mdwstrx: Lexapro / escitalopram taper or not?

[Tom37]

Seem like not a bad day but not a good day.... I bet if that anxiety eased it would be a game changer for you. 

 

At least it seems your reduction hasn’t changed anything for the worse which is good.....Dont be disappointed though if no improvement either as every change in dose the brain has to adjust again which as we know takes time.

[mdwstrx]

Hello.

Alto asked me to track on here for a week since the reduction from 7.5 to 7 mg.  Today is day 7 so I'll stop posting my tracking. Early mornings are still symptomatic and difficult.  However, I am sleeping.  Last night slept through the night with one quick break. 

 

Sunday, January 27, 2019   7 hrs. of sleep

·         Early a.m. Woke once, back to sleep.

·         6:00 a.m.  Woke, felt chest discomfort and shortness of breath, am starting to notice a very slight product when coughing.

·         6:30 a.m.  Up took 7 mg. Lexapro (5 mg. pill/2 mg. liquid) day 7 of reduction from 7.5mg

·         8:00 a.m.  Sweaty palms, nervous.

·         9:30 a.m.  sinus cleared/ sxs abate, including anxiety/nervousness, to the point of 'almost' being gone. 
          This sinus clearing/sx abatement has happened several times throughout wd. Not long lasting but welcome.

·         1:00 p.m.  The sx abatement has pretty much stayed with me since this morning unexpectedly. Other than sensitivity to neurofear and hot flushing, feel good.

·         4:30 p.m.  Started to feel sx returning a bit.  

 

 

 

[Tom37]

Sounds like a better day....encouraging signs.....hopefully you can string a few together in a row especially the periods of ‘almost no symptoms’.

[mdwstrx]

Thanks.  Yes, encouraging but not me by a long shot.  Like you, I feel like I'm another person, and I don't like me much this way.  Sick, afraid and uncomfortable.  Some day, I hope the old me returns.

[Tom37]

I understand....I feel like there are two of me at the moment especially mentally on days like today....one period it’s wd doing the thinking then next period it’s me....time is the great healer after all....(so they say).

[mdwstrx]

Today was a decent day.  Probably the best in awhile symptom wise.  Played 2 hours sports and had a friend visit in afternoon.  That was a tad triggering but not too badly. The chart below as it shows it's been almost two weeks since the last bad wave.  Praying it continues to improve but I also know nothing is guaranteed in w/d.  I think the windows and waves are intermingling during the days.  Yesterday, I felt decent until late afternoon and then I felt a 'wave' in the evening.   

 

[Tom37]

That’s great that you have gone two weeks without a wave....I can’t get that far yet. You seem to be progressing along so that must please you. Hopefully it continues but I guess bumps in the road are still inevitable, let’s just hope they are small bumps.

[mdwstrx]

Mods, I'm in the process of switching to liquid Escitalopram.   Presently taking 5 mg tablet and 2 mg liquid.  My tablet rx isn't refillable.  I have maybe a couple weeks of tablets left.  Is there a recommendation on how to progress the switch of the remaining 5 mg to liquid.  I'm thinking about halving the 5 mg tablet and increasing the liquid to 4.5 mg. After a week or so, then taking all  7 mg liquid? Is that advisable? Not sure how else to do it.

 

Thank you.

 

Tom , I don't think it's been 2 weeks w/o a wave unfortunately.  Maybe more that the waves are not as severe as they were.  You can see on the chart how sx are still up and down, just not as extreme.  

[ChessieCat]

Generally we suggestion 3 to 7 days on the following combinations:  3/4 + 1/4, 1/2 + 1/2, 1/4 + 3/4.

 

5 mg tablet and 2 mg liquid

2.5mg tablet and 4.5mg liquid

 

Yes, that looks reasonable.  It's probably the easiest way to do it.  I'd definitely try to do each for at least 1 week.  Longer if possible.  You'll need to work out how many tablets you have left to divide up.

[mdwstrx]

Thanks for your quick reply Chessie.  Thought you might be sleeping?  

 

After counting, I was way off.  I have 14 weeks of tablets left (not a couple) in the rx so I can hold for some time.  

 

 

[Tom37]

If they are not as severe then that is a good sign....I’m currently in middle of one and while not quite as bad as they were earlier on still tough....always the physical symptoms with mine that make them so difficult.

[mdwstrx]

I'm sorry that it's a bad wave.  Left a message on your thread about how after my last bad wave, things began to settle.  I don't know if it is temporary and another wave is lurking around the corner after two weeks.  I pray not. 

 

My days seem to be morphing into the same kind of thing...  Not symptom free but, after a bit of a rough start in the morning, I go into the day with minor symptoms that I just overlook to the extent I can.  Usually, a little burning and tension in arm, neck muscles, a bit of a headache that if I focus on, may sort of disappear.  Sometimes, I can feel slight buzzing and heart palpitations.  Often times, breathing feels shallow as if there is something in my lung and at times, can cough a bit but the feeling comes back.  Sleeping has been better with the fish oil supplements.  I seem to be averaging around 7 hrs. or so thankfully.   

 

Does anyone know, is this stabilizing?  If so, will improvement continue over time?  Also, while I'm not there yet, I would appreciate input about when I should consider tapering again.  

 

A bitter cold day.  Winds are howling outside and will be -25 c tonight. ....brrrr  ❄️

[ChessieCat]

8 hours ago, mdwstrx said:

Thanks for your quick reply Chessie.  Thought you might be sleeping?  

 

I should have been. 😒  I got up in the middle of the night because it was very sticky and I put the a/c on to cool the house down.  I haven't been able to work out how to use the timer.  I was also hungry.  After being up for an hour or so I went back to bed and had a lovely sleep until 7 am.  I've been waking up between 5 am and 6 am so made a nice change.

 

8 hours ago, mdwstrx said:

I have 14 weeks of tablets left

 

That's good.  You've got plenty to be able to do a cross over.

[mdwstrx]

2 minutes ago, ChessieCat said:

After being up for an hour or so I went back to bed and had a lovely sleep until 7 am. 

So glad to hear.   Can't wait 'til I get there again.   

[mdwstrx]

On 1/10/2019 at 3:47 PM, ChessieCat said:

 

Same with me.  I've been an an AD for 25 years.  Almost 20 years on citalopram SSRI which I believe pooped out on me.  That is something that Dr Shipko may not take into consideration, the drug reaching tolerance so a person would end up on a drug that isn't working yet still needs to taper because if they go too fast they will get withdrawal symptoms - stuck between a really large rock and a really hard place, especially if they are on a high dose of a drug.  And the other issues that needs to be considered about staying on a drug is the side effects which you get.  I've had numbed emotions for 25 years of my 61 years.

 

And 6 years on Pristiq SNRI.  I was taking 100mg and I'm now down to 4.75mg.  After trying to reduce my dose from 100mg to 50mg for 2 weeks I found SA, updosed, stabilised and have been tapering following SA's recommended tapering protocol.  I've also had two longer holds during my taper.  One of 3 months at 50mg and one of 7 weeks at 20mg to let my brain do any catching up it needed to do.  During my taper I do still experience withdrawal symptoms but they are generally mild, can increase a bit after a reduction, and have ramped up during stressful times.  I think this is just a normal part of tapering.  I doubt that a completely symptom free taper is possible considering that each time the drug is reduced the brain needs to adapt to not getting as much of the drug.

 

When we take a psychiatric drug, we are adding chemical/s to the brain.  The brain then has to change to adapt to getting the chemical/s.  It might have to change something to do with A and then once that change has been made it affects B so another change has to be made and so on down the line.  It is a chain reaction, a domino effect.

 

The same thing happens when we take the drug away.  That's why it's possible to experience such a vast array of withdrawal symptoms, and they can change, and be of different intensity.

Thanks Chessie for your information above.  Can you share a link to your intro?  Also, do you mind sharing why you began taking the SSRI to begin with?  For depression and/or anxiety? 

[ChessieCat]

17 minutes ago, mdwstrx said:

 Can you share a link to your intro?

 

There are links in my drug signature.

 

17 minutes ago, mdwstrx said:

Also, do you mind sharing why you began taking the SSRI to begin with?  For depression and/or anxiety? 

 

This is the link to the submission I made to the Scottish Parliament

 

[Tom37]

To me it sounds like your on the right track. From a few people who I have talked with when they stabilised they were either completely symptom free or any symptoms they did have were minor and of not much concern. Once this symptom free or pattern was established then they waited 30 days approx min before tapering a very small amount. 

 

I think the big thing we are we are looking for is a month of no big swings in symptoms....so consistency is key and as above should be very tolerable if any.

[mdwstrx]

Thanks for your info Chessie.  I’ll check the links. 

 

Tom, that’s really helpful. Thanks for sharing what you’ve heard and your thoughts.  Hope your feeling better as the day progresses.  I sure hope you’re right about being on the right track.  It’s coming for you too!

[mdwstrx]

21 hours ago, mdwstrx said:

My days seem to be morphing into the same kind of thing with an occasional wave during the day.  After a bit of a rough start in the mornings, I go into the day with minor symptoms that I just overlook to the extent I can.  Usually, a little burning and tension in arm, neck muscles, a bit of a headache that if I focus on, may sort of disappear.  Sometimes, I can feel slight buzzing and heart palpitations.  Often times, breathing feels shallow as if there is something in my lung and at times, can cough a bit but the feeling comes back.  Sleeping has been better with the fish oil supplements.  I seem to be averaging around 7 hrs. or so thankfully.   

Hi Alto.  

It's been 10 days since reducing from 7.25 to 7 mg. Escitalopram per your suggestion.  I posted daily records for the first 7-8 days on here.  I would like your opinion on whether there might be more improvement in the sxs or if this is what I can expect when stabilizing?  I included the chart below again.  The reduction is noted on Jan 20th.  Thank you.

 

[mdwstrx]

Had a routine physical yesterday.  They did blood work, ekg and chest x-ray for the breathing difficulty.  Nada, except low on vitamin D.  They advised me to take a Vitamin D supplement.  Any mod have opinions on that?

 

I'm grateful the chest x-ray showed nothing since the shallow breathing had me concerned.  These w/d symptoms are phantoms for sure; morphing and waving all the time.  The nurse practitioner said they routinely stop people at 2.5 mg also.  She didn't say but seemed skeptical that I was in w/d for 3 months.  This is the oddest thing I've ever been through where only people on this site get it.  Like tapping into some alternate universe....   

 

Today was a relatively good day.  I hope it continues. 🙏

 

[ChessieCat]

There are many existing topic on this site.  I like to use google and add survivingantidepressants.org to my search term.

 

vitamin-d3-cholecalciferol-or-calcitriol

[Tom37]

Glad everything came back fine....definitely unusual that we find the only understanding and support from this forum.

 

The symptoms are definitely all over the place for. Last Saturday had my best day in a while - still had symptoms but felt ‘a lot better’ . Then this week as been horrible....windows and waves apparently. Can’t wait to get a window with no symptoms all though at the moment feels like they don’t exist.

 

You seem to be tracking along ok....hopefully it keeps up.

[mdwstrx]

Thanks again Chessie.  I found this at the link so I think I'll wait to supplement until I stabilize... NOTE: Vitamin D is a daytime vitamin. Even if you take it in the morning, it can keep you awake at night. Just what I don't need.

 

Thanks for your support Tom. I read your entry and am sorry it's dragging on so.  It will improve.  It sounds a bit like me in that your windows and waves are intermingling?  Not sure what it means, if anything, but I hope it's a good sign.  I admire you for holding at 4 mg. and soldiering through this.  When ready, I'll have to begin again from 7 mg. when I was down to 2.5 mg.  

 

[ChessieCat]

1 hour ago, mdwstrx said:

I found this at the link so I think I'll wait to supplement until I stabilize

 

You might find just going outside for a short amount of time each day might help.

[Tom37]

No idea either what these waves/windows mean. I would like to think that waves mean your body is trying to fix something and a window means your body is currently ‘ok’ with where everything is at but who knows what they mean.

 

Im actually at 3.80mg after the updose from 3mg almost three months ago. Those .20 are important when tapering! Haha.....in all seriousness though if I ever get through this and get to be 90 percent or more I don’t think I will attempt to taper again. Im struggling dealing with this and I can’t risk doing this to myself twice especially when you see other slow taperers still running into problems.

[mdwstrx]

Yes, those .20 are important!  🙂  I was told if you go slow at the 10% or less taper, and listen to your body, you should be ok.  You say others are running into problems under the 10% tapers?  I hate to think about staying on this and not having access to it for some unknown reason.  

[Tom37]

Sorry if that alarmed you. You just see the odd person who still has trouble no matter how slow they go and I guess because of current situation that’s enough to put me off. Majority though seem to go very well especially if they listen to there body and not drop by the calendar. Just make sure you give yourself plenty of time once stabilised before starting to make sure your well and truly good to go.

 

I would love to get off them too and maybe once I’m through this and time passes I will give it ago.

[mdwstrx]

No worries. I don’t read a lot of the other postings if I can help it now as it was triggering so I thought maybe you’d read something of note that I missed. Given what we’ve been through and especially your last week or so, I get that jumping back into tapering isn’t your first priority.  But I think once your stronger and feeling better, you’ll be in a better position to assess.  There’s no obligation as someone on here told me. 😊

[mdwstrx]

Another day where I feel symptomatic but well enough to push it off to the back of my mind to be able to go about my limited business.  I've felt tense and a the buzzing inner feeling that makes me think it might be a slight wave today.  Played sports for a couple of hours. It's a welcome relief to get me out of house, allowing me to socialize while focusing on something other than w/d.  On the positive, slept through the night without getting up once for the usual 7 hrs.  I find it odd that when I wake, it takes a moment for sx to return.  Where do they go while I'm asleep? 🤔   I guess I really don't care since I'm thankful to be sleeping again.

[eymen23]

22 minutes ago, mdwstrx said:

Where do they go while I'm asleep? 🤔   I guess I really don't care since I'm thankful to be sleeping again.

 

Yes, I find this very interesting too. I have found a pattern in that I tend to sleep my best during periods when my symptoms are worse in the daytime, but then feel better in the daytime when I’m not sleeping as well.

 

It’s quite bizarre, but I wonder if the body is doing it’s best to make necessary repairs, and is sometimes sacrificing one thing for the other. I say that because in the past, when I’m stressed out, I get more anxious and I sleep worse, but with this process that’s not necessarily the case at all. 

[Gridley]

1 hour ago, eymen23 said:

It’s quite bizarre, but I wonder if the body is doing it’s best to make necessary repairs, and is sometimes sacrificing one thing for the other. I say that because in the past, when I’m stressed out, I get more anxious and I sleep worse, but with this process that’s not necessarily the case at all. 

 

 

On 12/4/2015 at 2:41 AM, apace41 said:

Basically- you have a building where the MAJOR steel structures are trying to be rebuilt at different times - ALL while people are coming and going in the building and attempting to work.

It would be like if the World Trade Center Towers hadn't completely fallen - but had crumbled inside in different places.. Imagine if you were trying to rebuild the tower - WHILE people were coming and going and trying to work in the building!  You'd have to set up a temporary elevator - but when you needed to fix part of that area, you'd have to tear down that elevator and set up a temporary elevator somewhere else. And so on. You'd have to build, work around, then tear down, then build again, then work around, then build... ALL while people are coming and going, ALL while the furniture is being replaced, ALL while the walls are getting repainted... ALL while life is going on INSIDE the building. No doubt it would be chaotic. That is EXACTLY what is happening with windows and waves.  The windows are where the body has "got it right" for a day or so - but then the building shifts and the brain works on something else - and it's chaos again while another temporary pathway is set up to reroute function until repairs are made.  

 

Edited February 2, 2019 by ChessieCat
fixed up quotes

[Tom37]

I tend to sleep better when had a tough day symptom wise. Maybe because it just tires me out so much physically and mentally that I’m to tired to care about sleeping well or not. 

 

At least if it was a wave today or the start of one it didn’t really affect your day which is good.....maybe they are getting less intense.

 

Take care.

 

[mdwstrx]

Good morning all.

• Slept pretty well. Woke pretty well. Feel pretty well so far but not sx free - yet. 
• Changed escitalopram tablet/liquid portions from 5/2 mg to 2.5/4.5 mg today. 

Have a healing and peaceful day. 🌞

 

[Tom37]

You seem to be really making progress....very pleased for you but also a little envious too....hopefully it keeps up!

[mdwstrx]

A relatively good day.  Mornings continue to be the most difficult but more manageable than before.  Sx are still present but not as strong.  There are glimpses of feeling good but then a sx pokes through to remind me I'm still in w/d.  It's been 19 days since the last bad wave.  Since then, I'd say it's been like a 19-day window with mini waves throughout the days.  Hoping it continues to improve.  

[mdwstrx]

Another day like yesterday.  Thank you Lord! 🙏  Improvement is happening.

Praying that others are healing too.