StarEyes

[StarEyes]

Hi,

 

I've been on 20mg Lexapro almost 20 years. I've tried 4 times to taper off, but I was cutting the dose 50% at a time; waiting weeks or as much as 9 months and then cutting another 50%.  As soon as I got off, I would wind up totally unable to sleep and in fight or flight 24/7.  From the information on this website, it looks like the tapering was far too rapid. I have managed to get off Klonopin and Trazadone in the past by pill-cutting without too much trouble. The last time I tried quitting Lexapro was a year ago with the help (and many, many supplements) from a naturopath, but, alas, with the same results.

 

 Until I saw The Withdrawal Project website and this site,  it seemed I would need to stay on Lexapro forever, since all my attempts to get off it failed. Now that I see there's another way, I'm trying to decide whether to try the slow taper, or leave well enough along and stay on it, because I do feel good, despite some very annoying side effects. I had sleep and anxiety issues before I got on it, but not like I get after tapering off. It seems like I've made good mental health progress over the past 20 years with therapy, yoga, meditation and following a behavioral sleep program from a book, but maybe I need the support of the drug to feel good. As an aside, I have chronic back pain that is much better managed than it was in the past, but the very helpful bodyworker I see for it says the Lexapro is drying up the fascia and interfering with healing, so she'd like to see me get off it. My life is in a calm, non stressful place, for the most part.

 

My question is: if I switched to liquid Lexapro and reduced my dose 5% a month, what do you think are the odds of a smooth ride off?

 

Thanks in advance for your advice. 

[Altostrata]

Welcome, StarEyes.

 

How much Lexapro are you taking now? See Tips for tapering off Lexapro (escitalopram)

[StarEyes]

I am taking 20mg.

[Altostrata]

Did you ever try a reduction of 10%? That might be enough.

 

If you have trouble with a 10% reduction, you might try 5%. More gradual tends to be better.

 

It may be most convenient to take 10mg of your dosage in tablet form and the rest in liquid form, until you get below 10mg.

[StarEyes]

 I have never tried a 10% reduction; 25% is the least I ever tried and it was usually 50%. I didn't make this up either; it was always at the advice of a medical provider.

 

Reading some of the stories on this thread, it sounds like people are having a great deal of difficulty even reducing 5% when they get to the last 5ml. Is it your impression that most people have this problem at the end of tapering Lexapro?  Or is it really hard all the way through?  I didn't realize it was more potent than the other SSRI's. After all that I've been through trying to get off these things, I know I'm not up for not sleeping at all. That's why I thought 5% might be a safer way to go. I'm not in a big hurry; after the last fiasco I just assumed I was stuck with them.

 

Thanks for the suggestion about using both tablet and liquid, and thanks for your advice.

[Altostrata]

Doctors don't have a clue.

 

You can taper by 5% if you wish to be extra-cautious. You might be able to do this a little faster, but try it once a month to start. Please carefully read the link I gave you.

 

People can and do go off Lexapro. Our method involves making smaller and smaller decreases, so it remains gentle.

[StarEyes]

The link was very informative, thank you. If I decide to taper, I will follow your advice.

 

What concerns me is whether I actually have had withdrawal syndrome or I just can't sleep without Lexapro due to psychological issues, that despite my best efforts,  are still there.

 

The first 3 times I tapered, in the early to mid-2000's,  it's pretty clear I had withdrawal syndrome: after I was off completely off Lexapro I  immediately  stopped sleeping. But the fourth time when I went from 20mg of Lexapro to 10mg is more ambiguous. I did a 50% cut, but I can't remember whether it was in March of 2012 or 2013. I dug up some old correspondence with my doctor and see that I started having problems sleeping in November of 2013 and was down to just a few hours of sleep by February 2014—at which point I went back up to 20mg. Could it have still been withdrawal syndrome if my symptoms occurred possibly 20 months after I reduced the dose? 

 

 

[Altostrata]

We often see withdrawal symptoms emerge after a large cut, such as 50%. Sleeplessness is a very common withdrawal symptom. It's far more likely your sleeplessness was from withdrawal, along with other symptoms, than from "depression."

[StarEyes]

Unfortunately, sleeplessness and anxiety under stress had been part of the picture for a long time before going on antidepressants.  The fact that these symptoms occurred possibly 20 months after the 50% cut makes me concerned that they are an intractable problem that will resurface if I get down to 10mg. 

[Gridley]

You would be better off to think that the problem won't be intractable.  Catastrophizing thinking isn't good for you and increases stress on your central nervous system.  

 

As Altostrata, our site's founder. has written:

 

"Why anguish over something that may never happen? Is this good for you?

 

If you are in a difficult spot with drugs, is it constructive to think it will last forever? As we can see over and over, many members here, even those who frequently post with  incessant irrational worries, get better, much to their surprise. They put energy into enhancing all that suffering for nothing."

 

Please remember, withdrawal symptoms can be delayed.

 

Delayed onset of withdrawal symptoms

 

As Alto said above, try a 10% or 5% taper.  50% is too much.

Why taper by 10% of my dosage?

 

Brain Remodelling

 

I am tapering Lexapro a bit slower than 10% per month (2 1/2% per week for four weeks with a 2-week hold).  In 16 months, I've tapered from 20mg to 7.4.  I have discomfort from time to time but am functioning and feel comfortable with this taper and am confident I will be able to taper to zero.  

 

 

 

[StarEyes]

Hi Gridley,

 

Thank you for the very helpful link from Alto: this sounds exactly like what goes on with me when I try to withdraw: 

 

"However, while the serotonin system is repairing itself, an imbalance occurs in the autonomic nervous system. The locus coeruleus "fight or flight" center becomes disinhibited and the glutamatergic system becomes more active than normal. This is called disinhibition of the alerting system, and it generates symptoms that are awful: panic, anxiety, sleeplessness, and dreadful imagery among them."

 

I wasn't like that before the drugs, so I'm thinking it is likely due to delayed withdrawal.

 

It is encouraging to me that you have been able to taper from so much from the Lexapro using a 2.5% a week plan with holds and that you are doing well with it. How did you figure out your method to do two week holds and the six week holds, and do you recommend that?

 

I suppose the only way I'll know if I can withdraw is if I try it in a slow, cautious manner and see how it feels.

[Gridley]

This taper was devised by Brassmonkey, one of our moderators, and is called the Brassmonkey Slide Method.   The purpose is to diminish the stress to the system caused by one 10% cut per month by spreading the cut out by four equal 2 1/2% cuts over the same time period.  

 

The two-week hold is part of the taper and is designed to let your CNS stabilize before the next four 2 1/2% cuts.  Twice during the taper thus far I was feeling more WD symptoms than I liked and so I extended my hold by four extra weeks until things calmed down.  I would say if symptoms are too much after two weeks then just hold until you feel ready to make the next cut.  This method has worked well for me, and I do recommend it.

 

I have used the Gemini-20 scale to measure my cuts, and I've been happy with it.  

 

Using a digital scale to measure doses.

 

Other methods are tapering liquid Lexapro or making your own liquid.  These are explained in the following link:

 

Tips for tapering off Lexapro (escitalopram)

 

 

[StarEyes]

I like the idea of the slide method—even more gentle than cutting 10% or even 5% all at once, and the holding periods do make it sound like they give the brain more time to remodel. 

 

The liquid does sound easier and more accurate to measure, though. I checked out the Gemini-20 on Amazon, and it seems like a number of people found it not to be accurate for measuring very small amounts.

 

I will ask my PCP if I can get some liquid Lexapro.

[StarEyes]

I am nearly 10 months into my  taper from 20 mg Lexapro using the Brass Monkey method and Lexapro tabs.. It was going well,  with just brief bouts of insomnia until last week.( Insomnia and anxiety were the reasons I went on Lexapro in the first place, 20 years ago). I had been holding at 13mgpw of Lexapro for two weeks. I had a little bit of trouble sleeping early in the week but wasn't anxious, so I went ahead and made my next scheduled cut of 2.5% to 12.7mgpw last Wed., Feb. 6. I will say that I was somewhat stressed  about a minor event in my life at the time. This was my halfway point, though, with an  weight of 10mgai, so I was pretty pleased and looking forward to some of Lexapro's pesky side effects to abate.

 

 That night I slept only 4 hours in two shifts but wasn't particularly anxious. (I have gone through severe bouts of insomnia even on 20mg). The next night (Thurs.) I slept 3 hours in two shifts, and started feeling anxiety in the middle of the night. I reread my sleep bible "Say Goodnight To Insomnia" that contains useful sleep hygiene advice.  Friday night I took 50mg Trazadone and slept 7 hours because I couldn't face another day of so little sleep. I did some journaling around my anxiety, the root causes and how to cope with it. Saturday night I did better: I slept 5 hours, woke up once and went back to sleep and felt relaxed. I also managed a 45 minute nap on Sunday afternoon, so I was feeling good and also confident that I was heading towards better sleep. 

 

Then last night I woke up after an hour and a half feeling panicky and disappointed that I was devolving towards anxiety again.I got back to sleep a couple of hours later for another hour and a half. In retrospect I think had too much stimulation (socializing, and media use) and not enough relaxation  on Sunday for being in such a precarious state

 

Now I am nervous and jittery and wondering if these are withdrawal symptoms or just my old symptoms from my pre-Lexapro days. My big fear is that this means I *need* 20 mg of Lexapro to keep from being in a state of anxiety and insomnia.

 

 I wonder if it makes sense to go back up to 13mgpw instead of 12.7. I know, in any event, I will follow Gridley's advice and hold for at least an extra four weeks. Any insight or advice would be much appreciated.

[Altostrata]

You can hold for a while, or you might want to try a slight updose to 12.8mg and hold for a month or so.

 

Looks like you might have hit the level where Lexapro saturation has decreased significantly, see Why taper? SERT transporter occupancy studies show importance of gradual change in plasma concentration

 

You've come a long way with your taper, congratulations.

[StarEyes]

Thanks, Alto. 

 

I think you might be right that I've hit the "uh oh" point on those charts. I'm going to take a nice long hold and hope for the best.

 

I did some further looking around on this site—I'd been concentrating on the tapering section. There is a lot of good information about sleep issues and neuro emotions. I think that's what's going on with me. It's like someone's hijacked my brain and convinced me I'm terrified of things that I normally wouldn't give a second thought.

[ChessieCat]

7 minutes ago, StarEyes said:

Thanks for this, Brass Monkey! I am only just seeing it now.

 

I recently posted on my thread about some severe insomnia and anxiety I was going through, almost ten months into the Brass Monkey taper. Now I see this is so common and happens to many people who are tapering. Sounds like there could be a lot of this in my future, as I am at 13mgpw, down from 25.5mgpw. It's very difficult, but knowing that it's part of the process and experienced by many takes some of the edge off.

 

 

Many members find that the lower their dose gets the slower they need to go, reducing less and/or holding longer.  Also some members find that there are particular doses which they have more difficulty getting past.

[StarEyes]

Thanks, Chessie, I will bear that in mind.

 

 I had a relatively smooth ride from 25.5 mgpw to 13 mgpw, so I didn't feel I had anything to post. Now, especially after another bad night, I think people on this site are admirable in what they are able to put up with and take in stride, especially over a period of years of withdrawal.

[Carmie]

Hi Stareyes, 

 

How are you doing?💚

[StarEyes]

Hi Carmie,,

 

I'm doing okay. I was going to hold for 4 weeks but had some anxious insomnia; I thought I'd start tapering again on Monday but then had some more of that. From what I've seen from others, it looks like cortisol spikes in the middle of the night. The anxiety feels like it's connected to minor events that normally wouldn't bother me, so I think it's just chemical. Still, annoying.

 

I want to be sure I've given my brain enough time to stabilize before going further. Ideally I would be feeling pretty good and free from annoying symptoms, but it seems like these symptoms may linger whether I continue tapering or not. I'm hoping to start tapering again next Monday, which will be 6 weeks. In an abundance of caution, I'm going to start with a 5% cut with the Brass Monkey method. After a week or two, if all goes well, I'm planning to do 5mg of Lexapro in pill form and the other slightly less than 5mg in liquid. It seems like the liquid will be less hassle.

 

Thanks for asking!

[ChessieCat]

18 hours ago, StarEyes said:

I'm planning to do 5mg of Lexapro in pill form and the other slightly less than 5mg in liquid.

 

I'm assuming you are currently taking 10mg Lexapro.

 

It is best to only make one change at a time.  So you wouldn't make a reduction at the same time as taking part of your dose as liquid.  You would stay on the same dose for a little while before making a reduction.

 

Q:  Is it possible to halve a 5mg tablet?  If it is, then it would be better to do a cross over and do 7.5mg tablet + 2.5mg liquid for 3 to 7 days and then go to 5mg tablet + 5mg liquid.

[StarEyes]

Hi Chessie,

 

Yes, I am at 10 mg Lexapro and have been on it since Feb. 11. I haven't switched to 5mg tabs; I still have about 24 of the 10 mg tabs. So I could do the crossover of 7.5 mg tablet + 2.5mg liquid for a week before going to 5mg tablet + 5mg liquid. 

 

Thanks for the sage advice; I'm very grateful for the help.

[StarEyes]

I've been holding at 10.1 mg for 7 weeks—I needed to slow down because of panic and sleeplessness. ( I started at 20mg last April, tapered for three months at 5% and then did a Brass Monkey slide at 10% until February 11.) I had some good days last week, but now I'm back to more of those symptoms than I feel I can handle. I think I need to reinstate.  But how much?

The last time I recall not having problems was late Nov./early Dec. when I was a 11.6 mg.

 

This feels like the same thing that's happened to me the other four times I tried to go off Lexapro  before, in the past 18 years, though always too fast. 

[Carmie]

Hi StarEyes, 

 

How have you been doing?💚

[Carmie]

Hi StarEyes, 

 

I’m wondering how you’re doing. Are you still holding?

 

How are your symptoms?

 

Sending hugs🤗