Hilaryous: 6 months post Lexapro 20mg

[Hilaryous]

Hello guys!

My history is pretty standard. I was on lexapro for about 2 years, and went off it for a year with only minor issues (dizziness, brain zaps).  I went on it again for three years at 20mg, and went off it in a way that i thought was standard titration (2-3 months titration).  The first few months I had memory issues that were abnormal such as words, topics that i've read about, etc.. I had overwhelming anxiety for the first 4 months off it, and some co-existing anhedonia. I thought my lack of interest/depressed mood came from my environment and current situation. Lately, the last two weeks my mood has gotten much better, and the anhedonia has disappeared.  My anxiety has improved as well. However, the last 4 months I have been having the worst brain fog.  I get de-realization/depersonalization. I have a hard time visually focusing which causes me to be unable to mentally focus. It feels like pressure inside my head--behind my eyes and temples--which makes me feel dizzy.  My short term memory isn't great, and I have trouble following a conversation sometimes.  

 

I finally had enough. I got my blood tested a few days ago, and everything is normal. I thought it may be anything from hypothyroid to B12 deficiency. I was suspicious of my SSRI even though I have never heard of extended withdrawal this long.  All i googled was extended withdrawal symptoms and SSRIs, and I wound up on this website.  I found people making posts with exactly how I felt even if I didn't know how to put it into words.  I even saw a post about neuro-emotions that talked about negative unbidden memories popping into your brain more often, which wasn't a symptom I had even connected to what I was going through. 

 

I don't know what to do at this point. I have a lot of pressure to perform in the next few weeks/months mentally, and I feel like i am losing my mind at the same time.   I have a referral to a neurologist. I started taking a variety of supplements from cbd oil to coconut oil and cordyceps mushrooms. I am considering just restarting the medication to see if things clear up, but I've been off of it for such a period I don't know if it's a good idea. Looking for advice from those in a similar situation. I appreciate any help. 

 

[Gridley]

Hello, Hilarious and welcome to SA.

 

To give members the best information, we ask them to summarize their medication 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. 
• Link to Account Settings – Create or Edit a signature.

Please include the dosage at which you jumped off Lexapro to zero and the date.

 

Your 2-3 month taper of 20mg was faster than we recommend, which would account for the withdrawal symptoms you have been experiencing.  At SurvivingAntidepressants, it is recommended that a person taper by no more than 10% of their current dose with at least a four week hold in-between decreases.  The 10 taper recommendation is a harm reduction approach to going off psychiatric drugs.  Some people may have to taper at a more conservative rate as they are sensitive to even the smallest drops.  
  

Before you begin tapering what you need to know

Why taper by 10% of my dosage?

 

Brain Remodelling

Tips for tapering off Lexapro (escitalopram)

 

To help you understand what you are experiencing, here is some information on withdrawal.  You may be experiencing other symptoms that you do not recognize as withdrawal.

 

What is withdrawal syndrome.

 

Glenmullen’s withdrawal symptom list.

 

When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

Youtube video, 4 minutes: Healing from antidepressants

 

Please be aware that sometime withdrawal symptoms don't appear immediately after a too-fast taper.

 

Delayed onset of withdrawal symptoms

 

Healing isn't linear.  There will be ups and downs.

Windows and Waves Pattern of Stabilization

 

You mentioned starting the drug again.  At six months out, you are outside the ideal time period for reinstatement (1-3 months after stopping the drug), so please be aware that reinstating the Lexapro may not work and could destabilize you further.  That said, reinstatement of a very small dose of the original drug is the only known way to help alleviate withdrawal syndrome.  The only other alternative is to try and wait out the symptoms and manage as best you can until your central nervous system returns to homeostasis.  Unfortunately no one can give you an exact timeline as to when you will start feeling better and while some do recover relatively easily, for others it can take many months or longer.  Please read:

 

About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic

 

Reinstatement isn’t a guarantee of diminished symptoms for everyone, but it’s the best tactic available.  Do not reinstate the full 20mg dosage of Lexapro, as your brain has already adapted somewhat to not having the drug over the last six months,  We usually suggest a much smaller reinstatement dose than your last dose.  These drugs are strong, and when updosing/reinstating it is better to start with a small amount and increase of symptoms remain unbearable.  If you take too much it may be too much for your brain and can cause you become unstable.  Sometimes it can be hard to regain stability after this happens.
 

After you have given us your tapering dates and jumping-off dosage in your signature, we can suggest a reinstatement dosage if you wish.  Then, after you have stabilized on the new dose (which can take several months) you can begin a safe 10% taper of the reinstated amount.  You will need to give it at least a week on the new dose.  It takes about 4 days for a dose change to get to full state in the blood and a bit longer for it to register in the brain.  Ultimately the decision to reinstate is yours, but thought I should bring this to your attention so that you can make the best decision regarding your health and well-being.  

 

You mentioned experiencing neuroemotions, which can be quite strong and convincing.  Here's a link:

http://survivingantidepressants.org/topic/14397-neuro-emotions/

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems.  I recommend you Google "SurvivingAntidepressants CBD oil"  and make your decision carefully.   Two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Please research all supplements first and only add in one at a time and at a low dose in case you do experience problems.

 

While it is often a first response to stress to take a B-Complex, in withdrawal it can be overstimulating.

 

Hypersensitive to B Vitamin or B-Complex  

 

Many members have found the techniques in the following two links helpful in coping with withdrawal.  

 

The Dr. Claire Weekes Method of Recovering from a Sensitized Nervous System

 

Non-drug techniques to cope with emotional symptoms.

 

Doctors know very little about tapering or withdrawal.  The information in these links is helpful when you talk to your doctor.

 

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

What should I expect from my doctor about withdrawal symptoms?

 

This is your introduction topic -- the place for you to ask questions, record symptoms, share your progress, and connect with other members of the SA community.  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 I am glad that you found us.

 

 

 

 

 

 

 

 

 

 

 

 

[Hilaryous]

Thank you so much for your thoughtful, detailed reply, and taking the time for me.  It really helps to put into perspective how I dealt with symptoms I didn't realize were from my SSRI until they detrimentally affected my cognitive abilities. I updated my signature, and the dates are really rough because I don't remember any exacts. I am curious what would be a reinstatement dosage being 6-7 mos out, but I probably will not go forward with it and just tough it out. One main thing is that I am just exceedingly grateful to have an answer behind all the weird symptoms I have had, and to have found this forum.  

 

My main focus for the next few weeks is mindfulness meditation, playing the piano, exercise, and recognizing that things will get better.

[Gridley]

I consulted with the other moderators about  possible reinstatement dosage.  Our best guess would be .25mg or at most .5mg.  

[Altostrata]

Welcome, Hilaryous.

 

As Gridley mentioned, fish oil and magnesium might be very helpful, please read those topics.

 

If you wish, you might try 0.5mg Lexapro to start, see how it affects you. It could be enough. Lexapro comes in a liquid for odd dosages, see Tips for tapering off Lexapro (escitalopram)