frisk: Insomnia induced by Lexapro (5 mg)

[frisk]

Hi everyone,

 

For the last 7 months I've been experienced extreme chronic relentless sleep maintenance insomnia. Every night I wake up after 1-2 hours of sleep no matter how little sleep I have, and once I'm awake it's impossible to fall back asleep for a few hours after which I repeat the process sleeping a little less each time. Naturally, I can manage like 3-4 hours of broken sleep. 

 

I started from being on 5 mg/daily cipralex for 4 months. One day I started experiencing these symptoms so I decided to stop the medication though I've seen 0 improvement. If anything it's gotten worse. I've done CBT-I, practice sleep hygiene, and have tried to keep a positive attitude but after a certain while this is is just unbearable. I don't know what to do feel and honestly feel like my life is over. It's been 7 months with 0 "windows". 

 

Please tell me someone on here has experienced something similar and has gotten better. 

 

Thank you 

 

Edited August 17 by Catwoman73
Name to Title

[Catwoman73]

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

 

If you could kindly complete your drug signature, we would greatly appreciate it.  Your drug signature appears at the bottom of all of your posts, and gives those visiting your thread a snapshot of your drug history, so they don't have to weed through all of your entries to know where you've been.  To complete your signature, click the following link, type your information in the box, and click save.  That's it!  You can refer to mine at the bottom of this post to see the general format.

 

Your Drug Signature

 

From what you have said above, it looks like you stopped your escitalopram cold turkey after being on it for four months?  Am I getting that correct?  If so, this is why you are experiencing such extreme insomnia.  Insomnia is a well-known withdrawal symptom when discontinuing SSRIs, particularly when not tapered properly.  Here at SA, we recommend tapering by no more than 10% of your CURRENT dose, no more often than every four weeks.  So, in your case, you would drop from 5mg to 4.5mg, 4.1mg, 3.7mg, 3.3mg, and so on.  This is known as hyperbolic tapering, and is designed to release the receptors in your brain from the drug slowly and gently, in order to minimize withdrawal symptoms.  You can read more about hyperbolic tapering here:

 

Why taper by 10% of my dosage?

 

Unfortunately, what's done is done, and we can't turn back the clock.  You have a couple of options.  You can ride this out, which is what I would recommend.  I know it's brutal- so many here suffer from severe insomnia.  But you will heal with time.  I will provide you with some info on dealing with insomnia shortly. 

 

Your other option would be to try to reinstate a small dose of escitalopram to see if it helps reduce your withdrawal symptoms.  We typically don't see a great deal of success with reinstatement this long after stopping the drug.  We don't know the exact window of time in which reinstatement will be successful, but observations here lead us to believe that it is best done within three months of stopping the drug.  But it is an option, if you wanted to try.  A word of caution here- you would have to start at an extremely low dose.  I would recommend 0.1-0.2mg to start.  This means that you would need to get a prescription for a compounded liquid formulation, or a prescription for 5mg tablets, and make your own liquid.  If you overshoot your ideal reinstatement dose, it can lead to a hypersensitivity reaction, and this would leave you in a world of hurt.  After reinstating at this low dose, you would need to hold at that dose for 1-2 weeks to see if it's helping before considering an increase.  So, even if it does work, it will take time to find the ideal dose that works for you.  And if you tell your doctor what you are doing, he/she will think you've lost the plot lol.  Most doctors have absolutely no clue how these medications actually work, and the damage they can do.  Here's some info on the reinstatement option:

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

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

 Hypersensitivity and kindling

 

Whichever option you choose, there are no magic bullets.  You will still have withdrawal symptoms, and you will have to deal with them until your brain and body has had a chance to heal.  This can take many months, as you have already figured out.  You would probably benefit from starting a symptom journal.  Track your withdrawal symptoms day to day, rating them on a scale of 1-10.  It is quite normal to have periods of feeling slightly better, and periods where you feel slightly worse.  This is known as the windows and waves pattern of stabilization.  It is much easier to identify your windows if you are keeping a journal, as they are not always really obvious in the early days of withdrawal.  Here is a list of typical withdrawal symptoms that you can use as a template for a journal, if you wish, and some info on windows and waves:

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

Windows and waves pattern of stabilization

 

I don't know if you are experiencing any other symptoms, so for now, I'm going to link you to several threads that talk about coping with insomnia.  I want to assure you that this is an extremely common withdrawal symptom.  So you are not alone.  A word of caution about supplements- it is quite common to become hypersensitive to all sorts of things while in withdrawal from psych meds- medications, supplements, and even foods.  So even if you do start one of the supplements that we recommend here, I would go with an extremely low dose to start, and see how you fare.  You can always increase the dose slowly over time if you tolerate a supplement well.  I am a prime example of hypersensitivity- magnesium has a paradoxical effect on me- it gives me severe insomnia and brain zaps!

 

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 (pay very close attention to dosing info here)

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

 

You have to keep experimenting to find things that work for you when it comes to managing symptoms.  Something that I have found really helpful with insomnia is listening to yoga Nidra on YouTube at night.  I generally choose a longer one- 1-2hrs, because I know it will take some time for me to wind down.  Even if you don't find sleep, yoga Nidra will aid in full, deep relaxation, which is the next best thing. 

 

There are some things you can do to provide your body and brain with the optimal healing environment.  Eat a balanced, whole foods diet, stay hydrated, get as much rest as you can, and get gentle exercise.  Avoid neurologically active substances, such as caffeine, nicotine, alcohol and recreational drugs.  Avoid taking other psychiatric medications to deal with the withdrawal symptoms of psychiatric medications- this has the potential to make things worse, and even if it doesn't, it will create a situation where you have to taper off of another drug down the road, thereby prolonging your tapering/withdrawal journey.  Outside of magnesium, we only really recommend one other supplement- omega-3 fatty acids.  Read more on that here:

 

Omega-3 fatty acids (fish oil)

 

In summary, you have NOT ruined your life.  The nervous system is a notoriously slow healer.  Patience is needed.  You could try reinstatement, but in my opinion, it's been long enough that it's not as likely to work as it would have been a few months ago.  Whatever you choose, you will still need to cope with your symptoms for a while.  Practice reacting to your situation with calm, deep breathing.  Use mantras like, 'I am healing' to help maintain calm- this will aid in healing of the nervous system.  Unfortunately, there are no magic bullets here- only time and patience.  I wish there was more we could offer here, but you do have our unwavering support, and this is a community that fully understands how difficult withdrawal is.  ❤️

 

This is your introduction topic- each member gets one intro topic.  Please post updates, questions and concerns here, on this thread.  But don't hesitate to explore the rest of the forum- there's lots of good information here!  And if you feel up to it, it can be helpful to engage with other members by reading and commenting on their intro topics.  Withdrawal can be a lonely journey, but this is a wonderfully supportive community.  Having a village around you makes the journey much more tolerable. 

[frisk]

Hi @Catwoman73! Thank you for the detailed response, I really appreciate it. 
To clarify though, the insomnia symptoms began while taking the cipralex. Just one morning I began waking up at 3 am, unable to fall back asleep and it’s remained the same since coming off the meds. I wish it was a case of withdrawal symptoms, because then I’d feel like the situation was less abnormal…. 

 

I’m just worried the medication has ruined my sleep structure. I see other posts of similar issues, but they’re all cases of withdrawing from the drugs. There’s another user who I’ve spoken to who has a similar issue as mine but it seems as though they haven’t found much relief either.

 

I won’t lie, it’s really rough but I’ll keep on pushing. Just sucks how I take these meds, having friends and family advocating for me to take these meds so I can start to feel better and they’ve made my life infinitely harder.

 

 

[Catwoman73]

You can still have withdrawal while on the medication in a process that we lovingly refer to as poop out.  We can take years to reach poop out, but it can also happen very quickly. If you look at the studies used to approve these drugs in the first place, you would see that the studies lasted, on average, about 8 weeks.  At the four week mark, most people were feeling relief from depression/anxiety, but by the 8 week mark, there was no difference in depression/anxiety between the group taking the medications and the group taking a placebo.  This shows that poop out can happen very quickly.  And when poop out happens, withdrawal symptoms ensue, even if you are still taking the meds.  In your case, I have no doubt that your cold turkey stop is continuing to exacerbate the poop out symptoms, because now the serotonin receptors in your brain are trying to adjust to the sudden absence of the drug. 

 

You haven't ruined anything- your nervous system just needs time to heal.  It can take a LONG time, so patience is going to be your best friend.  You are absolutely not alone in your struggles with family members, thinking that these meds are going to fix you, when in reality, they are making so many people significantly worse.  I'm glad you've found us- we can be your community and your shoulder to cry on while you are healing.