StDymphna: Sudden adverse reaction to Lexapro 20mg after 3 years.

[StDymphna]

Hi all. I have been on 20mg of Lexapro since 2021 for extreme physical anxiety symptoms. I could not sleep. The Lexapro helped me significantly and I experienced no effects except when upping my dose.

 

However, everything changed March 2024. I have been suffering stomach bloating and other related issues since the falls, so I decided to try a probiotic. After a few days, the probiotic seemed to be helping, but then I suddenly had an adverse reaction to Lexapro and am unsure if it is related or not. Because of this I got worried and only began taking 15mg for the next two weeks but experienced the same symptoms: increased heart rate, headache, nausea, muscle spasms, leg twitching, emotional bluntness, inability to be sexually aroused, chills, etc.

 

My doctor wanted me to cross-taper to Zoloft, starting at 25mg while dropping down to 10mg on the Lexapro. I took them together for two nights in a row and had horrible symptoms, like those listed above but my hands and legs were shaking badly and my teeth were chattering. This obviously concerned me so I stopped taking the Zoloft completely and was only on 10mg of Lexapro for a few days until one day I felt horribly numb, like I got crippling depression overnight. I felt so unhappy and suicidal, I decided to try the Zoloft again to stabilize me. So, for three days I took 25mg of Zoloft in the morning and 10mg of Lexapro at night. My symptoms were not as bad as they were when I took them together, but I still suffered reactions to both of them.

 

Last night, I took 25mg of hydroxyzine which I have been taking for the last week to help me sleep due to insomnia and anxiety surrounding my symptoms. I had the same reaction as I usually do when I take Zoloft or Lexapro, and I read that hydroxyzine can influence serotonin, so this concerned me. Because I had a reaction from the hydroxyzine, I wanted to be cautious and skip my dose of Lexapro for risk of further toxicity.

 

Today, I feel horrible. I am super nauseous, have had some chills, and have a very intense headache like pressure in my face.

 

I am lost.. Should I reinstate the Lexapro at the lowest tolerable dose for me and try to stabilize from there? I don't know what to do anymore, if I am suffering from adverse reactions plus withdrawal. I am so scared of beginning this journey because it seems like it will be a long road of unknowns and suffering.

[Erimus]

Hello, and welcome to Surviving Antidepressants. We are a peer support forum to assist in tapering off psychiatric drugs safely, or recovering from psychiatric drug withdrawal.

 

This topic is for anything relating to you, and any questions you have. Please do not start another topic.

 

We recommend tapering by no more than 10% of your CURRENT dose each month, to limit withdrawal symptoms. E.g. 10mg --> 9mg --> 8.1mg --> 7.29mg

 

All the answers you are looking for regarding tapering and antidepressant withdrawal are on this site. Please search around and continue to read as much as you can manage. Use the site search function to search for specific words or phrases, such as drugs or symptoms.

 

Here are a few of the most useful links:

 

Important topics in the Tapering forum and FAQ

 

Micro tapering

 

Why taper by 10% of my dosage?

 

Taking multiple psych drugs? Which drug to taper first?

 

How to make a liquid from tablets or capsules

 

Using a scale to weigh and measure doses

 

We only recommend two supplements. Omega 3 Fish Oil and Magnesium. Both should be introduced separately and increased slowly.

 

Regards

Erimus

[Erimus]

22 hours ago, StDymphna said:

Hi all. I have been on 20mg of Lexapro since 2021 for extreme physical anxiety symptoms. I could not sleep. The Lexapro helped me significantly and I experienced no effects except when upping my dose.

 

However, everything changed March 2024. I have been suffering stomach bloating and other related issues since the falls, so I decided to try a probiotic. After a few days, the probiotic seemed to be helping, but then I suddenly had an adverse reaction to Lexapro and am unsure if it is related or not. Because of this I got worried and only began taking 15mg for the next two weeks but experienced the same symptoms: increased heart rate, headache, nausea, muscle spasms, leg twitching, emotional bluntness, inability to be sexually aroused, chills, etc.

 

My doctor wanted me to cross-taper to Zoloft, starting at 25mg while dropping down to 10mg on the Lexapro. I took them together for two nights in a row and had horrible symptoms, like those listed above but my hands and legs were shaking badly and my teeth were chattering. This obviously concerned me so I stopped taking the Zoloft completely and was only on 10mg of Lexapro for a few days until one day I felt horribly numb, like I got crippling depression overnight. I felt so unhappy and suicidal, I decided to try the Zoloft again to stabilize me. So, for three days I took 25mg of Zoloft in the morning and 10mg of Lexapro at night. My symptoms were not as bad as they were when I took them together, but I still suffered reactions to both of them.

 

Last night, I took 25mg of hydroxyzine which I have been taking for the last week to help me sleep due to insomnia and anxiety surrounding my symptoms. I had the same reaction as I usually do when I take Zoloft or Lexapro, and I read that hydroxyzine can influence serotonin, so this concerned me. Because I had a reaction from the hydroxyzine, I wanted to be cautious and skip my dose of Lexapro for risk of further toxicity.

 

Today, I feel horrible. I am super nauseous, have had some chills, and have a very intense headache like pressure in my face.

 

I am lost.. Should I reinstate the Lexapro at the lowest tolerable dose for me and try to stabilize from there? I don't know what to do anymore, if I am suffering from adverse reactions plus withdrawal. I am so scared of beginning this journey because it seems like it will be a long road of unknowns and suffering.

I would reinstate a small amount of Lexapro and see how you tolerate it. Start off with 0.5 or 1mg and take it the same time you usually do. Don't take any more zoloft or hydroxyzine. I'm assuming you've stopped the probiotic, have you?

 

Regardless of what else is happening your brain and nervous system are in withdrawal from Lexapro, considering you took it for 3 years.

[StDymphna]

Thank you for your reply.  I am not sure if I am able to get so small a measurement with the resources I have...I only have 10mg of Lexapro and I was thinking of splitting that in half, and then splitting the 5mg in half, but maybe that is too much? 

 

I did stop the probiotic a couple days after all this happened.

 

I am concerned about serotonin toxicity so that is why I have not reinstated yet. I have been off Lexapro for two days, and I am seeing a psychiatrist tomorrow and hopefully she will be open-minded. I feel like I did experience serotonin toxicity with the Lexapro and the Zoloft and that is why I am worried about reinstating because I do not know the exact amount I can tolerate or will be putting my my system if I attempt to cut 5mg in half.

[Erimus]

37 minutes ago, StDymphna said:

Thank you for your reply.  I am not sure if I am able to get so small a measurement with the resources I have...I only have 10mg of Lexapro and I was thinking of splitting that in half, and then splitting the 5mg in half, but maybe that is too much? 

 

I did stop the probiotic a couple days after all this happened.

 

I am concerned about serotonin toxicity so that is why I have not reinstated yet. I have been off Lexapro for two days, and I am seeing a psychiatrist tomorrow and hopefully she will be open-minded. I feel like I did experience serotonin toxicity with the Lexapro and the Zoloft and that is why I am worried about reinstating because I do not know the exact amount I can tolerate or will be putting my my system if I attempt to cut 5mg in half.

You need to make a liquid suspension using the solid tablets you have. Please read: How to make a liquid from tablets or capsules

 

This can be as simple as dissolving your 10mg tablet in 20ml of water, and using a syringe to measure up 1ml. This would equate to 0.5mg.

[StDymphna]

Is it possible I could have a bad reaction to even 0.5?

[Erimus]

1 hour ago, StDymphna said:

Is it possible I could have a bad reaction to even 0.5?

Only one way to find out. We don't know if you're having an adverse reaction or if you're experiencing withdrawal from Lexapro.

 

If you speak with a psychiatrist they will diagnose you and prescribe medication, they aren't there to holistically heal you.

Edited April 8 by Erimus

[UnderstandingtheBrain]

@StDymphna How did your appointment go? I'm in a similar situation

[StDymphna]

So, the psychiatrist I am seeing seemed sympathetic to the SS idea, and believed I was definitely having reaction, but she wasn't super concerned about withdrawal...A few days ago I told her about my symptoms, but she still thought they sounded like "anxiety and depression" and SS (dry mouth, flush face, headache, muscle twitching) more than withdrawal, even though I know that some of these symptoms can be similar. She is concerned with reintroducing an SSRI right now and wants to wait until my "SS" symptoms have subsided and then wait 7 days after that.

 

The problem is I don't know how long it will be until she finally realizes that yeah, I am experiencing withdrawal. It has been a week since I went from 10mg to 0 and the past few days my withdrawal symptoms have been getting worse. It's been really hard on me trying to push through the last of this semester of college.. I really want to tell her about how sick I have felt today, but I am worried she is going to chalk it up to anxiety or tell me it is SS again and then I will have to wait even longer.. I don't know how I should tell her. Perhaps I should emphasize my nausea and headaches more and leave out stuff like crying spells or muscle shivering, I am not sure..

 

I really want to try and stabilize on a very low dose of lexapro, and she did seem open to letting me go this route with liquid lexapro, but she hasn't approved it yet since she's still worried about SS..

 

I just hope it is possible for me to restabilize on a low dose like .5-1mg and that it doesn't make things worse...

[StDymphna]

Update: I feel so pissed off.

I told my psychiatrist about my symptoms: mentioned pressure headaches, nausea, and dizziness. She it is possible it could be withdrawal but that this would be "atypical" she said that if I am comfortable she will send me the 1mg of lexapro, but I don't know how set she is on that because she told me to go to urgent care to rule out other issues. She says that pressure headaches can be from other things. She says if I don't clear up what I have now then "we lose time to get you help"

 

I don't know what to do to get her to give me the Lexapro! I am worried at urgent care they are going to say I have something else I don't know what to do I am so stressed about all of this.

[StDymphna]

Update again: she did end up prescribing me the liquid lexapro, told me to take 1mg, I am hesitant and will probably take .5mg. My doctor is still concerned about SS and I don't know if I should be too based on some symptoms I get at night:

 

I also have a question about my symptoms and why some kinds are like clockwork and... The symptoms I experience only in the evening, usually after the sun goes down is why my doctor is still concerned about SS. I become very anxious/agitated, I get another headache, my face flushes/has a hot feeling (no actual temperature though), and I have muscle twitches and shaking. This has happened pretty consistently since I have been off of my Lexapro. Is it possible I am still experiencing SS symptoms? If serotonin production increases at night and my body is so messed up already, is it possible I am hypersensitive to serotonin that even my body is producing and even if I have been off any SSRIs for a whole week? This is probably my OCD talking but I am not sure because it is so bizarre to me how consistent this set of symptoms is, alongside the fact that they feel very similar to what I have felt when I was having my adverse reactions...

 

My symptoms during the day can be crying spells, mood changes, derealization, but always include nausea, dizziness, brain zaps, and intense pressure headaches.

I also experience the morning anxiety spike right after I wake up, but sometimes it takes a few hours of being awake for my nausea and headache to hit me hardest.

[UnderstandingtheBrain]

3 hours ago, StDymphna said:

So, the psychiatrist I am seeing seemed sympathetic to the SS idea, and believed I was definitely having reaction, but she wasn't super concerned about withdrawal...A few days ago I told her about my symptoms, but she still thought they sounded like "anxiety and depression" and SS (dry mouth, flush face, headache, muscle twitching) more than withdrawal, even though I know that some of these symptoms can be similar. She is concerned with reintroducing an SSRI right now and wants to wait until my "SS" symptoms have subsided and then wait 7 days after that.

 

The problem is I don't know how long it will be until she finally realizes that yeah, I am experiencing withdrawal. It has been a week since I went from 10mg to 0 and the past few days my withdrawal symptoms have been getting worse. It's been really hard on me trying to push through the last of this semester of college.. I really want to tell her about how sick I have felt today, but I am worried she is going to chalk it up to anxiety or tell me it is SS again and then I will have to wait even longer.. I don't know how I should tell her. Perhaps I should emphasize my nausea and headaches more and leave out stuff like crying spells or muscle shivering, I am not sure..

 

I really want to try and stabilize on a very low dose of lexapro, and she did seem open to letting me go this route with liquid lexapro, but she hasn't approved it yet since she's still worried about SS..

 

I just hope it is possible for me to restabilize on a low dose like .5-1mg and that it doesn't make things worse...

Its hard to know if it was serotonin syndrome, drug interaction, an adverse effect, or withdrawal effect. Maybe you had all 4 this past month. I don't know much about the topic, but I assume that if the med is out of your body, then SS symptoms should improve? Escitalopram has a half life of about 30 hours, so I think it is already out of your system.

 

You say your symptoms are getting worse, so It makes sense it might be withdrawal now. Also it makes sense to try a low dose to see if symptoms improve. However, maybe she knows other reasons for not to. Also some doctors are not aware of the withdrawal effects this meds can cause. I would try to get an opinion from another psychiatrist.

 

Whatever you do, be very careful when changing the drug levels in your body. It seems that many of the negative effects and damage people get is because of a rapid change in dose. The key is doing everything gradual. I, myself, got into a nightmare for experimenting with 0.5-0.25mg for 4 days. 1 mg is not insignificant.

 

1 hour ago, StDymphna said:

I also have a question about my symptoms and why some kinds are like clockwork... The symptoms I experience only in the evening, usually after the sun goes down is why my doctor is still concerned about SS. I become very anxious/agitated, I get another headache, my face flushes/has a hot feeling (no actual temperature though), and I have muscle twitches and shaking. This has happened pretty consistently since I have been off of my Lexapro. Is it possible I am still experiencing SS symptoms? If serotonin production increases at night and my body is so messed up already, is it possible I am hypersensitive to serotonin that even my body is producing and even if I have been off any SSRIs for a whole week? This is probably my OCD talking but I am not sure because it is so bizarre to me how consistent this set of symptoms is, alongside the fact that they feel very similar to what I have felt when I was having my adverse reactions...

 

My symptoms during the day can be crying spells, mood changes, derealization, but always include nausea, dizziness, brain zaps, and intense pressure headaches.

I also experience the morning anxiety spike right after I wake up, but sometimes it takes a few hours of being awake for my nausea and headache to hit me hardest.

I don't know if its possible that your brain got sensitive to serotonin. It might be anxiety, but I don't know. I knew someone that used to get depressed usually at night.

[StDymphna]

4 minutes ago, UnderstandingtheBrain said:

 

Its hard to know if it was serotonin syndrome, drug interaction, an adverse effect, or withdrawal effect. Maybe you had all 4 this past month. I don't know much about the topic, but I assume that if the med is out of your body, then SS symptoms should improve? Escitalopram has a half life of about 30 hours, so I think it is already out of your system.

 

You say your symptoms are getting worse, so It makes sense it might be withdrawal now. Also it makes sense to try a low dose to see if symptoms improve. However, maybe she knows other reasons for not to. Also some doctors are not aware of the withdrawal effects this meds can cause. I would try to get an opinion from another psychiatrist.

 

Whatever you do, be very careful when changing the drug levels in your body. It seems that many of the negative effects and damage people get is because of a rapid change in dose. The key is doing everything gradual. I, myself, got into a nightmare for experimenting with 0.5-0.25mg for 4 days. 1 mg is not insignificant.

 

 

 

I don't know if its possible that your brain got sensitive to serotonin. It might be anxiety, but I don't know. I knew someone that used to get depressed usually at night.

I thought adverse effect could be the same thing as serotonin toxicity? It is hard to know, but the only thing I know for sure is that this kind of came out of the blue one day on my normal dose of lexapro, which is why I think it was initially SS/adverse reaction.

 

Oh wow, good to know. I have been off Lexapro 10mg cold turkey for a week, which is why I want to see if I can stabilize. I really hope a low dose will help me and not hurt me..if I do get an adverse reaction, does that mean I have to wait months and try to reinstate later? Even if I try a dose as small as 0.5mg?

[StDymphna]

"Do not expect immediate elimination of withdrawal symptoms. Though this sometimes does happen, often people feel a little better after reinstatement and then continue to gradually improve over weeks and months after that. Your nervous system has been through a lot and needs to settle down."

 

How do I know if upon reinstating it is taking a long time to stabilize, or that I simply reinstated at too low of a dose to help me? How long would one wait for improvement before deciding they need a higher dose?

 

I want to reinstate Lexapro after a too fast taper and cold turkey, both done out of fear of my adverse effects, which my psychiatrist believed were SS... 

15mg two weeks

10mg one week

cold turkey (due to a reaction to hydroxyzine on the third day in a row I was trying 25mg of Zoloft and 10mg of Lexapro. Because of the hydroxyzine reaction, I skipped my Lexapro dose for fear of a stronger reaction, hoping to get some answers when would be to meet with a new psychiatrist 4 fays later.) Also skipped out on the Zoloft I had only been taking it for a few days on and off. My doctor wanted to me to cross-taper to zoloft after hearing about my lexapro side effects 

 

So basically, too-fast taper due to a random adverse effect out of the blue.. and then cold turkey.

Is there hope for me to try and reinstate at a low dose? like probably less than 1mg. Should I be concerned about kindling? I am so anxious with all these unknowns...

[UnderstandingtheBrain]

9 minutes ago, StDymphna said:

I thought adverse effect could be the same thing as serotonin toxicity? It is hard to know, but the only thing I know for sure is that this kind of came out of the blue one day on my normal dose of lexapro, which is why I think it was initially SS/adverse reaction.

I would say SS is a type of adverse effect. And I think maybe the probiotics where not the initial cause, maybe it was something else, but who knows. When I used to take 10mg daily, I had periods of taking probiotics, and did not see any negative effect.

 

10 minutes ago, StDymphna said:

Oh wow, good to know. I have been off Lexapro 10mg cold turkey for a week, which is why I want to see if I can stabilize. I really hope a low dose will help me and not hurt me..if I do get an adverse reaction, does that mean I have to wait months and try to reinstate later? Even if I try a dose as small as 0.5mg?

I don't know much about the topic. I'm also in the process of deciding whether to reinstate or not. Last dose I took (aprox 1mg) gave me an adverse reaction, and I haven't recovered. But in my case, I took varying doses the days before, so maybe that's why I got that reaction. I'm currently trying to give it time, and to try different things, because I'm afraid of getting worse if I take it again. Also I need to get the liquid which is not available in my country.

 

10 minutes ago, StDymphna said:

Is there hope for me to try and reinstate at a low dose? like probably less than 1mg. Should I be concerned about kindling? I am so anxious with all these unknowns...

There is hope, and that is what makes more sense, honestly.

[SpeedDefrost]

4 hours ago, UnderstandingtheBrain said:

I don't know much about the topic. I'm also in the process of deciding whether to reinstate or not. Last dose I took (aprox 1mg) gave me an adverse reaction, and I haven't recovered. But in my case, I took varying doses the days before, so maybe that's why I got that reaction. I'm currently trying to give it time, and to try different things, because I'm afraid of getting worse if I take it again. Also I need to get the liquid which is not available in my country.

I've also thought about reinstating but I probably shouldn't bother because it was only a single dose I took (I was perfectly drug-free before this hell) and it has already been 7 weeks. But the more research I do on the mushroom supplements I took (Lion's mane, and a mix of extracts of various others) alongside the escitalopram the more I'm convinced that my "adverse" reaction was a bad interaction, and I essentially cold-turkeyed the equivalent of 10mg+, not just 5mg. It would explain why my nervous system is so upset right now.

Considering everything I've read on SA so far, If I were taking it for any longer and knew what I know now, I'd taper down just to be careful.

[StDymphna]

Tried melatonin for the first time during my withdrawal, as my insomnia has worsened. It isn't as bad as some people on this site, but I am afraid it will get worse. I have been getting 5-6 hours a sleep a night and I am used to close to 8 hours.. I am also a college student so not being able to fall asleep at night has been really stressful. 

 

I bought 1mg capsules and split it, I don't know how much I took because the powder kind of went everywhere, but maybe around 1/4 of the dose.

 

After I started feeling like I was experiencing an adverse reaction: headache, nausea, fast heart bear, loud stomach sounds/stomach discomfort, increased anxiety and agitation. Almost just like the serotonergic reactions I have gotten from my SSRIs. Although it is hard to tell because some of these symptoms are similar to my withdrawal symptoms, but I feel like I have experienced this particular set of symptoms enough to recognize it...

 

Could i be having an adverse reaction or a serotonergic reaction from just a tiny dose of melatonin? I just picked up liquid Lexapro I was supposed to try and reinstate tomorrow but now I am afraid of getting serotonin syndrome from .5mg...

[Erimus]

6 hours ago, StDymphna said:

Tried melatonin for the first time during my withdrawal, as my insomnia has worsened. It isn't as bad as some people on this site, but I am afraid it will get worse. I have been getting 5-6 hours a sleep a night and I am used to close to 8 hours.. I am also a college student so not being able to fall asleep at night has been really stressful. 

Have you read the information on the site regarding introducing melatonin?

 

Please read: Melatonin for sleep

 

6 hours ago, StDymphna said:

Could i be having an adverse reaction or a serotonergic reaction from just a tiny dose of melatonin? I just picked up liquid Lexapro I was supposed to try and reinstate tomorrow but now I am afraid of getting serotonin syndrome from .5mg...

Do not attempt to reinstate Lexapro at the same time you introduce melatonin. You need to try one at a time.

[StDymphna]

Yes I have read that. This morning I feel depressed, hopeless, and that I will have crying spells all day, haven't felt like this in a week because some of withdrawal symptoms were starting to improve since then including this. The melatonin made me wired like when I take an SSRI. I am going to wait a few days to try the Lexapro since I had this reaction...

[Erimus]

4 minutes ago, StDymphna said:

Yes I have read that. This morning I feel depressed, hopeless, and that I will have crying spells all day, haven't felt like this in a week because some of withdrawal symptoms were starting to improve since then including this. The melatonin made me wired like when I take an SSRI. I am going to wait a few days to try the Lexapro since I had this reaction...

I'd give it a week at minimum.

[StDymphna]

If this is what a tiny dose of melatonin does to me I am not confident that 0.5mg of Lexapro will give me a different result unless it is a worse one

[Tweed9674]

Looks like you are experiencing hypersensitivity to melatonin (and likely other drugs / supplements) because of withdrawal or SS. Many of us do.

We can't really assume that you won't tolerate 0.5mg of Lexapro. You'll have to try it. But as you said, waiting a bit is a good idea.

 

My own experience: There are a lot of things my body can't tolerate right now, but I was still able to reinstate Lexapro.

 

It's a bumpy road for sure. Stay strong!

[StDymphna]

2 hours ago, Tweed9674 said:

Looks like you are experiencing hypersensitivity to melatonin (and likely other drugs / supplements) because of withdrawal or SS. Many of us do.

We can't really assume that you won't tolerate 0.5mg of Lexapro. You'll have to try it. But as you said, waiting a bit is a good idea.

 

My own experience: There are a lot of things my body can't tolerate right now, but I was still able to reinstate Lexapro.

 

It's a bumpy road for sure. Stay strong!

I guess that's good to keep in mind...I guess I am worried for me because I have already been having adverse reactions to the Lexapro before I did 10mg cold turkey like you did.

[UnderstandingtheBrain]

Be very careful when reinstating. Do it with the support of a psychiatrist that knows about withdrawal. I now have PSSD, after trying very small doses (I did it in an incorrect way).

 

Reinstating and changing doses may increase your risk of PSSD. And believe me strong PSSD is probably one of the worst diseases someone can get.

[StDymphna]

Still holding on the Lexapro. I just don't know what the best thing is to do is, when to reinstate it, how much, etc. I am worried reinstating it will make things worse, but even if I should I don't know the best time to reinstate it.. I have been off 10mg of Lexapro cold turkey (plus too fast taper due to adverse reactions) since April 5th of this year, and recently had a setback- adverse reaction to less than 1mg of melatonin... I don't know what to do!

[Tweed9674]

 It's a very though call to make. I understand your fear of a bad reaction, I experienced it too.

 

Are the symptoms you had from the melatonin mostly settled?

How are your withdrawal symptoms right now?

 

I think that a reinstatment at 0.5mg would be the safest bet to test the waters. If you have an adverse reaction, the dose is small enough to not cause unbearable symptoms.

If you tolerate it, you can then go slowly and asses what dose work best for you.

[StDymphna]

I think they have.

 

Right now I experience nausea (not as much as the first week being off though), bad pressure headaches, bouts of akathisia where I can't concentrate or focus, bouts of tachycardia and palpitations, insomnia, mood swings, spontaneous crying, tiny pupils due to lessened ability to adjust from darkness to light, PSSD, chills when it's even a little cold outside, brain fog and concentration issues

[StDymphna]

Anyone else experience this?

Along with horrible insomnia, sometimes when I am about to drift off to sleep I get a half-awake nightmare. I feel the most intense panic I have ever felt, other bizarre sensations, and a bad headache. In this state I truly believe I am awake, and often dream of screaming, moving away from, or falling from my bed, and then I jerk awake. It feels so real.

 

Also, I am scared to reinstate a small dose of Lexapro, I have been off 10mg cold turkey since April 5th and I am very scared of serotonin syndrome again and my symptoms .

[Dahlia50]

 @StDymphna Hi, I know how hard it is. And to think about whether to reinstate or not.

 

I also have bad pressure headaches, akathisia, insomnia, mood swings, spontaneous crying, tiny pupils, PSSD, chills, brain fog and concentration issues. 

 

🙏

[Tweed9674]

On 4/24/2024 at 1:12 PM, StDymphna said:

Anyone else experience this?

Along with horrible insomnia, sometimes when I am about to drift off to sleep I get a half-awake nightmare. I feel the most intense panic I have ever felt, other bizarre sensations, and a bad headache. In this state I truly believe I am awake, and often dream of screaming, moving away from, or falling from my bed, and then I jerk awake. It feels so real.

 

Also, I am scared to reinstate a small dose of Lexapro, I have been off 10mg cold turkey since April 5th and I am very scared of serotonin syndrome again and my symptoms .

I've had these (without the headaches) when I first started taking Effexor over a decade ago. While harmless, it's terrifying and it doesn't help with sleep anxiety.

 

About the reinstatment, I'd try 0.5mg. If you have a bad / intolerable reaction, you stop right there. If things are tolerable, you hold for at least a week and reasses.

Keeping a journal of your symptoms might help with all this. Our memory can be quite unreliable in moments like these.

[StDymphna]

Context: CT'ed 10mg of Lexapro following a too fast taper, hoping to reinstate at a low dose after my semester of college is over (early may)

 

Update:

 

My withdrawal symptoms are still present, but, have never been as bad as they were the first week and a half after stopping. About the second week out, I had horrible insomnia for a week, where I was going to sleep at 2am, sometimes 5am. Now, my insomnia is still present but I no longer lay away for hours anymore. 

 

The symptoms I still experience are:

*= worst to deal with

-*pressure headaches (sometimes eyes hurt too) and *nausea (more windows than at the beginning though, and not as intense. still experience both of them daily

-scalp goosebump sensations

-morning anxiety (not every day)

-tiny pupils (not all the time though) and photosensitivity- though the photosensitivity has let up a bit this past week

-insomnia, accompanied often by tachycardia

-bouts of tachycardia, especially if i am moving fast which makes it worse

-*bouts of agitation and anxiety 

-chills

-tingling sensations and body aches, I notice these more when I am trying to fall asleep

-brain zaps, though they have GREATLY improved

-*PSSD

-*days where I feel really depressed, days where I have spontaneous crying, days where I feel very irritable and have moodswings

 

I am feeling somewhat hopeful today though, because the first time in over a month (began with my Serotonin Syndrome mid March) I was able to get aroused when I was with my boyfriend. It makes me have some hope that PSSD may not be permanent, but I am worried how these symptoms may change when I try to reinstate.

 

What I have noticed with withdrawal symptoms is that most of them are inconsistent and that they come and go. Which means I could have a few days to a week where I am able to get aroused but then I would not surprised if I stop being able to get aroused after that

[Dee12h]

I had a serotonin reaction today & am terrified to take another dose. It’s so hard to determine what’s WD & what’s an adverse reaction!

[StDymphna]

Update and Context

Context: Almost a month since CT of 10mg Lexapro following too fast taper from 20mg.

Update:

Experiencing a big wave the past couple of days. I have had the horrible insomnia come back, the feeling of being wired and pulsing with electricity which makes it take forever to fall asleep. 

Tuesday night: 2:30

-hour and a half nap following day

Wednesday night: 4:30

-was not able to nap

Last night: 1:30 (hour to fall asleep, definitely an improvement, probably since my body was so exhausted)

 

A lot of my other symptoms have worsened, in that they have been lasting all of today instead of being less intense and coming in for a few hours. I feel similar to how I felt the first couple of weeks off Lexapro..

 

I had a pressure headache that has lasted the entire day, nausea, feelings of depression, wanting to cry, photosensitivity, bad concentration, brain fog. It feels like it takes a lot of effort to listen and respond to people because of the concentration issues- that plus the depression is the perfect storm to stay away from people which is what I have been doing today...

 

Up until this point I have had bad days and good days, but the headaches and nausea came in waves of a few hours, but today I have been feeling crappy for the whole day

 

Worried about how long this will last. It has been really difficult being in college but I am so close to finishing the semester, I have to hold on until May 10th.

I am thinking about attempting reinstatement after I return home but extremely worried about SS since I do not know how much my body has kindled. I know I have had a strong reaction to 1mg of melatonin so it worries me to try .1mg of Lexapro.

 

Struggling a lot with acceptance. I have OCD, and I recently began ERP therapy for that. I am grateful I finally am, because it is really affecting my anxiety about the unknowns regarding this situation. I need tips on acceptance, coping despite feeling inhibited from doing and feeling normal things, coping without all the attempts to wish my situation away..

[Tweed9674]

A reaction to melatonin doesn't mean that you can't reinstate. It's a good sign that you have to be extra careful if you decide to reinstate.

 

You won't get SS from 0.5mg or 1mg Lexapro. But you can have an adverse reaction, that's a possiblity.

Going on a low dose is one way to mitigate the strength of the adverse reaction. It also help avoiding a kindling reaction.

 

I could not tolerate 5mg but 1mg was fine. Just like you, i'm hypersensible to many drugs right now. I can barely take a sip of 99.9% decaf coffee.

[StDymphna]

How can I tell the difference between SS and adverse reaction?

[Erimus]

2 hours ago, StDymphna said:

How can I tell the difference between SS and adverse reaction?

Serotonin syndrome is a severe reaction, very few people experience it. Many people read about the symptoms and convince themselves they have it. It is highly unlikely you will get serotonin syndrome from a dose of 0.5mg and under, especially given that you took 20mg of escitalopram for a number of years.