poohstix: Lexapro, possible kindling and attempt at taper

[getofflex]

19 hours ago, poohstix said:

I updated my signature to include my microtaper off lexapro. 

Thank you - it looks great! 

 

19 hours ago, poohstix said:

I had a couple of brief, several-day waves, one 3 weeks ago and one just ending right now. I am not sure if this was due to my possible accidental extra dose of lexapro on 10/29 or another reason.

It may very well have been from the extra dose.  It's good they were brief. I suggest you wait until you are stable for a couple of weeks, before resuming your taper.  

 

Stability

 

WD Normal

 

19 hours ago, poohstix said:

I've noticed that I'm decreasing my doses more rarely now. I started out doing a microtaper akin to a Brass Monkey slide but then, whenever I am more symptomatic than I would like, or when I am having a wave, I would just hold. Basically, when in doubt, hold. I wonder if this is overkill, but again, I would really like to not have to be where I was in early 2023.

I think you are doing the right thing! This is not a race, and it's good to really take your time and be patient.  We see far too many people who taper too fast, and end up very sick, and it can take many months to recover from that. I also went extremely slowly the last 2.5 years of my taper, and I'm very glad I did.  

 

I see that you are doing a linear taper.  This is fine, as long as the percent you taper doesn't exceed 10% of the current dose per month.  However, as you get into the lower doses, it is especially important to do the exponential taper, which is 90% of your current dose, not your original dose. These drugs affect a disproportionately larger number of receptors at the lower doses.  Look at the chart in the link.  Over on the left had side, at the lower doses, the drop is so steep, it is almost vertical.  That is why it gets harder to taper at the end, and it is especially important to go really slowly and carefully at the lower doses.  

 

SERT Transporter Occupancy Studies

 

 

 

 

[poohstix]

1 hour ago, getofflex said:

Thank you - it looks great! 

 

It may very well have been from the extra dose.  It's good they were brief. I suggest you wait until you are stable for a couple of weeks, before resuming your taper.  

 

Stability

 

WD Normal

 

I think you are doing the right thing! This is not a race, and it's good to really take your time and be patient.  We see far too many people who taper too fast, and end up very sick, and it can take many months to recover from that. I also went extremely slowly the last 2.5 years of my taper, and I'm very glad I did.  

 

I see that you are doing a linear taper.  This is fine, as long as the percent you taper doesn't exceed 10% of the current dose per month.  However, as you get into the lower doses, it is especially important to do the exponential taper, which is 90% of your current dose, not your original dose. These drugs affect a disproportionately larger number of receptors at the lower doses.  Look at the chart in the link.  Over on the left had side, at the lower doses, the drop is so steep, it is almost vertical.  That is why it gets harder to taper at the end, and it is especially important to go really slowly and carefully at the lower doses.  

 

SERT Transporter Occupancy Studies

 

 

 

 

Yes, I am doing a linear taper so far because the decreases at this point are 2-3%. I was going to decrease the decrements down the line so it’s always a 2-3% drop. 
 

What are your thoughts on getting a Covid vaccine? I’m leaning more toward getting one now, because it seems most people who have posted on the Covid/Covid vaccine thread have not had bad experiences. But I’d probably want to wait until it’s been some time since I’ve been in a wave?

[getofflex]

I don’t have an opinion on the Covid vaccine, one way or the other.  

[poohstix]

Update: I have been on my present dose of lexapro, 3.0, for almost three months now. I had my accidental up dose on 10/29 and may have had a couple of waves in November that I could attribute to that, but otherwise have been doing well. (I consider a “wave” to be days with symptoms that are at least 2/5 on my 1-5 scale or multiple days in a row with sleep problems).

 

However, I’m still stuck on when to go down in dose, since I understand stability means your symptoms are consistent and predictable.  When I have symptoms, they are mild: 1 on my 1-5 scale, and they last a couple hours a day at most. L But they are not necessarily predictable. I may have a stretch of almost symptom free days and then have a night of poor sleep. I may have a great night of sleep, but still have a symptom flare during the day even though it’s a weekend and nothing is going on. I’m still having a hard time determining what can trigger symptoms. At times I thought certain foods or activities acted as triggers, but eliminating them did not clearly help. The only thing I’ve been able to work out is that in the middle of my cycle (right around ovulation) things can get worse for 1-2 days. 
 

I guess my biggest concern is that things are going to get worse again if I decrease my dose. Things have definitely improved over time but I don’t want to go back to the way things were last winter and spring… even in the summer they were worse than they are now. Oftentimes, I think to myself, I am ready to decrease now, but then something happens: I have a poor nights sleep or symptoms and then decide against it. But this is probably not serving me well, because the symptoms I get could also be side effects, and I’m not working toward the long term goal of getting off meds.

[poohstix]

I ended up going down to lexapro 2.95 on 1/14. I figured that windows and waves were probably still going to happen no matter where I am in the taper process, and just because I am having windows and waves doesn't mean I am not stable. I think as long as I am having symptoms that are tolerable and within a certain range of severity, I can consider myself stable.

[getofflex]

I’m glad to see you doing a prudent and cautious slow taper now.  It is good that you are listening to your body and waiting until you feel stable to do so.  I remember too trying to figure out if I was really stable enough to taper and having the sleepless night. Good luck!   

[poohstix]

Update: I went down to 2.9 on 2/24. Things have been pretty stable. The most time passes, the more stable I seem to get. Now most days I have hardly any symptoms at all, and if I have a wave it is 1-2 days. 
 

The downside, I guess, is that this is me decreasing by a 2% at a time! (Forget the 10% rule lol). I guess I will be at this for a really long time and working with a compounding pharmacy or making dilutions myself is in my future a few years down the line. 

[getofflex]

13 hours ago, poohstix said:

The most time passes, the more stable I seem to get. Now most days

Yes, time and patience are the keys to getting off these drugs safely! I  applaud your patience.  It's much better to do a long slow taper, than rush things and go into CNS instability.  Keep up the good work!  

[poohstix]

On 2/28/2024 at 9:08 AM, getofflex said:

Yes, time and patience are the keys to getting off these drugs safely! I  applaud your patience.  It's much better to do a long slow taper, than rush things and go into CNS instability.  Keep up the good work!  

Thank you! 
 

I am also thinking about starting exercise again. I have not done any in a few months because I thought at one point it triggered a wave, but I hope that if I start with just 5 minutes here and there it should not be too bad.

 

The challenge right now with this process is that if there is something that I think could trigger a wave or seemed to trigger one in the past, I am reluctant to do it. As a result, I don’t feel comfortable traveling, I stopped exercising and I hardly spend time outside when it’s cold. I avoid large gatherings because of the risk of catching COVID, and have not gotten the most recent booster vaccine, because that too could have an unpredictable effect. I’ve stopped watching what I eat because I figure I need to have plenty of calories to build a new nervous system, so to speak, so I’ve gained weight. It’s ok, but it is all kind of limiting. 

[getofflex]

It's good that you will start exercising gradually.  Some of us, myself included, have exercise intolerance.  I'm able to walk for an hour, but 2 months ago tried doing some strength training, and it amped up my symptoms, so I've given that up for now.  I can relate, I also avoid things that I think might have triggered a wave.  

[poohstix]

On 3/1/2024 at 10:04 AM, getofflex said:

It's good that you will start exercising gradually.  Some of us, myself included, have exercise intolerance.  I'm able to walk for an hour, but 2 months ago tried doing some strength training, and it amped up my symptoms, so I've given that up for now.  I can relate, I also avoid things that I think might have triggered a wave.  

Update: I was very stable for months, and then I just got a sinus infection a few days ago, and suddenly I’ve got sleep problems again that are as bad as last January when all this started. I have not been prescribed any antibiotics because it’s too early in the course of the infection. 

My overall withdrawal Symptoms are still pretty minimal during the day. But at night it’s either being bothered by nasal congestion, or sweating/warm hands and feet (those two symptoms I’ve had recently as part of withdrawal), or nothing is happening but I’m just not sleeping. I fall asleep in the early morning when it’s soon time to get up, so I’m getting some sleep, just at the wrong time. This is ok on a weekend because I can sleep in some but going to work like this is going to be miserable.
 

Is this a thing that happens? An infection triggering a wave? I’m hoping that it’s just my body being under stress from the infection and will pass soon.

[getofflex]

2 hours ago, poohstix said:

Is this a thing that happens? An infection triggering a wave? I’m hoping that it’s just my body being under stress from the infection and will pass soon.

This could happen to someone who is not in withdrawal.  I suggest that you wait until this infection is past, and perhaps it would be prudent to hold on your dose longer than usual before you do another reduction.  Make sure you are well, and stable, for a couple of weeks before doing another reduction.  

[poohstix]

49 minutes ago, getofflex said:

This could happen to someone who is not in withdrawal.  I suggest that you wait until this infection is past, and perhaps it would be prudent to hold on your dose longer than usual before you do another reduction.  Make sure you are well, and stable, for a couple of weeks before doing another reduction.  

True, although before withdrawal/lexapro being back in my life in Jan 2023, I've never had sleep issues with infections. I guess it is possible that withdrawal changes how your body works, and anything that causes physiological stress can cause insomnia.