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What symptoms should I expect while tapering?


bubbles
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Hi everyone

 

I'm in my pre-taper stage, and I have a few questions, based on my previous attempt. I want to do this right this time. :)

 

My main symptoms (of the taper) were really a return of the depressed mood and anxiety. I tapered slowly enough not to get the brain zaps etc (though I've previously experienced them, so I know what they are). This lead my Dr to believe that I simply wasn't ready to come off the Lexapro, and therefore I should go back on it because the slow taper was to avoid the zaps etc, nothing to do with mood, which was a return of the original problem. (Note, I no longer agree.) He was supportive of my really slow taper, but thought it as far slower than necessary. I now think that my symptoms were really just something to do with the withdrawal. My question: are depression and anxiety common symptoms of the taper? Various lists of "discontinuation symptoms" do or don't list them.

 

On a side note, how do doctors understand the term "dysphoric mood"?

 

Lastly, on my previous taper (10% of original dose) I did stabilize at each increment, but only for a few days (roughly a 4 week interval). And each drop (at least after the first few) my mood stabilized a bit lower than the previous time. Should I be looking at several weeks at *stable* before the next drop, or is it sufficient to get stable at all? And, should I be aiming higher than "stable"? Should I be aiming at "cheerful"? I'm having side effects that are really bothering me (bruxism) and am keen to lower my dose, as it seems that side effects might be dose-related, so I want to hit that sweet spot somewhere in between "fast enough to get relief from my symptoms" and "slow enough to actually get off this med".

 

Thanks for getting this far!

Bubbles

2005 St John's Wort / 2006-2012 Lexapro 20mg, 2 failed attempts to stop, tapered over 4.5 months in early 2012

January 2013 started Sertraline, over time worked up to 100mg

July 2014 Sertraline dropped from 100mg to 75mg, held for six months, slower tapering until 2019 22 Dec 3.2mg

2020 Sertraline 19 Jan 3.1mg, 26 Jan 3.0mg; 1 Mar 2.9, 7 Mar 2.8, May (some drops here) 24 May 2.5, May 29 2.4, June 21 2.3, June 28 2.2mg,  July 4 2.1mg, July 24 (or maybe a bit before) 2mg, early Nov switched to home made suspension; 29 Nov 1.8mg; approx 25 Dec 1.6mg)

2021 Some time in about Jan/Feb realised probably on more like 1.8mg and poss mixing error in making suspension; doses after 10 Feb accurate; 10 Feb 1.6mg; 7 Mar 1.4, continued monthly

10% drops until 1mg, then dropped 0.1mg monthly.

May 2022,0.1mg, now dropping 0.01mg per week

My thread here at SA: https://www.survivingantidepressants.org/topic/1775-bubbles/page/18/

CurrentSertraline: 0.08mg / Armour Thyroid

 

 

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Depression and anxiety -- often exaggerated depression and anxiety -- are withdrawal symptoms. All lists of withdrawal symptoms include them. In our Journals section, we have many papers describing and listing withdrawal symptoms.

 

Doctors don't understand "dysphoric mood" any better than they understand any emotional state. It's just a term someone has thrown around to make you think they know more than you.

 

According to Dr. Joseph Glenmullen, your taper should be slow enough so withdrawal symptoms are almost non-existent. We might settle for very minor and lasting only a few days.

 

It does sound like your previous taper was too fast. You were reducing every 5 days?

 

We suggest reducing every month, starting with a 10% trial reduction. I'm sure you can see this schedule would take at least 10 months to complete. If you get no withdrawal symptoms from a 10% taper, you might reduce every 3 weeks. You'll need to find what your individual tolerance is.

 

The interlude for stabilizing is tricky because it can take several weeks or longer for withdrawal symptoms to appear. If you've made a second reduction in that time, the severity of the symptoms will be increased. This is why we suggest waiting a month after the first reduction to see how your nervous system is taking it.

 

Alternatively, some people have had success with very tiny decreases (5% or less) more often. But you'll need to find out your individual tolerance.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Alto, thanks for your response. My previous taper started at 5% every 2 weeks, but that put every second taper with my PMS, so I switched to 10% every 4 weeks. Symptoms were not minor, at least they were major enough to interefere with my life, and cause *major* sugar cravings. The sugar really helped my mood, but I gained 20pounds, ick; sugar cravings vanished when I reinstated the lexapro.

 

I might try 5% the first month, and see how I go?

 

The reason I asked about "dysphoric mood" is that I interpret it as depressed. The lex document I have (maybe from this site? not sure, I did lots of googling, lol) lists dysphoric mood as their first symptom of discontinuation.

 

Bubbles

2005 St John's Wort / 2006-2012 Lexapro 20mg, 2 failed attempts to stop, tapered over 4.5 months in early 2012

January 2013 started Sertraline, over time worked up to 100mg

July 2014 Sertraline dropped from 100mg to 75mg, held for six months, slower tapering until 2019 22 Dec 3.2mg

2020 Sertraline 19 Jan 3.1mg, 26 Jan 3.0mg; 1 Mar 2.9, 7 Mar 2.8, May (some drops here) 24 May 2.5, May 29 2.4, June 21 2.3, June 28 2.2mg,  July 4 2.1mg, July 24 (or maybe a bit before) 2mg, early Nov switched to home made suspension; 29 Nov 1.8mg; approx 25 Dec 1.6mg)

2021 Some time in about Jan/Feb realised probably on more like 1.8mg and poss mixing error in making suspension; doses after 10 Feb accurate; 10 Feb 1.6mg; 7 Mar 1.4, continued monthly

10% drops until 1mg, then dropped 0.1mg monthly.

May 2022,0.1mg, now dropping 0.01mg per week

My thread here at SA: https://www.survivingantidepressants.org/topic/1775-bubbles/page/18/

CurrentSertraline: 0.08mg / Armour Thyroid

 

 

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Right, try a 5% taper. It might be the key for you.

 

"Dysphoric mood" just means feeling low. It's a very vague term, as are most of the terms psychiatry uses for emotional states. Doctors aren't mind readers, they don't really know what anyone is feeling except for how the person describes it, which may be very inexact. Then doctors slap a label on it.

 

Psychiatry is nowhere near defining the emotional states it diagnoses all the time. That's one of the reasons it's such a mess.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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New here, and I just posted my intro. It's good to hear that anxiety/depression are normal symptoms of withdrawal. I am experiencing some bad anxiety right now.... and I have reduced a lot more than 10% a month so I guess it might get worse!

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Bubbles, there's also the "microtaper" style of tapering, where you reduce by a very small amount, 1-3%, but make cuts more often, maybe every three days to a week. Then after a few cuts (about three in my case) you take a longer break.

 

I don't do this by a schedule or formula, I do it by paying close attention to my withdrawal symptoms and holding longer whenever they seem to be ramping up at all.

 

This requires being VERY attentive to your symptoms and I also recommend keeping a chart of dose changes versus symptoms. But I find that it allows me to adjust my taper quickly and subtly as needed.

 

For me, when I make the larger cuts, the withdrawal symptoms are just too severe, even though they do pass after weeks of holding. It's just too extreme for my system. But as you can see, I am tapering multiple meds.

 

Also, if you're struggling with feelings of depression, I'd suggest doing the kinds of lifestyle things that help, and being really consistent about it for a while. Exercise has been shown over and over again to be more effective against depression than any medication. Light therapy (either natural sunlight, or a therapy lamp, or both) can also be quite effective. Watching ones diet can also make a difference (avoid caffeine, sugar, refined carbohydrates, aspartame, MSG; keep your blood sugar levels even).

 

I find that these things are really effective for me in helping with my bouts of the blues.

Started on Prozac and Xanax in 1992 for PTSD after an assault. One drug led to more, the usual story. Got sicker and sicker, but believed I needed the drugs for my "underlying disease". Long story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything. Amitryptiline, Prozac, bupropion, buspirone, flurazepam, diazepam, alprazolam, Paxil, citalopram, lamotrigine, gabapentin...probably more I've forgotten. 

Started multidrug taper in Feb 2010.  Doing a very slow microtaper, down to low doses now and feeling SO much better, getting my old personality and my brain back! Able to work full time, have a full social life, and cope with stress better than ever. Not perfect, but much better. After 23 lost years. Big Pharma has a lot to answer for. And "medicine for profit" is just not a great idea.

 

Feb 15 2010:  300 mg Neurontin  200 Lamictal   10 Celexa      0.65 Xanax   and 5 mg Ambien 

Feb 10 2014:   62 Lamictal    1.1 Celexa         0.135 Xanax    1.8 Valium

Feb 10 2015:   50 Lamictal      0.875 Celexa    0.11 Xanax      1.5 Valium

Feb 15 2016:   47.5 Lamictal   0.75 Celexa      0.0875 Xanax    1.42 Valium    

2/12/20             12                       0.045               0.007                   1 

May 2021            7                       0.01                  0.0037                1

Feb 2022            6                      0!!!                     0.00167               0.98                2.5 mg Ambien

Oct 2022       4.5 mg Lamictal    (off Celexa, off Xanax)   0.95 Valium    Ambien, 1/4 to 1/2 of a 5 mg tablet 

 

I'm not a doctor. Any advice I give is just my civilian opinion.

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The severe anxiety and depression are by far the worst of the withdrawal symptoms. I think it's even worse than the brain zaps. I can tell that it's definitely not the original anxiety/depression returning.

Taper from Cymbalta, Paxil, Prozac & Antipsychotics finished June 2012.

Xanax 5% Taper - (8/12 - .5 mg) - (9/12 - .45) - (10/12 - .43) - (11/12 - .41) - (12/12 - .38)

My Paxil Website

My Intro

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Shanti, I think my tapering symptoms were different to my original symptoms too, but it is hard after time goes by to tell. Hopefully keeping a journal will help.

 

Rhi, I'm interested in the microtaper idea, but I'm no longer recall how the Lexapro liquid comes. I do recall it tastes totally vile, though. :) I have an idea it is easy enough to dose in 1mg drops (5% in my case) and I *think* the increments on the dropper allowed pretty small drops too. Will have to wait until my appointment and see what I get.

 

Thanks everyone, for your support. I'm already feeling better about it all!

 

Bubbles

2005 St John's Wort / 2006-2012 Lexapro 20mg, 2 failed attempts to stop, tapered over 4.5 months in early 2012

January 2013 started Sertraline, over time worked up to 100mg

July 2014 Sertraline dropped from 100mg to 75mg, held for six months, slower tapering until 2019 22 Dec 3.2mg

2020 Sertraline 19 Jan 3.1mg, 26 Jan 3.0mg; 1 Mar 2.9, 7 Mar 2.8, May (some drops here) 24 May 2.5, May 29 2.4, June 21 2.3, June 28 2.2mg,  July 4 2.1mg, July 24 (or maybe a bit before) 2mg, early Nov switched to home made suspension; 29 Nov 1.8mg; approx 25 Dec 1.6mg)

2021 Some time in about Jan/Feb realised probably on more like 1.8mg and poss mixing error in making suspension; doses after 10 Feb accurate; 10 Feb 1.6mg; 7 Mar 1.4, continued monthly

10% drops until 1mg, then dropped 0.1mg monthly.

May 2022,0.1mg, now dropping 0.01mg per week

My thread here at SA: https://www.survivingantidepressants.org/topic/1775-bubbles/page/18/

CurrentSertraline: 0.08mg / Armour Thyroid

 

 

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You can also get a tiny 1mL oral syringe from pharmacies and veterenarians.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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