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AustralianMum: Change Desvenlafaxine to Lexapro?


AustralianMum

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Hoping to get advice on whether I should change back to Lexapro. Here is my story so far:

Prescribed 5mg Lexapro in Nov 2021 due to quite severe anxiety and depression post divorce. I have 3 teenagers with me 50/50 and I work full time. 
Gradual increase to 20mg Lexapro over next 1.5 years with GP advice.

Oct 23 - Dec 23 - too fast taper. No withdrawal symptoms. Jumped off 2.5 mg Dec 15th 2023.

Jan 24. - anxiety, depression and physical withdrawal hit. Difficulty working, broke off my relationship, really struggling badly.

March 24 - started back on 1mg Lexapro, and GP also put me on HRT for menopause.

Initial energy surge for 3 weeks then got an infection and had to go on antibiotics.

Completely crashed within 3 days and had very vivid suicidal ideation for 3 days. Phoned GP who advised me to go to A&E.

Was admitted to psych ward for 6 nights. Initially they increased me back to 5mg Lexapro then psychiatrist convinced me to switch to Desvenlafaxine 50 mg.

April-June 2024 - I have stabilized on Desvenlafaxine, and am nearly off Lexapro.

However, I have now read how hard it is to taper off Desvenlafaxine which I want to do within next year or so.

I am convinced my breakdown was due to too fast a taper off Lexapro.  Would it be better for me to request going back on Lexapro so I can try a

much slower taper? Can I switch back given I have only been on Desvenlafaxine for 3 months?

The only issue I have with Lexapro is it did make me very tired and I easily slept 10 hours a night. I was also not very energetic, and I have a lot more energy on Pristiq/Desvenlafaxine. I also still suffered periods of depression on Lexapro.

Edited by Emonda
Name to title

Nov2021- started 5mg Lexapro for anxiety and depression post divorce.

2021- Oct 2023 GP increased Lexapro to 20mg

Oct 23-Dec 23 - taper off Lexapro. Jumped off at 2.5mg

Jan 24 - March 24 - severe anxiety, depression, physical withdrawal symptoms.

March 24 - reinstate Lex at 1mg. GP also prescribed HRT for menopause.

April 24 - Antibiotics for infection. Complete crash. Vivid Suicidal ideation. Admitted to A&E for 6 days.

Psychiatrist increased me to 5mg Lex, then changed me to 50mg Desvenlafaxine. Agrees slow withdrawal from Lexapro.

June 19th 2024 - now on 50mg Desvenlafaxine and 0.5mg Lexapro + HRT gel and progesterone pill.

Have stabilized, but still get 1 week withdrawal symptoms every time I reduce Lexapro.

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  • Emonda changed the title to AustralianMum: Change Desvenlafaxine to Lexapro?
  • Administrator

Welcome @AustralianMum

 

7 hours ago, AustralianMum said:

I have stabilized on Desvenlafaxine,

 

That's good to hear.

 

7 hours ago, AustralianMum said:

I have now read how hard it is to taper off Desvenlafaxine which I want to do within next year or so.

 

7 hours ago, AustralianMum said:

Would it be better for me to request going back on Lexapro so I can try a

much slower taper? Can I switch back given I have only been on Desvenlafaxine for 3 months?

 

I've heard a presentation from Dr Horowitz stating that switching from one AD to another, which is perceived to be easier to taper, is not a great idea. You'll likely have WD symptoms from the one you've stopped and perhaps new side effects from the drug you've switched to.

 

As to a plan to taper, very slow is the way to go: Why taper by 10% of my dosage? The reductions should get smaller and smaller each month, for example: 10mg, 9mg, 8.1mg, 7.3mg etc. 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.

 

Keep this checklist on hand and monitor your symptoms along your tapering journey: Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

These links will be handy:

Windows and waves pattern of stabilization

Emotional Spirals

Non-drug coping strategies

Melatonin for sleep

Did you mean to say you are taking both ADs at the same time? If so, you should put both into the drug interaction checker (Google it).

 

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.

Don't change the manufacturer of your AD.

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

Please don't send me PMs. I am not a doctor. My comments are based on my personal experience with ADs and tapering. Consult your doctor about your own medical decisions.

Start of taper: Jan ’22 Vortioxetine 15mg, 

End year 1: 4.5mg, 

End year 2: 2.38mg, 

Year 3: 19 Jan 2.33mg, 26 Jan 2.28mg, 2 Feb 2.24mg, 8 Feb 2.19mg, 29 Feb 2.15mg, 7 Mar 2.10mg, 14 Mar 2.06mg, 21 Mar 1.99mg, 10 Apr 1.95mg, 17 Apr 1.91mg, 24 Apr 1.87mg, 1 May 1.83mg, 23 May 1.80mg, 30 May 1.76mg, 8 Jun 1.72mg, 13 Jun 1.66mg, 3 Jul 1.62mg, 10 Jul 1.58mg, 17 Jul 1.54mg

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Thank you Edmonda for your reply. I think you are right, I’m still reducing off the Lexapro (while on the Desvenlafaxine) and each drop is still horrible.

My concern is how hard it is to taper Desvenlafaxine as the pills should not be crushed and there is no liquid version.

I will continue researching and I think perhaps get my life back on track for a while first before attempting a taper.

Nov2021- started 5mg Lexapro for anxiety and depression post divorce.

2021- Oct 2023 GP increased Lexapro to 20mg

Oct 23-Dec 23 - taper off Lexapro. Jumped off at 2.5mg

Jan 24 - March 24 - severe anxiety, depression, physical withdrawal symptoms.

March 24 - reinstate Lex at 1mg. GP also prescribed HRT for menopause.

April 24 - Antibiotics for infection. Complete crash. Vivid Suicidal ideation. Admitted to A&E for 6 days.

Psychiatrist increased me to 5mg Lex, then changed me to 50mg Desvenlafaxine. Agrees slow withdrawal from Lexapro.

June 19th 2024 - now on 50mg Desvenlafaxine and 0.5mg Lexapro + HRT gel and progesterone pill.

Have stabilized, but still get 1 week withdrawal symptoms every time I reduce Lexapro.

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