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Dmm: Changing meds - lexapro stopped working after 13 years


Dmm

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I was on lexapro for 13 years. It has been an amazing drug for me. I have only been off it once 8 years ago and I had to go back on it straight away after my anxiety started again.

The last 12 months have been horrific because lexapro proved no longer effective despite my dose being increased from 10 to 20mg. The doctor then added mirtazapine which only helped with my sleep. He has tried to take me off lexapro 5 times and swap me onto another drug but each time I have plummeted. Most recently he swapped me from 5mg lexapro to 10mg citalopram and 10mg burspirone. After two weeks I started to feel swaddle. I was advised to reinstate lexapro at 10mg five days, stop citalopram and burspirone. So far the reinstatement hasn't improved things even though it did previously. Is this because reinstatement at higher dose or coming off citalopram or burspirone after two weeks?

Do you have any advice? I feel so extreme and trapped. My tingling in my face, head and arms is horrific as is the fear that comes over me and the upsetting thoughts.

Please help.

Thanks

D

Edited by scallywag
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  • Moderator Emeritus

Dmm -- Welcome to Surviving Antidepressants (SA)

I've moved your post to the Introductions Forum so that more people will see your question.

Lexapro is a powerful anti-depressant. I'm not surprised that you've had difficulty switching from it to another medication. Despite the Lexapro having stopped working, you are likely experiencing withdrawal from having discontinued Lexapro.

Educational topics on psych meds withdrawal:
Tapering -- what you need to know.
Glenmullen’s withdrawal symptom list.
How your brain responds to psychiatric drugs - aka "Brain remodeling"
Tips for tapering off Lexapro (escitalopram)

Some questions for you:

  • What were your symptoms that led to the conclusion that Lexapro had stopped working?
  • At one point in the last 12 months you were on Lexapro 20 mg. When was that?
  • What were the dose changes to get to 5 mg and when did they occur?
  • When did you make the switch from 5 mg Lexapro to 10 mg citalopram + 10 busipirone?
  • When did you reinstate to 5 mg Lexapro?
  • When did you discontinue citalopram and busipirone?
  • Are you still taking mirtazapine?
  • Are you taking any supplements?  If so, please list those.
  • What is your goal: Are you looking for medication recommendations or for suggestions about how to safely discontinue medication?

Please post the answers to those questions in a reply as well as in a posting signature as follows:

Summarize your history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.

  • Any drugs prior to 24 months ago can just be listed with start and stop years.
  • Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago)
  • Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016.
  • Please leave out symptoms and diagnoses.
  • A list is easier to understand than one or multiple paragraphs.
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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.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results

Cymbalta 60 mg 2012 - 2015; 2016: 20 mg to 7 mg exact doses and dates in this post; 2017: 6.3 mg to  0.0 mg  Aug. 12; details here


scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet

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Thank you so much for your reply.

1.i started feeling very anxious - not sleeping, shaking, racing thoughts.

2. I was on lexapro 20mg from May 2016 until August 2016 when I started tapering over three weeks before stopping it.

3. I reinstated lexapro at 5mg after trying to switch five times. Each time after 1 week of stopping it.

4. I stopped lexapro 3 weeks ago and started citalopram at 10mg and 5mg burspirone. After two weeks I started feeling bad so stopped citalopram and started lexapro at 10mg and stopped burspirone.

5. I reinstated lexapro five days ago.

6. I stopped citalopram 5 days ago and burspirone three days ago.

7. Yes 45mg.

8. No

9. I am looking for a replacement for lexapro, but feel I need to stay on a very low dose of it in the meantime.

 

Thank you so much xxxxxxx

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Welcome Dmm!

 

I found it difficult to understand in a liner manner your meds history and the symptoms happened in relevance of your meds.

It is best if you can list all you meds including time and dose along with major symptoms in your signature so everyone can get a quick info in your future post.

 

Thanks

Lex

Drug free Sep. 23 2017

2009 Mar.: lexapro 10mg for headache for 2 weeks.

2009-2012: on and off 1/4 to 1/3 of 10mg

2012 June--2013 Jan,: 1/4-1/3 of 10mg generic, bad jaw pain

2013 Jan-Mar: 10 mg generic. severe jaw and head pain;

2013 Mar--Aug. started tapering (liquid ever since) from 10 to 5 (one step) then gradually down to 2.25 mg by July. first ever panic attack, severe head/jaw pain

2013 Aug.: back to 2.75 mg; Nov: back to Brand Lex. 2.75mg -- 3mg,

2014 June: stopped PPI, head pressure/numbness. up-dosed 4.5mg, severe reaction mental symptoms added on

2014 Aug--2015 Aug: Micro taper down to 3.2mg, .025mg (<1%) cut holding 2-3 weeks.

2015 Aug 15th, Accidental one dose of 4.2mg. worsening brain non-functional, swollen head, body, coma like, DR

2016 Feb., started dosing 10am through 11 pm everyday 2/13--3.2mg, 3/15-- 2.9mg, 4/19-- 2.6mg, 6/26--2.2mg, 7/22 --1.9mg, 8/16--1.8mg,8/31--1.7m g, 9/13--1.6mg, 9/27--1.5mg, 10/8--1.4mg, 10/14--1.3mg, 11/1--1.2mg, 11/29--1.1mg, 12/12--1mg, 12/22--0.9mg

2017: 1/7--0.8mg, 1/15--0.7mg, 1/17--0.6mg, 1/20--0.52, 1/21--0.4mg, 1/22--0.26, 1/23--0.2, 2/13--0.13mg, 2/20--0.06mg, 3/18--0.13mg, 6/1--0.12mg, 7/6--0.1mg, 7/14--0.08mg, 8/17--0.04mg, 8/20--0.03mg, 8/28--0.02mg, 9/6--0.0205mg, 9/8--0.02mg, 9/17--0.015mg, 9/20--0.01mg, 9/21--0.0048mg, 9/22--0.0001mg,

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I have just written an extremely detailed post in my signature, but it doesn't seem to be there now? Can you explain how I save it?

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  MISSION ACCOMPLISHED:    (6 year taper)      0mg Pristiq      on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

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 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Hi Dmm, how are you feeling today?

I've started taking antidepressants in 2001. I took Cipramil for 3 years. Elflexor for 1 year. Lexapro 10mg - 20mg since 1992 approximately.

 

STARTING DOSE 20mg Lexapro 2016

 

19mg Lexapro (3rd January 2016)-Taper 5%

18mg Lexapro (8th February 2O16)-Taper 5%

17mg Lexapro (? March 2016) - Taper 5% -

16mg (16th May 2016) Taper 5 %

17mg (21st August 2016) + 5%

16mg (3rd January 2017) - 5%

15mg (4th February 2017) -5

14mg (6/02/18) -5%

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  • Moderator Emeritus

Hi DMM, your poor nervous system is struggling to stabilise after so many changes. 

 

I am tring to work out the details, thank you for answering Scallywag's questions. 

 

Lexapro 20 mg , tried to switch 5 times, what did you switch to those times? 

 

Reinstated 5mg after each of those times, can you tell us when they were, over the 13 years or recently?  How long were you taking 5mg?

 

In last 12 months

 

 

Lexapro doubled from 10 to 20mg because it was no longer working.  

 

Mirtazepine 45mg

 

Feb 2017

 

STOP Lexapro

 

Citalopram, 10mg Buspirone 5mg  for 2 weeks then stop

 

Reinstate lexapro 10mg

 

Currently 10mg lexapro 45mg mirtazapine.

 

I am sorry about all the questions, we need the details to build a picture. So far it looks to me like the problem started when the dose was doubled and you did not get any better. 

 

Often doctors double a  dose when on reality the dose needs reducing. After some time on a drug the body starts to reject it, doctors believe it is the illness worsening and increase the dose which doesn't help and majes things worse, so other drugs are added. It happens all the time! 

 

It is likely that you would have felt better if the dose was lowered in very small increments. 

 

There are major interations between lexapro and mirtazapine, and doubling lexapro then adding mirtazapine would have made you feel unwell. 

 

This is from the interactions checker from drugs.com

 

https://www.drugs.com/interactions-check.php?drug_list=1640-0,1013-565

 

For now I would stick with the 5mg of lexapro, switching to something else now will likely  not help and could make things worse. If you could answer the extra questions that would be very helpful. I am sorry that you are feeling so bad, you will get better but will take time. Your nervous system and brain need to stabilise, they are trying to re establish themselves and will get there if they are allowed to recover.  I am going to ask  the others to take a look, I have something in mind but want to run it by someone more experienced. 

**I am not a medical professional, if in doubt please consult a doctor with withdrawal knowledge.

 

 

Different drugs occasionally (mostly benzos) 1976 - 1981 (no problem)

1993 - 2002 in and out of hospital. every type of drug + ECT. Staring with seroxat

2002  effexor. 

Tapered  March 2012 to March 2013, ending with 5 beads.

Withdrawal April 2013 . Reinstated 5 beads reduced to 4 beads May 2013

Restarted taper  Nov 2013  

OFF EFFEXOR Feb 2015    :D 

Tapered atenolol and omeprazole Dec 2013 - May 2014

 

Tapering tramadol, Feb 2015 100mg , March 2015 50mg  

 July 2017 30mg.  May 15 2018 25mg

Taking fish oil, magnesium, B12, folic acid, bilberry eyebright for eye pressure. 

 

My story http://survivingantidepressants.org/index.php?/topic/4199-hello-mammap-checking-in/page-33

 

Lesson learned, slow down taper at lower doses. Taper no more than 10% of CURRENT dose if possible

 

 

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  • Moderator

Hey Dmm -

 

Wow.  While your original drug did stop working (and this frequently happens starting at around 5 years, sometimes sooner, sometimes later) - what your doctor did next was probably the source of your severe symptoms.

 

Each change that was made to drugs, shook up your brain and nervous system (and endocrine system & digestion, too, truth be told).  It can sometimes take 6 months to a year to settle from those kinds of changes.  We don't consider a 3 week taper to be a safe taper at all.  You were destabilized from a too-fast taper from the Lex when they gave you Citalopram, which didn't cover your withdrawals.

 

It will take awhile for the whole thing to settle down, and keeping things stable are key.

 

I think that MammaP is onto something when she talks about the interactions between Lexapro and Mirtazapine. 

 

When we get your signature with doses, changes, and dates and a better understanding of what has happened to you, we may be able to suggest a course of action for you to try.

 

Are you interested in getting off of the drugs?  This is a site for tapering, reducing, or eliminating drugs.  There are no other drugs which will make you feel better now.  Lexapro is the strongest one.

 

Stay at the same doses while we try and sort this out.

 

And this is a good time to work on Non-Drug Techniques for coping with Emotional Symptoms:  http://survivingantidepressants.org/index.php?/topic/1112-non-drug-techniques-to-cope-with-emotional-symptoms/

 

In the meantime, stay at your same doses, keep your lifestyle as simple as possible to support you through this difficult time.

 

I hope you see the sun today.

"Easy, easy - just go easy and you'll finish." - Hawaiian Kapuna

 

Holding is hard work, holding is a blessing. Give your brain time to heal before you try again.

 

My suggestions are not medical advice, you are in charge of your own medical choices.

 

A lifetime of being prescribed antidepressants that caused problems (30 years in total). At age 35 flipped to "bipolar," but was not diagnosed for 5 years. Started my journey in Midwest United States. Crossed the Pacific for love and hope; currently living in Australia.   CT Seroquel 25 mg some time in 2013.   Tapered Reboxetine 4 mg Oct 2013 to Sept 2014 = GONE (3 years on Reboxetine).     Tapered Lithium 900 to 475 MG (alternating with the SNRI) Jan 2014 - Nov 2014, tapered Lithium 475 mg Jan 2015 -  Feb 2016 = GONE (10 years  on Lithium).  Many mistakes in dry cutting dosages were made.


The tedious thread (my intro):  JanCarol ☼ Reboxetine first, then Lithium

The happy thread (my success story):  JanCarol - Undiagnosed  Off all bipolar drugs

My own blog:  https://shamanexplorations.com/shamans-blog/

 

 

I have been psych drug FREE since 1 Feb 2016!

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  • Administrator

Welcome, Dmm.

 

I hope you feel honored! Four fine moderators responded in your topic.

 

Poop-out is very common over long-term use of antidepressants. (It's also called tachyphylaxis, tolerance, adaptation, or habituation.) See http://survivingantidepressants.org/index.php?/topic/14356-targum-2014-identification-and-treatment-of-antidepressant-tachyphylaxis/and other topics on this in the Journals forum.

 

As JanCarol noted, this is a site for going off drugs. We think in terms of off-ramps rather than substitutes for whatever you're taking. We don't seek to treat "depression" -- we aren't doctors and don't know how to do it, anyway -- but to ease withdrawal symptoms so a person can minimize their drugs.

 

I agree with mammaP, I would give 5mg Lexapro a good try. Also, keeping the dosage low will reduce the risk of adverse interaction with mirtazapine.

 

How are you feeling now? Since you reinstated 5mg Lexapro, have any symptoms reduced? 

 

What is your daily symptom pattern? Please keep daily notes on paper of your symptoms, when you take your drugs, and their dosages.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • Moderator Emeritus

Hope you are ok DMM, I just want to clarify that it would be best to stay with 5mg of lexapro for now because changing it would make things worse, as it did when you switched recently. You took 5mg then reinstated at 10mg which would have been too high, lexapro is a very strong drug. And stay at the same dose of mirtazapine. When you're nervous system is more stable you could think about tapering down the dose of mirtazapine. If you don't want to be off altogether a lower dose can be much better. Often less is better but doctors keep increasing and adding drugs.  

 

When I started to taper my drugs the idea was to get off the ones I was taking and try new ones because of the side effects. As the dose lowered I felt better, then discovered through research that the chemical imbalance is a theory and not a fact. This meant I did not need the drugs for life, but needed to taper slowly so that I could get off them without withdrawal. It is about sneaking the drug away so slowly that the brain doesn't notice it.   Let us know how you are getting on.

**I am not a medical professional, if in doubt please consult a doctor with withdrawal knowledge.

 

 

Different drugs occasionally (mostly benzos) 1976 - 1981 (no problem)

1993 - 2002 in and out of hospital. every type of drug + ECT. Staring with seroxat

2002  effexor. 

Tapered  March 2012 to March 2013, ending with 5 beads.

Withdrawal April 2013 . Reinstated 5 beads reduced to 4 beads May 2013

Restarted taper  Nov 2013  

OFF EFFEXOR Feb 2015    :D 

Tapered atenolol and omeprazole Dec 2013 - May 2014

 

Tapering tramadol, Feb 2015 100mg , March 2015 50mg  

 July 2017 30mg.  May 15 2018 25mg

Taking fish oil, magnesium, B12, folic acid, bilberry eyebright for eye pressure. 

 

My story http://survivingantidepressants.org/index.php?/topic/4199-hello-mammap-checking-in/page-33

 

Lesson learned, slow down taper at lower doses. Taper no more than 10% of CURRENT dose if possible

 

 

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