Lyudik: 17 years of antidepressants - 3rd attempt to get off

[Lyudik]

Original topic title:  17 years of antidepressants, 2 failed quitting attempts, on number 3

 

Hey everyone! 

 

I'm Lyudik; I'm so glad to have found a community of others in my shoes, because I don't know anyone personally in a similar position, and I'm feeling pretty isolated in this experience.

 

I started Effexor XR in sophomore year of high school (2004) for intense anxiety (and subsequent depression). It worked well, without side effects. Near the end of senior year (2007), I wanted to start the next chapter of my life off meds, so I tapered with the help of my psychiatrist. Things were pretty stable that summer, but all hell broke loose when fall semester of college started. The stress of the transition brought the anxiety roaring back (but I didn't really notice other withdrawal-like symptoms). So I started back on Effexor (early 2008). Again, it helped me.

 

By fall 2013, I had had years of therapy under my belt, and I wanted to try going off again. Same story. This time, my psychiatrist put me on Lexapro, 15 mg (early 2014).

 

I've been on Lexapro since then (doing well), and decided I wanted to try going off again in 2021. Only this time I would go reaaally slow. I decreased to 10 mg in June 2021 and then to 5 mg in March 2022. This was before I found this forum, so I didn't realize that making big dose jumps (cutting it by half in March) was not advisable, even if the time between adjustments was long. With the first decrease in June 2021, I noticed an uptick in anxiety after about a month, but nothing unmanageable. But with the March adjustment, things have definitely gotten harder emotionally. Anxiety, feeling like every day at work is a battle for survival, just feeling overwhelmed by life. But it didn't happen immediately. This took weeks/months to develop. 

 

I've always assumed that my spirals after tapering were relapse (because I don't have other obvious symptoms, and anxiety was the primary issue). But now I realize that my first two tapers were way too fast. With this last one, I'm not sure... I think the dose jumps have been too fast, but the anxiety didn't come on immediately afterwards. I would be grateful for any input on that question.

 

The other question is what to do about the awful feelings I'm experiencing now. I think I want to try reinstating, but to what dose? Should I go back to 10 mg (the dose prior to the last reduction?) And then how long should I stay there before trying to go back down again? 

 

Also, on a practical note, how do people usually cut their pills? Kitchen knife? Is there a technique to keep them from crumbling?

 

Thanks for your feedback ❤️

 

Edited October 7, 2022 by ChessieCat
added topic title before shortening

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  I'm glad you found us.  You are correct, the large reductions are probably what is causing your symptoms.  Let me give you some basic info, then advice at the end.  

 

Have you or are you on any other drugs besides Effexor and Lexapro?  If so, please list those in your signature too.  

 

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.  Lexapro is an especially powerful drug - it is 2 to 4 times more powerful than other SSRI antidepressants, so super careful and slow tapering is even more important.  

 

 Why Taper by 10% of my Dosage  

 

On 10/6/2022 at 5:57 PM, Lyudik said:

Also, on a practical note, how do people usually cut their pills? Kitchen knife? Is there a technique to keep them from crumbling?

The link below will explain how to measure your doses.  You can make your own liquid from your Lexapro tablets and water, then take the dose with a syringe.  This is probably the easiest way.  

 

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

 

Finally, 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.  Here is some information about reinstatement.  

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

I definitely would not reinstate to 10 mg.  Since you have been on the 5 mg dose of Lexapro for 7 months, doing an updose now would be iffy, because your brain has had 7 months to adjust to the 5 mg dose.  What I suggest you do, is try a very small test updose.  Go up to 5.25 mg of Lexapro, and see if that helps, or makes you worse.  If it makes you significantly worse, go back to the 5 mg dose right away.  If you are the same, or only slightly better, than after a couple of weeks you could go up a tiny bit more.  What we are trying to avoid is kindling, which is explained here.  

 

Hypersensitivity and Kindling

 

Your other option is just to stay on the 5 mg dose for a while, and allow your system to adjust and stabilize. Learn and practice non drug coping techniques to deal with the symptoms and "awful feelings".   Let us know what you decide to do. 

 

 

 

[Lyudik]

Thank you for the information, getofflex! 

I'm going to get in touch with my doctor about trying to get a liquid prescription. 

Before I got your reply I took 7.5 mg for a couple of days (no immediate effects or symptoms), but I'll try to dissolve the pills and go to 5.25 mg as you suggest going forward. 

 

To the broader community: I would love to hear from anyone who has had a similar experience to mine and come out on the other side. Namely: purely psychological/emotional symptoms months after tapering too fast (anxiety especially), then tapering slowly and successfully in the future. Is it really possible???

[ChessieCat]

Success stories: Recovery from psychiatric drug withdrawal

 

Search results for Lexapro and escitalopram in the above topic (some members use both terms so there may be some duplicates:

 

https://www.survivingantidepressants.org/search/?q=lexapro

 

https://www.survivingantidepressants.org/search/?q=escitalopram

[getofflex]

4 hours ago, Lyudik said:

Before I got your reply I took 7.5 mg for a couple of days (no immediate effects or symptoms), but I'll try to dissolve the pills and go to 5.25 mg as you suggest going forward. 

I'm glad to hear that, because 7.5 puts you at risk for kindling.  Getting a liquid prescription would be the easiest route to go - that is what I did.  

[Lyudik]

I have an update: got the liquid prescription and took 5.25 mg for two weeks (up from 5 mg). It mostly didn’t feel very different. Then, I went up to 6 mg for 4 days (feeling anxious, but nothing too different). Then, I went to 7 mg for two days and felt really upset/anxious on the second day. Because the emotions were more intense, I dropped back to 6 mg for 6 days. Things definitely feel worse right now than they did on the 5 mg (feeling more overwhelmed, having more trouble sleeping). I’m wondering if this is kindling and whether I should go back to 5 mg. One thing that’s giving me some pause is that work stress has increased recently: I have a presentation looming next week, which most of the anxiety is centered on. So maybe the uptick in anxiety is due to that? On the other hand, if it is kindling, that could be exaggerating the feelings of anxiety around the presentation (it’s not the first time I need to give a presentation like this, but I’m freaking out more than usual about it…).

Right now, I’m leaning towards going back on to 5 mg. Any advice would be highly appreciated!

[getofflex]

4 hours ago, Lyudik said:

Then, I went up to 6 mg for 4 days (feeling anxious, but nothing too different). Then, I went to 7 mg for two days and felt really upset/anxious on the second day. Because the emotions were more intense, I dropped back to 6 mg for 6 days.

You've been varying your dose a lot more than I would suggest, and too quickly.  Please remember, these drugs, and especially Lexapro, is extremely powerful.  Doing what you did is a recipe for further destabilization and symptoms.  Had you asked for our input, I would have suggested you up the dose to 5.5 mg, stay on that a week or 2, and then see if that helped.  It is important that you stop making frequent and big changes to your doses, if you wish to achieve stability.  1 mg of Lexapro is a very big change, especially when we are already destabilized.  Please, read this link: 

 

Stability - Stop Jumping Around

 

5 hours ago, Lyudik said:

I’m wondering if this is kindling and whether I should go back to 5 mg.

It could be. 

 

I can't give you good advice until I get dates that you made these various changes.  I need: 

 

1) the date you went up to 6 mg. 

 

2) the date you went up to 7 mg. 

 

3) the date you dropped back down to 6 mg.  

 

Please put these dates in your signature box, so we can see this information automatically in each of your posts, and be able to help you better. 

 

[Lyudik]

I went back down to 5 mg today. Will try to hang out here for a while. 

[Lyudik]

I was just trying to update my signature… it hadn’t saved the first time. 
 

I understand that you’re trying to help me, which I appreciate, but I’m mostly just feeling chastised right now. I’m trying to figure this out, but it’s not always easy balancing the information here with what I hear from my GP and with my previous (albeit long-ago) experience of going up by 5 mg jumps with no problem. 

[getofflex]

11 hours ago, Lyudik said:

but it’s not always easy balancing the information here with what I hear from my GP

I'm sorry I made you feel chastised.  I will say that the advice your GP gives you is likely to conflict directly with the advice that we give you here.  So, you may need to choose which you want to go with.  The vast majority of doctors will go the path of putting you on more drugs, and reinstating you too high, etc.  And, doing those things puts you at risk of further destabilization and symptoms.  

 

22 hours ago, getofflex said:

1) the date you went up to 6 mg. 

 

2) the date you went up to 7 mg. 

 

3) the date you dropped back down to 6 mg.  

I was asking these questions above, because this would help me advise you on what dose to stick with at this current time.  I understand you may not remember the exact dates.  

 

Going back to 5 mg is probably OK.  The key is to try to stick with one dose for a while, and allow your nervous system to settle at this dose, instead of changing doses frequently.  Windows and waves are a normal part of recovery, and we suggest staying on the same dose for while, even if you experience a wave.  A lot of times, people change their dose because they have a wave, and end up changing their doses frequently, and their system cannot find stability because of the frequent dose changes, and gets worse.  

 

I realize you are going through a very tough time, and all the information here is overwhelming.   

[getofflex]

11 hours ago, Lyudik said:

my previous (albeit long-ago) experience of going up by 5 mg jumps with no problem. 

Yes, I can understand that.  

 

It is common to be able to make big dose changes early on and be OK.  But, once we have been on, off, and on these drugs a few times, our nervous systems tend to become sensitized, and then making these same dose changes will cause us to go into withdrawal and have significant symptoms.  That is why we suggest very small and careful dose changes on this site.  I hope this makes sense.