Figgy: 3 months off Lexapro - relapse or withdrawal?

[Gridley]

@Figgy

 

Here's is Brassmonkey's response:
 

 

 

She is using a liquid so to taper from the 0.01mg would be a matter of changing the dilution strength of the liquid and recalculating the volume of the new doses.

 

A reinstatement might work, but she mentioned that bad anxiety is what got her on the drugs on the first place. I suspect that there may be some of the "original conditions" showing through that needs to be addressed and controlled by non-drug methods. She should have been working on that during her taper, but it often gets overlooked and the drugs may have done a good job of masking it. With luck it's just a stabilization problem that would go away with an RI, long hold and further taper.

 

Reinstating at 0.01 might be a bit high, because she has been off completely for five months. I'd try 0.0025 of 0.005. She will have to dilute the original liquid to get that. Equal parts liquid and water and take her original dose volume will give the 0.005.

 

Something she might try is using a "rescue dose". If things get too bad, taking a drop of the liquid on a toothpick and placing it under the tongue can help on a one time basis. Erell has been using them with her prozac bridge. Not a long term fix, but can get one out of a bad spot.

 

 

[Figgy]

7 hours ago, Gridley said:

@Figgy

 

Here's is Brassmonkey's response:
 

 

 

 

She is using a liquid so to taper from the 0.01mg would be a matter of changing the dilution strength of the liquid and recalculating the volume of the new doses.

 

A reinstatement might work, but she mentioned that bad anxiety is what got her on the drugs on the first place. I suspect that there may be some of the "original conditions" showing through that needs to be addressed and controlled by non-drug methods. She should have been working on that during her taper, but it often gets overlooked and the drugs may have done a good job of masking it. With luck it's just a stabilization problem that would go away with an RI, long hold and further taper.

 

Reinstating at 0.01 might be a bit high, because she has been off completely for five months. I'd try 0.0025 of 0.005. She will have to dilute the original liquid to get that. Equal parts liquid and water and take her original dose volume will give the 0.005.

 

Something she might try is using a "rescue dose". If things get too bad, taking a drop of the liquid on a toothpick and placing it under the tongue can help on a one time basis. Erell has been using them with her prozac bridge. Not a long term fix, but can get one out of a bad spot.

Thank you for the response.  I really don't want to reinstate but if I do I will try Brass Monkey's dosage advice.  My primary care doc and my new therapist both believe I should just "go back on" Lexapro starting at 2.5mg and working up to 5mg.  I think they both believe I have deeply engrained, familial anxiety that is very tough to beat with therapy and need to be on for the an AD for the rest of my life.  I don't want to do it.  However,  If it comes to it... is it dangerous to start taking 2.5 mg again?  

I haven't given up but I would like to know if you think 5 HTP would help me with withdrawal symptoms after being completely off Lexapro for 5 months.  Thank you, Figgy

 

 

 

[Gridley]

25 minutes ago, Figgy said:

5 HTP

Some members have had positive experiences, others negative.  If you try it start at a low dose.  As with all drugs or supplements (natural or otherwise) that alter brain chemistry, you would need to taper the 5HTP when you stopped it.  Here is a link:

5-HTP (5-hydroxytryptophan) and l-tryptophan - Page 2 ...

25 minutes ago, Figgy said:

is it dangerous to start taking 2.5 mg again?  

You did a slow taper and jumped to zero at a very low dose. In the time you've been tapering and off the drug your brain has made accomodations to having less then none of the drug.  Reinstating 2.5mg poses the very real risk of overwhelming your brain and making matters worse.  If this happens it can take a long time to stabilize.  Brassmonkey in his post said reinstating 0.01 might be a bit high after being off the drugs for 5 months.  If 0.01 is too high, you can see that many multiples higher would not be a good idea.

 

31 minutes ago, Figgy said:

need to be on for the an AD for the rest of my life. 

These drugs when they came out were never intended to be taken long-term and the health effects of taking psychiatric drugs long term haven't been determined.  Robert Whitaker, in his book, Anatomy of an Epidemic, determined that those who went off all classes of psychiatric drugs, including antidepressants, did better in the long term than those who kept taking them.

 

Anatomy of an Epidemic

 

Here's a video book trailer by the author, Robert Whitaker:

 

Robert Whitaker, author Anatomy of an Epidemic video (11 minutes)

 

 

 

 

[Altostrata]

Figgy, if I were you, I'd try 0.01mg and see what happens. Please let us know how you're doing.

[Figgy]

On 11/4/2020 at 4:51 PM, Altostrata said:

Figgy, if I were you, I'd try 0.01mg and see what happens. Please let us know how you're doing.

Thank you.  Since I last posted I've had a complication or two.  I am in the throws of a bad bout of divericulitis (intestinal infection) causing awful nausea for almost 2 weeks and counting.  I am taking zofran and Phenergan.  I have not tried reinstating yet because I read up on these drugs and they are something called Serotonin antagonists or "blockers".  That scared me.  The reason I even bothered to look them up is because a sleep medicine doctor had me try 100mg of Gabapentin for sleep.  I took one and I hated it...made me feel awful.  I looked that up and I am not sure what it does but it messes with your brain chemistry.  

So, I don't know what to do.  Can I try reinstatement or are the anti nausea medicines going to be a problem?  As always, thank you so much.

Figgy

[Figgy]

On 11/9/2020 at 9:06 AM, Figgy said:

Thank you.  Since I last posted I've had a complication or two.  I am in the throws of a bad bout of divericulitis (intestinal infection) causing awful nausea for almost 2 weeks and counting.  I am taking zofran and Phenergan.  I have not tried reinstating yet because I read up on these drugs and they are something called Serotonin antagonists or "blockers".  That scared me.  The reason I even bothered to look them up is because a sleep medicine doctor had me try 100mg of Gabapentin for sleep.  I took one and I hated it...made me feel awful.  I looked that up and I am not sure what it does but it messes with your brain chemistry.  

So, I don't know what to do.  Can I try reinstatement or are the anti nausea medicines going to be a problem?  As always, thank you so much.

Figgy

Can someone please answer the post above about reinstating 0.01mg is ok try try while taking zofran and phengergan?  Also, could the 100 mg of Gabapentin the sleep doc told me to take (took it once a week ago) have caused me problems?  My WD symptoms are worse.  thank you,

Figgy

[Figgy]

On 11/4/2020 at 4:51 PM, Altostrata said:

Figgy, if I were you, I'd try 0.01mg and see what happens. Please let us know how you're doing.

 

Hi,  I can't get anyone to answer my posts on 11/04 and 11/09.   Can you please take a look?

Thank you very much,

Figgy

[manymoretodays]

Hi Figgy,

27 minutes ago, Figgy said:

 

Hi,  I can't get anyone to answer my posts on 11/04 and 11/09.   Can you please take a look?

Thank you very much,

Figgy

Can you go to Drugs.com and plug in your Zofran, Phenergan, and Lexapro.  And then copy the result here, on your page, or link us to them.

Have you started the .01 mg reinstatement? 

And if so, when do you take it?

When do you take your other drug(s)?

 

23 hours ago, Figgy said:

Also, could the 100 mg of Gabapentin the sleep doc told me to take (took it once a week ago) have caused me problems?  My WD symptoms are worse.  thank you,

 

And yes, the dose of Gabapentin, might have thrown you off a bit.  Which symptoms are worse?

Any improvements in symptoms overall?

Do share what symptoms are most bothersome, as then we can point you towards non-drug coping strategies too.

Hopefully, you'll get back to baseline very soon.

 

L, P, H, and G,

mmt

Edited November 11, 2020 by manymoretodays
spelling, elaboration.

[Figgy]

3 minutes ago, manymoretodays said:

Hi Figgy,

Can you go to Drugs.com and plug in your Zofran, Phenergan, and Lexapro.  And then copy the result here, on your page, or link us to them.

Have you started the .01 mg reinstatement? 

 

 

And yes, the dose of Gabapentin, might have thrown you off a bit.  Which symptoms are worse?

 

L, P, H, and G,

mmt

the symptoms anxiety and nausea are worse.  I have not tried reinstating yet as I don't want to make matters worse.  I don't understand about copying the results from drugs.com.  You want all the pages on each drug?

[manymoretodays]

1 minute ago, Figgy said:

the symptoms anxiety and nausea are worse.  I have not tried reinstating yet as I don't want to make matters worse.  I don't understand about copying the results from drugs.com.  You want all the pages on each drug?

 

Just the interaction report:  https://www.drugs.com/interaction/list/

I added edited a bit more to my last post too.

Let's see, when do you take your Zofran and Phenergan?  What time each day?

 

And you answered my other question(s), thank you.

[Figgy]

2 minutes ago, manymoretodays said:

 

Just the interaction report:  https://www.drugs.com/interaction/list/

I added edited a bit more to my last post too.

Let's see, when do you take your Zofran and Phenergan?  What time each day?

 

And you answered my other question(s), thank you.

I am taking the zofran for extreme nausea from diverticulitis but the nausea should have been gone by now.  I am concerned because of what I just read about zofran.  Please note the last mentioned side effect.  I have had to take alot of it. see below:

Zofran ODT side effects

Get emergency medical help if you have signs of an allergic reaction: rash, hives; fever, chills, difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• severe constipation, stomach pain, or bloating;

• headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats;

• fast or pounding heartbeats;

• jaundice (yellowing of the skin or eyes);

• blurred vision or temporary vision loss (lasting from only a few minutes to several hours);

• high levels of serotonin in the body--agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting.

 

[manymoretodays]

2 minutes ago, Figgy said:

I am taking the zofran for extreme nausea from diverticulitis but the nausea should have been gone by now.  I am concerned because of what I just read about zofran.  Please note the last mentioned side effect.  I have had to take alot of it. see below:

 

How often do you take it, Zofran, on average, and at what dose Ziggy?

Does the Zofran usually help with the diverticulitis nausea?

I've got you flagged, or notified the other mods who may be a bit more familiar with you, to stop on by too.

Try not to get overly worried right now.

[Figgy]

1 minute ago, manymoretodays said:

 

How often do you take it, Zofran, on average, and at what dose Ziggy?

Does the Zofran usually help with the diverticulitis nausea?

I've got you flagged, or notified the other mods who may be a bit more familiar with you, to stop on by too.

Try not to get overly worried right now.

I am taking 4mg of Zofran two or three times a day.   Sometimes I take 8mg another one for a total of 8mg if the nausea does not abate.  OMG...has Zofran thrown me into some sort of withdrawal syndrome hell?  The nausea is intense and like the worst stomach flu you've had.  I'm trying not to panic  but this nausea has been going on for two weeks.  I have a zoom appt with my Gastro doc today.  I can ask him about this but he will just think I'm crazy.  Thank you for helping me.

Figgy

[manymoretodays]

5 minutes ago, manymoretodays said:

Please note the last mentioned side effect

Which one please?

Have you been fainting?

Are you getting enough fluids in Ziggy?

 

Oh, okay, I see your recent post.  Nausea, big time nausea.

 

Just go easy with the gastroenterologist and talking about WD.  Ask them about any non-drug coping you could do for the nausea......they might have some good ideas, outside of using more medication.  You never know.

[Figgy]

9 minutes ago, manymoretodays said:

Which one please?

Have you been fainting?

Are you getting enough fluids in Ziggy?

 

Oh, okay, I see your recent post.  Nausea, big time nausea.

 

Just go easy with the gastroenterologist and talking about WD.  Ask them about any non-drug coping you could do for the nausea......they might have some good ideas, outside of using more medication.  You never know.

no fainting but elevated heart rate over many days documented by health care providers and some slight tremors.  Trying to drink as much fluids as i can.  But the question I really want an answer to is are the high seratonin levels stated in the side effects dangerous given my withdrawal and having been off lexapro since early June?  Will stopping Zofran make it better or does it cause a longer term problem.  This is what I really need advice about.  Anything you can do to get the answer to this question I would be very grateful for.

Figgy

[Gridley]

@Figgy

 

I ran the drug interactions among zofran, phenergan and Lexapro.  There's a major interaction between Zofran and Lexapro with respect to the Serotonin Syndrome you're concerned about.  I don't know if you're still considering reinstating 0.01 Lexapro.  The question would be whether such a small dose would pose a risk of SS.

 

Interactions between your drugs

Major

ondansetron  escitalopram

Applies to: Zofran (ondansetron), Lexapro (escitalopram)

Using ondansetron together with escitalopram 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.

Switch to professional interaction data

Major

promethazine  escitalopram

Applies to: Phenergan (promethazine), Lexapro (escitalopram)

Using escitalopram together with promethazine 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.

Switch to professional interaction data

Moderate

promethazine  ondansetron

Applies to: Phenergan (promethazine), Zofran (ondansetron)

Using promethazine together with ondansetron 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. 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.

 

Here's dosage information for Zofran, mostly in th context of chemotherapy.

 

Zofran dosage information (in more detail)

[manymoretodays]

I

35 minutes ago, Figgy said:

I am taking 4mg of Zofran two or three times a day.   Sometimes I take 8mg another one for a total of 8mg if the nausea does not abate.  OMG...has Zofran thrown me into some sort of withdrawal syndrome hell?  The nausea is intense and like the worst stomach flu you've had.  I'm trying not to panic  but this nausea has been going on for two weeks.  I have a zoom appt with my Gastro doc today.  I can ask him about this but he will just think I'm crazy.  Thank you for helping me.

Figgy

 

I don't think it's thrown you into some sort of WD hell, however, it may be adding to it, and giving you an adverse effect.  Maybe even a paradoxical effect.  That's when you get the opposite effect, from what a drug is supposed be doing.  We tend to be pretty sensitive to drug(s) during and even after WD.

More on Zofran's 5HT3 receptor antagonist effects here:  https://www.drugs.com/drug-class/5ht3-receptor-antagonists.html

I also found a couple other members experiences with Zofran.

Can you do a google search, just put in survivingantidepressants.org (followed by) Zofran

That would save me some time, as I've got to get on to some other stuff here on the ground.

 

35 minutes ago, Figgy said:

I am taking 4mg of Zofran two or three times a day.   Sometimes I take 8mg another one for a total of 8mg if the nausea does not abate. 

 

What have you taken of Zofran in the last 24-48 hours?  And maybe if you go with less, instead of more.......you might get relief.

How long have you been taking Zofran?

 

Edited November 11, 2020 by manymoretodays

[Figgy]

3 minutes ago, Gridley said:

@Figgy

 

I ran the drug interactions among zofran, phenergan and Lexapro.  There's a major interaction between Zofran and Lexapro with respect to the Serotonin Syndrome you're concerned about.  I don't know if you're still considering reinstating 0.01 Lexapro.  The question would be whether such a small dose would pose a risk of SS.

 

Interactions between your drugs

Major

ondansetron  escitalopram

Applies to: Zofran (ondansetron), Lexapro (escitalopram)

Using ondansetron together with escitalopram 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.

Switch to professional interaction data

Major

promethazine  escitalopram

Applies to: Phenergan (promethazine), Lexapro (escitalopram)

Using escitalopram together with promethazine 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.

Switch to professional interaction data

Moderate

promethazine  ondansetron

Applies to: Phenergan (promethazine), Zofran (ondansetron)

Using promethazine together with ondansetron 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. 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.

 

Here's dosage information for Zofran, mostly in th context of chemotherapy.

 

Zofran dosage information (in more detail)

Thank you but my question is have the high levels of seratonin in the Zofran already caused me SS?  (see zofran side effects I posted above) My extreme nausea is unexplained as it should have long since gone away as the diverticulits has been treated.  I also have rapid heart rate and some occasional twitches.  

[Figgy]

5 minutes ago, manymoretodays said:

I

 

I don't think it's thrown you into some sort of WD hell, however, it may be adding to it, and giving you an adverse effect.  Maybe even a paradoxical effect.  That's when you get the opposite effect, from what a drug is supposed be doing.  We tend to be pretty sensitive to drug(s) during and even after WD.

More on Zofran's 5HT3 receptor antagonist effects here:  https://www.drugs.com/drug-class/5ht3-receptor-antagonists.html

I also found a couple other members experiences with Zofran.

Can you do a google search, just put in survivingantidepressants.org (followed by) Zofran

That would save me some time, as I've got to get on to some other stuff here on the ground.

 

 

What have you taken of Zofran in the last 24-48 hours?  And maybe if you go with less, instead of more.......you might get relief.

How long have you been taking Zofran?

 

taking zofran for 10 days with from 1-4 times a day. And I don't know what a 5HT3 receptor antagonist means?  Is the zofran blocking seratonin or giving it to me.  Thank you for this one last question.  I know you have others to help.

[manymoretodays]

7 minutes ago, Figgy said:

Is the zofran blocking seratonin or giving it to me. 

 

Well, here we go...

5-HT3 receptor antagonists prevent serotonin from binding to 5-HT3 receptors in the small intestine thereby reducing the likelihood of nausea and vomiting. The way 5-HT3 receptor antagonists work to prevent postoperative nausea and vomiting is less well understood.

 

So it changes the serotonin and receptor response.  I know it seems kind of murky, and I am only a lay person.

Again, if it were me.....I'd minimize my dose/use of it, as much as possible.  It hasn't helped with anything, from what you are saying.

10 minutes ago, Figgy said:

What have you taken of Zofran in the last 24-48 hours?  And maybe if you go with less, instead of more.......you might get relief.

How long have you been taking Zofran?

 

11 minutes ago, Figgy said:

taking zofran for 10 days with from 1-4 times a day.

 

With only 10 days of use, you could reduce the dose by 1/4 each day, until off.

I'm sure you will get some input from your gastro doctor on this as well, Ziggy.

[Figgy]

1 minute ago, manymoretodays said:

 

Well, here we go...

5-HT3 receptor antagonists prevent serotonin from binding to 5-HT3 receptors in the small intestine thereby reducing the likelihood of nausea and vomiting. The way 5-HT3 receptor antagonists work to prevent postoperative nausea and vomiting is less well understood.

 

So it changes the serotonin and receptor response.  I know it seems kind of murky, and I am only a lay person.

Again, if it were me.....I'd minimize my dose/use of it, as much as possible.  It hasn't helped with anything, from what you are saying.

 

 

With only 10 days of use, you could reduce the dose by 1/4 each day, until off.

I'm sure you will get some input from your gastro doctor on this as well, Ziggy.

Thank you.

[Gridley]

@Figgy

 

According the the following Zofran blocks serotonin:

 

The most effective drug for the treatment of SSRI-related adverse effects on the GIT is ondansetron, a serotonin 5-HT₃ receptor antagonist that blocks the effects of serotonin in the brain and GIT.Oct 25, 2012

Here is a list of SS symptoms.  Nausea doesn't show up but high blood pressure does.

 

Signs and symptoms include:

• Agitation or restlessness
• Confusion
• Rapid heart rate and high blood pressure
• Dilated pupils
• Loss of muscle coordination or twitching muscles
• Muscle rigidity
• Heavy sweating
• Diarrhea
• Headache
• Shivering
• Goose bumps

Severe serotonin syndrome can be life-threatening. Signs include:

• High fever
• Seizures
• Irregular heartbeat
• Unconsciousness

 

 

 

 

 

Edited November 11, 2020 by Gridley

[Figgy]

26 minutes ago, Gridley said:

@Figgy

 

According the the following Zofran blocks serotonin:

 

The most effective drug for the treatment of SSRI-related adverse effects on the GIT is ondansetron, a serotonin 5-HT₃ receptor antagonist that blocks the effects of serotonin in the brain and GIT.Oct 25, 2012

 

Here is a list of SS symptoms.  Nausea doesn't show up but high blood pressure does.

 

Signs and symptoms include:

• Agitation or restlessness
• Confusion
• Rapid heart rate and high blood pressure
• Dilated pupils
• Loss of muscle coordination or twitching muscles
• Muscle rigidity
• Heavy sweating
• Diarrhea
• Headache
• Shivering
• Goose bumps

Severe serotonin syndrome can be life-threatening. Signs include:

• High fever
• Seizures
• Irregular heartbeat
• Unconsciousness

 

 

 

 

 

Thank you, Gridley that is reassuring but I am confused this is one of the side effects warnings on drugs.com that another moderator asked me to post. Please note the last one.  This is contradicting information and I am confused.  What do you think?

• severe constipation, stomach pain, or bloating;

• headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats;

• fast or pounding heartbeats;

• jaundice (yellowing of the skin or eyes);

• blurred vision or temporary vision loss (lasting from only a few minutes to several hours);

• high levels of serotonin in the body--agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting.

 

 

[Gridley]

12 minutes ago, Figgy said:

but I am confused this is one of the side effects warnings on drugs.com

It does seem contradictory, but the "high levels of serotonin in the body" in your list doesn't necessarily mean actual Serotonin Syndrome.  Also, it's a possible side effect--doesn't mean it's going to happen.  My list of serotonin syndrome symptoms come from the Mayo Clinic at this link.

Serotonin syndrome - Symptoms and causes - Mayo Clinic

 

 

[Figgy]

22 minutes ago, Gridley said:

It does seem contradictory, but the "high levels of serotonin in the body" in your list doesn't necessarily mean actual Serotonin Syndrome.  Also, it's a possible side effect--doesn't mean it's going to happen.  My list of serotonin syndrome symptoms come from the Mayo Clinic at this link.

Serotonin syndrome - Symptoms and causes - Mayo Clinic

 

 

Thank you.  

[Figgy]

On 11/4/2020 at 5:15 AM, Gridley said:

@Figgy

 

Here's is Brassmonkey's response:
 

 

 

 

She is using a liquid so to taper from the 0.01mg would be a matter of changing the dilution strength of the liquid and recalculating the volume of the new doses.

 

A reinstatement might work, but she mentioned that bad anxiety is what got her on the drugs on the first place. I suspect that there may be some of the "original conditions" showing through that needs to be addressed and controlled by non-drug methods. She should have been working on that during her taper, but it often gets overlooked and the drugs may have done a good job of masking it. With luck it's just a stabilization problem that would go away with an RI, long hold and further taper.

 

Reinstating at 0.01 might be a bit high, because she has been off completely for five months. I'd try 0.0025 of 0.005. She will have to dilute the original liquid to get that. Equal parts liquid and water and take her original dose volume will give the 0.005.

 

Something she might try is using a "rescue dose". If things get too bad, taking a drop of the liquid on a toothpick and placing it under the tongue can help on a one time basis. Erell has been using them with her prozac bridge. Not a long term fix, but can get one out of a bad spot.

 

 

 

Thank you for your response but I am not sure what you mean by "Equal parts liquid and water and take her original dose volume will give the 0.005."  So if I take some any amount of liquid lexapro and add the same amount of water I get a I get a 0.005 dilution.   Is this what you mean by the original dose volume?  So i should fill to the 0 .25 mark on a 1ml syringe or half way between .2 and .3?  Please advise as I as ready to try this.  If it works, relief after 3 days?

 

 

[Gridley]

@Figgy

I've tagged Brassmonkey, asking him to clarify.

 

Gridley

[brassmonkey]

You would mix equal parts of the liquid medication with water, for example 1mL liquid and 1mL water. From this you would use the syringe to measure the same amount as you were using for just the straight liquid medication. That will give a dose strength of 0.005mg.

[Figgy]

I guess i'm dense.  So this means after l the one to one dilution with water I take .025 mg on the 1m syringe?

[brassmonkey]

If that is what you were taking before doing the dilution, then yes.