Caesar65: Escitalopram withdrawal within only 5 weeks after taking it for 18 years/unbearable symptoms since 1 year after withdrawal/advice urgently needed!

[Altostrata]

I don't know. I cannot make those decisions for you.

[Caesar65]

3 minutes ago, Altostrata said:

I don't know. I cannot make those decisions for you.

 

3 minutes ago, Altostrata said:

I don't know. I cannot make those decisions for you.

I don’t expect you to make this decision, but after more than a year, it is very hard for me to make this decision. There was nobody who encouraged me or helped me in any way the first months after my rapidly withdrawal, probably it would have been better to reinstate shortly after stopping. It took me until almost 8 months until I was a little bit able to start to look for information about my symptoms. 
All my wish is getting an honest opinion from you. According to the many people who are having similar problems, you might know of, or remember some cases, which could perhaps help me. 

[Altostrata]

You'll have to look around the Introductions forum and see what other people did.

[Caesar65]

17 minutes ago, Altostrata said:

You'll have to look around the Introductions forum and see what other people did.

Of course I do that, but I don’t find someone who tried to reinstate after more than a year. What do you think about taking 5 HTP? Could this be an option overcome my very strong depression and deep sadness? And against my strong anxiety? 
 

[Altostrata]

11 minutes ago, Caesar65 said:

What do you think about taking 5 HTP? Could this be an option overcome my very strong depression and deep sadness? And against my strong anxiety? 

 

Up to you if you want to experiment with more drugs. Withdrawal is not a mental disorder.

[Caesar65]

7 minutes ago, Altostrata said:

 

Up to you if you want to experiment with more drugs. Withdrawal is not a mental disorder.

That means L Tryhtophan or the 5/HTP is no option? I thought it is only a supplement not a drug. 

[Altostrata]

Please read up on any supplements in the Symptoms and Self-Care forum. 

 

If they worked, we would routinely recommend supplements for recovery from withdrawal syndrome. As it is, there are only 2, fish oil and magnesium supplements, and these are not miracle cures, they might help you feel a little bit better. See

 

https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

 

https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

You might try a little bit of one at a time to see how it affects you. Please let us know how you’re doing.

[Caesar65]

9 minutes ago, Altostrata said:

Please read up on any supplements in the Symptoms and Self-Care forum. 

 

If they worked, we would routinely recommend supplements for recovery from withdrawal syndrome. As it is, there are only 2, fish oil and magnesium supplements, and these are not miracle cures, they might help you feel a little bit better. See

 

https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

 

https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

You might try a little bit of one at a time to see how it affects you. Please let us know how you’re doing.

Thanks for the tips, like you have recommended last week I stopped taking almost all of my supplements, beside the Omega Fatty Acids and Magnesium which I split into several smaller doses through the day. And for sleeping I just take valerian with hop.

But my sleep pattern changed, I think since January I can’t really sleep deep anymore. 

Since yesterday my heart palpitations are worse and don’t get better at all. Like I told you, they recently used to get better in the evening but now it’s already midnight here in Germany, and I feel them very strong with this terrible anxiety and all my other worse feelings. 

 

[Altostrata]

I gave you my best guess, @Caesar65

[Caesar65]

I like to express an important item I feel strongly engaged with and want to share it with you. I would like to find out, about the experience of others concerning this important point, which is bothering me a lot. 

 

I think that I am a so-called “ weak metabolizer “ and I think there are many cases of side-effects and withdrawal symptoms in context with it. This could be the reason why some people have only mild side effects/ withdrawal symptoms and the same of many others are worse, severe an long lasting. 
In my case, the regularly serum level control which shall be done already  before the prescription of an antidepressant was never done, and also not while I was taking it, and not, when I reported my worse side effects of Escitalopram. ( the same happened with Fluoxetin, Zoloft and all the others before the Lexapro Aera.) 

Whenever I didn’t feel less depressed, but side effects, the drug was just replaced by another one until Lexapro I got the prescription first in 2004 for 18 long years. 

In the German Guidelines it is very recommended, and in my case never ever done! And this is my explanation that I have become much more and stronger side effects over the years with Lexapro, and I was not aware of the reason given.

Perhaps I would not have been and would not be still in this unbearable situation as I am now, if the dose would have been moderate, instead of getting the prescription of the maximum dose of 20 mg. 😢The dose was changed several times, and remained until withdrawal for 20 mg. 

 

If serum levels are outside the therapeutic range, measures should be taken to correct this, e.g. Reassessing and promoting adherence;

Testing and discontinuation of interacting substances if necessary (levels too low, e.g., due to smoking, gingko, St. John's wort; levels too high, e.g., due to grapefruit diet);

Dose increase when levels are too low due to unalterable interactions or genetic predisposition (so-called "ultra-rapid metabolizers");

Dose reduction when the level is too high due to invariable interactions or genetic predisposition (so-called "poor metabolizer").

 

Among the cytochrome P450 (CYP) enzymes of the 2C family, through which about 20% of all drugs are metabolized, CYP2C19 plays the major role. Clinically relevant substrates include numerous antidepressants and neuroleptics, as well as clopidogrel and proton pump inhibitors. In this review, substrates, inhibitors, and inducers of the CYP2C19 isoenzyme are presented, the importance of genetic polymorphisms is addressed, and the clinical relevance of some interactions is described.

 

PS: Back to the weak metabolizer problem, I think about my mother, who had to take  Clopidogrel, because of her peripheral arterial occlusive disease.  And there were two stents in both legs and even though she took it, there always occured the same problems with the rapid reclosure again after a short time. And being a small metabolizer could have been the reason for this problem, the doctors said then. 

We went through horrible times, and mom was suffering for many years.

 

A possible reason for a lack of response to clopidogrel therapy ("clopidogrel resistance") could be the genetically determined variability of CYP2C19. In slow metabolizers, platelet reactivity may be preserved under clopidogrel therapy to the extent that stent thrombosis cannot be excluded after percutaneous coronary intervention (PCI). It has been shown in several studies that the presence of deficient CYP2C19 alleles in patients treated with clopidogrel is associated with an increased rate of cardiovascular events or stent thrombosis. For example, in the clopidogrel arm of the TRITON-TIMI-38 trial, the number of stent thromboses was increased threefold and mortality was increased by half when patients were carriers of a deficient CYP2C19 allele [9, 11].

 

[Caesar65]

36 minutes ago, Altostrata said:

I gave you my best guess, @Caesar65

I know, and I 🙏 thank you. 
 

[Caesar65]

On 3/16/2023 at 8:51 PM, Altostrata said:

You can dilute escitalopram liquid to take any dose you wish with an oral syringe.

What do you think of just crumbling the pills of Lexapro instead and using a special digital weigh to achieve the small doses I would need for the reinstating procedure? 

I am constantly confused, because I am really full with anxiety and not functioning well at all. I feel more debilitated since a while and it is hardly possible and very difficult for me to think logically. 
I still don’t find any successful stories of reinstating Lexapro after more than a year ago, which I could compare with my case. So I still hesitate and hesitate. 

The clerks in the pharmacy said different, one said all you need to do is to put on drop directly out of the bottle of liquid formula, ( syringe scale maximum 0,1 - 1,0 ml ) the other said it should be mixed with water first. It is only available in 20 m as liquid. 
 

[Altostrata]

5 hours ago, Caesar65 said:

The clerks in the pharmacy said different, one said all you need to do is to put on drop directly out of the bottle of liquid formula, ( syringe scale maximum 0,1 - 1,0 ml ) the other said it should be mixed with water first. It is only available in 20 m as liquid.

 

You need to get the pharmacist to confirm exactly what to do.

 

You can weigh fragments of a tablet if you wish. It's more work and error-prone.

[Caesar65]

On 3/22/2023 at 11:50 PM, Altostrata said:

I guess you might try reinstating 0.5mg escitalopram or 0.5mg citalopram, its milder sibling.

I made my hardest decision today on 26 th March 2023. You know, it has already been in the End of January 2022, since my complete withdrawal, more than a year ago. The last doses were only the crumbled parts of the pill, I am not sure, perhaps 1-2 mg, or less. 

I started today with reinstating, but with the liquid formula of Escitalopram 20 mg. 
And did it with a syringe having a maximum capacity of 1,0 ml.

 I pulled one drop out of the bottle in a small measure cup filled with 10 ml of water. 
And with the syringe I pressed according to the center of the first measure scale 0,05 ml only. I was not aware to be just on half of the first scale which shows 0,1 ml. I was so nervous and confused, full of anxiety. 
Shall I continue with the dose 0,5 mg tomorrow, which would mean to me, that the syringe will be filled half of the volumen with the mixed water?
And how long shall this dose or any dose after this be approximately maintained ?
And what if I don’t feel better but get worse withdrawal symptoms? 
 

 

[Altostrata]

Correct, 0.5mg at the same time each day, measured by the same method.

 

Droppers are not as accurate as the oral syringes, especially at very low dosages. Suggest you standardize your measuring method.

[Caesar65]

16 minutes ago, Altostrata said:

Correct, 0.5mg at the same time each day, measured by the same method.

 

Droppers are not as accurate as the oral syringes, especially at very low dosages. Suggest you standardize your measuring method.

Thank you for your advice. But for how long should I keep the dose of 0,5 mg?

In which small steps shall I increase the doses, 0,25 or 0,5 or less? 
When should I begin to take one drop, which is 1 mg? 


 

[Altostrata]

We need to see what a dose of 0.5mg does before considering next steps.

[Caesar65]

10 hours ago, Altostrata said:

 

We need to see what a dose of 0.5mg does before considering next steps.

 

It seems even worse to me! The anxiety increased and this early morning I woke up from anal spasms, which I also had sometimes in the last years before my withdrawal! 😥😥😥 I often had muscle cramps. 

And an investigation then  found no reason, no cancer. It is a side effect already with 0,5 mg. And like I wrote here earlier I also had this after I stopped taking St John’s Wort, too. I am so full of despair, everything seems hopeless for me😥😥😥 

[Altostrata]

Give it a week, take the same amount at the same time each day.

[Caesar65]

2 hours ago, Altostrata said:

Give it a week, take the same amount at the same time each day.

Ok, I try to hold on and take it until next Saturday, at this Day I started. 
But now my anxiety and strong heartbeat seems to be worse, it used to become a little better at the late evening, but now, it’s terrible 😞 And I feel very debilitated. 

But the truth is, that I didn’t ever want to touch this drug again anymore in my life! 
Maybe it was a big mistake to reinstate this drug, and my longtime endurance is now destroyed again!? My heart now beats loud and heavy and fast, it is frightening! 
 

[Altostrata]

What time o'clock do you take 0.5mg?

 

Please keep daily notes of times o’clock you take your drugs, their dosages, and your symptoms throughout the day. We need to know how you feel before and after taking each drug, and your symptoms in between. Post 24 hours of notes at a time in this topic, in a simple list format with time o’clock on the left and notation (symptom or drug and dosage) on the right.

 

Have you always been an anxious person, @Caesar65? Health anxiety?

[Caesar65]

On 3/30/2023 at 1:47 AM, Altostrata said:

What time o'clock do you take 0.5mg?

 

Please keep daily notes of times o’clock you take your drugs, their dosages, and your symptoms throughout the day. We need to know how you feel before and after taking each drug, and your symptoms in between. Post 24 hours of notes at a time in this topic, in a simple list format with time o’clock on the left and notation (symptom or drug and dosage) on the right.

 

Have you always been an anxious person, @Caesar65? Health anxiety?

I am an anxious person, and always had great fear for others, especially for my mom, who died almost 3 years ago. But I don’t have anxiety of becoming terminally ill, or something like that. I am not afraid to have or get cancer or anything like that. No hypochondriac. But since a while I am thinking about the unknown fact, that I could perhaps have  an unknown rare metabolic disturbance, which could be a reason for my depression. 

But what I really think is, that I am definitely damaged through the longtime use of these kind of drugs! I feel like being a victim of these kind of medication and treatment. I don’t even get the correct diagnosis for this longlasting withdrawal symptoms that I have since over a year!
The doctors deny it! And in the German ICD is still not a clear classification for this. 
 

I took it first starting last Saturday, 25.03.23 0,25 mg/ 1230hrs pm

and the following days until Friday, 31.03.23.  0,5 mg/ 1230 hrs pm

I will create a list format for you. 

 

All my symptoms remain unchanged, the strong anxiety, the heart beating loud, the  bodily weakness, the drowsiness permanently, fatique, the feeling of unreality, being separated from the world, not being able to make decisions of any  kind aso. Everything is always worse at daytime,  usually late at night it seems it’s getting better, except fe the weakness and drowsiness, and joylessness. But  surely not every night. 

 

But everytime I am taking the dose, I hesitate  if I should really do it or not. 
Because inside me is a big resist against this, I am not sure to do the right thing, and I always think, how much will I have to increase until I feel better? 
Maybe it is crazy to start again after more than a year ago? 
Will I ever feel better again and when?! And what about the side effects coming again?
 

 

 

 

 

 

 

 

 

 

[Caesar65]

22 hours ago, Caesar65 said:

Please keep daily notes of times o’clock you take your drugs, their dosages, and your symptoms throughout the day. We need to know how you feel before and after taking each drug, and your symptoms in between. Post 24 hours of notes at a time in this topic, in a simple list format with time o’clock on the left and notation (symptom or drug and dosage) on the right.

Request you kindly to read my last answer to your same question carefully, because recently I feel totally overwhelmed with everything. I am not even able to do simple things like this list. But I try to do my best to remember since last Saturday.

Since then I stopped all Supplements except Magnesium and Omega 3 Fatty Acids. 
 

Date: 25.03.23

0800 a.m. woke up and doozing until high noon

1230 p.m. 0,25 mg Lexapro 
1300 p.m. Breakfast with strong anxiety, drowsiness and bodily weakness and heart palpitations, feeling unreality and the other always described symptoms lasting all day long 

1700 p.m. teatime with some cookies

 

Date: 26.03.23

0900 a.m. woke up doozing until high noon

1230 p.m. 0,5 mg Lexapro 

1300 p.m. Breakfast with symptoms mentioned above lasting all day long

1800 p.m. teatime 

1900 p.m. dinner 

 

Date: 27.03.23

 

1000 a.m. woke up doozing until high noon

1230 p.m. 0,5 mg Lexapro 

1300 p.m. Breakfast with same symptoms mentioned above lasting all day long 

1800 p.m. teatime with magnesium 

1900 p.m. dinner with omega 3 

Date: 28.03.23 

 

0600 a.m. woke up with painful anal spasms 

0630 a.m. taking magnesium 300 mg

sleeping again until high noon

1230 p.m. 0,5 mg Lexapro 

1300 p.m. Breakfast with same symptoms mentioned above lasting all day long 

1800 p.m. teatime 

1900 p.m. dinner with Omega 3 

 

Date 29.03.23

 

0830 a.m. woke up doozing until high noon

1230 p.m. 0,5 mg Lexapro 

1300 p.m. breakfast with same symptoms mentioned above lasting all day long

1500 p.m. nausea all afternoon 

1800 p.m. teatime with magnesium 

1900 p.m. dinner with Omega 3

 

Date 30.03.23

 

0900 a.m. woke up doozing until high noon

1230 p.m. 0,5 mg Lexapro 

1300 p.m. breakfast with same symptoms mentioned above lasting all day long

1800 p.m. teatime with magnesium 

1900 p.m. dinner with Omega 3

 

Date 31.03.23

 

0830 a.m. woke up doozing until high noon

1230 a.m. 0,5 mg Lexapro 

1300 p.m. breakfast with same symptoms mentioned above lasting all day long

1800 p.m. teatime with magnesium 

1900 p.m. dinner with Omega 3

 

Date 01.04.23

 

0900 a.m. woke up doozing until high noon

1230 a.m. 0,5 mg Lexapro 

1300 p.m. breakfast with same symptoms mentioned above lasting all day long 

1800 p.m. teatime with magnesium 

1900 p.m. dinner with Omega 3

Sleep pattern has changed since January, I barely can sleep at night, guess I told you before. 
Late at night the heart palpitations and anxiety usually get better until next morning when I get up. 
I don’t smoke, I drink no alcohol since months. I used to drink sometimes on weekends one or two glasses of wine, that’s it. But since my withdrawal there is no desire for this anymore, like still no appetite for any food. When I was still on Lexapro 20 mg I often almost choked to death, I was often eating very fast and without chewing properly before! My mom and dad were very shocked always, when I couldn’t breath anymore and I vomited. 
 

 

[Altostrata]

Please include sleep pattern in your daily notes, post 24 hours of notes at a time.

 

On 3/8/2023 at 5:19 PM, Caesar65 said:

Already when I wake up in the morning, I always experience this terrible indescribable feeling, which restricts my everyday life so massively, I am already on sick leave for most of the year and also have great fear for my existence, great fear for the future.

 

How does your current symptom pattern differ from your symptom pattern on March 8?

[Caesar65]

18 hours ago, Altostrata said:

On 3/9/2023 at 2:19 AM, Caesar65 said:

Already when I wake up in the morning, I always experience this terrible indescribable feeling, which restricts my everyday life so massively, I am already on sick leave for most of the year and also have great fear for my existence, great fear for the future.

 

How does your current symptom pattern differ from your symptom pattern on March 8?

There is no big difference with all my descriptions of symptoms since last autumn, everything remains the same. But the sleep pattern changed since January/;February, and now in March it’s getting worse, I barely can sleep deep. It’s more like doozing. The only thing which disappeared in February is the loud humming sound in my ears, now it‘s always like noise and whistling. 

And I have no feelings of being hungry, I have to force myself to eat, but can’t eat much. But I drink a lot of mineral water, tea, juice and milk instead. 

[Catina7]

You dear, dear man....I'm so sorry for what you're going through.  As I said before, I've been dealing with a heavy and fast heartbeat myself.  I have to keep my stress level close to zero in order to function properly.  Some things that have helped me are:

1. EFT (Emotional Freedom Technique).
2. Listening to healing music on YouTube like Binaural Beats.
3. Vagus Nerve Reset Exercise or other things that stimulate the Vagus nerve (i.e. humming, gargling)
4. Holding my breath for as long as I can while bearing down (almost like I'm trying to have a bowel movement) and then releasing my breath through my mouth.

Sending you a hug and hoping that things improve soon for you.  Don't give up just yet!  

[Caesar65]

On 4/2/2023 at 3:44 AM, Altostrata said:

Please include sleep pattern in your daily notes, post 24 hours of notes at a time.

 

 

How does your current symptom pattern differ from your symptom pattern on March 8?

There is no difference since that date, all I can say I feel everything remains worse. 
Everything seems to overwhelm me, every little thing, I barely can concentrate and everything seems to be done delayed only. 

 

Date 01.04.23

0830 a.m. woke up doozing until high noon

1230 a.m. 0,5 mg Lexapro 

1300 p.m. breakfast like usual with a small piece of bread and same symptoms as usual (numbness, hopelessness, loneliness, anxiety, heart palpitations, no concentration, not able to do anything, I really want, but I can’t! great Forgetfulness! bodily weakness in arms; not able to do very simple things, aso. 

1700 p.m. teatime with magnesium 300 mg ( heart palpitations get better) 

1900 p.m. dinner with one capsule omega 3 
0300 a.m. going to bed but no deep sleep

 

Date 02.04.23

0900 a.m. woke up doozing until high noon

1230 a.m. 0,5 mg Lexapro 

1300 p.m. breakfast with same symptoms mentioned above lasting all day long 

1500 p.m. Nutrition with milk 

1800 p.m. teatime with magnesium 300 mg 

1900 p.m. dinner with Omega 3 one capsule 

0315 a.m. going to bed but no deep sleep

 

03.04.23

0830h woke up and doozing until high noon, feeling very exhausted as usual every morning 

1230h 0,5 mg Lexapro 

1300 h breakfast with some cookies and all the symptoms lasting all day long

1400 h Nutrition with milk 

1800 p.m. teatime with magnesium 300 mg 

1900 p.m. dinner with one Omega capsule

 

[Caesar65]

1 hour ago, Catina7 said:

Sending you a hug and hoping that things improve soon for you.  Don't give up just yet!  

Thank you so much for your kindness 🌹Stay in touch! 
Sending you hugs, too and wishing you the best, but I am really desperate. 

[AmitV]

13 minutes ago, Caesar65 said:

Thank you so much for your kindness 🌹Stay in touch! 
Sending you hugs, too and wishing you the best, but I am really desperate. 

You will get through this. I have faith that this time things will go well. 

[Caesar65]

28 minutes ago, AmitV said:

You will get through this. I have faith that this time things will go well. 

I pray every day, my friend. And for you, too! 
But I feel hopelessness. 

[Caesar65]

An important point is the nutrients of the body. 
I feel very concerned about this and think of it every day. 

Normally, a psychiatrist should have to investigate whether there is a deficiency in this regard before prescribing. But this never happened, nor did a serum check, despite my notification of the side effects.
An important point is the nutrients in the body. 

[Catina7]

12 hours ago, Caesar65 said:

An important point is the nutrients of the body. 
I feel very concerned about this and think of it every day. 

Normally, a psychiatrist should have to investigate whether there is a deficiency in this regard before prescribing. But this never happened, nor did a serum check, despite my notification of the side effects.
An important point is the nutrients in the body. 

 

I agree with you.  So many things need to be looked at first before a drug is prescribed, but unfortunately that's not the way it normally works.  Keep doing your research and finding ways to cope with your symptoms as these will help you to endure.  Don't feel like you are a lost cause.  I know that with time you WILL heal and get better.  

[Caesar65]

The anxiety is getting worse today, it is extremely unbearable! What shall I do?!!!😢😢 Help me please! Since the early morning it is constantly and very heavy, even more than some days ago. I started to take 1 mg Lexapro, one drop. 
Maybe everything with reinstating was a big mistake. But the doctor forced me to do it, he is threatening with sending me into a clinic, and then I would get stronger medication! 😢

[Altostrata]

We need to see your symptoms in the context of daily notes, 24 hours at time, include times you take your drugs and dosages and your sleep pattern.

[Caesar65]

1 hour ago, Altostrata said:

We need to see your symptoms in the context of daily notes, 24 hours at time, include times you take your drugs and dosages and your sleep pattern.

But I have written the daily  notes already from 25th of th March, in my last posts of the last days. Please See the Quoted messages. 

 

Date 04.04.23

0800h woke up with anxiety and drowsiness, heart palpitations, weakness like every morning; awaked until late night not really tired, but going to bed, no deep sleep; 

until 12O0 hrs doozing then getting up and taking 1 mg of Lexapro ( 1 drop of the bottle with liquid formula 20 mg ) 

then very small breakfast with some cookies and 1 glass of fruit juice and coffee with milk; some magnesium; 

then staring at the wall the whole afternoon, and going for a small walk at the cemetery like usual; All symptoms remain unchanged; no concentration possible to anything, not even able again to read the newspaper; drowsiness and deep sadness; 

1700 h teatime 

1900h a soup for dinner with Omega Capsules 

 

Date 05.04.23

0900h woke up with extreme unbearable anxiety and terrible feelings inside me, and loud strong heart beating, weakness in arms today also worse as usual; 

doctors appointment with great empathy from family doctor, but can’t help me; 

told me to hold on and not giving up; then laying in bed again for a while; 

unbearable anxiety makes me walk around from room to room in my small appartment; can’t stand it! What shall I do? 
0930 h one drop of Lexapro 

Laying again in bed until high noon

not being able to write about symptoms until afternoon, 

walking outside and crying at moms grave; wishing to come to her 

I can’t stand it anymore 

 

 

 

[Altostrata]

Please post daily notes in this simple list format without the narrative. Thank you.