Jakeblack14: Lexapro Taper and Withdrawal Timelines

[Jakeblack14]

Hey Everyone, 

 

I have been working on coming off of Lexapro for years and this is the closest I have ever been. 

Long story short, I have been weaning off lexapro after a couple of failed attempts of 20mg. I am currently at 5mg and having severe waves and windows of withdrawal. 

 

Looking for a little support that this is normal. I have a week or two where I feel phenomenal then suddenly a sharp drop where all the suicidal fake thoughts intrude. 

This also includes horrible chest pain, nausea, gastrointestinal issues, insomnia and just an overall feeling of dread. These last anywhere from two weeks to a couple of days. 

 

I am unsure about whether I should continue a taper, or if I should hold, but from what I am reading this is going to be a long arduous process. 

Any support or advise is appreciated. 

 

Been reading many of the articles on here and just now decided to try to become a member myself. 

 

Thanks so much. 

[Gridley]

Welcome to SA, Jakeblack14.

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.  Include your present taper with dates a d rate of taper.   A list format is best.

 

Please be sure to include your previous failed Lexapro taper attempts, including dates, rates of taper, lower dose reached and dates and amount of reinstatements.

 

Account Settings – Create or Edit a signature.

 

I tapered off 20mg Lexapro, finishing in late 2020 after a near-4 year taper, dropping to zero at 0.025mg.  It was arduous but doable.  You can see the details in my signature.

 

It sounds like you're familiar with our protocols but for your convenience I'm including some basics here.  We recommend tapering by no more than 10% of your current dose every 4 weeks.  

 

Why taper by 10% of my dosage?

 

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.  This is the method I used for my Lexapro taper, and it served me well.  

 

The Brassmonkey Slide Method of Micro-tapering

 

Since your nervous system may be sensitized by the two previous failed tapers, this method might be a good fit for you to switch to, keeping also in mind that it's a good idea to slow down at the low doses where you are and that Lexapro is the most potent SSRI on the market.  This means that even at the low doses it packs a wallop.  The lower you go, the slower you should go.  The graphs in this topic might help to explain the reason for this:

 

Why taper paper: dose-occupancy curves

 

Here are some comments from members about tapering at the low doses that I found helpful:

 

"I read the serotonin transporter occupancy study I think back before even starting my taper and I immediately saved it as a PDF! It helped me understand the impact of dropping to zero and how the decline is exponential when one reaches 4, 3, 2,  and <1mg. The study was groundbreaking in my opinion in terms of explaining patterns as it seems to corroborate the anecdotal evidence from people here experiencing a shock when they hit the low doses and zero."

 

and

 

"Basically, a study they did in 2004 found that the Serotonin Transporter Occupancy was about 80% when taking a 20mg dose and still nearly 50% at a 3mg dose.   Even at a 1mg dose, the occupancy was nearly 25%!"

 

It's very encouraging that you're having such extensive windows.  That's a excellent sign that your system is healing.  I found this analogy helpful in visualizing what's happening inside your brain:

 

   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.  

 

The Windows and Waves Pattern of Stabilization

 

What is withdrawal syndrome

 

Brain Remodelling 

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

What method are you using to get your taper doses?  The following link is specifically about tapering Lexapro, including how to get the nonstandard doses needed for 10% taper or a Brassmonkey slide taper.

Tips for tapering off escitalopram (Lexapro)

 

Regarding whether you should hold at 5mg or continue tapering, that depends on how you're doing.  It's an individual and subjective decision as to whether or not you need to hold.  Have your windows/waves gotten worse as you've gotten lower?  If so, a hold might be in order.  We'll be in a better position to make suggestions after you've completed your signature and indicated your taper rate.

 

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.

 

This is your introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community.  I hope you’ll find the information in the SA forums helpful for your situation.  I'm sorry that you are in the position that you need the information, but I am glad that you found us.

 

 

 

 

 

 

 

 

 

 

[Jakeblack14]

Thanks so much, 

 

I have included the signature, please let me know if you need more information or would like it formatted differently in any way. 

I appreciate the comments and links. I will look into the BrassMonkey Taper method. 
I have been researching this for quite a long time and trying to match up symptoms with withdrawal. 

 

I feel a little stuck currently as I am having windows and waves where the waves are quite severe and the windows are really good, thus my reason for determining whether or not a taper should be continued. 

 

When I reduced dosage 2mg at a time I had the same symptoms show up: 

3 days of feeling fine

3 days of severe anxiety

4-5 days of severe depression

3 days of hyper sexualized feelings

Then normal hold until the next drop

 

Now that I am at 5mg, I am not seeing that same pattern, I am more seeing this tendency to just have severe windows and waves (waves being mostly of anxiousness and suicidal thoughts as horrible chest pain, nausea, gastrointestinal issues, and insomnia).

Is this a common occurrence/does this still follow the waves and windows method? If so, does that mean I wait to reduce dosage until windows and waves stabilize or still reduce dosage and hope the waves are not too severe? 

 

Thanks again

 

[Gridley]

@Jakeblack14

 

It is much better to taper by a percentage of your previous dose rather than a straight decrease such as the  straight 2mg you've been doing.  Decreasing by a straight 2mg accelerates the amount you decrease each time, making it rougher and rougher with each drop.  By contrast, decreasing by a percentage of your previous dose decelerates the amount of each drop and makes things gentler on your system.  I suspect that the straight drops you've been doing are the source of your current problems.  The fact that 

 

56 minutes ago, Jakeblack14 said:

Now that I am at 5mg, I am not seeing that same pattern, I am more seeing this tendency to just have severe windows and waves (waves being mostly of anxiousness and suicidal thoughts as horrible chest pain, nausea, gastrointestinal issues, and insomnia).

Is this a common occurrence/does this still follow the waves and windows method? If so, does that mean I wait to reduce dosage

The severity of the waves indicates that a lengthy hold where you are at 5mg is in order.  You're at the lower end of the doses where the reductions can be really telling on your system.  This is not a time to "push through and hope things resolve."  It is a time to be gentle with yourself.  

 

Could you please put the months of the 2021 taper in your signature?

 

 

 

 

 

 

 

 

 

[Jakeblack14]

Agreed. When I got to 5mg I started to go down by 20% which was way to much and is why I bumped back up to 5mg after a bad withdrawal period and the beginning of this different cycle. 

 

Would it be beneficial to go up another mg to help these waves be less severe? Or would you think it might be better to just stay where I am at for a while? 

 

Any suggestions as to how helpful exercise is or getting out in general? I have been eating really well, when I was on Lexapro at a full dose, I was a devoted athlete, just don't know how hard to push, or if it is just better to accept the rest and avoid exercise in general.  

 

Thanks again so much for the support. (I have updated the signature)

[Jakeblack14]

Updating my thread as more of a journal than anything else. 

 

I am 1 month into stabilizing at 5mg. Just recently in the past week have I started to feel fairly normal. 

Probably going to hold to 5mg for another month just to truly allow my brain to rest until starting the brass monkey taper. 

 

If anyone thinks that is a bad idea or if I shouldn't wait that long, I would love to hear your feedback! 

Thanks!

[Hanna72]

Hi @Jakeblack14

23 minutes ago, Jakeblack14 said:

Probably going to hold to 5mg for another month just to truly allow my brain to rest until starting the brass monkey taper. 

 

Sounds like a great plan. We can never go wrong with extra time on holding. 
You are doing such a good job on your taper, congrats on making it this far. 

All my best to you. 
 

[Jakeblack14]

Hey team, 

 

Horrid withdrawals currently. Insomnia, Anxiety, Wicked Depression, barely able to eat, crawling through work, crying spells. 

Probably as a result of a stressful weekend. Very Scary. Trying to follow my own advice and drink water, eat some, move some. 

 

Trying to trust the process, but man, hell would be a nicer place than this. 

 

Really thought I was getting close to being able to starting taper again, but it seems we may need to restart the month wait. 

[Lady123]

Once you get down to the lower dosages, like you are in, you may need to consider tapering a smaller percentage. I’m at 2.1 mg/mL and I just hit withdrawal and I was tapering 8 percent. Proportionally, these drugs are stronger at the lower dosages. You can review that information on here. 

[Jakeblack14]

Hey everyone! 

 

Thanks for the information. As I mentioned, I am still sitting at 5mg and plan on doing a very very slow taper once I stabalize out. 

 

Looking for some advise - currently having lighter waves. If 1 - 10 is a scale and 1 is completely normal, I am fluctuating between a 3 and a 5. Finding that I feel pretty normal then will have waves lasting about 1-2 days moving me up to a 5. They are more frequent too. It used to be a HEAVY wave every 2-3 weeks now it's like a small wave every 3 days, but I still don't feel like myself.

 

So certianly able to function, but it's quite uncomfortable. I am wondering if it would be better to start a taper even while I have these lighter waves or if I should wait long until I don't have a wave for a couple weeks. 

 

Interested in any suggestions. 

[Jakeblack14]

@Gridley would you be able to offer some suggestions to the above? Or know someone who might? Thanks so so much. 

[catmama]

Hey Jakeblack14, I’m a fellow Lexapro sufferer/taperer. I feel your frustration with wanting to push through with the tapering. But I learned the hard way you have to go SLOW. White knuckling through it in a hurry to get to zero will lead to more hellish waves. I’m currently in a brutal wave now triggered by emotional stress. I’d been at 0.5mg for about three months, but even over those three months I didn’t feel like I was quite stabilized. So now I’m going to hold at 0.58mg (last dose where I felt stable) and just hooooolllddddd until my body tells me it’s time to resume the taper. 
 

I read that you’re an athlete. Exercise is truly the best natural antidepressant I’ve ever found. I had been lifting heavy throughout my taper journey and had been mostly doing ok up until a few weeks ago. I hope to get back to it eventually. But rushing the taper or neglecting the self-care (like rest days, proper nutrition, stress management, and extra sleep!) will lead to disaster 😭 

 

So keep holding. Slowly incorporate working out again, maybe at a 50% level to start, or do some deloading. Then let your body dictate how to proceed. I know it’s so frustrating and agonizing at times. But we have to trust that our bodies are healing and WE WILL GET BETTER. 

[Jakeblack14]

Hey everyone, interested in information about PAWS. If anyone has any links or information as to how to mitigate symptoms, helpful tips or tricks, been off of Lexapro for about 2 months and had light waves then hit with a pretty heavy one 2 times. Any information is great! 

[Jakeblack14]

Using this thread as a journal update. 

Have been nauseated, weak, unable to exercise, head tension and brain fog. 
Wicked morning anxiety. Just recently I have had alot of neck and back pain. Went to a Chiropractor 3 different times and it has not subsided. He wanted Xrays to rule out anything. 
Feels pretty crazy for sure. Waves are pretty constant, I get 1 good day here and there, but mood is completely unpredictable. Lots of anger, depression towards end of the day. 
Feels really hopeless. Have to fight daily to not creep back to medication. 

[Jakeblack14]

Starting to wonder if I need to bump back up. I am going on four months off medication, but this wave is heavy. My brain and body are completely agasint me. Feel really crazy. Almost bed ridden. Barely functioning. Maybe find a way to liquify the pill and start back at 1mg. Not sure, just pretty scared.

[modelarz71]

I've been taking 6 months on average 8 mg generic lexapro. I think I was hypomaniacal at the time, difficulty sleeping and racing thoughts. 
Were you like that? 
Did you function well with it ?
How was your sleep?
I don't know what to do next either. 
I also barely function

[Jakeblack14]

42 minutes ago, modelarz71 said:

Were you like that? 
Did you function well with it ?

I started to see a pattern as I weened off. Every drop would be 2-3 days of hypomania, almost just too good. 2-3 Days of wicked anxiety. 2-3 days of heavy depression. 2-3 days of hypersexual feelings. Then back to baseline. 
In the midst of that, I have insomnia, nightmares, just recently really fatigued, unable to perform basic tasks. Walking has become tiring (Used to be a tri athlete). Once I stopped medication, that pattern went straight out the window. Been basically 2 days of a window and 2 weeks of a wave. Debating if I should reinstate at like .5mg or if I should hold out and just trust the process. 

[modelarz71]

24 minutes ago, Jakeblack14 said:

W miarę odchodzenia zacząłem dostrzegać pewien wzór. Każda kropla oznaczałaby 2-3 dni hipomanii, prawie zbyt dobrze. 2-3 dni niegodziwego niepokoju. 2-3 dni ciężkiej depresji. 2-3 dni uczuć hiperseksualnych. Następnie powrót do poziomu bazowego. 
W międzyczasie cierpię na bezsenność, koszmary senne, ostatnio naprawdę jestem zmęczona, niezdolna do wykonywania podstawowych zadań. Chodzenie stało się męczące (kiedyś uprawiałem triathlon). Kiedy odstawiłem leki, ten wzór zniknął. Zasadniczo były to 2 dni okna i 2 tygodnie fali. Zastanawiam się, czy powinienem powrócić do dawki około 0,5 mg, czy też powinienem wytrzymać i po prostu zaufać procesowi. 

Unfortunately I can't advise you what to do because I don't know what to do myself.
These symptoms scare me and I only watch Tv.
I've been taking 0.5mg since June I think and it doesn't help now I'm taking 0.20mg and I don't know what to do next, I may have to take more because they want to send me to the hospital

[Aurorax]

It's hard to know what is right, but I wouldn't rock the boat at this point. There is no guarantee that reinstatement will help after being off for four months.
   Things may worsen before they improve, but you are on the right path and could see positive changes soon. Trust the process.

[Jakeblack14]

Good advice. I will update here as my situation progresses. 
For those of you that have already completed withdrawal or are going through it now, I am curious about food sensitives or what you guys eat while in withdrawal? At the worst of it, it is really difficult to eat anything at all let alone eat things that don't seem to make the symptoms even worse. Any suggestions or even what to avoid other than the basics like red meat and coffee/alchohol? 

[Aurorax]

My top three wd recipes:
Lukewarm water
Smoothies with banana/avocado and berries
Protein shakes

 

These are easy to prepare and drink. I guess a blended vegetable soup could have worked well, too.
   Many small meals throughout the day may help if you have problems with nausea/vomiting. Not eating or drinking enough makes everything worse in the long run, so try to eat even when it's hard. Make sure to get enough calories and protein.

 

I didn't have any food sensitivities that I was aware of, but I had a hard time keeping food down and could only eat fluid food for a while, so smoothies were a life saver.

 

[Jakeblack14]

Hey friends, 

Made it out of the wave, but have moved into a different kind of window. It doesn’t feel like I am dying anymore, just the depression is really heavy, kinda wake up with anxiousness and a little bit of depression, lots of weeping in the morning. Then do better as the day goes on. Seems to be “moments” when thought processes feel normal, then its back to depressive symtoms. 

Trying to determine how much excersize to do, may try to do some light climbing or maybe a light run, but we will see as the day goes on. 

[Jakeblack14]

Feeling pretty weak, depression is nuts. Mornings are alot harder than the afternoons. Forcing myself to eat little meals here and there. Brain fog and headaches. Mostly just tightness in the head and inbetween the eyes. Flu like feelings in the stomach. Tried Yoga, the next day was a little much, so I am thinking yoga was too much, really trying to not try to “fix” anything with exercise and just let the body heal, but my whole life I have always known that exercise is really helpful for depression and anxiety, but maybe not mediciation induced.

[catmama]

On 12/3/2023 at 10:39 AM, Jakeblack14 said:

my whole life I have always known that exercise is really helpful for depression and anxiety, but maybe not mediciation induced.

I have been struggling with this too. I have relied on exercise as a “natural antidepressant” for years. But now in this WD wave I can’t seem to tolerate anything. I’m so sorry you’re having a hard time. Are you able to take short walks? Or even do a half yoga session instead of a full one? Movement really does help mood so much. But it seems that any exertion that the body sees as “stress” during WD is a no no. Do you enjoy crafts or building models or anything? I’ve found that building Lego sets or quilting helps me, at least temporarily, boost my mood a bit when the depression is bad. 

[Jakeblack14]

On 12/4/2023 at 3:22 PM, catmama said:

Are you able to take short walks? Or even do a half yoga session instead of a full one?

I am, I am going to try another yoga session tonight, might shoot for just half of it depending on how I feel. Any exercise at all seems to make the nausea more prevalent, but we will see how it goes. Yeah, interior design is a hobby of mine, but difficult to really do much with it, more just explore for the future. How is your hold going? Any relief in symptoms? 

[catmama]

41 minutes ago, Jakeblack14 said:

How is your hold going? Any relief in symptoms? 

 

Those are great ideas! Hopefully the mini workout doesn't have negative effects. I know how frustrating that is. A couple weeks ago I was in a window and immediately jumped back into lifting heavy 4x  per week and now I've been paying for it. Dizziness is now the worst it's been in all of WD. It's been hard to even walk, go to work, do chores around the apt, etc. I had to have my mom take me grocery shopping a few days ago because it was too anxiety-inducing for me to go alone. Yesterday I focused more on eating healthy and drinking LOTS of water with electrolytes, and I'm feeling a slight bit better today, so hopefully if I continue, it will continue to help ease symptoms. 

 

You're wise to listen to your body and slow down. I know it sucks so much, especially when you're used to being an active person. If I've learned anything from this site, it's that WE WILL heal. Unfortunately, it's just not on a timeline we'd prefer. 

 

Also, interior design sounds really fun! I know it might sound a little silly, but maybe you could create a mini house or room and decorate that? Build mini pieces with cardboard or balsa wood, use recycled materials, craft paints, find toys and miniatures at thrift stores, etc. Could be fun and way to be creative without expending too much energy (or money).

[Jakeblack14]

22 hours ago, catmama said:

A couple weeks ago I was in a window and immediately jumped back into lifting heavy 4x  per week and now I've been paying for it.

Curious as to how long your window lasted?

Currently in a window right now, feel like I could totally go for a light run, but more just nervous to play around with how horrid waves can be. 
Yeah, totally get that, glad you have that relationship with your mom to do things like that. We will get better. 

Thats a very good idea, thanks for the suggestion

I have found TART cherry juice is a wonderful natural anti inflammatory that has helped my dizziness and foggy headedness in the past. When I treat my symptoms for waves as if it is from inflammation, I seem to feel better through it. But no Anti inflammatory drugs, they seem to make things worse in the long run. Lots of water, small meals, tart cherry juice, green things. 

[catmama]

2 minutes ago, Jakeblack14 said:

Curious as to how long your window lasted?

 

I'd guess my window lasted about two weeks-ish? I didn't feel back to "normal" during that period, but I felt well enough to get through the workday, weightlift, go out and about and be social. I did a strenuous hike the Friday after Thanksgiving and I think that's what finally did me in. I feel like my CNS really rebelled after that and I've been in a wave since, which is now about twelve days ago (feels like a lot longer 😢). I'll look into the tart cherry juice, thanks so much for the suggestion!

 

I hope your window continues!! 

[Jakeblack14]

Posting to add to the Journal: 

Finding that anything cardiovascular might increase my symptoms. 
When I say wave: I usually mean really intense anxiety and depression and flu like symptoms. 
Attempted a very light workout yesterday which did raise my heart rate some and I have been teary all morning and pretty sick. 
It's like I am in a window, but what I do in that window makes symptoms worse or better. Walking on eggshells kind of. 

[Giuly88]

On 12/7/2023 at 4:46 PM, Jakeblack14 said:

Posting to add to the Journal: 

Finding that anything cardiovascular might increase my symptoms. 
When I say wave: I usually mean really intense anxiety and depression and flu like symptoms. 
Attempted a very light workout yesterday which did raise my heart rate some and I have been teary all morning and pretty sick. 
It's like I am in a window, but what I do in that window makes symptoms worse or better. Walking on eggshells kind of. 

Hi Jakeblack14, 

 

Hope you are well. I was scrolling through my previous posts in my own thread and saw a post from yourself back in February last year when I had just joined SA.

 

I wanted to thank you for your encouragement. I chose not to reinstate in the end because my severe muscles and jerks made me really worried that I had kindled myself after having also been on and off escitalopram for a few years not knowing that I had been in withdrawal for years 🙁.
 

I can see you have finished your taper and are now sailing through the windows and waves of recovery. I can’t believe how hard this poison is to come off of. Unbelievable.

 

Well we are all brave survivors and I think that the strength and resilience that we have built throughout this ordeal will never leave us and will be our springboard and fuel towards a beautiful and successful rebirth and life afterwards. 
 

Much love to you ❤️ 

[Jakeblack14]

Adding to the journal: 

 

Had a wonderful 2ish weeks, followed by a three and a half day wave. Now back to feeling sick to the stomach and some wicked depression, but shorter waves means healing. 

[Jakeblack14]

Adding to the Journal: 

 

Nauseated most days recently. Things like walking too fast, doing really anything make me dizzy and sick. Kind of like a wicked vertigo. 

 

Having to back off and just not do anything. Really hate not being able to be active, but have to do what I gotta do. 

[Greatful]

@Jakeblack14  Hang in there, I'm right behind you....Lexapro is a nasty drug.  I can relate to the fatigue,  One day you can be fairly active and the next you can hardly walk around the yard without feeling weak and sooo physical tired.     I see you jumped at .8 ish?   I am at .3 and I'm not sure when to jump.  I had such a adr from this drug....You had a nice window not to long ago...The next one is right around the corner.

[Jakeblack14]

On 2/1/2024 at 10:17 AM, Greatful said:

@Jakeblack14  Hang in there, I'm right behind you....Lexapro is a nasty drug.  I can relate to the fatigue,  One day you can be fairly active and the next you can hardly walk around the yard without feeling weak and sooo physical tired.     I see you jumped at .8 ish?   I am at .3 and I'm not sure when to jump.  I had such a adr from this drug....You had a nice window not to long ago...The next one is right around the corner.

Thanks, you too, the waves seems to be coming more often but are a little lighter not the same as they were at the beginning. I am testing this half window I am in and not doing practically anything for exercise and test how the next full window feels. That's correct .8 was wayyyy too much, you are doing it the right way, are you taking the liquid version or the physical pill? 

[Greatful]

@Jakeblack14  Yes I am on liquid.  I take split the dose  0.15  x 2 = .3mg.  It's hard to comprehend the small amount on the spoon,  0.1 1/2ml how this can have any impact.  right now according to this chart .29mg has the sert occupancy of 15%  https://imgbb.com/7S1f6P6  Here is the sert for Lexapro.  

 

 

 

 

[Jakeblack14]

Any suggestions from you seasoned folk on tips for the depression. The anxiety waves were horrid, but the depression waves hit pretty hard too. Interested in coping strategies. Thanks in advance.