LouieC: Between a Rock and a Hard Place

[LouieC]

Looking for advice and reassurance.  Came off Xanax cold turkey after 4 months (took as presecribed).  Bad withdrawal landed me on zyprexa and ambien for a month. Tapered off.  Developed bad tinnitus during taper.  Intermittent.  Was put on escitalopram; titrated up to 15 mg over three months.  Became toxic, developed akathisia and severe, constant tinnitus.  Tests showed I am a poor metabolizer of E.  Doctor ordered immediate taper; have gone from 15 mg to 1.25 mg (liquid) in 2.5 months.  Akathisia has diminished, but still comes in waves ( though not as intense now) tinnitus is better but is reactive to sound and often gets bad.  With each drop I have gotten flu like symptoms which have cleared in about two weeks.  Hoping akathisia and tinnitus completely clear when get off the E. Been at 1.25 mg for 5 days — want to get off. Will A and T clear ?  I know taper has been fast —  am I doing more damage by getting off quickly ? Between a rock and a hard place.  E has done nothing but hurt me.  Akathisia and tinnitus have been disabling.  Am worn down.  Docs not much help.  Want life back.  Thanks.  

[Shep]

Hi, Louie.

 

Welcome to Surviving Antidepressants. 

 

Yes, the akathisia and tinnitus will get better over time. It sounds like some of it may be an adverse reaction, as you note. Whether a faster taper will cause fewer problems than the adverse reaction is hard to tell. We'll need more information and then we can better guide you in your taper.

 

Here is some information to get you started:

 

Tips for tapering off Lexapro (escitalopram)

 

Why taper by 10% of my dosage?

 

How psychiatric drugs remodel your brain

 

Healing from antidepressants. Patterns of recovery video (4 minutes)

 

The Windows and Waves Pattern of Stabilization

 

We don't recommend a lot of supplements, as many members report their nervous systems are simply too fragile to handle them. However, magnesium and fish oil tend to be calming to the nervous system and many people report they do help. Please only add in one supplement at a time and at a small dose. For more, please see:

  

 King of supplements: Omega-3 fatty acids (fish oil)

 

Magnesium, nature's calcium channel blocker

 

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Please continue to use this thread to document your taper and to ask questions. 

 

[LouieC]

Shep—thank you !   I have added and saved a signature.  Yes, have had bad reaction to the escitalopram.  Akathisia and tinnitus somewhat improved as I have come down in dose but still very difficult to bear.  Have also had what appear to be withdrawal symptoms.  Docs not knowledgeable.  Am housebound.  Need advice.  Thanks.  

[LouieC]

Shep, I edited signature so it is easier to read.  Thx. 

[Shep]

Thanks for adding your signature, Louie.

 

21 hours ago, LouieC said:

Akathisia and tinnitus somewhat improved as I have come down in dose but still very difficult to bear.  Have also had what appear to be withdrawal symptoms.  Docs not knowledgeable.  Am housebound.

 

I'm glad you're feeling a bit better from the akathisia and tinnitus, but what symptoms do you have that are keeping you housebound? 

 

On 5/12/2019 at 3:47 PM, LouieC said:

Been at 1.25 mg for 5 days — want to get off.

 

Your decrease was from 2.5 mg on April 17 down to 1.25 mg, which is a 50% reduction. Please note we only recommend reduction by 10% or less each month. The 10% is off the previous dose (not the original dose). 

 

Compared to before you made this last reduction, are you feeling overall better? 

 

If not, you're in a safe time period to go back up in dose, especially since your last reductions have been very rapid.

 

The other option is to hold until more of your symptoms resolve. The goal is to get you to what we call a "Withdrawal Normal" baseline. Please see:

 

WDNormal

[LouieC]

Symptoms keeping me housebound:  mood terrible.  Agitation / nervous.  Tinnitus disabling at times.  Unable to concentrate.  Went down to 1.25 on May 6.  Akathisia is better but still comes in waves, though less intense.  T seems marginally better but still disabling ( on top of agitation/ nervousness).  Felt ok for 3 days after the drop to 1.25 but have felt worse since.  Think I will hold until more symptoms resolve.  I have never felt well on E ( akathisia and T primarily) so don’t want to go back up if can help it.  Been 9 days since last drop.  Hoping symptoms start to ease up soon.  Trying to figure out size of next drop.  A and T are awful.  Really want to just jump off but afraid of the pain.   Any further advice is most welcome.  Thank you Shep.   

[Shep]

23 hours ago, LouieC said:

Felt ok for 3 days after the drop to 1.25 but have felt worse since.  Think I will hold until more symptoms resolve.  I have never felt well on E ( akathisia and T primarily) so don’t want to go back up if can help it.  Been 9 days since last drop.

 

Are you overall feeling better at the lower dose? 

 

If so, than holding sounds like a good option. It's very hard to tell if a rapid taper for an adverse reaction is going to be easier on the nervous system than updosing and tapering more slowly. Withdrawal can sometimes bring worse symptoms than the adverse reaction, so please let us know how you're doing over the coming days. 

 

Are you taking any supplements? If so, please let us know the name and doses and when you started taking them. 

[LouieC]

Shep:  am feeling better at the lower dose, but today is the first day ( 10 days since  drop to 1.25).  Akathisia has eased, mood still unsteady.     Tinnitus has been bad.  Very intrusive and puts cns on edge.  Like nails on a chalkboard.  What is your experience regarding whether and how long it takes for T to resolve ?  Anything I can do ?   Going to hold for a little while at 1.25 but T ( and residual A) is driving me to move off as soon as I can.  Thoughts ?  

Am on fish oil and magnesium (400 mg / day) for the last 45 days (approx).  

[LouieC]

Shep:  yesterday was good.  Ears less problematic; headache but not much more.  Out and about.   Today is bad.  Ears bad; headache, neck pain, mood.  Housebound.  

[Shep]

On 5/16/2019 at 11:39 AM, LouieC said:

What is your experience regarding whether and how long it takes for T to resolve ?  Anything I can do ?

 

Unfortunately for a lot of us, tinnitus can be one of the last symptoms to fade away. I still have it at 4 years off all drugs, but it's not nearly as bad and most days, I don't even think about it. It's become background noise that doesn't bother me. 

 

Here is some information that may help:

 

Tinnitus, another ear problem. What does all that noise mean?

 

I sleep with a fan running, which helps. Other people use white noise. Here's an example:

 

Sleep Sounds Deep White Noise | Fall Asleep & Remain Sleeping All Night | 10 Hours (video)

 

You can also get white noise apps for your cell phone. I also like listening to apps that have nature sounds such as pouring rain, which can help mask the tinnitus sound. 

 

On 5/16/2019 at 11:39 AM, LouieC said:

Am on fish oil and magnesium (400 mg / day) for the last 45 days (approx).  

 

Did these help your symptoms? Or were your symptoms so bad, that you couldn't tell? 

 

16 hours ago, LouieC said:

Shep:  yesterday was good.  Ears less problematic; headache but not much more.  Out and about.   Today is bad.  Ears bad; headache, neck pain, mood.  Housebound.  

 

Looks like you're getting some windows and waves activity, which is very normal during withdrawal. 

 

This may help with the "how long does it last" questions.

 

Are We There Yet? How Long is Withdrawal Going to Take?

 

Sometimes just knowing that your symptoms are normal can take some of the anxiety away. 

 

On 5/16/2019 at 11:39 AM, LouieC said:

Shep:  am feeling better at the lower dose, but today is the first day ( 10 days since  drop to 1.25).  Akathisia has eased, mood still unsteady.     Tinnitus has been bad.  Very intrusive and puts cns on edge.  Like nails on a chalkboard.

 

Please let us know how you're doing over the coming days. If you feel you would benefit from an updose, please post.

 

Otherwise, continue to hold and hopefully, you'll see more of those good days. 

 

[LouieC]

Shep:  Thank you.  The tinnitus is consistently the worst symptom.  Very loud; very bad.  Please tell me it fades faster than 4 years for some.....   Today feels like another good day.  So far.  Dr Glenmullen, in his book The Antidepressant Solution, writes about a different tapering pace, and does not mention post taper WD timelines as long as those I have seen on this website.  Am curious about why, if you know.  Thank you for all of the advice.  

[Shep]

Dr. Glenmullen's book is 13 years old and he's thinking about doing an updated version. This is Alto's thread about it:

 

The Antidepressant Solution by Dr. Joseph Glenmullen (Coming Off Antidepressants in UK)

 

Since you've read the book, please feel free to post your thoughts. 

 

On 5/18/2019 at 11:10 AM, LouieC said:

Shep:  Thank you.  The tinnitus is consistently the worst symptom.  Very loud; very bad.  Please tell me it fades faster than 4 years for some.....   Today feels like another good day.  So far.

 

Does the tinnitus keep you awake at night? 

[LouieC]

Shep:  no the tinnitus does not keep me up at night; rather, it diminishes in quiet environments, for the most part.  There is a high pitched squeal / hiss that reacts to sound.  There is a lower pitched constant hum/ring that does not.  In the morning when I wake up it is almost non existent.  But within minutes of getting up it is loud again.  Ears are also full most times, occasional pain and cracking.   

[LouieC]

Shep:  thanks for the link to the thread on Dr Glenmullens book.  His tapering schedule is much faster than what is recommended on SA.  In any revised version of his book he should consider and address the difference in views.  My problem is that I have had an adverse reaction to the E.  Like Karen in chapter 4 of his book, I became toxic.  I have never felt well on it.  Too stimulating for me, plus the tinnitus.  Would prefer a slower taper, but the E has hurt me.  Plan to hold at 1.25 until WD symptoms calm down, then  need to drop again.  Not sure by how much.  Will see how I feel I guess.  

[Shep]

14 hours ago, LouieC said:

Shep:  no the tinnitus does not keep me up at night; rather, it diminishes in quiet environments, for the most part.  There is a high pitched squeal / hiss that reacts to sound.  There is a lower pitched constant hum/ring that does not.  In the morning when I wake up it is almost non existent.  But within minutes of getting up it is loud again.  Ears are also full most times, occasional pain and cracking.   

 

I'm glad you're able to sleep without being bothered with the tinnitus.

 

If you work, are you able to use white noise in the background to help with the tinnitus while you're working? 

 

14 hours ago, LouieC said:

 Plan to hold at 1.25 until WD symptoms calm down, then  need to drop again.  Not sure by how much.  Will see how I feel I guess.  

 

Sounds like a good plan. You can go as slow as you need to. 

 

[LouieC]

Haven’t been able to work, between reaction to E and WD symptoms.    At work HVAC sets off the T.  Been struggling with it.  Hoping it diminishes as income down on the E.  Thanks Shep.