ScaredDad: Lexapro Reinstatement Help

[ScaredDad]

Please see medication summary.

 

I was told by my doctor to reinstate at 10mg while crashing hard after stopping lexapro (was off for a week and a half after tapering down for a way too fast month). To be honest with you at first I was better off and even yesterday I felt like 80% normal. But two days ago as well as today it’s like I’m plugged into an electoral outlet. Can’t eat, anxiety through the roof, numbness all over, and thoughts of well I guess I’ll have to end it if it gets worse creeping in. On the days I’ve felt like this also I get exactly zero minutes of sleep.

 

i have a daughter due in 10 weeks and a two year old at home. Given I’m having every other day waves to I stay at 10mg? What do I do?!? 

I am literally losing it. Please help.

Edited April 27 by Emonda
Name to title

[Emonda]

Welcome @ScaredDad

Sorry to hear things are not great.

 

You've made a lot of changes over the years, and these changes are going to leave you feeling poorly. It'll take time and patience to bounce back, but you will.

 

When tapering off this medication, slow is the way to go: Why taper by 10% of my dosage? Importantly, if you develop unpleasant side effects from tapering, halt the taper, give yourself time to settle, and once stable, taper more slowly and by smaller amounts moving forward.

 

4 hours ago, ScaredDad said:

ike I’m plugged into an electoral outlet. Can’t eat, anxiety through the roof, numbness all over,

 

These sound like typical WD symptoms. Have a read of a more comprehensive list of possible symptoms here: Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

4 hours ago, ScaredDad said:

On the days I’ve felt like this also I get exactly zero minutes of sleep.

 

Melatonin for sleep

 

4 hours ago, ScaredDad said:

Given I’m having every other day waves to I stay at 10mg? What do I do?!? 

 

I'd start by reading these two links:

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

Kindling

 

Reinstating generally works best if done within 3 months of stopping medication. The further out from stopping you are, the lower the dose you take to recommence. If you start too high, kindling is a real concern.

 

To confirm:

• You were taking 10mg each and every day of Lex from January 2024 to April 2024?
• When in April 2024 did you start to taper to 0mg?
• What steps did you take to get to 0mg? Was it CT, or gradual steps to 0mg?

 

A few more helpful links:

 

Windows and waves pattern of stabilization

 

Emotional Spirals

 

Non-drug coping strategies

 

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 fatty acids (fish oil)

 

Avoid alcohol. 

 

This is your own Introduction topic.  Each member has only ONE Introduction topic.  Your own Introduction topic is the best place to ask questions and the place to journal your progress.  This keeps your history in one place and means you do not have to repeat your story. 

 

Once again, welcome to S.A.

 

Emonda

 

 

 

[ScaredDad]

2 minutes ago, Emonda said:

 

 

To confirm:

• You were taking 10mg each and every day of Lex from January 2024 to April 2024?
• When in April 2024 did you start to taper to 0mg?
• What steps did you take to get to 0mg? Was it CT, or gradual steps to 0mg?

so I started on 5mg and increased to 10mg over the course of the month. Probably stepped into 10mg in mid January. I started to taper at the end of February by about 2.5mg every week but I hung around on 2.5mg for a while before stopping at the beginning of April. My biggest concern is what to do now that I’ve taken 5 doses of 10mg. I feel SO activated today I’m like on fire. I am essentially bed ridden unless I’m pacing or in the tub. I feel like I have to get off or at least down a lot. Still strange I felt so good yesterday.

 

 

2 minutes ago, Emonda said:

[Emonda]

4 minutes ago, ScaredDad said:

My biggest concern is what to do now that I’ve taken 5 doses of 10mg. I feel SO activated today I’m like on fire. I am essentially bed ridden unless I’m pacing or in the tub.

 

Reinstating at 10mg was clearly way too high, given your response.

 

28 minutes ago, ScaredDad said:

Still strange I felt so good yesterday.

 

The effect of the drug builds over time.

 

What's the right dose? Given the lack of consistency in your dose, it's a best guess. What has your doctor said given your response to reinstating?

 

It's best to start low and see how you respond. With the benefit of hindsight, perhaps 1mg may have been a better starting point - but no one really knows. 

 

It's helpful to monitor/record your symptoms so you can look back and see if the activation you refer to gets better.

 

I hope things settle...time and much patience is required.

[ScaredDad]

1 minute ago, Emonda said:

 

 

What's the right dose? Given the lack of consistency in your dose, it's a best guess. What has your doctor said given your response to reinstating?

 

 

I haven’t even talked to him. Considering I gave him my whole history and he still said to do this on top of prescribing abilify. Do I taper back or hold at 10? I’m legitimately unfunctional.

[ScaredDad]

@Emondaalso will I survive this? I am so scared I’m beyond kindled with all my prior alcohol use as well. I’m having big bad thoughts about easier ways 

[Tweed9674]

Hi @ScaredDad

 

I am also a dad of three young kid. I understand how scary and painful this is.

 

I've been through something similar just a few weeks ago after reinstating lexapro. From what you describe, your system might have become sensitive to Escitalopram / Lexapro.

Lexapro is a very potent SSRI and reinstating it at 10mg can be too much.

 

My personal experience reinstating at 5mg was very bad. I had to lower to 1mg. Once at 1mg, I started getting better after 5-6 days.

 

If you wish to have instructions to make a custom dosage (suspension in water) I can help you with that.

It's also important to know that if you lower the dosage, you won't feel immediate relief. It takes a few days for the drugs level to stabilize.

 

Considering how you are feeling, maybe a drop from 4 days of 10mg to 1mg could be done. I don't think holding 10mg is the answer right now though.

I don't have much experience with that, it's a tough call to make.

 

 

You will survive this. There are better days ahead.

[ScaredDad]

@Tweed9674that would be very helpful if you don’t mind I have 10mg tablets. As I sit here right now laying in bed unable to even shed a tear (lexapro?) while my wife and daughter watch tv in the other room I pray to God that you are right about being ok. You all may be what gets me through because I feel like no one else understands. 

[LostInCanada]

17 minutes ago, ScaredDad said:

Do I taper back or hold at 10?

Hi @ScaredDad welcome to SA.

When I reinstated after a 3 month period of zero drug, I reinstated at 5 mg and then went to 10 mg for 3 days which was a huge mistake. I dropped immediately back to 5 mg. You have only been taking 10 mg for 5 days. Did you feel better at 5 mg? You definitely are too high at 10 mg.

1 mg has been suggested by 2 members. You can always updose a bit from there if necessary.

[LostInCanada]

1 minute ago, ScaredDad said:

I pray to God that you are right about being ok.

You will get through this. Just important to get on a smaller dose and let your body stabilize from all the changes. 

[Tweed9674]

31 minutes ago, ScaredDad said:

@Tweed9674that would be very helpful if you don’t mind I have 10mg tablets. As I sit here right now laying in bed unable to even shed a tear (lexapro?) while my wife and daughter watch tv in the other room I pray to God that you are right about being ok. You all may be what gets me through because I feel like no one else understands. 

I have dad duties right now, but i'll get back to you in an hour or two.

 

Meanwhile, you can take a look at
 

 

[ScaredDad]

@LostInCanada

@Tweed9674thank you both so much 

[Tweed9674]

Here is how I do it:

 

1. I use a small plastic cup (mine is 80ml) in which I crush a 10mg tablet. You'll need to make a fine powder with the tablet.
2. I add 40ml of water to the cup (I use syringes to mesure the water).
3. Using a syringe, I stir the water and powder to make sure that the suspension is as even as possible.
4. With the syringe I quickly take 4ml of the resulting suspension.
5. I try to remove the air (if any) from the syringe to get a precise dosage.
6. What you don't use needs to be disposed. You cannot keep it for later.

 

That's it!  A crushed 10mg tablet in 40ml of water. You take 4ml.

 

About point 4, escitalopram is NOT soluble in water. You make a suspension. Once you stop stiring, the meds will fall at the bottom rather quickly.

To have a precise dosage, you need to act fast once you stop stiring.

 

You can usually buy syringes at a pharmacy and they don't cost much. You can ask the pharmacist.

 

The maths:

 

10mg / 40ml = 0.25 mg per ml

0.25mg * 4ml = 1 mg of Lexapro in  4 ml of water

 

As I said earlier, you will have to hold that dose and observe how you react. I'd give it at least 1 - 2 weeks before making another move.

Expect no improvement for a few days since the 1mg will build up with what you already took.

 

 

Many of us have been there, don't despair

[Catwoman73]

Hi @ScaredDad- you've gotten some great advice here.  I wanted to just add that I replace some of the water in my suspension with maple syrup.  It makes it taste better, and it helps keep the particles suspended in the liquid for a more even distribution.  

 

You absolutely will get through this!  When you're able, read the success stories here.  Focus on your health first while getting through this.  As parents, I know it's sometimes hard to put ourselves first, but I really think that your well-being needs to come first if you want to be fully present for your little ones.  Is your wife supportive?  Keep the lines of communication wide open, explain in as much detail as possible how you are feeling to help her understand.  I used to be a closed book due to a lot of past trauma, but I've learned to really open up to my husband, and he has become my biggest cheerleader, and my rock when I feel like I'm going to lose it.  We're here for you 100%, but it helps to have someone supportive nearby that can really hold you up when you need it. 

[Tweed9674]

1 minute ago, Catwoman73 said:

I wanted to just add that I replace some of the water in my suspension with maple syrup.

I am soooooo going to try that 👀 

Thank you!

[Catwoman73]

1 minute ago, Tweed9674 said:

I am soooooo going to try that 👀 

Thank you!

You're welcome lol...

 

I also just really like maple syrup! 😁

[Emonda]

3 hours ago, ScaredDad said:

also will I survive this?

 

Yep, you'll survive for sure 👍

 

Thanks, @Tweed9674 and @LostInCanada, for jumping in. I have commitments each Sunday morning (it's Sunday morning in my time zone), so I go offline for a while.

 

I'd test the waters at 1mg and see how you go. Things should settle down with time.

 

Please, avoid alcohol.

[LostInCanada]

@ScaredDad I will just add to Emonda’s caution about alcohol. Caffeine which includes green tea, black tea, coffee and chocolate can cause stress to your central nervous system. Also some react badly to msg, too much refined sugar and sodium nitrates. Trying to eat whole foods without additives and staying hydrated is ideal. Be patient, loving and kind to yourself. Concentrate on what you can do not on what you can’t. Even if it seems so small be proud of yourself. This is not an easy journey. 

[ScaredDad]

@Emondado I go straight to the 1mg?

[ScaredDad]

@Catwoman73thank you so much for the kind words. My wife is supportive but it is wearing on her… 

[Emonda]

17 minutes ago, ScaredDad said:

do I go straight to the 1mg?

 

Given that you reacted badly to 10mg and it's only been 5 or 6 days at that dose, yes, I'd drop straight to 1mg.

 

It is a best guess based on personal experience and observation of others on this site. The decision is ultimately yours.

 

Let us know how you progress.

 

Best wishes.

 

 

[ScaredDad]

@LostInCanada

@Tweed9674@Catwoman73

@Emonda

 

thanks everyone. I just took my first 1mg using a pill crusher to really get it to dust and the math Tweed suggested. I suppose I just sit and wait it out now. I’m level 10 scared but hopefully this change with the elimination of all stimulants and alcohol (no drink since April 6th when this really all started - last big party night was the day before I took my last dose) along with trying my best to rest will calm the system down.

 

I came to my mother’s house to ride this out for a bit and give my wife some room that she really needs. Also will be taking the next week off work.
 

ill report back.

[LostInCanada]

@ScaredDad good plan. Just try your best to distract your mind. I know it is hard. Be conscious of keeping your muscles relaxed. I know after I dropped my dose I felt immediately better. Keep us posted. It is good to keep hourly notes right now and rate symptoms in a scale of 1-10. We are here for you.

[ScaredDad]

@LostInCanadatbh you guys are legit angels on this earth and I hope to return this favor to others in the future. Here are my notes through almost 5pm just for a read if interested. 
 

4/28 - 1.00mg suspension 

   - slow and small wins from here is my motto

• may be a window idk but feel pretty good laying at my moms through 1117am. May be a little early call in himdsight
• Talking on the phone a lot and lots of screen time / thinking headache rolling a bit with mouth tingling on tongue and teeth. Shins tingling constantly as they have been for weeks. 1147am
• 1234pm anxiety “burst” (I think these are the neuro emotions people talk about. I have legit no control or influence, my body just send out fires) roll in and thumb twitches with increased teeth tingles -> 112 just yawning and chilling now -> “you don’t have to let it take you”, Move Forward - 1:50 headache but emotionally good
• Yesterday I could make a cramp lock in anywhere and that is sort of gone so hmm idk
• 344: symptom flair numb face legs and red flush on hands and warm. Same thing on tops of feet
• For the first time I’m watching these happen with a curious pov. Not that worse panic and other times will come that overwhelms me but for the first time ever experiencing this since December I’m not like what’s wrong with me!?! I know what it is and I know I will heal - I have to keep that mentality even in the thick 
• Well my neck just cramped turning my head and I had to like force it back to turn my head and that one messed with me
• Suicidal thoughts are gone though which is pretty tight 

   - remember: rest doesn’t make you weak. Your system needs it

[Emonda]

9 hours ago, ScaredDad said:

I just took my first 1mg using a pill crusher to really get it to dust and the math Tweed suggested.

 

Consistency and accuracy are very important.

 

Take the dose at the same time each day. Set an alarm at a time you know you can stick to.

 

As to the size of the dose, be as accurate as you possibly can.

 

9 hours ago, ScaredDad said:

I’m level 10 scared but hopefully this change with the elimination of all stimulants and alcohol (no drink since April 6th when this really all started

 

We've all been there. You will turn the corner. Be kind to yourself and patient.

 

9 hours ago, ScaredDad said:

I came to my mother’s house to ride this out for a bit and give my wife some room that she really needs. Also will be taking the next week off work.

 

This all sounds very positive.

17 minutes ago, ScaredDad said:

slow and small wins from here is my motto

 

👍

 

Keep us posted.

 

 

[ScaredDad]

At what point would I know if this just won’t work? I feel like I’m on acid all of a sudden. Like feel like I can’t control my arms. Jeeeeze I was so confident legit an hour ago. My whole body is vibrating.

 

i did take a Tylenol but no way that’s making my hands go deeply numb right? Usually it’s surface this is deep

[LostInCanada]

@ScaredDad it could be the Tylenol causing a reaction. I would suggest taking absolutely nothing so we can figure out if the 1 mg is going to work or not. Just breathe. You are safe and are going to be okay.

Can heat or cold help? Walking?

[ScaredDad]

@LostInCanada thanks and good point I won’t from here on out. To be fair the symptoms in my list I put above all started before the Tylenol.  It agreed! 
 

im going to take a warm bath! Does the warm bath actually convince the cns to calm down or is it just convincing me to calm down and then the cns? Just curious about these things. I have a full cold plunge set up that I’m terrified to use at the moment. 

[LostInCanada]

4 minutes ago, ScaredDad said:

Does the warm bath actually convince the cns to calm down or is it just convincing me to calm down and then the cns?

I think it's both. 

 

4 minutes ago, ScaredDad said:

I have a full cold plunge set up that I’m terrified to use at the moment

I understand. You don't want to rock the boat. Hopefully the warm bath will help.

[Tweed9674]

44 minutes ago, ScaredDad said:

At what point would I know if this just won’t work? I feel like I’m on acid all of a sudden. Like feel like I can’t control my arms. Jeeeeze I was so confident legit an hour ago. My whole body is vibrating.

 

i did take a Tylenol but no way that’s making my hands go deeply numb right? Usually it’s surface this is deep

You have to give it at least a week. It's going to be a bumpy road.

 

You won't know today. Probably not tomorrow either. It's okay.

 

You got this!

[ScaredDad]

Hey team what do I do here? I know I’m supposed to hold but my withdrawal symptoms are skyrocketing. Zero sleep, constant jerks and face scrunches if that is a thing 

[ScaredDad]

I’m calming down a bit. These neurological symptoms just really scare me

[LostInCanada]

2 hours ago, ScaredDad said:

These neurological symptoms just really scare me

Totally a normal response. I would like to see hourly notes starting with rising till sleep. Put in the time you dose(same time every day) and any symptoms by the hour.

Usually when someone changes from the pill to a liquid it is slowly over 2 weeks. You have done it in one jump. This is upsetting to your system as well. It will take a bit to settle on top of the previous rollercoaster caused by the doctor. 

I am so sorry you have to deal with this insanity. Know it is the drug not you. You are going to be fine. Your body is trying to find homeostasis. 

The daily notes will help alot. 

Thanks 👍💯🙏

[ScaredDad]

Current state through lunch. Understanding my levels are still coming and just about down from the 10mg. I am trying to be optimistic. In theory, even if I still felt symptoms, if I held at 1mg indefinitely you’d eventually stabilize in some form right? My heart says at a week we will for sure need an increase but waiting that out obviously!

 

4/29 

• Literally didn’t sleep 
• but got up at 445 in a panic over what is happening to me and drove to my moms to try and settle down and not disturb wife and daughter 
• Took lexapro 1mg at 7am sharp as I did yesterday
• No noticeable side effects from the lexapro itself through 1045. It doesn’t even feel like I’m taking anything if that makes sense. Definitely no activation reaction like with the 10.
• Headache and dizzy but could also be lack of sleep. Typical numb patches.
• Trying to nap and still getting these little hypnic jerks as I’m drifting off that don’t allow me to sleep. It’s like my body going wake up! I had this during my 2022 incident as well btw when I got deregulated and tapered back up. All went away in time. But I keep getting so scared like is this TD? Ahh but I don’t know if that’s what TD is. I’ve got to just calm down somehow and get some sleep but my mind won’t cross the line. This is just hyping jerks it has to be and is because my system is charged up still.
• Been in bed at moms since 5 am watching tv. 
• One note in the 2022 incident is I may have been on 2.5mg but idk if it was so much withdrawal as it was just deregulation causing withdrawal like symptoms. I was INSANELY stressed and drinking and smoking a lot when it came to a head. Doing myself no favors.
• Wife is bringing my dog over to hang with me when she goes on her lunch break and bringing food
• I ate a banana this morning and am getting hungry. I will say that I have had a more consistent appetite the last 36 hours and bowel movements starting back up. 
• 1130 ate a hamburger for lunch. Probably not the best I know but I’m working with what I got sometimes. 
• 1220 just like numbness on knees, forehead, tops of arms and dizzy as all get out when walking around. Maybe I’m overthinking everything now and trying to calculate how many MG are left in my system but getting anxious and legs buzzing a bit.

 

[Catwoman73]

7 minutes ago, ScaredDad said:

Current state through lunch. Understanding my levels are still coming and just about down from the 10mg. I am trying to be optimistic. In theory, even if I still felt symptoms, if I held at 1mg indefinitely you’d eventually stabilize in some form right? My heart says at a week we will for sure need an increase but waiting that out obviously!

 

4/29 

• I ate a banana this morning and am getting hungry. I will say that I have had a more consistent appetite the last 36 hours and bowel movements starting back up. 
• 1130 ate a hamburger for lunch. Probably not the best I know but I’m working with what I got sometimes. 

 

Yes, you will eventually stabilize!  But there's also nothing wrong with creeping up a tiny bit at a time to find that optimal level if that's what you need to do at the end of the week.   Be patient, continue to be aware of what is happening in your body, and keep writing it down.  Optimism is great, but not always easy- I really am Suzy Sunshine lol, but even I struggle sometimes.  When I'm struggling, I try to step outside myself, and look at my symptoms as interesting, rather than scary.  If that even makes sense lol.

 

The fact that your GI system is reacting more normally is a great sign!  There are serotonin receptors in your gut too- maybe they are bouncing back a bit quicker than the ones in your brain.... I think you're on your way to improvement!

 

Don't worry about the burger lol- the way I see it, you're in crisis mode.  You're surviving and that's all that matters.  Fed is better than not fed, even if what you are taking in isn't exactly filled with superfoods.  You can always clean up your diet when you are in a better mental place to do so.  Just go with it! 

[LostInCanada]

20 minutes ago, ScaredDad said:

hamburger for lunch.

Staying fed and hydrated is important. I found I need meat to cope. I was vegetarian before my cold turkey. Nothing wrong with a burger.

22 minutes ago, ScaredDad said:

Trying to nap and still getting these little hypnic jerks as I’m drifting off that don’t allow me to sleep.

I found sleeping being propped up helps. Also having the room dark (blackout) but leaving a low consistent light on helped me not to have startled waking. These jerks were common for me 

23 minutes ago, ScaredDad said:

445 in a panic over what is happening

The cortisol increases around this time 3am on till about 8am . Practice deep breaths, exhale through the mouth. 

26 minutes ago, ScaredDad said:

Headache and dizzy

Typical WD as well 

 

You will heal. Just be super accurate in dosing. No changes. No added drugs. Are you still smoking? Nicotine is a stimulant so if you can slowly reduce that would be great.