Monterey01245: limb/muscle achiness

[Monterey01245]

Tapered off of Lexapro which I was on for hot flashes. Every day, I have muscle achiness/tiredness. Has anyone else experienced this withdrawal symptom or do I have some horrible disease?

[Petunia]

Hi Monterey,

Welcome to SA,  tiredness and muscle aches are very common symptoms of withdrawal from antidepressants, how long have you been experiencing this?

 

Without knowing more details, its hard to say if this is due to withdrawal though.  If you could give us a little more information that would be helpful.  When did you stop taking Lexapro?  How did you stop taking it?  What dose and how long had you been taking for?

 

We may be able to help with this once we know more about your situation.

 

Petu.

[Rhiannon]

"Flu-like aches and pains" is one of the most common symptoms of AD withdrawal.

[Monterey01245]

Hello and THANK YOU SO MUCH FOR REPLYING. I was on only 5 mcg of Lexapro starting last August. I am very sensitive to drugs. So for example, when I was on Prozac, I was only on 2.5 mcg, might have graduated to 5 at some point but can't remember. I had no trouble getting off of Prozac. About a decade ago, I was on Effexor which was terrible for me to get off of, of course. I have been prescribed these drugs as they have the off label use of helping hot flashes. I have no estrogen in my body but don't want to take hormones. Most recently on the lexapro, I got as fat as a horse but for the first few months it really helped my hot flashes so didn't care (also helped my mood but that wasn't primary reason). I got to the point where the lexapro wasn't working for flashes anymore so I went up to 7.5 for maybe two weeks. Did nothing so went back down to 5 and then back down to approximately 2.5. All told, the tapering process was about two weeks. The doctor;s office said it would take maybe 3 or 4 days --- yeah, right! I got terrible insomina that even my ambien couldn't touch and I also got these tired, heavy, achy feelings in my legs and arms. I still get them, three weeks later. I don't wake up with them, they come on in the afternoon and later. My limbs feel very fatigued, heavy, like I am about to get sick but I never actually do. I am figuring it is the ssri withdrawal but then I thought maybe I have Lyme disease or something terrible. I should just go get tested but we only have catastrohic insurance. I will have to make an appt to see my doctor who I am sure will know absolutley nothing about protracted withdrawal, then have a blood test, all of which I will have to pay out of pocket for. I didn't have this limb achiness until I went off the drug. That's what makes me think it is connected. I know they say flu-like feelings are typical but I don't feel like I have the flu, just fatigued limbs. Thank you for listening. I have done so much research on this but it is so limited.

[Monterey01245]

Sorry, forgot to say, the tapering process from 5 mcg to O was about 2ish weeks and have been totally off for 2ish weeks but still have limb achiness.

[Petunia]

Hi Monterey,

 

Thank you for adding more details.  Most doctors don't know the truth about antidepressant withdrawal because they only know what they are told by the drug companies.  Many people experience withdrawal symptoms which last a lot longer than 3 or 4 days. 

 

When you say you were on 5mcg, do you mean 5mg?  Lexapro comes in 5 10 and 20mg tablets, so I assume you were on the lowest dose of 5mg.  Lexapro is a strong antidepressant and even 5mg needs to be tapered slowly.

 

Are you sleeping now?  Are you still taking Ambien?

 

Please would you put a short version of your drug and tapering history in your signature, it helps members see your situation when replying to posts.  Instructions for how to do this are here:

 

http://survivingantidepressants.org/index.php?/topic/893-please-put-your-withdrawal-history-in-your-signature/

 

We recommend reducing by no more than 10% every month in order to minimize the risk of experiencing withdrawal symptoms.  Please read through our tips for tapering Lexapro here:

 

http://survivingantidepressants.org/index.php?/topic/406-tips-for-tapering-off-lexapro-escitalopram/

 

Some people can go off these drugs with few problems, but others experience withdrawal which can last a long time.  No one can predict who will have problems, and how long they will last, but reinstatement is the only way of possibly reducing symptoms, and even that's no guarantee, the sooner you try it the more likely it is to work.

 

Because you have only been off for 2 weeks, there is a good chance that reinstating a small amount would stop the symptoms.  Then you could wait for a few weeks to stabilize again, and start a slower, safer taper.  Please read though our information about reinstatement here:

 

http://survivingantidepressants.org/index.php?/topic/3079-about-reinstating-and-stabilizing-to-stop-withdrawal-symptoms/

 

Please look around the site, there is a lot of information here and do let us know if you decide to try reinstating, we can help you decide what dose to try.

 

Petu.

 

 

[Monterey01245]

Again, I am grateful for the response. This is a silent epidemic, I had no idea. Nobody talks about this aspect of AD use. Wish I had known I don't know exactly how long I have been off the drug. Never thought it would be an issue so didn't pay much attention. Yes, I take Ambien, and have for a while as menopuause has given me insomnia in addition to hot flashes. But as I was tapering off Lexapro, Ambien didn't work either. it seems to be helping now, however. I have actually slept the last week. Yes, I was taking 5 mg of Lexapro, cutting up a 10 mg pill. Temporarilily went up to 7.5 because I built up a tolerance to the 5 mg. That probably didn't help in terms of withdrawal difficulty. So I am considering reinstating a small amount of Lexaparo so I won't be so achy. I have Prozac in my possession; should I just take a small dose of that instead to hlep me withdraw? That gives me terrible insomnia, too, but I have had no trouble getting off that in the past. Or is it better to go back to Lexapro in small doses?

[Petunia]

If possible, its best to reinstate the drug you are in withdrawal from and taper from that.  You may feel better by trying as little as 1 or 2mg.  If you decide to stop taking the ambien, you will need to taper carefully from that.

 

Do read through the links I posted and this one too:

 

The rule of 3KIS - simple, slow, and stable.

[Rhiannon]

Also, please see if you can get the liquid form. Cutting up a pill produces dosages that vary too much; it's just not possible to cut it that accurately. Varying doses can make symptoms worse.

 

You can make your own liquid, or you can use a milligram scale to get accurate doses, if you can't get a prescription for the liquid form.

 

I'd try 1 mg and see if you get relief. If so, please hold there for a couple of weeks, during which time you can figure out how to get a liquid form for tapering (by rx or make your own) and then when you're ready to taper you can come down off that last 1 mg by small increments.

[Rhiannon]

Also, check out the charts in this paper, starting page four or so: http://survivingantidepressants.org/index.php?/topic/6036-why-taper-paper-demonstrates-importance-of-gradual-change-in-plasma-concentration/

 

If anyone says to you that 1 mg is a meaningless small dose, print those charts and show them. Actually the last couple of milligrams produce a drastic drop in receptor occupancy.  Decreases at the lowest doses are much more powerful and significant than at larger doses.

 

In my case, for example, on citalopram, I started at 10 mg or about 60 to 70 percent receptor occupancy; now I'm down to just below 1 mg and that's still about 20% receptor occupancy. I'll be taking it down slowly.

[Monterey01245]

I have been considering reinstating but am now leaning towards just toughing it out and seeing if the achiness goes away. I am terrified at the idea of putting any more of the drug in my mouth! What I would love to know is if anyone has had this limb achiness, too. I don't feel like I have the flu (and haven't had the flu in 40 years so maybe forget how it feels) but just have the daily limb achiness. Am I alone in this?

[Rhiannon]

http://survivingantidepressants.org/index.php?/topic/6036-why-taper-paper-demonstrates-importance-of-gradual-change-in-plasma-concentration/?p=86093

 

Here's where Alto flips the charts so it's easier to see that we're talking about decreasing doses versus decreasing receptor occupancy.  This one's citalopram; I'll be getting as much change in my brain percentage wise going from 1 mg to zero as I got going from 10 mg down to about 3 or 4 mg. 

 

I'm just giving you all this because people will say "what difference does 1 mg make?" and also so you can see that your drop from 5 mg to 2.5 was not the same as the drop from 2.5 to zero. This is why we recommend slow tapering.

[Rhiannon]

It's up to you. Some people can just ride it out. Other people go into protracted withdrawal and find that it gets worse instead of better over time. And some people do okay at first, the symptoms resolve, and then they get hit down the road a few months out with worsening symptoms (usually more of the emotional symptoms) and they get diagnosed with a "relapse." Those are the most common outcomes we see. Nobody can say ahead of time what will happen for any one person, because there seem to be a lot of factors involved. 

 

The only thing we can say for sure is that slow tapering is your safest bet and the most likely to result in a good outcome for the long term.

[Jemima]

I went off of 10 mg. of Lexapro far too fast and had the muscle aches you describe, although mine started while I was decreasing the drug. (You can read my Intro by clicking on the link below.)  It took about two years for them to go away completely.  I especially suffered right before a change in the weather.  This went on starting in the fall of 2011 and ended early this spring, rather suddenly.

 

If I were you, I'd definitely reinstate a small amount, stabilize, and taper off from there. Since you're already having nasty withdrawal symptoms, chances are you'll have them over a long period of time (protracted withdrawal) and it's quite possible they'll get even worse.  No one can say for certain, but that's my guess.

 

Here are directions for making liquid medication: How To Make A Liquid From Tablets Or Capsules

[Monterey01245]

Yes, actually the muscle aches started before I totally finished taking the drug. I think they started somewhere in between th 5 and the 2.5 and the 0 dosing. I just hate the idea of going back on this drug which is making me sick but I understand the logic. If I take one ibuprophen, it seems to mitigate the muscle aches. I cannot tell you all how much I appreciate the suggestions and feedback. Yesterday the aches were pretty much gone for the first time but then back today which is what you all have warned me would happen.

[Altostrata]

Welcome, Monterey.

 

I'm the head administrator on this site and I must say our moderators Petu, Rhi, and assistant admin Jemima have given you solid gold advice studded with diamonds. Bravo! Beautifully done.

 

In the future, you may wish to pursue non-drug treatments for hot flashes. As you can see, antidepressants are extremely powerful drugs that doctors throw out like candy. While trying to manage a relatively minor symptom, you can get yourself into a much, much worse health situation by the use of the drugs -- and still have hot flashes!

 

Not only that, but when you take your complaints about withdrawal symptoms to your doctor, you may very well end up with a psychiatric diagnosis and be put on a psychiatric drug cocktail. So please watch out for that.

 

Many women with hot flashes do better with meditation, yoga, or exercise.

[Monterey01245]

Yes, good advice indeed. So appreciated. I know how the doctor's throw around the ADs like they are candy. I do appreciate their efforts on my behalf because I have had SEVERE hot flashes since I was 46 - and I am now 59. I am talking about flashes every 15 minutes or so. I have exercised the whole time and eat alot of soy (as I am a vegan). I have had blood tests that show I have no detectible estrogen in my blood, even when I was on bioidentical hormones with estrogen in it. I was so happy with LExapro at first -- my flashes went away within a day but then I grew tolerant in about 9 months. In retrospect, knowing how I would be suffering now, I would not have done it. People should be warned. Physicians should know but they are so ignorant or brainwashed themselves. It feels unethical for people to be prescribed these drugs with being forewarned. Since I had no trouble withdrawing from Prozac previously, I had no worries about Lexapro and was absolutely desparate to get relief from the flashes. When I went to my primary last August (the day she put me on Lexapro), I was in sweats every 10 minutes. And I have central air! No one is going to give me a psychiatric cocktail, that's for sure, because I am in the mental health field myself and know what's what with psychotropic drugs. But I can see how others are vulnerable to that minimization. And here I have often recommended to clients that they go on ADs but rest assured, I have already changed my tune! If it wasn't for the fact that these symptoms came on right when I started tapering, I would think that I have become a very ill person. I still will pay to have a blood test to rule anything out. Well, thanks for letting me ventilate. I am so impressed with this forum and the help I have received. I am glad I found you all.

[Altostrata]

I certainly understand why you tried antidepressants for hot flashes.

 

Hot flashes can be due to high histamines coming from the foods you eat. You might want to look into a low histamine diet. http://thelowhistaminechef.com/

 

Soy could even be the culprit!

[Monterey01245]

I have never heard of this! I will research it. I always figured I had such terrible hot flashes because I do not get estrogen fromn animal sources in my diet as I do not eat meat (22 years) or dairy (14 years). My mother died young from heart disease and diabetes so I don't know if I inherited the tendancy. I have been advised not to go on hormones especially so late in the game now though I did try the bioidentical a few years ago. Back to withdrawal symptoms, have you heard of folks getting through the aches and pains and myalgia within a month or so? I would assume that some get through it all within that time. Thank you again!

[Altostrata]

Hmmm, no dairy or meat -- probably not a histamine problem, though you don't know, one of your favorite foods might be the culprit.

 

Are you getting vitamin B12? That's a real deficiency in a veggie diet.

 

I've been on a Menostar mini-estrogen patch (14mcg/day) with no problems for several years now.

 

Yes, probably most people recover from withdrawal syndrome in a month or a few months. But since you've been on and off so many drugs, your nervous system might have become sensitized.

[Monterey01245]

If my system is 'sensitized' as you said in your last post, what does that mean?

 

Yes, we do take B12. Since we don't eat animals, we have to take supplements. When you eat animals, you get more of it (though you can still be deficient) because the animals have it from what they themselves eat. Thanks for mentioning that though.

[Altostrata]

"Sensitized" means your nervous system may react very strongly or in strange ways to neurologically active drugs, supplements, and even foods.

 

People with sensitized nervous systems have to be very careful about what they try as remedies for withdrawal symptoms.