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Toolbox: New to site and wanting advice re fast taper I have commenced

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Toolbox

I am new to this site and hoping to get some tips.  I have been on Lexapro for about 19 years ( now mid50s) and really want to come off it. I first went on when I suffered anxiety after suddenly losing my mother and really should not have stayed on so long. Tried coming off a few times and got irritable/ mood changes so resumed (all attempts were cold turkey).  Since Oct, at the advice of my doctor I halved to 10mg in one go for 6 weeks and then to zero from there about 6 weeks ago. I thought I was being slow and careful, but reading some of your posts, I have gone way too quick!  I had no idea about the withdrawal effects - and neither did my doctor either, it would seem!
 

in the last few weeks I have had vertigo/ dizziness which now seems to have resolved, but am very irritable/ short fused for the past 3-4 weeks.  I am unsure what to do now - should I wait it out and stay off the pills, or am I likely setting myself up for a big fail?  Shoukd I go back on some dose, and stay there for a while before tapering more slowly in 3-6 months time?  There is no big hurry, I just want to be aiming to get to zero at a safe point

 

any advice on the best path from here would be appreciated.  Unsure what I should do and if these symptoms will stay/ or get worse if I stay off tge a Lexapro 

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Gridley

Welcome to SA, Toolbox.  

 

As you now know, doctors know nothing about safe tapering or withdrawal, which they don't even believe exists. 

 

We recommend tapering no faster than 10% of current dose every four weeks.

 

Why taper by 10% of my dosage?

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF)

 

The Windows and Waves Pattern of Stabilization

 

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.  

 

Video:  Healing From Antidepressants - Patterns of Recovery

 

As to what to do now, that's a complicated question.  The first thing to consider is your current symptoms.   Is your only symptom irritability?  How significant is it?  Some people (there is no reliable statistic as to how many) are able to come off antidepressants with little difficulty.  It's possible you may be one of these.  

 

On the other hand, symptoms can be delayed after a honeymoon period, and there's no way to tell if that's going on in your case.  The 3-month point is a common time frame for this to happen.  This is what you're referring to when you talk about possibly setting yourself up for a fall down the road.  Another factor to consider is that you were on the drug for 19 years, which is a long time and could increase the likelihood of withdrawal down the road.  The following link is about delayed onset of symptoms after a too-fast taper.

 

Delayed onset of withdrawal symptoms

 

If you were suffering significant symptoms, I would suggest reinstatement of a very small dose of Lexapro (like 1mg), have you stabilize for several months, then taper down using the 10% method.  But your symptoms, if I understand correctly, are relatively mild.  So that you can make an informed decision, here is some information about reinstatement: 

 

Reinstatement of a very small dose of the original drug is the only known way to help alleviate withdrawal syndrome.  The only other alternative is to try and wait out the symptoms and manage as best you can until your central nervous system returns to homeostasis.  Unfortunately no one can give you an exact timeline as to when you will start feeling better and while some do recover relatively easily, for others it can take many months or longer.  

 

Reinstatement isn't a guarantee of diminished symptoms for everyone but it's the best tactic available.  You're still in the time period where reinstatement predictably works, up to 3 months after last dose.  It is best to reinstate as soon as possible after withdrawal symptoms occur. (Toolbox, here you see the rock-and-a-hard place aspect of the situation: if delayed withdrawal hits, say, at the 3-month point, the chances of reinstatement working are less, though not nonexistent, than if you had reinstated earlier.)  We usually suggest a much smaller reinstatement dose than your last dose.  These drugs are strong,  your system has become sensitized and If you take too much it may be too much for your brain and can cause you become more unstable.    Please read:

 

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

 

So there's the conundrum.  Do you reinstate 1mg, sort of like a vaccine, against the possibility of delayed onset withdrawal? Or do you ride it out?  Please read the links and let us know what you decide to do.

 

In the meantime--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) 

 

Add in one at a time and at a low dose in case you do experience problems.

 

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

 

 

 

 

 

 

 

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Toolbox

Thank you SO much for your detailed reply.  I have decided to go back on a small dose of 2mg of Lexapro and been to the doctor to get liquid form to get dosage right.  4 days back on and already noticing a big difference in my mood, energy and short temper.  I think I must have reached out just in time, as I was starting to feel like I was going over a cliff.  Is there anything I need to be aware of in now getting my body back on this small dose/ anything to expect?
 

the doctor suggested going straight back on at 10mg, so I am so pleased I had this information and could make a more informed decision.  There is no big hurry for me, but I do want to get off it completely. Just crazy that doctors are so ignorant of how to help you get back off the drugs!

 

one thing I have been struggling with and only just wondering if it might be related to withdrawal, is really heavy and aching legs- seems strange to be linked to the Lexapro but can’t seem to find another reason... is that common effect  of tapering off too quickly/ withdrawal?

 

thanks again - lifesaver!

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Gridley
2 hours ago, Toolbox said:

Is there anything I need to be aware of in now getting my body back on this small dose/ anything to expect?

I'm very glad the reinstatement is working.

 

As the dose gets to full state in the blood (another few) days, the effect should get stronger..  It still may take some weeks or months for your nervous system to settle down. You probably will continue to have waves and windows, but symptoms won't be as intense. Once you've stabilized you can start a 10% taper.

 

Muscle aches are a common withdrawal symptom.

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Toolbox

I have now been back on a small 2mg dose for 3 weeks after a fast taper. Initially felt a big difference - less angry/short tempered. Also has relieved to some extent the quite intense muscle aches/ tension in my body which I hadn’t realised was connected to the withdrawal - although still very achy and sore all over.  I do seem to be much more intense than when on the ADs.  I am so grateful to have found this site and to get some understanding of what is going on, as very confusing feeling like this.

 

at the same time I started my fast taper I also gave up alchohol completely, as it had crept into my habits way too much and was drinking a bottle/ and a half of wine each night on worst days.  So now almost 5 months alcohol free as well, which I am very proud of. But now realising - given my lack of understanding of the difficulties of getting off ADs- that it probably wasn’t the bes5 idea to do both together...  

 

just wondering to what extent the cold turkey of the alchohol might be adding to my withdrawal journey, and appreciate anyone thoughts on how this might affect my recovery and what to expect....  I am determined to keep going and weather this, but help from this site is really needed so I can understand better what I am doing to my body here?

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Toolbox

I have now been back on a small dose of Lexapro for 3.5 months - 3 mg from 20mg dose for almost 20 years.  Wish I had read info on this site before doing such a fast taper...  

 

in the last month I have really struggled with lethargy, nerve pains in my legs, arms etc , hot spells and General feeling of Hopelessness/can’t get excited by life-  not anything like what I was feeling when first prescribed anti depressants.  I have just over the last few days gone back up to 5mg to see if this might help, as unsure if due to withdrawing so fast or just coping with the whole Covid situation.

 

my question is whether I should just go back on my full previous dose?   Starting to wonder why I have done this and whether to accept that after 20 years, I need the anti depressants and unlikely to be able to live without.

 

really wanted to come off as don’t feel I shoukd need - but after so long am I now really better to accept I am dependent on them...

 

I would appreciate your thoughts and any advice?

 

 

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mdwstrx

Hi TB.

I'm sorry you're going through this.  Having been here myself, I know what a difficult road it is.

 

I've been on Lexapro/Escitalopram since 2002 - the year it was first approved in the US.  

After a relatively slow taper, my doctor advised I stop at 2.5 mg in 11/19.  Big mistake.

After 4 days I reinstated and found this site.  My doctor also wanted me to up dose to 10 mg. 

Moderators respectfully disagreed. I held an up dose at 7.5 mg. The excellent staff here

helped me to navigate a 4-5 month stabilization.  

 

Since then, I've successfully tapered to 2.65 mg. Most recently, that taper has led to some moderate

destabilization that is apparently not uncommon at the lower levels.  I've been advised to hold until it settles. 

 

I just received this great piece of advice from a moderator when (for the nth time :)), I voiced my doubts about being able 

to come off the drug.  I was told, "Rather than viewing that you want to come off, refocus on getting as low as you can in peace." 

 

So, my thoughts are:

First, get advice from staff on stabilizing.

Second, once feeling better, consider slow paced tapering knowing

that you can stop at any point you feel it becomes problematic.

 

I hope to resume tapering but time will tell.

 

Best wishes as you navigate your path.

Md 🌷

 

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Toolbox

Thank you for your thoughts MD - it really helps to know others are going thru this and understand. There just isn’t anyone who understands this that I can talk to.

 

i have been quite concerned about these new reactions - especially the feeling of what is life really all about/ hopelessness- as I have never felt this way before, and quite scary.  I thought it was al going well and had just had a stressful 6 week work role where I coode really well and was proud of how I dealt with the pressure- but in hindsight, perhaps that 6 weeks precipitated this difficult period and set me back.

 

i will hold at 5mg for now and see if it gets better after another week, but would appreciate thoughts from anyone else on how I should move next?  Need some support to know this is all worth it...

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Artistic1

Hi, TB. I've felt the hopelessness and lack of excitement about life that you describe. I still have bouts with those two emotions. They come and go, and what makes it worse is we can beat ourselves up with all kinds of guilt for feeling this way. And we think it will never end. But it is all part of the withdrawal and recovery. When you look at it as part of the process, you stop worrying about it so much and find a way to get through each day, knowing that ultimately, it will get better. I found a great book recently that really helped me to deal with this: "Recovery and Renewal," by Baylissa Frederick. It doesn't hit you over the head with a bunch of stuff, but provides reassuring information about how normal it is to have all these crappy experiences in withdrawal. 

 

I also see that you wrote it's scary to have these feelings. Yes, it is, and in my case, I let it spiral out of control with all kinds of negative thoughts. But if you can address that fear right away with some good CBT techniques, you will find the fear is baseless, and you'll be ahead of the game. Best wishes.

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