Nai1: reducing Lexapro 20mg

[Nai1]

Hello, 

I am coming off Lexapro. I’ve been on it for 6 months. This has been the first antidepressant I have ever taken and I take no other medication. Although I feel really good, I have started to get an extremely low pulse rate constantly and low blood pressure. This has been the case for about 3 weeks now. My pulse is hovering between 48 to 55 beats per minute. I am also experiencing dizziness when getting up. I had read that Lexapro can cause Bradycardia.
On 19th September I reduced the dose from 20mg to 15mg. I am planning to cut down every 3 weeks. I have decided not to jump from 15mg to 10mg in one go and will go from 15mg to 12.5mg. I will stay on each lower dosage for 3 weeks. Do you think 3 weeks is long enough for each step? Have you any recommendations with cutting down? Should I be doing it more slowly for example? Drops only exist in 20mg here, so unfortunately I cannot use these to reduce mg by mg. I am feeling extremely lethargic. I am putting this down to my low blood pressure. 

I hope you will get back to me. I was very happy to fall on your website and read your very helpful information. 

[Gridley]

Welcome to SA, Nai1.

 

You are going tapering much faster than we recommend.  We recommend tapering no more than 10% of your current dose every four (not three; three isn't long enough) weeks.  When you say "drops only exist in 20mg here," do you mean 20mg tablets?  How did you get your 15mg dose, by cutting tablets?

 

Why taper by 10% of my dosage?

 

If liquid Lexapro is available in Australia, that's the easiest way to taper.  If you can get liquid Lexapro, I would hold at 15mg for one week, taking half your dose in liquid and half in tablet form.  If you're feeling stable after that week, you can begin a 10% taper.  If you can't get liquid Lexapro, you can make your own liquid or use the Gemini-20 digital scale, available on Amazon, to weigh your dose by crushing tablets into powder between two spoons.  This link is specifically about tapering Lexapro.

Tips for tapering off escitalopram (Lexapro)

 

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 

 

Omega-3 fatty acids (fish oil) 

 

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

 

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 

 

Omega-3 fatty acids (fish oil) 

 

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

 

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

 

 

 

 

 

[Nai1]

Hello again,

‘Thanks so much for getting back to me. When I talk about drops, each drop is equivalent to a 20mg tablet, so my doctor thought it would be too hard for me to use them. I thought each drop would be 1mg and then it would have been fantastic for cutting down. I wish I could do it like that. I was wondering about asking the doctor if a compound pharmacy could make this dosage up for me. Does this happen? I am seeing my doctor on Tuesday again, so any extra information you can give me which I can pass on would be fantastic and extremely helpful. 
Today I am feeling very flat and so tired. I just haven’t got any energy. I’m putting this down to my low blood pressure and hope that will pick up soon. 
So currently I am at 15mg and have been on this dose for 16 days. I will not reduce the dose until 4 weeks is up. You say then every time I reduce it should be by 10%? So this means that the reduced dose will then be 13.5mg? My maths isn’t very good this evening - if I reduce by 10% each time for a month, how long will it take me to get off Lexapro completely? 
I will have to look on Amazon for that Gemini digital scale. Wish I could get hold of 1mg drops!

[Gridley]

5 hours ago, Nai1 said:

I thought each drop would be 1mg

We all wish this were so but unfortunately the drug companies don't make it easy for us.

 

Compounding pharmacies are definitely a workable solution.  One of our moderators, ChessieCat lives in Australia and has been using a compounding pharmacy for years to taper Pristiq.  You'd need your doctor to be cooperative and willing to give you a new prescription every four weeks for the next dose.

 

5 hours ago, Nai1 said:

You say then every time I reduce it should be by 10%? So this means that the reduced dose will then be 13.5mg?

Yes, every time you reduce it will be by 10% of your current dose.  13.5 is exactly right.  Any way to remember this is you multiply your current dose by 0.9.

 

5 hours ago, Nai1 said:

- if I reduce by 10% each time for a month, how long will it take me to get off Lexapro completely? 

An easy way to calculate this is that when you reduce by 10% every four weeks you will go down by half every six months.  So in six months, you'll be at 7.5mg.  Another 6 months, 3.7mg etc.  When you get down to the low doses it starts to feel very slow, because the halves are smaller and smaller. It can be hard to wrap your head around how long it takes, but the time does pass and with every reduction you're reducing your drug burden. If you'll look at my signature, you can see how long it's taken me to get from 20mg Lexapro to near jump-off point at 0.05.  I used a slightly slower tapering method, the Brassmonkey slide, so I reduced by half every nine months instead of every six on the 10% method.

 

 

[Nai1]

Lovely reply from you. Thank you so much. Would you say that when I was on 20mg Lexapro that this was the cause of my Bardycardia? This was the reason I actually thought I must reduce. 

[Nai1]

I just read your story. You’ve certainly been through a lot! You’re almost there with the Lexapro! Fantastic! Why did you decide to stop Lexapro?

[Nai1]

How could I get in touch with ChessieCat?

Can you get the oral solution where each drop is 1mg where you live?

[Colonial]

53 minutes ago, Nai1 said:

Lovely reply from you. Thank you so much. Would you say that when I was on 20mg Lexapro that this was the cause of my Bardycardia? This was the reason I actually thought I must reduce. 

 

Welcome Nai!

 

If you can update Your signature line with the as close to exact dates You started the Lexapro, the time of day taken and when You began dropping it from 20 to 15 it would be most helpful since as Your thread grows longer it will be harder to scroll back through Your entire history. Also, keeping a "Symptom chart" will be most helpful. Times-dates, length, etc of symptoms throughout the day. . It is the best way to see patterns between Your medication schedule and possible side effects or withdrawal patterns. It may be easier for you to deduce if the medication is responsible for a side effect if you are only on one med  but you phrases like "about 3 weeks ago" make it difficult to know what came first, the symptom or the WD, and since you dropped a very large percentage dose one could either be the cause of the other or make something worse. 

 

You can do some research to see if there is a compounding pharmacy in your area. If You have just recently made a 25% drop it would be wise to hold at that level for a good 10 weeks. I still don't see where You answered if You are on the pills or not? I'm not following the discussion about the "drops" and if your using a liquid of some sort.

 

[Gridley]

@Nai1

 

Regarding Bradycardia and antidepressants, it's certainly possible. Please read the following:

 

Although antidepressants are commonly used in clinical setting, numerous negative effects of antidepressants on the cardiovascular system have been reported to date, including bradycardia, tachycardia, hypertension, hypotension, orthostatic hypotension, electrocardiogram (ECG) changes, electrolyte abnormalities, ...

 

9 hours ago, Nai1 said:

Why did you decide to stop Lexapro?

I wasn't really having any problems with any of my three drugs.  I just wanted to be off them.

 

9 hours ago, Nai1 said:

How could I get in touch with ChessieCat?

 

Post in your thread with your question for her, preceded by @ChessieCat.  When the rectangle with @ChessieCat pops up, click on it and she'll alerted.  She recently posted in Nicjk's thread about compounding pharmacies in Australia, so there's good information about that for you there.  

2,548 views

 

9 hours ago, Nai1 said:

Can you get the oral solution where each drop is 1mg where you live?

No, no oral drugs available here.

Edited October 5, 2020 by Gridley

[Nai1]

Hello there 😊 

Just been to the doctor. I got hold of the oral drops! My doctor kept saying that 1 drop was 20mg last time I asked! I researched more and each drop is 1mg! The pharmacist didn’t even know about them. They also said each drop is 20mg. Then they had a look on the computer and saw it was in fact that 1 drop equals 1mg. Honestly..... where would we be without our own research! None in stock in 2 pharmacies, so they are ordering them in for me and they’ll arrive tomorrow. I’m so pleased, because this will enable me to go down slowly now milligram by milligram. When do you think I should go from 15mg to 14mg? I’ve been on the 15mg tablet for 17 days now. I must say my heart rate has increased, I’m not getting dizzy when I stand up, my head fog has gone and energy levels are up again. 
Here’s a photo of my prescription. Can you check that is in fact right. 1mg equals 1 drop. Your help is fantastic!

[Colonial]

 

2 hours ago, Nai1 said:

Then they had a look on the computer and saw it was in fact that 1 drop equals 1mg.

Here’s a photo of my prescription. Can you check that is in fact right. 1mg equals 1 drop. Your help is fantastic!

 

I see that it says 1 mg is equal to 1 ml but it doesn't say how many mls are in a drop.

I'm not saying your wrong, I realize your basing that on what they looked up on the computer but the photo it doesn't say anything about 1 mg equals 1 drop.

 

Do you have access to the site where they located that information? That 1 drop equals 1 mg?

If it is correct, than 14 drops daily would be 14ml.

Do you know why they have Qty: 15 ml listed?

 

Hopefully it's all correct and you can get reliable drop sizes each day!

It's wise to first stabilize on the dose you are currently taking before dropping again.

so You would switch to 15mg of the liquid first nd stay at that dose for a period to see if Your body has a reaction to the different formulation.

Mine certainly did from extended release pill to liquid drops but each med and each person reacts differently, so your change over may be mild.

Only time will tell.

We still need to know how your getting the 15mgs, if your just cutting a larger pill up, or are you dissolving the whole pill and consuming only 75% of it, etc.

 

Once you update the signature line with you med dates and symptom notes it will be easier to see if the issues are side effects or withdrawal symptoms.

This will determine how long you need to hold before changing over to the liquid for stabilization before than dropping again.

Glad you were indeed able to find them! 

 

 

Edited October 6, 2020 by Colonial

[Nai1]

At the moment I’m taking 1 x 10mg and then halving a 10mg tablet to make it up to 15mg. When I drop the dose to 14mg I was thinking of taking a 10mg tablet and 4 drops. What kind of reaction did you get with the drops?

[Colonial]

That seems wise to keep the majority of your dose in the old form as long as You can.

I was taking 2 controlled release tablets and switched to taking 1 and making up the rest of my dose with immediate release liquid suspension by syringe.

Since the liquid was immediate release instead of extended, I had withdrawal symptoms adjusting to almost 50% of my med absorbing differently.

Since there is always a concern regarding if the body will need time adjusting to the new formulation your plan seems wise for now.