DZippy: Lexapro tapering

[DZippy]

I’ve been on lexapro for 6 years for panic attacks that usually happened with situations at work.   I’ve since left that job.   I decided to try to get off the medication.  I was on 10 mg.  I have tappers to .75 for 4 weeks and 50 for 6 weeks and ready to taper to .25.   I have noticed vivid dreams, some fatigue, few headaches and two mini panic attacks.  How long will withdrawal symptoms last after last tapering off .25.  Also I have had sexual difficulties with climaxing.  With this go back to my normal after drug is out of my system? Many thx to any advice. 
 

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  Let me give you some basic info, and then give you some advice at the end of this post.  So, if I understand you correctly, you took 3/4 of a tablet, and are now taking 1/2 of a tablet?  And you wish to drop to 1/4 of a tablet?  I would suggest that you taper much slower than this.  I did just what you are doing, and it put me into significant withdrawal, and nervous system destabilization, which lasted for many months.  Your symptoms you are having are caused by the fact that your brain doesn't have time to adjust to the rate of tapering that you are doing.  

 

Can you please give us specific information in your signature about your drug history for all drugs and supplements 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 specific dates, include the day (as best you can say for example early March if you don't recall the day), drug names, and dosages of each medication decrease or increase.

 

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: 

 

On 10/24/2022 at 9:46 PM, DZippy said:

With this go back to my normal after drug is out of my system? Many thx to any advice.

No, getting the drug out of your system is not what will get you back to normal.  These drugs do not work like an Advil, where they work when they are in your system, and then we just need to get it out of our system.  These drugs actually make complex changes to our nervous systems that take a long time to reverse, which is why we need to taper very slowly and carefully.  Please carefully read this important link: 

 

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

 

You have been tapering much faster than what we suggest on this site.  I would strongly suggest that you wait a while before you do any further dose reductions.  This will allow your nervous system time to catch up to the reductions you have made so far.  These drugs get harder to taper, and withdrawal tends to get more challenging as we taper off the lower doses.  If it were me, I would stay on the current 5 mg dose for at least 6 to 9 months before doing any more reductions.  

 

I've given you a lot to read.  I would start with the links on how drugs remodel the brain, video on recovery from psych drugs, and why taper by 10%.  Please keep in touch.  

Edited October 30, 2022 by getofflex

[DZippy]

Thanks so much for the info.  I did add my drug history and supplements that I am taking.  I will continue on 5mg for a few more months as was suggested.  Thx again for all the info 

[getofflex]

On 10/30/2022 at 4:15 PM, DZippy said:

I will continue on 5mg for a few more months as was suggested.

Excellent.  I think you will find your nervous system will very gradually stabilize, and you may have windows and waves during this time.  Please keep us posted on how you are doing. 

[DZippy]

1 hour ago, getofflex said:

Excellent.  I think you will find your nervous system will very gradually stabilize, and you may have windows and waves during this time.  Please keep us posted on how you are doing. 

I found a compound pharmacy that will reduce my pills in whatever increments I want.  How long do u recommend for me to continue on 5mg?  Two months thus far.  What increments should I reduce after that and how long on each increment.  Thanks ever since much on your advice.  I feel like I have a good plan now.  Thx again

[getofflex]

On 11/4/2022 at 9:04 AM, DZippy said:

I found a compound pharmacy that will reduce my pills in whatever increments I want.  How long do u recommend for me to continue on 5mg?

What do you mean by "reduce your pills"?  Do you mean they will make a liquid?  A liquid would be the best option, because then, you have more control over your dosage amount.  Here in the USA you can buy a commercial Lexapro liquid from a regular pharmacy, which would be the easiest and most straightforward way to do it.  That's what I did.  

 

I would suggest staying at 5 mg for at least several months.  Listen to your body.  When you are stable for at least several (2-3) weeks, then try another reduction.  This link explains what we mean by stability: 

 

Stability

 

On 11/4/2022 at 9:04 AM, DZippy said:

What increments should I reduce after that and how long on each increment.

This is explained in my first post.  Please read the links below, which explains it all in detail.  The formula for a 10% reduction is current dose x 0.9 = new dose.  5.0 mg x 0.9 = 4.5 mg.  

 

On 10/30/2022 at 12:55 PM, getofflex said:

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

 

Edited November 13, 2022 by getofflex

[DZippy]

Ok.  I’ve been tapering from sept 2022 to present.  10mg to 4mg.  I’ve been struggling for the past 3 weeks.  What if want to go back to 10mg and give up the tapering.  Do I need to do it gradually.   Just want to feel like myself again

[getofflex]

Previous post moved to your intro topic to keep your history all in one place.  Please post questions and discussion about your situation in this one thread, to avoid confusion and duplication of efforts.  Thank you.  

Edited January 30, 2023 by getofflex

[getofflex]

On 1/27/2023 at 10:16 AM, DZippy said:

Do I need to do it gradually.   Just want to feel like myself again

That is what I would do.  It may be that once you get to a higher dose, you will feel better.  Then, you could hold on that for a while, and resume a slower taper in the future.  

[Shep]

On 1/27/2023 at 11:16 AM, DZippy said:

Ok.  I’ve been tapering from sept 2022 to present.  10mg to 4mg.  I’ve been struggling for the past 3 weeks.  What if want to go back to 10mg and give up the tapering.  Do I need to do it gradually.   Just want to feel like myself again

 

@DZippy Please do not go straight back up to 10 mg. Your nervous system will likely hyper-react to that dose and you risk kindling your nervous system (kindling is trauma to the nervous system). Your mind/body has been adjusting to the lower doses, so you'll want to be very gentle in your dosing changes. 

 

Do you remember what your doses were each month? If so, please list the amount of Lexapro you were on in September, October, November, December, and any changes made this month. 

 

Also, do you remember at what dose you were on where you felt better than you do now? The more details you can provide regarding your doses over these past few months and your symptom severity, the better we can recommend an updose that may help with the symptoms. Don't give up on your taper just yet. It looks like you tapered to fast, but let's try to find an updose that brings you some comfort from the worst of these symptoms. 

[DZippy]

I did speak to my doctor and went from 4 mg to 5 mg.  I felt pretty good on 5 mg.

I started in August from 10mg to .75 for 45 days.  Then went to 5 mg and stayed on 5 mg from mid September to January 1.  I felt great November and December and thought it was time to try 4 mg.  The first week of January I was ok but the last three weeks have been hell.  Everyday very anxious, vivid dreams, headaches.  So today I went back to 5 mg.  Not sure which direction to go now.  I sleep great, exercise everyday, no sugar, no alcohol and very limited caffeine.  I also have been taking b12, magnesium, omega 3’s.   I am retired.  I do volunteer work 3 days a week. Not much stress.  Anyway, any advice would  be greatly appreciated.  

Edited January 31, 2023 by DZippy
Spelling

[getofflex]

13 hours ago, DZippy said:

I felt great November and December and thought it was time to try 4 mg

When did you drop to 4 mg?  This is too vague. Can you at least tell us what month, and was it early, middle or late month?  This is very important, so we can suggest an appropriate updose.  And please add this information to your drug signature in a concise list, with only the date, as best you can remember, and the dose, of each dose change. As an online forum, we can only help you based on the information we have - the more specific, the better help we can give you. 

 

[DZippy]

Here is what you requested. 

July 2015- Aug 20, 2022- 10 mg

Aug 20, 2022-Sept 19- .75 mg

Sept 20, 2022-Dec 31, 2022- 5 mg

Jan 1, 2023- present 4mg

 

November/December on 5 mg I felt wonderful and thought I was ready to reduce to 4mg. But since reducing, I’ve have not had any good days.  Withdrawals have been tough. Vivid dreams, anxiety ridden all the time. 

[Shep]

3 hours ago, DZippy said:

Sept 20, 2022-Dec 31, 2022- 5 mg

Jan 1, 2023- present 4mg

 

November/December on 5 mg I felt wonderful and thought I was ready to reduce to 4mg. But since reducing, I’ve have not had any good days.  Withdrawals have been tough. Vivid dreams, anxiety ridden all the time. 

 

22 hours ago, DZippy said:

So today I went back to 5 mg.

 

Since it's been a month since you were on 5 mg, that may be too high a dose and your nervous system may hyper-react, since it's had a month to start adjusting to the lower dose.

 

You may only need to updose a tiny bit, perhaps 4.25 mg and see how you do. How did the day go on 5 mg? If it feels too much, you may want to reduce it down some. 

[DZippy]

Felt great all day.  Gonna stay the course of 5 mg

[getofflex]

When you reduced from 5 to 4 that was a 20% decrease, which is twice as big a reduction as what we suggest.  I strongly suggest that in the future, you reduce by no more than 10% of your current dose. So, when you eventually reduce the next time, go to 4.5. The formula is current dose x 0.9 = new dose.  5 x 0.9 = 4.5.  Rushing a taper won't save time, it will put you at risk of destabilizing your nervous system, and in the long run, it actually takes longer to get off, and you incur more suffering. 

 

I have copied your detailed recent taper info into your signature, so it appears with each post - this is very helpful to the staff. Thank you for giving us this info.  

 

15 hours ago, DZippy said:

Felt great all day.  Gonna stay the course of 5 mg

 

I'm glad you felt good yesterday.  I hope you continue to improve.  Please let us know how you are doing. 

Edited February 1, 2023 by getofflex

[DZippy]

Thx so much for your knowledge and support.  It helps tremendously