Halcyon: tapering escitalopram - time is not on my side

[Halcyon]

p.s. what is the general consensus (if any) on diet and how it affects success of withdrawing. I’ve seen some posts about this here and there. I have always had a sensitive gut and acid issues since I was a little kid. I worked out eating bland but I also tend to eat simple carbs (bread, rice, crackers) as they’re comforting and I digest them better than more complex carbs. It seems many swear by cutting out gluten but I would like to keep it if possible. I was tested for celiacs a few times when I was younger and it always came back negative. I have developed more of a sweet tooth in the last 10 years, but I’ve been working on cutting that out. I’ve been steadfast at avoiding sugary treats and what not.

[ChessieCat]

You could keep a food and symptom diary and see if there are any food/beverages which seem to worsen your symptoms.

 

To find discussion about diets/foods etc use a search engine and add site:survivingantidepressants.org the search term.

 

or

 

Check out the topics in the different forums.

[DataGuy]

7 hours ago, Halcyon said:

I’ve seen how withdrawal sensitizes peoples CNS to the point that lots of things can be harsh on them that were not before. Generally speaking, if one follows a slow taper does this make the CNS less sensitized?

 

If a slow taper takes a person 10 years or more, does the additional length of time on the drug tend to correlate with the chances of protracted withdrawal? I.e. I’ve been on a drug for 12 years, after 10 years of tapering to 0, does protracted withdrawal seem more likely from being on for a total of 22 years vs. 12. Does that make sense?

 

I think you answered your own question, @Halcyon. Although we have some very useful case studies here, it is tough to use those to predict any other person's individual case. Everyone has different genetics, is exposed to different environmental stressors, has a different history with medication or recreational drugs. So it is hard to extrapolate from anyone's story to another person. To minimize confounding we would need to run a very large randomized controlled trial with different taper rates and different drug histories. Then we might be able to tell you something useful about length of drug usage vs chances of protracted withdrawal. 

 

To me it does seem like more drugs + longer time usage + history of difficult withdrawals + recreational drug use = a more difficult taper and a greater chance of protracted withdrawal, which is what you would logically guess, but it is pure speculation based on observational study of individuals. People I know who have had the most difficult time tapering and with subsequent protracted withdrawal are people who've had 1) difficult withdrawals before  2) a history of drug use or alcoholism  3) drug toxicity like serotonin syndrome or overdose. Very difficult to conclude much from individual cases though. Actually almost every study has very limited predictive value in medicine except for very large randomized controlled trials, which you can read about in "Medical Reversal" if you want, by Vinay Prasad and Adam Cifu MDs. Even randomized trials have their limits though, and they need to be very carefully constructed to weed out biases and confounds. 

 

And yes, a slow taper seems to minimize CNS sensitization. Another thing that needs to be tested and studied rigorously. Glad you are being so diligent in learning about withdrawal, @Halcyon : )

Edited November 22, 2020 by DataGuy

[Halcyon]

Hi all,

 

Ive been doing more reading and trying to come up with things I can do to hopefully make my taper journey a success. 
 

I recently read an article on the RXisk site where a doctor mentioned tardive permanent conditions with little chance of improvement in older people vs younger people. I just turned 38. I’m not really sure where nervous system health and repairability stands for those at this age. I feel like 38 is still pretty young but then again maybe everyone feels that way. 
 

Anyways, I’m hoping to do some proactive things to hopefully (god willing) avoid a crash as I taper and pray that it will help me avoid akathisia and other tardive conditions. No idea how likely this is at 12/13 years of use. 

I was looking for some suggestions from moderators and other knowledgeable types on things I should make sure I’m supplementing or getting in my diet and lifestyle changes. 

 

I’m trying to get a half hour walk everyday (had been bike riding but it’s now too cold). 
 

I’ve read on here that b vitamins are needed but also that they can be too stimulating. There also seems to be a lot of different experiences with the type of supplementing.  I was low in B12 a couple years ago and couldn’t stomach pills. I had monthly b-12 shots. I’m not sure if that would be too much now. Should I still be trying to get a multivitamin or b vitamin in small amounts during my taper and only reducing if I run into an issue? I haven’t taken vitamins in a long time. 
 

Im looking at fish oil and magnesium supplements.  Are both of these generally good to take regardless of a taper? That’s how I’m understanding it.

 

I’m looking at beginning my next taper as a 5% decrease to test the waters. Not sure if I’m being too slow. I’m considering the brass monkey slide. I think I’m still confused about WDnormal even after reading the WDnormal description. My goal is not have the taper catch up with me unexpectedly.  With how windows and waves work, how do you know it’s been long enough to take your next taper step? If you have been symptom free for 2 weeks after a 3 week brass slide is that a safe enough time to continue? I get a bit confused since with a normal taper you have 4+ weeks but with the brass slide you have 2 weeks after 3 weeks of smaller drops presumably with symptoms. 
 

I’m looking into changing my general MD doctor to a more holistic DO doctor in my area but with COVID it will probably be slow going to get this set up. I would love to have a doctor that is knowledgeable in this stuff to work with but I don’t know that they exist around here. Of course my family and friends find this hard to understand. I’m also wondering if I should be getting some kind of blood tests done for my taper to know my health, but I’m not sure what I should get. 
 

 

[Colonial]

That's great your formulating a plan before you start.

One suggestion is to see if you can incorporate the magnesium and fish oil and any other nutritional changes before you start.

Your system will be more likely to accept them and if not, you'll know ahead of time and not have to wonder if its the supplement or the WD if there's a reaction,

 

The less variables the better, so if you have the B vitamins and all figured out ahead of time that will be less to have to consider as a reason for doing poorly later.

Making all the "good" brain chemistry changes now will go a long way to minimizing the potential pit falls later on.

 

As for the manner of the drops that's individualistic, some people do better with smaller drops more often and do well with the Brass slide.

I was one who had to leave more time in between drops because I didn't do well with what to my brain was constant tampering.

5% for 4 to 6 weeks is a good test, regardless if you want to drop all 5% at once and hold or drop 1.25% a week for 4 weeks and then hold another 2 weeks.

The key is consistency in plugging along at what works, and stopping for longer holds every so often if you feel a bit worse or go through a stressful period.

I'm not sure there should be a "presumption" of symptoms, but having some doesn't necessarily mean your going too fast but it's a caution sign.

 

[Colonial]

 

Sorry, I got cut off and had to break this into 2 posts.

 

While all the above is true about doing the preps ahead of the taper, my main concern for you is the mental blocks you have already put in front of yourself.

 "time is not on my side". This  opening "fact" as you see it has shaped every post and fear you've expressed and already led you to an opening bad decision.

All of your opening posts before the Sept. 1st reduction and since then revolve around this "false fact" you have convinced yourself that your age and time is your enemy in all of this, when nothing could be further from the truth. As of your first posts you had not made any major mistakes or had all that bad a drug withdrawal history to worry any of "Us" that your situation would likely be problematic, and seeing as how you were able to comprehend the seriousness of what can happen if people go too fast you seemed to make some very promising statements about going very slow  and starting off with 5% to 10% reductions and leaving plenty of time in between.

 

And then you promptly went out in a pregnancy worry induced panic and dropped your dose 1/6th from 15mg to 12.5mg in one fell swoop.

16.67% and by the inaccurate of most methods instead of getting a liquid script or making a liquid.

This is more disconcerting than any supposed study showing this or that about effects of being on a drug after so many years, etc.,

That you were led by so much fear over a potential possibility into doing something you knew had a guarantee for problems

 

At one point you even considered jumping straight to 10mgs based on the SERT Curve stating: "This would be roughly less than a 5% reduction in SERT occupancy and high enough on the hyperbolic curve that even if more than the normal 10% reduction, it would probably be well tolerated." Yet in your very next paragraph:  "Reading everyone's awful experiences with withdrawal often when having done even the 10% taper or 5% taper has me very concerned."

 

So it seems you have the proper prudence one moment but then, based on wanting to be off sooner than later for other reasons, placing a great deal of hope in one or 2 other sources that would advocate a somewhat risky plan for a first move.  I realize you want a healthy baby, but the information you are allowing to run in fear on very thin conjecture.  Things like:  SSRIs causing sperm to move slower than normal,  "some studies suggesting" serotonin affecting sperm motility, the hyperbolic curve of SSRIs having still large effects, etc.  You've accidentally allowed yourself to be placed in panic mode based on things with very little basis for proof. 

 

Accidentally destabilize yourself in fear, and it will do more damage to your sperm being healthy than going slow.

" Ideally, I would like to be off of the drug within a year or at least off of it enough that the damage to my sperm is significantly reduced.  Unfortunately, there doesn't seem to be a lot of information about that." Because there isn't anything reliable, so please don't torment yourself with worrying about things that do not have an answer.  You'll only make your anxiety worse and spike our symptoms chasing "what if" scenario's if you get stuck traumatized absorbing all of the 1 in 10,000 cases that are rare even for us. The Mother's health is much more important than the Father's sperm and if you get yourself in trouble and She is pregnant, that stress will be much more problematic for the baby.

 

So what about considering starting the first of the year having a reliable script to average  1 year  for 8% every 5 weeks and see how things go?

You can always make lower % drops and extend the wait period.

That's a much more sustainable plan on both ends yours and ours of being able to support you than jumping 16% in fear and then being frozen for 3 months.

 

What do you think?

 

 

[HopeToHeal]

I think you are still on the younger side. I am 40 and had an immediate adverse reaction, so my experience is a bit different (I only took escitalopram briefly and discontinued cold turkey), but I have had some of those “tardive” effects you’re concerned about. But I have seen significant improvements and do feel myself healing. I think “older” and “younger,” while relative to begin with, often tend to speak to geriatric versus non-geriatric age groups unless otherwise specified. 

[Halcyon]

Thank you both.  Colonial, you're correct, I'm not approaching this with the best attitude and it's something I'm trying to work on (probably not obvious). 

 

*My little negative rant*

The Stuart Shipko MIA article(s) are just very upsetting.  I've seen as much from others on here too.  He makes it sound like even with a careful slow taper, after 10 years of use, a tardive akathisia is common.  I really wish there was more clarification on just how common this actually is.  My worrying self sees how hard it can be going through the long slow taper.  I tell myself if you at least knew that the you were more than likely to avoid bad things at the end of the journey, that could give you hope.  But to hear it's likely to then end up with akathisia.  It just makes you feel defeated.  Like doing anything is going to make everything worse.

 

Perhaps a flaw to my nature (I've seen it criticized in articles talking about Generalized Anxiety Disorders), but when I am anxious about something like this, I find myself constantly trying to find proof and reassurance of things going well; I try to find ways to be prepared and stop worst case scenarios from happening.  It's hard for me to take a leap of faith on things.  Always has been.  It's probably why church never stuck for me growing up.

 

My wife, family, therapist all tell me that I need to remember this is probably very rare.  But when I see the thousands on here and other support groups online, it certainly does not feel so rare to me.

*End of Rant*

 

I will add that another thought which gives me massive upset over all I have found is that my wife has been on a high dose of Wellbutrin for the better part of 15+ years.  I worry what would happen to her if she tries to come off.  She's thought about trying to taper off, but I am fearful of the result.  I fear for her, us, and our future; it makes me very lost and upset with doctors we trusted, and it makes me wonder where do we go from here.

 

I agree with you that I need to work on my mindset and hope for this journey.  I try to read success stories on here for that.  I wish there were more that were from those who had long term use and tapered following the advice here.  It seems like most are from those that tapered too quick or not at all and made it back to recovery. Gridley is one of the moderators that has reached out in my topic.  His journey is inspiring to me.  Brassmonkey's posts are an obvious inspiration too.  I recently read Karma's posts.  She is also an inspiration.  So, I know successes are out there.  Just comes back to that leap of faith.

I'm going to try and introduce fish oil first, then if it goes okay, i will try a b-vitamin, and then magnesium.  Slowly with each to see how things go before continuing down the taper.  I also need to make the transition to liquid for my taper.  I'm hoping I tolerate it and that I don't have any problems with my body processing it too quickly compared to pills.  Otherwise, I think I will look into compounding and if that is not a good option, making my own.

[ChessieCat]

30 minutes ago, Halcyon said:

I wish there were more that were from those who had long term use and tapered following the advice here.

 

I've been successfully tapering following SA's tapering guidelines after being on an antidepressant since about 1992.  After trying to reduce my dose by 50% and suffering bad withdrawal symptoms for 2 weeks I found SA, updosed and have been tapering for the last 5 years and still have about 1 year to go.  Starting at 100mg Pristiq I am now down to 0.5mg.  Last month I turned 63.

 

38 minutes ago, Halcyon said:

I try to read success stories on here for that.  I wish there were more that were from those who had long term use and tapered following the advice here. 

 

Members who have successfully got off generally do not return to write their success story.  And there are also members who are very close to being off so they haven't written a success story yet because the criteria for this is to have been off the drug/s for at least one year and only have minimal symptoms.

 

Members who are suffering are the ones who return because they need support but the ones who are doing okay don't return because they are getting on with their lives.

 

Just like when you are sick you go to the hospital but when you are recovering you leave.  And you don't keep visiting the doctor when you are healing, you only see them when you need their help.

[Halcyon]

Thanks ChessieCat.  You're another of those on here that I watch, find inspiring, and hope for great things for.  I've started reading your journal and it also is very encouraging.  It definitely seems like a gentle and slow taper is possible.  I do not/cannot understand how that can still result in something like akathisia occurring 3/6/12 months after the complete jump.  It doesn't make sense to me.  What switch could possibly be getting flipped and waiting to get flipped internally until the absolute smallest spec of the drug is gone.  I really wish doctors/scientists would be looking into this more and finding answers.  Have you found you're able to tolerate supplements/vitamins during your taper (sorry I'm still early on in your journal if you're already talked about it)?

 

In other news, my wife wants us to get a puppy/dog first and worry about a baby less for right now.  I love dogs and am excited about the idea.  I've been trying to decide whether the companionship/responsibility would be a good thing for me during this endeavor or if it would be a stressor/bad for the pet if I was distraught in front of it much.  This would be our first pet together.

[DataGuy]

Always good to hear your updates, @Halcyon. I don't think tardive akathisia or withdrawal induced akathisia is quite as common as Dr. Shipko claims. There are many millions of people who take antidepressants and get off them with little problem. If akathisia were common you would have probably seen and noticed it regularly in your everyday life. It is a bit hard to overlook if someone has a severe case. True that it can manifest without the need to constantly move, but I think many cases involve motor restlessness. We should probably do a survey on that. I had one planned but have not yet followed through. 

 

Just my opinion, but I think the likelihood of akathisia appearing simply from slow tapering is very low. Things that would make it more likely would probably be extensive drug history, polypharmacy, history of difficult withdrawals, recreational drug use etc. I agree it needs to be studied much more extensively. Here is an older article on risk factors, if you are interested: https://academic.oup.com/schizophreniabulletin/article/21/3/431/1943937

 

I think getting a dog is a great idea. 

 

I wonder if it would help you to make a list of the arguments for and against your planned actions. For example, if you were trying to decide to start tapering, you would make a list of the pros vs the cons (may improve overall health, fertility etc vs may cause stress and difficulty at work). It may also help to try to quantify their probability and give justifications for why you think these things. This will help you clarify your thinking and avoid ruminating over the same subjects and may also go some ways towards satisfying you that you have fully investigated the risks and don't need to have them take up so much mental space and time. If you get new information, you can always add to the list. What do you think of that idea?

[mdwstrx]

Hi @Halcyon

I'm another long term escitalopram 'user' who is successfully tapering so far. Dr. Shipko's articles terrified me so much that I emailed him (2 years ago). He graciously replied and gave me permission to quote him. 

• At the time, he felt that this site was generally more optimistic than he was about long term AD users stopping, even with a slow taper.  However, he defined a slow taper as "tapering so slow that the patient has no withdrawal symptoms during the entire tapering process."  I saw in one of his articles that he had not followed anyone who'd tapered as slow as this site recommends. 

• He went on to say, "Harm reduction, by lowering the dose, is certainly a reasonable alternative. If you reduce the dosage, reduce it so slowly that you have no symptoms at all.  When a dosage cut results in symptoms, this is probably the stopping point. However, when symptoms appear months later, you most likely will be able to stop them with prompt reinstatement so the problems are not necessarily long term.  However, in a small percentage of people (I don't have any numbers on this) reinstatement makes people worse."  

My take from the above is that he has a lot of experience but not comparable to the experience on this site. I've been encouraged by the expertise of Alto and the mods to continue slowly. I carefully watch as other long term users have tapered and jumped off successfully. 3 have within the last 6 months and thankfully, they are doing well. The alternative, in my opinion, is to stay on the drug. There are risks for that as you can imagine. I am opting to go slow, day by day to see how far I get.

 

I hope this information helps you to find the confidence here that you need to decide.  

md

[Kernol]

On 12/5/2020 at 6:44 PM, mdwstrx said:

Hi @Halcyon

I'm another long term escitalopram 'user' who is successfully tapering so far. Dr. Shipko's articles terrified me so much that I emailed him (2 years ago). He graciously replied and gave me permission to quote him. 

• At the time, he felt that this site was generally more optimistic than he was about long term AD users stopping, even with a slow taper.  However, he defined a slow taper as "tapering so slow that the patient has no withdrawal symptoms during the entire tapering process."  I saw in one of his articles that he had not followed anyone who'd tapered as slow as this site recommends. 

• He went on to say, "Harm reduction, by lowering the dose, is certainly a reasonable alternative. If you reduce the dosage, reduce it so slowly that you have no symptoms at all.  When a dosage cut results in symptoms, this is probably the stopping point. However, when symptoms appear months later, you most likely will be able to stop them with prompt reinstatement so the problems are not necessarily long term.  However, in a small percentage of people (I don't have any numbers on this) reinstatement makes people worse."  

My take from the above is that he has a lot of experience but not comparable to the experience on this site. I've been encouraged by the expertise of Alto and the mods to continue slowly. I carefully watch as other long term users have tapered and jumped off successfully. 3 have within the last 6 months and thankfully, they are doing well. The alternative, in my opinion, is to stay on the drug. There are risks for that as you can imagine. I am opting to go slow, day by day to see how far I get.

 

I hope this information helps you to find the confidence here that you need to decide.  

md

hi @mdwstrx thanks so much for posting this as shipko”a pessimistic view on healing after long term use has been so damaging to me trying to hold on to hope that things can get better and then you find yourself convinced akathisia is around the corner and no hope of recovery - so did you take it from your conversation with him that he know longer believes this to be common occurrence and that people who have been on Ads for more than 10 years do have hope of recovery?  I wonder if he realises how damaging his words can be although I respect his work. 

[Gridley]

@Halcyon  @Kernol  @mdwstrx

 

Just as a note of encouragement, I recently finished a 4-year taper of 20mg Lexapro after 16 years' use without any hint of akathisia at any point.

[Kernol]

1 minute ago, Gridley said:

@Halcyon  @Kernol  @mdwstrx

 

Just as a note of encouragement, I recently finished a 4-year taper of 20mg Lexapro after 16 years' use without any hint of akathisia at any point.

thanks @Gridley and congratulations on finishing your taper. It is encouraging. I have and continue to have a very hard taper after high reinstatement but not experienced akathisia to date. I always try and hold on to hope that I will heal when my taper ends, maybe even before! or however long it takes after I finish so it’s good to hear. These statements from Doctors like Shipko and Healey are so discouraging especially for vulnerable people going through severe withdrawal. I am sure they don’t mean to be. I spoke to Dr Healey twice early on in my journey and he was the most negative person, gave me no hope! 

[mdwstrx]

@Kernol

Hi.  I'm jumping over to your thread as to not hijack Halcyon's. 👍

 

[Halcyon]

Thank you everyone.  Sorry I've run away from my thread again.  I've not made any more changes so far.  Still trying to decide what best to do.  I really do not want to stay on this drug and the only reason I would is if the harm of coming off of it would be worse than the harm of staying on it at this point.  I need to maintain my mental/physical health enough to hold down my job successfully and not make myself permanently disabled.  I would like to taper slowly and at least get down to smaller amount at the very least.  However, I'm having trouble understanding if a smaller amount of the drug would encourage tolerance to occur (since the treatment for tolerance is a larger amount of the drug).

I have been maintaining daily walks.  Additionally, I have been listening to audio books from Claire Weeks and a book about managing catastrophic thinking during my daily walks.  I have been trying to cut out sugary foods (had a couple slip ups over the holidays with treats at a family gathering).  I've purchased NOW Ultra Omega-3 enteric coated soft gels.  I plan to try those out tomorrow.

 

I feel ashamed because I have had some really bad "freak outs" over the last couple of weeks about all of this (yelling/crying/hyperventilating).  Mostly this has been due to triggering myself because I worry that by trying to come off of Lexapro after this many years of use (combined with the many years it will take to taper), I will end up doing more harm than good to myself in the long run.  Basically, I go into a full blown panic when I realize there is no guaranteed safe outcome to ending this drug and many in my same situation seem to have ended up stuck or worse after trying.  I feel very alone because I do not believe there are any doctors/therapists in my area that are knowledgeable about withdrawal and my family all think I am just looking at rare worst case scenarios/believe if withdrawal was as common/bad as I think they would hear more about it in the world.

 

How do those in a similar position deal with the long drawn out symptoms of a taper and not ruminate/dread the possibility of the end result not being success/healing?

 

In addition to the fear of akathisia, reading about the CNS being harmed (potentially permanently) makes it hard to decide what is the safest best approach for my life at this point.  It sounds like if you're tapering or fully off SSRIs after long term use, any use of most common medicines for other life ailments could have a very severe reaction (i.e. antibiotics, digestive medicines, antihistamines, etc.).  I don't take many other medicines, but I have had infections in the past that need antibiotics and I don't have the greatest teeth and occasionally need dental work that might require anesthetic. 

On that note, I currently must take pepcid daily for my chronic GERD.  This is a condition that's pretty prevalent in my family and I suffered from it before being put on SSRIs.  I cannot tolerate PPIs because they make me extremely sick at my stomach.  There was a suggested relatively new surgery I was a candidate for many years ago but I opted against it.  It was very invasive and many people did not tolerate it.  I felt like it was more of the same with doctors hitting a nail with a sledgehammer to solve a problem.  However, without my H2-antagonist acid reducer daily, I will get ill in the middle of the night from refluxing stomach acid (my esophageal sphincter does not close up enough).  I've read here about acid reducers complicating/jeopardizing successful tapers.  However, I am confident that I could not do without the acid reducer currently.  I have eliminated a lot of my diet over the years so that I do not produce too much acid and I elevate my bed to further reduce any reflux at night.

Also related to this, I would like to supplement b12 to encourage a successful taper but I know this is also too activating.  In the past I have had lower b12 levels (I suspect because of my acid reducing medications) and I was treated with b12 shots until my numbers were much healthier.  Due to the current COVID situation I do not think I could get a b12 shot as easily, so I am going to attempt using a b12 sublingual.  I'm not sure how many weeks I should supplement with it before starting a taper or if one could go ahead and start a taper while still using it.

 

Thank you to all that are listening.  Sorry if my messages are too ranting/rambling.  I hope that if I do decide to attempt this, I can rely on the expertise of the moderators on here (especially if I get into any trouble during the taper), despite all the posts of mine so far that have not contained a lot of progress.

 

P.S.

Thanks @DataGuy@Colonial@ChessieCatfor your feedback and suggestions.  I appreciate it and hope I don't pull you away at all from those in better need of your time when I post.

[Halcyon]

On 12/6/2020 at 3:20 PM, Gridley said:

@Halcyon  @Kernol  @mdwstrx

 

Just as a note of encouragement, I recently finished a 4-year taper of 20mg Lexapro after 16 years' use without any hint of akathisia at any point.

@Gridley, I did see that.  I tend to visit your topic for encouragement.  Congratulations! I am very happy for you! I hope that you're still doing well since jumping. I believe you had to deal with a benzo crossover shortly after cause of circumstances out of your control. 

 

Out of curiosity, do you believe that your other medications being in the mix helped or hindered your taper? When reading stories on here, I sometimes wonder if those on a benzodiazepine have better luck getting off a strong SSRI like Lexapro because the benzo pads the side effects.  I don't mean to make light of being on many medications too.  I know that it isn't ideal and that tapering off of a benzodiazepine is it's on world of struggle too.  Just curious what your take would be since you've become very versed in this stuff out of necessity and you appear to be someone who is very in tune with your body.

 

Also, just out of curiosity but having experienced what you have and being at the other end of your Lexapro taper, do you believe this is something you would have been able to work during?

[Halcyon]

On 12/5/2020 at 12:44 PM, mdwstrx said:

Hi @Halcyon

I'm another long term escitalopram 'user' who is successfully tapering so far. Dr. Shipko's articles terrified me so much that I emailed him (2 years ago). He graciously replied and gave me permission to quote him. 

• At the time, he felt that this site was generally more optimistic than he was about long term AD users stopping, even with a slow taper.  However, he defined a slow taper as "tapering so slow that the patient has no withdrawal symptoms during the entire tapering process."  I saw in one of his articles that he had not followed anyone who'd tapered as slow as this site recommends. 

• He went on to say, "Harm reduction, by lowering the dose, is certainly a reasonable alternative. If you reduce the dosage, reduce it so slowly that you have no symptoms at all.  When a dosage cut results in symptoms, this is probably the stopping point. However, when symptoms appear months later, you most likely will be able to stop them with prompt reinstatement so the problems are not necessarily long term.  However, in a small percentage of people (I don't have any numbers on this) reinstatement makes people worse."  

My take from the above is that he has a lot of experience but not comparable to the experience on this site. I've been encouraged by the expertise of Alto and the mods to continue slowly. I carefully watch as other long term users have tapered and jumped off successfully. 3 have within the last 6 months and thankfully, they are doing well. The alternative, in my opinion, is to stay on the drug. There are risks for that as you can imagine. I am opting to go slow, day by day to see how far I get.

 

I hope this information helps you to find the confidence here that you need to decide.  

md

@mdwstrxThank you for your information! I hope your taper is continuing to go well.  I have read some of your post.  I saw how hard you were hit at the beginning of your journey here and I am in awe at how strong you are.  You're very brave and very inspiring!

 

Shipko has certainly made me very distressed about how unsafe it may be for me at this point.  I know that in one of his earlier articles he mentioned what sounded like a slow taper similar to what they suggest here with an older individual on Effexor and made it sound like they were having success.  However, he never followed up about how things ended with that individual and his later articles make successfully tapering sound very rare.  Very upsetting/disheartening.

[Gridley]

5 hours ago, Halcyon said:

I sometimes wonder if those on a benzodiazepine have better luck getting off a strong SSRI like Lexapro because the benzo pads the side effects.

Though I certainly would never recommend starting a benzo to pad withdrawal from an SSRI, I did find that the benzo (since I was already on it) helped with SSRI withdrawal, especially in terms of sleep and anxiety. That's one reason why we recommend tapering the activating SSRI first, leaving the sedating benzo until later.  Similarly, also being on the tricyclic Imipramine (another sedating drug) helped.  

 

5 hours ago, Halcyon said:

do you believe this is something you would have been able to work during?

It would have been difficult, especially in any job involving stress (and most do). Interpersonal relationships would've have been a challenge.  Also, my creativity (I was a writer) went pretty dead once I was in WD.   On the other hand, the distraction might have been at times helpful. But on whole it would have been tough.

 

 

[DataGuy]

@HalcyonI worked during my taper. Worked until the very end, but I tapered far too rapidly (in a few months) and never found any good resources like SA until after I was off. It was actually ok for the majority of the taper, but went too fast at the end (not knowing you needed to taper hyperbolically) and that really did me in. Then I had a mess of a time trying to reinstate and retaper. I think you should be ok. You are very unlikely to end up disabled with a slow taper off a single drug. 

 

Tolerance occurs because your nervous system gets used to the drug, downregulates the receptors, and so requires more of the drug to get the same effect. You will be withdrawing and so while your body will feel like it requires more of the drug, your goal is to upregulate receptors as they slowly adjust to life without the drug.  So while you may feel the same effect that people feel when they hit tolerance, you will simply continue taking the same amount of the drug until your nervous system adjusts, wait a little while, and then cut again. This should allow your nervous system to slowly return to it's normal, drug-free state. 

[mdwstrx]

8 hours ago, Halcyon said:

Shipko has certainly made me very distressed about how unsafe it may be for me at this point.  I know that in one of his earlier articles he mentioned what sounded like a slow taper similar to what they suggest here with an older individual on Effexor and made it sound like they were having success.  However, he never followed up about how things ended with that individual and his later articles make successfully tapering sound very rare.  Very upsetting/disheartening.

 

Take heart @Halcyon and have faith 🙏.

Myself and others here have shown that a slow taper is not only possible but possible without 

debilitating symptoms. Your body will tell you. I have learned how to listen to mine, and 

you can too.

 

God bless.

Md

🕊️

 

[Colonial]

17 hours ago, Halcyon said:

I would like to taper slowly and at least get down to smaller amount at the very least.  However, I'm having trouble understanding if a smaller amount of the drug would encourage tolerance to occur (since the treatment for tolerance is a larger amount of the drug).

 

Tolerance is only an issue if your planning on staying on it for some sort of "benefit", whatever than means for you.

If your plan is to come off a med than you would, by definition, hit that somewhere along the way since you are no longer on the med.

But that is the point of tapering, to no longer have a med in your system.

 

17 hours ago, Halcyon said:

It sounds like if you're tapering or fully off SSRIs after long term use, any use of most common medicines for other life ailments could have a very severe reaction (i.e. antibiotics, digestive medicines, antihistamines, etc.). 

 

This can happen if you go too fast and destabilize, but as I said, the good news is you know about all of this ahead of time.

Most of the truly problematic cases are where people are taken off too fast, reinstate or poly drugged in an effort to combat wd symptoms.

 

17 hours ago, Halcyon said:

Also related to this, I would like to supplement b12 to encourage a successful taper but I know this is also too activating.

Not necessarily, for some but for those destabilized.

It may not be an issue for you.

I did suggest you make any supplement additions now to get your brain used to them before you begin to taper.

Once your brain is used to them being on them during wd shouldn't be an issue.

The same principle as those already on a benzo, if your on good supplements before you start your brain is already accustomed.

 

I think what's happening is your reading alot of "worse case scenario's" where things were done incorrectly and assuming it for yourself.

Coming off meds done properly should not be an issue.

So I'm not sure why your fixated on you having a really bad time when you have every advantage for it not to be such.

 

 

17 hours ago, Halcyon said:

 

 

I feel ashamed because I have had some really bad "freak outs" over the last couple of weeks about all of this (yelling/crying/hyperventilating).   triggering myself because I worry that by trying to come off of Lexapro after this many years of use I will end up doing more harm than good to myself in the long run.  Basically, I go into a full blown panic when I realize there is no guaranteed safe outcome to ending this drug and many in my same situation seem to have ended up stuck or worse after trying

 

I don't think it's a well planned and patient taper that would be the problem.

It would be the triggering and fear if you start to have even some normal symptoms and have this sort of reaction.

I don't think the taper is going to be your biggest issue.

It will be your reaction to the everyday ups and downs that may blow it out of proportion.

 

I don't think your fears of a worse case scenario are justified, but if your having this sort of reaction just thinking about it?

You really need to think why you are so pessimistic, (at least subconsciously) and how to go about getting a hold of your thought patterns.

I'm not sure you've come to the root of what it is your so scared about just yet.

I think there's something deeper your afraid of that hasn't surfaced yet, I just can't put my finger on it.

 

Did you decide to get the puppy?

 

 

 

 

 

 

Edited December 28, 2020 by Colonial

[Halcyon]

21 hours ago, Colonial said:

 

Tolerance is only an issue if your planning on staying on it for some sort of "benefit", whatever than means for you.

If your plan is to come off a med than you would, by definition, hit that somewhere along the way since you are no longer on the med.

But that is the point of tapering, to no longer have a med in your system

 

Thanks @Colonial!  I think this is where some of my confusion and concern comes into play.  Ideally I would like to get off of the medicine fully and successfully.  I've been reading a lot on the Inner Compass Initiative and what is called a harm reduction approach.  The idea is that you taper your drug slowly and that some people find they may not be able to get off the drug fully but at least are able to taper it to a much smaller amount.  They've reduced their drug burden and therefore hopefully reduced some of the harm from the drug on their body.  However, where I am confused is if a person manages to taper to a smaller amount but cannot get past that amount.  Does the smaller amount increase the likelihood the person's body will reach tolerance withdrawal symptoms?  Frustrating that there is no science/studies on this, but I wondered what the consensus was amongst the community here.

 

21 hours ago, Colonial said:

On 12/27/2020 at 2:19 AM, Halcyon said:

It sounds like if you're tapering or fully off SSRIs after long term use, any use of most common medicines for other life ailments could have a very severe reaction (i.e. antibiotics, digestive medicines, antihistamines, etc.). 

 

This can happen if you go too fast and destabilize, but as I said, the good news is you know about all of this ahead of time.

Most of the truly problematic cases are where people are taken off too fast, reinstate or poly drugged in an effort to combat wd symptoms.

 

I guess I'm somewhat confused here too.  Looking over threads here, it seems like there are a lot of people who do the slow and cautious taper (Gridley is a good example), but that still find there nervous system becomes sensitized to foods/medicines in withdrawal.  I could be misquoting, but I believe I've seen Gridley mention issues from nonvaccine at the dentist and becoming intolerant of certain foods.  It sounds like even if you introduce supplements early on before your taper, your CNS will still become sensitized during the taper and may not be able to tolerate some of them.  Am I misinterpreting something here? Anyone please feel free to chime in.

 

21 hours ago, Colonial said:

I don't think your fears of a worse case scenario are justified, but if your having this sort of reaction just thinking about it?

You really need to think why you are so pessimistic, (at least subconsciously) and how to go about getting a hold of your thought patterns.

I'm not sure you've come to the root of what it is your so scared about just yet.

I think there's something deeper your afraid of that hasn't surfaced yet, I just can't put my finger on it.

 

There could be many factors.  I do tend towards worry anyways and this is something I'm working on.  I just want to make sure I am not taking an ill advised unsafe risk by downplaying this issue as more of the same of my unnecessary worry. 

 

I think it honestly for me is fear of becoming ill/disabled and ruining my life by trying to fix the situation I find myself in.  Finding the lesser of the two evils.  I know many on here came into this situation after already hitting problems without the advise of slow tapers here.  There are also those that have started with the advise here though and gotten stuck or became worse.  I hate that I did not come across this information back in 2011.  It would have made my decision much easier for me.

As a bit of background for me, I grew up in a family where my father was severely physically disabled and it worsened overtime.  He was always mentally quite strong.  So much so that for a long time, I wouldn't say the physical disability was even noticeable for me growing up with him.  I currently live in a situation where a lot sits on my shoulders.  If I were to become too ill to keep my job, we would have a very hard time making ends meet day to day.  My wife works hard but her profession does not pay enough to handle our mortgage alone. She is also in a similar boat because she has been on Wellbutrin for 15 years and while she acknowledges what I'm finding she says it is too triggering for her to look into more.  So, she avoids it. Since this situation is so poorly recognized by our medical community, I don't believe I would qualify for any kind of FMLA or disability.  There's also trying to determine just how much I can endure.  Also, the activities that bring me joy - tv programs, video games, drawing, and reading.  If I became too affected by WD to be able to enjoy these things for years, that would be very hard.  So again, it's just trying to determine which is the lesser of the two evils.  Do nothing/do something.  Sorry for the rant.  

 

No puppy yet.  We've been busy with the holidays and COVID has also makes it a bit harder to go out to places.  We also need to figure out a fence situation for our backyard.  My wife thinks the dog might give me something to distract and feel joy for throughout this ordeal.  We're thinking of getting a smaller dog just because it will be easier to keep them around the house.  But we're hoping to get something that is not too yappy.  I like yorkis.  And we're also thinking about a bichon frise.

 

I'm on day 2 of my use of fish oil.  I'm only taking one pill right now to try and get used to it.  A bit of a squishy stomach yesterday, but otherwise okay.  I'm not positive I'll be able to take the amount that is suggested in our thread due to a sensitive stomach, but if that is the case, I'm guessing that any little bit is better than none (assuming it doesn't ramp up anxiety symptoms).

 

Sorry if I sound like a broken record at all too.  I've been trying to work on this as it is an apparently normal problem with those with anxiety issues (Claire Weeks talks about it in her books), but often times I find myself accidently asking questions I already have.

[Colonial]

5 minutes ago, Halcyon said:

However, where I am confused is if a person manages to taper to a smaller amount but cannot get past that amount.  Does the smaller amount increase the likelihood the person's body will reach tolerance withdrawal symptoms? 

 

 

I've honestly never heard of such thing as "tolerance wd symptoms".

There are wd symptoms, and then there is "tolerance" when whatever "benefit" a person feels they are receiving ends.

But usually "tolerance" is before wd, since tolerance  leads to dosage increases and or coming off a drug to try another.

This is where wd comes into play, if the taper is too fast.

 

But one really has to decide ahead of time if one wants to stay on the drug for any supposed benefit or not.

Because there is something to say that even if you think you are getting some benefit now, that could end next month.

Only you can decide if whatever benefit you are receiving is worth staying on the poison.

 

Then there is the reality that depending on what med you are on, it makes a person ineligible for using other meds for certain issues

Could the wd make you worse than staying on it?

Possibly, but not probable, since there is a percentage of people who can CT and have no issues whatsoever.

Granted we would never recommend that, but the truth is wd does not affect everyone.

A well planned taper reduces the risk even further.

 

I don't know what material you are reading that suggests that even those who do a "slow" taper suffer debilitating harm.

My suspicion is there idea of a "slow taper" isn't slow at all.

But if they feel a year is "slow", well then there you have it.

 

I was on Wellbutrin like your wife, 300mgs for 6 months, look me 3 plus years to get off it after initially crashing at the beginning.

I Was told I could just cut it right in half to 150mg, no problem, after being on it for that significant period of time.

Had to wait almost 9 months to stabilize.

If I had been given proper tapering instructions for a drug with a long half life and stuck to 10% every 2 months I most likely would have been fine.

 

Again, that's not to say I may not have had some "bumps" along the way but nothing like I had to suffer.

 

25 minutes ago, Halcyon said:

Also, the activities that bring me joy - tv programs, video games, drawing, and reading.  If I became too affected by WD to be able to enjoy these things for years, that would be very hard. 

 

Well, with all due respect, this is all part of adulthood.

If you want to be a Father someday, things that you "enjoy" like video games are going to have to take a back seat eventually.

The issue needs to be, how do I remain functional to fulfill my Duties in life more than how can I "enjoy' life personally.

Like all of us in life, you will have to prioritize what are your responsibilities to wife and family and society first.

Then whatever personal enjoyments that we enjoy can be added in after that.

 

32 minutes ago, Halcyon said:

Since this situation is so poorly recognized by our medical community, I don't believe I would qualify for any kind of FMLA or disability. 

 

Insurance companies and the government know more than they let on.

You would get disability, just don't expect them to take responsibility for why your disabled.

They have special labels for everything, and at the end of the day, the check is the check.

While we would all love the drug companies to be up front and take responsibility, in the end the benefit will mostly be the same regardless why your ill.

They will just label you as chronic fatigue or undefined neurological, etc.

 

37 minutes ago, Halcyon said:

 

There could be many factors.  I do tend towards worry anyways and this is something I'm working on.  I just want to make sure I am not taking an ill advised unsafe risk by downplaying this issue as more of the same of my unnecessary worry. 

 

Try this, try sneaking up on this question from behind...

Why do you think that a well planned taper is an "unnecessary risk"?

And if you think it is, then why are you obsessing about trying to get off the drug?

 

(There's some disconnect here "we" (you) haven't pieced together yet.

Take some time and think if it's really the potential risk that's keeping you from trying to get off the med.

Or is if some other fear of what life will be life for you drug free that is blocking you from trying, even though you seem to "want" to go off.

 

It's almost as if... and I could be dead wrong, but, it's almost as if, subconsciously...

You want to be off, but the fear of some physiological catastrophe happening after your off is really what your afraid of...

So you've created a mental block of blaming the "risk" of the WD as a reason not to go off.

When it's really the fear of the "what if" that might happen if your med free that's really putting up a road block to be willing to at least try.

 

Because you have a very good point, even if all you ever do if cut your med in half, that's a huge benefit in so many ways.

 

 

 

 

[Halcyon]

I would like to ask a question of the moderators as depressing as it is for me to because I think I know the answer.  I've been talking about this with my wife a lot lately and determining how likely I am to succeed at a slow taper from this drug and how rough there is a risk of the process being.

Here's the rub lately.  I think the trigger has been the anxiety over this.  I know reading people's stories on here that have also taken escitalopram or citalopram has triggered it.  Likewise, seeing some of the folks suffering on sites like twitter spikes it.  Also, knowing I've been on this drug for 12+ years and every day I do nothing I'm adding more time on and possibly more difficulty coming off.  But for the last two weeks I have found myself under extreme anxiety.  My appetite has been shot, I've been sleeping a lot more than normal, and I've had just a general anxiety going with surges of panic/anxiety attacks.

 

I've started to take a new online session in CBT (although I've read people saying it's not helpful here so that discourages me).  I've been doing daily walks, listening to claire weeks, trying to practice accepting and floating.

 

So the question, is there any point in attempting to start to taper if I am having all these struggles with anxiety currently.  Or is the general consensus that until that is better making any changes would result in problems?

 

I don't think this anxiety is related to the drug reduction I did in September.  I was having a lot of this anxiety before I made the reduction.  It's been 4 months and the anxiety has been worse over this holiday break and is very clearly triggered by my reading/worrying about the taper process.  

[Colonial]

2 hours ago, Halcyon said:

I think the trigger has been the anxiety over this. 

 

I think your probably right.

Your having a very similar reaction to some who, once destabilized or they start a taper, and they have any difficulty, panic and want to reinstate.

Because now they are worried about not knowing how bad it will get.

 

While that may be true for people already destabilized, for someone in your case I would not think it a risk.

Except for the fact that your already having what you call "freak outs" (yelling screaming crying, etc.)

And now your anxiety is spiked like someone already in WD.

 

My concern is your already making yourself sicker than the WD likely would, which is sad.

So one could say then adding WD on top of your current mental state is probably not wise.

Since you may just panic worse at the first sign of "normal" symptoms and reinstate up and down and make yourself sicker than if you did nothing.

But maybe that's what you want to hear subconsciously for some reason, IDK.

 

 I would love to help support you through a well planned taper considering what you have said you seem to have everything going for you.

Except for the mental block which may do more harm to you than starting a taper.

Until you get to the bottom of why your so afraid and incorporate non drug coping habits to cope you may make yourself worse.

And I don't think it's the healthy reading and preparations I think it's your overcome by the negative extreme stories that have you paralyzed.

Even though all indications they are ones that happened from bad planning and rushed tapers.

So you need to get to the bottom of why that is.

 

2 hours ago, Halcyon said:

So the question, is there any point in attempting to start to taper if I am having all these struggles with anxiety currently.  Or is the general consensus that until that is better making any changes would result in problems?

 

On the other hand, perhaps the only way to get past your fear is to begin, see it's not so bad, and gain some confidence.

The  anxiety itself should not preclude you from starting, it's WHY your having the anxiety and will you let it rule the taper?

That is what could sabotage the process.

 

Only you can decide how much self confidence you have and what your truly afraid of that's keeping you from trying.

We can't really answer that.

 

 

Edited January 2, 2021 by Colonial

[Halcyon]

Just a status update.  I'm not sure very many people are reading this and I can see a lot of people in a worst situation right now needing more feedback/help.  

I recently had some scheduled bloodwork to follow up on my health and see what I'm dealing with.  I've suffered with GERD and mild IBS for about 15 years or so.  Thankfully, I have not been able to tolerate PPIs for a long time.  At the beginning of my issues I had taken Protonix, but I found all the PPIs made me extremely nauseous to the point of not being able to tolerate them.  For many years, I was getting by watching my diet and taking generic Zantac.  I started getting tolerant of it and was recalled a while back (a source of major health anxiety if I think about it).  I was switched over to generic Pepcid and have had to take 40 mg a night.  The last few years on Zantac, I'd been having a b12 deficiency.  For a while I was getting b-12 shots monthly to correct the issue.  So, I wanted to see where my different levels were at.

My recent bloodwork now shows I am on the low side of normal for b-12 (286pg/ml - low end on the normal range is 230pg/ml).  I wanted to have the doctor give me a b12 shot as I've found the supplement to be stomach upsetting before, but he did not want to order this since I am no longer in the deficient side.  My folate levels were decent (13ng/ml - normal range being 3-16).  For the second time in two years, my vitamin d levels are showing as deficient (22ng/ml - normal range is 30-60).  I was hoping this wouldn't be the case as I walked/biked outside pretty consistently all summer and this winter).  However, when I look at my diet the majority of items I eat are not fortified with any D and up until recently I did not often eat any fish.  My cholesterol was also high which I'm looking at trying to correct.  

After reading the posts hear on heartburn drugs, I've been trying to address this and my vitamin deficiencies.  I recently tried to wean off of pepcid by reducing my medication by a 4th for a week (30 mg nightly).  Unfortunately, it resulted in my esophagus/les area becoming inflamed (sharp knife like pain worse when inhaling or moving in certain ways) and did not start to improve until I stepped my dosage back up to 40mg.  I've read that h2 blockers can also have rebound acid production on elimination.  I'm not entirely certain if this was that or if it was just the original issue breaking through.  I've looked over some proposed solutions diet wise for GERD but not sure where to proceed just yet.  It appears a lot of the proposed diets online are more fads that are cautioned against by many doctors and dietician/nutritionists and I probably do not want to add any more issues that might make SSRI withdrawal problematic.

I would like to begin a very slow taper that minimizes my withdrawal and hopefully increases my chances of success.  I've looked at what the users Karma and Rhiannon have done as a hopeful example since I would like to keep my symptoms minimal enough to maintain work/life.  My hope is that this slow withdrawal will also allow me to tolerate any needed nutritional supplements, but from what I am seeing in the various stories here, nothing is guaranteed.  Also, I would like to see if I can find a way to not need the Pepcid daily, but if I am not able to get rid of this medicine, I would like to get it down to a lower amount.  Regardless, I hope that it will not prevent a successful SSRI taper if my b-12 and D levels are good.  I imagine a successful minimal symptom withdrawal from my SSRI will take between 5-10 years minimum so I want to take whatever steps I can to make it successful.

My wife and mother feel that addressing my bloodwork numbers would be better to solve first before moving on to the SSRI taper and will help that be successful.  I hope so.  I guess everyone deals with, but sometimes, I see the length of time I've been on the SSRI and then see more time adding on and it panics me that I'm increasing the odds of never quitting successfully.  At the suggestion and urging of my mother I'm making an appointment with a DO in my area who has a background in functional medicine and is reviewed highly by patients.  I'm not confident it will be any better an experience than my usual visits with my current GP (MD), but we will see.  My mother is hopeful she will have better ideas to address the nutrition and will also be more receptive to the information on SSRI withdrawal.

 

Oh yeah, my current GP in my checkup said if I wanted to quit my Lexapro since I was basically on 10 mg and it was such a low dose I could just quit it whenever.  I swear... scary stuff.  

Wishing others well.

Hal

P.S. I forgot to mention for now since I am relatively stable CNS wise, I am taking a children's complete multivitamin that has D and B12 in lower doses.  Hopefully it's not too minimal to have any effect, but I figured it could not hurt things right now.

[ChessieCat]

From Post #1 of the Tips for Tapering Lexapro topic:

 

On 5/27/2011 at 12:16 PM, Altostrata said:

If you are taking 5mg of Lexapro, it's not tiny, it's equivalent to 10-20mg Paxil or Celexa.

 

On 5/27/2011 at 12:16 PM, Altostrata said:

Special considerations
A significant characteristic of Lexapro is that milligram for milligram, it is much stronger than other SSRIs. Chemically, Lexapro is a variation of Celexa; the molecule was re-engineered to be patentable as Celexa's patent was about to expire. The streamlined molecule is a more potent SSRI, 2 to 4 times stronger than others. (Wikipedia has a good explanation of this at https://secure.wikimedia.org/wikipedia/en/wiki/Escitalopram.)

However, many doctors are unaware that escitalopram is stronger than other SSRIs and dose it as though it were the same strength. Although the so-called usual starting dose of escitalopram, 10mg, is equivalent to 20mg-30mg or more of, for example, paroxetine (Paxil), your doctor may have moved you to an even higher dose. If you are taking 20mg of escitalopram, you are taking a hefty dose of an SSRI.

 

 

 

[Halcyon]

Thanks @ChessieCat.  Believe me, I'm well aware how wrong my GP is stating it's a low dose.  I was more just mentioning how crazy it is that had I not known this, how dangerous his advice would be.  Sorry if that was not clear.  I really do not understand how doctors still believe and say this advice.  It really makes me have a lack of confidence in anything they say which is probably not good.  I am assuming his advice on me addressing my vitamin D levels is correct though.

[Yesyes123]

Hey, are you dropping by cutting the pills or taking liquid?

[Gardenlife]

Hey there!! I’m late but just joined! I have been on lexapro for only about 16months however I was on Celexa which is like the sister medicine to Lexapro, for about 20 years.

I came off Celexa to have my first baby and have now come off lexapro for my second. I’m a girl and have never heard of or even thought about antidepressants and male sperm but that’s interesting! I am 37 and also feel

like I am running out of time!! I did a taper of 2 months because that’s what my doctor advised and then I found this forum and realized I did it way to fast so kutos to you for doing it slow!Get  yourself on a good magnesium supplement. And do the research because you don’t want one that will make you poop!! And you want one geared towards anxiety. And I would try a heavy dose. Everybody is different so no one really knows what each body needs. The recommended amount is around 400mg HOWEVER studies have been done with about 300mg PER MEAL AND AT BEDTIME, has helped depression and anxiety. That’s a lot more than 350mg a day. Also, studies have shown that people actually loose magnesium while stressed!!! So not only can magnesium deficiency cause anxiety, but anxiety can cause magnesium deficiency so people get stuck in an ugly cycle. I’m not a doctor but I sense you are a research guy so do the research and give it a try! There are also tons of other vitamins that maybe your body needs. How are you feeling now; 5 months after your post? I posted my first recently but still waiting for admin.

[DataGuy]

Hi @Halcyon,

 

Good to hear your update. It's excellent that you are so meticulous in getting everything in order before you start to taper. As for the low readings on vitamin D in spite of being outside and exercising plenty, I think that in some cases this can be related to long term psychotropic drug use. I have heard of quite a few people that have low readings despite getting plenty of sun and eating well. Psychotropics also tend to cause problems with lipids, cholesterol, triglycerides etc. Antipsychotics do this famously, but antidepressants can too. It has been pretty well studied now and there does seem to be an association between antidepressant use and a type II diabetes diagnosis. If you search the forum, I think you will likely find plenty who had vitamin D problems as well as metabolic issues. I know I had fatty liver prior to coming off meds, which cleared up post-withdrawal. @arbor mentions she was diagnosed with type II diabetes on ADs, but had the diagnosis reversed after coming off. So, in some sense, starting your taper may be the best thing you can do to begin to normalize your bloodwork results (assuming the drug is contributing to these issues). 

 

Hope all is well and things are not too stressful for you : )

[Halcyon]

@Yesyes123 Sorry, I have not been visiting my post in a while.  I'm currently holding at 12.5 mg until I get some needed nutritional deficiencies addressed.  I'm currently using pills but plan to try liquid when tapering.

@GardenlifeWelcome and I hope you get the relief you're looking for.  This seems to be the most informed place for SSRI withdrawal information.  I have been looking at starting to take a magnesium glycinate supplement.  Currently trying to decide on a good one.  I am stuck on tapering because of anticipatory anxiety right now.  Currently pursuing CBT and trying to make the best informed guess as to safety of coming off.
@DataGuyThanks DataGuy.  You're always a kind voice.

Recently met with a person also tapering after 17 years of poly pharmacy and was interesting to get their take on things.  In preparing for talking/looking for any possible supportive doctors/therapists, I looked into my drug history in more detail.  Scouring old records.  Discovered I've actually been on SSRIs a total of 15 years (had thought 12-13).  Also was on a tricyclic for a year and a half.  Made me very upset/disappointed to realize how long I'd been on the drugs already.  I updated my signature to reflect the changes.  Hopefully it isn't too cumbersome.

[jutland86]

Hi @Halcyon

 

Just read your thread, and I can see that you have started your taper. How is it going?

 

Hope everything is well