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Katy398

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

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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!

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Erell
Posted (edited)

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 by ChessieCat
added quote for context

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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. 

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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.

 

 

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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

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ChessieCat
Posted (edited)

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 by ChessieCat

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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

 

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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

 

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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

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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.

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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 

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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.

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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!

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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. 

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DataGuy
Posted (edited)

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 by DataGuy

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