Meerkat: Adverse reactions to Cymbalta and Lexapro. Now what?

[Meerkat]

Thank you in advance for reading this. Here is my situation: I have a long history of antidepressant use since I was put on zoloft at 14 to treat anorexia. I am now 41. In June 2019 I tapered myself off Cymbalta 30 mg with the help of prozac with minimal symptoms. This past year has been a year of personal growth. I've been meditating, exercising, eating well. I've had emotional challenges, but I've felt really good about myself and have been thoroughly enjoying life. I have 6 year old twin girls and an amazing husband.

 

Fast forward to March 2020. A string of stressful events including a back injury, Covid, etc led to severe anxiety, unlike anything I've ever experienced. Symptoms included whole body shaking, chest pain, shortness of breath. My doctor recommended I restart Cymbalta at 20 mg. I agreed in desperation. After 3 doses of Cymbalta, I had an adverse reaction including electric shocks down my spine, increased anxiety and other symptoms. My doctor told me to stop but recommended I start Lexapro 5 mg for 4 days, then increase to 10 mg. I seemed to tolerate the low dose of Lexapro but it didn't touch my anxiety. When I started the 10 mg dose, I felt terrible. Increased anxiety, internal tremors, flu-like symptoms. I stuck with it for 7 days before I decreased to 5 mg. I was then on 5 mg for 7 days, then 2.5 mg for 4 days on the advice of my psychiatrist. I took Lexapro for a total of 24 days. I am so angry at myself for taking it as long as I did. I am currently taking alprazolam 0.5 mg at night to help with sleep. 

 

I am day 2 off the Lexapro. I feel like death and am afraid I will never feel like myself again. I meet with my psychiatrist tomorrow who is going to recommend I restart Cymbalta at 5 mg, based on our last conversation. I feel like my CNS is hypersensitized and am fearful of restarting any medication after the events of the last 6 weeks. I also know I cannot continue going on feeling the way I currently do.

 

Can I expect improvement in physical symptoms in the next 10 days? I have to return to work as an RN and I have to be functional. Should I ride out the withdrawal symptoms or reinstate a low dose of Cymbalta?

 

Edited November 19, 2020 by ChessieCat
removed member name heading from post

[Gridley]

Welcome to SA, Meerkat.

 

You had an adverse reaction to Cymbalta in March of this year, and there is every reason to expect you will experience the same if you start it again.  An adverse reaction means the drug is like poison to your system. You system is high sensitized and dysregulated from the adverse reaction to both the cymbalta and the Lexapro, and throwing further drugs at the situation is not what we'd recommend.  Time is the healer as your body works to bring itself back to normal.    There is no way to predict how long it will take.

 

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 (glyciinate is a good form) and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Add in one at a time and at a low dose in case you do experience problems.

 

We'd recommend gentle exercise (nothing strenuous), a healthy diet and avoiding caffeine, sugar and alcohol.  

 

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

 

 

 

[Meerkat]

Thank you for your reply, Gridley. I saw my psychiatrist before seeing your response. She had me take one dose of Prozac 10 mg 2 nights ago to help with withdrawal symptoms. She’s also having me take benedryl 6.25mg at night and taking away the Xanax. 
 

It’s currently 5 am and I’ve slept a total of 3 hours. The Prozac has been incredibly stimulating and I’m wondering if the benedryl is too. I could handle all of this if I could just get sleep. It’s been 7 weeks of very little sleep now and I’m afraid I’m coming to my end. I’m agitated and restless in bed. Thoughts racing. Wondering if I need to admit myself. I feel like my life is ruined at this point. I am a shell of the person I was before this. My poor girls have lost their mother. 
 

I do take the supplements you suggested, Gridley. Any other thoughts on how to get through this? 

[Gridley]

2 hours ago, Meerkat said:

Any other thoughts on how to get through this? 

Are you taking the Prozac daily now?

 

Here are some links to help with sleep.

Tips to help sleep - so many of us have that awful withdrawal insomnia

 

Relaxation exercises, guided meditations, calming videos, sleep hypnosis

 

Tricks and tips to fall asleep faster

http://articles.mercola.com/sites/articles/archive/2017/02/16/tips-tricks-fall-asleep-faster.aspx?utm_source=dnl&utm_medium=email&utm_content=art1&utm_campaign=20170216Z1&et_cid=DM133787&et_rid=1889748952

 

This link contains helpful information, including insomnia and also non-drug coping skills.  

 

 Important topics about symptoms, including sleep problems

 

Some members have found Melatonin helpful with insomnia.   

See Melatonin for sleep   It's best to start at a very low dosage, such as .25mg, and gradually increase if needed to the lowest effective dose.  

 

[Meerkat]

Thank you so much for the info you passed on.
 

The Prozac was a one time dose that was supposed to help with withdrawal. 
 

Last night I took 0.25mg of Xanax, down from 0.5mg. I also took 7mg of benedryl. I slept from 10pm-12:30Am and was up the rest of the night. 
 

Currently, I am shaking all over but especially in my brain. I can’t sit still, and feel fluish and detached. I have severe brain fog and wish I could have some emotion, but cannot. 
 

I’m stopping the Benadryl as it is not helping. I talked to the doctor on call today who recommended not tapering down the Xanax yet. She also suggested propranolol or seroquel for sleep. I’m apprehensive but a good night of sleep would feel so good. 
 

Would reinstating another SSRI in a tiny dose make sense? I’m 6 days off Lexapro. Or is it better for everyone to push through? My goal is to be off these meds but not at the demise of my family, career and sanity. 

[Meerkat]

My psychiatric PA said that reinstating Lexapro at 1mg was an option. Or Effexor at a super low dose. Then stabilize and re-taper when appropriate. 
 

Any thoughts on going that route?

 

Thank you in advance for your insight and help. 

[Meerkat]

I thought I'd post an update on my journey so far. I am currently at 26 days no lexapro (after a rapid taper) and 16 days no xanax after using 0.25-0.5 mg nightly for sleep for 6 weeks. Looking back, I regret starting these medications at all and I wish I would have found this forum before I tried reinstating the Cymbalta or taking the Lexapro. It would have saved me a tremendous amount of suffering.  

 

In reference to my introductory post, I don't know that my reactions to Cymbalta or Lexapro can be classified as 'adverse', although thats what I thought at the time. After reading and researching, I think my body was still in withdrawal from my last taper off Cymbalta and was too sensitized to handle such a high dose of any antidepressant. My reaction to the Lexapro involved severe shaking, agitation and anxiety for 2.5 of the weeks I was on it and I just couldn't take it anymore, which led to the rapid taper of both the Lexapro and xanax.

 

After 26 days off Lexapro and 16 days of no xanax, my symptoms are severe anxiety which is usually bearable by 5pm, agitation, intrusive thoughts, depersonalization, brain fog, decreased cognitive ability, muscle aches and parasthesias. Brain and body shakes have pretty much gone away, which is a good sign I hope. I've instated a good sleep hygiene routine which often allows for 6-7 hours of decent sleep. Last night my sleep was terrible and I'm paying for it today. 

 

I'm able to function at work so far. I've drawn close to God, pray, journal and meditate daily. I take daily walks in nature, have a good support system, and do EMDR with a therapist 1-2x/week. I'm trying to stay hopeful but I'm just devastated at the toll this WD is taking on my once amazing life. 

 

At this point, I'm praying that this WD will be short-lived and I haven't done too much damage. I read others' posts of years of withdrawals and they terrify me. I can handle this another 4 weeks, but not years. Just looking for hope and encouragement anywhere I can. I do not want to go back on meds of any kind, but I'm afraid I might succumb in desperation. I just want my life and family back.

 

My current supplements: AM-probiotic, fish oil 2,000 mg, Lysine 200 mg, Mag Glycinate 200 mg, digestive enzymes with meals / PM - Mag Glycinate 400 mg, Ashwaghanda 300 mg, Zinc 30 mg

 

Questions for anyone who has the time to answer:

Is it better to take all my Mag glycinate in one dose?

Is there a "best" form of therapy to get through this hell?

[Altostrata]

Hi, Meerkat. Thanks for the update.

 

It's very possible your system was sensitized after going on and off drugs, and that's why you reacted badly. We see a lot of that here.

 

I'm sorry you're having these withdrawal problems. Why did you go off Lexapro and Xanax at the same time? Do you have any Xanax left?

 

Please update your signature.

[Meerkat]

Hi Altostrata, Thank you for your quick response. I just updated my signature. 

 

I went off Lexapro and Xanax about the same time at the recommendation of the Psychiatric PA I'm seeing. She felt that the Xanax was causing new depression that was not there prior to starting these medications. I also felt that the Xanax was possibly causing some rebound daytime anxiety. I do have a lot of Xanax left but do not like the thought of using it. I work in healthcare and can't take it while on the job anyway.

 

Yesterday was a good day with just moderate anxiety and parasthesias. My sleep was terrible last night so, again, I'm hurting today with constant severe anxiety and low mood. This just isn't me, but I'm not sure how much of this is actual withdrawal vs true anxiety stemming from life circumstances such as Covid, etc. I guess that is a question a lot of us face. So many people seem skeptical that I could still be experiencing withdrawal at 4 weeks out from my last lexapro dose and over 2 weeks since I last took xanax - especially considering I only took them for a short time.

 

I started using the DARE app today and hope that will be helpful. I also plan to see a functional medicine doc and try acupuncture. If anyone has experience with those interventions I would love your insight.

 

 

[ChessieCat]

1 minute ago, Meerkat said:

try acupuncture.

 

Acupuncture - Posts #6 & #8 (not detox or stimulation)

 

There are many existing topics on SA.  Please do your research before introducing anything new.  For example, some practitioners may suggest a complex supplement; some members find B vitamins activating (there is a topic for B vitamins).  It is better to take things individually and start at a low dose to see how you react.  

 

the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable/

 

You can do a site search.  I find it better to use a search engine and add survivingantidepressants.org to my search term.

[Meerkat]

Thank you so much ChessieCat! The acupuncture thread was very helpful.

[Meerkat]

Hello, I’m 8 weeks out from Lexapro. Main symptom is hellish anxiety and my mood has become much more depressed than it was before the most recent meds. I thought I was doing relatively okay so i cut out my nightly dose of Ashwagandha. My sleep noticeably improved. Six days later I start having left sided parasthesias, noticeably lower mood, increased agitation and chest pain. I took another dose of Ashwagandha 350mg to see if that was the cause and these symptoms subsequently went away. If I take it at night, it interrupts sleep. If I take it during the day, I feel awful by the evening. 
 

 I’ve searched the site for info on Ashwagandha and haven’t found much. I know supplements aren’t recommended in general (besides fish oil and mag). I’ve taken Ashwagandha since October 2019 and now believe it contributed to my bad reaction. Should I continue with it or be tapering off? I don’t want to do any more damage. Any advice would be greatly appreciated.  Thank you in advance. 

[Frogie]

Here is some information that ChessieCat wrote on a members thread about Ashwagandha:

 

There are many existing topics on SA.  I like to use a search engine and add site: survivingantidepressant.org to my search term.

 

 

ashwagandha-herb-for-anxiety-stress-and-toxic-overload

 

I hope it helps a little.

 

It looks like you did a really fast taper off Lexapro and jumped off at 2.5 mg? I know my Lexapro taper was not fun at all and I had problems. It took 4 years. I went down to .05 mg before I jumped off and had side effects for a few weeks after. I hit a wave around 6-8 months also.

 

Hopefully you’ll feel better soon.

 

Take care,

 Frogie xx

Edited July 13, 2020 by Frogie

[Meerkat]

Frogie, 

 

Thank you for the info you posted several months ago. I now am coming up on six months since my last doses of lexapro and Xanax. My biggest symptom is constant daily anxiety. I feel like I’ve entered a wave starting a couple weeks ago. The depression is relatively mild but the anxiety has ramped up and is constant except for my evening windows. You mentioned you hit a wave about 6 to 8 months out. How long did it last? How are you now?

[Meerkat]

To anyone who has time to answer, I’m trying with everything in me to accept this anxiety and withdrawal but I’m failing and feel like I’m just digging myself into a bigger hole of anxiety. The fear of the damage I’m doing to my body, the fear of withdrawal, the fear I won’t heal is relentless. I do all the things that are supposed to help...walk, meditate, pray, breathe, yoga. I’ve read Claire Weekes and am talking to a therapist. If anyone has a piece of wisdom or insight that helped them with acceptance I would be so grateful. Thank you. 

[ChessieCat]

When things change for the worse, it is a good idea to do some detective work to try to figure out if something that you did, did not do, experienced, consumed or stopped that might have contributed to it.

 

Sometimes it might not seem like much but if it has happened often or several different things have happened around about the same time, it can have an effect.

 

The major question that we ask is alcohol and antibiotics.

 

And of course this year we've had covid, race riots and the US election.

 

Something that you might not be aware of is that MSG is a neurotoxin.  It is usually in Chinese food but is often in savoury foods like frozen meals, tinned/canned foods, flavoured savoury snack foods and biscuits and chicken salt (which is why it tastes so yummy!)  I also try to steer clear of other flavour enhancers as well because they probably act the same way.

[Meerkat]

Thank you ChessiCat. I think I was starting to feel better (more calm) in September and October. I let my guard down and consumed a total of 6 alcohol drinks over the month of October to help myself relax and feel somewhat normal. Last drink was on October 31st. I've had nothing since then. Will obviously not be consuming any more alcohol. Other than that, I live in a place in the US where Covid numbers are out of control. I have the usual Covid stressors everyone is dealing with and work in healthcare. I had to get the flu vaccine for work on November 3rd after my request for exemption was declined.

 

My job may be a source of anxiety for me as I take care of people with all kinds of illnesses. Each illness on a patient's chart is another illness I could possibly have. I am terrified of getting sick or having to have surgery and needing a medication that could throw me back into the pit of acute withdrawal. I just started seeing a therapist to work on some CBT skills for this.

My only symptoms currently are this relentless anxiety that is very much physical and mild insomnia, which I can deal with. Some mild depression has creeped up since I've been severely anxious for 6 months. All of these get much worse around my period. I've cut out all the major food allergens. I'm thinking I may need to go on a low histamine diet but that means limiting my diet even more. Anything if it helps.

 

My mind is consumed with what else can be done to help myself get better for my own sake and the sake of my husband and two daughters. Should I be treating this as anxiety and pursuing therapy? How do I know this is in fact withdrawal? I don't mean to complain. I know that others are going through worse situations than mine. Just looking for a bit of calm in this storm.

 

[ChessieCat]

Please see this post written by BrassMonkey, especially about the member who drank alcohol:

 

 

[Meerkat]

Thank you for taking time to reply, ChessieCat. I’ve read through BrassMonkeys essays. I’m just in a rather low spot and looking for encouragement I guess. I obviously made a mistake with the alcohol. Will keep pushing through. My daily mantra is courage and determination. I know this will get better. My thoughts and prayers to all going through this. 

[ChessieCat]

10 hours ago, Meerkat said:

I’m just in a rather low spot and looking for encouragement I guess. I obviously made a mistake with the alcohol.

 

You might also be beating yourself up for having the alcohol.  What's done is done and cannot be changed.  However, you can learn from this.

[Meerkat]

Just checking in with an update. Ive avoided this forum as it is a huge trigger for me, as it is with many. I do read the success stories here and there. I was hoping that my next post would be my success story. Unfortunately, I'm not there yet, but I'm on my way. I'm coming up on my 10 month mark and I'd consider myself 60-70% recovered. I feel that I would be further if not for a recent medical setback.

 

My main symptoms currently are low to severe anxiety, moderate insomnia, nerve pain, and hormonal imbalance. Each day is a surprise as the anxiety comes in short windows and waves. The nerve pain began in January and is pretty persistent. I'm trying to find ways to cope without prescription medications so if anyone has any suggestions, please send them my way  My sleep is ok with a few decent nights per week of 6-7 uninterrupted hours. I no longer have the early morning panic wakings and I don't have to sleep with a mask or weighted blanket, which is nice. I still wake sometimes at 3-4 with a small cortisol spike but often am able to go back to sleep. My symptoms spike pretty severely each month with my cycle, which is getting shorter and shorter. I'm trying to tackle the hormonal imbalance and other issues with diet, which is proving pretty complicated and a little bit stressful. Anti-inflammatory, low-histamine, hormone balance diet...I'm feeling overwhelmed lately with what to put in my body or not.

 

Things that have helped me on this journey are meditation, prayer, yoga, daily walks, journaling, gratitude, somatic therapy/EMDR and the support and love of my family. They are what truly keeps me going. I use the DARE and Headspace apps frequently and use the Claire Weekes approach to facing the anxiety and other symptoms. I've been doing neurofeedback since September. Its expensive, but I do think it has helped to calm my nervous system. I've continued to work two days a week and am social when able given our current situation with the pandemic. 

 

I'm hopeful that I will be writing my success story sooner than later. I've learned so much through this journey about the kind of person I really want to be and what's really important in life, etc.  Also, that time is the greatest healer. I look forward to the day that I will look back on this as a bad memory that changed me for the better. I pray for strength for all of us going through this hell and that we come out of this stronger and happier one day.

[BooBoo19]

Thank you Meerkat for updating. I am only 5 weeks off taking my last lexapro and it feels like a life time.  I haven appetite, lost a lot of weight, do not sleep and have no joy in life.  The withdrawals are worse that the side effects of the drugs in my opinion.  I am ready to throw th towel in and say enough is enough but your updates have inspired me to keep going.  It is the lack of sleep that does it for me as well.  I like you try not to read all of the stories as they are triggers but I always read the success stories. Well Done you!!!

[ChessieCat]

You might find these helpful.  I've listened to them for my own pain issues and much of what is in there is non drug coping techniques like SA encourages members to learn and use:

 

Living with Chronic Illness or Pain - Happiness Isn't Brain Surgery Episode 20a

Living with Chronic Illness or Pain - Happiness Isn't Brain Surgery Episode 20b

Living with Chronic Illness or Pain - Happiness Isn't Brain Surgery Episode 20c

 

Nonpharmacological Interventions for Pain CBT for Chronic Pain Video

[Meerkat]

ChessieCat, Thank you for those resources. I will definitely check them out. Its my understanding that the nerve pain should go away after withdrawal in most cases, however, I'm worried about hardwiring my brain into my current state of discomfort...which, leads to more anxiety then more pain. Ah...the viscous circle. 

 

BooBoo, I remember vividly the struggle of the early days. Each day seemed like a lifetime. But it really is a matter of taking one day at a time. Eventually, those days will string together and you'll be marking your progress by months rather than days or weeks. It's still hard, but much more manageable for me at this point. Keep going. It will get easier.

[Meerkat]

I wanted to add that I've developed severe health anxiety over the last several months and I now know that the nerve pain is a direct result of that. I just had a visit with my primary care doc, got a thorough checkup and now my pain is magically gone...for now. I can look back and see that I've had health anxiety for a long time, but never to this extent. It amazing the tricks our minds can play on us.