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Nicjk: insomnia from Lexapro

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Nicjk
Posted (edited)

Are the doctors right?  Insomnia.

 

I gave birth to my son in March 2019 and experienced terrible postpartum anxiety. My psychiatrist put me on 20mg Lexapro (escitalopram) which I commenced on the 17th June 2019. In October I saw my psychiatrist and told him I wanted to taper off Lexapro - he told me to take 15mg for one week, 10mg for one week and then 5mg for the final week (three week taper). My last pill was on the 14th November 2019 and the day after my last pill I couldn’t sleep. Ever since then I have experienced terrible insomnia. I either find it hard to fall asleep or I wake a few times per night. My psychiatrist and doctor believe that my anxiety is waking me during the night but I think the insomnia is a withdrawal symptom. What are your thoughts? And is there anything I can do to ease my insomnia? Do I need to go back on Lexapro (6 weeks without the meds) and then taper more slowly? I have had my anxiety under control but the lack of sleep is sinking me downhill again. 

Edited by manymoretodays
moved to introduction from S and S, added title

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Nicjk
Posted (edited)

I started Lexapro in June 2019 due to severe postpartum anxiety. It worked but I had night sweats and vivid dreams, so my psychiatrist told me to go off it over 3 weeks. Week one 15mg, week two 10mg, week three 5mg. My last pill was in 14th of November 2019, and I was on Lexapro for just under 5 months. Since stopping I have had terrible insomnia (either can’t fall asleep or wake numerous times). My anxiety is under control. My psychiatrist and doc believe that my anxiety is causing the insomnia but I believe it is withdrawal. I have been off the Lexapro for 6 weeks now and am considering going back on it and tapering more slowly. What are your thoughts? Does it sound like my insomnia is withdrawals and do you have any tips? I can’t stand it for much longer because I have a busy baby to care for. I need sleep!

Edited by manymoretodays
added name, and none

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Sassenach

Hello Nicjk

I am not in a position to do a full introduction at the moment as it is early New year's morning in the UK.

Your symptoms are caused by a too fast withdrawal from the lexapro.

The only known way to mitigate withdrawal symptoms is to reinstate a small dose of the drug.

As you have been off the lexapro for 6-weeks if you wish to reinstate it should be done quickly.

Very important.

Under no circumstances should you take a normal dosi of the drug.

If you have 5 mg tablets available I suggest you cut one in half and take 2.5 MG maximum.

I will catch up with you later in the day to see what decision you reached.

Sassenach

 

 

 

 

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Nicjk

@Sassenach thank you so much for your prompt reply - especially seeing as it is early New Year’s morning. I am currently on holiday and my Lexapro is at home. I’ll be back home on Saturday and I am going to take your advice and take the 2.5mg. I’m so glad I posted here because I was very close to taking a full 10mg! If my withdrawals don’t ease up after a week of taking 2.5mg should I up the dose to 5mg? Thanks again and happy new year

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Sassenach

Hi

Would have liked for you to start tomorrow.

I hope the journey home is not too long.

 Lexapro is best taken in the morning so take 2.5 mgs  at time you will be able to keep to every day.

8 hours ago, Nicjk said:

If my withdrawals don’t ease up after a week of taking 2.5mg should I up the dose to 5mg?

We will review this once you start as it takes up to a week for the drug to reach full state in your body.

You will need to keep in contact so we can monitor you to achieve an optimal dose for your recovery.

Please contact me when you are home.

Happy New Year.

 

Sassenach

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Nicjk

@Sassenach I am heading home a day earlier so will start taking 2.5mg tomorrow morning. Fingers crossed this works! Speak to you soon and thanks again

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Nicjk

@Sassenach just a quick question - if I have reinstated too late and it doesn’t work, does that mean I just have to deal with the withdrawals for a while longer? Will my brain eventually heal and allow me to sleep again? 

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Sassenach

Hello    Nicjk  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 .

 

I am sorry you are having such a rough time but you are now in the right place.

 

To begin we need information regarding your drugs.

Are you currently taken or have you taken any other meds in the last 24months?

If so please list with doses and dates.

Are you or have you taken any supplements during the same period.

If so please list with doses and dates.

 

Hi Nic, hope Nic is ok, remembering jumbled letters for many members, not easy.

Time difference is a pain.

If you need a response urgently and cannot get me use the @(name) of an american mod.

All your posts will be notified to me and I am online 5-7pm uk time most days plus other random visits.


 

16 hours ago, Nicjk said:

if I have reinstated too late and it doesn’t work, does that mean I just have to deal with the withdrawals for a while longer? Will my brain eventually heal and allow me to sleep again? 

There is no reason to believe reinstatement will not work.

If not you would have to deal with the symptoms.

Yes you can and will heal as long as you accept this will be a slow and at times frustrating process.

Learning to accept the symptoms as part of your life helps healing as does a positive attitude.

 

"

On 4/27/2017 at 7:03 PM, 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."

On 1/1/2020 at 5:15 AM, Nicjk said:

My psychiatrist and doc believe that my anxiety is causing the insomnia but I believe it is withdrawal.

You are right, they are both wrong, sounds incredible I know but it happens all the time.

They then exacerbate the situation by prescribing more drugs, often Benzos , which are very addictive for some people, so begins the drugs merry-go-round.

It is therefore important not to let them prescribe anything other than your Escitalopram.

Do you have a repeat prescription for it?

 

I sent you a symptom checklist.

What are your current symptoms?

 

What to expect

It will take 7-10 days for the drug to reach full state in your body.

At that point we review your progress and decide whether the dose is correct.

There is no info. let alone any formula to calculate this and everyone reacts differently.

The site adopts a harm reduction policy which means we use as little of the drug as possible.

There are two reasons for this.

1. To avoid the risk of Serotonin toxicity.

2. It takes less time to taper properly off a small dose than a larger one.

There is always the possibility of an adverse reaction to the reintroduction of the drug ( this can happen even with a drug you have taken before).

After you reinstate, if you experience the sudden and severe onset an adverse reaction, stop taking the drug immediately and contact us.

I would like you to post a daily diary in the following format.

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

The numbers are severity from 1-10.

THe diary will also allow you look back and see your progress.

In W/D we often feel as though we are getting nowhere.

Many woman experience changes in their menstrual cycle.

Please see

aligning-tapering-to-menstrual-cycle/

 

Finally for now: Insomnia

On 1/1/2020 at 5:15 AM, Nicjk said:

Does it sound like my insomnia is withdrawals and do you have any tips?

Insomnia is very common in W/D.

The following help.

Regular bedtime every night

Completely darkened room, helps production of Melotonin to induce sleep.

No blue screen devices 1-2 hours before bed, phone definitely switched off.

If you must use them get blue light blockers

Hopefully sleep will improve as the drug starts to work.

 

However if it is unbearable you could try a small dose of Melotonin (.5mgs)

It is available as immediate release to help get you to sleep or extended release if you get to sleep but wake regularly.

Please note you need to start at a small dose as larger ones can cause a paradoxical reaction which causes your body to jerk awake.

It is a natural survival response but does not help sleep.

Once you re-establish your circadian rhythm it should not be needed.

I understand this is difficult with a baby so be patient and you will get there.

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.

 

Again welcome.

 

Sassenach

 

Apologies for mess below, this browser throws a wobbly from time to time.

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Nicjk

@Sassenach 

Are you currently taken or have you taken any other meds in the last 24months?

I took Largactil (low dose for sleep) June until around September. I started on Dothiepin (Dosulepin) a few weeks ago - my doc and psych refused to prescribe me sleeping tablets and they insisted that I try this low dose antidepressant for sleep. I took 25mg most nights but increased it to 50mg for about four nights. Last night I didn’t take any in preparation for taking my Lexapro today. The night before last I took 25mg. I have been taking Doxylamine for a few nights to help me sleep and my supplements: Melatonin 3mg for around 5 weeks (didn’t know I had to start low), zinc, fish oil, preGABA (converts into GABA), CBD oil (6 drops, 3 x per day), Rodiola containing ashwaghanda, L-theanine 200mg twice per day - all for around 5 weeks. 
What should I do about the melatonin? 

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Sassenach

Can please copy and paste the above info. into your drug signature adding dates and doses as best you can remember, link below.

That is quite a list and I will need to check it for interractions.

For the moment take exactly the same as you have been doing and I will get back to you as soon as I have chance check it out tomorrow.

Are you taking any of th

e above for specific diagnosed medical conditions.

Is your Melotonin instant or extended release?

 

Please add a signature.  Include 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. 

  • 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: http://survivingantidepressants.org/index.php?/settings/signature/

Below info. is a reminder for my use tomorrow.

1 hour ago, Nicjk said:

CBD oil (6 drops, 3 x per day

CBD inhibits the cytochrome P450 enzyme, which is involved in metabolizing many drugs.

 

 

 

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Nicjk

@Sassenach I checked with a pharmacist regarding dothiepin - it is fine for me to take 2.5mg Lexapro today because I was only on a very low dose of Dothiepin . The rest of my supplements are all natural and fine to take witj antidepressants (I checked before starting on them). None of them are for medical conditions- some were prescribed by my naturopath to control anxiety which they have been doing because I have had hardly any anxiety. I will stop the CBD oil because that’s the only thing that could possibly interact. I am on my way home now in the car so will edit my signature when I get home. Thank you!

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Nicjk

@Sassenach the melatonin is fast release. In Australia you have to be prescribed slow release melatonin by a doctor. Out of my supplements there is another one that could potentially interact with Lexapro - the Rhodiola. I have checked with my naturopath as to whether it is safe to take with an SSRI or not. She should get back to me soon. I won’t take the CBD oil again. 

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Nicjk

@Sassenach just an update - I felt very confident that 2.5mg of Lexapro wouldn't interact with my supplements (spoke to my naturopath who is famous for her knowledge here in Aus) so I took my 2.5mg Lexapro at 12:30pm today as soon as I got home. I will no longer be taking rhodiola (just to be safe) but will continue with my l-theanine if you believe it is safe to do so. I would also like to continue taking fish oil, zinc and magnesium. I have purchased melatonin that I can break in half so I will slowly reduce the amount I'm taking, starting by taking 1.5mg tonight instead of 3mg. Will post a diary entry tomorrow. So far the only symptoms I have are a cloudy head and a dry mouth (it has been 6 hours since I took the 2.5mg Lexapro) 

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jozeff

Hi nic,

 

Following your topic closely. I'm sorry you have to go through all this. I feel and understand your trouble. We have a 8-month old boy and a 8-year old son. I've been having terrible withdrawal symptoms myself. It's not easy with a baby in the house I know.

 

You have been going through a very rough time after crashing Lexapro. I find it absolutely terrible that professionals advise you to taper so fast. There is so much information about slow weaning off medication.

 

I have high hopes for you that this reinstatement might work. You've come to the right place that's for sure. Let us know how it goes and and I wish you the very best for 2020.

 

Think about not trying to fight your symptoms too much. I've been doing this for long time and it only makes things worse. If you feel good try to enjoy it if you feel bad try to accept it and float.

 

Good luck and cheers. You can do it!!

 

 

Jozeff

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Nicjk

@jozeff thanks so much for your concern and understanding. I’m sorry that you have been struggling too. It is definitely rough with little ones in the house! Especially busy boys that require a lot of energy from their parents. It takes a lot of strength to get up every day and stay positive. Sounds like you are a strong person - thank you for your advice. 
 

I’ll keep you updated and please feel free to reach out to me whenever you like.

 

All the best! :) 

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sunnysideup69
9 hours ago, Nicjk said:

@Sassenach the melatonin is fast release. In Australia you have to be prescribed slow release melatonin by a doctor. Out of my supplements there is another one that could potentially interact with Lexapro - the Rhodiola. I have checked with my naturopath as to whether it is safe to take with an SSRI or not. She should get back to me soon. I won’t take the CBD oil again. 

 

Hi Nickj and welcome. Your comment about the rhodiola caught my eye. I took it for some of the time during my first time on antidepressants with no problem.

 

When I tried to take it in WD with Citalopram, it really heightened my anxiety and caused increased symptoms and I was advised in a health food store NOT to take it with ads. It can become too stimulating. 

Once you go into WD, things can have a strange effect, and usual rules don't necessarily apply....

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Sassenach

Hi Nic

 

Well done.

Agree with most of your above.

Should have a complete plan by this evening

 

Sass

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Sassenach
Posted (edited)

Hi Nic

 

20 hours ago, Nicjk said:

I started on Dothiepin (Dosulepin) a few weeks ago - my doc and psych refused to prescribe me sleeping tablets and they insisted that I try this low dose antidepressant for sleep. I took 25mg most nights but increased it to 50mg for about four nights. Last night I didn’t take any in preparation for taking my Lexapro today.

This is a tricyclic antidepressant, can affect Serotonin and should really be tapered.

I see you have taken none last night.

Do you feel it was helping your sleep?

This something of a dilemma as you need to be off it ASAP as it not considered a safe drug any longer.

 
 
 
Items which should not routinely be prescribed in primary care DosulepinInformation about changes to medicines or treatments on the NHS: Changes to dosulepin prescribingThe NHS will be asking doctors to stop or greatly reduce the prescribing of some medicines from December 2017. This is because the medicines are:Not as safeas other medicinesORNot as good (effective) as other medicines ORMore expensive than other medicines that do the same thing. One of these medicines is dosulepin.This document will explain why thechangesare happening and where you can get more information and support.Why does the NHS want to reduce prescribingof dosulepin?The National Institute for Health and Care Excellence (NICE) saysthat dosulepin should not be prescribed for depression because it may be harmful in some people and it is very dangerousin overdose.Death from dosulepinoverdose can occur quickly, even beforeyou can be treated inhospital.As there are quite a lot ofsafety concerns aboutdosulepin, all patients currently taking itshould havea reviewwith their doctor. If dosulepin isdangerous should I stop taking itimmediately?You may suffer side effects if you stop taking dosulepinsuddenly. Your doctorwill support you toreduceyour dose of dosulepin gradually before you stop it and slowly introducea new medicine (if you are to be prescribed one). What options are availableinsteadof dosulepin?You can talk to your doctorabout the options availableso that you can come to a joint decision about what’s best for you.There are now many safer alternative antidepressants to dosulepinthat havefewer side effects. It’s also possible that you will no longer need to take an antidepressant at all.In exceptional (rare) circumstances dosulepin may continue to be prescribed if a consultant or other specialisthealthcare professionalsupports this decision.Items which should not routinely be prescribed in primary care DosulepinWhat do I do if my medicine has been changed and it’s causing me problems?If you have problems with your new medicine,you should speak to your doctor.Where can I find more information and support?You can speak to your local pharmacist,GP or the person who prescribed the medication to youNationalandlocal charities can offer advice and support, for exampleMIND provide a leaflet called ‘Making sense of antidepressants:www.mind.org.uk/media/4900726/antidepressants-2016-pdf.pdfThe NICE information for patients can be found at:www.nice.org.uk/guidance/cg90/ifp/chapter/About-this-informationThe Patients Association can also offer support and advice: www.patients-association.org.uk/or call 020 8423 8999Healthwatch: www.healthwatch.co.ukFind out more about the medicines that are being stopped or reduced: https://www.england.nhs.uk/medicines/items-which-should-not-be-routinely-prescribed/If you have any questions about dosulepinprescribing please email them to: england.medicines@nhs.net                                                                                                                                                                                                                  You need to off this ASAP but the sudden discontinuation may trigger W/D symptoms despite the low dose.
 
 
Edited by Sassenach

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Sassenach

Sorry browser acting up.

Suggest that you continue to take only 25mgs for the next few days and we review then.

I do think you should continue otherwise it will be difficult monitor the reinstatement effects.

L- theanine also affects Serotonin and will need to be discontinued in due course but not yet.

Essentially, L-theanine crosses the blood-brain barrier, and has the ability to modulate inhibitory neurotransmitters, selective serotonin, and dopamine to bring about anxiolytic and calming effects.

Good to see you have stopped CBD oil and Rhodiola.

Your other supplements look ok although I should point out we only recommend fish oil and magnesium.

A lot of change and more to come but be patient and we will get there.

Look forward to receiving your diary.

 

Sass

 

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Nicjk
2 hours ago, Sassenach said:

This is a tricyclic antidepressant, can affect Serotonin and should really be tapered.

I see you have taken none last night.

Do you feel it was helping your sleep?

Hi @Sassenach, the Dosulepin only helped with sleep for a few nights when I started taking it and then it didn’t help at all once my body got used to it. I only upped the dose to 50mg for a few nights and then went back down to 25mg because the 50mg didn’t help at all. I also had a few nights during few weeks I was on it when I stopped taking it. I never felt any effect to

my mood when I reduced or stopped the dose. I have been concerned about taking a tricyclic antidepressant with Lexapro as a pharmacist told me they shouldn’t be taken together, so I didn’t take it last night. I have been taking Doxylamine (Restavit) which is an over the counter sleeping tablet for the last few nights and it has helped me to sleep. I forgot to add that to my signature. It’s really disturbing that my psychiatrist told me I didn’t need to taper Dothiepin because I was on such a low dose not considered a therapeutic dose - these docs have no clue do they? 

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Nicjk

@Sassenach I should also add that Dothiepin (Dosulepin) only comes in a 25mg capsule that is very difficult to divide (I tried when first starting to take it) so I don’t know how I could have tapered off it. I will start my diary from today. Yesterday I experienced no symptoms from the Lexapro other than a foggy head and dry mouth. I slept well because of the Doxylamine. Thanks for all your help! 

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Nicjk

Hi @sunnysideup69, thanks for the welcome! That is very interesting (the Rhodiola). I had no idea that supplements effect you differently when you're withdrawing - this is all such a big learning curve for me. I'm impressed with your self help routine :) 

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sunnysideup69

 

41 minutes ago, Nicjk said:

Hi @sunnysideup69, thanks for the welcome! That is very interesting (the Rhodiola). I had no idea that supplements effect you differently when you're withdrawing - this is all such a big learning curve for me. I'm impressed with your self help routine :) 

Yep..... supplements can do a bit of a number on you. WD is really strange. It's horrible, but the plus side is, I've had to cut out some unhealthy things and pay attention to my nervous system. We'll get there eventually, all of us 😊

 

 

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Sassenach

Hi Nic

 

Just to be clear have you now stopped this completely?

19 hours ago, Nicjk said:

Dothiepin (Dosulepin)

 

20 hours ago, Nicjk said:

therapeutic dose

There is no such thing once your CNS is destabilised.

These drugs are very powerful and  there is no properly tested and documented way of calculating a reinstatement.

This why we use extreme caution and need all the facts, it is always possible to updose if necessary, but too high a dose can cause adverse reactions even death.

Which is why we need daily notes at least for the first couple of weeks.

19 hours ago, Nicjk said:

I had no idea that supplements effect you differently when you're withdrawing

Everything is different in W/D and it can be a long and difficult journey but do patiently and you will get well.

For now you need to take the same dose, same time every day and keep us informed.

It would be usual for you to feel some effects from the changes you have made.

Please remember taking two many products to help sleep can have a paradoxical reaction which will keep waking you.

It is trial and error, what works for one, does not for another.

Please add nothing else without asking.

How did you sleep last night?

How are you feeling?

What are your current symptoms?

 

Sass

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Nicjk
3 hours ago, Sassenach said:

Just to be clear have you now stopped this completely?

Hi @Sassenach, yes I stopped Dothiepin (Dosulepin) completely. My last dose was on the 1st of January. The pharmacist informed me that it wasn’t safe to take it along with Lexapro, seeing as they are both antidepressants. I have been taking 18.75mg of Doxylamine (3/4 of a pill) since the 1st of January and it has helped me to sleep through the night- I am too scared to stop taking it because it has really helped me to sleep. I could try taking only half tonight and see how it goes. I know you said to take my Lexapro at the same time every day but I had to adjust the time and will continue taking the pill at 9:00am every day from now on. Diary entry

 

3 hours ago, Sassenach said:

How did you sleep last night?

How are you feeling?

What are your current symptoms?


I slept well because of Doxylamine. And my melatonin has been reduced to 1.5mg for the last two nights. I am feeling fine mood wise - anxiety probably a 2 out of 10. Current symptoms: a foggy head for a few hours after taking Lexapro and definitely less energy - that’s about it. Insomnia is my main WD symptom so I will only know if it’s improving once I start weaning off Doxylamine. 
 

Woke 6:00am - felt fine

7:00am - had breakfast and supplements 

9:00am - took 2.5mg Lexapro

10:00am - foggy feeling and sluggishness 5

7:00pm - dinner

7:30pm - slightly anxious 4

9:30pm - took 1.5mg melatonin 

10:00pm - took magnesium and then 10 min meditation

10:30pm - took doxylamine

10:45pm - asleep

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Sassenach

Hi NIc.

 

Glad you are sleeping better it makes easier and helps with recovery as much of the brain's repair work is done during sleep.

Doxylamine is an anti-histamine and unlikely to cause you problems short tem.

You should keep taking this for the moment to help with your sleep and keep everything else stable.

20 hours ago, Nicjk said:

a foggy head for a few hours after taking Lexapro and definitely less energy

Please keep this well documented in your diary, both are WD symptoms but if they occur after taking the med we need to sure it is not an adverse reaction.

 

Sass

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Nicjk

Hi @Sassenach

 

5:00am woke up feeling anxious 5

6:30am breakfast

7:00am supplements

9:00am took Lexapro 

10:00am still anxious 5

10:00am - 8:00pm anxious and emotional 6

9:30pm - magnesium/melatonin

10:00pm - half a Doxylamine tablet

10:30pm - asleep

 

Things are looking promising - I slept until 5:00am even though I had only taken half a doxylamine. Is it possible that my body has already registered the Lexapro? I had an anxious day yesterday because I don't think I had such a restful sleep the night before. Feeling a bit better today. 

 

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Nicjk

Hi @Sassenach, I hope all is well. Thismorning I woke up at 3:00am in a real panic. I tried to use my breathing techniques but I was quickly escalating so I had to take a clonazepam - is that ok? I feel like my sleep quality has decreased since starting Lexapro. Even on the previous nights, I may have slept through but I feel like it was not restful sleep, hence my increasing anxiety. This could just be my anxiety talking but I'm scared that taking Lexapro again has messed around with my brain - do you think this is just a phase while my body adjusts to having the drug again? 

 

Yesterday:

6:00am woke up feeling ok

6:30am breakfast

7:00am supplements

9:00am took Lexapro

10:00am slightly anxious 3

10:00am - 8:00pm anxious 5

9:30pm - magnesium/melatonin

10:00pm - half a Doxylamine tablet

10:15pm - asleep

11:00pm - sleep disruption

3:00am - woke in panic 

3:20am - took clonazepam

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Sassenach

Hi Nic have you had panic attacks before?

Did you take lexapro this morning?

How have you felt during the day?

Have any other symptoms started or increased?

If possible get back to me before bedtime over there please.

Sass

 

 

 

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Sassenach
13 hours ago, Nicjk said:

clonazepam

Did this help?

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Nicjk

Hi @Sassenach sorry for my late response. Yes, I have had panic attacks before but my anxiety trigger is sleep (lack of sleep) so when I feel like I'm going to face the day without sleep my anxiety escalates. My panic attacks are rather mild - I just get the "fight or flight" feeling and my heart rate increases. Clonazepam does help. I have continued taking Lexapro and I can't say that any other symptoms have started or increased. The reason I went off Lexapro is because of the vivid dreams and the night sweats - my vivid dreams have returned. Is it only possible to decrease my withdrawals with Lexapro? Is there another AD I could take at a very low dose that might do the same job, minus the vivid dreams? 

 

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Sassenach

l-theanine Hi Nic

 

14 hours ago, Nicjk said:

The reason I went off Lexapro is because of the vivid dreams and the night sweats - my vivid dreams have returned.

Did they stop when you ceased Lex and were there any other med changes at the time?

Do you wake with a jerk and feel wide awake?

14 hours ago, Nicjk said:

when I feel like I'm going to face the day without sleep my anxiety escalates

We refer to this as fear of the fear and coping techniqes can help.

Will come back to this if necessary.

Did these dreams start after you reduced Melotonin from 3 to 1.5mgs?

15 hours ago, Nicjk said:

Is there another AD I could take at a very low dose that might do the same job, minus the vivid dreams? 

It may be possible to change A/Ds but only as a last resort as it can lead to it's own problems.

We would be even more reluctant to recommend a change as you are doing so well at present.

( I do understand how important the sleep issue is )

One possibility is a parodoxical reaction as you are taking  melatonin 1.5mgDoxylamine (Restavit) 18.75mg for sleep plus occasional Clonazepam.

 

l-theanine

The ratio of caffeine to theanine is generally 1:2 (100 mg of caffeine with 200 mg of theanine)

What dose are you taking and when?

 

I will ask @Altostrata to comment on parodoxical reaction as she much more experienced in this area than me.

 

Sass

 

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Altostrata

Hello, NIc.

 

On 1/6/2020 at 12:31 PM, Nicjk said:

Hi @Sassenach, I hope all is well. Thismorning I woke up at 3:00am in a real panic. I tried to use my breathing techniques but I was quickly escalating so I had to take a clonazepam - is that ok? I feel like my sleep quality has decreased since starting Lexapro. Even on the previous nights, I may have slept through but I feel like it was not restful sleep, hence my increasing anxiety. This could just be my anxiety talking but I'm scared that taking Lexapro again has messed around with my brain - do you think this is just a phase while my body adjusts to having the drug again? 

 

Yesterday:

6:00am woke up feeling ok

6:30am breakfast

7:00am supplements

9:00am took Lexapro

10:00am slightly anxious 3

10:00am - 8:00pm anxious 5

9:30pm - magnesium/melatonin

10:00pm - half a Doxylamine tablet

10:15pm - asleep

11:00pm - sleep disruption

3:00am - woke in panic 

3:20am - took clonazepam

 

It takes about 4 days for a dose of Lexapro to reach full effect,  so you're right on time.

 

2.5mg might be a bit too much. Suggest you reduce it to 2.0mg. Escilatopram comes in a liquid for this purpose, or you can make your own liquid, explained here Tips for tapering off Lexapro (escitalopram)

 

Please let us know how you're doing.

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Nicjk
38 minutes ago, Altostrata said:

2.5mg might be a bit too much

Hi @Altostrata, thanks so much for the info. My anxiety has now levelled out and I've been doing pretty good - had barely any anxiety yesterday. I am currently breaking my 10mg Lexapro tablets into quarters which is proving to be quite difficult because they often crumble - so I've booked a doc appointment for next week so that I can get a prescription for the liquid form. The only thing really bothering me now is the vivid dreams. Seeing as I have been on 2.5mg since the 3rd of Jan, do you suggest I stay on this dose? 

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Nicjk
4 hours ago, Sassenach said:

Did they stop when you ceased Lex and were there any other med changes at the time?

Hi @Sassenach, yes the vivd dreams stopped when I stopped Lexapro and there weren't any med changes at the time. As you know, Lexapro is known to suppress REM sleep so rebound REM happens - meaning that dreams can become incredibly vivid. I remember my dreams in great detail every morning and they only started up again once I'd been back on Lexapro for around 4 days. They aren't too bothersome at the moment so I can live with them. 

 

4 hours ago, Sassenach said:

Do you wake with a jerk and feel wide awake?

No this hasn't happened for a couple of weeks

 

4 hours ago, Sassenach said:

Did these dreams start after you reduced Melotonin from 3 to 1.5mgs?

No they started around 4 days after I started Lexapro again. I had reduced my melatonin a few days before that.

 

4 hours ago, Sassenach said:

What dose are you taking and when?

This is difficult to work out because I have two teaspoons of instant coffee. I am actually about to run out of l-theanine and I don't plan to buy any more - I will have my last dose this evening. 

 

In terms of my anxiety, it has levelled out a lot. I have been feeling pretty good and last night I only took half a doxylamine pill and slept quite well - even despite the dreams. Will keep you posted! Thanks again 

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