GoldWing: Lexapro reinstatement after 3 months (Escitalopram)

[GoldWing]

Hello. 36 years old. Battled anxiety and panic disorder for many years. Was prescribed Lexapro 15mg for general anxiety at age 30. My first and only SSRI. No problems or side effects ever with the trearment, was very effective. 

 

In January 2023 I decided it was time to taper off - too fast. Went from 15 to 0mg in 12 weeks. Withdrawal symptoms didn't start until week 10 with brain zaps. Aside from that symptoms were mild until late May with a 3 week wave of severe depression. That magically improved entirely then morphed into the anxiety phase with increasing bouts of panic attacks/agoraphobia and signs of hypersensitivity to light, coffee, certain foods, etc. 

 

Reinstated 2.5mg of the lexapro 8 days ago knowing reinstatement window was closing. Kept at it as I saw immediate boost in mood and positivity the first two days, BUT added new akathasia, muscle tension, jerking awake and disturbed sleep throughout the week whereas before I was sleeping fine. Still getting 7-8 hours. 

 

In the past week, general anxiety and sensitivity to food, light, sounds, stressors is up with a dash of disturbing derealizaron here and there. I'd say on the border of manageable and unmanageable. Required a 0.25 xanax on a couple of days. Had a hypo-mania type day with a euphoric feeling but a fatigue crash the next. But there are windows of relaxation and positivity each evening. 

 

Yes the taper was too fast and I now realize reinstating at 2.5mg was running a risk. 

 

Should we tune down, or stick it out at this dose looking to stabilize? 

 

Note: I take the dose at 11pm each night and can't tell immediately what it does. Sleep jolts/disturbed sleep and buzzing muscle tension during day are the prominent new symptoms.

 

Love you all who work and contribute to this forum. 

 

 

[Altostrata]

Welcome, @GoldWing

 

On 7/21/2023 at 6:30 PM, GoldWing said:

Reinstated 2.5mg of the lexapro 8 days ago knowing reinstatement window was closing. Kept at it as I saw immediate boost in mood and positivity the first two days, BUT added new akathasia, muscle tension, jerking awake and disturbed sleep throughout the week whereas before I was sleeping fine. Still getting 7-8 hours. 

 

Smart! Please explain more about these new symptoms. What times o'clock do you take your drugs, with their dosages? Are these new symptoms worse at any particular times of day?

[GoldWing]

16 hours ago, Altostrata said:

Welcome, @GoldWing

 

 

Smart! Please explain more about these new symptoms. What times o'clock do you take your drugs, with their dosages? Are these new symptoms worse at any particular times of day?

 

Hi Alto. Akathasia was always worse from wakeup until the evening. Ive now been taking 2.5mg for 2 weeks at 11pm before bed each night. 

 

This week my sleep has improved significantly. No jerking awake, more relaxed. Daytime akathasia has improved to just muscle fatigue in the legs. General anxiety still too high for my liking - avoiding busy places as it brings a little panic to the table. This was the direction my withdrawals were going in before reinstatement. Positive windows have been larger this week though. 

[Altostrata]

@GoldWing sounds like you're stabilizing. 

 

Many people find fish oil and magnesium supplements helpful, 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.

[GoldWing]

Update 5 weeks after reinstating 2.5mg lexapro. Akathisia went away after a few weeks but returned for the past week - neck pain and buzzing in the legs. This is accompanied by daily anxiety usually improving at night. Had mixed windows and waves.

 

It's been 5 months since my taper to 0mg (reinstated 3 months later).

 

Luckily getting full, restful night sleep. Taking 120mg magnesium daily. Eating good, in shape. But agoraphobia and muscle weakness is at its worst since the process started.

 

I'd like to stabilize here. Sometimes I wonder if going to 5mg would help down the road, but the first few days of reinstatement were rough.

[Altostrata]

6 hours ago, GoldWing said:

neck pain and buzzing in the legs.

 

How does this compare to the symptoms you had in June?

 

6 hours ago, GoldWing said:

the first few days of reinstatement were rough.

 

What happened in the first few days?

[GoldWing]

16 hours ago, Altostrata said:

 

How does this compare to the symptoms you had in June?

 

 

What happened in the first few days?

 

In June I had a big depression crash for 3 weeks which improved back to normal. Then a month later anxiety started kicking in with hyper sensitivity, couldn't handle coffee or certain foods anymore.

 

After reinstating I noticed a little boost in positive mood but that quickly turned into akathisia (didnt have this before), sleep twitches, disturbing dreams. Then those all improved after the first week.

 

Week 5 of reinstatement (this week) akathisia came back. Given this is a new thing since reinstatement plus anxiety not improving I'm wondering if this is even a beneficial dose.

[Altostrata]

Quote

April 10th - July 13th:  3 months at 0mg with various withdrawals. 

 

In June, you had acute withdrawal syndrome from going off Lexapro.

 

On 8/20/2023 at 3:30 PM, GoldWing said:

Then a month later anxiety started kicking in with hyper sensitivity, couldn't handle coffee or certain foods anymore.

 

Development of other withdrawal symptoms and hypersensitivity is typical of protracted withdrawal syndrome.

 

On 8/20/2023 at 3:30 PM, GoldWing said:

After reinstating I noticed a little boost in positive mood but that quickly turned into akathisia (didnt have this before), sleep twitches, disturbing dreams. Then those all improved after the first week.

 

What do you mean by akathisia?

 

On 8/20/2023 at 3:30 PM, GoldWing said:

Week 5 of reinstatement (this week) akathisia came back.

 

Please describe this symptom. Does this occur every day? At any particular times of day? How long does it last?

[GoldWing]

11 hours ago, Altostrata said:

What do you mean by akathisia?

 

 

Please describe this symptom. Does this occur every day? At any particular times of day? How long does it last?

 

This symptom is an electrical feeling/tension/buzzing sensation mostly in my neck (made worse by too much computer use) and legs. Sometimes its more mild and my legs simply feel very weak. Usually worse in the morning, improves by evening but causes leg jerks/twitches during sleep. It's accompanied by negative mood and anxiety.

 

I had a nice window all day yesterday with much less anxiety but still muscle weakness in the back and legs.

[Altostrata]

It may take a while for you to stabilize with the reinstatement, with symptoms in the The Windows and Waves Pattern of Stabilization

 

How do you feel now compared to early July?

 

5 hours ago, GoldWing said:

This symptom is an electrical feeling/tension/buzzing sensation mostly in my neck (made worse by too much computer use) and legs.

 

Those symptoms sound more like paresthesia, a common withdrawal symptom, than akathathia. Fish oil and magnesium can help.

 

Quite often, they are related to posture while you spend hours at th in one position. You may also wish to do some stretching of the affected areas, or get chiropractic, massage, acupuncture, or physicial therapy treatment.