TampaDad: seeking advice on reinstatement

[TampaDad]

Hello to the forum.  I found this site today and have only read a few posts, as I am in crisis and need some suggestions.

 

History:  20 years of antidepressant meds.  On Lexapro since it was released in the US.  My dose has been as high as 40 mg in the past.  For the last several years my dosage has been 20 mg Lexapro, plus 300 mg Wellbutrin.  (add ambien to sleep, klonopin or xanax when upset, weekend alcohol.)

 

I recently lost my psychiatrist relationship so I decided to get off all meds and see how I did.  8 week taper from 20 mg lexapro to 0.  Last dosage was probably 2.5 mg for a week and last taken about 3 weeks ago.  I am still taking 150 mg Wellbutrin as I still have some of those pills left and have not tapered yet...I was planning to taper off the wellbutrin after getting off lexapro.

 

My emotional symptoms have me looking for advice.  I feel anger, rage, negative recurring violent and hateful thoughts.  I cannot be around anyone without being vicious toward them.  I am avoiding my wife and work interactions in hopes of not losing my job.  These symptoms are far worse than my reasons for quitting the meds.  My depression and anxiety were never as bad as this rage -- even at their worse.  

 

I only knew to taper as slowly as possible and since symptoms were not severe while tapering I continued.  Now they are insufferable.

 

Should I go back on the lexapro so that I can try tapering more slowly at a later date?  Or is that a bad idea since I've been off for three weeks?  I don't know the basic school of thought here and my topic search on this site has not been helpful.  The antidepressants worked but I slept 10 hours per night and had sexual difficulties.  Those issues were far smaller than losing my job, marriage, or getting in an altercation with some unsuspecting store clerk.  I am not suicidal, but weepy, angry, and don't know how to proceed.  

 

I guess my taper was too fast, reasons for quitting SSRI were not compelling, I should be under a doctors care, etc.  BUT, regardless of this, should I start a 2.5mg does today?  Or is that going to do more harm?  Advice would be appreciated because I don't want to make it worse with bad assumptions.  

 

Thanks.

Male, 56 years old

[Gridley]

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.

 

Account Settings – Create or Edit a signature.

 

Three weeks out is not too late to reinstate.  Reinstatement works most predictably within three months of the last dose, and you are well within that time.  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.   We usually suggest a much smaller reinstatement dose than your last dose.  These drugs are strong, and when reinstating it is better to start with a small amount and increase if symptoms remain unbearable. Your system has become sensitized and 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.  

 

 I would not recommend you reinstate the 2.5mg that was your last dose.  I would suggest instead that you reinstate 1mg and see if that provides some relief from your withdrawal symptoms.  It takes about 4 days for a dose change to get to get to full state in the blood and a bit longer for it to register in the brain.

 

Then, once you have stabilized, which can take several months, you can begin a slow 10% every four weeks taper off the Lexapro.  

 

Why taper by 10% of my dosage?

 

I would not make any changes to the Wellbutrin until you are off the Lexapro.

 

You will need to find another source for Lexapro and Wellbutrin.  It doesn't have to be a psychiatrist; any GP can prescribe them.  

 

 

 

 

 

[TampaDad]

Ok thanks Gridley. Starting 1mg reinstatement now. 

[SkyBlue]

1 minute ago, TampaDad said:

Ok thanks Gridley. Starting 1mg reinstatement now. 

 

Let us know how it goes, TD. : )

[Carmie]

Hi TampaDad, 

 

Hope all goes well with your reinstatement. Quick tapers cause such havoc. I hope you stabilise again soon n then taper down slowly. 

 

Wishing you all all the best n sending hugs🤗

[TampaDad]

Can anyone provide a link for material my wife might read.  I can't convey the emotional impact and why I can't be around anyone.  Thanks in advance.

 

[jozeff]

Hello tampadad,

 

Welcome. Let's hope your reinstatement will bring you some relief. You tapered fast...but....not everybody is gonna have major problems. The most problematic cases, including myself, visit SA website of course. 

Very wise of yours to look around for information.

You know, my wife doesn't always understand my behavior either. It's very hard to see someone having fun and the next moment I'm in bed hoping to make it the next hour.

 

I hope you are going to be just fine!

 

Let us know how your 1 mg is going!

 

Cheers

 

Jozeff

 

[Gridley]

41 minutes ago, TampaDad said:

Can anyone provide a link for material my wife might read.  I can't convey the emotional impact and why I can't be around anyone.  Thanks in advance.

 

 

TampaDad,

 

Google "surviving antidepressants rage anger" and you will find some links.  Read through them to see if they might be helpful.  Also Google "ssri withdrawal rage anger"

 

In addition,  read through the links listed in the following.  These links don't deal specifically with withdrawal induced rage but might be helpful in explaining what you're going through:

 

What is withdrawal syndrome. 

 

Aggressiveness is one of the common withdrawal symptoms:

 

Glenmullen’s withdrawal symptom list.

 

Finally, this link is an excellent explanation of what's going on in your brain and why:

 

Brain Remodelling

 

Pick and choose which links to ask your wife to read.  Too much information can be overwhelming.

 

[TampaDad]

Most helpful and good advice about keeping it simple and not giving too much overwhelming detail. 

[TampaDad]

I have reinstated on 1.25 mg if Lexapro for 5 days and I believe it has helped with my symptoms. 

[Gridley]

That's great, TampaDad.  Please keep us updated on how you're doing.  

[Carmie]

On 9/1/2018 at 4:40 AM, TampaDad said:

I have reinstated on 1.25 mg if Lexapro for 5 days and I believe it has helped with my symptoms. 

 

Hi Tampadad, 

 

Glad to see your symptoms are a bit better. Hope u continue to stabilise, there is no timeframe in any of this but we all eventually stabilise n then we can taper again. One step at a time. 

 

Wishing you all the best💚

[TampaDad]

Well it is not going so well lately.

 

I am now taking 2.5mg Lexapro and my mood is frequently foul and angry -- just looking for something to be mad about.  I do not like to be around people.  I have started having severe pain.  Worst is the joint where my big toe joins my foot in the ball.  It causes a limp and I can't even walk for exercise.  Icing it has temporary relief.  I've done nothing to injure it.  Other very noticeable pain are the base of my neck, outer edge of left foot (5th metatarsal) knee tendons.  It's only been a couple of days since I realized that these are new symptoms of discontinuation.  My foot pain is severe enough to wake me in the night and be unable to get back to sleep.  I am a real joy to be around.  But I have not lost my job yet so I'm still treading water.  I'm really disappointed that I am now manifesting physical symptoms too.  

 

I have been at 2.5mg Lexapro for about 1 week so perhaps I'll try a higher dose and see if it improves these new symptoms.  

 

Also, I ran out of the 10mg generic pills and now I have 20mg pink illegal pills from India.  They are hard to split and I think the pain symptoms are worse on these.  So perhaps I'll go to the primary care doc this week for a new prescription.  I WAS going to seek a foot xray until I realized how this matches up to the timeline of my discontinuation so I'm confident seeking a physical solution is a waste of time.  Boy, this is all great...

[TampaDad]

On a side note:  Any suggestion on how to find a doctor in my area who is knowledgeable and can treat me through discontinuation?  Thanks.

[Gridley]

I would go to your doctor as soon as possible to get a prescription for the generic Lexapro.  It's important that your doses be consistent.

[TampaDad]

Hi. I am back with a 4-year check in. In Fall of 2018 I reinstated and have been steady at 10mg Lexapro (only 25% of my highest dosage) and 150mg Wellbutrin (50% of my prior dosage.)  All symptoms from my “too fast” taper have gone. I think in 2023 I will begin a very slow taper of the Lexapro while keeping the Wellbutrin stable. This site was very helpful to recognize the difficult withdrawal I was experiencing and provide advice. Life is steady and the symptoms abated…but slowly!

[ChessieCat]

Thank you for coming back to provide an update.

 

There are links to both Lexapro and Wellbutrin tips for tapering in post #1 of this topic as well as many other helpful links:

 

Important topics in the Tapering forum and FAQ

 

Please note that Lexapro is a very strong drug; see the Post #1 in the Tips for Tapering Lexapro (in the above link) to see the comparison.

 

Why taper by 10% of my dosage?

Dr Joseph Glenmullen's WD Symptoms Checklist

 

Please remember to listen to your body/symptoms and not to make a reduction unless you are stable.  If you are sick or experiencing additional stressors it is a good idea to stop tapering.  It took me 6 years to get off 100mg Pristiq and I've now been off successfully for 1 year.  At times I was frustrated and impatient but I had the support of other members here and in the end it was worth taking the time to do a careful taper and manage to get off the AD after taking them for 25+ years.

 

This taper method gives more control of your taper; keep it in mind for when your dose gets lower:

 

Brass Monkey Slide

 

Many members find that the lower their dose gets the slower than need to go.  There is a link to a video in Post #1 of this topic:

 

Why taper paper: dose-occupancy curves

 

And please be aware that the jump of dose is very low, generally about 0.025mg, but for Lexapro, because it is stronger, you might need to go lower.

 

When to end the taper and jump to zero?

 

managing-the-endgame-taper

 

[TampaDad]

After a too fast taper, reinstatement, and a 4-year hold, I am preparing for a very slow taper. 
 

I was planning to taper off my 10mg lexapro first while holding steady my 150mg Wellbutrin. Does anyone suggest tapering Wellbutrin first?  Tapering both at the same time?

 

I shocked my nervous system thus the 4-year hold. 
 

I ordered a scale, read about Brass monkey slide taper, and plan to only go down 1% in first taper. So I think I am ready. But I’ve learned to ask for suggestions FIRST, before making potential mistakes that could have been avoided. Thanks in advance. 

[ChessieCat]

Taking multiple psych drugs? Which drug to taper first? this is a link to more information
Summary:  If you're not having an adverse reaction from the other medications, taper the most activating drug first. This is usually an antidepressant or stimulant (ADHD drug).

 

Tapering two drugs at the same time is generally not recommended.  When there is more than one variable, if an issue arises you will not know the cause.

 

Depending on the interaction of 2 drugs, some members taper one drug for a while, hold, then taper the second drug for a while, hold and then repeat the process.

 

 

 

Edited November 22, 2022 by ChessieCat