Mascasa: Oral Lexapro taper

[Mascasa]

@Heathwell the tummy ache etc is gone. I get periods of anxiety and then some weepy “want a be”coming. But that happened while on the med. So when I restart I want to maybe try and do 1 or 1.3 each week.

[Heath]

So you mean 1 or 1.3 % per week? 

 

and symptoms are getting better then. That is very good to hear!

 

yes symptoms are minimal for me. Short term memory and my cognitive thinking was worse this time. 
 

yes I do drop a smidge each week but I still hold at least 2 weeks after a 4 week taper. 
 

 

 

[Mascasa]

@Heath Yes I meant a 1 or 1.3 % drop. So if I begin my taper in about two weeks the next drop would be 8.9 (if only the 1), then 8.8 8.7 and 8.6 with a hold for two weeks? Is that how you have been moving through?

[Heath]

Yes that is how I have been tapering for a few months. 
 

 

[Mascasa]

@Heath I think that is the way I am going to go.  Might be able to try 1.5 and see then if too much drop back. I think the earlier issues I was having was the compounding of all the tapers without holding a long length of time to have my body catch up. I remembered you showed me in an earlier post my reductions.

[Mascasa]

@Heath Just transferred over to the new brand after the slow transition. So going to stay here a week. Then go to 8.9, etc. as I start the taper again. So hoping for minimal symptoms. Dealing with other health issues and just don't want more on the plate. How are you? Quick question. Did you ever change anything major in your diet during the taper?

[Heath]

1 hour ago, Mascasa said:

@Heath Just transferred over to the new brand after the slow transition. So going to stay here a week. Then go to 8.9, etc. as I start the taper again. So hoping for minimal symptoms. Dealing with other health issues and just don't want more on the plate. How are you? Quick question. Did you ever change anything major in your diet during the taper?

I am glad the transfer went well!

 

you have held at 9 ml for 6 weeks. From what I read you are saying the withdrawal symptoms are better. And I know you said you are still having some anxiety. If you are having no side effects from lexapro then. I would hold another 6 weeks at least. You will feel better . The more stable the less withdrawal symptoms. 
 

yes I am basically trying to stay away from not so healthy food. 

[Mascasa]

@Heath Thanks. 
I had anxiety on Lexapro. It never totally helped. I know I get impatient now that I am transitioned over to the other brand. Think just a drop to 8.9 in about 2 weeks would be problematic?

[Heath]

Like I said I would hold a little longer than that. But that’s me.  See how you feel in 2 weeks. 
There is no real fixed timing here. It’s what your body tells you. 

[Mascasa]

@Heath thanks. I know. It’s such a challenge right now because there are so few things I can take with Lexapro that would help with the other health issues. Will hang out a bit longer and see how things go. 
you are still at 5.9?

[Heath]

Yes holding at 5.9

[Mascasa]

@HeathWho prescribes or follows  you for your lexapro? Is the Celebrex for your back? 

[Heath]

Psycho dr. Lexapro and gp for Celebrex for back. GP said she would fill the lexapro too if I need her to. 

[Greatful]

@Mascasa

Hi stopping by at another Lexapro victim, lol.....These drugs are nasty........I just switched to liquid.  Looks like you're  using camber manufacture to..........Is  yours liquid?  

 

[Mascasa]

@Greatful I was on Camber. They couldn't find it anymore. So I transitioned to Amneal. You are splitting yours into am and pm? Can you share why?

[Greatful]

@Mascasa  We are trying the split because I am a ultra fast Metabolizer of this drug. We are wondering if I can't stabilize because it is in and out so fast.....Not a steady level in my system.

It's been a horrible time since I started the drug........Not stable to begin with from wd from prior drugs.........I might also be having a adverse affect from it.............So far I have seen a improvement with the split........Once I feel ready we are going to start the taper again...........

all I can say is these drugs are awful to get off of...........They didn't really do my much good anyway.....over 20 years of thinking I was unhealthy, when it could have been the drugs the whole time.......

[Heath]

@Mascasa How are you doing ? 

[Anya324]

On 1/2/2022 at 10:52 AM, Mascasa said:

@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.

How’s was the transition? I have been getting Camber from CVS since July also. I have noticed that some bottles aren’t as strong as others. Like, I feel like I’m in WD all over again about 10 days into a new bottle. This has happened two times in 3 months so I’m done. Funny thing is that my CVS can totally get more-it is in fact all they can get so I had to go on a hunt for a different manufacturer at a different pharmacy. And guess what I found….??? Amneal!  I am very low on my “good bottle” of camber so my transition is gonna have to be fast. I am slightly terrified. 

[Anya324]

On 1/2/2022 at 10:52 AM, Mascasa said:

@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.

How’s was the transition? I have been getting Camber from CVS since July also. I have noticed that some bottles aren’t as strong as others. Like, I feel like I’m in WD all over again about 10 days into a new bottle. This has happened two times in 3 months so I’m done. Funny thing is that my CVS can totally get more-it is in fact all they can get so I had to go on a hunt for a different manufacturer at a different pharmacy. And guess what I found….??? Amneal!  I am very low on my “good bottle” of camber so my transition is gonna have to be fast. I am slightly terrified. 

[Greatful]

@Mascasa  Hey fellow Lex victim--How are you doing? 

[Mascasa]

@GreatfulWell, hello to you to. I am currently on 7.2 of Lexapro. Tapering pretty slowly. I usually hangout at at a level for about a month, then taper again. Experiencing some lows right now. Just tapered Saturday. Kind of my pattern.  I am at a year of tapering right now. Didn't think in a million years this was how long it was going to take. I was only on it for 1 year and 6 months. But don't want to chance it.

How are you doing? I see you are down to 2 mg. How are the w/d or side effects if any?

I will need to update my signature. I just haven't been on any of the sites in along time. Figured I just had to do what I had to do. Maybe when I get lower will need some help with the measuring.

[Heath]

@MascasaHow are you?

Dont forget to update your signature as you taper. 
I hope you are doing well!

[Heath]

@MascasaHope you are doing well?

[Mascasa]

Hi,

I am trying to get some advice. In my profile you will see I am doing a slow taper. I am at 4.9 since Nov. 9th. However, the symptoms of nausea, dizziness, and now throwing up are brutal. I am wanting to go back to 5mg and just hold there for a good while. Please advise.

I am trying to teach while doing this and it's kicking me you know where.

@Altostrata

[Heath]

Hello @Mascasa! 
I just caught this at end of my lunch break.I wanted to say hello 👋. 
 

I will ask you a few questions as I know Altostrata or mods will want to know. 
 

How long have you had these symptoms?
When did they start?
Are symptoms debilitating keeping you from normal daily tasks? 

Have you changed or added any other medication or supplements?

Has any other change in life come up? Are you taking prescription liquid lexapro? 

Are you still taking same brand lexapro?

 

If you can please update your signature so she can help you easier and faster. And answer your questions. 
try and fill in from December 21 until now the best you can. Just dates and dosage example Nov 2022 4.9mg. They need to see the taper rate and consistency. 

Hang on Mascasa 👍

 

[Mascasa]

@HeathI thought I did update my profile. I went in and edited it to show the updates. I will try again. I would say the drop from 5mg to 4.8 for a week was rough. So went to 4.9. The symptoms have been well over 10 days and now throwing up.

Yes, I know they are keeping me from doing normal things. But I am in charge of a reading lab and 5 teachers. So here I am, very sick, and at work.

I have most of the same supplements. The one I did change but it's been awhile is the brand of iron.

Yes, I am taking liquid. Been the same manufacturer the whole time. So I am going to reorder a new batch and see if that helps.

I haven't been on here in awhile. Taper hasn't been easy. Not going to lie. But this is really brutal right now. Just want to go back up, but need advise. 

I will try and update the signature again.

[Mascasa]

@HeathI updated the signature. I am missing some of the dates. I recently started keeping it on my phone. In the past I would keep it on a paper calendar. But really haven't changed anything at all. Kept the 5% and hold for 4 weeks. Pretty consistent.

[Heath]

1 hour ago, Mascasa said:

@HeathI thought I did update my profile. I went in and edited it to show the updates. I will try again. I would say the drop from 5mg to 4.8 for a week was rough. So went to 4.9. The symptoms have been well over 10 days and now throwing up.

Yes, I know they are keeping me from doing normal things. But I am in charge of a reading lab and 5 teachers. So here I am, very sick, and at work.

I have most of the same supplements. The one I did change but it's been awhile is the brand of iron.

Yes, I am taking liquid. Been the same manufacturer the whole time. So I am going to reorder a new batch and see if that helps.

I haven't been on here in awhile. Taper hasn't been easy. Not going to lie. But this is really brutal right now. Just want to go back up, but need advise. 

I will try and update the signature again.

Thank you for updating signature! 
Just a date and ML of each drop and any other medications in signature will make it easy for moderators to read. 
And details and questions in your introduction. 
 

so you have held at 4.9 for 3 weeks and symptoms seem to be getting worse than the wd normal? 

 

I completely understand, I am at 5 ml and it has gotten a little tougher so we may have to go slower. I’m glad you have been doing a slow taper. I have had to updose before also. Hang on a mod will be along shortly. 

[Mascasa]

@HeathI updated the signature. I am missing some of the dates. I recently started keeping it on my phone. In the past I would keep it on a paper calendar. But really haven't changed anything at all. Kept the 5% and hold for 4 weeks. Pretty consistent.

Yes, I will update when I get home and have my paper calendar.

Yes, the symptoms are getting worse. Once I stabilize I plan on dropping a bit slower. In fact, I just want to hang out at 5 for a while. @HeathThis medicine never really worked for me at all. Gave me problems getting on it, being on it and now coming off it. So I think it really doesn't agree with me.

My question would be to updose back to 5? I haven't done any changes since last December.

[DataGuy]

Hi @Mascasa,

 

Sounds like you really have it rough now : (. I would not hesitate to updose to 5mg, or even a bit higher than that, until symptoms abate. You have tapered quite a bit (seems like 75% over an 18 month period) and you are getting to the tough part. If I remember correctly, you start to see steeper drops in receptor occupancy with Lexapro once you get to around the 5mg mark, so it is ok to really slow it down. 

 

There is also the possibility that you could be experiencing delayed withdrawal from previous reductions. It is best not to push things. You can think of the difficult symptoms as your nervous system's way of protesting overly rapid reductions. That is why we recommend symptom-based tapers, which is rapidly becoming the standard of care in medicine (even the CDC is catching on).

 

Just let your body tell you at what pace you need to go and don't worry if it seems slower than it "ought" to be. Trying to force things is typically counterproductive and can result in more intense and protracted withdrawal syndrome. I know this sounds a bit discouraging, but the good news is you can be very much in control of your symptoms and functionality, you may just need to slow things down a bit.

 

After your symptoms improve and stabilize, I would recommend holding for a few weeks before starting to taper again. This will allow your nervous system to heal and help avoid a similar flare up on your next cut. 

 

I will try to dig up that receptor occupancy curve for you. 

[Mascasa]

24 minutes ago, DataGuy said:

Hi @Mascasa,

 

Sounds like you really have it rough now : (. I would not hesitate to updose to 5mg, or even a bit higher than that, until symptoms abate. You have tapered quite a bit (seems like 75% over an 18 month period) and you are getting to the tough part. If I remember correctly, you start to see steeper drops in receptor occupancy with Lexapro once you get to around the 5mg mark, so it is ok to really slow it down. 

 

There is also the possibility that you could be experiencing delayed withdrawal from previous reductions. It is best not to push things. You can think of the difficult symptoms as your nervous system's way of protesting overly rapid reductions. That is why we recommend symptom-based tapers, which is rapidly becoming the standard of care in medicine (even the CDC is catching on).

 

Just let your body tell you at what pace you need to go and don't worry if it seems slower than it "ought" to be. Trying to force things is typically counterproductive and can result in more intense and protracted withdrawal syndrome. I know this sounds a bit discouraging, but the good news is you can be very much in control of your symptoms and functionality, you may just need to slow things down a bit.

 

After your symptoms improve and stabilize, I would recommend holding for a few weeks before starting to taper again. This will allow your nervous system to heal and help avoid a similar flare up on your next cut. 

 

I will try to dig up that receptor occupancy curve for you. 

@DataGuy Thank you for answering. I think you are correct. Might be a bit of delayed wd.  I have seen the SERT chart on the fb Lexapro page. So I know things are a bit challenging. The crazy thing is I was only on this for 1 year and 5 months. Now at month 20 ish. So the recommendation would be to go back to 5 and hang out there for a bit? Then let things settle down before I taper again. 

 

[DataGuy]

Ok, I'm glad you have seen the graph, because it was a bit of a rigmarole to find.

 

Yes, updosing to 5mg should be fine and you can even go up a bit more to 5.1 or 5.2mg. It really isn't a big deal. Sometimes we need to take one step back so we can take two steps forward : ). Just remember that it will take a few days for your body to feel the full effect of the updose as the drug reaches a new steady state in your plasma. 

 

Here is the receptor occupancy curve for lexapro (escitalopram) from this article entitled: "Regional differences in SERT occupancy after acute and prolonged SSRI intake investigated by brain PET"

 

You can access the article via Sci-Hub here and the image is on page 8 (I just remembered we have a very low max total image size on this site). 

 

Hang in there and I hope you have a smooth ride down : )

 

PS you are doing a great job, @Heath : )

 

 

 

 

 

[Mascasa]

1 hour ago, DataGuy said:

Ok, I'm glad you have seen the graph, because it was a bit of a rigmarole to find.

 

Yes, updosing to 5mg should be fine and you can even go up a bit more to 5.1 or 5.2mg. It really isn't a big deal. Sometimes we need to take one step back so we can take two steps forward : ). Just remember that it will take a few days for your body to feel the full effect of the updose as the drug reaches a new steady state in your plasma. 

 

Here is the receptor occupancy curve for lexapro (escitalopram) from this article entitled: "Regional differences in SERT occupancy after acute and prolonged SSRI intake investigated by brain PET"

 

You can access the article via Sci-Hub here and the image is on page 8 (I just remembered we have a very low max total image size on this site). 

 

Hang in there and I hope you have a smooth ride down : )

 

PS you are doing a great job, @Heath : )

 

 

 

 

 

 

[Mascasa]

Just now, Mascasa said:

 

@DataGuyThank you again. Yes, will go back up tomorrow.  Just need to figure out if it is 5 or 5.1. I don't remember being sick at 5 at all. Some symptoms obviously but not like this where the stomach hurts and so dizzy. I really want to stabilize so I can consider getting a back surgery. That has been hanging around for awhile and I want it fixed. But would like to be stable first.

[Mascasa]

@DataGuy @HeathI went back to 5 mg this morning. Hoping things start to look up in the next few days.  @Heath You are at 5 mg too? 

 

[Heath]

Yes I am at 5.4 ml since July. Run into some trouble,  the drops started catching up. So I am holding for several months and see .