sandnit: escitalopram tapering - I think have withdrawal

[sandnit]

Today I felt really terrible, like an anxious mindless zombi with headaches/ headpressure and lots of other WD symptoms. It is so hard to accept, not run away with bad thoughts and to stay positive but I'm doing my best! But I hope this wave will give me some relief soon !!!!  This will pass I just have to accept it. 

 

This can't be a good time to start my taper ...... For now I'll stick with 5mg. 

Getofflex I would love to hear your opinion on this.

 

 

[Jakeblack14]

Hey Sandnit, 

 

I am currently also on 5mg and going through waves and windows. 

I think it is wise to listen to your body and hold. I totally get the feeling of wishing to start the taper, however I find it wise to hold as long as you need to until the symptoms subside. 

 

I don't see in your signature any supplements, are you taking anything to help with the withdrawal? I know this community does not usually recommend supplements, but one of the Moderators recently commented on my post about Magnesium and Omega 3.

@Gridley

"We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium (glycinate is a good form) and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Add in one at a time and at a low dose in case you do experience problems."

 

I have been taking both of these at night to help with insomnia and just working through the withdrawals. 

Good luck, I know if feels hopeless, but you're doing great. 

 

[sandnit]

@Jakeblack14 thank you so much for your reply. I agree holding is the wise thing to do. I just have to accept and ride it out as long as it takes.

 

Yes I take omega 3 and magnesium. Thanks for the heads up I will put this in my signature.

 

Again I'm thankful for you reply. Good to see you made it to 5mg! Good luck to you! 

 

 

[sandnit]

@Jakeblack14 How are you planning to do the 10% taper when you are ready? By using the liquid form ?

I'm still taking pills and wondering how i should taper when i start again. Where i live we have tapering strips that can be made tailor made. Really easy to use but the only disadvantage is i cannot hold when i think it is necessary to hold so i'm also thinking of using the liquid form. 

 

Ps. i hope you don't mind me asking, what WD symptoms are you dealing with? 

I'm dealing with all sorts of WD symptoms the worst are:

 

* Extreme tinnitus

* Dizzy like feeling. Like standing on a boat. 

* Head pressure and stabbing head pains 

* Body zaps and muscle twitches /electric shock sensation in my body 

* Jaw clenching

* Anxious

* Derealization / like watching a movie / or the feeling it isn't real .... very weird

* Anhedonia /  i do not really feel emotions and i have no motivation whatsoever

 

All the best to you!

 

 

 

[OffPills]

Hi Sandnit,

 

I just started following your thread because I’m in a similar situation like you, and living in the same country. Huge respect for you going trough this an still be working and taking care of a child!

 

I’ve used the tapering strips, and I switched to oral drops. Reason being with tapering strips there is no possibility to stop and stay at a certain dose when WD symptoms appear, just like you mentioned.

 

when deciding to switch to the oral solution be aware that one drop equals 2mg (not 1mg), and the solution is better absorbed by the body so I needed to recalculate my dose.

Also, you being at 5mg, one drop of 2mg will be to big of a step so measuring with a syringe or diluting the solution is necessary.

 

[Jakeblack14]

@sandnit I do plan on using a liquid form to go down in dosage using the either the BrassMonkey Sliding scale or the normal 4 week 10% taper.

 

"A variety of the 10% taper is the Brassmonkey slide taper, which entails 4 equal weekly drops with a 2-week hold.  It's more gentle than the 10% taper but takes a bit longer.  With the 10%/4 week taper you reduce by 1/2 your dose every 6 months; with the Brassmonkey slide it's by 1/2 every 9 months. " - @Gridley

The Brassmonkey Slide Method of Micro-tapering

 

Unfortunately the liquid version is more expensive, and you can make your own solution using the pill if needed: 

 

9 hours ago, sandnit said:

Ps. i hope you don't mind me asking, what WD symptoms are you dealing with? 

 

I do not mind at all, I have had every single one of the symptoms you have mentioned so I would categorize your symptoms as expected or normal, however the tinnitus only lasted about a day. The zaps I got early in the process of tapering and especially at night. I also had a couple other symptoms such as nausea, bowel issues, loss of appetite, insomnia and severe headaches. 

 

[sandnit]

@Jakeblack14, thanks for the elaborate answer. I appreciate it so much. I think I'm going to use the liquid form as well. 

 

5 minutes ago, Jakeblack14 said:

I also had a couple other symptoms such as nausea, bowel issues, loss of appetite, insomnia and severe headaches.

 

Yes I actually had all and still have some of these as well. I guess it is all part of the WD journey.....

 

Thanks again!!

[sandnit]

I'm really struggling here. I feel so awful, this is the worst i have felt so far i think.  Constant feeling of dread/ doom is the worst symptom at the moment. Together with all the other symptoms it is so hard and it feels so permanent, like it is never going to end. 

I tell myself it will end but it is hard to believe at the moment. 

Does anybody know if it is common to have such brutal and long waves coming in after a 3,5/ 4 month hold on 5mg ....... Did my fast taper to 5mg cause that much damage?

 

Sorry for all the jabbering ...... i'm just so insecure and worried at the moment.

 

[Nicolas45140]

46 minutes ago, sandnit said:

I'm really struggling here. I feel so awful, this is the worst i have felt so far i think.  Constant feeling of dread/ doom is the worst symptom at the moment. Together with all the other symptoms it is so hard and it feels so permanent, like it is never going to end. 

I tell myself it will end but it is hard to believe at the moment. 

Does anybody know if it is common to have such brutal and long waves coming in after a 3,5/ 4 month hold on 5mg ....... Did my fast taper to 5mg cause that much damage?

 

Sorry for all the jabbering ...... i'm just so insecure and worried at the moment.

 

As mark told me, it’s probably the Paxil WD that you suffering and not the escitalopram…. 

Think of that also.

[sandnit]

@Nicolas45140, the last paxil I took was in 2017. In my ,case I think the really fast escitalopram taper is hurting me at the moment. 

 

I'm really interested what Getofflex thinks about this

[sandnit]

On 2/17/2023 at 5:02 AM, Nebula said:

Hi Sandnit,

 

I just started following your thread because I’m in a similar situation like you, and living in the same country. Huge respect for you going trough this an still be working and taking care of a child!

 

I’ve used the tapering strips, and I switched to oral drops. Reason being with tapering strips there is no possibility to stop and stay at a certain dose when WD symptoms appear, just like you mentioned.

 

when deciding to switch to the oral solution be aware that one drop equals 2mg (not 1mg), and the solution is better absorbed by the body so I needed to recalculate my dose.

Also, you being at 5mg, one drop of 2mg will be to big of a step so measuring with a syringe or diluting the solution is necessary.

 

@OffPills, thanks for the reply and the heads up about the tapering strips. It is a good initiatief but the fact that we can't hold when we need to hold is still an issue with this.

I see you use citolapram. I use escitalopram. I it think one drop equals 1mg for escitalopram. But still this would to bit of a drop when I want to use the 10% method. So I would still need to use a syringe or dilute it. 

 

Anyway at the moment I'm in a big wave so I need to hold until things get better. I hope they do quickly because it is freaking hard at the moment.

 

Great to see you made it to 6mg! Do you have had a lot of WD symptoms ??

 

Edited October 20, 2023 by Karma
Name update

[Jakeblack14]

4 hours ago, sandnit said:

I'm really struggling here. I feel so awful, this is the worst i have felt so far i think.  Constant feeling of dread/ doom is the worst symptom at the moment. Together with all the other symptoms it is so hard and it feels so permanent, like it is never going to end. 

I tell myself it will end but it is hard to believe at the moment. 

Does anybody know if it is common to have such brutal and long waves coming in after a 3,5/ 4 month hold on 5mg ....... Did my fast taper to 5mg cause that much damage?

Hey @sandnit I am really sorry you are working through the WD. 
From what I have been reading, it is common. It will pass even though it is hard to see the light at the end of the tunnel. It was helpful for me to have an idea of how this would happen using an analogy: 
 

   On 12/3/2015 at 10:41 AM,  apace41 said: 

Basically- you have a building where the MAJOR steel structures are trying to be rebuilt at different times - ALL while people are coming and going in the building and attempting to work.

It would be like if the World Trade Center Towers hadn't completely fallen - but had crumbled inside in different places.. Imagine if you were trying to rebuild the tower - WHILE people were coming and going and trying to work in the building!  You'd have to set up a temporary elevator - but when you needed to fix part of that area, you'd have to tear down that elevator and set up a temporary elevator somewhere else. And so on. You'd have to build, work around, then tear down, then build again, then work around, then build... ALL while people are coming and going, ALL while the furniture is being replaced, ALL while the walls are getting repainted... ALL while life is going on INSIDE the building. No doubt it would be chaotic. That is EXACTLY what is happening with windows and waves.  The windows are where the body has "got it right" for a day or so - but then the building shifts and the brain works on something else - and it's chaos again while another temporary pathway is set up to reroute function until repairs are made.  

 

It's highly likely that your brain experienced something, some neurological pathway, some healing that needed to be done and took the opportunity to do it even a couple months down the road. 

You are doing great even though it may not feel like it. 

 

[sandnit]

@Jakeblack14, I have read the world trade center analogy some time ago and it is just what I needed to read right now. Thank you so much for reminding me of this. This is just healing going on in my head...... Nothing more;) 

 

 

[OffPills]

Hi Sandnit,

 

Sorry about the wave you’re in. Best to hold like you say and hope the wave passes quickly.

 

I was unaware that Escitalopram drops equal 1mg.

 

When you’re ready to switch to the oral solution keep in mind that pharmacy’s are forced by our health insurance company to prescribe the cheapest brand. And prices fluctuate, so its likely you’ll receive different brands. Oral solution is less commonly used than tablets and sometimes a brand is not available in my experience. Also, manufacturers are allowed to deviate 10% (if I remember correctly) of the active substance, which is a lot. I try to get as much as possible and my pharmacist tries to stick to one brand for me, as I’ve had bad experiences with switching between brands.

 

Yes, I’m currently on 6mg. Last 2 reductions WD symptoms are more severe than in the beginning of the taper. But in retrospect I went too fast and will stick to the 10% protocol in the future.

 

 

[sandnit]

@OffPills,

 

Yes the insurance companies are just out for the money and not for helping people. Those are some good tips, thank you for them.

 

What did you experience when you switched from tablet to oral solution?  And did you hold for a while to get your body adjusted to the oral solution before tapering again? Do you know the shelf live of the oral solution?

 

 

Edited October 20, 2023 by Karma
Name update

[OffPills]

Hi Sandnit, I hope you’re feeling a bit better today.

 

I remember the transition went smoothly. I switched directly from tablet-form to the solution, but I did hold for a while to adjust. You might find this topic useful: 

https://www.survivingantidepressants.org/topic/25691-cross-over-changing-form-eg-tablet-to-liquid-of-drug-or-changing-brand-of-same-drug/

 

I just checked the shelf life of my current bottle. Expiration date is August 2023. 

 

[sandnit]

Hi @OffPills, 

 

I still feel very weird but I have had some short moments where I felt clearer. 

 

Thnks for the topic and information. Very helpful!

Edited October 20, 2023 by Karma
Name update

[Altostrata]

On 2/15/2023 at 2:43 AM, sandnit said:

Hi all, i hope you are doing ok !!

 

Update:

 

Some days ago i had a short window of only 3 or 4 days but soon another wave hit me hard again. My head feels like it is under pressure and i have the feeling like i'm walking on a boat, anxiety, anhedonia and derealisation is also strong. 

My last window was much longer (almost 5 weeks with some off days). 

 

I know this is not a linear process but it is so hard to accept sometimes. I have the feeling i'm going backwards instead of forwards due to the short window. 

....

Question Getofflex,  is it not uncommon to have these swings in lengths of windows and waves? I'm still questioning if the drug itself has something to do with it, I never had a stable good time on it and i always had a lot of side effects.....

 

@sandnit When we talk about waves and windows, we are talking about a symptom pattern like yours. In fact, you are fortunate to have such long windows.

 

What were the symptoms you had after you first started escitalopram? What were your ongoing drug-related symptoms while you were taking it? Why did you increase the dosage to 20mg in April 2022? Why did you reduce to 15mg in June 2022? 

 

After you reduced to 15mg in June 2022, how did your drug-related symptom pattern change?

 

Did you ever skip a dose of escitalopram or take it off-schedule?

 

What times o'clock do you take each of your drugs, with their dosages? Do you feel better or worse at any particular times of day?

[sandnit]

@Altostrata, thank you for your reply.

 

I didn't track my symptoms daily back then and my memory is pretty bad but I'll do my best to recall.

I did track my mood daily. I posted some screenshots below (maybe helpful?)

 

11 hours ago, Altostrata said:

What were the symptoms you had after you first started escitalopram?

I was started directly on 10 mg. I remember in the first week I had a couple of days that I had this weird euphoric feeling, sort of felt high. The weeks after that the anxiety ramped up, intrusive thoughts, nausea, sweating a lot, bad sleep and I thought I had a stomach flu but I now think it was the med that caused it. I probably forgot a few symptoms.

 

11 hours ago, Altostrata said:

Why did you increase the dosage to 20mg in April 2022?

After 6 or 7 weeks on 10mg most of the physical symptoms had resided but I only had felt ok for a couple off days but overall still felt bad and my doctor told me 10mg was to low for me and told me to go to 20mg. After upping the dose most of the symptoms stated above returned for a couple of weeks but then i had 3 weeks where i felt sort of good. Didn't have much anxiety and i didn't care much about everything. But then after 6 weeks on 20mg anxiety suddenly spiked and intrusive thoughts returned and i could sleep more than a couple of hours.   

 

11 hours ago, Altostrata said:

Why did you reduce to 15mg in June 2022? 

My doc thought we overshot the target with 20mg and had me reduce to 15mg. 

 

11 hours ago, Altostrata said:

What were your ongoing drug-related symptoms while you were taking it?

Hard to say because of all the quick updosing and tapering but i didn't feel like myself, i had no emotions (during last waves i also felt really flat), GI problems and had a weird kind of anxiety. 

 

11 hours ago, Altostrata said:

After you reduced to 15mg in June 2022, how did your drug-related symptom pattern change?

After reducing to 15mg i basically got all the symptoms that i got during starting the med but they were much much worse and intense. I got really sick like a stomach flu and I also got weird thoughts about death which i never had before (i wasn't planning to commit suicide but i could stop thinking about it). I think these were acute WD symptoms. After that is was mostly down with short up periods. 

 

11 hours ago, Altostrata said:

Did you ever skip a dose of escitalopram or take it off-schedule?

I had a handful of times i couldn't recall if it took my dose and i decided not to take it. I thought is was better to skip than double up (since a couple of weeks i have a tablet case so i can check if it took the dose or not). I also had a couple of times that i took the dose an hour to a couple of hours later. But basically i almost always take it at the same time plus or minus half an hour.

 

 

12 hours ago, Altostrata said:

What times o'clock do you take each of your drugs, with their dosages? Do you feel better or worse at any particular times of day?

I take a 5mg escitalopram tablet at 18:00 (after diner). And omega 3 and magnesium dose after breakfast. 

Early mornings are often bad and after lunch i often feel worse. In the evenings i tend to feel somewhat better although i'm often really tired. 

A also have days the whole days is basically bad like the last few days.

 

 

 

 

 

 

[sandnit]

@Altostrata,

 

As english is not my native language i thought i might add this

i was just reading one of the success stories This person describes nicely how i experienced going on the drug and being on the drug

On 2/16/2023 at 3:05 AM, SunPrism said:

Just getting on the drug proved to be difficult. I was experiencing derealization/depersonalization, feeling "high", colors looked too bright, and I felt deeply emotionally blunted. When I brought these concerns up to my doctor, I was told that I was on such a small dose that it couldn't possibly be causing those symptoms and to continue taking the medication. I decided to try to stick it out because I knew it could take some time to get used to it, and so it wasn't until three months later when I hit my breaking point. I was making a chili and accidentally cut my finger on a can of tomato sauce. I vividly remember standing there watching the blood come out of my finger and not caring whatsoever that I was bleeding. That lack of concern somehow sparked this fear inside of me that something was terribly wrong and I needed to get off the drug.

 

[Altostrata]

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.

[sandnit]

@Altostrata, 

 

I think I caught the flu, I have a fever and a splitting headache. My son had it last week. I'm not sure if it is representative if I keep a list now.

What do you think?

On 2/20/2023 at 10:19 PM, Altostrata said:

 

 

[Altostrata]

You are correct, it would not help us to look at your daily symptom pattern while you're ill.

[sandnit]

@Altostrata, ok I'll wait until the flu is over

[sandnit]

@Altostrata, one more question from my side. Would it be harmful for me to go from 5mg tablet form to 5mg liquid form in preparation for tapering further in the future?

[Altostrata]

I would not make a change in escitalopram while you're feeling ill.

 

You do not need to change over to 5mg liquid, you could take 1/2 tablet (2.5mg) with 2.5mg liquid.

[sandnit]

@Altostrata, the 5mg pills I have are un-splittable. While tapering to 5mg I bought a pill splitter, even with that they would break up unevenly. At that time I thought such small discrepancies did not matter. But looking back now it probably contributed to how I'm feeling now? The liquid will probably not be from the same brand as the tablet. I reckon this could be problematic to?

 

I had a video conferencing call with my psychiatrist yesterday (she recognises it is WD thank god). She reckons it is best to stick with the 5mg pill for the time being until things stabilise more. What do you think about this? 

 

I'm still ill and have a high fever. So Ill hold off doing the daily list for the time being until I get better. 

 

I just want to get on with thing and get this poison out of my system but that is probably not realistic and helpfull. I'll try to work in this in the meantime.

 

 

 

[Altostrata]

Why can you not split your 5mg escitalopram tablet?

 

20 hours ago, Altostrata said:

I would not make a change in escitalopram while you're feeling ill.

 

[sandnit]

1 hour ago, Altostrata said:

Why can you not split your 5mg escitalopram tablet?

They split unevenly with the pill cutter. Also with a sharp knife.  I will search the site and see if I can find out how other people do it. 

 

I will not make any changes

[sandnit]

@Altostrata, here is the first daily list.

 

05:00 wake up anxious, thoughts racing. Body zaps and muscle jerks. Try to sleep but can't. Doze a little 
07:00 out of bed. Feel anxious. Jaw clenching 
07:15 morning coffee. Still anxious. Head Pressure and DR is building.
Tinnitus getting louder.
08:00 No appetite but ate some breakfast anyway. Took 150mg of magnesium citrate and omega3 690mg, omega3 also contains vitamin D3 50ug
08:30 upset stomach and diarrhea probably remnant of flu
08:40 body twitches or zaps. Still anxious, head pressure, DR. Have short feeling I'm walking on a boat .
10:00 ate a pear. All symptoms still present except little less anxious.
10:30 muscle twitching in face
11:30 feel little better overall 
12:30 went for a walk. Notice lower back pain and Anxiety manageable. 
13:00 watery diarrhea probably remnant of flu
13:15 no appetite but ate lunch 
14:00 more anxious and head pressure.
15:00 less anxious. Feel tired
17:00 still feeling ok but tired
17:30 ate diner
18:00 took 5mg escitalopram
Evening is pretty good but really tired
22:00 lights out 

 

Hope this is ok?
 

 

 

[Altostrata]

1 hour ago, sandnit said:

08:30 upset stomach and diarrhea probably remnant of flu

 

Does this happen every day after you take "150mg of magnesium citrate and omega3 690mg, omega3 also contains vitamin D3 50ug"?

[sandnit]

6 hours ago, Altostrata said:

Does this happen every day after you take "150mg of magnesium citrate and omega3 690mg, omega3 also contains vitamin D3 50ug"

@Altostrata No it doesn't 

[sandnit]

Do I need to provide more information?

[Altostrata]

It's possible that you are still recovering from the 33.3% escitalopram reduction in late September. That was quite a large reduction.

 

Did you take any covid tests when you had the flu in late February? Ordinarily, I would ask if your symptom pattern had changed in the last 2 months, but since you were ill only recently, it's difficult to interpret your symptom pattern as withdrawal.

 

Magnesium citrate can cause loose stools, suggest you divide your 150mg dose morning and evening. Some people have a similar reaction to fish oil capsules. You might stop the fish oil for a few days and see if the loose stools also stop.

 

Does 5mg escitalopram make you sleepy?

 

 

[sandnit]

28 minutes ago, Altostrata said:

It's possible that you are still recovering from the 33.3% escitalopram reduction in late September. That was quite a large reduction.

@AltostrataYes I think you are right. I also did a 50% reduction (from 15 to 7,5mg) only three weeks before that 33% reduction. That didn't do me any good did it?

 

35 minutes ago, Altostrata said:

Did you take any covid tests when you had the flu in late February?

Yes, it was negative.

 

36 minutes ago, Altostrata said:

Magnesium citrate can cause loose stools, suggest you divide your 150mg dose morning and evening

Thanks for the suggestion, I will try it.

 

38 minutes ago, Altostrata said:

Does 5mg escitalopram make you sleepy?

No I think it doesn't make me sleepy.

 

The last couple of days have been better for me. I do not dare to say is but maybe there is a window opening?

 

 

Thank you for your help Altostrata

[Altostrata]

Just now, sandnit said:

I also did a 50% reduction (from 15 to 7,5mg) only three weeks before that 33% reduction.

 

Yes, it's likely you reduced too fast and now you're dealing with protracted withdrawal from those reductions.

 

However, intermittent windows indicate you may be stabilizing on 5mg.