amc2020: introduction and looking for advice

[amc2020]

Hi there-

 

Looking for reinstatement advice. 

 

After having a panic attack in mid-March 2020, I was prescribed klonopin for acute episodes, along with Lexapro to take on an ongoing basis.  Before the panic attack, I was having symptoms of general anxiety (difficulty relaxing, circular thoughts, insomnia, etc), though I never felt depressed.  I did not heavily research these drugs before taking them. 

 

The klonopin was effective in calming me down and allowing for sleep, and in late March 2020, I began taking a very low dose of the 10mg Lexapro that I was prescribed- about 2.5mg for a week, up to 5mg for 5 weeks or so. At first, I felt great-- I could sleep, my thoughts were logical and clear, and I was able to remain positive despite being in NYC during the height of the pandemic (and working an incredibly stressful job).  In early June 2020, I increased the dosage to the full 10mg pill. By late June, my brain was hazy, I had rapidly gained about five pounds, I was extremely tired, and I was having a difficult time orgasming and decreased sexual thoughts- though I still had some libido, lubrication, arousal, etc. 

 

I consulted with my doctor and decided to come off the Lexapro, and though she said to decrease the dose over 2-3 weeks, I did not think too much of it.  I dropped down to 5mg for a week and felt improvements in my sexual desires/sensitivity.  The week after I dropped to 2.5mg, and then stopped altogether.  For about a week or two, I felt the withdrawal- I felt anxious, depressed, and agitated, but attributed it to coming off the drug. 

 

August 2020 until about 14 days ago, I felt incredibly flat- no strong emotions, along with severe sexual dysfunction (numb clitoris, inability to orgasm, no libido, no lubrication, no sexual thoughts, etc). Upon reading this and other forums, I have concluded that I must have PSSD. I decided to reinstate with my doctor's guidance; I started at 2.5mg 14 days ago. The first two days I felt an increase in my libido and emotional functioning, but that initial bubble has since stopped though I have continued to take the low dose. 

 

I'm looking for advice if I should continue at this dose, increase to 5mg, or try to slowly taper back down?

 

This has been incredibly distressing so appreciate any guidance (and hopeful stories!).

 

Many thanks.

[Gridley]

Welcome to SA, amc2020.

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.  This signature will appear beneath all your posts and is very helpful to the staff.  A list format is best.  Use this link and press "save."

 

Account Settings – Create or Edit a signature.

 

You are experiencing withdrawal caused by your extremely fast taper of Lexapro.  PSSD is one symptom of withdrawal.  You will heal but it can be a very slow process, the length of which is impossible to predict.

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

How are you feeling now with the 2.5mg dose?  I know the initial bubble has passed but is the 2.5mg generally causing no problems?

 

I would not increase to 5mg.  Your system is very sensitized and too much of the drug could overwhelm it.  I would hold at 2.5mg for several months to let your system stabilize.  At that point--but definitely not now-- you can begin a slow taper down to zero.  We recommend tapering by no more than  10% of your current dose every four weeks.

 

Why taper by 10% of my dosage?

 

For future reference, the following link is specifically about tapering Lexapro, including how to get the nonstandard doses you'll need for your taper.  When you're ready to taper, SA recommends you switch to liquid Lexapro, which will be an easy and accurate method to get your doses.

 

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.

 

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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

[amc2020]

So appreciated!  

 

I have not had any adverse effects from the 2.5mg dose, except perhaps that my emotions are more muted. That said, I have been sleeping better and feel generally more calm. I am disappointed that the so-called bubble did not remain, and I wonder if those feelings will return when I stabilize? 

 

Thank you for the reply.  This site and the frequent assurances that this too shall pass, with some time, have been enormously comforting during what is an extremely troubling experience. 

 

P.S. I thought I saved the signature, but alas, as I see this post published it's not there.  Will ensure it is for future reference. 

[Gridley]

That's good that the 2.5mg reinstatement isn't causing any problems, that you're sleeping better and that you're feeling calm.   As I said, I'd hold there for several months before you start to taper.

 

For sure, this too shall pass. 

 

You'll need to do your signature on a computer rather than a phone.  If you used a phone, that's likely the problem.