Nimbus: my experience with Escitalopram after 3 months of stopping

[Nimbus]

Hi there,

 

I had my last dose of Escitalopram Jan 4th 2023 (about 3 ish months ago). I started on it back in 2018 to help with my depression and social anxiety which it worked so well for and as of May 2022 I was finally in a good space in my life where my doctor and I figured we’ll try wean off it. 

 

My history of the drug is as follows: 

- 2018 - end of 2019: 20mg

- 2019 - 2020: 10mg

- 2020 - May 2022: 5mg 

- May 2022 - Jan 2023: started taking every second day, then third, then fourth until I got to Jan where I had my last

 

At the start (stopping completely) I felt fine and then about a month in I started getting very dizzy, panic attacks, anxiety (not social anxiety but to the stage that if i went out to a basketball game or restaurant i’d have a panic attack), feeling disconnected from myself, brain fog, blurry vision, heart palpitations. I’ve been dealing with this for about a month and a half now, some days worse than others. Typically when I know something is coming up it gets worse. 

 

I’ve gone to the doctors (who hasn’t even mentioned this could be to do with coming of SSRIs) and done a lot of blood tests, heart tests and all seems to be fine so after googling a lot yesterday and today I figured it could be to do with coming off escitalopram??

 

It’s consuming most of my life right now as I can’t do things I want to all the time. To help Ive been doing the following:

- exercising

- eating / sleeping well

- meditating / yoga 

- taking hemp CBD oil (10% CBD) twice a day (morning and night)

- taking magnesium, vit C and vit D daily

- Doctor gave me propanlol to try (didn’t do much). Also gave me a benzo which made me feel great but don’t want to have more than one as I don’t want to get addicted.

 

Im trying to stay positive but it’s starting to get to me a bit. My questions are, am I doing the right things? Does this sound like it’s to do with coming off anti depressants? Any advice on what I can do better? Idea on how long it will last? Anyone had similar experiences? 

 

Thanks in advance! 

 

Edited March 13, 2023 by Gridley

[Gridley]

Welcome to SA, Nimbus.

 

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.  Please include the dosage information in your post and clarify the following:

-Re "2019-2020 10mg" -- Did you taper or just drop from 20 to 10?  Or did you taper and if so at what rate?  Month dates for all please.

-Re "2020 - May 2022" -- Same questions as previous.  We need dates and rate of taper.

-Re "May 2022 - Jan 2023" -- Same questions as previous.  We needs dates of when you made each change, every 2nd day, etc.

Very important: I need to know the last dose you were on in Jan 2023 before you stopped taking the drug.

Use this link:

 

Account Settings – Create or Edit a signature.

 

From your post, I can't tell your taper rate from 20mg to zero.  We recommend tapering no faster than 10% of our current dose every four weeks.

 

Why taper by 10% of my dosage?

 

We never recommend skipping doses to taper.  Skipping doses causes the amount of the drug in your bloodstream to go up and down, battering the nervous system.  This causes withdrawal.   See these links:

 

 NEVER SKIP DOSES TO TAPER 

 

Skipping Days vs Every Day Dosing Graph

 

The symptoms you describe are typical withdrawal symptoms very likely caused by the dose skipping.  Skipping one day between doses is a 50% reduction, 5 times faster than we recommend; skipping 3 days and 4 is even faster.  Withdrawal caused by a too-fast taper is extremely common; we see it multiple times every day on this site.

 

So that you have a better idea of what you're experiencing, here is some information on withdrawal:

 

What is withdrawal syndrome.

 

Brain Remodelling 

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

Reinstatement of a very small dose of the original drug is the only known way to help alleviate withdrawal syndrome.  It isn’t a guarantee of diminished symptoms but it’s the best tactic available. The only alternative is to try and wait out the symptoms and manage as best you can until your central nervous system returns to homeostasis.  Unfortunately no one can give you an exact timeline as to when you will start feeling better and while some do recover relatively easily, for others it can take many months or longer.  

 

Reinstatement predictably works up to 3 months after last dose, so you're within the time frame.   It is best to reinstate as soon as possible after withdrawal symptoms occur. We usually suggest a much smaller reinstatement dose than your last dose.  These drugs are strong, and when reinstating it is better to start with a small amount and increase if symptoms remain unbearable. Your system has become sensitized and If you take too much it may be too much for your brain and can cause you become unstable.  Sometimes it can be hard to regain stability after this happens.   Please read:  About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic

 

If you want to reinstate, please let me know and we can suggest a very small reinstatement dosage.  Please do not reinstate without giving us the opportunity to suggest a dosage.  Once you've stabilized on the reinstated dosage, which can take several months,  you can begin a 10% per month taper down to zero.  To suggest a dose I will, as I said, need the last dose you were on in January.

 

We don't recommend CBD oil or any other substance that has psychotropic effects.  The following link on SAM-e is equally applicable to CBD and explains some of the reasons we don't recommend CBD:

 

SAM-e (S-adenosyl-L-methionine)

 

 

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.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Edited March 13, 2023 by Gridley

[Nimbus]

Thanks for getting back to me @Gridley and providing some awesome info! I’ll check out all your links that you listed.

 

In terms of when exactly I reduced my intake, I don’t exactly know the specific month. What I do know is that I went from 20mg to 10mg without tapering (took 20mg one day and then the following days I took 10mg). This is the same thing I did when lowering my dose from 10mg - 5mg. The only time I tapered was when I fully came off where I took 5mg every second day for a month, 3rd day for a month, 4th day for a month, 5th day for a month until I finally had my last AD on Jan 4th. Probably not the exact answer you were after but hopefully it helps.

 

Regarding CBD oil, what makes you not recommend this? The link you posted really only had info/comments around SAM-e. I’m very new to taking CBD oil to help manage the panic attacks I get so any info specifically about CBD oil would be really appreciated.

 

Thanks again :)

[Gridley]

@Nimbus

 

We really need the drug signature.  We can't make any recommendations without it. 

 

 

Account Settings – Create or Edit a signature.

Re CBD, the same reasons we don't recommend SAMe would apply to CBD: it's a psychotropic drug that affects your brain and nervous system, which are sensitized from withdrawal, and there's no way to tell what effects another psychotropic drug will have on you.   If you want to take it, you're of course free to do so.  Here's a link with information about CBD.

 

Cannabis, marijuana, hashish, THC, & CBD / …

 

If you Google SurvivingAntidepressants.org CBD, you'll find some more threads.

 

[Nimbus]

Thanks @Gridley, Ive just updated my signature. I’m not American based so the dates are day/month/year haha

 

Cool I’ll have a look at some of the threads. Seems like it works for some people and others not so much? Is there anything else I can be doing perhaps instead of CBD oil that can manage / reduce panic attacks? Panic attacks and feeling lightheaded / dizzy are my main symptoms 

 

My other question is, my doctor is looking at getting me on Accutane to clear my acne up. Will this interfere with my withdrawals? 

[Gridley]

4 hours ago, Nimbus said:

Is there anything else I can be doing perhaps instead of CBD oil that can manage / reduce panic attacks?

This link has some ideas for dealing with panic attacks.

 

4 hours ago, Nimbus said:

Accutane

People in withdrawal can react to any medication or supplement.  I'm no expert, but from what I've read Accutane doesn't jump out at me as particularly likely to exacerbate withdrawal.

 

5 hours ago, Nimbus said:

Seems like it works for some people and others not so much?

True.  It works most predictably if done within 3 months of your last dose.  If I'm understanding your signature correctly, your last dose was in February, so you'd fall within the time frame.

[Nimbus]

@Gridley What link is that? 

 

I’ll ask my doctor more around the accutane.
 

Whoops my bad, was meant to me January. Just updated. What would reinstating look like? Do you have to do it with the same antidepressant? Or could I do with a more mild antidepressant? 

[Gridley]

@Nimbus

 

Sorry, here's the link:

 

Sudden fear, terror, panic, anxiety, or sensory overload …

 

4 hours ago, Nimbus said:

What would reinstating look like? Do you have to do it with the same antidepressant? Or could I do with a more mild antidepressant? 

It's done with a very small dose of the same antidepressant.   Definitely not a different antidepressant. The dose would a small percentage of the last dose you were taking before you stopped taking Escitalopram.    To determine what that dose to recommend, I'd need to know the last dose of Escitalopram you were on before you stopped taking the drug on January 4, 2023.   Was it 10mg every fifth day?  For information on reinstatement, please read:

 

About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic

 

 

 

[Nimbus]

Cool thanks for the link @Gridley.

 

Yeah it was 10mg every 5th day 

[Soup]

Please look up accutane  side effects it can have some serious ones just on its own 

[Nimbus]

My anxiety is so bad I can’t even go to the supermarket without feeling a panic attack coming on. I can barely leave the house… 

 

Im not sure what to do, do I reinstate and talk to a psychiatrist about it? I don’t trust my doctor anymore… 

 

Ive been through a month and a half already though so do I just give up on that effort? I feel hopeless. 

 

Thanks by the way @Soup

[Soup]

I see you are taking doxycycline I would suggest Checking  out the side effects of that drug on drugs.com  . Anxiety seems to be a theme with a lot of antibiotics ….. 

[Nimbus]

@Soup Thanks yeah I’m keen to get off it. Any idea if I can just stop taking it or do I need to taper?

[Soup]

@Nimbus sorry that I am not sure of that I would ask a moderator that question 

[RachelSusan]

@Nimbus Sorry to read about your anxiety. To me it sounds like coming off the anti-depressants, but I am not an expert, I am just someone guessing. Your mod could better advise you.

 

I hope you can figure out what is going on and get rid of the anxiety.

Edited March 15, 2023 by RachelSusan

[Nimbus]

Thanks @RachelSusan! I read your story, congrats on getting through it  

 

Im not sure who to ask regarding coming off doxy. I can’t trust my doctor anymore since they weaned me off AD incorrectly 

[Nimbus]

I’ve also booked in to see a mental health psychologist who may have a better understanding of this all and what I should do e.g. push through or reinstate 

[Gridley]

7 hours ago, Nimbus said:

I’ve also booked in to see a mental health psychologist who may have a better understanding of this all and what I should do e.g. push through or reinstate 

I'd suggest you be very discerning in ascertaining if the psychologist knows what he/she's talking about.  Key questions would be knowledge of: taper rate, severity and duration of withdrawal, and amount to reinstate.  If they espouse skipping doses to taper, you know they're ill-informed. 

[Nimbus]

That’s a good point @Gridley. I think I’ll stop doxy cold turkey (seemed like there weren’t many side effects looking online), just go to a normal therapist and try get though this. I’ll keep you updated 

[Nimbus]

@Gridley Ive been slowly getting better. Still get panicy and anxious. I had a question, will one off lorazepam put me into a wave of withdrawal symptoms ? I have a big work conference tomorrow and need to get through it, currently pretty anxious in those situations so thinking of taking a lorazepam for this one off occasion