Camille: Lexapro WD "threshold"from 5mg to 2.5mg?

[Camille]

Everyone is different, for some people tapering slowly doesn't help or doesn't make them avoid terrible symptoms. I don't think I should have stopped my med. In September, when I reduced from 10mg to 7,5mg and immediately felt anhedonic, I think I wrongly interpreted it as a withdrawal symptom whereas it could have simply been the proof that the medication was working. If you feel good or good enough on the med, don't take the risk of reducing it thinking that tapering slowly will allow you to avoid suffering, for some people it doesn't. For some people , they barely feel a thing when tapering and at one point, for unknown reason, everything goes bad. If you think you might be prone to ADWD and you fell good on them, you might think twice about taking the risk to reduce your meds even if you don't believe in meds or are ideologically against them. And tapering doesn't alleviate the suffering for everyone

[Go2zero]

On 2/4/2021 at 11:12 PM, Camille said:

My pharmacist will occasionally change the brand of the med and I don't mind because it doesn't make any noticeable change on me. Right now, the 7,5mg part of the pill is from a brand called " Biogran" and the 1,25mg part is from "EvoluGEN".

 

Changing brands or generics can lead to withdrawal symptoms. Although the active ingredient should be the same, it is clear and often proven that different makes are often not having the same effects. Lots of generics seem to be different from the original and other generics. You should ask you doctor and pharmacy to keep providing one and the same version. If possible best the original one.

 

 

On 3/2/2021 at 7:39 PM, Camille said:

Interesting Update : In February, I started the process of converting my solid med into liquid. Initially, I wanted to go this way : every week convert 1,25mg into liquid until total. After 1 week, when I started converting 2,5mg into liquid, I began having symptoms that I usually recognize when "overdosing", which were insomnia, anxiety, sweating, difficulty swallowing, trouble with my vision. So i concluded that the liquid form was more "powerful" than the solid one and little by little, after some experiments (that were probably pretty risky in retrospect, but also the overdosing symptoms were pretty nasty) it led me to figure out, based on my physical symptoms, that the appropriate dose in liquid form for me was 3,5mg.

 

You seem to be making conclusions here that a solution (self made from pills) is much stronger than dry pills. This is NOT true. When you make the solution in the right way and you dose it in the right way, it is as strong as the pills.

 

However one should always make a gradual transfer from pills to liquid. Changing 1 time as you did, may cause symptoms...

 

How do you make the solution? Please explain in detail. Maybe the problem of your current situation lies in making mistakes in making the solution. 

 

How much mg of the pill (pill weight and active ingredient) do you use? How much water do you use? How long do you keep the solution? (it should be kept for maximum 5 days and refridgerated). When you use too much water (you write 125 ml per day?) the solution may loose strength much earlier during 5 days. Or the active ingredient will not spread evenly when using too much water.

 

Explain in all details how you make (and take) the solution please!

 

 

 

On 5/11/2021 at 2:02 PM, Camille said:

On 3/5/2021 at 2:22 PM, Yesyes123 said:

I truly hope you are right that 3.5mg is the right dosage for you, but that sounds like a VERY big drop from your previous dose. It honestly sounds a bit scary to me. There shouldn't be such a big difference in potency from the liquid to solid, if any at all? 

Hey I know that seems crazy, but not impossible! When dissolved, the med is absorbed "buccally" (like directly into the blood through the tissue in your mouth). When you swallow it, it goes through a completely different system of absorption (through your digestive system and liver). 

 

This theory does not apply for SSRI's. These meds need time to build up in the body for what they do. They are NOT working immediately. The comparison with cannabis you make somewhere in your thread, makes no sense. Cannabis creates effects within minutes. A SSRI needs several days!

 

My conclusion is that you have made an extreme change in dose when going from 8,75 to 3,5 mg in february of this year. The theory about stronger effect in liquid form does not hold!

 

The effect of such an big dosage change may be felt not before 2-4 months after doing so. So the fact that you felt worse and worse after May this year, may very well be the result of this way too big drop in dosage in February (or March high you also mention somewhere)

 

 

On 5/20/2021 at 10:42 PM, Yesyes123 said:

I'm confused about what you're doing - you're taking 120mL of Lexapro liquid with 3mg active ingredient? 

 

See my comments above. I do not understand this either.

 

On 5/23/2021 at 11:46 PM, Altostrata said:

3mg is a very small amount of escitalopram, but it has about 20% receptor occupancy. There is no such thing as a "therapeutic dose" when you're decreasing the drug. Obviously, if you get withdrawal when you decrease, the drug has some effect on you.

 

Often the last little bit is the most difficult. You may wish to stay at 3mg per day for a good while, perhaps a couple of months, to let your nervous system regroup before making further decreases.

 

 

 

On 5/26/2021 at 6:22 PM, Yesyes123 said:

Hey! The actual effects of a dose reduction (or any alteration) usually can't be felt immeditately. It takes at least 4 days, sometimes a lot more, for effects to be felt. It seems to me the effects you felt from the small reduction might have been from something else...

 

Edited September 1, 2021 by Go2zero

[Go2zero]

On 8/14/2021 at 8:31 PM, Camille said:

Thank you @Yesyes123 for your encouragement. Unfortunately, I can't up my dosage like you did because I experience adverse reactions whenever I try upping my dosage.  Thanks for your advises and recommendations, it means a lot

 

What kind of adverse reactions you get when you updose. When and how did you updose? What was your dosage and with how much did you updose?

2 hours ago, Camille said:

Hello I am taking 3mg (homemade liquid) since March, I didn't do anything in late July. I just think withdrawal works differently for different people, I didn't feel any withdrawal until this hit me very suddenly one day. I had tried before going under 3mg and I was hit with the same horrible sensations so I had to go back on 3mg. It's like 3mg is some kind of threshold.

 

As said in my earlier post, the effects of a too big change in dosage often are felt after a period of 2-4 months. At first one thinks that everything is OK after the big drop in dosage. (sometimes people even start feeling much better). And then after 2-4 months the BIG BANG comes....

 

I guess this is what has happened. Probably you came in heavy withdrawal because of this.

 

Stabilizing is what you need to do. Any big change in meds may make this worse. I agree that hospitalization may mean more meds.....

 

The only thing you could do is maybe a light up-dose of the escitalopram.

 

Before you do anything, please answer in most detail how you measure and make your own liquid. If you would have made a mistake there, the problem could be found there as well....

 

[Altostrata]

@Camille, how are you making your liquid? How long are you keeping it?

 

The "anhedonia" you felt when you reduced Lexapro most likely was a very common withdrawal symptom. It's a very common mistake people make to think this is "depression" returning.

 

If you don't think you should have gone off Lexapro, you can take it again, or its gentler sibling, citalopram (Celexa). Suggest that since your system has been sensitized by withdrawal, you might take a low dose, no more than 5mg, of citalopram to start. Lexapro (escitalopram), is 2-3 times stronger, milligram for milligram.

 

On 3/2/2021 at 10:39 AM, Camille said:

Interesting Update : In February, I started the process of converting my solid med into liquid. Initially, I wanted to go this way : every week convert 1,25mg into liquid until total. After 1 week, when I started converting 2,5mg into liquid, I began having symptoms that I usually recognize when "overdosing", which were insomnia, anxiety, sweating, difficulty swallowing, trouble with my vision. So i concluded that the liquid form was more "powerful" than the solid one and little by little, after some experiments (that were probably pretty risky in retrospect, but also the overdosing symptoms were pretty nasty) it led me to figure out, based on my physical symptoms, that the appropriate dose in liquid form for me was 3,5mg.

 

 

No, if you make it properly, the liquid gets into your system faster than the tablet, that may give you these symptoms. The way to fix it is to slightly reduce the liquid dosage, take it in divided doses, or introduce it more gradually.

 

Quote

progressively figured out that for me the liquid was way more powerful than the solid and turns out that the equivalent liquid dose for 8,75mg solid was 3,5mg homemade liquid

 

This is incorrect. By substituted 3.5mg for 8.75mg, you made a huge decrease in your overall dose and probably precipitated worse withdrawal with additional decreases by May.

 

 

Quote

June 19 : back on 5mg/June 23: back on 10mg, major WD gone after a few days /End ofJuly 2020: feeling amazing, like I never did before but I cannot pinpoint exactly why. Are the meds suddenly working although they never did before ? Did the probiotics repaired my gut? 

 

We know that reinstatement can reverse withdrawal syndrome, that is the "amazing" feeling. The meds are not suddenly working. Reinstatement can make you feel better. After a while, you can taper off slower and more systematically if you wish.

 

Currently, you are experiencing withdrawal syndrome, which often causes despair. Your taper did not go bad for an unknown thing. Please consider updosing to reduce your withdrawal symptoms.

[Camille]

Hello, thank you all for your answers.

Right now I am incredibly depressed but no longer suffering mentally or suicidal. My parents still want to hospitalize me and give me some meds but I am afraid I'll react badly to them and suffer more. When I tried last December an updose from 7,5mg to 10mg Lexapro I experienced adverse effects (insomnia, "mild aka?", visual disturbances, difficulty swallowing). When I tried an antihistamine last April I also experienced an adverse reaction so I'm afraid I'll react badly to any psych med I'm given. How to make them understand that trying more meds carry a huge risk of more suffering ?

I still regret ever trying to stop my meds but what is done is done and I cannot go back even though I wish. 

[Go2zero]

5 hours ago, Camille said:

Right now I am incredibly depressed but no longer suffering mentally or suicidal.

This is a good sign! It may go very slow but it is a sign of healing from withdrawal.

 

5 hours ago, Camille said:

My parents still want to hospitalize me and give me some meds but I am afraid I'll react badly to them and suffer more.

 

There is a big chance of adding meds when hospitalized. And yes, this may things make worse.... 

 

 

On 9/1/2021 at 11:06 AM, Go2zero said:

My conclusion is that you have made an extreme change in dose when going from 8,75 to 3,5 mg in february of this year. The theory about stronger effect in liquid form does not hold!

 

The effect of such an big dosage change may be felt not before 2-4 months after doing so. So the fact that you felt worse and worse after May this year, may very well be the result of this way too big drop in dosage in February (or March high you also mention somewhere)

 

On 9/2/2021 at 3:14 AM, Altostrata said:

This is incorrect. By substituted 3.5mg for 8.75mg, you made a huge decrease in your overall dose and probably precipitated worse withdrawal with additional decreases by May.

 

We need to get things clear about how you make your liquid and how long you keep it (and how long kept it before during the last period). This will enable to come with a better conclusion what happened and what you can do.

 

 

Please answer all the underneath questions. We need to have your answers in order to give a decent advice ! Please answer to questions of the moderators here. 

 

On 9/2/2021 at 3:14 AM, Altostrata said:

@Camille, how are you making your liquid? How long are you keeping it?

 

On 9/1/2021 at 11:06 AM, Go2zero said:

How do you make the solution? Please explain in detail. Maybe the problem of your current situation lies in making mistakes in making the solution. 

 

How much mg of the pill (pill weight and active ingredient) do you use? How much water do you use? How long do you keep the solution? (it should be kept for maximum 5 days and refridgerated). When you use too much water (you write 125 ml per day?) the solution may loose strength much earlier during 5 days. Or the active ingredient will not spread evenly when using too much water.

 

 

 

 

 

Edited September 3, 2021 by Go2zero

[Greatful]

@Camille  Hang in there Camille,  everything will work out, listen to the mods they will help get things figured out for you.❤️

[Camille]

On 9/1/2021 at 11:06 AM, Go2zero said:

My conclusion is that you have made an extreme change in dose when going from 8,75 to 3,5 mg in february of this year. The theory about stronger effect in liquid form does not hold!

@Go2zeroThanks a lot for trying to help me. I don't think that's the reason for what happened because had I done the 10% taper, I would also be at 3mg by July (started my taper in September). I think we are all different and tapering is a solution for some people but for others it doesn't work that easily. We are all on this website because doctors don't believe we're capable of assessing our own symptoms and their cause (they'll say it's our anxiety acting up even though we know it isn't). Here I am reporting that for me 3mg was like a threshold, above it I had absolutely no symptoms (except for anhedonia) and below it all hell broke loose. So I don't think it was a problem of not tapering slow enough. Antidepressant Withdrawal is not like benzo withdrawal where symptoms are kind of predictable every time you decrease your dose. For example on 10mg, i was not anhedonic and when I decreased to 7,5mg I was anhedonic. I don't think the anhedonia "WD symptom" could have been avoided by tapering slower. It's a structural thing that happens and that will take years to resolve and was not avoidable even by tapering slower. That's what I mean with the term "threshold dose". This website is great but one obvious conclusion it should draw is that we are all different and some people should not be advised to go off their ADs and maybe we should tell some people that if they feel good on their AD and if they're at risk for withdrawal, it's not worth the risk of tapering because tapering AD is not like tapering Benzo, you don't know what to expect, even if you're ideologically against ADs, the ideology is not worth the suffering. This website is about awareness of severe Withdrawal from ADs. One conclusion of the existence of such a phenomenon is that some people should not be advised to come off their meds, ever ! especially if they're not feeling bad on them. 

On 9/3/2021 at 11:51 AM, Go2zero said:

 

We need to get things clear about how you make your liquid and how long you keep it

I dissolve 3,75mg of pill in 150mL of water every morning and extract 30mL with a seringe, leaving me with 120mL of solution or 3mg. I don't think that's the problem.

[Camille]

On 9/1/2021 at 11:23 AM, Go2zero said:

 

What kind of adverse reactions you get when you updose. When and how did you updose? What was your dosage and with how much did you updose?

When I updosed from 7,5mg to 10mg last December, I experienced insomnia and a very disturbing feeling of inner agitation that did not completely go away after reducing again.That's why I am afraid of uping my dose, I don't want to experience this inner agitation.

Right now, the crisis is over, i can eat again and am not feeling as unbearably bad as I was, just exhausted and depressed. What happened was crazy and just shows how unpredictable WD is.

[Altostrata]

13 minutes ago, Camille said:

When I updosed from 7,5mg to 10mg last December, I experienced insomnia and a very disturbing feeling of inner agitation that did not completely go away after reducing again.

 

Your body was telling you that 10mg was too strong for you, @Camille This rather disproves your theory that more is better, doesn't it?

 

From the history in your signature, it is perfectly clear that your reduction from 8.75mg escitalopram tablet to 3.5 liquid provoked worse symptoms, symptoms that are not associated with depression or whatever psychiatric disorder you think you have but acute antidepressant withdrawal.

 

However, if you think tachycardia proves that you need to be a lifelong psychiatric patient, you are probably correct.

 

On 9/3/2021 at 1:21 AM, Camille said:

My parents still want to hospitalize me and give me some meds but I am afraid I'll react badly to them and suffer more.

 

Your parents want to do this because they think you're saying you want drug treatment for your symptoms.

 

Of course, it's highly likely that if you go into the hospital, you will come out on a batch of drugs. But that's your choice, and your theories seem to go in that direction -- you believe you need drug treatment, and apparently are sometimes very dramatic in your demands for help. This is what your parents are responding to.

 

We do not provide drug treatment here, we provide peer support for going off drugs.

 

I am not sure why you are participating here. You have strong opinions about what you've experienced from voluntarily going off Lexapro and ignoring everything we've told you here about withdrawal. You seem to be convinced you need drug treatment. Why do you not simply go to the hospital, get your drugs, and argue with your doctors instead of arguing with us and your parents?

[Onmyway]

Camille,

Not sure where you are getting this impression that we are encouraging people to come off of antidepressants on this website - we are telling people that IF they want to come off of them, they can reduce their withdrawal symptoms by doing it slowly. No one is saying that people will not have withdrawal symptoms if they taper slowly but whatever symptoms they have will be more bearable than if they stopped taking their medicine abruptly. This, in turn, will allow them to lead a more normal life if they taper at a very slow rate - less than 10% of their previous dose every 4 weeks.

 

You have made a 60% drop which has caused you severe symptoms. Maybe you didn't know not to make such a big drop or you did know and made the drop anyway. Either way it was a choice you made and it was a mistake.

Your logic on how you would have reached the same dosage in 3-4 months anyway and how that means that you should be better by now is simply wrong. You can jump off of an 11 story building instead of taking the stairs but you won't be back on your feet in 10 mins after that even it that's how long it would have taken you to come down the stairs. 

 

You will now have to live with your mistake. People here are trying to help you not to make that mistake again by pointing your errors. What you do with that advice is up to you and you will have to bear the consequences of that decision be it suffering, hospitalization, putting your life on hold etc.

 

You seem to have your theories that are not empirically supported about what is going on and refuse to listen to the common wisdom and refuse to accept that you have made that mistake. That's your right but in that case you can't blame your serious symptoms on what we say or on what you claim we do. 

 

We are in the business of helping people suffer less withdrawal symptoms if and  when they decide to come off their medications. We do that by giving advice based on our common experience, on the mistakes of others and based on current research literature. We advocate a harm reduction approach.

 

You are free to do whatever you want and to take as many drugs as you want. It's your body and you're the one suffering. 

 

However, you are not in a position to tell other suffering people what to do and what they should have done. In their sensitized state this can actually cause harm and that's not something we condone.

 

Hope you stay well and recover quickly.

OMW

 

[Yesyes123]

@Camille I believe the way to go is:

 

1. Focus on stabilizing at a single dose

 

2. Start very slowly decreasing dose once stable

 

3. Learn what dose decrease rate works best for you (10%/ month is the guideline)

 

4. Stick to it and be EXTRA careful at dosages below 5mg, and even more below 3mg and as you get lower.

 

Peace and healing

[Camille]

On 9/6/2021 at 12:51 AM, Onmyway said:

You have made a 60% drop which has caused you severe symptoms. Maybe you didn't know not to make such a big drop or you did know and made the drop anyway. Either way it was a choice you made and it was a mistake.

Your logic on how you would have reached the same dosage in 3-4 months anyway and how that means that you should be better by now is simply wrong. You can jump off of an 11 story building instead of taking the stairs but you won't be back on your feet in 10 mins after that even it that's how long it would have taken you to come down the stairs. 

So in your logic, someone who experience protracted withdrawal after 1 year off antidepressants could have avoided it by doing the 10% reduction method?

Doing the 10% reduction method, he also would have been off after 1 year.

[Camille]

On 9/6/2021 at 12:51 AM, Onmyway said:

You will now have to live with your mistake.

Yes I know (mistake being wanting to taper my meds even though I was perfectly fine on them), I just wanted others to avoid the same mistake I did just because they are ideologically against ADs. I want people to understand that tapering does not always avoid terrible WD symptoms. We are not all the same, some people have been ruined by psychiatry, some people can avoid too much suffering by tapering, some people are doing pretty fine on ADs. I though this site was about aknowledging the horrors of WD symptom from ADs and give appropriate advice to each member. Sometimes the appropriate advice is "Please be aware of the dangers of stopping your meds and be sure to weight risks and benefits". In my case, because I thought that tapering would make it all fine, I took the wrong decision.

For example, when I did my first decrease last September and that I experienced anhedonia, I thought that it was a withdrawal symptom that would go away in 2 months. Now I know that it could take years to lift and that tapering would not have made me avoid the anhedonia.

It was completely my fault, I just want other people to avoid it.

[jozeff]

Don't understand

49 minutes ago, Camille said:

So in your logic, someone who experience protracted withdrawal after 1 year off antidepressants could have avoided it by doing the 10% reduction method?

Doing the 10% reduction method, he also would have been off after 1 year.

I  don't understand the discussion.

 

The important thing is that person a who CT on day 1 and person b starts tapering 10 % per month on day 1 they will both be drug free after 2 years. In fact person a will be drug free immediately....

 

Person a may very well have had a terrible time whereas person b had manageable symptoms. Chances are person a will be suffering for another 2 years and person b is doing pretty well.

 

I see it like this. Throwing a ping-pong ball against a window will never crash it. Even if you do it a thousand times. If you smash the weight of 1000 ping-pong balls at once your window will be broken and it might take a lot of effort to fix it.....small manageable steps will cause less damage in the end. That's just how nature, physics and biology works.

 

Cheers

 

Jozeff

 

 

 

[Onmyway]

46 minutes ago, Camille said:

So in your logic, someone who experience protracted withdrawal after 1 year off antidepressants could have avoided it by doing the 10% reduction method?

Doing the 10% reduction method, he also would have been off after 1 year.

@Camille please read carefully my previous post. I'm not interested in having a fight with you.

 

What I am telling you is that the level of cumulative misery the person in your scenario 1 (tapering at 10% or less) would go through would be much less than the level of cumulative misery that same person would go through in scenario 2 (cold turkey) over the, let's say, 3 years of coming off of these medicines. That would allow the person who is tapering to hopefully avoid hospitalization, to keep a job, to keep their relationships more or less stable, to be able to enjoy life more. You very well know that the person who is tapering cannot come off of their medicines in 1 year at a 10% reduction unless they jumped off at a fairly unsafe level at the end. 

 

You are one point away from being banned from this site.

 

Our goal is to support people who want to be supported not in having ideological fights on whether going cold turkey off of psychiatric medicines is better than tapering. You might find a better audience for that on Twitter but even the psychiatric establishment agrees that tapering is better than cold turkey quitting so I doubt you'd find support for your idea there either.

 

Hope you feel better soon

OMW

[Onmyway]

10 minutes ago, jozeff said:

Don't understand

I  don't understand the discussion.

 

The important thing is that person a who CT on day 1 and person b starts tapering 10 % per month on day 1 they will both be drug free after 2 years. In fact person a will be drug free immediately....

 

Person a may very well have had a terrible time whereas person b had manageable symptoms. Chances are person a will be suffering for another 2 years and person b is doing pretty well.

 

I see it like this. Throwing a ping-pong ball against a window will never crash it. Even if you do it a thousand times. If you smash the weight of 1000 ping-pong balls at once your window will be broken and it might take a lot of effort to fix it.....small manageable steps will cause less damage in the end. That's just how nature, physics and biology works.

 

Cheers

 

Jozeff

 

 

 

Hi @jozeff,

Camille is taking exception to a comment I had made in a previous post. She had said that she made a large (60%?) cut and after a few months wasn't feeling better even though if she had tapered off at the 10% rate she would have been at the same dosage as she is now with the 60% drop and holding.

 

I tried to explain that a large drop is like jumping off of the 10th floor and tapering is like taking the stairs. When you jump from the 10th floor your recovery will take a while before you can walk again. You won't be back on your feet in 10 min even if you could have walked down in 10 min with minimal injury (risk of twisting your ankle still remains).The idea was that jumping and walking are different levels of injury. Maybe not the best analogy but illustrates the idea of larger damage from large jumps than from smaller ones.

 

I see her comment as arguing for the sake of arguing rather than for the sake of coming to a productive solution or learning and this is the last explanation I'm going to give. I don't know what we can offer Camille on this forum if she's not interested in taking our advice.

Edited September 8, 2021 by Onmyway

[brassmonkey]

This discussion has gone on far past the point of being productive. It is time to put an end to it.

 

This site is dedicated to helping it's members remove these drugs from their bodies and lives in the least painful way possible. We have spent many years and worked with 10s of thousands of people, including many of the top ADWD experts in the world to develop tapering plans that are safe and effective. Using our small staff of volunteers we try to customize our general reduction plans to our members specific needs. It can be an over whelming task at times but we do our best. We do not tell members what to do, but rather provide information and experience as guidance so they can make an informed decision as to the path they wish to follow.

 

Because each persons situation is highly individual their experience will vary. Over the years we have seen just about every type of WD case there is and have learned that they have several things in common. They are all going to take about the same amount of time from first reduction, be it CT or taper, to recovery. How that time is spent, in mild discomfort or acute WD, is what we are trying to control. Slow controlled tapering provides milder symptoms while a CT/fast taper will result in the same amount of time, possibly longer, spent with intense/debilitating acute WD symptoms.

 

It is up to the individual member which path they wish to follow. All of our staff members have been or are going through the same experience as the general members, so we know how it feels. For that reason we express concern for people trying to "get the drugs out of their system as fast as possible". Yes, you will remove the drugs from your system, but you will be paying heavily for it for years to come. Having been there I don't wish it it on anyone.

[jozeff]

2 hours ago, Onmyway said:

You are one point away from being banned from this site.

 

 I'm absolutely  not in charge here but I didn't get the feeling that Camille was very offensive to anyone.

 

I too have been extremely frustrated and disappointed  while trying to get off these awful meds and have had doubts about what everybody was saying on this website while in withdrawals. We behave like angry kids sometimes and the more experienced moderators and fellow sufferers must correct us and push us back on track again.

 

We came all here for a reason and we shouldn't forget that. So Camille, try to focus on your own healing and not on everybody's theories. It's your body and only you feel what has to be done. If one leaves this forum or gets kicked out nobody will come to your home and help you out. You have to do it yourself and the people around you.

 

Pick the things you like here or that are helpful to you.

 

Hope you will feel better soon!!

 

Jozeff

 

[Colonial]

23 minutes ago, jozeff said:

I'm absolutely  not in charge here but I didn't get the feeling that Camille was very offensive to anyone.

 

@jozeff

As Brassmonkey said, this conversation is no longer productive and needs a break.

 

At this point we have members from Spain, France, Netherlands, Brazil, Turkey and USA:

5 to 6 different languages all giving input in a very narrow timeline.

The loss of productivity may simply be the main points of this conversation are being lost in translation.

 

That being said, coming in and reading the last 2 pages all at once, some of the main points of the moderators do not seem to be being grasped by Camille or Yourself.

 

That is why the moderator asked for a break.

So as not to cause anymore emotional upset than necessary.

Please do not add to the accidental frenzy.

 

Thank you.

Edited September 8, 2021 by Colonial

[jozeff]

Ok, your right!

Let's focus on healing and helping and not on a sideshow. We all need our energy for important stuff 😌

[Altostrata]

Camille has been insensitive in her responses to other members.

 

We are not an an ideological campaign to persuade people to go off their drugs. We assist people who have made the decision themselves to go off their drugs. If you want to continue to take your drugs, we're not going to argue with you.

 

We have seen that very gradual tapering seems to allow people to go off their drugs with manageable withdrawal symptoms.

 

Sometimes people think taking the drug in the first place was a terrible mistake and others feel, after trying to go off the drug, attempting to go off is a terrible mistake. We have some members who have decided to go back on the drugs. We don't condemn them.

 

In fact, one of the major techniques we recommend here is reinstatement of the drug to reduce withdrawal symptoms, before attempting to taper again. We have lots of people who've done that.

 

@Camille, it seems you regret trying to go off your drug and you're looking for someone to blame other than yourself. You may also be in denial that it can be difficult to go off psychiatric drugs due to factors that have nothing to do with a mental condition. 

 

The purpose of this site is to assist tapering off psychiatric drugs if you choose to do so. There is no point in your continuing to argue with people here about whether anyone, such as yourself, should ever go off psychiatric drugs. It's an individual decision. Any further agitation on your part will get you banned.

 

You may find more validation on sites such as patientslikeme.com or depressionforums.org

 

If you want treatment with psychiatric drugs, there are thousands of doctors who would be willing to prescribe for you. Please let us know should you want assistance with tapering.

[Camille]

"It is theoretically possible that a minimum threshold of SERT inhibition is required before clinical effect is seen, with levels lower than this having minimal effects; this may correspond to withdrawal effects as well. However, withdrawal effect from other medications do not observe threshold effects, and withdrawal effects have been observed at many doses during tapering of SSRIs, suggesting withdrawal is likely to be continuous entity"https://kclpure.kcl.ac.uk/portal/files/109308247/Horowitz_Taylor_A_method_of_tapering_SSRI_treatment_to_mitigate_withdrawal_symptoms.pdf

 

 

 

[Colonial]

7 hours ago, Camille said:

 However, withdrawal effect from other medications do not observe threshold effects, and withdrawal effects have been observed at many doses during tapering of SSRIs, suggesting withdrawal is likely to be continuous

 

It's very good news to see your moving past this fascination with "threshold" numbers that you have had since your very first post and are now quoting studies showing that withdrawal is most likely continuous and NOT something that is only the effect of going below a certain level. 

 

Before going forward, please update your medication signature to be in line with requested limits.

 

Drugs, Dates, times and Dosages ONLY.

Please remove symptoms and theories.

We request staying as close as a 12 line "limit" as possible.

 

"As the signature is limited to 12 lines, we expect you will condense your drug history. The last few years usually will do.

 

FOR READABILITY, SHORT LINES ARE BEST.

• A list is easier to understand than one or multiple paragraphs
• Include ALL drugs, doses, and dates (starting and stopping)
• Any drugs prior to 24 months ago can just be listed with start and stop years
• Use actual dates or approximate dates (e.g. mid-June 2018) rather than relative time frames (e.g. 3 months ago)
• Spell out months (e.g. "January" or "Jan" as 9/1/2016 can be interpreted as 9 Jan 2016 or 1 Sept 2016)
• Please leave out symptoms and diagnoses

 

This is all that is needed:

 

February 2020: LEXAPRO 15mg/April : lowered to 10mg:  7,5mg then 5mg/ June 15 : lowered to 2,5mg 

June 19  5mg/June 23:  10mg, Sept 2020 :  7,5mg  March 4th :  3mg,  May 26th :2,7mg  June 3rd :3,125mg,

 

With a concise history as such, it is quite clear the WD symptoms are due from too rapid a taper with not enough time inbetween dosages to stabilize

 

How to Summarize Drug History in Signature - Introductions and updates - Surviving Antidepressants

 

 

 

 

[Camille]

I was on 3mg from March to now. For 5 months, I no anxiety, no depression, nothing, no suffering. Twice during this period I tried going below 3mg, once at 2,7mg and once at 2,8mg. Both time it created unbearable suffering that completely resolved after going back at or above 3mg (except now). Let's accept that people experience AD WD differently. We're on this website because doctors don't believe that we could be experiencing what we are experiencing because the majority of people don't. We're the best suited to understand that we are all different in the way we react to this med and to WD. Let's aknowledge that other people's experiences might differ from our own.

 

Of course, tapering has minimized the amount of suffering. I do not deny that. I would be in a worse shape today had I gone directly to 2,5mg for example. And from now on, if I choose to continue my taper, I'll do an extremely slow taper and suspect symptoms after each decrease to be increased anxiety and its consequences (such as insomnia). Basically from now on, I suspect tapering will indeed be pretty continuous and predictable.

 

There are other accounts of people on this website doing a respectable taper, not experiencing barely any WD symptoms until they reach a certain point/threshold and all hell suddenly break loose. 

 

The same way going below 10mg created anhedonia. 10mg = no anhedonia/ below 10mg = anhedonia. Does that not look like the definition of a threshold? I mistakenly thought the anhedonia was a transient normal WD symptom that was gonna go away after a few weeks of stabilization, like a diminution of my ability to feel pleasure that was gonna "up-regulate" gradually in a way, it didn't. and then it was too late and I couldn't go back on 10mg.

 

AD tapering is not a continuous , linear and predictable process for everyone. It is not the same as benzo tapering/withdrawal. I believe AD WD has both a continuous aspect to it and a thereshold aspect to it for some people.

[jozeff]

Hi Camille,

 

I find the threshold thought interesting but I think you went into withdrawal from jumping from 3 to 2.7 mg. If I go down by 10 % at once Im starting to feel terrible in a day or 3-5. If I do a  2.5 % decrease I get manageable symptoms.

 

I couple of years ago I thought 15 mg citalopram was the sweet spot but I take 6 mg currently  and I don't feel better or worse than I did back then.

 

The trick is to go so slowly your body doesn't notice the different.  For person a this could be cold turkey and for person b this could take 5 years.

 

I think it sounds reasonable to assume that 3 years would be sufficient to go off any drug at any dose for a healthy person. Unfortunately there are a lot of people here who suffered CT withdrawals or switched drugs too many times and are damaged and need more time to heal.

 

Gridley  or brassmonkey  once said to me: you are overthinking stuff...

I think you might be doing the same.

 

Thinking about these things is ok but sometimes we have to accept that we just don't know everything.

 

 

Hope you get well!

 

Jozeff

 

[Colonial]

8 hours ago, Camille said:

I was on 3mg from March to now. For 5 months, I no anxiety, no depression, nothing, no suffering. Twice during this period I tried going below 3mg, once at 2,7mg and once at 2,8mg. Both time it created unbearable suffering that completely resolved after going back at or above 3mg

 

I think the understanding of a "threshold" as your using it is much more complex and contains many more variables than just what ever particular dose you arrived at when not feeling well.  You remain fixated on a number without bringing the other calculations into effect and doing so, you fail to see how the other issues that have gone wrong in your taper are now playing a bigger part than you recognize.

 

This phenomena can and does happen to people anywhere along their taper if they have not waited enough time to stabilize before dropping again or a host of other things in their lives, illness, stress, etc

 

The important thing to remember is just because we are symptom free at that moment does NOT mean our brains and bodies have completely recovered from what has gone before and we can restart the taper.

 

In reality, you had set yourself up for these sorts of crashes by your entire taper being too fast.

You went from 15mgs to 3 in a very short time.  In fact, you had hints of problems headed your way in September 2020 when you "went anhedonic" at 7.5 mgs

 

Your mistaking the very last move you made as the reason for your troubles in stead of understanding the symptoms are a sign the entire taper was too fast.  Then you accidentally set your central nervous system up for a kindling effect where any drop you make can be difficult as a result of this.  Perhaps this is what your doing, mistaking a kindling effect and the fact that you have rushed the taper throughout as something other than it is.

 

Just because Your symptom free for a few months does not mean your ready to re begin your taper. It all depends on everything that has gone before if your system needs more time. Some members need 6-12 months.

 

So while there are times, as you say, where people are going along and seem to get "stuck" at a certain level, you can generally go back and find places in the overall taper that were too fast, based not on just the formula, but on their entire life in play.  Also, what is too fast is different for everyone. I personally think the 10% every 4 weeks, seems to work well at higher med levels, it is too much at lower levels and 5% every month to 6 weeks is better.

 

Now, in a sense, if your just playing a game of language, one might say that is a "threshold" of sorts, where the percentage drop needs to be lowered per drop or the wait time extended, but that does not extrapolate that the threshold itself is the problem, it is that the person is continuing to try to drop too high a percentage at lower levels of the drug. 

 

You dropped 10% from 3.0 to 2.7 and had problems, the thing to do is make smaller percentage drop of 5% and test the waters, so to speak.  How well one does depends on it they had done the beginning of their taper too fast and did not wait long enough to recover in between crashes.

 

Again, just because one is currently symptom free does not mean one has fully recovered. It very well may have been that if you had waited 9 months to stabilize at the 3mg mark after the issues at the 7.5 mark, you may have been fine dropping to 2.7mgs.  But in all honesty?  You did not wait long enough to stabilize when you up dosed back to the 7.5 mark after that crash. You fail to bring that into your equation.  You have failed to see the subtle signs along the way that indicated your particular taper was too much, too fast.

 

So, the understanding of thresholds does have merit in knowing what the total amount of stress and drops our bodies can endure in a certain period of time, but it is based on many factors, NOT just a particular dose level. One's entire life has to be taken into account, illness, stress, a death in the family, etc. Wether a taper is too fast or not is based not just on med calculations

 

In reality, by the time you crash at a certain dose level, you had already passed the point of no return in failing to factor in many other variables that had more to do with your body hitting its "cumulative threshold" than the dose you are now at and want to blame as being the problem

 

I have held a sort of theory similar to yours, that there is a cumulative amount per 6 months and per year that the body can take, and that "threshold", as you like, is much lower than 10% every month.  That there is a cumulative threshold per year our body can take, and if we rush through that, we end up crashing and needing extended holds of 6 months, etc.  But notice it is the entire cumulative threshold over time that is the issue, not a particular mg mark that is the problem. 

 

In theory, your on the right track in realizing there is something bigger at play, your just blaming the result as the problem and not seeing the inner working of everything at play.

Edited September 16, 2021 by Colonial

[Altostrata]

I have no idea what this "threshold" argument is about and would like to see it stop.

 

When they get down to very low doses, some people have to take a vacation from tapering for a while and let their nervous systems regroup. This is explained by the ever-increasing angle of the curve shown in Horowitz & Taylor, 2019. At a very low dose, it is almost perpendicular, meaning further reductions will slide quickly down in terms of receptor occupancy.

 

There is probably individual variance in the shape of the curve. If you run into trouble reducing below 3mg, your nervous system is telling you that you need to reduce more gradually, to tiptoe down that very steep curve.

 

@Camille how are you doing now?

[Camille]

Hello Altostrata, I was suffering to a degree that i didn't imagine was humanely possible, I wanted to die every second of the day, I had never experienced something like that, my original condition did not compare at all to that. So obviously, I am 100% convinced that I was experiencing withdrawal and not a return of my original condition. I was convinced that there were nothing to be done for me and was imploring my parents to kill me. They brought me to a hospital, I told them that I was terrified of taking any medication but they convinced me to try ECT. I had 3 sessions already and have been feeling better after each one. Today I feel almost completely normal albeit some memory loss , a bit of confusion and some trauma of what happened. i just hope that it'll last, I'm so scared that it'll come back.

[Altostrata]

That's good, @Camille It's rare we hear of success with ECT.

 

You've had 3 ECT sessions over 3 weeks. In what ways were you feeling bad before ECT, that have changed since you've had ECT?

[Camille]

I mentioned the "threshold" argument not just for the sake of arguing but because I want people to be aware that tapering does minimize the suffering but does not necessarily avoid it completely and I think some people should be advised to stay on their meds. I've just been traumatized by my own experience and wish that NO ONE experience the same. 

I had 3 ECTs in 1 week. Before the ECT, I woke up on August 1st in a state of intense constant panic and unbearable mental torment that made me suicidal every minute of the day (I had never been suicidal in the slightest of ways before) that I had experienced when trying to further diminish my meds on May 26th. This was in no way my "original depression" or even a depression.

After the first ECT, life was bearable but I was not fine either, after the second I was further better and after the 3rd one, so as of right now, I'm feeling almost normal, although completely traumatized by what happened. I hope this is gonna last, I'm so scared that it won't

 

[Altostrata]

What kinds of benzodiazepines did you receive during your ECT treatments?

 

While you have your opinions, you do not know what you're talking about when it comes to tapering off drugs. You may take that as a hint not to persist.

[Camille]

I didn't receive any benzos. ECT is administered under anesthesia with a muscle relaxant.  I'll update here to inform if the benefits are lasting or not. Fingers crossed they are.

[Altostrata]

You might verify which benzos were used as "anesthesia with a muscle relaxant".

 

After each ECT treatment, how long did you feel better before you began to feel worse again?

[Camille]

I did 3 ECTs a week the first 2 weeks, then twice a week the 3rd week and then once a week this week. I don't "feel worse again" yet. They want me to take Lamictal but I'm scared, they would start at 25mg.

[Greatful]

@Camille  Why do they want to put you on Lamictal if your not doing worse.  They are quick to add meds.  Is there anyway you can wait for awhile to see how you do with the  ECT treatments.

Are you still on Lexapro?

 

I am trying to get off of Lamictal and it is not easy. It really slowed me down and my memory was affected.  Recalling words, trying to think a though or idea through was hard at times.  It really affected my work,  it could not do the math and focus to do my paperwork.

Read Kiasofia's thread.  She was on Lex and had ECT and Lamictal and Lithium.  She is off everything but 32.5mg of Lamictal. Tapering that.

http://.survivingantidepressants.org/topic/24831-kiasofia-recovering-from-the-damage-done-by-escitalopram-and-tapering-lamictal/

 

Here is some things I learned about Lamictal.  Do some research before you take anything.

 

Lamictal also binds and weakly inhibits several other signaling receptors in the brain, including those to which dopamine and serotonin normally bind. By inhibiting these receptors, signaling in the brain is “tuned down,” or reduced, which can also decrease seizure activity

 

Lamotrigine enhances the release of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter that attenuates neuronal electrical activity associated with paroxysms.

 

 researchers have found that lamotrigine also inhibits release of the neurotransmitter glutamate.

 

GABA is inihibitory.  If a nerve releases GABA - it is to Inhibit function - this could be to "slow it down" or it could be to "limit the sensory input" so that we can process it.  In the same way, GABA might be released to help "steady" your hand while doing something like painting a very detailed painting.  GABA "shores up" movements to make them more fluid.   That's just in a nutshell. Of COURSE it does a lot more than this, but the idea is that GABA is present in the ENTIRE CNS and ALWAYS working to balance every sensation, movement, etc.

This statement is from the article  "What is happening to your brain"

 

 

During both trials submitted to the FDA for the approval of the anticonvulsant Lamictal (lamotrigine) for treating people diagnosed with bipolar disorder, the researchers changed their primary way of measuring the drug’s effectiveness many times, including once more after the trials were completed. The FDA medical review noted that the drug would have failed to beat placebo if not for the final, last-minute change in what the researchers were measuring.

Source: U.S. Food and Drug Administration. “Medical Review: Lamictal.” (June, 2003)

 

I am sorry you are struggling and having a hard time stabilizing.( I have been trying to stabilize for 10 months).  Please do some research on meds before you start the poly med down hill slope.

Somehow I ended up on 4 meds by the time I said stop........ Yes it is painful and scary, just don't make decisions just in hopes of a quick fix.❤️

 

https://withdrawal.theinnercompass.org/page/about-withdrawal-project

This is another wed site that is great for information.  

I got this from there site. It is a inter view from a top person at the FDA

https://www.survivingantidepressants.org/topic/25541-are-psychiatric-medications-safe-the-fdas-answer-may-surprise-you/

 

 

 

 

Edited October 14, 2021 by Greatful