mdwstrx: Lexapro / escitalopram taper or not?

[mdwstrx]

Hi @Jennings

You're not troubling me at all. I'm happy to share what I can remember. 

 

The lower arm burning that I recall was an electrical sensation. It also manifested as an inner 'buzz'. I'm sure it was wd related but I don't know what it's called. It disappeared, thankfully, toward the end of the 5 months it took for me to stabilize.

 

I wish I could be more helpful.  I'm sorry you're going through this now.  It's beyond awful.  Saying prayers for you that it stops.  

md

🙏

 

[Crochet]

Your story gives me hope, you are such a strong person.

 

Take care,

Crochet

[Frogie]

@mdwstrx

 

Hi,

 

I just wanted to drop by and see how you were doing?

 

You’re getting lower and lower!

 

Take care,

 Frogie xx

[mdwstrx]

Hi @Frogie
Thanks for dropping by. 😊 

I’m doing very well. I apologize for delayed

reply. I’ve been traveling. Dropping again today. 
 

I hope you are doing better. Time is such a great healer. 
md

🌵🌞

[mdwstrx]

@Crochet

Hi. I apologize for having missed your post above. Thanks for the compliment about being strong. 😊 It's very appreciated. But my inner strength is from the Spirit in me. I looked for and, as promised, received faith. I now understand when Jesus said all things are possible to him that believes. It has been especially true on this journey. 💜

[Frogie]

@mdwstrx

 

Traveling! How wonderful you’re able to do this during wd. That just proves how well you are tapering.

 

Enjoy yourself😊

 

Take care,

 Frogie xx

[Crochet]

Thinking about you this morning - sending light and love.

[Crochet]

I wanted to note - we were in Sedona at the same time - December 2019.  I wonder if we passed each other on a trail.

[mdwstrx]

@CrochetPossibly!
It’s such awesome hiking! Got to see it in March this year too! The first few days we were blessed to see the white snow on the red rocks before it warmed up nicely! Beautiful country 🌵🏜💜!

[Frogie]

@mdwstrx

 

Look how far you are, 1 mg!

 

Just wanted to stop by and say congratulations! 
 

One step closer to 0😊

 

Take care,

 Frogie xx

[mdwstrx]

1 hour ago, Frogie said:

One step closer to 0😊

 

Hey @Frogie

Absolutely. Thanks for stopping by! 

Hope you're doing better!?

md

🌞

 

[Frogie]

1 hour ago, mdwstrx said:

 

Hey @Frogie

Absolutely. Thanks for stopping by! 

Hope you're doing better!?

md

🌞

 

I'll be ok, eventually. 

Thanks😊 

[mdwstrx]

Brief update for the record. 

 

I have been sailing along doing two 5% (roughly) reductions each of the first two weeks. Then holding for 2 weeks for a total 10% monthly taper. 

 

I dropped by 5% 12 days ago to .095 mg. This month, I refrained from the second week taper due to an upcoming event.  Nonetheless, withdrawal symptoms have ramped up uncharacteristically. Feeling neuropathy, hot flashes, shortness of breath, depressed mood, performance anxiety and general nervous feeling about the future. Overall, a lack of normal self-confidence. Holding indefinitely until this resolves. Do you think it will @brassmonkey, @Gridley and/or @Frogie? These are some of the same symptoms the drug kept away for so long.🤷‍♀️

md

🌧️

 

[Johni]

Hello. I totally feel your situation. although I didn’t have such problems before the drugs but I do now. and I walk miles from the end. i don't know what will happen that way. I wish you perseverance.

[Frogie]

@mdwstrx

 

I’m sorry you’re going through all of those symptoms, but know they are wd symptoms. I had them and many more the lower I went on my taper with Lexapro. The lower I went on my taper, the more wd symptoms showed up. But they did go away.

 

I think, with a good long hold like you are doing it will resolve itself and you’ll be back to “wd normal”.

 

Hang in there!

 

Take care,

 Frogie xx

[Gridley]

2 hours ago, mdwstrx said:

 Holding indefinitely until this resolves.

That's what I would do.

 

I found that on my Lexapro taper that at certain dosages along the way, symptoms would ramp up without any apparent reason.

 

Congratulations on getting down to 0.9mg.  The very low doses may have to be tapered more slowly.

[mdwstrx]

@Gridley, @Frogie and @Johni

Sometimes all we need is reassurance from those who have been there.

Many thanks.

md

[Frogie]

You’re more than welcome!

[Crochet]

I think about you often, and am praying for you.

[Crochet]

I am so glad to hear that you are back to WD normal!

[mdwstrx]

 

On 7/13/2021 at 8:22 PM, Crochet said:

I am so glad to hear that you are back to WD normal!

Thanks @Crochet but things are a bit rocky presently again.

 

I decided to cut 2.6% 5 days ago since I felt much better. Knowing I have a big event in 3 weeks, I got nervous and reversed the cut 2 days later deciding best to hold 'til after the event. I then had one 5oz glass of wine that night as I occasionally do. The next day felt like acute wd - waking at 3 am, unable to sleep and having lower gi issues, depressed and anxious feelings all day? it was rough. Slept better next two nights with anxiety just under surface level today - gnawing away at my nerve endings. Def not withdrawal normal. 

 

May be stuck at this level for some time as any little drop is proving uncharacteristically problematic. I hope that things normalize in the next 2 weeks for my event or it'll be miserable.  Grateful for the progress I've made, but the way I feel presently, I can't see putting myself out there for much. Played sports yesterday and was definitely hyper and a bit cranky. Had to really work to not show it. Amazing how this wd melts an otherwise strong self confidence and personality. 😏

[Leo1983]

Hi

 

Im 3 year out from a CT. 

 

I can relate to your big event and the occasional glass of wine. 

 

I have just been on a stag party to York. Leading upto the event you think i was waiting for the day to arrive for my execution. 

 

Also the wine.... Whilst drinking i feel ok! However, the following days/weeks im sure the alcohol sends me dafter than i already am.

 

I was just posting the other day and thought to myself..... Im still writing on this forum almost 3 year after stopping these drugs.... Is it the drugs? Or just the new me........ 

 

I hope you feel more stable for your event. 

[mdwstrx]

7 minutes ago, Leo1983 said:

Leading up to the event you think i was waiting for the day to arrive for my execution. 

@LeoSo sorry to hear but amazingly accurate description. Exactly how I feel. I should be excited! Instead, like you, I am dreading it, almost sick at my stomach wondering how in the world I'll get past it successfully. Rubbish!

 

Not necessarily the new you, just the changed, evolving one. What is it that Alto says about our nervous systems? "Can't step into the same river twice."

🙏

[Leo1983]

Yeh but i really am sat here hoping that one day i will actually return to my old functioning self that could turn up any event. 

 

[mdwstrx]

@Go2zero

Quoting a post you made "1mg escitalopram still gives a very high serotonin receptor occupancy (SERT) around 45%. At 10 mg the SERT is around 80%. So that shows why stopping at 1mg is still a very big jump to zero!"

 

Can you share your source pls?

Thank you.

md

 

 

[Go2zero]

The formula to calculate the SERT for Prozac is: (86xdose in mg)/(1,94+dose in mg).

I do not have the exact formula for calculating the SERT for escitalopram/Lexapro. But I do know that the SERT graph curves do not differ that much from Prozac.

 

If you want to use the Prozac formula to calculate the SERT for escitalopram you should multiply the escitalopram dose by 2, since 10mg escitalopram is comparable with 20 mg Prozac. So the formula would be then (86 x dose in mgx2)/(1,94 + dose in mgx2).

 

 

Please know that these calculations are not exact. Everybody reacts different in SERT to specific dosages. But this formula is giving an average.

 

More important is that it calculates and shows clearly how extremely high the SERT still is at very low dosages. Many of us think that they can stop after they went 90% down in dosage. Not knowing that the SERT may around 30% (whereas the SERT was around 75% at the full dose of 100%)

 

This thread says a lot about this subject: Please read everything to get a good understanding. However the SERT occupancy graphs say nearly everything at one glance, if you really understand them.

https://www.survivingantidepressants.org/topic/6036-why-taper-sert-transporter-occupancy-studies-show-importance-of-gradual-change-in-plasma-concentration/

 

 

More interesting information about this subject:

 

https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.161.5.826

 

Edited July 20, 2021 by Go2zero

[Crochet]

I'm sorry that you're back in it and I hope things settle soon.  It looks like you might be coming up with a plan based on SERT Occupancy which sounds like a good idea.  I'm with you.

[mdwstrx]

20 hours ago, Go2zero said:

Please know that these calculations are not exact. Everybody reacts different in SERT to specific dosages. But this formula is giving an average.

Thank you! @Go2zero

md

🌼

[mdwstrx]

@Crochet

Thanks!! Appreciate you!  Hope you continue to do well. I'm feeling much better, thankfully. 🌤️I'm always amazed at how you can feel so bad, like a different person when the reduction hits. And then eventually (assuming it's not a crash) it works itself back to wd normal within a matter of days. Holding now for a time.

md

💜

 

[mdwstrx]

Hi @brassmonkey,

 

I know you're very busy so apologies for having to reach out. When you have a moment, I'd like an opinion. 

1. While not currently at wd normal from my last cut, I'm considering using Lorazepam for an upcoming 1-day event. It seems to be the only way through the performance anxiety. Adrenaline is beating me up presently: that same feeling you might get if standing in front of hundreds of people - unprepared (though it's just a special day meeting🤷‍♀️). The nondrug techniques aren't helping and frankly, I'm dreading what might otherwise be a pleasant event, scared I might 'spin out' due to the anxiety.

On the tapering front, I'm on an extended hold these past 6 weeks as follows: 

• 6/12 - 5% cut was uncharacteristically rough but faded back to wd normal, or so I thought.
• 7/11 (month later) - 2.6% cut attempted and reversed on day 2. 
• 7/13 (day 3)- wd ramped up on cue and has yet to fade back to wd normal.
• 7/22 - may have taken a double dose (one morning/one evening).
• Today - 4 hrs sleep last night and def feeling it.

In addition to neuro emotions and other common wd symptoms, last night I felt some of the old, unsettling hypnogogic activity that was present in acute wd over 2 and a half years ago. I'm hoping these symptoms dissipate and I see a return to wd normal soon w/o having to up-dose. Obligations are a bit difficult but thankfully, not as bad as a crash. Yet I can see where getting past this point may be very tricky, if doable.

 

Thanks in advance for your time and thoughts on the matter. 

md

[brassmonkey]

I learned many years ago that it is very easy to "freak one's self out" anticipating a public event. When ever the negative thoughts would pop up I would AAF them and things usually go pretty smoothly. Even the most experienced actors get uptight before going on stage, so you are in great company. I wouldn't resort to drugs to get through because they will get in the way more than they will help.

 

It sounds like your systems are ramping up because of the obligations. Quite normal because of the additional anxiety. Work on relaxing and floating and maybe hold on the reductions until the obligations have past.

 

YOU GOT THIS.

[Leo1983]

Can i ask here..

 

Are we waiting for a CNS to heal so we can get back to life.

 

Or are we learning to deal with a mental health problem forever?

[mdwstrx]

2 hours ago, brassmonkey said:

I learned many years ago that it is very easy to "freak one's self out" anticipating a public event.

Thanks @brassmonkey!! 

I learned that as well as a nonretired person through many conference presentations and VIP meetings. AAF worked better when I was on a much higher dose of AD. Now with the neuro-emotions, AAF (or willingness) isn't quite cutting it. So, will do my best and see where that leads. I've been googling CBT vids that help, at least in the moment. But this isn't wd normal -yet so praying that things settle down so I can AAF. And guarandarntee, I'm holding 'til obligations pass!!!

 

Really appreciate you reply and support!!

md

🌼

[mdwstrx]

37 minutes ago, Leo1983 said:

Can i ask here..

 

Are we waiting for a CNS to heal so we can get back to life.

 

Or are we learning to deal with a mental health problem forever?

Both I do believe Leo.

💜

[mdwstrx]

Update:

Been holding 2 months since last cut. Having lots of cortisol and adrenaline rushes, hot flashes, early waking. No fun. Hoping for wd/normal soon.

md

🙏

 

[Frogie]

@mdwstrx

 

The lower your taper on lexapro, the harder it gets I found. It seems as though your body just doesn’t want to give it up so it fights with you. 
 

I had a moderator on here tell me once that you want to be kind to lexapro because it’s like pulling a tigers tail, mean and nasty. And they were correct.

 

 I’m glad you see the signs and keep holding. You will stabilize and hopefully soon😊

 

Take care,

 Frogie xx