mdwstrx: Lexapro / escitalopram taper or not?

[Carmie]

Hi md, 

 

It’s lovely to read you’re doing so well, sending hugs🤗

[Tom37]

That is good to hear! Crazy how we all heal and respond to these drugs differently.

 

Hopefully I’ll be following you soon.

[mdwstrx]

Carmi  - Thanks and hugs back to you! 

 

Tom - I was so happy to read your day improved today!  It takes awhile but once I realized the worst might be behind me, it  allowed me to look forward; that’s helped me a great deal.  It’s not 100% but I’d say 80 - 85%.  Yes, we heal differently but we do heal - in our own time.  You are too!

[Tom37]

I can’t wait to get that point when the worst is behind me which for me is the constant changing of symptoms.....80 to 85 percent is awesome!

 

Just remember once you are at a nice stable place that you need to let the brain/cns settle before tapering....you will be like a three legged stool with one of those legs not quite fully ‘set’ so easy for it to topple over if you don’t t give it enough time to set properly.

[mdwstrx]

Good advice Tom.  I don't think stabilizing is here yet... 

 

Things had been looking up then had a bit of unsettling news. 😯 Took me back a few steps unfortunately.  Today at about 60%.  Headache, not as much sleep, hot flushing, achy, feeling inner buzz, emotionally feel week.  Hope it dies down.  Feeling the inner unsettled feeling too; as if I want to escape this body. Haven't felt that in awhile. System feels like it was hit with hammer again; a throbbing and raw feeling.  Not a good day so far.

 

Will try to rest and take it easy  this afternoon after playing sports this morning.  

[Tom37]

That’s not good....just your body saying that it’s not happy and needs more healing so along comes a wave to make some more adjustments. Then when it’s over that 80/85 percent might be 85/90 percent.

 

Hopefully you start feeling better better this evening and tomorrow.

[mdwstrx]

Thanks, needed some kind words today.  

 

Today is also day 4 of changing dosages from tablet to liquid -  Was taking 5 tab/2 liquid mg and moved to 2.5 tab/4.5 liquid   Wonder if that has anything to do with it?

 

[Tom37]

No problem....it’s always very disappointing when you lurch backwards but seems to be the nature of recovery. Try not to worry and remember it’s only temporary and we have to go through the bad periods to get to the other side and when we get there just imagine how special it will be.

 

The change could well have had an effect but if it has it should settle down soon but the moderators will know more.

[mdwstrx]

 

4 hours ago, mdwstrx said:

Today is also day 4 of changing dosages from tablet to liquid -  Was taking 5 tab/2 liquid mg and moved to 2.5 tab/4.5 liquid

 

 

Hi Alto or mods. Can wd sx be triggered  due to the above?  Having quite a uncomfortable wave  after several weeks of manageable sx where I thought stabilizing was occurring. 

[eymen23]

Hi mdwstrx,

 

Some members do find that symptoms flare up with any changes to their medication. Whether that be a change in manufacturer, changing the timing of doses, switching between tablets and liquid, or vice versa.

 

As an example, I was forced into switching generics as my GP would no longer prescribe 5mg tablets and the pharmacist wouldn’t assist. I had a flare up of symptoms which started on day 7 of the change and by day 15 things seemed much more stable, but not as they were. 

 

Some people can switch manufacturers or go from tablet to liquid, without any real change in symptoms, whilst some appear to be more sensitive. If you’ve been fairly stable in recent weeks and things have taken a backslide several days after making such a change, it would be sensible to assume you’re sensitive to changes like this. 

[Tom37]

Slight possibility it could be a delayed response to your drop?

 

During my tapering I often had a two or even longer week wait before I felt symptoms which was really annoying. They were only minor then and passed in a few days but delayed response to drops isn’t uncommon but either way it will pass!

[mdwstrx]

Thanks Eymen and Tom.... I'll watch today to see how things go.  Yesterday's wave coincided with receiving some upsetting news too so it could have been that as well or a combination??  On the positive side, I slept 8 hrs last night, only one wake up call and back to sleep afterwards.    Dreamed and remembered, so that was unusual and woke feeling refreshed.  Maybe things will settle today. 🙏

[mdwstrx]

A better day than yesterday but still feel sx.  They are minimized but there.  Hot flushing, buzzing, aches, tension, slight burning under skin.  Manageable but not feeling like being around folks.  Hoping tomorrow sees more improvement. 

 

[mdwstrx]

Alto,

I seem to be reacting to an increase in the liquid escitalopram. 

I initiated the crossover as follows:

 

Jan 15th:   5 mg. tablet/2.5 mg. liquid. 

Jan 20th:   5 mg. tablet/2 mg. liquid

Feb 2nd :   2.5 mg. tablet/4.5 mg. liquid

 

Today is day 6 at the 2.5 mg. tablet/4.5 mg. liquid combo.  Do you think I should hold or go back to all tablet?  Should I have waited to switch until stable?

 

Below is a record of days/sx. 

 

Wednesday, January 30, 2019    7 hrs. of sleep

4:00 a.m. Woke back to sleep

5:30 a.m. Woke dozed in and out

7:30 a.m. Up took 7 mg. Lexapro (5 mg. pill/2 mg. liquid) decaf coffee, cereal

8:00 a.m. Feeling sxs but they are less intense and can be placed in background.

10:00 a.m. sxs still present.  Inner buzz, chest congestion, on edge, hot flushing, slight burning, tingling in arms.

 

Thursday, January 31, 2019    7 hrs. of sleep

5:30 a.m. Woke dozed in and out

6:30 a.m. Up took 7 mg. Lexapro (5 mg. pill/2 mg. liquid) decaf coffee, cereal

8:00 a.m. Feeling sxs but they are less intense and can be placed in background.

Played sports… felt good most of day

5:00 pm feeling buzzy and a little tense/breathless at a low level.

10:00 p.m. bed

 

Friday, February 1, 2019    7 hrs. of sleep

5:45 a.m. woke

6:30 a.m. Up. took 7 mg Lexapro (5 mg. pill/2 mg. liquid) decaf coffee yogurt, fell tension, slight buzz

8:30 a.m. to sports workout.  Feeling almost irritable due to tension.

12:00 p.m.  Feel nervous and on edge.

5:00 p.m. Watching television- too stimulating with audience noise and hoopla.

10:00 p.m. bed

 

👉Changed from 5 mg. pill/2 mg. liquid to 2.5 mg. pill/4.5 mg. liquid

 

Saturday, February 2, 2019    7.5 hrs. of sleep

2:00 a.m. Woke back to sleep

6:00 a.m. Woke dozed in and out

6:30 a.m. Up took 7 mg. Lexapro (2.5 mg. pill/4.5 mg. liquid) decaf coffee, yogurt feel tension, slight

9:00 a.m. Feel ok, very slight sx including a little short of breath and heart palpitations.

Rest of day went ok.  Still sx but slight.

 

Sunday, February 3, 2019    7 hrs. of sleep

Forgot to log

 

Monday, February 4, 2019   7 hrs. of sleep +1 hr. on sofa

2:00 a.m. Woke back to sleep

5:30 a.m. Woke to hot flushing - dozed in and out

6:30 a.m. Up. Took 7 mg Lexapro (2.5 mg. pill/4.5 mg. liquid) decaf and muesli

7:00 a.m. sx – vestiges of chest tightness and breathlessness. Slight tension but can overlook.  Still sensitive to fear and loud noises. Slight buzzing. Heart palpitations.

9:00 a.m.  played sports.  Sx in background.

4:30 p.m.   upsetting news but handled ok. Feel ok.

10::30 p.m. bed

11:30 p.m. still awake thinking of upsetting news.

 

Tuesday, February 5, 2019   5.5 hrs. of sleep

5:00 a.m. Woke

6:30 a.m. Up took 7 mg. Lexapro (2.5 mg. pill/4.5 mg. liquid) decaf and muesli

7:00 a.m. Burning in arms, headache, nerves feel raw.

9:00 a.m. Played sports– was irritated as didn’t feel well. Had to forcibly ignore.

Rest of day felt pretty much the same.  Only felt better by lying in the sofa having a calming evening practicing mindfulness and listening to asmr vid.

10:30 p.m. bed

 

Wednesday, February 6, 2019   8 hrs. of sleep

2:00 a.m. Woke back to sleep

6:30 a.m. Woke to hot flushing - dozed in and out

6:45 a.m. Up took 7 mg. Lexapro (2.5 mg. pill/4.5 mg. liquid) decaf, yogurt and muesli

8:00 a.m.  sx include slight ache in arms, hot flushing, tense in neck, slight breathlessness, headache, burning in arms.

2:00 p.m.  Day at home spent relaxing.  Felt ok most of day with above with slight symptoms.

11:00 p.m bed

 

Thursday, February 7, 2019  7 hrs. sleep

2:00 a.m. Woke back to sleep

6:30 a.m. Up took 7 mg. Lexapro (2.5 mg. pill/4.5 mg. liquid) decaf and muesli

8:00 a.m. sx include slight ache in arms, tense in neck, slight headache, head hurts behind eyes, slight burning of skin, pounding heart and breathlessness. Achy chest.

9:00 a.m played sports, hard to focus with sx.

[mdwstrx]

Alto,

If it helps to summarize, the new/returned sx are:

• muscle jerking at night, 
• hot flushing
• aching in back/chest
• weird fuzzy headache centered behind eyes
• heart pounding
• short of breath
• tingling in limbs
• burning in limbs

 

More questions.  

At this point, have I crossed the point of no going back to the way it was?  So that coming off totally is the only option?

I fear these new sx since I was holding relatively steady for a couple of weeks.  See chart below.  So it seems things have changed for the worse and not sure why.  

 

[bubble]

On 1/30/2019 at 6:16 AM, mdwstrx said:

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.  

On 2/4/2019 at 7:58 AM, mdwstrx said:

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.  

On 1/28/2019 at 6:45 AM, mdwstrx said:

However, I am sleeping.  Last night slept through the night with one quick break. 

 

 

Hello md and thank you for reaching out on my thread. I had to come here to remind myself of your situation and then I remembered: oh that's that guy with that amazing graph! Which clearly shows that you are stabilizing nicely in a normal although extremely painful and frustrating non-linear manner.

 

It seems that you have been hit by a bad wave that made you (again) question your path and whether and if you were going to stabilize. But that's just the nature of the beast and that's why we look at a bigger picture. One bad day doesn't mean anything. You say you had a window of 19 days. That's amazing! Stabilising doesn't mean that you are not going to get hit by a wave and that it isn't going to be vicious, sometimes as bad as it ever was. It means windows will get longer and clearer, waves shorter and less severe.  

 

The glimpses of feeling good are a great sign! It means you are still in there, intact and that this flood is retreating, revealing more and more of you until you resurface. It doesn't mean that you will not get washed over again like you did now.

 

Your present despair is perfectly understandable and happens to all of us. Just as we were tricked into believing that improvement is linear as you were we get reminding of its true nature. 

 

In response to your question, it is very much stabilizing. As one might say,  a clinical example. As far as I can make it out there have been some dosage changes, you mighty have reinstated at a too high dose but so did I. And I still stabilized. I was also very impatient to start tapering. I lasted for 4 months before kind advisers here couldn't stop me any more. 

 

For each of us stabilisng takes different time depending on a great number of variables such as our drug history, how we stopped drugs, how many times, how long we were on, how many drugs, natural sensitivity of our CNS and who knows what. But it happens. Also, it means different things to different people. It doesn't have to mean that you are completely symptom free. Due to my drug history that would be very difficult to expect. But it means that you can leave with your symptoms and more importantly feel like you can put up with rocking the boat further with a cut. I'm glad that you are aware that you are not there yet. Holding is so very important. It is such hard work. It is when healing happens. Invest time and patience in it and your brain will be very grateful to you.

 

I'm not sure if I  was able to reassure you but I'm confident that this wave will be short lived and that you will soon bounce back on your graph. 

 

The bigger picture of the graph is a true testament of your stabilization. The dip of today is just a testament to the nature of that process. You will remember how at every dip in your graph you must have felt equal despair as today but when you look at that particular dip in the context of the whole graph you see it for what it was: a very temporary blip. The same will be true of today's blip.

[mdwstrx]

Good morning.  Wow... what a thorough, kind and caring response, Bubbles. 💜 Thank you for taking the time to familiarize yourself with my situation and to address my concerns.  You, the mods, Alto and this site are all amazing and a Godsend.

 

I took your reply to essentially say, look at your own chart, you are getting better; reminding me that healing isn't linear on a day to day basis but over time, it improves.  Yep, maybe this is a wave though  I was concerned it was the liquid medication change.  It's hard to tell but I thought the new sx might be an indicator that the liquid is the culprit.  Stabilizing to me means getting to a point where I'm able to live life without feeling like I need to retreat to the safety of my SSRI bunker (home).  For those of you who have been through it and emerged on the other side, I am grateful for any insight you can give.  I know none of us are alike but to know it's possible to get better gives much hope and reassurance.

 

I hope your tapering continues successfully (and without issue) and you find comfort in knowing how much you are helping others as you help yourself.  Thank you!

 

PS... thanks too, for the kind words about the chart.  The dips are the windows (0) and the peaks are waves (10) on a scale of 1-10 based on my subjective perception.  It's not perfect but it helps me to see a picture of where I've been and where I'm headed.  Pictures tend to make more of a lasting impression for me. 

 

 

[Altostrata]

md, the liquid is absorbed faster than the tablet and may be hitting your nervous system harder.

 

You might go back to half liquid and half the dose in tablet form for a few days, let you system get used to it.

 

It may be that you can reduce your total daily dosage a bit to compensate for the stronger effect of the liquid, or you may wish to divide the dosage for a while, taking the liquid portion later.

 

Also, here's a good way to improve sleep -- soft music 

 

[mdwstrx]

Thanks Alto.  I like the idea of reducing a bit.  I will try reducing liquid by 5% to 6.6 mg. unless you think I could get away with going a full 10% to 6.3??

 

Things settled a bit yesterday but I find that since wd, I am easily triggered to anxiety even though some sx have improved (can you tell)?    

 

I also like the music.  Thanks for the suggestion.

 

[mdwstrx]

Reduced Escitalopram from 7 mg. to 6.6 mg.

4.1 liquid/2.5 mg tablet

[mdwstrx]

Sunday, February 10, 2019   7.5 hrs. sleep

·         2:00 a.m. Woke back to sleep

·         6:30 a.m. Up took 7 mg. Lexapro (2.5 mg. pill/4.1 mg. liquid) hot flushing and night sweats, woke to some low-level anxiety. 

·         8:30 a.m. – 10:00 a.m. Sweaty palms, racing heart, slight burning in arms, diarrhea. Short of breath, chest ache, hot sweats.

 

Does this ever end? 😥

[Leo1983]

Hi md....

 

I understand your pain. Its awful daily. I think the long duration is pretty common. 

 

If you check out success stories its all taken along time to feel better. 

 

Keep going

 

Chin up. 

[mdwstrx]

Thank Leo.  I've read the stories but they seem to speak more in terms of tapering/stabilizing rather than crashing/stabilizing.  

Appreciate your support and hope you are doing better.   Read through your posts and had to laugh out loud at this...

 

Hi. Can i ask morning Cortisol. We all have it to wake us up. 

BUT - in withdrawal is something making it worse in the morning?

Just before I stopped tablets I did not wake up like Freddy Kruger was sat at my bedside. 

 

Mornings are really tough.  Hope your's are improving.  (((hugs)))

[Leo1983]

Lol. I try to make a joke. 

 

I stopped Lexapro and crashed but i have seen it through and slowly getting better. The first 6 month were just crazy. Never in my life experienced anything like it.

 

9 month out tomorrow for me off meds. I personally think once your off true healing starts. Thats just me. 

 

Also i was only on the drugs months not years. They are awful horrible things. 

 

I see people tapering for 2 years and still crash at zero. I see people CT and heal. I see people CT and get back on. I see people stop and be fine. Who knows what is best. I just stick to seeing people heal eventually. 

[mdwstrx]

Jokes are good. 💜  We need more lightheartedness.  And we are healing, just soooo slooooooow  🐌🐌

[Leo1983]

We will all see it through together! 

 

Yes laughter sometimes reminds you how its guna be.

[apace41]

6 hours ago, Leo1983 said:

I see people tapering for 2 years and still crash at zero. I see people CT and heal. I see people CT and get back on. I see people stop and be fine. Who knows what is best. I just stick to seeing people heal eventually. 

 

Just to be clear, while these are all possibilities and when you are playing with brain chemistry there is no guarantee, the experience of the moderators and, in particular, Alto and others who have seen more A/D withdrawal than the vast majority of psychiatrists COMBINED, have concluded that the best outcomes are achieved with a slow and careful taper of something approximating no more than 10% of the prior dose per month.  I would not want this comment misconstrued as a "it doesn't matter how you go about it" comment which I suspect is not what was intended.

 

Best,

 

Andy

[Leo1983]

As always Andy no its not what i meant.

[mdwstrx]

Today has been a much better day so far.  I'm also going to try to break from the site for a few days.  It's good to step away from the wd mindset for a time, if we can.  We shall see if feeling better keeps up.  Appreciate all the kind comments and ongoing support.

[Leo1983]

Can i just agree moving away does help..i think it is also a sign of acceptance and that your progressing.

 

I had a month away and to be honest did me the world of good. However you always know the site is there. 

 

Hope that helps you.

[Tom37]

Hey,

 

Good to see you had a better day after a rough patch.

 

Hopefully it continues for you and as you get further on in this journey.

 

Im sure we will stabilise at some point it’s just a matter of hanging on in there until we do.

 

Take care.

 

 

[Carmie]

Hi md, 

 

I know you’re having a little break from this site, but I just wanted to say thanks for popping around to my thread the other day.  I hope that you’re coping okay. One day at a time does it, and when things get too hard a minute at a time.

 

Do you have some good distractions to help you get through the rough patches? 

 

Glad you had a better day. When those windows come it certainly helps us to see that we are healing. Wishing you all the best in your continued healing.💚

[mdwstrx]

Checking in to say things are going well here and also to do some research on tapering.  Yesterday was a bit rough as I had the inner restlessness that is so distracting for me and keeps me from relaxing or focusing on anything other than wd.  Had lunch with a friend and had to really make the effort to not focus inwardly.  Today was a much better day.  Slept 8.5 hours last night!  🌞  Woke feeling refreshed until "it" began to slowly creep in but at a very low level.  Most of the day, the restlessness was gone.  I went to a lovely church luncheon and saw old friends. Even the shortness of breath that's been so concerning for me stayed away with only a few hints that it was there.  Praying things continue to look up.

 

Carmie, thanks for popping in. Hoping your time away gave you some peace and that things are going ok for you.  💜

 

 

 

 

 

[mdwstrx]

Posting a change and my abbreviated chart.

 

I'm hoping to get away with reducing the 6.6 mg. to 6.5 mg for simplicity sake.  Otherwise, I have to use 2 syringes since I'm doing 2.5 mg tablet and 4.1 mg. liquid.  

 

I've slept quite well the past two nights.  Even with dozing on the sofa for a bit before bed. Things seem to be settling with occasional but shorter waves.  I'm relieved that yesterday was the first time in awhile that I've seen the symptom line break under 2 on the chart recently.  It shows me my baseline can improve.  Praying it gets to 0.   

 

[Tom37]

Glad you had a good day....windows and waves until it all melts away.....that’s the goal anyway.

 

That is an awesome sleeping effort!

[mdwstrx]

Tom... you might have a hit! 😂  🎵windows and waves 'til it all melts away🎵

 

Yes, another good day.  On my way to a friend's place for dinner.  Enjoying while I can.  Not sure when the next wave will wash in.

 

Continued prayers for all on this site, especially the awesome mods and Alto.