Danae: Weaning off Lexapro- A failed try to discontinue after a 3 month tappering

[Danae]

Hello Everyone, 

 

I could use your advice for weaning off lexapro (Cipralex). I am a new member on this site , I come from Cyprus (europe) and I would like to share my story with you.

 

I was on lexapro (cipralex 20mg ) for 11 years since I was 23 years old (now 34). I recently wanted to come off  the medicine, I went from 20 to 15 then to 10 , 5 and 0 mg within 3 months period. I was ok on 5mg but after i stopped from 5 to 0mg i had severe anxiety and panic on week 8. We decided with my doctor to reinstate on the lowest dose. 5mg . Reinstatement started working ( I am on day 6 now- still on fight/flight mode but I am geting better day by day) but I am really worried it would be really difficult to finally stopped this medicine. withdrawals were really bad. My doctor could not advice how to wean off 5mg and I srongly believe there is a method of slower tappers from 5mg to 0 mg.

 

I would like to ask you if you know how is it possible to make a dosage of 2,5 mg , 1,5 mg and 0,5mg of this medicine so I can successfully tapper down really slow so my nervous system will adapt without having severe withdrawals .

 

Do you believe an oral solution would help making these dosages?

 

Do you know if there is a protocol for making these dosages by crushing the pills? 

 

Thank you in advance for your time

 

All the best

Danae

Danae

 

 

Danae

[Danae]

39 minutes ago, Danae said:

 

Thank you in advance for your time

 

All the best

Danae

 

ps: I see that the reccomendation for minimizing withdrawals are 10% reduction every 4 weeks. My question is How am I supposed to make this reduction if the pills come at 10 and 20 mg only. In my country there is not even the option of 5mg taplets. 

Do u believe that oral solution will help? This is also not availabla in Cyprus but I guess I will have to order from other countries. If u also know a company that delivers after a prescription is given, I would appreciate if you give me this info 

 

Thank you 

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  I went through something very similar to you in 2017.  I tried to wean off my Lexapro with the same fast tapering method, because it was recommended by my doctor.  It didn't work, and I ended up reinstating to 5 mg. on my own.  This really helped, but I reinstated right away - just about 3 weeks later.  Let me give you some basic information, then some specific suggestions at the end.  

 

Can you please tell us about what day in April you went to 0 mg?  If you don't remember, was it early, middle, or late April?  Thanks.  

 

Here is some important information about how these drugs actually work.  This explains why we get symptoms from going off of these medications, and why it's so important to taper slowly and carefully, and be very cautious about changing our doses: 

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

Video on Recovery from Psych Drugs

 

Windows and Waves Pattern of Stabilization

 

 

Tapering is best done extremely slowly, and we generally taper by 10% of the current dose no more than once every 4 weeks, so that the reduction becomes exponentially smaller.  And, the lower we go in our dose, the more important it is to be extra careful in our tapering, and really take our time and listen to our bodies  before doing another dose reduction.  This is probably why you had the trouble when you went from 5 mg to 0 mg. 

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering Cipralex/Lexapro/Escitalopram

 

Here is a link with checklists of common WD symptoms: 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

Stability is really important when we are tapering off psych meds.  Please read the link about stability:

 

Keep It Simple, Slow, and Stable

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 

Magnesium

Omega 3 Fish Oil

 

I'm very glad to hear that your reinstatement is working.  It should continue to gradually improve your symptoms.  It can take a couple of months for a reinstatement to reach its full effectiveness.  If I were you, I would hold on this dose of Cipralex for a very long time, to allow your brain a chance to recover and stabilize.  Your future taper will be much easier if you do this.  Patience is the key to really getting off these drugs.  Be sure you take your same dose, each and every day, at the same time of day.  I would wait about 6-12 months before trying to taper again.  Listen to your body.  When you feel like you've been stable for a while, then you can start tapering again.  

 

As to your practical questions about measuring non standard doses, you have several options.  These are all explained in the link above "Tips for Tapering Lexapro/Cipralex".  And please note that we reduce by 10% of the current dose, not 10% of the original dose, so that the reduction becomes smaller and smaller. 

 

Please let us know if you have any further questions.  

[Danae]

Thank you for taking the time to give me all this information . That would be very valuable. 

My last dose of Cipralex 2,5 mg was 30/4/23.  In May I had some symptoms but I was managing to control my anxiety until mid June when I had severe anxiety attacks. 

 

I will listen to your suggestion and wait for at least 6 months before  going back again to 2.5mg /daily.. I will stay there for at least 3-4 months. and then I will use the liquid solution to tapper further down. My plan is to tapper every 4-6 weeks from 2.5mg to 2mg (2drops), 1mg (1 drop), 0,5 mg (half drop). What is your thought on this?

 

My question to you, is how you would be able to measure a 0,10 mg and 0,005mg lexapro. What is your method?

 

Kind Regards

 

Danae 

[getofflex]

What date (month and day) did you reinstate to 5 mg of Cipralex?  Please put this info in your signature - thank you.  

 

When you reduce, please do not go from 5 mg to 2.5 mg.  That is a 50% reduction, and is too fast.  It is especially important to do small reductions, especially at the lower doses.  As stated above, we suggest you reduce by 10% of your current dose.  that is 5 mg x 0.9 = 4.5 mg.  It will be easy to measure non standard doses with the liquid.  If you are on the tablet now, please stabilize first, then gradually switch to liquid before you do a reduction: 

 

Week 1: 3/4 tablet, 1/4 liquid 

week 2: 1/2 tablet, 1/2 liquid

week 3: 1/4 tablet, 3/4 liquid 

week 4: 100% liquid 

 

Do not do a reduction at the same time you switch from tablet to liquid.  Wait until you make sure you do not react to the switch to liquid before reducing again.  If you do react, wait until this stabilizes before reducing the dose.  

 

Please measure your liquid with a syringe, not a dropper, for an accurate dose.  Find out from your pharmacist how many mg of Cipralex are in 1 ml of the liquid, so we can calculate you liquid dose properly.  

 

9 hours ago, Danae said:

My plan is to tapper every 4-6 weeks from 2.5mg to 2mg (2drops), 1mg (1 drop), 0,5 mg (half drop). What is your thought on this?

 

I would not suggest this.  Again, we suggest reducing by 10% of the current dose.  The formula is current dose x 0.9 = new dose. For example, 5.0, 4.5, 4.1, 3.7, and so forth.  It is very slow, but this way it will be much easier to taper, and minimize your risk of going into severe withdrawal, which can cause major disruption to your life, and take many months to recover from.  

 

Please read this link, to understand more about measuring your dose with a syringe.  

 

Tips for Tapering Cipralex/Lexapro/Escitalopram

Edited July 3, 2023 by getofflex

[Danae]

ok thank you. I updated my sıgnature. I will stay at least 10 months on 5mg and the start tappering. Another question, how often do suggest to make this tapper reductions

 

Tx

 

Danae

[getofflex]

39 minutes ago, Danae said:

I will stay at least 10 months on 5mg and the start tappering.

Excellent.

 

39 minutes ago, Danae said:

Another question, how often do suggest to make this tapper reductions

We suggest every 4-6 weeks.  We also suggest you listen to your body, and wait until you have felt stable for a couple of weeks before deducting.

 

Stability

 

WD Normal

[Danae]

23 minutes ago, Danae said:

ok thank you. I updated my sıgnature. I will stay at least 10 months on 5mg and the start tappering. Another question, how often do suggest to make this tapper reductions

 

Tx

 

Danae

The problem is that in my counry, they dont sell the liquid form . I will have to order it from a UK pharmacy.  

 

UK version Cipralex oral drops solution 20 mg escitalopram in each 1 mL(millilter of solution) and then 1 mg per gtt(drop) EU-pil, 4306.pdf

(this one comes with the dropper attached to the bottle, each gtt(drop) then equivalent to 0.05 mL(millileter)).

 

So 20mg in 1mL. Using an insulin syringe (1ml)the smallest one  - If I take 0.1ml this will give me, 2mg of Escilatopram. 

                                                                                                                 If I take 0.05 ml this will give me 1mg of Escilatopram

 

Using a syringe the lowest dose I can get is 1mg and I will not be able to make 10% reductions. Also I cannot combine with the tablet cause 5mg tablets are not existent in my country. 

I believe its best for me to go buy a Pippette and measure the medicine in microns ul (1ml=1000ul ). This is the only way I can make these reductions

 

 

[getofflex]

You can get small 1 ml syringes that measure up to 0.01 ml.  I used these for my own liquid taper, and they worked quite well.  These can be ordered on amazon.  Perhaps your pharmacist may be able to get some for you.  For your 5 mg Cipralex dose, you would take 0.25 ml of the liquid.  You should be able to do 10% reductions with this.  You could also dilute this liquid with distilled water, but then you would have to keep it in the refrigerator, and use it in a short period of time.  

 

You can also make your own liquid with the tablets.  The link above will explain how - "Tips for Tapering Cipralex". 

 

 

Edited July 4, 2023 by getofflex

[Danae]

Hope I can find these type of syringes. Thank you for your help . I will revisit this conversation in 10 months time.

 

Best Regards

DC

[getofflex]

I know this is all overwhelming.  I'm assuming that to get your current 5 mg dose, you are splitting a 10 mg tablet in half?  When you decide to do your crossover from the tablet to the liquid, it is safest to switch gradually.  We call this a cross-over.  However, in order to measure the non standard doses of the tablet, you would need to grind them into a powder and measure this on a small scale.  This topic will teach you how to do this.  

 

Using a Scale to Weigh and Measure Doses

[Danae]

Things are getting more complicated than I thought. Yes I am splitting the 10mg tablet in half.

 

Why switching to a liquid would be problematic and distabilizing for the nervous system? I mean is the same medicine

 

I will consider trying the pill crusher/powder method only instead of the liquid.

[getofflex]

I know there is a lot of info to take in and process, and it can be overwhelming.  

 

Most of our nervous systems on this forum are ultra sensitive to any kind of drug changes.  I believe the liquid drug gets into our system faster than the solid form, and this takes some time to get used to.  

13 hours ago, Danae said:

I will consider trying the pill crusher/powder method only instead of the liquid.

That would work just fine.  

[Danae]

Hello I am Danae 35yrs.. I posted few weeks back about my story. I was on Cipralex since I was 23 years old. I only stopped the medicine for 1 month and 24 days. after which I reinstated at 2,5mg for 4 days, then 5 mg for 12 days. Then upped to 10 mg on 10th of July until today

Regarding symptomatology: since the reinstatement I started seeing improvement in symptoms. Sleep went from 4 hrs to 7-8 hrs after few weeks. Anxiety reduced from lets say 100% to 20-30% during daytime. 

 

I saw improvement in anxiety but not completely resolved. The most scary symptom is shallow breathing , I had to quit cigarettes. Sometimes went to the point of breathlessness/Dyspnea. This was fueling my anxiety even more and started improving 3 weeks after taking 10mg (although not completely resolved!!). Shallow breathing and dyspnea is so scary:( ! 

 

My nervous system is still on a hyperarousal stage. I am wondering if I entered a persistent PROTRACTED WITHDRAWAL STAGE where the nervous system is sensitive to everything like  caffeine, tobacco, vitamin supplemets etc .? Will this ever stop? 

 

(I was using GABA 500mg occasionally and L-Theanine 175mg daily to reduce anxiety in the morning but now had to stopped , as GABA gave me withdrawals similar to benzos and L-theanine at high doses increased my dyspnea. I continue to  take Magnesium and Omega 3 fish oil).I dont take any benzodiazepine , only when needed (lexotanil half 1,5mg tablet , but I avoid using even if I have dyspnea since I dont want to have withdrawals)

 

I read the story from Altrostrata and other stories and wondering if I ever get out of this. I read sometimes reinstatement doesnt work for some people. Although I see improvements after increasing dose its a really slow process for me. Today is week 6 after I started 10mg Cipralex, 8th week since Reinstatement at lower dosages and month 4 since I stopped Cipralex on May 1st.

Tomorrow I am discussing with my physician to increase dosage to 15 mg. I will probably increase tomorrow. Any successful stories with reinstatement? how long do you believe is needed to exit the hyperarousal state and sensitivity stage?

 

Thank you in advance. ( ps: pls excuse my english. its not my first  language)

Kind Regards

Danae

 

 

[Altostrata]

Hello, @Danae

 

Since you've already benefited from 5mg reinstatement, it is likely that eventually you will stabilize. Stabilization can be very slow and uneven. See The Windows and Waves Pattern of Stabilization

 

You're now taking 10mg since July 7? How has your symptom pattern changed since then?

 

Do you intend to eventually taper off completely?

 

Please add questions and updates to this topic, do not start any more Introductions topics.

[Danae]

Hello and thank you for your response. 

I increased the dosage to 10mg on 10th of July and made another increase to 15mg on 22nd of August after discussing with my psychiatrist . I definitely saw improvement with 10mg. I was able to sleep normally and breathlessness was much improved although was not completely normal. Also I was practicing meditation, mindfulness and gymnastics at the same time. It was like I was not anxious on my mind but my body was fixed on a fight/flight mode and hypersensitivity (very weird feeling and sometimes scary sensations that fueled anxiety even more)
Now, 15 mg seem to do the work and completely resolve breathlessness, electric shock sensations and chest pains. I will stay on this dosage until I stabilize and heal the nervous system for 8-10 months at least. Then I will tapper at a slower pace , and stabilize at lower dosages. I hope I will be able to stop the drug one day, at least this is my intention. More wise now as a 3 month tapper is not working for me. I will definitely use your advice on this site for discontinuation.