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nofriendsphoebe: Third time tapering off Escitalopram(Cipralex/Lexapro)


nofriendsphoebe

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Original title:  Just tapered off last 5 mg Escitalopram/Lexapro, strugging!

(mod note- 2019 October title ^, title updated to most recent title from 2021 July)

 

New to this forum, hope I'm doing this right!  I've been on 10mg of Escitalopram (Lexapro) for 5 years, prescribed at 21. About a year ago I went down to 5mg, and 3 weeks ago I stopped taking the 5mg. 

 

I was told that 5mg was an okay dose to taper up/down (it's only half a pill!) but now being on here I'm worried I should have tapered more and not just stopped taking the 5mg. I had some physical symptoms of withdrawal the first week I stopped, which went away, but my anxiety returned this week and has been pretty destabilizing. It's worse in the morning and then gets better in the evening. 

 

I'm not sure if I should ride it out or take a little more (2.5mg?) for a few weeks/months and then taper down...

Edited by manymoretodays
see mod note, updated title after merging Introductions

2014 - started 10mg Escitalopram

2015-2017 - 15mg

2017 - feel lethargic; go down to 10mg, no WD symptoms 

2018 - try quitting cold turkey; bad WD, reinstate at 5mg  

2019 -2021 try to taper off too quickly, reinstate at 2.5mg and hold; few WD symptoms (headaches, GI symptoms, bouts of panic) but mostly windows!

2022: switch to liquid to begin tapering from 2.5 ML (didn't bridge from pill form first which may have led to more WD symptoms)

- Jan-March 2.3ML; GI symptoms (diarrhea, heartburn, stomach cramps); some panic/hypochondria; 

- March: 2.2ML; begin getting constant vertigo. take a steroid for two days at advice of ENT and have big setback 

Currently: 2.6 ML and holding 

Supplements: B12 and D3 for deficiencies; Magnesium 400mg + B2 400mg for migraines; fish oil 

 

Link to comment
  • Moderator Emeritus

Hello   Phoebe   and welcome to SA.

 

This site is run entirely by volunteer Administrators and Moderators, all have been through or going through withdrawal.

There are no commercial interests or influences  involved .

 

Why were you prescribed Escitalopram originally?

 

On 10/30/2019 at 1:53 AM, nofriendsphoebe said:

I was told that 5mg was an okay dose to taper up/down (it's only half a pill!)

I presume it was a doctor or psych who told you this.

Escitalopram is a very powerful drug and going up and down by 5mgs is definitely not a good idea.

On 10/30/2019 at 1:53 AM, nofriendsphoebe said:

my anxiety returned this week and has been pretty destabilizing. It's worse in the morning and then gets better in the evening. 

Classic W/D ( withdrawal symptoms ). The morning is because Cortisol spikes to wake you up, and reduces during the day before Melotonin is produced to help you sleep.

On 10/30/2019 at 1:53 AM, nofriendsphoebe said:

About a year ago I went down to 5mg, and 3 weeks ago I stopped taking the 5mg. 

Did you experience any symptoms after this reduction?

On 10/30/2019 at 1:53 AM, nofriendsphoebe said:

 

I'm not sure if I should ride it out or take a little more (2.5mg?) for a few weeks/months and then taper down..

Unfortunately it is likely that the symptoms will increase if you do nothing.

Please see

dr-joseph-glenmullens-withdrawal-symptom-checklist/

Reinstatement is definitely the best way forward.

about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms/

the-windows-and-waves-pattern-of-stabilization/

the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable/

why-taper-by-10-of-my-dosage/

If you have 10mg pills available a 2.5 mg dose would be a good idea.

I suggest you do this as soon as possible to mitigate symptoms.

It is important to understand your CNS ( central nervous system ) is already destabilised and this is not an instant fix.

It will take time for  your system to settle around the new dose.

Please keep a written diary of your symptoms in the following format as we will ask you to post this if you reinstate.

DATE:

 

6 a.m. Woke with anxiety 5
8 a.m. Took 2.5mg Lexapro
10 a.m. Stomach is upset
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Feel a bit better
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache 3
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Feeling dizzy 6
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke but got back to sleep

 

Please feel free to browse the site, it is a wealth of info.

Other members threads will give you an insight and the opportunity to share experiences.

 

Please advise us of your decision.

 

Again welcome.

 

Sassenach

 

Escitalopram 10mgs from mid 2007 ( can't remember exact date) to 11th Dec 2018

Fentanyl patches ( don't remember dose ) from Nov 2014 to 11 Dec 2018

Quit both cold turkey Dec 2018

Reinstated 3rd March 2019 2.5 mgs.

Updosed  8March to 5mgs and holding

25/11/19 Started taper 4.5mgs and holding

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner

If you are going through Hell, keep going. NCIS series 15, David MaCallum:rolleyes:

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Thanks for your comments! I was prescribed at 21 for school-related anxiety. It was both a psychiatrist and research online that made me decide to taper down my 5mg -- I was told being on 5mg only is basically not a therapeutic dosage, more like placebo (clearly not true!). The first time I tapered down I did it too fast (from 10mg to 0mg in the span of a couple months) and had a huge resurgence of anxiety, but when I went back just on 5mg for the past year I was doing great. 

 

I've been feeling better today and yesterday -- less panic in the morning, able to get through the day -- but still higher anxiety than on 5mg. I'm under a lot of stress right now with grad school midterms and relationship stuff, which isn't helping. I'm still wary of reinstating because I don't want to have to do this all over again, but I will reconsider -- so the idea is that not reinstating by 2.5 could mean longer & worse W/D  in the long tern?

 

On 10/31/2019 at 1:55 PM, Sassenach said:

Hello   Phoebe   and welcome to SA.

 

This site is run entirely by volunteer Administrators and Moderators, all have been through or going through withdrawal.

There are no commercial interests or influences  involved .

 

Why were you prescribed Escitalopram originally?

 

I presume it was a doctor or psych who told you this.

Escitalopram is a very powerful drug and going up and down by 5mgs is definitely not a good idea.

Classic W/D ( withdrawal symptoms ). The morning is because Cortisol spikes to wake you up, and reduces during the day before Melotonin is produced to help you sleep.

Did you experience any symptoms after this reduction?

Unfortunately it is likely that the symptoms will increase if you do nothing.

Please see

dr-joseph-glenmullens-withdrawal-symptom-checklist/

Reinstatement is definitely the best way forward.

about-reinstating-and-stabilizing-to-reduce-withdrawal-symptoms/

the-windows-and-waves-pattern-of-stabilization/

the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable/

why-taper-by-10-of-my-dosage/

If you have 10mg pills available a 2.5 mg dose would be a good idea.

I suggest you do this as soon as possible to mitigate symptoms.

It is important to understand your CNS ( central nervous system ) is already destabilised and this is not an instant fix.

It will take time for  your system to settle around the new dose.

Please keep a written diary of your symptoms in the following format as we will ask you to post this if you reinstate.

DATE:

 

6 a.m. Woke with anxiety 5
8 a.m. Took 2.5mg Lexapro
10 a.m. Stomach is upset
10:30 a.m. Ate breakfast
11:35 a.m. Got a headache, lasted one hour
12:35 p.m. Ate lunch
4 p.m. Feel a bit better
5 p.m. Took 2.5mg Lexapro
6 p.m. Ate dinner
9:20 p.m. Headache 3
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Feeling dizzy 6
10:30 p.m. Fell asleep
2:30 a.m. Woke, took 3mg Ambien (NOT "took 1/2 tablet Ambien")
2:45 a.m. Fell asleep
4:30 a.m. Woke but got back to sleep

 

Please feel free to browse the site, it is a wealth of info.

Other members threads will give you an insight and the opportunity to share experiences.

 

Please advise us of your decision.

 

Again welcome.

 

Sassenach

 

 

2014 - started 10mg Escitalopram

2015-2017 - 15mg

2017 - feel lethargic; go down to 10mg, no WD symptoms 

2018 - try quitting cold turkey; bad WD, reinstate at 5mg  

2019 -2021 try to taper off too quickly, reinstate at 2.5mg and hold; few WD symptoms (headaches, GI symptoms, bouts of panic) but mostly windows!

2022: switch to liquid to begin tapering from 2.5 ML (didn't bridge from pill form first which may have led to more WD symptoms)

- Jan-March 2.3ML; GI symptoms (diarrhea, heartburn, stomach cramps); some panic/hypochondria; 

- March: 2.2ML; begin getting constant vertigo. take a steroid for two days at advice of ENT and have big setback 

Currently: 2.6 ML and holding 

Supplements: B12 and D3 for deficiencies; Magnesium 400mg + B2 400mg for migraines; fish oil 

 

Link to comment

Update: I have reinstated at 2.5 mg, will keep a log of symptoms :)

2014 - started 10mg Escitalopram

2015-2017 - 15mg

2017 - feel lethargic; go down to 10mg, no WD symptoms 

2018 - try quitting cold turkey; bad WD, reinstate at 5mg  

2019 -2021 try to taper off too quickly, reinstate at 2.5mg and hold; few WD symptoms (headaches, GI symptoms, bouts of panic) but mostly windows!

2022: switch to liquid to begin tapering from 2.5 ML (didn't bridge from pill form first which may have led to more WD symptoms)

- Jan-March 2.3ML; GI symptoms (diarrhea, heartburn, stomach cramps); some panic/hypochondria; 

- March: 2.2ML; begin getting constant vertigo. take a steroid for two days at advice of ENT and have big setback 

Currently: 2.6 ML and holding 

Supplements: B12 and D3 for deficiencies; Magnesium 400mg + B2 400mg for migraines; fish oil 

 

Link to comment
  • Altostrata changed the title to nofriendsphoebe Just tapered off last 5mg of Escitalopram/Lexapro, struggling!
  • 2 weeks later...

Update: I have kept up with the 2.5 mg for 2 weeks. All of my anxiety symptoms have subsided, I am sleeping well and eating normally again, but I am feeling depersonalized and lethargic. I believe I may have reinstated at too high a dose. I read here that I should stay on this dose for at least another two weeks before tapering, but the lethargy is really intense. I wonder if I should lower to 2mg?

2014 - started 10mg Escitalopram

2015-2017 - 15mg

2017 - feel lethargic; go down to 10mg, no WD symptoms 

2018 - try quitting cold turkey; bad WD, reinstate at 5mg  

2019 -2021 try to taper off too quickly, reinstate at 2.5mg and hold; few WD symptoms (headaches, GI symptoms, bouts of panic) but mostly windows!

2022: switch to liquid to begin tapering from 2.5 ML (didn't bridge from pill form first which may have led to more WD symptoms)

- Jan-March 2.3ML; GI symptoms (diarrhea, heartburn, stomach cramps); some panic/hypochondria; 

- March: 2.2ML; begin getting constant vertigo. take a steroid for two days at advice of ENT and have big setback 

Currently: 2.6 ML and holding 

Supplements: B12 and D3 for deficiencies; Magnesium 400mg + B2 400mg for migraines; fish oil 

 

Link to comment
  • Moderator Emeritus

Hi Phoebe

 

Good to hear you are feeling somewhat better.

DP & DR are normal W/D symptoms.

derealization-or-depersonalization-dr-and-dp/

I am also on Escitalopram and lethargy was an issue for me, much improved now.

1 hour ago, nofriendsphoebe said:

I believe I may have reinstated at too high a dose. I

If the dose was too high you would be experiencing adverse reactions, but the symptoms you describe are W/D normal.

1 hour ago, nofriendsphoebe said:

I read here that I should stay on this dose for at least another two weeks before tapering

You should stay on this dose until your symptoms are stable ie. not varying from day to day.

This may take months rather than weeks but you will feel better as your CNS settles.

The following will help you understand what is happening in your brain and why it takes so long.

On 8/30/2011 at 8:28 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.

On 12/3/2015 at 3:41 PM, apace41 said:

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

 

If you begin to taper too early you will re-enter withdrawal and have to start all over again.

You are reacting quickly and well to the re-insatatement.

I know patience is not easy for the young but is the only way here.

Please keep us updated.

Sassenach

Escitalopram 10mgs from mid 2007 ( can't remember exact date) to 11th Dec 2018

Fentanyl patches ( don't remember dose ) from Nov 2014 to 11 Dec 2018

Quit both cold turkey Dec 2018

Reinstated 3rd March 2019 2.5 mgs.

Updosed  8March to 5mgs and holding

25/11/19 Started taper 4.5mgs and holding

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner

If you are going through Hell, keep going. NCIS series 15, David MaCallum:rolleyes:

Link to comment
  • ChessieCat changed the title to nofriendsphoebe: Just tapered off last 5mg of Escitalopram/Lexapro, struggling!
  • 1 year later...

Third time tapering off Escitalopram(Cipralex/Lexapro)

(mod note ^ new topic title, merged with previous Introduction)

 

Hi! I'm finally trying to get fully off of Escitalopram. I've been on doses of 5-15mg for the past 7 years - last year I tried to taper off and went too quickly, and I've now been stuck on 2.5mg for the past year or so. I'm hoping for help coming up with a schedule and understanding how to use a syringe (my pills come in 10mg form that are breakable in the middle to make 5mg halves - I can't replace them because I'm living internationally). 

 

Is it still good practice to do a 10% decrease even on such a low dosage? And I'd dissolve 5mg in 5ml water? If I understand correctly a withdrawal schedule would then still be over a year, which feels SUPER daunting.

 

Advice appreciated! 

 

 

 

Edited by manymoretodays
name to title, merged Intro's most recent to first)

2014 - started 10mg Escitalopram

2015-2017 - 15mg

2017 - feel lethargic; go down to 10mg, no WD symptoms 

2018 - try quitting cold turkey; bad WD, reinstate at 5mg  

2019 -2021 try to taper off too quickly, reinstate at 2.5mg and hold; few WD symptoms (headaches, GI symptoms, bouts of panic) but mostly windows!

2022: switch to liquid to begin tapering from 2.5 ML (didn't bridge from pill form first which may have led to more WD symptoms)

- Jan-March 2.3ML; GI symptoms (diarrhea, heartburn, stomach cramps); some panic/hypochondria; 

- March: 2.2ML; begin getting constant vertigo. take a steroid for two days at advice of ENT and have big setback 

Currently: 2.6 ML and holding 

Supplements: B12 and D3 for deficiencies; Magnesium 400mg + B2 400mg for migraines; fish oil 

 

Link to comment
  • manymoretodays changed the title to nofriendsphoebe: Third time tapering off Escitalopram (Cipralex/Lexapro)
  • Moderator Emeritus

Hi phoebe, and welcome,

 

How are you doing on 2.5 mg now?  Any WD(withdrawal).

How did you do your decreases?

 

And good to make a plan.  And yes, definitely to practice doing a 10% or even less decrease, as you continue your taper. 

Better than dissolving your Lexapro in water would be to use a NS, solution, or normal saline solution.  There's more on that in the Lexapro tapering topic, and I'll link you up to that momentarily.  The links will be the underlined topics, just click on them to read.

 

We would love to see your drug history in a signature too:

How to List Drug History in Signature

^ explains what we'd like to see, and how to do it.  The signature will then appear below all your posts, and serve as a quick reference to your case, here, and where ever else you might post on site.

 

We generally recommended that a person taper by no more than 10% of their current dose, with at least a four week hold in-between decreases.  The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.
 
More about what happens, when a person starts to come off psychiatric drugs, and WD(withdrawal)
 
 

 

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.  The CNS likes stability. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.
 
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 and omega 3 (fish oil). Many people find these to be calming to the nervous system.

 

Omega-3 fatty acids (fish oil) 

 

This is your introduction/journal page where you have now introduced yourself to the community, you can ask questions here regarding your tapering, give updates, and just keep a record of your journey.

 

Good that you are here phoebe, to make some plans now, for when you might resume your taper.  I think it might be a great idea to just HOLD for the immediate future, while figuring out your taper.  It may take more than a year, don't get stuck on time frames just yet.  Let us help support you, and guide you further.

 

How are you dosing your Lexapro now?  Are you taking 1/2 of a 5 mg tablet, or 1/4 of a 10 mg tablet?

 

Plenty of friends here.

 

Love, peace, healing, and growth,

manymoretodays(mmt)

 

Late 2023- gone to emeritus status, inactive, don't @ me, I can check who I've posted on, and I'm not really here like I used to be......thanks.

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016.  And.....I quit smoking 11/2021. Lapsed.  Redo of quit smoking 9/28/2022.  Can you say Hallelujah?(took me long enough)💜

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider.  My success story:  Blue skies ahead, clear sailing

 

Link to comment

Thanks! I think I added my signature correctly. 

I'm doing well on 2.5. Some manageable WD symptoms (mostly headaches that come in the same spot and sometimes jitteriness/anxiety). 

I use a 10mg pill that I cut into quarters. 

 

 

1 hour ago, manymoretodays said:

Hi phoebe, and welcome,

 

How are you doing on 2.5 mg now?  Any WD(withdrawal).

How did you do your decreases?

 

And good to make a plan.  And yes, definitely to practice doing a 10% or even less decrease, as you continue your taper. 

Better than dissolving your Lexapro in water would be to use a NS, solution, or normal saline solution.  There's more on that in the Lexapro tapering topic, and I'll link you up to that momentarily.  The links will be the underlined topics, just click on them to read.

 

We would love to see your drug history in a signature too:

How to List Drug History in Signature

^ explains what we'd like to see, and how to do it.  The signature will then appear below all your posts, and serve as a quick reference to your case, here, and where ever else you might post on site.

 

We generally recommended that a person taper by no more than 10% of their current dose, with at least a four week hold in-between decreases.  The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.
 
More about what happens, when a person starts to come off psychiatric drugs, and WD(withdrawal)
 
 

 

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.  The CNS likes stability. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.
 
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 and omega 3 (fish oil). Many people find these to be calming to the nervous system.

 

Omega-3 fatty acids (fish oil) 

 

This is your introduction/journal page where you have now introduced yourself to the community, you can ask questions here regarding your tapering, give updates, and just keep a record of your journey.

 

Good that you are here phoebe, to make some plans now, for when you might resume your taper.  I think it might be a great idea to just HOLD for the immediate future, while figuring out your taper.  It may take more than a year, don't get stuck on time frames just yet.  Let us help support you, and guide you further.

 

How are you dosing your Lexapro now?  Are you taking 1/2 of a 5 mg tablet, or 1/4 of a 10 mg tablet?

 

Plenty of friends here.

 

Love, peace, healing, and growth,

manymoretodays(mmt)

 

 

2014 - started 10mg Escitalopram

2015-2017 - 15mg

2017 - feel lethargic; go down to 10mg, no WD symptoms 

2018 - try quitting cold turkey; bad WD, reinstate at 5mg  

2019 -2021 try to taper off too quickly, reinstate at 2.5mg and hold; few WD symptoms (headaches, GI symptoms, bouts of panic) but mostly windows!

2022: switch to liquid to begin tapering from 2.5 ML (didn't bridge from pill form first which may have led to more WD symptoms)

- Jan-March 2.3ML; GI symptoms (diarrhea, heartburn, stomach cramps); some panic/hypochondria; 

- March: 2.2ML; begin getting constant vertigo. take a steroid for two days at advice of ENT and have big setback 

Currently: 2.6 ML and holding 

Supplements: B12 and D3 for deficiencies; Magnesium 400mg + B2 400mg for migraines; fish oil 

 

Link to comment
  • 6 months later...

Hi! Long-time struggler with Escitalopram. A couple years ago after an unsuccessful taper I stabilized at 2.5mg (cutting a 5mg pill in half) and have been doing very well holding there. However in the past week (a day since starting a new refill of the medication, same manufacturer, same dosage) have had absolutely debilitating symptoms. They're the same side effects I have always had but multiplied tenfold to the point that I had to take some time off work: crazy brain fog, nausea, head pressure/headache to the point where I was forcing my eyes to stay open. I spoke to my doctor today after several days of this and she suggested I take my 2.5 every other day instead of every day, not to taper but to hold here, but I know this forum says not to do that. I am just at a loss at this point with what the problem is and can't have these symptoms continue to this degree! Any advice?

2014 - started 10mg Escitalopram

2015-2017 - 15mg

2017 - feel lethargic; go down to 10mg, no WD symptoms 

2018 - try quitting cold turkey; bad WD, reinstate at 5mg  

2019 -2021 try to taper off too quickly, reinstate at 2.5mg and hold; few WD symptoms (headaches, GI symptoms, bouts of panic) but mostly windows!

2022: switch to liquid to begin tapering from 2.5 ML (didn't bridge from pill form first which may have led to more WD symptoms)

- Jan-March 2.3ML; GI symptoms (diarrhea, heartburn, stomach cramps); some panic/hypochondria; 

- March: 2.2ML; begin getting constant vertigo. take a steroid for two days at advice of ENT and have big setback 

Currently: 2.6 ML and holding 

Supplements: B12 and D3 for deficiencies; Magnesium 400mg + B2 400mg for migraines; fish oil 

 

Link to comment
  • Moderator

Hi @nofriendsphoebe 

I moved your topic here as you are looking for advice on your own situation and not on a specific symptom so it's good to keep these in the same place and reference quickly. 

 

Please do not take your pills every other day. That is horrible advice. You might want to try lowering your dosage a bit - maybe by 10% and see if that will improve symptoms.

 

Different drugs can vary (legally) by up to 20% in their bioavailability for the same dosage but that usually is an issue if you have different manufacturers. Might be worth calling the manufacturers with info on your batch etc and see if they can give you information. 

Are there any other things that may have caused the uptick in symptoms - like a new antibiotic or supplements, alcohol, stress?

 

Also, I'd consider an alternative way of getting to 2.5 mg than cutting into 4ths which tends to be imprecise and at these low doses it will matter. Check the first post of this thread for details on alternative ways to get the right dosage. 

Tips for tapering off escitalopram (Lexapro) - Tapering - Surviving Antidepressants

 

Hope you feel better soon, 
OMW

Edited by Onmyway

"Nothing so small as a moment is insurmountable, and moments are all that we have. You have survived every trial and tribulation that life has thrown at you up until this very instant. When future troubles come—and they will come—a version of you will be born into that moment that can conquer them, too." - Kevin Koenig 

 

I am not a doctor and this should not be considered medical advice. You can use the information and recommendations provided in whatever way you want and all decisions on your treatment are yours. 

 

In the next few weeks I do not have a lot of capacity to respond to questions. If you need a quick answer pls tag or ask other moderators who may want to be tagged. 

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months, trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax - 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week (off by 4/14/19- no tapering)

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875, 12/31/21 - 0.85, 1/7/22 - 0.825, 1/14/22 - 0.8, 1/22/22 - 0.785, 8/18/22 - 0.59, 12/15/2022 - 0.48, 2/15/22 - 0.43, 25/07/23 - 0.25 (mistake), 6/08/23 - 0.33mg

 

Supplements: magnesium citrate and bi-glycinate

Link to comment
On 1/25/2022 at 3:40 PM, Onmyway said:

Hi @nofriendsphoebe 

I moved your topic here as you are looking for advice on your own situation and not on a specific symptom so it's good to keep these in the same place and reference quickly. 

 

Please do not take your pills every other day. That is horrible advice. You might want to try lowering your dosage a bit - maybe by 10% and see if that will improve symptoms.

 

Different drugs can vary (legally) by up to 20% in their bioavailability for the same dosage but that usually is an issue if you have different manufacturers. Might be worth calling the manufacturers with info on your batch etc and see if they can give you information. 

Are there any other things that may have caused the uptick in symptoms - like a new antibiotic or supplements, alcohol, stress?

 

Also, I'd consider an alternative way of getting to 2.5 mg than cutting into 4ths which tends to be imprecise and at these low doses it will matter. Check the first post of this thread for details on alternative ways to get the right dosage. 

Tips for tapering off escitalopram (Lexapro) - Tapering - Surviving Antidepressants

 

Hope you feel better soon, 
OMW

Thank you! @Onmyway! I went back to every day and am dissolving my pill in water to decrease 10% - although switching to the liquid version of the medication soon to make it easier. Could you help me confirm my math: I'm trying to take 2.2mg, so my pharmacist told me to dissolve 5mg pill into 5ml water and take 2.2ml of the water. Is that correct? And I imagine when switching to liquid form I just take 2.2ml directly? 

2014 - started 10mg Escitalopram

2015-2017 - 15mg

2017 - feel lethargic; go down to 10mg, no WD symptoms 

2018 - try quitting cold turkey; bad WD, reinstate at 5mg  

2019 -2021 try to taper off too quickly, reinstate at 2.5mg and hold; few WD symptoms (headaches, GI symptoms, bouts of panic) but mostly windows!

2022: switch to liquid to begin tapering from 2.5 ML (didn't bridge from pill form first which may have led to more WD symptoms)

- Jan-March 2.3ML; GI symptoms (diarrhea, heartburn, stomach cramps); some panic/hypochondria; 

- March: 2.2ML; begin getting constant vertigo. take a steroid for two days at advice of ENT and have big setback 

Currently: 2.6 ML and holding 

Supplements: B12 and D3 for deficiencies; Magnesium 400mg + B2 400mg for migraines; fish oil 

 

Link to comment
  • 1 month later...

Hi all - I am in need of advice. I have been starting a VERY slow taper off 2.5 mg escitalopram using liquid medication. I did 2 months on 2.3ML and felt mostly fine, minus some GI symptoms (diarrhea, heartburn) and fatigue. This Monday I went down to 2.2ML, so like 5%. Within 24 hours I started experiencing symptoms around 1-2PM right after eating lunch (or while eating lunch, and then for the rest of the day) where I feel very lightheaded and dizzy, like the room is dropping, and bouts of panic. After the fourth day of this I called my psych nurse (she is very helpful with the WD process and takes me seriously), and she suggested I take the 0.1 ML I dropped just so we could see if it made me feel better and know it's WD and not something else. I did feel almost immediately better.

 

I will keep talking 2.3 ML now because I am scared of fainting and can't keep up with my job feeling like this. I'm not sure at this point if I should hold for another month and try tapering again, or explore her suggestion of trying to switch to Prozac while going off Escitalopram more quickly, because Escitalopram gives me migraines w/ extreme drowsiness and I'm not sure how much longer I can keep on it.

 

For context I did do some labs at the doctor last week and everything looks mostly normal except my B12 levels are a bit low, so I guess I will start supplements for that soon. No other supplements right now except occasional magnesium from epsom salt baths and an electrolyte powder which also has some Vit C (both of those I take only a few times a week).

 

I'm feeling very helpless atm and would appreciate any suggestions!

2014 - started 10mg Escitalopram

2015-2017 - 15mg

2017 - feel lethargic; go down to 10mg, no WD symptoms 

2018 - try quitting cold turkey; bad WD, reinstate at 5mg  

2019 -2021 try to taper off too quickly, reinstate at 2.5mg and hold; few WD symptoms (headaches, GI symptoms, bouts of panic) but mostly windows!

2022: switch to liquid to begin tapering from 2.5 ML (didn't bridge from pill form first which may have led to more WD symptoms)

- Jan-March 2.3ML; GI symptoms (diarrhea, heartburn, stomach cramps); some panic/hypochondria; 

- March: 2.2ML; begin getting constant vertigo. take a steroid for two days at advice of ENT and have big setback 

Currently: 2.6 ML and holding 

Supplements: B12 and D3 for deficiencies; Magnesium 400mg + B2 400mg for migraines; fish oil 

 

Link to comment
  • 2 weeks later...

Hi! Hoping to find a mod for some advice - @Onmyway are you still around? I’m still on my 2.3ML Lexapro but my NP suggested splitting my dose AM and PM because I metabolize it too quickly and it’s giving me intense vertigo. I did that today (1.2MG at 11 am and and 1.1 at 4PM) but now I’m seeing guidelines here that I should have moved half the dose every hour a day until getting to a full 12 hours apart. What should I do tomorrow - hold at the 5 hour split I did today, or go back to full morning dose and gradually split apart from there? 
 

thanks! 

2014 - started 10mg Escitalopram

2015-2017 - 15mg

2017 - feel lethargic; go down to 10mg, no WD symptoms 

2018 - try quitting cold turkey; bad WD, reinstate at 5mg  

2019 -2021 try to taper off too quickly, reinstate at 2.5mg and hold; few WD symptoms (headaches, GI symptoms, bouts of panic) but mostly windows!

2022: switch to liquid to begin tapering from 2.5 ML (didn't bridge from pill form first which may have led to more WD symptoms)

- Jan-March 2.3ML; GI symptoms (diarrhea, heartburn, stomach cramps); some panic/hypochondria; 

- March: 2.2ML; begin getting constant vertigo. take a steroid for two days at advice of ENT and have big setback 

Currently: 2.6 ML and holding 

Supplements: B12 and D3 for deficiencies; Magnesium 400mg + B2 400mg for migraines; fish oil 

 

Link to comment
  • Moderator Emeritus

If you haven't noticed any major issues then it may be okay to take the dose with the 5 hour interval.  But I would definitely hold on that timing for a little while before moving further apart.

 

At least you didn't jump straight to 12 hours apart! 😉

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

Link to comment
10 minutes ago, ChessieCat said:

If you haven't noticed any major issues then it may be okay to take the dose with the 5 hour interval.  But I would definitely hold on that timing for a little while before moving further apart.

 

At least you didn't jump straight to 12 hours apart! 😉

lol, I guess that’s true. I got some bad chills right after taking it - aside from that have just been drowsy. But I’m worried about messing up my sleep. Would it be safer to go back to full dose in the AM and slowly split?

2014 - started 10mg Escitalopram

2015-2017 - 15mg

2017 - feel lethargic; go down to 10mg, no WD symptoms 

2018 - try quitting cold turkey; bad WD, reinstate at 5mg  

2019 -2021 try to taper off too quickly, reinstate at 2.5mg and hold; few WD symptoms (headaches, GI symptoms, bouts of panic) but mostly windows!

2022: switch to liquid to begin tapering from 2.5 ML (didn't bridge from pill form first which may have led to more WD symptoms)

- Jan-March 2.3ML; GI symptoms (diarrhea, heartburn, stomach cramps); some panic/hypochondria; 

- March: 2.2ML; begin getting constant vertigo. take a steroid for two days at advice of ENT and have big setback 

Currently: 2.6 ML and holding 

Supplements: B12 and D3 for deficiencies; Magnesium 400mg + B2 400mg for migraines; fish oil 

 

Link to comment
  • Moderator Emeritus

Instead of going back to one dose you could take 2nd dose 2 or 3 hours after the first dose.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

Link to comment
12 hours ago, ChessieCat said:

Instead of going back to one dose you could take 2nd dose 2 or 3 hours after the first dose.

and keep doing that daily? i guess i'm confused by my end goal... i do want to see if splitting doses helps, but dont want it to destabilize me too much. i definitely feel pretty weird this morning after the first 5 hour split yesterday.

2014 - started 10mg Escitalopram

2015-2017 - 15mg

2017 - feel lethargic; go down to 10mg, no WD symptoms 

2018 - try quitting cold turkey; bad WD, reinstate at 5mg  

2019 -2021 try to taper off too quickly, reinstate at 2.5mg and hold; few WD symptoms (headaches, GI symptoms, bouts of panic) but mostly windows!

2022: switch to liquid to begin tapering from 2.5 ML (didn't bridge from pill form first which may have led to more WD symptoms)

- Jan-March 2.3ML; GI symptoms (diarrhea, heartburn, stomach cramps); some panic/hypochondria; 

- March: 2.2ML; begin getting constant vertigo. take a steroid for two days at advice of ENT and have big setback 

Currently: 2.6 ML and holding 

Supplements: B12 and D3 for deficiencies; Magnesium 400mg + B2 400mg for migraines; fish oil 

 

Link to comment

update: took the full dose this AM, feel better than when I woke up after splitting it yesterday. I think I need to cut out alcohol (had a birthday recently and had a few too many drinks that week and I bet that led to bad vertigo from WD). So I'll stabilize at the full 2.3MG every AM for a few more weeks and then try a 10% taper again. If that doesn't work, stabilize and bridge to Prozac. Not sure I'll ever manage to get below where I am on this drug.... I want my life back :( 

2014 - started 10mg Escitalopram

2015-2017 - 15mg

2017 - feel lethargic; go down to 10mg, no WD symptoms 

2018 - try quitting cold turkey; bad WD, reinstate at 5mg  

2019 -2021 try to taper off too quickly, reinstate at 2.5mg and hold; few WD symptoms (headaches, GI symptoms, bouts of panic) but mostly windows!

2022: switch to liquid to begin tapering from 2.5 ML (didn't bridge from pill form first which may have led to more WD symptoms)

- Jan-March 2.3ML; GI symptoms (diarrhea, heartburn, stomach cramps); some panic/hypochondria; 

- March: 2.2ML; begin getting constant vertigo. take a steroid for two days at advice of ENT and have big setback 

Currently: 2.6 ML and holding 

Supplements: B12 and D3 for deficiencies; Magnesium 400mg + B2 400mg for migraines; fish oil 

 

Link to comment

so sorry -- one more question for you, @ChessieCat. Looking back I wonder if my vertigo happened because I went too quickly from pills to liquid back in mid-January and at the same time did a 0.2 mg jump from 2.5 to 2.3...do you think reinstating at 2.5 would fix the vertigo? It's becoming debilitating... I am seeing an ENT next week but am becoming worried the effects my be permanent...

2014 - started 10mg Escitalopram

2015-2017 - 15mg

2017 - feel lethargic; go down to 10mg, no WD symptoms 

2018 - try quitting cold turkey; bad WD, reinstate at 5mg  

2019 -2021 try to taper off too quickly, reinstate at 2.5mg and hold; few WD symptoms (headaches, GI symptoms, bouts of panic) but mostly windows!

2022: switch to liquid to begin tapering from 2.5 ML (didn't bridge from pill form first which may have led to more WD symptoms)

- Jan-March 2.3ML; GI symptoms (diarrhea, heartburn, stomach cramps); some panic/hypochondria; 

- March: 2.2ML; begin getting constant vertigo. take a steroid for two days at advice of ENT and have big setback 

Currently: 2.6 ML and holding 

Supplements: B12 and D3 for deficiencies; Magnesium 400mg + B2 400mg for migraines; fish oil 

 

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  • Moderator Emeritus
7 hours ago, nofriendsphoebe said:

I think I need to cut out alcohol

 

alcohol-and-beer

 

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

Link to comment
  • Moderator Emeritus
10 hours ago, nofriendsphoebe said:

and keep doing that daily? i guess i'm confused by my end goal... i do want to see if splitting doses helps, but dont want it to destabilize me too much. i definitely feel pretty weird this morning after the first 5 hour split yesterday.

 

That's the reason why part of the dose is moved by 1 hour each day.  If you are very concerned then you could try moving by only 1/2 each day.

 

Please see:

 

dose-splitting-for-interdose-withdrawal-from-short-half-life-drugs

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

Link to comment
  • Moderator Emeritus

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

Link to comment
19 minutes ago, ChessieCat said:

I’m trying to do one change at a time but the vertigo is really scaring me. It’s been non stop for 2 weeks and it’s becoming destabilizing. I don’t think I’m willing to split the dose, even very slowly, and risk disrupting my sleep, which is so good right now. So after making a mistake trying that once yesterday I decided against it and went back to AM immediately. But I’m still stuck with vertigo. So if reinstating at 2.5 ml has the potential to fix the vertigo, I’m prepared to do that and hold there for awhile. I’m just wondering if it’s possible it will fix it.
 

I will also be cutting out alcohol. 

2014 - started 10mg Escitalopram

2015-2017 - 15mg

2017 - feel lethargic; go down to 10mg, no WD symptoms 

2018 - try quitting cold turkey; bad WD, reinstate at 5mg  

2019 -2021 try to taper off too quickly, reinstate at 2.5mg and hold; few WD symptoms (headaches, GI symptoms, bouts of panic) but mostly windows!

2022: switch to liquid to begin tapering from 2.5 ML (didn't bridge from pill form first which may have led to more WD symptoms)

- Jan-March 2.3ML; GI symptoms (diarrhea, heartburn, stomach cramps); some panic/hypochondria; 

- March: 2.2ML; begin getting constant vertigo. take a steroid for two days at advice of ENT and have big setback 

Currently: 2.6 ML and holding 

Supplements: B12 and D3 for deficiencies; Magnesium 400mg + B2 400mg for migraines; fish oil 

 

Link to comment
  • Moderator Emeritus
8 hours ago, nofriendsphoebe said:

I think I need to cut out alcohol (had a birthday recently and had a few too many drinks that week and I bet that led to bad vertigo from WD).

 

If the vertigo happened or worsened after the birthday party I think it would be better to not change your dose at this time.  If the cause was the alcohol then increasing the AD might not make things "better" and might actually might things worse.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

Link to comment
4 minutes ago, ChessieCat said:

 

If the vertigo happened or worsened after the birthday party I think it would be better to not change your dose at this time.  If the cause was the alcohol then increasing the AD might not make things "better" and might actually might things worse.

Thanks for the response. How would it make things worse, just so I understand? 

My NP suggested reinstating at 2.5 also so that the ENT has more information when I go to him next week about the vertigo. 

 

2014 - started 10mg Escitalopram

2015-2017 - 15mg

2017 - feel lethargic; go down to 10mg, no WD symptoms 

2018 - try quitting cold turkey; bad WD, reinstate at 5mg  

2019 -2021 try to taper off too quickly, reinstate at 2.5mg and hold; few WD symptoms (headaches, GI symptoms, bouts of panic) but mostly windows!

2022: switch to liquid to begin tapering from 2.5 ML (didn't bridge from pill form first which may have led to more WD symptoms)

- Jan-March 2.3ML; GI symptoms (diarrhea, heartburn, stomach cramps); some panic/hypochondria; 

- March: 2.2ML; begin getting constant vertigo. take a steroid for two days at advice of ENT and have big setback 

Currently: 2.6 ML and holding 

Supplements: B12 and D3 for deficiencies; Magnesium 400mg + B2 400mg for migraines; fish oil 

 

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  • Moderator Emeritus
3 minutes ago, nofriendsphoebe said:

How would it make things worse, just so I understand? 

 

I don't know if or how it might make things worse.  But other members have had this happen when they have tried to "fix" things.

 

The effect of changing doses and going on and off psychiatric drugs is cumulative.  So even if you were able to updose previously with no issues, there is no guarantee that it would work the same way next time.

 

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

Link to comment
12 hours ago, ChessieCat said:

 

I don't know if or how it might make things worse.  But other members have had this happen when they have tried to "fix" things.

 

The effect of changing doses and going on and off psychiatric drugs is cumulative.  So even if you were able to updose previously with no issues, there is no guarantee that it would work the same way next time.

 

sure, i do understand that - i guess taking into account that this symptom starting appearing after i went down 10% (the alcohol played a part, but i had been drinking before then, as well), and that going back up 10% is not a giant leap to reinstate...seems like not a very risky reinstation to alleviate a symptom? are there examples from other people of what might go wrong with a small reinstation?

2014 - started 10mg Escitalopram

2015-2017 - 15mg

2017 - feel lethargic; go down to 10mg, no WD symptoms 

2018 - try quitting cold turkey; bad WD, reinstate at 5mg  

2019 -2021 try to taper off too quickly, reinstate at 2.5mg and hold; few WD symptoms (headaches, GI symptoms, bouts of panic) but mostly windows!

2022: switch to liquid to begin tapering from 2.5 ML (didn't bridge from pill form first which may have led to more WD symptoms)

- Jan-March 2.3ML; GI symptoms (diarrhea, heartburn, stomach cramps); some panic/hypochondria; 

- March: 2.2ML; begin getting constant vertigo. take a steroid for two days at advice of ENT and have big setback 

Currently: 2.6 ML and holding 

Supplements: B12 and D3 for deficiencies; Magnesium 400mg + B2 400mg for migraines; fish oil 

 

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  • Moderator Emeritus
6 hours ago, nofriendsphoebe said:

going back up 10% is not a giant leap to reinstate

 

It is your decision whether you updose or hold on the current dose.

 

I am not sure when you were last taking 2.5mg.

 

When updosing it is better to increase by small increments.  The longer you have been at a lower dose the more adaptation the brain has made to getting less of the drug, so a smaller updose is suggested.

 

It takes about 4 days for a dose to get to full strength in the blood and a bit longer for it to register in the brain.  If you do decide to make a small increase you will need to be patient and it is suggested to wait at least 1 week on the increased dose.  If after 1 week you do not notice any improvement then you could increase a tiny bit more.  However if you notice some improvement during the first week wait an additional week and then reassess.

 

The idea of updosing is not to get rid of the withdrawal symptoms completely but to bring them to a bearable level.  Some members keep updosing trying to find that "perfect dose" and end up taking too high a dose and make things worse.

* NO LONGER ACTIVE on SA *

MISSION ACCOMPLISHED:  (6 year taper)      0mg Pristiq  on 13th November 2021

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering from Oct 2015 - 13 Nov 2021   LAST DOSE 0.0025mg

Post 0 updates start here    My tapering program     My Intro (goes to tapering graph)

 VIDEO:   Antidepressant Withdrawal Syndrome and its Management

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  • 3 months later...

I’m wondering if anyone has had long term side effects from switching from pills to liquid? I regrettably did this too quickly and with a tiny dose reduction at the same time and 6 weeks later had vertigo that hasn’t gone away months later. Wondering if it’s the liquid and if I should try to switch back to pills at this point or if it’s just withdrawal in general and I should wait longer to stabilize.. 

2014 - started 10mg Escitalopram

2015-2017 - 15mg

2017 - feel lethargic; go down to 10mg, no WD symptoms 

2018 - try quitting cold turkey; bad WD, reinstate at 5mg  

2019 -2021 try to taper off too quickly, reinstate at 2.5mg and hold; few WD symptoms (headaches, GI symptoms, bouts of panic) but mostly windows!

2022: switch to liquid to begin tapering from 2.5 ML (didn't bridge from pill form first which may have led to more WD symptoms)

- Jan-March 2.3ML; GI symptoms (diarrhea, heartburn, stomach cramps); some panic/hypochondria; 

- March: 2.2ML; begin getting constant vertigo. take a steroid for two days at advice of ENT and have big setback 

Currently: 2.6 ML and holding 

Supplements: B12 and D3 for deficiencies; Magnesium 400mg + B2 400mg for migraines; fish oil 

 

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  • manymoretodays changed the title to nofriendsphoebe: Third time tapering off Escitalopram(Cipralex/Lexapro)
  • Moderator Emeritus

Hi there phoebe and welcome back.

  

1 hour ago, nofriendsphoebe said:

I’m wondering if anyone has had long term side effects from switching from pills to liquid? I regrettably did this too quickly and with a tiny dose reduction at the same time and 6 weeks later had vertigo that hasn’t gone away months later. Wondering if it’s the liquid and if I should try to switch back to pills at this point or if it’s just withdrawal in general and I should wait longer to stabilize.. 

 

Best to post your questions in your topic after 4 month absences, as that gives us a chance to review your topic while trying to advise.  I also found your first Introduction topic(October 2019) and merged your subsequent July 2021 topic to it right here.  Just one Introduction per member please as that keeps your information all together.  I did leave your inquiry in the topic you posted it in too.  I just know that(due to my own experiences) below the 5 mg point for escitalopram can be crucial.......and should always be undertaken slowly.  Sadly......we cannot undue our prior errors, often due to lack of knowledge.......but happily we all eventually heal, or that's the story I've adopted.  I sat on 5 mg of escitalopram for over a year as my singular medication, and approached withdrawing without enough information.  I mean this was years ago, and I was just getting into online and peer generated information.    I also had more than 20 years of many more drug trials and combinations.  As an aside, I did tend to drink more as well as use pot, when on Lexapro.  Anyway......I too, went to liquid and jumped right down to 3 mg over a period of a couple of weeks and crashed badly.  Wound up remedicated, in the hospital, and all I have to say about that is never again!!! 

 

So, from looking at your topic above........

I see the switch from solid escitalopram to the pharmaceutical liquid happened in January of this year, 2022.

Along with the immediate switch to liquid you decreased the dose at the same time from 2.5 mg to 2.3 mg( 8%) in January.

Symptom report in March:

On 3/17/2022 at 1:49 PM, nofriendsphoebe said:

I did 2 months on 2.3ML and felt mostly fine, minus some GI symptoms (diarrhea, heartburn) and fatigue. This Monday I went down to 2.2ML, so like 5%. Within 24 hours I started experiencing symptoms around 1-2PM right after eating lunch (or while eating lunch, and then for the rest of the day) where I feel very lightheaded and dizzy, like the room is dropping, and bouts of panic.

 

And then at some point you tried an updose to 2.6 mg escitalopram.

Is this what you are presently taking?

Was there any improvement in the vertigo symptom after updosing back to close to the 2.5 mg dosage?

Do note the years and dates for drug changes in your signature as well, rather than terms like "currently" or "at present".  Otherwise, the signature isn't of much help..... through the years, AND we have to spend undue time piecing your particulars together.

You can get to your signature for editing using this link:  Account Settings/Signature

 

Also you tried splitting your doses(then decided against as you immediately got some new symptoms).

Went to an ENT, tried steroids.

Worsened with alcohol consumption as well.

Have you been able to continue to maintain without alcohol?  For now that would be a good/great idea.

Any recent new trials of anything.....drugs or other stressors?

 

And okay, so for your main question- Wondering if it’s the liquid and if I should try to switch back to pills at this point or if it’s just withdrawal in general and I should wait longer to stabilize.. ?

 

I'm doubtful that it is due to the liquid escitalopram......and mainly because the vertigo did not set in until 6 weeks after you did the cold switch from solid to liquid.  I think it's more likely due to the rapid descent   Sure, you could try going to back to solid 2.5 mg escitalopram..........I am just doubtful that it is anymore than due to WD and if it was me, I wouldn't want to rock the boat.  So I'd go with continuing to HOLD longer, at the 2.6 mg dose,  while trying perhaps some position maneuvers or anything else that does not involve medication right now.  The advantage with staying on the liquid concentration, is that eventually it will be easier to titrate when you do resume a nice 10% or less taper from each previous dose.

 

When do you take your escitalopram now, time of day?  And when does the vertigo set in?

Did the ENT suggest any non-drug coping to you for the vertigo?

Are you drinking plenty of fluids? (I just ask that one as my sister had vertigo and lot's of fluids did really seem to help)

 

On 3/28/2022 at 11:09 AM, nofriendsphoebe said:

If that doesn't work, stabilize and bridge to Prozac.

And hmmm..........I'm not sure a bridge makes a whole lot of sense.  I'm dubious that would improve the vertigo.  You might need to consider just non-drug coping and continuing your taper again at some point......if your goal is to eventually become drug free.  The only real advantage, from my point of view is that the longer half life of Prozac may just lead to a longer lapse period before experiencing WD(if you are going to, and you, obviously, are one that has experienced WD symptoms).  I don't think it would touch the lingering WD symptoms you've had.  Time may be your best defense now. 


You'll find this topic definitely of interest:  Dizziness, vertigo, light-headedness, rocking or swaying sensations

Do scroll on through the entire topic, as there are a couple places where you'll see some articles touching on the whys of symptoms like yours, when ceasing, or..... more abruptly tapering an SSRI drug like yours.

 

Best, Love, peace, healing, and growth,

mmt

 

 

 

 

Late 2023- gone to emeritus status, inactive, don't @ me, I can check who I've posted on, and I'm not really here like I used to be......thanks.

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016.  And.....I quit smoking 11/2021. Lapsed.  Redo of quit smoking 9/28/2022.  Can you say Hallelujah?(took me long enough)💜

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider.  My success story:  Blue skies ahead, clear sailing

 

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  • Moderator Emeritus

I vote for taking longer to stabilize and am doubtful, it's solely due to the crossover to liquid, even with the dose drop.

Anyway.......discussed more at length in your introduction topic here.

Late 2023- gone to emeritus status, inactive, don't @ me, I can check who I've posted on, and I'm not really here like I used to be......thanks.

Started with psycho meds/psychiatric care circa 1988.  In retrospect, and on contemplation, situational overwhelm.

Rounding up to 30 years of medications(30 medication trials, poly-pharmacy maximum was 3 at one time).

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!  Tapered @ 10% every 4 weeks, sometimes 2 weeks to

2016 Dec 16 medication free!!

Longer signature post here, with current supplements.

Herb and alcohol free since 5/15/2016.  And.....I quit smoking 11/2021. Lapsed.  Redo of quit smoking 9/28/2022.  Can you say Hallelujah?(took me long enough)💜

None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider.  My success story:  Blue skies ahead, clear sailing

 

Link to comment
On 7/16/2022 at 1:37 PM, manymoretodays said:

Hi there phoebe and welcome back.

  

 

Best to post your questions in your topic after 4 month absences, as that gives us a chance to review your topic while trying to advise.  I also found your first Introduction topic(October 2019) and merged your subsequent July 2021 topic to it right here.  Just one Introduction per member please as that keeps your information all together.  I did leave your inquiry in the topic you posted it in too.  I just know that(due to my own experiences) below the 5 mg point for escitalopram can be crucial.......and should always be undertaken slowly.  Sadly......we cannot undue our prior errors, often due to lack of knowledge.......but happily we all eventually heal, or that's the story I've adopted.  I sat on 5 mg of escitalopram for over a year as my singular medication, and approached withdrawing without enough information.  I mean this was years ago, and I was just getting into online and peer generated information.    I also had more than 20 years of many more drug trials and combinations.  As an aside, I did tend to drink more as well as use pot, when on Lexapro.  Anyway......I too, went to liquid and jumped right down to 3 mg over a period of a couple of weeks and crashed badly.  Wound up remedicated, in the hospital, and all I have to say about that is never again!!! 

 

So, from looking at your topic above........

I see the switch from solid escitalopram to the pharmaceutical liquid happened in January of this year, 2022.

Along with the immediate switch to liquid you decreased the dose at the same time from 2.5 mg to 2.3 mg( 8%) in January.

Symptom report in March:

 

And then at some point you tried an updose to 2.6 mg escitalopram.

Is this what you are presently taking?

Was there any improvement in the vertigo symptom after updosing back to close to the 2.5 mg dosage?

Do note the years and dates for drug changes in your signature as well, rather than terms like "currently" or "at present".  Otherwise, the signature isn't of much help..... through the years, AND we have to spend undue time piecing your particulars together.

You can get to your signature for editing using this link:  Account Settings/Signature

 

Also you tried splitting your doses(then decided against as you immediately got some new symptoms).

Went to an ENT, tried steroids.

Worsened with alcohol consumption as well.

Have you been able to continue to maintain without alcohol?  For now that would be a good/great idea.

Any recent new trials of anything.....drugs or other stressors?

 

And okay, so for your main question- Wondering if it’s the liquid and if I should try to switch back to pills at this point or if it’s just withdrawal in general and I should wait longer to stabilize.. ?

 

I'm doubtful that it is due to the liquid escitalopram......and mainly because the vertigo did not set in until 6 weeks after you did the cold switch from solid to liquid.  I think it's more likely due to the rapid descent   Sure, you could try going to back to solid 2.5 mg escitalopram..........I am just doubtful that it is anymore than due to WD and if it was me, I wouldn't want to rock the boat.  So I'd go with continuing to HOLD longer, at the 2.6 mg dose,  while trying perhaps some position maneuvers or anything else that does not involve medication right now.  The advantage with staying on the liquid concentration, is that eventually it will be easier to titrate when you do resume a nice 10% or less taper from each previous dose.

 

When do you take your escitalopram now, time of day?  And when does the vertigo set in?

Did the ENT suggest any non-drug coping to you for the vertigo?

Are you drinking plenty of fluids? (I just ask that one as my sister had vertigo and lot's of fluids did really seem to help)

 

And hmmm..........I'm not sure a bridge makes a whole lot of sense.  I'm dubious that would improve the vertigo.  You might need to consider just non-drug coping and continuing your taper again at some point......if your goal is to eventually become drug free.  The only real advantage, from my point of view is that the longer half life of Prozac may just lead to a longer lapse period before experiencing WD(if you are going to, and you, obviously, are one that has experienced WD symptoms).  I don't think it would touch the lingering WD symptoms you've had.  Time may be your best defense now. 


You'll find this topic definitely of interest:  Dizziness, vertigo, light-headedness, rocking or swaying sensations

Do scroll on through the entire topic, as there are a couple places where you'll see some articles touching on the whys of symptoms like yours, when ceasing, or..... more abruptly tapering an SSRI drug like yours.

 

Best, Love, peace, healing, and growth,

mmt

 

 

 

 

Thank you for the detailed response. I am also doubtful it’s the switch to the liquid, but prior to that switch to liquid I had already been on 2.5mg pills for upwards of two years, so it wasn’t a quick withdrawal except for going down from 2.5 to 2.3 when I switched to liquid (only 8% reduction as you said).
 

When I got the vertigo I went back up to 2.6 and have stayed there in the past three months. The symptoms have gotten slightly better, but that could also be because of the supplements I am taking for vestibular migraine which I may have as a result of all of this. I’m not sure if updosing more might help at this point. 

2014 - started 10mg Escitalopram

2015-2017 - 15mg

2017 - feel lethargic; go down to 10mg, no WD symptoms 

2018 - try quitting cold turkey; bad WD, reinstate at 5mg  

2019 -2021 try to taper off too quickly, reinstate at 2.5mg and hold; few WD symptoms (headaches, GI symptoms, bouts of panic) but mostly windows!

2022: switch to liquid to begin tapering from 2.5 ML (didn't bridge from pill form first which may have led to more WD symptoms)

- Jan-March 2.3ML; GI symptoms (diarrhea, heartburn, stomach cramps); some panic/hypochondria; 

- March: 2.2ML; begin getting constant vertigo. take a steroid for two days at advice of ENT and have big setback 

Currently: 2.6 ML and holding 

Supplements: B12 and D3 for deficiencies; Magnesium 400mg + B2 400mg for migraines; fish oil 

 

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