CookieBlue: Lexapro taper feeling stuck at a microdose

[CookieBlue]

Hi there everyone, Im really hoping to get some perspective on my situation as it feels as though Im a bit of a loss.

 

My story: 

In May 2016 I suffered a mental break due to high situational stress which resurfaced trauma. I experienced panic attacks, depression, paranoia (induced by an acne medication started in the days prior) instrusive thoughts, etc.  Not knowing what was happening I saw an MD that prescribed me Zoloft. After 2 days on it I became desperate and ended up in hospital where I was switched onto Lexapro 15mg and Risperidone 0.5 for my racing thoughts and sleeping pills.

I was released after 2 weeks and soon after I quickly gave up the sleeping pills. I underwent psychotherapy and in February 2017 I gave up the dose of Risperidone and reduced my Lexapro to 10 mg. 

In spring of 2018 I talked to my MD about feeling strong enough to begin my taper as I felt like I'd been functioning well. The side effects of reduced emotions, 30lb weight gain and low libido were nagging me so he said I was approved to go. I did some research and began reducing at what I thought was a slow taper; in retrospect I can see it wasn't. I did my best to cut the pills and did this:

-10mg to 7.5mg for 2 weeks

- 7.5mg to 6mg for 3 weeks

- 6mg to 5mg for 2 weeks

And so forth...

As I tapered I experienced WD symptoms like anxiety, panic, dizziness, crying spells etc. As a result I started seeing a therapist who was supportive of what I was trying to do.

When I got to smaller doses I switched to a liquid form of lexapro and managed to wean myself to 1.2mg and then it was TOO MUCH. I reinstated to 1.3mg and recovered for months as my work life became so complicated and I needed time to help myself.

That last taper was in Sept 2018 and here I am nearly 10 months later. I have been changing my lifestyle and working through again resurfaced traumas with a new therapist, and Im feeling more like that mild to moderate depression is lifting. I have been struggling again with a lack in range of emotions and wondering if this is a me problem or a medication issue. The therapist seems to think that my anxiety and mild/moderate depression are back and new meds is the key solution. With all the progress I've made and how I've grown in over 3 years makes me think otherwise, so I feel stuck.

 

Being on such a low dose how should I go about continuing my taper? Is it possible Im experiencing a poop-out that I've read about? Just looking for advice!

On the day to day my mood is stable not much anxiety except around my cycle. Just again those flattened emotions which is frustrating. 

This website has been a guide post for me in educating myself, thank you so much!

 

 

 

 

 

[Gridley]

Welcome to SA, CookieBlue.  

 

Looking at your taper schedule--

 

10mg to 7.5mg for 2 weeks

- 7.5mg to 6mg for 3 weeks

- 6mg to 5mg for 2 weeks

And so forth..

 

-you went much faster than what we recommend, which is no faster than 10% of current dose every four weeks.  Your first cut was 25% and your holds were very short.  

 

Why taper by 10% of my dosage?

 

As a result, you experienced the withdrawal symptoms you described, which are typical withdrawal symptoms.  Without holding for the recommended four weeks (or longer) and tapering too fast, the withdrawal symptoms built up.  It's not surprising that at 1.2mg it finally became too much, as at the lower doses (congratulations at getting so low!) it's even more important to taper slowly.  

 

What is withdrawal syndrome.

 

Glenmullen’s withdrawal symptom list.

 

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.  

 

These explain it really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

   On 8/30/2011 at 2:28 PM,  Rhiannon said: 

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.

It's very encouraging that your symptoms are improving and that your depression, which is another typical withdrawal symptom, is lessening. Yes, it would be a shame to throw away all the progress you've made.  It's important to be aware that

the vast majority of doctors haven't the foggiest notion of protracted withdrawal (they don't believe it exists) and will almost invariable say it is "the return of the underlying condition," as indeed your therapist has said, and off you go on the drug merry-go-round.

 

Ten months is not that long a hold, given your fast taper. Your system has been catching up and continues to need to do so.   My recommendation is that you hold longer, perhaps three more months, then let's re-assess your situation.  If you have stabilized, which means not the absence of withdrawal symptoms but rather that they are tolerable without big swings, then I would suggest a very slow taper farther downward, perhaps by 0.1mg every 4-5 weeks with a 2-week hold in between.  Let's capitalize on all the progress you've made and make the final SLOW push to zero.

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker  (magnesium glycinate is an excellent form of magnesium)

 

Omega-3 fatty acids (fish oil) 

 

Please research all supplements first and only add in one at a time and at a low dose in case you do experience problems.

 

This is your Introduction topic, where you should ask questions, post updates and connect with other members.  We're glad you found your way here.

 

 

 

 

 

 

 

 

 

 

[ChessieCat]

Hi CookieBlue and welcome from me too,

 

You might find the information in this topic helpful, especially #11:  WDNormal (withdrawal normal)

 

are-we-there-yet-how-long-is-withdrawal-going-to-take

[CookieBlue]

Thank you so much for the replies and advice!

 

Sometimes it feels as though focusing on the lack of my emotional range is what is making me depressed, along with stress my body has faced repairing itself. 

 

I take Omega 3 fish oil capsules which is great. I guess Ill just see how it goes. 

 

When the taper is complete and I am out of meds, what will I have to expext in terms of emotions? I know I build up what I have from memory, but Im also curious to what the initial "feeling" breakthrough is like for most. 

[Altostrata]

Welcome, CB.

 

On 7/19/2019 at 12:29 PM, CookieBlue said:

Im feeling more like that mild to moderate depression is lifting. I have been struggling again with a lack in range of emotions and wondering if this is a me problem or a medication issue.

 

Many people are distressed by the emotional anesthesia induced by antidepressants and that lingers when you're off the drug. This is not a "me" issue, it's the after-effects of the drug. You might say that reducing emotional range is how they "work."

 

Typically, we see very slow recovery from this and whatever withdrawal symptoms you might have. That you're seeing some improvement now is a familiar pattern -- your nervous system is stabilizing and adjusting to your current Lexapro dosage. That's how slow recovery from withdrawal symptoms is.

 

You'll want to go off your current dosage very gradually. For when you're ready to taper again Tips for tapering off Lexapro (escitalopram)

 

Also see

 

The Windows and Waves Pattern of Stabilization

 

Are We There Yet? How Long is Withdrawal Going to Take?

 

"Is it always going to be like this?"

 

Overwhelmed, demotivated, apathetic? Cannot get going on interest or action

 

Apathy, anhedonia, emotional numbness, emotional anesthesia

 

Derealization or Depersonalization

 

The importance of recognizing you're feeling good

[CookieBlue]

Thank you so much for the tips! 

 

Because I'll be starting my taper again from 1.3mg what would the 10% reductions look like as they get smaller? I'll need to hunt for a smaller syringe

[ChessieCat]

See this post: 

 

[CookieBlue]

Hi Everyone,

 

Its been a long time since my last post and I thought I'd add an update as my mood this morning felt called to. 

 

After this initial post I have been holding my Lexapro dose of 1.3mg since October 2018. So its been almost a year and a half. The WD symptoms I had around mood swings are there still but come in waves instead of being at a constant, and apart from the emotional flattening I feel stable. Much more than I did last year which is incredible! I implemented regular exercise, Omega 3s, Vitamin D for the winter months and while life hasn't been smooth- its been manageable. 🙃

 

I had plans to try and pick up my taper again (very slowly as I am extremely sensitive to medication in general I've realized) this summer along with the help of a therapist to use as a touch point on this plan- but yet again I'm feeling stuck. 

 

With the pandemic in full-swing I realize that tensions are high and resources are going to be more difficult to attain IE. counselling. I want to continue with my plan as I am still so frustrated with the emotional anesthesia but I want to serve my body in the best way possible. And the anxiety around this time is conflicted between doing what I want, and the distress of the world's norm. 

 

Any advice from people feeling a similar way? I know this is a time we all need to virtually unite as self-care and mental health problems are more more vulnerable. 

 

Also when I do begin my taper I'm considering going a drop down on the compound. Is this unwise, or a safe alternative to the 10% decrease. 

 

Any info would be appreciated. We will all get through this xx.

[Altostrata]

Good to hear from you, CookieBlue.

 

What do you mean by "a drop down on the compound"? Are you referring to a tick on the syringe when you draw up a liquid?

 

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