ToesInTheSand: Constellation of Symptoms

[ToesInTheSand]

Thank you, Rhi. I had read that particular passage but it was helpful to read it again. Are there any cites for the info? I'd like to bring it in to my pcp for her to read.

[Rhiannon]

I think there are citations in Anatomy of an Epidemic for the changes in serotonin receptors and other neurobio changes in response to the drugs. The stuff about genes turning on and off is basic neuroscience, I don't have specific citations but it's all over the place. Neuroplasticity, same thing. Homeostasis, same thing. Well established concepts in physiology. (Although these drugs were introduced before we knew about neuroplasticity--that came along in the 1990's.)

 

As far as the exact sequence of events in response to psych meds, and whether or not and how the brain attempts to regain homeostasis, I don't know if there are studies on that. Not in humans, for sure, but there may be some stuff in rats. That sort of research is not likely to get much funding since it implies that screwing around with brain chemistry might not be good for us (doh).

 

I'd say read Anatomy and take that to your doc. It's exhaustively researched and documented, and it has much more of the relevant background and context.

[ToesInTheSand]

Excellent. Thank you very much!

[ToesInTheSand]

I just got back from a visit with my awesome GP. She spent a good half hour with me and listened to what has been going on. She is going to help me with the Lexapro - staying on the 3.75mg for several months, then dropping it when I'm stable. She also told me that the cimetidine interacts withn a lot of meds and basically makes the liver unable to process meds. So she switched me to ranitidine and gave me carafate instead of pepto, which she said contains aspirin and makes things worse on the long run. I can take that as needed. Also recommended a book on CBT that I am getting from the library. And I got a hug at the end. . So I'm feeling relieved. Stomach is better today, though still no appetite and was hard to eat. Hopefully I'm coming to the other side. GI doc is tomorrow afternoon.

[ToesInTheSand]

An update: I haven't had the Lexapro headache in a couple days. Previously I would get a headache across my forehead along with a weird dizzy/woozy sensation. I am still on the 3.75mg of Lexapro. GI issues are still bad, though I haven't had the horrible empty feeling in a couple days. I went to work yesterday, but felt very nauseated/acidy/burpy last night and felt bad this morning so did not go to work. I am still having a lot of trapped stomach gas and don't have an appetite today. It has been one week and two days since I reinstated.

[Altostrata]

That's progress, Toes. It can take some time for your nervous system to stabilize after reinstatement.

 

You might try some mild probiotics to settle your stomach. Please see our Symptoms and Self-care forum for suggestions.

[ToesInTheSand]

Thanks, Alto. I am trying to see it as progress, but when I am still having oher very uncomfortable symptoms, it's hard to be positive. I have tried probiotics in the past and they have made things worse, but am open to trying again. I have a call in to my GI doc so I am hoping to discuss this stuff with her on Tuesday.

[Altostrata]

I have found ginger and turmeric capsules to be helpful for stomach-settling.

 

With probiotics, one has to go carefully, try a portion of a capsule at first. They can have big effects.

 

You can go a long way towards cultivating gut bacteria with diet, too.

[Pokeshaw]

Thank you Pokeshaw. It really is a very trying time. What stresses me most at the moment is what to do about my job. I feel so up and down physically that it is impossible for me to go to work some days and I never know how I'm going to feel until it's morning and I get out of bed and attempt to eat. I dont't know what is the Lex and what is whatever is wrong with my stomach. I have a history of (mostly undiagnosed) stomach and bowel issues. The L-glutamine - how did that make you feel? No interaction wih the Lex?

 

Hi Toes - i have copied your reply that was on Pokiok's page.

 

the glutamine did not seem to interact with the Lexapro. i was at the time having constant various symptoms but the acute inflammation was what concerned the doc the most since i could not eat and was in a lot of pain. so i followed his recommendations and used about 1/2 a teaspoon in a 1/2 a cup of water and sipped it with each meal. i never took it alone. always with food. over a period of a couple of weeks my stomach healed nicely and i was able to eat. i think i used it for about a month. i still had the reflux to deal with but over time that calmed down considerably.

i also understand about work. it was very hard for me as well and sometimes it still is. stress is a difficult factor. i have had to really commit to meditation and relaxation and breathing techniques. especially on the crowded nyc subways. i was dealing with pretty extreme vertigo and nausea and it was all i could do to listen to calming meditation music and repeat healing mantras over and over just to get there. Work itself sometimes distracted me from the symptoms. i had been on disability for 3 months but it didnt really help. i just walked around in circles most of the time in a loop of anxiety and panic. the focus on getting to work and showing up for life seemed to help me.

P

[pokiok]

It took me a good couple of weeks before I felt some relief after reinstating, so hold steady! And I'm glad to hear you had a good visit with your GP, sometimes it's just nice to know that they're actually listening to you, not just nodding their head mindlessly.  My GP will ask me first thing I walk in if I'm still taking my "tablets", as she thinks I'm a loon and a simple cold that I'm visiting her for is just in my imagination. Needless to say, it's time I switch GP's!

[ToesInTheSand]

I was able to go to work yesterday but had some sudden bad nausea last night that seemed to mess things up this morning. Also, what is with the waking up early? It has been happening since I reinstated and was never a problem before. I get very sick if I get up too early, so this is concerning. Also, it makes me tired! I had a headache today, I'm guessing from the lost sleep (even though I was able to sleep off and on from 6:45 until about 9:30ish). I got bloodwork done today to test for h.pylori. I cannot fast, so that means I can't have any of the GI tests to see what's wrong with my stomach. I feel like if this bloodwork comes back negative, which I think it will, I will be left on my own to figure it out. I know I am not the only person in the world with low blood sugar and the inability to fast. Why am I not being offered other options?

 

My main concern and stressor right now is work. I have worked two days out of the last ten. I need to make money but I cannot go in to my office job reliabily due to how I feel. I feel completely paralyzed with no options for income. I contacted a former boss and a former professor asking if they had any work I could do at home -i.e. transcribing interviews of their study subjects. No response yet. I don't know what my options are as far as temporary disability, or if that is an option at all. I don't know how much longer I will be able to call out of work. Every day i have stress and dread about whether I will be able to go in and having to tell my boss I'm not coming in.

 

I feel so alone in all of this. No one can tell me what my symptoms are from. Am I taking too much Lex? Too little? Was the med keeping this at bay while I was on my full dose (even though this type of episode happened while on the full dose, but didn't last this long and was due to a traumatic event)? Is this withdrawal even though I reinstated? Is this separate from the med? How long is this going to last? I am losing my life, here! I don't know what to do. I need to solve the work/income problem immediately. Has anyone else been unable to work? What did you do?

[Petunia]

Hi Toes,

I'm sorry you are still having problems and suffering with symptoms.  I think its been 2 weeks now, since you reinstated 3.75mg of lexapro.  From reading back through your thread, I get the feeling that the reinstatement may be helping, slightly, but that your secondary worry and anxiety about your situation is causing you a lot of stress and making your symptoms worse.

 

Did you get the book on CBT?  I think that learning how to control your thinking will be be very helpful.  Anything which helps you to stay in the moment and not worry about the future will reduce stress and help the reinstatement to work faster.  Guided meditations, mindfulness and breathing techniques can help with this.  Pleasant distracting activities can help too.

 

Are you keeping good daily notes of your symptoms?  This is important so that you can clearly see any improvement.  Its a good idea to also document external stressors so you can see what else is contributing to symptoms besides withdrawal.

 

Early waking is a common symptom of withdrawal and a destabilized nervous system, but the fact that you are sleeping and are able to go back to sleep when you do wake up is good.  If you are able to go into work, that's also a good thing, I know the symptoms are very uncomfortable, but they wont harm you and this way, you will keep your job, and that's one less thing to worry about.

 

Read through this topic on reinstatement again:

 

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

 

Please give it a bit more time, learn some relaxation skills and I'm confident you will start to feel some relief soon.

 

Petu.

[Altostrata]

If you think you might benefit from a higher dose, I might try going up slightly to 4mg and see what happens. It will take about 4 days for the change to fully register in your system. If you get an immediate bad reaction, back down.

[ToesInTheSand]

Alto - I think I would rather stay where I am. Thing seem to be improving, though very slowly. I actually made it to work two days in a row. I am definitely still experiencing effects, which I think is combined with IBS symptoms today. I am trying to take it one day at a time, one hour at a time sometimes.

[Altostrata]

Of course, toes.

[ToesInTheSand]

I realized today that the Lexapro may be causing or worsening depression. I have been having periods of crying or almost crying, lack of interest in anything (which I previously attributed to feeling horribly, but I'm not feeling nearly as bad stomach-wise now), no or low appetite, anger.... Today i exercised for the first time in over two weeks (normally it is several times a week - running and weights). I went to the park and walked, thinking I should take it easy. The longer I walked, the angrier and more depressed I got. I had nothing to do but think, and my thoughts were all about how my life has gone to crap and how I feel so paralyzed to change anything, etc. all very unhappy thoughts. Every day I think about running away. I don't even feel like I get a whole weekend anymore because I spend Sundays filled with dread about having to go to work the next day. I can't even enjoy the day. I just want a new life.

[Petunia]

I realized today that the Lexapro may be causing or worsening depression.

 

Hi Toes, I'm sorry you are still feeling unwell.  Its unlikely that this is being caused by your reinstatement of Lexapro.  I think its been just over 2 weeks now, since you reinstated 3.75mg of lexapro.  From reading back through your thread, I get the feeling that the reinstatement may be helping slightly.  But it can take some time.

 

After reinstatement, the amount of time needed to alleviate withdrawal symptoms (stabilizing) varies according to the individual. Relief can be felt immediately, after some weeks, or after some months.

 

Be patient after you reinstate. Reinstatement may not immediately eliminate all withdrawal symptoms. You may still experience waves of symptoms, which usually lessen as time goes on.

 

Read through this topic on reinstatement again:

 

http://survivinganti...rawal-symptoms/

 

Please give it a bit more time. 

 

If the way you are thinking about your situation is making you feel worse, CBT would probably help. Once you get stabilized and taper properly, given enough time, you will recover.  Its much better to focus on these positive thoughts about your future recovery than dwell on the temporary situation you are in now.  I understand how difficult it is when the depressing thoughts just seem to come from nowhere, but we do have control over what thoughts we allow to stay.  With practice, its possible to notice the thoughts as they arrive, then just let them go without getting caught up in their downward spiral.

[ToesInTheSand]

Petu - why do you think this is not being caused by the lexapro? I wasn't having an issue with depression previously. I was on the lexapro for panic disorder. These are mostly new symptoms in the past few weeks.

[Petunia]

Depression is a common symptom of withdrawal.  If the lexapro wasn't causing depression at 7.5mg, then its less likely to cause it at 3.75mg, as the dose decreases, any side effects usually do too. 

 

Withdrawal causes all kinds of symptoms to occur in waves and through the stages of recovery.  But its not caused by the drug, but the absence of the the drug your brain and nervous system has become dependent on.  All the recent changes, then stopping completely, then the reinstatement cause the nervous system to become destabilized, it usually takes a while for it to settle down again, while this happens, symptoms arise in a wave like pattern. Please read the reinstatement topic again.

 

Three days ago you wrote that things were improving.  Keep notes on paper of your symptoms so you can get a clear picture of what's happening.

[ToesInTheSand]

Oh, so you're saying this is still withdrawal? Things with my stomach are improving, though it is slow and one step forward two back type of thing. The emotional stuff seems to be getting worse, or at least not improving even though physically I am better than two weeks ago. My deep unhappiness wih my life and my seeming inability to change anything is not helping things.

[Petunia]

I think its a combination of withdrawal and the emotional stress of trying to deal with the shock and trauma of the whole situation.  When we find ourselves in a situation where we feel like we are losing control of our life, that causes huge emotional stress.

 

 My deep unhappiness wih my life and my seeming inability to change anything is not helping things.

 

Is this feeling of deep unhappiness what you mean by 'new depression', or is this something you have had for a while?

 

It might seem like you can't change anything, but you are.  You have found this site and are learning how to taper properly, you have a new, supportive GP, you are doing what you need to do to take care of yourself and get better.

[ToesInTheSand]

Thanks, Petu. All of this is a huge emotional & physical mess. I am now on 5mg of Lexapro. My doctor feels that a lot of my current stomach issues are due to anxiety. She also put me back on Buspar, even though I told her I didn't feel it did anything when I was on it previously. I came off without issue, so I agreed to try it again. 5mg daily, much less than the previous dosage of 15mg bid.

 

I apparently need an abdominal ultrasound to rule out gallstones and this has me extremely distressed for numerous reasons. My doctor said she wants to get my anxiety level down so I can manage to have the test. The fasting is the issue causing me anxiety (I have low sugar and attacks cause me great anxiety and distress) along with the possibility of a positive result requiring surgery. Needless to say, I have very significant medical anxiety. Always have.

 

I am still having problems with eating, especially in the morning, and have no appetite. I am nauseated at times and full of air. It has been months since I have felt well and I am so emotionally drained and have no idea when this will end. It is so isolating.

[Altostrata]

Toes, are you following any gentle natural gut healing protocols? Taking a probiotic?

[ToesInTheSand]

No. I have tried probiotics in the past and every time they made my symptoms worse. I am avoiding foods that seems to bother me. I felt relatively decent today, which I am not getting invested in since in all of this I haven't had two decent days in a row.

[Altostrata]

Interesting. You might look at our discussion of histamine intolerance, see if that fits http://survivingantidepressants.org/index.php?/topic/3503-histamine-intolerance/

[ToesInTheSand]

So, I am still pretty incapacitated by symptoms. The other day I remembered I had been cold-turkeyed off of Zoloft after being on it for 20 days during the Lexapro taper. Could I be experiencing withdrawal from that (even though I reinstated the Lexapro)? This was in August.

 

I am having a lot of GI issues, mainly loss of appetite, nausea, and IBS. It seems like any little stressor causes a setback. I recently went back to work after being out for a month due to these symptoms. I had started to get my appetite back prior to this, and even had gone for a run a couple times. When I had to go back to work because my temp disability was over, I got worse again. I can't even work my normal M-F schedule because I just don't feel well enough. If my appetite would come back I would feel a lot better. At this point I am going to be starting intensive outpatient therapy for the anxiety because I cannot function well. I am also dealing with feelings about a relationship thst has presumably ended. I just don't know what to do anymore. I can't tell what is causing what, I don't know how to deal with the unpredictable symptoms, and I feel very alone in this.

[ToesInTheSand]

I wanted to come back and give an update on what's been going on. I started the intensive outpatient therapy (IOP) in the middle of November. It's helping some. I've also recently started meditating. That it helping as well. However, I am still unable to work. The physical symptoms are still debilitating a lot of the time. I've also realized in the last couple of days that my emotions have been flattened throughout this ordeal. My anxiety seems to have transformed from panic attacks to a more generalized anxiety. It's daily, and it's almost constant. I don't know which is worse.

On Friday I have an appointment with the pdoc at the IOP program. When I saw him last month he agreed that the Lexapro is not good for me at this point due to all the symptoms I've been having. He and I wanted to wait until I'd had some more therapy in the program so that I felt better able to deal with coming off of the med. I am scared to come off, because I'm afraid I'll feel worse due to withdrawal, but I'm also looking forward to being free of this drug. When I see the pdoc I will be requesting a prescription for the liquid so I can taper as slowly as I need to.

[Petunia]

Thanks for updating Toes, I'm glad to hear that you are feeling a little better, I think 'general' anxiety is an improvement on panic.  Are you still having GI issues?

 

If you don't feel ready to start tapering, then you could hold for a little longer, then when you did start, perhaps try a 5% cut to see how it effects you.  What are the side effects you are getting since reinstating the Lexapro?