phillyfan24: Lexapro taper too fast/reinstatement too high a dose?

[Dizzy4]

 

On 1/15/2019 at 3:04 AM, phillyfan24 said:

i left so quick he forgot to hand me my script for the buspar, to which he called 5 min after i left to come pick it up. I will not be picking it up and will be on the hunt for a new doctor.

 

Also, brain fog continues to be really high last few days. 

 

We're so vulnerable when we're foggy, its when we most need a doctor with a good bedside manner. I felt so stupid and humiliated the last time I saw my ex-doctor but I just didn't have the mental clarity or energy to make my case (that I was experiencing new symptoms versus elevated anxiety as he suggested).  I hope the fog clears today.

[phillyfan24]

Quick update w/ yesterday’s daily symptoms:

 

10AM: wake up ( got about 11 hours of sleep...getting sleep has no been a problem, still always tired.) brain fog/DR present 

10AM: take 20mg lexapro, 2 fish oil pills

10:30AM- breakfast - protein smoothie with half a bagel and PB

11:30AM: drink preworkout 

12PM: gym (weights and cardio) 

1:30PM: go home, drink protein shake, eat lunch -chicken and veggies 

2-4PM: relax in bed, do some school stuff

4-7PM: house work (moving into a new room)

7PM: dinner - turkey, beans, veggies. Get into argument with family. Explained what is going on, they don’t understand and say they get stressed from time to time and maybe they should take a pill. This def increased my fog/DR. 

8PM-11PM- relax. Take epsom bath, watch Sixers play. 

11PM- take quarter tab of my buspar and go to bed. 

5AM-5:45AM- woke up, got quick snack (do this every night) and couldn’t immediately fall back asleep. 

10AM - wake up, repeat 

 

 

My fog/DR is constant throughout my days still, only noticeably worse after a stressful event. 

@Altostrata Thursday night will be my last time taking a quarter tab buspar. Since my fog has gotten worse during this taper, would you recommend cutting the quarter tab in half (thus taking .625mg) for 4 days, or stopping altogether? 

[Altostrata]

I guess the increased fogginess might be Buspar withdrawal. Can you hang in there? It probably will go away in a few weeks.

 

At least it's not an increase in anxiety. Being able to sleep is a good thing, it helps your nervous system heal.

 

Might as well cut the quarter tab in half -- a quarter is easier to cut horizontally through the middle of the pill, like cutting the layers of a cake apart. Then you can go off 0.625mg.

 

 

 

[phillyfan24]

So it has been a little bit since I updated things: 

 

So Wednesday night I fell asleep accidentally without taking my Buspar (was tapering down) and I woke up and felt....better! Decrease in brain fog for sure. So I have been off the buspar since then and am currently just taking 20mg lexapro. Sleep is going well also!

 

Only symptom I have now is the DP/DR, mainly DR. @Altostrata would you still recommend I stay at 20mg for a little bit? I have had this DP/DR since this all began. My concern is that the period of time I was off lexapro my body adapted a little and is now not accepting the same dose of lexapro, contributing to the DR. The reason I’m asking is because as soon as I stopped the buspar the fog went away, so maybe the reinstatement of lex is causing the DR and beginning a slow taper could help? Or I’m overthinking things? Let me know what you think. 

[Altostrata]

Well, there you go, Buspar side effect.

 

Yes, I would stay at 20mg Lexapro for a month or more, enjoy the vacation from drug changes. Your nervous system has been through a lot.

 

The DP/DR might be a side effect of Lexapro or a legacy of withdrawal shock. If the latter, it should gradually go away. Hang in there.

[phillyfan24]

5 hours ago, Altostrata said:

Well, there you go, Buspar side effect.

 

Yes, I would stay at 20mg Lexapro for a month or more, enjoy the vacation from drug changes. Your nervous system has been through a lot.

 

The DP/DR might be a side effect of Lexapro or a legacy of withdrawal shock. If the latter, it should gradually go away. Hang in there.

@Altostrata ok will do! Thank you so much for all your help thus far! I am so ready to start my taper and get off the lexapro, but I am going to stay here for the near future and hope to stabilize further and hopefully my DR will diminish as well. 

[phillyfan24]

Just wanted to update since it has been about a month since I checked in...

 

I have been on solely 20mg of Lexapro for a month and have been on this dose since December (tapered off buspar during this time). My sleep has been fantastic, however, I feel as tho i can always sleep. For example, I'll sleep 9-10 hours during the night, and still be tired all day (this is in fact why i went to doctor to begin with and began this entire mess). I also still have the DP/DR (which I have had since this started in September) which has not gotten better. 

 

To sum it up, i am dealing with the DP/DR and fatigue, but most concerning is the DP/DR, as it has left me emotionally numb. I keep second guessing if this is still an effect of the nervous system shock, or a side effect of the lexapro reinstatement. I would love to hear some input if I should stay on 20mg lexapro, or begin to taper? I have 8 weeks left in my final clincal (YAY!), so I was thinking of beginning the taper when that is over, but I do wonder if lowering my dose would alleviate some of the DP/DR...any thoughts?!?!

[ChessieCat]

3 hours ago, phillyfan24 said:

I have 8 weeks left in my final clincal

 

My personal opinion is not to rock the boat.  You've only just stopped the buspar.  We would suggest holding after finishing drug anyway.  And good luck too.

 

Edited February 17, 2019 by ChessieCat

[phillyfan24]

Update (3/4/19)

 

Want to keep updating my status for everyone. I am the same as i was last update about 3 weeks ago. sleeping well (Excessively in fact), but DP/DR continues to be prevalent. I am still taking 20mg escilitopram in the morning, along with two fish oil tablets and melatonin at night. 

 

I do have a doctors appt with a new psychiatrist on March 22nd. Does anyone have advice on what I should be looking to do? My best guess is he will attempt to switch my medication or add additional medications, but i am going to ask for a liquid version of lexapro to begin a gradual wean, which i hope will relieve my DP/DR. 

 

Of major concern, the DP/DR has affected my ability to learn and pay attention significantly. I take my final exam in mid April and then my boards in mid july, and am terrified as I have been studying but have not been able to retain much information. I am also hoping that reducing my dosage of escitalopram will help this.

[Gridley]

Your best guess about what your new psych will do is likely correct.  You probably already know that psychiatrists have little, if any, knowledge about withdrawal or tapering.  These two links provide some guidance about talking to your psych:

 

What should I expect from my doctor about withdrawal symptoms?

How do you talk to a doctor about tapering and withdrawal?

 

[phillyfan24]

It's been a while since i have posted so just wanted to update and get some advice from the community

 

I have finished my final clinical and passed my first major exam =D I graduate in one week with my doctorate =D. While it has been a HUGEEEEEEE relief, I am still feeling the same as I was months ago. Derealization/brain fog (is there a major difference between the two, not sure which is the correct definition of what i am feeling but I believe it is DR), and increased fatigue (sleeping 12 hours at night, naps during day). However, I have no increased anxiety/depression. I had been on 20mg Lexapro for ~5 months and was hoping that with time the DP/DR would go away or at least get better (it is chronic 100% of the day), but it hadn't. I had begun to taper and am currently at 15mg Lexapro, which I have been on for one month. I plan to stay at this dose for AT LEAST one month. I was hoping that maybe the dP/DR was a side effect of the lexapro and it would ease as I decrease my dose, but so far that has not happened =(. 

 

An update on my doctors appts: I had a new psych appointment and explained everything. He (of course) told me that I was having a "depressive episode" and required more medication. He prescribed me the lowest dose of welbutrin to add to the lexapro, but i am not taking this. He also referred me to a neuro, whom I saw and said that I have lyme disease/some sort of infection, as my wbc count was very low. Testing shows I DO NOT have lymes, but she still believes I do. She thinks it is a coincidence that all my symptoms started when i went of my meds, and that they would have still occurred had i never went off them (I do not). She also was concerned about my white tongue and prescribed me an antifungal, which I have been taking for 2 weeks and following a no sugar/gluten diet, with absolutely no improvements (She never tested for candida, just kinda said "well if it is yeast, this will kill it."

 

In summary, I'm sure this is all happening because of the medication even tho all these doctors say otherwise. Could someone help explain something to me tho? I had minor DP/DR when i lowered my dose of lexapro way back when this all started. When i went off completely, it got 10x worse. I understand this. But when I reinstated back to 20mg, it helped ease the DP/DR a tad bit, but has not gone away since! Does this mean that reinstatement didn't work for me? Is lexapro not even doing anything at this point? Did i reinstate too much and my body is rejecting it and when i continue to decrease dose i will feel better? 

 

I know this is alot of info/questions, but I am just eager to get better. Would love to hear advice from everyone

[Gridley]

48 minutes ago, phillyfan24 said:

But when I reinstated back to 20mg, it helped ease the DP/DR a tad bit, but has not gone away since! Does this mean that reinstatement didn't work for me? Is lexapro not even doing anything at this point? Did i reinstate too much and my body is rejecting it and when i continue to decrease dose i will feel better? 

 

A couple of questions, Phillyfan:  you mention going off the Lexapro completely but this isn't reflected in your signature.  Could you add this and the date?  Were you on 20mg Lexapro at some point prior to Dec.7?  If so, please show this in your signature.

  
Account Settings – Create or Edit a signature.

 

If you went from 5mg to 15mg Lexapro, that was a big jump and may have caused some instability.  However, the fact that your symptoms eased indicates that the reinstatement did some good.   Reinstatement doesn't eliminate withdrawal symptoms but rather alleviates them to some degree.

 

How stable are you feeling?  Are you considering tapering the Lexapro?  If so, be sure to go slowly.  

 

Why taper by 10% of my dosage?

 

You made many changes to your Lexapro dosage, and it's impossible to say what the "sweet spot" dosage for your system is right now.  A decrease could help.  

 

 

[phillyfan24]

27 minutes ago, Gridley said:

 

A couple of questions, Phillyfan:  you mention going off the Lexapro completely but this isn't reflected in your signature.  Could you add this and the date?  Were you on 20mg Lexapro at some point prior to Dec.7?  If so, please show this in your signature.

  
Account Settings – Create or Edit a signature.

 

If you went from 5mg to 15mg Lexapro, that was a big jump and may have caused some instability.  However, the fact that your symptoms eased indicates that the reinstatement did some good.   Reinstatement doesn't eliminate withdrawal symptoms but rather alleviates them to some degree.

 

How stable are you feeling?  Are you considering tapering the Lexapro?  If so, be sure to go slowly.  

 

Why taper by 10% of my dosage?

 

You made many changes to your Lexapro dosage, and it's impossible to say what the "sweet spot" dosage for your system is right now.  A decrease could help.  

 

 

Hello Gridley, 

 

i updated my signature. I was on 20mg lexapro for 5 years until august of 2018 when my doc reduced me to 15 and then began a cross taper to prozac. I was off lex completely for about one week (while taking 20mg prozac). As i said, I am still feeling dP/DR and fatigue, but this has been apparent since this has begun, so I guess you could say I have been stable. 

 

I am currently at 15mg lexapro...i went down to 17.5mg and am now down to 15mg where i plan to stay for a month. I went down by these increments because i did not have an opportunity to get liquid/measure precisely (also thought that maybe I was taking TOO MUCH lex, so i was eager to decrease to see if this helped my symptoms), but I have a doctors appt in one month where I plan to ask for the liquid or use a compounding pharmacy to follow the 10% rule. 

[bubble]

You can make your own liquid by dissolving the tablet in water and taking the dose you need with a syringe. Check out the Tapering Lexapro thread for more details.

[phillyfan24]

quick update as it has been about a month since i posted. 

 

Had doctors appointment where we switched to celexa 20mg once/day, as it is cheaper and supposedly very similar in structure to lexapro. Since i was on 15mg lexapro, i am assuming from my research that 20mg celexa would be around 10mg lexapro? So i guess i can consider this a reduction? It has been one week since i started the celexa with no major change in symptoms (i do take longer to fall asleep at night, but no major concern there). I am still dealing with the same symptoms - DR/brain fog/just feeling like i am not experiencing my surrounding environment like i had before, and excessive fatigue. I do workout 6 days per week, lifting and cardio, but i have noticed since this all began i am cutting the time of my sessions in half as i just hit a wall halfway through.

 

one major question that is consuming my thoughts all day. Is this DR/brain fog/feelings of detachment a symptom of depression, or is it due to the antidepressants and my body not accepting them? I have a constant yo-yo effect from my doctors and family telling me it is a symptom of depression and i should be taking medication until i get better. On the other side, I still wonder if tapering in the beginning so quick caused my body to basically reject antidepressants, which is causing these side effects and the reason why going back on the lex didn't resolve these symptoms and make me feel like i was prior. This leads me to want to get off of these medications. I just want to get better and am willing to try anything at this point, as it is almost a year since this all began   I have my state boards in a month and studying has been impossible...it is so difficult for me to retain and information/focus.

 

[BigPharmaStinks]

On 6/13/2019 at 1:35 PM, phillyfan24 said:

quick update as it has been about a month since i posted. 

 

Had doctors appointment where we switched to celexa 20mg once/day, as it is cheaper and supposedly very similar in structure to lexapro. Since i was on 15mg lexapro, i am assuming from my research that 20mg celexa would be around 10mg lexapro? So i guess i can consider this a reduction? It has been one week since i started the celexa with no major change in symptoms (i do take longer to fall asleep at night, but no major concern there). I am still dealing with the same symptoms - DR/brain fog/just feeling like i am not experiencing my surrounding environment like i had before, and excessive fatigue. I do workout 6 days per week, lifting and cardio, but i have noticed since this all began i am cutting the time of my sessions in half as i just hit a wall halfway through.

 

one major question that is consuming my thoughts all day. Is this DR/brain fog/feelings of detachment a symptom of depression, or is it due to the antidepressants and my body not accepting them? I have a constant yo-yo effect from my doctors and family telling me it is a symptom of depression and i should be taking medication until i get better. On the other side, I still wonder if tapering in the beginning so quick caused my body to basically reject antidepressants, which is causing these side effects and the reason why going back on the lex didn't resolve these symptoms and make me feel like i was prior. This leads me to want to get off of these medications. I just want to get better and am willing to try anything at this point, as it is almost a year since this all began   I have my state boards in a month and studying has been impossible...it is so difficult for me to retain and information/focus.

 

I have a very similar story as you if you read my thread. The DP/DR and brain fog will not fully resolve until you get down to very low doses of Lexapro. I tried waiting on 10mg of Lexapro but the severe brain fog and DP/DR did not resolve, so now I have been tapering. The brain fog and DP/DR are triggered by withdrawal but then when one tries to reinstate the serotonin receptors are very down-regulated among other neurotransmitter systems, so the medication no longer works like it should.

[phillyfan24]

On 6/17/2019 at 10:50 AM, BigPharmaStinks said:

I have a very similar story as you if you read my thread. The DP/DR and brain fog will not fully resolve until you get down to very low doses of Lexapro. I tried waiting on 10mg of Lexapro but the severe brain fog and DP/DR did not resolve, so now I have been tapering. The brain fog and DP/DR are triggered by withdrawal but then when one tries to reinstate the serotonin receptors are very down-regulated among other neurotransmitter systems, so the medication no longer works like it should.

 

Thanks for reaching out...i read your post, and yes, we seem to be in a very similar position with. Unfortunately for us, this is getting in the way of our future endeavers in the medical field. How has the brain fog/DR been since you been tapering.. has it gotten worse or better? 

[phillyfan24]

@Altostrata @ChessieCat

You guys have been so helpful throughout this process and i wondering if you could help me again. 

 

i was recently switched from 15mg lex to 20 mg celexa by my doc, as he thought (Wrongfully) that my symptoms were from the lexapro. Regardless, I understand that these two drugs are extremely similar chemically, and that i believe 20mg celexa would be equivalent to 10mg lex, so i clearly made a fairly large drop (which i have not noticed any effects from yet *knock on wood*). 

 

My question is, if i am following the 10% rule, that means that I technically just made my taper longer, correct? would i have been better off staying on the lexapro. Even though I dropped my dose and have not had any side effects, i am having a hard time seeing this as a success since I just lengthened by taper by a number of months. Hopefully, since this drug is less potent compared to lex, i will experience fewer withdrawals? 

[Altostrata]

Sorry, philly. The only advantage in switching to Celexa is that you won't have side effects from Lexapro, you'll have them from Celexa; they may be milder.

 

Your taper is not shortened by the switch. How are you feeling? Any improvement?

[phillyfan24]

@Altostrata thanks for replying. I feel the same, just Brain fog and fatigue with memory and concentration problems. Otherwise, no changes since the switch. My concern was that I was on 15mg lex and by switching to 20mg celex, I have lengthened my taper even tho I technically decreased my overall dose since lex is about 2x as strong. 

[RichT]

48 minutes ago, phillyfan24 said:

@Altostrata thanks for replying. I feel the same, just Brain fog and fatigue with memory and concentration problems. Otherwise, no changes since the switch. My concern was that I was on 15mg lex and by switching to 20mg celex, I have lengthened my taper even tho I technically decreased my overall dose since lex is about 2x as strong. 

 

No, you won't have increased your tapering time. I must admit I'm puzzled by what your doctor has done. Escitalopram and citalopram are effectively the same drug except that citalopram consists of both left-handed and right-handed forms of the drug, only one of which is active, whereas escitalopram contains only the active form. 

[phillyfan24]

32 minutes ago, RichT said:

 

No, you won't have increased your tapering time. I must admit I'm puzzled by what your doctor has done. Escitalopram and citalopram are effectively the same drug except that citalopram consists of both left-handed and right-handed forms of the drug, only one of which is active, whereas escitalopram contains only the active form. 

ahh i see, well i feel better that I wont have extended my taper time. And yes, I was also very confused as well. From what he explained, he believed that lexapro was no longer working (in reality, i am going through withdrawal). Since lexapro had worked so well before, he thought that maybe celexa would work since it was chemically similar. Overall, i guess it does not matter if im on celexa or lexapro, but one positive is celexa is much cheaper. I think switching has helped me realize that i am truly in withdrawal, as i had begun to wonder previously if maybe my body was no longer accepting lexapro. Even tho very similar, this proves to me that no AD is going to ease my symptoms and the best bet is to gradually taper off.

[Altostrata]

Given the drugs are so similar, you may be experienced a common side effect of both of them, or of how your nervous system reacts to SSRIs in general. Not sure what to do, you've been through a lot of pointless drug switches.

 

Hold for a month and then start tapering Celexa? See Tips for tapering off Celexa (citalopram)  for background. Please let us know how you're doing over the next month.

[BigPharmaStinks]

On 6/18/2019 at 12:17 PM, phillyfan24 said:

 

Thanks for reaching out...i read your post, and yes, we seem to be in a very similar position with. Unfortunately for us, this is getting in the way of our future endeavers in the medical field. How has the brain fog/DR been since you been tapering.. has it gotten worse or better? 

I stopped at 0.9mg because I kept getting paradoxical adverse reactions to Lexapro. I'm 6 days off and symptoms are much less severe than they were when I stopped at 10mg last summer. Derealization is almost gone but still have severe dissociation, severe brain fog whih is rendering me unable to study for any exams no matter how hard I try to read through the material. I think it will take several more months for me to see some more substantial improvements. My brain fog got better after staying on 1mg for several days then back to hell so i never stabilized. If I were you, once you stabilize, I would start tapering off and your brain fog and dp/dr will start resolving very slowly.

[phillyfan24]

Update:

 

it has been about 7 weeks since i was switched from 15mg lexapro to 20mg celexa. The first two weeks i noticed no difference whatsoever in my fog/derealization, however, I did notice that my fatigue is much decreased now, so i am attributing this to a side effect of the lexapro. I do take much longer to fall asleep at night tho. The next two weeks i experienced an exacerbation of my fog and derealization/memory problems, which i attribute to large jump that i made (15mg lexapro is equal to roughly 30mg celexa). The previous 2-3 weeks have been back to how i had been feeling regarding constant dr, fog, memory problems, concentration problems, etc, but i am still no longer fatigued like previously, so that is a major plus. I have held constant at this dose to stabilize as much as possible, and to not rock the boat prior to my board exam tomorrow. 

 

I plan on reducing 10% tomorrow, as I believe I have "Stabilized" as best I can at this dose. 

[phillyfan24]

Have been on 18mg Celexa for one week now. Have noticed a minor uptick in DR and brain fog, as well as anxiety...however, this is tolerable at this moment. I also found out I passed my board exam! So next step is to apply for a full time job, which terrifies me, as I cannot imagine working a demanding job with the DR and brain fog..however, I am just going to keep trucking along...

Question for the mods @Altostrata @ChessieCat...I started to taper because I believed I had given enough time to truly stabilize, but my DR/brain fog never went away. Looking back at my timeline, I realize that between all the increases/decrease/new medications, I was only on a stable dose 20mg lexapro for 2.5 months. Reading other intro topics, it appears that maybe i should have tried to further stabilize for a longer period of time, such as 6+ months. I would love to be able to stabilize to the point where my DR/brain fog is relieved, especially since I will be working soon. Do you recommend that I continue to taper, or maybe try to stabilize at a current dose, such as 20mg celexa for multiple months and than taper when i am 100% stable? i am unsure if this is a smart thing or if this is just my increased anxiety taking over...any input is truly appreciated!

[Gridley]

58 minutes ago, phillyfan24 said:

o you recommend that I continue to taper, or maybe try to stabilize at a current dose, such as 20mg celexa for multiple months and than taper when i am 100% stable?

 

phillyfan24,

 

Given that you're going to be starting a job soon and that you've gone up and down in dosage, I would hold where you are at 18mg for a few months to stabilize.  It's important to understand what "stabilize" means.  The following is from Brassmonkey:

 

"Stability is when a persons symptoms even out to a constant level. No big swings in either direction up or down just a consistent feeling of blah. ...  "

 

AND 

 

"When we are tapering Stability is the driving factor.  After a reduction is made we have to work our way through the spike of symptoms which indicates that body is confused and having to make changes to adjust to the different dosage.  Once that spike has passed there is still healing going on, even if we don't feel it.  We need to allow time for that healing to happen before we make the next reduction.  Which is why it is so important to hold after a reduction.  Once the body has stabilized ...  then we can make the next reduction."

 

Congratulations on passing your boards.

[phillyfan24]

21 hours ago, Gridley said:

 

phillyfan24,

 

Given that you're going to be starting a job soon and that you've gone up and down in dosage, I would hold where you are at 18mg for a few months to stabilize.  It's important to understand what "stabilize" means.  The following is from Brassmonkey:

 

"Stability is when a persons symptoms even out to a constant level. No big swings in either direction up or down just a consistent feeling of blah. ...  "

 

AND 

 

"When we are tapering Stability is the driving factor.  After a reduction is made we have to work our way through the spike of symptoms which indicates that body is confused and having to make changes to adjust to the different dosage.  Once that spike has passed there is still healing going on, even if we don't feel it.  We need to allow time for that healing to happen before we make the next reduction.  Which is why it is so important to hold after a reduction.  Once the body has stabilized ...  then we can make the next reduction."

 

Congratulations on passing your boards.

Thanks for getting back to me gridley. 

 

I have read the posts about stability, and I have come to recognize that my "stable" still has DR/brain fog/memory issues. I was just curious if i were to hold for say 6 months, if those symptoms would alleviate. i know its impossible to tell. Since i have had these cognitive issues since the beginning of a way too fast taper about a year ago, I constantly wonder whether I should stay at a single dose until these symptoms alleviate (no matter how long that may take), OR that my symptoms are now the result of my destabilized nervous system reacting to the antidepressant, which would of course make me want to continue my slow taper. 

i do plan on holding at 18mg for AT LEAST a month and see how I feel from there

[Gridley]

19 minutes ago, phillyfan24 said:

I was just curious if i were to hold for say 6 months, if those symptoms would alleviate.

As you say, there's no way to tell.  I was basing my recommendation to hold on the upcoming job and the fact that you've gone up and down in dosage since April, plus changed drugs from Lexapro to Prozac and back to Lexapro, plus started then went off Buspar with a fast taper, all of which which are destabilizing.   

 

We all want to be making progress, but holding is "doing something," which is allowing the body to stabilize.

 

Please keep us updated and let's see how things stand in a month with respect to your job search and symptoms.

 

[Altostrata]

On 8/5/2019 at 10:58 AM, phillyfan24 said:

Do you recommend that I continue to taper, or maybe try to stabilize at a current dose, such as 20mg celexa for multiple months and than taper when i am 100% stable?

 

Stop tapering when you feel you need it, you don't have to push through symptoms. You can always resume tapering when you feel more confident about it.

 

Some people do hold much longer than a few months, to give their nervous systems a good rest. It's possible you might want to take tapering vacations now and then throughout your taper. This is fine.

[ChessieCat]

And when you do start tapering again you could always make a small test reduction to see how things go.

 

You might also consider Brass Monkey Slide which is a gentler way of tapering. It would also allow you to hold off on a reduction if there is something stressful going on in your life at that time, but still be heading in the right direction of getting off the drug.

[phillyfan24]

Alto, chessie, and gridley,

 

thank you guys for the advice! It feels like this 10% cut has been harder than when I switched from 15mg lex to 20mg celexa! But I am able to tolerate the symptoms. I keep reminding myself that 20mg celexa would technically be 10mg of lexapro, and that I have cut my “total AD dose” in half. Def helps me keep along. I was hoping as I got lower, the brain fog and DR would resolve, but that has not happened (yet at least). I plan on sticking at 18mg until I get comfortable in my new job, however long that may be. I think the brass monkey method may also be good for me as well seeing how my CNS is so sensitized now. 

[Gridley]

20 minutes ago, phillyfan24 said:

I plan on sticking at 18mg until I get comfortable in my new job, however long that may be. I think the brass monkey method may also be good for me as well seeing how my CNS is so sensitized now. 

 

Good plan, phillyfan24.  

[phillyfan24]

Just about a month on 18mg...This cut has been harder than most, and I theorize it is because I only spent a month when I switched from 15mg to lex to 20mg celexa and I may still be feeling that...Anyways, I plan on continuing to hold for a little bit, probably multiple months to A) see if I can stabilize (Ive never held more than 2.5 months, so I wonder if I will have less symptoms if I hold for >4 months) and B ) I will be starting a new job soon, which is sure to have some increased levels of stresss in the early going. 

My current MAIN symptoms: Derealization, anhedonia, memory problems

My other symptoms that are not as severe: Dry mouth, trouble falling asleep (but no problem getting >8 hours), anxiety at times

 

I have also looked at the ingredients in some of my workout supplements that i have been taking..both contain B vitamins so I have stopped taking them. I am down to one cup of iced coffee per day, and would like to continue to taper off caffeine. 

While i love the energy boost that caffeine gives me, it really amplifies my derealization for about an hour...

 

Also, I saw my doctor today and really long story short, I was able to get the liquid prescribed to me. He also prescribed smaller 10mg doses. 

 

So my question to the mods...Should I save the liquid or begin to use it now? Should I do 10mg tablet, and 8mg liquid?  Right now at around 18mg, I have been just cutting tablets and weighing it using a scale. It is super annoying and I always kinda stress myself out sometimes thinking that maybe the scale is off.

[ChessieCat]

6 minutes ago, phillyfan24 said:

So my question to the mods...Should I save the liquid or begin to use it now? Should I do 10mg tablet, and 8mg liquid?  Right now at around 18mg, I have been just cutting tablets and weighing it using a scale. It is super annoying and I always kinda stress myself out sometimes thinking that maybe the scale is off.

 

That's good news that your doctor is providing what you need to taper.

 

Check the concentration of the liquid.  Also check the use by after opening information.

 

When changing completely form of the drug, eg from tablets to liquid, we suggest doing a cross over by doing 3-7 days of the following combos:  3/4 + 1/4, 1/2 + 1/2, 1/4 + 3/4.  Only make one change at a time, so do not make a reduction at the same time as changing to part liquid.

 

If you can cut a 10mg tablet in half easily you could do 10mg + 5mg tablet and add 3mg liquid = 18mg.  Take this combo until you get to 15mg.  Or you could do the 10 5 3 combo for a few days and then take 10mg tablet plus 13mg liquid.

 

Once you get to 15mg you could take 7.5mg tablet + 7.5mg liquid for a few days before taking 10mg tablet plus 5mg liquid until you get to 10mg.   When you get to 10mg you could take 7.5mg tablet plus 2.5mg liquid for a few days then you could take 5mg tablet plus 5mg liquid until you get to 5mg.

 

 

[phillyfan24]

On 8/23/2019 at 7:45 PM, ChessieCat said:

 

That's good news that your doctor is providing what you need to taper.

 

Check the concentration of the liquid.  Also check the use by after opening information.

 

When changing completely form of the drug, eg from tablets to liquid, we suggest doing a cross over by doing 3-7 days of the following combos:  3/4 + 1/4, 1/2 + 1/2, 1/4 + 3/4.  Only make one change at a time, so do not make a reduction at the same time as changing to part liquid.

 

If you can cut a 10mg tablet in half easily you could do 10mg + 5mg tablet and add 3mg liquid = 18mg.  Take this combo until you get to 15mg.  Or you could do the 10 5 3 combo for a few days and then take 10mg tablet plus 13mg liquid.

 

Once you get to 15mg you could take 7.5mg tablet + 7.5mg liquid for a few days before taking 10mg tablet plus 5mg liquid until you get to 10mg.   When you get to 10mg you could take 7.5mg tablet plus 2.5mg liquid for a few days then you could take 5mg tablet plus 5mg liquid until you get to 5mg.

 

 

Thanks Chessie

So I have been doing some math in prep for when i get the liquid and begin the switch, and realized that I initially calculated my dosage slightly wrong. I am now on 17.5mg, not 18 (thankfully not a huge difference)....this is exactly why I wanted to get the liquid..it gets confusing for me using the scale right now. 

 

The concentration is 10mg/5mL. I think i understand what you are saying, could you confirm that this is right..

I am going to start by doing 15mg in tablets weighed and 2.5mg of lexapro in liquid (1.25mL of the liquid)..I'll hold here for about a week. Then I would go to 10mg in tablet, 7.5mg in liquid (3.75mL) and stay here for a few months to stabilize further. Do you think this is OK, or should I add in a middle step here?