Learn about Ziggy

[Ziggy]

....because I desperately want to learn from folks on this website. I have never joined an online forum but I believe my circumstances warrant my membership. I was put on Paxil in 2000. I was in my late teens and battling depression. From there my affair in antidepressants snowballed until I didn't know who I was anymore. After Paxil, I was put on Effexor. I believe there was a brief period where I was not medicated.

 

My anxiety was at an all time high and was then put on Lexapro for depression and anxiety. This made me feel better so I stayed on it. I went from 10 to 20 and even 30 mgs at one point. Somewhere along the way I was diagnosed as bipolar and placed on 200 mg of Lamictal. A few years later I was put on 300 mg of Wellbutrin. I am also currently taking klonopin for anxiety and Ativan as needed.

 

So daily, for several years now, I have taken lexapro, lamictal, Wellbutrin and klonopin. I woke up one day and wondered, why am I on all these pills? I was put on these drugs at such a young age that I have not known adulthood without being medicated. With the support of my psychiatrist, I have successfully tapered my lamictal to 50 mg. I have also tapered the lexapro to 2.5 mg.

 

Now, here is where the troubles begin. I have tapered the lexapro under the supervision of a doctor over a year's time. For the last month I have taken a crumble of that 2.5 mg lexapro and decided to try discontinuing because I thought I was on the lowest possible dose. MISTAKE! After day 4 no lexapro I started having all the horrible withdrawls that come with SSRI's.

 

It started with fatigue, but over the next 6 days I entered what I considered to be hell on earth. It felt like I was withdrawing from heroin. Dizzy, nausea, body aches, crying spells, flu like stuff...ugh. The only thing I didn't get were the dreaded brain zaps, which I think is because I tapered. But I couldn't believe after tapering slowly and for so long that this evil drug could still do this to me. Maybe it's because I've been on it so long?

 

Well anyway I was bound and determined not to take it but at day 11 (today) I felt like I was dying and gave up. I took 2.5 mg and within an hour felt some relief. I still feel like crap but it's nothing like before. I feel a sense of hopelessness that I will ever get off this blasted SSRI and I will be bound by the chains of lexapro forever. Any advice on how to do this with minimal/tolerable withdrawl symptoms would be appreciated. I would like to hear your experiences. Thank you


2000 - Paxil, cannot remember dosage
2001 - 2002 - Effexor
2004 - lexapro, 10 mg
2005 - lexapro, 20 mg
2007 - lexapro, 30 mg and lamictal, 200 mg
2011 - lexapro, 20 mg, lamictal 200mg and Wellbutrin 300 mg
2013 - lexapro 20 mg, slowly taper lamictal to 50 mg, Wellbutrin 300 mg, Ativan .5 mg as needed
2014 - present - taper lexapro from 20 mg to 2.5 mg, lamictal 50 mg, Wellbutrin 300 mg, Ativan .5 mg as needed, klonopin .5 mg 3 times per day

Edited February 8, 2016 by KarenB
added paragraph breaks

[SquirrellyGirl]

Welcome to SA, Ziggy!  I am glad that you found the forum.  You will get tons of help here!

 

That is good news that the reinstatement of 2.5 mg of Lexapro relieved your withdrawal symptoms for the  most part  It will take about four days for the drug to reach a steady state in your system, so hopefully you will continue to stabilize.  You will likely need to stay at this dose for 4 to 6 weeks to stabilize further before thinking about tapering again.  Your system has taken a hit and needs to settle out before being challenged again with any more changes.

 

The mods here are very experienced and will give you excellent guidance.  I'm sure one will be along shortly.  It would be helpful for them to know how you did the taper from 2014 to the present.  Was it by breaking tablets, using a liquid, alternating days, etc?   How long did you stay at each dose before cutting again?  Did you experience symptoms as you reduced?

 

You may have already been familiarizing yourself with the site, but I'll give you some links to get started:

 

Why to use a 10% taper method:  http://survivingantidepressants.org/index.php?/topic/1024-why-taper-by-10-of-my-dosage/?p=8902

 

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

 

This one is for later, but pertains to tapering more than one med:  http://survivingantidepressants.org/index.php?/topic/2207-taking-multiple-psych-drugs-which-drug-to-taper-first/

 

I have two meds I want to come off of, venlafaxine and mirtazapine.  I came off ven too quickly back in 2014, and went through 10 months of withdrawal hell before being put on mirtazapine because I couldn't eat or sleep.  When that didn't work (because it couldn't hold up to the ven withdrawal), I reinstated the lowest dose of ven and like you, felt dramatically better in an hour!  No one realized I was in protracted withdrawal - won't go into the why's now.  

 

Once I realized that it was withdrawal that had caused my nightmare, I resolved to come off the meds for good, and happily found this site for guidance.  I am now at 37% of my highest dose of mirtazapine, and at 73% of my reinstatement dosage for ven.  It has been going really well, though I've had a bobble over the last several days, likely due to switching to a home-made liquid mirt.  Will reassess. It's been quite an educational experience!

 

You will find tons of support here. I'm glad you joined us!

SG

[Ziggy]

Thank you for your quick reply Silver Star! Also thank you for the information on howling to wait before trying to taper again. It's strange, because I was able to lower my dose of lexapro from 20 slowly down to 5 mg without any real trouble. I would use a pill cutter to split 20's into 10's, etc. it wasn't until I went from 5 mg to 2.5 mg that I really noticed any withdrawl symptoms. Maybe the lower you go the harder it gets? What I went through these last 11 days I never want to experience again. I hope someone has insight on how to taper from 2.5 to 0 and not feel like dying. Looking forward to the support of this group. Glad I joined!

[SquirrellyGirl]

This paper explains why the last part of a taper is the hardest:  

 

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

 

At the minimum effective dose, your receptors are still blocked by about 80%, but cuts below that amount start to free up receptors precipitously.  See the graphs in the paper for a dramatic visual on this. So, small cuts lead to big drops in occupancy, and once those receptors are freed up, that causes a big imbalance in serotonin again.  Couple that with the fact that the nervous system pushed back against the drug-created imbalance (now too much serotonin in the gap between nerves) by down-regulating serotonin production and receptors, the imbalance can get rather extreme with relatively large cuts in dosages.  Our nervous system can be pretty sluggish about up-regulating, especially after many years on a drug.  Therefore, the 10% (or less if needed) taper is our best hope at allowing our nervous system to remodel to lesser and lesser amounts of drug before finally having the training wheels removed, all the while hopefully allowing us to remain functional.

 

I'm willing to bet that between 10 and 5 mg, the occupancy rate doesn't change much (the flatter part of the curve), but below 5 is when things drop off rapidly.

 

SG

[Fresh]

Hi Ziggy , welcome.

 

Yes , we can help you with that - how to taper slowly down from 2.5mg without feeling like you're dying (or wishing

you would die!).   You're right , the lower you get the harder it is.  

Taking 2.5mg away from 50mg might be fine , but taking 2.5mg from 5mg is a whole other ball-game.

 

As well as the links SG gave you , try reading "How to Nake Liquid From Capsules or Tablets" here    

How to make a liquid from tablets or capsules

 

If you can make liquid from now , you'll be getting precision dosing , which is essential as you get lower.

 

Good to have you on board ,  Fresh

[Ziggy]

Thank you Fresh and SG for the input. It gives me comfort to know I am not alone in the vicious cycle of trying to get off these drugs. It makes a lot more sense to me now that going from 2.5 to 0 was a bad, bad idea! I'm going to let my body regroup for a month or so before I try to taper again. I really put it through the ringer ???? Do you think that's enough time or should I wait longer? I will definitely look into the liquid solution because I want to be as accurate as possible to avoid withdrawl symptoms. Man it feels good to talk about this with like minded people, because every psychiatrist I've ever had swears there are "minimal" withdrawl symptoms with these drugs. Couldn't be further from the truth thanks.

[SquirrellyGirl]

I'm so glad to be able to help there, Ziggy!  Holding longer is better, as long as you feel you need.  I got going a bit hastily after I reinstated, because I was so desperate to not be taking the "poison," but I have since slowed it down.  We have to try to try wipe the idea of the goal out of our minds, because thinking about how long it will take to get there can be distressing.  Better to know that it will take as long as it takes, but that the very process of taking less and less is far better than doing what un-enlightened people would be doing, on their doctor's orders:  increasing doses chasing tolerance, switching to new meds, resigning themselves to having to take the meds for the rest of their lives due to failed attempts.  We're moving in the right direction for better health :-)

 

While stabilizing, it would be a good idea to start looking into alternative methods of stress management and coping skills.  Most of us came to these drugs because we didn't have such skills to deal with our lives, with our depression/anxiety/OCD, whatever, but it is never too late to learn, and we will need these skills, if not for dealing with withdrawal symptoms, then for dealing with our "old selves" popping up when we are off.  I'm working on that, myself.  There's lots of good stuff in the Symptoms & Self-Care section:  http://survivingantidepressants.org/index.php?/forum/8-symptoms-and-self-care/

 

SG

[Ziggy]

Yesterday was my 11th day without Lexapro. I tapered slowly (obviously not slow enough) because I went through hell with withdrawls. It was so severe by the 11th day that I reinstated and took 2.5 mg (higher than what I was on at last taper before discontinuation). Within 1 hour my symptoms went from shaking uncontrollably, writhing in pain, dizziness with inability to walk, and crying to resting comfortably in my bed with "flu-like" symptoms. I know everyone's experience with reinstatement is different but for me it just shows how much power this drug has over my body and how dependent I am on it to live. Today I feel like crap, malaise, etc but it's much better than where I was 24 hours ago. I think I will continue to feel more "normal" over the next few days.

[Sarabera]

Hi Ziggy,

You've gotten some good advice, i was very impressed by that graph that showed how much low doses still impact us. Just wanted to say welcome, because my last cat's name was Ziggy, and I was terribly fond of him. You've got a good attitude and I think you'll do well.

Sarah

[Ziggy]

Hi Sarah, thanks for the welcome. I am very glad to have joined this site. I have a parrot named Ziggy, too. ????

[SkyBlue]

Hi Ziggy,

 

I wanted to add my "welcome" and say that I am glad you are here. Everyone on this thread has mentioned good things, 

the 10% notion; importance of self-care, etc. but I just wanted to chime in and add my encouragement. Hang in there -- we

are all here for you.

 

Welcome.

[nz11]

Thanks for joining sa Ziggy I ran your drugs through the interactions checker

http://www.drugs.com/interactions-check.php?drug_list=1488-899,703-357,1430-848,1013-565,440-203

Interactions between your selected drugs

Major bupropion escitalopram

Applies to: Wellbutrin (bupropion), Lexapro (escitalopram)

Talk to your doctor before using buPROPion together with escitalopram. Combining these medications may increase the risk of seizures, which may occur rarely with either medication. In addition, buPROPion can increase the blood levels of escitalopram, which may increase other side effects. You may be more likely to experience seizures with these medications if you are elderly, undergoing alcohol or drug withdrawal, have a history of seizures, or have a condition affecting the central nervous system such as a brain tumor or head trauma. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. You should avoid or limit the use of alcohol during treatment. 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.

 

Moderate lorazepam bupropion

Applies to: Ativan (lorazepam), Wellbutrin (bupropion)

Excessive use of LORazepam, or abrupt discontinuation following long-term use, may occasionally trigger seizures in patients taking buPROPion. Talk to your doctor before using these medications together if you have any questions or concerns. 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.

 

Moderate bupropion clonazepam

Applies to: Wellbutrin (bupropion), Klonopin (clonazepam)

Excessive use of clonazePAM, or abrupt discontinuation following long-term use, may occasionally trigger seizures in patients taking buPROPion. Talk to your doctor before using these medications together if you have any questions or concerns. 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.

 

Moderate lorazepam lamotrigine

Applies to: Ativan (lorazepam), Lamictal (lamotrigine)

Using LORazepam together with lamoTRIgine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. 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.

 

Moderate clonazepam lamotrigine

Applies to: Klonopin (clonazepam), Lamictal (lamotrigine)

Using clonazePAM together with lamoTRIgine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. 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.

 

Moderate lorazepam escitalopram

Applies to: Ativan (lorazepam), Lexapro (escitalopram)

Using LORazepam together with escitalopram may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. 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.

 

Moderate clonazepam escitalopram

Applies to: Klonopin (clonazepam), Lexapro (escitalopram)

Using clonazePAM together with escitalopram may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. 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.

 

Moderate lamotrigine escitalopram

Applies to: Lamictal (lamotrigine), Lexapro (escitalopram)

Using lamoTRIgine together with escitalopram may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. 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.

 

No other interactions were found between your selected drugs.

Note: this does not necessarily mean no interactions exist. ALWAYS consult with your doctor or pharmacist.

Other drugs that your selected drugs interact with

• Ativan (lorazepam) interacts with more than 300 other drugs.
• Klonopin (clonazepam) interacts with more than 400 other drugs.
• Lamictal (lamotrigine) interacts with more than 200 other drugs.
• Lexapro (escitalopram) interacts with more than 500 other drugs.
• Wellbutrin (bupropion) interacts with more than 300 other drugs.

Interactions between your selected drugs and food

Moderate lorazepam food

Applies to: Ativan (lorazepam)

Alcohol can increase the nervous system side effects of LORazepam such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with LORazepam. Do not use more than the recommended dose of LORazepam, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

 

Moderate bupropion food

Applies to: Wellbutrin (bupropion)

Using buPROPion with alcohol may increase the risk of uncommon side effects such as seizures, hallucinations, delusions, paranoia, mood and behavioral changes, depression, suicidal thoughts, anxiety, and panic attacks. On the other hand, sudden withdrawal from alcohol following regular or chronic use can also increase your risk of seizures during treatment with buPROPion. If you are prone to frequent or excessive alcohol use, talk to your doctor before starting buPROPion. In general, you should avoid or limit the use of alcohol while being treated with buPROPion. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. 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.

 

Moderate lamotrigine food

Applies to: Lamictal (lamotrigine)

Alcohol can increase the nervous system side effects of lamoTRIgine such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with lamoTRIgine. Do not use more than the recommended dose of lamoTRIgine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Switch to professional interaction data

Moderate escitalopram food

Applies to: Lexapro (escitalopram)

Alcohol can increase the nervous system side effects of escitalopram such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or limit the use of alcohol while being treated with escitalopram. Do not use more than the recommended dose of escitalopram, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. Talk to your doctor or pharmacist if you have any questions or concerns.

Switch to professional interaction data

Therapeutic duplication warnings

Therapeutic duplication is the use of more than one medicine from the same drug category or therapeutic class to treat the same condition. This can be intentional in cases where drugs with similar actions are used together for demonstrated therapeutic benefit. It can also be unintentional in cases where a patient has been treated by more than one doctor, or had prescriptions filled at more than one pharmacy, and can have potentially adverse consequences.

Duplication Tranquilizers

Therapeutic duplication

The recommended maximum number of medicines in the 'tranquilizers' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'tranquilizers' category:

• lorazepam (active ingredient in Ativan (lorazepam))
• clonazepam (active ingredient in Klonopin (clonazepam))

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

Duplication Psychotherapeutic agents

Therapeutic duplication

The recommended maximum number of medicines in the 'psychotherapeutic agents' category to be taken concurrently is usually three. Your list includes four medicines belonging to the 'psychotherapeutic agents' category:

• lorazepam (active ingredient in Ativan (lorazepam))
• clonazepam (active ingredient in Klonopin (clonazepam))
• escitalopram (active ingredient in Lexapro (escitalopram))
• bupropion (active ingredient in Wellbutrin (bupropion))

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

Duplication CNS drugs

Therapeutic duplication

The recommended maximum number of medicines in the 'CNS drugs' category to be taken concurrently is usually three. Your list includes five medicines belonging to the 'CNS drugs' category:

• lorazepam (active ingredient in Ativan (lorazepam))
• clonazepam (active ingredient in Klonopin (clonazepam))
• lamotrigine (active ingredient in Lamictal (lamotrigine))
• escitalopram (active ingredient in Lexapro (escitalopram))
• bupropion (active ingredient in Wellbutrin (bupropion))

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

Duplication Benzodiazepine anticonvulsant agents

Therapeutic duplication

The recommended maximum number of medicines in the 'benzodiazepine anticonvulsant agents' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'benzodiazepine anticonvulsant agents' category:

• lorazepam (active ingredient in Ativan (lorazepam))
• clonazepam (active ingredient in Klonopin (clonazepam))

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

Duplication Benzodiazepines

Therapeutic duplication

The recommended maximum number of medicines in the 'benzodiazepines' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'benzodiazepines' category:

• lorazepam (active ingredient in Ativan (lorazepam))
• clonazepam (active ingredient in Klonopin (clonazepam))

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

Duplication Antidepressants

Therapeutic duplication

The recommended maximum number of medicines in the 'antidepressants' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'antidepressants' category:

• escitalopram (active ingredient in Lexapro (escitalopram))
• bupropion (active ingredient in Wellbutrin (bupropion))

Note: The benefits of taking this combination of medicines may outweigh any risks associated with therapeutic duplication. This information does not take the place of talking to your doctor. Always check with your healthcare provider to determine if any adjustments to your medications are needed.

...................................//......................................................

 

I woke up one day and wondered, why am I on all these pills?

Boy can i sure relate to this.

 

Hope you are feeling ok

[Ziggy]

Recently I tapered off of lexapro too quickly. I endured 8 days with no lexapro and pure hell. I have since reinstated 5 mg of lexapro (been at 5mg for 3 weeks or so) and although I am no longer in excruciating pain, I have times throughout the day when I just don't feel good. Could it be that my body is still struggling to restabilize at this dose? I was fine on 5 mg for over a year and was fine. I am confused/discouraged