JCanada: escitalopram reinstatement? Help!

[JCanada]

Hi,

hopefully someone can help guide me with reinstating escitalopram. 
I reduced from 20 mg to 5.9 mg Over the course of 2 years.  I felt “ok” as I reduced under 10 mg and kept just reducing my taper by the same amount resulting in larger drops of the drug in my system.  Big mistake.  I reinstated to 7mg 2 months ago and felt a little better but still have frequent waves of anxiety, insomnia, depersonalization, etc.  

I’m ready to just increase my dose to stabilize further and stay there for a long time.  
I need guidance as to the best course of action. 
how much do I initially increase? How long do I stay there?  I’d be fine returning to 10 mg and staying on it to be honest.  What is the best way forward?? 
 

I want to be the best version of myself for my children. I need mental well-being and presence in their life.  I’m  willing to increase to be well for now.

 

thanks for your help!!!

 

 

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  Congratulations for reducing your Lexapro to 7 mg.  You are correct, in that a linear taper (reducing by the same amount) is hard on the nervous system.  Not only that, Lexapro is an especially powerful drug - 2 to 4 times more so that other SSRI drugs.  We will need thorough and concise information about your complete drug history, in order to properly guide you in your reinstatement. Please don't reinstate just yet - 10 mg may be too high of a dose for reinstatement.  

 

Can you please give us specific information in your signature about your drug history for all drugs you are on and have been on, especially for the past 18-24 months?  It would be especially helpful to have the details of your drugs in a concise vertical list (no symptoms), only drug names, specific dates (as best you can say for example early March if you don't recall the day) and dosages of each medication decrease or increase.  Use this format:

 

Drug name: date, dose, date, dose, date, dose…

Drug name: date, dose, date, dose, date, dose…

Etcetera

 

Please read the link below for instructions.  This will allow us to give you the best guidance.  

 

How to List Drug History in Signature

 

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 changing our doses: 

 

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

 

 

Tapering is best done extremely slowly, and we generally taper by 10% of the current dose no more than once every 4 weeks, so that the reduction becomes exponentially smaller.

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering Lexapro

 

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 when we are tapering off psych meds.  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

 

So, now to your question.  You want to updose on the Lexapro, to reduce/eliminate your withdrawal symptoms.  Going back on a small dose of your drug, or increasing your dose, which we call reinstatement, is best done very carefully.  This is temporary, and after stabilizing you would then taper gradually off of this.  There is some risk involved, and we need more specifics about your drug history before we can suggest a good dose at which to reinstate.  Here is some information about reinstatement.  

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

When we hear back from you, we can give you more specific suggestions about your reinstatement. 

 

[JCanada]

Hi,

I’ve just updated my signature- thank you for the recommendation.

I have increased my dose to 7.5 mg for now and will stay here to monitor.

I’m not looking to taper again for some time.  I am looking to return to a therapeutic dose for now and really stay out to stabilize and feel well.  
I had previously been on 10 mg for the longest stretch of my “drug” life and that had served me well.  I feel ok with this decision as I am needing to be well for my children and family. 
I need help moving in this direction.  My nervous system has had quite the workout the past few years and I’d like to stabilize and be well for a long while before approaching this again. 
please help - I am so grateful to this community!!

[JCanada]

I would still love any feedback or thoughts on how increasing can be done safely.  I do believe I need to find a dose to help eliminate the symptoms for now and then I might try decreasing again further down the line.  
I was given the advice of 0.5 mg increase for 2 weeks then see how it goes and increase again with same amount for 2 weeks.  Are there any signs that I should be looking for to know whether to continue to slow down?

I don’t want to risk having the medication stop working at all.  Just trying to be cautious.

 

Thanks to all 

[ChessieCat]

The idea is not to get rid of withdrawal symptoms completely but to reduce your withdrawal symptoms so that they are tolerable.

 

Some members have tried to find their "perfect" dose and have ended up making things worse.

 

It is better to compare how you are feeling now with how you felt at your worst, not how you felt at your best or how you want to feel.

 

One thing that is very important to understand that the effect of psychiatric drugs is cumulative . There are SA members who have been on/off drugs and up/down in dose multiple times with no issues, then one day they do the same thing that worked before and their nervous system cannot cope with it.

 

Stability

 

WDnormal

 

And Brassmonkey talks more about it here:

 

tao-of-the-brassmonkey

 

[JCanada]

Thank you for taking time to respond.

 

Also - please forgive me for this question as I don't want it to come across it the wrong way - but, it truly is a genuine question:

what is the purpose of coming off an anti-depressant if an individual is feeling well on it?  Would there be any benefit?  It seems to me that reducing the medication with the suffering and nervous system disruption it causes (or has in my case) doesn't seem like it balances to the benefits of just staying on.    

I'm not arguing that at all that one SHOULD stay on it, but that maybe that isn't the worst thing if symptoms are alleviated and one is functioning well in life.  I suppose I'm trying to balance the 'reason' why I'm doing this and all the pain this is causing for (what feels like) an arbitrary reason (just because I think I SHOULDN"T have to take a medications, or I SHOULD be like everyone else).  

 

I'm guessing people continue to stay on their medications for their lifetime and are well.  No?

I dunno.  Everytime I read the posts here, I feel more and more panicked and destined to doom and suffering.  If I go up, I'm screwed.  If I reduced, I'm also screwed.  What is the point?  PLease forgive me.  I'm feeling so angry about where I've ended up.  I hate that I had to take medication in the first place, but I also I hate that I've tried to come off it with such difficulty.  I just want to find a spot where I can be at ease for awhile.  I'm sorry.  Just feeling very discouraged about this.

 

 

[JCanada]

Hi, 

hoping someone might be able to reach out to me and assist me through this.  
I increased my escitalopram to 7.5mg (from 7) 2 weeks ago when the withdrawal symptoms were awful.  My nervous system seems more calmed and I can now eat, sleep (mostly) and feel less panicked and depersonalized.  
I want to stabilize for some time (ideally avoiding more deep deep waves) before I try to reduce again.  
would it be wise to increase to 8mg to give a little “boost” and stay there for several months? Or, do I stay at 7.5 mg.  I’m wondering if that’s enough to counteract the P/W symptoms from reducing a few months ago.   I just need a reprieve from this for awhile so I can refuel my resilience and motivation to keep going.  

 

does the withdrawal symptoms eventually go away, even without changing any medication dosages? 
 

thank you  for any thoughts and opinions :)