LeoD: escitalopram protracted tapering

[ChessieCat]

WDnormal (withdrawal normal)

[ChessieCat]

On 2/25/2019 at 7:32 AM, LeoD said:

Have I mentioned brain fog and inability to focus and think clearly as one of my main complaints

 

This is a very common symptom.  brain-fog-blank-mind-comprehension-cognitive-and-memory-problems

 

[ChessieCat]

Thank you for changing your avatar.  Much different now.  Is it a close up of a dog's nose?

[Leo1983]

Leo D. Why dont you take a look at my thread. You seem to be following a similar pattern early on in wd.

 

Just a thought. 

 

The advice i can give is it takes a long time. It feels like groundhog day. However it does get easier. 

[LeoD]

8 hours ago, ChessieCat said:

Thank you for changing your avatar.  Much different now.  Is it a close up of a dog's nose?

Yes, a part of the dog that is less than 0.05 MB😄

[eymen23]

22 hours ago, LeoD said:

Are you going to answer my questions about stabilization while on the drug, or is it a tough one😳?

 

Hi Leo,

 

I’m sorry to hear how much you’ve suffered after tapering from Lexapro and reinstating. I recently started slow tapering from the generic version of this drug (Escitalopram) and it has been hard work at times. 

 

I see you want to know whether you can stabilise on a 15mg dose. This is a common question here, will I ever stabilise on x mg of <insert drug>? Unfortunately, every person and scenario is different, so we can never answer with 100% certainty, but from what we have seen with other members, yes it is possible to stabilise on a certain dose of a drug. The fact that you had that window on the 15mg dose is encouraging, unfortunately it sounds like you jumped the gun a little early and began tapering before your nervous system was ready. 

 

To maximise your likelihood of stabilising and more quickly, it’s important to:

 

a) take the same dose every single day

b) take your dose at the same time 

c) take the same medication every day i.e. same manufacturer and tablet or liquid. 

d) eliminate any non-essential stress from your life

e) learn non-drug coping techniques to deal with the difficult days along the way

 

Once we are taking a certain dose and find that we are not feeling well, it’s very tempting to change it, because our minds/ bodies are intuitively telling us that something is wrong and that need to fix it. Unfortunately, this feedback system can become problematic in withdrawal. 

 

For example. If I started a new job and suddenly found myself feeling stressed every day and sleeping poorly, it would be easy to identify that the job is too stressful and is causing these symptoms. It would also be reasonable to assume that changing job or quitting this job, would allow the symptoms to gently fade away. However, if we find that we feel bad on a certain dose of SSRI, it doesn’t necessarily mean we need to change it. In fact, more often it is an indicator that the body has lost balance, and it needs consistency. The only exception is where one has a very bad adverse reaction, as soon as they start or reinstate a drug. 

 

If you try to keep your mind away from whether the 15mg dosage is causing this, and focus on aspects a-e above, we will be able to help ascertain whether the dosage needs to be changed in the longer term. After all, time and observation often provides the answers that others can not. 

 

Good luck with holding at 15mg and I hope you get some relief soon. 

[Altostrata]

Leo, what is your current symptom pattern? Is it better or worse at any particular time of day? How's your sleep?

 

How has your symptom pattern changed since Feb. 23?

 

What times of day do you take your drugs, and their dosages?

[LeoD]

Thank you eymen23! I will stick with your advise and stay on 15 mg untill i feel better, if ever.  I kick myself for lowering the dose prematurely despite people here telling me not to. I must admit, we have the best experts here. But i was feeling well and was hopeful to start tapering again! 

 

Alto, 

I take 15 mg before bed. Sleep is Ok. Actually, exactly 4 days after i had lowered to 13.75 mg in Feb 2019, i had a sleepless night, and then all other symptoms re-appeared with a bang. This is how i knew i had rushed to taper. Updosed to 15 a few days later and the sleep got better again. Other symptoms are unrelenting..,

My symptoms are brain fog, pressure around head and eyes, chills, and terrible depression with thoughts of death.  I seem to be somewhat better in the morning, can function throughout 12 pm, and then it gets worse around 1-2pm. No windows to enjoy for 2 weeks now, and i had pretty good ones before i lowered the dose. It is striking how sensitive i have become! Before, in earlier taper attempts, I was able to decrease the dose much faster and felt nothing bad at these high levels. 

 

Hope we all recover...

L. 

[LeoD]

Hi Altostrata, 

Hope you are well. I have a question about methyl folate. I do have the MTHFR mutation. Do you recommend supplementing with it (doctor prescribed Deplin), or is it going to make things worse? Probably does not have to be Deplin, but any reputable over the counter supplement? 

Thanks!

L. 

[ChessieCat]

folic-acid-folate-l-methylfolate-and-deplin-vitamin-b9

 

the-importance-of-mthfr-methylation-b-vitamins-eat-leafy-green-veggies

 

[LeoD]

18 minutes ago, ChessieCat said:

folic-acid-folate-l-methylfolate-and-deplin-vitamin-b9

 

the-importance-of-mthfr-methylation-b-vitamins-eat-leafy-green-veggies

 

So is this a no? Do not use Me- folate?

[ChessieCat]

I've asked the other mods for their opinion.

[eymen23]

2 hours ago, LeoD said:

Hi Altostrata, 

Hope you are well. I have a question about methyl folate. I do have the MTHFR mutation. Do you recommend supplementing with it (doctor prescribed Deplin), or is it going to make things worse? Probably does not have to be Deplin, but any reputable over the counter supplement? 

Thanks!

L. 

 

Hi LeoD,

 

The MTHFR mutation is fairly common amongst the population and there is no cause for concern from a gene test alone. You should only really take specific supplements if there is a proven deficiency and you are displaying symptoms related to said deficiency. 

 

This trend of doctors ‘prescribing’ nutrients to treat nutrient deficiencies based solely on gene tests is very baffling to me. Eating a balanced diet with sufficient amounts of leafy greens will usually suffice.

 

FYI - Methyl folate supplementation can cause extreme symptoms in some patients, including panic attacks and even hallucinations. It is a very powerful nutrient and it is involved in many reactions within the bodies methylation cycle. At best, one should slowly build up their methylfolate with adequate amounts of B12. My honest advice would be to focus on eating a balanced diet and slowly healing from your SSRI related symptoms. There are far too many unknowns in the world of methylation and gene testing. 

Edited March 21, 2019 by eymen23

[LeoD]

Thanks eymen!

So you guys have not seen any evidence re: me- folate helping with wd symptoms in people with MTHFR polymorphisms? What about SAM-E?

 

[ChessieCat]

The only supplements which SA recommends are Magnesium and Omega-3 Fish Oil .  Try a small amount, one at a time, to see how it affects you.

 

There are many existing topics on SA.  I like to use google and add survivingantidepressants.org to the search term.

 

This is an existing topic about sam-e.

[eymen23]

18 minutes ago, LeoD said:

Thanks eymen!

So you guys have not seen any evidence re: me- folate helping with wd symptoms in people with MTHFR polymorphisms? What about SAM-E?

 

 

The honest truth is LeoD, it’s a total hit and miss. 

 

When it comes to supplements, the results vary depending on the individual. The only supplements we recommend here are magnesium and fish oil, as these two supplements have reliably produced benefits with less adverse reactions amongst members. 

 

SAM-e is another supplement involved in the methylation cycle. There are some studies suggesting it can help with depression, but it’s incredibly difficult to know how you will respond. 

 

A very important question I have to ask is, what are you hoping to achieve with MTHFR or SAM-e? 

 

When we are feeling bad it is natural to look for a cause and try to find a solution, but without methylation testing to back it up, MTHFR and SAM-e seem like quite random choices. When it comes to SSRI’s, very often the best healer is time. 

Edited March 21, 2019 by eymen23

[LeoD]

 

51 minutes ago, eymen23 said:

A very important question I have to ask is, what are you hoping to achieve with MTHFR or SAM-e? 

 

When we are feeling bad it is natural to look for a cause and try to find a solution, but without methylation testing to back it up, MTHFR and SAM-e seem like quite random choices. When it comes to SSRI’s, very often the best healer is time. 

I have the MTHFR polymorphism (677 homozygous)so i was wondering if there was any evidence that supplementation that helps methylation may help with withdrawal symptoms, especially depression.

[ChessieCat]

2 hours ago, ChessieCat said:

folic-acid-folate-l-methylfolate-and-deplin-vitamin-b9

 

the-importance-of-mthfr-methylation-b-vitamins-eat-leafy-green-veggies

 

 

I suggest you read through the posts made by Altostrata in the above topics.

[LeoD]

Hi All, 

Need encouragement to keep fighting. Holding the dose of 15 mg Lexapro. Have not had windows in weeks. Very discouraged. My symptoms are mental- cognition, memory. And bad depression with all kinds of neuroemotions and thoughts, inclding disturbing ones. Work is unbearable- i am a scientist and a manager, not being able to think and remember is killing me and causing more depression. Very worried about not being able to provide for my family and becoming a mouth to feed. Ready to give up and start another med. Welbutrin is what is on the table. The logic- i am being poisoned alrwady by Lexapro, why not add another one to the mix and may be feel better, at least temporarily... Please remind me why this is wrong. Hate to go on another drug, but see no other option.

Help!

 

[LeoD]

No one seems to have an opinion))). Update: it has been 1O weeks since re-instating back to 15 mg of Lexapro and about 10 months since I got back on the drug after an unsuccessful taper. In April i had 6 good days and 6 good half days, much better than March. May so far has been tough, only 2 half days. Does this make sense? Am i going in the right direction or am i stuck? 

Feeling very low today. 

[ChessieCat]

The fact that you have noticed some improvements is a good sign.  It's important to remember that stabilising is NOT linear, which is why it is called the windows and waves pattern.  We are only a week into May so 2 half days is still good.

 

I have found these really helpful in understanding what is happening and help me to be patient and accepting.

 

Recovery isn't linear it happens in a Windows and Waves Pattern

 

Withdrawal Normal Description

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.  And of course the opposite is the same.

 

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.

 

are-we-there-yet-how-long-is-withdrawal-going-to-take

 

These explain it really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

On 8/31/2011 at 5:28 AM, Rhiannon said:

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long.

 

AND

 

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.  

 

[LeoD]

Hi All,

It has been awhile since I posted. No major improvements, as a matter of fact it is getting worse. Specifically bothersome is increasing anxiety. Tightness of breath, nausea, constant worrying about the situation, which obviously is contributing to brain fog, which interferes with functioning even more, and so on. The pdoc is suggesting Xanax, of course. A very low dose ))). Before i go there, any advice on helping  anxiety with herbs, teas, etc. I meditate, take long walks and it helps, but not for long. 
Thanks!

L.

[Gridley]

9 minutes ago, LeoD said:

helping  anxiety with herbs, teas, etc. I meditate, take long walks and it helps, but not for long. 

Chamomile tea is good.

 

I've had relief from anxiety with this restorative yoga pose.

10 minute Restorative Yoga for Relaxation | Up the wall

 

These links can help too:

 

Audio:  How to Recover from Anxiety - Dr Claire Weekes
 

VIDEO:  Peace from Nervous Suffering - Claire Weekes (1 hour) (http://sendvid.com/vgquc1dg)
 

Anxiety Stuff - all kinds of stuff about anxiety attacks and things that help …

 

[Dylanmatthew]

Hey, Leo. Sorry you're feeling worse. Can you even function enough to enjoy life whatsoever and go to work? I am on a low dose of Xanax for emergencies actually. I haven't taken any yet but I feel more fatigue and anhedonia than anything. So depressing to me and unmotgatinf to hear how you're feeling worse. 

I am better than a year ago but not by much. I'm very touch starved. Lonely. I am considering a way out. If you catch my drift. 

[LeoD]

Hi All,

I am struggling with Lexapro wd. Was on 15 mg, feeling bad ( wd induced bad depression, bad cognitive issues, memory, some anxiety). Decreased to 13.5 and then to 12 mg over 2 months. Started Feeling worse. Waited for 2.5 months, no improvement. Is this my new wd normal, and should i taper a bit more risking feeling even worse, or should i give it more time on 12 mg?

Thanks

Leo

[Gridley]

9 hours ago, LeoD said:

should i give it more time on 12 mg?

I would hold a bit longer to stabilize.

[LeoD]

How long? What if i am already stable on this dose?

[Gridley]

3 minutes ago, LeoD said:

How long? What if i am already stable on this dose?

I would give it at least a month.  A 2 1/2month hold isn't that long. "Stable" means more or less the same symptoms every day with no big swings.

[LeoD]

That

1 hour ago, Gridley said:

I would give it at least a month.  A 2 1/2month hold isn't that long. "Stable" means more or less the same symptoms every day with no big swings.

Than I am stable, same symptoms, no big swings, it’s just they are not getting better... 

[Gridley]

9 minutes ago, LeoD said:

Than I am stable, same symptoms, no big swings, it’s just they are not getting better...

I'm going by the fact that you're feeling worse.  It's your decision, but I would err on the side of caution by holding longer.  We never know what's going on in WD.  It could be that your system needs to catch up from your previous drops.

[LeoD]

Ok, I dropped from 12 to 11.5 mg ( only  4%!) after the 2.5 month hold, and 3 days later i am feeling it! A bad wave, worse than before. Depression, cognition, chills, shakiness, coordination, suicidal ideations-   all much worse. I am not sure i can tolerate this. Now, the question is whether to updose or to try to get through this. How long do i have until up-dosing is not likely to reverse symptoms to the before the drop baseline?  If i decide to updose, to what level?

Thanks as always!

Leo

[Gridley]

2 minutes ago, LeoD said:

3 days later i am feeling it! 

It takes a little over a week before a dose change is in full strength in the bloodstream. The fact that you're feeling the increase in symptoms indicates you were not ready to taper.   If you updose (which would be my recommendation) it would be to go back to the previous 12mg.  

[Dylanmatthew]

Leo how do you function in life always feeling so unwell? Life is truly suffering and I'm wo seeing if it's worth it. 

[LeoD]

Thanks Gridley!

Dylan, I have no choice. I have children.

[LeoD]

Gridley, is it possible that such a small drop (4%)  at otherwise high dose (12 mg) creates such a huge change in symptoms? Is it possible that this would have happened anyway, just another bad wave? Just curious what you think. It is soooo unsatisfying to have to updose!!!

[LeoD]

And also, with Lexapro WD, does the wd normal quality of life improve with each slow enough taper? Or does it get harder with every does decrease? Typically?