Rosemary: Lexapro Withdrawal

[Rosemary]

Hi all,
This is my first time ever on a forum so please be patient with me.

13 years ago I was diagnosed with PTSD and OCD and put on Luvox, which I took for 6 years until it started to not work. Docs then switched me to Lexapro when I became severely depressed, and then when that started losing efficiency at the end of last year they added Valdoxan. I have also been through inpatient treatments, CBT,ACT,DBT and have also tried TMS (didn't work).

 

I finally decided in May this year that I wanted to be AD free so started to taper the Lexapro, went from 20mgs to 10(got a slew of side effects) and then after 6 weeks went from 10 to 5 (no side effects) and then 5mg every other day and then finally at the end of August came off the Lexapro (still taking Valdoxan but it's not an SSRI).

The first two weeks were fine, no physical side effects just feeling a bit anxious, however the last two weeks and in particular the last 5 days have easily been the worst in my life. extreme anixety, ocd rituals, crying non stop, no appetite, insomnia, agoraphobia, anhedonia. just no will to do anything. also very snappy at everyone, no patience, very irritable and short tempered.

prior to coming off the meds I was calm, peaceful, always the nicest person in the room, non confrontational, positive and happy. even though the meds made me numb I was able to live somewhat a normal life.

do you think this is a relapse of whatever I had 13 years ago? or is it just a normal adjustment for my brain going from high doses of SSRIs to nothing at all in a (relatively) short amount of time?

help please!! I don't know whether to go back on the drugs or what to do. I am at my wits end.

Thank you so much,
Rosemary

Edited September 23, 2016 by scallywag
tags added

[ChessieCat]

Hi Rosemary,

 

Welcome to SA.  I'm about to head off to bed so I'll quickly give you some links to read.  You can then ask questions here in your topic.

 

1. About reinstating and stabilizing to reduce withdrawal symptoms
2. Why taper by 10% of my dosage?
3. Tips for tapering off Lexapro (escitalopram)
4. glenmullen_symptoms_AS Appendix 1.pdf
5. Brain Remodelling (Rhi's Description of Brain Healing)
6. Video:  Healing From Antidepressants - Patterns of Recovery

[scallywag]

Rosemary -- Welcome to Surviving Antidepressants (SA)
 
Thanks for confirming that your username isn't your "real world" name by PM (private message).
 
A request: Posting something like "10 mg mid-June, 5 mg mid-July, every other day 5 mg mid August" will allow us to get a quick understanding of your history with as few computations as possible.

When you have a chance could you put approximate dates for your Lexapro dose changes in your signature?

 
What you are experiencing is *almost* certainly withdrawal from Lexapro, not a relapse of what arose 13 years ago. To understand why I say this, have a look at links #5 & #6 that ChessieCat posted above.
 
Not knowing any differently, you did a fast taper off Lexapro -- from 20 mg to 0 in 4 months. Fast tapers of SSRIs throw some of us a passel of withdrawal symptoms. You have landed in that group and not with the "unicorns" who easily tolerate cold-turkey stops and fast tapers. Chessie's link # 3 provides useful downloads of a list developed by a psychiatrist who has treated people with these symptoms and advised safe tapers to reduce the risk of them. Another topic where you can read about withdrawal symptoms
What is withdrawal syndrome
 
The best known way to deal with these symptoms, which arise from your CNS (central nervous system) undoing the adjustments it made while you were on Lexapro for 6 years, is the "hair of the dog that bit you."  That means reinstating a small dose of Lexapro. Please read Chessie's link #1 to get more information about the potential benefits and the risks.
 
If after reading the topic on reinstatement you decide that you'd like to reinstate, please post that decision and/or any questions here in your introduction. Please do not take any Lexapro just yet.  Once we've answered any questions you have and know that you've decided to try this, we'll suggest a dose for you to consider.

[AliG]

Hi Rosemary,

do you think this is a relapse of whatever I had 13 years ago? or is it just a normal adjustment for my brain going from high doses of SSRIs to nothing at all in a (relatively) short amount of time?

help please!! I don't know whether to go back on the drugs or what to do. I am at my wits end.

It's most likely not a relapse. That is just something doctors like to trick us up with. A lot of us got put on these drugs for reasons that were not solid - as in no particular reason except they had their " little book of so - called medicine" called DSM. Any anomaly can be classified as " mental illness". 

 

I would reinstate a small amount and then taper off slowly.

 

Have a read of the links and then let us know what you think .

.

[Rosemary]

Hi everyone,

Wow thank you all so much for your replies! it's so comforting to know I'm not alone in this.

 

I've had a good read on a everything posted here, as well as some other sites. While it seems like what I am going through is some sort of discontinuation syndrome, I am stil tossing up whether to go back on the medicine to lead a somewhat normal life. I'm young (21), have a job, am doing a uni degree, and a large social group of friends. Since I have been off the lex, I haven't been able to work, go to uni, see my friends and my rituals are keeping me up for hours at night. I am crying everyday even in public, and my mum has had to quit her job to stay with me everyday.

 

Ok so my questions are

1) if I reinstate, won't that reverse everything I've gone through in the last four months and made it seem as if it was 'for nothing'?

2) if i reinstate, will that not mess my brain synapses up even more because of the coming off/going back on

3) has anyone had any luck with supplements? I'm currently on magnesium and fish oil, but have done a heap of research into 5HTP, SAMe, St. John's wort, l-tryptophan, inositol, and even the herby ones like Gotu kola. will taking these lessen the withdrawal effects, or should I reinstate and start taking them which will help when I do decide to withdraw?

4) if I was to reinstate, should I go back on the 5mg dose that I have been on for the last 4 weeks or will my brain be too sensitised for that?

 

Also, Long shot but if anyone is from Sydney and can recommend a good physiologist/naturopath/homeopath/anyone really to have a chat with this I'd love to know!!

 

AliG- thank you for your reply! I agree that a lot of people were put on meds for no particular reason, however I was 8 years old and began extreme rituals and aggression, crying, typical OCD stuff. I'm not sure if the doctors made the right move giving me antidepressants at such a young age but listening to my parents recount my behaviour, it seems like I went through months of rituals and suffering before being 'normal' again when they put me on the Luvox. I'm in two minds about whether I actually had OCD (but what else could it have been at such a young age) and was misdiagnosed and then put on antidepressants which causes this decade long battle, or if it was poor mental health and they made the right choice.

 

Scallywag- yepp I'll change it now.

 

Thanks again everyone!

Rosemary

[ChessieCat]

"Since I have been off the lex, I haven't been able to work, go to uni, see my friends and my rituals are keeping me up for hours at night. I am crying everyday even in public, and my mum has had to quit her job to stay with me everyday."

 

This definitely sounds like withdrawal symptoms.

 

1) if I reinstate, won't that reverse everything I've gone through in the last four months and made it seem as if it was 'for nothing'?

 

When we take the drug our brain adapts to getting the drug.  Since you have been off for 4 weeks the brain will have made some adaptation, but it still needs some of the drug.  Not the same amount that you were on.  Many members find that a reinstatement of a small amount is enough to bring the withdrawal symptoms to a tolerable level.  Once you stabilise you could then do the recommended 10% taper, with a hold of 3-4 weeks to allow the brain to adapt gradually as the drug is reduced, instead of trying to do it all in one go.

 

2) if i reinstate, will that not mess my brain synapses up even more because of the coming off/going back on

 

SA's recommendation is to try a small amount of the drug and, if there is no immediate bad reaction, to keep on that dose for about 10 days, keeping notes on paper of which symptoms reduce, worsen or stay the same.  The brain is physiologically dependent on the drug, not physically dependent.  At the moment your brain is very busy trying to regain homeostatis which is why your are getting the withdrawal symptoms.  If you give it what it needs it should be able to stabilise.

 

My personal experience:  I am a professional typist.  After being on half my dose for 3 weeks and suffering very bad brain fog during that time, I suddenly found that I wasn't able to type.  I updosed and within 4 hours my foggy brain was clearing and I was able to type.  It was an amazing turn around and I knew it wasn't placebo because I had a baseline to compare to.

 

3) has anyone had any luck with supplements? I'm currently on magnesium and fish oil, but have done a heap of research into 5HTP, SAMe, St. John's wort, l-tryptophan, inositol, and even the herby ones like Gotu kola. will taking these lessen the withdrawal effects, or should I reinstate and start taking them which will help when I do decide to withdraw?

 

Magnesium and fish oil are the only 2 supplements that SA recommends.  Taking other supplements, especially at this time, can muddy the waters.  If you start something new and also reinstate and you have issues we won't be able to work out what is causing what.  The only known way to reduce withdrawal symptoms is to take the drug that your brain needs.

 

4) if I was to reinstate, should I go back on the 5mg dose that I have been on for the last 4 weeks or will my brain be too sensitised for that?

 

As stated above, you start back on a small dose.  Your brain will have made some adjustments during the 4 weeks so 5mg will be too much.  Because we don't know how much your brain has adapted, and we don't know if you will have a reaction to the drug, the recommendation is to start low to test the waters.

 

 

You have been provided with a lot of information.  It can be overwhelming.  I suggest you read back over the links because you may have missed something and/or it may make more sense on a second reading.

 

Also, Long shot but if anyone is from Sydney and can recommend a good physiologist/naturopath/homeopath/anyone really to have a chat with this I'd love to know!!

 

Yolande Lucire, Forensic Psychiatry and Pharmacogenetics, 5/203-233 New South Head Rd, Point Piper NSW 2027, (02) 9327 1499

Website: www.drlucire.com 

SA member Fresh has seen her.

 

Edit:  Just realised you were asking for physiologist/naturopath/homeopath

Edited September 24, 2016 by ChessieCat

[Rosemary]

Hi Chessie Cat,

 

Thanks for your reply. Certainly a lot of information and I have taken some time to read back over everything as well as go through the links around the site. definitely some good information and a lot of it makes sense as to what I am going through right now.

 

I felt very hopeless today and was in a particularly bad way, and decided to take 2.5 mg of Lexapro about 5 hours ago. I'm not sure if this has worked yet or how long it will take for the withdrawal symptoms to reduce/SSRI side effects to start, but I'm hoping it will be a small enough dose as not to wreck my brain but a large enough dose to allow me to manage my symptoms better.

 

As I previously stated, I never started with depression and only developed this during teenage years, and in fact only developed anxiety at the beginning of this year. However the original symptoms of extremely severe OCD has been the most exacerbated during my withdrawal, and I am finding this extremely hard to cope with without the use of the meds.

 

Hopefully the Lexapro will allow me to manage my OCD better to get to a place where I feel I can withdraw at a SLOW rate of 10% every 4 weeks.

 

Do you think 2.5mg will be sufficient for now?

 

Many thanks

[ChessieCat]

We probably would have suggested trying 1mg to start with to see whether it would have brought you relief from the symptoms.  You were alternating days in August which would have been an average of 2.5mg per day and because you had been off this for 1 month we would have suggested a dose lower than the 2.5mg.  It is good that you didn't go back on to 5mg.

 

It's not so much the dosage amount, as being a consistent dose.  It's important to take the same dose daily at a similar time.  You might start to feel some improvement within the first day, but it does take 4 days for the drug to get to a steady state in the blood and then about another week for it to register fully in the brain.

 

Be aware that you may feel some improvement and then a symptom may worsen.  Healing is not linear.  Please see Windows and Waves Pattern of Stabilization.  It is very important that you do not increase your dose at the first sign of a symptom worsening.  You will need to hold on this dose for 3-4 months before beginning to taper.  If after about 10 days you find that you have had no improvement, then we would discuss options with you.

 

Please keep notes of what symptoms ease, if anything worsens and things that stay the same.  Being able to give us this information if you have any issues will help us to work out if reinstatement is working.

 

You might find this topic helpful:  OCD Obsessive Thoughts, Compulsive Behaviours.  In Dunerbug's first post this stood out:  "The ocd I'm experiencing now is so vastly different than the ocd of my past."

 

It's important to learn Non-drug techniques to cope.   Also be aware of Neuro Emotions

 

I hope you start to feel some relief soon.  Let us know how it goes.

[mysterium]

Thank you for asking these questions, Rosemary. I was having a hard time putting the words together, I appreciate it!

[PatriciaVP]

AliG- thank you for your reply! I agree that a lot of people were put on meds for no particular reason, however I was 8 years old and began extreme rituals and aggression, crying, typical OCD stuff. I'm not sure if the doctors made the right move giving me antidepressants at such a young age but listening to my parents recount my behaviour, it seems like I went through months of rituals and suffering before being 'normal' again when they put me on the Luvox. I'm in two minds about whether I actually had OCD (but what else could it have been at such a young age) and was misdiagnosed and then put on antidepressants which causes this decade long battle, or if it was poor mental health and they made the right choice.

 

When my cousin's daughter was 11, she started started to exhibit the exact same symptoms you're describing here. The doctor wanted to start her on meds, but her mother insisted she have blood-work done first. Turns out the poor kid was just extremely low in her Vitamin D levels. They increased her Vitamin D intake and the symptoms disappeared. So yes, unless they did extensive testing to rule out anything else when you were younger, there is a good chance you were misdiagnosed.

 

I'm not telling you this to make you sad, angry or regretful. Just wanted to let you know there is a good chance that you do NOT have a life-long illness that will control you forever and ever. It may have been a mistake that, in time, you will heal from.

 

Peace, love and healing.

[Altostrata]

Hello, Rosemary, how are you doing?