Mascasa: Oral Lexapro taper

[Heath]

Just remember withdrawals cause physical pain. And makes old injury pain worse. I made a little drop Sunday and my neck and shoulder been hurting all day. 
 

[Mascasa]

Need some advice. I have been using the manufacturer Camber for my liquid lexapro taper. The pharmacist called today and no one is carrying it anymore. So I have tried early in the taper Amneal manufacturer and it didn't agree with me. Luckily earlier in the taper the pharmacist found some. But now he cannot. So I am in need of some advice of what to do? I will go out and see if anyone can find some, but if not? @Altostrata  Anyone??

[Heath]

How did the amneal not agree with you?
 

This exact thing happened to me.  But I went out searching and ended up on Amneal from Walgreens. I’ve been stocking up. I’ve been going to get a refill about every 3 weeks. If you have a monthly script you should be able to get at 3 weeks. I am gonna do my best not to let it get low again if something like that happens. 
 

you can google search type in drug brand then surviving antidepressants. There is a lot of info on SA. Example below. 

 

[Mascasa]

@Heathi thought it made the day I took it a bit worse. But I got my brand back pretty quickly. Now it’s a complete no go. I am guessing I need to somehow coordinate the two of them to go over to the new brand?

[Heath]

We’re you having withdrawal symptoms before you took the amneal brand or at same time ? 
The reason I ask is if nervous system is more stable the changing to different brand may not bother you. 

[Mascasa]

Gosh I know it was early on but don’t remember exactly when I’m the taper. I was reading about making my own using the pill form and water and suspending agent. I just wish they hadn’t discontinued mine.

[Heath]

If you are becoming more and more stable most likely symptoms will be minimal when you change brands. If you do experience symptoms it would be temporary. Did you get a new script?

[Mascasa]

@Heath I am not sure yet about if the script was transferred to Target/CVS. I will have to follow up today. I hope I can switch over. I did see a post about transitioning over. But I would have no idea how to do both oral liquids to do that.  At this point I just want something that will not make things too unstable and be consistent.

Any thoughts on making one's own oral liquid?

[Heath]

For me I would only make liquid if I had to.  I try and keep things as simple as possible. 

[Mascasa]

Thanks I think I am agreeing.

[Mascasa]

@Heath think a direct switch? Saw where you might have to transition?

[Mascasa]

I reread and saw where you said to make liquid.? Are you thinking that over buying it from the pharmacy. If I made it then I would be getting exactly the same thing each time until taper over.

[Heath]

I meant I would make it only if I had to. 
I would buy it already liquid to make things simple 

[Heath]

4 minutes ago, Mascasa said:

. If I made it then I would be getting exactly the same thing each time until taper over.

If you made liquid from tablets you would still be in same situation because you wouldn’t always get same brand tablets 

[Mascasa]

Well let me see what CVS has to say today. If they can guarantee the same brand I will do that. If not might have to make mine. Doesn’t look hard at all.

physical symptoms have eased up. Still anxiety and weepiness.  But that has been me on it and tapering. How are you?

[Mascasa]

I would have to continue and request Lexapro and not generic. I was on Lexapro when I started the taper. Have some left. Just wish this monkey wrench hadn’t happened.

[Heath]

I’m doing ok. Neck pain went away. Had antsy jitters yesterday at work.
 

Oh yea if you can get lexapro brand every time. I see! 
 

I have never made liquid. I don’t know how hard or easy  it is. I’m in the rat race life so I like just buying liquid script. 
 

17 hours ago, Mascasa said:

@Heathi thought it made the day I took it a bit worse. But I got my brand back pretty quickly. 

 

so let’s say

option 1

you get the amneal brand (change brands). It might make the day or week worse in your symptoms? 
Option 2

get lexapro brand pill (change brand). And Make liquid. It might make the day or week worse? 
 

It appears to me either way you will be changing brands. But with option 2 you will have an extra step of making liquid. 
 

and option 2 would cause me more stress changing brands and changing from liquid to pill and back to liquid. 

 

sometimes I have to lay it out like that for a troublesome decision. 

 

any time we make a change during withdrawal symptoms even going from liquid to making liquid there’s a chance for more symptoms. 
 

I did have more symptoms when I changed brand pills years ago. I had more symptoms when I changed from pill to liquid and when I changed liquid brands. The extra symptoms were not permanent . Uncomfortable but not permanent. That’s my experience . 
I personally would make the least change possible and continue to hold.

 

I know there is a procedure to change from pill to liquid but I haven’t found anything on changing from brand x to brand y. So you could treat it the same way. 
1/4 amneal and 3/4 camber each day for a week . Then 1/2 amneal and 1/2 camber for a week and so forth. 

If you are torn on what to do ask getofflex or a moderator for their thoughts. 
 

 

[Mascasa]

Glad you are feeling ok. Gosh thanks for all the info. I am very torn. I so don’t know what to do. I don’t know how to do the transition formula you might have to help me there. This whole thing has brought on anxiety. @getofflexor @Altostrata Heath suggested to check with you.

[getofflex]

What specifically is your question @Mascasa?  

[Mascasa]

@getofflexI am wondering how to proceed with my liquid taper? My brand was discontinued. I have 1 week left. I can change manufacturer or make my own. 
I have been sensitive to changes in a prior manufacturer.

if I go with new brand how to switch. 
I can use my pill to make my own liquid.

what do you use to taper?

I am currently on 8 months with the same manufacturer.

 

[Heath]

I googled liquid pill transition surviving antidepressants  and found this that Gridley advised. He is a moderator. 
 

On 12/27/2019 at 11:35 AM, Gridley said:

Our general recommendation for a crossover, whether from new brand to old brand generic or tablet to liquid is:

 

3/4 old, 1/4 new for 3 to 7 days 

1/2 old, 1/2 new for 3 to 7 days

1/4 old, 3/4 new for 3 to 7 days

all new thereafter

 

Stay at the same dose during the crossover period.

 

 

 

If you change to a pill and make liquid that will be more changes to make during the instability going on rt now.

 

I would stay with buying the liquid the new brand -  And do this crossover to new brand as Gridley described. 

 

I know it’s hard to do try and stay calm. Our emotions run away with us during withdrawals mine do. Do a google search emotional spiraling surviving antidepressants . There is a lot of info on this to help. 
 

read about the crossover he explains. It’s not hard to do. 
 

I would stay with buying the liquid. 

[Heath]

This is in addition to previous post

Ok I found the thread on cross over. 
explains very well also. read this. 
 

 

[Altostrata]

Heath has given you excellent advice about how to change brands if you are very sensitive to their formula variations.

[getofflex]

Yes, what Heath said is very good.  

[Mascasa]

@Heath. @getofflex  @Altostrata thank you all. I will do as advised. I have one big question. I may only have enough of the old to get by for a week or week 1/2. The discontinuation of mine caught me by surprise. So I am so hoping I can get the most out of the transition. I don’t have the new one yet. Hoping Monday. Then start on Tuesday. If I did 3/4 and 1/4 it would be 6.75 and 2.25? I will have to check in my syringes how to do that.

[Heath]

Mascasa that is correct the first week would be 6.75 ml of old brand and 2.25 of new brand.  
 

as syringe goes. If you need to you can round up on old and down on new or vise/versa as long as you keep total dose the same. Example 6.8 ml and 2.2 ml. 
 

So you don’t have enough old brand to do this for 3 weeks ?
if you are running low on the old brand . You can calculate this out to do a change  Like maybe every 5 days instead of 7 . Or even every 3 days  Just example. 
just make sure you are consistent. 
 

do not forget in calculating you will be taking 1/2 of old brand in the second change so you may have more than you think! 

[Heath]

@Mascasahow many ml do you have now ?

[Mascasa]

@Heathi made the decision to go with Amneal. My local pharmacy has it or can get it. Plus the compounding pharmacy substituted it for my Camber. So I started today with the transition. I used 6.8 of Camber and 2.2 of Amneal. I was nervous about the .8 and .2 on the syringe. I am going to show you my syringe for that.

I will see how many ml I have of Camber.

[Mascasa]

@Heath This was the smaller syringe I used to get the .8  and the .2. I am so hoping I was correct. My bigger syringe was straight 6 and 2. Then to the 6 added the .8 on the smaller syringe and .2 to 2. This the correct way? So depending on how much is left of the Camber will determine how to proceed. So maybe 3 days this way, 3 days 1/2 & 1/2, and then 3 days on the next until fully transitioned?

So next will be to see how much Camber is left.

Thank you.

 

[Mascasa]

@Heath I have more than I thought of Camber 90 ml. So could do a 5 day?

[Heath]

 

 

20 minutes ago, Mascasa said:

 This was the smaller syringe I used to get the .8  and the .2. I am so hoping I was correct. My bigger syringe was straight 6 and 2. Then to the 6 added the .8 on the smaller syringe and .2 to 2. This the correct way? So depending on how much is left of the Camber will determine how to proceed. So maybe 3 days this way, 3 days 1/2 & 1/2, and then 3 days on the next until fully transitioned?

So next will be to see how much Camber is left.

Thank you.

 

Yes that is correct way to do it

 

7 minutes ago, Mascasa said:

@Heath I have more than I thought of Camber 90 ml. So could do a 5 day?

Yes my calculations says You could do 5 days each step safely with 90ml. 

[Mascasa]

@Heath thank you so much for all your help. I was so anxious over this yesterday. Glad I have a plan. So will do this for 5 days then the 1/2 & 1/2 etc. Full 9 on new at the end. But thinking when I have transitioned over to stay a week at 9 and then start taper? I will have had at least 2 months at 9. 

[Mascasa]

@Heath just saw you are hitting 5.9!

[Heath]

It always makes me feel much better when a decision is made and a plan is set👍  
 

Just see ha how you feel after a month or so before you taper. It makes it so much better to taper when you are stable.

[Mascasa]

@HeathI am closing in on the transition from  one brand to the other. Then a week on the one brand. I am thinking of trying your taper of a smidge each week. How is that working for you? Minimal side effects?

[Heath]

How are you feeling? Are the withdrawal symptoms you were having gotten any better?