Tapering2023: Medication or withdrawal?

[Tapering2023]

Hi. 
 

I have been tapering off lexapro for 6 years very slowly. 10% of the last dose, even 5% the last few months. 
 

I am having non stop suicidal ideation. Depression and fear spirals. 
 

It’s been going on for 3-4 months.

 

I’ve never had these symptoms before. I am wondering if this is still withdrawal or if it’s the lexapro itself. 
 

it doesn’t make sense for withdrawal to last this long with as slow of a taper I’m doing. 
 

Im waiting on more blood work to come back, most of it has been normal so far. 
 

not sure what to do in this situation. I worry this is the meds themselves. I hope it’s withdrawal and I can just stabilize at .672 mg. 

[Emonda]

Welcome to S.A. @Tapering2023

 

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12 hours ago, Tapering2023 said:

I have been tapering off lexapro for 6 years very slowly. 10% of the last dose, even 5% the last few months. 

 

Sounds like you have been diligent and patient. Well done.

 

For me, I've had to switch to the brassmonkey slide (micro taper). I'm even finding 2% per week rough at the moment. You can read more about this here: BrassMonkey slide.

 

12 hours ago, Tapering2023 said:

I am having non stop suicidal ideation. Depression and fear spirals. 

 

I'm sorry to hear this. Unfortunately, they are known withdrawal symptoms. Have a read of the WD symptom checklist.

 

Have you noticed Windows and waves pattern of stabilization as you have tapered?

 

Have you tried any of these non-drug coping strategies?

 

12 hours ago, Tapering2023 said:

It’s been going on for 3-4 months

 

Have you continued to taper through this period? I'd hold your dose for as long as required until stability returns.

 

For me, prior to finding S.A., I tapered beyond my body's capabilities (felt the WD symptoms you described) and chose to up-dose to the last dose I felt okay. I stabilised and stayed there for ~5 months.

 

12 hours ago, Tapering2023 said:

I’ve never had these symptoms before. I am wondering if this is still withdrawal or if it’s the lexapro itself. 

 

It sounds like withdrawal symptoms. I have been told and read that the lower the dose, the more challenging some of us find it to taper....the lower you go, the slower you may need to go.

 

I'm not down to your level (and am on a different AD), but I'm certainly finding it harder now than it was months ago as the dose gets smaller.

 

12 hours ago, Tapering2023 said:

I hope it’s withdrawal and I can just stabilize at .672 mg.

 

The moderatos will value seeing your taper schedule in your drug signature. Maybe something will jump out at one of us. Just confirming, you are at 0.672mg? I'm just making sure the decimal point is in the correct spot.

 

Are you drinking any alcohol? I've had to eliminate it. It was just making tapering harder and triggering WD symptoms.

 

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

Magnesium

Omega 3 Fish Oil

 

Please post any updates here in your thread. It is helpful to keep everything related to your journey in one spot. You are very welcome to jump onto someone else's page and interact with them. The encouragement members give each other on this site is wonderful to see.

 

Sing out with any questions. 

 

Once again, welcome to S.A...and remember to add your drug signature.

 

Emonda.

[Tapering2023]

Yea. I am hoping to God I stabilize on this dose soon. 

 

It is validating I guess that the constant self-harm thoughts are withdrawal. 

 

I have noticed windows and waves, but the last couple months I have been fighting for survival. 

 

I am at .672mg yes. No, I am not drinking alcohol. I also am eating as healthy as I can. 

 

I also take magnesium glycinate, and high EPA omega 3. 

 

 

[Emonda]

 

On 10/20/2023 at 3:20 AM, Tapering2023 said:

it doesn’t make sense for withdrawal to last this long with as slow of a taper I’m doing. 

 

I've certainly read accounts of others here at S.A. on the same AD, tapering very slowly, who have had similar experiences. 

 

Continue to be patient, Tapering2023. You're doing the right things.

 

Please keep us posted.

[LostInCanada]

@Tapering2023 welcome to SA. Sorry you have to go through this. What was your previous dose before .672mg? I am wondering if a small updose would help. Something between the previous dose and this dose but closer to this dose. Maybe even .68 or .685mg. Check out edgewater9, it helped him alot. What do you think @Emonda ?

[Emonda]

Thanks heaps for jumping in, @LostInCanada 😃. Sage advice from your corner of the globe, as always 👍

 

What are your thoughts on a small up-dose, @Tapering2023? I referenced my own experience with up-dosing to see how you'd respond to the idea.

 

On 10/20/2023 at 4:26 PM, Emonda said:

I tapered beyond my body's capabilities (felt the WD symptoms you described) and chose to up-dose to the last dose I felt okay. I stabilised and stayed there for ~5 months.

 

I'm with LostinCanada. The up-dose should be very small to see how your body responds.

 

...I've got to race out the door now, but I will come back to this in a few hours.

[Tapering2023]

Won’t I be on the risk threshold for an adverse reaction by this point though? 
 

It’s been close to 3 months. 
 

I’m doing NAD+ iv therapy as I’ve read a lot about it and felt comfortable doing it. Please don’t speak on any negative affects of this or what I should or shouldn’t do in this regard as this will make it worse for me. 
 

are the same constant suicidal thoughts  something common? 
 

Im worries that this is a drug reaction and not a tapering reaction. 
 

having no basis for real clarity on this is making it extremely difficult. 
 

I read that it can be withdrawal, that it can be symptoms from lexapro itself. 
 

I don’t know. 
 

I didn’t consider up dosing because of the adverse reaction part. 
 

if you believe that will help I certainly will. 
 

 

[LostInCanada]

@Tapering2023 because the SI has only been happening the last few months it seems to me your system is just trying to catch up with all the dose reductions. What were the exact reductions the past 4 months or as close as you can remember? Did you keep tapering despite the SI? Usually when experiencing any increase in withdrawal it is best to hold longer. SI is a very common withdrawal symptom and usually an indication the taper is too fast.

[Emonda]

1 hour ago, Tapering2023 said:

Won’t I be on the risk threshold for an adverse reaction by this point though? 
 

It’s been close to 3 months. 

 

Hi @Tapering2023

That would certainly be a consideration if you'd been at 0mg for 3 months.

 

In your case, you've been holding at 0.672 for 3 months. Any up-dose should be very small to see how your body responds. You should then wait a week or two and reassess.

 

If you read the introduction of edgewater9, you'll see they increased a very small amount, waited a week or so, and then added another small amount. They have responded well.

 

At what dose did you last feel stable? In my situation, if I were to up-dose, I'd consider ~2% maximum, as that would have been the approximate previous dose that I stabilised at before the most recent drop. For you, 2% would bring you up to ~0.68 ish as mentioned by LostinCanada.

 

1 hour ago, Tapering2023 said:

I’m doing NAD+ iv therapy as I’ve read a lot about it and felt comfortable doing it

 

I have no experience with this. Out of curiosity, has this been in place well before your 3-month rough patch? Has anything else changed in your routine/life over the past 3 months?

 

Emonda

[Tapering2023]

Emonda, I just started doing NAD+ IV's this week because the symptoms have been so bad. 

 

In terms of things changing drastically, no. I started a new job but it is honestly the best job I can have right now. 

 

Good people, pay, not a crazy amount of stress, and its remote. I can work wherever I want. 

 

Working around people has been a lifeline though. I can't work alone.

 

In terms of going up to .68, I am intrigued by this... but I am also scared. 

[Emonda]

1 hour ago, Tapering2023 said:

Emonda, I just started doing NAD+ IV's this week because the symptoms have been so bad. 

 

Ok. I would have been concerned if the SI appeared at the same time you started this...but that is not the case. As I said, I'm not familiar with it...so I can't comment.

 

1 hour ago, Tapering2023 said:

In terms of things changing drastically, no. I started a new job but it is honestly the best job I can have right now. 

 

Good people, pay, not a crazy amount of stress, and its remote. I can work wherever I want. 

 

Working around people has been a lifeline though. I can't work alone.

 

This all sounds positive. Changing jobs can still cause underlying stress/anxiety in the transition period. It's been years since I've changed jobs, but I recall it took be 6 months to feel settled, despite it being a job I was excited to move into. So, I wouldn't discount this as causing some destabilisation.

 

1 hour ago, Tapering2023 said:

In terms of going up to .68, I am intrigued by this... but I am also scared. 

 

My up-dosing experience was before finding S.A. I had no idea what I was doing, but it worked out. I'd do things much differently knowing what I know now. I was adjusting my dose (including the up-dose) by way too much for each reduction....very small adjustments are the way to proceed.

 

Since finding this site, I've come close to up-dosing maybe twice but held off with the encouragement of my wife and this site. It was tough, but I'm glad I managed to ride it out.

 

In your situation, I don't know the intensity of your feelings, and if it is all the time etc. You're the judge of that and the only one that can make the decision.

 

Feeling scared sounds like a reasonable response. You don't have to make a decision today. Sleep on it. Reflect on the past 3 months. Has there been any improvement at all?

 

If you make the decision to up-dose, less is more. See how you respond to a small amount. The smaller the change, the lower the chance of an unwanted reaction. Increasing to 0.68mg is a 1.12% increase.

 

Keep us posted.

 

Emonda

Edited October 22, 2023 by Emonda
typo

[Tapering2023]

Thank you Emonda. It seems like the symptoms have gotten worse this month. 
 

I am trying NAD+ patches for a few weeks and waiting on blood work to come back. 
 

If I don’t see improvements in 3-4 weeks I’m going to try the updose to .68. 

[Tapering2023]

So today was a very scary day. 
 

I am going to go up to .682. 
 

You said to hold there and even up dose more after if necessary…?

[Emonda]

Sorry to hear it was a scary day, Tapering2023.

 

That's good you've made a decision for a small up-dose.

 

I would stay there for 1-2 weeks at a minimum. Give yourself time to adjust before considering any further increase.  

 

Let us know how you are going.

 

Emonda

[Tapering2023]

Okay, I will. You’ve found doing this small updose twice is most effective? 

[Emonda]

35 minutes ago, Tapering2023 said:

You’ve found doing this small updose twice is most effective? 

 

Not suggesting that.

 

What I am saying is that it is better to try a smaller amount and see how you go - hopefully, the small amount will give you relief, and you can just hold at 0.682 until the symptoms abate.

 

Some people rush the decision to increase further because they don't get instant relief. Continue to be patient.

 

The problem with a larger amount is the potential for an unwanted reaction.

 

Let us know how you go.

[Tapering2023]

Hey. I’m desperate for relief right now. Yesterday and today I’ve had intense panic. 
 

I’m only on day 2 of the up dose at .683 from .672.
 

would it be okay to take saffron with the new updose? 
 

I desperately need some relief. 

[Tapering2023]

Now I can't sleep because of the underlying fear and panic. 

 

Do you guys have any recommendations for coping?

 

Also since I did the updose from .672 to .683, is the saffron safe?

 

If so do you know a safe dosage?

 

Desperate for any type of relief.

 

Not sure how I see myself living like this past a month.

 

I am hoping to God that the slight updosage helps.

 

 

[Tapering2023]

Any success stories on updosages would be helpful I think. 

[LotusRising]

What coping skills are you using currently when you have the intense feelings of panic? Have you tried any breathing exercises? Box breathing is a great technique - there are a multitude of youtube videos on it. Personally, I had a hard time with breathing exercises when my panic was at its worst. But, I would cope by getting outside and walking, reassuring myself that it would eventually pass. 

 

You could try this link:

 

 

Another member sent me this in the early stages of my taper. Not everyone can tolerate binaural beats, but I listened to it endlessly, along with many others. It gave me something to focus on that didn't have lyrics and for me, it was calming.

 

 

 

[Tapering2023]

Thank you lotusrising.

 

Can someone send me the forum link on updosing from almo?

 

Also is going from .672 to .683 enough for a 10-day hold? I've already started so I will continue this.

 

I would like to do an increase to .7mg if after 10 days I do not see relief. 

 

Any thoughts?

[Altostrata]

Hello, @Tapering2023

 

On 10/24/2023 at 2:18 PM, Tapering2023 said:

Hey. I’m desperate for relief right now. Yesterday and today I’ve had intense panic. 
 

I’m only on day 2 of the up dose at .683 from .672.

....

 

 

Did this panic occur after you took your first dose of 0.683mg?

 

On 10/19/2023 at 9:20 AM, Tapering2023 said:

I am having non stop suicidal ideation. Depression and fear spirals. 

 

When did you start to get these feelings? Are these feelings why you went on escitalopram and Klonopin in 2017?

 

Did they begin after you started NAD+ iv therapy? How do you feel before and after you get a NAD+ iv treatment?

[Tapering2023]

Alto I’m at a loss. I switched to this SMA weigher from a syringe. I tried the dosage that I thought was .55 and it showed as .672, so I have been taking that for 2 months. 
 

But I tried putting a .55 marker again in the syringe and it shows .74 instead of .672. 
 

then I tried .5 on the syringe and it came out to .728. 
 

I don’t know how to even get the accurate dose right now and that’s probably why I’m so ***** up. 
 

suicidal thoughts started 2 months ago when I started the .672 on the weighing scale. 
 

gemini-20 weighing scale. 

[Tapering2023]

Just did another syringe read at what’s supposed to be .5 and it came out to .724 on the scale.
 

this doesn’t make sense to me. 
 

is the scale accurate or is the syringe…

[Tapering2023]

Alto, the safest way is to go from .672 to .683 and hold for 1-2 weeks? 
 

because honestly after this syringe thing I went down way more than expected. 
 

I need to ideally be at .724 according to the weighing scale….

[Tapering2023]

Actually .55 is what I was usually taking from the syringe and that just came out to .767 on the scale… what in the world! 

[Tapering2023]

Alto, sorry. 
 

I stopped the NAD+. The panic could be from there I don’t know honestly. 
 

panic didn’t start until a few days ago. 
 

it’s honestly the lack of knowing what’s causing what and what to do to solve it. 
 

Saffron? Probiotics? Probably not because of more destabilization. 
 

Nad+? No. 
 

updosing relying on the scale? Not even having faith in its accuracy now. 

I’ve never had the suicidal thoughts before until I started using the scale for a .672 dosage. 

 

im at a loss alto. What should I do? Just still use the scale and take .683 for 1-2 weeks then do another updose? 

 

I honestly thought .672 is what I was taking but it was actually between .74 and .77 from the syringe. 

[Tapering2023]

I was able to sleep 8 hours last night. Felt comfort in the 4th day of the updose. Having faith that going up will help. I believe all of this is from going down too quickly. 
 

also I’ve had a lot of doctor appointments, blood work, and Iv therapies that would be stressful to anyone especially someone in withdrawal. 
 

im finally done with those. 
 

Panic has not been as bad this morning, but weighing the syringe dosages and seeing how different they were on the Gemini-20 was confusing and made me cry in fear and helplessness. 
 

reading the reinstatement forum doesn’t bring me much peace either. It scares me more because there is so much uncertainty with my situation. 
 

It looks like I’ve been taking fluctuating dosages using the syringe for 6 years of tapering. 
 

What I’m going to do now is hold at .682 until 10 days. (Tonight will be day 5 of the updose)
 

then I’m going to increase it again to .7 for another 10 days if I don’t have a relief of symptoms. 
 

the only thing I know to do after that if I don’t get relief is go to .72, then .74 using the weighing scale over 20 days. 
 

.74 is around the dosage I thought I was actually on according to the .55 syringe weight. 
 

I may go up to .76 and then hold there for as long as it takes symptoms to subside. 
 

I know this is a pretty intense updose plan and it could be too quick, but I’m desperate for some hope and something to put my faith in right now.

 

the thoughts of harming myself constantly are the hardest thing to deal with. There is not anyway to stop them other than putting my hopes in these slight updoses. Taking another medication will only makes things worse, and saffron and probiotics can also make things worse I’ve read. 
 

if you are going to reply, please only reply with things that are hopeful. I need all the hope I can get alto. 

 

[Altostrata]

I don't understand what's going on with your syringe measurement. You might take it to your pharmacist to get clarification about your method.

 

Good to hear that your nervous system has settled somewhat.

[Tapering2023]

@Altostrata So here's something interesting... I just found out that I have pneumonia... do you recommend a specific probiotic while I take the antibiotic?

 

 

[Altostrata]

I am sorry, you will need to discuss this with an infectious disease specialist or pulmonologist or other MD.

[Tapering2023]

@Altostrata it’s okay. I’m taking an antibiotic and introducing a probiotic with it. I saw a thread you posted about digestive gold. However, this probiotic has ATP and Coq10. 
 

I shouldn’t take that in withdrawal from what I’ve been reading… any insights? 
 

Also, is it possible that the new panic symptoms are from the updose from .672 to .682? 
 

Seems unlikely to me but how would I know? Any articles on this? 

[Altostrata]

It's possible the antibiotic and whatever else you take for pneumonia will cause adverse effects. If I were you, I would not make any more psychiatric drug changes until after you've recovered from pneumonia.

 

8 hours ago, Tapering2023 said:

I’ve never had the suicidal thoughts before until I started using the scale for a .672 dosage. 

 

When was that? Did you start NAD+ therapy at the same time? Were you adding or stopping off any other drugs then? 

 

8 hours ago, Tapering2023 said:

I stopped the NAD+. The panic could be from there I don’t know honestly. 

 

Could be you upset your system with the NAD+ therapy.

 

1 hour ago, Tapering2023 said:

Also, is it possible that the new panic symptoms are from the updose from .672 to .682? 

 

 

I don't know. Could be you upset your system with the NAD+ therapy or it's a symptom from the pneumonia.

[Emonda]

14 hours ago, Tapering2023 said:

I was able to sleep 8 hours last night. Felt comfort in the 4th day of the updose. Having faith that going up will help.

 

That's good to hear and sounds very positive.

 

14 hours ago, Tapering2023 said:

but weighing the syringe dosages and seeing how different they were on the Gemini-20 was confusing and made me cry in fear and helplessness.

 

14 hours ago, Tapering2023 said:

It looks like I’ve been taking fluctuating dosages using the syringe for 6 years of tapering. 

 

As you know, consistency is important. I use a homemade liquid with a syringe. I don't weigh it as well, I just stick with the same brand and size of syringe consistently.

 

I purchased 100 x 0.5ml syringes, and that's all I use for my taper.

 

16 hours ago, Tapering2023 said:

suicidal thoughts started 2 months ago when I started the .672 on the weighing scale. 

 

Did you change the amount in the syringe as a result of what you were seeing on the scale? If so, that could explain the way you are feeling.

 

14 hours ago, Tapering2023 said:

I know this is a pretty intense updose plan and it could be too quick, but I’m desperate for some hope and something to put my faith in right now.

 

Maybe refer back to the first quote from you I posted above. It's been 4 days, you slept for 8 hours and you felt comfort in the updose. This sounds positive.

 

10 hours ago, Tapering2023 said:

I just found out that I have pneumonia

 

This is significant in my eyes. Whenever I have an illness, it makes the WD feel 100 times worse. It feels like the worst of WD symptoms. I remind myself when getting sick that I know I'll feel mentally fragile and that it will pass as I recover from the illness.

 

I'm with Alto; wait until you recover from pneumonia before making any changes.

 

Sending you warm wishes... 

 

 

[Tapering2023]

Thanks Emonda. Taking an antibiotic for pneumonia now. 
 

I started getting akathisia which I’ve never had. Didn’t sleep 1 minute last night. 
 

im considering going to an in patient care facility in Sedona and taking off work. 
 

I’m hanging on by a thread it feels like. They have all types of inpatient care there and actually know about the severity of PAWS. 
 

 

[Altostrata]

We only offer peer counseling here. We're not responsible for adverse effects you might get from antibiotics you're taking for pneumonia.

 

Good luck.