hannahG: Scared and confused

[Rosetta]

Yes, it passed.  It was very distressing.  I felt that I couldn't cope with life if my mind was 8 years old, and the ability to control and endure my emotions was that poor.  

 

I'm still sad.  I still miss my grandparents, and I still feel as if I "lost" all those years I was on ADs when I'm in a wave.  But that feeling goes away during Windows, too.  The feeling of loss has a different quality now.  I think it's more in line with what everyone feels after 20 years have passed and one isn't happy with her current life.  It's more intense than a normal person might have, but it's more normal in quality.  I don't feel as desperate as I would if I were 8.  (That was when my mother took me to live with her, and I wonder if that has something to do with the reason I had the time travel to that age?)  Now, I can accept that my grandparents are dead -- even if I'm in a wave -- and that they aren't coming to save me, but I do have tears running down my cheeks just because I'm writing this.

[hannahG]

Seeking advice from a mod:

Since RI I have had a really awful stuffy head-type headache. Makes me feel extremely out of it.

I am wondering if i should decrease my dose to about .75mg? .5mg? Im currently still taking 1.25 mg but the head side effect is concerning me. I have a new job starting in march which requires that i pass a number of assessments. I need to be able to think clearly and this RI seems to have dulled my intelligence and capacity to think.
 

[hannahG]

Rosetta,

I am so sorry i didnt see your message. When i posted i somehow missed this thread had moved into its third page!! It looks as though i was being so insensitive.

Im so glad the time travelling passed for you. I agree that there must be a reason you traveled to that age and there must be a reason i traveled to mine. It sounds like it was just a really challenging time for both of us. Im glad you are having windows though. That is a wonderful sign of healing.

I am still really struggling with head pains and wondering what to do - please could anyone offer their thoughts on what i should do. It feels like a really 'chemical' headache in that its not an organic headache. Definitely from the escitalopram. I really need to know what i should do! 

[hannahG]

I think i will drop back to 0.5mg today unless someone thinks its a bad idea

 

[ChessieCat]

If you have decided to reduce I think it would be better to try reducing by a smaller amount, possibly to 1mg, and see if that makes a difference.  I think it would be gentler on the brain to reduce by a smaller amount.  You could always reduce by another small amount after a few days if you feel no improvement.

[hannahG]

Thanks chessiecat. I will do that.

I have been dry cutting my pills up until this point but now i will have to rely on a water solution that i will make using the instructions on SA. 
I worry about it not being accurate or effective. Hopefully i have no reason to worry. 

[ChessieCat]

Accuracy and consistency is very important, especially with lower doses.

[Rosetta]

No worries about the response, Hannah.  I don't expect quick responses.  

 

The headache sounds concerning, but WD is so strange.  I don't know what qualifies as a bad reaction to a reinstatement and I didn't find a topic by searching.  Sorry.

 

Maybe read here:

 

 

[JamesF]

Hi Hannah, if I may add a few points to whats been said; 

 

• Some symptoms, or even a temporary intensification during the initial weeks of reinstatement is normal and to be expected. This is due to the normal onset effects of SSRIs, and because the onset of any drugs in a hypersensitive nervous system is likely to be a bit of a bumpy ride. They may well be very temporary and resolve with time. It may be early to form conclusions about what these symptoms mean, or to react to them with dosage changes. For instance, I had extremely loud tinnitus that intensified for the first 2-3 weeks of reinstatement, but this has since diminished to almost nothing. 
   
• I'd be careful about adjusting doses up and down frequently, because it may well delay stabilisation, as well as add another variable of potential withdrawal. For instance, if you were to drop to 0.5 after being on 2.5 then 1.5 for a week (say average of 2), your body has probably already have started adapting to this dosage level, so dropping it could induce new symptoms or withdrawal.
  
  In this regard, I believe stability of dose is often more important than the precise dose (be it 1.25 or 1 or 0.5). I've often read accounts of people frequently updosing, reducing, and removing in an attempt to alleviate symptoms and seen it lead to further destabilisation and confusion. I believe the correct approach is usually to simply allow the body to stabilize on a particular dose with a long hold, rather than believe that the dosage level is itself the issue.
   
• Likewise, switching from dry cutting to liquid may introduce another variable. Metabolism/uptake might be slightly different, depending on how you prepare it.
   

So overall, I think stability and holds are your friend, although it is still quite early in your case it a small reduction may well be fine. I'd be cautious about making many changes, since this doesn't allow you to form clear conclusions (ie what would the pattern have been with a hold? might it have improved greatly with time?), and may even introduce additional factors that muddy the waters (are new symptoms now due to the drug itself, or a dosage cut or change of formulation?).

Keeping everything constant is both kindest to your body when it comes to stabilising - and also makes it the easiest to form clear conclusions about causes and next steps.

Warm regards and hope things improve soon 

Jay

[hannahG]

When I make my Lexapro liquid using the instructions here, I end up with a lot of white sediment which obviously is not dissolving. The remaining liquid is a bit cloudy I think.  My question is: is the active Lexapro dissolved in the water,  leaving the fillers as the sediment or is the active ingredient still in the particles ?

 

I always do my best to swirl it around to evenly distributed the particles but I do wonder what's what.

[ChessieCat]

Here is the discussion Tips for tapering off Lexapro (escitalopram)

 

And this:

 

On 9/1/2017 at 9:53 AM, ChessieCat said:

From the very first post in this topic:

 

2. Measure the water (or pharmacy liquid)

• With an oral syringe: Draw room temperature (not hot, not cold) water into an oral syringe and convey it to the container. A 10mL (10cc) or 20mL (20cc) oral syringe is handy for this purpose.[br][br][br]
  
  For example, if you wish to make 30mL of a solution, fill the 10mL syringe 3 times with clean water and inject it into your container.
• With a graduated cylinder: For example, if you wish to make 30mL of a solution, fill the graduated cylinder to the 30mL mark and pour it into the container.
• With a 100cc (100mL) medicine bottle: Fill carefully to the 100cc or 100mL line. You'll have to bring the bottle up to your eye level to do this. Please note the measurements on these bottles are less exact than the graduated cylinder.

To mix, put the cap on the container, tightly, and shake it gently. You will be able to see particles swirling around in the water (some of the filler used in tablets and capsules is insoluble).
 
Wait until the tablet chunks are dissolved before taking a dose.

 

[hannahG]

Thanks Jay 

 

I appreciate your thoughts on all of this. 

 

A little scary too as I did end up reducing to 1mg and liquid solution. I couldn't cut my pills up accurately into 1.25mg  (1/8th) let alone 1mg. I don't have scales so a liquid solution seemed like the only way to get an accurate measure. 

 

I'm very worried that I shouldn't have changed anything and stuck to 1.25 but it's been two doses at 1mg now and so am anxious I've made a horrible decision and equally scared that it night be worse to go back to 1.25 dry cutting.

[ChessieCat]

12 minutes ago, hannahG said:

reducing to 1mg and liquid solution

 

SA recommends only making one change at a time otherwise you won't know what is causing any issues.

[hannahG]

47 minutes ago, ChessieCat said:

 

SA recommends only making one change at a time otherwise you won't know what is causing any issues.

I can't make one change without making the other. This is so stressful.  I'm rely working myself into a state. 

 

I tried to cut up 1.25mg dry for tomorrow but I wasted at least 10 pills trying to get an even cut. I don't have scales so I'm literally halving a 10mg all the way down to 1/8th

 

I don't know to do. 

[ChessieCat]

I'm a bit confused.  I thought you were dry cutting 1.25mg and then changed to liquid so you could get your dose accurate.

 

Edited March 1, 2018 by ChessieCat

[JamesF]

9 hours ago, hannahG said:

I can't make one change without making the other. This is so stressful.  I'm rely working myself into a state. 

 

I tried to cut up 1.25mg dry for tomorrow but I wasted at least 10 pills trying to get an even cut. I don't have scales so I'm literally halving a 10mg all the way down to 1/8th

 

I don't know to do. 

Hi Hannah. 100% get some scales and definitely don't do it by halving. I used to do this kind of cutting by sight during my first attempt at withdrawal. But  when I got a scale, I found even visibly even cuts were often 10-20%+ off in weight. These error margins and daily fluctuation in dosage can almost certainly cause flucutations in symptoms, interdose withdrawal, etc.

The "gemini scale" for 0.001g accuracy 0-20g capacity is recommended and what I used. Then make sure you calibrate it before each and every use. There are some threads about that in the tapering forum. Weigh and reweigh, using a small craft knife to chisel it down to the goal weight. Then keep the remaining crumbs for the following days. 

 

 

Weighing sounds about 175343 x better than doing it by sight, or switching to liquid. By sight it's inaccurate, and my liquid it's another variable changing which probably isn't wise so immediately after reinstatement. Being very precise and constant in your doses is super important, especially at low doses.

 

It's your choice ultimately, but my hunch would be that the difference between 1.25 and 1 would be negligible in terms of symptoms - so maybe best to hold stable and see what happens with the pattern of symptoms over the next few weeks. Is it changing? Improving? What's the pattern? It might take a little while to forum a conclusion and/or get past onset symptoms. These are early days.

Jay

[AliG]

9 hours ago, ChessieCat said:

I'm a bit confused.  I thought you were dry cutting 1.25mg and then changed to liquid so you could get your dose accurate.

 

 

Could you explain where you are at ~ right now ?

[mammaP]

3 hours ago, JamesF said:

It's your choice ultimately, but my hunch would be that the difference between 1.25 and 1 would be negligible in terms of symptoms - so maybe best to hold stable and see what happens with the pattern of symptoms over the next few weeks. Is it changing? Improving? What's the pattern? It might take a little while to forum a conclusion and/or get past onset symptoms. These are early days.

Jay there is a huge difference when it comes to very small doses,  1.25mg is 25% more than 1mg. Even at low doses we advise people to make only very tiny adjustments. 

[mammaP]

Hannah liquid can be difficult to get the hang of but it is worth it to get the doses consistent.  I also have trouble with residue for my taper but if I dissolve in tepid water it dissolves better.  I use a specimen jar, put in the syringe and pump it a couple of times, this agitates the liquid so the particles are more even, then draw out the right amount. Having the same dose every day is important. Right now you are getting different doses and even at such small amounts it makes a difference. Put in a 1mg tablet, add 10ml water and take 2.5ml. It will last a few days. My jars are the 20ml ones that are used for urine tests, but the levels are not accurate so I use my syringe to add the water. 

[JamesF]

1 hour ago, mammaP said:

Jay there is a huge difference when it comes to very small doses,  1.25mg is 25% more than 1mg. Even at low doses we advise people to make only very tiny adjustments. 

Misunderstanding? She said she's been taking 1.25mg and is thinking of reducing to 1mg. I said I would probably hold steady, for the reason of small adjustments having large effects (since it introduces new variables), as you mention

[mammaP]

I was referring to you saying that the difference between 1 and 1.25 would be  negligible in terms of symptoms. Sorry if I confused you. 

[JamesF]

12 minutes ago, mammaP said:

I was referring to you saying that the difference between 1 and 1.25 would be  negligible in terms of symptoms. Sorry if I confused you. 

For clarity,  since she only just reinstated a week ago and has been taking 1.25mg, I meant this reduction probably wouldn't make a difference in onset symptoms, which are likely to occur during initial stabilisation. Tapering such doses in long term withdrawal is definitely not negligible in terms of symptoms (as we all appreciate from the withdrawal trenches). And said to hold steady because the CNS may have already adapted to 1.25mg, so reducing it introduces another variable. 

[ChessieCat]

To any members following Hannah's topic, please note that JamesF is not a moderator.

 

@JamesF it takes about 4 days for a dose change to get to full effect in the blood and a bit longer for it to register in the brain.  The brain would have made some adaptation to the new dose so reducing the dose would have some effect on her symptoms.  She also changed to liquid.  When changing to liquid we recommend staying at the same dose before making a reduction.  Not doing both at the same time.

 

Edited March 2, 2018 by ChessieCat

[hannahG]

James, for what it's worth i don't really see you as saying anything too different from anyone else and I'm really grateful for your help. I hope you don't feel attacked. This whole thread has made me sad. 

 

 I had no idea how different the doses could really be when just eyeballing and dry cutting. I doubt I ever did take 1.25mg consistently for more than 4 days given this fact. 

 

I feel really depressed today. It all just feels too much. My brain is having the weirdest sensations since RI. They're similar to brain zaps but slightly different. 

 

I'm totally overwhelmed with indecision about what to do with my medication.  It's all a crapshoot anyway. Seems like no matter what I do I can't win. 

 

Honestly I just want to die. I wish I had never come off and now there's nothing I can do to help myself feel better. 

[hannahG]

19 hours ago, AliG said:

 

Could you explain where you are at ~ right now ?

Sorry my post wasn't clear. My head isn't. 

 

When I went to 1mg I switched to liquid.  When it was mentioned that liquid would be a risk, as would changing to 1mg, I tried to prepare a 1.25 dose by dry cutting to resume taking that the next day.  I went through ten pills trying to get an even cut and gave up. I don't know how I ever managed to get anything resembling an even 1.25mg the first few days.  So anyway I have continued taking 1mg liquid as i have no idea how to get 1.25 by dry cutting. It would be days before I could get a scale and get that dose precisely. I thought about taking 1.25mg liquid but I doubt I ever took 1.25mg consistently anyway by dry cutting without scales. 

 

TLDR: I am taking 1mg liquid  

[hannahG]

I could really use some kind words.

 

I feel as though I have damaged my brain beyond repair. The sensations in my brain are so hard to explain but they're not natural.  Its almost like that feeling when you put your tongue on a battery as a kid (I'm not the only one right?). Except it's in my brain.  This only happens when I reinstate. I'm unsure if this means it's a bad idea. 

 

Apart from that I'm just feeling hopeless. At the bottom of the barrel. I haven't felt this low in a long time and I just want some support. 

[mammaP]

On 24/02/2018 at 11:28 PM, hannahG said:

I am a few days into my reinstatement and last night I had my first almost normal sleep!!! A couple of times I woke up as it felt like I stop breathing in my sleep and I suddenly needed air. It could just be in my head though. Whatever it is, it's an odd feeling.

 

I actually think in starting to feel a lot better mentally too. I still feel like I've got ways to go - but compared to before RI I am feeling a lot of improvement. I hope it continues.

 

 

On 24/02/2018 at 3:33 AM, hannahG said:

 

I followed you your advice and dropped back to 1.25mg

 

No vertigo today so perhaps this is a more appropriate dose.

 

 

On 27/02/2018 at 12:19 AM, hannahG said:

I believe i am starting to feel a little better every day. I hope that it continu

These quotes all looked very positive and that reinstatement was going to work. 

Edited March 2, 2018 by mammaP

[mammaP]

On 27/02/2018 at 5:20 AM, hannahG said:

Since RI I have had a really awful stuffy head-type headache. Makes me feel extremely out of it.

Just a few hours before this post you posted that you were feeling better every day. There will be symptoms that come and go, it's all part of the healing process and we need to just let them come and go. Looking for a quick fix by changing doses can make things worse. I learned this from bitter experience! 

 

 

1 hour ago, hannahG said:

When it was mentioned that liquid would be a risk, as would changing to 1mg

I am a little confused, did one of the team tell you that liquid was risky? It is much more reliable than dry cutting and easy when you have got used to it. 

 

35 minutes ago, hannahG said:

The sensations in my brain are so hard to explain but they're not natural.  Its almost like that feeling when you put your tongue on a battery as a kid (I'm not the only one right?). Except it's in my brain.  This only happens when I reinstate. I'm unsure if this means it's a bad idea. 

Did you have these when you were feeling much better?  Or since you went back down to 1mg?  These are usually due to withdrawal but equally can be because of inconsistent dosing. 

 

All this can be very scary but you really need to try and relax, and not worry about what will happen in 3, 6, 9 months, or even next week. The most important thing for you right now is that your doses are consistent. If you keep changing them when you get a different symptom you will never stabilise. You will experience windows and waves as your body and brain heal and regain balance. 

There are no quick fixes for withdrawal,  reinstatement is the only way to help, otherwise you would have to tolerate the withdrawal for however long it takes.  I reinstated and had ups and downs with some distressing symptoms sometimes but it was better than the full blown withdrawal and i did stabilise.  You have to stick with the same dose, every day in order to become more stable. It will get better, it really will. 

Edited March 2, 2018 by mammaP

[hannahG]

Thanks mammaP.

 

I meant changing from dry cutting to liquid could be risky as it does introduce a new variable given I was previously dry cutting. Not that liquid is inherently a risk. Am I right in saying that? 

 

These brain sensations are not new. I had one failed RI attempt early Jan because of this side effect (I got scared and abandoned my attempt). Then when I tried to reinstate again recently, from the very first dose I have had these sensations.  So it is not because I dropped to 1mg. 

When I said I felt better I simply meant the vertigo had stopped and that in itself was having a profound effect on being able to function. Oh and my sleep improved somewhat. 

 

I am aware changing doses hasn't been wise. I think it just shows how desperate I've been to try alleviate the symptoms. 

[mammaP]

We understand Hannah, we have all been where you are and know how frightening it is.  Changing anything at all takes a few days for the brain to adjust but ultimately if you get a more consistent dose with liquid that is the best way if you don't have the best scales. Personally i have a few scales and couldn't get on with any of them, my hands are arthritic and getting the small amounts was impossible. .  I have found liquid much better and more controllable.  Can you tell me what the problem is with making liquid? I will help if I can and you will soon get the hang of it. 

[Rosetta]

HI Hannah, My heart goes out to you.  Thus is such a difficult time, but you will get though it.

[ChessieCat]

This isn't criticising, just showing what changes you have made in such a short period of time to help you understand why you are feeling like you are at this time:

 

• Feb 21st 2018: Second RI attempt 2.5mg 
• Feb 24th 2018: Changed RI dose to 1.25mg 
• Feb 28th changed RI dose to 1mg

 

In just over a week you have made 4 changes.  3 doses changes (3 days, 4 days, 3 days) and tablet to liquid.  As well as possible inconsistent doses when dry cutting 1.25mg.

Edited March 2, 2018 by ChessieCat

[hannahG]

Chessie,

It feels like criticism. I am well aware of the changes I've made as I have repeatedly commented. This is exactly why I feel incredibly stressed. I 

 

Thank you rosetta,

I really appreciate your kind words. That's what I'm really seeking here. I feel very scared and I just want to know I'm going to be OK.

 

Mamma P, 

Thanks again.  I have no issues with making the liquid.  So far I have just been dropping 5mg into 5ml and extracting 1ml then discarding the rest. Is there a better way I could be doing it? I thought about diluting it 5mg:50ml and extracting 10ml. Would that be correct too? 

[Rosetta]

46 minutes ago, hannahG said:

.  So far I have just been dropping 5mg into 5ml and extracting 1ml then discarding the rest. Is there a better way I could be doing it? I thought about diluting it 5mg:50ml and extracting 5ml. Would that be correct too? 

 

Hi.  

 

I'm not sure if you would take 5 ml as a dose from the 50ml of solution or would it be 10 ml?  That 5 ml doesn't look quite right to me.  You are using 10x as much water so maybe the dose would be 10 ml.  I wish my math skills hadn't been damaged.  Mods?? @mammaP

 

I'm not experienced in tapering, or making liquid, but I have seen SA members comment more than once that using more liquid allows for a sense of better control because the person is not trying to get such a small amount of liquid into a syringes otherwise. Another comment I've seen is that you could extract the amount you intend to discard and then drink what is left in the container.  I think it all depends on how much your syringe is designed to hold.  Does it hold 10 ml?  

 

 

[hannahG]

9hi rosetta.

 

How strange. I realized I wrote 5ml instead of 10ml but edited my post straight away. Not sure why it still says 5ml on your end!!

 

10ml is correct in my mind too. 

[mammaP]

Yes that would work, and be more precise. Or you could dissolve a 10mg in 100ml and use it for 2 days.  This would avoid any differences that is caused by cutting if the halves were not equal. It would need to be in a bottle or jar with a cap to avoid evaporation and be kept in the fridge. Whatever you feel most comfortable with.