Theo: withdrawal symptoms several months after reducing the dose

[Theo]

Good afternoon everybody and Merry Christmas!

 

I don't know how to start the thread,hence I will go straight to the point.I have been on Escitalopram for the last 3 years,taking a dosage of 20mg.I was prescribed the medicine because I had suffered from OCD since my adolescecnt years.Starting the medication was a life-changing moment,because medication helped me in many aspects of my life and ever since I started the medicine I considered this period as the most succesful of my life.

 

Seven months ago,I felt confident enough and since I wanted to get rid of medication eventually,I spoke with my doctor and we decided to cut the dose in half,so I started taking the 10mg pills.For the first 3-4 months everything was fine and I didn't notice any difference.The problems started in September with issues in my sleeping schedule,and following I started having problems with my memory and focus.After a few weeks new symptoms were added,including complete lack of motivation,depression and confusion even by the simplest things.Luckily enough,I don't have the so-called brain zaps,which as I am reading are very common in withdrawal from antidepressants.

 

The worst thing is that I quited my job couple of weeks ago,because I couldn't handle all those horrible emotions anymore.I feel like I am stuck in the bottom and I really don't know how to get through this situation.During the day,I make so many thoughts about my problem,going from ''I have depression,it's not withdrawal'' to ''It's totally withdrawal,I just can't have depression'' and then back and forth.

 

What I wanted to ask is how long this will take until it's over and when it's over will I find myself again or I will just be an improved ''version'' of how I was during withdrawal.I know the answer is not standard,so I just want to hear some people's cases and how they handled it.Moreover,I am curious if anybody in here had a honeymoon period of several months just as I did.

 

Thank you in advance!

 

Edited December 26, 2018 by ChessieCat
added space

[ChessieCat]

Hi Theo and welcome to SA,

 

SA recommends tapering by no more than 10% of the current dose followed by a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.  Why taper by 10% of my dosage?

 

When reducing the drug too quickly we can experience withdrawal symptoms, because the brain is trying to adjust to not getting the drug which it has been used to getting.  Dr Joseph Glenmullen's WD Symptoms Checklist

 

Before the current drug I am taking (Pristiq) I was taking citalopram for about 20 years and decided to cold turkey it.  I didn't know anything about withdrawal symptoms back then.  I felt really great for 2-3 months.  Better than I had felt in a long time.  Then bam!  I got very sick with what at the time I thought was the flu (I now know that it was more than likely delayed withdrawal) and was bedridden for 2.5 weeks and lost 8kgs because I couldn't eat.  I ended up being prescribed Pristiq because I was told (incorrectly - it is a myth) that I needed an antidepressant like a diabetic needs insulin.  I was fortunate that the Pristiq did help with the withdrawal symptoms.  I had a completely different experience when I reduced my Pristiq dose by half.  I had extreme cog fog for 2 weeks which lifted when I increased my dose after finding and joining SA.  I have since been tapering following SA's protocol and I'm down to 5mg and only experience mild withdrawal symptoms.  Withdrawal Symptoms - Delayed Onset

 

If you are still taking 10mg, you might find that taking a tiny bit more might help to relieve the withdrawal symptoms.  Escitalopram is a very strong drug so even a tiny 0.25mg might be enough to bring the symptoms to a bearable level.  It is better to start with a small amount and if needed increase by another small amount than to risk taking too much.  During the time you have been on 10mg (beginning May) your brain will have made some adjustments to getting a lower dose.

 

It takes about 4 days for a dose change to get to full level in the blood and a bit longer for it to register in the brain.  You will need to be patient and stay as calm as possible and not panic during this time.  When we panic we can make bad decisions.  The idea of updosing isn't to get rid of the withdrawal symptoms completely but to bring them to a bearable level.  The smaller the dose you can stabilise at the less drug you will need to taper.

 

This topic explains how to get the dose you need:  Tips for tapering off Lexapro (escitalopram)

 

You will need to keep daily symptoms notes on paper so that you can be objective and see any small improvements which occur. 

 

Healing isn't linear, it occurs in a Windows and Waves Pattern of Stabilization

 

This is your own Introduction topic where you can ask questions about your own situation and journal your progress.  Please let us know what you decide to do and how things go.  Please update your drug signature whenever you make a change so it remains current. Thank you.

[Theo]

Thank you very much for your answer ChessieCat.

 

I visited my doctor today and he told me to increase the dose to 20mg for 2 months and see how it goes.I was reluctant but I trust him and I will probably go back to 20mg from tomorrow.I also got myself some fish oil supplements for one month.I will update you with my progress over the next weeks.

 

Take care.

 

Edited December 27, 2018 by ChessieCat
removed quoted post

[ChessieCat]

Going back to 20mg will most probably be too much.  Please read Post #1 of this topic:  About reinstating and stabilizing to reduce withdrawal symptoms

 

Sorry, I forgot to post the link to it in my previous post.

 

The reason this site exists is because most doctors do not understand withdrawal from antidepressants and more importantly many do not know how to treat it.  It sounds like your doctor thinks you have relapsed and are suffering from your original condition when it is more likely to be withdrawal from reducing your drug too quickly.

 

Taking too much of the drug might make things worse.  We have seen this happen to other members on SA who have followed their doctor's suggestion and increased their dose too much.  It is better to increase by small amounts.

 

Pharmaceutical companies use the term "therapeutic dose" which they teach the doctors.  Therapeutic dose is an arbitrary term and doesn't mean much.  arbitrary:  based on random choice or personal whim, rather than any reason or system.

 

SA prefers to think in terms of "lowest effective dose" which is the lowest dose which works for an individual.

 

As mentioned in my previous post it is better to increase by small amounts than to bombard your nervous system with a high dose.  Please read the information I gave at the top of this post.

 

 

Edited December 27, 2018 by ChessieCat

[Theo]

Bonsoir ChessieCat.

 

I honestly do not know what to do.I am so confused between what I am reading on this website and what my doctor is telling me.This morning I took my 10mg pill as usual and did not increase as my doctor suggested.I feel a bit better compared to when WD started and I wanna keep on fighting.We will see how it goes.

 

Thank you for your support.

[Kostas]

Hi, 

When I was stopping citalopram after a couple of years on 20 mg, I was feeling fine between 6-12 months, before symptoms hit me hard and force me to retake the original dose to calm down! 

Fortunately every time within a month, I was feeling fine again. 

That happened three times, being on off the drug for 13 years. 

Finally I was able to get off it with a very slow tapering and long holding periods, lasting almost 7 years. 

Now I am off the tablets for 6 years, and almost fully functional. 

Off course keep in mind that everyone is deferment! 

 

[Theo]

Good afternoon,

 

I decided to increase my dose to 20mg after a conversation with my neurologist.I know that on this website,the recommended updose is a minimum one,but he is an open-minded and good doctor and he really cares on how I am doing,therefore I trust him.In any event,5 days have passed and I still feel no difference.It needs more time I know.I am experiencing windows every morning and night,but the rest of my day is a living hell.Severe anxiety,intrusive thoughts that I cannot kick away,cannot concentrate to read or watch a movie and going out of the house seems like an extremely difficult task.I also feel sleepy all the time.

 

I wanted to ask if anyone else in here had the same pattern of windows only in the mornings and nights?I was also wondering if there is any chance that the medicine is not working on me anymore and if I'll have to change?

 

That is all for now.Thank you for reading me!

[Altostrata]

What time of day do you take escilatopram? How's your sleep?

[Theo]

10 hours ago, Altostrata said:

What time of day do you take escilatopram? How's your sleep?

Hi Alto,

 

I take one pill every morning.When I go to sleep I usually put something to watch on my lap top and I fall asleep quite easily.The problem is that I wake up early in the morning (6am) and then struggle to go back to sleep,I finally do for 1 or 2 hours more but it's not a proper sleep.Therefore I would say that I get about 5-6 hours of good and 1-2 hours of bad sleep during the nights.My legs are also restless when I try to go back to sleep early in the mornings.

 

Thank you.

[jozeff]

Hi Theo!

 

Welcome and so sorry for your suffering. Are you taking the 20 mg now? If it's possible for you I'd slowly build up from 10 instead of doubling your dose.

 

I went up from 15 to 25 mg citalopram in 2017 and that was not much fun...

Steady is key here and I heard that many times here. 

 

I know you want to take action immediately. I feel you.

 

About the waves.....I have the exact same thing. In the morning I'm ok, around noon I feel terrible most days and after dinner around at 7 I start to feel really relaxed and normal.

 

I had a period where the mornings were horrendous but that seems to have shifted.

 

Good luck and I hope you will feel better soon!

 

 

Jozeff

[Theo]

Hi Jozeff,

 

Greetings to the beautiful Netherlands!Thank you for your answer.Yes I increased the dose from 10 to 20mg about a week ago but haven't felt any difference yet.As I can see on your signature you tapered Effexor in 2015 and then in 2016 you started taking citalopram.What happened and you started medication again?Was it because of withdrawal or because of relapse?And may I ask what was the original reason that you were prescribed Effexor back in '99?One more question for the end:How is your professional life going nowadays?I had to leave my job about 3 weeks ago and that was the biggest hit of this whole withdrawal period.

 

Take care and keep strong!Looking forward for your answers.

 

Theo.

[Altostrata]

Please let us know how you're doing, Theo.

 

Magnesium may help the leg tension. A lot of people find fish oil and magnesium supplements helpful, see
http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/

http://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

Try a little bit of one at a time to see how it affects you.

 

[ChessieCat]

Keep it Simple, Slow and Stable

[Theo]

Thank you very much guys for your responses.It has been a true nightmare.And I cannot explain how I feel to my family because this whole condition is so strange with all the mood swings and foggy thoughts.Not to mention that I don't want them to be extremely worried about me.If they actually knew how I felt inside me they would be really really concerned about my well being.

 

Another thing is that my mother was always trying to pursuade me to reduce the dose and she was the one that finally convinced me to reduce it back in May.During some bad waves I thought of telling her that  this whole thing is her fault, but I know I will regret it the moment I say it.She also has to deal with her own matters and I don't want to be a burden and make her feel guilty.Maybe she already does feel guilty.I don't know.

[jozeff]

Hi Theo,

 

I started venlafaxine in 99 after my relationship ended and especially after my parents divorced, I was 23 at the time and living with my parents. This stuff helped me tremendously and I built up my life and studied chemistry, traveled, had a new relationship...

 

In 2016 I started citalopram after being off of venlafaxine for a few months. It could very well have been WD.

 

The citalopram helped me get less agitated and reduced my depression. I had my first panic attack however on Citalopram. I fluctuated too much and that made me very unstable. 

 

I have a job but I stayed home for a couple of weeks a few times..

I'm lucky that I am able to do that.

 

 

Jozeff

[Theo]

Good afternoon guys,

 

I reinstated to 20mg 2 weeks ago and I feel just a bit better.I am also taking fish oil supplements but not sure whether they are helping or not.

 

Mood swings still happening,windows have grown a bit longer,but I definitely need more time.My patience is running out though.I also see bad dreams every night.The most disturbing feeling is that future seems so hopeless and I cannot make any plans due to my condition.I feel a gap inside me 24/7.

 

I believe that eventually my doctor will recommend taking another medicine to boost my mood and I am really afraid that I will end up in a drug cocktail.So many thoughts,so many fears,a living nightmare.

 

Thank you for reading me.

[Theo]

Hello guys,

 

25 days ago I reinstated to 20mg Escitalopram after being on 10mg for 7 months.I experienced withdrawal symptoms from September and on and I haven't felt much different so far.I feel a bit calmer now,but I don't get windows and waves anymore.It is more or less an emotional flatness during the whole day.

What do you think I should do?Should I go for a different drug?I am really confused and I believe if I go to my doctor he'll probably recommend another drug,but I don't wanna end up in a drug cocktail.

[Altostrata]

Emotional flatness is a side effect of escilatopram and other antidepressants.

 

It probably was unnecessary for you to increase the dosage to 30mg. It might have taken a few months, but your nervous system probably would have settled down on 20mg.

 

This is a site for tapering off drugs. We do not treat "depression" or recommend new drugs to chase an ideal state of being. If what you want to do is feel good on drugs, you'll have to work with a physician. However, you may never have that honeymoon feeling on psychiatric drugs again.

 

Otherwise, to go off drugs, you'll have to be patient and learn non-drug methods to manage your mood issues.

 

It seems you are quite impatient. I'm not sure we can help you.

[Theo]

Hi Alto,

 

I increased the dose to 20mg not 30!You are right I'm quite impatient I just wanna go through this and stop feeling like a ghost.

 

I'll try tapering off for sure in the future.I don't want to take ADs for life.Anyways thank you for your reply.

[Altostrata]

2 hours ago, Altostrata said:

Emotional flatness is a side effect of escilatopram and other antidepressants.

 

It probably was unnecessary for you to increase the dosage to 30mg. It might have taken a few months, but your nervous system probably would have settled down on 20mg.

 

This is a site for tapering off drugs. We do not treat "depression" or recommend new drugs to chase an ideal state of being. If what you want to do is feel good on drugs, you'll have to work with a physician. However, you may never have that honeymoon feeling on psychiatric drugs again.

 

Otherwise, to go off drugs, you'll have to be patient and learn non-drug methods to manage your mood issues.

 

It seems you are quite impatient. I'm not sure we can help you.

 

My mistake -- you might have stabilized on 10mg.

 

Please note that as long as you're taking any antidepressant, you may experience the side effect of emotional flatness. That's how these drugs "work." Some people like this effect.

[Carmie]

Hi Theo, 

 

How are you doing since your reinstatement?💚

[Theo]

Hi Carmie,

 

Thank you for your interest.I reinstated 3 months ago more or less.I am doing much better compared to how I was in December.My sleep is decent,my apettite has gone back to normal,my social anxiety has been mitigated and I am also making some sort of plans for the near future.On the other hand,withdrawal symptoms haven't been completely eliminated.There are still parts of the day when I don't feel like myself or I feel totally unmotivated to do anything.

 

All in all,I am better but I need to give myself more time.This withdrawal period in my view,makes you think a lot about yourself and the people around you(especially those close to you).Unfortunately,when you think too much,it is very likely that you think negatively,so it doesn't help with moving on.I have made so many negative and terrible thoughts about my family during the last few months that I honestly feel so embarassed even to look at them in their eyes.I never believed that I was capable of thinking those stuff.

 

Being in withdrawal is a very tough lesson.A lesson on appreciating how much value the physical and mental health has.On the other hand,it is such a traumatic experience that when I see other people suffering I tend to think that ''this is nothing compared to what I felt during withdrawal''.After all those awful emotions while in withdrawal,there is a danger of feeling desperate and be unable to see any meaning or beauty in life.I know this is not the right way of thinking,but I cannot help it.That's why I call it a trauma,because the effects of it stretch beyond the duration of withdrawal.

 

What I have noticed both from personal experience and from reading other peoples' stories in here,is that during withdrawal one wants to hide from everything and everyone.Feels like a burden even by sharing this ''little secret'' called withdrawal.He doesn't want anyone to know about it.He feels bad about feeling bad.In addition,a common pattern is that people believe that they have some sort of brain damage.In the beggining of withdrawal I was afraid I had a tumour.Thinking more clearly now,after reinstating,I would like to give a word of encouragement to everybody in here.Your brain is not damaged,it is just trying to adopt to changes!Think about how you were before withdrawal,think about you!Don't let withdrawal steal your good memories from you!You can overcome it!Time is your ally.

 

I think that's all for now.It's been a while since I wanted to write my thoughts on withdrawal in general,not only about my personal experience.I hope whoever reads this also shares his opinion.

 

Have a lovely day everyone and keep strong!There's light ahead!

[India]

On 3/28/2019 at 12:26 AM, Theo said:

Being in withdrawal is a very tough lesson.A lesson on appreciating how much value the physical and mental health has.On the other hand,it is such a traumatic experience that when I see other people suffering I tend to think that ''this is nothing compared to what I felt during withdrawal''.After all those awful emotions while in withdrawal,there is a danger of feeling desperate and be unable to see any meaning or beauty in life.I know this is not the right way of thinking,but I cannot help it.That's why I call it a trauma,because the effects of it stretch beyond the duration of withdrawal.

This is so spot on. I felt it too with my previous trauma put the medication trauma on top and it is tenfold . 

[Carmie]

Hi Theo, 

 

So glad to hear the reinstatement worked. 💚

[Theo]

Hello again SA after a while,

 

I wasn't visiting the forum very often,but I would log in once a month to read a few posts.This time I decided to post an update about myself since there have been some changes lately.

I am taking 20mg Escitalopram currently as I updosed in the end of last year having been hit by severe withdrawal.

The reinstatement helped in some ways as I managed to find a job again and make some plans for my future.I still had issues with anhedonia but the job kept me very busy and wasn't thinking about it a lot.

The thing is that it's been about 15 days that demotivation is back for good along with restless legs and I am struggling even to get out of bed in the mornings.

I am not sure if it is a bad wave or just the medication has worn out.

I spoke with a psychiatrist back in my hometown in Greece and he said that it might be a good idea to switch to Effexor.I am not sure if I want to take effexor though that's why I decided to give it few more weeks until I make my desicion.

That's all for now.

Hope sb share their views.

[Theo]

Hello guys,

 

It's been a while since the last time I posted here but there have been many developments regarding my taper since the end of last year.

 

So up untill September 2019 I was on 20mg Escitalopram but it pooped out and my doctor put me on 75mg Effexor in October 2019.I didn't improve at all and hence I had my dose increased to 150 which made me feel slightly better.The side effects of Effexor were quite rough and I decided to taper off taking 150mg one day and 75mg the next one.Gradually I made it 75mg every day and then 37.5mg.

 

I took the last Effexor dose of 37.5mg on the 14th of February and for a couple of weeks the only symptom I had was mild dizziness.

 

I was doing well until one month ago.It was the beginning of June and suddenly I stopped having any feeling at all and being completely motivated to go out,work,exercise or anything else.

 

Apparently I have once again been struck by withdrawal symptoms but the worst thing is that I have only been experiencing a huge have during the past one month without a glimpse of hope on the horizon.There was not a single good moment.

 

Any advise guys?Any opinions?

[Altostrata]

Theo, since you started here, it seems you have mistaken an adverse effect of antidepressants for a psychiatric condition.

 

On 1/21/2019 at 12:06 PM, Altostrata said:

Emotional flatness is a side effect of escilatopram and other antidepressants.

 

So then you switched to Effexor, got more adverse effects from it, and you went off that in an irregular way that we would never recommend.

 

Going on and off drugs and dosing inconsistently can make your nervous system sensitive to a lot of things. Drinking alcohol, for example, or antibiotics can bring on a wave of symptoms similar to withdrawal syndrome.

 

Many people find fish oil and magnesium supplements helpful, see
https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/
https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

You might try a little bit of one at a time to see how it affects you.

 

I don't think we can help you further.

[Theo]

Hello Alto,

 

I understand what you are saying.The thing is that every action I took,I did so in accordance with psychiatrist's advice.

 

Hence the change to Effexor,which improved my condition,but as I said the side effects were quite rough.

 

What I need to know more about,is people who had an acute withdrawal and didn't experience windows at all.

 

Because the past month has been worse than a nightmare.Lately,I also started getting intrusive thoughts which make me terrified and I cannot escape from them.Other symptoms are very low quality of sleep,poor memory and concentration and complete lack of motivation.I am so fed up that I don't even feel like taking care of myself anymore and do anything to improve the symptoms.

[Theo]

Also a short question:Has anyone tried transcranial magnetic stimulation for depression or other conditions?

[Erell]

2 hours ago, Theo said:

Also a short question:Has anyone tried transcranial magnetic stimulation for depression or other conditions?

I don't have my computer these days so i'm not able to give you the link, but there is a thread about TMS in " Symptoms and selfcare" section. 

 

An easy way to find things on SA is to use Google with the words "survivingantidepressants" + "TMS" 

 

2 hours ago, Theo said:

Hello Alto,

 

I understand what you are saying.The thing is that every action I took,I did so in accordance with psychiatrist's advice

 

Unfortunately, psychiatrists and doctors don't have a clue about WD and even deny it. They also deny adverse effects.

It can be quite upsetting when we realize how dangerous these drugs are and how useless psychiatry can be.

 

This is why SA is very important : we have here thousands testimonies from people who went through this before.

And from these testimonies we can try to understand better the process and define careful rules.

 

I'm curious : did you take a look to some topics on SA ?

Again, I unfortunately can't paste links with my Phone, but please take a look to our many topics.

 

Take care ❤

 

[ChessieCat]

Here's the TMS topic: 

 

tms-transcranial-magnetic-stimulation

 

This topic has recently been updated.  You might find some of the information helpful:

 

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

 

 

Edited July 10, 2020 by ChessieCat

[Theo]

Thanks very much for the information @Erell and @ChessieCat 

 

Also yes I have been reading the threads on this website for the last one and half year. So I have found plenty of information about withdrawal symptoms and ways to manage them.