LucyLou: switching to Prozac to taper from there

[LucyLou]

Well still doing ok. Don’t notice any effects yet.👍🏻

[LucyLou]

Today went well too

[LucyLou]

Today dizzy and internal jitters if that makes any sense. And really tired. Right now wish I would’ve waited to drop. Beginning of the school year and so much to do 😳

[LucyLou]

Haven’t had any noticeable symptoms since last check in.

[Carmie]

On 9/28/2018 at 12:05 PM, LucyLou said:

Well still doing ok. Don’t notice any effects yet.👍🏻

 

On 9/29/2018 at 10:48 AM, LucyLou said:

Today went well too

 

On 9/30/2018 at 6:45 AM, LucyLou said:

Today dizzy and internal jitters if that makes any sense. And really tired. Right now wish I would’ve waited to drop. Beginning of the school year and so much to do 😳

 

21 hours ago, LucyLou said:

Haven’t had any noticeable symptoms since last check in.

 

Hi Lucylou, 

 

It’s nice to see that you’re having lots of good days. 

 

Sending hugs🤗

[LucyLou]

On 10/5/2018 at 3:30 AM, Carmie said:

 

 

 

 

Hi Lucylou, 

 

It’s nice to see that you’re having lots of good days. 

 

Sending hugs🤗

Thanks Carmie

[LucyLou]

So my frustration tolerance is super low and I’ve been getting very angry. Been getting overly overwhelmed by life. My teaching assignment is much more difficult this year and I have to get up an hour earlier so even though I try get to bed early not getting enough sleep or exercise. I don’t think this is the whole reason for my emotional troubles though, and my husband, who is a pretty good gauge thinks it’s at least partially due to meds. It’s crept up on me just like last fall when I dropped.

 

So... i’m updosing from 5 to 5.1ml tonight. Crazy that it is the exact day (11/9) I updosed a bit last year. Kind of disappointing but I have to be able to function and still am slowly going down on the medicine.

 

I think I am going to need to start diluting the liquid to keep measuring accurate as future drops get smaller.

[LucyLou]

I’d love any suggestions for how to best dilute my 5mg/5ml liquid escitolopram to make it manageable for doses measured to .xx (example: 5.05 mg equivalent dose).

 

I’d like to measure no smaller than 0.2 in the liquid. Below that I’m afraid of inaccuracies....

[ChessieCat]

Are you currently dissolving a 5mg tablet in 5mL of water?  If yes, then 1mL = 1mg dose.

 

If you dissolve 5mg tablet in 50mL water then 1mL = 0.1mg dose

 

If you dissolve 5mg tablet in 500mL water then 1mL = 0.01mg dose

 

 

Lexapro and Cipralex liquid is measured in drops.  1 drop equalling 1mg dose.  If this is what you are using then you would add 5 drops in lieu of a 5mg tablet and you can use the same measurements as shown above.

 

I hope that helps.

[LucyLou]

I had total meltdown tonight w/ husband. 😢. I was overwhelmed, crying, scratched my arm up (I’ve done this before — not new — it happens when I’ve felt my Brain chemicals were off, like before tapering if I forgot a dose or sometimes just happened b4 tapering; has gotten better w/ tapering overall, but has happened after some drops and sometimes that’s when I’ve updosed.)

 

i took 5 ml rather than 5.1 tonight b/c maybe updose made me worse, more agitated? IDK. I am going to get period in 2 days probably and alway have agitated pms. 

 

Read ads on here today that I should try get last bit of med out of syringe and whoops I had been doing that. That may have been messing up dose. I think I started doing that sometimes when the top that goes b med bottle for syringe wasn’t fitting in bottle anymore (size change?) so I was feeling insecure about dose. Won’t do that anymore and maybe that will help.

 

Chessie Cat thanks for reply. I don’t make liquid, I have script for liquid form, but it is 5ml=5 mg and I want to change ratio so liquid has less medicine for easier measuring.

[ChessieCat]

1 hour ago, LucyLou said:

I have script for liquid form, but it is 5ml=5 mg

 

I had written out instructions for this before but deleted it.  But I've definitely got my head around it.  Please double check my calculations.

 

a) If you add 5mL (5mg) drug liquid to 45mL of water it will be a total of 50mL solution.

 

So 5mg dose = 50mL solution.

 

Divide both sides by 50   -->   0.1mg dose = 1mL solution     OR     1mL = 0.1mg dose

 

OR

 

b) If you add 5mL (5mg) drug liquid to 495mL of water it will be a total of 500mL solution.

 

So 5mg dose = 500mL solution.

 

Divide both sides by 500   -->   0.01mg dose = 1mL solution     OR     1mL = 0.01mg dose

 

 

TO CALCULATE YOUR DOSE:

 

a)   1mL = 0.1mg

 

     Multiply both sides by 10 to get whole numbers

 

      10mL = 1mg

 

To get a 5mg dose you would multiply 1 x 5 on the right.  So do the same on the left.

 

     10mL x 5 = 1mg x 5

 

     50mL = 5mg

 

OR

 

b)  1mL = 0.01mg

 

     Multiply both sides by 100 to get whole numbers

 

     100mL = 1mg

 

To get a 4mg dose you would multiply 1 x 4 on the right.  So do the same on the left.

 

     100mL x 4 = 1mg x 4

 

     400mL = 4mg

 

 

And example using b) to get 4.85mg dose:

 

     100mL x 4.85 = 1mg x 4.85

 

     485mL = 4.85mg

 

You would then 500mL - 485mL = 15mL

 

Measure out and dispose of 15mL

 

 

 

I need to work out what you can do once you get to 4mg.  My brain has gone a bit numb.  I'll post it once I've figured it out.
 

 

Edited November 11, 2018 by ChessieCat

[ChessieCat]

Okay, managed it.  You could keep making your solution using 5mg dose if you wanted to or reduce it like these.  Doing this will keep the solution to the same concentration.

 

 

c) If you add 4mL (4mg) drug liquid to 36mL of water it will be a total of 40mL solution.

 

So 4mg dose = 40mL solution.

 

Divide both sides by 40   -->   0.1mg dose = 1mL solution     OR     1mL = 0.1mg dose

 

 

OR

 

d) If you add 4mL (4mg) drug liquid to 396mL of water it will be a total of 400mL solution.

 

So 4mg dose = 400mL solution.

 

Divide both sides by 400   -->   0.01mg dose = 1mL solution     OR     1mL = 0.01mg dose

 

 

 

Once you get to 3mg you would add 3mL to 27mL to make 30mL   OR   3mL to 297mL to make 300mL 

 

 

Calculating the dose is the same as the previous post because the solution is the same concentration.

[LucyLou]

Looking for advice.

 

today i’m a total wreck. Not functioning. Went on as long drive to isolate myself from my family, still felt really angry at husband and despair and shame at myself, felt like I’ve ruined son’s life b/c our fight upset him. Also disproportionate worry about something about my son.

 

I took 5 ml of escitalopram last night. After reading about neuro-emotions on this site today realized that I’ve been experiencing neuro-anger in past weeks. Everything that might be frustrating is over the top maddening to me and triggers thoughts like “no matter what I do I just can’t get ahead (or stay on top of things)”

 

should I updose to 5.1? Did that Fri and don’t want to bounce around dose but maybe that was a good idea...

 

i’ll take suggestions...I don’t really care about having to move backwards and have a bit higher dose. Just want to be ok over the winter and can accept that I may be making cuts only once or twice a year in spring then summer.

[LucyLou]

Wanted to add that I was prescribed amoxicillin for sinus infection Oct 18. Just read that some people get bad reaction to antibiotics. I think this corresponds with the onset of neuro-anger. Seems to have started up a week after that.. last week Oct on I have been over-angry...

[ChessieCat]

Yes, the antibiotic might be the cause.

 

My response to the previous post.  The answer isn't always to increase the dose.

 

I think it would be much better to be trying out non drug techniques to see what might help:

 

 

Non-drug techniques to cope

 

dealing-with-emotional-spirals

 

Dr Claire Weekes suffered from anxiety and learned and taught ways of coping.  There are videos available on YouTube.

 

Claire Weekes' Method of Recovering from a Sensitized Nervous System

 

Cognitive Behavior Therapy (CBT) for anxiety, depression

 

Audio:  First Aid for Panic (4 minutes)
 

CBT Course:  An Introductory Self-Help Course in Cognitive Behaviour Therapy
 

Audio:  How to Recover from Anxiety - Dr Claire Weekes
 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help ...
 

Resources:  Centre for Clinical Interventions (PDF modules that you can work through, eg:  Depression, Distress Intolerance, Health Anxiety, Low Self-Esteem, Panic Attacks, Perfectionism, Procrastination, Social Anxiety, Worrying)
 

Video:  Relaxing Calm - Progressive Muscle Relaxation - with music (15 minutes)
 

Video:  Relaxing Rolldown - quick relaxation exercise with music (4 minutes)
 

Video:  EMDR - Relaxation - Positive Thinking
 

Video:  EMDR - Balloon

[LucyLou]

Went back up to 5.1 ml two days ago (11/20/18) and it has improved my frustration tolerance and that has made life more manageable so I’m going to hold here. Got better syringe and a bottle plug thingy which is helping me measure.

 

Work has been very stressful and fairly unrewarding  and it’s not just neuroemotions. For the last ten years I’ve worked as a literacy coach (working w/ teachers more than students) and the last 4 years part time reading teacher and literacy coach. Due to funding issues I am back in classroom full time and we became s middle school (6-8 with different school day structure) and when I last taught full time 10 years ago we were a junior high and I taught ninth grade. I work so much better w/ ninth graders than the younger students and after much thinking, processing w/ my therapist for a few years now, think I need to make a real effort to find a high school English or reading  (or literacy coaching) job in a district near my home/-I have a 25-45 min commute and that’s stressful and also hard w/ taking son to appts and activities. It’s too soon in school year for jobs to be available but I can update resume, put in electronic applications, and research and even contact principals of places that I’d like to work. This decision has given me some hope and I’m writing here to further my commitment to this change. Which is scary. I have good friends at the school and worked there for 20 years, my entire teaching career.

[LucyLou]

Updosed to 5.2 ml last night due to ongoing depression. Feel better already. Plan to hold here til spring. 5.2 ml was the last dose where I felt okay on an ongoing basis.

[Altostrata]

Those darned antibiotics. Please update your signature and let us know how you're doing.

[LucyLou]

Can’t believe it. Last night I thought I was using a dropper to dose 0.2 ml and it was actually 2 ml. So I took 7ml instead of 5.2! 😳😳

 

I was tired and relaxed and pretty nonreactive at school today. Tonight I measured it w/ dropper again—I can’t believe when I found it in the bag of oral syringes from the pharmacist that I thought it measured up to 0.25 instead of 2.5 🙄—and realized it was a way bigger dose than I thought when I got it in my mouth, looked at the dropper, realized my mistake and spit it out and then measures 0.2 on my 5ml oral syringe and took that. So I may have taken more than5.2 today if I swallowed some of the stuff I spit out.

 

I hope I don’t react from that one day accidental updose. I’m afraid it will somehow make 5.3 ml trigger withdrawal as if I just dropped 1.8 ml. And I have a job interview Monday and grading and prepping for interview this weekend!

 

i can’t do anything now so will try to just let go.😟

[ChessieCat]

29 minutes ago, LucyLou said:

i can’t do anything now so will try to just let go.

 

That's all you can do.  Continuing to worry about it will only add more stress and could make things worse.  You are not the only one who has done something like that.  There have been other members who have double dosed, others who don't know whether they have taken there dose so have taken a small amount instead of risking none at all, others who have missed a dose completely and me who halved my dose when I picked up the 0.5mg capsules instead of the 5mg capsules.  I didn't discover my mistake for 5 days.  I made the decision that I wasn't going to beat myself up about it or worry about it.  What was done was done and I couldn't change it.  My anxiety did increase for a few days afterwards, but I would just think, yes, I know it's because of the dose mix up.

 

Good luck for the interview.

[Carmie]

Hi LucyLou, 

 

I’m sorry you made a mistake with calculations. So easy to do with brains like ours. I’ve accidentally double dosed a couple of times. There’s no use crying over spilt milk though. The first time I did it I freaked it, the second time I stayed calm.

 

If you get symptoms from it you will eventually stabilise. Yes, don’t stress about it as you’ll make it worse. Stress, whether good or bad, can ramp up our symptoms.

 

Take care, sending hugs🤗

[LucyLou]

So this morning I feel dizzy and lips feel funny. Hope this passes. Feels like withdrawal symptoms☹️. Hope it passes soon. Could withdrawal be re-triggered by taking a higher dose by accident just once or twice?

[LucyLou]

Also feel foggy and tired.

[ChessieCat]

It can be hard to tell if it is caused by the double dose or from the added stress.

 

The more you focus on it the more stressed you will be.  Please try to stay as calm as possible.  If something appears just say to yourself oh yes, I accidentally took an extra dose, this feeling/symptom is probably from that.

 

On 4/28/2017 at 4:03 AM, brassmonkey said:

 

AAF: Acknowledge, Accept, Float.  It's what you have to do when nothing else works, and can be a very powerful tool in coping with anxiety.  The neuroemotional anxiety many of us feel during WD is directly caused by the drugs and their chemical reactions in the brain.  Making it so there is nothing we can do about them.  They won't respond to other drugs, relaxation techniques and the like.  They do, however, react very well to being ignored.  That's the concept behind AAF.  Acknowledge, get to know the feeling involved, explore them.  Accept, These feelings are a part of you and they aren't going anywhere fast. Float, let the feeling float off as you get on with your life as best as you can.  It's a well documented fact that the more you feed in to anxiety the worse it gets.  What starts as generalized neuroemotinal anxiety can be easily blown into a full fledged panic attack just by thinking about it.

 

I often liken it to an unwanted house guest.  At first you talk to them, have conversations, communicate with them.  After a while you figure out that they aren't leaving and there is nothing you can do to get rid of them.  So you go on about your day, working around them until they get bored and leave.

 

It can take some practice, but AAF really does work.  I hope you give it a try.

 

[LucyLou]

Thanks. I will do this.

[LucyLou]

Really struggled with anger and sadness (rage and tears) since the accidental updose. Work stress has been intense too, so not sure which one is causing the other... it was a perfect storm  of emotional shame spirals.

 

But today feel like I’m stabilizing. Was happy and hopeful and even energized at work.

 

such a relief! Did self-forgiveness meditation this morning and trying to get back in that meditation groove and listened to Tara Brach on self-forgiveness on way to work.

 

Monday went to my AA meeting Monday—which I always do, been sober and going to meetings like 21 years—and talked a bit about struggling w/ weaning medication—which I don’t usually do because afraid some will consider it an outside issue—which helped.  Then went into detail sharing w/ my two girlfriends after meeting which felt again like relief... some shame reduction. I asked for help with an extremely difficult class (I teach middle school English and reading) and am so glad I took the risk because I recieved great support.

 

So... thought I’d check in with some good news.😊

[LucyLou]

I am wondering about occupancy rates for Lexapro because it is clear that getting down to 5 ml has been too hard so far. Is this typical?

[ChessieCat]

We have members here who find that certain doses seem harder to get past during their taper.

 

Many members have also found that the lower their dose gets the slower they need to go, by reducing less and/or holding longer.

 

From Why taper paper: dose-occupancy curves

 

On 4/25/2014 at 6:08 AM, Altostrata said:

 

Correct, but you don't know when you're leaving your own personal saturation zone.

 

[ChessieCat]

Brass Monkey Slide

 

Micro-taper instead of 10% or 5% decreases

Rhi's "Start Small, Listen to Your Body" Taper Plan

[LucyLou]

Well, still feeling pretty ok. Some time off work due to snow and cold (I’m in Minnesota), which has been a nice impromptu break.

[LucyLou]

Wow. Just keep hoping that I'm on an upward trend but really feel down. Teary, alternately anxious about work stuff and then no interest. Plus, my one nasal cavity feels like to never recovered from infection on New Year's. I was only prescribed 7 days of antibiotic, and in the past that hasn't been enough. But thought I'd go with it in case antibiotics were causing trouble mentally/emotionally. Yesterday my head hurt so bad during the day felt like I couldn't think, so put off work until evening--I am a teacher and often have weekend work and with all my emotional stuff can't seem to get ahead. Today was a staff development day and I didn't get as much sleep as I should've (went to bed later and then son woke me up because he couldn't sleep). My head was hurting so bad and I felt so disinterested in our work, too, which made me teary (?), that I went home sick. Have a dr. appt. for sinus trouble tomorrow and called to see if I could get in today but can't. Really hate work and trying not to and want to be on a leave but scared I'll never come back from that and am seriously consider career change or moving to high school but how can I make this move when I am so out of sorts emotionally?! 

 

Had an interview for an instructional coach position (I was well qualified because up until last year had been a literacy instructional coach since 2010, sometimes part-time teaching, too) and ended up making a dosing mistake the Thursday before and cried all day of the interview and went at 3 p.m. and did best I could do. I don't think it was awful and they may have already picked who they wanted before interviews (sometimes is the case) but anyways didn't get the job. That was so hard to go interview when feeling so sad and also incompetent. And I have been struggling with feeling incompetent. Been doing EMDR with my therapist around this. Just did a target around a really bad early career experience which was maybe not ever really processed due to medication suppressing feelings and we still have more work to do on target and I feel really raw waiting a week now to do more. Thinking of trying to get a sooner appt. Tried last time I saw her but could inquire again.

 

Just feeling hopeless today I guess. And also just wondering if regarding work if I am worse off than before I began this process. My husband says he thinks I am doing better at home and he thinks its been a good idea. (And he would say if he thought I needed to just return to my original or a higher dose.) 

[LucyLou]

So was reading a bit about windows and waves. Really didn’t gee them when I started tapering. Was more like here are some withdrawal symptoms and now I’ve adjusted aNd good til next drop. What I’m dealing with now (and I guess this fall when I dropped to 5 mg at the end of Sept. has been a wave that crept up on me — affecting emotions and exacerbating SAD and work stress with some little windows. I’ll have moments or chunks of time — not usually whole days but have had a few days strung together too — when the sadness/depression/anxiety lessens. I guess I need to accept this. Reading about windows and waves helped but the fact that waves are stronger now not lessening feels different than the description. However, this is probably because I’m in the hard part of Lexapro taper at the smaller dosages where things are dropping off.

 

Love to hear from others about this and if they think this makes sense.

[eymen23]

LucyLou,

 

What you’re describing is in line with what I’ve seen other members report after slowly tapering down from high doses.

 

There’s the fact that, yes, the incremental impact/action of the drug is greater as you get to the lower doses. In other words, you might need to go slower, as your dose gets lower. 

 

There’s also a chance that although you have tapered carefully by waiting to feel stable before making another cut, that the taper has ‘caught up with you’. Meaning that although you were sensible with the timings of your previous cuts, you’ve

reached a point in your taper, where the dosage has been lowered beyond what your nervous system has adequately adapted to, and you’re feeling it. 

 

I also see (apologies I’ve not read everything in detail) that you’ve had some external stressors. They can be tough on anybody, but especially for somebody experiencing withdrawal symptoms. 

 

Lastly, I can see you dropped to 5mg, before making a small updose, along with a small hiccup in regards to taking the incorrect dose one day. It sounds like you made a sensible move on the updosing, but your nervous system may still be grappling with the changes. Once things start to wobble, it can take quite some time to get balance. 

 

I tnink based on everything I’ve noted above. A decent hold at your current dose would be sensible. Whilst your nervous system is re-establishing homeostasis, it’s likely you will experience windows and waves and unfortunately, for some period of time you may find yourself having more waves than windows. As the dust settles, the waves should ease up and become less frequent.  

[LucyLou]

Thanks for your response eymen23. 

 

I am at work and crying during lunch. I don’t think I can continue on this way and need to go back to a dose where I felt stable and was doing my job ok. 😔

[SkyStreamer]

43 minutes ago, LucyLou said:

Thanks for your response eymen23. 

 

I am at work and crying during lunch. I don’t think I can continue on this way and need to go back to a dose where I felt stable and was doing my job ok. 😔

 

 Hi LL! 

 

I'm fairly new to both this site, as well as to the tapering and withdrawal experience. 

 

I just wanted to say that I'm sorry you're going through such a tough time. I had an extremely difficult WD period a few months ago. Sometimes I look back and wonder how I got through it. But, somehow I did. And, many on this site have gotten through some very difficult WD periods. Usually, light always follows darkness, and windows always follow waves. 

 

During WD times, I find saying these mantras, deeply from your heart and consciously, can help a lot:

 

1. 'I don't have to be afraid of this' (i.e. these symptoms, these thoughts, these stressors)

 

2. 'I don't have to worry about this.'

 

3. ' I don't have to give this my focus.' 

 

In addition to this, if you can try and make some attempts to accept your situation, state and circumstances during the very difficult moments, then this can also help reduce you symptoms by a noticeable degree. 

 

Another support for me are the YouTube guided relaxation meditations by Michael Sealey. Many people who suffer from anxiety have reported his meditations to be hugely helpful. 

 

For what it's worth, you'll be in my thoughts & prayers  

[LucyLou]

Updosed to 5.3 ml.