about how best to get such a small dose. But previously I've definitely had doctors say "Oh, you want to get off this? Well, why don't you try this other ssri instead then." They act like these pills are the holy grail and you'd be crazy not to want to take them.

 

You're right. One day at a time, one hour at a time. It's hard not to regret the past or worry about the future, but when I do, it only makes me feel worse.

 

Thank you, I'd very much like to know how to make small doses... would it be easier if I asked my GP for liquid Lexapro? She told me one drop is 1mg so it might be hard to go smaller, but maybe if I dilute it? Or is it better to stick with pills? 

 

Thank you for your support and advice, I really appreciate it.

 

On 12/23/2018 at 4:12 PM, JackieDecides said:

I'm glad things are going better and you found this place - so much good information, just what a doctor should know about and doesn't. 

 

Thank you, Jackie. I'm extremely glad I found this place, too... it's upsetting just how little knowledge doctors actually have about the medications they so easily prescribe. It's hard not to feel bitter, but I'm trying to focus on healing instead of blame and regret. It's not always easy, though.

 

Thank you for the kind words of support, I really appreciate it. 

[Gridley]

31 minutes ago, annadee said:

I'm wondering whether I should updose to 1 mg, though I'm not eager to do so. Do you think I should give it a little bit longer?

 

It's only been six days.  I would give it longer at your current 0.5mg.

[Gridley]

33 minutes ago, annadee said:

would it be easier if I asked my GP for liquid Lexapro? She told me one drop is 1mg so it might be hard to go smaller, but maybe if I dilute it? Or is it better to stick with pills? 

 

Switching to liquid constitutes a big change and you only want to change one thing at a time--which for you right now is the reinstatement. If you changed to liquid now and then had problems, you wouldn't know what was causing them, the switch to liquid or the reinstatement.   

 

Is the scale working for you to measure the 0.5?

 

 Using a digital scale to measure doses

 

[annadee]

Thank you for the advice, Gridley. I'll stay at this dose a bit longer and see how things develop. 

 

I'm managing with the scale, though it's pretty fiddly work. I can't guarantee all my doses are all the exact same, but they all weigh 6-7 mg (a tenth of one pill, since I'm cutting up 5 mg pills).

[jozeff]

Hi Anna,

 

Is it possible for you to crush the pills first and create a powder. You can crush multiple pills and weigh your dose from that stock.

 

Be aware that 0.5 mg active ingredient is not the same as 0.5 mg pill. Your 5 mg tablets weighs more  then 5 mg. It contains 5 mg active ingredient.The pill contains other substances that form the actual tablet. I guess you figured that out already but telling you just to be sure.

 

You can always create a solution which is very accurate and easy to use. Way easier than fiddling with crumbs of a tablet. Some people seem to very affraid to make their own solution but it is really very easy.

 

You have plenty of pills to work with in the Netherlands because of insurance so you don't need to store things in the fridge. I create my own solution every day in about 1 minute. Of course this is not possible for people who have to pay for these pills themselves. They are better of storing solution as long as possible.

 

I hope you will stabilize very soon and feel a lot better.

 

Happy healing!

 

Jozeff

[composter]

Hey Anna, glad you've find this site and the resources on here! Totally empathize with feeling mislead and unheard by medical providers. Although in my case I'm fortunate to have found several that DO listen and learn from my experience.

 

This may be a controversial opinion (don't want to get under fire from the mods) but I think the mods on here tend to be very conservative when it comes to reinstatement. They fear the hypersensitive/paradoxical reaction to low doses of the med. Reinstatement can be very helpful (it was in my case) and you may derive more benefit from a higher reinstated dose. During my acute withdrawal, I saw almost no benefit from a 5 mg reinstatement (which I did for about a week) but saw immediate benefit from a 10 mg reinstatement (each day was consistently better than the next).

 

Of course this is all a decision you will make with enough information. And, a higher dose means longer time to taper. BUT it could mean a faster time to stabilize. Just want to put in my two cents.

[Gridley]

54 minutes ago, composter said:

he mods on here tend to be very conservative when it comes to reinstatement.

 

Because of the hypersensitivity of the CNS in withdrawal, we recommend reinstatement at the lowest dose that mitigates withdrawal symptoms.  You can always go up.  But if you RI too high, it may be too much for your brain and can cause you become unstable.  Sometimes it can be hard to regain stability after this happens.  

[jozeff]

Hi, I think it would be wise not to reinstate too high a dose. You come from zero now and can always go up further. If your ri dose is too high you will be jojoing and that might be less pleasant for your brain.

 

Composter may be right of course but everyone is different. My mother quit Zoloft cold turkey 20 years ago and she never looked back. Not one complain about WD ever!

If we only understood the brain a bit better...

 

Cheers

 

Jozeff

[annadee]

Thank you all for your advice. I've taken it into consideration and, after consulting with my GP today (who has, fortunately, been very helpful and understanding), I've decided to updose my reinstatement to 1 mg. It has been 9 days since I started on 0.5 mg, and while I'm noticing some improvement, it's very slow and I'm still having some extremely difficult moments. Ideally I'd like to take as little as possible, but if 1 mg helps me feel more stable, it's worth it. 

 

Jozeff, my mother has cold turkeyed an ssri (I believe it was paroxetine) without problems before as well... some people are lucky! Thank you for the tip about making a solution, I might give it a try when I start tapering down in the future, though I need to get an oral syringe first. 

 

Composter, I'm glad you've found helpful medical providers! I'm fortunate that the doctor I'm seeing now is being very supportive as well. I'm hesitant to go too high with my reinstatement dose because of the amount of time that has passed since I quit, but after what happened to me I'm very careful with these pills now... they're clearly more powerful than either I or my medical providers knew.

[Gridley]

Please keep us updated on how you do with the 1mg.

[annadee]

1 minute ago, Gridley said:

Please keep us updated on how you do with the 1mg.

 

I will, I'll keep updating this thread with my experiences. 

[ChessieCat]

And remember to keep daily symptom notes which helps you to be objective about them and can help you to notice small improvements which you might not feel.