Shoehorn: long-time lurker tapering off escitalopram / Cipralex / Lexapro

[Shoehorn]

Hello everyone! I'm sorry to have been a lurker until now. Your advice and support of each other has been a great comfort to me during my own tapering journey.

 

I was diagnosed with severe clinical depression about 2 years ago. It came out of nowhere during my menopausal years, with no personal or family history of depression, and it went undiagnosed for a few months because doctors couldn't figure out why I was so severely physically exhausted (my first and primary symptom). Every test showed I was physically healthy and fine, but obviously I wasn't. A naturopathic doctor even insisted I should take hormones, which made no sense to me since during menopause your body already can't process your natural hormone load. My mental state got worse and worse. I won't go into details, but I'm sure many of you know the kind of thoughts that road leads to.

 

Finally I got a fantastic doctor who took time to listen. He said I was showing all the classic signs of severe depression, and said he didn't know what the root of my problems was but that the depression had to be treated NOW, and fast. I went on escitalopram (Cipralex) that same day.

 

It was a very long and very hard pit to dig myself out of, but eventually I got there. Cipralex is a tough drug to get used to, as I imagine all antidepressants are. But I was lucky and didn't have to try various ADs to find one that worked. I know many, many people are not so lucky.

 

It took about a year to get and stay stable, to the point where my doctor and I agreed I could start tapering off the Cipralex. I was taking 15mg daily. He suggested a 1-month reduction with alternating dosages and said Cipralex was one of the easier SSRIs to taper down. Fortunately I had discovered this site a couple months earlier 😁 and had read a lot about tapering safely. I decided to try the self-made liquid suspension method since liquid escitalopram isn't available here in Canada.

 

The first couple of 10% tapers went well, so well in fact that I got overconfident and thought I could speed it up a bit. Big mistake of course! I crashed hard about 5 - 6 weeks into the larger reduction. I decided to ride it out, knowing from this forum that things WILL get better and that it would take my body a while to recover. It wasn't fun. Once I finally felt stable, I stayed at that dose for an extra month before trying to reduce again. Once I got to 10mg, I stopped and held there too for awhile.

 

I started my taper a year ago at 15mg. I am down to 7mg now. I reached 7mg a few months ago and decided to hold again, because the winters here are difficult for me with the short days and little sunlight. I feel very stable though and will start another reduction in February. I plan to hold again for awhile once I get to 5mg.

 

When I start a reduction, the effects don't kick in until 3 - 4 weeks later. This seems to be my pattern. So I reduce every 6 - 7 weeks instead of the usual 4 weeks.

 

I still have a long way to go. I'm not in any rush, it just seems strange to need such an incredibly long time to come off a drug. I have to keep reminding myself how these drugs work and WHY it takes so long. 😐 Fortunately my doctor support this tapering plan and agrees that some people are just more sensitive to these drugs, if this plan works for me then I should keep doing it.

[ChessieCat]

Hi Shoehorn and welcome to SA, finally,

 

Thank you for telling us your withdrawal/tapering story.  I'm very pleased that you found SA so early in your tapering journey and before you followed the doctor's suggestion of alternating days.  That's a big no no.  Skipping Days vs Every Day Dosing Graph

 

It seems like you are doing really well with your taper and listening to your body/symptoms and acting according to them.

 

Many members find that as their dose gets lower the slower they need to go, by reducing less and/or holding for longer.  This is also very interesting:  Why taper paper: dose-occupancy curves

 

Have you seen the Brass Monkey Slide?  That might be the way to go.

 

Please create a drug signature using the following format.  Keep it simple by following these instructions (NO diagnoses or symptoms please - thank you):

• details for last 2 years - dates, ALL drugs, doses
• summary for older than 2 years - just years and drug/s

Account Settings – Create or Edit a signature

 

This is your own Introduction topic where you can ask questions about your own situation and journal your progress.

[Shoehorn]

Thanks for the warm welcome, ChessieCat!

 

Quote

Many members find that as their dose gets lower the slower they need to go, by reducing less and/or holding for longer.  This is also very interesting:

 

I noticed this. Going from 15mg to 10mg seemed fine, but from 10mg to 7mg was a lot harder overall. I expect going from 7mg to 5mg will take a while.

 

I should add that my main withdrawal symptoms so far are minor dizziness, memory lapses, headaches and occasional down days and anxiety for no obvious reason, it just comes and goes. It isn't fun but it's all manageable and I keep reminding myself, this is OK and it will pass. At the start of tapering when I switched from pills to liquid, I also had nausea. And I would wake up every morning with stiff and sore fingers, which is an odd side effect I couldn't find any other reports of! The nausea and stiff fingers gradually went away after a few months.

 

It's interesting that the higher dose helped my pre-menstrual symptoms too, it was an added benefit! Now that I'm tapering, the pre-menstrual symptoms are returning to their original levels. It's not my main concern though. I expect that will be rocky for another few years as I continue through menopause.

 

I did read the Brassmonkey Slide Tapering Method post some months ago, thanks for the reminder to read it again!

[ChessieCat]

29 minutes ago, Shoehorn said:

Going from 15mg to 10mg seemed fine, but from 10mg to 7mg was a lot harder overall. I expect going from 7mg to 5mg will take a while. 

 

15mg to 10mg = 33% reduction

 

10mg to 7mg   = 30% reduction

 

You have been make too large a reduction.  My suggestion would be to hold at 7mg for at least 3 months, possibly longer, and give you brain a chance to catch up with adapting to not getting as much of the drug.  If you don't hold now, you will most probably run into bad withdrawal symptoms down the track and you may not be able to get stable.

 

Why taper by 10% of my dosage?

 

Dr Joseph Glenmullen's Withdrawal Symptoms

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

If you are finding that your withdrawal symptoms are unbearable or start to worsen I would suggest that you updose by a small amount.  Even 1mg may be enough to take the edge off the symptoms.  Your last reduction should have been to 9mg from 10mg so updosing to 8mg is reasonable.  See Post #1 of this topic:  About reinstating and stabilizing to reduce withdrawal symptoms

 

Please change your drug signature so we can easily see the dates and doses.  I've added in the 10mg.  Please add the date you reduced to 7mg in December.  Thank you.

 

Escitalopram:  10mg Dec 2016

15mg - May 2017

10mg - Jan 2018

  7mg - DATE Dec 2018

[Shoehorn]

Quote

 

15mg to 10mg = 33% reduction

10mg to 7mg   = 30% reduction

 

 

Sorry I should have been more specific. Those were the overall ranges, I did 10% reductions per month within each range. (Except for a month where I did 2 reductions in 1 month because I was overconfident, that's when I had major withdrawal symptoms.)

 

I reduced to 7mg on September 1. I've been stable since then and will reduce to 6.3mg on February 1.

 

I will update my signature with the reduction dates and dosages. I'm glad I kept detailed notes!

[ChessieCat]

Okay, then please put the dates and doses in your drug signature so we can see exactly how you reduced.  Thank you.

 

EDIT:  Sorry just noticed the last line of your post as I replied.

 

 

Edited January 2, 2019 by ChessieCat

[ChessieCat]

I was actually a bit puzzled when I was checking those figures.  Now I know why.

[Shoehorn]

Well it was an eye opener reading all my tapering notes. I forgot about the bout of "withdrawal flu" I had during my third reduction! 😓

[ChessieCat]

I've found it interesting looking back at my first few post here on SA.  I think I was in a much worse state than I realised.  I have often said that with the brain fog it took all my concentration to walk.  And over the 2 weeks I drove to and from work 2 days each week.  I'm very thankful that I stayed safe, especially the second week.

[Shoehorn]

That sounds scary! I'm glad you made it through without having an accident.

 

Reading my tapering notes and my daily log from when I started treatment, yes, it is scary to read how bad things were. It is hard to remember without the notes though. I think my brain intentionally wants me to forget that time period because it was so traumatic.

 

It is so comforting even on bad days to read everyone else's experiences and know I'm not going through this alone and that healing is taking place even if I can't see it. Thank you for sharing.

[Shoehorn]

Update: I've been very stable on 7mg Cipralex (Lexapro) since September. Now that the worst of winter is over, I'm continuing my taper. I reduced to 6.4mg on February 1.

 

Now that I've been through several reduction cycles, my notes show definite patterns in tapering symptoms and when they tend to happen. For example, for the first week of a reduction I get very mild headaches in the evenings and my sleep is restless. That goes away after 6 or 7 days, then I have a good week, then at the start of the 3rd week I go through a noticeable dip where I feel tired, unmotivated, anxious and mentally blah. I come out of the dip after about 4 or 5 days.

 

I'm just starting the dip phase now. It is comforting to go through my notes and see that this is a normal pattern for my taper and it will resolve soon.

[Altostrata]

Well done, Shoehorn. Now you know your symptom pattern, you can better manage your tapering.

 

If the symptom pattern gets worse, you may wish to decrease by 5% rather than around 10%. It's possible you can make smaller decreases more often than every month, but you'll have to track your symptoms to make sure your nervous system is accommodating at the rate of your taper.

 

A lot of people find fish oil and magnesium supplements helpful, see
http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

http://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

Try a little bit of one at a time to see how it affects you.

 

[ChessieCat]

Have you seen this taper method, which is reducing 10% over a 6 week period?  Brass Monkey Slide

[Shoehorn]

@Altostrata Thank you. I have been taking magnesium daily for over a year. It does help with sleep! I use a magnesium spray on my feet and legs at bedtime. Last year I took fish oil for several months but didn't think it helped me.

 

@ChessieCat Thank you, I did read about the Brassmonkey Slide method. I might try it in future, after I get down to 5mg.

[ChessieCat]

2 hours ago, Shoehorn said:

Last year I took fish oil for several months but didn't think it helped me.

 

On 2/13/2019 at 10:20 AM, Altostrata said:

The effect of fish oil, if you feel any, is very mild. But your nervous system uses omega-3 fatty acids to repair itself.

[Shoehorn]

I eat chia seeds most days, which have a lot of omega-3, they are good with yogurt and granola! 🙂

[SkyStreamer]

Hi  @Shoehorn !

 

I noticed you haven't posted on this site since your February drop. I just wanted to check in and see how you're doing? We're both Canadians, and we're both tapering the same AD - so I feel a kind of affinity with you.

 

I've been going through a wave lately. It's been very challenging. But, I'm not a quitter, so I'm going to try and just accept and endure. Eventually, I'll improve, and in the long term, fully recover.

 

Anyways - you're in my thoughts. And I hope you're doing ok. 

[Shoehorn]

Thank you SkyStreamer! It's very kind of you to check in and see how I'm doing.

 

I'm sorry to hear you have been sucked into another wave. It can be frustrating eh? But I promise, with each wave that passes you are recovering more and more. Even if it does not feel like it at the time. Eventually you will learn your patterns and when you are in a wave it's easier to remind yourself that this cycle is normal and it will pass soon.

 

I also have been in a wave lately. Life stress has been heavier than usual and I also had a bout of stomach illness that took a while to recover from. This wave was much deeper than previous ones but I am finally coming out of it. My original schedule called for reducing Cipralex another 10% on April 1 but I decided to hold at my current 6.4mg for another few weeks at least. I will wait until I am completely past this wave.

 

I hope spring is coming soon for you, and with it sunnier days to raise your spririts!

 

 

[Shoehorn]

Quick update. Thankfully the wave I was in last month has passed. I reduced another 10% (to 5.8mg) yesterday. So far, so good. I plan to hold at 5.8mg for at least 6 weeks.

[Carmie]

Hi Shoehorn, 

 

Wishing you all the best with your latest drop. I tapered a couple of days ago too, so far so good, it always tends to hit me around day five or so. I always eventually stabilise again though. Our brains have a marvellous capability to heal. 

 

All the best with your continued tapering too.💚

[Shoehorn]

On 4/21/2019 at 1:25 AM, Carmie said:

Wishing you all the best with your latest drop. I tapered a couple of days ago too, so far so good, it always tends to hit me around day five or so. I always eventually stabilise again though. Our brains have a marvellous capability to heal.

 

Thank you @Carmie. I used to worry about my pattern of side effects because it seemed to start much later than most. Many SA'ers say they start to have side effects from a reduction within 5 or 7 days. I do not get mine until 3 weeks or even later. It is weird. But it seems to be consistent so that is comforting.

 

Reading your signature, you have been through a lot and come out strong. I admire you! I wish you the best for your continued taper.

[Carmie]

1 hour ago, Shoehorn said:

 

Thank you @Carmie. I used to worry about my pattern of side effects because it seemed to start much later than most. Many SA'ers say they start to have side effects from a reduction within 5 or 7 days. I do not get mine until 3 weeks or even later. It is weird. But it seems to be consistent so that is comforting.

 

Reading your signature, you have been through a lot and come out strong. I admire you! I wish you the best for your continued taper.

 

Hi Shoehorn, 

 

Everyone is different when it comes to withdrawals, and the patterns that may happen at one stage may totally change in the future too. Withdrawals are all over the place, there’s nothing linear about them whatsoever, I’ve learnt that in my case. 

 

A lot of people get delayed withdrawals too, like you, and that’s happened to me as well. Some people who haven’t felt the drop early on have decided to taper too soon because they thought they were doing fine. Off course, then they ended up having to hold a lot longer because the waves lasted a lot longer. I’ve done that in the past, thinking I’d be okay. Nope, not a good idea! I’ve learnt so much on this site since then. I’m all for holding as long as it takes now, and then a bit longer. The holds are just as important as the tapering. 

 

Thanks for  your kind words, wishing you all the best with your continued taper too.💚

Edited April 24, 2019 by Carmie
Typo brain fog

[Shoehorn]

Hello everyone! Time for an update.

 

At my last update in April 2019, I had just reduced a further 10% to 5.8mg. That reduction went OK and over the next 3 months I reduced further to 5.4mg and then 5mg. I have been holding at 5mg since August. I decided to do a long hold because I was traveling in September and did not want to reduce during the winter. Winter is always a difficult time for me, I'm in Canada and my area gets only 8 hours of sunlight a day and often none at all because it's raining!

 

The last few months, I've been doing very well on 5mg. About 5 weeks ago I went to the drugstore for my final refill of my current prescription, and they did not have my usual generic available. The replacement generic is not a brand I've tried before. I am taking the exact same dosage, still 5mg pills cut in half along the score mark, the same as I have been doing since the summer. For the past week I have been having the same symptoms I get during a reduction, namely extreme mood changes (up one minute and down the next) and tightness in my finger joints, which I only ever get during a reduction.

 

I am worried this new generic isn't as potent or effective and it's forced my body into another taper even though my dose hasn't changed. I think the worst of it is over though and hopefully things will smooth out soon.

 

Thanks to other threads on SA, I know there can be differences between generic versions and some people may be sensitive to them. Maybe I am one of those unlucky people!

 

Fortunately I continue to do well other than this current bump in the road. I plan to start reducing again in February or March once the days get longer, if I feel good.

 

I wish you all good health and stability for this holiday season!

[Gridley]

12 hours ago, Shoehorn said:

Thanks to other threads on SA, I know there can be differences between generic versions and some people may be sensitive to them.

I'm glad the worst appears to be over.

 

People can react to different brands of generic and also to a cold switch from one brand to another.  In case this happens again, it's a good idea to keep an inventory of your Escitalopram so you can do a crossover from old to new, which will minimize the effects of the change.

 

We recommend this crossover when switching brands of the same drug:

3/4 old, 1/4 new for 3 to 7 days

1/2 old, 1/2 new for 3 to 7 days

1/4 old, 3/4 new for 3 to 7 days

all new thereafter

 

Congratulations on your slow taper and getting down to 5mg.

[Shoehorn]

Hello, I have not updated in a long time I see!

 

I have been holding at 5mg Cipralex (Lexapro) since August 2019. I had planned to start tapering again in February or March 2020, but then covid-19 hit the world and everything was very stressful for me with job and financial uncertainty. I didn't want to cause any more stress by putting my body through tapering and having to think about it, so I held at 5mg for over a year.

 

I was finally ready to start tapering again this summer. In July I reduced from 5mg to 4.6mg. (I do a liquid taper and my syringes have .2ml marks, so even numbers are easier for me.) The plan is to hold until September. My withdrawal symptoms usually take 3-4 weeks to appear so I prefer longer holds.

 

I'm considering switching to the Brassmonkey Slide method after the next cut, as I am getting to lower dosages now.

 

For the past year I've been taking magnesium 200mg and fish oil daily and will continue those supplements.