Moonpie: need help and supporting tapering off of Ativan

[Moonpie]

Need Lexapro taper advice

 

In addition to my question about Lexapro tablets when pill weights vary, I have another one. I want to do this right!   will it be okay to taper the .001 every 4 days with Lexapro, or is that too fast? Thank you! 

 

Edited January 2, 2019 by ChessieCat
added new topic title to post

[ChessieCat]

Hi Moonpie,

 

Each member is permitted to have only 1 Introduction topic where they can ask questions and journal their progress.  This keeps a member's history in one place.   Please do not start any more Introduction topics.  I merged another one you made on December 29, 2018.  Thank you.

 

53 minutes ago, Moonpie said:

will it be okay to taper the .001 every 4 days with Lexapro

 

Tapering an AD is different from tapering a benzo.  Your method of tapering every four days would be a very tedious way of doing it.

 

SA's suggested method is to reduce by no more than 10% of the current dose followed by a hold of about 4 weeks to allow your brain to adapt to not getting as much of the drug.  The easiest way to calculate the dose is the multiply the current dose by 0.9  Some members prefer to reduce by less than 10%.  If you reduce by 5%, then multiply the current dose by 0.95.  You deduct the % reduction amount from 100 and then divide by 100.  So a 3% reduction you would multiply by 0.97:  100 - 3 = 97   97 / 100 = 0.97

 

See:  Why taper by 10% of my dosage?

 

Tips for tapering off Lexapro (escitalopram)

 

Brass Monkey Slide

 

Micro-taper instead of 10% or 5% decreases

Rhi's "Start Small, Listen to Your Body" Taper Plan

 

Because you are weighing your dose, you will need to be careful that you don't get your numbers confused.

 

There is some really helpful information about this in using-a-digital-scale-to-measure-doses

 

Here is an example.  You will need to substitute 10mg for the 20 mgai AND your mgpw.  There are posts in the above topic explaining how to weigh a few pills and get the average pill weight amount to use for the calculations:

 

On 12/3/2018 at 11:47 AM, ChessieCat said:

 

BrassMonkey beat me to posting but I'll post anyway because I've broken it down which might help you to understand the concept.

 

active ingredient in a tablet is abbreviated mgai

pill weight of tablet abbreviated mgpw

 

20 mgai = 240 mgpw = 0.240 gpw (what it reads on the scale)

 

To make a 10% reduction you multiply the current dose by 0.9 so you would multiply all figures by 0.9

 

20 mgai x 0.9  =  18 mgai

240 mgpw x 0.9  =  216 mgpw

0.240 gpw x 0.9  =  0.216 gpw (what it reads on the scale)

 

 

 

Edited January 3, 2019 by ChessieCat

[ChessieCat]

I have just read this post by one of the other moderators posted in another member's topic:

 

On 12/29/2018 at 1:12 PM, bubble said:

 

Now I also just remembered to add why I'm not fond of frequent cuts even if they are tiny: as we all know, WD symptoms are delayed. Sometimes mine appear 14 days after the cut. It means I feel very well for 14 days and it would be easy to make another cut and then I would end up with a cumulative effect that would snow ball me really badly. So my strategy is not to make a cut before I have experienced (and ridden through) the WD from the previous cut. This might be something to consider once you get to planning your way forward and based on this experience.

 

[Moonpie]

Does that mean keep making cuts until symptoms appear and then hold until they are gone?  That's what I did with the Ativan.

[ChessieCat]

No, the idea with tapering an AD is to taper so you don't get withdrawal symptoms.  Or if you do, only minor ones.  When you get withdrawal symptoms that are more than minor it means you have reduced too much.  This is what we try to avoid.

[ChessieCat]

1 minute ago, ChessieCat said:

This is what we try to avoid.

 

The reason we try to avoid them is because if this happens too often you can end up destabilising your nervous system.  Once you become destablised it can take a long time to get stable.  In some instances members have not been able to regain stability.

 

[Moonpie]

I am concerned 10% is too much for me or even 5%.  I was soooo sensitive to Ativan.  If I didn't have to work I would try larger doses and see what happens. I can't afford to miss any work.  I cannot remember who suggested I try the .001 but it was a game changer.  That is why I want to try it with the Lexapro.   Before I found this group I was having some very bad withdrawls with the Ativan.  Here is the section in the mircro-tapering post by Altostrata where I got the every 4 days.  "If no withdrawal symptoms, you may be able to reduce by the micro amount more often, such as every 4 days. For most drugs, it takes about 4 days for a change to fully register. If you go faster than that, you might exceed your tolerance for dosage reduction and not know it until it's too late."  Math is not my forte.  I did not understand the formula above about mgai and mgpw.  What % would you suggest I reduce and how long should I hold?  I am a big chicken when it comes to tapering.   Thank you for your help and patience.    

[ChessieCat]

You don't have to reduce 10% you can reduce less.  Did you check out the links I posted before?

 

Brass Monkey Slide

 

Micro-taper instead of 10% or 5% decreases

Rhi's "Start Small, Listen to Your Body" Taper Plan

[ChessieCat]

1 hour ago, Moonpie said:

What % would you suggest I reduce and how long should I hold?

 

You can try any % reduction less than 10%.  How long you hold would depend on the % reduction you make.  Withdrawal symptoms can sometimes take 2 to 3 weeks before they show up which is why 4 weeks is the suggested hold time.  However if you only made a small reduction and you don't get withdrawal symptoms you could reduce the length of the hold.  See Rhi's "Start Small, Listen to Your Body" Taper Plan

 

                              Multiply

% Reduction        Current dose by

0.5%                      0.995

1%                          0.99

2%                          0.98

2.5%                      0.975

3%                          0.97

4%                          0.96

5%                          0.95

6%                          0.94

7%                          0.93

7.5%                      0.925

8%                          0.92

9%                          0.91

10%                        0.9

 

 

If you need help with working out the weighing of your doses I suggest you post in this topic:  using-a-digital-scale-to-measure-doses

 

Once you get set up with the mgai and mgpw then it will be simple for you.

 

 

[Moonpie]

Thank you. Yes I read all the posts you sent me.

[Moonpie]

I am curious in the whole scope of things how does tapering an AD differ from a Benzo.  Thank you. Moonpie

[Moonpie]

Okay, went ahead and took the plunge. Began tapering my Lexapro at .5%. Every 4 days on January 1.   Yes I am a coward lol. I'm just testing the waters and sticking my big toe in. So far so good just finished my sixth day. I am still reading over and working through all the information that was given me.. Froggie is such an inspiration.  Right now I am optimistic. no matter what I will hang in there and keep going. All the advice and the wonderful support I have gotten here has  helped me more than I can say. He go!!!!! Moonpie

[Moonpie]

I just watched a video posted on the website from an earlier date. The link was to a YouTube video on using digital scales. The woman took 5 pills which would be 5 days of dosage for her. she crush them up and wait out the amount she needed individually call her taper. That was the first that I had seen that on the site. Is that something that is recommended? Instead of dry shaving a pill? It was posted on Hibari's page 5 hours ago. 

[ChessieCat]

It's up to you.  Use whatever method you find easiest.  However, it may be easier to crush the pills as BrassMonkey explains:

 

On 1/29/2018 at 7:12 AM, brassmonkey said:

 

Yes you are making sense, and that is the correct dose.  But... the weight of the pill itself is also measured in mg not in grams as you have it indicated.  A pill that weighed 79 grams would be larger than a quarter and very hard to swallow.   for future reference it would be better to refer to the weights  like this:

 

weight of the actual pill or the measured weight of the dose  xxmgpw  milligrams pill weight

strength of the desired dose xxmgai  milligrams active ingredient

 

Might I also suggest that you start figuring your dose using the average pill weight instead of calculating each pill individually. The minute differences in the pills won't make a difference in the dose, it also allows you to crush several pills at one time and just measure out the amount of powder you need at any one time.  You can then do a progressive calculation using the mgpw of the previous dose to calculate the weight of the new dose instead of starting over each time. For a 10% reduction you would multiply the previous mgpw by 0.90 to get the new dose weight.  This greatly reduces the chance of making a math error.

 

 

[Moonpie]

Thank you for your replies.  I am also considering making my own liquid Lexapro.  I watched the video and it is a lot less intimidating than I thought. I think this would be great for measuring liquid.  I feel more comfortable using my own med instead of stitching to a liquid that would be different. Shaving pills isn't as easy with the Lexapro as it was with the Ativan so I think I want to do liquid.  I have orange syringes that go as low as .1 mg and up to 3 ml.  I looked for the links on making your own Lexapro liquid but an unable to find them.  I also have found 60 cc syringes at a farming store that come 2 to a package. 

Here come all the questions:

1. I want to continue to taper at .5mg every 4 days.  It is working.  I am on 10 mg of Lexapro at night.  How much water would I need to dissolve  my pill in and how much would I need to draw out each time?

2.  Will my regular pill in liquid form change the way it is absorbed differently and how it makes me feel?

3. Does any one know if the pharmacy solution you can purchase to use instead of distilled water would make absorption any different.  

I appreciate your help.   Moonpie

 

[Moonpie]

i read through the Ryder's post on making a titration and am still confused number wise.  Could you please help me figure out my amount of liquid int he 10 mg Lexapro and what dose each ml will equal.  From what I read I need to transition even with making my own liquid.  Is that correct?  Not sure how to cut the pills to transition as you described as I have already been shaving them and am on a reduced dose.  I appreciate all your help!  Moonpie

[Altostrata]

Moonpie, a liquid is easier to taper by tiny amounts. You can get liquid Lexapro by prescription from your doctor, see Tips for tapering off Lexapro (escitalopram)

 

Since a change from tablet to liquid can be a little difficult for your nervous system, we recommend taking part in tablet form, such as 5mg (Lexapro comes in 5mg tablets), and part in liquid form for a while, until you taper down to the 5mg tablet. Then you can cut the 5mg tablet in half and continue to take part as 2.5mg tablet and part in liquid, etc.

 

If you have 10mg tablets, one option is to dissolve them in 20mL water. Then you would have 1mg of the drug in 2mL water.

[Moonpie]

I wanted to post an update. Doing great on my Lexapro taper. I wish I had done crushing my pills and measuring the powder instead of shaving off of pills for my Ativan to. This is so much easier! Thank you everyone for your support and help. Just wanted to say slow is the way to go! So worth it!

[ChessieCat]

🐌👍🏼☺️

[Moonpie]

Thank you Shep!!!! Moonpie🤗

[Shep]

You're welcome, Moonpie. I see you did make it over to your main intro thread. Excellent. 

[Moonpie]

Ok I hope I am on the right thread this time!  I wanted to report on my double dosing last Sunday.  I went ahead and took my regular tapered dose Monday night.  Other than a day or two of being super tired and sleeping every chance I got there were no other problems!!  Thank you for your support and encouragement.  Learned a BIG lesson and will be more careful from now on.  Still no repaired van.  Everything is going through red tape still one more step and they can start working on it.  Even though it is a hit financially I am looking at it positively that I am getting a rest from all the extra work I have been doing and  decluttering.  My dog is very happy and isn't having anxiety now that I am home more.  Moonpie☺️

[Moonpie]

Hello everyone, I am still plugging along reminding myself that the tortoise won the race.  This tapering is so crazy as it can throw a loop at any time and a new one at that.  I have a new symptom.  Lately in the afternoons and night I am hit with severe depression to the point i feel pressure in my chest.  I was not put on Lexapro for depression. It is gone by morning and only hits at night. Could I be doing something wrong or is this just another wave to surf?  As always thank you for you help.  Moonpie 

[Shep]

Yes, it could be a wave. When was your last reduction? 

[Moonpie]

It was 5 days ago. Made an error in my date. This has been happening for several months.

 

[Shep]

20 hours ago, Moonpie said:

This has been happening for several months.

 

Did it start after your Ativan jump last November? Perhaps you're still dealing with benzo withdrawal? 

 

Have you had your thyroid levels checked recently to make sure that's not causing upticks in symptoms? 

[Moonpie]

I waited almost 2 months to start the Lexapro taper.  Thyroid levels are perfect.  Does everyone have symptoms months or years after tapering?

[Shep]

21 hours ago, Moonpie said:

Does everyone have symptoms months or years after tapering?

 

Yes, for anyone who becomes dependent on psych drugs, it generally takes many months to several years to completely heal the damage. Please see:

 

Are We There Yet? How Long is Withdrawal Going to Take?

[Moonpie]

Thank you for the links.  They are very helpful. At almost 66 years of age I wonder if I will see the end of my work.  I have one more drug to taper after this.   Since Buspar will be my last one,  is the last drug you go off of harder because then there is  nothing in your system anymore?   I still choose to plug along and be able to function, faster is definitely not better. Appreciate everyone's support and encouragment.  Moonpie

[Moonpie]

 Hoping someone is on this late that can help. More weird stuff. The last three days I have been taking a home mix of equal parts of lemon juice honey and Brandy. I have made it where the entire mix is 3/4 of a cup and I have taken two to three tablespoons before I go to bed.  I am very sensitive to alcohol I do not drink. For my cough. Tonight I suddenly got clammy and sweaty. And now I am having trouble quitting yawning. When it started I was yawning every few seconds. Googled it, bad idea. It says heart attack or stroke but I also found that ssri"s can cause excessive yawning. Need to go to sleep. Was thinking about taking a Benadryl to knock me out but I do not want to make things worse. Help!

[Leo1983]

Hi Moonpig.

 

Sorry to hear you cant sleep, i remember this so vivid. It was awful so i do understand. 

 

I can say YES yawning is a common sympton of SSRIS.

 

Alcohol from my own experience, only ramps up symptoms. I can feel good sometimes whilst drinking however i pay the peive and i notice i sleep less.Also it is well documented that alcohol affects sleep. 

 

Hope this helps. I cant advise on the Benadryl. 

 

Take care 

 

Lee

My apologies Moonpie lol

[Leo1983]

I tried to apologise for calling you Moonpig after i sent the original post however it then merged my apology at the bottom of the post. 

 

Take care

 

Lee

 

[Shep]

7 hours ago, Moonpie said:

 Hoping someone is on this late that can help. More weird stuff. The last three days I have been taking a home mix of equal parts of lemon juice honey and Brandy. I have made it where the entire mix is 3/4 of a cup and I have taken two to three tablespoons before I go to bed.  I am very sensitive to alcohol I do not drink. For my cough. Tonight I suddenly got clammy and sweaty. And now I am having trouble quitting yawning. When it started I was yawning every few seconds. Googled it, bad idea. It says heart attack or stroke but I also found that ssri"s can cause excessive yawning. Need to go to sleep. Was thinking about taking a Benadryl to knock me out but I do not want to make things worse. Help!

 

Since alcohol affects GABA receptors similar to benzos, you may want to avoid it until you've completely healed from withdrawal. Dr. David Healy refers to benzos as "alcohol i a pill". 

 

Many people report that Benadryl causes paradoxical reactions during withdrawal, so if you do use it, go with a very low dose. Please note that Benadryl should not be mixed with alcohol. You may find some helpful ideas here: 

 

Colds, cold remedies, and the flu

[Moonpie]

Thank you Shep.  I finally got to sleep last night.  Today I have the urge to yawn but am not doing it.  It is a strange feeling in the back of my throat that makes me feel like I need to. Could this be a crazy symptom? Silly but scary.  I guess I thought such a small amount mixed with the other things would not matter.

[Moonpie]

Thank you Leo, LOL big time on the moonpig!  The amount I got of alcohol was so tiny.  How long did it take your yawning to go away.  Last night it was every few seconds.  Moonpie

[Leo1983]

Hi. 

 

Prozac made me yawn all day and Sertraline. 

 

I also used to bite my teeth together alot.

 

Bloody awful things when you think about it. 

 

It stopped when i stopped the drugs. I would never touch 1 again. 

 

I see what i have gone through and so many other poor people. Disgrace!