DewyDawn : want to stop escitalopram, have to fight dizziness

[DewyDawn]

Please note, non-native speaker, excuse any typos I’ll made !

First : I’ve just discover this forum and it came as such a big relief to read so many testimonials. It’s like a bunch of hands streched out to me, thank you.

Before AD : I have no particular history. Always been a bit negative and/or pessimistic but, hey, look at the world we’re living in ! Had some « low » periods wich had been attributed to either seasonal depression or PMS. Ob-gyn put me under several contraceptive pills which I quickly abandonned considering no improvement in my mood but lots of other side effects…

Depression and the « need » of AD : IMO, totally work-related. New Boss is unfair, misogynistic, unethical, disobeying the law, runs his lab through micromanaging and public humiliation. I did try to change my work but, fyi, trying to move from a permanent position in French public service is nearly impossible. Took me some time to realize I was depressed, as « I » did not have a problem, it was my work which was the problem. It took a huge fight with my boyfriend to accept that I was putting a normal face at work while being a total wreck at home. I was oversleeping, unable to eat (BMI under 18) and crying all the time, thinking of ending all.

Starting AD : May 2021, I went to my GP to explain the situation and ask for help to « function » again. I refused medical leave as I strongly believe, still today, that it would have triggered suicide attempt…  I was prescribed escitalopram, 10mg and talk therapy. GP warned me AD could make me feel weird at the beginning. Oh boy, weird was underrated !! I had vertigos, profuse swearing, cardiac arrhytmia, muscle cramps, vomiting/diarrhea, could not feel my arms for at least 3 solid weeks.

Started on 15mg in September 2021 as no improvement in my depressive state. Work/environment was worse because I told the boss/family/friends I was quitting. No one was happy with this decision.  The side effects of AD were bad but for a shorter period (less than 10 days).

GP put me on 20mg in December 2021 because I was in a « dangerous area » : unemployed, boyfriend had left, quitting my permanent position meant no unemployment money, and no support from friends/family judging me reckless to have quit. I went (myself) back to 15mg after a few weeks because of the crippling side effects.

First withdrawal symptoms : February 22, was an « accident ». I went to help a lonely friend who broke her shoulder and I forgot to bring my AD. Five day out chicken cold, started to feel dizzy. Got worse, not feeling safe to move from the flat without falling, sweating, headaches. I though I had a bad flu. Got back on AD, 10mg (as I was afraid of strong side effects) Dizziness stayed for more than a month. Went to an ophthalmologist and ENT doctor but nothing was wrong.

April 22, I asked my GP how to stop AD. I had a new job, was feeling fine and did not want to stay under AD for too long. GP advised me to take it slow and made me take 10mg/5mg EOD, then 5mg for two days and 10mg on the third, then 5mg « alone » when I’m feeling like it. Late June 22 : 3 days on 5mg alone and dizziness is here, forte. Hold on for three weeks but started crying spells, headaches, oversleeping. Anhedonia, no taste in food. GP put me back on 10mg saying I’m relapsing.

Mid July 22 : I still really want to stop AD. I’m starting the 10mg/5mg plan again.

Currently on 5mg but dizzy and exhausted. Once is happenstance, twice is coincidence, three time is enemy action a pattern… My GP is totally discarding the idea of WD symptoms, is even now suggesting changing AD (?).

I guess I’m going too fast. And I’m not convinced with the EOD pattern. I’m really concerned, a bit frightened, about how strong and present the dizziness is. And I was not under AD for so long/so strong !

I think I may need a better tapering plan.

[Onmyway]

Dear @DewyDawn, 

welcome to SA. Glad you found your way to us. Your instincts are absolutely right - you are having withdrawal effects and your doctor is incompetent (mildly put) which is not uncommon among psychiatrists. Even the drug labels are warning about inconsistent dosing so any doctor that suggests skipping days or alternating doses is incompetent in my book. 

 

Withdrawal is real. The Royal College of Psychiatrists in the UK has acknowledged it, it has been in the literature for a long time. We also know that ADs are no better than placebo - read a weep: https://pubmed.ncbi.nlm.nih.gov/25279271/ and that the chemical imbalance theory of depression/anxiety etc is BS (I can link more articles if you'd like). So there is no such thing as relapsing because you are not taking your medicines - you are in withdrawal. And no, switching ADs is not likely to help anything. 

 

The only way we know how to make withdrawal bearable is through very slow tapering. SA's recommended rate is no slower than 10% of your previous dose a month but you could also microtaper. Escitalopram is quite hard to come off of as it is very strong at the usual doses that it is prescribed. 

Why taper by 10% of my dosage? - Tapering - Surviving Antidepressants

Why taper? SERT transporter occupancy studies show importance of gradual change in plasma concentration - Tapering - Surviving Antidepressants

The Brassmonkey Slide Method of Micro-tapering - Tapering - Surviving Antidepressants

 

Here is some more info on tapering escitalopram. 

 

 

Thank you for filling in your signature, it really helps us advise you better. Let me know if you have any more questions. 

OMW