LunaLex: Lexapro Crash after unsupervised taper

[LunaLex]

WARNING. This is very long and took me hours to write. I didnt know what to include. I figured more information was more information so.. Here it all is. If anyone has advice on what i should cut please do advise!

 

TLDR is i accidentally went cold turkey off 2.5 1x week Escitalopram, have been treating it all wrong with propanolol, thc and cbd. Countless mood and physical symptoms. Believe I have kindled and made going back on impossible. Scared to wait this out incase of psychosis. Scared to reinstate. Terrified of everything and tired and unable to sleep. 

 

 

 

Okay, I dont know what to write here, so ill give a small summary background and history I took from my summary for applying for the board. My mental health and my lack of steady GP has made finding dates VERY hard and I went through a lot of patchy on off med periods so its a little unclear, sorry. I did my best to match referrals and old receipts for rough dating. 

 

History-

Depression and suicidality 2003~2013. 2013, suddenly panic attacks and anxiety, went to psych, was prescribed Sertraline, unsure dose.

2013~ 2016

Sertraline - Felt no better & hated side effects so CT. Didn't notice WD.

Tried Desvenfalaxine, then Fluoxetine. No improvement on depression within months like I wanted, side effects too horrible. CT off both. 

Tried Escitalopram, helped panic attacks. CT off all and no WD noticed. 

During these years I was bad, very depressed, barely left bed, would hold jobs for months and then drop. Mostly same since 2003. 

2016~2019 Mental Health crisis around August 2016 led to being in and out of ER, decided reinstate medication.

40mg Escitalopram initially followed by addition of Wellbutrin,  75 up to 150mg.  Escitalopram reduced to 20mg sometime btwn August 2016 and Feb 2017, then down to 10mg by July 2017.  All unsupervised tapers, doctors saw my doses changing and were unphased. No WD experienced. Stabilized. Struggled with depression and anxiety, but no panic. No suicidality. 

 

2019-2020  Started to be lax with occasionally not taking meds. Stopped Zyban cold turkey during 2020 or 2019 due to night sweats, feeling stable and feeling like it affected my memory. Ocasional forgetting to take escitalopram for a few days.  Mostly stable Escitalopram at 10mg. 

 

2020-2022 Minor depression but the best i had been, even before meds. Have not had suicidal feelings in 6 years, no panic attacks. I spent years slowly working up a reward system for myself to encourage myself to do things like shower daily, cook and eat real food. During this time none of that is an effort and I begin adding to things. I institute a cleaning schedule with WEEKLY house cleaning. I cook. I eat regularly. I exercise on and off. I feel stable and HAPPY for the first time ever. Even my hard days pale in comparison and instead of not leaving bed or eating for 30hrs my worst times are a week where my chores are a bit lax. I get a job by CHOICE. 

 

But I begin to notice through this two things - I went on Escitalopram to manage panic attacks and now im only having mild anxiety... But I have TERRIBLE emotional blunting. I can't laugh, I can‘t cry. Bad things will happen and I can feel it like a pressure under the surface. I even listen to sad things to TRY and cry and nothing. 

 

I begin to try and taper. To be honest I think I tried CT and the brainzaps put me off.

Over 2020 maybe, but mostly 2021, I Taper unsupervised down to 5mg daily... then every other day I try and push it and only take meds when noticing brainzaps. I DO NOT KNOW that means withdrawal or that i am essentially entering withdrawal every few weeks. Noticing 5 is still producing annoying blunting I go down to taking 2.5 1-2x week by late 2021, only when I have brainzaps. I told doctors about this and nobody said anything, nobody said not to do this! 

 

During 2020~2021 I start to, in retrospect, have what was probably withdrawal symptoms. My Anxiety has waves and days or weeks of being moderately bad in a way I've never experienced. I latch on to certain almost intrusive worries and struggle with them a lot. I begin to obsess about finances, my weight, healthy food, calories etc. It only gets as bad as mild crying on some intermittent days tho. Its draining but liveable. This makes me more encouraged to try and not take Escitalopram as I have never found it helpful for my general anxiety and rumination and would like to find something not blunting. 

 

November through January I feel my best ever. I start a new job and have a week in January this year where I take 5mg because im struggling with anxiety, then went back down to 2.5 “as needed”  Mild brain zaps in February, twice I have days where i feel derealized and dizzy, but hours later i have a migraine so unsure if withdrawal or symptons of migraine.  Start to feel mildly depressed early March - My contract at my Job is up and its the first job I have managed 2 days a week at without burning out. The depression feels rational though, im worrying about ever having real money or holding down a full time job, since my “best” I still cant handle it. This still feels like my depression. I try and stick to the 2.5 because it wards off brainzaps, but i dont feel emotionally blunted. 

~~~~~~~~~~~~~~

WD AND CURRENT ISSUES START HERE. 

 

17/03 2022 Sudden HARD crash. I feel.. weird.Dizzy, so dizzy i feel like im falling over. Spacey, nauseous. I take my 2.5 but it does not improve. First panic attack in 6 years on the 19th. 

 

On 20th Tried reinstate at 5mg, just in a prayer for stability, not knowing what is happening.  Maybe mild help at most. I wake up having a panic attack at 4am the 21st and cant calm down. derealization, nausea.. I see the GP on the 21st, he says my dosage was so low as to be pretty much nonexistant and taking the meds again wont give relief. I feel like im going insane because I can feel calm mentally and start having panic attacks out of nowhere. I stil feel okay emotionally but this is eating at me.  Put on propanolol every 4 hrs as needed, when i first take it and the physical symptoms calm down I feel INSTANT relief and cry. 

 

21st-But, for the first time ever I have insomnia- Ive always fallen asleep at like 2-4am and awake at 10-12, but during depression usually I am a sleep for 16hrs straight type. Im having migraine headaches, i cant keep food down. Im mixing antiemetics and propnaolol. I feel SO DIZZY i lay in bed all night feeling like im falling. I take a maxalt and manage an hour and a half sleep for the first time in two days. 

 

22ng I begin to suspect withdrawal now. Net says 3wks so I decide to try and hold. I distract myself by cleaning, I start having hot and cold flushes.  Laying in bed gives me panic attacks. I get dizzy and scared of more panic attacks and not sleeping ever again, followed by heart pounding and shaking and hot and cold flushes back to back for hours. I take two temazepam i found that expired in 2019 and feel no better, sleep an hour or so. 

 

23rd. Messaging my mum everyday, she wants me to try CBD and THC. I get an appointment. Im starting to feel less panicky per day, only random attacks rather than back to back all day, seemingly untriggered, sudden chills and heart pounding. Except if I lay down, then I always panic. I try the couch and the floor, i try breathing exercises and progressive muscle relaxation. I go buy Restavit. I emotionally collapse. I barely remember this so here is what I sent my mother>

 

“ Last night was ***** at first. Hysterical crying on the floor, felt like I was dying, [partner] even went searching for valium bc i was so ***** but found none.  Went to bed early and was exhausted but still could not pass out for an hour of panic(continous chills and feeling like i had been dunked in cold water and shaking and chest felt tight etc). Took the sedatives and still could not, got up and paced around for a bit which felt SO funny bc I was dizzy and struggling to walk but if I stopped I panicked so I was just stumbling back and forth around the kitchen. I went back to bed and eventually somewhere between 5am and 9am passed out and then slept until frickin 6pm.

Beginning to suspect its some weird delayed onset ssri discontinuation syndrome. It kinda FEELS physically like getting brainzaps does. The fact its random out of nowhere, no trigger, cant calm myself mwntally, comes in waves, so much worse at night. I feel a lot better today. Not even taken a single beta blocker. Chest has been a bit tight all day and struggling a bit with feeling like nothing is real. Starting to have scalp crawling tingles now so hopefully not gonna be a repeat of last night.”. 

 

 Prescribed THc and CBD oils. The next few days are a fog and I dont message my mum so Im unsure what happened. I know my panic attacks started to not happen I know they stopped around saturday the 26th so I stop taking propanolol.  I know my insomnia sucked. I took restavit a few times during this, it helped twice and didnt twice. I started to feel okay and even good on sunday and monday. My anxiety was a 4~5 on this day from the 7~10 it had been. 

 

By 29th of March I begin my THC and CBD and am not feeling good. I take my CBD to no effect. The THC makes me feel GOOD. Not euphoric but the closest to how i felt emotionally and anxiety wise for the first time since this started. But dont even manage the 4hrs of sleep ive gotten the last few days. I think this is a BAD idea bc I start to feel BAD on the 30th and panicky again.  

 

I dont remember this week well. I have no messages during this time. I take CBD 0.125ml at 100mg per ml on 29, 30th, 31st and 0.25 on the first. Nothing, maybe minorly more anxiety. 

THC is a 10thc15cbd per ml mix. I take 0.25ml 29, 30th at 7:44pm AND 144 am And take a restavit and STILL can not fall asleep and feel nothing on the 30th. I try 0.5 on the first, I actually do sleep. I take 0.5 on the 02 and cant sleep at all again. I feel focused and calm and awake so I drop them both. 

 

I convince myself all the other websites are right and look to the 7th as a day all will resolve. On and off dizzyness and constant insomnia this week, falling asleep for barely 4 hrs most nights. Tummy and appetite issuesstill but no panic. My mood effects start coming in this week. I flip between total fog inability to engage with or enjoy anything zoned out on the couch for hours exhausted and existing, to crying spells of hours out of nowhere. But I can eat without nausea most days and I can do some cooking, i manage to cook two meals for mt partner. I start to notice fluey symptoms~ body aches and post nasal drip and cough.

 

On the 6th I start thinking about giving up on holding. I cant stop sobbing hystericallt all day. take some thc at 0.25 ml and despite barely any effects on 0.5 I feel kinda high. My mood and appetite feel really good and I have mild warm and fuzzies. I crash though and cant sleep and after the come down im shaky

 

"my nervous system is so fried. went to bed at 4, fell asleep at 1030am. slept from then till 11:40, then 12:25 to 1:30 then 1:40 to 4:30. maybe 4 and a half hours total. I feel wide awake but also tired the whole time and cant tell if im falling asleep. Im scared of benzos as a solution tho" Im beginning to be scared of how im effecting my partner and his mood and sleep as my only support. I had two good days again that week and went out one day. I am struggling emotionally more and more. I cant be alone or I spiral. I sit in my partners room on the floor while I scroll, being in a room with someone helps. 

 

I take restavit for the fifth time in two weeks on the 7th.  Ive had mixed results and groggyness 12hrs later but im desperate so I take 50mg. I SLEEP. The next few days I take 25mg, I wake up every two to four hours but I manage 6 hours. Even if I take restavit at midnight I dont fall asleep till 8 am most days but SLEEP IS SWEET RELIEF. Still anhedonic and weepy. Dont manage chores this week. 

~~~~~~~~~~~~

 

 

Which brings us to the last few days. A fresh hell. Im struggling. Not distracting myself. Thoughts start to get worse. 10th i cry and obsess till bed time about how I will be stuck like this forever. I get stuck on the idea that even if I go back on my meds I can only work 2 days a week. I get stuck on obsessing about money. All the therapists in my area are 100~800$. How will I ever get therapy and get better. How will I ever get on disability with no proper history. 

 

11th is my worst day yet. I cry about that some more. I cry about being stuck like this. About a two year possible taper. About why am i having WD symptoms. About fear of waiting this out and it not getting better. Fear of going back on and kindling happening bc I ***** myself up with the once a week bullsh*t. And then having to go through this anyway. About a two year taper of no emotions. About not having sleep at all without restavit no matter what I do. I take 0.25 mg of thc in the afternoon. I feel euphoric and quite high. Then I feel BAD about that. What if i have to get high every day to cope? My boyfriend has addiction history, this is wrong to do around him. Etc. I cry a LOT FOR HOURS. I finally calm down for a few hours. I have an existenstial crisis about turning 30 and only having worked part time jobs and my mental health and having not ever lived. About finally feeling like I was coping enough to keep my emotions and house i order and now this. Im inconsolable for hours and cry till mt partner falls asleep. I dont sleep. I have intrusive thoughts. I feel suicidal for the firsy time in years. I consider going to the ER, second time i consider that recently. 

 

I take THC at 1030, hoping for a nap or at least relief for a few hours. BAD BAD BAD. When it kicks in, despite being the same dose i couldnt feel two weeks ago or was happy on yesterday I start.. hallucinating, I guess? Its all the symptoms of tripping on LSD. Letters on my keyboard mildly glow, words wiggle, afterimagea when I blink. I PANIC. THC ISNT MEANT TO DO THIS. I start to shake, like intense shivering, can barely type to my partner. He comes home from work for lunch. 

 

I worry that ive induced psychosis. we talk about the hospital. Im having paranoia now, that i've induced psychosis, that if I go in theyll put me on benzos, that im never going to be okay again. I cant eat. I feel like throwing up. My stomach is bad. 

 

Hours later I calm down. I feel fragile as glass. I keep crying on and off. Im actually stable enough by 10pm to enjoy playing some games with mt partner for the first time ina week. But I cry a lot. I apply here. I read a lot. Food tastes bad still. No appetite. Feel exhausted but wired. 

 

I take half a restavit. I spend hours writing this. I argue with my mum about whether to reinstate or whether ive made things too bad for that.

 

Ive been awake 30 hours now. Im going to take another half a restavit. I know I shouldnt. I know how much I have done wrong. I know Ill be groggy till 4pm tomorrow. I know Im in a very bad place. The panic attacks are gone, I still get mild dizzyness on and off. I still get chills. But mostly my emotions are now a mess. I have never cried this much in my life. I feel like i have no control over my thoughts and emotions. I spiral and ruminate and feel depressed the last few days. 

 

My mum wants me to go to an inpatient hospital, or talk to the ER. I am afraid of being put on benzos by someone who doesnt understand. My boyfriend wants me to hold for two more weeks, since its changing so rapidly and i have new symptoms every day and ive passed the headaches and panic attacks. 

 

I am very scared. I dont know what to do. Taking two years to taper down and having to suffer withdrawals anyway sounds like hell. The risk of kindling and the fact I didnt feel better with the 2.5 or 5 the first week scares me so much. I dont know if im more afraid of living like this for much longer in the hope it will resolve, or of trying to go on meds and that kindling and being even WORSE, or of years of suffering when i might resolve in a few more weeks when i have already made it through almost four weeks of hell.  I am scared though. And this week I am suffering. And I need advice. 

 

I know I wrote a lot. Im sorry. Ive been so scared and nobody around me understands and all want me to find help from a doctor and i am so afraid the doctors will make it worse. The THC sure did and the advice to not reinstate might have. 

[LunaLex]

Wednesday 13/4

 

Sleep- 530 am to 530 pm in bed. 

1030 total, 430 Deep and 443 Poor. 12 hrs in bed. Avg 1-2 hr.

 

6pm - No appetite. Heart pounding, alert, panicky. Mild Nausea. Feeling Teary. Force self to eat and food tastes okay.  Body feels tired. Anxiety 6.5/10 Mood 4.5/10

 

8pm. Alertness has ebbed, mild chest tightness. Scalp and face tingles. Tightness, discomfort etc under right shoulder blade is back. Physical tiredness worse. Mind feels okay, not teary, a ittle bit anxious and sick of this. Mood 5/10

 

10pm - small wave of anxiety, mostly physical. Heart thumping, chest tight. Temp regulation off, quite cold. Still no appetite. Shoulder bothering me. Feeling some happiness!! Came 3rd Trivia. 

Anxiety 5/10 Mood 6/10

 

1133- Home from trivia. While feel better than I have recently im aware of how im having waves of chills and tensions and anxiety for a few minutes. Aware of how much I dont feel like myself and feel unstable. Tearing up a bit over it but trying not to let the weeping start. Hunger and appetite now tho! Trying to relax with cat after claw clips. Anxiety 5/10 Mood 5.5/10

 

3:17am Mildly teary. Struggling with mild DP/DR and hard thoughts and feelings. Nobody can relate to what im going through, Ive gone crazy, Ill never feel joy again etc. Not feeling even close to usual love or happiness toward my partner and cat is hard. Dinner took too long to make, eating now. Headachey. Took 25mg Doxylamine now. Anxiety 5-6/,10, Mood 5.5/10

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  The symptoms you describe sound typical of those of a person in withdrawal from psychiatric drugs.  It sounds as though your nervous system is probably sensitized from the extensive drug history and drug changes and irregular dosing.  But with proper self care and lots of patience, you can overcome this.  Am I correct in understanding that now you are altogether off the Lexapro?  Do you currently take any other drugs besides doxylamine?  

 

Here is some important information about how these drugs actually work.  This explains why we get symptoms from going off of these medications, and why it's so important to taper slowly and carefully, and be very cautious about making any drug changes (adding or dropping drugs, changing doses, skipping doses, etc). 

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

Video on Recovery from Psych Drugs

 

Windows and Waves Pattern of Stabilization

 

Here is a link with checklists of common WD symptoms: 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

Stability is really important.  Please read the link about stability:

 

Keep It Simple, Slow, and Stable

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

Omega 3 Fish Oil

 

Since this is already pretty long, I will make a second post with some more links that will address your specific situation.  

 

[getofflex]

What you are going through is a very difficult and scary thing.  I'm going to post some links that may help you to cope with what you are dealing with in a calm and rational manner.  This will go a long way to alleviating your suffering.   One thing we want to try and unlearn is attempting to use drugs and mind altering substances to lessen our withdrawal symptoms.  The drugs are what created the problem in the first place, and using more drugs to try and feel better often only makes the problem worse, because our nervous systems are sensitized, and the drugs often further destabilize the nervous system.  Also, when our nervous system is destabilized, the drugs can sometimes do unpredictable things, and we don't react the way most people react to the drugs.  One example is someone taking an antihistamine to help with sleep, and instead of helping with sleep, it may do the opposite, and keep us awake.  

 

Antihistamines for Withdrawal Insomnia

 

Consideration About Stability - Stop Jumping Around

 

Please read the following link thoroughly and carefully.  It will really help you if you apply these principles.  In this link, please pay special attention to item number 8.  

 

Steps for Managing WD Symptoms

 

Here are some other links to help cope with your symptoms.  

 

Emotional Spirals

 

Acknowledge Accept Float

 

Music to Calm Anxiety

 

Breathing Technique for Anxiety

 

Meditation

 

Cognitive Behavior Therapy for Anxiety Around Withdrawal

 

We do not suggest the use of CBD or THC while people are in withdrawal.  This link explains why: 

 

THC, CBD, etc

 

Also, skipping doses is not a good way to taper at all.  It's unfortunate that some doctors suggest this. 

 

Never Skip Doses to Taper

 

I realize I have bombarded you with a lot of information.  The most important stuff is in the first post, and also in the link "Steps for Managing WD symptoms" above.  Take your time to look through it all, and feel free to ask any questions.  I just want to reassure you that things will not always be this bad, and that you should gradually and slowly recover from this - the keys are time, and patience.  Keep us posted! 

[LunaLex]

Hi, 

Thank you so much for your response. 

I am currently taking no Lexapro, just a contraceptive pill. I am attempting to not take the doxylamine  tonight, but I must admit I am scared. I find not sleeping has the worst effect on my symptoms the next day and my ability to cope with them. 

I have read a lot of how to cope with insomnia on this forum and attempted to institute it during the second and third week without any luck and many nights of 0 sleep. 

Ive been lucky so far in that the doxylamine has had no adverse reactions or keeping me awake, but I recognise I am probably becoming mildly emotionally reliant on it which is why I shall try and go without tonight. 

 

I had a skim of some of the emotional spirals topic the day before yesterday, but not the rest. Ill go through them tomorrow, the steps for managing one looks really helpful. Thank you. 

 

I was wondering if you had any advice as to whether I should consider reinstatement? I never meant to CT in the first place and I was not ready and prepared to go off, really. I've had a big window today but I am not coping with the waves. The lowest easily prescribed dose in Australia is 10mg, is it worth trying to get a GP to prescribe 1mg|ml liquid from a compounding pharmacy and attempting to reinstate at 0.5 and retapering when I am in a better supported place emotionally? Or have I messed with my system too much and should just hold?

[ChessieCat]

2 hours ago, TentacleFinn said:

I was wondering if you had any advice as to whether I should consider reinstatement? I never meant to CT in the first place and I was not ready and prepared to go off, really. I've had a big window today but I am not coping with the waves. The lowest easily prescribed dose in Australia is 10mg

 

If you are considering reinstating Lexapro / escitalopram, then you might consider changing to citalopram which is a gentler sibling of escitalopram.

 

Please see Post #1 of these topic about how to get non standard doses:

 

Tips for tapering off citalopram (Celexa)

 

Tips for tapering off escitalopram (Lexapro)

 

Lexapro is a very strong drug, which is explained in Post #1 of the above topic.

 

[ChessieCat]

Please carefully read Post #1 of this topic:

 

About reinstating and stabilizing to reduce withdrawal symptoms

[LunaLex]

Hi @ChessieCat

Thank you for your quick response. 

 

I've read those posts backwards and forwards the last few days. 

In Aus the lowest Citalopram is 10mg tablets, no liquid.

There is a Escitalopram liquid at 20mg a ml or 10mg tablets at the lowest. I am not sure I could make my own liquid at home well but would be willing to try. 

 

I know its often best to try and reinstate on the same thing you went off. If I was to get a special script made at 1mg/ml liquid of Escitalopram {if possible} would it be safe or wise to try reinstating. And if so would I try at 0.5ml, or 1? I know either is suggested in the reinstating topic. I was unsure if my tapering with missing doses changes things. Or since I was on Escitalopram would it be 0.25?

 

I know reinstating may not work. I thought there is a chance I may be okay at a month still. 

 

If anyone could give me advice on what to reinstate at I would appreciate it. 

[LunaLex]

Sleeping without the Restavit was not fun. I got about 5 and a half hours, waking up once an hour. Which is similar to usual, but every time I woke I felt as if I hadnt slept and felt very alert and mildly anxious as opposed to the gentle sleepy feeling of a good wake up.  Woke with a headache and some nausea, feeling some intense neuro sadness, anger and anxiety. 

[LunaLex]

Today is not a good day. Intense nausea, waves of high anxiety with chills all over, scalp feels tight and cold. The waves of anxiety bring rhe overwhelming feeling of wanting to cry. Lots of hard neuro emotions and spiralling thoughts.  Feeling a bit helpless today to the point of being tempted to try reinstating 2.5mg, since the doctor is not in till tuesday. Going to try and hold and perhaps call an out of hours service. 

 

Having a good day yesterday makes such an intense wave hard. Just trying to sit in a blanket on the couch and get some sun and hold. 

 

Hope everyone else is having a nice easter. 

[ChessieCat]

2 hours ago, TentacleFinn said:

I know its often best to try and reinstate on the same thing you went off.

 

This is generally true.  However in this case escitalopram and citalopram are very similar drugs.  Some members have difficulty getting off Lexapro which is why SA sometimes suggests reinstating with citalopram.

 

Celexa is citalopram:

  

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

 

Chemically, Lexapro is a variation of Celexa; the molecule was re-engineered to be patentable as Celexa's patent was about to expire.

 

 

Making your own liquid is very simple.  I've done it myself.  A 10mg tablet in 10mL of water gives a 1:1 ratio so 1mL of liquid contains 1mg dose.  A 10mg tablet in 100mL of water gives a 1:100 ratio so 1mL of liquid gives a 0.1mg dose.  Being able to make it with more water means it is easier to get the dose you need.  I bought a 100mL graduated cylinder and some syringes (1mL, 3mL, 5mL) and found it very easy to get my doses, even down to 0.00125mg.

 

One of SA's members uses an adjustable volume pipette.  See these posts:  adjustable volume pipette

[ChessieCat]

11 minutes ago, TentacleFinn said:

tempted to try reinstating 2.5mg

 

According to your signature it has been 1 month since you were taking 2.5mg Lexapro.  You might find that trying a very small dose, like 0.1mg-0.25mg might be enough to ease the withdrawal symptoms.

 

It is better to start with a small dose and increase by small increments than to risk taking too much.

[LunaLex]

Thank you @ChessieCat. I am a bit scared to make my own liquid, i decided to start by calling a telehealth doctor tomorrow and seeing if i can get a compound liquid at 1mg per ml and if not I may have to venture into my own. 

 

I also wanted to ask about stabilizing and updosing. If I reinstate at 0.25, how long should I wait to feel better? A week? Two?

 

I am very unwell today. As well as a lot of bad neuro emotions ive been very very nauseous. I took a metaclopromide to force food down and my heart started racing within a few hours and face tight, dizzy having trouble focusing, feeling a bit faint. 

 

Has anyone experienced this before? 

[getofflex]

17 hours ago, TentacleFinn said:

I know its often best to try and reinstate on the same thing you went off. If I was to get a special script made at 1mg/ml liquid of Escitalopram {if possible} would it be safe or wise to try reinstating. And if so would I try at 0.5ml, or 1?

I would agree with Chessie Cat in saying that you could try a reinstatement to citalopram, instead of escitalopram.  The 2 drugs are very similar.  They are siblings of each other, but citalopram is milder, and easier to get off of.  But it is your choice.  However, realize that escitalopram is very powerful, and is 2x to 4x stronger than other SSRI's.  So if you do reinstate Lexapro, I should suggest a very low dose.  I would go with what CC suggested - between 0.1 to 0.25 mg of escitalopram.  

 

Give it at least a week.  If you feel significantly worse, then stop the reinstatement right away.  It takes about a week for it to get in your system fully and register.  If you do OK on that, and need more relief, we can always carefully and gradually increase the dose. 

 

Please let us know what you decide to do.  

 

 

 

 

[LunaLex]

I had a hard night of 0 sleep, everytime i was falling asleep i would hypnic jerk which would send a rush of (cortisol? adrenaline?) through me with chills and I would wake right back up. I feel better today emotionally but way more sick. I payed 35$ on telehealth for a doctor to tell me I was an idiot for how I had done this and essentially not believe me. 

 

I ended up making a liquid last night (5mg in 10ml of water) and after the doctor just sent me a normal pill script AND the compounding pharmacy wouldnt pick up AND my partner had to cancel heading to see his family for easter due to how physically sick I am today i snapped and took 0.5ml/0.25mg of the liquid. Now to wait and see how I feel. Fingers crossed. 

[getofflex]

7 hours ago, TentacleFinn said:

due to how physically sick I am today i snapped and took 0.5ml/0.25mg of the liquid. Now to wait and see how I feel. Fingers crossed. 

This is fine, but please stick with it, and don't just take this drug impulsively out of desperation and panic.  These drugs are extremely powerful, and need to be respected and dealt with very cautiously.  It's not like an ibuprofen, where one dose will take the pain away, and once you stop taking it it's out of your system.   If you jump on and off the drugs, you will probably end up making yourself even worse, and it takes a very long time for a badly destabilized nervous system to sort itself out - months to years.  Stay with this reinstatement for at leas a week, and see if it helps.  Just one dose may not make you feel better.  Please read this if you haven't already: 

 

Consideration About Stability - Stop Jumping Around

 

 

 

Edited April 16, 2022 by getofflex

[LunaLex]

8 hours ago, getofflex said:

This is fine, but please stick with it, and don't just take this drug impulsively out of desperation and panic.  These drugs are extremely powerful, and need to be respected and dealt with very cautiously.  It's not like an ibuprofen, where one dose will take the pain away, and once you stop taking it it's out of your system.   If you jump on and off the drugs, you will probably end up making yourself even worse, and it takes a very long time for a badly destabilized nervous system to sort itself out - months to years.  Stay with this reinstatement for at leas a week, and see if it helps.  Just one dose may not make you feel better.  Please read this if you haven't already: 

 

Consideration About Stability - Stop Jumping Around

 

 

 

Thank you Lex. 

I definitely plan to stay reinstated - My plan was to reinstate anyway. The only impulsive part was taking my own home made liquid as I wanted to wait till I had a proper liquid out of fear. I know I will take a while to heal. 

 

On that topic: I am now approaching 48 hours straight awake. Hypnic jerks were causing intense rushes of cortisol ans have been preventing ANY sleep. I tool a Doxylamine as that had been helpful previouslt and have had a reaction - My system got mad and within an hour I started having some of my bad anxiety WD symptoms. My scalp is tight, chills and shaking all over like a chihuahua, flipping to overheating easily, some nausea, headache. Mostly feeling very jittery with waves of dread. Still sedated me so im very tired but the anxiety is larger. 

 

Am I still safe to take my dose of Lexapro tonight?' How long can this not sleeping go on for? Ive tried all the insomnia topic tips and not even managed an hour. I will definitely not touch the Doxylamine again. 

[LunaLex]

6am- had hypnic jerks till 3, cold chills, scalp tingles and cortisol surges every time I tried to fall asleep. No sleep in 40 hrs. Mood 3, anxiety 8 Took a Restavit. 

7am- Began shivery shaking uncontrollably and having panic attacks every time I closed my eyes, probably the restavit turning on me. Tried breathing excercises, quiet podcast, getting up and leaving the room. No luck.

2PM- Have been in and out of bed with 0 sleep. I last slept 5 hours, 48 hours ago.  too tired to distract myself and too panicky to sleep. Everytime I close my eyes my skin and scalp gets cold and starts to crawl and I begin to feel my heart race, I also start to dream/mild audio hallucinations. Then i sit awake eyes opening and closing, unable to keep my eyes focused. The only times this didnt happen I jerked awake whilst nodding off.  Took a propanolol an hour ago and the full body non stop shaking has stopped. Still feel shaky under my skin and weak.

Considering hospital, feeling very low and very scared.

Just want to rest and reset. Trying to drink an up and go now. Mood 2 Anxiety 9

230pm Went to bathroom, bowels very unhappy. Shivering restarted.  Laying in bed riding waves of shivers and anxiety in hope of rest.  Mood 2 Anxiety 9

 

-----

Its been a hard week. I had an okay day Wednesday, Thursday was good and then Friday, Saturday and today have been hellish. Has anyone ever gone into hospital and come out of it more stable or feeling better? I feel unsafe and scared. Sleep has always been my safe healing place and its gone. Im barely able to keep my eyes open and still can't sleep. Its been 50 hours since I slepr and i only got 5 sh*tty hours that day. I feel exhausted and unstable and like I can not handle this. 

 

Should I just head to emergency?

[LunaLex]

Things got worse before they got better. I started getting quite hysterical emotionally and feeling suicidal. Was advised the hospital would be unhelpful so my partner called an urgent care doctor service at 7pm.

 

I took my meds at 730 or 8 and slowly began to calm down a LOT Anxiety went from a 10 and mood A 2 over the next few hours, by Midnight or 1 I felt content and like a moderately more anxious version of myself. Tried napping but still couldnt fall asleep, brain not quite slow enough.  Finally got our call back at 2am or so, was prescribed 2mg slow release melatonin and 5 emergency 10mg temazepam. 

 

Our script was ready at about 4am so we picked it up, I took 5mg [half a pill] of the temaze out of fear at 420am. [64 hrs awake at this point]. Fell asleep at 530 and slept till 330pm with two wake ups. Was hoping for more sleep but take what you get I guess I plan to just try and take the melatonin tonight and hope for the best, I am worried though. I guess if I can't sleep by 4 am I may take the other 5mg. 

[LunaLex]

Journal for the last three days

15/4

Slept 740~930 Bad,

9:30~1101 mostly light, two wake ups

11~12 Good

12~13:25 Medium

5:30 total, only one good hour. Woke up alert and anxious every hour to two.

3:30pm Been awake two hours, trying to calm down but only feeling worse. Laid in bed an hour, moved to couch and trying to get sun in hope it helps serotonin. Nauseous, no appetite. Chills, scalp cold. Skin and scalp keeps crawling. Waves of cortisol and anxiety. Teary and feeling awful. Desperate and horrible. Mood 4 recent 2 usual. Anxiety 8~9

1am  Terrible day. Nausea all day, managed to eat after taking a pramin but it made symptoms worse. Lead to heart racing and feeling panicky and out of control as well as faint and dizzy and unable to focus. All symptoms bad today. Took 12.5 mg Doxylamine in a prayer for sleep tonight.

Mood 3 Anxiety 9

 

16|4

Never slept. Went to bed dizzy and feeling faint and sickly, force ate an egg salad sandwich for dinner. Tried to doze off at 4am feeling a lot calmer from the Doxylamine. As soon as I dozed off I got a hypnic jerk which sent my system into a panic and began a circle of dozing off and then jerking awake until 11am. Tried to do breathing, muscle relaxation and even got up and walked around. Ate an apple and took another 12.5mg Doxylamine at 6am in despair. No improvement. Mood 5 Anxiety 8

3pm bowels have been not good and nausea. afraid to take another pramin. am a lot calmer today than yesterday - maybe from the antihistamine. Ate two slices of dried bread and stomach is very angry. Very tired. Mood 3 Anxiety 8

5pm intense nausea, dizzyness, derealization, zaps. Partner decided to stay home to keep an eye on me. Mood 3 Anxiety 8

6pm Took 0.25mg in 0.5ml water of home made solution. Drank an Up and Go.

Anxiety easing a bit, so is nausea, probably placebo and from doing something. Dizzyness worse.

Mood 4 Anxiety 6~7

8pm Reading and working my anxiety up. Ate a meat bun and a bowl of peas to try and get caloric intake up. Feeling a little better but anxious, unstable, a bit spiraly and emotional. Lot of fear of the longterm, reading other's stories currently is bad for me. Lot better physically.

Mood 5 Anxiety 6

11pm ate Indian takeaway. Felt waves of dizziness and couldnt finish eating, felt kinda faint. Ate a samosa and half a bowl of rice with curries. 

Mood 6 Anxiety 6

1am going to try and sleep. Overtired and very anxious about sleep and its making me weepy and spirally. Trying to calm down and breathe. Partner gave small massage. Mood 5.5 Anxiety 7

 

17/4

6am ~had hypnic jerks till 3, now cold chills and scalp tingles and cortisol rushes. No sleep in 40 hrs. Mood 3, anxiety 8 Took a 25mg  Doxylamine.

7am began shivery shaking uncontrollably and having panic attacks every time I closed my eyes, probably the Doxylamine turning on me. Tried breathing excercises, quiet podcast, getting up and leaving the room. No luck.

2PM　Have been in and out of bed with 0 sleep. Last slept 5 hours 48 hours ago.  too tired to distract myself and too panicky to aleep. Everytime i close my eyes my skin and scalp gets cold and starts to crawl and i begin to feel my heart race, I also start to dream/mild audio hallucinations. then i sit awake eyes opening and closing, unable to keep my eyes focused. The only times this didnt happen i jerked awake.  Took a propanolol an hour ago and the full body non stop shaking has stopped. Still feel shaky under my skin and weak.

Considering hospital, feeling very low and very scared.

Just want to rest and reset. Trying to drink an up and go now Mood 2 Anxiety 9

230pm went to bathroom, bowels very unhappy. Shivering restarted.  Laying in bed riding waves of shivers and anxiety in hope of rest. Mood 2 Anxiety 9

8pm ate curry and rice, feeling nauseous, skin burning symptoms, feeling really terrible and planned to head to the hospital as emotions are totally out of control. Took meds now or 730?Mood 1 Anxiety 9

11pm feeling a lot calmer. scalp is still cold and prickly. Still having trouble dozing off, zaps when trying to sleep but not full panic. Waiting for doctor to call back. Mood 3~4 Anxiety 7~8.

2:30am Doctor was very very helpful. He understood what I was going through. Prescribed 10mg of Temazepam, 5 emergency tablets 

and melatonin. Encouraged me to work through finding what works with me meds wise. Picked up temazepam at 3:30 ish.

4~5 am Took 5mg of temazepam and barely felt sleepy but managed to doze off, mildly worried. Mood 4 anxiety 7

 

18/4

3:30 ~ slept 9 hours. Woke up feeling kinda weird, drunk almost, and nauseous. slept 5 hrs then 2, then 2. 

4:30 Nausea subsided.Had a decaf and two english muffins. Feeling very tired, quite dizzy and kinda weird in the head. Scalp a bit zappy and tingly. A bit blunted but not weepy or spirally or super anxious, closer to mild anxiety and mild anhedonia. Headachey Mood 4.5 Anxiety 5?

6:20pm Laid down from 5-6 for a while in Mikeys room and then in Bed. Couldnt sleep, mind mildly racing. Very aware of moderate physical symptoms- cold scalp, brain zapping non stop, muscles twitching. Got up ans took 0.25mg of liquid I made thursday night.

630 Vertigo, Eyes a bit unfocused longdistance, face hot and burning, lots of brain zaps.Cold scalp tingles.  A little tired of not feeling normal and a little scared of sleep tonight. Dont feel sad or spiralling or despair or like crying though!!. A little anhedonic and quite irritable actually and sick of withdrawals. But not horrible. Closer to a bad day with w hangover. Headaching. Mood 4 Anxiety 6

[Ariel]

Hi @TentacleFinn

Just a little note to say hello and I'm so sorry you're going through this.

The good news is that you've come to the right place. SA is such a supportive community and the mods know what they're doing. It's amazing how dedicated, brilliant, and generous the volunteer staff are!

I'm very sorry you're having this awful experience. I understand it can feel very scary. Please know you are not alone. Many people before you have gone through this and healed, and you will, too. It takes time but it does get better. And in the meantime, many of us are living through our various individual versions of withdrawal together here on SA and find strength and inspiration in each other. 

One of my favorite threads on SA is the success stories thread. Reading about others' recoveries and healing trajectories can provide a source of comfort and hope when withdrawal is really kicking my butt. Here's the link:

https://www.survivingantidepressants.org/forum/28-success-stories-recovery-from-psychiatric-drug-withdrawal/

 

It sounds like you're really in the thick of it. No pressure to reply to this message, feel free to ignore completely. Take care and just be really gentle with yourself. I'll be thinking of you and wishing you well. All the best,

A.

[LunaLex]

@Ariel, hello!

 

I was actually deep into reading your thread when you posted here. It felt a little fated and I shed a tear at your kind words. I love the way you write and love reading your insights into your life, thought and experiences.  I relate a lot to where you have been, and where you are now is close to where I was two years ago, so hearing from you brings me a lot of comfort. 

 

I am not a very strong person when it comes to my own mind and I have always been very sensitive - both to medicines and things like light and sound - long before this. So it is very easy for me, blindsided like so many of us are by withdrawal when I was at my best after a decade of darkness, to be pulled down into catastrophizing. My own little whirlpool of despair and fear of this and the future. Especially when it is still so acute and my symptom charting is an 8 most days in all sections. It is hard to distract oneself when right IN it. 

 

My biggest fault is impatience and fear - I had so much hope and plans for this year. I want to be better, now, already. I spent so long disabled, I want a job, I want to go to school. I‘m scared of more time spent healing, time lost to surviving. Scared that I will lose months or years to this. Scared of the unknown, of making things worse while trying to navigate making it through this. Scared there are no absolutes and answers, that unlike a grievous wound I can not just go to the hospital, have a surgery, take a painkiller and know what will happen. And most of all scared of the impact of this on my partner. I am scared and I am sad and angry. 

 

But you are absolutely right. I know I am lucky to have found this place. I could be all alone in this, but I am not. So many people are working through this, trying to survive and heal and working together to figure out how to help themselves and eachother. I think once things calm down a little I will find more and more solace in that and I look forward to when I can help others, too, as it is something I have always loved.

 

In the mean time I need to learn acceptance, that this is where I am and that will not change overnight {as much as I wish to wake up better every day} and my only job now is to heal and learn to be patient with myself in that. And to learn hope. 

 

Sorry, I mostly ended up rambling about myself! I will finish my toast, do the dishes and then leave you a little note. But what I meant in all this is Thank you so much, you words mean everything to me right now, and bring me a lot of hope. I will bookmark the healing stories to look at. 

[getofflex]

On 4/16/2022 at 6:11 PM, TentacleFinn said:

The only impulsive part was taking my own home made liquid

This should be fine, as long as you carefully follow the instructions on this site about homemade liquids.  Many people here taper using homemade liquids. 

 

Question:  since you started the reinstatement, do you feel significantly worse than you felt before you started the reinstatement?   

 

6 hours ago, TentacleFinn said:

Drank an Up and Go.

What is this?  Does it contain caffeine, or activating stuff?  

 

6 hours ago, TentacleFinn said:

6pm Took 0.25mg in 0.5ml water of home made solution.

I take it this is 0.25 mg of Lexapro?  

6 hours ago, TentacleFinn said:

Took meds now or 730?

This was on April 17.  Did this include your Lexapro reinstatement?  Please specify which meds you take, and the time of day, thank you.  You should take your Lexapro and other meds at the same time each day, for stability.  

 

Did you take your Lexapro and other meds on April 18?  I don't see that in your journal.  It's very important to stick with the same Lexapro (0.25 mg) dose each and every day, unless it has made you significantly worse.  It sounds like you felt a bit better on the 18th, which is good.  

Edited April 18, 2022 by getofflex

[LunaLex]

32 minutes ago, getofflex said:

This should be fine, as long as you carefully follow the instructions on this site about homemade liquids.  Many people here taper using homemade liquids. 

 

Question:  since you started the reinstatement, do you feel significantly worse than you felt before you started the reinstatement?   

 

What is this?  Does it contain caffeine, or activating stuff?  

 

I take it this is 0.25 mg of Lexapro?  

This was on April 17.  Did this include your Lexapro reinstatement?  Please specify which meds you take, and the time of day, thank you.  You should take your Lexapro and other meds at the same time each day, for stability.  

 

Did you take your Lexapro and other meds on April 18?  I don't see that in your journal.  It's very important to stick with the same Lexapro (0.25 mg) dose each and every day, unless it has made you significantly worse.  It sounds like you felt a bit better on the 18th, which is good.  

Hi! I only just realised I made my solution of water, not saline. I am careful to stir it a lot beforehand, but is this likely to be an issue?

 

I actually think on average I feel significantly BETTER, but I am unsure about the sleep. The last few days prior to today were WORSE but that, i think, was sleeplessness. I guess I will have to see tonight.  After taking my meds I feel a lot better. So far that I have noticed, on an close to empty stomach I start to feel better 2 hours later, which peaks at about 4 hours to feeling almost good, close to "myself". By 8 hours I seem to be feeling a little worse again. Today I ate I lot and am only feeling it 4 hours and it peaked at 6 hours. 

 

Meds was meant to indicate lexapro, sorry. I try to clean up my entries from my own notes to here but forgot. It was between 7:30 and 8pm on 17th and its in the second last entry, 630pm for the 18th. I try to take it consistently, but am losing track of time sometimes at bad points. 

 

If I can wake up at a good time tomorrow, such as before midday, I was thinking of taking half my dose and half later, so I dont have to feel bad until 10pm. Would that be too much of a change too soon? I am hoping to be able to see a GP tomorrow and get a compounded liquid made in the next few days, would that also be too big a change?

 

Up n Go is a " liquid breakfast". Like a smoothie, I drink it to try and get my intakw up as Ive barely been taking in 800 calories lately. https://www.sanitarium.com.au/products/up-and-go/dairy-free/vanilla-ice-flavour#4 It doesnt feel activating, though i do now notice it has some vitamins. 

 

Thank you for your checking in and advice so much!! I saw your taper is close to a toothpick, congratulations!

[getofflex]

1 minute ago, TentacleFinn said:

Hi! I only just realised I made my solution of water, not saline. I am careful to stir it a lot beforehand, but is this likely to be an issue?

That should be fine.  Stir gently, so as not to cause foam.  Keep it refrigerated, and it will spoil after about 4 to 7 days.  

 

2 minutes ago, TentacleFinn said:

I actually think on average I feel significantly BETTER, but I am unsure about the sleep

 

I'm glad.  It sounds like the reinstatement is working.  Stay on this, and if you are still OK after a week or two, you could increase your dose of Lexapro slightly if you wanted to. 

 

4 minutes ago, TentacleFinn said:

I try to take it consistently, but am losing track of time sometimes at bad points. 

Please do whatever it takes to make sure you have a regular daily dosing schedule.  If you have a smart phone, you could set up a reminder on it.  There are apps that will give you an auditory reminder to do something.  Or you could set up some other system.  Perhaps your partner could do this for you.  Missing a dose can cause big problems, especially to an already destabilized nervous system, which you have.  I'm glad you took it on the 18th - I didn't see that at first. 

 

7 minutes ago, TentacleFinn said:

If I can wake up at a good time tomorrow, such as before midday, I was thinking of taking half my dose and half later, so I dont have to feel bad until 10pm.

I wouldn't change the timing of the dose at this point.  That, too, is likely to worsen your symptoms.  Our nervous systems are extremely sensitive to any drug changes, and this includes timing of dose, splitting a dose, even switching from tablet to liquid. 

 

9 minutes ago, TentacleFinn said:

I am hoping to be able to see a GP tomorrow and get a compounded liquid made in the next few days, would that also be too big a change?

 

I don't think that should be a problem, just make sure you know how many milligrams of Lexapro are in 1 milliliter of the liquid, so you don't accidentally take the wrong dose.  It would be ideal if they could make a strength where 1 ml contains 1 mg, then you don't have to do as much math.  

 

 

[Altostrata]

Hello, @TentacleFinn

 

Your chronology is confusing, to say the least, because it seems your long-term practice was to take psychiatric drugs irregularly. What we've seen is that a history of going on and off drugs, skipping doses, and withdrawal syndrome tends to make the nervous system hyper-reactive to all kinds of things, including drugs and sometimes even foods.

 

You also seem to react emotionally to drug upsets. You're now in a very unsettled place with probable withdrawal syndrome and perhaps reactions to drugs, etc., too. You will need to stay calm to benefit from peer support. If you keep bouncing into the hospital, you'll come out on more drugs and your situation will become even more confusing.

 

We need to analyze your symptom pattern. This requires that you stick to a regular daily drug schedule, or your symptoms will be all over the place. It is unclear about what you are taking now.

 

Please keep daily notes of times o’clock you take your drugs, their dosages, and your symptoms throughout the day. We need to know how you feel before and after taking each drug, and your symptoms in between. Post 24 hours of notes at a time in this topic, in a simple list format with time o’clock on the left and notation (symptom or drug and dosage) on the right. This can show if your symptoms are adverse effects from one of your drugs.

[LunaLex]

Hi @Altostrata, Thank you so much for popping by. 

 

Irregular does describe my long term for the most part. I was never really made aware of the risks of medication and had never experienced withdrawal symptoms. I did not have a reliable Primary Doctor. From 2016 I have taken the Escitalopram more often than not - the dates in 2017 are when I reduced. Discontinuations I believe were never more than a few days. In 2020 and 2021 I started skipping doses, which I was not told was an issue by doctors when I explained. I was blessed to never have a hyper reactive nervous system till this happened. 

 

I am trying to stay calm, very very hard trying-my physical symptoms are crippling and I am not handling it well. I am very scared and desperate to stabilize as this is having a big impact on my finances and relationship as I can't function. Ive always been highly sensitive emotionally and anxious which is how I ended up medicated, Im very prone to panic. I haven't been in to the hospital yet, but my whole family want me to go in and it is hard to push back. 

 

I currently am taking a contraceptive pill daily and reinstated at 0.25 mg of Escitalopram 3 days ago. I have taken a single 2mg of Melatonin 18/4 at 2am,but noticed no change. After 64 hours without sleep I took 5mg of temazepam on 17/4.I was given propanolol but thought it was the culprit of my sleep so I stopped taking i it. 

 

Is there a safe amount of days a week I can take Temazepam, like every third or fourth if i have 0 sleep? I did not sleep at all again last night and sleep seems to be my biggest symptom trigger. My insomnia has steadily worsened since a week ago, before reinstatement, from fragmented to now zero sleep.  Whenever I dont sleep my emotional symptoms get worse and I am more aware of and sensative to physical symptoms. This causes a downward spiral of trying different things (previously doxylamine which helped till it went paradoxical, propanolol and thc oil) in hope of rest. I have followed everything in the sleep topic with no success. Already my symptoms today are much worse, with chills and panic symptoms. 

 

Sorry, I was trying to keep a short list but i have a lot of symptoms and dont know what is important to include, like food or stuff I was doing incase of relevance to triggers. Do I relist symptoms every hour they are still relevant? or just start and end?

[LunaLex]

8 hours ago, getofflex said:

I wouldn't change the timing of the dose at this point.  That, too, is likely to worsen your symptoms.  Our nervous systems are extremely sensitive to any drug changes, and this includes timing of dose, splitting a dose, even switching from tablet to liquid. 

Okay, thank you so much. At what point could I look at changing the time or dose splitting to benefit from feeling good four hours after, a week?

[LunaLex]

Yesterday - 18/4 - full journal. Is this too long still?

3:30pm - slept 9 hours, split 5|2|2. Nausous and disoriented. 

4:30pm Nausea less. Had a decaf and two english muffins.  Very tired, vertigo, heavy headed. Scalp tingling. Mild anxiety.

5pm attempt nap due to fatigue. Cant sleep, mind racing. Hyper aware of physical symptoms- cold scalp, brain zapping non stop, muscles twitching. 

620pm took 0.25 mg homemade Escitalopram liquid. 

630pm Vertigo still, face hot and burning, lots of brain zaps, headache. Sleep related anxiety, able to not spiral or cry. 

1030pm Vertigo BAD, very dizzy, eyes can not stay focused and move on their own. Anxiety is going up, appetite down. Heart thumping mild shakyness.

12am Ate two slices of toast, half a family can of baked beans with goat cheese very slowly from 11pm. 

1230am Feeling lots better. Vertigo down, dizzyness down, headache and tingles gone. Mood way up. Able to do chores. 

2am Taking 2mg sustained release melatonin now, face is numb and itchy. Muscles are tense. Bed anxiety. Mood is good, able to laugh and enjoy tv show. High Appetite. Eating light meal ~ Miso soup with wakame, bowl of peas and a few gyoza.

5am heading to bed. Mood still very good. Licorice and Peppermint tea.Sleep anxiety, not sleepy. Tired. Headaching. 

 

630 am. No sleep, mild hypnic jerks. Trying to stay calm, no panic yet. Progressive muscle relaxation and meditation podcast. Laid on couch and breathed. 

730 am Anxious now. restless and hard to focus thoughts and breathe slowly. Got up to pee and breathe. 

830am Heart thumping. Can no longer calm self with breathing. Anxiety worsening.

930am Scalp cold, face tingling and numb. Cant keep eyes open but when I close them panic increases. Mild shaking all over. 

1130 am Moved to Couch at 1030. Writing journal. Have not calmed down. VERY tired. Anxiety 8|10. Dread surrounding today and sleep. All symptoms of last 3 hours continue. Trying to follow anxiety suggestions on SA. 

[getofflex]

20 hours ago, TentacleFinn said:

Okay, thank you so much. At what point could I look at changing the time or dose splitting to benefit from feeling good four hours after, a week?

It sounds as if you believe that the 0.25 mg Lexapro reinstatement is helping you for several hours after you take it.  However, this is dubious. Lexapro does not work like an ibuprofen or Tylenol.  Please reread the first link in my first post about how SSRI drugs work.  Not only that, it has a long half life - 30 hours, so I don't see any benefit in splitting the dose to twice a day.  When drugs are taken more than once daily, it is because they have a short half life.  Also, it doesn't reach peak blood plasma levels until 5 hours after you take it.  

 

In all people, our cortisol levels start to rise in the morning.  They peak in the morning, and they gradually come down through the afternoon and evening.  A nervous system sensitized by frequent drug changes and irregular drug dosages over the years will feel this cortisol spike very intensely, and hence symptoms of nervous system activation such as anxiety, restlessness, racing thoughts, high heart rate, agitation, panic, ect.  Many, many of us on here have high anxiety and nervous system activation in the morning, and gradually feel less activated as the day goes on, and into the evening and at night.  I still have this issue sometimes, but much less intensely than in my early withdrawal.  

 

If I were in your shoes, I would continue on the 0.25 mg reinstatement for at least a week.  If you do OK on that, meaning it doesn't make you significantly worse, then we can increase the dose a little bit.  

 

Thank you for posting your daily journal on here.  Please continue to do this.  I understand that not sleeping is very very tough.  I had this problem too in early recovery, and many of us have too.  I believe that the reinstatement has a good chance to help, but it takes time for a reinstatement to fully get into your system, and to start to work.  We have to do the reinstatement extremely carefully, because with your history, you are at high risk of kindling, and making things even worse.  

 

It may help you to take a gentle walk in the morning.  This will help you to get some exercise, which helps to burn off cortisol and adrenaline, and will help to calm you.  And, getting out in natural light early in the day and doing exercise will help you set a good circadian rhythm, and probably eventually help you with sleep at night.  I would try to work my way towards going to bed a little earlier each night, and being awake during the day, to set your circadian rhythm.  I've been working on my circadian rhythm this way for a while, and I believe it has helped.  Do stimulating things earlier in the day, and gradually to more restful and less stimulating things as the day goes on.  For several hours before bed, avoid stimulation of any kind, such as TV shows or chores.  Watching electronic screens can be stimulating.  

 

Also, even decaf coffee has some caffeine in it, so you may consider eliminating 100% of all caffeine.  I've done this, and switched to herbal tea.  Soda tends to have caffeine in it too, as does green, black, and white tea.  Even a small amount of caffeine could trigger a sensitized nervous system.  

 

How to Improve Circadian Rhythm

 

Managing the Cortisol Spike

 

Adrenaline or Panic Nighttime Awakenings

 

 

 

 

Edited April 19, 2022 by getofflex

[getofflex]

I wanted to post some links that could really help you with your state of mind.  One of the big problems many of us have during this bizarre experience of SSRI WD, which is like no other, is that we become terrified of the symptoms, terrified of the future, terrified of a long taper, etc.  And, this panic and terror feeds right back into our WD, probably raises our adrenaline, which makes us even more anxious and sleepless, etc, and then these worsening symptoms feed right back into even more severe anxiety and panic, etc.  So, we are caught in a nasty downward spiral.  It sounds to me like may are doing this.  I'm not saying this in judgement, but to try and help out.  Read these links carefully, especially the first two, and let us know what you think.  

 

Steps for Managing WD Symptoms

 

 

Healing from antidepressants. How to speed up the recovery process

 

Emotional Spirals

 

Acknowledge Accept Float

 

Music to Calm Anxiety

 

Breathing Technique for Anxiety

 

Meditation

 

Learning new mental practices takes time and repeated efforts, so please don't give up after the first few tries.  It takes several weeks to learn new mental habits. 

 

Edited April 19, 2022 by getofflex

[LunaLex]

10 hours ago, getofflex said:

sounds as if you believe that the 0.25 mg Lexapro reinstatement is helping you for several hours after you take it.  However, this is dubious. Lexapro does not work like an ibuprofen or Tylenol.  Please reread the first link in my first post about how SSRI drugs work.  Not only that, it has a long half life - 30 hours, so I don't see any benefit in splitting the dose to twice a day.  When drugs are taken more than once daily, it is because they have a short half life.  Also, it doesn't reach peak blood plasma levels until 5 hours after you take it

Youre most likely right that it is cortisol, or a placebo. I've just found within 4-6 hours of taking my dose for the last 4 days I feel a TONNE better, at 11 or so every night my mood is very improved, a lot of symptoms let up, anxiety lessens.  And then by 6am it starts to dip again back into anxiety. 

 

I do try to go to bed earlier, It is hard to sleep when finally feeling happy and awake and good abd to not want to enjoy that 11pm window. Is it possible even with the halflife, my meds make me more awake at night?

 

I‘m struggling this last week as i have progressed from the fragmented 2 hour blocks of sleep to straight up not sleeping at all. It is very scary. I was awake 64 hours earlier this week, slept 9 hours and then was awake another 40 before I could not handle it and took 10mg PRN temazepam - 5mg at 4am and 5 at 7 am. Fell asleep at 8 and woke up at 12. All that Benzo risk for four hours. My heart is pounding even through the sedation, despite being exhausted. At least it stops me panicking. 

 

I have b lackout blinds AND have begun melatonin. How long is the cortisol so all consuming? How long did it take you to manage a few hours fractured sleep? Last week i was falling asleep AT 6am or 8am and till 2pm so the sudden cortisol vice grip is jarring, the morning spike consumes 16 hours of my day. The severity of every day is so tiring and at least sleep is a break. 

 

I know I need patience. I am greatful I am functional in the evening. The ever developing nature of new frustrations 5 weeks in makes feeling like one is not backsliding, difficult.  Ive been taking some late afternoon walks to try qnd get some sun. The early day sun is very activating. 

[LunaLex]

5 hours ago, getofflex said:

And, this panic and terror feeds right back into our WD, probably raises our adrenaline, which makes us even more anxious and sleepless, etc, and then these worsening symptoms feed right back into even more severe anxiety and panic, etc.  So, we are caught in a nasty downward spiral.  It sounds to me like may are doing this.  I'm not saying this in judgement, but to try and help out.  Read these links carefully, especially the first two, and let us know what you think.  

You're absolutely right in that next post that im stuck in terror spirals. Thank you for understanding. All I know is fear right now. I know im in early days at 5 weeks but im just so tired of everyday being so intense, so severe. I feel like my nerves are fried and everyone around me is so scared for me, which is hard. Reaching to my family for reassurance returns begging of inpatient care. 

 

Currently deep breathing seems to make me panic more. I struggle more trying to calm down in my space at home. It all feels “wrong” right now. It is as if the more I try and soothe it the more I feel activated - deep breathing and soothing music and meditation makes me start to shake and I have NO idea how to approach this opposite effect. 

 

I appreciate the links though. I will keep trying as maybe practice will make the panjc reaction stop. Thank you for tryimg to help me stay sane. 

[LunaLex]

24 hour Journal. 

19|4

12pm laid down, waves of anxiety, waves of nausea and intense hunger.

2pm Feeling a bit calmer. Dont think I slept but may have in ten minute bursts, feel like im concious the whole time. 

330 Feeling cold and shaky. Sleep distress. Bowels difficult. Nausea. Very tired.

440pm Feelinfg paralysed by  fatigue and anxiety.  Want to cry but can not. Struggling to talk, move and think. Mild nausea. Eating 2 english muffins now.

5:40 Finished 3|4 of food over 40 minutes. Managed to dress and walk to pet store. Hard to type and think. Better while moving. Heart beating a lot, anxiety high, chills, feet tingling.

6pm took 0.25mg of newly mixed Lexapro Hand shaky, and bubble issue means it may be betweem 0.25 and 0.3

630pm Tired, eating last 1|4 breakfast. Anxiety down from 9~7.

825 Heart racing more as tiredness and cognition get worse. Anxiety 8

1030pm Walked to the shops with partner. Feeling a bit less spiralling and out of control. Anxiety felt lower, till I got in the door and had a burst of anxiety related to sleep. No appetite yet. Nausea is down. More awake than I have been all day.

11pm. Mild appetite. Jaw and back is very tense suddenly. Very tired. Anxiety down to a 6 and mood very up.  Face feels mildly burning.

 

20|4

12:30am  1mg sr Melatonin. Eating dinner. Appetite okayish, mild mild nausea. Jaw tension. Mood is good, anxiety is okay.

230am Try to go to bed despite feelinf awake now. Lay in bed feeling very relaxed. No sleep. 

4am no panic but not sleeping.  Take 5mg Temaze at request from partner.

6am Feel cortisol but able to not panic

7am still no sleep 5mg didnt help, legs cramping,  sweaty. Calm but not sleepy. Take the other 5mg Temazepam as its been 41 hours awake.

7:30am Fall asleep finally and suddenly. Dream. Manage some good sleep.

10 briefly wake up, fall back asleep at 1030.

12:30 Awake after 4hours, around time first 5mf wears off, so much for 8 hours. Mildly shaky, sweaty. Able to not panic though. Very tired.

230pm: Laid in bed till now riding waves of cortisol. Brain zaps, cold and burning head. Can feel the calming wear off and that is hard. Sitting wrapped in a blanket in the sun quietly. VERY tired, eyes wont focus. 

330 pm, headed to doctors to try and get compounded script. Minor brain zaps, very tired, cogfog. 

 

Im noticing mt anxiety seems to slowly come back at 6am, slowly get worse till the evening around 6pm is crippling and I get more desperate. Also around midday I start to get more tired and fatigued. Right now im struggling to keep my eyes open and they wont stay focused, but If I lay down as soon as my eyes drift shut I start to get bad zaps and bad shivers. This is hard because I know I am meant to use the cortisol to do more stimulating things but Im EXHAUSTED. Nausea and food tasting not great is big around now. Also often shaking and trouble understanding things and concentrating. 

 

Then it abruptly drops off between 10 and midnight and I wide feel awake, clear, in a good mood with mild anxiety. My appetite comes back and I get hungrier. I feel close to myself. 

 

I know the cortisol is probably why im anxious, but isnt it meant to make me focused and awake? Why am I so tired during the day, but despite using black out blinds and melatonin Im wide awake at night. Why am I not even passing out for two hours like others? I am terrified of relying on Benzos but since friday I have been awake 104 hours and only slept for 13, both times after temazepam usage. The 4 hours already has made me feel better today, yesterday my anxiety was a 8 during the day, today its a 6. Do I need to ask my GP about a benzo crutch and try and take it every third day?

[getofflex]

9 hours ago, TentacleFinn said:

Reaching to my family for reassurance returns begging of inpatient care. 

It's your decision whether or not to go into the hospital.  However, just be aware that they will probably put you on more drugs if you do go.  And this will put you at risk of going back on the drug merry go round with worse nervous system destabilization.  I'm sorry things are this way with our health care system in this era, but they are.  

 

Unfortunately, it sounds like you are experiencing severe nervous system destabilization and withdrawal from psych meds.  It's a very rough place to be. I totally get it.  I've been there.  In fact, I'm in a rough spot myself right now.  Didn't sleep much last night.  I'm still experiencing protracted withdrawal myself.  Do know that with time, this will very slowly get better.  If you are able, try reading some of the success stories. Please know this:  in time you will recover and get better, if you take proper care of yourself.  I know it's really hard to believe when you feel this badly, so that is why the success stories will help you to believe that this can and will get better.  

 

Success Stories

 

Also, try listening to and reading Baylissa.  She is very soothing, comforting, and encouraging.  

 

https://baylissa.com

[LunaLex]

Hi @getofflex

 

Thank you for your words. I have read that a lot. Its so hard to express to people. My Mum wants me better so desperately and wants to help and thinks doctors can fix this. I have friends who have gone into hospital and had their meds changed and came out better (none who were already in withdrawal, mind) who are proponents for it. The only person I have in my real life who tries to understand is my partner, who five weeks in is at his wits end with me, though he is trying SO hard. 

 

I saw a new doctor today, the fourth one now to try and explain. He listened and gave me a liquid prescription. He also pushed me to consider taking the Temazepam and argued theyre fine in the short term. I do feel so much better on sleep, SO much better, so it is hard to know what to do. Is there a way - maybe every third day - to engage with this safely? I know that has its own risks and I do not know how to weigh those risks against the pain of 40~70 hours of wakefullness to my coping. 

 

I really want to be stronger. I fell for all the "withdrawal lasts 3~6 weeks" lies of hope. Realizing I may be in for years and that doctors cant save me is terrifying. 

 

I was very hopeful by the stories of some people who saw a large improvement almost as soon as they reinstated. I try to remind myself it can take a while. I am already doing much better this week at five days in, when I sleep,  and part of me KNOWS this. Today was okay! My symptoms in the evening or after sleep average a 4~6 now instead of an 8! I am scared I will be unlucky and not stabilize on reinstatement. 

 

I just want to stabilize, to be at WDNormal, to be at a point where every day doesnt feel dire and feels bareable, and be at a point where I can engage with things during the day so I can distract myself. Just a moment of forgetting, a little break from this.  Not even for my own sake, my impatience is out of desire to minimize pain for my loved ones since this is ALL I think about. My conversational skills are rather one note. 

 

You seem in your thread to have approached this with grace and patience from point one. How did you do this? How long before the average day felt "moderate" and not "severe"? I know everyone is different, but a lot of success stories spell a year of acute struggles! 

 

And how did you deal in your darkest days with not letting it impact your relationships? When every day is surviving and every symptom fills your head.