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LeoD: escitalopram protracted tapering


LeoD

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No, they have been with me since my last failed taper. They have been getting worse lately with the dose decrease. I do not see much difference  between 8.6 and 8.5 mh.

Lexapro started 2006, 10 mg 2007 tapered to 0 over a month. Felt poorly, got wd but did not know

2008  Put back on L, 20 mg 

2015-16 tapered to 0 over several months. Severe Discontinuation symptoms several days after.

2016: 20 mg, 2016-April 2018 slow taper to 0. 

2018 April: Drug - free!!! June: Withdrawal started 🤯 July: Back on Escitalopram, 10 mg, Nov: 15 mg,

2019: Feb 15 13.75 mg, Feb 23 updose to 15 mg, Sep 6  13.75 mg, Sep 16 12.5 mg, Oct 5 11.25 mg, Oct 23 updose 12 mg

2020: Jan 13 11.5 mg Jan 16 updose 11.9 mg, Feb-Dec  slowly tapered from 11.6 to 6.6 mg. 

2021: Oct 5 mg

2022: Jul 3.8 mg

Holding due to bad symptoms of tiredness, brain fog, depression. 

Bupropion trial sep- nov 2019 no relief from wd. 100, 150, 100, 75, 50, 0 mg

Testosterone Aug 2019-April 2021 - injections, stopped abruptly, experienced wd from T discontinuation . Nov 2021 - current - topical. Massive wave from T re-introduction

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 Hey, Leo. Seems we are both suffering still. I hope one day this will all end for us either is death or we get better. 

2010 bupropion(?) approx 1 month, cold turkey

2013 Lexapro 10mg from 2013-2015. Reduced to 5mg for 2.5-3ish years. Reduced to 2.5mg for 2 months then stopped early Sept 2018
Dec 8th 2018 Lexapro reinstated 0.5mg

Link to further details 

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You can count on that!!! ))))

Lexapro started 2006, 10 mg 2007 tapered to 0 over a month. Felt poorly, got wd but did not know

2008  Put back on L, 20 mg 

2015-16 tapered to 0 over several months. Severe Discontinuation symptoms several days after.

2016: 20 mg, 2016-April 2018 slow taper to 0. 

2018 April: Drug - free!!! June: Withdrawal started 🤯 July: Back on Escitalopram, 10 mg, Nov: 15 mg,

2019: Feb 15 13.75 mg, Feb 23 updose to 15 mg, Sep 6  13.75 mg, Sep 16 12.5 mg, Oct 5 11.25 mg, Oct 23 updose 12 mg

2020: Jan 13 11.5 mg Jan 16 updose 11.9 mg, Feb-Dec  slowly tapered from 11.6 to 6.6 mg. 

2021: Oct 5 mg

2022: Jul 3.8 mg

Holding due to bad symptoms of tiredness, brain fog, depression. 

Bupropion trial sep- nov 2019 no relief from wd. 100, 150, 100, 75, 50, 0 mg

Testosterone Aug 2019-April 2021 - injections, stopped abruptly, experienced wd from T discontinuation . Nov 2021 - current - topical. Massive wave from T re-introduction

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  • Administrator

Might be a good idea for you to stop tapering now, let your nervous system rest for a while. Does Lexapro make you sleepy?

 

It is possible you are a fast metabolizer of Lexapro and at the lower dosage, the level in your bloodstream is lower by mid-afternoon. What you might do is gradually move it earlier by an hour or so each day until you are taking it in the morning.

 

If it makes you sleepy, taking the whole dose earlier probably isn't a good idea, you might split the dose.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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I am actually a slow metabolyzer of SARIs according to the CytP450 profile. Also i have the short SERT variant and MTHFR 677T homo.

A great combination))$

Lexapro started 2006, 10 mg 2007 tapered to 0 over a month. Felt poorly, got wd but did not know

2008  Put back on L, 20 mg 

2015-16 tapered to 0 over several months. Severe Discontinuation symptoms several days after.

2016: 20 mg, 2016-April 2018 slow taper to 0. 

2018 April: Drug - free!!! June: Withdrawal started 🤯 July: Back on Escitalopram, 10 mg, Nov: 15 mg,

2019: Feb 15 13.75 mg, Feb 23 updose to 15 mg, Sep 6  13.75 mg, Sep 16 12.5 mg, Oct 5 11.25 mg, Oct 23 updose 12 mg

2020: Jan 13 11.5 mg Jan 16 updose 11.9 mg, Feb-Dec  slowly tapered from 11.6 to 6.6 mg. 

2021: Oct 5 mg

2022: Jul 3.8 mg

Holding due to bad symptoms of tiredness, brain fog, depression. 

Bupropion trial sep- nov 2019 no relief from wd. 100, 150, 100, 75, 50, 0 mg

Testosterone Aug 2019-April 2021 - injections, stopped abruptly, experienced wd from T discontinuation . Nov 2021 - current - topical. Massive wave from T re-introduction

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Hi Alto,

I will definitely stop tapering for now and hope this will get better.


It does not make me sleepy.


I am actually a slow metaboliser of SSRIs according to the CytP450 profile. If I decrease it substantially, as I have in the past, I feel the change on day 4. If I skip a dose, which has happened may be 3-4 times in 10 years, I do not sense it immediately. I have tried taking it in the morning, though not recently, and have not seen an improvement with the afternoon sluggishness. Makes me think this will not work but I may try again.

Also I have the short SERT variant (so SSRIs are not supposed to work for me) and MTHFR 677T homo.

A great combination)))

 

My B12 is low normal now and I was told to take Me-B12, which I do. It does not seem to be helping though. 
 

Any other hints?

Thanks!

Leo

Lexapro started 2006, 10 mg 2007 tapered to 0 over a month. Felt poorly, got wd but did not know

2008  Put back on L, 20 mg 

2015-16 tapered to 0 over several months. Severe Discontinuation symptoms several days after.

2016: 20 mg, 2016-April 2018 slow taper to 0. 

2018 April: Drug - free!!! June: Withdrawal started 🤯 July: Back on Escitalopram, 10 mg, Nov: 15 mg,

2019: Feb 15 13.75 mg, Feb 23 updose to 15 mg, Sep 6  13.75 mg, Sep 16 12.5 mg, Oct 5 11.25 mg, Oct 23 updose 12 mg

2020: Jan 13 11.5 mg Jan 16 updose 11.9 mg, Feb-Dec  slowly tapered from 11.6 to 6.6 mg. 

2021: Oct 5 mg

2022: Jul 3.8 mg

Holding due to bad symptoms of tiredness, brain fog, depression. 

Bupropion trial sep- nov 2019 no relief from wd. 100, 150, 100, 75, 50, 0 mg

Testosterone Aug 2019-April 2021 - injections, stopped abruptly, experienced wd from T discontinuation . Nov 2021 - current - topical. Massive wave from T re-introduction

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  • 1 month later...

All, 

On 7.9 mg and stopping the tapering because of how poor i feel. Been thinking about what else i can do to feel better again (tiredness,  brain fog, depression). 
My TSH is 3.7, which is normal but higher than optimal (around 1). My endocrinologist says that there is ~30% chance that i will feel better if i “optimize” The thyroid function by taking a low dose of the hormone. Should i try? How do we think about thyroid replacement in the context of withdrawal and taperIng? What are the risks/benefits?

Thanks!

Lexapro started 2006, 10 mg 2007 tapered to 0 over a month. Felt poorly, got wd but did not know

2008  Put back on L, 20 mg 

2015-16 tapered to 0 over several months. Severe Discontinuation symptoms several days after.

2016: 20 mg, 2016-April 2018 slow taper to 0. 

2018 April: Drug - free!!! June: Withdrawal started 🤯 July: Back on Escitalopram, 10 mg, Nov: 15 mg,

2019: Feb 15 13.75 mg, Feb 23 updose to 15 mg, Sep 6  13.75 mg, Sep 16 12.5 mg, Oct 5 11.25 mg, Oct 23 updose 12 mg

2020: Jan 13 11.5 mg Jan 16 updose 11.9 mg, Feb-Dec  slowly tapered from 11.6 to 6.6 mg. 

2021: Oct 5 mg

2022: Jul 3.8 mg

Holding due to bad symptoms of tiredness, brain fog, depression. 

Bupropion trial sep- nov 2019 no relief from wd. 100, 150, 100, 75, 50, 0 mg

Testosterone Aug 2019-April 2021 - injections, stopped abruptly, experienced wd from T discontinuation . Nov 2021 - current - topical. Massive wave from T re-introduction

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  • Moderator Emeritus

SA provides support for tapering / withdrawal of psychiatric drugs.  We don't do general medicine.

 

However, SA has many existing topics.  Please avail yourself of the information in a topic if you have a question about something not related to tapering /withdrawal so you can read the discussion by other members.  I suggest you use a search engine and search for:

 

site: survivingantidepressants.org thyroid

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • Moderator Emeritus

Hi Leo. I have read your entire thread and would like to offer a little unsolicited perspective.

 

It does not appear to me that you have ever been stable since your reinstatement. We know you CAN stabilize, because you seem to come around after each of your tapers. But from the beginning, it really looks to me like you began tapering too soon, and continued to taper before you stabilized completely. It doesn't surprise me that these cuts have caught up to you, especially considering your poor metabolizer status. I am concerned that you are not giving your CNS a chance to improve it's overall baseline. It sorts out the acute changes from the cut, but there's still underlying instability that doesn't get addressed because you're already on to the next cut. Granted this is only my theory, but I believe it bears consideration. A house built on a shaky foundation will only stand for as long as the winds stay calm. 

 

I too am a slow metabolizer of SSRIs. I had to hold for 10 long months after reinstatement for total stability. Even after that time, I gave it another 2 months before I started cutting my dose. Then I promptly ran myself off into a ditch by piling tapers on top of each other. Because I have been holding again for a while, I have now learned the hard way that, due to my slow metabolism of zoloft, I have a minor but noticeable "boomerang" effect of withdrawal symptoms about 30 days after a cut, which last around 2-3 more days. Given my metabolizer status, this makes sense to me. I theorize that the delayed symptoms are due to the dose cut finally and completely clearing. After I come out of this wave and restabilize, I now know I must wait about 6 weeks between dose decrements to let that second "mini wave" settle out. This might be what is happening to you, too, but you don't realize it because you're already on to the next cut.

 

I know you say you felt better making micro cuts in quick succession, but I'm not certain that's what a poor metabolizer should be doing. I think it's possible you're not waiting long enough to see if, like me, you get a final spate of symptoms, and because of that, the WD continues to become cumulative.

 

It's possible that a nice long hold would pay big dividends for you. I'm talking about holding still for at least 2-3 months to give your CNS a chance to process all the changes it's been asked to make. It's at least something to consider, and it might make the rest of the trip down to zero much easier for you.

 

Just the Sunday evening musings of a fellow traveler in this bumpy road. I hope you find a big window soon!!

 

 

2016 - Zoloft 50 mg for klonopin w/d

Approx. Nov 2017 - successful taper of klonopin; Approx. Jan. 2018 - rapid taper Zoloft over 2 wks - no w/d symptoms; May 2018 - Reinstate 50 mg Zoloft per doctor; Aug 2018 - Rapid taper Zoloft over 3-4 weeks - no w/d symptoms for 1 mo.; Late Oct 2018 - pdoc rx'd 5mg lexapro -took for 1 wk; Early Nov 2018 - Reinstate 25 mg Zoloft; updose to 37.5 on Nov 28, 2018; Nov 30 2018 - returned to 25mg Zoloft upon mod. advice; Dec 9 - Dec10 2018 - 12.5mg zoloft liquid+12.5mg zoloft pill; Dec 11 2018 - 25mg zoloft all liquid; Feb 14 2019 - updosed to 26.25 mg liquid; Mar 6 2019 - updosed to 26.88 mg liquid - new symptoms; Mar 13 2019 - back down to 26.25 mg per mod suggestion

Dose Changes: Dec 2 2019 - 5% to 25mg; Jan 14 2020 - 10% to 22.5 (increase in sxs all month); Mar 10-15? 2020,  accidental updose to 25mg; Mar 22 2020 - back down to 22.5mg; Apr 12 2020 - 2.5% to 21.94mg; Apr 19 2020 - 2.5% to 21.375mg (symptom increase); May 17 2020 - 2.5% to 20.625mg; May 24 2020 - 2.5% to 20.1mg - Jun 14 2020 - noticed uptick in symptoms settled 2 days later - July 10 2020 - onset of wave

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Thank you, Dejavu, I think and hope you are correct. I will give it time.

Lexapro started 2006, 10 mg 2007 tapered to 0 over a month. Felt poorly, got wd but did not know

2008  Put back on L, 20 mg 

2015-16 tapered to 0 over several months. Severe Discontinuation symptoms several days after.

2016: 20 mg, 2016-April 2018 slow taper to 0. 

2018 April: Drug - free!!! June: Withdrawal started 🤯 July: Back on Escitalopram, 10 mg, Nov: 15 mg,

2019: Feb 15 13.75 mg, Feb 23 updose to 15 mg, Sep 6  13.75 mg, Sep 16 12.5 mg, Oct 5 11.25 mg, Oct 23 updose 12 mg

2020: Jan 13 11.5 mg Jan 16 updose 11.9 mg, Feb-Dec  slowly tapered from 11.6 to 6.6 mg. 

2021: Oct 5 mg

2022: Jul 3.8 mg

Holding due to bad symptoms of tiredness, brain fog, depression. 

Bupropion trial sep- nov 2019 no relief from wd. 100, 150, 100, 75, 50, 0 mg

Testosterone Aug 2019-April 2021 - injections, stopped abruptly, experienced wd from T discontinuation . Nov 2021 - current - topical. Massive wave from T re-introduction

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  • Moderator Emeritus
58 minutes ago, LeoD said:

 I will give it time.

I hope you do. The hardest job is to resist the temptation to make a cut. Please respect the Lexapro. It's crazy strong.

2016 - Zoloft 50 mg for klonopin w/d

Approx. Nov 2017 - successful taper of klonopin; Approx. Jan. 2018 - rapid taper Zoloft over 2 wks - no w/d symptoms; May 2018 - Reinstate 50 mg Zoloft per doctor; Aug 2018 - Rapid taper Zoloft over 3-4 weeks - no w/d symptoms for 1 mo.; Late Oct 2018 - pdoc rx'd 5mg lexapro -took for 1 wk; Early Nov 2018 - Reinstate 25 mg Zoloft; updose to 37.5 on Nov 28, 2018; Nov 30 2018 - returned to 25mg Zoloft upon mod. advice; Dec 9 - Dec10 2018 - 12.5mg zoloft liquid+12.5mg zoloft pill; Dec 11 2018 - 25mg zoloft all liquid; Feb 14 2019 - updosed to 26.25 mg liquid; Mar 6 2019 - updosed to 26.88 mg liquid - new symptoms; Mar 13 2019 - back down to 26.25 mg per mod suggestion

Dose Changes: Dec 2 2019 - 5% to 25mg; Jan 14 2020 - 10% to 22.5 (increase in sxs all month); Mar 10-15? 2020,  accidental updose to 25mg; Mar 22 2020 - back down to 22.5mg; Apr 12 2020 - 2.5% to 21.94mg; Apr 19 2020 - 2.5% to 21.375mg (symptom increase); May 17 2020 - 2.5% to 20.625mg; May 24 2020 - 2.5% to 20.1mg - Jun 14 2020 - noticed uptick in symptoms settled 2 days later - July 10 2020 - onset of wave

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  • Moderator Emeritus
18 minutes ago, Dejavu said:

Please respect the Lexapro. It's crazy strong.

 

And just to stress the point this is from the Tips for Tapering Lexapro topic:

 

On 5/27/2011 at 12:16 PM, Altostrata said:

 

If you are taking 5mg, it's not tiny, it's equivalent to 10-20mg Paxil or Celexa.

 

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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Hey, Leo. I saw you mentioned your thyroid number. Mine is also about 3.7 when I got my blood work done Oct 2019. I thought that was high and was one reason why I felt so fatigued and unwell all the time everyday. Well, my Dr. Said it's in their normal range so he didn't want to treat it with thyroid hormones. I feel I could've benefited from that but I'm too unmotivated, depressed, and scared to go and find ANOTHER Dr and get a blood test which scares me all on its own.

I hope we make it out of this. I've been holding on my 0.5mg Lexapro for 2 years because it's become such a habit and I'm afraid to even continue and taper. Life is a joyless hell of anhedonia and I somewhat look forward to the coming collapse of society here soon.

 

2010 bupropion(?) approx 1 month, cold turkey

2013 Lexapro 10mg from 2013-2015. Reduced to 5mg for 2.5-3ish years. Reduced to 2.5mg for 2 months then stopped early Sept 2018
Dec 8th 2018 Lexapro reinstated 0.5mg

Link to further details 

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  • 1 year later...

Hi All, 

Have not been here over a year, slowly have been tapering from 7.5 mg to 5 mg during that time. Currently sitting on 5 mg for ~ 3 weeks. I am not decreasing, but my symptoms are getting worse, especially in the last month. Depression like never before, always on the brink of crying, complete brain fog, no motivation, no memory, loss of sleep at night, rumination and thoughts about being better off dead .

The eternal question: to wait, to updose or to keep tapering. If I wait and keep feeling worse, will I miss the window to updose? Updose how? Should I hope that the symptoms will subside or is this unrealistic at this point?

Do we know of cases when depression and cognition improve during a long hold? I do not think I can just wait for it to stop getting worse - where I am now is not consistent with functioning at all. Need an improvement.

Advice please?

leo 

Lexapro started 2006, 10 mg 2007 tapered to 0 over a month. Felt poorly, got wd but did not know

2008  Put back on L, 20 mg 

2015-16 tapered to 0 over several months. Severe Discontinuation symptoms several days after.

2016: 20 mg, 2016-April 2018 slow taper to 0. 

2018 April: Drug - free!!! June: Withdrawal started 🤯 July: Back on Escitalopram, 10 mg, Nov: 15 mg,

2019: Feb 15 13.75 mg, Feb 23 updose to 15 mg, Sep 6  13.75 mg, Sep 16 12.5 mg, Oct 5 11.25 mg, Oct 23 updose 12 mg

2020: Jan 13 11.5 mg Jan 16 updose 11.9 mg, Feb-Dec  slowly tapered from 11.6 to 6.6 mg. 

2021: Oct 5 mg

2022: Jul 3.8 mg

Holding due to bad symptoms of tiredness, brain fog, depression. 

Bupropion trial sep- nov 2019 no relief from wd. 100, 150, 100, 75, 50, 0 mg

Testosterone Aug 2019-April 2021 - injections, stopped abruptly, experienced wd from T discontinuation . Nov 2021 - current - topical. Massive wave from T re-introduction

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  • Moderator Emeritus

First question is has anything happened during this time; eg alcohol, antibiotics, sickness, operation, major life stressors (financial, relationship, moving, job, travel).

 

If not, then:

 

Q: Has the worsening of your symptoms come on gradually over a long period of time?

 

You have been on the same drug for a long time.  There is a possibility that the drug may have reached tolerance, also known as poop-out and technical name tachyphylaxis.

 

Tachyphylaxis, Reaching Tolerance or as It's Lovingly Known “Poop-Out”

 

tolerance-or-poop-out-or-tachyphylaxis

 

 

Generally:

 

"Regular/normal" withdrawal symptoms happen after making a reduction and then improve fairly quickly.

 

Poop out also produces withdrawal symptoms (and the normal "solution" is to take more of the drug, which after reaching poop out again needs to be increased) but they happen gradually and do not improve with a long hold.

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • Moderator Emeritus

Brassmonkey had to taper out of poop out from Paxil. 

 

I've just done a search and found a couple of good posts by him about this issue:

 

☼-brassmonkey-talking-about-myself

 

☼-brassmonkey-talking-about-myself

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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