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Nicjk: Insomnia from Lexapro

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Altostrata

If you find 2.5mg comfortable, I would stay on 2.5mg. It's a crutch so your nervous system can settle down, this may be gradual.

 

The liquid form will allow you to be more accurate in your measurement.

 

Please let us know how you're doing.

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Nicjk

Hi @Sassenach, yesterday I did fine anxiety wise but woke up with a jolt wide awake at 1:30am. I had only taken half a doxylamine tablet and 1.5mg of melatonin before bed. I had to take another half and a clonazepam to get back to sleep because I was so awake. I will see how it goes tonight - I don't want to keep taking more than half a doxylamine at night because they aren't recommended to be used long term and I need to start weaning. 

@Altostrata I know you recommended that I take only 2mg Lexapro but is it possible that my body has now got used to the 2.5mg and I need to take 5mg? Waking up with a jolt, wide awake was one of my main WD's after stopping Lexapro 

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Sassenach

Hi Nic

 

Could not make it on here last night.

Alto's suggestion means she feels the dose may be a bit high and stimulating you too much.

20 hours ago, Nicjk said:

but woke up with a jolt wide awake at 1:30am

Is this the first time, as previously said you did not wake with a jolt?

Are your dreams consistent in content?

Are related to any current or previous stress or stressor in your life.

20 hours ago, Nicjk said:

my body has now got used to the 2.5mg and I need to take 5mg

Your body is just getting used to it but we would never recommend doubling a dose that seems to working well apart from sleep issues.

Think about it logically, you are doing far better than most so taking an A/D to help sleep,would not be a good idea.

Double the dose would also take nearly three times as long to taper.

You have had a lot of changes since joining us and all will affect you.

You are off l-theanine

I suggest:

you use decaf coffee and tea.

Do not take Melotonin for now especially as yours includes B6 ( B vitamins are stimulating for many in W/D)

Take Doxylamine (Restavit)  at full dose for a week or so and see if sleep improves.

I know you do not want to take it for too long but you have to use all tools at your disposal at this time.

If you do this we will know whether it is a paradoxical reaction.

If you decide to do this it is important you keep everything consistent, take the doses same time every day to enable us to better analyse what is happening.

 

Sass

 

 

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Nicjk
3 hours ago, Sassenach said:

Think about it logically, you are doing far better than most so taking an A/D to help sleep,would not be a good idea.

Hi @Sassenach, thanks for all the helpful advice. I will stop the melatonin and perhaps try a full doxylamine pill. I woke up again with a jolt at around 3:40am - I took a higher dose of Doxylamine (18.75mg as a pose to only half a tablet) so I am concerned that it is losing it's effectiveness. The only WD symptom I had before deciding to re-start Lexapro was night waking and sometimes the inability to fall asleep - lack of sleep is debilitating for me and it makes my anxiety worse. The only WD symptom I wanted to "fix" was the night waking because I feel so much more rested when I don't wake in the night. The dreams have calmed down now and I haven't had any for the last 2 nights, but I have also woken up wide awake for the last two nights. My anxiety has been under control for the last few days but I have been feeling tired because of the night wake ups. I'm just concerned that 2.5mg is not enough, but I do understand your points. Though I would take 5mg and have a longer withdrawal process if it meant that I would start sleeping properly again. 

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Nicjk

@Altostrata sorry that I'm bringing you into this again but there is more likelihood that you'll be able to respond, being in the USA. Seeing as I have tolerated the 2.5mg Lexapro (only had bad anxiety for one day) would it pose any harm for me to go up to 5mg? I felt pretty crappy yesterday and I am feeling bad again today because I am waking up in the night again - not anxiety, but instead feeling very drained and tired. I always find it difficult to go back to sleep after waking up. Night waking has been my main WD symptom and the reason why I have reinstated Lexapro, so it's disheartening that I'm waking up again in the night. 

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Altostrata
Nicjk
32 minutes ago, Altostrata said:

What happens after you wake up between 3-4 a.m.?

Hi @Altostrata, usually I have to take another half of doxylamine or a clonazepam to get back to sleep. I use an eye mask and ear plugs, plus I have good sleep hygiene. The wake ups only started after I went off Lexapro. I’m scared that they won’t stop because they make me feel like utter crap. They are not at a regular time, sometimes they happen at 1am too. How long can I expect to experience the insomnia? It might be different for each person but it really worries me because I need energy to take care of my busy baby

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Nicjk

@Altostrata and @Sassenach just an update. I went with my gut and started taking 5mg just over a week ago. I am now doing really well. I plan to stay on 5mg for a few months and then slowly titrate off Lexapro. I appreciate your initial help, but wonder why you ghosted me. Perhaps my withdrawals weren't extreme enough? Lack of sleep is a killer for mothers with babies so I am glad that I went with my gut on this one. 

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Altostrata

Hello, Nicjk.

 

We didn't ghost you, but lost your response among the others.

 

You were taking 2.5mg, then went to 5mg? Sometimes an updose is needed in reintatement. Please let us know how you're doing.

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Nicjk
21 minutes ago, Altostrata said:

We didn't ghost you, but lost your response among the others.

I can totally understand that you have many people to respond to every day who are equally important but I started to wonder why @Sassenach hadn't checked up in 9 days. 

 

22 minutes ago, Altostrata said:

You were taking 2.5mg, then went to 5mg? Sometimes an updose is needed in reintatement. Please let us know how you're doing.

 

Yes I was taking 2.5mg and felt like my body got used to that dose and my withdrawals remained the same. A few days after starting 5mg I started getting sleepy at night again and falling asleep easily. I also stopped waking up a lot during the night. This has helped my mental state immensely so I feel like I made the right move by increasing. When I start titrating off in a few months - is the liquid escitalopram suitable even though I have been taking the brand name Lexapro pill? My doc said that escitalopram comes in liquid form but not Lexapro. I'm assuming they're the same thing? Many thanks for your response

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brassmonkey

Hi Nic-- Sass is dealing with his own WD experience at the moment and has had to step away from the forum for a short while.  I'm quite sure he will be dropping by when he returns.

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Nicjk

@brassmonkey I'm sorry to hear that! Hoping he is doing ok and I totally understand. Sometimes you just need your space. Wishing Sass all the best. 

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Altostrata
5 hours ago, Nicjk said:

When I start titrating off in a few months - is the liquid escitalopram suitable even though I have been taking the brand name Lexapro pill? My doc said that escitalopram comes in liquid form but not Lexapro. I'm assuming they're the same thing?

 

The liquid will be escilatopram but a different brand and form. To start, we recommend taking part of your dose in your familiar tablet form and the other part in liquid, to ease the transition.

 

I'd let your nervous system settle for a good while before tapering again.

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Nicjk

Hi @Altostrata, I reinstated Lexapro 2 months ago thanks to your kind advice and I have stabilised. Is it vital for me to stay on the Lexapro for around 3 months before beginning my slow taper? I am having very vivid dreams again and it is definitely due to the Lexapro. I am so keen to get off it again. 

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Nicjk

Hi @Altostrata and @Sassenach, I hope you are both staying safe during this crazy time. Is it possible for me to get guidance again please? As you will see by my signature, I allowed myself to stabilise on 5mg from January to March, before beginning my slow taper. I wasn't able to get Lexapro in the liquid form so instead I used a mini scale and sliced small amounts off my pill ensuring that I weighed the amounts every day. I was completely fine until I got to 0.03g (note: grams not mg) and then my WD symptoms started again in full force. Bad anxiety and multiple night wakings. On the 16th of March I couldn't take it anymore so I increased my dose to 5mg again (0.06g). The WD symptoms have stuck around - is my body trying to acclimatise to the higher dose again? Is it likely that I will stabilise again as I did before? Thanks so much 😞

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Altostrata
5 hours ago, Nicjk said:

On the 16th of March I couldn't take it anymore so I increased my dose to 5mg again (0.06g).

 

Did this have any benefit? If so, what? What symptoms do you have now?

 

Are you taking any other drugs now? Clonazepam? If so, how often?

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Nicjk
23 minutes ago, Altostrata said:

Did this have any benefit? If so, what? What symptoms do you have now?

Upping my dosage to 5mg has not had any benefit yet. I have been on 5mg for 8 days now - do you think I am going through initial side effects from increasing my dose? The symptoms I have now: mild depression, high anxiety, insomnia

 

25 minutes ago, Altostrata said:

Are you taking any other drugs now? Clonazepam? If so, how often?

I have been taking clonazepam on and off for the last 5 nights. Either half a tablet or a full 0.5mg tablet when I am feeling very anxious when going to bed. 

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Altostrata
10 hours ago, Nicjk said:

mild depression, high anxiety, insomnia

 

This started after you increased to 5mg?

 

How many times a week do you take clonazepam? Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms throughout the day. Post 24 hours of notes at a time in this topic, in a simple list format with time of day on the left and notation (symptom or drug and dosage) on the right.

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Nicjk
9 hours ago, Altostrata said:

This started after you increased to 5mg?

 

@Altostrata yes it did. I think I made a mistake by jumping straight to 5mg when I should have gone back to the dose that was working for me before I started having the WD symptoms again.The dose that worked for me was 3.3mg (0.04g). I am planning to go back to taking 3.3mg tomorrow and I will stay on that for a while. Do you think it is a bad idea to decrease tomorrow? 

In terms of the clonazepam, I only started taking it again just over a week ago and I am taking 0.25mg (half a pill) nightly to manage my anxiety. 

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Altostrata

Yes, if you can't sleep, 5mg is too high for you. 3.3mg might be sufficient. It will take at least 4 days for the change to fully register. Please let us know how you're doing.

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Nicjk

@Altostrata thank you for the advice. I went down to 3.3mg yesterday and last night had horrendous insomnia (worse than on 5mg) - is it possible that my body has already registered the change? In terms of clonazepam, I have decided to not take it anymore incase I become dependent so I didn't take any last night. I feel like I made a big mistake by jumping to 5mg after my unsuccessful taper to 0.03g (7th of May). I should have gone back to the previous dose of 0.04g. I hope I haven't caused further issues in the WD process 😢

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Altostrata

Suggest you let the reduction to 3.3mg settle out over 4 days or more.

 

On 5/23/2020 at 8:26 PM, Nicjk said:

In terms of the clonazepam, I only started taking it again just over a week ago and I am taking 0.25mg (half a pill) nightly to manage my anxiety. 

 

If you also stopped taking clonazepam when you made the change in escitalopram, it's very possible that's why you had insomnia -- you were somewhat dependent on clonazepam.

 

We strongly recommend changing only one drug at a time.

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Nicjk

@Altostrata thank you for the advice to stay on clonazepam for the meantime. I have only ever taken it sporadically so I haven't developed a dependence on it, but now is not the time to stop taking it. I have slept for the last 2 nights but it has been very restless sleep with lots of vivid dreams. I have been sweaty in the morning from turning so much. Could this be a "start up" symptom? Just concerned that I have messed myself around by going from 5mg suddenly to 3.3mg

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Altostrata

Perhaps you could do with a little less clonazepam. @Shep, what do you think?

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Shep
16 hours ago, Nicjk said:

@Altostrata thank you for the advice to stay on clonazepam for the meantime. I have only ever taken it sporadically so I haven't developed a dependence on it, but now is not the time to stop taking it. I have slept for the last 2 nights but it has been very restless sleep with lots of vivid dreams. I have been sweaty in the morning from turning so much. Could this be a "start up" symptom? Just concerned that I have messed myself around by going from 5mg suddenly to 3.3mg

 

From your signature: 

 

Quote

Mid June 2019 to current - Clonazepam 0.5mg (infrequently, only when required) 

 

Nick, sorry if you've already posted about this, but I haven't had a chance to read your entire thread yet - how many days a week have you been taking clonazepam? Please note it's possible to become dependent on a benzo, even with periodic use. The half life of clonazepam is 18 - 50 hours, so if you're a slow metabolizer, you would still have about 13% of this drug in your system after 6 days of the last dose. 

 

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Nicjk
14 hours ago, Shep said:

The half life of clonazepam is 18 - 50 hours, so if you're a slow metabolizer, you would still have about 13% of this drug in your system after 6 days of the last dose. 

Wow this is very interesting @Shep. I had no idea. I have only been taking clonazepam every night for about 8 nights. Before that it was every now and then (once a month?). For the last 8 nights I have cycled between taking half of a 0.5mg pill or a full pill. Last night I took a full pill because I was very anxious and woke up wide awake at 3am.

In terms of Lexapro, I have been tapering slowly for months and I finally reached 2.5mg on the 7th of May. Around 3 days later horrible anxiety and insomnia kicked in and I gave in and went back up to 5mg on the 16th of May. I should have gone to my last effective dose of 3.3mg but in my anxious state I jumped straight up to 5mg. I then dropped back down a small notch to 4.2mg on the 25th May. I'm still having trouble with anxiety and insomnia - is it likely that I am just re-adjusting to the new dose? I'm scared that the lower dose is no longer effective for me 

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Nicjk

@Altostrata hoping you can clarify this for me. As you know I jumped from 2.5mg to 5mg on the 7th of May, and then you and I agreed that the 5mg might be too strong so I dropped down to 4.2mg. Isn't that drop the same as doing a fast taper? Wouldn't it have been better if I had stayed on the 5mg for at least a month and then went down to 4.2mg? 

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Shep
6 hours ago, Nicjk said:

Wow this is very interesting @Shep. I had no idea. I have only been taking clonazepam every night for about 8 nights. Before that it was every now and then (once a month?). For the last 8 nights I have cycled between taking half of a 0.5mg pill or a full pill. Last night I took a full pill because I was very anxious and woke up wide awake at 3am.

 

Please decide if you wish to stay on clonazepam or not. Please note it only takes 2 - 4 weeks to develop dependency and we've seen people who became dependent in as little as 10 days on benzo forums. 

 

Some of your recent symptoms may be rebound anxiety or paradoxical reactions, especially with the varying doses. 

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Altostrata
12 hours ago, Nicjk said:

@Altostrata hoping you can clarify this for me. As you know I jumped from 2.5mg to 5mg on the 7th of May, and then you and I agreed that the 5mg might be too strong so I dropped down to 4.2mg. Isn't that drop the same as doing a fast taper? Wouldn't it have been better if I had stayed on the 5mg for at least a month and then went down to 4.2mg? 

 

No, you'd been taking reinstated Lexapro only a couple of weeks, takes a month or more for your system to get adapted to a dosage.

 

How are you feeling at 4.2mg? What time of day do you take it, how do you feel before and after?

 

As Shep observed, your inconsistent clonazepam dosing may be causing some of your symptoms. After 8 days of taking it, you may be dependent already. What happens when you don't take it?

 

 

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Nicjk
10 hours ago, Shep said:

Please decide if you wish to stay on clonazepam or not.

@Shep thank you for this info. I am no longer continuing with clonazepam. Last night I didn't take it and I woke up at 4am - unable to get back to sleep. Perhaps my body is adjusting to not having it anymore. Can you recommend anything to manage anxiety overnight? I already take Magnesium before bed. Is CBD oil a bad idea? 

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Nicjk
1 hour ago, Altostrata said:

No, you'd been taking reinstated Lexapro only a couple of weeks, takes a month or more for your system to get adapted to a dosage.

Oh thank you, this puts my mind at ease. The optimal amount for me was 3.3mg so I am going to decrease to 3.3mg today and stick with that for a month or more. 

 

1 hour ago, Altostrata said:

How are you feeling at 4.2mg? What time of day do you take it, how do you feel before and after?

I am still waking every night at 3am - 4am unable to get back to sleep. Anxiety has decreased over the last 4 days and it seems to stay at the same level - the only time I feel the anxiety is when I wake up in the early hours of the morning. I don't notice anything significant before or after taking the pill - I take my pill at 8am every morning. Do you think slow release melatonin will help with the 3:00am - 4:00am waking? 

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Altostrata

It sounds like your system is settling down.

 

Waking between 3 and 4 a.m. is very common, it's the beginning of the rise in morning cortisol. See

 

Tips to help sleep -- so many of us have that awful withdrawal insomnia

 

Path to Better Sleep FREE online for everyone from the US Veterans Administration

 

Music for self-care: Calms hyperalertness, anxiety, aids relaxation and sleep

 

What is the sleep cycle?

 

Melatonin for sleep: Many people find it helpful

 

TV or computer use in evening can disrupt sleep: Bright light signals the brain that it's daytime

 

3 hours ago, Nicjk said:

Do you think slow release melatonin will help with the 3:00am - 4:00am waking? 

 

Maybe. Start at a very low dose, don't overdo melatonin.

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Nicjk

@Altostrata last night I practised perfect sleep hygiene - had a bath before bed and took magnesium. I could not fall asleep for a few hours because my heart was pounding so hard. The only way I could get to sleep was to take a clonazepam and a sleeping pill. Is there anything I can take in the middle of the night instead of clonazepam? I am very concerned about getting hooked on it. I couldn't lie there with my heart pounding through my chest all night so needed something to calm me down 

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Altostrata
21 hours ago, Nicjk said:

a clonazepam and a sleeping pill

 

What does this mean? Dosages? How often are you taking clonazepam?

 

Please be aware that if you take clonazepam even intermittently, you can get rebound anxiety when it wears off some hours later. You may be causing these cycles with your use of clonazepam.

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Nicjk

@Altostrata I have basically taken clonazepam 0.5mg for the last few weeks, usually at night time (one tablet) due to my anxiety from coming off Lexapro. I believe you are right that I’m causing rebound anxiety. For the last few nights I have had a pounding heart and I have been unable to fall asleep without taking a clonazepam - I am probably dependent on them now 😥. I spoke to my psychiatrist today because my mental health is declining rapidly due to not enough sleep. He has told me

to increase Lexapro to 5mg for a week and not go off clonazepam until I stabilise on the Lex. I am concerned that the longer I stay on clonazepam, the harder it will be for me

to get off it. @Shep do you think it’s safe for me to cold turkey off 0.5mg clonazepam taken for 3 weeks? I do believe it is causing the pounding heart and terrible anxiety

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Shep
35 minutes ago, Nicjk said:

I am concerned that the longer I stay on clonazepam, the harder it will be for me

to get off it. @Shep do you think it’s safe for me to cold turkey off 0.5mg clonazepam taken for 3 weeks? I do believe it is causing the pounding heart and terrible anxiety

 

Once you're dependent on the drug, you're dependent. It likely will be harder on your nervous system to stop the benzo cold turkey than it would be to continue taking it until you're off the antidepressant. And then you can slowly taper off the benzo. 

 

Once you're dependent on a drug, going cold turkey is like jumping out the third story window. Tapering is like taking the stairs. 

 

38 minutes ago, Nicjk said:

I have basically taken clonazepam 0.5mg for the last few weeks, usually at night time (one tablet) due to my anxiety from coming off Lexapro. I believe you are right that I’m causing rebound anxiety. For the last few nights I have had a pounding heart and I have been unable to fall asleep without taking a clonazepam - I am probably dependent on them now 😥.

 

On 5/29/2020 at 5:46 PM, Nicjk said:

I am no longer continuing with clonazepam. Last night I didn't take it and I woke up at 4am - unable to get back to sleep.

 

I'm combining these two quotes to find out exactly what nights you've taking clonazepam and what nights you've skipped it. It's possible the pounding heart rate is from interdose withdrawal (withdrawal in between doses) due to sporadic dosing. 

 

Please update your signature to include when you've been taking periodic clonazepam and when you've gone for stretches of nights of continued use, if you have that information available. Your signature is here:

 

Account Settings - Create or Update Your Signature

 

Does the pounding heart symptom go away soon after you take clonazepam? 

 

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