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pattypan: wanting help with Lexapro taper

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pattypan
Posted (edited)

Admin note: link to benzo forum thread - Pattypan: Benzo Taper when it's only PRN

 

Hello, 

I am new here. I have a diagnosis of Obsessive Compulsive DIsorder- I have had this for as long as I can remember. I was first medicated for it ( in my teens) 20+ years ago. I was on and off meds throughout my teens/20's. 
In 2015- I had an OCD "episode" that scared me to death and back on medications I went. After a few trial and errors I was stable on Lexapro for 4.5 years. I recently took myself down from 30mg to 20mg ( over the course of 1 week- yes- i had headaches, involuntary movements and brain zaps).  
As of yesterday I tapered to 15mg. I am feeling pretty bad today... and I understand I should be decreasing by 10% but for some reason that seems unreasonable to me.... 
( in the past I have successfully tapered off of prozac, wellbutrin, celexa, zoloft and don't recall any of those being notable- I DO remember tapering off of Luvox was terrible) 
Any supplements or advice you may have to ease these taper symptoms? 
My goal is to be completely off of Lexapro in 1 month. Too soon? 
also- No i am not involving my doctors in this decision or this taper... I just don't trust that they know enough in regards to how to taper and they wont respect my decision to taper. 
Thanks in advance!

 

Edited by Shep
added link to benzo forum thread

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Gridley

Welcome to SA, pattypan.

 

As you know, we recommend tapering by no more than 10% of current dose every four weeks.  So, yes, by our protocols and based on our experience you are tapering way too fast.


Why taper by 10% of my dosage?

 

It is of course your decision how you taper.  Some people may be able to taper more quickly than what we recommend, but many can't and run into withdrawal problems months down the line.  This is quite common.  Will you be one of the lucky ones?  No one can tell.  That's why we recommend a harm-reduction method of 10%.  I understand that is difficult to wrap one's mind around how long a safe taper takes, but unfortunately that's the fact of the matter.   

 

Here is some information on withdrawal and the reasons why a slow taper is advisable.

 

 
 
When we take medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  
 
These explain it really well:

 

 

   On 8/30/2011 at 2:28 PM,  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.

 

Please be aware that sometime withdrawal symptoms don't appear immediately after a too-fast taper.
 
 
Lexipro is a very strong antidepressant, perhaps the strongest, and 30mg is a very high dose.  It may be that at 30mg you had more drug than you needed and that the drop to 20mg might be tolerated.   As you get into the lower doses it is increasingly important to taper more slowly.  My suggestion would be that you go back up to 20mg and hold there for several months until you stabilize, then taper using the 10% method.
 
We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium (magnesium glycerinate is a good form) and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

 

 

Please research all supplements first and only add in one at a time and at a low dose in case you do experience problems.
 
While it is often a first response to stress to take a B-Complex, in withdrawal it can be overstimulating.
 
 
Please add a drug signature, including drugs, doses, dates, and discontinuations & reinstatements in the last 12-24 months. Also include supplements. This will help us give you the most accurate advice we can.  It can be as simple as the date 4 1/2 years ago when you started Lexapro (was this at 30mg?), and you're recent taper with dates and doses.
  • Any drugs and supplements prior to 24 months ago can just be listed with start and stop years. 
  • Please use actual dates or approximate dates (mid-June, Late October) rather than relative time frames (last week, 3 months ago) 
  • Spell out months, e.g. "October" or "Oct."; 9/1/2016 can be interpreted as Jan. 9, 2016 or Sept. 1, 2016. 
  • Please leave out symptoms and diagnoses. 
  • A list is easier to understand than one or multiple paragraphs. 
  • This is a direct link to your signature:  Account Settings – Create or Edit a signature.
Please continue to use this thread to document your taper , post updates, ask questions and connect with other members.  I'm glad you found your way here. 
 
 
 
 
 

 

 

 

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pattypan

Thank you for your response. I will go back to 20mg tonight. The Quote from Rhiannon makes a lot of sense and i've never thought about it that way.... I will also look into the B-complex article. 

Thank you!
 

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Gridley
50 minutes ago, pattypan said:

Thank you for your response. I will go back to 20mg tonight. The Quote from Rhiannon makes a lot of sense and i've never thought about it that way.... I will also look into the B-complex article. 

Thank you!
 

 

Sounds good.  Please keep us updated.

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Mase77

I would definitely take it slower if I were you as well. 20 mg is considered a high dose so staying on that for awhile is a good idea. Personally, I wouldn't try a taper thats any quicker than 3 months. Its a marathon not a sprint when it comes to tapering off medication. Best of luck to you !

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Altostrata

The tapers we recommend take quite a bit longer than 3 months, see Why taper by 10% of my dosage?

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pattypan

As i am exploring this site more and more i wonder if the "episode" i had back in 1/2015 that got me back on an SSRI was relating to a fast wean from Wellbutrin and Buspar the prior year... I think it had been 6-8 months after I completely weaned... 


I will do a 10% taper. i do not want to mess with this!

 

I guess I always thought- "oh I will just feel really shitt for 2 weeks and then i will be fine." I am learning that is NOT the case- but wonder how people are able to directly correlate the wean to the new symptoms that occur weeks/months after discontinuing the medication??
 

thanks for any insight!

 

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pattypan
On 6/25/2016 at 1:43 PM, scallywag said:

Glenmullen's list is set up to identify whether a symptom was present. You could use the checkboxes to insert a rating. 
 
I've created a simple word file (.docx) that could be used to track the timing of symptoms. 1 page/day or more if needed. 
 
Clicking this link will open a download page on the Mediafire site. If you're not using an ad-blocker, you may see a very busy page. Look for the big green rectangular download button:


Daily Symptom Tracking Template

PDF of Daily Symptom Tracking Template

 

 Any way I can get a copy of these templates? links no longer work. 

 

thank you!

 

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pattypan
19 hours ago, Altostrata said:

The tapers we recommend take quite a bit longer than 3 months, see Why taper by 10% of my dosage?

 

 

i feel a little dumb asking but, oh well- SO I currently take 20mg- a 10% taper would be decreasing by 2mg every 4 weeks, correct?
 

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Gridley
1 hour ago, pattypan said:

 

i feel a little dumb asking but, oh well- SO I currently take 20mg- a 10% taper would be decreasing by 2mg every 4 weeks, correct?

 

You reduce by 10% of current dose, not the original (in your case 20mg) dose.  Your first reduction would be 10% of 20mg = 2mg, 20mg - 2mg = 18mg.  Four weeks later you would reduce by 10% of 18mg = 1.8mg, so your second reduction would be 18mg - 1.8 = 16.2mg.  And so on.  When you get down to the really small doses, 10% of current dose will be very small, which its why is takes quite a while to get down to zero.  Here's how a 10% taper from 20mg looks:

 

Month Dose
1  20.0
2 18.0
3 16.2
4 14.5
5 13.0
6 11.6
7 10.4
8 9.3
9 8.2
10 7.3
11 6.4
12 5.7
13 4.9
14 4.3
15 3.7
16 3.2
17 2.7
18 2.2
19 1.8
20 1.5
21 1.1
22 0.8
23 0.6
24 0.3
25 0.0

 

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RichT
3 hours ago, pattypan said:

I guess I always thought- "oh I will just feel really shitt for 2 weeks and then i will be fine." I am learning that is NOT the case- but wonder how people are able to directly correlate the wean to the new symptoms that occur weeks/months after discontinuing the medication??
 

 

 

Speaking personally, a big clue was that the new symptoms were unlike anything I had experienced before, so it was clearly not a recurrence of my original depression and anxiety. A second clue was that a lot of my symptoms were mentioned in descriptions of known withdrawal symptoms for my medication (Aripripazole). If you find the same for your medication, then it's a fair bet that withdrawal is to blame (or is at least a significant factor).

 

warmest wishes

 

Rich

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ChessieCat
8 hours ago, pattypan said:

Any way I can get a copy of these templates? links no longer work. 

 

The link does still work.  The download is a green rectangle at the top right of the page.  To fill it in on the computer you will need to "enable editing".  I suggest you keep a blank version of it, a "master ", and use copies.

 

However, there are some other versions which I created:

 

PDF Monthly List of Dr Glenmullen's Symptoms to Print

 

PDF Monthly List BLANK to Print
 
Excel Spreadsheet Monthly format of Dr Glenmullen's Symptoms to use on the computer

 

Please also see:  dr-joseph-glenmullens-withdrawal-symptom-checklist

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Shep

For those who are helping Patty with her antidepressant taper, please note she has started a benzo forum thread here:

 

Pattypan: Benzo Taper when it's only PRN

 

Patty, please do not reduce your antidepressant until you have worked out your benzo schedule. It's best to only make one change at a time.  Please see:

 

The rule of 3KIS: Keep it simple. Keep it slow. Keep it stable.

 

Also, please update your signature to reflect that you are currently taking .25 mg of Klonopin PRN (you posted in the benzo forum that you are only taking .25 mg and you currently have .5 mg listed in your signature). And you may want to add it to the 2019 line (right now it looks like you were only on Klonopin in 2015). 

 

Keeping your signature organized and updated helps us give you the correct tapering information. A direct link to your signature is here:

 

Account - Settings - Create or Update Your Signature

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pattypan

Done. Thank you. 

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pattypan
Posted (edited)

Topic title:  So what next?

 

I am tapering off of Lexapro. I'm scared. What will happen?

WIll the anxiety and intrusive thoughts come rushing back in? 
How do I prepare for this?
I know it will be awhile before i am completely off but i am needing advice, support, etc re: what others have been through/are going through. 

 

Thank you in advance!

 

Edited by ChessieCat
added topic title

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pattypan

When I read what everyone goes through to get off these drugs it makes me wonder if my taper is a mistake.
If i should just bite the bullet and stay on for life.....i think im scared either way. Scared of being on this and scared of the tapering WD and scared of how i will cope off of Lexapro. 

@Shep @ChessieCat @RichT any insight would be great. 

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PatriciaVP

Hi there Patty, 

I fully understand your trepidation about getting off the drugs. Reading about the struggles of others as they rid themselves of poisons disguised as treatments can be painfully disheartening. 

I have been at this for almost four years now and there have been times when I questioned my sanity for even attempting it. I have found it helpful to look at this process not as healing from an illness or injury, but as a journey- a journey back to my true self. My true self was full of creativity, drive, joy and love. The drugs took this from me, and the only way to get back there is to rid myself of them.

The experience has been like climbing a mountain. My feet are sore from stumbling over jagged rocks. Everything around me is obscured by thick fog. I find myself needing to hide in dark caves to escape terrorizing storms sometimes for days. But every once in awhile I reach a peak, the air clears and I am overwhelmed by the beauty of what's possible. 

 

This is taking a long time. I am now reducing at less than 5% of my dose every 6-8 weeks because any more is intolerable, but I am rediscovering me. I am hoping and planning again.  That which seemed impossible while on all the drugs is now flickering on the horizon. 

 

Do what's best for you. If that means tapering by less than 10 percent to avoid withdrawal symptoms then try 5, 2 or even 1 percent.  If it means staying on the drugs indefinitely that's okay too. Just don't let fear created by the experiences of others keep you from your own mountain top. You have to remember most of us only come on here when we're in pain. We're not sharing the triumphs. 

 

Peace, love and healing. 

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pattypan

@PatriciaVP Thank you for your response. I do wonder "who" i am now... I feel like knowing what i know now about protracted WD I have been on these meds since i was 15. I might not even know my self at all... I am definitely less emotional, excitable, creative than i was before this round of medication. I am scared though. Mostly scared of what the OCD and intrusive thoughts and checking behaviors will look like. the episode that got me on 30mg of Lexapro was the worst thing that has ever happened. It was worse than watching my mother die when i was 16, worse than alll the heartbreak that just sort of happens in your 20's, worse than anything i  have been through.  
i am scared that it will happen again. the thoughts, the sleeplessness, the feeling of complete insanity. 

baby steps. Maybe that episode was just protracted WD from an unsafe Wellbutrin taper... I never did my tapers with medical advice or slowly... 25% down until it was gone was typically what i did... 

If you dont mind me asking- were you on 40mg of Lexapro for OCD/Panic? are you off now? did it all come back???

Thank you for your kind words. 

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PatriciaVP

That fear makes sense especially considering what you've been through in the past. You need to remember,  however, that what the moderators are suggesting here is totally different- very slow and much easier on the system. There's no reason to believe you will react anywhere near as badly as you did in the past.

 

I went on the Lexapro originally for depression and anxiety caused by several years of upheaval in my life.  The Lexapro led to side effects which led to other labels which led to more meds and so on. You can read the whole story at www.psychfree.net. Seems like we have something in common when it comes to trauma. 

 

I am down to 5mg now from a high of 40mg, and am tapering very slowly. Less than 5% every 6-8 weeks. 

 

It didn't all come back. I'm not even sure what "it" was now, so much time has passed. 

 

Difficult and even painful emotions come up almost every day, but this process has given me the opportunity to find healthier ways to deal with them. I meditate on a regular basis and that has helped shift my view making it possible to see all emotions as informative and helpful and to respond to them in a more positive way. 

 

You need to decide what emotional health looks like for you. If you can make room in that picture for depression, anxiety, anger, etc - if you can find a way to be OK with those things- you can survive without the drugs. You may even find that you prosper. If not, you will find this process much more difficult and the outcome may not be to your liking.

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ChessieCat
Posted (edited)

It's important to learn and use non drug coping techniques.

 

Understanding what is happening helps us to not get caught up with the second fear, or fear of the fear.  This happens when we experience sensations in our body and because we don't understand them we are scared of them and then start to panic.

 

This document has a diagram of the body explaining what happens in the body when we become anxious:

 

https://www.getselfhelp.co.uk/docs/AnxietySelfHelp.pdf

 

 

Audio FEMALE VOICE:  First Aid for Panic (4 minutes)

 

Audio MALE VOICE:  First Aid for Panic (4 minutes)

 

Non-drug techniques to cope

 

dealing-with-emotional-spirals

 

Dr Claire Weekes suffered from anxiety and learned and taught ways of coping.  There are videos available on YouTube.

 

Claire Weekes' Method of Recovering from a Sensitized Nervous System

 

Audio:  How to Recover from Anxiety - Dr Claire Weekes

 

 
Resources:  Centre for Clinical Interventions (PDF modules that you can work through, eg:  Depression, Distress Intolerance, Health Anxiety, Low Self-Esteem, Panic Attacks, Perfectionism, Procrastination, Social Anxiety, Worrying)
 
On 4/28/2017 at 4:03 AM, brassmonkey said:

 

AAF: Acknowledge, Accept, Float.  It's what you have to do when nothing else works, and can be a very powerful tool in coping with anxiety.  The neuroemotional anxiety many of us feel during WD is directly caused by the drugs and their chemical reactions in the brain.  Making it so there is nothing we can do about them.  They won't respond to other drugs, relaxation techniques and the like.  They do, however, react very well to being ignored.  That's the concept behind AAF.  Acknowledge, get to know the feeling involved, explore them.  Accept, These feelings are a part of you and they aren't going anywhere fast. Float, let the feeling float off as you get on with your life as best as you can.  It's a well documented fact that the more you feed in to anxiety the worse it gets.  What starts as generalized neuroemotinal anxiety can be easily blown into a full fledged panic attack just by thinking about it.

 

I often liken it to an unwanted house guest.  At first you talk to them, have conversations, communicate with them.  After a while you figure out that they aren't leaving and there is nothing you can do to get rid of them.  So you go on about your day, working around them until they get bored and leave.

 

It can take some practice, but AAF really does work.  I hope you give it a try.

 

 

Edited by ChessieCat

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pattypan

@ChessieCat Thank you! I look forward to reviewing all of this info!

 

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pattypan

@PatriciaVPThank you for sharing your story!
I am reading through now. Wow! what a ride... these drugs/diagnoses are crazy!

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pattypan

Hard exercise DEFINITELY causes me trouble. I waled about 3.5 miles yesterday and then went to a moderately intense yoga class at 6pm. 
I was DOG tired when i got home and was in bed by 9.

I have decreased my melatonin recently- ( and brand) only taking.3mg AND my MIL talked me into trying some CBD at bedtime. 
So at 8:30 I took ~8mg CBD and .3mg Melatonin and was awakened this morning by the electrical feel beneath my skin. I remember this feeling welll. It was constant- every day in the early AMs when i was taking Luvox- not a scary feeling but pretty annoying when you are trying to sleep. 
SO anyway- had that this AM and have just NOT been able to wake up. I even took a nap on my (yoga mat on my ) office floor on my lunch break. 
Maybe I am getting sick or maybe I am just out of it!

There have been NO other changes. 
I will take the melatonin again tonight ( maybe) but i am definitely done with the CBD... I just think it makes me feel weird....

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pattypan

Iam 35 days off Benzos ( was taking .25 Klonopin 4-5 nights/week for around 7 months) I have a few symptoms that are either from AD withdrawal or Benzo withdrawal. ( mostly right cheek numbness- not all the time mostly in the evening or afternoons and sometimes body buzz when waking up) 
Yesterday was VERY weird for me. I was SO tired. SO tired that on my lunch break- i closed my door- rolled out my yoga mat and fell into a DEEEP sleep for at least 30 minutes. I continued to feel realllly sleepy all afternoon and got in bed by 8pm. i tossed and turned until 1130- no screens on, no tv, no lights- normal bedtime ( and i typically sleep okay). 
io hope it isn't insomnia kicking in... I HAVE to have good sleep! 
Thoughts? 
@Shep @ChessieCat
 

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