Franklander: A Dance with Escitalopram

[Franklander]

2 AM here and for me to risk losing another sleeping night, it says of how much dire my life has become.


My real name is Vitor, 23 Y/O, Male and middle-class Brazilian.

Ever since the age of 17 I've been suffering from undying stress due to a troublesome relationship, ever since I've contemplated the voyage of the magical healing that psychiatric meds would proportionate, people say with age comes regret for what should have been, mine has arrived with no preemptive sign.

Since 2013 I've started my first psychiatric treatment, 10mg of Escitalopram (Exodus, a medication that - so far - is only available national-wide), my mood went from downhill to upwards jolly, my med
also diagnosed what could have been  ADHD and suggested me to start a parallel treatment with Ritalin LA 20mg (which later was increased to 30mg and much later reduced to 10mg). Past almost a year into the beginning of the treatment, and my doctor saw no use for me to carry on with SSRIs, instructing then to stop aburptly, so far I've exited the road symptomless, or with ones that I couldn't notice at such time, since my troublesome affective relationship went from bad to worst every single day. 

2014's dawn and i've lost touch with my girlfriend, the shock basically made me rush into my old med once again, had a terrible reaction that - if not by my current state - would have been the worst time of my life. The experience already made me wary of the dangers underlying such meds. Worst would come when my Health Insurance retracted my membership, on the basis that my monthly automatic payments were not being made due to an error, with no prior warning from any part. Universal Healthcare here is a mess, and when trying to make an appointment, on 2014, I'm still yet to hear any previews from any part. I was basically lost at that point. Forced into Cold Turkey from both meds, which would have been bad, have I not associated with the recent loss of my girlfriend. I can't remember that much about the symptoms.

2015 I've found another psychiatrist who basically reinstated me into both meds, but things started to spiral down from here, on July I've lost my job and had to head out to my parents, with the second "withdrawal" I started to be wary of the first underlying condition: Brain Fogs. I've basically grown and lived in my own imagination, for the first time in my life, trying to visualize thoughts was an out of reach task, something I did naturally taken away from me. I basically gave up on writing and drawing for some time. And after it, symptom after symptom came after me, the bad sinus, the erratic emotional swings, hyperarousal, hyperthermia, akethesia. All except for the Brain Zaps. The constance of intake and withdrawals basically spinned my head, and I can't say whether or not I'm into
a dead end. I tried reintroducing Escitalopram probably 2 more times (both 7,5 mg), but the sleepiness was so crippling that I've basically gave up trying.

2016 and here I am, symptoms I've never had any notice until now, my mind totally blank, impossible to sleep with the burning skin and lightheadedness. I don't feel fatigue that much, but I'm panicking almost all of the time.

Coming here was a struggle, admiting that I'm sick was a blow to my morale and self-steem, and trying to tell yourself you're fine is the worst.
My ability to feel joy have been dulled, but I think I'm slowly turning back to enjoy games, the hardest blow is the brain fog and cognitive impairment, not being able to
contextualize and love being imaginative. I've read so many terrifying stories, but at the same time, I think embracing the first community that would accept my phase
is absolutely necessary. My family is clueless of my symptoms, so were and are most of my friends, which I've lost so many.


I'll definitely miss my 20's, if I ever remember them.





Sorry for such sloppy and grieving carthasis, and thank you to anyone who took your time reading.
 

[Fresh]

Hi Franklander , I'm glad you found us , welcome.

 

Can you give us a little specific information:  when did you reinstate which drugs in 2015 , what doses.

How did you go off them?   When were your last doses?

 

The concept you had of reinstating a small amount is something that is successful for many members , but it sounds like 7.5mg was too big of a dose.

 

We suggest reinstating 1 or 2mg  see if you get symptom relief , without causing toxic side effects.  

Please read our link on reinstating here:  http://survivingantidepressants.org/index.php?/topic/7562-about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms/

 

The symptoms you're experiencing are typical of withdrawal , the panicky feeling , burning skin , insomnia.

Take a look through the Symptoms and Self Care section to see how others manage these symptoms , what's useful or helpful.

 

Please click FOLLOW at the top right , and you'll receive an email each time someone posts.

 

Best wishes ,  Fresh

[Franklander]

Thank you Fresh.

I reinstated the drugs around April to June, Ritalin has always around 10 mg, I was very strict about its dosage. Lexapro was around 10 to 20mg at the last stages, which were around September to October, I've tried reinstating it around 7.5 mg so far between the months following it until now. 

My last dosage was 7.5 on Febuary 19th. It was an aburpt stop, I planned tapering, but I couldn't just leave my bed sometimes, so it was sudden as that.


Thank you very much for reading, my greatest fear has been the thought of no-end to this nightmare.



 

[Fresh]

Ok , this information is really helpful.  

I'd be inclined to try reinstating the lexapro , as you've been off it the shortest time.

We suggest just 1 or 2 mg , so that if you DO have an adverse reaction , it's a tiny dose and will wear off quickly.

You know it's an adverse reaction if your symptoms get worse within 24 - 48 hours.  If that happens , you need to stop.

 

After 4-7 days on the starter dose , you can decide if you need to increase it , or if that's enough.  It takes 4 days to get to a steady state in the blood stream , so minimum 4 days before increasing.

 

Please could you have a go at filling in your signature with your drug history , years , dates , dosages etc.

This comes up each time you post , so readers can see your journey at a glance.

Instructions are here  http://survivingantidepressants.org/index.php?/topic/893-please-put-your-withdrawal-history-in-your-signature/

 

This is a time to begin to explore non-drug methods of managing your anxiety.  You have so many years ahead of you , and once you get past this hiccup , you'll be able to begin reconstructing your life , and creating the type of life you want and deserve.

[Franklander]

I'm restarting it at this moment, if it happens a cessation of symptoms, how should I proceed? How can I know the best way to taper?

[Ali4]

If you notice immediate relief just hold at that dose, it takes 4 days to become steady in your blood, once you stabilize then you can start a nice slow taper. Once your stable, the mods here will help you with the best way to taper, hang in there!! Ali

[Franklander]

Past a couple of hours ever since the reinstatement, and I think - for the most part - I'm stabilized, most likely will readjust the dosage.
I believe the topic went way past its original purpose, where can I open a new one for help and management?

[ChessieCat]

Hi Franklander

 

As Ali4 said, give the reinstatement at least 4 days - this is when it will reach full dose in your blood.

 

There is no need to start a new Topic.  This is your Intro/Update topic and you can continue to ask questions and post your progress here.  That way it keeps all of your history together.  Each member has 1 Intro/Update topic.

[Fresh]

Hi Franklander ,  it sounds like you are having a good response to your first dose.  That's very promising.

 

Because it takes 4 days to be stable in your blood stream , you may have symptoms come back again until that happens.

Don't be worried , this is normal.

 

Try and take your dose at the same time each day.

 

How much did you take?  Why do you think you need to adjust that dosage?

[Franklander]

Hey Fresh, thank you very much. I was so mentally impaired from the point of the original post that I look back with slight disappointment.
If it wasn't for this post, I would be in a very bad shape.


Because the medication is actually solid (a 15mg pill), I took a knife and took a little chunk, I'm assuming it is around 1-2mg.
I suppose I'll have to switch for a liquid one, since it is far much easier to get hold of your dosage.

From the moment of the dosage and after it I was relieved by the cessation of the panic surges, but by now I'm struck with a mild anxiety. The brain fog is mild as well.
Maybe that is a signal of a needed readjustment. 



Off-topic: I can't stress enough how much of a blessing has been finding this place, I can hope my journey can be as smooth as possible, and I can get into contact with people who
are sharing this burdensome trip. But I guess I still have a long road ahead.

[Fresh]

That's fine to start , but it is important to get accurate doses.  The easiest way is to make a liquid solution yourself.

 

If you dissolve a 15mg tablet in 15mls of water , you can draw up exactly 2mg with a plastic syringe.

See the link with instructions here http://survivingantidepressants.org/index.php?/topic/2693-how-to-make-a-liquid-from-tablets-or-capsules/

 

Same time every day for 4 days , then see if the dose is suitable , or needs to go up a little.

 

You're at turning pint in your road , and the rest of the way , you'll be in good company.

 

[Franklander]

By now (01:36 AM) here, I'm having another surge of a possible panic attack. The cognitive impairment still is probably nowhere to see, but I think I'm freaking out.

[Fresh]

These little waves of panic and symptoms will come until you stabilize , and it is going to take a week or so at least.

Hopefully each day will be more normal and less weird ... that's what we're watching for.

 

Remind yourself that the panic is temporary , it always passes.  Do whatever you can to distract yourself in the meantime.

[Franklander]

2nd of reinstatement, by now the panic attacks cessated, had a well-slept night. 
I've had another take of more or less the same dosage of yesterday, but I still need to get hold of the tools to help me withdrawal.
My heart is palpitating and I'm slowly building into an euphoric state.
Is it alright if I keep this page as a diary too keep track of these symptoms?

[AliG]

Frank .  This is your Introduction thread to post questions /concerns  and to track your progress. A journal , of sorts .

Your lessened symptoms is a good sign .

What are the other " tools " that you need?  Are you taking 2mg ?  Please keep track of your symptoms in the next few weeks.

 

Rate symptoms daily to track patterns and progress

 

Ali

[Franklander]

The ones to facilitate my tapering: on the page that Fresh offered me, they are not that simple to acquire from here but I think I'll have to do what it takes.
Brain fog and confusion have diminished, but I'll have to discipline myself not to overthink my current predicment, whenever I end on the page of Tapering on 
Lexapro and people who've been on Protracted Withdrawal, my panic attacks just escalate. I feel so stupid for not having the info I've acquired now, and doing it all wrong.


Can I offer my status before/after the reintroduction now?  maybe it'll give more clarity. I can't believe there's a page of people willing to help me that much.



 ----:After the cessation of 02/19 (Rating according to the occurence and severity of symptoms -- Except for the range of sleep):----

 

Brain Fog: 9
Bad Short-Term Memory: 10
Burning Skin: 10
Insomnia: 10
Painful Joints/Muscles: 6
Brain Zaps: 0
Dizziness: 0

Mood Swings: 8
Panic Attacks: (Triggers specifically after a bad slept night/ desperation over symptomns/ hopelessness)
Anxiety: 1 (Usually comes with the panic attacks and triggered usually by an awfully slept night, other than that, nowhere to be seen)

 

Range of Sleep: (8 hours of sleep - Fragmented -  Sometimes due to an interruption of my sleep, basically worsening my symptoms)

 

 

 

 

 

----:After Reinstatement (1-2 mgs):----

Brain Fog: 4
Bad Short-Term Memory: 8
Burning Skin: 7
Insomnia: 5
Painful Joints/Muscles: 3
Brain Zaps: 0
Dizziness: 0 
Mood Swings: 2
Anxiety: 8 (Unfortunate side-effect, Is it a sign of sensitive brain?)
Panic Attacks: 3 (It seems the triggers are random at this point)



Range of Sleep: (8 hours of sleep - Uninterrupted Today)




 

[ChessieCat]

Hi Franklander,

 

"I feel so stupid for not having the info I've acquired now, and doing it all wrong."

 

We can only make decisions based on the information we have at the time.  It is good that you found this site and now have the information you need to taper the way SA recommends.

"I can't believe there's a page of people willing to help me that much."

 

That's what this site is all about, people with knowledge helping people gain that knowledge.  And other people supporting and encouraging them.

 

"The ones to facilitate my tapering: on the page that Fresh offered me, they are not that simple to acquire from here but I think I'll have to do what it takes."

 

What, specifically, are you having problems getting?  If you post what they are, members might be able to offer suggestions.

_______________

 

It is a good idea to update your signature each time you change your dose.  Please include the date, drug & dose.  This way the information will be current and members can see it easily without having to read back through your posts to find the information.

 

As you have already found, certain things can trigger anxiety.  It is good that you have recognised that reading some things on this site causes it for you at the moment.  This is the link to Success stories: Recovery from withdrawal

 

You might find these help you to understand what happens as our brains adapt to getting less of the drug that it is been used to getting:

 

Brain Remodelling

Best Description of Healing Process

[Fresh]

Hey , try not to be hard on yourself.   Part of the condition usually involved berating oneself which is a total waste of time.

You did as best as you could ... you didn't have any good information or support.

When I tapered in 2012 , I went down in 1/4 increments cause I didn't know there was a better way.  Bad move , but I recovered.

 

Try a pharmacy for the tools you need ... a small glass jar , a 10ml syringe , and a 3ml syringe and you'll be ready.

 

Stay away from reading things that disturb you ... try music , relaxation tracks , tv , a walk outside , a bath , anything.

In the Symptoms section there are threads that have helpful ideas , have a look through.

[Franklander]

Second day of reinstatement, and this anxiety is killing me at this point. going CT and reinstating is taking its toll on me.
It seems I'm sexually impaired now.

Thank you very much for the kind words. My memory still fades me, but my dialect has been somewhat restored.

I guess the most frightening thing is the thought of being trapped in this situation. One way or another, I'll have to be calm.

Do I have to wait for the 4 days until deciding whether or not I should regulate the dosage? How long must I taper?
I'm sorry, at this point, looking for answers is freaking me out. I'm restricting myself on the contents I should see.



 

 

[Ali4]

Takes 4 days to become steady in your blood, try to stay calm, I know it takes alot of patience,but you will get there. Let's see how you feel in a few days. Ali

[ChessieCat]

Hi Franklander,

Your CNS (Central Nervous System) has received a very big shock by going off the drug suddenly.

 

Just remember:  HEALING IS HAPPENING.  All you need to do is take care of yourself and try and keep stress to a minimum so that your brain can do what it needs to, which it is very capable of doing.  The worst thing you can do is try and hurry the process along.  It will take as long as it needs to take.  It might feel like you are doing nothing.  In fact you are doing nothing and that is what is needed at this time.

 

It is also a good idea to learn coping skills.  Claire Weekes is highly recommended.

 

Audio:  How to Recover from Anxiety - Dr Claire Weekes

 

Audio:  First Aid for Panic (4 minutes)
 

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

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)

 

The next stage is stabilising,  holding for 2-3 months before you  consider tapering, which is giving your brain a chance to catch up.

[Franklander]

3rd Day after reinstatement, when I realized that I could heal, my anxiety stopped and the panic withered. I'm noticing muscle twitches and some involuntary spasms. When trying to sleep, I went into manic state which delayed my usual sleeping schedule. Have had a fragmented dreamless sleep until my last attempt, which I experience very vivid dreams. No sign of the bad sinus or the skin burns at this point. My memory is slowly coming back, even with the brain fog.

As always, never experienced the terrifying Brain Zaps.

 

I guess I need to realize how important is the fact that reinstating is a very good sign.

[Franklander]

After taking today's dosage, some of older symptoms came back, I'm starting to get sleepy again and my awareness has been partially dulled. A little bit of anhedonia as well.
I believe it has to do with the dosage, I think I've went unto 2mg. If that's the case, keeping it to 1mg might be the only
reasonable route.

Just a question: I've been on coffee for a very long time, and I haven't taken it for almost a week, is it possible that it has some kind of correlation?
Can I take caffeine even under SSRI? Even by a little?

[ChessieCat]

Hi Franklander,

 

It is suggested not to drink coffee, cola drinks or alcohol as these can be activating.  Even watching action, exciting or scary movies can be a trigger and so can loud music or noise, or crowds, bright lights, too much strenuous exercise.  Sugar is another substance that can sometimes cause problems.  I found that I couldn't play certain games because they I would get a rush of adrenaline.  I can play some games for a short while, but not a long as I used to.

 

If you have been a regular coffee drinker, especially drinking 4 or more cups or 2-3 very strong coffees each day, you may be experiencing some withdrawal from the caffeine in the coffee.

[Franklander]

Yesterday was terrible overall, had little sudden migraines and stichting sensations over my head, besides the burning sensation and the intense heat.
Watched a very calm film and I can't recall it, I guess Brain Fog is unavoidable at this point.

Sleeping felt like going back to where I began, had one interlude of a dreamless sleep that I can barely remember, and another one of freakish ones (which I don't mind) that I've had to make an
effort on remembering that I've actually slept.

I don't know what to make of these signals: Is it a sign of upgrading the dosage? Do I have the luxury of doing it at this point?
Is my brain really accepting reinstatement? I feel psychologically avoidant of Lexapro.

 

 

 

(I used to be a heavy drinker a long time ago, my last coffee routine has always been 1 cup per day tho).

[AliG]

I believe it has to do with the dosage, I think I've went unto 2mg. If that's the case, keeping it to 1mg might be the only
reasonable route.

 

Are you on 1 or 2 mg ?   Please, stay at the same dose , and keep notes. What dose did you reinstate ? 

[Fresh]

How did you go getting hold of a syringe?  

Until you've been on a measureable dose for 4 days , it's not possible to assess if it's enough or too much or too little.

If you chip bits off a tablet , there could easily be a 50% margin of error either side of 1mg , so you could be taking between

0.5 and 1.5mg

[Franklander]

I've had a talk with my father (Who also had a history of chemical dependancy) and he's going to auxiliate me on everyway possible.
I've told him about the materials I need to get hold to and he's going to provide me with them as I speak.
Should I delay the intake of today's dosage?

[Fresh]

Yes ,  if it's going to be possible to take it in the next 5 or 6 hours , better to hold off and take your first accurate dose.

 

That's awesome that your father is supporting you.  What dose are you going to take and stick with for at least 4 days?

[Franklander]

I've only got hold of the syringes, distilled water is yet to be held. Is it that much of an issue? I'll most likely go with 1mg and see how it develops, is it possible to adjust the dosage in between the next four days?

 

Update: I have an appointment with 28th and I'm apprehensive to how I should approach the issue.

[ChessieCat]

Hi Franklander,

 

I'm not sure about whether it is necessary to use distilled water.  I search for "distilled" in the Tips for Tapering Lexapro and nothing was found.  I found this post by Alto Strata in How to make liquid from tablet:

 

"My rule of thumb has always been no more than a week, unless I get explicit stability information from a pharmacy or online.

 

This applies to suspensions made with distilled water or pharmacy liquid.

 

The major risk is spoilage from bacteria or mold, as with other opened foods in the refrigerator."

 

 

 

You might find reading the following helpful before your appointment.  Remember that it isn't necessary for you to tell your doctor or therapist that you are tapering, unless you wish to.  Also you do not need their permission to taper.  You just need a prescribing doctor who will provide you with what you need.

 

How do you talk to a doctor about tapering and withdrawal?

What should I expect from my doctor about withdrawal symptoms?

[Fresh]

It would be fine to use bottled water to get started.   You'll need to dispose of the remainder after a week.

 

Start with 1mg.  

There's no point changing it before 4 days because it takes that long to reach a steady state in your blood stream.  

Until that time , your symptoms will jump around.  You may feel after 4 days that there's been enough improvement

that you'd rather stay on 1mg.  The lower the dose you can stabilize on the better.

 

It's fine if you choose to start on 2mg , but please stay on that dose. As you've already had a few small doses , we

know that you're not going to have an adverse reaction.  

 

The doctor is a week away , hopefully you'll feel much more calm by then , and it will easier to explain to him what

you're doing.

[Franklander]

Yesterday I did dillute the pill on bottled water and took exactly 1mg at 8:30 PM. (Apologies for it, I've Bolded the moment most terrifying for me at this point)

A moment of stability that lasted around 2 hours has been followed by awful headaches and sharp pains around my head and around the neck, as
if someone has been stitching needles inside my brain.

My awareness has been alterated somehow, as if I can remember a bit who I've been and wish to become again.

My Bowels have had moments of noisy functioning, I'm being hungry more than usual and having aches in my belly.

 

I don't know what I can figure about this feeling, is it anhedonia, or is the fact that my former self wasn't that easily amused by anything.

 

I feel somehow nauseated in moments.

 

Confusion is frequent at this point.

 

My cheeks feels swollen and sometimes numb.

 

I've had a brief moment of sleepiness that helped me to get into slumber quicker, but ever since my sleep pattern
has become light, I've been awaken, and the sharp stitchings only increased, after it a moment of burning sensations on the same spots.
For a moment I've thought I was about to have a Stroke, the skin burning hasn't cessated but I managed to sleep again.
 

A noticeable pattern of sleep is a dreamless sleep followed by a morbidly strange and often terrifying dreamful one.


 

 

Thanks for the links, talking about withdrawal with a psychiatrist is somehow a gamble, I just hope to find one that can actually grasp
this phase of my life. I have still some questions left after tonight


1. Is it possible to have a Stroke while withdrawing from Lexapro? If these signs look like one, at such point, is it possible to stop taking it at this point?

2. It has been quite a while ever since I last took Ritalin, is it possible that I'm still suffering from withdrawal from it? I believe it is way far too late at this point to try any reinstatement.

3. Should I avoid sexual relationships at this point?


Thank you very much to however reads this, I hope I don't sound obnoxious at this point. Even though I'm not panicking, still is a scary set of symptoms. Even thought I've been warned that it will be like this until my body stabilizes.

[Franklander]

8:30 PM here, yet to take another dosage. It seems whenever I feel hopeful about my recovery, some of the symptoms are supressed.
 

[Franklander]

18:16, and ever since I woke up (been awakened) I'm at a good window. It seems 1mg of liquid Lexapro has become stabilized in my blood.
The only symptoms I can recall beside the usual Brain Fog (which I highly suspect of my former withdrawal of Ritalin) are the usual stomach aches (similar to when you're at many hours without nurturing)
and the stings around my body/head. Heart Frequency has been been increased as well. Mental Confusion has been noted. I hope I'm stabilized for now.
 

[Fresh]

This is very good news Franklander.  You're responding really well , and hopefully will continue to feel more and more like your usual self.

 

There may still be hiccups - that's the nature of this recovery.  Don't get alarmed if you feel bad for a few hours here and there.  

 

Try reading "The Windows and Waves Pattern of Stabilization"  here  http://survivingantidepressants.org/index.php?/topic/82-the-windows-and-waves-pattern-of-stabilization/