Breeze: Support for Mom to taper my daughter

[Breeze]

Hello, I’m so glad this site exists and so grateful I found it. Anyway my daughter 15 is on lexapro 20mg since October 2023 for anxiety/selective mutism. She has been working and dealing with this lots of therapy since 5yrs old. The start of this school year things just turned for the worst and she asked me to get her help with medication. She was being bullied being the “weird” kid in class that doesn’t talk just became too much.  Anyway the medication did work giving her that edge she needed to break from the anxiety along with us moving her school and starting fresh and therapy. The way the pediatrics Phychiatrist  moved her to 20mg lexapro was so fast that I think I’m traumatized and scared. She had so many side effects from the medication the biggest that she still has is insomnia and the stomach pains.  I got “yelled”for not giving her Klonopin and doing the melatonin.  I was told

she may be developing eating disorder that we stopped saying anything about the stomach issues. Anyway we did change the phychiatrist and got a new therapist also. The Phychiatrist’s is “younger” doctor and I asked him to prescribe liquid lexapro so we can taper her off slowly.  His response liquid tastes horrible she can drop 2.5 mg asap. I refused I asked for liquid and once she transitions to liquid we can start 1mg drop and monitor withdrawal symptoms hopefully none.  I’m just so discouraged with the pediatric phychiatrist how they wanted to add more medication and just “arguing” with me when I refuse.  Refused klonopin after she started she hated the brain fog she got from it we have been doing melatonin but she still is so tired during the day.  
 

Anyway I was told to start the liquid no need to slowly introduce it. I went in the middle 10mg pill and 10mg liquid two days now seems ok nothing changing no new symptoms. I’ll do every few days switch by 5mg to liquid and then wait and start the taper 1mg

 

thank you if you read so far any advice/ opinion guided to specific info greatly appreciate it 

Edited May 10 by Emonda
Name to title

[Onmyway]

Hi @Breeze, 

welcome to SA.  So sorry you have to go through this. Dealing with Psychiatry is not for the faint hearted. But I am glad you are advocating for your daughter and I am glad she is getting better. But lexapro 20mg is a very, very high dose especially for a child so lowering it will likely deal with a lot of the side effects. 

 

Regarding transitioning to liquid - when you are substituting half pills and half liquid are you using the same pills and cutting in half or are you using a new manufacturer? If you are doing the latter, you may be introducing small dosage variations which in general do not matter and may be OK but if your daughter is sensitized it may be easier to switch to liquid directly. 

 

You are doing the right thing looking for help. I hope your daughter gets better soon. Anxiety is not easy on anyone and so much harder on kids. 

OMW

[Breeze]

Thank you so so much for the info the liquid is different manufacturer starting tomorrow we will do all liquid. She is ready.  My gosh I never in a billion years would have expected child psychiatrist to ignore side effects and just want to medicate heavily to “fix” side effects. She has a good therapist now and new phychiatrist for the medication.  I need to be fully informed moving forward can’t trust the doctor for her overall well-being 

[Onmyway]

Hi @Breeze

 

I would consider cutting 2mg instead of 1 one you ascertain that the liquid transition is OK. This is because of the side effects. It's still within the 10% guidelines of SA and may provide relief quickly. Also, is she taking the medicine in the morning or in the evening?  Switching to morning may help with sleep if you don't already do that. Always use syringes rather than droppers with liquid. 

 

You need to wait a couple of weeks for the full effects of a lower dose to be noticeable. I have a feeling she'll feel much better in a few months. Please watch your daughter closely. These drugs and the changes they bring in young people can be dangerous. 

 

I can't believe someone prescribed 20mg of escitalopram to a child. The normal dose is 10mg for adults. No wonder she's having those side effects. I think you should report the doctor to the medical board. They shouldn't be doing this. 

 

Do any of these symptoms apply to your child while on the medicine ?

 https://www.mayoclinic.org/diseases-conditions/serotonin-syndrome/symptoms-causes/syc-20354758

 

Omw

 

 

Edited May 10 by Onmyway

[Alfred1977]

You might want to do an hyperbolic/exponential taper...20mg -> 18mg, 4 weeks holding time, 18mg -> 16.2mg, 4 weeks ht, 16.2mg -> 14.58mg, ... and so on, steps getting smaller and smaller because the lower the dose, the stronger the change in effect when reducing an antidepressant.

[Breeze]

Just thank you ! We will wait a few days to make sure she adjusts to the liquid she usually feels negative effects within a day or two and then go to 18mg and wait at least four weeks. She takes it in the morning 7am I was able to quit my job to watch her those first months my gosh I just don’t know how we avoided hospitalization (long story) and I didn’t know any better. I just feel so awful. We went from 5mg side effects within two days (where told it can’t be the medicine it doesn’t work that fast) than 10mg for week, 15mg another week and then 20mg. Apparently therapeutic dosage is 20mg I’m just so angry the more I learn. 

[Breeze]

My gosh what hell is this.. I feel awful just thinking I was doing what was best for my kid  only to make such a horrific decision for her to start this medicine. So many times we said the side effects to the doctor only to be ignored and upping the dose classic gaslight…. Anyway I need to deal with the now.  Transitioned fully on liquid lexapro started 19mg on the 11th of May (decided on 1mg drop because switching to liquid not to create more issues) agitated, stomach, insomnia and soo lethargic the same just the fifth day on 19mg she slept almost all day today started 18.5mg she is so tired of feeling like crap.  We are talking about a kid that was advanced academically to barely be able to do any school work from being so lethargic and always that nauseous feeling.  I try not to read too many stories cause I’m getting scared I want my kid back  (just venting I don’t know what else to do I want to take the pain away from my daughter.) she would rather be selectively mute than all this side effects. 

[Alfred1977]

19 hours ago, Breeze said:

Transitioned fully on liquid lexapro started 19mg on the 11th of May (decided on 1mg drop because switching to liquid not to create more issues) agitated, stomach, insomnia and soo lethargic the same just the fifth day on 19mg she slept almost all day today started 18.5mg she is so tired of feeling like crap.

Did she tolerate the liquid well?

 

Don't go down on 18.5mg if she is still symptomatic from the previous reduction. The more symptoms a reduction causes the more time you should give it. If symptoms are severe, you need to take back the reduction and increase to the previous dose.

 

Especially at the beginning of a taper it is good to very slowly because this is a learning process. You two need to figure out how your daughter is reacting and learn reading her body and symptoms. So if this first reduction of 5% caused significant symptoms, don't go faster than 5%/4 weeks at the beginning. If you are more experienced later and know what your daughter can handle, you can speed this up.

[Breeze]

We think she transitioned ok just felt more tired than the usual tired and one day she slept all day. The problem and I don’t know how to monitor this she always had the agitation, nausea and insomnia from the first week we started the medication back in October it just never went away and we were just ignored and the doctor just kept on upping the dose. Now the new Phychiatrist’s wanted to change medication and add more medicine for sleep we both refused she wants to be done with medication. I’m sorry I’m just sooo sick when I think about it.  You are right we should hold on longer since we did 18.5 for two days now and no new symptoms we will hold here for four weeks and until school Is over to make sure ok before moving forward 

 

thank you for the reply sooo much 

[Alfred1977]

2 hours ago, Breeze said:

The problem and I don’t know how to monitor this she always had the agitation, nausea and insomnia from the first week we started the medication back in October it just never went away and we were just ignored and the doctor just kept on upping the dose.

Sorry I wasn't aware of this. This complicates the matter if the baseline is symptomatic. It is thus harder to understand what the reductions are doing with her.

It is not unusual that updosing an antidepressant causes symptoms like that. I had also a lot of tension and insomnia from increasing my dose. However, if this is going on since October this is pretty severe. So those symptoms are probably an adverse reaction from the drug. 20mg Lexapro is a pretty hefty dose.

In this case it doesn't make sense to wait for symptoms to resolve completely...they will never if they are caused by the drug itself.

2 hours ago, Breeze said:

Now the new Phychiatrist’s wanted to change medication and add more medicine for sleep we both refused she wants to be done with medication.

In general it is a pretty bad idea to take a second drug against the side effects of the first one...and then a third against the side effects of the second one and so on...

 

2 hours ago, Breeze said:

You are right we should hold on longer since we did 18.5 for two days now and no new symptoms we will hold here for four weeks and until school Is over to make sure ok before moving forward 

See above. I wasn't aware that the baseline is symptomatic. I think as Onmyway said above it might be good to do at least the 10% taper and go down to 18mg in a first step.

It would still be good to observe carefully what the reductions are doing with her.

 

I am sorry what happened to you. Prescribing those drugs to children is really awful.

What is she doing right now? Is she going to school?

[Catwoman73]

On 5/22/2024 at 2:02 PM, Breeze said:

My gosh what hell is this.. I feel awful just thinking I was doing what was best for my kid  only to make such a horrific decision for her to start this medicine. So many times we said the side effects to the doctor only to be ignored and upping the dose classic gaslight…. Anyway I need to deal with the now.  Transitioned fully on liquid lexapro started 19mg on the 11th of May (decided on 1mg drop because switching to liquid not to create more issues) agitated, stomach, insomnia and soo lethargic the same just the fifth day on 19mg she slept almost all day today started 18.5mg she is so tired of feeling like crap.  We are talking about a kid that was advanced academically to barely be able to do any school work from being so lethargic and always that nauseous feeling.  I try not to read too many stories cause I’m getting scared I want my kid back  (just venting I don’t know what else to do I want to take the pain away from my daughter.) she would rather be selectively mute than all this side effects. 

Hi @Breeze- I'm so sorry you and your daughter have gone through this.  I, too, am stunned they would put her on 20mg.  That is a whopping dose!  Please don't beat yourself up over your decision to proceed with medication for your daughter.  I did the same thing with my daughter's ADHD meds- I trusted the doctors, and given my own history with psychoactive medication, I probably should have known better.  But a wise person here reminded me that we make the decisions we think are best at the time.  None of us have a crystal ball.  And all of us have been taught to trust medical professionals. You will get your daughter back.  It's just going to take some time.  Keep the lines of communication open with her- kids tend to bury a lot.  Oh, and the gaslighting... yeah, that seems to be a pretty standard thing around here.  It sucks, but the good news is that you're here now, and you'll be much more informed, and be able to make good decisions moving forward.  Hang in there! 

[Breeze]

I

17 hours ago, Alfred1977 said:

m sorry what happened to you. Prescribing those drugs to children is really awful.

What is she doing right now? Is she going to school?

We had to move her to an alternative school all thanks to this medicine (she received “Emotionally Disturbed” label ) I feel now I’m slowly waking up and seeing things clear again like we where in a fog and so scared I can’t even type how scared and worried that maybe something was actually wrong with her so hard to explain . This decision to go on medication has changed our entire family.  On a positive note last evening she was able to “tolerate” her brother and came downstairs to hang with us for a bit a positive change that I haven’t seen in a long time she also didn’t wake up at 2am. Today we started her 18mg.  Just thank you I really appreciate the info.  
 

as prescribing these medications to kids I fully agree there should be much much better protocols this is just not right at all 
 

 

[Catwoman73]

30 minutes ago, Breeze said:

I

We had to move her to an alternative school all thanks to this medicine (she received “Emotionally Disturbed” label ) I feel now I’m slowly waking up and seeing things clear again like we where in a fog and so scared I can’t even type how scared and worried that maybe something was actually wrong with her so hard to explain . This decision to go on medication has changed our entire family.  On a positive note last evening she was able to “tolerate” her brother and came downstairs to hang with us for a bit a positive change that I haven’t seen in a long time she also didn’t wake up at 2am. Today we started her 18mg.  Just thank you I really appreciate the info.  
 

as prescribing these medications to kids I fully agree there should be much much better protocols this is just not right at all 
 

 

Oh, the labels... sadly, those are very hard to shake.  Keep fighting for her- I really do believe that healing CAN be easier and faster for the young, so here's hoping that's the case for your daughter.  It sounds like she had a nice window last night- that's a very good sign.  Just take it one day- one hour even- at a time.  It's a crazy journey, but you will get through this!

[Alfred1977]

@Breeze

24 minutes ago, Catwoman73 said:

Keep fighting for her- I really do believe that healing CAN be easier and faster for the young, so here's hoping that's the case for your daughter.

I agree. Your daughter is taking the AD for a relatively short time and she is young (and thus her brain works faster and is more adaptable). Both gives me hope that she will recover faster and better from this.

 

Here is a list of symptoms you can look out for in the time after a reduction:

http://drglenmullen.com/wp-content/uploads/2013/10/AS-Appendix-1.pdf

 

Probably it's good to take notes on the symptoms of your daughter.

Edited May 24 by Alfred1977

[Breeze]

edit to say that pdf looks so useful I will print it out THANK YOu!!!!
 

I really hope the healing is fast it finally feels we are heading and doing the right thing.. thank you for that I didn’t understand what “windows” was when I was reading posts I will explain that to her (I missed her so much the version she was before the medicine and my gosh I sound like an idiot we all where surprised when she came down stairs and so happy)

[Breeze]

An update: today we started 17mg will wait a week or two and then drop another half a mg for the month depending how she feels. she has been doing so much better at 18mg she seems a bit less agitated and was also able to go to the mall with her friend the other day without feeling like death from being so tired. 

[getofflex]

Hello, @Breeze.  Can you please add the details of her taper so far in the signature line?  Please list specific dates, as best you can remember, (month/day/year), and the dosage of each reduction.  This will really help you get the best help for your daughter, and minimize the chance of the taper going wrong, which could cause big problems.  Thank you.  

 

On 5/9/2024 at 10:30 PM, Onmyway said:

You need to wait a couple of weeks for the full effects of a lower dose to be noticeable.

Because of the above, I suggest that you wait at least 2 weeks before doing another reduction.  There is often a lag time for withdrawal symptoms to show up.  You want to make sure her nervous system is stable before doing each reduction.  The nervous system instability can be cumulative when people taper too fast.  

 

Please let us know how she is doing as she tapers.  

 

[Breeze]

I updated the signature thank you, we will have to hold on 17mg for a few weeks 3days after dropping to 17 she felt like she was getting the flu slept 15hours straight more agitated than usual.  I hate this so much. On a positive note though she is better than when she was on 20mg 

[Breeze]

Today when she woke up she said the best thing I heard in a long time.. the more she drops lexapro the better she feels.  She woke up better than yesterday she asked me not to drop until after our vacation so she can enjoy it.  Next drop will be July 18 and I want to ask should I do one mg drop or half mg drop? 
 

thank you all I’m so scared with this and it feels so lonely trying to navigate this disaster of medication I beyond appreciate all the info 

[getofflex]

16 hours ago, Breeze said:

3days after dropping to 17 she felt like she was getting the flu slept 15hours straight more agitated than usual.  I hate this so much.

Yes, this is the brain getting confused because of the change in dosage. It's withdrawal due to physical dependency on the drug.   I'm glad you only dropped by 1 mg, and that you will wait a few weeks until these things resolve.  The best thing to do is not do another reduction until she has been stable for 2 weeks.  Here is what we mean by stability:

 

Stability

 

It's wonderful that she is able to sleep.  Most of us end up with severe insomnia in withdrawal.  

 

Has she tried any non drug techniques for managing the symptoms?  Taking a gentle walk outside can help with the agitation.  This helped me a lot in the past.  

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

16 hours ago, Breeze said:

On a positive note though she is better than when she was on 20mg 

That's very good!   

 

1 hour ago, Breeze said:

Next drop will be July 18 and I want to ask should I do one mg drop or half mg drop? 

She should be fine with a 1 mg. reduction.  This is less than 10% of her dose.  Our protocol is no more than a 10% drop of the current dose.  This sounds like a good and reasonable plan.  

 

1 hour ago, Breeze said:

thank you all I’m so scared with this and it feels so lonely

 She will be fine, as long as you continue to taper her off very very carefully and slowly.  Slow is the way to go.  

 

Please be ultra cautious about taking her to any psychiatrist.  Be aware that if a doctor tries to prescribe any psych drugs for her in the future, you and she have every right to say "no".  We see this so many times on the forum, and it almost always makes the person much worse to be put on another psych drug once the nervous system is destabilized by withdrawal and/or adverse reactions.  There are good and sound non drug alternatives for dealing with anxiety and depression.  

[Breeze]

1 hour ago, getofflex said:

Please be ultra cautious about taking her to any psychiatrist.  Be aware that if a doctor tries to prescribe any psych drugs for her in the future, you and she have every right to say "no".  We see this so many times on the forum, and it almost always makes the person much worse to be put on another psych drug once the nervous system is destabilized by withdrawal and/or adverse reactions.  There are good and sound non drug alternatives for dealing with anxiety and depression

I agree fully we learned so so much this year it has been pure hell thankful I found this site and the pressure this so called child Phychiatrist’s the first one put us through is totally unethical.  She knows to never again go on any psychiatric medications ever what makes me sooo upset in November and December she asked to stop she was not feeling good from the start of lexapro and he scared us so much I have to forget so we can move forward but it’s just so so wrong.  
 

Just thank you for the reassurance perfect 1mg drop July 18 

[Breeze]

 First time CVs gave half the prescription on the orange bottle that we have been getting and half the prescription the direct from manufacture bottle. Should I return the medication? I don’t want to create any extra instability for my daughter. Thank you. The orange bottle is from camber pharma also I saw 

[getofflex]

According to my husband, who is a retired pharmacist, these 2 liquids should be exactly the same - from the same manufacturer.  If they are, it would be fine to give your daughter.  To be sure, I would call the pharmacist and ask them.  I would also ask them if this is the same manufacturer as her previous prescriptions.  

[Breeze]

1 hour ago, getofflex said:

According to my husband, who is a retired pharmacist, these 2 liquids should be exactly the same - from the same manufacturer.  If they are, it would be fine to give your daughter.  To be sure, I would call the pharmacist and ask them.  I would also ask them if this is the same manufacturer as her previous prescriptions.  

Thank you sooo soo much !