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mdwstrx: Lexapro / escitalopram taper or not?

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brassmonkey

If you want to go just by the numbers, your idea would fit well within the recommended reduction schedule.  The recommended 10% every four weeks taper is the fastest that can be done and still maintain some control over the symptom load.  It is a base point where we start people out to see how they react to tapering and then we adjust it accordingly. Many, if not most, members end up going slower.  In reality tapering has nothing to do with numbers, but rather the bodies ability to remain stable while the control of the drug is withdrawn and the body is allowed to heal.  Remove the drug too fast, either by speed or quantity, and the body reacts badly in the form of WD symptoms.  Having those symptoms to build up by not allowing the body to keep pace with its healing sensitizes the body to the removal of the drug requiring a very long time for stabilization followed by a very conservative taper.  In the end trying to speed things up usually leads to things taking a lot longer.

 

People who are doing a 10% reduction in one shot rarely can do their reductions every four weeks.  The symptoms just don't resolve themselves that fast.  They often end up having to throw in a long, several month hold, to let things settle down before they continue.  Being at 3.7mgai you are coming into the low range of your taper.  This area traditionally has been much more sensitive to reductions, as is demonstrated on the SERT loading charts. I would not recommend trying to hurry things up.

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mdwstrx

Thank you @brassmonkey.  Sound advice.

I’ll settle down and continue the 4+3 schedule.😌

I’m  grateful to be able to do that with minimal symptoms so far. 

Dropping more in the first 2 cuts followed by 2 smaller cuts

seems to be working well for me instead of 4 equal cuts.  

So I’ll continue that too. 

 

I’m so thankful to have access to your input and to this forum. 

md 🌻

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Frogie

Hi!

 

Just wanted to stop by and see how you were doing?

 

 I hope well.

 

Take care,

 Frogie xx

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mdwstrx
On 2/5/2020 at 8:35 AM, Frogie said:

 

Just wanted to stop by and see how you were doing?

 

Hi @Frogie!

Sorry I missed your visit 😊

It made me feel really good that you inquired. Thanks! 

I'm doing well.  Sorta... 

 

I'm on my 2nd week of tapering this go around (bm slide).  

7% so far in the last two weeks.  I've been doing the big hits the

first two weeks and the smaller ones the last two weeks.

Symptoms have ramped up a bit unfortunately.  Muscle, head

aches, pins and needles, heavy hot flushing and you're old friend, nausea.

The last one is new to me. Off and on the last 3 days.

However, sleep is very good, thankfully.

 

Hoping you're doing well too!  I haven't checked your site but

will head over now.  💜

Md

 

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Frogie
9 hours ago, mdwstrx said:

 

Hi @Frogie!

Sorry I missed your visit 😊

It made me feel really good that you inquired. Thanks! 

I'm doing well.  Sorta... 

 

I'm on my 2nd week of tapering this go around (bm slide).  

7% so far in the last two weeks.  I've been doing the big hits the

first two weeks and the smaller ones the last two weeks.

Symptoms have ramped up a bit unfortunately.  Muscle, head

aches, pins and needles, heavy hot flushing and you're old friend, nausea.

The last one is new to me. Off and on the last 3 days.

However, sleep is very good, thankfully.

 

Hoping you're doing well too!  I haven't checked your site but

will head over now.  💜

Md

 

Wow,

 

Sounds like you’ve gotten hit hard this time. Hopefully the symptoms will abate soon for you. The nausea is no fun at all. It seemed to be my best friend, ha, ha. I found at Walmart, Nauzene. It worked really well for the nausea. It was over the counter and didn’t cause any other side effects. You could give it a try. Glad your sleep is good though. I had lots of sleepless nights. Now I’m sleeping pretty well.

 

 I think right now I’d take the 3 days of nausea over this “stuff” in my legs. At least it went away.

 

 I’m glad you are doing well though. Keep it up, you’re almost done😊

 

It’s great to talk with you.

 

Take care,

 Frogie xx

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mdwstrx

Quick check in.

 

3 mg. heading for 2.95 mg. at the end of next week, before my next scheduled hold.

 

I am grateful for the knowledge, time, efforts and advice from members,

staff and administrators of this forum. It is the only place I've found that

has provided a safe path off these drugs.  

 

To all,  please stay safe taking precautions to keep healthy as you are holding or tapering.

In time, with this forum and God's grace, I fully believe we all have the ability to get to

where we want to be, off these drugs. 🙏💜

 

Md 🌺

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mdwstrx

@brassmonkey

 

Hi Tom,

You had stated in a recent post above, " I would not recommend trying to hurry things up." However, another moderator's recent post indicated they were tapering Lexapro using the brassmonkey slide and are currently at .60 mg.  They estimated that they had, "Maybe 5-6 more months to get off the Lexapro, maybe a little less..."  At a 10% taper, I calculate it will be another 2 years approximately - assuming a jump off at .05 mg.  Please see below table.  I have seen others long time users who tapered faster than 10% at the end as well and successfully stopped.  

 

My question: Is there a formula greater than 10% monthly reductions under the 1 mg. mark?  If so,that would greatly reduce my taper time.  My calcs, at a 10% taper show I have another 3 years of tapering ahead of me.  Most of that time will be spent under 1 mg. 

 

In reality, I am tapering approximately 11-12% every 6 weeks or between 7-8% a month.  I am having very minor symptoms toward the end of the taper  (mostly pins and needles and hot flashes).

Thank you for any insight you may have.

Md 🌻

 

0.60 4/1/2020
0.54 5/1/2020
0.49 6/1/2020
0.44 7/1/2020
0.39 8/1/2020
0.35 9/1/2020
0.32 10/1/2020
0.29 11/1/2020
0.26 12/1/2020
0.23 1/1/2021
0.21 2/1/2021
0.19 3/1/2021
0.17 4/1/2021
0.15 5/1/2021
0.14 6/1/2021
0.12 7/1/2021
0.11 8/1/2021
0.10 9/1/2021
0.09 10/1/2021
0.08 11/1/2021
0.07 12/1/2021
0.07 1/1/2022
0.06 2/1/2022
0.05 3/1/2022

 

 

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brassmonkey

Hi Md-- This subject has been coming up a lot lately and I actually have an article in the process of being approved that deals with it. But I can give you the basics right now.

 

When a person gets to the very low doses we are starting to refer to it as the Endgame Taper and it is a game changer on how things are done.  People dealing with the dry cutting methods of weighing out powder each time find that their scales are only accurate down to about 4mgpw. Because of this it then becomes necessary to start doing visual divisions to the powder to get further reductions. By carefully dividing the 4mgpw of powder in half and in half again it is pretty easy to get 25% reductions for three reduction cycles and then 50% for two reduction cycles.  Depending on the AIC (Active Ingredient Concentration) of their particular medication this will give a final dose of about  .03mgai.  This is a very acceptable jump off point, and only takes six reduction cycles. Which would be between six and nine months, if all went well.

 

It does mean that the Brassmonkey Slide is no longer possible.  It could be done, but manipulating those small piles of powder to get the interim doses would be a real pain, and really wouldn't buy you much.  If ones symptoms are well under control and very mild the lager percentages shouldn't be a problem.

 

For people using liquids the process is a bit easier because they can work with their dilution ratios and syringe sizes to have very fine control over the dose size. The final Exit Target Dose is determined by using the AIC for dry cutting and homemade liquids, while a fractional amount is used for commercially made liquids.

 

If you can give me the average weight on one of your pills and the strength that is listed on the package, we can determine the AIC for your medication and calculate what the Exit Target Dose would be and how to do the reductions to get there.  You wouldn't be working by mgai weight any more but rather by mgpw , but it's good to know the strength of the dose you're aiming for. 

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mdwstrx

@brassmonkey

"If you can give me the average weight on one of your pills and the strength that is listed on the package,

we can determine the AIC for your medication and calculate what the Exit Target Dose would be and how

to do the reductions to get there."

 

I am tapering using liquid escitalopram (5mg/5ml)

 

I find it's true that using a liquid allows very fine control over the dose size.

However, it also seems then, that the finer control equates to a significantly longer taper period under 1 mg.

 

Do you agree?  In the moderator's case I mentioned above, it appears that it will be about a 10 month taper from 1 mg to jump off.

In a straight 10% monthly taper using liquid, it would take 36 months to taper from 1 mg to jump off.

 

If accurate- it's astonishing.  

 

 

 

 

 

 

 

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brassmonkey

Yes, that look accurate. It's amazing the difference in time the two different percentages can make.  Now it's more of a matter of how your body reacts to each reduction.  If you are currently having very mild symptoms and have been for a while, then it may be possible to increase the percentage you are reducing by and speed things up a bit. It's all about how comfortable you are with where you are at and if you want to try and speed things up. Personally I think taking three years to taper the last mg is excessive.

 

 

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mdwstrx
21 hours ago, brassmonkey said:

Now it's more of a matter of how your body reacts to each reduction.  If you are currently having very mild symptoms and have been for a while, then it may be possible to increase the percentage you are reducing by and speed things up a bit. It's all about how comfortable you are with where you are at and if you want to try and speed things up. Personally I think taking three years to taper the last mg is excessive.

@brassmonkey

 

Thanks Tom.

 

From our discussion, I've learned that for the end game taper:

  • tapering a pill vs liquid makes a significant difference in speed of the taper, and
  • a 10% taper at 1 mg. and below may be considered excessively slow, and
  •  it may be acceptable to speed things up depending on body's reaction.

I presume at 2.95 mg., I'm not low enough to be considered end game, yet. 

So I'll continue the BM slide for now, creeping up on the total mo. cut to approximate 10% mo. cut, while

closely monitoring symptoms.  

 

I'm anxious to read your article for further direction.  I hope that it addresses both liquid and pill tapering.  Surely, the

recommended rate of taper should be the same regardless.

 

Md 🌷

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Frogie

Hi md:

 

Just thought I’d drop by and say hi and see how you were coping?

 

 I’m doing ok. Just plugging along with my Xanax taper.

 

Staying home like we are supposed to and only going to the store in the morning once a week only when we can’t get things by curbside.

 

 I’m doing some sewing, making some masks. But didn’t get my full order from Joann’s, so I’m just about out of materials. I’m great full I received what I did. Just trying to stay busy in the house. Watching a lot of movies.

 

Going to disinfect the house today. 
 

Sorry I rambled, just wanted to check in with you😊🌻

 

Take care,

 Frogie xx

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mdwstrx

Hi @Frogie!

I've been thinking about you and how you're almost done with the Xanax taper!

You say you're ok and plugging along.  I hope that means that the awful symptoms 

in your legs are less, even gone? 🙏  Your taper off Lexapro is inspiring and

I am closely comparing to my numbers as I get lower.  Thank you for blazing such

a successful trail!

 

I feel like I'm in a race, tapering against time with current events.  It's unsettling but I distract

from those thoughts with prayer and by being mindful that all is ok in the present. This site and 

our journey has taught us some valuable coping techniques!  My last taper cycle left me with 

some unpleasant feelings for about a week but those are beginning to dissipate. Yay!

 

Like you, I get out to get groceries. Other than that, I walk/ride the local bike trail;

sometimes taking my little dachsie. It's a treat! :)  I've got plenty of Spring yard-work and

am thinking of growing some veggies... so lot's to do.  Plus I promised a friend a quilt

and it's only just started.

 

Good for you for making masks! JoAnn's was great in providing materials!  I think

they have run out of the materials here too.

 

Thanks for checking in!  It's so appreciated and good to hear a bit about how you're doing.

I'll pop over to your page too to check for more of an update.

God bless and take good care my friend!

 

Md 🌼

 

 

 

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mdwstrx

@brassmonkey

 

Quote

 

"Because of the limitations of the scales when I reached about 2.5mgai (active ingredient) I switched from tapering 10%ai to tapering 1mgpw (pill weight). This put me in the 8-10% range per drop.  I also increased the speed to every four weeks, with longer holds when it felt like I should. With the new schedule the pattern changed a bit.  The first few drops tended to have symptoms start up around day three, peak on days four or five then taper down over the next week and be cleared by the end of the four week period. 

 

After passing 1.5mgai things changed again to nothing until day four or five and then hitting fairly hard for a day or two, subsiding and holding fairly steady for a week or so and then fading off to WDnormal. 

 

There were two instances where I held an extra week because things hadn't settled out.  My impression has been that WDnormal has raised with each drop since 1.5mgai."

 

 

 

Good morning. :) 

 

I have a question about the above info pulled from some of your past posts. It appears that you successfully sped things up at the end game of your taper (from 2.5 mg on down).

 

Can you please clarify if you did:

  • one monthly cut or,
  • 4 weekly cuts with no hold (unless needed)?  

Thanks!

Md 🌺 

 
 

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brassmonkey

I continued to do a 2.5% a week for four weeks with an additional two week hold Brassmonkey Slide until I got down to 4mgpw on the scales.  From there I started to do the visual divisions, but maintained the six week schedule.  I was doing a lot of international travel at the time which did mess up the scheduling, so some reductions were held for up to eight weeks. Even though it was a tiny dose I didn't want to rush things. I think on my lowest dose (0.08mgai) I only held for four weeks because I was leaving on trip and didn't want to be bothered any more.

 

In terms of speeding things up, it was more a matter of making larger reductions instead of taking less time between them.

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mdwstrx

@brassmonkey

Thank you for the clarification.  I'm not sure what I'll do when I get below 1 mg.  in

order to avoid having to taper for 3.9 years longer, if possible.  It helps to see how

others handled the low doses.  

 

 

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Frogie
On 4/18/2020 at 8:24 AM, mdwstrx said:

Hi @Frogie!

I've been thinking about you and how you're almost done with the Xanax taper!

You say you're ok and plugging along.  I hope that means that the awful symptoms 

in your legs are less, even gone? 🙏  Your taper off Lexapro is inspiring and

I am closely comparing to my numbers as I get lower.  Thank you for blazing such

a successful trail!

 

I feel like I'm in a race, tapering against time with current events.  It's unsettling but I distract

from those thoughts with prayer and by being mindful that all is ok in the present. This site and 

our journey has taught us some valuable coping techniques!  My last taper cycle left me with 

some unpleasant feelings for about a week but those are beginning to dissipate. Yay!

 

Like you, I get out to get groceries. Other than that, I walk/ride the local bike trail;

sometimes taking my little dachsie. It's a treat! :)  I've got plenty of Spring yard-work and

am thinking of growing some veggies... so lot's to do.  Plus I promised a friend a quilt

and it's only just started.

 

Good for you for making masks! JoAnn's was great in providing materials!  I think

they have run out of the materials here too.

 

Thanks for checking in!  It's so appreciated and good to hear a bit about how you're doing.

I'll pop over to your page too to check for more of an update.

God bless and take good care my friend!

 

Md 🌼

 

 

 

Hi @mdwstrx!

 

Sorry it’s taken me so long to get back to you. I have been thinking of you a lot.

 

 I’m doing ok with my taper. The lower I get the more “wobbly and creepy” my legs feel. But, Apace41 told me about some spray magnesium, that does help some. But I’m going to be ok. Just a different withdrawal than Lexapro.

 

You are getting really low on your Lexapro. Congratulations! Just take it nice and slow and you’ll do fine. I think in these times we should all take things slow and smell the roses, as they say. I have learned to see all the little things that matter the most right now. Don’t make the mistakes I made on my Lexapro taper. You’re doing wonderful 😊

 

 I don’t have a bike, but we’ve been taking our little chiweenie, Delilah, for walks around a park that’s a block away from our house.  You have a dachshund? I grew up with them, such sweet dogs. Delilah is 1/2 dachshund, 1/2 chihuahua. A super sweet little girl. We rescued her from a rescue place that takes dogs from high kill shelters. I’ve actually been cooking a lot. I don’t cook well, but no ones gotten sick, lol. Did yard work yesterday. Planted some pansies and ornamental grass. Things that can still stand a freeze if we would get one. 
 

My fiancé got furloughed in March, but hopefully is going back to work May 11. They want to open our state back up next week. I’m a little nervous, so I’m just going to do what I’ve been doing. I do a lot of curbside pickup, and go very early in the morning to get what has to be picked up, like fresh veggies, then I’m out. It’s definitely different times and will be for quite some time.

 

 I know 4 people that got the virus. One was hospitalized for 5 days. He just went off oxygen a few days ago at home. But thank God they are all ok. We have worried about my fiancé’s parents through all of this. She’s 87 and he’s 92. They are on lockdown, but we take them things they need. Just set them by the door, call her, she comes out and gets it and we wave from the car. Then off we go home. We do FaceTime and play Yahtzee with her and she enjoys that.
 

I didn’t get my whole order from Joanns but made the best of it. I sewed 15 masks, and I have enough material to sew a few more. It keeps me busy. And jigsaw puzzles are keeping my mind busy. A quilt? Wow! I wish I knew how to do that, and the material. That would be fun.
 

I’m sorry for rambling. I really hope you’re doing well. I pray that every will be alright and stay healthy. 🙏🏻🙏🏻🙏🏻
 

God bless you too 🌻

 

Take care,

 Frogie xx

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mdwstrx

Checking in with a brief update. Still holding at 2.65 mg.

 

I was a bit too aggressive with the last two months' taper.  I thought I could up the amount a bit

or shorten the hold but was wrong.  I'm thankful I skipped the 4th taper of the last cycle because

I had a delayed onset of symptoms.  Even holding  now for 16 days, the wd symptoms are rough. 

Emotional spirals ending up in crying, hot flashes galore, trouble sleeping, and early morning waking.

To top it off, mild to moderate feelings of anxiety and depression. I might have to hold an extra week

before considering another cut.

 

Prayers for healing for all.

Md 🌷

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Frogie
14 hours ago, mdwstrx said:

Checking in with a brief update. Still holding at 2.65 mg.

 

I was a bit too aggressive with the last two months' taper.  I thought I could up the amount a bit

or shorten the hold but was wrong.  I'm thankful I skipped the 4th taper of the last cycle because

I had a delayed onset of symptoms.  Even holding  now for 16 days, the wd symptoms are rough. 

Emotional spirals ending up in crying, hot flashes galore, trouble sleeping, and early morning waking.

To top it off, mild to moderate feelings of anxiety and depression. I might have to hold an extra week

before considering another cut.

 

Prayers for healing for all.

Md 🌷

Hi md:

 

Sounds like you are having a rough ride. I’m sorry to hear that.

 

 I went through that a few times and had to updose because I went too fast, too hard. So, I’m glad you are holding. You are very smart.


Just stabilize again and you’ll be back “to normal “ in no time. Whatever “normal” might be lol...

 

Wishing you a good recovery 😊
 

Take care,

 Frogie xx

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mdwstrx

You are such an encouragement @Frogie 

Thank you and God Bless.

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Frogie
20 minutes ago, mdwstrx said:

You are such an encouragement @Frogie 

Thank you and God Bless.

You’re welcome.

 

Have a great day🌻🌹

 

Take care,

 Frogie xx

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mdwstrx

Good morning.

@brassmonkey

 

Day 19 of hold since last cycle on the BM Slide.

Unsettled, anxious and depressed.  Emotional spirals

are occurring more frequently the lower I go.

 

I'm wondering if these wd feelings will subside? The

lowest dosage I've ever been on is 2.5 mg.  Before

stopping then in 2018, I recall crying ALOT.  Then

came the awful crash and up dosing to stabilize.

 

Closing in on that same dosage.  Is this the point of no

return?  The 'oops' point I think Alto referred to?

 

My son has advised that I need to be on my

game for the next year or so as he/wife consider a family.

At what cost, they say, should I pursue this goal?

It's been tense with my emotional swings of late.

 

How do I know I won't implode if I continue tapering?

 

I'm alone.

I'm scared.

I want that feeling back where I had a tough skin,

where I could roll with the issues. My son use to think

I was the strongest person he knew.  

 

Seeking encouragement and thoughts.  It's just me.

If me no longer works, I'm SOL.

 

Md🥀

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brassmonkey

After doing a quick read of your thread it looks like you need to take a long hold and let things settle out for a while. You've been tapering at a steady rate for over a year now so it would be a good idea to let things catch up, stabilize and resolve before continuing. Sixteen days is basically the standard hold time for the Brassmonkey Slide and it a variable that can easily be extended as needed with any reduction. I would give thing several months to settle out before continuing.

 

You are moving into the an area that is known to be tricky to taper through. Things frequently start getting rough between 3 and 2mgai and need to be handle d carefully and slowly. Listening to your body is very important. The emotional spirals are telling, it means that things are happening too fast for our body to adjust to and if you add in all situational tension from modern daily life and future family life it can really add up. Reread the Dealing With Emotional Spirals thread and try to find your triggers and patterns so you can work out some coping strategies for dealing with them. Also review the threads on coping techniques as you deserve to take the best care possible of yourself.

 

If your son is old enough to be planning a family then he is old enough to be taking the responsibility for them, and should not be trying to force you to compromise your personal health to fit his personal plans. To expect you to "be on top of your game" to support him is unacceptable. Being someones "rock" is a two way street.  If he can't/won't be there for you, after you've been strong for him all his life, is a selfish and shameful thing. In the next few years he may be having a tough time of it by his own choosing. By no fault of your own, you are currently going through one of the hardest things a person will face in their life.  There is a very big difference. Enough of that rant.

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mdwstrx

@brassmonkey

 

You make so much sense.  Thank you!

 

I've read the suggested exceptional threads. They're what identified for me the recent

issues I've been having.  I will be using them and continue learning.

 

I've been very needy of late with son and moody with efforts to bond better with d-i-l.

They don't understand even though I told them I was undertaking this journey. 

 

I chose the wrong wording above. He didn't 'advise' but stated.

His comment was in the context of ironing out the complicated mil/dil thing. 

He's an EE working for a state utility. A good guy. I've been working on the 

mil/dil thing for awhile though. 

 

But you are 100% right.  Wondering 'at what price' isn't being supportive. I'm sure

like so many, they see this not as a temporary thing but as the emergence of the new me.

 

Given that I thought it could be, I understand.

 

Thank you again.  Your advice couldn't be better.

Md

🌼

 

 

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ChessieCat

 

1 hour ago, mdwstrx said:

 I hit a bit of a bump here at 2.65 mg. Been on hold for about 20 days now and still having symptoms.  Was having emotional spirals and feeling depressed and panicked about living alone. One son is in Ca, the other lives an hour and a half south of me. Was advised to hold a couple months. Did you ever have to hold like this?  Makes we question  if I can ever get off. 

 

I'll respond to your question in your own Intro topic.

 

You, like me, have been on an AD for a long time.  Taking an AD numbs our emotions.  As we are coming off the AD our emotions start to reappear.  This may not be linear and gradual, but may come in fits and starts.  The time that they appear wil for different people.

 

The other thing to realise is that we have been numbed for such a long time and we are "reawakening" much older than we were and many things have changed during that time.  It can be overwhelming for us to cope with the changes when our emotions are more awake than they have been in a long time.

 

It's also important to understand that everybody goes through changes in their lives and even people who haven't been numbed by ADs can feel overwhelmed at times.  It may be just a little bit harder for us at times as we are learning to cope with having emotions once again.

 

"Was advised to hold a couple months."

 

It is generally a good idea to hold for longer if you have noticed that you aren't at WDnormal.  See: 

Or if you are going through a stressful time or if you are not well.

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ChessieCat

 

2 hours ago, mdwstrx said:

Makes we question  if I can ever get off. 

 

Instead of thinking can I ever get off, think in terms of I've reduced my dose, I'll see how low I can get.  Originally my plan was to get down to 50mg, then I just kept going, and going, and going.  It's not a race.  You go at the pace that your brain and body allow, taking your own circumstances into account along the way.  It's got nothing to do with how strong and/or determined you are as a person.

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mdwstrx
10 hours ago, ChessieCat said:

Instead of thinking can I ever get off, think in terms of I've reduced my dose, I'll see how low I can get.

That's good advice. I have just started to refocus like this.  I know it's a very helpful strategy. 🙂

Thank you Chessie.  

 

 

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Frogie

Md:

 

I just read what ChessieCat wrote to you. She’s very good and experienced.

 

I also tell myself all the time, look how far I’ve gotten, not how far I have to go.

 

It helps me get through really tough days.
 

You are doing wonderful and you’re going to make it❤️🙏🏻🌻
 

Take care,

 Frogie xx

 

P.S. For what it’s worth, my son and dil think I’m crazy for taking this long to get off my meds. And my dil is a nurse. She has no compassion for things like this. She thinks you should just buck up and stop taking them. I can see you are struggling with this and I’m sorry.  I just let them have their opinion and I do what is right for me. You’ll get through this and build a strong relationship with them. I’m actually getting there with mine. You just have emotions coming through right now that you haven’t had in a long time because of these meds. Brassmonkey is very smart and gives wonderful advice as does ChessieCat as I said in my post.❤️

Edited by Frogie

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