mdwstrx: Lexapro / escitalopram taper or not?

[mdwstrx]

@Frogie

Thank you, my friend, for your thoughts. I agree it has gotten difficult at this low dose. In fact, the anxiety feels as if there is a task master standing over me with a whip ready to beat me each time I try to interact with anyone. I can't focus on the conversation or enjoy the activity because the whipping going on behind the scenes is painful and distracting. My stomach is in knots, and it also feels as if I'm on a rollercoaster. 

 

Today I golfed/lunched and was on edge whole time. It was all I could do to keep focus and I know people can feel I'm 'uncomfortable' in my skin. I'd give anything just to relax (AAF) and enjoy. It's been two months since cutting to .095. I am asking the mods @Gridley, @brassmonkey and anyone else, should I up dose to become more stable since I feel like I'm on my last nerve?!?. If so, by how much? It's at a time I need to be stable and it's not happening. I take magnesium twice a day, occasional propranolol etc.

 

Many thanks,

md

 

[brassmonkey]

Being that you are firmly into the Endgame Taper you really need to "play it by ear" and do what your body dictates. So you will need to adjust each reduction as required. That could be a longer hold, a slight updose or the like. You could try a "rescue dose" to see if an updose would help. If you updose I wouldn't go to more than 0.1mg.

[Gridley]

3 hours ago, mdwstrx said:

should I up dose to become more stable since I feel like I'm on my last nerve?!?.

I agree with Brassmonkey that if you do updose it shouldn't be more than to 0.1mg.

 

That doesn't answer your main question.  You're the only one who can decide whether a small updose is the best idea.  We are in the realm of the unknown here.  There's no guarantee that an updose will help.  You could give it a week or two weeks and see how you feel before deciding.

 

Anxiety is my main symptom too.  A lot is situational.  I relate very much to your symptom description.

 

 

 

[mdwstrx]

Thank you @brassmonkey and @Gridley

It feels like a step back.  But I will go to 0.96 mg. in morning. Hope it works.

 

I'm very sorry that you relate Gridley. It's an awful feeling. Cortisol and adrenaline pumping thru I guess...usually situational for me but of late it's more often then not. Did you ever updose on your escitalopram taper? Did you have same trouble going lower? If this settles, I'm concerned I may be at the lowest point because as @Frogie said, don't wanna pull the "tigers tail". If it doesn't settle, don't know what to do. 

[Gridley]

18 minutes ago, mdwstrx said:

Did you ever updose on your escitalopram taper?

No, I never did.  I would hold longer when I had problems but never updosed.  That's just me, of course.

 

18 minutes ago, mdwstrx said:

Did you have same trouble going lower?

Many people report problems at certain doses, different for everybody.  I had some problems around the 3mg mark.  But when I got really low, it went pretty smoothly.

Edited August 3, 2021 by Gridley

[Frogie]

Yes I updosed a few times. But I made some bad mistakes and tapered too fast a couple of times. Lesson learned. I did what I was told to do from there on out and I did ok. Not great but it didn’t kill me either lol… I had a lot, and I mean a lot of nausea among the other symptoms. I jumped off at .05 mg though and probably should have tapered down a little further.
 

You could updose .10 mg like Gridley and Brassmonkey said. Then give it a good long hold and I think you’ll be ok. You’re doing great with your taper. You’re almost there! 

[mdwstrx]

13 hours ago, Frogie said:

You could updose .10 mg like Gridley and Brassmonkey said.

@Frogieoh.. thx!!  Misread and was thinking it was .001 so would updose to .096.  Guess a 0.1 increase would be to 1.05mg. I may try going to 1 mg. 

 

[Frogie]

3 minutes ago, mdwstrx said:

@Frogieoh.. thx!!  Misread and was thinking it was .001 so would updose to .096.  Guess a 0.1 increase would be to 1.05mg. I may try going to 1 mg. 

 

I’d try that and see if it helps. I bet you’ll feel some relief within a few days to a week. If you don’t want to go up .10 mg, you could try .05 mg and see if that might help. I went up that much quite a few times. You could always increase if the .05 mg doesn’t help.
 

In the meantime, keep your chin up. Not the end of the world by any means 😊 just a little bump in the road. Nothing you can’t handle.

 

Take care,

 Frogie xx

[mdwstrx]

 

On 8/4/2021 at 9:22 AM, Frogie said:

You could always increase if the .05 mg doesn’t help.

Yes, I think that's the safest way to try it. Went back to 1 mg. this morning. Even that seems like a lot after having reduced so far.🤷‍♀️This underlying anxiety is brutal, especially in the mornings as we all know. Thank you @Frogie!

[Frogie]

@mdwstrx

 

You’re welcome. I hope you can find your sweet spot and be able to stabilize for a while!

[Leo1983]

@mdwstrx

 

Hi

 

Can i just ask underlying anxiety? Is thats your anxiety or what the withdrawal does the lower you go. 

[mdwstrx]

53 minutes ago, Leo1983 said:

Can i just ask underlying anxiety? Is thats your anxiety or what the withdrawal does the lower you go. 

Hi @Leo1983

I really can't tell you. It seems that up until this bump, I'd get the same stuff but it would fade over days and then I'd be back at wd normal. It's been 2 months since last real reduction and it hasn't faded yet. I've been on this a long time and had situational anxiety before... but not like this constant undercurrent. 

[mdwstrx]

On 8/3/2021 at 6:28 PM, Gridley said:

I would hold longer when I had problems but never updosed.

Thanks @Gridley

I would hold too normally but some opportunities are presenting for which I need to be back at wd normal quicker. Hopefully the .05 updose will help.

[Leo1983]

Yeh that is along time. 

 

I too had situational anxiety however, i never had anxiety morning noon and night until i started and stopped these crappy drugs. 

 

I would be inclined to think it is when you pull the drug away the CNS is going wild. 

 

I never was like this until the drugs. 

 

Im going to discuss my case with a professional. 

 

Hope you feel better soon. 

[mdwstrx]

On 8/3/2021 at 2:20 PM, brassmonkey said:

You could try a "rescue dose" to see if an updose would help.

Hi @brassmonkey

Today I updosed from .095 to 1 mg. It's been a different day. Anxiety not as heavy but just a feeling of not being right and a bit nauseous, apathetic and down. I reread your comment above and at second glance, not sure I completely understood . What do you mean by a "rescue dose" as opposed to updose?

 

Also, do you think I should have stepped up incrementally by .025 instead of .05?  Hoping kindling isn't a factor on updosing? Do you think I'll see immediate effect or perhaps within the usual 4 day time it takes for the system to register the change? Sorry to trouble you with so many questions. Hopefully, it won't get worse.  

 

Thank you.

md

[brassmonkey]

A "rescue dose" is a tiny bit of the medication taken as a one time thing to alieveate severe symptoms. Usually it is done by dipping a toothpick liquid and sucking off the small drop of medication that clings to it.

 

Going directly from .095 to .1 should not be a problem. It appears that it started to work right away, which is common. Things should improve more over the next few days.

 

Trying to avoid kindling is the reason why we recommend such small updoses. This one is small enough to not cause problems unless you are extremely sensitive. Any kindling would have been felt with in a few hours of taking the dose. I'm glad it is helping.

[mdwstrx]

@brassmonkey
So many thanks Tom!!! You're a Godsend.🙏 I don't quite understand why the last taper hit so hard and wouldn't resolve. I'm not sure how long to hold after this stabilizes. 

[brassmonkey]

I would hold for several weeks after things stabilize. Each reduction is a new experience, we can try to find a pattern between them, and sometimes can. But symptoms will always be unpredictable. I learned to "expect what I get".

[Crochet]

Praying that relief comes swiftly and completely.

[ChessieCat]

  

On 8/8/2021 at 6:23 AM, mdwstrx said:

I have a question. I'm having problems finding a syringe that will accurately pick up and display the small dosages. Are you tapering liquid? If so, what syringe do you use?

 

I did a search in the liquid topic for syringe and this is the link to the results:

 

https://www.survivingantidepressants.org/search/?q=syringe&quick=1&type=forums_topic&item=2693

 

I purchased "slip tip" syringes.  This is the Australia eBay ones that I bought.  If you check out the images provided they have labelled what type of syringes they are:  https://www.ebay.com.au/itm/123759915424

 

A couple of members use a tool that you can "dial in" the amount of liquid you require.  They have provided link/s to what they have purchased.  The posts are on the last couple of pages of this topic:  how-to-make-a-liquid-from-tablets-or-capsules

[mdwstrx]

Thank you @ChessieCat

 

update:

Holding from this summer's mini crash that resulted in up dosing from .95 to 1 mg. Symptoms still present... slight burning in arms, low grade anxiety constantly as if my nervous system is extremely weak. Hot flashes, waking through the night and a general pain in my nerve endings, especially in arms and legs. Definitely a decline in my usual withdrawal normal status. No plans to resume taper until this fades. Not sure it will? Feel like I'm in no man's land...

[Crochet]

Hi Mdwst, 

 

It will fade.  If I've learned anything from this experience, it's that there is a tendency towards change and improvement, timing is just unpredictable.  I hate that you are in pain.

 

Much love,

Crochet

[mdwstrx]

@Crochet

Thank you for your kind words. They mean a great deal and are helpful. I'll jump over to your thread to see how things are going. Well, I pray. 

 

Much love... in return,

md

[mdwstrx]

@brassmonkey

Sorry to trouble you again but looking for some advice as to whether I should continue to hold or consider another up dose as presently not at wd normal. It's making life challenging and I can't consider tapering 'til this smooths out.

 

Today is day 24 from an up dose (.095 to 1 mg on 8/6/21) to address significant w/d symptoms from the previous taper. Not sure how I got into trouble with a consistent taper but it found me nonetheless! 

 

I had improved symptoms but now they're fluctuating and certainly not back to wd normal yet. I'm noticing some rumination along with anxious mood swings, hot flashes, early morning waking, cognitive dysfunction (missing turns, forgetting things etc).🤷‍♀️

 

Would appreciate any thoughts on where to go from here. Thanks Tom!

[brassmonkey]

Even with a reinstatement there are going to be swings in symptoms. As long as they are not too extreme things should be fine with holding. If they seem to be getting slowly worse on average then another small updose might be in order. That was a pretty small one to start, which is the best way to do it.

[mdwstrx]

@brassmonkey 

Thank you for your reply! 

17 hours ago, brassmonkey said:

As long as they are not too extreme things should be fine with holding.

Does "be fine" mean eventually settle - even though it's been 3 months since initial reduction? I suspect a couple of 'good' stressors may be adding to the mix. I'm practicing mindfulness, meditation, sports, good nutrition, etc. Reinstating is gamble correct? How does reinstating to 1.05 mg fit w/tapering? Heading the wrong way on a gamble seems counterproductive unless you think that timing is the issue and anticipate a future successful reduction. 

[brassmonkey]

Yes, given time things should settle and return to your baseline. state.

 

There are a lot of factors involved in a reinstatement that make it unpredictable. If done sooner rather than later it is usually more successful, but is still highly dependent of how sensitive ones body has become to changes. There is no way of gaging that sensitivity before hand.

 

Going backward during a taper is sometimes called for. If the symptoms become intolerable it indicates that the medication has been removed too quickly for the body to adjust. Increasing the drug by a very small amount can help alleviate those symptoms. Once a person has regained stability they can start to taper off again. All it does is slow down the process, but hopefully makes it more comfortable.

[mdwstrx]

@brassmonkey 

 

Happy Sunday! It's a beautiful September morning from here. Hope it is for all! 

 

It's been well over two months and two up-doses from .095 mg to 1.05 mg since w/d normal. Brief update:

• Day 6 -today - slept mostly well, woke twice from bad hot flashes. Nausea, brainfog, chemical anxiety
• Day 5- systemic chemical anxiety back. Worse day yet. Propranolol took edge off! Forgetful, unfocused.
• Day 4- debilitating chemical anxiety faded. Thought it might be gone. Not so.
• Day 1- reinstated to 1.05 mg.

Feelings of fluctuating stability throughout the days. Reinstating again has restarted the stability clock without seeing improvement, at least yet. I'm second guessing having not held at 1 mg. Holding indefinitely unless thoughts are to reduce again to 1 mg.??

[brassmonkey]

Yes, hold for a while and let things settle in. Making an updose can cause a spike in symptoms for some people. It should settle out and calm down.

 

Ahh Fall.... I love it. We are sitting at 102F today. September and October are the hottest months here, followed by November which is usually the coldest. I find it ironic working on Halloween decorations in such heat.

[mdwstrx]

2 hours ago, brassmonkey said:

Ahh Fall.... I love it. We are sitting at 102F today. September and October are the hottest months here, followed by November which is usually the coldest. I find it ironic working on Halloween decorations in such heat.

@brassmonkey

Your reply above gave me a big smile and warm feeling! Enjoy your decorations! If I recall, you go big for the holiday! 😈👻🎃

[brassmonkey]

We are in the middle of changing themes this year. We've done a carnival for about ten years and are changing over to a circus this time. Building circus acts, weight lifter, balancing act, saber toothed tiger taming act, and a 17 foot tall Ferris Wheel. Lots of fun, but a lot of work especially in the heat.

 

[mdwstrx]

Another beautiful early fall day! 

Feeling better (90%) since reinstating from .095 mg to 1.05mg.

Holding...

md

🌻

 

 

[mdwstrx]

@Thelongestroadhome

Thanks for your concern and support! I went back and read some of your posts. It's a crazy ride, isn't it! 

It seems so often that the default is darkness encroaching unless we actively seek the light; ADWD or no.

It's a choice! Our attitude allows us to successfully probe the darkness and it's easy enough to let that drop

without encouragement from others such as yourself. I hope you're seeing much light these days!

md

💜

[mdwstrx]

On 9/5/2021 at 2:07 PM, brassmonkey said:

Yes, hold for a while and let things settle in. Making an updose can cause a spike in symptoms for some people. It should settle out and calm down.

Checking in again @brassmonkey

 

Still feeling rough two months into mini crash. Last updose was to 1.05 mg on 8/31.

Symptoms have morphed into what I think is a mild akathisia. 

 

Two questions.

1. Continue to hold?

2. Is taking .25 mg Lorazepam, spaced out by a week or longer risking addiction?

 

I'm well aware of the dangers of benzos and see it as an absolute last resort. However, until this nagging inner agitation fades, I must be functional at times when Propranolol isn't cutting it.  

 

Another gorgeous fall day! Temps are beginning to cool a bit here in the Midwest.

Early harvest is beginning. Great time of the year! 

md

🍂

[brassmonkey]

Yes, I would continue to hold. Work with the relaxation exercises, deep breathing, meditation and the like.

 

Be really careful of the Lorazepam, once a week shouldn't be a problem, but you never can tell.

[92sharks]

@mdwstrxI would like to suggest adding acupuncture to your self-care routine, if possible. I think there are many, many benefits with acupuncture. Let your acupuncturist know what you are dealing with and what symptoms you need help with. Acupuncture can support your CNS and for me is a pretty passive way of self-care. I just lay there and try to relax. It is one thing I don't have to force myself to do or expend much energy to get there. It is one of my "tools".