piscesrising28: Tapering off escitalopram - still confused!

[piscesrising28]

Hi there,

I've read lots of the extremely helpful info on this site but still a little confused. I started a taper from 10mg of escitalopram according to GP advice and got down to 1/4 pill (2.5mg) every three days but I now want to taper much more slowly and stably, taking some medication every day instead of skipping days. I used the Brassmonkey taperoff calculator to create a schedule but once I weighed out my pill I can't figure out how i'm going to accurately taper such small increments of weight - a whole 10mg pill weighs 0.14g and the most precise drug scale I could find online stops picking up the weight of the pill once I go below 1/4 of the whole 10mg dose. Feeling a bit lost and confused about how to do it accurately - especially as I'm really struggling (I assume from withdrawal) with brain fog/memory and concentration problems and total lack of motivation. Should I measure out 1/4 and then divide it by eyeballing? But reducing that by 10% feels like maths I can't do! Any help very much appreciated

Edited August 20, 2021 by manymoretodays

[Go2zero]

Welcome to this support site. Before we can answer your questions, please give us more information first. Good that you came here. There is a lot of knowledge to be found and shared here. Also the members can support each other here.

 

As I understand you have tapered already from 10mg every day to 2,5mg every 2 days.

 

Please understand that skipping doses is asking for trouble, so you have made a good decision to going to take a daily dose.

 

https://www.survivingantidepressants.org/topic/22958-never-skip-doses-to-taper/

 

Furthermore I get the impression that you are tapering quite fast. Maybe too fast. Lots of doctors say this is possible. But our experience is that slower tapering leads to much less problems with possible withdrawal. We advice to taper not more than 10% per month of the last taken dosage.

 

https://www.survivingantidepressants.org/topic/1024-why-taper-by-10-of-my-dosage/

 

If you go back to daily dosages it would be a good idea to stay on this daily dose for a while (some weeks) to get used to a lower but daily dose, before continue tapering.

 

There are 2 good ways to weigh or measure small dosages. You could ask for a prescription of liquid ecitalopram. With a 1ml oral syringe you can measure dosages very careful.

 

Or you make your own liquid solution from the escitalopram. Therefor you need scales that can weigh 1/1000mg. The Gemini 20 is a good example. But there are more good models. Important is that the scales weigh up to 1/1000mg

 

Here you can find a description how to make your own liquid. I do it myself also every 5 days and it takes me les than 10 minutes. I prefer it over the ready made liquid, since it is much cheaper and the ready made liquid is so thick that is is not easy to handle in a syringe.

 

https://www.survivingantidepressants.org/topic/2693-how-to-make-a-liquid-from-tablets-or-capsules/

 

 

 

 

 

[piscesrising28]

Thank you - definitely agree it was too fast! I want to slow it right down - I don't think they provide my AD in liquid form on the NHS but I will ask. I think my error was the scales i bought were in increments of 0.01g but I need 0.001 so going to try and fix that. I think I find the liquid thing too confusing to do the maths for - it hurts my head to think about and then I just want to give up! is there any other info that I should provide? I'm now taking 1/4 pill - 2.5mg - of escitalopram daily and will stay there for a few weeks 

[Go2zero]

On 8/23/2021 at 11:02 AM, piscesrising28 said:

I'm now taking 1/4 pill - 2.5mg - of escitalopram daily and will stay there for a few weeks 

 

Do I understand you are taking 2,5 mg daily now, where you were taking 2,5 every third day before? 

If so, you take 3 times as much as before. First you took 2,5 mg in 3 days and now 7,5mg (3x2,5mg) per 3 days?

 

When I understand this right you have made a big increase in dosage. 

 

Could you please update your signature and specify in detail with dates and dosages how you tapered down from 10 mg to where you are now? If you do not know the exact dates, you can make estimates.

 

We can assist you in calculating the dosages you should take and how to make your own liquids. It is easier than you think. 

[piscesrising28]

Yes - actually spoke to my GP and he recommended going to 5mg a day so that's what I'm now doing even tho feels like a big increase. But I'm having such terrible relapse type symptoms I just feel like I need to get back on an even keel before thinking about tapering tho who knows if that will happen. Will update my signature  now

[piscesrising28]

As mentioned in my signature, now trying to decide if it's insane to just go back to 10mg dose and hope I feel better then start again in 6 months??? I'm panicking basically as unable to work properly which in itself always sends me into a big anxiety spiral 

[jozeff]

On 8/21/2021 at 1:03 AM, Go2zero said:

Important is that the scales weigh up to 1/1000mg

I think you mean 1/1000 of a gram.

 

1/1000 mg is 1ug and scales to weigh  that cost 10 thousand euro's.

Cheers

 

Jozeff

 

[Go2zero]

9 hours ago, jozeff said:

I think you mean 1/1000 of a gram.

Yes, you are right. So 1/1000 gram (is same as 1mg)

[Go2zero]

10 hours ago, piscesrising28 said:

As mentioned in my signature, now trying to decide if it's insane to just go back to 10mg dose and hope I feel better then start again in 6 months??? I'm panicking basically as unable to work properly which in itself always sends me into a big anxiety spiral

 

You have gotten in withdrawal because you went down in dosage too fast from 10 mg daily to 2,5mg every three days (0,8 mg average per day).

Skipping daily dosages is like asking for withdrawal problems. 

 

Going too much up in dosage is also a way to sensitize the nervous system. You should best stabilize for at least one month on a dosage that is not too high. Do not change dosage again before you feel better and much more stable.  The more you will updose the heavier WD symptoms may get. 

 

https://www.survivingantidepressants.org/topic/6632-the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable/?tab=comments#comment-525233

 

If I were you I would certainly not take more than the 5 mg you are taking now. As a matter of fact this is already a very high up-dose since you were only taking 2,5mg per 3 days (average of 0,8mg per day). Better would be 2,5mg - 3 mg

 

[piscesrising28]

What if my original symptoms have come back

 

I've been tapering  very slowly off escitalopram over the past 10 months and I'm down from 10mg last spring to 2mg now. Along the way I've had symptoms that seemed clearly linked to the withdrawal like massive brain fog, random crying jags out of nowhere etc.

But I've had a couple of stressful things happen and I'm experiencing HORRIFIC anxiety of the kind I used to before I ever took SSRIs, and of the kind I haven't really experienced since I took escitalopram (although I did get some of it previously while on citalopram). It very much does feel like a relapse of old symptoms and I'm finding it really hard to cope with - affecting my work and sending me into a spiral where not working well causes me further anxiety. It's making me want to give up all my progress and just turn back to an SSRI in the hope of some relief. 

Any advice?

 

 

Edited July 27, 2022 by ChessieCat
added topic title before merging with intro topic

[ChessieCat]

54 minutes ago, piscesrising28 said:

I've been tapering  very slowly off escitalopram over the past 10 months and I'm down from 10mg last spring to 2mg now.

 

Please provide the details of your taper since the start of 2022 so we can assess if you are going too fast.

 

 

[ChessieCat]

By details, I mean please list the dose and the date you started that dose.

 

Q:  Do you drink alcohol?

 

Q:  Have you taken antibiotics?

 

Q:  Have you continued tapering when you are still experiencing withdrawal symptoms?

[piscesrising28]

- yes a bit but always have and this is a new/ resurgence of old feeling I haven't had for ages

-no

-no - i don't think these are withdrawal symptoms. I've been stable on my dose for a month but only started to feel this way this week and I won't go down again until I feel better

 

I was at 3mg 9th May

2.5mg 30 May

2 mg 27 June 

[ChessieCat]

9 hours ago, piscesrising28 said:

- yes a bit but always have

 

Please read:

 

On 7/6/2020 at 5:50 AM, brassmonkey said:

Drinking alcohol is a major factor in excellent recoveries getting derailed.  We just had a case of a member who has been drug free for several years with an excellent recovery underway.  They had a couple of drinks over the weekend and tripped off their symptoms all over again.  Luckily, it cleared in a few days, but that is not always the case.

 

and:

 

alcohol-and-beer

 

SA's recommended taper rate is NO MORE than 10% of the CURRENT DOSE followed by a hold of at least 4 weeks to allow the brain to adapt to not getting as much of the drug.

 

Why taper by 10% of my dosage?

 

Some people think that they can go faster because they are on a lower dose, but the opposite is quite often the case.  Many members find that the lower there dose gets the slower they need to go.  The video linked in Post #1 of this topic explains it quite simply:

 

Why taper paper: dose-occupancy curves

 

Escitalopram is a very strong drug:

 

On 5/27/2011 at 12:16 PM, Altostrata said:

If you are taking 5mg of Lexapro, it's not tiny, it's equivalent to 10-20mg Paxil or Celexa.

Consequently, when you taper off escitalopram, you should be careful to decrease by small amounts, as each drop is magnified by escitalopram's extra potency. If you find withdrawal symptoms from a 10% decrease to be too difficult, after 3-4 weeks decrease by a smaller amount.

 

You are tapering faster than the recommended 10%.

 

I was at 3mg 9th May

2.5mg 30 May      16.6667% decrease

2 mg 27 June       20% decrease

 

Post #1 of this topic explains how to get non standard doses:

 

Tips for tapering off escitalopram (Lexapro)