MiguelFreeman: question about Lexapro

[Shep]

20 hours ago, MiguelFreeman said:

do i  try to take the lost dose possible and stabilize in that before i start any taper ?

 

Yes, if you feel you're dependent on Xanax, then you would pick the lowest dose needed to be comfortable, stabilize for several weeks, and then start a taper. You may wish to do a micro-taper since you're still recovering from prior drug withdrawals. 

Micro-taper instead of 10% or 5% decreases

 

What time(s) of day to you take Xanax? Please list the time o'clock. 

[MiguelFreeman]

@Shep Normally I take it when I start getting anxious around 9 o'clock that's when i take 0.125 mg  then try to hold as long as possible until the anxiety starts ramping up and then take the other dose normally its in the afternoon 

i was quite stable on that schedule but after taking that one tablet of Lexapro i can feel my cns is sensitive since i am waking up whit cortisol spikes like i had in the past 

and my anxiety elevated from a 4 to a 7 

Just to inform you that i was on the 0.5 xanax xr  for 1 week around 02/2023 after that week i went back to standard Xanax  since XR was 2 strong 

i have now realized the mistake i did taking this drug it did help with the panic attacks but i, unfortunately, took it for 2 long since i had lost quite alot of weight from my increased anxiety my close relative the lives whit me (my mother) was constantly nagging me to take it and i fail to realize the mistake i was doing 

[MiguelFreeman]

today was able to stay at 0.25 split in 2 doses one taken in the morning around 9:30 am the other one i held has long as possible until  i started feeling anxious and having muscle spasms and i took it around 10:3 pm

 

now that i realized the huge mistake i did am scared 

 

[6ofclubs19]

Hi MiguelFreeman, just browsing your thread and wanted to say sorry you’re going through this. Sounds like you’re also under a lot of stress too. I don’t really have any advice as I’m just an observer, but I am sending you healing vibes, I know you can get through this. Maybe take a soak in the tub in some epsom salts for 20 minutes. That helps me sometimes. Good luck. 

[MiguelFreeman]

@6ofclubs19 Thank you for your kind words unfortunately last year i was under a lot of stress from work and at home which caused me to fall back to my old problem of depression that in turn turned into anxiety that escalated to panic attacks after i fell sick whit gi issues after a food poisoning while testing for the causes of my gi issues i had some parasites and h, pylori that i picked up in a restaurant probably, but while testing for that i complained to my gp about my aching lower glute she dismissed it has been normal pain from my work

(i am a car Bodyworker) but since i have lost confidence in her i decided to see a private doctor that in turn found out something was wrong whit my SI joints, after doing a cat scan they grew suspicious,did some blood work and a MRI that confirmed that i must likely have ankylosing spondylitis, that can also affect the gut by developing into IBD , i recently quit my current job after getting a better job offer so in terms of stress from that work is gone but now my main concern is my health and getting rid of the Xanax that i have been on for the last 2.5  mouths 

 

maybe if i had the opportunity to have had therapy done while i was taking lexapro maybe i would have had the tools to deal whit all of this preventing my mental health from going downhill,i did hold 3 + years where i was alright  but this recent mouths really did a dent on my mental health and after losing almost 22 pounds it even made it all worse 

 

but fortunately, i am currently going to therapy and will probably start going once a week to be more intense 

and hope this new job won't have quite a high level of stress 

getting closer to my 25th anniversary hope by then i am in a better place mentally 

[Shep]

12 hours ago, MiguelFreeman said:

today was able to stay at 0.25 split in 2 doses one taken in the morning around 9:30 am the other one i held has long as possible until  i started feeling anxious and having muscle spasms and i took it around 10:3 pm

 

now that i realized the huge mistake i did am scared 

 

 

Xanax has a half-life of 6 - 12 hours, depending on how fast you metabolize it. So you may be getting interdose withdrawal symptoms, which means you're going into withdrawal in between doses due to the short half life. 

 

Some people find they need to take their total daily amount of Xanax and divide it out 3 or 4 times a day to prevent interdose withdrawal symptoms. You may want to take the total amount you wish to take during the day and divide it into 3 or 4 doses, evenly distributed throughout the day and evening. 

 

You may wish to keep a journal (either here in your thread or on paper) with the times you take it and how you feel before and after each dose. This can help you decide the best schedule for your symptoms. You can read more about journaling your drug and symptoms here - Keep notes about your drug dosages and daily symptom pattern

 

There's nothing to feel scared about, Miguel. There are many success stories of people who've come off benzos and other psych drugs. There's no reason to think you won't heal. 

 

Success stories: Recovery from psychiatric drug withdrawal

[MiguelFreeman]

Thank you @Shep for helping me i did heal from Lexapro  but the horror stories from Benzos made me quite depressed 

i have noticed that 0.25 is the total dose where i am comfortable, i was taking it in 2 half  today i took it quite late around 12:20  

so my question is shude i divide the dose even if I don't have symptoms, for example, shude i try a lower dose then 0.25  or just split up the 0.25 in 4 parts and take for example 3 parts and the 4 part if i feel the symptoms or just take the 0.25 in 4 parts for now and then think about tapering 

 

Sorry about my grammar but it's been a while since i wrote  big texts in english 

[Shep]

First, your grammar is fine. We can understand what you're writing. 

 

The most important thing is to be consistent with your dosing. This means setting a schedule and taking the same dose at the same times every day. If you want to take .25 mg four times a day, take it four times a day at the same times every day, regardless of how you feel. In the long run, this is best. Withdrawal comes in windows and waves, so you may have one day where you're having more symptoms than other days. But don't adjust your benzo to handle waves. Doing so will cause uneven fluctuations of the drug in your system and make it harder in the long run. 

 

Another thing to keep in mind - the more you divide the dose up, the lower the peak concentration amount will be. For example, if you only dose once a day, that full amount of .25 mg will be stronger than if you divide it out and take .0625 four times a day. 

 

Some people like to take a higher dose at night for sleep and only take a smaller amount earlier in the day to keep away interdose withdrawal. 

 

But whatever you decide to do, the important thing is to be consistent and take the same amount at the same times every day. 

[MiguelFreeman]

@Shep ok thinking about doing  1  in the morning after i get to work around 8 am the other around 13 o.clock the other one at 17 am at the last dose at 10pm

gona try this for a couple of days and keep a jornal  might post here but don't wonna spam in here  so we chould have  constante comunication stream 

 

once again tnx for your help

 

[Shep]

Please also make sure you're eating healthy, drinking plenty of water, taking a walk outside in the sun every day, doing some gentle stretches or yoga, etc. All of this is important during withdrawal. 

 

Please keep us updated with how you're doing as you set up your schedule. 

[MiguelFreeman]

@Shep i have notice that i lacked in those good habits once the depression came back i lacked so basicaly my life was work and home and staying in the pc all day 

now i am gona start slowly changing those bad habits  trying to make a habit to meditate at night and jornaling  its going slow but whit time they will became habits i need to have a very strong support sythem to prevent me from ever again falling in depression and anxiety loop 

[MiguelFreeman]

@Shep hope you doing great ,so far things are going good i followed your advice on deviding the dose and felt quite nice no real anxiety today quite calm had just a bit in the morning but other then that was fine 

in your opinion what whould be the recomended time to hold in this dose and schedule ?

[Shep]

11 hours ago, MiguelFreeman said:

@Shep hope you doing great ,so far things are going good i followed your advice on deviding the dose and felt quite nice no real anxiety today quite calm had just a bit in the morning but other then that was fine 

in your opinion what whould be the recomended time to hold in this dose and schedule ?

 

Glad to read you're doing better, Miguel. Here is a great post to help you decide when you should taper - you'll want to be at what Brassmonkey calls "withdrawal normal":

 

Withdrawal Normal

 

 

[MiguelFreeman]

@Shep hi shep tnx for linking me that post it showed me a new light on the subject so far i am gona hold doing this 4 times a day since i am about to leave my job and starting anoter one so gona hold for now and keep a jornal of my symptoms ,but so far is just anxiety in the morning on a scale of 4 /10 and during the day is quite stable some days a bit more other days a bit less anxiety so in the end of the mouth i will see 

 

but lest imagine in the end of the mouth if decide to start the taper do i just take one of those halfs from the day 

insted of taking 4 parts i only do like 3 and dont take the other one ?

 

when i was tapering lexapro i had it in liquid form and was using a diabetic syringe to measure 

but whit xanax i only have the pill 

 

[Shep]

16 hours ago, MiguelFreeman said:

but lest imagine in the end of the mouth if decide to start the taper do i just take one of those halfs from the day 

insted of taking 4 parts i only do like 3 and dont take the other one ?

 

when i was tapering lexapro i had it in liquid form and was using a diabetic syringe to measure 

but whit xanax i only have the pill 

 

Are you able to get liquid Xanax in your country? The liquid formula is the easiest to taper. You may want to check in with your doctor and see if it's available. Let us know. 

 

Please update your signature with your Xanax start date and dose. 

[MiguelFreeman]

@Shep the liquid from is not available in my contry and my doctor wanted me off xanax (so she gave lexapro again )so even it it was i doubt she whould proscribe it 

the only thing i have is pill form but since i have been taking xanax since january 16 i thought it taper whould not be that hard 

[MiguelFreeman]

So far things are going greate the anxiety is not spiking out of the normal only in new situation it gets a bit higher but nothing that is above a 5/10

Just worried about the taper since its been around  2 months, 27 days since i started xanax 

was on rx 0.5 for one week and then back to 0.25 normal xanax 

thats one of the reason i am in doubt if i shude wait a bit more before the taper 

 

[Shep]

12 hours ago, MiguelFreeman said:

@Shep the liquid from is not available in my contry and my doctor wanted me off xanax (so she gave lexapro again )so even it it was i doubt she whould proscribe it 

the only thing i have is pill form but since i have been taking xanax since january 16 i thought it taper whould not be that hard 

 

It only takes 2 - 4 weeks to become dependent on Xanax, and once you're dependent, you're dependent. So even though you've only been on it for 3 months, that's more than enough time to become dependent. I would still use a very slow taper to get off it, especially since you're still in recovery from antidepressant withdrawal. Please be gentle with your nervous system. 

 

Are you more comfortable tapering Xanax by liquid or by using a scale? Here is information on both:

 

Using a scale to weigh and measure doses

 

How to make a liquid from tablets or capsules

 

Once you decide which method you'd like to use, please let us know and I can provide more detailed information to get you started. 

 

 

[MiguelFreeman]

@Shep going for sulution since i made something similar before i had the liquid lexapro

but wonder how i will do it whit xanax since its quite smaller dose compared to lexapro 

[Shep]

2 hours ago, MiguelFreeman said:

@Shep going for sulution since i made something similar before i had the liquid lexapro

but wonder how i will do it whit xanax since its quite smaller dose compared to lexapro 

 

 

Because Xanax won't dissolve easily in water, you can add propylene glycol at a concentration of 1mg/mL.

 

Or you can use Vodka. You will only need a tiny amount of Vodka to dissolve the pill. Since you're only taking .25 a day, 1 mL of Vodka will likely be enough. 

 

After you dissolve the pill in propylene glycol or Vodka, you would then add water. 

 

Please note - not everyone uses propylene glycol or Vodka. Some people simply use water and mix the pill as best as possible. This creates a suspension, as supposed to a solution. 

 

Here is a really great video that shows you how to do a liquid benzo taper:

 

Use water to taper your benzo! video (4.5 minutes)

 

Here are some helpful tips:

 

Top 5 Water Tapering Questions Answered

 

 

Please post if you have any questions. 

 

Edited April 13, 2023 by Shep
added information

[MiguelFreeman]

i watched the video and was bit confused since when i tapered lexapro i used 10 ml and 10 mg pill 

but doing it whit water  whit xanax i need your help for this cuz i didnt realy get the dosage of water she was using 

+ do i  dose multiple times a day or do i switch to a single take per day when tapering whit liquid 

can you help me out finding the  water and medication ratio becouse i am  bit confused 

@Shep i rather go whit water since i am not realy confident in using pg or vodka 

will the suspencion work the same ?

if so can you guide me on the ratio of water to drug and 

how many times a day 

 

i am quite alot more carefull now becose its a benzo and they can kill 

while on lexapro i knew that if i f up i whould only mess my taper a bit 

[MiguelFreeman]

Today after taking my first dose of the day i had a spike in anxiety after taking the dose whit chest presure and lump in the troath feeling 

is this a sigh that i am not ready to taper or some rondom reaction 

i did take the dose 1 hour and half latter then usual (forgot to take it )

 

[Shep]

 

15 hours ago, MiguelFreeman said:

do i  dose multiple times a day or do i switch to a single take per day when tapering whit liquid 

 

If you need to take Xanax two or more times a day in order to not have interdose withdrawal, you can still do this with liquid.

 

Some people will only take one dose in liquid and the other doses in tablet and use the liquid dose to taper. Or you can take all doses in liquid and remove an equal amount from all doses. There are many ways to set up your taper.

 

The first step is to stabilize on a set schedule. Once you do that, we can talk about the best way for your taper off. 

 

2 hours ago, MiguelFreeman said:

Today after taking my first dose of the day i had a spike in anxiety after taking the dose whit chest presure and lump in the troath feeling 

is this a sigh that i am not ready to taper or some rondom reaction 

i did take the dose 1 hour and half latter then usual (forgot to take it )

 

 

I agree - this is a sign that you're not ready to taper. I'm glad you're also noticing this. It's okay to wait and until you're on a set schedule and feel ready to taper. 

 

This post may help you decide when it's time to taper:

 

Withdrawal Normal

 

How many hours are you sleeping at night? 

[MiguelFreeman]

@Shep tnxf or the post above corrently i am sleeping around 7 and half hours  sometimes 7 hours but still clearing up my sleep hygine

and i dont wake up in the middle of the night  

 

[Shep]

1 hour ago, MiguelFreeman said:

@Shep tnxf or the post above corrently i am sleeping around 7 and half hours  sometimes 7 hours but still clearing up my sleep hygine

and i dont wake up in the middle of the night  

 

 

This is excellent, Miguel. Were you sleeping this well before you added in Xanax back in January? If not, when did your sleep improve? 

[MiguelFreeman]

@Shep i was sleeping worse before january after xanax it improved a bit at least i didnt wake up in the middle of the night ,it improved after the first week and now its better since i quited my stressfull job ,so now i 100 %focused on my health 

in your opinion shude i wait until i get this phase of the new job pass and then start the taper or just relax at this dose 

still having some anxiety spikes expecialy when i have to resolve some issue or something new 

had to stop therapy for now since i am changing jobs the insurence in changeing also 

but the new insurence will cover better therapyst 

 

Hope you doing well

[Shep]

@MiguelFreeman While you're going through so many life changes, yes, it may be good to stop tapering and hold. Once you're at an even baseline after all of the life changes, than you could make a micro-taper of say 3 or 5% to test how you do. 

[MiguelFreeman]

@Shepok i agree after i stabelise on my new job and get the final verdict of my AS diagnosis i will see how i fell and will start the taper but will ask for advice when i start on how to do the water titration to taper and what relasion of water to drug i shude do etc 

one again thank you for your time and for helping me

hope you are doing well and wish you the best 

[Shep]

10 hours ago, MiguelFreeman said:

get the final verdict of my AS diagnosis

 

Miguel, what does "AS" stand for? 

[MiguelFreeman]

@Shep Ankylosing spondylitis    they are suspecting i have it and my MRI scan confirms i have inflammation on my si joints  Ankylosing spondylitis - Symptoms and causes - Mayo Clinic

 

[Shep]

14 hours ago, MiguelFreeman said:

@Shep Ankylosing spondylitis    they are suspecting i have it and my MRI scan confirms i have inflammation on my si joints  Ankylosing spondylitis - Symptoms and causes - Mayo Clinic

 

 

I'm sorry to read this, Miguel.

 

Are they prescribing additional medications to help with this? If so, you may want to enter them in this drug interaction checker to make sure it's safe to take what they're prescribing.

 

Drug Interaction Checker

[MiguelFreeman]

@Shep Well still have to go to one more appointment to see if it's confirmed and then i will discuss what my rheumatologist  what are the options 

but i am currently taking Esomeprazol 20 mg once a day but i need your advice the doctor the gave me this didn't seem like a good doc i had an Endoscopy done and i had moderated chronic gastritis  and h pylori but i had also some Entamoeba coli that she treated whit metronidazole but after i finished that she didn't get me off esomeprazole 

and told me i needed to do another endoscopy and one colonoscopy (also did some blood work to test for IBD and it came back  negative except for one that was inconclusive 

i am considering stopping the esomeprazole since i have been taking it for 5 months now and going to a private GI doc to get a second opinion 

do you consider this a good plan 

I did not feel confident about the quality of care of that doc 

 

[Shep]

@MiguelFreeman If you don't feel confident about that doctor, than yes, a second opinion is always a good idea. I'm glad you're being a good advocate for yourself. That's really important. 

 

Please be careful coming off the esomeprazol, if you decide to do so. This thread will give you the information on tapering this drug:

 

Tips for tapering off stomach acid blockers or PPIs (esomeprazole, lansoprazole, omeprazole)

 

Here are the instructions from that thread:

 

On 5/23/2013 at 6:02 PM, Altostrata said:

How to taper a stomach acid blocker or PPI

Tapering an acid blocker is easier than tapering a psychiatric drug. The reason you taper PPIs is to avoid rebound acid production, not withdrawal. A gradual taper allows your digestive system to adapt. You can taper faster than with a psychotropic drug.

 

To allow your stomach to regain natural acid production and prevent rebound reflux,  my guess as a medical non-professional is a good rate would 25% per week. If you get rebound reflux, stop decreasing, let your digestion settle down, and take taper by smaller amounts than 25%.

For example, to taper Prilosec OTC, I would open the Prilosec OTC capsule, carefully pour 1/4 out, put the capsule back together, and take the other 3/4. Do this for a week. Then pour more out a half, take 1/2 capsule for a week. Then take 1/4 capsule for a week. After that, stop taking the drug.

 

If you do need to come off the esomeprazol, do so when you're not making any changes to the benzo you're currently taking. Only one change at a time. Please see:

 

The rule of 3KIS: Keep it simple. Keep it slow. Keep it stable.

[Altostrata]

You need to get h pylori and other stomach infections treated, @MiguelFreeman Esomeprozole is not a treatment for infections.

[MiguelFreeman]

@Altostratai will do that  trying to get good insurance now since i switched jobs 

been having a lot of diarrhea and pains in the gut don't know if its ibs (still have inconclusive blood results for IBD) 

 

my anxiety went true the roof recently  had to bump up 0.312 mg of Xanax so one pill and a quarter since am having gi problems and have no access to premium health care now until i fix my insurance problem it might take 2 mouths  

the NHS from Portugal is good but mental health is still lacking 

and i didn't like the way the gi doc from there treated me so am gonna resort to the private health care system

 

been taking esomeprazole for 5 months while being h pylori positive but no treatment directed to h pylori 

at the time the gi doc said that 90% of people had it and shude only worry if i had a family history of stomach cancer

but at the time my biopsy results already showed moderate gastritis 

 

 

[Shep]

12 hours ago, MiguelFreeman said:

my anxiety went true the roof recently  had to bump up 0.312 mg of Xanax so one pill and a quarter since am having gi problems

 

Be careful upping the Xanax. This can cause more problems in the long run. 

 

Are you able to use ginger tea or other non-drug remedies for GI issues?