829maxx: reinstate Lexapro or not after tapering withdrawal

[829maxx]

Hi All,

New to this forum. I was taking 20mg of Lexapro for about a year and a half for anxiety. I’m planning on starting a family soon, so told my doctor I would like to try and get off the Lexapro. His recommendation was to taper from 20 to 10mg for 1 week, then 5mg for one week, and then done. About a few days into taking 5mg, I had some mild side effects. I am now 4 days completely off and having more major side effects that are effecting my day-to-day. I’m experiencing a surge in the head, dizziness anytime I move around, and hot flashes. I messaged my doctor today and he told me to go back onto 10mg and taper much slower this time. 

 

My question is whether I will feel relief if I got back on at 10mg (and hopefully the slower taper works better), or, since I’m 4 days into no SSRI, I should try to stick it out with the hopes it goes away in the next few days?

 

also, if I go back on, will I feel relief fairly quickly?

 

would love your opinions and thoughts!

[ChessieCat]

Hi maxx and welcome to SA,

 

I'm really pleased that you have found SA when you did.  SA recommends reinstating at much lower doses than what doctors do.

 

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 the drug is taken away too quickly we can get withdrawal symptoms:  Dr Joseph Glenmullen's Withdrawal Symptoms

 

The only known way to reduce withdrawal symptoms is to reinstate the drug your brain has adapted to.

 

Please read Post #1 of this topic:  About reinstating and stabilizing to reduce withdrawal symptoms

 

It is better to reinstate a small amount of the drug and increase by a small amount more if necessary than to risk taking too much.  The lower the dose you can reinstate at also means less you have to taper.  Lexapro is a strong drug.  You could try reinstating 2mg and see how that affects your symptoms.  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.  Generally I would have suggested taking 5mg but because you want to get off the drug as soon as possible I think it would be better to try a smaller reinstatement dose.  You might find that you need to increase by a bit more, but you might not need to go all the way back to 5mg. 

 

The idea of reinstating isn't to get rid of withdrawal symptoms completely but to bring them to a bearable level.

 

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

 

Please keep daily symptoms notes on paper so that you can see how the reinstatement is affecting your symptoms.

[ChessieCat]

Here's some additional information which might help you to understand what is happening:

 

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

 

Withdrawal Normal Description

When we take a psychiatric drug, we are adding chemical/s to the brain.  The brain then has to change to adapt to getting the chemical/s.  It might have to change something to do with A and then once that change has been made it affects B so another change has to be made and so on down the line.  It is a chain reaction, a domino effect.

 

The same thing happens when we take the drug away.  That's why it's possible to experience such a vast array of withdrawal symptoms, and they can change, and be of different intensity.

 

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

 

These explain it really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

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

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

 

AND

 

On 12/4/2015 at 2:41 AM, apace41 said:

Basically- you have a building where the MAJOR steel structures are trying to be rebuilt at different times - ALL while people are coming and going in the building and attempting to work.

It would be like if the World Trade Center Towers hadn't completely fallen - but had crumbled inside in different places.. Imagine if you were trying to rebuild the tower - WHILE people were coming and going and trying to work in the building!  You'd have to set up a temporary elevator - but when you needed to fix part of that area, you'd have to tear down that elevator and set up a temporary elevator somewhere else. And so on. You'd have to build, work around, then tear down, then build again, then work around, then build... ALL while people are coming and going, ALL while the furniture is being replaced, ALL while the walls are getting repainted... ALL while life is going on INSIDE the building. No doubt it would be chaotic. That is EXACTLY what is happening with windows and waves.  The windows are where the body has "got it right" for a day or so - but then the building shifts and the brain works on something else - and it's chaos again while another temporary pathway is set up to reroute function until repairs are made.  

 

[ChessieCat]

When you get a chance, please create your drug signature using the following format.   Keep it simple.  NO 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

 

 

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

[829maxx]

Hi All,

I’ve read many threads on here in regards to tapering a very small amount (like 10% at a time). I’m going to taper off Lexapro (after having to reinstate it after withdrawal). I’m curious how to go about this accurately since the pills only come in 5, 10, 20mg. The 5mg don’t seem to have any cut lines on them to accurately cut in half and pill cutters aren’t the most accurate.

 

thanks all!

[Gridley]

 

4 minutes ago, 829maxx said:

I’m curious how to go about this accurately since the pills only come in 5, 10, 20mg.

 

You have several options for getting small nonstandard doses of Lexapro, which are described in the link below.  Basically you can get a prescription for Lexapro liquid, you can make your own liquid, or you can cut your Lexapro tablets and weigh them.  The latter is what I do, using the AWS Gemini-20 scale, available on Amazon.  

 

Tips for tapering off Lexapro (escitalopram)