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TriD

TriD: tapering from antidepressant after short term use

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TriD

I went through a high stress period for 3 months when i was diagnosed by my psychiatrist with Adjustment Disorder due to marked events in my life at the time which caused me non stop severe panic attacks, anxiety and major depression.

 

I took escitalopram starting at 10mg to 25mg over 6weeks. Now my life is sorted amd problems gone, i want to ask advice as to how i should taper off the drug as i feel i dont need them anymore.

 

Q. Do i need to slow taper as my use was only 6week mainly on 15mg and 20mg. I understand some people are on the drug for years, while i was only ever them this once due to my marked event due to stress. I dont have a history of GAD, OCD, DEPRESSION. im male 43yo and medium weight.

 

I also dont use drugs, smoke or drink.. And im perfectly strong and healthy without any chronic health problems.

 

Just want to know if i need to taper if its only 6weeks on escitalopram?

 

Thanks

Tri

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ChessieCat
Posted (edited)

Hi TriD and welcome to SA,

 

I'm really pleased that you found SA before starting to get off your drug.  Unfortunately many of our members usually end up here because they are in difficulties from trying to get off too quickly.

 

To start with please create your drug signature.  Keep it simpleNO diagnoses or symptoms please.  Thank you.

  • details for last 2 years - dates, ALL drugs, doses
  • summary for older than 2 years - just years and drug/s

Account Settings – Create or Edit a signature

 

 

Generally SA's recommended method to get of a psychiatric drug is to taper by no more than 10% of the current dose with a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.  Unfortunately, six weeks is enough time for your brain to have adapted to getting the drug.  However, if you have not previously taken any psychiatric drugs, then you may be able to taper faster.

 

When we reduce a dose we can sometimes experience some mild withdrawal symptoms as the brain gets used to a lower dose.  This is reasonably normal.  If the withdrawal symptoms are more than mild than it means you are reducing too much/too quickly and will need to slow down.  It's important to listen to your body and your symptoms.  It's a good idea to keep daily symptom notes so that you can be objective about them.

 

It's important to note that as your dose gets lower you may need to slow down.  This topic is helpful for understanding this:   Why taper paper: dose-occupancy curves

 

This is your own Introduction topic where you can ask questions about your own situation and journal your progress.

 

I will check with the other mods about what size reduction you could try.

 

LINKS:

 

Before you begin tapering what you need to know

 

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

 

Why taper by 10% of my dosage?

 

Dr Joseph Glenmullen's Withdrawal Symptoms

 

Keep it Simple, Slow and Stable

 

Windows and Waves Pattern of Stabilization

 

Withdrawal Normal Description

 

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


What should I expect from my doctor about withdrawal symptoms?  

 

Tips for tapering off Lexapro (escitalopram)

 

 

Edited by ChessieCat
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ChessieCat

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.  That's why it's possible to experience such a vast array of withdrawal symptoms, and they can change, and be of different intensity.

 

The same thing happens when we take the drug away.  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.  

 

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ChessieCat

During any taper, there will be times of discomfort.  We strongly encourage members to learn and use non drug coping techniques to help get through tough times.

 

Understanding what is happening helps us to not get caught up with the second fear, or fear of the fear.  This happens when we experience sensations in our body and because we don't understand them we are scared of them and then start to panic.

 

This document has a diagram of the body explaining what happens in the body when we become anxious:

 

https://www.getselfhelp.co.uk/docs/AnxietySelfHelp.pdf

 

 

Audio FEMALE VOICE:  First Aid for Panic (4 minutes)

 

Audio MALE VOICE:  First Aid for Panic (4 minutes)

 

Non-drug techniques to cope

 

dealing-with-emotional-spirals

 

Dr Claire Weekes suffered from anxiety and learned and taught ways of coping.  There are videos available on YouTube.

 

Claire Weekes' Method of Recovering from a Sensitized Nervous System

 

Audio:  How to Recover from Anxiety - Dr Claire Weekes

 

 
Resources:  Centre for Clinical Interventions (PDF modules that you can work through, eg:  Depression, Distress Intolerance, Health Anxiety, Low Self-Esteem, Panic Attacks, Perfectionism, Procrastination, Social Anxiety, Worrying)
 
On 4/28/2017 at 4:03 AM, brassmonkey said:

 

AAF: Acknowledge, Accept, Float.  It's what you have to do when nothing else works, and can be a very powerful tool in coping with anxiety.  The neuroemotional anxiety many of us feel during WD is directly caused by the drugs and their chemical reactions in the brain.  Making it so there is nothing we can do about them.  They won't respond to other drugs, relaxation techniques and the like.  They do, however, react very well to being ignored.  That's the concept behind AAF.  Acknowledge, get to know the feeling involved, explore them.  Accept, These feelings are a part of you and they aren't going anywhere fast. Float, let the feeling float off as you get on with your life as best as you can.  It's a well documented fact that the more you feed in to anxiety the worse it gets.  What starts as generalized neuroemotinal anxiety can be easily blown into a full fledged panic attack just by thinking about it.

 

I often liken it to an unwanted house guest.  At first you talk to them, have conversations, communicate with them.  After a while you figure out that they aren't leaving and there is nothing you can do to get rid of them.  So you go on about your day, working around them until they get bored and leave.

 

It can take some practice, but AAF really does work.  I hope you give it a try.

 

 

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TriD

Thanka for reply Altostrata.

 

I was starting from initial 20mg lexapro tapering about 3weeks ago. I know its 2x the strength of citalopram. The initial 5mg increment drops were ok 20 to 15mg to 10mg. Over 3 weeks. I take it every day. But from 10mg - 5mg i started to experience widthdrawal effects. Ive been on 5mg for 5 days. I understand from your link there is a steep drop in concentration at lower doses, at current 5mg im feeling fine. So i will drop slowly to zero at 25% every 4days and monitor if i need to take smaller increments or more time needed for each step drop. Im pretty good with this drug and it doesnt cause me major peaks amd throughs.. Hope to be 0mg in 2-4 weeks.

 

I only took escitalopram/lexapro for 6weeks but based on my research anything over a month requires tapering.

 

Thanks

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Altostrata
4 minutes ago, TriD said:

I understand from your link there is a steep drop in concentration at lower doses, at current 5mg im feeling fine. So i will drop slowly to zero at 25% every 4days

 

Please do NOT do this. This is not "slowly" after your fairly drastic dosage decreases. You already got a red flag when you experienced withdrawal symptoms before.

 

If I were you, I'd stay at 5mg for a month, let your nervous system rest, then reduce by 10%, as in Why taper by 10% of my dosage?

 

Do NOT count on being able to updose if things go wrong, sometimes you can't get back to stability.

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TriD

Okay thanks i will stay on the 5mg for a month

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TriD

Hi, ive been on lexapro / escilatopram mainly 10mg and 20mg for around 6weeks due to a marked event that trigger a nervous breakdown resulting in panic attacks, anxiety and major depression.

 

Now im tapering at 5mg. i had a stessor today at work during a negative review of my performance which i took pretty badly mentally.

 

I was a bit surprise my body reacted so poorly to it, a strong burning and tightening from inside my chest that ran up to my neck and tingly all the way down my harms, followed by dizzying headaches

...felt i was losing control in the grip of fear and anger. Which i never did in the past.

 

My question is, while on ADs does your nervous system recover strength or does it remain weaken as the drugs work to buffer you from shocks?

 

And.. After ive tapered and off all drugs will my strength and composure return? I hope this isnt permamet because i dont want a future instance like this have such a profound impact on triggering such an anxiety reaction, when in the past i was far more resilient, today it was so sensitive that i went back into an anxiety attack so easily, i was surprised it was still possible.

 

Whats the expected recover time? And also to return ones nervous system to full strength

 

Thanks

Tri

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