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Chicago77

Chicago77: tapered off Lexapro ... still have bad withdrawal symptoms

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Chicago77

Hi,

I've been taking 10 mg of Lexapro for the last 12 years. I decided in October 2015 that I wanted to get off Lexapro. I read that you should taper off the drugs slowly so that's exactly what I did over a 6 month period. I was completely off in March 2016 and the first 2 weeks I was fine. Then the 3rd week I started to get heart palpitations, anxiety, extreme fatigue(body feels so heavy), terrible brain fog, dizziness, shaky, tingling and numbness in left foot and muscle pain that shifts to different areas of my body. At first I didn't think it was related to coming off Lexapro so I went to the doctor to get a bunch of blood tests. I also got an MRI because I could barely focus at work and was getting dizzy all the time. Everything came back normal, so the only thing I can think of is the discontinuation of Lexapro. It's now June 2016 and I still feel bad. I'm so tempted to just start back on a small dose of Lexapro to see if this stops it, but then am going to have to go through this for even a longer period time again when I stop taking it again? Is it normal to have these symptoms after tapering for 6 months and being totally off for 3 months? This is hell! Please help!

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savinggrace

Yes, this is completely normal and if you do some reading here, you will find many stories like yours. I will let a moderator advise you, but my best guess is that you will be advised to go back on a small dose to see if you can stabilize and then taper off that, perhaps at a slower rate. There are good links on the home page, especially about slow tapering. Your taper was significantly faster than 10%, which is understandable because you were feeling okay then, but now you aren't. It happens all the time and I think you have every reason to be optimistic if you stay open-minded to this stabilization and slower tapering process. A Moderator will be along soon to help. Meanwhile, stay calm. This is doable.

 

Grace

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SquirrellyGirl

Hello Chicago77, welcome to SA!

 

Savinggrace is correct, it looks as though you are in withdrawal from Lexapro, and your taper, though slow by most doctors' standards, was still too fast.  Those of us on these drugs for years, not months, must go especially slowly or risk protracted antidepressant withdrawal syndrome (PAWS).  All your symptoms fit.

 

First, it would help if you could fill in your signature block with your drug history, including the taper schedule, how long at each dosage, and when you came off.  This shows up under all your posts and allows us to see your history at a glance.  Please put your Withdrawal History in Signature.  Please include all drugs you are on, Rx and OTC.

 

I'm going to give you some links to read that will help you understand why this happens and why reinstating a very small dose would be prudent.

 

Introduction to AD Withdrawal Syndrome

Brain Remodelling (Rhi's Description of Brain Healing)

About reinstating and stabilizing to reduce withdrawal symptoms

Why taper by 10% of my dosage?

 

Reinstatement really is the best course, because otherwise withdrawal can continue on for quite some time, months and even years, with a Windows and Waves Pattern of Stabilization

 

I would suggest reinstating 1 mg of Lexapro.  When people come off too quickly, the nervous system becomes sensitized, and a larger reinstatement could cause an adverse reaction, so we like people to try a small amount to; if you feel bad right away, then there is less to come off and less destabilization caused by such a small amount.  Read the link for more information.

 

You are probably wondering how you could possible measure 1 mg.  Here's info for Lexapro:

 

Tips for tapering off Lexapro (escitalopram)

 

Since your nervous system is highly sensitized by withdrawal, we recommend people take the following supplements:

 

Omega-3 Fish Oil

Magnesium

 

Are you taking any other supplements?  Some, such as the B vitamins, can be activating.  People often become sensitive to things that used to not be problematic, such as sugar, caffeine, and alcohol, so be aware of that.

 

Read up on the links and come back with questions!  If you click "follow" above, you will be notified of replies to your thread.

 

SG

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Chicago77

Thank you both! I can understand having anxiety and heart palpitations are withdrawal symptoms, but does it make sense to have muscle pain and stiffness as well as body heaviness? I've never experienced anything like this before in my life. Also, if I do decide to try and go back on 1mg of Lexapro, how long does it take for these symptoms to go away?

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SquirrellyGirl

1 mg is a starting dose, but may not be enough to overcome all symptoms.  It will be a matter of feeling your way along.  If you feel immediately worse, stop the reinstatement.  If you don't feel any different after a week, then it may be necessary to titrate up by equally small amounts until you feel improvement. 

 

We don't want to overshoot and have you start with too much 1) due to the risk of an adverse reaction and 2) we don't want to over-shoot your level of healing because then there could be side effects such as on start up, and you'd have that much farther to go to come off.

 

Physical withdrawal symptoms make very much sense when you consider there are nerves throughout the body and something like 80-90% of your serotonin exists outside the brain!

 

SG

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savinggrace

Hi,

 

Hope the 1 mg. updose is helping.

 

Yes, muscle, joint, and even bone pain can be expected in w/d.  I can always tell when my body is in heavy w/d by the amount of tension I have in my arms, especially, and back pain.  I read so much here about the mental symptoms of withdrawal, but so much of mine is physical, but then again, I have been a "snail taperer" and am not actively tapering now.  Just holding and giving my body a rest.  I think cold-turkeys and really rapid tapers exacerbate the mental symptoms more, though I have no evidence of that, just an observation.

 

I highly recommend hot epsom salts baths for the pain and muscle tension causing the pain.  Oh, yeah, last night I started getting restless legs syndrome  in my foot/ankle and before it ramped up, I sprayed magnesium oil on it and rubbed it in, and it stopped the agitation...just stopped it.  I am a bit cynical about these kinds of claims, but I really don't think this was a placebo response.  You can get magnesium oil on-line or make it yourself..(much cheaper)

 

Grace

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Chicago77

So if I decide to take the 1mg of Lexapro and it doesn't work after a week, get off immediately?

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Chicago77

I'm just nervous to reinstate it because I've been off now for 3 months and I read the chances of it working are slim.

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SquirrellyGirl

You are at the cusp, and so you need to weigh the pros and cons.  If you feel that you can handle with waves, knowing what you know now, then continue forward without reinstating. Have you had any windows?  That would be a good sign.  If you debilitated by the withdrawal symptoms, then trying the reinstatement may be worth a try.  With the former choice, withdrawal could last quite a long time, granted with windows and waves.  

 

One has to weigh one's personality into the equation.  Sometimes we see people here who get really upset by every new symptom, suffer bad health anxiety, and can't grapple with the fact that these symptoms are transient - they just panic and are fraught with anxiety.  They may have no support system.  These folks are not good candidates for riding the protracted withdrawal rollercoaster ride.  Then you have people who take each symptom in stride, find comfort in knowing that the symptoms are "just withdrawal," and they plug away day after day without getting overly flustered.  They may have been support in place as well, and are good at self-soothing.  They are the ones who can handle the PAWS rollercoaster ride.

 

Withdrawal is hard and leaves one susceptible to stress.  You need to be willing to take it easy on yourself, take personal days from work, nurture yourself through.  I didn't know I was in withdrawal when it hit me hard, and I was completely freaking out thinking I'd gone mad.  Had I known what was happening to me, I'm not sure but I think I might have been able to ride it out.  I guess we never really know until we're in it.

 

Personally, I reinstated at a rather large dose 10 months out and it worked for me, stabilized me within an hour.  Not everyone gets that dramatic a response.  Sometimes it takes weeks or months for stability to come after a reinstatement.  Also, if not doing worse, it might be a matter of adding a bit more.

 

You just need to weigh it out for yourself :-)

 

SG

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Chicago77

Sorry what are waves and windows?

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dowdaller

Hi chicago,

 

I'm just nervous to reinstate it because I've been off now for 3 months and I read the chances of it working are slim.

 

If your able to get by without reinstating I wouldnt reinstate, what you are going through is normal, it will pass, but you are the only that can decide. Good luck with whatever you decide. 

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Chicago77

Thank you everyone! I've decided not to reinstate because I've been off Lexapro for 3 months and I'm nervous it will make me worse at this point. I can tell you that my anxiety, shakiness and heart palpitations have subsided a little. However, what I'm left with is chronic fatigue(including very sore muscles and body heaviness-I feel paralyzed when I wake up) and bad brain fog. My liver enzymes are elevated and I've read that anti-depressents can cause a fatty liver(not a big drinker). I'm taking milk thistle to try and help me liver. Did anyone else develop chronic fatigue with withdrawal? 

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Christian

Yes I have and many others have fatigue. The meds cause fatigue and it's also a WD symptom. It's tough to say how long it will last. It looks like you still have your sleep intact. If that's the case there's a good chance you will heal quicker.

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Chicago77

Now I have terrible muscle pain in a lot of my body as well. Ugh! I have fibromyalgia symptoms. Heaviness, pain, fatigue, burning feeling and brain fog. I wonder if I'm going to be left in this state now that I'm off Lexapro. Has anyone else felt like this?

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SquirrellyGirl

No, you won't be left in this state, Chicago, just more protracted withdrawal.  Are you on Magnesium?  Another member reported that calcium lactate is helping with restless leg syndrome.  Here's a link for non-drug techniques of dealing with pain.

 

SG

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Chicago77

Thanks I will try magnesium. I wonder if it's normal to have pain in the same places everyday. Also this heaviness is so strange. I feel like I have an elephant on my back. Do you know?

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Chicago77

I have terrible pain in my right arm and it has spread to my right leg now. I wonder how long the pain lasts for.

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SquirrellyGirl

I DO know!  Recently, I'd cut my mirtazapine with the result being that feeling, especially in the morning.  I likened it to wearing a heavy rubber suit, but I like the elephant analogy as well!  I have shaken the feeling with further tapering, however.  So, this, too, shall pass :-)

 

A lot of people have the pain complaint. I'd have to dig for a reference but someone once brought up that these drugs affect the ligaments and tendons.  I've had episodes of plantar fasciitis that lasted YEARS, as well as a case of tendonitis that lasted a year, triggered by doing some yoga poses.  Shooting mystery pains, as well.  My right elbow is suffering from tennis elbow that I can't for the life of me figure how it started.  I don't play tennis and don't recall doing anything that could be considered a precipitating event.  Serotonin functions throughout the body, so this is likely one of the manifestations of reducing.

 

What has been a curiosity to me is the asymmetric manifestations.  Dry eye in my right eye only, muscle twitches in my right thigh or left tricep, stuff like that.  Weird.

 

SG

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Chicago77

Years?! Ugh I don't think I can go through all these symptoms for years. I'm barely holding on as it is just hoping that maybe there is going to be a day really soon that I feel a little better. :( When I hear "years" it makes me want to just get back on Lexapro even if it's for life, just so I don't have to feel this way anymore.

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Chicago77

Squirrellygirl, do you think it's too late to reinstate 1 mg of Lexapro? I've been off since March 1st but my symptoms have been terrible since last week in March. What will happen if I try it? Can I make myself worse than I already am?

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SquirrellyGirl

Chicago, first of all, the pain I was having was while I was on Effexor, as far as the plantar fasciitis is concerned, and the pain I had from yoga did take a year to get over but by no means was it debilitating.  I really don't think your pain situation is of the same ilk, and I'm sorry if I made you think that way.  Pain is a common withdrawal symptom that resolves. I think my pain was due to the fact that tendons and ligaments are apparently affected by serotonin and so the drugs themselves affect tendons and ligaments, perhaps making it easier to get injured.

 

It would really help if you would fill out your signature block, Chicago, because when you ask about reinstating 1 mg, I don't remember your situation from previous posts so look to that sig block to get caught up.  Now I need to re-read your thread to get a sense of what is going on. Please put your withdrawal history in your signature

 

You said in your initial post that you tapered off from 10 mg over 6 months.  What dose did you jump off from?

 

Please read this reinstatement thread:  About reinstating and stabilizing to reduce withdrawal symptoms

 

I have no idea how reinstatement will go for you.  I happened to reinstate at 10 months at a higher dose than we generally recommend, but I hadn't found SA, yet, and it happened to work for me. We recommend starting with a very small dose to test the waters and make sure you don't have an adverse reaction.  It takes four days for a reinstatement dose to become steady state, and a few days more to determine whether it is helping or not.  If you feel worse right off the bat, then stop.  After a week, if that dose has helped a little but not quite enough, you titrate up with another small increase.

 

So, at three months out you are on the cusp of it being less likely to work, but you need to decide weighing the pros and cons.  If your symptoms are truly debilitating, then the risk may be worth it and it may just fix you up!  I would start with perhaps 0.5 mg.

 

SG

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Chicago77

Hi, 

 

It's me again. So I decided not to try and reinstate in fear that it would set me back. However, my pain on my muscles, joints and tendons has spread from my arm to my right leg. I've been to many doctors and the neurologist thinks that getting off the lexapro might have triggered some sort of Fibromylgia. He suggested taking Gabapentin to relieve the pain. I've only been on it for 5 days at 300 mg and I don't feel any different. My concern is if I start taking another drug that might not even help the pain(have no idea if this pain is related to withdrawals from Lex) and then I have to try and get off the Gaba too or have w/d from that drug. Ahhhhh! This is a lose lose situation I feel like. I'm just trying to rule everything else out of why I have this pain. I will say that my anxiety, heart palpitations, shakiness and subsided. I',m just left with some brain fog, fatigue/heaviness and PAIN! They are the these physical symptoms I can't shake which makes me think I have something more serious. All my blood work and MRI came back normal. Do you really think this pain can be from withdrawals and how long does this last? Thoughts on taking gaba for the pain? I'm thinking of stopping that drug now since it's only been 5 days on it. 

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scallywag

Chicago, if you continue the gabapentin for any length of time, you will want to taper off it. It, like many psych drugs, is not something you can suddenly stop taking.

Tips for tapering off Neurontin (gabapentin)

 

You've tried 300 mg gabapentin.  If you're not getting the relief you wanted from it, discontinuing it is one valid choice of many.  In an attempt to diminish the pain you're experiencing, your doctor will likely either add another pharmaceutical to the mix or replace the gabapentin with something different.

 

Your concern above about Lexapro and liver toxicity: The doses that SquirrellyGirl suggested for you to consider are low. At 0.5 mg and 1 mg, it's 5-10% of what you took for 12 years.  The load on your liver to metabolize a reinstatement dose will be much less than when you were taking 10 mg.

 

Let us know what you decide and how you're doing.

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Chicago77

Sorry just so I understand correctly, I should ween off the Gabapentin even if I took it for only 5 days?

 

Is there anything I can do for the pain that's not a pharmaceutical drug? Do you know how long the pain will last? Thx!

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scallywag

If you intend to stop the gabapentin abruptly (cold-turkey) after 5 days on it, sooner is better than later.
 
I can't tell you how long the pain or any symptom will last, unfortunately.  As for how to alleviate it, SquirrellyGirl posted (#6 above) a link to a thread: Tension, pain, twitches, spasms in muscles and joints  Have you read that for ideas?
 
There's also GiaK's topic: Non-drug techniques for physical pain.

 

And, What to do for pain when you can't take meds

 

Searching the intro forum for titles with the word "pain" might yield good information as well.

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Chicago77

Does anyone know how you know if you have reached your peak with withdrawal and you are headed toward recovery? I've read the tread about windows and waves, but I can't tell if I have them or not. From what I understand it sounds like you don't gradually get better, it's more of a situation where you have good days and bad days until you don't have anymore bad days? For me, I have had symptoms that have completely gone away, a few that have gotten better and one symptom that has gotten worse which is my muscle/nerve pain throughout my body. Does this mean I'm getting worse?

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DaddyCee

Hi Chicago77.

 

Sorry to hear you are in a bad way.  There is no telling when one reaches the peak of withdrawal as everyone of us are different and I don't believe that WD is linear. You will get good and bad days so if you really want off from these meds then unfortunately it will take time for your CNS  (Central Nervous System) to get to back to normal.

 

It is a long road to recovery, but each day is one more day closer to it.  If you can stick it out through the tough times then you will feel a lot happier and better in yourself.

 

I was on the meds for 15+ years and I am nearing 3 years off now and I have started to see great improvements.  The final part of my taper from 5mg to 0 was done in 1 month so far too fast and is why I have been stuck in protracted withdrawal for quite a time.

 

You will feel better soon and I suspect that the pain you are feeling is not a hidden underlying illness but just WD being wicked as she always is.

 

Be kind to yourself.

DC.

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Chicago77

Oh gosh! 3 years?! It's only been 4 months for me and it feels like a lifetime already. The thought of not getting better for 3 years makes me so upset. :(  I'm so thankful that I'm better enough to be able to work now because I've seen a lot of people on here that have lost everything. So you are saying that even though I feel 99% of my symptoms are gone or better, I still may get way worse in the future? 

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scallywag

Chicago, it sounds as if your symptoms are improving: some have gone away, a few have gotten better and one has gotten worse. Pain is an awful symptom to have continue, let alone worsen.

 

That you've experienced improvement in most of your symptoms is a good indicator that you're on your way to recovery. With our current understanding of the brain+CNS and our current technology. there isn't a way to see what's actually happening in your CNS. It's probably working away upregulating receptors and transmitters that were downregulated, or vice versa depending on the drug,  when you started the psychoactive.

 

Comparing ourselves with others is tempting: Are they improving faster? Are their symptoms better or worse than mine? When reading other members' updates and comments, do what you can to catch yourself comparing and to prevent yourself from falling in the comparison-trap. For a biological process such as your CNS restabilizing after psych-drug use, comparisons are not valid -- the other person has his CNS which responded in its own way and is recovering in its own way. Maybe when someone somewhere decides to fund studies on withdrawal and recovery from these drugs, we'll have good data on which to base conclusions and predictions.

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Chicago77

I know I keep going back and fourth but I don't know what to do. My pain has become almost unbearable along with my fatigue. Of course my mood is terrible too. If I try and reinstate 1mg of Lexapro(after 5 months of my last dose) can it help my pain? I know you said it takes 4 days to get back into your system and I run the risk of it not working. If after 4 days, I don't feel better, do I just stop taking it again? Do I have to start all over with the withdrawal process?

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scallywag

Chicago, the only way to find out if Lexapro will ease the withdrawal muscle pain, is to try it: Take 1 mg each day at the same time, observe your symptoms and record them on paper, and if you like here in your intro thread.

 

It takes about 4 days for the daily metabolism of the drug to become a stable cycle (same daily peak and low).  It may take another 4 - 6 days for your CNS to react to the change and stop sending out the signals that you experience as symptoms.  If your symptoms, particularly the pain, are eased, then it becomes a question of balancing time, symptoms and dose.  If the pain isn't eased by a reinstatement, then we have to look at your symptoms and do some detective work.

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Chicago77

If the 1mg doesn't work after the suggested amount of time, do I stop taking it abruptly? Will I have to start withdrawal all over again from the beginning?

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SquirrellyGirl

You should be able to stop taking the 1 mg without starting withdrawal all over again.  Presumably you are already IN withdrawal, which is why you are considering reinstatement, so there's no "starting over again."

 

Scenarios:

 

1.  Triggers an adverse reaction:  stop right away

2.  Nothing happens:  stop, or up-dose again

3.  Slight improvement:  either wait to see if things gradually get better, or updose a tiny bit more if symptoms are still too extreme.

 

Good luck!

SG

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Chicago77

If it works and I do stabilize does that mean this brain fog, fatigue, pain could go away. I'm barely able to function at work.

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