Mariah Five weeks into tapering off Lexapro

[Mariah]

I am currently tapering off Lexapro.

Several years ago, before the difficulties of withdrawal were widely known, I stopped taking Paxil. It was uncomfortable -- lots of brain zaps and occasional vertigo. I swore I'd never take antidepressants again, but about four years ago, I felt I needed something for the depression I could not shake. I was prescribed 10 mg Lexapro.

Two years ago, feeling better, I tried to taper off by cutting out 1/4 of a pill (so I was taking 7.5 mg, down from 10). I experienced brain zaps, nausea, and deep fatigue that interfered with day-to-day life. I resumed the drug, thinking maybe I was stuck for life.

Recently I came across Adele Framer's NIH article referencing this website and recommending a slow reduction of 10 percent at a time. I have now completed the first month of tapering at that rate. At 9 mg, I did have some withdrawal symptoms, mostly brain fog and low energy, but they were mild. I had no brain zaps, which is great because that was the most uncomfortable aspect of my earlier efforts.

This week, I took off another 10 percent. Symptoms have been stronger, but still way better than those earlier efforts (and still no brain zaps!). I've resolved to be patient and take it slowly. I'll stay at this level at least another month.

I'm currently tapering by cutting and weighing pills, but am going to poke around this website for other suggestions.  Complicating things slightly is the fact that my PCP went back to school more than a year ago, and the medical practice has yet to find a permanent replacement for her. I'm now on my third temporary pcp, so feel pretty much on my own in this process.  This week I'm going to start looking at other practices in hopes of finding a practitioner who is already established.

Edited August 20, 2023 by Mariah
additonal details

[Mariah]

Correction to first graph: I was prescribed Lexapro about six years ago, not four.

[Altostrata]

Welcome, @Mariah

 

Good to hear you're doing better with gradual tapering. After a reduction, how long do withdrawal symptoms last?

 

FYI Tips for tapering off escitalopram (Lexapro)

 

Please let us know how you're doing. 

[Mariah]

I had symptoms of low energy and brain fog most of the first week of my second taper, and they were most noticeable on the sixth day. On the seventh day, I felt pretty close to normal, other than being low energy in the late afternoon. At their worst, the symptoms have been annoying, but quite manageable. I'm so glad there are no brain zaps!

Escitalopram Initial dose: 10 mg

First taper: about 9 mg for 4 weeks

Second taper: about 8 mg, currently in 2nd week

 

[getofflex]

Hello Mariah, and welcome to the forum.  Good for you for doing a slow and cautious taper.  I'm glad it is going well. 

 

I just want to make you aware that it is important to taper by 10% of the current dose, not 10% of the original dose.  That may be why your withdrawal symptoms were stronger this time.  When you reduced from 9 mg to 8 mg, that was about a 12% decrease.  You may want to hold for a longer period of time, just to allow your nervous system a chance to stabilize before your next cut.  An easy formula for calculating your decrease is current dose x 0.9 = new dose.  So, your next decrease would be 8 mg x 0.9 = 7.2 mg.  This link below explains why it is so important to reduce by smaller and smaller increments, especially as we get to the lower doses. 

 

 Why Taper by 10% of my Dosage  

Edited August 23, 2023 by getofflex

[Mariah]

Thank you! This is helpful, and I'll use that schedule from here on.

[Altostrata]

@getofflex has it right. Please do not reduce again until you are completely clear of the withdrawal symptoms, then taper by 10% of your current dose -- each reduction is a smaller amount.

 

Are you using the liquid to taper? See Tips for tapering off escitalopram (Lexapro)

[Mariah]

Thank you!

 

I’m not using liquid, but am going to ask to have it prescribed. I’ve been cutting and weighing pills, and it’s difficult to be precise as I’m sure you know!

[Altostrata]

Suggest you take 5mg in tablet form and the rest in liquid, taper from the liquid.

[Mariah]

Ok, thank you.

[Mariah]

I'm nearly two weeks into my third taper off Lexapro. I'm taking about 7.1 mg. Withdrawal symptoms have been the same as before: easily fatiguing is the most prominent, and there's been some foggy-headedness. Symptoms started two days after the taper and were present longer -- about 10 days -- than the previous tapers, which were pretty much gone after 7 days. The symptoms don't interfere with my ability to work. I've been tapering every 4 weeks. Because the symptoms took longer to dissipate this time, I may wait 5 or 6 weeks before the next taper.

[Altostrata]

Are you tapering by 10%? You might taper by 8% instead, perhaps the withdrawal symptoms won't last too long.

[Mariah]

Yes, 10 percent. The symptoms are tolerable, but I’ll give 8 percent a try if they become less so. Good idea — thank you!

[Mariah]

The doctors still don't understand how difficult it is to get off antidepressants! Here is the response I received to my request for liquid escitalopram, in which I explained my process of tapering off 10 percent every 4 weeks:

"My usual recommendation is to take 5 mg and then stop completely. Do you have concerns about withdrawal from previous experience? I could consult with our pharmacist on the issue if that would be helpful but from a withdrawal perspective stopping at 5 mg would be ok for most people. Please let me know your thoughts."

Complicating matters is that this is not my pcp. I've never met this doctor. She is filling in until a permanent replacement for my pcp comes on board. I've been without a pcp for more than year, during which time there have been 4 substitutes. I've been trying to find an established pcp with whom I can build a relationship, but so far no luck.

Anyway, I've responded to this doctor, telling her that I do indeed have experience with withdrawal. I sent her a link to Adele Framer's article on the NIH website. 

 

 

[Altostrata]

Unfortunately, very few doctors understand anything about psychiatric drug withdrawal.

[Mariah]

It's been quite some time since I checked in. I've been slowly and steadily tapering off Lexapro. I'm now down to about .3 mg -- so low, it's hard for me to be precise about the amount. A few days ago, I reduced about .3 mg from my previous dose. My withdrawal symptoms have been mild, but I'm still impressed by the fact there are symptoms even at this small amount. Symptoms were low energy on the first day, wakefulness in the middle of night on the first night. I still have these symptoms, but they are quite mild -- just enough to remind me of what I'm doing.

As for the past few months: I found that once I got to 3 mg, I was able to pick up the pace of reductions. Sometimes I did the next reduction the next week. Sometimes I waited two or three weeks. I let my symptoms guide me.

 

I am grateful for the advice offered in this forum.