Escitalopram21: WD from escitalopram and quetiapine

[Altostrata]

52 minutes ago, Escitalopram21 said:

but in may and june before tapering i felt well 80% of the time. 

 

Do you mean May and June 2022?

 

Suggest you go back to 3mg. Apparently 80% well was not stable enough.

[Escitalopram21]

@Altostrata Thank you for the reply 🙏🏻

Yes may and june 2022. After March it was a shift and i started to feel better and better. 
 

Its already been more than 3 months since the reduction, i dont want to question your expertise but i find it to be a long time. 

[Greatful]

@Escitalopram21  My heart goes out to you....I have the crazy phobia's too.  These drugs sure do a number on us don't they.....

I agree 3 months is a long time.....You could just be in wave and it will stable out.  I guess you will have to be the one to decide to sit tight and ride the wave or updose....When did you go to liquid?  

Are you having any let up in the symptoms ie in the evening?

 

Sending you a big encouraging hug🤗

[Altostrata]

On 9/22/2022 at 12:36 PM, Escitalopram21 said:

Thinking of you too my friend 💛

I dont want to sound too negative, but it has not been a walk in the park the last two months. I was thrown into some of the worst waves ever when starting the new job in august. Still not completely recovered and now fighting a bad flu. 
I am afraid i might need some antibiotics but i am scared. Do you happen to know if low dose aspirin is safe to take to prevent having to take antibiotics? 
@Greatful

 

Are you over the flu? Could it have been covid?

 

How has your symptom pattern changed in the last week?

[Escitalopram21]

13 hours ago, Altostrata said:

Are you over the flu? Could it have been covid?

 

How has your symptom pattern changed in the last week?

Barely. I was bedbound for 10 days and still have some symptoms but now working. 
I took covid tests but they were negative. 

Last week I had 3,5 good days and then i was driving my car and got a little bit scared. Since then i have been dissociated, alternative between sleeping super deep and waking up in the nights. I wake up exactly 1:25 and 6:24 the nights i wake up and some nights one time inbetween. 
i have this feeling of doom almost all the time everyday except for those 3,5 good days last week. 
I have trouble with concentration and i have random thoughts and Random anxietyflushes. 
i feel like scared child most of the time.

 

Dont know if this is my trauma or wd. If its wd i should do so much therapy but of its trauma then i really need some support. 

[Altostrata]

Very hard to tell, it may be ongoing effects from covid. People are reporting odd symptoms like this.

[Escitalopram21]

@Altostrata

NOW i got a fever again and a positive test, so now it is corona. What the first round was is hard to tell. 
 

 

[Greatful]

@Escitalopram21  Sending you an encouraging hug🤗.....You will get through this.... If your brain/thoughts try to tell you differently, don't listen to them... Remember to be even more gentle and kind to  yourself....♥️

[Escitalopram21]

Thank you dear @Greatful❤️‍🩹

Just hoping there wont be any big setbacks!!

[manymoretodays]

Oh buggars!  Sorry to hear that Excitalopram21.

My hope is that you will be seeing more good days again soon.

Many around here are getting the Delta strain, and doing okay with it overall and after.  Thankfully.

I don't know what is hitting hard in Finland now, but hoping you've already seen the worst of symptoms.....from Covid.......wouldn't that be nice.

 

Anyway, HOLD tight with your current dose I say.

 

And heal, quickly.

L, P, H, and G,

mmt

[Escitalopram21]

Thank you @manymoretodays

It seems like a relatively mild one so hopefully revovered in a few days 🙏🏻

[Greatful]

@Escitalopram21  How are you doing?🌞

[Escitalopram21]

Hello @Greatful

I am okey, hanging in here. 
My biggest concern is that i might be reaching tolerance.. 

A few days now after taking the drug i feel super dizzy, weak in my whole body, a sense of tightness, heart pounding like crazy, physical anxiety and electricic feeling in my brain. 
I am far from okey to drop again but i might not have another choice. 
This happened in the summer right before i decided to do the drops and now almost half a year later. 
 

Any thoughts on this? @Altostrata

[Escitalopram21]

On 11/13/2022 at 4:54 PM, Escitalopram21 said:

A few days now after taking the drug i feel super dizzy, weak in my whole body, a sense of tightness, heart pounding like crazy, physical anxiety and electricic feeling in my brain. 

Also severe fatigue is reoccuring. I have had it on and off and the severe fatigue and brainfog was the reason i Wanted off the medication in the first place.

I am really scared.
I started traumatherapy so i dont feel like i am in a position to taper so a possible popp out is scaring me a lot.

This anyone have any thoughts on what is going on? I have not had symptoms in a few weeks and physical symptoms not in months,

 

 

[Escitalopram21]

I have not tapered in soon 6 months and now a few weeks ago i started feeling worse after taking me meds, help!! 
@brassmonkey@Altostrata

[Escitalopram21]

@manymoretodays

Are you able to help me switch syringe or count how to dilute my medication more to get to smaller doses?

[Escitalopram21]

@manymoretodaysi have the 20mg/ml solution and draw 0,15 ml solution and 0,15 ml water mix them and then draw 0,285mI. I would like to dilute my solution more with 0,30 ml water, what would that make? How much should i take?

[manymoretodays]

Didn't you just have Covid Escitalopram21?  I mean I wonder if it, your symptoms of late might be due to that?  What do you think?

 

Are you are still taking 2.85 mg escitalopram and 0.285 mL to get that dose?

 

I'm going to just copy my old post of calculations over here now, to refer to:

https://www.survivingantidepressants.org/topic/25363-escitalopram21-wd-from-escitalopram-and-quetiapine/?do=findComment&comment=614666

 

Do you have some bigger syringes now, a 3 mL syringe or a 5 mL syringe?

And then you will still need your 1 mL syringe to measure out your excitaloprom too.

 

So if your take the usual 0.15 mL from your escitalopram concentrate that is 20 mg/1 mL you have 3 mg escitalopram.

And then you add that to 2.85 mL of water, you'll have 3 mg escitalopram in 3 mL of liquid.  You might want to measure and mix it in a separate container and then draw up your dose of 2.85 mg, which now is 2.85 mL.

 

I would do the extra dilution before any further tapering to see how you adjust to it.  I see you posted again so I am going to look now.

 

[manymoretodays]

And okay.  You can do a smaller increase in dilution too.

14 minutes ago, Escitalopram21 said:

@manymoretodaysi have the 20mg/ml solution and draw 0,15 ml solution and 0,15 ml water mix them and then draw 0,285mI. I would like to dilute my solution more with 0,30 ml water, what would that make? How much should i take?

 

If you only add 0.30 mL of water to your 0.15 mL(3 mg) of concentrated escitalopram, then to get your dose of 2.85 mg, you would then take 0.427 mL.

 

You'd have 3 mg escitalopram in 0.45 mL of volume.

 

You would first have a total solution of 0.45 mL that has 3 mg of escitalopram in it.

And take 0.427 mL to get a dose of 2.85 mg of escitalopram.  I would just round up your volume to 0.43 mL.

 

Does that make sense.  2 options really.

1. you dilute the 0.15 mL(3 mg of escitalopram) more so your total dose is a bigger volume.  And perhaps easier to measure?

2.  you dilute the 0.15 mL(3 mg of escitalopram) with less, but more than you had been,  that too, might make it easier to measure.

 

Option 2, you aren't making as large a change in dilution, and you might even tolerate that better.

Option 1, if you mix your medication in the larger dilution well, you'd likely do okay, and it will be easier to measure once you start to taper again.

 

With the change in dilution factor, I wouldn't recommend that you taper at the same time.  I would rather wait and see how you adjust to the dilution change, or give your body a chance to adjust before tapering.

 

Let me know what you decide to do.  How much more dilution you do.  And then how it goes.  Or.......if needing further clarity or clarification.  I don't mind E21.

 

 

Edited December 1, 2022 by manymoretodays
another clarification

[Escitalopram21]

@manymoretodays thank you for this thorough explanation! 
I Will look into getting the 3 or 5 ml syringes and figure our what is the better option for me. 
 

I’ll let you know once i am attempting diluting more. 

Thank you again 🙏🏻
I Hope you are doing well!

[Escitalopram21]

@manymoretodays

I actually encountered a problem. I have always worked out every single drop from the top of the syringe. I read later that one shouldnt. When i have my ready solution i have 0,32 ml. How does this affect switching/using two syringes? 
I realized that might mean i am actually taking more than 2,85?

[manymoretodays]

Hi E21,

Doing well here, thanks for asking.  And for your patience.  Couple things going this past weekend and now.......I think my ultra flu vaccine caught up with me 48 hours later.  I just got zapped with feeling tired, almost exactly 48 hours after the injection earlier today, while out and about.  Hopefully short lived. 

 

So okay.  If you are winding up with a total volume of 0.32 mL that then contains the 0.15 mL from the excitalopram concentrate, and another 0.15 of water.........hmmm, maybe you've actually drawn up each closer to the 0.16 mL mark?  Except that we don't which......the water or the escitalopram concentrate......

 

Anyway, we'd figured out that the 0.15 mL of escitalopram concentrate was 3 mg.

And then you had an equal volume of water 0.15 mL.

To give a total of what we thought was 3 mg of escitalopram in 0.30 mL total volume.

 

And now, I think we could go with that 3 mg of escitalopram concentrate is in the 0.32 mL total volume.

 

So with that in mind, the current more accurate dose that I calculate out that you take when you use just 0.285 mL of the total volume to be 2.67 mg versus the 2.85 mg that you thought.

 

If you've been real consistent with measurements over time now, you really have not made a recent change in dose.  Consistency is good.  Always.  Same way of measuring is part of that.

 

So basically when you do a further dilution, we just need to work out how to get the 2.67 mg dose strength again.

 

So mull that all over, and let me know what you think.  Again, unlikely that you recently decreased your dose, if you have been consistent all along, starting from 0.32 mL of total volume.

 

On 11/20/2022 at 9:08 AM, Escitalopram21 said:

I have not tapered in soon 6 months and now a few weeks ago i started feeling worse after taking me meds, help!! 

 

And then there was that darn Covid infection of yours too!  Is this ^ persisting?

 

Hoping to hear of improvement......I mean I'm always hopeful, but let us know please how you've been more recently.

 

And best.

L, P, H, and G,

mmt

[Escitalopram21]

Sorry to hear you have been having more symptoms lately. Hopefully they have resolved by now. No worries about the late reply, nothing urgent in my case. @manymoretodays

 

The problem is my syringe. I am superconsistent with my measuring but when started tapering i didnt know i wasnt supposed to empty the top so i have done that. It adds up and makes a bigger volume then. If i would dilute my dosage ten times i would be able to go down in really small decreases. What would that make?

 

I am not sure what causes my symptoms. Today again i experienced a lot of symptoms and now hours after taking my dose i feel dizzy, weak, nauseos and had a lot of toothache. Crashing, burning and cold sensations in my brain.  I dont know what is causing it but i am afraid there is something off with my dosage.

[manymoretodays]

Hi there.  No, not more symptoms.......just a could be expected response after my flu vaccine.  It did not persist and me, I'm a happy camper.  Oh my.....just loving this holiday season and finding some new places out in nature really close by.  And I mean beautiful places.  Then....off to ski next week snow or no snow.  There should be some, and they have super duper snow making machines too.  There is most definitely some of the natural kind.

 

6 hours ago, Escitalopram21 said:

The problem is my syringe. I am superconsistent with my measuring but when started tapering i didnt know i wasnt supposed to empty the top so i have done that. It adds up and makes a bigger volume then.

 

What do you mean by "empty the top" of your syringe.  See if any of these help.  I starred the article and video that come from the first post of my first link :

Using an oral syringe and other tapering techniques:

Go to these:

*How to Read Syringes: 8 steps(with pictures)

*The video on how to read a syringe

 

And for your concerns, the measurements on the syringe, all have to do with volume only.  Millileters(mL's) or fractions of mL's.  They don't tell you the milligrams(mg's) or dose, or dose strength, of mgai (mg active ingredient)

 

And then you might have an oral(by mouth) syringe with a tip......is it what is in the tip that you are talking about?  Do you use your syringe to squirt the medication in your mouth when you take it?  If so, I would just go with what naturally comes out of the syringe when you have pushed the plunger part all the way down and stick with that.

 

If you have been "emptying the top" for a long time now......that would mean you have not made any recent changes in volume that you take, or in the mgai that you take, or the dose strength.  The 2 are related, but not the same thing. 

 

Volume= mL's 

Dose, or dose strength= mg, or mgai

 

So let me know what exactly you mean by "emptying the top" of your syringe. 

 

Then we can know for sure how many mg(milligram) in how much millileter(mL) you mix up.  And then how much of that you take.  And then how much of a dose you are getting.

 

On my last figuring out, calculations, math.......I came up with 2.67 mgai(dose or dose strength) in the 0.285 mL that you take now.

 

6 hours ago, Escitalopram21 said:

If i would dilute my dosage ten times i would be able to go down in really small decreases. What would that make?

 

You are presently going with 3 mg of escitalopram in 0.32 mL total volume.

 

Definitely easier to measure if you went up to 3 mg of escitalopram in 3.2 mL total volume.

(and that is ten times further diluted)

 

Do you have the 3 mL syringes, or even 5 mL syringes would work.

 

You'd still need your 1 mL syringe to measure out your escitalopram. You'd mix the 0.15 mL of escitalopram from your escitalopram concentrate bottle, with 3.05 mL of distilled water.

Then when you took 2.85 mL of this mixture, you would still have 2.67 mgai or dose/dosestrength.

 

You would need a small mixing container to mix your medication/drug and your distilled water in.  And then the 3 mL or 5 mL syringe to draw up your dose with.

You could also use your 1 mL syringe when you had doses that fell into smaller increments.

 

For example you could draw up 2.8 mL in a bigger syringe and then just .05 mL in the 1 mL syringe.

 

And here's a even different scenario too:

What if you put 1 mL of your escitalopram concentrate into 19 mL of distilled water.

You would then have 20 mg of escitalpram in 20 mL of total volume.

Then to get 2.67 mg(what I think your present dose is) you would draw up 2.67 mL.

Boy, that would make things easier.

 

Okay, I am going to stop this one now.  And also reply once more in regards to your present symptoms.

[manymoretodays]

7 hours ago, Escitalopram21 said:

I am not sure what causes my symptoms. Today again i experienced a lot of symptoms and now hours after taking my dose i feel dizzy, weak, nauseos and had a lot of toothache. Crashing, burning and cold sensations in my brain.  I dont know what is causing it but i am afraid there is something off with my dosage.

 

Symptoms both before and after your dose?

Is this happening everyday?

 

It sounds like you have been consistent with your dosing method........correct me if any recent changes in your method........it did not sound like it. 

And so, I think likely your fear that something is off with your dose is just another WD symptom.  An anxious type symptom or fearful like symptom.

 

Let us know on the bolded question E21. 

Thanks. 

Maybe a slight updose might help then.

 

 

[Escitalopram21]

I am happy to hear you are well and enjoying the holiday season and skiing. 
 

I rewatched the video on syringes and i have the exact same 1 ml as she has in the video. When i refer to the top i mean the pointy part of the syringe. I have always been emptying every drop from the syringe even the top both when drawing medication and water. I just recently realized it makes more that 0,3 ml in volume because i usually draw only what i need but when i have been trying to draw everything from the plastic container i use to mix medication and water in I realized that it makes more solution that i thought. Also after drawing my readily mixed solution I always draw 3 syringes full of water and flush it into my mouth after taking my dose. 
I get the symptoms every now and then, but havent had them before my covidinfection i think. But also until last summer i felt so bad otherwise that i am not sure if i had them or not. I might not have noticed them until my overall baseline was better.. i am not sure. 
 

The symptoms comes only after taking my meds around 40 minutes after and lasts 2-5hours. And no changes in method since summer. 
 

Thank you from the bottom of my heart for having this diskussion with me and taking my concerns seriously 🙏🏻

[manymoretodays]

Okay.  Sounds good with your accuracy of measurements.  I found the 1 mL syringe at 5.08 minutes into that video.

 

And so, for present dilution, you are at 3 mg or 3mgai escitalopram in 0.32 mL of final volume.

And then you take 0.285 mL for your dose, and your current dose is less than we thought......it is the 2.67 mg dose or mg or mgai(those can be interchanged).

 

On 12/10/2022 at 3:21 PM, manymoretodays said:

Today again i experienced a lot of symptoms and now hours after taking my dose i feel dizzy, weak, nauseos and had a lot of toothache. Crashing, burning and cold sensations in my brain.  I dont know what is causing it but i am afraid there is something off with my dosage.

 

Is this a daily thing E21? And if so, for how long, best you can recall, has it been happening?

I'm doubtful it is to do with your dosage being off......I think you've been consistent and same dose now since August, at least.

There's a couple things we can try.

If you want to work first on further dilution of your escitalopram, you can do that.  You need to get a 3 mL or 5 mL syringe.  Keep your 1 mL syringe too.

 

That might be what I would do now.  What would you like to do?

We just don't promote a dose change of any kind while doing a change in dilution, or any new formulation of a drug.

 

Or you could go down again, taper by perhaps just 5% of your current dose.

2.67 mg X 0.95 =which would be 2.54 mgai for your new dose.

 

If you only want to go down by 2.5% then:

2.67 mg X 0.975= 2.60 mgai for your new dose.

Present AIC or active ingredient concentration is 0.93 mg/mL.......this we'll need to work out how much in volume you'd take, if you make a change in dose, or taper without a new more diluted formula.

 

And yet another option......I did see you discuss if maybe you are metabolizing the escitalopram too fast now.......and might want to try splitting your daily dose, into 2??

 

Okay,  all things to think about.  Me I would want to make measurements easier for myself, and would go with further dilution.  And getting a 3 mg per a whole 3 mL solution.  I would just add 2.85 mL of water to the 0.15 mL of your escitalopram concentrate(and that equals 3mgai, or the dose strength) because then you would have a nice 3 mg in 3 mL and it would simplify measurements a lot.  AND make it easier when you get to doses less than 1 mg.

 

I hope this is all fairly straight forward to read and absorb.  Ask away, if needed.

 

And best.

L, P, H, and G,

mmt

 

Oh, it is a symptom, a WD symptom too.......the obsession on what you've done wrong, or why you have any symptoms......I mean I think it is.

And then I really didn't touch on if you think a small updose might help now.......I'm leaving it for you to decide if you'd like to try that.  Likely your intuition is better than mine when it comes to you and your symptoms and your body and all.

[Escitalopram21]

@manymoretodays

I would say that i have had these symptoms on and off since the beginning of november. And i had covid almost exactly one month before that. I dont feel like i need an updose, a supersmall decrease feels more accurate. I updosed in august 2021 when i didnt know about withdrawal and i have the same symptoms as when updosing. Like my body is not handling the E well.
 

Would a bigger volume mean less Escitalopram? That would be fantastic 🙏🏻 
I Will try to draw all of the solution for a few days to make sure exactly how much final solution i have. Especially if that determines how much i am actually taking. 
 

[Escitalopram21]

HOW on earth is it possible that my measuring differs a lot when i am beeing superconsistent? I dont dont dont get it. My total ranges between 0,33-0,37 when i draw everything. I have been trying to figure it out because i have no idea. What am i doing wrong??

[Escitalopram21]

So the total volume has varied a lot. I decided to get 0.5 ml syringes instead of 1 ml. The difference is that the 1 ml had so called dead space and that is what i mean by emptying the top. I measured the top and that makes 0.06 ml, even though Google says 0.076.

 

The median from my last measurements these few weeks would be 0.343 but i dont know what has made the total volume differ so much; it has been anything from 0.32-0.37.

But naturelly when the total volume differs this much it is not possible to know if it is the medication or the water that is off so i Guess i have been taking very inconsistent doses. Apparently my symptoms is from this.

 

 I now got my hands on 0.5 ml syringes without the dead space and now mix 0.18 ml of Escitalopram and 0.18 ml water and draw my 0.285 from that. My total volume is then 0.360 and with the same amount of water and that should make a 10mg/ml since i have the 20mg/ml. Yes?

 

It feels a lot easier to measure medication more precisley now with these new syringes. Wish me luck with getting consistent doses. 
Please let me know if there is anything off with my calculations 🙏🏻
 

[Escitalopram21]

I am so sorry for disturbing you, could confirm me on this? I have so much symptoms and trying to figure this out. When taking my dose with the syringe without the tip/dead end would that make 0.1715 and 0.343 instead of the 0.285 that i thought. 
anyone? @Altostrata@brassmonkey@manymoretodays

[Escitalopram21]

Second day of taking 0.34 with the 0.5ml syringe. The syringe makes the measuring a lot more accurate.

I Hope that this is a good dose to take. I have no idea since the doses have been varying so much. The 0.34 should be not too high regarding the 0.285 plus 0.06 in the tip but still not a big drop either i Hope. I really hate this situation i have i am in now with not knowing and i have work challenges coming up in a few weeks. 
 

So far i’ve taken 0.34 for two days. 
I had pretty much no symptoms day one, day two i have had a headache, nausea, no appetite but still a feeling of not becoming ”full enough” when eating, like my digestion tract is numb? 
I ruminate constantly about the dosage beeing wrong or Wright and i have a feeling of not beeing really present. 
I would love to take my exact dose but how can i know what that is now??? 

[manymoretodays]

I thought your problem was more the teensy weensy volumes you are dealing with.

And that basically that makes measurements difficult.

 

Escitalopram21,

I am not really following your "amount in the tip of the syringe".

Your measurements have nothing to do with what is left in the tip of the syringe......nor do you need to keep stressing on that.  I don't think you do.  Need to stress on that.

If your total volume can remain the same, that's what you are after.

Total volume is measured by the lines on your syringe.

Nothing to do with what is left in the tip of the syringe.

 

And.....also, what happened to trying to get a hold of a larger syringe.......I think that might be a great idea.  To get a 3 mL or 5 mL syringe.  And then, just use your little syringe to get the 3 mg of escitalopram(which was 0.15 mL of your concentrate, correct?) 

Add it to 2.85 mL of water and then you have 3 mg of escitalopram in 3 mL and can more easily take the 2.85 mg dosage.

 

Dosage changes sound pretty minimal really, with your worries on volume and total volume.

So......unlikely you are causing more symptoms to occur.

At least that is my take on this all.

 

3 hours ago, Escitalopram21 said:

So far i’ve taken 0.34 for two days. 
I had pretty much no symptoms day one, day two i have had a headache, nausea, no appetite but still a feeling of not becoming ”full enough” when eating, like my digestion tract is numb? 
I ruminate constantly about the dosage beeing wrong or Wright and i have a feeling of not beeing really present. 
I would love to take my exact dose but how can i know what that is now??? 

 

Good!  Yay.  Yes.

I know honey......you are overly ruminating.  And yes, that is a WD symptom in itself too.  It's not your fault.

No being present.....like this?:

Derealization or Depersonalization(DR and DP)

 

DP/DR can be tough.  Do you write?  Or are you a creative?  That can help one get through the "twilight zone" periods I found, and think.  Make it something a bit outside of yourself......it's easy enough to do when you are in it.........observe it.  And accept that it is there.  Try not to fear it.  Work around around it as best you can.

Again, it is not a forever thing.  Just oh so......ugh......and weird while it is ongoing.

 

Are you with people mostly or alone?  Do the opposite of whatever the answer to that is every now and then.  As tolerated.  Sometimes that helps.  If you are with people a lot......do some alone time.  If you are mostly alone........do some people time, even just briefly.  And again......observe, fall back from fear or panic.......to just observe......what is going on around you?  what does it look like?  what does it sound like?  Stay away from fear/anxiety thinking.

I know.....like that is easy.  No it is not.  I know.  It is now, for me anyway.......again, not to gloat......just to give hope.  And I have moments sometimes too.  Still.  They are so very manageable though. 

 

Okay.  You are in lower doses with the escitalopram.

Are you open to getting to using a 3 mL syringe and having 3 mL be your total volume ?

With the new syringe then we can just ignore any fluid in the tip.  If it doesn't come out, don't force it out of the syringe.

And use the syringe to take your dose too.

Are you using the present syringe to squirt your final dose into your mouth?

Or into a small amount of juice or flavored liquid that you immediately drink?

 

Okay, my 2 cents if you will.

You are getting there e21, you are.  I mean you've had illness to recoup from too.  It's not easy.

 

L, P, H, and G,

mmt

 

 

 

[Altostrata]

Don't worry about what's in the tip of the syringe.

[Escitalopram21]

@manymoretodays

Thank you so much for your reply. I Will reply to you more thorogly later.
I Will also get to diluting my dose more after my symptoms have gone done now that i can get more accurate measuring. 

[Escitalopram21]

I hurt my back really bad yesterday and now i am in the ER. 
Is there anything i can get that someone knows from experience doesn’t mess with my nervous system??? 
I am in so much pain that k almost couldnt get here even with the help of my husband.