choytu: Cipralex (Escitalopram) Tapering

[choytu]

Hello,

I have been trying to stop taking Cipralex three times since 2017.

My medications were two - 10mg Cipralex a day and 2x0.5mg Fluanxol.

I started taking it slowly as my psychiatrist suggested - 2/3 days 2.5mg, then 2/3 days 5mg, then 10mg. At 10mg it was the first time I felt heart palpitations - I am an active athlete and never had heart issues.
 

The first time it was not actually Cipralex by Lundbeck, but Lenuxin (which contains again escitalopram). I remember that I did not know, and my psychiatrist did not tell me there were going to be withdrawal symptoms. I started forgetting to take the 10mg tablet and started skipping days. I was feeling some mild withdrawal symptoms like headache or fatigue, but overall, not anything too debilitating. I stopped the medicaments successfully back then (summer 2018)

I was one year of any medicaments until the summer of 2019, when I experienced some stressful situations. I had anxiety with panic attacks mostly and some stomach problems. Back then my mother forced me to start taking the pills again, although I was strongly against it, but at that time I was trusting my mother, because she had experienced severe depression in her twenties as well.

Summer of 2020, I started a relationship with a girl. It was again a year since I have been taking Cipralex 10mg and Fluanxol 2x0.5mg. I started what I considered slow tapering - I started taking half the dose of both pills (5mg Cipralex and 1x0.5mg Fluanxol). After a month or two things were overall fine. Then I stopped the fluanxol and was left with 5mg Cipralex. I tapered again half (from 5mg to 2.5mg) and was feeling good, so I started skipping days.
It was year 2020 (winter) and I started feeling anxious, I started sweating at night, had tremors, nausea, developed agoraphobia. Then I also started experiencing sleep issues and decided to go back to 5mg and when I got back to 10mg I had restored my sleep.

Continued taking Cipralex and Fluanxol until 2021 (winter) - 1 year again on medication. I went to my psychiatrist and said that I want her to make a tapering plan for me. She said 4 months on half dose (5mg Cipralex) and 3 months afterwards on 1/4 dose (2.5mg Cipralex). After that to go to consultation again. I did as she said, and everything was good. Then (April 2022) I went on consultation and asked how I can stop taking them completely, so she said:
1 week - 1 day take 2.5mg, 1 day skip;
2 week - 1 day take 2.5mg, 2 days skip;
3 week - 1 day take 2.5mg, 3 days skip;
4 week - 1 day take 2.5mg, 4 days skip;
5 week - completely stop.

I did as she said and started experiencing withdrawal but continued with the taper. Stopped Cipralex completely at the beginning of May 2022. Then three months of hell started. I experienced severe withdrawal effects such as daily headaches, fatigue, nausea, stomach problems, electric shocks (in the head), anxiety, depression (I never had until this moment). But the withdrawals that were unbearable were two - insomnia (could not sleep for days or have had 1-2 hours broken sleep) and vomiting (everything I ate, even though I tried anti-vomiting oral solution - I vomited that too).  When I contacted my psychiatrist after the first 2 weeks, she said that it is not withdrawal anymore, rather than that the previous anxiety/depression I had has returned so I need to again go on medication - I refused and wanted to try everything.

I was so fatigued due to lack of sleep and stomach/vomiting issues that I could not do sports (which I know helps a lot). But although was tired, my body refused to rest (could not sleep).

I tried everything to improve my sleep, because I thought otherwise, I can die without sleep + it worsened the anxiety, fatigue, concentration - mint + valerian (drops), lavender scents, relaxation music, passiflora, 4-7-8 breathing, nothing helped. At one point it was so bad I was considering smoking weed and drinking alcohol (which is totally not me!).
I went to another psychiatrist, and he prescribed me Tritico (trazodone) - 25mg for sleep. I slept 7-8 hours every day for a week! But then after that it just stopped working for me. I tried increasing to 50mg, then 75mg, then 100mg, but again could not sleep. Afterwards tried Tritico XR + Xanax 0.25mg, but that did not go well for me. Although there were some hours I slept fine, I felt with 0 power and was lying in bed for days, so I stopped taking it.
My psychiatrist was going to prescribe me a sleeping pill (Essognu), which I know that can cause very easy dependence, so I refused that option.

My girlfriend left me, because she could not handle it. I could not work, because of the sleep and vomiting issues. I was almost going to be hospitalized. So, for the 3rd time I was forced to go back to Cipralex, Fluanxol + Agomelatine (Valdoxan) for sleep. I decided to stop these things that are killing every emotion in me, I cannot feel happiness nor sadness and I want to try everything (even if I manage to lower the dose of the Cipralex and continue to take it forever - even that will be great!).

And here I am after 3months (from September 2022, now December 2022) - my sleep returned and my stomach issues + vomiting are nowhere to be found, but I have heart palpitations and daily headache again. I stopped Fluanxol and Valdoxan and am only on Cipralex 10mg, but I need your advice:

1. How to taper it correctly - in Bulgaria there is no liquid version of Cipralex, I can order from a friend in Germany. Have tried to dissolve the pill with water and to take it via 10ml syringe, but it seems it is faster distributed in my body, and I feel strange.
2. How to cope with the two things that forced me to get back on antidepressants - insomnia + vomiting.

Please give me your advice.
Thank you sincerely!

Edited December 3, 2022 by manymoretodays
name to title

[manymoretodays]

Welcome choytu, and thank you for your patience,

 

And okay I'm finding that Fluanxol is the brand name for the antipsychotic(AP) or neuroleptic Flupentixol.

And I will deposit some references on it here now:

Flupentixol-Wikipedia

https://www.news-medical.net/drugs/Fluanxol.aspx

https://www.medicines.org.uk/emc/product/998/smpc

https://www.medbroadcast.com/drug/getdrug/fluanxol-tablets

 

It's just that I don't believe we have information, or tapering information, on this drug here yet, so these may come in handy.

Thanks for getting your signature done.  Appreciated.

And I may give you lot's of information today.  Take your time with it all.  I'll try to help you learn how to taper correctly.

 

On 11/30/2022 at 2:40 PM, choytu said:

And here I am after 3months (from September 2022, now December 2022) - my sleep returned and my stomach issues + vomiting are nowhere to be found, but I have heart palpitations and daily headache again. I stopped Fluanxol and Valdoxan and am only on Cipralex 10mg, but I need your advice:

1. How to taper it correctly - in Bulgaria there is no liquid version of Cipralex, I can order from a friend in Germany. Have tried to dissolve the pill with water and to take it via 10ml syringe, but it seems it is faster distributed in my body, and I feel strange.
2. How to cope with the two things that forced me to get back on antidepressants - insomnia + vomiting.

 

Okay.  So right now you are still on Cipralex 10 mg.

And you rapid tapered off both Fluanxol and Valdoxan(agomelatine).

 

Well We go with a harm reduction model for tapering.  And this is what that looks like:

Why taper by 10% of my dosage? (click on the underlined passage to go to the topic, and if need be, scroll up and start with the first post in any topic)

We don't encourage the big jumps or skipping doses like your doctor did.  The 10% is calculated off each previous dose.  This is an important concept to get familiar with now

Tips for tapering off Lexapro, Cipralex(excitalopram)

there are more ideas for getting tapering doses in this topic ^

 

We also have a topic on Valdoxan, so will include that here:

Tips for tapering off Valdoxan(agomelatine)

 

More information also, that applies to tapering when taking multiple drugs:

Taper more than one drug at a time?

Taking multiple psych drugs? Which drug to taper first?

 

 

About reinstating and stabilizing to reduce withdrawal symptoms

When we reinstate, we often do it at lower dosages than what you have tried.  For right now, I just want to put this topic here for reference.  I'm not at all certain if any reinstatement would be of any value right now.

And....it's pretty confusing as you just jumped off 2 medications, and hard to know which or if both are responsible for your present symtoms of insomnia and vomiting.  You may have been a bit ambitious with your tapering to date.  And  WD(withdrawal) has set in.  Sometimes it's best to just slow down and HOLD, without tapering too.....and give the nervous system a chance to recover and begin to reset.

You've had a lot of drug changes and have been chasing WD for some time now.

No doubt your body and nervous system need some time now to rebalance.

 

When was "today"?  Was that November 30th, when you wrote that in your signature and when you jumped completely off the valdoxan and Fluanxol?

 

Here's what happens when we come off our drug(s) and then more on what WD(withdrawal) is, and what it looks like, and how we begin to heal from it:

Brain Remodelling

What is withdrawal syndrome.

 

Dr.Glenmullen’s withdrawal symptom list.

Look at the downloadable PDF, to see what other symptoms you've had of WD

 

The Windows and Waves Pattern of Stabilization

 

When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made.  The CNS likes stability. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur. And sleep is really important during withdrawal. 

 

Some tips for dealing with insomnia now:

Tips to help sleep: so many of us have that awful withdrawal insomnia

 

And big oops, as you said your sleep had returned.  That is awesome.  Great!

And the below is an oops as well.

 

Topics and ideas for coping with nauseau and vomiting:

Digestive problems: nauseau, diarrhea, bloating, GERD(vomiting included)

What to do for dizziness, queasiness, nauseau

 

How is your weight holding up?  I would definitely stick with bland foods and plenty of fluids.  Dry toast, week tea, bananas, rice, applesauce, and possibly yogurt might be tolerated?

 

Never mind ^.

Current symptoms are palpitations and headaches.

More about those symptoms now, and possibly some coping tips:

Irregular heartbeats, palpitations, tachycardia, bradycardia

Migraine, headache, neck ache/pain and head pressure

 

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 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) 

 

Try to avoid throwing every possible supplement at your symptoms now.  That might only prove to make things worse.  No doubt that you are dealing with a very sensitized nervous system right now.  Go slow, start low if you do add Magnesium or Omega's now.  Just make one change at a time.  Otherwise it can be impossible to know what is responsible for what.

 

The rule of 3KI's, simple, slow, stable

 

I am going to stop there.  And hope I have not overwhelmed you.  I am so sorry for all that you have been through now and since 2017 with the drugs and situations both.  Very tough.

For right now......HOLD steady would be what I would do, on the 10 mg dose of escitalopram.

 

Please keep us updated.  Tell us more.  Ask us any questions right here, on your page now, your Introduction.  You've introduced yourself to the community now.  And can keep kind of a progress report and journal going here too.

 

Welcome again.  And best.

Love, peace, healing, and growth,

moderator manymoretodays(mmt)

Edited December 7, 2022 by manymoretodays
better links for current symptoms, stike outs

[choytu]

Thank you for welcoming me manymoretodays!

So, I found this site and for the first time learned that I have been trying to taper my medications wrongly (too fast).
I started reading about the 10% taper method and other things.

Also I updated my signature to show that at the time of this writing I am currently on 10mg Cipralex.
I am experiencing three symptoms that I do not know where are they coming from - nausea (when I exercise), heart palpitations (when I exercise mostly) and some tension headaches. I think that these symptoms have to due with my intake of Cipralex, then the first ever heart palpitation I noticed, was right after I took my first dose of 10mg Cipralex (back in 2017).

My plan for now is firstly to switch from 10mg Cipralex tablet to Cipralex Oral Solution 20mg/ml, so that I can taper afterwards more precisely with a syringe and liquid form of the medicament.
I read that it should be this way:

• 3-7 days - 3/4 tablet (7.5mg), 1/4 liquid (2.5mg) - (20mg in 1ml, 1mg = 0.05ml, so 2.5mg = 0.125ml taken with a syringe of 1ml)
• 3-7 days - 1/2 tablet (5mg), 1/2 liquid (5mg) - (0.05ml * 5 = 0.25ml)
• 3-7 days - 1/4 tablet (2.5mg), 3/4 liquid (7.5mg) - (0.05 * 7.5 = 0.375ml)
• all liquid from here - 10mg = 0.5ml liquid

I also will start to include Magnesium Citrate (which supposedly is good for headaches and heart) - 2 pills/day and Omega 3 - 4 pills/day (1 pill contains 360mg EPA and 240 DHA), so total of 1500mg EPA and 1000mg DHA.

Read also that Ipecacuanha 30c Homeopathy is good for nausea and also ginger tincture or ginger tea, so will try that as well.

I will keep writing here when I notice something and will keep this as a journal for my progress.

[manymoretodays]

Hi choytu,

Good to see you posting.

And woah, I don't know from where your current symptoms come, whether it's WD from Valdoxan, or Fluanxol, or an effect of Cipralex.........it is difficult to know exactly.

 

I might, to be on the safe or harm reduction side of things, give it another month or more......before beginning to taper from the 10 mg Cipralex.

 

9 hours ago, choytu said:

My plan for now is firstly to switch from 10mg Cipralex tablet to Cipralex Oral Solution 20mg/ml, so that I can taper afterwards more precisely with a syringe and liquid form of the medicament.
I read that it should be this way:

• 3-7 days - 3/4 tablet (7.5mg), 1/4 liquid (2.5mg) - (20mg in 1ml, 1mg = 0.05ml, so 2.5mg = 0.125ml taken with a syringe of 1ml)
• 3-7 days - 1/2 tablet (5mg), 1/2 liquid (5mg) - (0.05ml * 5 = 0.25ml)
• 3-7 days - 1/4 tablet (2.5mg), 3/4 liquid (7.5mg) - (0.05 * 7.5 = 0.375ml)
• all liquid from here - 10mg = 0.5ml liquid

I also will start to include Magnesium Citrate (which supposedly is good for headaches and heart) - 2 pills/day and Omega 3 - 4 pills/day (1 pill contains 360mg EPA and 240 DHA), so total of 1500mg EPA and 1000mg DHA.

Read also that Ipecacuanha 30c Homeopathy is good for nausea and also ginger tincture or ginger tea, so will try that as well.

 

This is all really sound ^.  You've been studying I see.

The only concern......would be the Ipecacuanha.  Mild ginger tea might be all you need?  And I am not familiar with Ipecacuanha at all.  But.....due to our hypersensitive(now) nervous systems when in WD, and during and after other WD's, and/or frequent drug changes.........go real easy with anything other than Omega3's or Magnesium.

More about this ^:

Important topics about tests, supplements, treatments, diet

 

Magnesium is best used split up throughout the day.  And I found the help from Omega3's took awhile for me anyway, to build up, and then really help. 

Don't change more than 1 thing at a time.  And then wait too.  After you've tried something new too.  Wait a week, or 2 before trying anything else.  Just good rules of thumb......or practices to stick to.

 

You are sounding like you are off to a good start, prior to tapering Cipralex(escitalopram).  Don't get or feel rushed, or think that you might be one of those unaffected by too many tapers, and too fast.........I'm referring to previous tapers of other drugs. 

Holding can be healthy and healing too.

 

9 hours ago, choytu said:

I am experiencing three symptoms that I do not know where are they coming from - nausea (when I exercise), heart palpitations (when I exercise mostly) and some tension headaches. I think that these symptoms have to due with my intake of Cipralex, then the first ever heart palpitation I noticed, was right after I took my first dose of 10mg Cipralex (back in 2017).

 

Current symptoms ^.  I'll link you to some topics.  Likely WD and maybe due to Cipralex(escitalopram) too.

 

Irregular heartbeats, palpitations, tachycardia, bradycardia

Exercise...Do more, do less, do nothing? What worked for you?

-digestive-problems-nausea-diarrhoea-bloating-gerd/

-what-to-do-for-dizziness-queasiness-nausea/

-migraine-headache-neck-ache-pain-and-head-pressure/

 

Good report choytu, good update.  Thank you.

 

Best.  L, P, H, and G,

mmt

 

[choytu]

Hello there!

I have been doing normal on the dose that I am right now - currently switching from Lexapro tablet (10mg) to Lexapro liquid.
Current dose: 5mg tablet, 5mg liquid - 10 days have passed since I started with this dose.
Still remaining symptoms (I think there is no withdrawal whatsoever as for now, but rather the symptoms are from taking the Escitalopram):

• mild nausea when I exercise
• numbness in the head

Actually I wanted to talk about something else.
I noticed that since I started taking Cipralex 10mg I sleep for a long periods at night (10, 11 hours), which is something that is not natural for me.

Also when I mentioned in the above post the headaches as a symptom, I would more better describe it as a numbness in the head/forehead.
When the sun is strong, for example in the summer, and is shining on my head, this also contributes for me to vomit and for overall nausea.
Are there any topics related to this symptom?
Should I consider going to an MRI scan for the head?

Thank you in advance!

[manymoretodays]

Hi choytu,

Unfortunately.......things will not be perfect, or as you wish them.......for awhile I expect.

You have had so many change in drugs in even the last 4 months, it's hard to say what is Cipralex related versus what is withdrawal related.

The switch to liquid is okay, and nice that you are doing a slow cross over.  That's good.

If I were you.  I wouldn't begin tapering for at least another month.

You stated "no withdrawal effects) from Fluanxol and then from Valdoxan, but it is possible that some of your symptoms are WD effects from those drugs.

 

Okay, sleeping 10 to 11 hours.  That's a lot. 

When do you take the Cipralex?  What time of day?

 

Can you set an alarm and get up after 8 hours?

 

I gave you some topics on the symptoms asked about in my previous post.

And you are welcome to further search on your own.

Here's a helpful topic for doing symptom searches or other searches on topics of interest:

See:  How to Do a Site Search on Surviving Antidepressants

 

It's up to you on getting further testing done.  I wouldn't personally.  I have yet to see anyone who got an MRI, have any abnormal findings at all.

 

These are fairly typical WD symptoms.

Is the vomiting frequent and current?

I would try small bland frequent meals if so.

Is your weight okay?

 

Thank you for updating choytu.

 

L, P, H, and G,

mmt

 

 

[choytu]

Hi, manymoretodays!

So, yeah, I decided to take your advice and continue at least for a month taking the 10mg Cipralex.
In the meantime I will switch slowly to 10mg liquid and will keep it for some time.

Yes, I know 10-11 hours is too much, it can be that that is causing my headache/head numbness?
I will start setting an alarm to get up after 8, 8:30 hours.
I am taking Cipralex at the morning, for example at 10:30/11 am.

For the vomiting part, as for now I do not vomit.
I have had nausea some days, but have not lost any weight.

The problem was the last time I tried stopping the Cipralex.
Vomiting was frequent (1,2 to 4,5 times a day), everything I ate my stomach could not handle.
I burped a lot also. Tried to take anti-vomiting liquids that my GP has prescribed, but sometimes vomited them as well.
I was scared that I would dehydrate and would need to go to hospital to infuse my body with liquids.

Thank you for the advice!

[manymoretodays]

On 12/19/2022 at 1:34 AM, choytu said:

Yes, I know 10-11 hours is too much, it can be that that is causing my headache/head numbness?
I will start setting an alarm to get up after 8, 8:30 hours.
I am taking Cipralex at the morning, for example at 10:30/11 am.

 

I think it's more likely WD causing the headache and head numbness.

A little bit of groggy from the ton of sleep likely adds to it.  My hope would be you ARE healing, and that the sleep might even be helpful.

So many suffer insomnia......so your sleep is really kind of nice to hear about.

This topic may speak to the head numbness a bit more.  It's a long topic, so start at the beginning, and you may find comfort in that others have had similar symptoms too.

Paresthesia: pins and needles, numbness, tingling, burning sensations aka neuropathy

 

And good.  Yay.  A nice HOLD time with the Cipralex while you transition to liquid.  And just to HOLD too.  That is a good idea.  And then when you proceed to taper, let's start slowly........10% or less of your 10 mg current dose.

It may take awhile, but this time I think you can do it.........slow and steady like the turtle.  Turtles are great!  Turtles come out ahead in the end!

 

Happy holidays.

L, P, H, and G,

mmt

[choytu]

Hi manymoretodays!

 

Merry Christmas. I wish you to be healthy!

 

I have another question.

While on this dose (10mg Cipralex) I am feeling very tired, fatigued. I yawning very frequently, although I am sleeping good.

 

Are there ways to cope with this fatigue and tiredness (I do think this is a side effect from the escitalopram) ?

 

I am not drinking any coffee, as well as not drinking any energy drinks.

 

Thank you for your response in advance!

Happy Holidays!

[manymoretodays]

On 12/28/2022 at 3:02 AM, choytu said:

Are there ways to cope with this fatigue and tiredness (I do think this is a side effect from the escitalopram) ?

 

Hi choytu,

Me as well.......think it might be a side effect from your escitalopram.  That yawning thing too.  I had that.

I'm not finding a topic that speaks to this very well at the moment.

And it also may be some WD mixed in too.

 

Is it winter where you are at?  More darkness and cold?  We do all have a tendency to sleep a bit more, or be like bears in hibernation maybe??  when it is winter.  So......that being said I would not stress worry over it too much now.

 

Okay, good, good.......I think you are doing good holding and getting shifted to liquid too, and waiting just a little longer...... before resuming tapering.

 

L, P, H, and G,

mmt

[Dee12h]

When I was on too much I got very tired too. I think it’s a side effect from the med. I’m tapering lexapro too. It gets better as you go down! (Not saying go down now as you’ve been through a lot.)

[choytu]

Hello guys!

I will be switching now to full liquid, then again hold on for a month or two on the liquid.
I have these things that are unanswered in my head and I wanted to bring them up.

When I start tapering (which is by 10% of the last dose), what should I do if for example on a specific dose I get withdrawals that are severe and cannot be handled - for example I get insomnia and vomiting and It does not ease for couple of weeks? Should I go back to the previous dose and lower with a smaller amount?

And what happens if I stop the med completely, but I get withdrawals afterwards, that are disabling? Should I reinstate a small amount in order to ease the symptoms?

Please feel free to link topics about it and give advice.

Thank you!

[manymoretodays]

On 1/9/2023 at 2:55 AM, choytu said:

When I start tapering (which is by 10% of the last dose), what should I do if for example on a specific dose I get withdrawals that are severe and cannot be handled - for example I get insomnia and vomiting and It does not ease for couple of weeks? Should I go back to the previous dose and lower with a smaller amount?

And what happens if I stop the med completely, but I get withdrawals afterwards, that are disabling? Should I reinstate a small amount in order to ease the symptoms?

 

Hey choytu,

I'd try to avoid too many ups and downs with doses if you can help it.

If nervous.......try a 5% taper to start.  And.....if symptoms occur, but are manageable, don't updose.  Just note when they resolve so you will know for the next round.

 

Don't even go there.  Yet.  Why would you get disabling withdrawals after you stop your drug?  Why are you thinking way in advance now, and thinking negatively on outcomes?

 

Work on mindfulness, and staying present......the day at a time thing.

Rebuilding self-confidence, accepting anxiety

 

And more:

MEDITATION AND MINDFULNESS
 
Easing your way into meditation for a stressed-out nervous system
 
Mindfulness and Acceptance
 
Good links for anxiety/worry

Inhabiting our bodies in meditation http://wp.me/p5nnb-aSX

Meditation can heal the brain which can heal the mind and body

Mindfulness, Meditation, and Prayer after Brain Injury

Pranayama Breathing for Anxiety and Depression

 

Likely not what you expected but well......you got me responding, what can I say?  🙂

 

L, P, H, and G,

mmt

 

 

[choytu]

Hey @manymoretodays,

Sorry did not want to said negative, but just it happened to me twice already (when I tried stopping Cipralex),
although the first time was very fast (for 3 months with 1/2 drops) and second was fast (for 7 months with 1/2 drops).

I am trying to reassure myself.
Will check the links, too.

Thanks!

[manymoretodays]

It's okay.    I remember your story.

You are going slower this time and this is good.  Yay!

And you can always readapt a taper at any time, based on your symptoms and response.

This should all be very comforting now choytu.

It'll start to be.

 

 

[choytu]

Hey @manymoretodays!

I switched fully to liquid Cipralex (10mg) and I would say that everything is fine at this moment. My sleep is good, eating okay (although sometimes when I eat sweet I get nausea, but not vomiting), playing sports, working, headaches are gone as well. Currently the only medicament I take is Cipralex, so that is an improvement, because at one time I was on 3/4 medicaments at once.

The only side effects that I experience from the Cipralex and that are not good are:

• daily fatigue (I am so tired every day - yes it is Winter, but again it is not something typical for me).
• heart palpitations (extrasystoles) - most of the time after I played football - I am taking magnesium.
• emotional numbness (like I am so monotone, almost no laughter and no crying as well, although I had a situation where a friend told me very sad stories about herself).

I am thinking of starting to taper the Cipralex slowly (because a month is almost passing from I switched to liquid fully).
What do you think about all the stuff?

Thank you for your time!

[choytu]

Hey @manymoretodays,

To the above question, I have also one additional.

Do you know anything about pure CBD (without THC)?
I hear that it helps for withdrawal symptoms (insomnia, fatigue, depression and anxiety, etc.)?
And also in what form it is best to take it?

[manymoretodays]

Choytu,

I am going to advise against any CBD with your Cipralex/escitalopram.

The reason being that the metabolism of CBD in the liver, may interfere with the escitalopram metabolism in the liver, and increase the level of escitalopram.

Not something you want to mess with now.

https://dailycbd.com/en/drug-interactions/escitalopram/

 

I wouldn't do it.  It's just too unpredictable.

We have our own topic too, it's gotten lengthy and includes marijuana usage too.  I'll go ahead and link it and I recall JanCarol posted something there similar to what I found.    You could scroll through and look for a post authored by JanCarol.

Cannabis, marijuana, hashish, THC, and CBD/ cannabidiol or Hemp oil

 

I am totally game for you beginning a taper.

Might I suggest 5% only from your current dose.

10 X .95 = 9.5 mg as your first taper dose, with a 5% taper only.

 

If you feel like 10% will go okay, and I think it might, then you would do:

10 X .90 = 9 mg for your first taper dose, with a 10% drop.

 

Either or is fine Choytu. 

You could.......do 5%, and wait 2 weeks, and if nothing new in symptoms(or improvement even......could happen), then do the the rest of the 10 %, or down to 9 mg total dose. 

Then wait another 2 weeks before tapering again.

Kind of a modified brassmonkey, but without the extra hold time.

 

If you do 10% to start.  Hold for a whole 4 weeks before another taper.

 

All things considered you are doing good right now and sound ready, just nervous. 

 

Non-drug coping will come in handy too as you begin.  What have you got going now with that?

 

I'm impressed.  I think you are doing good.  Hope I am not too late on my thoughts around you using CBD.  Just toss it if not.  I don't think it's for you.

 

Best.  L, P, H, and G,

mmt

 

[choytu]

@manymoretodays, you are not to late on the CBD topic.

I have not tried it and yes I saw that it can increase the level of escitalopram,
but seems like it helps people when they are off all medicaments, because it influences the same brain parts as the Lexapro.

As for now I am planning to do as you advised:

• 5% reduction - waiting 2 weeks
• Then again 5% reduction if everything is fine after last taper reduction.
• If I feel something is of I will hold more after every reduction.

One thing I need to ask is where do you find a good oral syringe to calculate your dosage?
Mine is divided in 0.2ml.
Could you share link?
 

[choytu]

And also what do you mean by non-drug coping? Meditation, breathing, walks?

[manymoretodays]

Hi there Choytu,

On 2/16/2023 at 4:45 AM, choytu said:

And also what do you mean by non-drug coping? Meditation, breathing, walks?

 

^ exactly!  So you have some already.  Keep adding to your repertoire.

Good to have some techniques to shift your thinking too when it strays or spirals to hopeless, or anxious/fear, impatience or what have you?  When you feel down and like you can't possible get up again.......do it anyway, even though your innermost might at odds with the idea.  Eventually the state of mind being will change with repetition.

 

I think your syringes look great actually.  Where did you get them?  What you might do next, and I would try this before that first taper.  Don't despair though if you've already gone to 9.5 mg dose, you can still do this(what I'll go over below):

 

So right now you get your 10 mg escitalopram in 0.5 mL.  (20 mg escitalopram per 1 mL)

 

If you add your current 0.5 mL which is 10 mg escitalopram to 9.5 mg of water that would then net a 10 mg per 10 mL concentration.

Best to use some purified water.

Find a nice little container.

And first put in 9.5 mL and then your 0.5 mL of concentrated escitalopram.

At that point you can just drink it all to get your 10 mg dose.

Add a little water to your container after you take your dose and drink that up too......just so you don't miss any of the mg's of dose.

 

You could also once you have the correct dose and volume add it to juice too, if it is bitter.

 

When you get to 9.5 mg with your taper or if you have begun, use your smallest syringe to take out 0.5 mL (of the finished solution of water and medication).  You'd ingest the remaining 9.5 mL to get your dose of 9.5 mg.

Pictures of the syringe like you have and then a 10 mL syringe are here:

Using an oral syringe and other tapering techniques

 

You'd want to get a 5 mL or 10 mL syringe to measure your purified water.

 

I got my syringes from the pharmacy/where we get medications in the U.S.  They just let me have them for nothing.  If Amazon is a thing there.....you can buy some.

You might want to put clear tape over the syringe markings so those don't wear off with repeated use and cleansing.

 

Later on.....as your dosage decreases, you can do your even mL measurements in a larger syringe and use the smaller one to get the increments of 1 mL(same as the mg once further diluted).

 

Hoping this simplifies.  Alot of verbage I know. 

 

Hoping all is well, and going well choytu.  Check on in with questions or just general stuff too.

 

Best, L, P, H, and G,

mmt

Edited February 24, 2023 by manymoretodays

[choytu]

Hi there @manymoretodays,

 

I decided to stick with the “10% of last dose and hold for a month” taper.

 

I have a question though:

I am intimate with a girl and although I like her, I struggle with ejaculating (it takes much more time than usual, sometimes I even cannot finish).

 

Could that be a side effect of Cipralex?

Are there any topics about it?

[Fifree]

Hi 

 

sexual disfunction is a well known side effect of many SSRIs unfortunately.
 

It’s not you, it’s the drug. 

[choytu]

Hi @Fifree,

 

would it be better after some consistent tapering?

[Fifree]

Hopefully it will improve choytu especially because you are young. You can search the site and find others who have experienced this problem. I’m not a mod or anything so don’t have any special insight. I just happened across your post and wanted to reassure you that you’re ok. I found this article that may give you some reassurance. https://www.healthline.com/health/erectile-dysfunction/antidepressant-sexual-side-effects#takeaway

[Caesar65]

On 11/30/2022 at 10:40 PM, choytu said:

Stopped Cipralex completely at the beginning of May 2022. Then three months of hell started. I experienced severe withdrawal effects such as daily headaches, fatigue, nausea, stomach problems, electric shocks (in the head), anxiety, depression (I never had until this moment). But the withdrawals that were unbearable were two - insomnia (could not sleep for days or have had 1-2 hours broken sleep) and vomiting (everything I ate, even though I tried anti-vomiting oral solution - I vomited that too).  When I contacted my psychiatrist after the first 2 weeks, she said that it is not withdrawal anymore, rather than that the previous anxiety/depression I had has returned so I need to again go on medication - I refused and wanted to try everything.

Hi Choytu, I think we go the same hell.

I was on Cipralex for 18 years, and because of the side effects, which were getting stronger over the last years, I decided to stop taking it. And that happened according to advice of my doctor but only within a short period of 5 weeks!

Since last End of January I feel the same Symptomes that you also have. 
Currently I think about reinstating through very small doses, but I am very scared if this will take away my symtoms or make them even worse, after more than a year after stopping. What were your experiences when you reinstated the drug, it would be very nice, if you want to tell me about it. How long did it take you to feel better, and did the symptoms get better, or the side effects showed up again? 
It is really a nightmare, my whole lfe is completely destroyed, I have to say. 😢😢

I also still have the heart palpitations, the terrible nausea for months, the melancholy, the grief, the unbearable anxiety, and all the other undescribable feelings, which nobody understands. And I remember that I had heart problems already while taking Cipralex, and much more side effects, but was not aware for the reason for it.

I was emotionally numb, I only was functioning. 
I wish you the best, abd hope you will feel better very soon.

When I think of me, I am so hopeless, and can’t make any decision, what to do! 

 

 

 

[choytu]

Hi @Caesar65,

I am sad to hear that you go through this awful situation as well.

 

I do think you stopped the antidepressant way too fast. You have been taking it for so long, that you would need probably the slowest taper - something like the “BrassMonkey method”.

 

I did reinstated after 3 months of hell. After 4/5 months, the symptoms decreased and faded (I can sleep, I don’t vomit, no headache, although I do have fatigue, sexual difficulties, emotional numbness and heart palpitations which are the side effects of Cipralex).

 

I am planning on a very slow taper this time with 10% decrements and 1 month hold. Hopefully it goes well.

 

Sending love!

[choytu]

Hello @manymoretodays,

Do you have a good topic on dealing with fatigue as a withdrawal symptom?
I am feeling tired much of the day and if I try to do sports - football, I need to recover for the next 2/3 days, which is not normal for me.

I have been going to massages and heated pools in order to relax my body, which helps a little bit, but would appreciate if you find something

Thank you

[choytu]

On 4/4/2023 at 12:17 PM, choytu said:

Hello @manymoretodays,

Do you have a good topic on dealing with fatigue as a withdrawal symptom?
I am feeling tired much of the day and if I try to do sports - football, I need to recover for the next 2/3 days, which is not normal for me.

I have been going to massages and heated pools in order to relax my body, which helps a little bit, but would appreciate if you find something

Thank you

Some tips for dealing with fatigue?

@manymoretodays

@Altostrata

[manymoretodays]

Hi choytu,

It sounds like you are doing pretty good and just did another 10% taper from the 9 mg of escitalopram.

 

Totally new onset fatigue after exertion?  Or has this been the case for awhile?

 

I would say absolutely rest when you need to.  And perhaps plan ahead for it when doing heavier exertion in bursts.  Try to alternate with some gentler exercise like walking, swimming, yoga for example.

Some do find they have to modify exercise a bit while tapering and beyond too.

See:  Exercise......Do more, do less, do nothing? What worked for you?

 

You could also, if you'd like, do a modified brassmonkey slide with your tapers, and instead of doing the whole 10% every 4 weeks......

You could do 5% every 2 weeks, and then do an additional 2 week hold after you've done 2 of those, or the full 10%.

You are still stabilizing from previous ups and downs with drugs now and that might be gentler on your system.

 

So if you want to do that then 4 weeks from this recent taper would look like this.

8 mg X 0.95(5%)= 7.6 mg first

Then 2 weeks later.  7.2 mg which gets you to 10% total taper from 8 mg.

And then wait 4 weeks after you get to 7.2 mg before resuming tapering.

 

See if that goes smoother.  Up to you.  It might make sense though to be gentler given your history and previous tries with the hopes that given more adaption time after changes you won't experience much in the way of symptoms.

 

And best.  L, P, H, and G,

mmt

[choytu]

@manymoretodays

Thank you for the advices.

I might as well do as you say, regarding the modified brassmonkey. 

 

As of today, there are some quite big changes happening in my life like moving out, new dog etc. and therefore I have decided to stay on the 8mg until I am again comfortable with the new things.

 

But yes, fatigue is happening from time to time. Especially if I exercise I feel good at the moment, but the two next days I feel super exhausted.

 

Need to do it easier, as you said like walks, jogging, swimming.

 

Also, do you know something about gut health. When sometimes I do not get enough sleep (because of the dog) I feel nauseous and I burp and my stomach is irritated. Any suggestions on that?

 

Thank you a lot!

[choytu]

Hi @manymoretodays,

Leaving an update here.

On 20.05 I tapered again 10% and now I am at 7.2mg.

 

Feeling overall well.

 

I do have unfortunately extrasystoles throughout the day and also I feel tired/exhausted even though I rest quite a lot and sleep well.

 

I see that I should be making only light to moderate exercise like walking, spending time in nature, swimming, some stretching?

 

Any other suggestions for the fatigue? I am taking also 500mg magnesium/day.

 

 

[choytu]

Hi @manymoretodays, @Altostrata!

I still have not heard any suggestions on the upper things I listed
Can you give some advice?

Anyways, I am leaving an update here. Overall feeling well, with some minor things that I find annoying - for example, the tiredness and fatigue most of the time, I feel like spaghetti - sometimes my feet and my hands and my body are super tired, even though I am getting enough rest (9 hours of sleep and I am working from home).
Maybe I need to add some moderate exercise, although my favourite sport is football and I almost can't play it, because it is really exhausting...

I have held the last taper (6.4mg Cipralex) two months and from yesterday (1st Sept) I tapered again 10%, which is 5.8mg Cipralex.
Hopefully all goes well

[Altostrata]

Did escitalopram always make you feel tired?

 

On 11/30/2022 at 1:40 PM, choytu said:

At 10mg it was the first time I felt heart palpitations - I am an active athlete and never had heart issues.

 

Has the symptom pattern of these palpitations changed as your dosage has decreased?

 

On 6/15/2023 at 2:00 AM, choytu said:

I see that I should be making only light to moderate exercise like walking, spending time in nature, swimming, some stretching?

 

This is a good idea. Since you've been athletic, you may wish to start with light exercise and gradually increase in intensity.

 

[manymoretodays]

Hi choytu,

You held for 2 months then.  And overall symptoms the same throughout?

If that's the case, it may be like tolerance, or tolerance.  What do think of this:

Tolerance or "poop-out" or Tachyphylaxis

and another:  Tolerance or "poop out" or Tachyphylaxis

 

Unfortunate, that your baseline, if this is........has not improved.  Fortunate only in that you can manage it, and it does help to know I think that it won't last forever.  It doesn't seem to for anyone I've seen.

 

I know when you came in, here, it was much the same I think?

 

I'll include this too:  Scrontz's 10 steps for Managing an Adverse Reaction or CT Withdrawal

That ^ may not fit exactly your specifics, it's just meant to work as encouragement for you, acceptance even, and that although this takes it's sweet time, there is a healing/recovery in the future.  Pep talk if you will.

 

I certainly agree, get out there in nature if you can, and swimming too......I'm a fan.  If you have not been doing these things, I'm hoping that by doing them now you'll really benefit.  Do you get a change of seasons color show in your location??  Your latitudes and longitudes away so I don't know.  I hope though that shifting nature helps you shift too, in a positive way.......sometimes it's tricky.

 

Me, I have to shift around my usual practices from time to time, even now, drug free for some years, to maintain and cope at my best.  Nothing going on out of the ordinary for you either?  You didn't mention anything.  I know you had to curtail some of your favorite activities awhile back and maybe you grieve that a little too.  Start slow though, try something new and gentle.  Yoga, my friend?  Or Qigong?  Check out the youtube, often there is good stuff there.....easy to follow and try.

 

Report back choytu.  Thanks for the questions and also update.

 

Best, L, P, H, and G,

mmt

 

 

Edited September 5, 2023 by manymoretodays
more, and checking links

[choytu]

On 9/4/2023 at 12:41 AM, Altostrata said:

Did escitalopram always make you feel tired?

 

 

Actually, no. But I would always be sleepy and sleep a lot.

 

On 9/4/2023 at 12:41 AM, Altostrata said:

Has the symptom pattern of these palpitations changed as your dosage has decreased?

 

 

Good observation. I almost forgot about that, because I have not gotten them in a while now. Which just showcases that it is withdrawal related.