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Finn25

Finn25: need guidance

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Finn25

Hello,

I am looking for some guidance on beginning a taper from Lexapro 20 mg.  I have been on a nightmarish roller coaster for the last 7 months, and I'm so glad that I found this forum which has finally given me the answers I've been looking for. Here is my history:

 

I was prescribed Paxil 10 mg back in 2004 by my GP to address social anxiety issues. I'm an anxious person by nature, but I can see now with 20/20 hindsight that my nervous tendencies were nothing that should have ever been blunted by medicine.  But nevertheless, I started taking it and it became my crutch.  I considered trying to stop several times, but the brain zaps I got after a couple of days off prevented me from following through. As time went on, stopping the med just became something to procrastinate.  I felt ok, and believed that I was on a very low dose, so what's the harm? 

 

At the start of 2016, I determined that I needed to try getting off for good, after my wife told me she felt the medicine was making me zoned out.  I had heard getting off Paxil was difficult, but that once you were past the 6-week mark or so, you should be out of the woods. I had never had an issue with the drug before, so didn't do much research on the topic. I talked to my GP about it and he told me to taper over the course of a couple of months.  So beginning in February, I took 7.5 mg for 3 weeks, 5 mg for 3 weeks, and 2.5 mg for two weeks. I took my last dose of Paxil on April 1st. During the taper period and for the next 5 weeks following, I experienced the brain zaps, but that was my only real negative symptom. I thought I had gotten off lucky with a relatively easy taper.  Then around the 2nd week in May, after the brain zaps had stopped, the real withdrawal hit.  Severe anxiety/depression, ruminating and constant negative thoughts, and insomnia were the worst symptoms.  It felt as though someone had flipped a "pain switch" within by body.  I lost my appetite completely and quickly dropped 10-15 pounds, which led to health anxiety. Just the thought and feel of how loose my clothes were fitting sent me into an internalized panic.  I struggled along for two weeks before going back to my GP as a complete trainwreck.  Of course, his diagnosis was that I was relapsing, and suggested switching to Lexapro 10 mg, primarily because it was generally faster acting than other ADs and had less side effects. 

 

At this point, I didn't care what I had to do to fix myself, I just wanted to be fixed. In my desperate state of mind, I agreed and started the Lexapro on May 23rd. The first couple of weeks were bumpy as I had heightened anxiety, but I attributed that to starting a new drug. The next two weeks were better, but there was still this underlying feeling that something just wasn't right.  At my 1-month follow-up, I told him that I was still having bouts of anxiety and that I just didn't think the Lexapro was working as it should. He offered me two options, switch to Zoloft or bump up the Lexapro dosage. I chose to switch to Zoloft, thinking that maybe Lexapro was just not the right AD for me, and so I did an immediate cut-over. The first two weeks on Zoloft 50 mg were very good, for whatever reason.  My mind seemed clear and the anxiety relented.  Then by the 3rd week, I had a complete reversal and the "pain switch" got turned on again.  At this point, I could barely function. My mind and heart would race so fast at work, I would just have to walk outside so I would hyperventilate. After 10 days of pure misery, I went to see a different GP at the same clinic on July 21st.  The new doc recommended (surprise) going BACK to Lexapro and increasing the dosage to 20 mg.  

 

Again, out of shear desperation, I agreed, except this doc recommended a 3-4 day "washout" period to allow for the Zoloft to leave my system.  So I stopped taking the Zoloft and I immediately got relief from all my symptoms.  Very similar to when I cut over from the Lexapro to Zoloft, I had mental clarity and felt more like myself. After a few days of feeling better, I determined that I'd just see how long I could go without any medication at all.  So for the next 4 and half weeks, I took nothing.  During this period, I felt very similar to when I was fast tapering the Paxil, I had pretty severe brain zaps, but my mood overall was good.  Then at exactly one month from completely stopping the Zoloft, the brain zaps ended but I crashed once again.  This time, there was more depression than anxiety, and a couple of new symptoms popped up, a thumping in my ear that caused a few sleepless nights and an eyebrow twitch that was a constant reminder of my issues and stoked my health anxiety.  I had crying spells unlike anything i had ever experienced. I didn't know what to do and despair and hopelessness invaded my mind.

 

I ultimately decided that I'd give the Lexapro another try, since it was what was last prescribed by the doctor.  I started with 5 mg, thinking I wanted to be on the lowest possible dosage, but that only lasted 6 days as I was still in a horrible place.  I bumped it up to 10 mg and powered through for about 6 weeks.  My symptoms would come and go during this period, but I kept going, clinging to the hope that the medication would kick in at some point. In the 6th week, after trying to convince myself I was feeling better, I had a complete meltdown day that seemed to be as bad if not worse than when I first fast tapered from Paxil.  This threw me right back into the trap of fearing the worst, what if I never get over this? 

 

I decided that I would get a second opinion aside from my GP and went to a psychiatric clinic where I saw a nurse practitioner.  In the end, her recommendation was no different, bump the dosage to 20 mg. So on October 19th, I started taking 20 mg. 

 

I had a really bad week the 2nd week taking 20 mg, but have felt pretty good since then, feeling more like how a felt during the 12 years of Paxil.  Almost as if I have stabilized on the 20 mg.  

 

Around the time of my NP appointment, I started doing what I should have done from day 1: researching how to get off ADs and happened to discover this site (how I wish I would have found it back in February!!)  I've spent the last few weeks absorbing the all the info about protracted withdrawal, which is undoubtedly what I have been dealing with. What a bittersweet revelation that, on the one hand I've sent my CNS into pure chaos mode, but at the same time getting the validation that my issues were NOT due to any depressive/anxiety relapse, and that I could repair and heal over time.  Since I have confused my system with other meds over the last 7 months, I don't know which periods in my history were windows/waves from not taking Paxil, but I'm sure that this is what I was experiencing in some capacity. 

 

When I went back to see the NP earlier this week, I told her I believed that I was going through Paxil withdrawal, and that all my issues stemmed from that. I could tell she didn't necessarily agree, and she thought that I would always need to be on an AD of some kind, but she was willing to work with me on a tapering schedule that I would be comfortable with.  I convinced her to write the Rx for the liquid form of Lexapro. 

 

So before I begin this journey, I'd like to get some recommendations from this forum about tapering.  After reading about reinstatement, I feel like I'm sort of in no-mans-land as far as reinstating the Paxil, as I've had 7 months of healing from THAT med. On top of the fact that I've now got an accumulation of a different drug I have to deal with. If anyone does believe, however, I should reinstate Paxil, I'd welcome your thoughts.

 

Now that I've been on Lexapro for 9-10 weeks (3 weeks at 20 mg), would the 10% taper guideline still apply for it, as well?  I understand that patience is required and you simply cannot rush it.  But I was just wondering if anyone had a similar scenario where they were able to taper at a faster clip from a "replacement" med because you hadn't been on it as long. It scares me that I am now taking Lexapro at a dosage that is equivalent to four times the amount of Paxil I took for 12 years.  I would prefer to lower my dosage as quickly as possible (as we all would I guess), but again understanding that my brain will go only at its own pace. 

 

What I had considered is decreasing by 20-25% increments until I reached 10 mg, then applying the 10% the rest of the way. Since I've gone through essentially 2 cold turkeys, I have a really good idea of when my withdrawal symptoms start after a dose cut, which should help in determining the reductions.

 

Another concern I have is that I have not completely turned the corner from the Paxil withdrawal, and that symptoms may pop up complicating the Lexapro taper.  Anyone else had a similar scenario? 

 

I welcome your feedback, and I can't thank you enough for this site and the hope it has given to me. 

Edited by scallywag
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scallywag

Finn -- Welcome to Surviving Antidepressants (SA)
 
So good that you've found us before embarking on another big-steps-down then jump-off discontinuation from an SSRI.  It's absolutely wonderful that you successfully persuaded the NP to prescribe liquid Lexapro. That will give you so much control over your own process.
 
It doesn't matter that you've been on Lexapro for a shorter period of time than you were on Paxil. You are coming out of a period of CNS (central nervous system) instability. We recommend the 10% taper for anyone who has taken a medication for more than 2 months, possibly for even less time. Symptom patterns will not necessarily be the same because you are not in the same place. You are decreasing a different drug after having destabilized your CNS (central nervous system) by the cold-turkey cessation of Paxil.

 

Decreasing by 20 or 25% poses a much higher risk of triggering w/d symptoms at the best of times.

 

You've updosed to 20 mg of Lexapro because of symptoms about 4 weeks ago. It's way to early to taper right now. Please wait at least 2 weeks after your symptoms have stabilized before tapering. Even longer, 2 months, provides a more solid foundation .

 

Please be gentle with your brain, body and life.
 
The need for speed: Re-read the 10% tapering topic. You'll see that we suggest doing a 4-week hold twice to learn what symptoms arise and how long after the dose reduction they occur.  If you have no major problems and want to test moving faster, then you could consider doing a 3-week hold for 2 reductions. If no major problems with that, you could test how you do with 2-week holds.
Why taper by 10% of my dosage?

 

You've probably already read this, but here's the link just to be complete:

Tips for tapering off Lexapro (escitalopram)

 

I hope you'll find the information in the SA forums helpful for your situation. I'm sorry that you are in the position that you need the information, but am glad that you found us.

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Finn25

Thanks so much Scallywag. I'll wait another month before starting the taper and stick to the 10% when I do. It's hard to have patience, but I'll do anything to avoid a repeat of the last few months.  Thanks again. 

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ChessieCat

Hi Finn and welcome from me too.

 

Patience, throwing out the calendar, as well as listening to your body, are the 3 golden rules for tapering.  Also learning Non-drug techniques to cope with emotional symptoms

 

These might help:

 

Keep it Simple, Slow and Stable

 

Six Mistakes I've Made in Withdrawal

 

Brain Remodelling


Video:  Healing From Antidepressants - Patterns of Recovery

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grandmaD

Welcome to this site!  What an amazingly well articulated summary!  Sadly, it is the same old story for many of us!  It is so good you found this site and have access to so much valuable information, help and support.  I wish you all the very best!

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Finn25

I wanted to provide an update, because I've come to a hurdle in the road and I need some guidance as to how to get by it. I've been tapering the Lexapro since the first of December, and have been doing really well. Minimal symptoms, sleeping/eating well. I've put back on about 12 lbs. from the horrendous spring and summer I experienced.  Since beginning the taper, I've tracked my anxiety level each day on a 1-10 scale, and I've only had a couple of blips where I rated the day a 4.5, but those anxious days faded in the following days.  I've rated several days 0, which I count myself lucky based others' experiences I've read about in this forum.

 

This morning however I woke up this morning at 4:30 with the anxiety and panic that I became unfortunately familiar with in May 2016 when I crashed from a too-fast Paxil taper. It's mind-blowing to me how quickly it can spring on you.  It's not as intense as the worst waves I experienced last year, but it's enough to for me to question whether I've done something to trigger it. 

 

The difficulty I'm having is since I'm not "dancing with the one I brought", I can't distinguish whether symptoms are related to Paxil withdrawal (11 months removed from last dose), side effects of a more potent drug in Lexapro, or withdraw symptoms from tapering. Perhaps it's a combination.  Today's symptoms feel more like a lingering wave from Paxil withdraw that I would have had regardless of the current dosage of Lex, but my dosage is the only major thing I can change so I'm inclined to do it, if will help.

 

I'm on day 4 of a dosage drop from 13.0 to 12.6 mg.  Before that, I had spent 5 weeks doing the Brassmonkey Slide from 14.5 to 13 mg, and was relatively symptom free. Should I bump back up to 13 and stay there a while? Or power through at 12.6 for a few days?

 

Thanks in advance.

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ChessieCat

It's hard to say what has caused it.  It has coincided with a dose drop so it may be that.  However, the following graph shows your Lexapro use from September 2016.  Your symptoms may also be from going a bit too quickly in December and January.

post-5985-0-85570700-1488753203_thumb.jpg

 

It takes about 4 days for the drug to get to a steady state in the blood and a bit longer for it to register in the brain.  If it is bearable I suggest you give it a total of between 10 days to 2 weeks, keeping daily notes of symptoms.  You need to listen to your body, not the calendar, for when you should reduce again.  It is better to hold for a bit longer than to try and drop too soon.

 

Many members find that the lower their dose gets the slower they need to go.  See this discussion:  Why taper paper: dose-occupancy curves

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Finn25

Thanks Chessie. I'll plan on sticking with 12.6 for as long as I can.  I probably did go faster than I needed to in December/January, but I had some issues that I believe were side effects of the high dosage, but those have subsided now that I'm down under 15 mg, so I'll try to be more patient going forward. Here's hoping that tomorrow will be a better day for all. Thank you again.

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Frogie

Hi Finn25:

 

I'm currently tapering off liquid Lexapro.

 

I was doing really well at 8.1.

 

Then I went down 10% to 7.3, and I started getting nauseous. Nausea is my biggest symptom.

 

So, I just went back up to 7.6 yesterday. Hopefully it will help with my nausea.

 

Just be careful with Lexapro. It's mean. I was told that it's like a tiger, don't pull its tale. And I did.

 

Maybe we can corespond, since we are both going off Lexapro.

 

Thanks...

 

Take care,

Frogie xx

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Finn25

Hey Frogie,

 

I'm so sorry you're having a rough go with the nausea. I can't imagine having that as my bug-a-boo symptom.  Hopefully your uptick will kick in very soon and give you some relief.  

 

It's awesome that you are down in the 7 mg range.  I'm currently holding at 11.4 and really lucky that most of my symptoms are more nuisances than life-altering. I really have been fairly stable since around the December timeframe, with a few blip days in between where my anxiety ramped. But lately it's just been mild things like a thumping sensation in my right ear that comes and goes that just sort of nag me. But I've found that those types of things are fading over time, and so maybe your nausea will too as you adjust. Right now I'm just trying to get a feel for how I react to the cuts. I've trimmed around 2-3% each week, and I hold an extra week if I feel like I need to. The plan is to have an extended hold at 10 mg, so we'll see how the next few cuts go.

 

Hang in there Frogie! Wishing you and everyone much healing

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Frogie

Hey Frogie,

 

I'm so sorry you're having a rough go with the nausea. I can't imagine having that as my bug-a-boo symptom.  Hopefully your uptick will kick in very soon and give you some relief.  

 

It's awesome that you are down in the 7 mg range.  I'm currently holding at 11.4 and really lucky that most of my symptoms are more nuisances than life-altering. I really have been fairly stable since around the December timeframe, with a few blip days in between where my anxiety ramped. But lately it's just been mild things like a thumping sensation in my right ear that comes and goes that just sort of nag me. But I've found that those types of things are fading over time, and so maybe your nausea will too as you adjust. Right now I'm just trying to get a feel for how I react to the cuts. I've trimmed around 2-3% each week, and I hold an extra week if I feel like I need to. The plan is to have an extended hold at 10 mg, so we'll see how the next few cuts go.

 

Hang in there Frogie! Wishing you and everyone much healing

Hi there:

 

I hope any of the symptoms you have let up soon.

 

I was stupid and cut my Lexapro from 20mg to 10mg in June, 2016. I've been paying for it ever since.

 

In December I felt really good. And so Jan I went down to 9.1, I was fine. Then February 8.1, was ok. Then came 7.3, and the nausea. I fought it for over a month, so updose do to 7.6. Hoping that will get rid of my nausea. I've tried to taper before and my body doesn't like the 7's at all. So hopefully, taking it very very slow, I can get past it.

 

A moderator told me that Lexapro was mean like a tiger, don't pull its tail. Boy do I believe them.

 

I hope you heal very well.

 

Take care,

Frogie xx

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DaveB

Any update Finn?

 

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Finn25

Hello,

I'm looking for some guidance/support from this great community. As a quick update, I've been doing well with my taper the past year to 18 months. Things had seemed to even out and I've really learned a lot about how my body reacts to drops. I've not felt 100% back to my old self, by any means, and have bad days, but nothing so much that it would eliminate my appetite or cause insomnia . 

 

I had worked my way down to 5mg by the start of December, and my plan was to stay there for at least 12 weeks.  But after around 4 weeks, I started getting just hints of issues, such as high cortisol mornings, but nothing just too alarming. I've also had some relatively minor life stressors during the past few weeks that could have caused some further destabalization.  I felt like it was ok because I was going to stay at 5mg for as long as I felt like I needed to. Then out of convenience I changed pharmacies and the new one filled my Rx with a generic that was made by a different manufacturer than I had previously. So, on Friday was the first dose of the new manufacturer, and that morning, I felt kind of jittery and anxious at work, but it faded for the most part. I considered swapping back to the old generic (I still have a couple of weeks worth), but the decent afternoon made me reconsider. On Saturday, I felt great. The best day I've had in weeks. Almost too good, I guess, as I should have known something was up. Yesterday morning was the start of the worst wave I've had since I started tapering. The anxiety feels entirely chemical. And I just woke up this morning at 3:45 am completely wired and dreading the day.

 

My plan is obviously to switch back to the Rx from the previous pharmacy and see if that helps, but is this a common phenomenon among people in WD, when switching manufacturers? I understand that the various generics can vary in potency, but this almost feels like I'm trying a cold swap to a different drug altogether. 

 

Thank you for your time.

 

 

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eymen23

Hi Finn,

 

Some people seem to really notice a switch across to a new generic and some

people don’t notice much at all. You’re certainly not the first person to report a flare up in symptoms following a rapid change over. Most people

find that over time their symptoms settle back down on the new generic, but I have seen some members report not feeling quite the same for an extended period of time.

 

I switched generics just over 5 weeks ago without any cross over period, and my symptoms became more intense after 7 days or so. Truth be told, I still feel like my body is adjusting to that change, but I am much better. 

 

We recommend that if possible, any adjustment in medication should be done slowly. @Carmie is currently switching from compounded pills to her previous prescription, and is doing so over a 3 week period. Perhaps have a look at her thread for more information, but below is an example transition schedule:

 

3/4 dose of A, 1/4 dose of B for 3-7 days

1/2 dose of A, 1/2 dose of B for 3-7 days

1/4 dose of A, 3/4 dose of B for 3-7 days 

Then continue with the full dose of B

 

It sounds like you have the ability to get your old generic, so I would strongly consider transitioning back to the old generic and staying on it, for peace of mind. I was forced to switch, as the GP changed my dose to 10mg from 5mg and they refused to give me the old 5mg tablets. The pharmacy tried to give me a different 10mg tablet last time I went. I calmly and politely asked if they could provide pills from the old manufacturer, as I like to keep things as consistent as possible. They were more than happy to give me the usual generic. 

 

Please don’t continue your taper until you stabilise from the change in generics.

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Finn25

Thank you eymen. Good to know that it's not uncommon when switching generics.  I switched back to the old generic and will request that my Rx be transferred back to the pharmacy that uses the previous manufacturer.

 

I took the new generic for 3 days, and today will be day 3 back on the old. Day 1, I felt almost instant relief and had a decent day. Yesterday, I had some periods of moderate anxiety, but manageable. This morning, I've awaken to some overwhelmed and panicky feelings. Starting to wonder if the real issue is that I've gone too fast in my taper and I've hit that "uh oh" point. This will be day 65 of 5 mg, so I'm really not wanting to updose.

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ChessieCat

It would be a good idea to hold for a while and give your brain and nervous system a chance to recoup after the changes you've made because of the different generics.

 

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

 

You might also consider Brass Monkey Slide

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Finn25

So I'm really struggling right now. Waves of anxiety today with little relief. In my head I'm trying to tell myself this is the combination of life stressors, the new generic flip-flop, and a sinus infection that won't go away, all hitting me at once. But deep down this feels like I have made a huge mistake by taping too fast. I was having high cortisol morning wakeups around the middle of January. And maybe the generic manufacturer change and changeback was the tipping point. I've had this congestion I've been dealing with for about 10 days, but I'm scared to take anything to clear it up because of how I might react to it.

 

I've been at 5 mg for 70 days, and I don't want to thwart the healing process, but I can't help but think an updose may be in order? I guess my broader question is, the symptoms indicate that the body is rewiring itself, but at some point do the severity of the symptoms become counter-productive to the healing? I've had waves that lasted a few days before, but this time it really feels like I turned over the apple cart.

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ChessieCat

If you think you have a sinus infection you should get tested for it and get it treated.  When we are sick our symptoms can increase.  If you have an infection your body is busy trying to fight it.

 

cipro-levaquin-azithromycin-z-pack-and-other-antibiotics

 

It may also be due to histamine because you are on a low dose of your drug. 

 

histamine-food-intolerance

sibo-sifofood-allergieshistamine-intolerance-after-ssri

 

vicks-nasal-stick

nasal-rinsing-for-allergies-via-neti-pot-or-squeeze-bottle

allergies-sneezing-stuffed-up-antihistamines-and-what-to-use-for-allergy-relief
 

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eymen23

The change in generic may well have aggravated your system if you were already somewhat destabilised. It might take a bit of time for things to settle back down. 

 

If you also have an infection, that could be making matters worse as Chessie noted.

 

In terms of withdrawal symptoms becoming counter productive in terms of recovery, many people have cold turkeyed or rapid tapered due to poor guidance from their doctor, and then gone on to heal after very intense waves. I don’t believe there is a critical point at which we must updose or make a change, for risk of not being able to recover. 

 

Sometimes making additional changes can actually lead to a worse outcome. Your body may still be reacting to the flip-flop as you named it, and by updosing so soon afterwards, you might find you actually become more destabilised.

 

I recommend that for the next week or so you keep notes, which include symptoms, drug doses and timing, meal timing and sleep patterns. That way, if you’re still having difficulties, some of the more experienced mods can weigh in as to whether an updose would be sensible. Or whether you might be best off holding. Right now with the recent drug change and  lack of daily notes, I suspect it might be too much of a guess. 

 

Hope this makes sense. I will post the note format here shortly.

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eymen23

Example of daily symptom notes:

 

6 a.m. Woke with anxiety
8 a.m. Took 2.5mg Lexapro
10 a.m. Stomach is upset
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Feel a bit better
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Feeling dizzy
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke but got back to sleep

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Finn25

Thanks @ChessieCat and @eymen23.

 

Monday

5:30 a.m. Decent sleep but woke with anxiety (5 out of 10)

6:30 a.m. Ate breakfast, took 5 mg Lexapro, 200 mg chelated magnesium, 2 g fish oil

6:30 - noon Felt considerably better; thinking the worst is behind me; appetite better (anxiety 2/10)

noon - Ate lunch

noon - 6:30 p.m Still feeling ok (2/10)

6:30  p.m. -  Ate dinner

7:30 p.m.   - Symptoms start ramping again - strange head pressure, anxious thoughts, burning on the back of my neck, rapid heartbeat; feels like wave (6/10)

11:00 p.m. - Went to bed but symptoms continuing to ramp

1:00 a.m - Fell asleep for an hour or two; awakened by panic

4:30 a.m. - Decided to just get up rather than lay in bed and ruminate (7/10)

 

The congestion is better, but still have nagging cough.

 

The timing of the symptoms Monday was almost reversed from Sunday. I had an extremely tough go in the morning, but the "pain switch" as I call it was turned off in the afternoon, and I ended up pretty exhausted and wanted to go to bed Sunday night. Obviously, I think I'm in a windows and waves pattern right now, and trying to trust that I will stabilize at some point. I was just hoping to avoid crashing again, and that's what this feels like.

 

After reading through Chessie's info, I've tried eliminating as many high histamine foods as I can and will see if that helps any.

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Finn25

Tuesday - Very rough morning and afternoon, but window opened evening

 

6:30 a.m. Ate breakfast, took 5 mg Lexapro, 200 mg chelated magnesium, 2 g fish oil

6:30 - Very high anxiety (8/10)

noon - Ate lunch

noon - 4:00 p.m  Still miserable

4:00 - 6:30 p.m. Starting to subside a little, feel more like myself (5/10)

6:30  p.m. -  Ate dinner

7:30 p.m.   -  Feel very tired now that in window and reality of no sleep sets in

10:00 p.m. - Got a great nights rest

 

 

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DaveB

How have you been the last few days? Sounds like maybe things are settling for you?

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Finn25

I've been slacking on providing daily symptoms notes on here, but for the past week, I've been in a 24-hour wave/window cycle. One full day of a wave of symptoms, then one full day of a window. It was almost like I could set my watch by it. Then yesterday I was expecting the wave to hit around mid-afternoon, but it never came and I was able to sleep well last night. I am getting some symptoms this morning (anxiety, dread) after I woke, but not as intense before, and hopefully will be shorter lived. I'm optimistic that the worst is behind me, but know it may be a while before things settle.

 

I'm guess I should consider the 3-day swap to a different generic as a dose change event. At any rate, my plan is to stay at 5 mg for as long as it takes to completely stabilize and then some. I have another theory about why this wave hit me now. I've been reading about the 12-18 month and 3 year waves that will happen after someone ends a drug. This happens to be around the 3-year mark from my fast taper off Paxil. And looking back at my notes, the only other wave I've had that could compare with this one happened around the 14-month mark in the summer of 2017. I realize I'm tapering a different drug now, but perhaps there's a part of my body still withdrawing Paxil. Or maybe it's just coincidental, but I thought it interesting at least.

 

 

 

 

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Finn25

I apologize for not having detailed notes for the days previously. Here is what I jotted down as a summary in my notes from each day:

 

Wednesday 2/13 - After good night's sleep, much much better; appetite returned; then wave returned around 4:00 (overall anxiety level 4/10)

Thursday 2/14 - Wave still affecting me; maybe not as intense as last week; (5/10)

Friday 2/15 - Better day; no wave in the afternoon (1.5/10)

Saturday 2/16 - Slept well; some wavelike symptoms after getting up; negativity; burning neck; cleared by mid-morning; blurry vision bugging (3/10)

Sunday 2/17 - Just feeling off still, but better than a week ago; appetite still not 100%; better PM; late night life stress event caused rapid increase in symptoms (5/10)

 

Monday (4/10)

7:00 a.m. Awoke from around 6 hours of sleep with some anxiety (5 out of 10)

7:30 a.m. Ate breakfast, took 5 mg Lexapro, 200 mg chelated magnesium, 2 g fish oil

7:30 am - noon  Felt better with energy; felt like a window (2/10)

noon - Ate lunch

noon - 2:00 p.m Still feeling ok (2/10)

2:00 p.m. - 6:30 p.m Started feeling rise in symptoms: blurry vision, disconnected feeling (5/10)

6:30  p.m. -  Ate dinner

7:30 p.m.   - Symptoms held at manageable level (4/10)

11:00 p.m. - Went to bed and was able to fall asleep

 

 

Tuesday (7/10)

6:30 a.m. - Awoke from actually a very good nights sleep; ate breakfast, took 5 mg Lexapro, 200 mg chelated magnesium, 2 g fish oil

7:30 a.m. - Symptoms begin ramping: blurry vision, loss of appetite, strange head pressure feeling; just out-of-it (6/10)

noon - Ate lunch; feel about the same; trying so hard not to dwell on symptoms; anxiety ramping

noon - 8:00 p.m Symptoms continue to ramp and starting to overwhelm; neuro fear is crippling (8/10)

8:00 p.m.- Ate small dinner; appetite just not there

 

After a couple of manageable days, I was content that holding at 5 mg was the right thing. Now I'm back in the worst wave of the past two weeks, and in that place right now where I really feel like I need to DO something.  It's been 79 days since the drop to 5 mg, but only 16 days since my generic manufacturer flip-flip. Would an updose to 5.3 mg be too risky at this point? As I read back through this, I don't know that I've given you enough detail to be able to advise me. If so, let me know what else would help. Thanks for your time.

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ChessieCat

The fact that you have had a couple of good days is a really good sign.  Looks like you are getting a reasonable amount of sleep.

 

As you say it has only been 16 days since the change to generic.  When you make a regular dose reduction we suggest holding on that dose for 4 weeks.  It may be there is a difference in the dose you are getting from the generic from what you were getting with the brand.  But we don't know if this is in fact the case, but if it is we don't know whether it is more or less.  This is why we suggest only making one change at a time, ie not reducing at the same time as changing form of the drug.  I know you didn't do that, it was just an example.

 

My personal opinion is that it would be better hold on 5mg.  Hopefully you'll see some more improvements in the next week.

__________________________________________________________

 

Please note that when making an increase we suggest making a small increase.  Going from 5mg to 5.3mg is a 5.66% increase and would most likely be too big a jump up.

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Finn25

Thanks @ChessieCat . Just to clarify because I didn't fully explain in the last post. I was on a particular generic, switched to a different generic for 3 days, then switched back to the original generic after I reacted poorly. So it was this:

 

Old generic 5 mg for 60 days: symptoms slightly increased in the latter 30 days

New generic 5 mg for 3 days: symptoms significantly increased

Back to generic 5 mg for 16 days

 

Don't know if that changes anything, as you may still consider that a dose change event.

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ChessieCat

Thank you for reminding about that.  I hadn't gone back over your posts before commenting.

 

Yes, any change is a an event.  If it happened that the new generic was a different dose to the old generic it means you could have increased then decreased then increased again or decreased then increased then decreased again.  And it's possibly you had a bad reaction to some other component in the tablet other than the drug, so it could have been a dose change and a bad reaction.   However, we don't know so it's no good worrying about it.  That is only going to add stress.  It's an unanswerable question.  Unless you want to spend money getting the doses checked by a lab 😊

 

And now that I've been reminded of the situation, if it was me, I definitely would not be increasing the dose.  Hang in there, you've just hit a rough patch and hopefully will be back to smooth/er traveling soon.

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Finn25

Quick update as I've gotten myself into a rough way. I tried a small updose on 2/20 to 5.2 and stayed there for 10 days. My symptoms were consistent with the previous 2 weeks. It was like I was cycling 24 hour wave/windows. The waves have been the worst I've experienced. Irrational anxiety, sleeplessness, agitation, unable to be still, burning, pressure sensation in my head. Then after a horrible day on Friday 3/1, I made a very panicky and desperate decision to updose all the way to 10 mg. Today is my 4th day to take 10 mg, and I now realize what a mistake that was. In the wave/window pattern I was experiencing, this was supposed to be the "window" night, but instead, I'm as worked up and agitated as I've ever been. Feels like I'm in a tailspin and I'm losing the able to function. I'm really frustrated with myself right now for not following the advice of ChessieCat. In my head, I can't stop dwelling on what dose I should take tomorrow, and going forward. Any advise on what it should be? If I need to provide any more details on my symptom pattern, just let me know. Thank you

 

 

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ChessieCat

You could try going back to the previous dose OR going midway, 7.5mg.  It takes about 4 days for a dose change to get to full level in the blood and a bit longer for it to register in the brain.

 

You've made 2? dose changes as well as generic drug changes, A to B than back to A.

 

Only you can decide what to do.  I've just provided some options.

 

I imagine that you will be feeling the impact of the changes for a few weeks.

 

Please post your daily symptoms notes here in your topic.

 

Remember, only make one change at a time.  I suggest that you don't go adding in anything else at this time.  It will only confuse things.

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Vonnegutjunky

I hope you find relief soon Finn! 

Many people on here are trying to stablize and it can be quite difficult! 

But not impossible! 

 

your not alone! 

Take care! 

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Finn25

So I wanted to give an update as to where I ended up.  I made the decision to go back to 6 mg and have been holding there for 16 days. Since then, it seems like I've gotten my footing back some. But I still have the symptoms that started the wave in January. 

 

The Good: Sleep has gotten much better, getting 6-7 hours a night for the last 10 days or so. Restlessness is practically gone. Appetite has returned for the most part, however, having lost so much weight in such a short time still causes anxiety for me for some weird reason. But, appetite is getting there.

 

The Bad: Blurry vision continues to plague me. It does tend to go up and down in intensity, so I believe it to be WD-related which gives me hope that it'll abate, but it's such a consuming symptom for me, and it doesn't seem to fall into the same window/wave pattern as my other symptoms. I had my eyes checked in January when it started in earnest, but it checked out ok.  I'm considering getting a second opinion if I don't improve.  The issues usually begin with a blind spot showing up in one of my eyes, kind of like a migraine aura. Then it will move around, or switch eyes if it starts early enough in the day. Sometimes it will start first thing in the morning, sometimes it'll start around midday.  If it does get better, I will sometimes get a headache of varying intensity afterward, again indicating it could be a migraine variant. I'm coming up on 3 months for this symptom.  I've dealt with an eye twitch that was pretty pesky for a couple of months, so I'm hopeful this will run it's course and start to fade. I also still have head pressure/pain, and I get a really weird hot, twitchy feeling on the left side of my head just above the ear. It almost feels like the hair on my head at that one spot is standing up. So strange. 

 

I again apologize for being neglectful in posting daily symptoms. I have to sit at a computer screen all day at work, and so combine that with my blurry vision issues, I try to limit "screen time" at home at night. I think I know the answer to this, but would the prevailing advice be to stay at 6 mg to stabilize for the next few months? That is my plan at this point, but just wanted to make sure the wiser individuals in this forum agreed. Thank you

 

 

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Altostrata

Thanks, Finn. It sounds like for now, 6mg is doing the trick. Please update your signature.

 

It may take some time for your system to settle down from prior drug changes. See The Windows and Waves Pattern of Stabilization

 

A lot of people find fish oil and magnesium supplements helpful, see
http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/
http://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

Try a little bit of one at a time to see how it affects you.

 

Do you find you are sensitive to light? If so, you might want to wear tinted glasses while looking at computer screens, see

 

Light-sensitive? Try blocking out blue light

 

Computer Program Adjusts Blue Light to Time of Day

 

Light flashes made me sick?

 

Are you getting regular gentle exercise? That may reduce the hypersensitivity Inactivity may make sympathetic nervous system hypersensitive...

 

Please let us know how you're doing.

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ChessieCat
20 minutes ago, Finn25 said:

I have to sit at a computer screen all day at work, and so combine that with my blurry vision issues

 

I bought and use blue light glasses, AKA gaming glasses, as I have a lot of issues with the light now.  When I don't wear them I notice a "flare" or blurriness on the text on the computer screen (depending on which computer screen I am using) and can't focus on it.  I find them very helpful and struggle on the days that I forget to bring them to work.  I wear prescription glasses and was able to buy over glasses.

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Finn25

It doesn't seem like my issues are with light sensitivity, per se. But I'll definitely look into getting some gaming glasses to see if it helps. Thanks so much!

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ChessieCat

They are not expensive, in the US at least, so it would be worth trying them out.  I had to get mine mailed and even though they were cheap the postage cost was double the cost of the glasses.  But they have been worth it.

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