Tapertime: Help with tapering! Lexapro and Wellbutrin

[Tapertime]

hello! Here is a quick timeline - added detail of long term cannabis user ~once a day for many years with a few breaks here and there

~2016 Lexapro until 20mg
~2019 Lexapro 25mg
~2019-2020 Lexapro 20mg, Wellbutrin 150, then 300mg
~2021 Lexapro 10mg, Wellbutrin 300mg
^in the mix along the way 1mg ativan as needed, gabapentin - dont recall dose
2022 added in Ritalin
2023 swapped to vyvanse 30-40mg
2024 Started HRT testosterone, immense improvement in overall mental health 
Trying now to taper off of wellbutrin and lexapro
Started lexapro taper, started withdrawal symptoms, mainly dizziness and overactivation and insomnia
Reintroducing either 2.5 or 5 of lexapro 
Wanting to lower wellbutrin to reduce activation, unsure how to proceed, psychiatrist unhelpful. 
 

I also decided to simultaneously take a break from weed which maybe wasn’t the best idea?

 

i tapered lexapro with a few days of 7.5 down from 10mg even tho my dr told me I could go straight to 5mg. I went to 5 and felt good after about a week or two I went to 2.5 for a few days and my psychiatrist said I should be fine to stop after that. She was wrong, symptoms got worse today, day 3 maybe off completely. Super dizzy. Very over activated. She prescribed me 150mg of Wellbutrin XL to start tapering down on that. 
 

thinking of taking 2.5, or even 1.25mg of lexapro while trying 150mg of Wellbutrin. Thoughts?

 

Should I hold off on the Wellbutrin taper?

 

she also told me with Wellbutrin all I can do is go from 300 to 150 to 0 which doesn’t seem like a great idea to me. 

is there a way to taper? It’s XL
 

should I bring weed back into the mix? 

feeling stuck. Currently 3am and can’t sleep. I took a 2.5 of lexapro after feeling super dizzy today and it has helped a bit. 

 

Edited July 16 by Emonda
Name to title

[Catwoman73]

Hi @Tapertime, and welcome to SA!  We are a community of volunteers providing peer support in the tapering of psychiatric medications, and their associated withdrawal syndromes. 

 

I know Emonda has already sent you a warning, but if you could please complete your drug signature, we would greatly appreciate it.  Please include dates to the best of your recollection, as timelines really do matter in making decisions on how to best proceed.  In order to complete your signature, please click the following link, fill in the box, and click save.  That's it!  You can use mine below as an example of the expectation. 

 

Your Drug Signature

 

While I wait for some more specifics on dates, I'm going to provide you with a few useful links to read.  The first is our tapering advice.  Here at SA, we recommend using a harm reduction taper, or hyperbolic tapering method.  This means reducing your dosage of one medication at time, by no more than 10% of your current dose, no more frequently than every 4 weeks.  This method of tapering is designed to minimize withdrawal symptoms.  Read more here: 

 

Why taper by 10% of my dosage?

 

As is typically the case here at SA, your doctor has tapered you much too quickly, and has left you in a bad state.  I'm so sorry this happened to you.  To be fair, I do think doctors are victims too- pharmaceutical companies continue to state that withdrawal is mild and short lived.  Unfortunately, we know better. 

 

We also recommend only tapering one drug at a time, typically starting with the one that is more activating for you.  Here is some more information on choosing which drug to taper first:

 

Taking multiple psych drugs? Which drug to taper first?

 

If you want to reintroduce the escitalopram, a lower dose is better to start.  I see you took 2.5mg and are so far tolerating it ok, and got some relief, which is good news.  What you have done is reinstating in order to reduce withdrawal symptoms, and this is something we recommend regularly.  If it is helping at 2.5mg, please do not increase any further right now!  More is not better with reinstating.  I would strongly recommend you hold this for AT LEAST a week, preferably closer to a month, to see how you fare.  Here is more information on reinstating.  Please be sure to read the info on hypersensitivity- this can happen if you reinstate too high a dose.  2.5mg is higher than I would have recommended, but since you are feeling a bit better, I think you will likely be ok.  

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 How long does it take to stabilize after reinstating or updosing?

 Hypersensitivity and kindling

 

I would strongly recommend starting a symptom journal.  As you stabilize, you will likely have periods where you feel better, and periods where you feels worse.  This is a normal part of the process, and is called the windows and waves pattern of stabilization.  Read more here: 

 

Windows and waves pattern of stabilization

 

And here is a template of typical withdrawal symptoms.  You can use this as a base for developing your own method of tracking symptoms. 

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

As for Cannabis, we do not recommend the use of ANY substances to deal with withdrawal symptoms.  This includes alcohol, cannabis, caffeine, other psychiatric medications, supplements (outside of magnesium and omega-3 fatty acids).  And do be very careful introducing anything new at this point- your nervous system is very destabilized, and it is quite common to be hypersensitive to medication, supplements, and even foods during withdrawal.  Start with very low doses, and go from there. 

 

As for coping with all of this while you stabilize and subsequently taper, we recommend non-drug coping mechanisms.  I will provide links to some of this information, but you may find some of your own, too.  I have found swimming to be very helpful with my body pain, headaches and fatigue, and it is very conducive to a mindfulness practice as well!

 

Non-drug techniques to cope with emotional symptoms

 Easing your way into meditation for a stressed-out nervous system

Music for self-care: calms hyperalertness, anxiety, aids relaxation and sleep

Ways to cope with daily anxiety

"Change the channel" - dealing with cognitive symptoms

 

Insomnia is a common complaint around here, so of course we have some recommendations there as well:

 

Tips to help sleep: so many of us have that awful withdrawal insomnia

 Path to Better Sleep FREE online for everyone from the US Veterans Administration

 Magnesium, nature's calcium channel blocker 

 Melatonin for sleep (read carefully- very low doses are best!!!)

 

In summary, based on what I can see so far, I think you should maintain the 2.5mg of lexapro for a week to (preferably) a month.  Give yourself time to stabilize on that.  Start a symptom journal.  If you find your symptoms getting worse on the 2.5mg of lexapro, you can reduce the dose, or stop altogether (if the worsening happens in the next week or so).  Hold your Wellbutrin dose, and I would absolutely not reintroduce cannabis.  Your nervous system needs stability right now.  It's going to take time and patience, but I promise, if you stay the course, you will stabilize, and be able to taper in a safer, slower way down the road. 

 

Most of all, please don't lose hope!  You are in good company here.  Many of us have been exactly where you are.  I do find it helpful to engage with other members.  Read their threads, offer support.  You can also check out our success stories forum as well- I read them when I'm having the really bad days. 

 

And never forget- we are healing all the time, whether it feels like it or not!  You can get through this, and we're here to help. ❤️‍🩹

[Tapertime]

Hello,

 

I am transgender and I started tapering my antidepressants as a results of feeling the best I have felt in years after starting hormone replacement therapy (HRT). 
 

I went way too fast as advised by my psychiatrist, tried to taper from 10mg lexapro to 0mg in just a few weeks. I’m currently back on 1.25mg and dealing with some gnarly withdrawal symptoms. 
 

my symptoms have been mostly physical and my mental state has been okay so far considering the hell my body is going through right now. I also decided to quit my nightly cannabis use shortly before, putting my body through a lot without realizing it. 
 

Mentally I’ve been feeling okay until tonight. I’m up with some insomnia and it just dawned on me how tapering will likely impact my upcoming top surgery. 
 

I cannot describe in words how important this surgery is to me and how much it will improve my quality of life. I’ve been waiting on insurance approval but anticipate I will be able to get this surgery in a few months. 
 

I wish I had not started tapering now because I have read about the potential to become more sensitized to all sorts of things and now feel so fearful about the effects of having started a taper before this surgery. 
 

keeping in mind that the surgery will include full generalized anesthesia, medication for anxiety beforehand, medication for nausea, medication for sleeping, medication for pain, etc. 

 

I’m currently wishing I could just go back in time and not have started this process until after that surgery but I did not realize in the slightest what I was getting myself into. 
 

Please help with any possible advice keeping in mind that this surgery is my #1 priority. I would literally rather go back to my old regular doses of both medications I intend to taper than have to postpone this surgery. I do not know what to do and I’m afraid if I talk to my surgeon about it she will say I will be just fine (which is obviously not true). 
 

I just want to be able to get this surgery, I don’t know what to do. I think originally my thought was I would be off of these meds before the surgery but after learning new information and experiencing withdrawals I obviously realize that is not the case. 
 

I just wanna go back y’all, can I go back? Can I just go back to the doses I was on before and go back to using cannabis or am I ***** now? Has starting the taper put me on a train I can’t get off?

Edited July 18 by Emonda
Name to title

[Emonda]

Hi TaperTIme,

I've moved your new post back here to your own thread. Please keep posting here.

 

Can you add the tapering dates to your signature please. Once you add that, someone will be is a better place to try and help.

 

Best wishes.

[Tapertime]

Hello,

thank you for the feedback. Unfortunately I do not know the exact dates of my tapering as I was not keeping close track until really the past few days. I can edit it to reflect a rough timeline. 

[Catwoman73]

8 hours ago, Tapertime said:

Please help with any possible advice keeping in mind that this surgery is my #1 priority. I would literally rather go back to my old regular doses of both medications I intend to taper than have to postpone this surgery. I do not know what to do and I’m afraid if I talk to my surgeon about it she will say I will be just fine (which is obviously not true). 
 

I just want to be able to get this surgery, I don’t know what to do. I think originally my thought was I would be off of these meds before the surgery but after learning new information and experiencing withdrawals I obviously realize that is not the case. 
 

I just wanna go back y’all, can I go back? Can I just go back to the doses I was on before and go back to using cannabis or am I ***** now? Has starting the taper put me on a train I can’t get off?

 

This surgery is absolutely critical to your mental and physical wellbeing- I hear you loud and clear.  I think the best thing you can do is hold all your meds right now.  Don't try to taper at all.  Engage in lots of the non-drug coping techniques I have provided links to.  Practice them constantly.  If you are very sensitive and struggle on the other side of the surgery, you are going to want to have some tools in your toolbox to get you through it.  The key to success here is preparation.  

 

Yes, your surgeon will likely say that you will be just fine.  And you will.  Try to fight against that kind of catastrophic thinking- challenge those negative thoughts with the question, 'is this really true?'  Yes, there may be some struggles post-op, but you will get through it!  You can provide your body and mind with the tools to do it that much faster by eating a healthy, balanced diet, getting adequate hydration, gentle movement/exercise, lots of sleep, and engaging the non-drug coping mechanisms I discussed above.  Keep in mind as well that we need significantly more calories post op- like, 50% more than normal to facilitate healing.  So plan for some good comfort foods for those times post op that might be challenging!

 

As for going back, well, unfortunately, it's not that simple.  Returning to your previous doses of your meds might work out fine, but it might make things significantly worse.  We have seen many people here develop extreme hypersensitivity to their meds when trying to increase to formerly well-tolerated doses.  I would not want to risk that, if I were in your shoes.  Your job right now is to get yourself as stable as humanly possible before your surgery.  It takes work to provide your body and mind the optimal environment for healing and stability, but I know you can do it!

 

So take a few big deep breaths, sit down, and create a plan.  Start with some meditation- guided ones on YouTube are a good start.  I also like walking meditation (kills two birds with one stone- gentle exercise and mindfulness!)- go for a walk, pay attention to the sights, sounds and smells around you.  If your mind wanders, acknowledge the thoughts, and bring it back to the present.  Practice makes perfect here- eventually, your mind will automatically go to a place of calm when symptoms ramp up.  Try progressive relaxation meditations at bedtime to help with insomnia.  Continue to challenge negative or catastrophic thinking with the question 'is this true?'  Listen to gentle, quiet music.  I'm a big fan of acoustic guitar myself!  Spend time in nature, even if it's just lying in a lawn chair listening to the birds.  Consider developing these tools to be your job right now.  And planning for your post op period will help calm your mind as well.  Who will help care for you?  Where will you recover- at home, or at friends' or family's homes?  Can you do some cooking/freezing in advance to ensure you have healthy and satisfying food readily available?  Thinking through this period of time now will do wonders for your mental health. 

 

You are not **** now.  You just have to adapt to your current circumstances.  There's not a doubt in my mind that you can do this.  Please keep reaching out for support here- we are here for you 100% of the way.  

[Tapertime]

Thank you so much for this thoughtful response it means a lot to me right now and I appreciate it immensely. Your words are very comforting to me right now. I will definitely plan to hold my meds where they are right now and hope for the absolute best. 

 

If my withdrawal symptoms don’t subside in the next few weeks I’m curious about whether it would be a good idea to go from 1.25-2.5mg on my lexapro in hopes of stabilizing that dose in the meantime. I’m not sure if I haven’t looked at the right topics but I still feel pretty confused about reinstating doses and my psychiatrist at this point is just on board with whatever I want to do and is not much help unfortunately. 
 

I did see some advice online about stabilizing at the dose that worked for you previously but it did not have specifics about how to do that and felt a little too good to be true like time traveling back to that dose. 
 

Wherever I end up I will definitely hold until after the surgery. Just very stressful with so many moving pieces! Wish I had known had evil and insidious these drug cocktails were before getting on them at such a young age (started in my teens). 
 

Thank you so much for responding so thoughtfully. 

[Tapertime]

Hello again, back for more support.

 

Today has been pretty sh*tty as well. I just tried to leave my apartment to go to the gym but I am so dizzy and got sweaty just taking out my trash on the way to my car and my body was just basically asking me not to go right now. Huge bummer because I know the gym will make me feel a tad better when I am able to go.

 

My question is, having reinstated the 1.25mg for the past 3 days, is it a bad idea to go back up to 2.5mg tomorrow? Do I have to feel sh*tty like this for weeks to go back up to there? I just wanna feel better. I could also just go back to 300mg of Wellbutrin, I've only been on the 150mg for about 3 days as well. I want to do whatever will likely make me feel better faster, even if it means going back on these evil meds in the meantime and then tapering back down correctly after my surgery. 

 

Thanks in advance for any help.

[Catwoman73]

Jumping around with dosages is not going to make you feel any better, and it has a very strong possibility of making things worse.  Like I said previously, the quickest way to stabilizing yourself is holding- don't change a thing- and engaging in a lot of excellent self care practices.   It can take a long time to fully stabilize.  Think months, not days or even weeks.  I wish there was better news, but more medication is not the answer here- the only way out of this is to do the work.  Three days is extremely early in the stabilization process- you're going to have to be super patient.  

 

Good for you for acknowledging that the gym likely wasn't a wise decision.  That is a great example of good self care.  That doesn't mean you have to sit on your butt though- on days like that, I go for a slow walk, listen to the sounds of nature, focus on what is going on around me.  This is mindfulness, and it is, in my opinion, the best tool to help you cope.  Stay present. Focus on what is around you at all times.  For example- when doing dishes, focus on how the warm water feels, the weight of each dish, the sound of the soap suds, etc.  This kind of presence can keep you grounded, and prevent you from spiralling into dark thoughts. 

 

Hang in there, and be patient!  If you haven't read the link I provided on the windows and waves pattern of stabilization, I would definitely recommend you do so.  Start a symptom journal, and celebrate the small wins.  It's a long journey, but you can do it!

[Tapertime]

Okay I think I am supposed to post in the same thread still?

 

Catwoman73 thank you so much for the responses you have written me, I sobbed reading them at the time from a mix of the emotional rollercoaster of tapering and just appreciation for how thoughtful and helpful your responses were. I am so grateful to you I felt so low in those moments and your responses were so incredibly helpful. 

 

I followed your advice and did go for a walk that day and practiced mindfulness and despite my current state at that time feeling unbearable, it helped a bit.

 

It has been about a month since then and thankfully side effects have been much more bearable and I have stopped beating myself up for tapering too quickly. I have held where I am at now for the whole month. 1.25mg of Lexapro, 150mg XR Wellbutrin, and 30mg Vyvanse. 

 

All of the side effects are still present they are just significantly milder and more manageable, thankfully the mental side effects dont seem to have lasted very long but I am definitely still battling the physical. I started taking fish oil as recommended on here and I did go back to smoking a bit of weed before bed to help me sleep because my body was used to that for so long and it has helped a lot. I also have been going to the gym and lifting weights most days which helps me feel a bit better and helps with my appetite because I know I won't be able to lift as heavy if I am not eating enough, but truly there's a lot of force feeding myself and drinking my meals. 

 

My current dilemma though is this:

 

I think the Wellbutrin dose is too high.

 

Initially I was put on Wellbutrin to counteract side effects from Lexapro (I think I was on 25mg at the time). Now that my Lexapro dose is so low (1.25mg) I think my Wellbutrin dose is too high and not being balanced by the other med. I feel strongly that lowering my Wellbutrin dose will help a lot with some of what I am experiencing now (high heart rate, headaches, jittery, low appetite, trouble sleeping, feeling tired and not tired at the same time) but I don't know where to go from here at 150mg XR, I feel a bit confused by the advice on here. 

 

I saw my psychiatrist this week and she said that lowering my Wellbutrin dose seems like it would help with what I am experiencing but I am just terrified of moving anything w my meds now, I told her I wanted to hold for another month before considering a lower dose but truthfully I do think it might help to lower it I am just terrified of side effects from tapering again. I am less than two weeks out from my Fall semester of grad school starting up.

 

My other fear with any more tapering is that as I have mentioned I will be having surgery somewhat soon, I am still waiting on insurance, there was a little bump that delayed approval, but theoretically I will be getting surgery most likely in December and I worry about being hyper sensitized to meds and having a more miserable recovery than necessary.

 

I'm looking for opinions, should I try dropping Wellbutrin at all?

 

My Psychiatrist recommended I try switching to 100mg SR which is a different formulation and a lower dose - sounds risky to me, but I did okay going from 300mg-150mg so maybe it would be okay? I am just not even sure if I should try dropping it at all or if I should hold until after surgery. But I know the balance of meds I am on right now is not right, I need the Wellbutrin to be lower and it doesn't feel good right now, I am just terrified of even attempting to taper it even a little bit. Also, tapering Wellbutrin requires getting IR and taking it throughout the day and I worry about how a different formulation might impact me. Best case scenario though, it helps and I get a bit of relief. 

 

Thoughts? Thanks in advance. 

[Tapertime]

Me again, hoping for a response to my most recent post!