Chris90: story and Lexapro withdrawal

[Altostrata]

Chris, I am struck by your absolutely classic case of post-acute withdrawal syndrome.

 

We seldom see such clear examples of the progress of recovery from PAWS because people so often take other drugs to treat it and the prescription cascade becomes very complicated.

 

You are experiencing classic waves and windows. Please do come back as soon as you can and give as much detail as possible. You're a classic!

 

On 6/4/2019 at 11:36 AM, Chris90 said:

Time to post an update I guess.

 

Yesterday I went to my biweekly visit with a psychologist.  As embarrassing as it was, I told him all about my PSSD issues.  He basically told me that because I’ve been reading and obsessing about this so much and increasing my anxiety levels, it has become psychogenic, and that what I was describing wasn’t possible.  He guaranteed me these problems will go away(specifically promised on his left nut lmao), but that I needed to get back to the lifestyle I was living while I was on the SSRI, start eating and drinking again, which I haven’t been doing much of for a couple weeks, and to keep away from anything related to PSSD.  I didn’t really believe him.  In fact I was pretty crushed to hear his response based on his level of experience.  He also told me I couldn’t be going through withdrawal anymore, which I 100% disagree with him on, since today I’ve had some mild shocks.  He also told me my 3 month taper off of 20mg Lexapro was considered slow.

 

So I followed his advice since yesterday, and I’m happy to report that I just experienced a 90% reduction in PSSD symptoms.  The only real issue I had was finishing, but I still got there without too much trouble.  Everything else was in the 90%-100% normal range.  Maybe the psych is onto something.  I’m still having the cortisol mornings, and general anxiety throughout the day though, which really sucks.  I think the high cortisol has probably messed up my hormones for the time being.  It’s almost like it has hijacked my brain.

 

This psychologist knows absolutely nothing about post-acute withdrawal syndrome, but if he managed to teach you some stress reduction tips, that's a good thing.

 

It could be that you relaxed a bit after seeing this person and that helped your nervous system and the PSSD along. Adding anxiety over PAWS to the anxiety generated by PAWS does make it all worse.

 

Other than that, I don't think this guy has any secret sauce for addressing PAWS.

 

19 hours ago, TriD said:

his tapering doesnt look right...

From 15mg - 5mg in 3months has little effect as the drop should be at the LOW doses. 

if he drop from 5mg to 0mg in 1month in April/May it means he is dropping at a 60%+ 5HTT blockage to 0% in 1month, thats almost cold turkey.

 

Id ask did he felt anything from 20mg - 5mg, I doubt he did - thats only 80%-60% with 60% still buffering ... but it would hit hard at 5mg - 0mg.

probably going through WD now and another 1-2+ months because of this taper, its commonly prescribed but its WRONG.

final taper should be 5mg, 2.5mg, 1.75mg, 1mg, 0.5mg, 0.25mg, 0mg .. id suggest over 3months.

 

See my attached PDF...

 

Chris90

June 2018 - Began 20mg Lexapro, multivitamin(1 daily), fish oil(3 x 1g daily).

February 2019 - Tapered to 15mg Lexapro.

March 2019 - Tapered to 10mg Lexapro.

April 2019 - Tapered to 5mg Lexapro.

May 2019 - Stopped taking Lexapro.

 

 

Doc2.pdf 90.09 kB · 4 downloads

 

Thanks for that hard work, TriD. Yes, it does look like those SERT curves are at least a metaphor for neurological adaptation to SSRIs. But the same trajectories for tapering seem to hold true for drugs that don't act on SERT. Hmmmm?

 

Please note that while the SERT curve theory might apply on a statistical average, there is inevitably a wide range  individual variation. We don't know where the saturation plateau is for any individual and we don't know where the plunge is, either. So we go slow the whole way.

 

One way or another, we do know that Chris's nervous system did not have time to adapt during his taper, because he has PAWS.

 

I'm happy to see that it looks like you're on a recovery arc, Chris. Please think of your nervous system as in a vulnerable healing stage, don't do anything that will cause unusual stress, let it continue to settle down.

 

A lot of people find fish oil and magnesium supplements helpful, see

https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/
https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

Try a little bit of one at a time to see how it affects you.

 

[Chris90]

48 minutes ago, Altostrata said:

Chris, I am struck by your absolutely classic case of post-acute withdrawal syndrome.

 

We seldom see such clear examples of the progress of recovery from PAWS because people so often take other drugs to treat it and the prescription cascade becomes very complicated.

 

You are experiencing classic waves and windows. Please do come back as soon as you can and give as much detail as possible. You're a classic!

 

 

This psychologist knows absolutely nothing about post-acute withdrawal syndrome, but if he managed to teach you some stress reduction tips, that's a good thing.

 

It could be that you relaxed a bit after seeing this person and that helped your nervous system and the PSSD along. Adding anxiety over PAWS to the anxiety generated by PAWS does make it all worse.

 

Other than that, I don't think this guy has any secret sauce for addressing PAWS.

 

 

Thanks for that hard work, TriD. Yes, it does look like those SERT curves are at least a metaphor for neurological adaptation to SSRIs. But the same trajectories for tapering seem to hold true for drugs that don't act on SERT. Hmmmm?

 

Please note that while the SERT curve theory might apply on a statistical average, there is inevitably a wide range  individual variation. We don't know where the saturation plateau is for any individual and we don't know where the plunge is, either. So we go slow the whole way.

 

One way or another, we do know that Chris's nervous system did not have time to adapt during his taper, because he has PAWS.

 

I'm happy to see that it looks like you're on a recovery arc, Chris. Please think of your nervous system as in a vulnerable healing stage, don't do anything that will cause unusual stress, let it continue to settle down.

 

A lot of people find fish oil and magnesium supplements helpful, see

https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/
https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

Try a little bit of one at a time to see how it affects you.

 

Thank you for posting on my thread, and thank you for the support you offer with this website.  It really helps to have such a large support group with people who can relate to what I’m experiencing.

 

The psychologist does know some stuff about post accute withdrawal.  He specifically mentioned Paxil and I immediately thought of your story.  However, he thinks post accute withdrawal is something that resolves over a few months at most, and that Lexapro is very easy to get off of, even from 10mg.

 

As far as PSSD goes, I think at a minimum he’s partially correct.  On Monday and Tuesday after I sort of put my faith in what he told me, started eating and drinking normally again, and stayed away from anxiety inducing PSSD content, PSSD almost vanished for me by Tuesday around noon.  Today, I didn’t eat breakfast for 3 hours after waking, only had a slice of ham, looked at more PSSD content, and sure enough, the symptoms all worsened.  

 

There are a variety of factors at play here in my opinion, and they all enhance each other.  The key factor is cortisol.  Cortisol drives my fight or flight response, makes me not eat or drink because of how anxious I get, lowers testosterone, and drives me to look at PSSD content, which keeps cortisol sky high.  Being in fight or flight or near a panic attack kills sexual functioning entirely.  Not eating keeps vitamin levels deficient, especially vitamin B, which can cause the whole nervous system to work poorly, most noticeably at the peripheral level.  Low testosterone also produces symptoms identical to PSSD, including numbness, which for me isn’t actually numbness as I can still feel pinches just fine, there just isn’t as much of a pleasurable feeling.  When all of these things keep driving each other, the symptoms worsen.  I got stuck in this loop for around 2 weeks, and the dysfunction I experienced got worse over that two week period until it was indistinguishable from what I experienced when I first started taking Lexapro.  

 

I’m still taking the fish oil and magnesium.  The magnesium especially seems to have a calming effect.

 

Thank you again, Altostrata.

 

 

 

 

 

[TriD]

For me there are some tell tale signs that my body is still recovering and it isn’t just my anxiety over this, and it’s been quite a traumatic experience to say the least.

 

when I dropped to zero, I got insomnia after 2 days which lasted about 2 weeks with vivid dreams and nightmares quite frequent and waking 4hrs at a time, which I know for me is typically lexapro. That faded in time and now I’m sleeping well and dreams are gone.

 

my nervous system is still sensitive as any supplement I take even at small doses causes agitation for hours later, and I’ve tried every supplement known. 

 

Still get get some morning depression and sad thoughts as serotonin is lowest during waking. All the above I never had before I started psyche meds and it’s clear it isn’t anxiety related as they are physical symptoms, but overall I am fine.

 

it would take 1-2 months for all these things to fade, I notice the changes can be quite slow, and stressing about symptoms tend to make things worse.

 

so I guess I would say if you are keeping positive then just stick with what you are doing and just let time pass. Best approach imo is if you can just go about life and not even be aware of it, and it will just vanish in time. That would be best outcome

[Altostrata]

On 6/5/2019 at 2:00 PM, Chris90 said:

There are a variety of factors at play here in my opinion, and they all enhance each other.  The key factor is cortisol.  Cortisol drives my fight or flight response, makes me not eat or drink because of how anxious I get, lowers testosterone, and drives me to look at PSSD content, which keeps cortisol sky high.  Being in fight or flight or near a panic attack kills sexual functioning entirely.  Not eating keeps vitamin levels deficient, especially vitamin B, which can cause the whole nervous system to work poorly, most noticeably at the peripheral level.  Low testosterone also produces symptoms identical to PSSD, including numbness, which for me isn’t actually numbness as I can still feel pinches just fine, there just isn’t as much of a pleasurable feeling.  When all of these things keep driving each other, the symptoms worsen.  I got stuck in this loop for around 2 weeks, and the dysfunction I experienced got worse over that two week period until it was indistinguishable from what I experienced when I first started taking Lexapro.  

 

You're overthinking this. Stop looking at PSSD content. Look at videos of puppies and kittens instead. Also, eat a lot of leafy green veggies.

[Chris90]

19 hours ago, Altostrata said:

 

You're overthinking this. Stop looking at PSSD content. Look at videos of puppies and kittens instead. Also, eat a lot of leafy green veggies.

>tfw big brain ruminator

[Altostrata]

Seems about right.

[Chris90]

So I now see the psychologist once per week instead of biweekly.  Just got home.

 

I presented him with what my symptoms over this past week have been and what I think is causing them.  I have to say I’m feeling pretty good to get some acknowledgement from a professional.

 

I told him about the PSSD issues.  Since having almost normal functioning and feeling on Tuesday, my functioning went back to normal, but feeling dropped significantly.  I also told him about the anhedonia, lower than usual appetite, rumination, lack of motivation, inability to concentrate, etc.  He agrees with me 100% that I have low dopamine, desensitized D2 receptor sites, and low T.  He also acknowledged that SSRI’s lower dopamine over time, and, get ready for this, you aren’t going to believe it...he believes I’m in post accute withdrawal!

 

The bad news is that I have quite a hole to dig my way out of.  I have to cut way back on nicotine and anything else that causes a dopamine spike.  I’m vaping the equivalent of around 80 cigarettes per day.  This has to come back down to about 20 cigarettes per day.  Soda has to go completely.  I guess I’ll be drinking black coffee now.  The 30 pounds I gained on Lexapro has to go as well.  Looks like I’ll have to get in shape and stay in shape.  This is going to be rough.

[Altostrata]

Hello, @Chris90, how are you doing?