civilwar142pa: Four months off Lexapro

[civilwar142pa]

This is my first time posting in a forum because my psychiatrist told me three months is generally the end of withdrawal symptoms, especially when you were on a low dose like I was. Yet I'm still having bad symptoms. I was on Lexapro for about 15 months at 5mg with one month trying 10mg only to drop back down because of bad side effects. 

 

Now after nearly four months off the main thing I have is severe anxiety around my period. Two-three days before and lasting through the week after. I get shaky, anxious, panicky, have pressure and pain in my head and face, sore throat. 

 

Is this a normal reaction? It seems extreme for four months off of only 5mg, but since I couldn't up to 10mg maybe I'm more sensitive to this type of med? 

 

I know this can't last forever but it's hard to see the light at the end of the tunnel when I'm literally incapacitated for almost two weeks per month. 

[Gridley]

Hello, civilwar, and welcome to SA.

 

Anxiety is a very common withdrawal symptom after a too-fast taper.  We recommend a taper no fast that 10% of current dose every four weeks.

Why taper by 10% of my dosage?

 

 

Doctors know very little about antidepressant withdrawal, and withdrawal can last quite a bit longer than three months.  Unfortunately, no one can say how long.  Lexapro is a very strong antidepressant, and 5 mg, while lower than what many are prescribed, is still quite powerful.

 

I'm going to give you several links that will help you become better informed about your situation.  Please don't be overwhelmed with all the information, and take your time reading them.

 

To help you understand the symptoms you are experiencing, here is some information on withdrawal.  The withdrawal time doesn't necessarily correlate with the time you were on the drug.  These drugs alter the architecture of the brain, and the time necessary to heal the brain and return to homeostasis is, unfortunately, impossible to predict.  

 

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

 

Is anxiety your only symptom?  Is it intolerable?  If so, you might want to consider reinstatement. 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

 

If reinstatement of a small dose of Lexapro is something you want to consider, let us know and we can suggest a dosage.  Reinstatement isn’t a guarantee of diminished symptoms for everyone, but it’s the best tactic available. 

 

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, but 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 non-drug techniques in the following links helpful in dealing with withdrawal symptoms, including anxiety.

 

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

 

Non-drug techniques to cope with emotional 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.

 

 

 

 

 

 

 

 

 

[civilwar142pa]

I do have a couple of questions with this but first I have to so reinstatement really isn't an option due to insurance changes and in unreliable GP, but also after four months off I'm not sure how much reinstatement could really help. 

 

My first question is if anyone else has noticed that WD anxiety is different than the initial anxiety that Lexapro was used to treat. For me, my initial anxiety was very localized in thoughts and very occasionally a tight chest, dizziness, etc. 

 

Now this WD anxiety is almost a full body experience. Tingling in my limbs, muscle tightness, head pressure, headache/migraine, and it's far more volatile. I've been trying to put my CBT tools into action to combat it but sometimes these tools that we're so helpful before either don't do a thing or actually make the anxiety worse. A few days ago I went to the pharmacy to get some prescriptions for my mother and almost had a panic attack in the car. I had to sit in the parking lot in the car for a few minutes to calm down a bit. That didn't happen with my initial anxiety.i had three full blown panic attacks, but there was some warning and a reason behind them. But that was almost two years ago and after a few months of CBT I never came close to another panic attack until about a week ago. 

 

My second question is if allergies are related to WD. With the head pressure I've been having I also have a lot of sinus drainage. I tried Claritin a few weeks ago, took it for 3-4 days in a row and it helped the head pressure a lot, but also the anxiety, too. I'm not sure if the Claritin helps with that too or if just the reduction in that one intrusive physical symptom was enough to break that wave of anxiety. 

[Petunia]

Hi Civilwar,

I'm sorry for what you are going through, I was also taking Lexapro at a 5mg dose. For me this was enough, the 10mg I was prescribed was a too high dose for me. As Gridley pointed out, Lexapro is a strong anti-depressant and often doctors will prescribe a high dose which may cause unpleasant effects. I also tapered much too fast from 5mg and ended up in withdrawal. My doctor had said to me that I was on such a low dose, I could just stop taking it and probably wouldn't notice any different. He was wrong.

 

But to answer your questions. Withdrawal anxiety is often different from normal anxiety. As you have noticed, there is often no obvious trigger for the sensations, and when there is, the reaction is intensified beyond what would normally be experienced. I originally started taking antidepressants for mild to moderate situational anxiety. But in withdrawal, my symptoms have been about 100 times worse than I ever experienced before and I had symptoms I never had previously.

 

Withdrawal can cause the entire nervous system to behave chaotically, which can bring a wide array of unpleasant sensations and subjective states. This is how you can be sure its withdrawal and not a return of your previous problem.

 

CBT wont fix withdrawal anxiety because it's caused by a malfunctioning nervous system, not dysfunctional thoughts and behaviors. But it will help to prevent any secondary anxiety which can be caused by unnecessary worrying about symptoms and the withdrawal process. Withdrawal symptoms can't be stopped, they need to be accepted calmly. In time, they will reduce and go away. In the mean time, use your CBT techniques to stay calm.

 

Antidepressants have an anti-histamine like effect, so when you stop taking them, there can be a rebound histamine sensitivity effect, which may bring an increase of histamine related symptoms. Personally I've had increased sinus and allergy type symptoms as I've been recovering. Some people experience increased itching and reactions to high histamine foods.

 

Its not a good idea to take anti-histamines if you can possibly avoid it. It's better if you can let your system re-balance itself naturally.

 

I will list some topics you may find helpful:

 

What is withdrawal syndrome?

 

Rate symptoms daily to track patterns and progress

 

Keep notes on paper

 

Dr. Joseph Glenmullen's withdrawal symptom checklist

 

Patterns of Recovery  (a short video)

 

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

 

Allergies and overactive immune system - Surviving Antidepressants

 

Here is the link to our symptoms and self care section, you may find some useful ideas to help manage symptoms as you recover.  Especially read the topics pinned at the top.

 

This site has a topic on just about everything withdrawal related, to search the site, use Google and type in 'survivingantidepressants.org' followed by the subject or key word/s you are interested in. You will reach a list of related topics.

[civilwar142pa]

Update here. It's been about four months now completely off Lexapro. Still having pretty bad anxiety often coinciding with an odd pressure headache that has been pretty constant. Some of it may be from allergies, because I do have some drainage, but I've never had a headache like this before. 

 

Yesterday I had some exciting news and I got so so focused on it, I think I must've gotten overwhelmed. I did some yoga before bed to help with my tense neck and back, went through my usual bedtime routine after that but when I did lay down to go to sleep, I couldnt. It was like my body was vibrating with anxiety. This morning the headache is worse. My neck and shoulders are sore, so I'm hoping throughout the day and tomorrow some of the tension will be gone there. 

 

I just so wish I'd found this site before agreeing to my psychistrists taper schedule. It was way too fast, but I've been off so long, I'm really not interested in reinstatement. I think I might try to write out the withdrawal symptoms I'm having to keep better track of the waves and windows because this past month, unlike the previous two, my anxiety level was not too terrible right up until I got my period. So that seemed like progress but the past week and especially overnight and this morning it's pretty bad. 

[civilwar142pa]

About 4.5 months off lexapro now, still have bad anxiety, brain fog, hot flashes, chills, lots of fun stuff. Starting to get annoyed by this honestly. I had a "window" if you could call it that a few days ago. One day of feeling almost normal, then anxiety came back like a freight train. Annoying. 

[Altostrata]

Yes, those windows are welcome but frustrating when they close.

 

If you are inclined towards reinstatement, Celexa is a close relative of Lexapro and is available as a generic for very little cost from Walmart, Target, or Walgreen's. Even 0.5mg might help. You'd make your own liquid, see Tips for tapering off Celexa (citalopram)

[civilwar142pa]

Like I said above, I'm not interested in reinstatement. It's been far too long anyway and could cause more problems. 

[Altostrata]

It's not too late. It's up to you, if you find your present symptom pattern is too difficult.

[civilwar142pa]

So I may have to take the plunge and try reinstating. I was coping fine and now I've got some other health issues going on and that's ramping up the anxiety to new heights. 

 

Question: what dose would I even reinstate with? I was only on 5mg to begin with. Does 1-2mg make sense to reinstate, hopefully stabilize and then taper properly from there? 

 

I have a doctor's appointment tomorrow and hope to discuss it with him but beyond starting that conversation, I'm not sure what I need to communicate to him. 

[Rose9975]

I am curious what other therapies or methods have you tried to address your anxiety?

[civilwar142pa]

I've been through multiple forms of therapy. Most recently CBT in the past two years which has been more helpful than anything before. I can handle my anxiety much better now, but CBT tools don't work with withdrawal anxiety. That's another fun thing I've found out during this process. I can generally keep from adding to the withdrawal anxiety, but nothing I do touches the WD symptoms. 

[Rose9975]

I know I understand it must be awful xx

[Rose9975]

CBT never worked for me give me a hug, someone emotionally attuned, massage & let me cry anyday.....something to regulate my nervous system....we are all different to what works for us 💞

[civilwar142pa]

I should also add that I adopted a dog last year. I had one before that passed away and thought getting another one would be helpful. My therapist agreed it'd be a good idea, so I adopted a young lab mix. Before if I had a bad day I wouldn't get out of bed until noon. Now I've got to get up and take care of him and get him outside. It helps to have some outside motivation like that. Plus he's a great hiking partner and he's always good for a laugh. 

[ChessieCat]

42 minutes ago, civilwar142pa said:

Question: what dose would I even reinstate with?

 

On 8/10/2018 at 4:53 AM, Altostrata said:

Celexa is a close relative of Lexapro and is available as a generic for very little cost from Walmart, Target, or Walgreen's. Even 0.5mg might help. You'd make your own liquid, see Tips for tapering off Celexa (citalopram)

 

Above is what Alto posted previously.

 

I suggest you check out these topics before seeing the doctor:

 

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

What should I expect from my doctor about withdrawal symptoms?

 

8 minutes ago, civilwar142pa said:

I can generally keep from adding to the withdrawal anxiety,

 

That is good.  Adding to the withdrawal anxiety is second fear. 

 

Non-drug techniques to cope

 

Audio:  First Aid for Panic (4 minutes)

 

CBT Course:  An Introductory Self-Help Course in Cognitive Behaviour Therapy

 

Audio:  How to Recover from Anxiety - Dr Claire Weekes
 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help ...

 

On 4/28/2017 at 4:03 AM, brassmonkey said:

AAF: Acknowledge, Accept, Float.  It's what you have to do when nothing else works, and can be a very powerful tool in coping with anxiety.  The neuroemotional anxiety many of us feel during WD is directly caused by the drugs and their chemical reactions in the brain.  Making it so there is nothing we can do about them.  They won't respond to other drugs, relaxation techniques and the like.  They do, however, react very well to being ignored.  That's the concept behind AAF.  Acknowledge, get to know the feeling involved, explore them.  Accept, These feelings are a part of you and they aren't going anywhere fast. Float, let the feeling float off as you get on with your life as best as you can.  It's a well documented fact that the more you feed in to anxiety the worse it gets.  What starts as generalized neuroemotinal anxiety can be easily blown into a full fledged panic attack just by thinking about it.

 

I often liken it to an unwanted house guest.  At first you talk to them, have conversations, communicate with them.  After a while you figure out that they aren't leaving and there is nothing you can do to get rid of them.  So you go on about your day, working around them until they get bored and leave.

 

It can take some practice, but AAF really does work.  I hope you give it a try.

[civilwar142pa]

I've never heard it called AAF but that same sort of technique is one of the first things I learned to use during CBT. It does work really well. I know that my initial anxiety wasn't as bad as my current anxiety, but with those techniques I learned, I can cope much better even with the stubborn WD anxiety. 

 

I'll check out those links. Thank you. 

 

Does it make more sense to reinstate with the same drug (Lexapro in my case) or to go to another one like celexa? Cost of medication thankfully isn't a concern for me at the moment. My copays are pretty low. 

[ChessieCat]

It's generally better to reinstate the drug you had been taking.  If you reinstate a different drug you will not be able to tell what is causing any issues.  Withdrawal from previous drug, start up/side effects/bad reaction to new drug.

 

Please carefully read Post #1 of this topic:  About reinstating and stabilizing to reduce withdrawal symptoms

 

Please note that Lexapro is stronger than Celexa.  If you reinstate Lexapro it would be better to start with 0.25mg.

 

From:  https://psychopharmacologyinstitute.com/antidepressants/ssris/citalopram-escitalopram-differences-similarities/

 

• Regarding prescribing tips, escitalopram equivalent dose is half that of citalopram

 

Tips for tapering off Lexapro (escitalopram)

[civilwar142pa]

I saw my doctor today. He had no idea about withdrawal. Said after a month Lexapro is out of your system so you'll have no withdrawal. I almost laughed out loud. But he was receptive to letting me try a small dose so he prescribed me liquid Lexapro. If my other issue (Hashimotos thyroiditis) isnt the culprit, I'll try a low dose and see how it goes. I've got blood work pending for my thryoid function so I should know the results in a day or two.

[Altostrata]

As ChessieCat suggested, don't overdo it. I would try maybe 0.25mg Lexapro and see what it does. Trust us, a little can go a long way. Better to put your little toe in first.

 

Please let us know how you're doing.

[ChessieCat]

8 hours ago, civilwar142pa said:

liquid Lexapro

 

Please check the strength/concentration of the liquid.  As an example:  In the UK, the liquid form is available at a 10mg:1mL or 20mg:1mL concentration.

[civilwar142pa]

So I've looked through some of the other threads about headaches, but haven't been able to find anything about my specific situation. For the past 5 weeks I've had a headache that goes from pain to pressure to even a feeling of heaviness at the top and front of my head. I was hoping to get that resolved before I started the Lexapro again but after trying multiple medications through my doctor and stretching exercises, I still haven't been able to get rid of this. I would think if this were a withdrawal symptom that it would have happened earlier, but could it still be from the withdrawal?

Either way I'll probably start the Lexapro again in the next day or two at 0.25 and see what happens. 

[ChessieCat]

The headache sounds like it might be a withdrawal symptom.  #45 on this list:  Dr Joseph Glenmullen's WD Symptoms Checklist

 

delayed-onset-of-withdrawal-symptoms

 

 

Edited September 24, 2018 by ChessieCat

[civilwar142pa]

Interesting. Thank you. I'll start the Lexapro again in the morning and see how it goes.

 

[civilwar142pa]

Well I went to take the Lexapro this morning and found out the measuring spoon from the pharmacy doesn't have markings for 1/4mL and also is too big for me to measure out that small amount accurately. I'm at a bit of a loss because my official dosage on the prescription was 2.5mg. without half markings I can't accurately measure out that dose either. Not sure what the ohaacy pharmacy was thinking there but either way I can't take the Lexapro unless I can figure out a way to measure out the fractional doses. 

 

Edited September 25, 2018 by ChessieCat
correction

[civilwar142pa]

I am going to check with the pharmacy to see if they have a smaller syringe

[manymoretodays]

On 9/11/2018 at 6:09 PM, Altostrata said:

As ChessieCat suggested, don't overdo it. I would try maybe 0.25mg Lexapro and see what it does. Trust us, a little can go a long way. Better to put your little toe in first.

 

Please let us know how you're doing.

 

On 9/11/2018 at 10:10 PM, ChessieCat said:

Please check the strength/concentration of the liquid.  As an example:  In the UK, the liquid form is available at a 10mg:1mL or 20mg:1mL concentration.

 

Hi civilwar,

Okay, good to check with the pharmacist now.  To double check the strength/concentration and then just start with a little bit.  To go over measurements and get an appropriate sized syringe as well.    You want to base your small dose on mg(milligrams).....so get really clear on what concentration you have now with the pharmacist please.  Accuracy and then consistency of measurement is really important!

 

You can, if need be.......further dilute the concentration/strength of your liquid Lexapro with water.  You would want to take just a small amount from the main prescription bottle and then further dilute it and store it separately.  It's best if you just reconstitute a small amount at a time, that way you will have your main supply(the liquid Lex prescription) intact.  You could then use your diluted solution, to be on the safe side........for up to 3 days.   Store it in the refrigerator and protect it from light.

 

Love, peace, healing, and growth,

Best,

mmt

Edited September 25, 2018 by manymoretodays

[civilwar142pa]

Ok so I was able to get smaller syringes so I can measure out my dose properly. The label on my bottle says 5mg/5mL so no issues with the concentration there. I just took 0.25 so we'll see how it goes. I hope it helps because I'm in a tough spot at the moment. 

[ChessieCat]

You will need to be patient.  It takes about 4 days for the dose to reach full level in the blood and a bit longer for it to register in the brain.  Please keep daily symptom notes so you can see how reinstating is going.

[civilwar142pa]

Update. So I'm been taking the Lexapro 0.25 for 8 days now. Didn't expect to notice much change, but I feel like my anxiety has been slightly worse than before. My period is also a few days late, which never happens except when starting stopping this medication, so the hormonal element is probably contributing as well.

Here's my daily log:
 

DATE: 9/25/18

MEDS: tirosint 75mcg, Lexapro 0.25mg, multi vite w/ omega 3s, vite d, magnesium 200mg

Woke up at 730 with anxiety 8. Anxiety 7-8 throughout day with spike early afternoon. Headache still all day.

 

DATE: 9/26/18

MEDS: tirosint 75mcg, Lexapro 0.25mg, multi vite w/ omega 3s, vite d, magnesium 200mg

Woke up multiple times during the night. Had weird dreams. Anxiety slightly lower around 7 throughout the day. Headache still all day. Slightly more energy.

 

DATE: 9/27/18

MEDS: tirosint 75mcg, Lexapro 0.25mg, multi vite w/ omega 3s, vite d, magnesium 200mg

Slept a bit better last night but woke up early. Headache a bit worse today feeling spacy and a bit off-balance. Anxiety around 6+-7 all day.

 

DATE: 9/28/18

MEDS: tirosint 75mcg, Lexapro 0.25mg, vite d, magnesium 200mg

Woke up too early. Headache worse with spacy feeling, head pressure, dizziness. Anxiety around 7 today with spike with shaking late afternoon.

 

DATE: 9/29/18

MEDS: tirosint 75mcg, Lexapro 0.25mg, multi vite w/ omega 3s, vite d, magnesium 200mg

Bad night of sleep, weird dreams and waking up throughout the night. Anxiety around 6+ throughout the day. Got a little more exercise than normal.

 

DATE: 9/30/18

MEDS: tirosint 75mcg, Lexapro 0.25mg, multi vite w/ omega 3s, vite d, magnesium 200mg

Weird dreams last night, woke up only once. Headache slightly better, more foggy less pressure. Anxiety around 6+ throughout the day

 

DATE: 10/1/18

MEDS: tirosint 75mcg, Lexapro 0.25mg, multi vite w/ omega 3s, vite d, magnesium 200mg, Tylenol 500mg

Bad night of sleep last night, weird dreams, woke up often. Headache same as yesterday. Anxiety around 6+ during the day, but situational anxiety slightly less than it has been recently.

 

DATE: 10/2/18

MEDS: tirosnt 75mcg, tylenol 500mg, lexapro 0.25

Bad night of sleep, woke up multiple times, woke up in the morning with higher anxiety than normal. Headache about the same as yesterday. Anxiety around 7 generally but spiking throughout the day with hot flashes. Nauseated as well (food I ate or lexapro?)

 

Edited October 4, 2018 by ChessieCat
unbolded

[WarriorWomanLV]

Civilwar, any update? I've also decided to reinstate at .25mg

[civilwar142pa]

Hey WarriorWoman!

I'd say the last week or so, maybe ten days, I've noticed a difference. The little uptick in anxiety I had has gone away and my baseline anxiety level is ever so slightly lower. The main difference I've noticed is in my sleep. Before I was either waking up constantly with anxiety or being unable to fall asleep or waking up hours earlier and being unable to go back to sleep. In the past week I've only had one night where I had trouble falling asleep and I haven't been waking up with the bad anxiety like I was before. 

[WarriorWomanLV]

Civilwar, that's great news. I have also been feeling better since day 2 of my .25mg reinstatement. Same as you, baseline anxiety is lower and no more cortisol spikes when i wake up. Crazy how that small amount is making a huge difference. Im still monitoring myself to see if i need to updose a bit. Let me know if you've decided to settle at a certain dosage. We're very lucky to have found this site and the staff who's been giving great advice!

[civilwar142pa]

Update: I've been at 0.25mg for almost two months now. I'd say for the past week, maybe two my anxiety has been worse again. I'm thinking that's due to me getting used to the medication again and I'm considering updosing a bit but wanted to get some advice on that first. 

 

Is it "normal" when reinstating to have fluctuations after a new dose? I know it is when initially starting a med, but is reinstatement a different sort of process?

 

And if I do updose, what should I go to? 0.5mg? More or less? 

[WarriorWomanLV]

Hi Civilwar, 

 

I'm not a mod, but someone who has also reinstated a small amount like you. Is it possible you're experiencing a wave from the initial withdrawal and will just need to ride through it? I guess my thought process is if we keep updosing when a wave hits, how are we supposed get off of this thing?? Also, i read one of the introductions on here with someone who had reinstated (at a bit higher dose than us, about 1mg or maybe even 2.5). He said that when he hit a wave he actually felt that it was his cue to taper. And when he did, he felt better after a few days. Please keep this in mind. I'm sure I'll also eventually run into this issue. 

 

Did anything trigger your anxiety? Changes to the environment or diet? Close to your period? I hope you'll feel better soon!

[civilwar142pa]

Hey warriorwoman,

 

I guess it's possible but I've never had much of a wave/window pattern to my withdrawal. It's been mostly steady, which is why I was thinking I may need to updose, since that pattern isn't the norm for me. 

 

I haven't had any real triggers that I could blame it on. My period was last week and I did have a little uptick then, but it wasn't anything major.

 

It's just so frustrating not know what's happening, you know? And not knowing what the best route out is. But it'll get figured out eventually, I suppose.