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mdwstrx: Lexapro taper or not?

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mdwstrx

Diagnosed with panic and adjustment disorder 1987. Experienced  3 situational depressions (1 was postpartum).   SSRI for 30 yrs.

 

Just RI Lexapro to 5 mg after a failed 4 day discontinuation from 2.5 mg.  Seems to be helping in waves and windows.  Dr appointment next month but he has told me  that if I stop Lexapro, protracted w/d possible with treatment resistant depression surfacing.  Advises that I should consider staying on for life.  I am afraid of both staying on and discontinuing.  I've read about severe, untreatable akathisia, protracted w/d and all other horror stories.  I am worried that one or two months out from discontinuing, symptoms will return that can't be treated.

 

1. Will a gradual slow microtaper from 5 mg. (after stabilization) prevent a protracted w/d?

2. What if  I experience another situational depression,  how to treat it then? 

3. What are risks of staying on a low dose SSRI 2.5 or under?

4. Is that better than risking protracted and untreatable w/d?

 

Last situational depression 8 yrs ago, Dr switched SSRIs and now I realize what I went through was was w/d on top of the depression.  Had to rely on Lorazepam for 3 months and did a gradual successful taper off.   I believe I was very fortunate given the horrific Benzo stories.I cannot fathom relying on Benzos again and would rather stay on Lexapro low dose than risk benzo dependence.

 

I would appreciate thoughts on the above.  Thank you!
 

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Gridley
 

Hello, mdwstrx, and welcome to SA.

 

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.  Please include your tapering rate.
 
 
We do not credit the view that people should stay on these drugs for life, though that is a commonly held belief of psychiatrists.  What psychiatrists call "resentment-resistant depression" is very often antidepressant withdrawal, which generally psychiatrists do not believe it.  To address your questions:
 
1.  A slow micro taper after stabilization will mitigate the severity of withdrawal.  
 
 
2.  We recommend Non-drug techniques to cope when dealing with withdrawal and situational depression.  I would've been much better off learning and applying these techniques instead of going onto Lexapro 14 years ago.
 
3.  If you want to stay on a low dose, that's your decision.  One of the risks of staying on the drug is "poop-out," when the drug stops working for you.  Also, there were no studies done on the long-term effects of these drugs when they were approved, so there may be many unknown dangers.  We are the long-term study guinea pigs.
 
4.  Untreatable protracted WD is rare.  Generally, symptoms resolve over time.  Personally, I wouldn't make my decision based on a fear of it.
 
One further thought: we generally advice a very small updose, much smaller than the updose you made from 2.5 to 5mg.  During the time you were at 2.5, you brain made adjustments to the lower dose and may not be able to handle the 5mg.  Please read:
 
About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic
 
Since you've only been on the 5mg for four days, you might want to consider decreasing your dose to 3.5mg (2.5 + 1mg).  
 
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.  
 
You are certainly wise not to go back on the benzos.
 
 
 
 
 
 

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mdwstrx

Thank you for your informative response Gridley.    I will add a signature and check out your links.   You stated: One further thought: we generally advice a very small updose, much smaller than the updose you made from 2.5 to 5mg.  During the time you were at 2.5, you brain made adjustments to the lower dose and may not be able to handle the 5mg.  

 

I initially reinstated to 2.5 mg for 4 days and then updosed to 5 mg for the last 9 days.  It's been ebb and flow of w/d symptoms since.  Yesterday was an anxious day followed by night waking and about 4 hrs sleep.  Today seemed very bearable.  It comes and goes.  Do you think I should consider dropping to the 2.5 mg at this point?  

 

As for relying on the non-drug techniques, the anxiety I felt during my last situational depression required some immediate and urgent relief - therefore the Lorazepam.  It may have been withdrawal from an SSRI switch midstream as the depression set initially while I was on an SSRI (maybe zoloft to lexapro). I don't recall.  I don't believe non drug techniques would have helped that level of anxiety.  This time, I RI before anxiety got that bad.  Dr. prescribed both Propranolol and Lorazepam as needed but I've successfully avoided using either so far. I intend to continue that course.  My biggest fear is starting down a final course of tapering with a point of no return.   Once stabilized on this RI, I am scared that if I begin a 10% taper and get to some nth dosage or zero, all hell will eventually  break lose at some pt and nothing will work.  Then what does one do?  My only recourse to date was the experience relying on the benzos and that is unacceptable.  

 

 

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Gridley

I understand your concerns.  Since you seem to be doing reasonably well at 5, in the interest of stability why don't you stay there?  

The rule of 3KIS: Keep it simple. Keep it slow. Keep it stable.

I would stabilize there for for several months.

 

1 hour ago, mdwstrx said:

 Once stabilized on this RI, I am scared that if I begin a 10% taper and get to some nth dosage or zero, all hell will eventually  break lose at some pt and nothing will work. 

 

Let's not worry about the 10% taper at this point.  I wouldn't concern myself with what-ifs at this point.  I would suggest you just hold at 5mg and get yourself stable. Stability and constancy are very important.

 

I think you mentally will feel more comfortable with that course (and our mental attitude is very important).  Down the road we can see what might best be advisable.  There is no obligation to go to zero.  

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mdwstrx

Thank you Gridley.

 

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Altostrata

Welcome, md.

 

How are you feeling now? What side effects have you had while taking Lexapro before?

 

As it seems you have made many drug changes recently, it might be a good idea to stay at 5mg Lexapro for some months. When your nervous system has stabilized, you might then consider tapering by 10% per month -- if you decide going off the drug altogether is best for you.

 

"Situational depression" never has been a valid reason for taking antidepressants long-term. "Situational depression" has always been understood as temporary.

 

If your doctor has been telling you that you will need to stay on Lexapro for life because of "situational depression," your doctor doesn't know what that means. It could be your doctor means you have "major depression." It's possible he or she is not knowledgeable about psychiatric diagnosis or psychiatric drugs at all.

 

No one can guarantee you that you will never have "situational depressioin" again; life has its ups and downs -- that is normal. If you go off an antidepressant, you will have to manage "situational depression" with non-drug techniques. As Gridley suggested, see Non-drug techniques

 

You will need to stop thinking of the drug as a solution to your problems. If you have a difficult family life, you will continue to have a difficult family life, with all its stresses. You'll need to address this if you want to go drug-free.

 

Given your history, it seems entirely possible to me that every episode of "situational depression" could have been from skipping doses or temporary discontinuation of the drug for medical treatment -- in short, withdrawal syndrome. We recommend a very gradual taper to avoid this.

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mdwstrx

Thanks for your prompt reply Alto.  I so appreciate your expertise and kind words.

 

Today I am feeling better, sleeping better the last few nights but still having mild symptoms:  waves of anxiety, burning in lower arms, a feeling manifesting occasionally that all is not right.  Weird because then I forget for awhile until the feelings resurface.  Like in shower, thoughts of mildly feeling overwhelmed and uncomfortably unable to tolerate so I got out.  I think you call these neuro emotions on this sight.  Thank you for asking.

 

I believe my diagnosis is panic disorder; adjustment disorder w/anxiety.  Going through the last 30 years in hindsight gives me a clearer picture. I think I can accurately say that the SSRI helped me navigate a stressful career, raising two sons and weathering two divorces.  I tried counseling but nothing seemed to address the anxiety and panic attacks except the SSRI.  Not having a choice of leaving my job, the SSRI seemed my only coping alternative and I was assured it was nonaddictive.  After starting the SSRI, life seemed to dramatically take off where there was never a down time or adequate support to attempt to taper off.  The doctors suggested I needed it and I felt I did.

 

As you know, teasing out the finer causes of anxiety is difficult.  I had social anxiety before my first situational depression.  That occurred in 1987 way before the term situational depression or adjustment disorder was being used,  I think.  The second episode was 5 yrs later, postpartum and occurring while I was off the SSRI. The third episode was divorce  which occurred while I taking Lexapro.  The gp had me switch from Lexapro to Prozac to Zoloft and back to Lexapro within a couple months time.  I was very il w/severe anxiety, thus the need for the Ativan.

 

I am now retired. Little to no stress. No difficult family life now that I am single which is a mixed blessing.  Also, blessed w/2 good sons, a  good pension,  great insurance.. life is good!  Until I decided to taper and quit the lexapro.  :(    I now see a psychiatrist - not a gp, who was recently rated as one of 3 best in town.  He  advised me I could stop the Lexapro after gradual (over a year and a half)  self- tapering to 2.5 mg.  He told me it was  well below therapeutic levels.  He also told me after I notified him of the w/d symptoms that I should now consider staying on this for life.  The alternative was facing treatment resistant depression or what I guess you term protracted w/d.

 

My ideal is to stop the medication but not at the cost of my mental health.  If I can achieve a very slow taper without debilitating w/d and without protracted withdrawal, then I am 100% on board.  I am so confused. Can you tell?

 

❤️

 

 

 

 

 

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Altostrata
4 minutes ago, mdwstrx said:

Today I am feeling better, sleeping better the last few nights but still having mild symptoms:  waves of anxiety, burning in lower arms, a feeling manifesting occasionally that all is not right.  Weird because then I forget for awhile until the feelings resurface.  Like in shower, thoughts of mildly feeling overwhelmed and uncomfortably unable to tolerate so I got out.  I think you call these neuro emotions on this sight.  Thank you for asking.

 

This is a good sign. It can take some months to stabilize.

 

We don't put much store in psychiatric diagnosis or psychiatric history here. People change. Often they were misdiagnosed all along. The drugs change your wiring, too.

 

Please let us know how you're doing.

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mdwstrx

thanks.

 

One last attempt (for now) to satisfy my concern.  Do you know of people on this medication as long as I have been that successfully taper off with manageable symptoms that end after stopping the drug? 

If so, is it common or uncommon or do most have significant issues stopping? 

Lastly, what if one tapers off only to face  a resurgent depression/anxiety a month or two later.  How is that handled if SSRI's no longer work.  Or will they?

 

 

 

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mdwstrx

Today is day 20 of my RI to 5mg of Lexapro.  I have the windows and waves.  I was sleeping through the night for most of the last week.  Then last night woke again at 2:00 with hot flushing. Took a propanolol to see if it would help. Couldn't sleep and got up at 6:30.  Distracted myself from symptoms today by playing pickle-ball with friends.   Tonight I feel edgy, anxious, nauseous and have mild burning in my lower arms.  The doctor told me to updose to 7.5 mg if anxiety kept up.  Should I?  Thank you.

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ChessieCat

Please add dates to your drug signature so that we can easily see when you made the dose changes.  Thank you.

 

30 yrs SSRI History

Tapered Lexapro over a year to 2.5   DATE when you reach 2.5mg

After 75 days, discontinued.  DATE you stopped

Following 4 days, w/d symptoms began.

RI to 2.5 mg for 4 days  DATE you reinstated

Updosed to 5 mg DATE you updosed

 

You are feeling bad after 1 night of sleep issues.  That is to be expected.  It happens to everybody at times.  Panicking and increasing your dose is not a good idea  In fact, you reinstated at twice the amount that you had jumped off so increasing your dose is probably not a good idea anyway.

 

 Stabilising doesn't happen in a linear way.   Windows and Waves Pattern of Stabilization   You've been sleeping through for most of the time which is a good sign.  There will be times of discomfort and we need to be patient and learn way to get through the uncomfortable times instead of reaching for a "quick fix".  We need to learn to be patient and learn and use Non-drug techniques to cope and  Sleep problems - that awful withdrawal insomnia

 

As Alto stated:

 

On 12/2/2018 at 8:30 AM, Altostrata said:

 

This is a good sign. It can take some months to stabilize.

 

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mdwstrx

Thank you Chessie, for your prompt reply. I was feeling like maybe the amount was too low to be effective but I forget it’s withdraw.  You guys do an invaluable job on this site!  I can’t tell you how comforting it is to reach out and ask a question in the throws of this horrible panic and have someone kindly reassure us. God bless you all. 

 

I will fine tune signature tomorrow. Replying on phone now. 

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mdwstrx

Hello.  Updating my last message.  Today has been a true Godsend, thank you Lord!  It makes me want to encourage others that there is hope out of the nightmare feelings of w/d.  Just last night, I was anxious enough to consider up dosing making me realize how these w/d symptoms really mess with your thought process.  I slept 8.5 hrs.  Woke feeling edgy but engaged in my morning exercise routine until 11.  Slight traces of being off still but the 'window' has lasted all day.  It's now 3 pm and I'm feeling much like my old self with a few passing waves.  Praying it continues but I  imagine I'm not out of the woods yet according to other stories here and expect there will be other big waves.   Over the next month or two, I''ll be researching how to appropriately taper down to 0.  I am hoping to find answers to the following questions on this site but would appreciate any thoughts others may have as well.  

 

  • Is it likely that protracted w/d will set in after a long slow taper having been on an SSRI for almost 30 yrs.?
  • As one tapers into the lower numbers  can it trigger a full w/d or are do symptoms always gradually begin giving one a clue and time that they need to slow/stop?  
  • Does up-dosing always remedy w/d symptoms during a careful, gradual taper?  Or, can one pass the point of no return and must finish off the taper in w/d? 
  • Should I now consider switching to prozac and holding for some time to make a planned taper easier?  I have read one can go thru w/d switching drugs too.  Is this accurate?
  • What is kindling in the context of multiple w/ds?  How dangerous is it?

Lastly, unrelated to my situation, can anyone tell me if discontinuing Wellbutrin after 2-3 years use is as difficult as the SSRIs?  

 

Thank you for any opinions on the above.

 

 

 

 

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ChessieCat
1 hour ago, mdwstrx said:

Lastly, unrelated to my situation, can anyone tell me if discontinuing Wellbutrin after 2-3 years use is as difficult as the SSRIs?

 

Wellbutrin IS an SSRI, which may be prescribed as a smoking cessation aid.  If you are asking on behalf of another person, it would be better for that person to join as a member so they can get the necessary information first hand and be supported during their taper.  It is difficult for the mods to assist someone through an intermediary.

 

 

You've ask a lot of questions, to which, generally, answers can be found on the site.  To save time, I've given you some information and links below, and if after reading you still have questions, please ask them here in your intro topic.  Thank you.

 

Is it likely that protracted w/d will set in after a long slow taper having been on an SSRI for almost 30 yrs.?

 

The idea of tapering is so that the brain adapts as you go.  are-we-there-yet-how-long-is-withdrawal-going-to-take

 

As one tapers into the lower numbers can it trigger a full w/d or are do symptoms always gradually begin giving one a clue and time that they need to slow/stop?  

 

Many members find that the lower their dose gets the slower they need to go, reducing by less and/or holding for longer.  Please see above Are We There Yet link and why-taper-sert-transporter-occupancy-studies-show-importance-of-gradual-change-in-plasma-concentration

 

Does up-dosing always remedy w/d symptoms during a careful, gradual taper?  Or, can one pass the point of no return and must finish off the taper in w/d?

 

about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms

 

Withdrawal Normal Description

 

This statement from the reinstatement topic also applies to tapering too quickly - so reworded:  Don't reduce your drug too quickly assuming that updosing is a safety net.:

 

On 10/9/2012 at 10:17 AM, Altostrata said:

 

Don't suddenly go off medication assuming that reinstatement is a safety net. This is one of the reasons we advocate gradual tapering to minimize withdrawal symptoms. Once the nervous system is destabilized by withdrawal, all bets are off. Humpty Dumpty has fallen off the wall.  (Humpty Dumpty is a character in a children's nursery rhyme - he is an egg.)

 

Reinstatement does not always work, and you may have to live with severe withdrawal syndrome for a long while. Medicine wants to believe the acute phase of withdrawal lasts only a few weeks. From what people have posted on the Web, it can last many months.

 

 

 

Should I now consider switching to prozac and holding for some time to make a planned taper easier?  I have read one can go thru w/d switching drugs too.  Is this accurate?

 

Generally it is better to taper the drug you are currently taking.  Changing to a new drug:  you can experience WD from old drug, have start up/side effects/bad reaction to new drug.  Because of the change you would not know what is causing any issues.  For example, I have previous experience taking Prozac and got very weak muscles from it so I know that I have an issue with that drug.  However, if I didn't have previous experience and did a cross over to Prozac and got weak muscles, as per the above explanation, it would make it very difficult to know what caused it.

 

the-prozac-switch-or-bridging-with-prozac

 

What is kindling in the context of multiple w/ds?  How dangerous is it? 

 

tolerance-or-poop-out-or-tachyphylaxis

 

 

Edited by ChessieCat

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mdwstrx

Thank you Chessie. 

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ChessieCat
2 hours ago, ChessieCat said:

Wellbutrin IS an SSRI, which may be prescribed as a smoking cessation aid.  If you are asking on behalf of another person, it would be better for that person to join as a member so they can get the necessary information first hand and be supported during their taper.  It is difficult for the mods to assist someone through an intermediary.

 

Why taper by 10% of my dosage?

 

Tips for tapering off Wellbutrin, SR, XR, XL (buproprion)

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mdwstrx

Hello.  In reading through a thread of another person here on the site, one of the moderators said, “Lexapro is one of the hardest drugs to withdraw from.”  This statement frightens me as I consider a taper and makes me more want to consider switching SSRIs, though I have read the above thoughts  on that topic as well.  Is the statement accurate?  Is Lexapro won of the hardest?

 

Trying to gather all available info before tapering. 

 

Thank you!

 

 

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ChessieCat

You don't have the starting dose in your signature (please add it).  You've already had experience tapering down to 2.5mg over an 18 month period.  How did you feel during that time?  I think that is a better thing to go on rather than other people's experiences.  There are so many variables involved and as Altostrata says we are all an experiment where N=1.

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Gridley
9 hours ago, mdwstrx said:

“Lexapro is one of the hardest drugs to withdraw from.”

I've never read that Lexapro is one of the hardest drugs to withdraw from (that dubious distinction goes to other AD's).  

 

Everyone's experience is different.  In the course of two years, I've tapered Lexapro from 20mg to 4.4mg using the Brassmonkey slide taper (2 1/2% of current dose for four weeks with a 2-week hold).  I have about two years to go.  I have remained functional with no need to updose.   I certainly have WD symptoms but they remain tolerable.  

 

Switching or bridging to another AD is an option but it carries several drawbacks that should be considered.  If you haven't already, please read:

 

The Prozac switch or "bridging" with Prozac
 

 

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mdwstrx

Thanks Chessie and Gridley.

I had very little problems tapering from 20 mg down to 7.5 mg  A few slight blips from 7.5 mg to 2.5 mg.   I cannot fathom why my Dr. felt jumping off at 2.5 mg  was ok -  given all the things I've now read on this site.  I am concerned about going lower than 2.5.

 

Unfortunately, having a bad day today.  Nausea, very uncomfortable (anxious) and seemingly fixated on this.  Being single, I am telling folks I am around since keeping it 'secret' seems to make me more anxious.  I'll probable regret being so open but at this point, I have other thing to be concerned about.  If I try to distract myself, it helps.  But so uncomfortable that my thoughts keep coming back.  And now a new symptom is emerging.  Muscle jerks in my left  

thigh muscle.  Is it called Myoclonus?  How serious is this new development?

 

I have a call into the Dr. and waiting to hear what he thinks.  

 

Thank you all for your invaluable info and opinions.

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ChessieCat

Have you seen this topic:  When to end the taper and jump to zero?

 

Some members find that the lower their dose gets the slower they need to go, by reducing less and/or holding for longer.  Why taper paper: dose-occupancy curves

 

In general it is better to continue tapering the drug you are on instead of switching because you might experience WD from the old drug, start up/side effects/bad reaction to the new drug.  You won't know what caused any issues if they happen.

 

We are going to experience times of discomfort and withdrawal symptoms may change in severity, length of time we get them and/or what you symptom you experience.  It's important to learn to be patient and stay as calm as possible and try not to introduce panic.  Anxiety adds extra, non-WD symptoms and can confuse you as you don't know what is WD and what is anxiety.  We strongly suggest that members learn and use Non-drug techniques to cope

 

You might find it helpful to log and rate your symptoms.  There are links to pages for printing or using on the computer here:  Dr Joseph Glenmullen's Withdrawal Symptoms

 

How do you talk to a doctor about tapering and withdrawal?


What should I expect from my doctor about withdrawal symptoms?

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Gridley

Jumping from 2.5mg was far too high.  

 
The graphs in this topic might help to explain the reason for this:

 

 
The following link will give you some more information about when to jump off.
 
 
I know you had a bad experience jumping off due to bad advice at 2.5mg.  But if you taper off very slowly and to a very low dose before jumping off, you will do much better.  Brassmonkey tapered down to 0.046mg active ingredient before he jumped.  Others have tapered down to .1mg.  
 
 
Edited by Gridley

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mdwstrx

Thanks to you both for such quick responses.  I am keeping a log of symptoms.  I'll read (reread in some cases) the links you posted.  You both are very kind.  I hope you don't mind but I'd like to let you know what the Dr. says to get your opinion.  After his last advice, I intend to second guess everything. 

 

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Leo1983

Hi guys

 

Just a little extra.... hope it helps.

 

Lexapro is a very very powerful drug. It is x3 the strength of Citalopram its sister drug. Its mechanism of action is superior to other SSRIs and it is highly selective which receptors it binds too.

 

A thought i had when reading your post is you say you jumped off at 2.5mg. Taking into consideration Lexapro is upto x3 stronger than Citalopram that would mean you jumped of at 7.5mg Citalopram. 

 

My point here is Lexapro is strong and although 2.5mg seems small its actually not due to Lexapro's potency. This may explain your suprise at your symptoms. 

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mdwstrx

I just heard back from my doctors office.  His direction is to up my dose of Lexapro to 7.5 for a week and then raise it to 10 mg.  My appointment with him is not until January so I've asked to be put on the cancellation list. 

 

In an earlier message, I was told, "Panicking and increasing your dose is not a good idea  In fact, you reinstated at twice the amount that you had jumped off so increasing your dose is probably not a good idea anyway."

 

Another article I read says, "In order to decide what dosage to reinstate at, take your previous maximum dosage and reduce that number by 10% for each month since you started weaning.  Since your goal is to wean off of an SSRI, you don’t want to start at too high a dose, but at the same time, you don’t want to start at too low a dose.  A low dose reinstatement will take longer to reach stability, which will extend the whole process of tapering."

 

Although I've asked before, and was told I need to learn to be patient and use non drug coping techniques, can  up-dosing help to stabilize?  I believe once stable, I can begin a proper taper but don't believe I can be patient for months feeling like this if a temporary up-dose will in fact, help with the symptoms. With no disrespect to any of the moderators here, I am very, very tempted to try this to see if it does help.  Unless there is critical reasoning that this would be more harmful than helpful.

 

And thank you Leo!  I appreciate your input as well!   I have also read where Lexapro is much stronger.  So I believe you're right.  

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Leo1983

Your welcome.

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Gridley

It is of course your decision.  We and your doctor are in disagreement.  Just as updosing can help to stabilize if the dosage is correct,  updosing too much can be extremely destabilizing because your brain can't handle the higher dose.  This destabilization can be long-lasting.  Since September 1, you have made four major changes to your Lexapro dosage, including a too-high jump to zero.   Your brain needs stability now, not another (or two more) dose changes.

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mdwstrx

Thank you Gridley.  Please know I am weighing all information to feel better.   I just found this quote from ******, Founder at Surviving Anti Depressants.org

 

To avoid setting off a potential kindling reaction, it’s safest to try reinstatement at a very low level. Depending on the drug, this means perhaps 1 milligram to start.

If you don’t have an immediate bad reaction, give it a week to see if this is enough. If you feel you need a higher dose, go up by perhaps 1mg per week.

After withdrawal symptoms go away completely, you can taper off by very tiny amounts over months to avoid bringing on withdrawal symptoms again.

Edited by Altostrata
masked name

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Altostrata

mdw, you went back to 5mg about 2 weeks ago. How have your symptoms changed over the last 2 weeks?

 

It's possible 5mg is enough, and you just need to give your nervous system a little more time to settle down.

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Carmie

Hi mdwstrx, 

 

Everyone on this site cares about your wellbeing. 

 

Please answer Altostrata’s question. 

 

We will all get there in the end. 

 

Wishing you the best in your recovery n sending hugs🤗

 

 

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mdwstrx

Good morning Altostrata and Carmi.

 

Everyone on this site has been beyond kind. Thanks for the Hugs and back to you. I appreciate this site  and have the utmost respect for you, Altostrata and your team.

 

 I am struggling these last two days maybe more than before but definitely more than recently.  In the end, I have to weigh your advice, my research, my Doctor's advice and my own situation and reach a conclusion.  There is apparently no easy/quick answer. The 3 times I've gone through something similar (situational depression), it always got better over time.  I know without a doubt this will too.  I am very discouraged by reading story upon story of months and months of this agony.  If gradual up-dosing to a therapeutic level helps to stabilize, then I accept it and will stabilize to reassess at that point.

 

Have my symptoms changed over the last two weeks?   

 

Symptom are:

  • insomnia
  • nausea
  • no Appetite (lost 6lbs so far)
  • if I move too quickly or if I have a bad thought, a wave of anxiety washes over me and fades out
  • sensitive to loud noise
  • hyper focus on my situation (searching for answers daily and hard not to bring it up with others... it's like ignoring a leg that's been cut off and people wonder why you're limping)
  • Hot flushing
  • Sweaty palms
  • Lower bowel issues (D) to be delicate
  • *shortness of breath with the anxiety
  • parathesia (burning in lower arms, fingers)
  • tingling and pins and needles
  • *myoclonus (jerks) especially at night but yesterday while I was engaged in sports
  • dull headache behind the eyes
  • *uncomfortable in my own skin (Akathesia or anxiety - Most likely anxiety as I feel a need to breath deeply at times (short of breath) and don't feel the need to move.)
  • lack of concentration

* newer or seemingly more intense on some days since up-dosing

 

Thing that have cleared since up-dosing:

  • Cortisol spikes at night and in morning (thank the Lord!)
  • Was sleeping more through the night until the last 2 nights

 

The symptoms above  have been present since before up-dosing and have since fluctuated from overwhelming to not so bad.  Mostly on the verge of overwhelming,  Especially the Anxiety.   Yesterday it was too uncomfortable and I gave in and took 5 mg Propanolol.  It helped to calm things so that I didn't have the terrible uncomfortable feeling like I wanted to jump out of my skin.

 

I  up-dosed 2.5 mg of Lexapro last night for a total of 7.5 mg for the day and this morning 7.5 mg. along with 5 mg. of Propanolol and 250 mg of daily Magnesium. I am doing everything I can think of to avoid reliance on a benzo like I had to do 8 years ago for several months.  Or worse yet, end up at the emergency room.

 

I am going to try  give it a week to see if anything improves before even considering up-dosing more.  I have read and read and read and researched and I still don't know whether this is a recurrence or an 'upset nervous system.   I think you're definitely right, Altostrata, it's very probable that my system needs time to settle down/stabilize but it's not doing it on it's own in a manner that I can deal with.  It's all over the place and these symptoms are consuming me.  I appreciate  that you know these feelings. 

 

Your thoughts on the above and others are greatly appreciated.  

 

Many thanks.

 

 

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mdwstrx

Good morning. 

 

Day 3 at up-dose to 7.25.

  • Slept well last night after an acceptable day with an almost pleasant window in the evening 
  • Woke  today with a low sense of dread (akathisia) and parathesia

Finding that .5 mg Propanolol really helps the debilitating akathisia making it bearable.  Researching but would appreciate any thoughts on relying on .5 mg Propranolol  daily if needed until this all subsides.  My rx is for 10 mg pills, take 2X a day as needed.  Trying to keep at bare minimum.  

 

Continuing to lose weight.  Down 8 lbs.  

 

Thank you for any input to the above.

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WantoffVen

Hi mdwstrx, I am a 65 year old retired woman from Peoria, IL so we should be close in age. I have been on benzos and AD's for over 30 years and I'm weaning off Effexor which everyone knows is the TOUGHEST to wean off - lol. I want to encourage you to have patience. I have so much longer to go to even get off the Effexor and then not counting the benzo I'll probably die before I get there but at least I will die trying. I tend to read the stories and realize how much BETTER I am doing than so many others and you really aren't doing badly compared to many others. So let's look at the glass half-full. Here anytime you want to talk.

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mdwstrx

Thanks again Chessie.  I'll explore those links!

 

Hi WantoffVen.  Thank you for the encouraging note!  Yesterday and today have been relatively good days for me.  So yes, I am definitely looking at the glass half full.  I admire you for your outlook.  I believe as long as we're trying to better ourselves, there is always hope!    I am learning so much through this site.  I am uplifted to hear you're doing better than many on here and gladly will correspond if you'd like.  Lastly, I am a firm believer that the good Lord is watching over all of us, with his outstretched arms for those seeking Him. He has been my rock through all of this!  (Not to take away from Alto and her team , smile).

 

 

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ChessieCat
1 hour ago, mdwstrx said:

Lastly, I am a firm believer that the good Lord is watching over all of us, with his outstretched arms for those seeking Him.

 

Have you seen this topic: lets-pray-for-one-another

 

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