BetterDays23: Between a Rock and a Hard Place

[BetterDays23]

Hello,

 

I stumbled upon this forum while looking for support through an unfortunate situation I'm in. I visited a similar site 3-4 years ago when tapering from benzos and it was incredibly helpful. I'll try not to write a book in my intro, but I do want to be thorough.

 

I have been on SSRIS for most all of my adult life. I'm 35 now and began with Paxil when I was 18. Over the years I switched from Paxil to Prozac to Lexapro to Luvox. I'm well-versed in how helpful the medicine can be in crisis, but also in how they can cause crisis. Long story short...

 

I had been taking Lexapro since the beginning of the pandemic for depression, panic attacks, and OCD. My most recent dose, 40 mg, was targeted at the OCD, and had been in place since about February of this year. While it did help minimize OCD symptoms, it caused emotional blunting and now recently a spike in panic attacks. 

 

I told my psychiatrist I was experiencing the concerns and inquired of different medicines. He suggested a fast taper off Lexapro over three weeks (40 to 20), and then a direct switch to Luvox. 

 

Life has been a bit of a nightmare ever since. Shortly after starting the Luvox I began experiencing increased anxiety, anger and irritability, a lack of feeling in control, and physical symptoms such as dry mouth, cough (ongoing), and chest pain and tightness (also ongoing). 

 

After some back and forth phone conversations I was able to get in to see my psychiatrist yesterday. At this point I'm barely functioning. I don't go out at all, and I just feel....out of sorts. High anxiety, crying spells (or attempted crying spells, thanks to the emotional blunting), and a lack of hope or drive. 

 

After explaining all this, my psychiatrist told me to stop taking the Luvox immediately. He plans to put me on Effexor, but wants to wait about a month since he's going on vacation in a week.

 

I'm pretty well versed in these meds, so I was pretty upset, given the likelihood I'm already withdrawing from the Lexapro, and would now add a Luvox withdrawal to the mix. 

 

His solution was for me to try positive thinking, not worry so much, and if needed, start 5 mg. Lexapro on Monday to hold me over until he returns and prescribes the Effexor.

 

I'm beside myself, to be honest. I've always held my psychiatrist in high regard, as he spent two years helping me taper from Klonopin, but this incident is really bothering me. 

 

I'm fearful that these withdrawal symptoms will be ongoing, and waiting to start the Effexor will just make things worse. As I said I'm already having trouble functioning, and spend most of my days lying in bed. I have a full time job that I do not want to lose, and my friendships and relationships are struggling. 

 

To be quite honest, I'm hoping to find some validation here that my fears about this process are valid, as well as support through the next few weeks. I have Hydroxyzine, which does seem to take the edge off, but it makes me so drowsy I don't want to do anything. 

 

Thank you for any support you can provide during this very difficult time.

 

TG

[Emonda]

Welcome to the community @BetterDays23.

 

I'm sorry to read of your current circumstances. I'd be beside myself, too, if my doctor stopped my meds and said they couldn't see me for one month.

 

The moderators will be better able to assist you if you complete your drug signature. To do this, please click on your screen name (top right corner of your screen), account settings, and then signature.

 

9 hours ago, BetterDays23 said:

I'm hoping to find some validation here that my fears about this process

 

Sounds like a reasonable response to a stressful situation to me. I recall over the years, my doctor swapped me from one AD to another because of side effects on three occasions. I was quite uptight through the process.

 

I can't offer any advice about starting a new AD. Given your doctor is not going away for another week, I'd be back on the phone to chat again before they leave.

 

Another moderator may drop along shortly with comments about potentially reinstating Lexapro.

 

There are so many resources on this site. It'd be worth reading the following, given your effective CT from ADs: 

 

Once again, I am sorry to read of your distress.

 

...please remember to update your drug signature...

 

Edited August 27, 2023 by Emonda
fixing a typo

[Shep]

15 hours ago, BetterDays23 said:

After explaining all this, my psychiatrist told me to stop taking the Luvox immediately. He plans to put me on Effexor, but wants to wait about a month since he's going on vacation in a week.

 

I'm pretty well versed in these meds, so I was pretty upset, given the likelihood I'm already withdrawing from the Lexapro, and would now add a Luvox withdrawal to the mix. 

 

His solution was for me to try positive thinking, not worry so much, and if needed, start 5 mg. Lexapro on Monday to hold me over until he returns and prescribes the Effexor.

 

 

Welcome to Surviving Antidepressants, @BetterDays23

 

Are you here to get off of antidepressants or are you just in the process of changing drugs? 

 

The reason I ask is because we're a site exclusively dedicated to helping people taper. We aren't medical professionals, so we can't help you transition from one drug to another. I just want to clarify what your intentions with these drugs are. 

 

If you're here to taper, please set up a signature. Here is how:

 

Please summarize your drug and withdrawal history in your signature

 

It's possible you may benefit from reinstating the Lexapro, but it depends on the timeline of when you made these changes, as well as if your goal is to get off antidepressant for good or if you're simply transitioning over to a new drug. Please let us know your goal. 

Edited August 27, 2023 by Shep
fixed typo

[BetterDays23]

Thank you both! I will work on my signature. 

[BetterDays23]

Update: I am reinstating at 5 mg of Lexapro (at doc's direction) in hopes some of the discontinuation symptoms will abate.

 

Hope to have my history updated by end of day. Struggling to remember the pre-college years.

[BetterDays23]

Update: I've been taking 5mg Lexapro to stabilize for four days. It's definitely been up and down. I'm not entirely sure what my goal is at this point (get off meds or stay on), but I do know that I cannot make that decision until I'm able to talk to my doctor on the 21st of this month. He's currently on vacation. 

 

I've been experiencing a lot of akathisia, or what I believe is akathisia. I just constantly feel like I'm going to jump out of my skin. I don't really like to stop moving, and even sitting down to eat (and staying in a sitting position) has been rough.

 

I've also noticed that my fears and obsessions are incredibly prevalent, and they seem to be running my days right now. I can't say I'm functioning well. Trouble eating, anxiety about eating, and trouble concentrating are my biggest issues right now. 

 

I'm so very overwhelmed.

[Emonda]

@BetterDays23

I hope you stabilise on 5mg and start to feel better soon.

 

Be patient; it may take 3-4 weeks for the WD you describe above to ease.

 

5 hours ago, BetterDays23 said:

I'm not entirely sure what my goal is at this point (get off meds or stay on), but I do know that I cannot make that decision until I'm able to talk to my doctor on the 21st of this month

 

I try to avoid big decisions when I'm not feeling well. There's no rush. Stabilise, hold for some months, and then consider what your goal may be.

 

Wishing you well.

 

Emonda

[Shep]

@BetterDays23 As you navigate the decision to stay on these drugs or to taper off, you may want to read Robert Whitaker's book Anatomy of an Epidemic. Whitaker's work comes highly recommended here. He also runs the website Mad in America. 

 

Also, there's this brilliant documentary called Medicating Normal, which you may be able to google to find ways to stream it. They also have a YouTube channel with a number of videos you may find helpful - Medicating Normal YouTube Channel

[Shep]

Another helpful resource before talking to your doctor: How do you talk to a doctor about tapering and withdrawal?

[BetterDays23]

Thank you, Shep. I sincerely appreciate it.

[BetterDays23]

These past few days have been a real struggle. I'm not sure if the reinstatement isn't working, but I'm so anxious. From the moment I open my eyes in the morning till the moment I go to bed I feel like I'm going to jump out of my skin and I'm restless with severe anxiety. Eating has been difficult,  and I can't find much joy in the day.

 

In short, everything seems pretty bleak since each day feels worse than the last. 

 

I don't feel like I have many paths at this point, as my psychiatrist is on vacation and had previously informed me that there won't be anyone in the office to back him up. If I go to the ER they will most likely pump me full of more drugs, such as benzos, which I don't really want. And I'm not even sure if I'd qualify for inpatient treatment, but even if I did, that's pretty drastic. 

 

Will this go away?

[Emonda]

That's a great book Shep mentioned. I heard about it on this site a few months back and valued the read. When you are feeling settled, you might like to have a read.

 

6 hours ago, BetterDays23 said:

These past few days have been a real struggle.

 

Sorry to hear that, BetterDays23. I don't recall if it was asked above. Are you drinking alcohol or caffeine? I had to cut those things out as it was just adding to my anxiety.

 

Everyone is different, but for me, a little exercise helps with my mood/anxiety. I've read others here say they find it unhelpful....so you need to find what works for you in that department.

 

7 hours ago, BetterDays23 said:

Will this go away?

 

In my experience and the experience of many others on this site, yes, it will.

 

It has only been around 7 days since you reinstated 5mg of Lexapro. It'll take a little while yet to see improvement. Time and patience re your friends in this process.

 

You might like to have read of this have a read of these non-drug coping strategies. 

 

 

[BetterDays23]

Update: It's really been more of the same here. Feelings of depression are prevalent, and I've spent a lot of time either in my bed or on the couch. I'm pretty much housebound. Eating has been difficult. An hour or so before mealtime I begin to feel anxious, and then I'm anxious throughout the meal. I usually don't finish a meal. 

 

Graphic, but I've also been gagging, retching, and vomiting. 

 

I spoke with my psychiatrist today. Short and to the point, as always, he wants me to start on Effexor (Venlafaxine) 37.5 mg tomorrow. I'm taking 5 mg. Lexapro now, as mentioned in the thread, and he wants me to stop that. Argues that while some of what I'm feeling may be withdrawal, it also sounds like my depression is relapsing. 

 

I'm not sure what to believe anymore, to be honest. I had want to feel better, and I don't know that any "next move" is going to be the right move, you know? I'm going to try it because I don't know any other option. I'm not really functioning. 

 

Questions:

 

1 - Is it possible that starting Effexor and getting back on ADs at a therapeutic dose will help these symptoms go away?

 

2 - What types of things should I look out for in relation to kindling?

 

Thank you, everyone, in advance.

[Emonda]

Hi @BetterDays23,

I'm sorry things have been difficult. It's been around three weeks since you reinstated, right? Personally, I'd give it a little longer, rather than start from scratch with another AD.

 

To answer your questions:

1: There is no way of knowing. It'd be an experiment. 

2: You can read more about Hypersensitivity and Kindling here

 

8 hours ago, BetterDays23 said:

Argues that while some of what I'm feeling may be withdrawal, it also sounds like my depression is relapsing. 

 

The Doctor had you taper from 40mg of Lexapro to 0mg in three weeks. I'd be going with WD rather than a relapse. Have a read of the  WD symptom checklist. Can you relate to the items on the checklist? Does that give you confidence that you are experiencing WD?

 

Time and patience have been of great benefit to me when I have experienced WD....very difficult at the time, but has proved beneficial for me.

 

I hope this helps with your questions.

 

Emonda

 

 

[BetterDays23]

Hi, 

 

I just want to provide some clarity. I began tapering off Lexapro 40 mg in early July. I took 30 mg. For real weeks, then 20 mg. for about two weeks. I stopped 20 mg. on 8/3 and started Luvox shortly thereafter. I took that for about two weeks before stopping it and reinstating 5 mg. Lexapro. 

 

As of this morning I have decided to begin the Effexor and monitor my symptoms carefully. As such, yesterday was my last day at 5 mg. Lexapro. 

[Emonda]

19 hours ago, BetterDays23 said:

As of this morning I have decided to begin the Effexor and monitor my symptoms carefully.

 

I hope it works out well for you, @BetterDays23. Let us know how you go.

 

Remember to update your drug signature.

 

Emonda

 

[Shep]

20 hours ago, BetterDays23 said:

As of this morning I have decided to begin the Effexor and monitor my symptoms carefully. As such, yesterday was my last day at 5 mg. Lexapro. 

 

@BetterDays23 You are free to try additional drugs if you feel that's best, but we do not provide support for ongoing medication management. We provide support for those who wish to taper and find non-drug ways for getting through the withdrawal symptoms.

 

Please take questions about your symptoms to your doctor. You may want to look at your drug history of going from one drug to the next to see if it served you well, as that history is likely going to repeat as you continue to trial more antidepressants, resulting in higher levels of nervous system hypersensitivity and kindling. 

 

Let us know if you decide to taper in the future. 

[BetterDays23]

I appreciate all the advice given in the last few weeks throughout this time.