Lostboytravles: Ride It Out or Reinstate

[Lostboytravles]

Looking for advice.  Quit Lexapro (20 mg/day) cold turkey at the beginning of the year after 11+ years.  I should have known better, as I unsuccessfully attempted to quit in 2014 with a fast taper (10 mg for two months, 5 mg for two months, 5 mg every other day for 2 months, then stopped).  Dealt with brain zaps initially, maybe some other minor symptoms, but nothing debilitating.  About 5-6 months later, however, acute emotional symptoms set in very abruptly.  The first time it was triggered by smoking weed for the first time in a while.  This time I went to bed feeling relatively normal, and woke up early in the morning feeling awful.  Severe anxiety, depression, dysphoria, apathy, some brain fog.  I never felt like this before going on the medicine, and I now doubt I was ever depressed before the medicine. 
 

I am trying to decide if I should reinstate or ride it out from here.  My quality of life is very low currently.  Days and weeks are just slipping by.  I dread getting out of bed every day and am getting pleasure out of nothing.  I am about to turn 31 and am not thrilled at the idea of losing the rest of my early 30s to this withdrawal.  The more I learn about ADs, the less I want to be on them, but if a slow taper will get me off them without feeling this way, I think that is the way to go.  However, if there is a good chance that I slow taper, and then still have to go through this process at the other end, I will feel I have wasted that much more time in addition to doing further damage by being on the meds for more time. 
 

What are the chances that A) I am close to a breakthrough (it seems that most people are dealing with this issue for MUCH longer), B ) that a slow taper is successful at mitigating withdrawal symptoms .   I know no one can answer these questions with certainty, but I am interested in any and all advice.  Something’s got to give, this is no way to live.

Edited November 14, 2019 by Shep
added username to title

[Gridley]

Welcome to SA, Lostboytravles.  I'm sorry you're feeling so bad.

 

You are experiencing withdrawal from your cold turkey, and your symptoms are typical.  Unfortunately, there is no way to predict how long it will last.  While some recover fairly quickly, others take months or longer.

 

What is withdrawal syndrome.

 

Glenmullen’s withdrawal symptom list.

 

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.  

 

This explains it really well:

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

Reinstatement works most predictably within three months of your last dose.  The fact that you're over eleven months out makes reinstatement risky and carries the possibility that it will make matters worse.  If I'm reading you correctly, you're asking whether you could reinstate 20mg and slowly taper from there.  Your central nervous system now is not the same CNS as when you were on 20mg previously and is very sensitized from the cold turkey.  In addition, in the eleven months you've been off the drug, your brain has become somewhat accustomed to not having the drug, and a reinstatement of too much Lexapro could overwhelm your system and destabilize you further, a destabilization that could take a long while to recover from.  Please read:
 

About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic

 

The decision of whether to reinstate or ride it out has to be yours.  If you do decide to reinstate, I would suggest a very small dose--no more than 1mg Lexapro.  If you have a bad reaction, you should stop immediately.  

 

This link explains how to obtain small dosages, either getting a prescription for liquid Lexapro, making your own liquid and weighing using an AWS Gemini-20 scale.

 

Tips for tapering off Lexapro (escitalopram)

 

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. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Please research all supplements first and only add in one at a time and at a low dose in case you do experience problems.

 

Please let us know what you decide to do and keep us updated.

 

This is your Introduction topic, where you can ask questions and connect with other members.  We're glad you found your way here.

 

 

 

 

[jozeff]

Hi lostboy!

How are you doing today?

 

Hope you are feeling a bit better. 

 

Cheers

 

Jozeff

[Lostboytravles]

Hey Jozeff, 

 

Thanks for checking in.  
 

All things considered I suppose I am feeling better.  I wait tables at restaurant, and recently I have been able to fake a smile and fumble my way through customer interactions, which I was incapable of doing not too long ago.  The balance of my symptoms seems to have shifted.  The depression used to outweigh the anxiety, but now it feels vice versa.  I have never felt anxiety like this before, it is almost like a tangible thing in between my shoulder blades or at the base of my neck/spine.  It has been interfering with sleep a bit.  I can get to sleep ok and usually get several good hours, but once I get up to go to the bathroom or am roused for some other reason I usually just toss and turn until the sun comes up.  
 

I am struggling to convince myself this is still all withdrawal.  I am sure that withdrawal is compounding my feelings and negative thoughts, but I feel just as sure that I am objectively dissatisfied with my life, the opportunities and potential that I have squandered, my lack of resolve and work ethic, my capacity to emotionally connect with others and interact socially.  I could go on, but that is for a therapist not this forum (still looking for a decent one, not much luck).  
 

In short I feel pretty miserable, but I’d be lying if I said I’m not a little better than I have been.  I miss the medicine quite a bit, and have come very close to reinstating.  In fact, the soonest I can see my psychiatrist is Dec 19, and I am planning on asking for liquid, just in case I decide to reinstate and taper.  I have had an epic inner battle over this.  Family and friends (including a psychiatrist friend who is very young and seems pretty hip to WD) have encouraged me to reinstate and taper.  If I knew it would work I would have already, but I am terrified of A) kindling, b) it just not working, but setting me back to square one with recovery/withdrawal, C) withdrawals occurring even after a successful reinstatement and subsequent slow taper.  
 

Again, thanks for checking in, would love any feed back or updates on how you or anybody else is doing.

[Katy398]

Hi Lostboytravis,

I too am at 11 months cold turkey from lexapro, I was on 40 mgs but my last dose after a fast taper was 20 mgs

Reinstating is such a tough decision. I’ve been tempted so many times but for me the fear of Kindling has been stronger than my fears of coping with withdrawal. The thought of getting worse fills me with fear I know I can’t cope with anything worse than I’m already facing. 

Like you the anxiety is off the scale, coupled with bouts of insomnia has made managing WD all the more challenging. 

We have quite a few similarities in our journey. I wish you all the best in your decision, it’s a tough call that only you can make. I just wanted you to know that I really empathise with where you’re at.

Take care thinking of you.

Kx

 

[jozeff]

Hi Lostboy,

 

As far as I am informed you are now 5 months into CT. After reading a lot on this website for 2  years I know that:

 

reinstating is most likely to be succesfull  the sooner the better after CT. Since you are 5 month into wd you should not wait another few months before deciding

 

Why not try a very low dose and work from there?  Citalopram has a very high receptor occupancy at relative low dose (in the range of 25% occupancy for 1 mg citalopram dose). Why not try 0.25 mg and see how that goes. If you feel worse after 1 or a couple of days, quit. If it works you can carefully search for the dose you might need. 

 

Do you have a scale or is it possible to dissolve a pill. I dissolve a 10 mg pill in 10 ml and take 0,5 ml for example with a syringe and voila you have 0.5 mg. Not too difficult to be honest.

 

Your symptoms are, unfortunately, completely normal. I used to like a lot of stuff and didn't worry all the time. Don't like my job right now, very agitated, start to panick when my kids are crying. Just feel awful a lot of the time.

 

You are not abnormal.

 

Decide what you are going to do and go for it!!

Sounds easy I know, ....

 

cheers

 

Jozeff