☼ Icebat: Lexapro (escitalopram) withdrawal

November 14, 2015

Hi All,

I've been reading this forum for a while and the topics here have been indispensable, especially regarding dealing with withdrawal symptoms as I prepare myself for a slow taper off of my remaining dose.

Pre-backstory

I’m in my early 20s and I just graduated college in late 2014 with a high GPA and a degree in Computer Science. I’ve got a strong resume with projects under my belt. I should be starting my career right now but can’t due to antidepressant withdrawal, but I keep telling myself that I will get better and it will happen, I just need some more time to heal mentally and spiritually.

Backstory

On January 1st of this year (2015) I suffered the first panic attack of my life. I’ve always had weird heart flutters and missed beats, so I thought I was having a heart attack and dying. The day that I had this awful panic attack, I didn’t get much sleep the night before and I didn’t eat much that day (triggers, I know). I also smoked pot regularly (I am clean now) which in retrospect I figure could be messing with my seratonin. I had bad depersonalization that day, basically forgot who I was for a few hours, and over the next month or so I was bedridden feeling shaky every day, suffering a chain of panic attacks in bed. I was immediately prescribed ativan (lorazepam) to help dull the panic attacks, and shortly thereafter, desperate for something to stop the chain of panic attacks, I was prescribed Lexapro. I took the Lexapro 5mg for the first week and 10mg for the second week, and basically over the next few months my panic attacks got generally better but my mental health got generally worse. My doctor upped me to 20mg Lexapro and I got so disoriented and out-of-it that my mom had to start walking me up to the door of my therapy appointments, because I didn’t feel like I could do it alone.

I decided to taper down off the Lexapro because my panic attacks had basically vanished, the Lexapro was causing some bad side effects (at higher doses making me confused and disoriented all the time, at the lower doses mostly just preventing me from getting decent sleep, so I was feeling tired all the time). I felt like the panic attacks would probably not come back, since I was on a good new pattern of diet, exercise, supplements (fish oil, magnesium, probiotic and multivitamin), and I also stopped smoking weed completely, which I think may have been a big contributor to the initial panic attack.

Anyways, I had miraculous success taking the dosage down from 20mg to 10mg, from 10mg to 5mg, and from 5mg to 2.5mg, with almost no withdrawal effects. The side effects improved steadily with each dosage decrease, and I’m very grateful that I had so little trouble getting down this far.

The big trouble started happening about a month ago. I had thought that I had tapered down successfully from 2.5mg because I felt pretty great for 3 weeks on 1.25mg (¼ of a 5mg pill) with no discernible withdrawal symptoms (Sept 9 2015 to Sept 29 2015). On my psychiatrist’s suggestion, I dropped the lexapro completely (0mg) on Sept 30 and I felt worse and worse for about 4 days. On the 4th day I almost had a panic attack, and I felt so depressed and shaky that I took a small fragment of my pill to try to stave off the symptoms. Literally 15 minutes after taking the pill fragment I went from feeling terrible to feeling great, browsing the internet on my phone. So I stabilized again on 1.25mg after about 5 days, or so I thought.

1.25mg (¼ of a tiny 5mg pill) is terribly difficult to measure - there was one time I wasn’t sure if I even took my pill fragment or if it fell on the floor, since it was so small I couldn’t feel it on my tongue. So I started pushing it against the roof of my mouth so I could be sure it was actually in my mouth. But that made it start to disintegrate before it hit my stomach, so… basically I think that my true dosage was getting really uneven. I felt really tired some days and needed naps, and other days I felt mostly fine. So I figured I could get a more consistent dose if I switched to the liquid, which my psychiatrist prescribed for me.

Latest Chapter

So on 10/28/2015 I switched to the liquid. I figured that the liquid form would be much more readily absorbed by my body than the pill fragments and I was right. I started out with 1.2mg of the liquid and it felt like way too much (cloudy head, sleepy all day), so over the course of 2 days I lowered it to 0.9mg, which felt pretty fine for 5 days. I felt like I was getting better and that I could even start driving and running errands around town with my mom again if I just waited a few more days.

On 11/4 I made a really, really stupid headstrong decision. I felt like I could reduce my symptoms even more if I just reduced the dose by a tiny bit further. So that day I cut from 0.9mg to 0.8mg (which in hindsight was a HUGE cut especially considering how recently I had changed the dose before that). The depression came back in such full force that I immediately had to put the dose back up to 0.9mg 2 days later, but reupping the dose didn’t help at that point. I continued to get worse and worse (more depression/anxiety) until my mom pointed out that I was only eating like 800 calories every day - I knew that my appetite was shot, but I had no idea I was eating so little.

On 11/11 I started counting calories and now I’m getting at least 2000 per day, with an ultimate goal of 2500. I upped the lexapro from 9mg to 9.5mg daily and the crippling depression is partway gone now. Anyways now it’s 11/14 and I think I’m seeing some progress, but I can never be sure, and these symptoms are very difficult to work through every day.

Today

Over the last few days, every morning I wake up nauseous and depressed, and every night I get anxious and need to take a 0.5mg lorazepam to calm down. Progress is slow for me and I’m impatient, but I keep trying to remind (convince?) myself that my body is working very hard to right itself chemically, and that if I just hold this dose and don’t do anything else stupid with it, I will feel a little better by next week, and yet a little better by the week after. I could really use some reassurance though :/

My First Question

I’m taking 0.95mg in 2 doses daily (0.475mg at 11am and 0.475mg at 1:30pm). On 0.95mg I feel like my seratonin levels are very unbalanced (depressed/hopeless in the morning, decent around noon, anxious by afternoon/evening). When I accidentally took my second lexapro dose at about 4pm one day instead of 1:30pm, that night I went into a drug-trip kind of sleep (almost like an alternate reality) which was a little scary but most of all exhausting and made me feel disoriented and confused and anxious the next day. As of the last few days, I wake up after vivid dreams exhausted, not at all rested, depressed, and with a burst of adrenaline. Will my body actually be able to get used to such a low 0.95mg dose taken mostly towards the beginning of the day like this? If I just stick it out for another week or two, my mood will start to level out again so that I’m not getting these big daily mood swings, right? If not, where do I go from here?

Thank you everyone for your support.

November 14, 2015

Welcome Icebat,

Thank you for sharing your story. I'm sorry to hear what you've been through, and now you're having trouble tapering off your drugs. After reading through what you've written, it occurs to me that your symptoms may be partly related to ativan, or rather, the way you are taking it. This is a short acting benzo, if you take one dose at night, you could be experiencing rebound anxiety the next day, it can also cause depression. Usually, when someone has a nervous system sensitized by withdrawal, we recommend splitting any dose of a short acting benzo so that it can remain stable in the blood. How many doses needed depends on the particular benzo.

You might want to go to our Members-only benzo forum for more information about this. I'm not certain this is causing a problem, but its a possibility.

Why are you splitting your lexapro dose, this is usually only taken once a day. How long have you been taking it like this?

You have certainly been tapering Lexapro too fast and jumping around with your doses, this has most likely caused the symptoms you are having. I suggest you stop tapering for now and try and stabilize at .95mg

I upped the lexapro from 9mg to 9.5mg daily...

You meant from .9mg to .95mg here right?

We suggest reducing by no more than 10% of the current dose every 4 weeks, this reduces the risk of withdrawal symptoms arising. Please read through this which will explain why:

Why taper by 10% of my dosage?

Tips for tapering off Lexapro (escitalopram)

Also see: The rule of 3KIS: Keep it simple. Keep it slow. Keep it stable.

Stabilization can take a while, its hard to say how long, but it tends to happen in a windows and waves kind of pattern.

The Windows and Waves Pattern of Stabilization

I’m glad you found us, we’re here to support you.

Petunia.

November 15, 2015

Welcome, Icebat.

What you might do is slightly updose to 1mg per day, then take 0.2mg of the dose to the afternoon or evening. (You'd take 0.8mg in the morning.) The larger dose earlier in the day covers those symptoms in the afternoon. The smaller evening dose is to forestall any hangover the next day.

Consistency is very important, stay at the same dosage pattern for at least several weeks at a time. You've been a little irregular in your dosing, that might have brought on some of the strange symptoms you report.

How often do you take the Ativan? When a benzo wears off, there's often a rebound effect of anxiety or panic.

Forget balancing your serotonin, that's a myth. These drugs don't balance serotonin any more than LSD or MDMA do (both serotonergics).

November 15, 2015

Hey Icebat, welcome. Glad you found SA.

Petunia and Alto covered everything I wanted to say - "the benzo may be causing problems" and "the myth of balancing serotonin"

Your taper has been more conservative than most - and I sense you are listening to your symptoms to see when you can drop. The last part of the taper is the hardest part. Stand firm. Hold, and your body and brain will thank you for it.

I just read this, and you might like it, too:

http://survivingantidepressants.org/index.php?/topic/919-six-mistakes-ive-made-in-withdrawal/

Hang in there, it may seem rough right now, but it can get better. How are your coping tools? Non Drug Techniques for Coping with Emotional Symptoms

You're never alone in the world.

November 15, 2015

Thank you so much everyone for the kind replies - I've started reading some of the resources you've linked.

Why are you splitting your lexapro dose, this is usually only taken once a day. How long have you been taking it like this?

I split up the dose initially because I wanted to slowly adjust to taking it twice daily (once in morning and once at night). I had gotten used to splitting up the dose because that's what I did when I was on 10mg and 5mg and it seemed to work out well. This time when I tried with my 0.95mg, I ended up getting withdrawal symptoms due to trying to change too many variables at once, so I just froze the dosing times in place where they are, hoping that I could wait out the withdrawal, then in a few weeks when the symptoms settle down I could continue to move the doses to morning/night to get a more even daily blood level.

Welcome, Icebat.

What you might do is slightly updose to 1mg per day, then take 0.2mg of the dose to the afternoon or evening. (You'd take 0.8mg in the morning.) The larger dose earlier in the day covers those symptoms in the afternoon. The smaller evening dose is to forestall any hangover the next day.

Consistency is very important, stay at the same dosage pattern for at least several weeks at a time. You've been a little irregular in your dosing, that might have brought on some of the strange symptoms you report.

How often do you take the Ativan? When a benzo wears off, there's often a rebound effect of anxiety or panic.

Forget balancing your serotonin, that's a myth. These drugs don't balance serotonin any more than LSD or MDMA do (both serotonergics).

Recently I've been taking the ativan 0.5mg in the late afternoon or early evening. Last night I woke up in the middle of the night at about 4am and noted how calm and relaxed I felt, but of course when I woke up for good at 8:30am I did so with an adrenaline burst and a bout of depression. Just a couple weeks ago I was able to sleep in until 9:30am and at times even 10:30am, so not being able to get back to sleep for another hour at around 8:30 is new.

I'm kind of scared to change the times that I'm taking the Lexapro, especially since that one time that I took a dose at 4:30pm caused such vivid dreams that night (as I said, like a drug trip) that I was really out-of-it the next day. But if moving a small amount of my dose to the evening could help me feel better in the morning (and maybe help alleviate this new symptom of depression/cortisol mornings), then I would be eager to try.

Thank you all so much for the support so far - I'd like to ask are there any threads about vivid / unpleasant dreams? Because my sleep patterns have always been fragile for as long as I can remember, and the Lexapro has only made that more difficult.

November 15, 2015

Do you take Ativan every day? Why was it prescribed?

My guess is your morning symptoms are from Ativan rebound. But you might adjust the Lexapro dose first and see what that does.

November 15, 2015

Do you take Ativan every day? Why was it prescribed?

My guess is your morning symptoms are from Ativan rebound. But you might adjust the Lexapro dose first and see what that does.

Since about 2 weeks ago I've been taking the Ativan more and more to get through the anxiety. Basically I get anxious when I feel bad every day and I'm not seeing improvement on a day to day basis. So when I'm anxious, I feel worse, then I worry about how bad I'm going to feel the next day, and so on. I want to say that dosage change in the Lexapro (I think both up or down?) and the accompanying withdrawal depression (or reinstatement energy) is generally the seed for the anxiety spike/cycle.

After I tapered down from 5mg, but before 2 weeks ago (i.e. for the past 5 months or so), I've needed the ativan literally less than once a month. I was originally prescribed it for panic attacks (took it copiously every day in January this year for instance), but for the last few days I've been taking it every day (0.5mg) afternoon/evening to stave back the health anxiety again.

I would be a little bit surprised, but not hugely, if the ativan rebound is what's causing me to wake up early and not be able to get back to sleep, just because that’s a symptom I don’t remember having before, though I haven’t had anxiety problems like this in months. I have a feeling that it’s more the lexapro, but it may be a combination of the two (ativan and lex). The morning depression I would hazard to guess is the lexapro.

Thank you again for the help. I’m having a better day today (I was even able to play some mellow video games, which was distracting in the best way!) so my hope is that I can coast on this positive mood and continue to ride out the anxiety over the next few days as my body continues to get used to this dosage pattern. I have a feeling that as I start to feel better in general, the anxiety will begin to recede as it has in the past.

And I’ll start introducing a teeny tiny bit of lex late at night, gotta be conservative so that I don’t end up with more sleepless nights from “drug trip” dreams, but if I can balance it properly then that might help with the morning withdrawals. Thank you again Altostrata for the idea - and thank you so much for contributing to all of the incredibly helpful resources on this forum.

Also, thank you so much Petunia for the advice, and JanCarol for the support!

November 19, 2015

Dear Icebat,

Your story has similarities with mine, although I was already on drugs when I graduated from a highly regarded Business School and should have been off to get a job, jump into life, etc...

I do not know what is causing what in your case, but I really would like to tell you to be careful with Ativan which is a benzodiazepine... I am sadly a long-term benzo user, I took what I had been prescribed (along with ADs), never was told such drugs were not to be used more than 4 weeks and that tolerance builds up quickly (hence your need to take more and more of the drug? ).

Benzos are not a long-term solution... at all.

I am of course not a doctor and absolutely not telling you what to do, just be careful... I'd hate it for you to become overly dependent on this other drug to manage your lexapro withdrawal.

Please take care of yourself,

Julz xxx

November 19, 2015

Hi Everyone,

I haven’t been improving as fast as I expected over the last few days. I’m still getting very interrupted sleep with vivid and sometimes unpleasant dreams, and feeling anxious and depressed in the morning and at night, despite taking 0.5mg ativan at 4pm daily (which maybe helps 50% for a few hours, during my worst time of the day). I’m tired all the time and my appetite is shot - every day my stomach feels bad after I eat anything. It’s been difficult to get enough food in me every day, but I’ve been counting calories and trying to eat all day to get up to at least 2000. I’ve been making sure to drink enough water, and I am walking at least 2 miles every day (sometimes 3 or 4). Often when the evening comes I barely have the mental composure to watch videos on the internet - if I’m lucky I’ll be able to play some mellow video games sometime in the late morning or late evening. I’m getting mood swings between feeling mostly normal and feeling panicky along with terrible gnawing anxiety and depression.

I haven’t changed my dosage times yet for fear that I could make it worse, but since it’s been 8 days and I’m still feeling miserable mostly every day, maybe I should start trying to change my dosage times slowly? I have a suspicion that maybe the 27hr half-life of the Lexapro is working against me, and that my blood levels are fluctuating too much for my body to properly adapt to. I was in the middle of adjusting my dosage times in mid October when I started feeling bad, and I never changed the dosage times since then, so for the last week I’ve been taking daily 0.475mg at 11am and 0.475mg at 1:30pm.

I am considering doing what Altostrata recommended - moving a small amount of the dose to the evening. This would carry the risk of making my dreams more vivid and interrupting my sleep more, but it might end up doing more good than harm. First though I wanted to know if anybody knows of anyone who had or is having trouble stabilizing on a very low dose, and if they have had any experience with dosage times. I remember seeing the dose-response curve for SSRIs elsewhere on this forum, so that’s what’s making me think that there’s a chance that spreading out dosage times could be more important at such low doses of Lexapro.

Thank you again for all the help.

November 21, 2015

Good onya for picking a time/dose on Ativan and sticking to it!

Alto says that the lex is long half-life. That means it takes 27-32 hours for half of a dose to leave your system. As you can see, that's more than a day.

I don't have enough experience with that one to know whether it is sedating or activating or just plain crazy making, so you will have to use your own body wisdom. Except for the sleep inducing ones, I'd be inclined to gradually move the whole dose to the am. It's really important not to mess with your sleep. Crazy dreams are a sign of sleep disruption, and sleep is the most important part of withdrawal (that's when your brain heals). If you did that, would it make you too dozy or dopey throughout the day?

Apart from that, it's still sounding like you are rattling from your previous fast tapers. Changing your doses too much too soon might be harder. The last part of a taper is often the most difficult part, there's no harm in taking your time, going slowly.

I hope you heard some music today.

December 31, 2015

Update!

The transition from the pills to the liquid lexapro was difficult (this leads me to believe that it is absorbed differently) but I feel like I’m slowly starting to improve. I am benzo-free again (the withdrawal was unpleasant but only lasted a couple of days, and was a piece of cake compared to Lexapro). I’m able to play video games with friends again some nights depending on how I feel, and during my on-days I’ve been able to spend a couple hours out of the house (during my off-days it sometimes even feels difficult to get out for a 15 minute walk). I am able to generally eat normal food now, though I stay away from anything greasy or spicy. For reference, I went from a ~1.25mg fragment of a 5mg pill daily to 0.95mg liquid formulation.

So my entire daily formulation has been as follows: 0.95mg Lexapro at 11:30am, multivitamin probiotic and fish oil at night. During the day I have been walking 1 mile around the neighborhood, though just today I was able to bump that up to 2mi again (hopefully I will be able to keep that up!), and eventually I may be able to do a daily 4mi again.

3 weeks ago I visited an expensive and experienced psychiatrist who specializes in difficult cases of medication discontinuation. Firstly he advised me to move my 0.475mg at 11:30am and 1:30pm all to 0.95mg in the morning, because “Lexapro is generally activating, so taking your whole dose in the morning will reduce sleep disruption”. He advised me to continue taking my taper very slowly, and prescribed Doxepin 0.1-0.9mg nightly “as an antihistamine, to improve my sleep and daytime anxiety”. I am to take 1 drop of the 10mg/ml solution nightly, then if I don’t see any effect after a few nights I am to take 2 drops, etc. until I see some effect, then I can gauge whether it’s positive and if I should continue. I was afraid to take any for the last 3 weeks, then yesterday my mom convinced me to try it because it has the potential to help with my bad sleep / nightmares.

The biggest thing I’m struggling with now is sleep. Sleep has always been a precarious thing for me even before starting the Lexapro about a year ago. Sometimes I have relatively benign dreams and sometimes I have bad dreams, but one thing for certain is that I always have LOTS of dreams, and I wake up a little bit disoriented every morning. Here’s my experience from the last week - I got a nasty cold about 5 or 6 days ago, and just yesterday and today it’s starting to go away. But 2 and 3 nights ago I had terrible nightmares (and sleep paralysis, false awakenings and panic awakenings) that left me disoriented and anxious most of the next day. So last night I tried 1 drop of the Doxepin at bedtime. Tumultuous dreams like usual, but no nightmares, paralysis, false or panic awakenings. Then I woke up and felt actually relatively good this morning. Coincidence? Not sure at this point, it might just be that I’m continuing to get better from my cold. But I’m thinking of doing 1 drop of Doxepin for a few more nights and then considering 2.

I’ve read a couple things online about preventing excessive dreaming and the general idea that I got was that you dream more when you’re not in the deepest stages of sleep (REM rather than NREM), so the idea is to do things that are conducive to deep sleep, such as not eating right before bed, developing a regular sleep pattern, and I’ve even read that sleeping on your back leads to more lucid dreams than sleeping on your side.

Also of note is that something went seriously awry with my left leg last month, to the point where it was in constant shooting pain every day, I couldn’t keep still, and I was walking with a limp. I started to go to the chiropractor regularly again, and it cleared up about 95% after a couple weeks, though my left arm and leg still feel a slight tingle every few days for a couple minutes.

In any case, I have a few questions - first of all, has anyone had success using an antihistamine (like Doxepin microdose) while coming off of Lexapro or another SSRI? Secondly, does anyone have any tips / threads to share about squashing (dealing with? coping with?) excessive dreams and/or nightmares? And finally, is it really wise to take my entire dose in the morning rather than split up in some fashion? Thanks!

December 31, 2015

Hi Icebat,

Just did a check on Doxepin and it is a tricyclic antidepressant!!! So I did a drug interaction check. Sorry to be the bearer of bad news.

Interactions between your selected drugs

Major doxepin escitalopram

Applies to: doxepin, Lexapro (escitalopram)

Using escitalopram together with doxepin can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should contact your doctor immediately if you experience these symptoms during treatment. In addition, combining these medications can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

December 31, 2015

Dear ChessieCat. Thank you for looking out for me but I am well aware of that. That page is automatically generated and it assumes a standard therapeutic dose of both drugs, which isn't my situation. Doxepin as an antidepressant is generally taken in the range of 25mg-150mg, where it has significant interaction with other drugs that act on the seratonin system (like Lexapro). My prescription for Doxepin as an antihistamine and anxiolytic is for dosage between 1mg and 9mg (going up very slowly, one single drop every few days, until I find a place with positive effects and without any negative ones). Like I said, I am planning to start at 0.5mg until I see how it affects me.

Cross-tapering (which is more involved than what I am doing, since my proposed dose of doxepin is so low) is actually more common than you would think - it's not as simple as "never take these two together because it's dangerous". In fact in this thread, there's a column that describes tapering from citalopram (similar to lexapro) to tricyclics.

I already know that at these doses there isn't any physical danger. I've read elsewhere on these forums that antihistamines can sometimes be useful for tapering off of SSRIs. I'm looking for people who can tell me from experience whether this is a worthwhile thing to try. From the studies I've read, Lexapro doesn't have a major effect on the histamine system, whereas Doxepin has an antihistamine effect at very low doses (much lower doses than it has a traditional antidepressant effect, which would be a drug interaction).

EDIT: I just realized that two posts up I mistakenly listed Doxepin as 0.1mg-0.9mg, it's actually 1mg-9mg (0.1-0.9ml at 10mg/ml). My starting dose would be 0.5mg (0.05ml). Too late to edit that one unfortunately.

December 31, 2015

Hi Icebat, Because you said it was an antihistamine I assumed you didn't know it was an AD. Glad you've done your research. Unfortunately some people don't and end up having issues which is why I was concerned. Thank you for understanding CC

January 2, 2016

Thanks for updating Icebat

I have a few questions - first of all, has anyone had success using an antihistamine (like Doxepin microdose) while coming off of Lexapro or another SSRI?

Actually, we don't recommend using any kind of drugs to help with tapering or to treat symptoms of withdrawal, not even a tricyclic antidepressant which may work more like an antihistamine at a low dose. Whether or not you will find it helpful, I don't know there have been mixed responses from using antihistamines, see: Antihistamines and what to use for allergy relief - Symptoms ...

Secondly, does anyone have any tips / threads to share about squashing (dealing with? coping with?) excessive dreams and/or nightmares?

Increased dreaming and nightmares are common when coming off an anti-depressant. These were some of my first symptoms after I stopped taking lexapro. I've gone through stages of having nightmares every night and disturbing dreams, then it would settle down for a while, then start again. Over time they have reduced and are pretty much back to normal. I remember when I was taking lexapro, I didn't dream much, it probably takes a while for the sleep/dream system to get back to normal while tapering and when drug free.

The only other thing I might mention is that taking vitamin B6 can increase dreams, or make them more vivid, so if you are taking a mixed B group vitamin, you might want to stop that.

And finally, is it really wise to take my entire dose in the morning rather than split up in some fashion? Thanks!

Yes. Lexapro is usually only taken once a day, there is no point in splitting the dose.

January 17, 2016

Hey all, on January 5th I went from 0.95mg to 0.9mg, and then on Jan 8th to 0.85mg, and I've been on 0.85mg since then. Sleep is still an issue, and I'm still having vivid dreams that make it so I wake up many times during the night, and don't feel rested when I wake up.

Yesterday I had what I call a "depression attack", where everything seemed bleak and negative for a short while. When that happens, I lay down in a dark quiet room and become aware of the neuro-emotions and remember that they aren't genuine, they are just a product of the Lexapro/withdrawal. Then it goes away after about an hour at most and I usually feel pretty fine the rest of the evening, I guess after my brain has a chance to re-stabilize its chemistry.

It seems like I'm already on such an incredibly low dose though, and my drop was only roughly 10% and was more than a week ago. Is Lexapro really this fickle to dosage changes, or is it possible that there is some sort of limbo spot at very low doses where the Lexapro is no longer regulating my chemistry, but my body is not quite able to take back the reins? Do I just need to continue this hold at 0.85? It just feels like it will take a long time to get off of the Lexapro at this pace... Maybe there is something wrong with my sleep outside of the whole Lexapro thing?

I'm seeing a sleep specialist in a few days to see if there is anything mechanically wrong with my sleep, because my sleep has never been great, but it's also never been this bad.

P.S. I took the Doxepin for 2 nights a few weeks ago and it didn't seem to be doing any good, so I decided to stop it.

January 17, 2016

Icebat sorry your having such a hard time I'm also having very rough time as well....also was wondering I have been going through hell the last 2 weeks. im on 1.6 compounded formulated liquid escitalopram and wondering I feel like I have dropped in dose because of aweful withdrawal symptoms but I have been on this dose since oct 2015....can the liquid loose its potency over time....I feel like I cut the dose but im on this dose more than 3 months xmas eve was 3 months......does any body know? nivek

January 18, 2016

Hi Nivek, I'm sorry to hear you're having trouble with Lexapro too. If there's something I've learned it's that it takes a lot longer to stabilize on a certain dose than I think it would, but for me it does happen eventually. I don't have any experience with the compounded liquid, because I have the generic liquid directly from the manufacturer. When I switched from the pills to the liquid (at 1/4 of a pill to the liquid equivalent) I went through an incredibly rough patch that lasted almost 2 months, complete with bad anxiety and depression (I never had depression symptoms before starting the Lexapro, it was prescribed for panic attacks). This leads me to believe that at least in my case, the liquid was being absorbed differently than the pill. I'm just recently regaining a bit of my joy and positivity, and I'm feeling more comfortable in my body, but it's still very much a windows and waves sort of pattern. It gets pretty scary at times, and sometimes it feels like I'm moving backwards, but at least for me it continues to get gradually better if I zoom out and view my progress a few months at a time.

I would recommend checking out the windows and waves thread, and maybe one of the more experienced forum members will have some more advice. They say that the last part of the taper is the hardest and that definitely lines up with my experience. Just stay strong, because it WILL get better, even if it seems like it's taking a long time!

January 21, 2016

I saw the sleep specialist yesterday, and they scheduled a sleep study, but the appointment isn't for 3 weeks, so the results won't be back for about 6 weeks from now. In the meantime I am getting 8 hours of sleep a night and waking up super tired and feeling like I got maybe 1hr. Often I feel just trashed, tired and edgy and high energy in a bad way, and I am starting to take naps again daily.

I am on only 0.8mg Lexapro right now (taken at 11:30am) and I'm not really struggling with depression symptoms anymore, but the sleep ones have been really difficult. Because I'm not getting good sleep my nervous system has been really sensitive. My best time of day is after I've gone to bed at 10pm and have just laid down in the dark for 2 hours, then I get up at about midnight to see if anyone else is still up and to get a snack. I feel pretty much normal at that point, with almost no symptoms. I literally feel more rested after lying in bed trying to get to sleep for 2 hours than I do after I sleep for 8 hours.

So I was thinking, what if I just try to stop the Lexapro altogether now? I would probably get more restful sleep, and I have Klonopin and/or Ativan on hand to help me with possible depressive/panic rebound and in case my nervous system is still sensitive. I am not prone to depression, only as a withdrawal symptom of the Lexapro (which was prescribed for panic attacks). I just feel like if I can get the Lexapro to stop messing with my sleep, then I (and my sensitized nervous system) might really be able to start to recover.

Are there any resources I could read to try to gauge whether it would be beneficial or detrimental to just stop the Lexapro at this 0.8mg dose in light of the sleep issues? Has anybody else had symptoms like this at such low doses? I am starting to think that the detriment of staying on this low dose might outweigh the potential bad effects of jumping off entirely very soon, especially since I would have to wait 6 weeks anyway to see if there's anything wrong with my sleep. So that's why I am considering jumping off for good. Thoughts?

January 21, 2016

Hi Icebat , it's a tough decision - when to jump off.

Try reading "When to end the Taper and Jump to 0" here http://survivingantidepressants.org/index.php?/topic/11051-when-to-end-the-taper-and-jump-to-zero/

and

"Experiences after Tapering to 0" here http://survivingantidepressants.org/index.php?/topic/7843-experiences-after-tapering-to-zero/

If you do jump , and become aware of new symptoms resurfacing , you could reinstate asap.

bw , Fresh

December 19, 2017

Update: My last dose of Lexapro was on 4/16/2016, over a year and a half ago. My sleep finally improved once I insisted on a sleep study, was diagnosed with moderate Sleep Apnea and got a CPAP machine. For god's sake check your Vitamin D levels too, mine were really low. My lexapro-induced depression I would say is completely lifted, I feel optimistic and not depressed at all anymore, at least unless I forget to take my B vitamin. I am still working on other health stuff though.

The biggest key for me was to (1) make sure I was eating super healthfully (and it took a long time for me to figure out what that was - pay attention to your poops, make sure you are regular and that you don't eat too little, nor too much beyond your digestive capacity) and (2) find a really good therapist to help me learn mindfulness, which I use alongside gentle cbt techniques. A large daily dose of B vitamins does wonders for me on the chemical side, I just need to remember not to take it too close to bed or it disturbs my sleep. And my sleep by the way - it's not perfect but it actually feels ok now! I mean, I finally don't get nightmares anymore, and once in a blue moon I even get a GOOD dream I don't wake up feeling amazing yet, I'm still working on that, but I wake up feeling a bit rested instead of literally more tired than when I went to sleep.The difference is mind-blowing.

I went to work (desk job with a lot of typing) for about 9 months working 20 hour weeks, between about Oct 2016 and Jul 2017. I could have never dreamed of that while on the Lexapro. I was really tired at work but I was able to get stuff done, and the social/friend connections with my coworkers were absolute aces and made me feel great. HOWEVER, in July of this year (just over 1 year after stopping the Lexapro), I started getting strange symptoms at work like diarrhea all the time, terrible nightmares and being unable to think straight, especially right after eating lunch. I have been off of work since then (since July this year) trying to figure out what is wrong, I saw a few doctors and read a bunch online and figured out that my digestion took a wrong turn somewhere, I probably have gut dysbiosis and might even have a bacterial/viral parasite, probably because I was overeating due to not really having a hunger reflex since the whole lexapro thing, so I would just eat on a schedule because I would never really get hungry. Also the intense stress of the lexapro probably caused a bacterial die off in my gi tract. So I saw a couple of alternative doctors and they put me on a diet of basically just cooked organic vegetables, fruit, high quality meat, bone broth and seeds, as well as giving me betaine HCl (extra stomach acid) and digestive enzymes. And now I am no longer getting diarrhea all the time. I reintroduced quinoa and allergen-free dark chocolate, and I am adding more stuff slowly. I learned a lot about the Ayurvedic health system, which focuses on achieving strong digestion/assimilation, not just of food but of emotions and experiences as well.

I vaguely remember one of those little sun icons you put on success stories in these forums... I would say that from the Lexapro I am like 98% better. I no longer feel like a disembodied consciousness floating in a sea of antidepressant-induced terror. I just feel like a normal person working on my (admittedly still a bit poor) health now. I'm not "healthy" yet, but I am much better than right before the doctor prescribed the lexapro because I am no longer clueless what it means to lead a healthy lifestyle (Hint: Unlearn everything about health and diet that you learned as an American, make your health role model a compassionate and loving buddhist monk). There is no more hopelessness, I love myself and take care of myself, and I get little moments of joy here and there (a couple times a week) where I just feel super relaxed, not anxious at all, I'm smiling and cracking jokes with my family and stuff, and just... happy.

I look back on my forum post and see I only posted my initial post 2 years ago and I think "wow", I am a totally new person now. Feels like a lifetime ago (certainly feels like at LEAST 5 years). Good thing I took my health into my own hands and stopped trusting my doctor and psychiatrist.

Oh and I have been reading a LOT, too.

Book List

The Mood Cure - Good intro to neurotransmitter levels, very simplified though, It was helpful but I realized it was dangerous to only attack my mood from that one narrow angle. I would recommend to read this book but don't look at it as the end-all be-all, realize it is just a tiny slice of the pie.

The Antianxiety Food Solution - I was very hopeful about this one, it seemed to make a lot of sense as I was reading it. It didn't end up working for me but it might work for others. Had some good info but I wish it had told me how to gauge how much I should be eating.

In Defense of Food - Opened my eyes to how messed up the food system in America is. Big impetus for me to cut out processed food entirely and eat unprocessed plant and grass-fed/free-range animal products ONLY, which I do to this day.

Comfortable with Uncertainty by Chodron - Didn't mesh with me, this book is a recipe for an existential crisis, I can't recommend it. I think it's for people with great brain chemistry who are distraught over their life circumstances, it basically just tries to tell you that nothing really exists or matters lol

Hope and Help for your Nerves - This was really useful back when my body was super whacked out. It basically reassured me that I would be able to get it back into balance and that I wasn't stuck having panic attacks every day forever. I put it down when I stopped having panic attacks.

Declutter Your Mind - Very easy read that points out some of the things that some people get hung up on easily, like overcomplicating their life and not setting priorities/goals. Short intro to meditation/breathing. This is one for when you start feeling the grip of the antidepressant slowly releasing.

Gut and Psychology Syndrome - Talked about the link between gut/digestion issues and mental/neurological issues. Followed their plan of drinking a lot of bone broth and taking sauerkraut and probiotics, and very slowly but surely my diarrhea started improving and my mind became less foggy.

The Good Gut - You are not just your own cells, you are also the bacteria in your gut. Antidepressants, stress, and malnourishment affect your gut, which then go on to affect mood and disease progression and even personality. This one is huge. It's based on cutting-edge research, I strongly recommend reading it.

The Hot Belly Diet - Don't bother, it's overhyped, skimmed it and other books have better info. If you want a better thing with less hype check out The Prime:

The Prime by Kulreet Chaudhary - A western-trained Indian neurologist who started getting neurological issues and neuro meds weren't working. She finally, stubbornly, turned to Ayurveda out of desperation and her symptoms improved and she wrote the book. I am currently reading this one and putting it into practice.

Could it Be B12? - Yes, it could be, but if you are eating well and still have a B12 deficiency, you likely have a nutrient absorption problem which means poor digestion, for which I might recommend a different book like The Prime, or Gut and Psychology Syndrome. I'm not saying don't get this, but it's hard for me to believe that B12 deficiency could exist in someone with strong, efficient digestion who is eating really well. Taking a B12 supplement might be very useful but don't stop looking for the underlying cause.

Adrenal Fatigue: The 21st Century Stress Syndrome - Not bad but the writing style and illustrations didn't really appeal to me. You learn a lot about adrenal fatigue, but I noticed my adrenals started falling into line naturally as I found a diet that worked for me and learned mindfulness and how to cope with stress.

Say Good Night to Insomnia - Good if your are psyching yourself out about sleep. If like me though you had a great sleep routine, you felt relaxed before bed, you were sleeping enough, it didn't take you too long to fall asleep and you didn't wake up in the night but you still woke up feeling awful, then this book is pretty useless.

Sleep Soundly Every Night, Feel Fantastic Every Day - This is the real sleep book you want. Goes into a lot more than just "stop psyching yourself out". Talks about PTSD and sleep, and other comorbidities. Talks about how drugs interact with sleep. Plus it has all the info from the previous book.

The Healing Power of the Breath - Book about how to breathe deeply and properly, and do regular breath training. Couldn't get super into it, though it sounds really good in theory. I did end up doing the breath exercises for a few weeks with my mom. Ended up dropping the breath exercises after I realized that deep breathing during my meditation seemed to do a similar thing.

The Edge Effect - Not bad but is kind of redundant to Depression Free Naturally, which I would recommend over it.

Why Isn't My Brain Working - Great book with fantastic info, but has absolutely no info on how to put any of it into practice. Good to gain background into aging and combating cognitive decline. Just don't expect him to give you a roadmap.

Ayurveda Lifestyle Wisdom by Acharya Shunya - What a positive, uplifting book. If you want a kind, gentle and inspiring intro to Ayurveda with practical tips, this is absolutely the book. I put the tips into practice, especially getting up at 6am to meditate, and I felt great for a week or so with a bunch of energy. It's hard for me to keep that schedule long-term, but I am always working my morning alarm earlier. It reminded me of my belief that the universe is love and light, even the darkness is light, to me on a visceral level the book just felt true. I really need to re-read this one again soon...

Fat For Fuel - The best intro to Keto diet imo. Unlike most other diets, keto is actually a natural way that people have eaten historically, and it has actual proven results in weight management and the treatment of certain types of mood and neurological conditions. I cycle into light keto every few weeks and make sure with my test strips that I hit ketosis. Usually it is just by doing a low-carb day of bone broth, meat and sauteed veggies. Just to keep my body's metabolism on its feet.

50 Things to do Before Seeing a Psychiatrist - Story of how a guy bootstrapped himself out of a really awful drug addiction, panic attack, hospitalization, and turned into a successful musician who leads a happy and stable life. The intro starts a little terrifying but just remember that he got way better, and the Things To Do are pretty good tips.

--> ***Depression Free Naturally*** <-- - This one connects all of the tiny biochemical bits in a very good, comprehensive and actionable book on depression. They go into histamine imbalance, mineral and vitamin deficiencies, diet, lifestyle, basically they cover a LOT of topics. If you only read one book, especially if you are struggling with depression, start with this one imo.

There came a point for me in learning about alternative health (several years and dozens of books in, as well as the complete failure of western doctors in treating my disease), where I started connecting the dots and realizing that some alternative medicine is more scientific than Western medicine, you just have to read a lot and know it inside out so that you don't fall into any of the health craze/fad stuff and only follow advice that is backed by science and common sense. It is impossible to make your own opinions when you just mirror the ones society feeds you. Educate yourself, western medicine is often a lot less scientific than you think, in the strictest definition of the word. Take your health into your own hands and only trust what makes sense and rings true to you, I did and I'm glad.

December 19, 2017

My God, icebat!

I don't check on here often but just happened I saw your update since like 1.5 yrs ago!

i read through your entire thread as it ha lots in common with my journey!

Im so happy to hear your great success recovering from the worst life hit by the poison lexapro!

You ou are a true inspiration and I want to congratulate you on the huge achievement getting your life bacK!

can you shed a bit more about the last period from 0.8mg lex to zero, and early time after you stoped lexapro?

thank you for sharing your uplifting update!!

best,

lex

December 20, 2017

Thank you LexAnger! To be honest I was afraid to come back and post here, and dredge up this trauma from my past and have to think about it again. But I had just been watching an interview earlier today where the speaker urged people not to just suppress trauma, but to meet it and integrate it, so I wanted to come check in with this fantastic community that did so much for me. It's been a long time but I finally feel like the emotional block is beginning to lift and I am closer to processing emotions somewhat coherently again (another wip, but I am on a positive path now), and I have to always remember that since I survived it in the first place, I am more resilient than I think.

To the best of my memory, after I stopped the Lexapro my symptoms just very gradually got better and better, over the course of, well until here I am today (minus the digestion hiccup I had in July that I am still working on). As the depression started to lift, the other symptoms got a bit easier to deal with, because I started to freak out about them less and be more optimistic that they would go away in time. Then they started to slowly get better too (though notably some of them like nightmares and "brain lurches" didn't actually go away until I started my ultra-clean diet in July, even though I thought I was eating healthy before). I realized I had a LOT of inflammation in my gut which led to inflammation in my brain (a few of the books I read talked about this), and when I was able to get the inflammation under control using an anti-inflam diet (currently gluten, grain, soy, dairy, legume, and nightshade-free, though eventually I will add legumes, nightshades, non-gluten grain and a little soy back in) and gut supplements (homemade bone broth I consider to be a supplement due to how powerful it is at healing the tight junctions of the gut), it was like my mind is going from a sputtering, lurching engine to a smoother ride (still a work in progress). I am also considering a fecal microbial transplant to re-establish some beneficial bacteria that I believe I was born without a lot of, but then lost even a lot more of during the lexapro experience (the book The Good Gut convinced me of this).

I have been able to really connect the dots using my books, and integrate a lot of different viewpoints and medicinal modalities on my quest to figure out the root of what's up with me. It's kind of funny how my research took me from neurotransmitter deficiency to amino acid deficiency to vitamin deficiency to poor digestion, then I find Ayurveda and it teaches that the root of health is strong digestion / assimilation of nutrients. I just think about all the Americans who eat terrible just like the commercials tell them to (and even some health institutions like the American Heart Association!!), have digestion issues and then chronic diseases start to creep in (and it's not their fault, because that's the way American society pushes everyone towards). I am still learning more and more things from my books, and they have allowed me to improve myself from many different angles at once - from my thoughts, from my diet, from my routine/lifestyle, from supplements, etc.

I see from your sig that you have hit zero mg yourself recently? How's it going? Like I said, it absolutely blows my mind that my initial post here was just a short two years ago, I have seen so much progress since then, and I wish the same for you! I am happy to take a shot at any specific questions if you have them!

December 20, 2017

Thank you so kindly icebat for your quick response and sweet offer for questions!

i can tell how much effort and great learning you did that helped you getting where you are now! Tons of wisdom and strenth! You should be very proud of yourself!

im in very bad shape still if not the worst. My major mistake is staying on the meds AFTER I got huge hit from updosing for fear of WD. Even now I'm off the drug now for about three months, the damage from the updose is still causing very deliberating symptoms.

You mentioned you felt confused, and disoriented when you were at high dose. How did those improve over time? I have many severe symptoms, but these two are the most heart breaking as I'm like living in a coma or dream with a paralyzed brain.

Lex

December 20, 2017

Hi Icebat

Thanks for posting, I have some questions for you, if you don't mind.

I was at 1.5mg successfully for a long time. I accidentally updosed to 2mg and things went bad, updosed more to 5mg, things went even more bad. Worst time of my life. I now tapered over the course of 2.5 months back to 1.47mg. Most sxs are gone now, but now I'm hit with WD and feel destabilised. I'm in my second week at this dose. Lexapro helps me now in the morning to lessen the anxiety, which is good. Normally it only excerbated it immensely.

Now my questions: how did the taper went from 0.8mg to 0 for you? And how long did it take to stabilise at 0.8mg-1mg for you? Because I'm still in bad shape at the moment. Did you have an increase of anxiety at 0? Or while tapering from 0.8mg to 0?

I'm too thinking of going down faster than recommended because of the bad effects Lex has on me now. I'm wondering what I could be in for the coming weeks/months...

Kind regards,

TWB

December 21, 2017

On 12/19/2017 at 9:45 PM, LexAnger said:

You mentioned you felt confused, and disoriented when you were at high dose. How did those improve over time? I have many severe symptoms, but these two are the most heart breaking as I'm like living in a coma or dream with a paralyzed brain.

I'm very sorry to hear you are going through that too, LexAnger. I know how you feel, I remember on the Lexapro having entire days where I would wake up and barely be able to tell the difference between when I was awake and when I was asleep, aka dreams and reality. I feel like reality is really finally congealing on me again after floating around in that sea of strange consciousness while on the Lexapro, and I feel pretty decent in general in that department now (no dp/dr for over a year now). I would say 80% of days I feel grounded enough in reality that I don't really think about it I just have a normal day, the other 20% I am still functional but I am aware that something is off with my brain/chemistry but I don't feel "disconnected" really, just say to myself "I'm feeling right now what it feels like for my brain to be inflamed" or "I'm feeling right now what it feels like to be a bit low on seratonin or catecholamines", or "I have low blood sugar I should eat a piece of fruit" (I used a diabetes meter for a couple months and found that my blood sugar was crashing at times) or "what I am feeling is being exacerbated by normal sleepiness, I need to get to bed early tonight". I figured out by myself what some of the more common issues feel like by reading The Mood Cure and doing trials of some of the amino acids mentioned in the book (I started doing these trials a few months after my final Lex dose), then using mind/body meditation as they kicked in to study the differences in my consciousness and the way my body felt and the way my thoughts flowed. I took it extremely conservatively at first (like opening up a capsule and weighing out 1/5 of it on a tiny scale), to make sure I didn't make anything worse by experimenting with the amino acids too aggressively. GABA was one that was particularly good for "body anxiety", when my body just felt super wired and I wanted it to calm down. I ended up only taking 20mg (that's right 20mg not 200mg) and I could feel a difference from that, just enough for me to finally relax a bit in the evenings. Way later I would read that hypersensitivity to GABA is a sign of a leaky blood-brain barrier, that THAT is a sign of a leaky intestinal lining, and that THAT is a sign of poor diet / poor digestion that needs to be addressed.

At one point (at high dose on the Lex) my sleep was so bad that I was literally feeling more tired after waking up than when I would go to bed. But for months after stopping the lexapro I would still sleep terribly and get nightmares and very strange dreams. I have noticed that my sleep quality is very strongly tied to how closely tied to reality I feel the next day (how "grounded" I am). Nowadays, on the rare occasion that I have a great night sleep with great dreams, I tend to feel energetic and great the next day. But mostly I just sleep "ok" and then feel "ok" the next day, not complaining because "ok" is worlds better than the lexapro. I got my cpap in early April 2016 just before finishing the taper, and that helped my sleep a lot, which helped my groundedness during the day. My doctor never thought to check for sleep apnea, I even mentioned it and he said I didn't have it and it wasn't worth testing for, well I insisted and was diagnosed positive (in the "moderate" category too, not like barely or slight). He was wrong about a lot of things though including the lexapro.

My sleep quality started to slowly improve after the last Lex dose, but like I said the really big improvement I saw in my sleep quality was when I restricted my food groups a ton, started tracking calories and eating more with a goal of 2300cal/day (I only hit 2000 most days though because my digestion gets overloaded), and started pounding down home made bone broth to try to fix my gut (thank you for helping make it when I wasn't feeling up to it, family!) My hunger reflex is still absolutely shot since the Lexapro (I maybe feel real hunger every week or so if I'm lucky) so I have to keep careful attention to when and how much I am eating, and just eat on a schedule. There were points on the Lexapro that I was only eating 800 (!) calories a day for weeks at a time because I was just never hungry and I wasn't tracking my calories in a food log. I would eventually realize that digestion and assimilation of food is how the body repairs EVERYTHING, and that eating very healthy and eating enough every day (but not beyond digestive capacity so as to get diarrhea or feel awful after meals) are critical. Earlier this year I would also learn that my poop was trying to tell me a story that I was ignoring, and that getting diarrhea all the time meant that I needed to change my diet.

Whereas I used to remember my dreams every night and even wake up confused and disoriented, after about 6 months I was getting consistently good enough sleep to drag my sleepy butt into a part time job consistently every day (I called in sick a day or so every month or two, but they were flexible). I still get vivid dreams but mostly they have neutral content, a small amount of them are good and a small amount of them are bad, but it's not the bad like on the Lexapro where I would wake up and question reality and whether I was actually awake, or wake up in the middle of the night and go to the bathroom feeling like I was literally in a very strange, dark, depressing and inhuman dream. Nowadays it's more like I wake up and I'm like "well that was a bad dream" and then I just forget about it and get on with my day, like I imagine normal-people nightmares are.

So it got better by itself, but I did do a lot to "help" it along, including diet, lifestyle, light lamp / sun exposure, meditation, amino acid supplements, vitamin supplements (and blood tests), which I would be happy to get into detail with if you're interested. I quite literally feel like a new person though, I am very pleasantly surprised by the progress I have made over the last year and a half. I attribute a LOT of it to my reading and understanding my health better in a more holistic way, so I could start to break down what I could improve in my life to support my mind and body, and what habits I could break that were drilled into me by my childhood and general american lifestyle.

Granted I was only on the Lexapro for a couple years and even shorter on the large dose, but I do feel like I am pulling a 180 and I truly believe that another 2 years from now (ok maybe 5 at the most) I will be feeling better than before I started the lexapro due to all the new health knowledge I am gaining. I could have never seen this while I was in the lexapro hell. I feel like I will probably be a "real" person again within the next few years, and be able to work a normal job and have a normal joyful life again (and travel without freaking out or falling asleep in the car, still working on that one!)

On 12/20/2017 at 1:26 AM, TheWayBack said:

Now my questions: how did the taper went from 0.8mg to 0 for you? And how long did it take to stabilise at 0.8mg-1mg for you? Because I'm still in bad shape at the moment. Did you have an increase of anxiety at 0? Or while tapering from 0.8mg to 0?

I'm too thinking of going down faster than recommended because of the bad effects Lex has on me now. I'm wondering what I could be in for the coming weeks/months...

Hi The WayBack! Thank you for your questions. I am going to be real with you and say that I don't remember the last bit of my taper very well. It's been over a year and I'd be lying if I said my memory is great, though it's better than when I was still really recovering from the Lex. But I've had a really bad memory my whole life (I was that kid who always forgot important stuff in middle school) so that's at least something that is not new and I have learned to compensate for. What I do remember is that the Lexapro continued to have a hold on me for a few months afterward until I was really feeling good enough that I could concentrate on a job and not be overly distracted by my consciousness throwing strange things at me. Even then I would feel dark clouds of depression and anxiety during work, and I would have to remind myself that I was still in the healing process, but it wasn't anything that took away my concentration for too long, though I did have some pretty unproductive days here and there. As I mentioned above, the depression/anxiety got kicked down a notch once I started working directly on repairing my gut and eating extremely healthy food, which I am now able to digest for the most part.

Looking back at the spreadsheet I used to rate my anxiety while I was finishing my taper, I don't note any huge spikes in my anxiety scores during or immediately after the taper. That's not to say the anxiety / disorientation wasn't there, because it was still with me in its normal strong force for a couple months, just that it didn't spike or do anything wacky or more scary than usual near the end of the taper. I was very gradual and consistent with the taper, before I hopped off I was doing 1 drop of the liquid stuff per day, which I estimated at 0.03mg. To give you an idea, I held 2drops/day for a week and then 1drop/day for a week before hopping off.

I attribute probably about 60% of my success so far to my body healing in time, and about 40% to the changes I've made to my life after reading so many health/depression books. Though the changes didn't make me feel great within a week or even within a month or a few months, they definitely helped reduce symptoms over the course of a half year to a year or so. There are so many variables at play with anxiety/depression that you can give yourself a little competitive edge against the antidepressant by learning how everything interacts in your mind and body. As an example, I had my mind blown a couple months ago when I read The Good Gut and learned that vitamin (and even neurotransmitter) deficiencies (and then exacerbation of depression/anxiety) can be caused by too many bad bacteria living in your gut and not enough good ones, and that this bacterial profile starts at birth with whether you are natural or c-section, then whether you receive antibiotics as a baby that change the composition of your gut flora and can predispose you to disease later in life. They are doing studies where they take poop out of brave mice and put it into depressed/anxious mice, and those mice become brave. And there is other evidence starting to pop up that shows that the standard american diet makes you lose gut diversity, just like biodiversity in a forest for example, and it makes your entire system less resilient including your brain (the gut is quite literally a second brain, and it interfaces with your main brain all the time). Certain probiotics are being studied for their ability to reduce anxiety and depression. I'm not saying everybody should rush out and get a fecal transplant, but it goes to show you that there is a LOT that science (not big pharma or the medical system, but real scientific science) is learning about anxiety/depression, and it helps to understand it better and give your body the edge in its fight back to your true, happy "inner self", which I believe every day our bodies are doing their best to fight for no matter how bad shape we are in.

Apologies I feel like I am starting to ramble. I have just never shared this stuff with anybody else for the most part, so it's just all coming out here. I don't mean to romanticize any of this or say that it was easier to get out of the Lexapro trap than it was - it was absolute hell that I wouldn't wish on my worst enemy, and before I started the Lexapro I had no idea that that unique brand of torture on earth (and seemingly off of earth and outside of my body/self) was even possible. But that all said, I am beginning to integrate my experiences and I am beginning to heal. Just thinking about it no longer sends me into a state of psychological shock (it's about a 4/10 discomfort thinking about it), and I can envision a time in the future when I have fully healed from it, integrated all the new things I have learned about health and happiness, and become wiser and stronger than if the Lexapro trial was never thrown my way (my life had started to devolve into pot smoking, junk food and drinking when I started the Lexapro, now I am 100% clean of all 3).

February 1, 2018

Thanks for answering Icebat! I hope to see some improvement along the way! I jumped to 0 four days ago.

February 9, 2018

On 2/1/2018 at 5:12 AM, TheWayBack said:

Thanks for answering Icebat! I hope to see some improvement along the way! I jumped to 0 four days ago.

Congratulations, that's a huge achievement! I wish that you feel better and better!

February 9, 2018

On December 19, 2017 at 2:37 PM, Icebat said:

Update: My last dose of Lexapro was on 4/16/2016, over a year and a half ago. My sleep finally improved once I insisted on a sleep study, was diagnosed with moderate Sleep Apnea and got a CPAP machine. For god's sake check your Vitamin D levels too, mine were really low. . . .

A large daily dose of B vitamins does wonders for me on the chemical side, I just need to remember not to take it too close to bed or it disturbs my sleep. . . .

HOWEVER, in July of this year (just over 1 year after stopping the Lexapro), I started getting strange symptoms at work like diarrhea all the time, terrible nightmares and being unable to think straight, especially right after eating lunch. I have been off of work since then (since July this year) trying to figure out what is wrong, I saw a few doctors and read a bunch online and figured out that my digestion took a wrong turn somewhere, I probably have gut dysbiosis and might even have a bacterial/viral parasite, probably because I was overeating due to not really having a hunger reflex since the whole lexapro thing, so I would just eat on a schedule because I would never really get hungry. Also the intense stress of the lexapro probably caused a bacterial die off in my gi tract. So I saw a couple of alternative doctors and they put me on a diet of basically just cooked organic vegetables, fruit, high quality meat, bone broth and seeds, as well as giving me betaine HCl (extra stomach acid) and digestive enzymes. And now I am no longer getting diarrhea all the time. I reintroduced quinoa and allergen-free dark chocolate, and I am adding more stuff slowly. I learned a lot about the Ayurvedic health system, which focuses on achieving strong digestion/assimilation, not just of food but of emotions and experiences as well.

I vaguely remember one of those little sun icons you put on success stories in these forums... I would say that from the Lexapro I am like 98% better. I no longer feel like a disembodied consciousness floating in a sea of antidepressant-induced terror. I just feel like a normal person working on my (admittedly still a bit poor) health now. I'm not "healthy" yet, but I am much better than right before the doctor prescribed the lexapro because I am no longer clueless what it means to lead a healthy lifestyle (Hint: Unlearn everything about health and diet that you learned as an American, make your health role model a compassionate and loving buddhist monk). There is no more hopelessness, I love myself and take care of myself, and I get little moments of joy here and there (a couple times a week) where I just feel super relaxed, not anxious at all, I'm smiling and cracking jokes with my family and stuff, and just... happy.

I look back on my forum post and see I only posted my initial post 2 years ago and I think "wow", I am a totally new person now. Feels like a lifetime ago (certainly feels like at LEAST 5 years). Good thing I took my health into my own hands and stopped trusting my doctor and psychiatrist.

Oh and I have been reading a LOT, too.

Book List

The Mood Cure - Good intro to neurotransmitter levels, very simplified though, It was helpful but I realized it was dangerous to only attack my mood from that one narrow angle. I would recommend to read this book but don't look at it as the end-all be-all, realize it is just a tiny slice of the pie.

The Antianxiety Food Solution - I was very hopeful about this one, it seemed to make a lot of sense as I was reading it. It didn't end up working for me but it might work for others. Had some good info but I wish it had told me how to gauge how much I should be eating.

In Defense of Food - Opened my eyes to how messed up the food system in America is. Big impetus for me to cut out processed food entirely and eat unprocessed plant and grass-fed/free-range animal products ONLY, which I do to this day.

Comfortable with Uncertainty by Chodron - Didn't mesh with me, this book is a recipe for an existential crisis, I can't recommend it. I think it's for people with great brain chemistry who are distraught over their life circumstances, it basically just tries to tell you that nothing really exists or matters lol

Hope and Help for your Nerves - This was really useful back when my body was super whacked out. It basically reassured me that I would be able to get it back into balance and that I wasn't stuck having panic attacks every day forever. I put it down when I stopped having panic attacks.

Declutter Your Mind - Very easy read that points out some of the things that some people get hung up on easily, like overcomplicating their life and not setting priorities/goals. Short intro to meditation/breathing. This is one for when you start feeling the grip of the antidepressant slowly releasing.

Gut and Psychology Syndrome - Talked about the link between gut/digestion issues and mental/neurological issues. Followed their plan of drinking a lot of bone broth and taking sauerkraut and probiotics, and very slowly but surely my diarrhea started improving and my mind became less foggy.

The Good Gut - You are not just your own cells, you are also the bacteria in your gut. Antidepressants, stress, and malnourishment affect your gut, which then go on to affect mood and disease progression and even personality. This one is huge. It's based on cutting-edge research, I strongly recommend reading it.

The Hot Belly Diet - Don't bother, it's overhyped, skimmed it and other books have better info. If you want a better thing with less hype check out The Prime:

The Prime by Kulreet Chaudhary - A western-trained Indian neurologist who started getting neurological issues and neuro meds weren't working. She finally, stubbornly, turned to Ayurveda out of desperation and her symptoms improved and she wrote the book. I am currently reading this one and putting it into practice.

Could it Be B12? - Yes, it could be, but if you are eating well and still have a B12 deficiency, you likely have a nutrient absorption problem which means poor digestion, for which I might recommend a different book like The Prime, or Gut and Psychology Syndrome. I'm not saying don't get this, but it's hard for me to believe that B12 deficiency could exist in someone with strong, efficient digestion who is eating really well. Taking a B12 supplement might be very useful but don't stop looking for the underlying cause.

Adrenal Fatigue: The 21st Century Stress Syndrome - Not bad but the writing style and illustrations didn't really appeal to me. You learn a lot about adrenal fatigue, but I noticed my adrenals started falling into line naturally as I found a diet that worked for me and learned mindfulness and how to cope with stress.

Say Good Night to Insomnia - Good if your are psyching yourself out about sleep. If like me though you had a great sleep routine, you felt relaxed before bed, you were sleeping enough, it didn't take you too long to fall asleep and you didn't wake up in the night but you still woke up feeling awful, then this book is pretty useless.

Sleep Soundly Every Night, Feel Fantastic Every Day - This is the real sleep book you want. Goes into a lot more than just "stop psyching yourself out". Talks about PTSD and sleep, and other comorbidities. Talks about how drugs interact with sleep. Plus it has all the info from the previous book.

The Healing Power of the Breath - Book about how to breathe deeply and properly, and do regular breath training. Couldn't get super into it, though it sounds really good in theory. I did end up doing the breath exercises for a few weeks with my mom. Ended up dropping the breath exercises after I realized that deep breathing during my meditation seemed to do a similar thing.

The Edge Effect - Not bad but is kind of redundant to Depression Free Naturally, which I would recommend over it.

Why Isn't My Brain Working - Great book with fantastic info, but has absolutely no info on how to put any of it into practice. Good to gain background into aging and combating cognitive decline. Just don't expect him to give you a roadmap.

Ayurveda Lifestyle Wisdom by Acharya Shunya - What a positive, uplifting book. If you want a kind, gentle and inspiring intro to Ayurveda with practical tips, this is absolutely the book. I put the tips into practice, especially getting up at 6am to meditate, and I felt great for a week or so with a bunch of energy. It's hard for me to keep that schedule long-term, but I am always working my morning alarm earlier. It reminded me of my belief that the universe is love and light, even the darkness is light, to me on a visceral level the book just felt true. I really need to re-read this one again soon...

Fat For Fuel - The best intro to Keto diet imo. Unlike most other diets, keto is actually a natural way that people have eaten historically, and it has actual proven results in weight management and the treatment of certain types of mood and neurological conditions. I cycle into light keto every few weeks and make sure with my test strips that I hit ketosis. Usually it is just by doing a low-carb day of bone broth, meat and sauteed veggies. Just to keep my body's metabolism on its feet.

50 Things to do Before Seeing a Psychiatrist - Story of how a guy bootstrapped himself out of a really awful drug addiction, panic attack, hospitalization, and turned into a successful musician who leads a happy and stable life. The intro starts a little terrifying but just remember that he got way better, and the Things To Do are pretty good tips.

--> ***Depression Free Naturally*** <-- - This one connects all of the tiny biochemical bits in a very good, comprehensive and actionable book on depression. They go into histamine imbalance, mineral and vitamin deficiencies, diet, lifestyle, basically they cover a LOT of topics. If you only read one book, especially if you are struggling with depression, start with this one imo.

There came a point for me in learning about alternative health (several years and dozens of books in, as well as the complete failure of western doctors in treating my disease), where I started connecting the dots and realizing that some alternative medicine is more scientific than Western medicine, you just have to read a lot and know it inside out so that you don't fall into any of the health craze/fad stuff and only follow advice that is backed by science and common sense. It is impossible to make your own opinions when you just mirror the ones society feeds you. Educate yourself, western medicine is often a lot less scientific than you think, in the strictest definition of the word. Take your health into your own hands and only trust what makes sense and rings true to you, I did and I'm glad.

Thank you for putting all this valuable information here. I have been off ADs for one year, and my digestion is very off. This appears to be the time frame when you noticed your diet was the issue. I'm feeling great one day and very bad the next in rapid cycles of periods when there is no anxiety to periods of intense anxiety. This is a new phase it seems. I will look more closely at your suggestions. Congrats on getting to 98% healed!! -- Rosetta

February 11, 2018

On 2/9/2018 at 10:42 AM, Rosetta said:

Thank you for putting all this valuable information here. I have been off ADs for one year, and my digestion is very off. This appears to be the time frame when you noticed your diet was the issue. I'm feeling great one day and very bad the next in rapid cycles of periods when there is no anxiety to periods of intense anxiety. This is a new phase it seems. I will look more closely at your suggestions. Congrats on getting to 98% healed!! -- Rosetta

Thanks Rosetta! I'm glad my info is of some use to you! Here are a few things that have been helping for me as my digestion is off:

I count calories to make sure I am eating enough (others might need to make sure they are not eating too much)
I hydrate mostly between meals, and don't drink more than a little water/drink with my meals
If I am not hungry but I need to get more calories, I drink fresh ginger tea, which tends to stimulate my hunger a little bit and makes it easier to eat.
I take apple cider vinegar (diluted) and digestive bitters before I eat meat (I am not super good about this but I do seem to make a small improvement when I do)
I track my bathroom trips and stool consistency to notice any patterns that could signal that I need to change up my diet/lifestyle
I eat fruit separate from every other type of food, which is an Ayurvedic technique to avoid reducing digestive power. According to Ayurveda, fruit digests quickly and should be eaten at least 20min before a meal, or a few hours after a meal when the meal is done digesting (though with my sluggish digestion it feels like sometimes the food never fully stops digesting!)
Lately if my digestion gets really bad for a few days straight, I do a Khichdi (rice and mung bean) monodiet for a few days which is very easy for me to digest.

Regarding the anxiety, something that helped for me was to study it carefully through meditation to determine what part of the anxiety was in my mental landscape and what part of it was actually carried in my body. Then I was able to come up with a nutritional/diet/relaxation strategy for the "body anxiety" and a meditation/supplement strategy for the "mental anxiety". It was far from a silver bullet but it helped a bit once I was able to separate the two. I wish you healing!

February 11, 2018

Thank you, IceBat!! This change in my journey has been very distressing. I hope I can benefit from your experiences. Someday, I'll read more of your thread. For now, wishing you well! -- Rosetta

February 11, 2018

Update! I started a blog and a twitter to share my healing journey so far. I am trying an Elemental Diet soon for my digestive issues, and my plan is to post updates on twitter as I go along on the diet, then write a blog post to summarize my experience.

My twitter: https://twitter.com/gutfeelingblog

My blog: https://gutblog.github.io/ (Newest post posted a couple days ago, "The Gut Feeling", talks about my recent digestive issues and the new doctors I am working with)

March 23, 2018

Hi Icebat, i see your blog regarding gut issue..i just wanna to ask have you have you got tightling in your neck or face area....i means numb face and feel blocking throat...i believe its a gut issue. Right now i took probiotic for almost 1 months sometimes got improvement. But lately these 3 days i took 1 dose of proton pump inhibitor - nexpro 20mg ended up got adverse neurological effects. My faces area feel extremed tightness and made me could breathed. For your information im just off lexapro for 6 mths (took over 9mth period) and off lorezapam for 7.5 mths (took over 8mth period). I really hope can get more improvement like you cos look at your medicine history is almost same like me too.

Got any solutions or improvements for gut issue....right now i hit with bad withdrawal more worse than before.....any solution would help me release? Thanks.

March 23, 2018

Hi Icebat, Thanks for your blog, to give me so many usefull information and your experiences give me a hope. So good.....

March 27, 2018

On 3/23/2018 at 2:28 AM, Miracle123 said:

Hi Icebat, i see your blog regarding gut issue..i just wanna to ask have you have you got tightling in your neck or face area....i means numb face and feel blocking throat...i believe its a gut issue. Right now i took probiotic for almost 1 months sometimes got improvement. But lately these 3 days i took 1 dose of proton pump inhibitor - nexpro 20mg ended up got adverse neurological effects. My faces area feel extremed tightness and made me could breathed. For your information im just off lexapro for 6 mths (took over 9mth period) and off lorezapam for 7.5 mths (took over 8mth period). I really hope can get more improvement like you cos look at your medicine history is almost same like me too.

Got any solutions or improvements for gut issue....right now i hit with bad withdrawal more worse than before.....any solution would help me release? Thanks.

On 3/23/2018 at 2:37 AM, Miracle123 said:

Hi Icebat, Thanks for your blog, to give me so many usefull information and your experiences give me a hope. So good.....

Dear Miracle123, thank you for stopping by my thread and sharing your experience!

Back when I was on the Lexapro I sometimes found it very difficult to swallow, however I have never had tingling around my neck or face as far as I can remember. What I remember as far as my own symptoms is that I got a lot of sciatic nerve pain, especially in my left leg and foot. At times it seemed to jerk uncontrollably and all I could do was lay on my side on the couch twitching and waiting day after day for my next chiropractic appointment. Chiropractic work helped keep it at bay temporarily (it wasn't a fix), but I would guess what eventually ended up curing it (at least for two years so far, fingers crossed), was time off of the Lexapro and my whole food diet. I also think the fish oil and b-complex may have helped. The brands I take (well, I stopped the fish oil a couple days ago) are Nordic Naturals Ultimate Omega (fish oil) and Source Naturals Coenzymate B-Complex Sublingual. Fish oil supplements are easy to get poisoned from by cheap brands, so be sure to pick a good one. I found Nordic Naturals by word of mouth, but eventually found this list: https://labdoor.com/rankings/fish-oil It's pretty common to find SSRI users with good neurological benefits from Fish Oil in their withdrawals. I would do more research specifically on fish oil in relation to SSRI withdrawal and form your own opinion.

One thing that helped for me in terms of gut function was to start with a goal of my stools being regular, and not diarrhea (which was mostly my issue) or constipation. I started from ground zero not really having any idea of what I was doing, except that the idea that eating a lot of whole foods would help. After some research I started by eating mostly vegetables, with some grass-fed meat and fish, and cutting out gluten, grain, dairy, nightshades, and legumes. When that didn't work (still diarrhea) I tried the Khichdi monodiet which I saw near-immediate results with, after just two days. I had tried the Khichdi on someone else's request not thinking it would really work ("yeah sure it can't hurt, I'll try it just to say I did"), but to my surprise my stools had become normal and my mood much improved. It was temporary and I knew I had to get back on real food at some point. At that point I tried the GAPS diet http://www.gapsdiet.com/. I followed it mostly but not all the way, but it seemed to help a little anyways. Mostly I just started eating almost only chicken soup, lots of homemade bone broths (though it got very expensive and I needed help making it from my family) , eventually adding live sauerkraut, steamed vegetables and cooked organic meats. This was not an immediate respite like the Khichdi monodiet. I have heard miracles about L-Glutamine, I didn't end up trying it myself. Some other ideas I didn't try but just to throw out there are L-Glycine and collagen powder. Lastly I have had some mixed success in mental clarity with 1-day bone broth fasts.

I recently got to the point that I could take antibiotics without the fear of them wiping out my remaining gut flora and me dying. I was reluctant to take them but it turns out I have had chronic rhinosinusitis (recently confirmed by CT) ever since I was diagnosed with "panic disorder" and put on the lexapro/lorazepam in the first place. I suspect mold in my last home may have caused it, and the sinusitis may have a fungal component.

Did you take the PPI for heartburn? I used to have a lot of heartburn a couple months ago, and the Elemental diet really helped me with that like nothing else did. Before the elemental diet I would always get heartburn whether or not I took Betaine HCl with my meals, and I was taking digestive enzymes with every meal. I also noticed that if I ate too much it would put me on the couch feeling like I had food poisoning. The heartburn was so bad that I seriously feared I might develop esophageal cancer. Now I don't need the HCl even when I eat meat, and I only take the enzymes a day or two a week. If I eat a full meal I don't feel sick anymore.

I tried Ultimate Flora Extra Care probiotic first and that seemed to help. Recently I am trying Visibiome instead, at the recommendation of my chronic fatigue / digestion MD. I finished with the 2-week antibiotic course yesterday (Augmentin), and now I am doing 2 packets of regular strength Visibiome daily (900 billion bacteria total). I was taking 1 packet/day before the antibiotic. It's not a night-and-day difference but it does seem to be helping. I figure that 900 billion is a big blast to my gut, as long as it can handle it (I'm monitoring symptoms like diarrhea, emotional lability, bloating, gas). What seems to be working for me in terms of probiotics is to really pay attention to my body, and as long as my body is ok with it, to ramp up the probiotic high. If you get bloating, more diarrhea, etc, stop ramping up or back down. I've also read to cycle brands of probiotics every couple months to inoculate your gut with as many different strains as possible, I haven't collected enough data to determine whether this is effective for me yet. One thing to keep in mind is that with many probiotic strains, especially lactobacillus, they don't take up permanent residence in the intestine very quickly. A lot of their documented effect happens as they pass through you, so they have the most potent beneficial effect while you are actively taking the probiotic.

Lastly I highly recommend mindfulness meditation. At first it was very painful to sit with my symptoms without any distraction. I could only meditate in 3-minute stretches. But eventually with practice I was able to go longer, and it has helped a lot with being able to coexist more peacefully with my emotional state. Before I ever got on the Lexapro, back when life was hunky dory (well I mean it wasn't, but it was a "normal" life), I was reading Mindfulness in Plain English. While I was on the Lexapro (and to this day) I have a meditation teacher who came to me as a therapist covered under my health insurance. Lately I have been doing guided meditation using the Headspace app with Andy Puddicombe's soothing voice. Also helpful have been my daily walks.

Your medicine history is indeed very similar to mine. If you have any more questions, shoot and I'll get back to you when I am able! I hope that part of my healing journey will help guide your path to recovery as well. I wish you a speedy recovery, to feel clear-headed, energetic and joyful, and to make sense of, grow from, and come to peace with your experience.

Warm wishes,

Icebat

March 28, 2018

Hi Icebat, i really so touch and appreciated you willing to share your useful experience and information. Thanks for your kindnesss and helpful. Right now i also bought high range omega fish oil quite expensive but dont know how pure is it.... just took it eveyday 1. Maybe i finish this stock i will try to located the brands u recommend but might worry my countries not supply it. I think of B complex too but due to my so sensitive body i so probia to take any medicine or supplement. Last tuesday just 1 dose ppi (nexpro 20mg) i hit again with bad withdrawal like my nerves system mess and flare up. Ended up i landed on ER cos feeling my face and throat numb, choking sensation and could breathed on saturday after jogging. Done ECG and untrasound for kidney,gasblandder stone, liver all seem clear. Go back with some medicine but i havent took any.

I also took probiotic + inulin for intestinal microflora (10 billion) over 1 month now hope this will help. Sound like yours is very high range probiotic. I can only take small portion meal with more frequent. Even i eat small potion my stomach easy get full and stomach also feel cramping when my muscle thightling especially neck and throat area. Currently i try Slippery Elm Bark Solaray US brand to monitor.Sometimes i so confused to treat them is withdrawal or health problem. But i always convinced myself is a withdrawal dont worry will be over even i in scared and panic stage. Whole body jerk or like a electrical shock all i got come from nervous damage or readjust i think.

About meditation....i really could do it...maybe for few minutes. Meditation is a helpful for mind peacefull but i more enjoyed sit down and read others member stories like you to keep me going further.

I also wishing you well, joyful and good healthy .

Warmest wishes,

Miracle

☼ Icebat: Lexapro (escitalopram) withdrawal

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