mdwstrx: Lexapro / escitalopram taper or not?

[Carmie]

Hi md, 

 

 I see you did a crossover to the liquid. That certainly could have ramped up your symptoms. Also, doing two hours of very physical sports could also have done the same thing. 

 

As long as we have these medications in our bodies, whether we are tapering or not, we can still have symptoms. I remember on higher doses of Seroquel, when I wasn’t tapering, I had severe internal shaking every morning. It was so bad that it would wake me up, and I dreaded the mornings.

 

I’ve had symptoms even (on the small doses as well) when I stopped tapering for six months or more to give my body a break. 

 

Also when we jump off at the end, as you know, we can still continue to get symptoms. Slow and steady is the only way to go when it comes to tapering.

 

As regards updosing, it can work if you do it soon enough, but on the other hand it may not work. It really isn’t a safety net, but it’s the best strategy we have if someone has tapered too quickly or cold turkeyed or their symptoms are too severe. It helps a lot of people, but sometimes it doesn’t work, or it makes the symptoms worse. There’s no guarantee. Everything in this journey is all over the place.

 

I won’t be jumping off my meds until I’m down to 0.0something or lower. I feel every small drop as my body is so sensitised because of the millions of meds I was put on and off. It all started with chronic pain. 

 

That’s quite a list of people you know that are on meds or have been on meds. It looks like the doctors are handing them out as lollies.🍬🍬🍬

 

As regards how hard it is to get off certain meds, that’s different with everyone too. Some people have been on the meds for a week or two and are really struggling to get off them. One thing is for sure, we really weren’t meant to be taking these meds. 

 

I’m not sure about the tapering of your friend’s meds as she’s only taking it once a week, but I’d say taper it anyway, instead of jumping off. I could ask the other mods. Could you please tell me a bit more though, is she getting symptoms from taking the medication once a week? Did she get withdrawals when she tapered down to once a week? How did she taper?

 

I was happy to read your achiness and flushing has subsided. I hope you enjoy the rest of your weekend. We had cyclone warnings over the last few days, but I think it’s no longer in the high category range. I’m sure there will be a million surfers at the beach.🏄🏼‍♂️

 

You said taking 6.5mg is a lot in liquid. How much liquid are you actually taking? I’m at 7.5mg, which is 6ml, it isn’t a lot. I crush the 25mg tablet in 20ml of water. When I go down to the teeny tiny doses I’ll probably be adding more water though. 

 

Take care, sending hugs🤗

[mdwstrx]

Thanks Jackie!  Appreciate your kind thoughts. 💜

[mdwstrx]

Hi Carmie.

Just saw your post, sorry for delayed reply.  I am hoping my symptoms stop eventually and I get back to the way it was before wd without symptoms.  When do I know wd is over if I'm not actually tapering?  My rx for liquid escitalopram is 1mg = 1ml.  So it's 6.5 ml.  I'm sure it's tiny in comparison to say 20 , 15 or even 10 ml but it seems like a lot compared to a little pill.   

 

I read thru some of your thread.  I hope you're feeling better from your virus and that your tapering is going ok.   Thanks for always being pleasant and caring in spite of your own challenges.  It's very appreciated. 💖

[mdwstrx]

Check in. 

 

Today was a bit better than the past couple of days;  very low key.  Had a slight inner restless feeling but manageable.  Symptoms are way down in intensity thankfully but still there.  Praying that at some point, they fade away.  I'm not really comfortable about tapering until they are gone.  Will they go away completely?  

[Tom37]

They are weakening so they will eventually go unless they are drug side effects. You may not quite get to 100 percent but should be very close if not. I personally think if you still have symptoms that are not side effects then there is still some wd/instability going on especially if you where symptom free before tapering but that’s just me.

[mdwstrx]

Day 4 on all liquid.  Transition went as below. Reductions were recommended by Alto along the way to accommodate sx.  Feeling edgy, heart pounding and achy in chest/head/arms with slight burning skin.  

  

Date	Tablet/Liquid	Mg.
6-Dec	7.5	7.5
15-Jan	5/2.5	7.5
20-Jan	5/2.0	7
2-Feb	2.5/4.5	7
10-Feb	2.5/4.1	6.6
14-Feb	2.5/4	6.5
17-Feb	1.25/5.25	6.5
21-Feb	6.5	6.5

[Carmie]

On 2/24/2019 at 12:20 PM, mdwstrx said:

Hi Carmie.

Just saw your post, sorry for delayed reply.  I am hoping my symptoms stop eventually and I get back to the way it was before wd without symptoms.  When do I know wd is over if I'm not actually tapering?  My rx for liquid escitalopram is 1mg = 1ml.  So it's 6.5 ml.  I'm sure it's tiny in comparison to say 20 , 15 or even 10 ml but it seems like a lot compared to a little pill.   

 

I read thru some of your thread.  I hope you're feeling better from your virus and that your tapering is going ok.   Thanks for always being pleasant and caring in spite of your own challenges.  It's very appreciated. 💖

 

Hi md, 

 

Thanks for your kind words. 

 

How were you feeling on the meds before you started tapering? You said you didn’t have any symptoms? I’m gathering you may then eventually go back to that if you stabilise. From my own personal experience I couldn’t tell you, as I have CFS, which is a CNS illness, so a lot of the symptoms people get in withdrawals I already had even before the medication and withdrawals. I have Derealisation/ Depersonalisation, brain fog, am in bed a lot of the time, have very little strength, am faint most of the time etc etc. I’ve been like this for nearly 25 years. 

 

Hope all goes well on your liquid. I did a crossover back to my original tablet from compounded tablets, it’s day 19 since I’ve been totally on my original tablet now. I’m going to give it at least another week and a half before I start tapering again. It’s great only having to do one water titration every night now. 

 

Take care, sending hugs🤗

 

[mdwstrx]

Thanks for the reply Carmie.  Yes, I felt good before tapering. I hope you are correct.  I seem to be improving but have had a bit of set back in the crossover.  At least that is what seems to be the culprit.  Maybe it's just a wave.

 

I'm really sorry to hear about your CFS.  You do a marvelous job of uplifting others!  Thank you. 💜

[mdwstrx]

Today was a better day.  Sunshine! 🌞 

Sx were low key but present. The neuro fear is ever present if I focus on it. 

Things normally that wouldn't bother me do.  I hope it all eventually fades away.  

 

 

[Tom37]

Glad you had a a good day.....I bet the symptoms will eventually fade away completely....just the cns still not happy enough so produces symptoms but once it is they will be gone!

 

The neuro fear is no fun...I get it too and it’s ridiculous but because it’s so ridiculous it’s quite easy to tell it’s wd. It’s when it’s more subtle that makes you think twice.

 

Enjoy the sunshine.

 

[mdwstrx]

Another good day.  Feeling a lot like my old self with occasional reminders of 'IT' still being present- but very slight today.  

Plus the sun was shining again; but not for long.  Snow/rain then cold forecast.

Would the NZ people pls, pls send us their warm sunny weather. 

 

Here in the midwest, it really only rocks in the late spring, summer and fall.  Hence mdwstrx only for 3/4 of the year unless you're a 🐧! 😉

 

 

[Tom37]

You can have the last of our ☀️! Definitely starting to cool down a bit here so more pleasant at night for rest and sleep. 

 

Your really tracking along well now....soon you will be having completely symptom free days. 

 

Thanks for your links too. If only life around us stood still while in wd.

[mdwstrx]

Checking in this morning.  Still having slight symptoms.  I plan to step away for awhile to focus on life instead of wd to the extend I can; until I am able to begin a taper (or an ugly, intense wave rears it's head).  I'm grateful for the help I have been and will be receiving here. Thank you for all you do for everyone!  I keep all on this site in my prayers; that recovery is quick, healing is complete.  Wd is a beast but one that is conquerable.  It's like the ultimate video game boss!  It keeps getting up, resets and redos are necessary, but patience, time and strategy will pay off in the end.

[Leo1983]

This is a good sign. 

 

Good luck. 

[mdwstrx]

Hi Alto. 

 

Checking in with you to get your opinion on when you think I should begin my taper.  Should I wait until April or consider a slight reduction mid March?    

 

Wd symptoms have been very minor.   Of the remaining sx, what is present feels at about a .5 to a 1 on a scale of 1-10. I’m sleeping  on average 8 hrs each night.  I actually got 9 in last night and overslept this morning.  

 

Thank you.

[bubble]

How long have you been this stable? We usually advise a month of stability before resuming the taper. You can't make a mistake with holding and stabilizing but you can with rushing. 

[mdwstrx]

Then April it is if not May.  Thank you.

[planifolia]

Hi mdwstr

 

I am currently also going through reinstatement of lexapro and have a horrific time trying to stabalize. Due to my concentration difficulties and fatigue it was difficult for me to go through your entire process so far. But just wanted to know if you managed to stabalize at the end? And if so how long did it take? 

 

I have been trying to stabalize for about 4months and my goodness it has been hell of a 🎢  

 

many thanks

[mdwstrx]

Hi Planifolia.  So sorry to hear that you're having such a rough time.  Praying that things get much better for you.  I'm not very knowledgeable about the process and how other factors might impact stabilization.  But I have faith in Alto and the mods.  Following their knowledgeable lead, I am in the process of stabilizing and just about there.  Symptoms became much more stable at the 3 month mark but still fluctuated so that I was functional at about 75%.  It is just shy of the 4 month mark now and I'm between 90 and 95% back to 'myself'.  
 

 

 

 

 

 

 

 

[mdwstrx]

Hello. Question for mods.  Just getting over wd and now have a uti.  Dr. will most likely prescribe antibiotics. Don’t think I have a choice in taking it if i want it to clear. 

 

Question 1. Will antibiotic set wd back if I take?

Question 2. Does wd contribute to uti?  Seems like a lot on site have gotten one.  I haven’t had one in twenty years.  

 

Thank you. 

[Gridley]

2 minutes ago, mdwstrx said:

Hello. Question for mods.  Just getting over wd and now have a uti.  Dr. will most likely prescribe antibiotics. Don’t think I have a choice in taking it if i want it to clear. 

 

Question 1. Will antibiotic set wd back if I take?

Question 2. Does wd contribute to uti?  Seems like a lot on site have gotten one.  I haven’t had one in twenty years.  

 

Thank you. 

 

The fluoroquinolones, like Cipro, can cause major problems. 

 

Fluoroquinolone antibiotics

 

For more on antibiotics during withdrawal, please see:

 

Cipro, Levaquin, Azithromycin (Z-Pack), and other antibiotics

 

[apace41]

16 minutes ago, mdwstrx said:

Question 1. Will antibiotic set wd back if I take?

 

I think that if the situation is something where you have a clear infection that will only respond to antibiotic treatment you should go ahead and have the treatment.  With the exception of Gridley's well-taken point that quinilones are potentially devastating (to anyone but especially in w/d), I don't think antibiotics are necessarily an issue in w/d (although some seem to have had modest difficulty the vast majority have been fine).  Having said that, since our bodies tend to be depleted and more susceptible, the fact that antibiotics adversely impact gut flora and the microbiome should be considered.  I would suggest finding a high-quality probiotic to take at least during the course of the antibiotic treatment and probably for 2-3 months thereafter.  It won't be 100% protective but it should offset some of the havoc that the antibiotic wreaks.

 

20 minutes ago, mdwstrx said:

Question 2. Does wd contribute to uti?  Seems like a lot on site have gotten one.  I haven’t had one in twenty years.

 

I think that w/d can't be directly traced to increased infections but it stands to reason that the body is being depleted of a lot of reserves while fighting its way to heal from w/d.  The weakness that arises potentially exposes the body to more immune system challenges.  Anecdotally, based on what I've seen, I think there is an increased incidence of infection for those who are in w/d.

 

Best,

 

Andy

[mdwstrx]

Thanks to both mods, Gridley and Andy, for your quick reply!  Waiting to hear results of the test, tomorrow. 

I appreciate the guidance and will steer clear of the fluoroquinilones (fqs) if an antibiotic is necessary.  Let's hope it isn't.   

 

 

[ChessieCat]

2 hours ago, apace41 said:

Having said that, since our bodies tend to be depleted and more susceptible, the fact that antibiotics adversely impact gut flora and the microbiome should be considered.  I would suggest finding a high-quality probiotic to take at least during the course of the antibiotic treatment and probably for 2-3 months thereafter. 

 

You need to take it at a different time to when you take the antibiotic.  Not sure about the spacing though.

[mdwstrx]

Thanks for the reminder Chessie.  I read that somewhere on the internet and thought about it when I saw Andy's comment.  Then promptly forgot.  lol.  

I have no idea what kind of probiotic to take or what they do.  Sounds like I need to research.

 

[Gridley]

11 minutes ago, mdwstrx said:

I have no idea what kind of probiotic to take or what they do. 

 

Antibiotics kill all bacteria, good and bad, including the beneficial gut bacteria that are important for many reasons.  Probiotics replenish, air least to some extent, the gut bacteria killed by antibiotics.  It's best to take the probiotic as distant in time as possible from the time you take the antibiotic.  Once you've finished the course of antibiotics, you should continue to take the probiotic, as Andy said, for 2-3 months after.  

[mdwstrx]

Thanks Gridley.  What do you mean here?  Also, might want to check this out when you have some free time.  CR is apparently questioning the safety of probiotic supplements.

23 minutes ago, Gridley said:

as distant in time as possible from the time you take the antibiotic.

 

It's been awhile since posting an update so I might as well take the opportunity.  Mostly, been doing very good.  Almost back to my old self... until the last 4 days.  I've had symptoms that aren't overpowering but definitely wd related; today especially; aching, slight burning under the skin, headache, tired etc... along with a slight lingering sense of neuro fear. I suspect it's a wave and hope it will fade soon.  Before this wave, I was almost able to forget about wd.  I am anxious to begin a taper but holding until the mods and Alto think it's safe.  I was hoping for April, but will defer to those more knowledgeable than myself. 

 

 

[Gridley]

1 hour ago, mdwstrx said:

 

as distant in time as possible from the time you take the antibiotic.

 

Many hours away from the time you take the antibiotic.

 

Re the article about the dangers of probiotics.  It seems a little catastrophic to me, but you be the judge.  Just for me personally, I've been taking probiotics for many years, before tapering and in withdrawal, with no ill effects.  Of course, everybody's different.  It does seem important to me to replenish the good gut bacteria after it's killed by the antibiotic, but decide for yourself.

 

If you are concerned, you could consider the foods mentioned in the CR article.

 

 

Edited March 13, 2019 by Gridley

[mdwstrx]

Thanks again. I appreciate your opinion.  I’ll research a bit more to see which ones are better. 

[mdwstrx]

Update. Have taken two100 mg Macrobid capsules of a total 6 capsules prescibed for UTI.  So far so good. Praying it stays that way.  These antibiotics have their own horror stories.   

[mdwstrx]

Took last dose of Macrobid and survived.  No ill effects that I can tell, thankfully.  Appreciate the mods insight into antibiotics etc.

 

Still looking at 4/1 to begin a taper if Alto thinks it's not too soon.  Wondering if reducing from 6.5 mg. to 6 mg. is too much to begin?

 

 

 

 

[Altostrata]

19 minutes ago, mdwstrx said:

Still looking at 4/1 to begin a taper if Alto thinks it's not too soon.  Wondering if reducing from 6.5 mg. to 6 mg. is too much to begin?

 

Seems reasonable if you're stable over the next couple of weeks.

[mdwstrx]

Thanks Alto.  Hope you're having a good weekend and taking some time for yourself.  

[planifolia]

On 3/8/2019 at 3:02 AM, mdwstrx said:

Hi Planifolia.  So sorry to hear that you're having such a rough time.  Praying that things get much better for you.  I'm not very knowledgeable about the process and how other factors might impact stabilization.  But I have faith in Alto and the mods.  Following their knowledgeable lead, I am in the process of stabilizing and just about there.  Symptoms became much more stable at the 3 month mark but still fluctuated so that I was functional at about 75%.  It is just shy of the 4 month mark now and I'm between 90 and 95% back to 'myself'.  
 

 

 

 

 

 

 

 

🙏 Thank you! Did you stay at 7.5mg the entire 4months? 

[mdwstrx]

9 hours ago, planifolia said:

🙏 Thank you! Did you stay at 7.5mg the entire 4months? 

Hello again Planifolia.  I just checked your thread and see that things are still very rocky.  I am sorry.  I wish I knew more so I could give you the advice needed to help things settle.  We're all so different and many things factor into recovery.  But, I can tell you what worked for me.  

 

Within the first month of stopping 2.5 mg. escitalopram, I made several dosage changes. 

• SA (Alto and mods) recommended I stay at 2.5 mg since I had already reinstated that amount before finding SA. 
• My doctor recommended creeping back up to 10 mg. over a several weeks.  SA respectfully disagreed. 
• I opted to follow the doctors advice and up-dosed to 5 mg and then to 7.5 mg.  Not only did it not help, it seemed to make things a bit worse. 
• Alto then suggested I reduce to 7 mg.   As things started to settle a bit, I opted to switch from tablet to liquid (in order to later resume tapering).  In so doing, symptoms spiked a bit. 
• Alto recommended I might be able to lower the dosage again to compensate for the faster metabolizing liquid.  I reduced and held at 6.5 mg.   
• I stabilized pretty quickly then over the next month.  All in all, for me, it was about a 4 month ordeal from reinstating to stabilizing.  

I found the following things helpful in order of what I believe resulted in  my healing.

1. Faith in God and in the ability to recover quickly
2. Prayers to God, in the name of Jesus
3. Self advocating by researching and learning
4. Finding this website and it's unbelievably caring/knowledgeable administrator and team; as well as the other members who are able to share there similar experience.  It helped tremendously to know I wasn't alone.
5. 2.5 mg of propranolol PRN during the first 2 months (for the akathesia like symptoms I experienced ) I believe this kept me from having to take a benzo.  I also had to take OTC nausea meds to counteract nausea from the Propanlol.
6. NO other drugs (including alcohol and caffeine) 
7. NO supplements other than the fish oil and magnesium recommended by SA.  The fish oil really helped me to sleep if I took it right before bed.
8. No stress in my life (I'm retired)
9. Knowing I had family and friends in the background
10. Routine 10:00 bedtime
11. Relatively healthy diet
12. Mindfulness (Headspace.com)
13. ASMR videos (especially Christian artists reading scripture - it calmed and reassured me)
14. Daily exercising (raquet sports) which incorporated a social aspect (There was a 2-3 week period where symptoms didn't allow)

So this is probably TMI but hopefully, something above will help you and/or others. 🙏

[planifolia]

On 2/16/2019 at 4:19 AM, Tom37 said:

Good to hear....your definitely getting there. Symptoms reducing in intensity is a very good sign. 

 

One of the guys on here who has helped me, crashed and took about 12 months to stabilise and his description was of symptoms all over the place for the first several months, then a pattern started to emerge, then the symptoms slowly started reducing in instensity until they stopped all together as he stabilised so your on the right track.

 

Dont read into the 12 months time frame either as just an example.

 

Hopefully it keeps up!

Hi Tom, just wanted to ask the name pf the viy? Just looking for some hope, as I’m struggling to stabalize. Thank you