Problems after Lexapro reinstatement following med-free decade

[snappcrack]

Hello everyone,

 

I was on and off different medications, including multiple SSRIs, from adolesence into my late 20s, which ended with a very bad clonazepam withdrawal. The following decade had its challenges of different PAWS symptoms, including some bad waves, but for the most part, I lived a fairly rich and functional life. My withdrawal from Lexapro in 2007 was also extremely quick and took many years of tinkering with supplements, exercise, and other methods to deal with, but over time it was fairly manageable.

 

Over the past year, as personal issues mounted one after the other, I found myself in a state of genuine psychiatric crisis. The benzo PAWS precipitated a two week period of extreme dysautonomia and insomnia which was helped with Trazodone, and I was back to being chemically stable for the next month or so. However, the psychological issues that existed independently of any of these chemical questions were not adequately addressed, and after a period of extreme spiraling, I attempted to reinstate Lexapro at 5mg, which I took for one day.

 

Within a few hours, I found that pretty much all my lingering SSRI PAWS symptoms were gone, I was thinking extra clearly, and was feeling quite optimistic. The next day, however, I found myself experiencing intense anhedonia, brain fog, and anxiety, along with other symptoms that I attempted to ameliorate with some supplements that had previosly helped but ended up just inflaming everything. Over the next couple days I experienced unprecedented DP/DR, inability to feel emotions, and a bizarre difficulty crying. At the end of the week, I took a dose of about .1mg which that night again ameliorated most of the symptoms, only to have them return over the next day or two. 

 

In the past few weeks, I've instituted a true microdose of around 0.01-0.02mg, which has seemed to attenuate some of the DP/DR, but the the emotionlessness has remained. I also implemented low dose lamictal, and I can't tell if it's helping or revving up my system even more in the long run. I've found, oddly, that when I don't take the Lexapro microdose for a day, the dyspnea/emotional blunting actually goes away, so I don't know what is caused by the SSRI, what's caued by withdrawal, or what is psychological. Even after bringing the microdose back after one day off, within seven hours after taking it, I actually feel my mood lift, followed by all the other symptoms mentioned. Right now, I'm having immense trouble thinking clearly, much more brain fog, headache, emotional flatness, and more tingling in my feet along with dysautonomia than usual.

 

I don't know if I should attempt to switch to Prozac or sertraline, increase the Lexapro, dose it multiple times a day, get off entirely, add more lamictal, remove the lamictal, or what. Like many others on this forum, every option feels like a bad one with hidden risks, and I have to remind myself to not feel personal guilt over this situation.

 

Thanks very much for any help.

[Emonda]

Welcome @snappcrack

 

On 3/30/2024 at 10:16 AM, snappcrack said:

I don't know if I should attempt to switch to Prozac or sertraline, increase the Lexapro, dose it multiple times a day, get off entirely, add more lamictal, remove the lamictal, or what.

 

This site exists to help people slowly taper off ADs. We are unable to assist with swapping from one AD to another.

 

Have you tried counselling for the personal issues you refer to? Are you avoiding alcohol and recreational drugs?

 

Emonda

[snappcrack]

My point was that I have no idea what the next move is. Why was my entire post reduced to one clause of one sentence? I don't see anyone else on this forum getting treatment this dismissive.

[Emonda]

From personal experience, I know how hard it is to get off these things.

 

It takes ~4 weeks to develop a dependence on these meds, so I'd avoid them if I were in that window.

 

If I understand your post correctly, you are two weeks in.

 

3 hours ago, snappcrack said:

My point was that I have no idea what the next move is.

 

This would be my next move:

 

3 hours ago, Emonda said:

Have you tried counselling for the personal issues you refer to?

 

And if you are drinking alcohol or taking recreational drugs, I'd avoid those.

3 hours ago, Emonda said:

Are you avoiding alcohol and recreational drugs?

 

Regards, Emonda

 

[snappcrack]

I'm not on any alcohol or recreational drugs and have not been for the past ten years.

 

I stopped my microdose about a week ago now. The issue that is most concerning to me which has showed almost no sign of abating is this horrific anhedonia/numbing and I am wondering how long this has taken for most people to resolve. My concern is that since this came after a reinstatement rather than a withdrawal/taper that there is no hope of it recovering.