skyline069: Escitalopram/Lexapro - Could this still be prolonged withdrawal

[skyline069]

Dear Survivingantidepressants-community,

 

during my recent problems with psychiatric drug withdrawal I have become an attentive reader of your forum - always regretting that I didn't come across it - or the philosophy behind it - before my whole story with withdrawal started. Please don't disregard my question on the basis that I'm not yet in a position to taper since I have been polydruged in hospital during an acute crisis. The crisis is now under control so I'm now able to evaluate my situation with a clear mind.

 

To put it in very short terms: I have been on and of Escitalopram 5 mg for the entirety of my 20s and early 30s. It was prescribed for the usual mixture of panic/anxiety and depression. I never had a hard time with the drug and it always did what it was supposed to do so I remained in a state of total naiveté regarding the effects of abrupt discontinuation and reinstatement during the four or five times I tried to get rid of the drug. 

My luck turned in late 2023 when I went without the drug for 6 months (cold turkey) only to realize that I have developed a mild form of PSSD in the process of discontinuation. I tried reinstating the drug almost immediately at 2,5 mg (stupid, I know) which gave me serotonin syndrome, agitation and got me hospitalized.

In hospital they put me on Lorazepam 4x a day 0.5 mg. First I refused to take any further antidepressants, but my depressive symptoms got out of hand quickly and I developed an episode of depressive psychosis which resulted in a drug cocktail including Risperidon, Quetiapine and Wellburtin.

 

Leaving the basic facts behind I now want to describe the situation that puzzles me so much at the moment: My depressive symptoms are unlike any depression I have experienced so far. Wellburtin and Lorazepam have mellowed it but I still feel it underlying my current state. Far more than a reactive depression it feels like a neuro-depression, meaning that it is oddly detached from reality and seems to be a painful buzzing in my brain and chest. Now being polydruged I still feel the underlying agitation, non stop raised heart rate and pounding and I'm mostly only able to fall asleep with the help of said drugs. My question is the following one: Do you think that SSRI-Prolonged withdrawal syndrome could still play a role here? During the 6 months I went without the drug I didn't notice severe symptoms apart from the subtle ones of PSSD which took me months to even notice. Otherwise I'm at loss at explaining the weirdness and severity of my symptoms which persist even though I'm treated with anti-psychotics and benzos.

 

Any help or suggestion is gratefully welcomed.

 

[Onmyway]

Hi @skyline069

welcome to SA. Thank you for completing your signature. Sorry you have had such a difficult time that required hospitalization. I can't imagine how scary it must be to have psychotic depression. 

 

Do these symptoms seem to you as side effects more than withdrawal? Side effects would ramp up after you take up your medicines - within a couple of hours.  I am assuming that wellbutrin would cause some agitation while the lorazepam and quetiapine may tone things down. How do you react to wellbutrine and risperidone within a few hours? When do you take your medicines? Is there a pattern to your symptoms during the day? 

 

I will be back when you answer these questions. 
OMW

 

[skyline069]

Hi Onmyway,

 

thank you for your quick and kind answer. I take Wellburtin in the morning, Risperidone at noon and Quetiapine in the evening. Since I took one pill of 5 mg Escitalopram four weeks ago I feel as if the underlying agitation hasn't gone away and is just masked by the other Meds. Wellburtin has taken away the edge of acute depression and Quentiapine allows me to sleep, Lorazepam probably keeps things at bay as well, but there is this ongoing agitation in the background that swells up and down mostly without a clear pattern but peaks in the morning. I suspect that maybe my brain is still adapting to the lack of Escitalopram (I also have symptoms of PSSD which seems to be in favour of this theory). If this would be the case and I'm still in some kind of withdrawal situation I could at least be hopeful that I come out of this state sooner or later.

[skyline069]

I realized that I didn't clearly answer the question: No I don't think these are side effects since I don't experience peaks after taking them. The meds rather hold at bay a state that started with my adverse reaction to 5 mg escitalopram four weeks ago. The doctors want me to taper Lorazepam soon which makes me afraid that the underlying agitation will become hard to manage again. If I knew that this was some kind of withdrawal symptom I could at least see the light at the end of the tunnel.

 

 

 

 

[Onmyway]

Hi @skyline069

it sounds to me like an unsettling of the nervous system (which is what withdrawal is ultimately) which does go away slowly with stability. Once you are in withdrawal, introduction of a new or sometimes the same old medicine can cause an adverse reaction (in your case escitalopram). It doesn't seem that you have an adverse reaction to your current medicines.

 

Doctors are worried about addiction from benzos (lorazepam) and may force you to come off of it soon. That may destabilize things further. If you can ask them to follow the SA protocol for coming off of lorazepam rather than a faster one, it may not destabilize things too much. We usually recommend cutting no more than 10% of previous dose every 4 weeks. If you are not forced to taper off now, we'd recommend not changing anything for a few months. 

 

Have a look at the Symptoms and Self Care forum to see if others have your symptoms and what may have worked for them. 

Hope things get better soon. 

OMW

Edited January 4 by Onmyway

[skyline069]

How can I stabilize myself further in this situation? Right now the electric buzz of withdrawal seems unbearable. I think Wellburtin lost its efficacy. Should I go up in dosage or increace the Lorazepam dose for now? Or just try to wait it out? 

[Ck1111]

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[skyline069]

Hi SA-Community,

 

I have an update to make and hope that someone can help me identify my symptoms. 

I recently missed two doses of risperidone and the weirdest Things started happening. Over the course of the following days my head felt like it was about to explode, I head a weird tingling sensation in head and neck and bouts of worsening anxiety DP/DR feeling as if my body was weightless and so on. All of this culminated in a series of seizures that lasted for hours at a time and left me thinking I was about to die. After each seizure I had the impression that I have been more removed from life and my surroundings and more anhedonic. Now my whole body aches 24/7 like the capacity to feel comfort and pleasure through my body has been removed my body and mind is a continuum of nerve pain, depression and anxiety as if my dopaminergic system throughout my body just died. Can anyone help me to find out what could have happened.