☼ Katy398: I’ve tapered too quickly, what should I do?

[mstimc]

7 hours ago, Katy398 said:

Thank you so much @mstimc Fantastic piece. I’ll start work on finding a some feel good films or music. Nothing springs to mind at the moment but I’m sure there must be something buried deep in some dark corner of my healing brain. Thanks again Mstimc it’s a great explanation just what I needed, your a gem 💎 

Thank you, Katy, I'm glad my explanation helped.  Remember, this isn't a contest or a race--let healing come at your own pace.  When I was going through WD and recovery, I'd sometimes envy others who seemed to be healing faster or "better" than me.  Once I eased up on myself, things got a lot easier!

[Erell]

Hello Katy,

 

  

6 hours ago, Katy398 said:

There seem to be lots of folk on here who know a lot about Lexapro. I know it’s one of the strongest ADs but I’m looking for a source of  information that states this, that I can give to my Dr. She has told me unequivocally that this is not true.  I was prescribed double the registered dose 40mgs and sadly I know she will not take a peer support group seriously. Does anyone know of another source for this information.  I have to go for some routine blood tests soon and I want to give her some information about Lexapro. It’s so dangerous that GPs do not know it’s strength. 

 

 

I've seen your request on Tom37's thread (above) : you may find what you're looking for if you read the links provided in this topic (see first post) :

 

 

Take care ☀️

 

Edited July 19, 2020 by ChessieCat
added quote for context

[Katy398]

Thank you @Erell,

Thats wonderful thank you for getting back to me. Unfortunately it gives a link to Wikipedia that doesn’t really state it’s strength related to other SSRI ( or at least my WD brain can’t find it) I have to say I’m going through a shocking wave,  which is really disturbing and my cognition is severely impaired. I hope you are ok and managing to ride the ups and downs of this life. Take care @Erelland Thank you. 

[ChessieCat]

This is from Post #1 of the Tips for Tapering Lexapro topic which Erell linked you to:

 

  

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

 

However, many doctors are unaware that escitalopram is stronger than other SSRIs and dose it as though it were the same strength. Although the so-called usual starting dose of escitalopram, 10mg, is equivalent to 20mg-30mg or more of, for example, paroxetine (Paxil), your doctor may have moved you to an even higher dose. If you are taking 20mg of escitalopram, you are taking a hefty dose of an SSRI.

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

 

 

[Katy398]

Thank you @ChessieCat, It was kind of you to get back to me. I read the link a while back but unfortunately the Wikipedia link it has does not make the comparative strength of Lexapro clear. Sadly but very true,  my doctor would not consider a peer support group as a valid source and point blank said the information was false. So unless I find another source she will not believe me. 

Thanks for your consideration, Chessie, 

Kind Regards

Katy

[ChessieCat]

This one should be good.  I've put your drug in red and bolded the other common antidepressants and added the brand names:

 

https://www.sciencedirect.com/science/article/pii/S0165032715001512

Dose equivalents of antidepressants: Evidence-based recommendations from randomized controlled trials

Results

We included 83 studies (14 131 participants). In the primary analysis,

 

fluoxetine 40 mg/day was equivalent to     PROZAC

paroxetine dosage of 34.0 mg/day,             PAXIL

agomelatine 53.2 mg/day,

amitriptyline, 122.3 mg/day,

bupropion 348.5 mg/day,

clomipramine 116.1 mg/day,

desipramine 196.3 mg/day,

dothiepin 154.8 mg/day,

doxepin 140.1 mg/day,

escitalopram 18.0 mg/day,                           LEXAPRO

fluvoxamine 143.3 mg/day,

imipramine 137.2 mg/day,

lofepramine 250.2 mg/day,

maprotiline 118.0 mg/day,

mianserin, 101.1 mg/day,

mirtazapine 50.9 mg/day,

moclobemide 575.2 mg/day,

nefazodone 535.2 mg/day,

nortriptyline 100.9 mg/day,

reboxetine 11.5 mg/day,

sertraline 98.5 mg/day,                                 ZOLOFT

trazodone 401.4 mg/day, and

venlafaxine 149.4 mg/day.                          EFFEXOR

 

Sensitivity analyses corroborated the results except for doxepin.

 

 

Here are some others:

 

https://www.healthalliance.org/media/Resources/generic-antidepressants-chart.pdf

 

https://www.emedexpert.com/compare/ssris.shtml

 

https://ahpnetwork.com/wp-content/uploads/2017/09/Switching-Scenarios.pdf

 

 

 

Edited July 19, 2020 by ChessieCat

[ChessieCat]

And this from drugs.com gives the recommended doses:

 

https://www.drugs.com/dosage/lexapro.html

[Katy398]

Fantastic Chessie I feel really well armed now and I found a source comparing escitalopram with citalopram

 

https://www.nhs.uk/medicines/escitalopram/

 

“Escitalopram and citalopram are both medicines used to treat depression.

They may sound similar, but they're different medicines.

Differences include:

 

•.  escitalopram doses are half that of citalopram“

 

Thank you for your support @Erell and @ChessieCat

 

[Tom37]

Hi Katy,

Just thought I would check in and see how your wave was going?.....I slipped back into one on Sunday as well after feeling so so much better.
 

Hopefully the intrusive thoughts are not too bad for you at the moment as they are hideous.

 

Take care

 

[Katy398]

Thank you so much @Tom37 for checking in on me. Unfortunately I’m still in the thick of a huge wave, which to be honest has intensified greatly by onset of  recent personal stressful events. I am trying so hard to take life moment by moment but it’s so hard when I’m struggling to cope with actual real stressful events as well as neuro-emotions. Catastrophic   intrusive thoughts surrounding the events, added to the additional WD symptoms make life feel unbearable at times. The intrusive thoughts are so horrible but the inability to manage any level of day to day stress on top of Covid and these additional stresses  that would send most non WD sufferers off scale there’s no wonder I’m so frightened of life. My sister tells me that all I can do is breathe, which to be honest is all I manage at times. My mantra is ‘This too will pass!! Then after that Covid will pass and after that WD will pass!!

I hope you benefit from your sleep. Seeing a pattern is good and knowing sleep returns in time can help you weather the insomnia storms. 

 

Lexapro is such a demon but we will conquer it!!!!

Take care Tom

Warm Regards K

[mstimc]

Hi Katy

One way I've used to help handle intrusive catastrophic thinking is to intentionally catastrophize a scenario until the situation becomes so absurd or harmless it loses its power.  I used to dread making mistakes at work, and then worry about getting fired, which meant we'd lose our house and then get divorced and couldn't send out son to school, etc.  I'd take it to the worst possible outcome.  then I'd do a reality check; I was good at my job and people make mistakes all the time.  Any mistake I'd make could be fixed.  It was very much the same thing I'd tell a coworker or a friend in the same situation.  I also remind myself that 90% of what we worry about never happens, and I've always handled the reality of a situation much better than the anticipation of it.  Fighting the thoughts didn't work for me, but once I accepted them, then dealt with them on my terms, it really helped.

[Katy398]

Hey Thank you @mstimc,

You always offer such sound advice. I am finding that I am managing to practice acceptance most of the time but when a colossal wave comes out of the blue and knocks me off my feet,  I seem to forget. It’s all I can do, to just scrabble  around ‘feeling for the sand under my feet whilst trying to catch my breath’.  I feel like I’m drowning in this wave. Now after 31 months since zero I’m finding  it is usually the general real life stresses that knock me over. I have absolutely no resilience strategies to manage them.  I lose my footing and I plummet. With the stresses that life hurls at me, SI often gets added into the mix. All I can do is reach out my hand and hope there is someone out there who will grab it and help me find my feet again, ready for the next wave!!!

Look  I believe I have a set number of waves that I am going to have to ride on this WD journey,  obviously we don’t  know how many that will be but after each one I acknowledge I’m one more down and that does help, but this wave is huge, and I feel I’m back at the beginning again I really do.. Can I ask why do you think my brain has to default to suicidal ideation when a life stress ploughs into me? 

Thanks again M, you are such a wonderful support to me. I hope life in Portugal is ok for you, during these difficult times.?

Take care 

[ChessieCat]

1 hour ago, Katy398 said:

Now after 31 months since zero I’m finding  it is usually the general real life stresses that knock me over. I have absolutely no resilience strategies to manage them.  I lose my footing and I plummet. With the stresses that life hurls at me, SI often gets added into the mix. All I can do is reach out my hand and hope there is someone out there who will grab it and help me find my feet again, ready for the next wave!!!

 

You might consider seeing a counsellor and learning life coping skills.  My daughter suffers from anxiety and has found what she has learned very helpful.  Even though things do upset her she has learned to deal better with things when they happen.  She has been taught skills of how to respond when something happens instead of reacting to it.

[mstimc]

3 hours ago, Katy398 said:

Can I ask why do you think my brain has to default to suicidal ideation when a life stress ploughs into me? 

Hi Katy

 

Thank you for the kind words.  Its good to know I've been able to help.  

 

I think the suicidal ideation comes from the same place a wave does--a response to adrenaline and the fear instinct.  I've had the same thoughts many times, and they've always come at a time of high or prolonged stress and anxiety.   We just get so frustrated with repeated waves that our fear response kicks in and it seems the easiest answer is to just end it all.   Of course, the logical brain knows that's not a real answer and would solve nothing, not to mention the effect on our loved ones and other relations.  When I had these thoughts, I'd tell myself I was meant for something better and to have a positive effect on the world (at least in some small way).  I also remind myself 90% of what we worry about never happens.

 

I've also found I'm much better at dealing with the reality of a negative life situation than I am with the anticipation and fear.  I find "reality checking" helps--try to look at a situation as if you're observing from the outside, and assess the real-world likelihood of what you fear coming true.  The reality is almost always nowhere near as bad as what your anxiety is telling you it is.

 

Finally, try to take Chessie's advice.  My therapist and I practiced CBT to help me manage my anxiety and OCD and it really helped.  We're born with anxiety so it may never 100% go away, but there are ways we can manage it and be happy, just as with any other chronic condition.  Hang in there!

[Katy398]

Thank you @mstimcand @ChessieCat, You know, having just read through the last few posts I realise I’m actually only 19 months from zero not 31, (a whole 12 months out). My level of confusion is so heightened that even attempting to sort out the stresses  I’m faced with, is clearly not possible . I’m stuck with fear and my brain is not able to think clearly. I am just going to focus on calming my nervous system for the time being. I have an appointment with a counsellor on Tuesday I will try and change them to weekly. This wave is huge, I feel like I’m back at the beginning and I’ve forgotten everything I’ve learnt and been practicing over the last year or so. Kind words are so soothing. Thank you again  for being there for me, Take care. 

[DataGuy]

I know how you feel @Katy398. I think I have just realized that I was low in sodium after deteriorating for about a month. This is a problem I had already solved two years ago but forgot... *facepalm*. Hopefully that was it. It is rough because you get so uncomfortable and stressed that it can be really tough to think straight, get motivated or even have the energy to solve the problem. Wish you best of luck with successful therapy.  : )

Edited August 1, 2020 by DataGuy

[Altostrata]

Hello, Katy, how are you doing?

[Katy398]

Thank you @DataGuy and @Altostrata, for checking in on me. I really appreciate it. I feel like I’m hanging on by a thread. This wave is huge. I’m trying to accept where I’m at  but  neuro-emotions of deep fear, cling to me with sharp claws. It feels like the early days, a rabbit in the headlights, confused terror. I really thought my self help strategies were working,  but this feels like I’m back at the beginning again. To be honest it’s shocking.  I hope you are both doing ok. Thanks again K

[Altostrata]

I'm fine. Katy, reinstating a bit of citalopram (substituting for Lexapro), perhaps 1mg to test, is still a possibility for you. Citalopram comes in a liquid so you can take very small amounts.

[mstimc]

1 hour ago, Katy398 said:

I’m trying to accept where I’m at  but  neuro-emotions of deep fear, cling to me with sharp claws

 

Katy, fear is such an atavistic and primordial emotion its very hard to overcome once it gets control of your thoughts, because it originates in the ancient "fight or flight" part of our brains.   Fighting it is almost impossible because you're trying to overcome a genetic feeling with your intellectual mind, and the genetic side includes physical as well as emotional feelings.  I've found the best way to deal with this is to constantly tell myself they're just feelings and emotions with no connection to reality.  Its not easy and I've often found myself repeating that affirmation over and over again throughout the day, until I start believing it.  But its more effective than trying to fight the feelings on an intellectual level, and certainly better than staying in my own mind giving more and more power to my negative thoughts.  Keep trying!

[Cigale]

Hello @Katy398 - I am so sorry that you are going through this. As a fellow Lexapro victim, I have been following your journey and keeping you in my heart. I also am dealing with intense anxiety and fear and can struggle to use my coping tools. Along the lines of what @mstimc has recommended, one simple thing that sometimes helps is to tell myself these feelings are just sensations in the body - like a shiver or a hot flash - and I try to breath into them. I also try to notice where I am tensing in the body - usually jaw and shoulders - and try to relax those areas. 

 

Sending you healing hugs - Cigale

[Katy398]

Thank you @Altostrata, @mstimc, @Cigale,  For coming by and trying to help. It’s so kind. Take care,  stay connected,  Warm Regards K

[Altostrata]

@Katy398, before you took Lexapro, you were on and off a series of drugs. Did you get withdrawal symptoms from any of the prior drugs?

[Katy398]

Thank you @Altostrata,

I tried to withdrawal from Prozac and went back on because I thought it was my old symptoms returning. Pristic was horrible I got anxious even if I was an hour or so late taking it. Other than that I didn’t try. Looking back now I had really difficult times changing over to another drug but then they changed me over because they realised I’d reached tolerance and was going through a difficult time managing stress so who knows what was happening. To be honest I’m actually too scared to reinstate in case I kindle and feel worse,  before I feel better. I can’t imagine I’d could cope with feeling worse than this. I’ll put my head down ‘fasten my seat belt’ and hold on tight. A moderator suggested  CBT which I’m trying to organise. Thanks for your support. I hope you are ok. Kind Regards. K

[Altostrata]

You'll probably find CBT helpful for some things, like worrying thoughts.

[Shelton]

Hey Katy! How are you? I have read your thread. You came terrified just like me after basically stopping cold turkey. I just want to say I hope you’re okay and improving. Where you able to continue working through it all? I’m struggling tremendously. Hang in there! I wish I was where you are right now. 

[Katy398]

Thank you for checking in @Shelton,

I’m at 21 months now. I can see improvements from that early terror. I still go through waves and windows,  the daily early morning cortisol rush is the hardest.  Doom and dread is horrid and an inability to manage any stress seem to be my main hurdle.

Financially I had to work but spoke to my boss and was very lucky to be able to reduce all levels of responsibility. I had many more sick days than usual, warning my boss that this may happen made it easier to accept. I actually found the routine of work a support.  My whole world was falling apart but pushing myself for work was beneficial. Not easy by any means, lots of tears and supportive phone calls on the commute but it seemed to help me in the long run. I left at midday a couple of times.

I am now working really hard on, little bite size daily routines,  to try and lift me out of a crippling lack of motivation.

 

I found the site too late to reinstate safely and I was so terrified of getting worse. I just thought any worse and I will need to be hospitalised.   Fear stopped me from reinstating. I was CTed by a psychiatrist so thought it safe!!  

I do believe we all get through this eventually and acceptance of all symptoms was my biggest breakthrough which happened over a year ago with the help of Claire Weekes. 

Take care Shelton.  you can do this ,day by day sometimes, and minute by minute other times.🌻

[mstimc]

Hi Katy

 

Great to see you're maintaining a positive attitude despite the challenges.  You will indeed get through this and be such a stronger and more resilient person for it!

[Katy398]

Sadly I’ve plummeted and suicidal ideation plagued me throughout my waking hours and sometimes even in my dreams. 

[mstimc]

Hi Katy

 

You are in a wave.  You will come out of it if you accept the reality that your suicidal thoughts are being driven by negative rumination.  You have worth in this world, to your family, your friends, and to people you haven't even met yet.

 

If you really feel suicidal, please reach out to emergency services right away!

[Katy398]

Thank you Mstimc, 

Such Kindness.

Rest assured I have a clear safety plan in place. Top of the list is talk to someone. Beyondblue have an app for this I think. 

 

[Katy398]

Is it just me?

Throughout this withdrawal my memories have been sabotaged. Why does this happen,  is it normal? Memories from my past  induce anxiety. 

Listening   to music. All my favourite bands that I used to sing along to with such joy, now triggers me. Finding old photographs  trigger me. WHY? What is going on in my brain? My son is playing a song that reminds me of the first flat I rented with my partner,  many years ago. I’m getting surges of anxiety. WHY!!! Why have all my warm, fuzzy memories been stollen from me. Is  this normal for withdrawal? I’ve had it for the majority of my 22 month journey.  I can understand why we can’t regulate our emotions yet but to replace the pleasant with pain is just so unjust. I cannot understand the  biological  reasoning.

Acceptance for me is so much easier when I understand what is happening in my brain. I can clearly understand the ‘vine on a trellis’ analogy but this is incomprehensible. Why are  all my wonderful memories  poisoning me. It’s as if a beautiful, delicate flower, blooms from that  poor battered vine, yet the scent is foul and repugnant.  If anyone has any insight,  I’d really appreciate it or ....

Is it just me?

Best wishes to you all, I am so grateful there are folk out there who understand.  

Thank you 

 

[ChessieCat]

Yes, it's reasonably common here at SA.  The other thing that seems to be fairly common is having memories about some stupid thing just pop into your head that you can't work out what made you think of it.

 

memories-from-pre-drugged-years-surfacing

 

There are many existing topics on SA.  The best way to find them is the use an internet search engine and add site:survivingantidepressants.org to the search string.  I easily found the above link just by searching memories.

 

My theory is that while we are reducing the drug the brain is busy trying to work things out.  And there are lots of things for it to work out.

 

These might help.  I particularly like the Rubik's cube analogy in the video.  With the help of a YouTube video I have managed to solve a Rubik's cube.  There are times during the process that you are sure that you've messed it up but then a couple of moves and it's getting closer.  And then last couple of moves viola! it's solved.

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

  

On 12/27/2015 at 6:37 AM, Altostrata said:

 

Basically- you have a building where the MAJOR steel structures are [...] 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 [...] to rebuild the tower - WHILE people were coming and going and [...] 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 [...] 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. 

 

 

[Johni]

@Katy398

I cannot concretely confirm this in this way. I prefer not to get anything out of me. But it’s not just the memories of the past that don’t really evoke anything from me, nor the present. It's hard to do anything like that.

[Leila]

Hi @Katy398,

two months ago I experimented such a kind of what you wrote in your last post. It seems like my mind reviewed past situations and put them under a dark light with the purpose of destroying beliefs on which I found my existence. I cried a lot. It seemed to me that I had to cry my ex-me like a person no longer alive. Maybe we had to restart and put new memories (I hope more good and good) to renew our old Us.

I would tell you that you are so strong and I admire you for your costancy!

I would ask to you if (during these years) it seemed that the feeling of doom or dread is decreased... I'm struggling with the same issues unfortunatly...

[mstimc]

5 hours ago, Katy398 said:

Acceptance for me is so much easier when I understand what is happening in my brain. I can clearly understand the ‘vine on a trellis’ analogy but this is incomprehensible. Why are  all my wonderful memories  poisoning me. It’s as if a beautiful, delicate flower, blooms from that  poor battered vine, yet the scent is foul and repugnant.  If anyone has any insight,  I’d really appreciate it or ....

Hi Katy

I think this is just another way anxious and negative thought patterns try to take us over.  The anxious mind demands attention, and will try to poison even our most pleasant thoughts and memories.  Positive thoughts and feelings rob anxiety of its power, so it does everything it can to pull you back into negative thoughts and ruminations.  I think I've mentioned it before, but its so hard to let ourselves believe its okay to feel okay.  Sometimes we need to tell ourselves, just for these few minutes I'm going to enjoy this memory and not let anxiety ruin it.  Every little victory will help!