BellaC: tapering Lexapro / escitalopram

[BellaC]

Hello @ChessieCat,

Wow you've come a long way from 100mg to 1mg on Pristiq! 

 

Thank you for the advice and you are 100% right! These days, I definitely experience more mood relates symptoms which are harder to deal with. When the mood symptoms hit around May, 2020, I was so concerned that they wouldn't go away. The reality is, thank goodness, they do go away slowly with time. It just takes longer.

 

It's wise to hold longer and maintain 10% reduction. However, since my dosage is so low, my mini digital scale fails detect anything below 0.3mg. It's practically impossible for me to do 10% deduction with current tool. I heard some members use liquid form and successfully measure low dosage with a syringe. I currently measure out 0.3mg than divide it by eyeballing (not recommend), with this way, my best bet is just by holding longer and making sure symptoms subside before I get lower.

 

As you said, It's very exciting to be so close to the end. To me, also a little scary because I know I have to make the "jump off" call soon, approximately in 6 months since I am at 0.15mg. It's time for me to research how to properly do it... any advice is appreciated! 

 

Stay safe and healthy. 

 

[ChessieCat]

1 hour ago, BellaC said:

I heard some members use liquid form

 

I think it would be a good idea changing to prescription liquid to you can reduce by 10% or less, see:  Tips for tapering off escitalopram (Lexapro), to complete your taper, especially considering that Lexapro is a strong drug.  Be aware that a fast metaboliser might need to dose twice daily so please be on the alert for interdose withdrawal.  The gentlest way to change from tablet to liquid is to do a cross over using each of these combinations for 3-7 days:  3/4 tablet + 1/4 liquid, 1/2 + 1/2, 1/4 + 3/4, then all liquid.  If you get symptoms at any stage you would stay on that combination for longer.

  

On 5/27/2011 at 12:16 PM, Altostrata said:

 

However, many doctors are unaware that escitalopram is stronger than other SSRIs and dose it as though it were the same strength. Although the so-called usual starting dose of escitalopram, 10mg, is equivalent to 20mg-30mg or more of, for example, paroxetine (Paxil), your doctor may have moved you to an even higher dose. If you are taking 20mg of escitalopram, you are taking a hefty dose of an SSRI.

If you are taking 5mg of Lexapro, it's not tiny, it's equivalent to 10-20mg Paxil or Celexa.

 

[manymoretodays]

Hi BellaC!  Wow.  You've come a long way.

Is that 0.15 mg your dose then?  Are you weighing now?  What is that in pill weight?

I like how brassmonkey did the final stretch.  I think he had to just divide up crushed powder, into smaller piles.  The  Gemini10 scales will read down to .001 gram in pill weight / 1 mg in pill weight.

Just wondered.

You've been trooping right along.  Good job!

L, P, H, and G,

mmt

 

[Altostrata]

On 8/26/2018 at 10:14 PM, manymoretodays said:

Tips for tapering off Lexapro

 

 

Tapering with the liquid is described in this topic. Strongly recommend you get the prescription liquid or make your own liquid rather than pushing around piles of powder.

[manymoretodays]

And okay.  Concur.  Thanks Alto.

But do clarify what your dose is BellaC?  I just want to know.

[BellaC]

@manymoretodays Hello there, I’m using Gemini mini digital scales too. My pill is 5mg Lexapro/generic escitalopram, pill weight is 0.068g (each one weights slightly different varying from 0.066g-0.069g, majority of the time it weighs 0.068g). 

I currently measure out 0.002g, which is equivalent to 0.15mg escitaloprám. 
 

I’m at the point of pushing power around... which obviously is not ideal. I do have more mood symptoms along with physical pain, but overall I am doing okay. Looking back, I’m probably one of the lucky people who don’t get too many “intense“ withdraw symptoms. But again “intense” is subjective. so I’m not sure if it’s because my symptoms are really not that bad, or, I tolerate them better. I guess both. 
 

@AltostrataThank you for the liquid form information! I will definitely check it out. Better safe than sorry. 
 

I’ll keep everyone posted.  

[entcian24]

Wow! This has been such an informative & timely topic for me. Kudos to  @BellaC for so much clarity & updation.

 

Until 31 Oct 2020, I was taking 2.5 mg half tablet of escitalopram & 0.7gm solution(3.2mg escitalopram in all) . And things have gotten pretty bad since then, when I decided to switch to 3mg :all-liquid!

Will definitely try crossover technique. I jumped to all-liquid because cutting up the tablet was so much inconvenient & asymmetric.

 

Had to ask this: Do you weigh scale the crushed powder & swallow it with water? Or do you put the powder in gelatine capsules?

@ChessieCat,any suggestions on doing cross over are also welcome.

[manymoretodays]

On 10/9/2020 at 1:31 PM, BellaC said:

I currently measure out 0.002g, which is equivalent to 0.15mg escitaloprám. 

 

Thank you for clarifying, BellaC.

 

I just quoted entcian24, over to their Introduction as well.  So that we can all respond to their questions, on their topic, over there.

 

And best,

L, P, H, and G,

mmt

Edited November 25, 2020 by manymoretodays
link to entcian24 topic

[Yesyes123]

This is the most amazing and hopeful story of Escitalopram tapering I have seen so far.

 

You make this seem like a walk in the park! I hope my taper will be somewhat like yours.

 

Thanks so much for sharing. Hope you are doing great!

[Altostrata]

@BellaC, how are you doing?

[BellaC]

Hello @Altostrata, 

Thanks for checking on me. I realize that I have not updated for a while, and that's because I have been struggling a lot with the withdrawal symptoms in the past few months. I am quite familiar with these symptoms because they were exactly what I experienced 10 years ago during my first depression/anxiety episode. What bothered me the most are the physical pain (almost feels like chronic pain), as well as moderate anxiety although there is no danger present. These symptoms seem to appear as a result of decreased dosage however they have not gone away like before. Sometimes I get a good day and most of the days it's difficult to pull myself out of the anxiety/pain mode. I am still taking liquid form using a syringe, and I have been holding 0.071 dosage since May 2021.

 

The second challenge is self doubt. I start to question whether it is relapse or just withdrawal symptoms, as most of the time I am stuck in pain and the "good days" are rare, even in the good days, my physical pain is always there. I also noticed the brain fog: it is difficult for me to concentrate, and it requires a lot more effort to complete small daily tasks. I generally feel a lot better and relaxed during the evening, maybe my adrenaline just slows down at bedtime. 

 

For now, I plan to hold my dosage and take some time to manage my symptoms.

[Altostrata]

It appears these symptoms got worse with your last 2 reductions. How's your sleep?

 

Is the shoulder pain in your mousing shoulder? Are you spending a lot of time on the computer? How much exercise are you getting?

[BellaC]

19 minutes ago, Altostrata said:

It appears these symptoms got worse with your last 2 reductions. How's your sleep?

 

Is the shoulder pain in your mousing shoulder? Are you spending a lot of time on the computer? How much exercise are you getting?

 
Hi Altostrata, 

 

You are right, the synonyms got worse around my last 2 deductions. My sleep is good and normal. 
 

My shoulder pain is on both side, around collarbone, it feels more painful if I press down shoulders. I suspect it might be psychological somatic pain associated with my anxiety.  Both of hands sometimes feel tingling/pain sensation as well, occasionally loss of grip strengths. 
 

I spent a lot of time sitting in front of computer and I don’t exercise enough. 

[BellaC]

Hi all,

 

I am logging in to provide an update of my status. I am doing much much better recently, and my anxiety/depressed mood and somatic pain are almost gone. I tapered to 0.064mg liquid Lexapro on 10/1/21, and have been doing good so far.

 

Many changes came after I found out Dr. Peter A. Levine's Somatic Experiencing approach to treat physical pain related to trauma, and started to follow the exercises in his book Healing Trauma in late September. I felt a shift immediately and after a few days, my shoulder pain decreased by 60%, which enabled me to continue the taper after almost 5 months of holding. 

 

It's important to mention that my uncomfortable bodily sensations (including pain, racing heart and butterfly in stomach) are the primary contributors to my depressed or anxious mood. I don't feel depressed or anxious if my body is comfortable and relaxed. My body is at ease = my mind is at ease. This is exactly how psychotropic medications work: to make your body comfortable FIRST, so that your mind has a chance to work through issues, if any. 

 

This is why Dr. Peter A Levine's approach makes so much sense to my situation. I was at a stage where my mind has processed the trauma but body still remembers. Somatic Experiencing approach taught me to reconnect with my body and slowly get out of the "stuck" stage. When my body and mind was stuck, everyday was the same, I had to make effort to endure the suffering and not give up. Now I don't feel stuck anymore, I am able to move forward, absorb new information and enjoy life again. This feeling of ease and flow is so good and I'm grateful to be able to experience it again.  

 

I highly recommend that you check out Dr. Peter Levine, his books and Somatic Experiencing therapy, as I believe most people here took meds in the first place to "get rid" of some unbearable bodily sensations which could be labeled as certain diagnosis. 

 

Stay safe.

[BellaC]

Off Lexapro for 1.5 months & updates

 

I'd like to update everyone here that I am officially off Lexapro after 12 years. My last dosage was 0.016mg lexapro in home-made liquid form, and I stopped it on March 11, 2022.

 

It has been more than a month since, and I thought I would share my current symptoms. I am experiencing a similar set of withdrawal symptoms as my previous tapering stages (mostly in later stages), but a more severe version. I currently experience anxiety (symptoms like palpitation, irritability and panic), mood swing, pain in shoulders, low motivation and difficulty concentrating (as I am anxious and shaky). I also noticed that the anxiety symptoms have caused difficulty falling asleep and some very very scary nightmares. Sometimes I have urges to cry but that doesn't occur too often. Interestingly, these symptoms are like waves, somedays I feel better and some days I just feel the worst, it is hard to predict the days, sometimes I feel good in the morning then it gets worse towards the evening, sometimes it's the other way around. My cognitive function is directly correlated to my symptoms. When I have minimal or mild symptoms, I can read, learn, think and go with the flow of information. But when the days are hard, my brain can barely process any information, or it just keeps drifting. For instance, if I am trying to read a paragraph, I would have to read 3-4 times repeatedly to grasp it. This kind of toll on my mental power is exhausting, and is my biggest challenge right now. As I like to be productive and goal oriented, being unable to use my brain makes me feel "stuck" as many tasks are currently being parked. 

 

I take fish oils and eat a balanced diet, meditate and exercise regularly. I do find physical exercises helpful although in my case, I have to perform some quite high intense exercise in order to "feel" the benefits afterwards. I am also considering taking some Magnesium supplement to see if it helps with my anxiety and sleep. 

 

This is still not a success story yet but I am getting there. I also feel lucky that I still get some good days, I hope those good "windows" gets longer and longer with time.

[Altostrata]

Thanks for updating us, @BellaC How have your symptoms changed in the last 10 days?

[BellaC]

On 4/27/2022 at 10:32 AM, Altostrata said:

Thanks for updating us, @BellaC How have your symptoms changed in the last 10 days?

Hi @Altostrata, I did not have significant change of symptoms in the past 10 days, they remain the same. 

I do notice that medium to high intensity cardio exercise lasting more than 30 min helps with my symptoms, I feel somewhat better afterwards. The longer the exercise, the longer the effect will last. So if I run for 40 min, I usually experience milder symptoms for 7-8 hours. They are not completely gone and will return, but I am glad at least this one thing is working. I don't experience similar effect with weight training, which is interesting. 

 

[ChessieCat]

@BellaC

 

Please condense your drug signature.  It is too long and takes up a lot of room.  It makes it difficult to see your posts.

 

It have very good information it in BUT it is too detailed for a drug signature.  We need to be able to see your drugs and dates at a glance and not have to read through it to find the information.

 

Instructions:  Withdrawal History Signature

 

I have pasted the current drug signature below so that you still have the information:

 

Lexapro 20mg: 2010-2017 (I was doing fine for those years)

PCP recommended tapering in June 2017

Tapering instructed by PCP:

• 20mg & 10mg every other day: 6/2017-12/2017, No sx
• 10mg: 12/2017-2/2018, Anxiety and hormone imbalance 
• Restated 15mg: 2/2018-7/12/2018, No Sx

Self Tapering:

---------digital scale weighing method below-----------------------------------------------------------------------------------------

2018

• 15mg & 12.5mg every other day:7/12- 8/8, No sx
• 12.5mg : 8/9- 8/28: palpitation, brain fog, diarrhea, dreams, obsessive thought. Subsided on 8/29.
• 11.2mg: 9/14 -10/12: mild sx. Subsided by 9/27/2018.
• 10.2mg: 10/13 - 11/7: lethargy, mild shoulder pain. Subsided in 2 wks.
• 9.2mg: 11/7- 12/10: no sx

2019

• 8.4mg: 12/11/18- 1/7/19: mild sx. Subsided in 3 days.
• 7.3mg: 1/8-1/26/: no sx
• 6.6mg: 1/27-2/25: pain, palpitation, anxiety. Subsided in 1 wk.
• 5.67mg(15% cut): 2/26-3/26: dreams, pain, palpitation. Subsided in 2 wks.
• 5mg: 3/26-4/25: no sx.
• 4.1mg: 4/26-5/19: slight palpitation, gone by 5/8.
• 3.4mg:5/20-6/23: no sx
• 2.8mg:6/24-7/21: palpitation, anxiety and dreams. subsided after 2 wks.
• 2.45mg:7/22-8/18: slight palpitation, down mood, gone by 1st week; diarrhea daily. subsided after 3 wks.
• 2.1mg:8/19-9/18: slight palpitation, dreams, constipation. gone by 3rd wk.
• 1.69mg: 9/19-10/16: slight WD sx.
• 1.38mg: 10/17-11/18: anxiety, depression sx. gone by 4th week.
• 1.17mg: 11/19-12/16: 2nd week-somatic pain, anxiety, diarrhea, better by 3rd wk.

2020 (new year yay!)

• 0.92mg: 12/17/2019-1/26/2020: holding, has been 6 wks: somatic pain, down mood, dream, some diarrhea.
• 0.76mg: 1/27-3/1: somatic pain, palpitation in first 2 wks, diarrhea in 3rd wk, gone by 4th week.
• 0.65mg: 3/2-3/28: I did not track sx
• 0.55mg: 3/29-5/5: I did not track sx
• 0.46mg:5/6-6/3: overall mood is a little low, sad and pessimistic sometimes, sensitive towards stress. stabilized after 4wks.
•  0.38mg: 6/4-7/19: depressed mood, sensitive towards loud sound, improved after 1 month
• 0.31mg:7/20-8/23:depressed mood initially, sensitive towards loud sound, improved after 1 month
• 0.23mg: 8/24-10/4: depressed, somatic pain, less , social, easily cry, low motivation. got better after almost 2 months!

--------- Homemade liquid solution below------------------------------------------------------------------------------------------

• 0.15mg :10/5-11/5: pain in shoulder, depressed, gone after 1st week.
• 0.13mg:11/6/20- 12/7/20: depressed. stable after 1 month.

2021 (new year yay!)

• 0.11mg: 12/8/20-1/3/21:depressed, pain in shoulder, ease after 1 month.
• 0.097mg: 1/4/21-3/7/21: depressed, anxiety, mood swing, pain in shoulder. improved after 2 mons.
• 0.084mg: 3/8/21-5/9/21: increased anxiety, shoulder pain, difficulty concentration, negative thinking pattern. improved after 2mons.
• 0.071mg: 5/10/21-9/30/21: increased anxiety, shoulder pain, difficulty concentration, negative thinking, lack of motivation. Improved after doing Somatic Experiencing exercises after the book Healing Trauma by Peter Levine
• 0.064mg:10/1/21- 11/1/21:  No sx, minimal pain
• 0.051mg:11/2/21-1/9/22: anxiety, shoulder pain, low motivation. ease after 2 months.

2022 (new year yay!)

• 0.032mg: 1/8/22-2/28/22: palpitation, pain in shoulder, ease after 1 month.
• 0.016mg: 3/1/22-3/10/22: anxiety, palpitation.
• 0 mg: 3/11/22 (jumped off!): anxiety ( palpitation, irritability, panic), mood swing, pain in shoulders, low motivation, difficulty concentrating, slow mental processing, difficulty falling asleep, nightmares.

 

Edited April 30, 2022 by ChessieCat

[Altostrata]

That is interesting, @BellaC Good to hear that exercise helps. Do you enjoy it?

 

Suggestions: 1) Don't overdo it, be aware of your limits. 2) Expect the benefit will gradually extend over time, exercise is helping your system to re-regulate. Be patient!

 

Please let us know how you're doing.