Figgy: 3 months off Lexapro - relapse or withdrawal?

[Figgy]

I was on lexapro for 10 years and tapered off.  I have been completely off for 3 months.  At first I felt pretty good but anxiety has been creeping back, that feeling like you are watching yourself in a movie instead of real life.  I feel agitated, my memory is scary and wake up every morning around 5am regardless of what time I go to bed, and lastly, just not happy.   

 

How do you know if this is withdrawal still or relapse?  I know withdrawal is difficult but relapse is also a real possibility. My doctor will be of no help.  He already told me before I tapered I would be done with withdrawal very quickly....drug half life etc. etc.

 

I would appreciate any advice.

[apace41]

Hi, Figgy.

 

Welcome to SA.  Gut reaction is that this is withdrawal, but without having your history and speed of taper it is hard to fully assess. 

 

Please put your withdrawal history in your signature

 

In general we at SA suggest a 10% monthly reduction at most.  Here are some links that will be useful to you.

 

What is withdrawal syndrome? 

 

Why taper by 10% of my dosage?

 

Our general guidance on tapering Lexapro is the following:

 

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

 

So, long story short, if you can provide some additional information we can provide you with some additional thoughts and help.

 

The things you are citing, however, are very standard in withdrawal.  If you didn't have them prior to starting on the drug then it is HIGHLY LIKELY that it is, in fact, withdrawal.

 

Best,

 

Andy

[Figgy]

Thanks Andy,

Updated my signature as you suggested.  I have always had generalized anxiety and went on lexapro originally due to a family crisis that caused me to barely function and cope.  I just stayed on it.  I can stick this out if it is withdrawal but I don't want to ever go back to that woman close to a breakdown. 

Did I taper too fast?

[ChessieCat]

Hi Andy,

 

Glad you found SA.  You will find excellent information and support here.

 

It appears from your taper history that you may have tapered too quickly.  Please wait until someone with more knowledge replies before doing anything, but I suggest you read the following so you can better understand what and why they suggest something.

 

Brain Remodelling

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

You can use your Intro topic to ask questions and post updates and as a record of your recovery.

 

Good luck.

 

CC

[Figgy]

Thanks CC for your answers.  I guess I don't understand how i could have tapered more than I did.  My dose was 5mg or half of a 10mg tablet.  I reduced to a quarter of a tablet for about a month then off.  Trying to cut it any smaller would have resulted in odd shapes and crumbs.  What should I have done.

 

After 3 months off...the link you sent me says reinstatement is unlikely to help and could cause problems.  Not sure what to do.  It is a big struggle and I don't know how to get out of my own head and just live...I feel like I'm in a fight for my mental health.

 

Best,

Figgy

 

P.S.  It is really amazing to find a place to ask some questions and get an answer!  I am grateful.

[brassmonkey]

Hi Figgy-- welcome to the group.  I'm sorry to hear that you're feeling so bad right now.  Most of the things you're currently feeling are more than likely WD symptoms from a very fast taper.  Seeing that you are 3 months out reinstatement gets a bit tricky, but it can still work. If you were to start taking a very small dose, say 1mg it should help to reduce the symptoms you're feeling.  It won't help immediately as it takes four days for any dose change to become steady state in the blood and start taking effect.  Because of the symptoms you are now feeling it could take several weeks for things to settle down.  Making up such a small dose takes a little practice but is really pretty easy to do. Some people crush their pills and use a jewelers scale to weigh out the new dose, while some people opt to make their own liquid.  Here are a couple of threads on how to do it:

 

How to cut up tablets or pills

 

How to make a liquid from tablets or capsules

 

Using an oral syringe and other tapering techniques

 

These and the threads Andy and CC suggested should be plenty to overload you with information. If you have any questions just ask.

 

Thank you for putting your details in a signature block it is very helpful.  It looks like there may be a typo on the second line though. 

[apace41]

Did I taper too fast?

 

Unfortunately, yes.  I know it seems counterintuitive because you can't see how to get the pills smaller, and they don't make smaller mg pills, but that's part of the way big pharma makes it hard to get off their "stuff."

 

The best way to taper more slowly is in liquid form because it is easier to make fine gradations.  In the alternative, members use sensitive scales and cut pills or remove beads in capsules to get to the right interim mg levels. It is not easy work, but it can make all the difference.

 

Given how fast you came off the med, I feel much more confident that what you are suffering from is, in fact, withdrawal.

 

Read the links and ask questions after you understand where you are.

 

Best,

 

Andy

[KarenB]

Welcome Figgy,

 

You are in good hands here - so glad you found this site and can feel supported.  What I love about being here is no longer feeling alone in this w/d journey.  Wishing you well...

 

Hugs,

KarenB

[Figgy]

Thank you, Brass Monkey...I did have a typo in the second line of my signature.  I have read the suggested links about making a liquid from tablets but I don't feel confident I can do that and not screw it up or make the wrong concentration for myself.  Just trying to figure it out is making my head swim.

 

Also according to the reading, reinstating after 3 months sounds perhaps riskier than just staying off?  If I do nothing can I expect to be better over time?

How much time?  

 

Lastly, my family has become increasingly worried about how bad my memory has become over the past few years.  I realize this may be a separate (an unfortunate) issue but can 10 years of lexapro mess with your memory and/or cognitive abilities?

 

Thank you all.

Figgy

[AprilShowers]

Welcome Figgy. 

 

I don't have much advice to offer but I think you will find support here and you're not alone. It takes the brain time to adjust to any change so take good care of yourself right now. I wish you the best and you're not alone here. 

[Mort81]

Hey Figgy I took Lexapro aswell. I am very certain it's WD not a relapse. 3 months is not a longtime to experience these feelings. You tapered too fast and your doctor will be of little help right now. I would agree with brass monkey to try to reinstate a small dose but that would be only if your symptoms are really bad. If you dont reinstate recovery time is not easy to predict. It could happen at anytime or take a while. We don't have enough studies thanks to big drug companies that hide evidence of this. It seems most people who don't have a severe WD recover within a year but those that do it can be a much longer time. 1-3 yrs

I also think your memory will continue to get better. WD effects people on so mmay levels and temporary cognitive impairment seems to be quite a popular symptom.

[AliG]

 Figgy '

 

What have you decided to do ?  You feel like you're in a " fight for your  mental health" because you are . 3 months out is borderline. You have to make a choice, as to whether you are going to reinstate. The window is closing . No one can predict how long withdrawal will last . If I were you I would try a small reinstatement , and give it 4 days  and then reassess.  However, it's totally your choice. You have been on ( the drug )  a long time , therefore might have a protracted withdrawal.

 

Ali

[Figgy]

I am still trying to decide what to do.  Yesterday when I found this site was a very bad day. So, yes...saying i was fighting for my mental health sounded pretty dramatic but it is a fight.  What do you mean it is borderline?  Reinstate with what dose for 4 days?

 

Late in the day yesterday I forced myself, really had to force myself to go outside for a brisk walk and I found it did help. Today is a better day.

 

I am functioning, some days on the edge of panic but functioning.  My families concerns about my memory has really scared me. My memory is not good and i have been aware of it for some time.   Reinstating and feeling better is so tempting but I have come this far and I am intimidated by trying to titrate lexapro.  I am terrible at math and would surely goof that up.  How bad is my withdrawal?  I have nothing to compare it to.  

 

When I feel really terrified I have the option of taking a half of an alprazolam but I don't know if that is a good idea or a bad one..

Thank you everyone..

[brassmonkey]

Hi Figgy--  The whole process seems to be so overwhelmingly complex it's boggling, I totally understand.  As for how long it will take, no one can tell.  Some people can come off years of use CT with no problems while others take only a couple of pills and suffer for a very long time.  For most it takes a lot longer than they would like and for the people who CT or Fast Taper it frequently takes even longer.  After a CT or Fast Taper there is a honeymoon period where things feel tolerably well, then after a few months the symptoms blindside the person.  We see it all the time here.  Yes there is some risk in reinstating after three months, that is why we recommend that you start at a very small dose and see what happens and then maybe increase it if things go well.  For many the prospect of feeling functional out weighs the risk of a bad reaction.

 

Memory problems and brain fog are two of the primary symptoms of WD and they will improve with time.  For those of us who are holding down full time jobs it can be a real challenge, but it can be done.

 

Could one of your family members help with making up the liquid?  Getting them directly involved could increase their support.

[Figgy]

Thank you, Brass Monkey.  Unfortunately the memory issues have been going on long before I discontinued Lexapro.  That is why I asked if just taking the drug can cause issues with it?

 

What is the risk of reinstating after 3 months?  What is it that can happen?

 

Thank you!

[AliG]

Figgy ,

 

I posted at the same time as Brassmonkey , but lost it  !  I was pretty much going to say the same thing . You are feeling ok , now , but months down the track , is when this thing can hit with " full force" However, once the window is shut , you're forced to deal with it , and there are no other options. You could have years of " protracted withdrawal ".

[brassmonkey]

Hi Figgy -- "what were we talking about?" lol  Yes memory loss happens while on the drug, not just after coming off of them.  When I was on my full dose of Paxil I had real trouble remembering what I did five minutes ago.  It's one of the big reasons I started to taper off.  Things are much, much better now.

 

When a person comes off these drugs too fast it throws their brain into chaos which causes the WD symptoms.  It also can make the CNS sensitive to any type of psych drug. Worst case is for some people introducing even a small amount of the drug pushes things over the limit and the brain reacts very badly with what is called an adverse reaction.  This usually happens very quickly and the only thing to do is to stop taking the drug and wait for things to settle.  Most of the time there will be a little more confusion on the brains part and then it will recognize the drug as the key it was looking for and settle down relieving some of the symptoms at the same time.  I have seen many more people get relief from a small updose than who had trouble.  The ones who had trouble usually started with to big of a dose which caused the problems. 

[Figgy]

What window?  When does it shut...

 

I was feeling fine right after I discontinued .  I think I am experiencing WD now.  Perhaps you are telling me it could get a lot worse.  

[AliG]

Figgy ,

 

I've been up all night.    I'm just saying , the option to reinstate runs out . The longer you leave it the less likely it is to work . It's up to you. Just trying to help , and ease a little of the pain.  I've had years of it and just trying to save you from that . Take it or leave it . Up to you.       Ali

[ChessieCat]

Hi Figgy,

 

I can understand that you probably feel overwhelmed at the moment.  I did when I first joined and was going through withdrawal and had a foggy brain.  Your poor memory certainly wouldn't be helping you.  The members and staff here have a wealth of knowledge and experience.

 

Nobody, and I mean nobody, is able to say what will happen if you don't reinstate.  Likewise nobody can say what will happen if you do.  However, I think (and this is my personal opinion, not direct advice) that reinstating a small amount for 4 days, as suggested, would be worth trying and might give you some relief from the withdrawal symptoms.  If you post during and at the end of 4 days, suggestions could be offered as to what you do after that.

 

This link is about Keeping it SIMPLE, SLOW and STABLE especially 2.c. Do not jump around in dosage.

 

I found this video helpful:  

 

Unfortunately nobody but you can decide what to do.  Just a thought.  Maybe writing a pro's and con's list might help.  Having things buzzing around in your head, especially when you can't think clearly, can make it harder to decide what to do.

 

All the best.

 

CC

[Figgy]

Ok, thank you everyone.  If I am understanding things correctly....although I began experiencing withdrawal after about 2.5 - 3 months after ceasing Lexapro you are all saying I could get much worse and therefore should try a small dose for 4 days?  If yes, what do you consider a small dose?

[ChessieCat]

Hi Figgy,

 

Someone should be along soon who will be able to suggest a dose.  Sorry I can't help with that.

 

CC

[bubble]

1 mg

[Mort81]

I would also suggest 1mg

[Figgy]

Thank you, everyone.

I am having a medical procedure on Wednesday that requires conscious sedation (yes, the dreaded colonoscopy).  Anyway, I am thinking of trying the 1mg for 4 days to see how I do but I don't want to risk an adverser reaction until I get through this procedure which is 4 days away.

 

So, after Wednesday, I will try it.  If I have a bad reaction, I stop.  If I feel better I will be asking what I am suppose to do next.

 

This is such a hard decision as my WD symptoms are currently not so bad.  I am only doing this because you all seem to feel I am going to be blindsided down the road and I don't want that.  And yes, 10 years is a long time on this drug.

 

Best,

Figgy 

[Altostrata]

Hello, Figgy.

 

I had a colonoscopy without any drugs whatsoever. I had no problems, and I'm a small woman. It was no more uncomfortable than a sigmoidoscopy.

 

You could discuss this with your doctor; it's important that the doctor have experience doing non-sedated colonoscopies.

 

If a drug is necessary, you might request propofol only. It wears off quickly and poses fewer problems for people whose systems are sensitized by withdrawal.

[Figgy]

HI,

I did decide to go ahead and try reinstatement.  I took 1mg of lexapro on Monday.  Today is day four.  I am not sure I am feeling better but I am not feeling worse.  It's funny....I can feel the effects of the lexapro like I did when I first started to take it all those years ago.  For me it is repetitive thoughts and even more strange getting a musical phrase stuck in my head.  These went away over time but I remember it well as I was very concerned about it.

 

So, where do I go from here?  I would like to think if I go up to 2mg I will begin to feel alot better but I need advice as to when/if I should try that.  When I do find relief how long do I stay there before trying to reduce more slowly than I did the first time?  

 

Thank you in advance...I so appreciate it.

[apace41]

So, where do I go from here?  I would like to think if I go up to 2mg I will begin to feel alot better but I need advice as to when/if I should try that.  When I do find relief how long do I stay there before trying to reduce more slowly than I did the first time?  

 

Very good news that you are feeling no adverse effects from reinstating at 1mg.  As I'm sure you appreciate, this is WAY more art than science and, as the saying goes, "your mileage may vary."  If it were me I would wait out until I had reinstated for a full week and, assuming no change, I'd up it to 2mg.  Good reason to be optimistic that it will help, especially if you seem to be reacting the same way.

 

I would sit at 2mg for a while and see how that goes for you.  If you stabilize on that level you will pretty much know it.  Once stable for a couple of week or a month, I would start to think about a nice, very slow, gentle taper off the 2mg.

 

Best,

 

Andy

[Figgy]

Thank you, Andy.  I will stay at 1mg for a full week and then try upping it to 2mg.  I'll let you know.  

 

One question:  The smallest increment syringe I can find has 1mg as the lowest possible measured dose.  How do you eventually taper down below 1mg if you can't measure it?

 

thank you.

[apace41]

One question:  The smallest increment syringe I can find has 1mg as the lowest possible measured dose.  How do you eventually taper down below 1mg if you can't measure it?

 

Dilute the liquid mixture, Figgy.  If you double the liquid then you halve the resulting amount, and so on and so on....

 

Cheers,

 

Andy

[Figgy]

Thank you, Silver Star.  I will check in on Monday when I have been on the 1mg for a week.   This site has been a godsend for me.  I am very grateful.

Figgy

[Figgy]

Hi,

I followed Silver Star's good advice and stayed on 1mg for a full week.  I am feeling much better.  I am trying to decide when to go up to 2mg.

 

I am still not convinced this was withdrawal?  The state I was in was close to the state I was in when I originally went on Lexapro.  I do not want to go back to where I was when I found this site.  So, I have some questions if someone can please answer.

 

How long can I be on this small dose and have it continue to be effective? Long term, traveling with liquid I make myself that has to be refrigerated is not very practical.  

 

If I decide I don't want to risk going off again will I need to get back to my original dose?  

 

I know this site is about helping people get off these drugs but I'm pretty scared about trying to withdraw again.  Thank you in advance.

Figgy

[apace41]

Figgy,

 

First off, "Sliver Star" is a designation based on how many posts a member has made.  Each of us has a screen name like "Figgy".  If you use "Sliver Star" you could to addressing lots of people.  LOL.  Happens a lot!

 

Great news that you are stable at 1mg.  If you are there is NO REASON to increase to 2mg.  I would stay here for a while.  Yes, it may be awkward for you to deal with liquid and refrigeration, etc., but to on the lowest effective dose for managing your symptoms that seems like a good trade-off.  I don't see any reason for you to start to try to taper now.  Let's see how you are on 1mg for another week or so.  It will also allow you to decide how you want to proceed. 

 

We are about trying to help people withdraw from these meds safely, however, it is not our role to force people to go off them.  We would, however, never advocate you increase your med dose from a level where you are stable simply for convenience.  It could have an adverse effect on you.

 

My approach if I were you would be to take a while longer at 1mg and if I remained stable, perhaps early next year I would try to do a very, very slow taper down from 1mg. 

 

But that's me.

 

Andy

 

[Figgy]

Thank you, Andy.

The reason I was considering going up to 2mg was to get back to how well I was feeling when I went off.  But, I will take your advice and stay at 1mg for another week.  

 

Are you saying I could still have a bad reaction if I up my dose?  All I want for right now is to get back to where I was and stay there until after the first of the year.  I hope this is a reasonable expectation given how helpful the 1mg has been.  

 

I am still struggling to understand how such little doses can be effective.  A previous comment that I didn't see until too late suggested I might have trouble with conscious sedation from a medical procedure.  Is there a related problem with sedating valium type drugs because of WD?

 

Thank you again,

Figgy

[apace41]

I'm not sure I follow you, Figgy. Are you saying you want to go back up to 15mg?

 

If you feel good at 1mg why go all the way back up? Plus, the reason the small dose works is because of the sensitizing of your CNS. For the same reason, going back to 15mg can have a paradoxical effect.

 

So long as 1mg worked that's where I would stay.

 

Andy

[AliG]

Hi Figgy,

 

I'm pleased that you seem to have stabilized on 1 mg. Reinstatement may not eliminate all of your withdrawal symptoms. You may still experience waves of symptoms, at certain times. That is the nature of withdrawal . When you say you want to get back to where you were and stay there, do you mean your symptoms, perhaps?  Either way, it might be a good idea to keep track of your symptoms, to identify any patterns and help make any further decisions on dosage , in the future.

 

http://survivingantidepressants.org/index.php?/topic/2390-dr-joseph-glenmullens-withdrawal-symptom-checklist/

 

Did you end up having your colonoscopy ?  What drugs, if any were you given?

 

I'm glad you are feeling better.

 

Ali