Fishfanatic: Intro

[Fishfanatic]

Hello to you all and thank you for having such an informative site.  I will give an outline of my current situation:

 

1. 50 year old male married with two youg children... girl 5yrs and boy 2yrs
2. currently prescribed 10mg of lexapro  for  anxiety and .75 klonopin for sleeping
3. Been on both meds for approximately 6 weeks
4. taking a multi vit along with fish oil and a B-complex.
5. Never been on anything before except for antibiotics.
6. Seeing a psychologist once to twice a week learning mindfulness, meditation and other things
7. Seeing a psychiatrist once a week to monitor any symptoms.
8. I feel jittery in the morning and and i cant seem to get more than 6 to 7 hours of sleep each night and i cant think about napping during the day.  Never had problems sleeping before.
9. I would like to start to roll back these medicines as i feel things are getting better.

 

The anxiety started in November when some things went wrong financially, which also coincided with a case of epididymitis in which i was prescribed an antibiotic ( levofloxacin) for 6 weeks.  My vitamin D was also low.  I feel the the combination of the antibiotic and stess caused my spiral.  Felt like a rat trapped in a cage with no escape.  December is when my sleep started to suffer.  Could only get about 4 to 6 hours a day no matter what i tried.  Started seeing the psychologist in January but I couldn’t shake the funk no matter what.  This is when i decided to see the psychiatrist.

 

So... I’ve  been on the above routine for about six weeks and i can definitely feel the side effects of the medicine...

• feeling a little slower mentally 
• feeling a little weaker physically
• feeling jittery in the hands with my motor skills

The doctor has me taking the two meds about an hour before i want to go to sleep... oh , and i also take 3mg of melatonin about 30 minutes before I sleep.  I still have trouble sleeping.

 

My feeling of well being has gotten much better as well as my financial situation so i want to start coming off these meds.  Also, my vitamin D is at a much better level due to constantly sunning.  Given my profile should i start the taper slowly and which meds should I start with.  Ive read benzos first and I’ve read benzos second.  Anyone have some advice for my plan of attack.  Much thanks in advance 

 

Fish Fanatic

[Altostrata]

Welcome, Fishfanatic.

 

Thank you for a very complete introduction.

 

It sounds to me like 10mg Lexapro is too much for you. It can keep you awake and make you feel jittery. My guess is you are sleeping because the clonazepam is canceling this effect out for 6 or  7 hours, then the Lexapro takes over.

 

The dopey feeling is clonazepam hangover, which is quite common, as is a side effect of depression.

 

If it's the doctor's custom to routinely prescribe clonazepam along with Lexapro because he or she expects you to have sleep difficulties, she or he is doing it wrong.

 

Many people take Lexapro earlier in the day because it is activating. If I were you, I would move Lexapro earlier in the day, an hour at a time, until you're taking it in the morning rather than the evening.

 

Once that gets settled, let's see how you're doing. Please keep daily notes on paper about your symptoms, when you take your drugs, and their dosages. You can post in this topic to let us know how it's going.

 

Then, you'll probably want to gradually reduce the Lexapro, and after that, go off clonazepam. Please be aware that after more than a month of regular use, you are probably physiologically dependent on one or the other or both, and you'll want to carefully taper to avoid withdrawal symptoms, which could affect your ability to work.

[Fishfanatic]

Thanks for the welcome Altostrata.

 

The reason she had me taking the two at night is because i complained that I felt the lexapro was making me feel jittery when i was taking it in the morning and she thought the two would benzo would lessen the side effects!  I kinda saw where she was coming from but i would have thought a dose reduction would have been a better approach. Well i met with the P two days ago and complained that the jitters and anxiety i felt was still there... the lexapro in particular.  I surmised this as i couldn't really put an emotion or thought to it and it would lessen as the day progressed.  Well she changed my dose to 5mg and moved it to the morning. This will be my second day on this regimen.  I felt like i got a better nights sleep last night and didn't seem to have as much jitters in the morning.  I know that since the half life is over a day i wont feel the full effects for a few days but it already seems promising.  I went along with the 5mg drop because i don't like the jittery restless feeling especially when working on the computer.  After reading your reply i may be taking a chance but i figured since i haven't been on that long i may be OK.  I already purchased my scale and pill crusher for the clonazepam and remaining lex taper.  i think i am hooked on the clonazepam because it doesn't seem to have the same feeling as when i first starting taking it.  i wish i came across this site earlier on.  I do have to tell you that the meds did seem to provide relief in the very thick of it, when i was in pretty dismal shape, particularly the clonazepam.

 

I will start keeping a daily journal

 

One other thing i forgot to mention is that i try to exercise for 30 minutes every other day.  seems to help me 

[Fishfanatic]

I have a question regarding how long lexapro stays in your system. Since i just lowered the dosage from 10mg  to 5mg as described in my previous post.  Taking into consideration the half life of the drug how long will it take for the drug level to stabilize in my system... Hypothetically, since i know everyone is different.

Thanks

[ChessieCat]

Hi Fishfanatic and welcome to SA from me too,

 

It takes about 4 days for a dose change to get to a steady state in the blood and a bit longer for it to register in the brain.

 

I'm going to give you lots of links to check out.  Please don't feel overwhelmed, just work your way through them one at a time as you feel able.

 

SA recommends tapering by no more than 10% of the previous dose followed by a hold at that dose for about 4 weeks to allow the brain to adapt to not getting as much of the drug.  This is because psychiatric drugs create a physiological dependence, not physical like caffeine or nicotine.

 

Patience is needed to get off these drugs.  We suggest throwing out the calendar and listening to your body and your symptoms.  If after 4 weeks you don't feel stable, are unwell or life circumstances are a bit more stressful than usual (for example the Christmas period, winter time, or job change) it is better to stay at that dose for a bit longer until things settle down.

 

Why taper by 10% of my dosage?

 

Dr Joseph Glenmullen's Withdrawal Symptoms

 

Important topics in the Tapering forum and FAQ

 

Windows and Waves Pattern of Stabilization

 

How do you talk to a doctor about tapering and withdrawal?

What should I expect from my doctor about withdrawal symptoms?

 

Brain Remodelling

Video:  Healing From Antidepressants - Patterns of Recovery

 

Keep it Simple, Slow and Stable

Keep Notes on Paper

 

Rate Symptoms Daily to Check Patterns and Progress

Tapering Calculator - Online

 

The only supplements which SA recommends are Magnesium and Omega-3 Fish Oil.  Try a small amount one at a time to see how you react.  It is best to make only 1 change at a time.  It is also better not to start taking a complex vitamin because if you experience issues you will not know what exactly is causing it.  B vitamins can be stimulating especially B6.  hypersensitive-to-b-vitamin-or-b-vitamin-complex  If trying anything new, start with a small amount to see how you react and build up to the recommended amount.  

 

Even with a careful and slow taper you will most likely experience times of discomfort.  It is best to learn and use Non-drug techniques to cope

 

There are many existing topics and discussions on this site.  You can use the site search function on the main page of the site at the top right, or use a search engine and include survivingantidepressants.org in your search string.

 

As I said, lots of information, but I really want you to have what you need so you can have a successful taper.

 

This is your own Intro topic where you can ask questions and journal your progress.  We suggest that members visit each others Intro topics so that can support and encourage each other.

[Fishfanatic]

Hello and thanks for the info ChessieCat,

I have dropped from 10mg to 5 mg and it is day three.  Definitely more than what is recommended on this website... so far i am feeling OK in general.  The 10mg was giving me the jitters and some low level anxiety.  Maybe that has gotten a little better since reducing the dose.

 

Regards

[Fishfanatic]

So far it has been 6 days since i reduced from 10mg to 5mg per day.  Definitely feeling better and going to the P today.  I'm going to hold it here and then start the gradual taper.  Since i have only been on this med for a short period of time should i try a faster taper than 10% a month?  I would appreciate some thoughts on this.

 

Thanks

[ChessieCat]

It's good that you are feeling improvement.  However, please don't get too eager to reduce too quickly.  You were on 10mg for about 2 months which is long enough for the brain to change.  You have already reduced by half but it has only been 6 days.  Some members don't feel withdrawal symptoms until about 3 weeks after a reduction so I suggest you hold at 5mg for at least 3 weeks, keep daily notes on paper.

 

After the 3 weeks, we can then reassess.

 

It would be better to get off slowly and be off for good than to try and go too quickly and have to updose or hold for longer.  We have some members here who if they had reduced 10% every 4 weeks they would be off by now but they reduced too quickly and it is taking them longer than if they had followed SA protocol.

 

Some members find that once they experience bad withdrawal symptoms they have difficulty stabilising again.  Patience is needed.

[Fishfanatic]

Thank you for the advice.  I will take it.  i plan to stay here for at least another two weeks.  If i still feel good should i cut 10 % every 2 weeks, 3 weeks, or more than 10%?  This may be a little premature but as you can see i am pretty eager.

Thanks again for your help.

[ChessieCat]

Be prepared to hold longer if needed.

 

For reductions from the next one onwards I think sticking to 10% is a better idea, giving it 3 weeks and assessing how things are after that.  Again, hold longer if needed.

 

Stabilising After a Reduction - What Does That Mean?

Withdrawal Normal Description 

[Fishfanatic]

I was hoping that if this 50 reduction still feels good after 3 weeks i could possibly go 10% every 10 to 14 days?  Does that even sound like a feasible strategy?  I find it interesting that i have actually felt better by going from 10 to 5.  The P was a little resistant at first because i weigh about 203lb and she felt i should be able to handle the dose.  I insisted that i was getting jitters and anxiety from the meds... i couldn't put an emotion on it... just the physical feelings.  i didn't even have the jitters when i got my anxiety.  I'm going to leave the clonazepam last.... although i would love to start getting off of that drug as well.

A

[Gridley]

We recommend you taper only one drug at a time.  Otherwise, if a problem develops you won't know which drug is causing it.  You are doing it right, tapering the activating Lexapro first and leaving the sedating benzo for later.

 

Taking multiple psych drugs? Which drug to taper first?

 

[Fishfanatic]

Thanks for the reply Gridley.  i just dropped from 10 to 5 and it's been 7 days and i have felt better with less jitter and low level anxiety.  On ChessieCats recommendation i'm going to hold at 5mg for another 2 weeks barring any withdrawal symptoms for a total of 3 weeks.  If that works i was thinking of dropping 10% every 10 to 14 days since i would have tolerated a 50% drop.  Does this sound like a reasonable approach.

[Gridley]

 

The excerpt below about faster tapers, written by Altostata, the site's founder, is from 
Why taper by 10% of my dosage?

 

"If you think you can taper faster than 10% per month, follow this harm reduction approach to starting your taper:

• Initially, make a 10% reduction and hold there for a MONTH. It can take several weeks for withdrawal symptoms to emerge. Do that again the second month.
• If you have very minor or no symptoms from these 2 reductions, you can try reducing by 10% (calculated on the last dosage, the amount of decrease keeps getting smaller) every 3 weeks. Do that twice. If no problems, reduce by 10% every 2 weeks. Do that twice.
• If no problems after 4.5 months of very gradual reduction, you may be able to reduce by 10% every week.
• If significant withdrawal symptoms appear, STOP TAPERING. Hold at your current dosage for some months, stabilize, then make smaller cuts or go slower. Listen to your body.
• If you do not stabilize after some months, consider a slight updose and hold to stabilize. You will not be able to taper faster than 10% per month after that, and may need to go even slower.
• "Jump off" at the end when you are taking less than 98% of the original dose and reductions no longer cause any reaction at all.

Under this method, the fastest taper takes about 12 months."

[Fishfanatic]

Got it.  I will keep you all updated. After 3 weeks I will evaluate the next move with everyone’s help 👍

[Fishfanatic]

It's been 9 days since i reduced from 10mg to 5 mg of lexapro.  So far i am feeling better.  Still have some slight jitters but not as bad.  Can't wait to start tapering as i don't think this med totally agrees with my system.

Al

[ChessieCat]

Q:  Have you ever taken any psychiatric drugs prior to February this year?

 

If yes, please add this information to your signature.  Thank you.

[Fishfanatic]

Hi ChessieCAt...  No, i have never been on any my entire life.  These are actually the first drugs i have been routinely taking except for a round of antibiotics, which i think is what helped get me in this anxiety spiral.

 

Al

[ChessieCat]

Please don't be too impatient.  Please re-read Alto's post above.

[Fishfanatic]

Yes.  I re-read through the various posts.  Holding here as recommended.  Feeling better... even my blood pressure has dropped.  The only thing i feel every once in a while is a weird pain in my head similar to when i first started the drug.  It isn't very strong and only last for a view seconds.  Has anyone else felt these feelings?

 

Al

[Fishfanatic]

Ok. I need some quick help. Just came  from the psychiatrist.   As you already know from my previous posts I don’t seem to agree with Lexapro. It was giving me the jitters and some low-level anxiety at the 10 mg dose. So, the doctor pushed me down to 5 mg and I’ve been at that dose for 14 days.  The psychiatrist agrees that Lexapro probably is not agreeing with me so, she wants to put me on paxil instead at a 10mg dose starting tomorrow.  She said i should see signs of change within a day or so.

 

Some of my anxiety symptoms still are:

1. slight tingly in my toes
2. able to constantly crack my knuckles (weird right?)
3. able to crack my neck more than usual
4. some low level jitters in the hands
5. slightly weaker in the hands

 

Experience on lexapro:

1. Seem to give me the jitters and low level anxiety.
2. Started on Feb 9th at 5mg for 4 days then started taking 10mg.
3. Lowered dose to 5 mg on the March 28 and have felt better since.
4. While i am feeling better i still have some jitters and restlessness. 

 

I am still taking .75 clonazepam each night approximately one hour before bedtime.

 

Does this seem like a good route since lexapro seems to not agree with me.  When i reduced from 10mg to 5 i definitely felt better across the board.  less of all of the symptoms.  my final goal is to get off all of this stuff but maybe i should switch to something initially more agreeable?

 

I just came from the P and the pharmacy with the paxil.  what are your thoughts on switching?

 

Thanks Again

Al

[Fishfanatic]

Hi all... if i make the switch i will do it on Friday or Saturday so i have the weekend to assess the situation.  Still would like someones opinion on this given my situation.

 

Thanks

Al

[wantrelief]

Hi Al,

 

I am not a moderator, nor expert, but I would advise against switching.  From your posts, it sounds like Lexapro has helped somewhat but you are experiencing what are either side effects or adverse effects and you want to get off of it.  If that is your goal, I would stay with Lexapro and when you feel like things are stable enough, not getting worse, you can start a taper off....it sounds like you already got some benefit from the lower dose so hopefully as you lower even further you will feel better. Switching can sometimes end up causing way more problems in the end than benefit and it would not be worth that risk in my mind, especially as you haven't had the greatest reaction to Lexapro which might indicate that you may not be well suited for any of these meds.  

 

I hope this helps.  Hopefully others will chime in with what they think.  

 

[Fishfanatic]

Thanks for the reply Wantrelief.  Since i don't seem to agree with the lexapro the doctor wanted to switch me to another flavor of ssri.  I don't think i will stabilize on the lexapro more than i have already.  lowering the dose from 10 to 5 actually made a difference in feeling better.  The psychiatrist was thinking that if i would feel better on the paxil and then i could hold there for several weeks and start the taper.  so far the 50% drop in Lexapro has only made me feel much better.  By the way, i was prescribed these meds for anxiety brought about by a particular set of circumstances.

 

Thanks again

Al

[Fishfanatic]

Does anyone else have any advice. I haven't made the switch yet.  I am waiting until tomorrow so i have the weekend to deal with any issues.

 

Thanks

Al

[Fishfanatic]

All, I think i am going to decide to just taper off of this lexapro in lieu of changing to the paxil.  Any advice out there.  My wife wants me to just get off of the meds period but she doesn't have experience with this stuff.

 

Thanks

Al

[Gridley]

Jitters and restlessness, while unpleasant, don't in my opinion rise to the level of an adverse reaction necessitating a switch to another drug.  Lexapro, like all SSRI's, is an activating drug, and the fact that you felt better at 5mg is a hopeful sign.  My suggestion would be to stick with the Lexapro, the devil you know. You don't know how the Paxil will agree with you, and Paxil is one of the more difficult AD's to taper off.

 

Keep in mind that as you get to the lower doses, we advise you to slow the taper, either by smaller cuts or longer  holds.

[Fishfanatic]

Hi Gridley,

Yes i was kind of thinking the same thoughts.  the fact that i went from 10mg to 5mg means i might be able to taper faster.  Its been 15 days since i reduced the dosage and i feel better.  I was going to hold at least until three weeks at this dose until starting the taper.  the doctor feels i shouldn't be feeling any adverse reactions if i am on the right medication and dose.  Interestingly i asked  her if i could just lower the dose of lexapro again to see if i felt better and she just responded that i might as well not be on anything.  I responded back and said, "isn't that the goal?"  I am being treated for anxiety so the jitters and restlessness to me defeat the purpose of the med since its exacerbating the symptoms.

She wants substitute 5mg of lexapro with 10mg of paxil.  Is that even the same dose comparatively or is it apples to oranges?

Thanks for your help Gridlley need to make this decision soon

 

Al

[Gridley]

My advice is to stay on the Lexapro and taper slowly.  

 

 

 

[Fishfanatic]

I think I will take your advice.  It's been 16 days since i reduced from 10mg to 5mg so i don't think i want to complicate things with a completely new med.  I will deal with what i have as the jitters should reduce more as i taper the medicine.

 

Al