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Victor3

Victor3: going off Lexapro

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Victor3

Suffering from severe stress, overthinking and anxiety for over 15 years. Was on cymbalta for about 5 years. Then tried to withdraw from it using amino acids and herbs on my own. But had serious withdrawal symptoms and psychosis. Then I was prescribed Lexapro 20 mg and rexulti 1 mg. I was able to withdraw from rexulti after 2 years. But still currently on Lexapro 20 mg since 4 years. I want to wean off this time. I am so planning to get the SPECT scan done at the Amen clinics soon if it can be helpful. I am currently 35 years old and not going to give up this time.

i tried to lower the dose by 15% (approx) 3 weeks back for 3 days and had severe withdrawal symptoms like fever, headache, muscle pain, sore throat, brain zaps, loss of control. I went back to my original 20mg dose and doing fine now since this week. Is it a good idea to take fish oil, multi vitamins, and other natural herbs while tapering off Lexapro so brain can produce new neurotransmitters?

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Altostrata

Welcome, Victor.

 

I moved your post here to start your Introductions topic, ask questions about your situation, and track your progress.

 

When did you last take Rexulti?

 

Please read this Tips for tapering off Lexapro (escitalopram)

 

The key to going off psychiatric drugs is very gradual tapering. This enables your nervous system to adjust to the drug changes and produce its own neurotransmitters. There is no way to rush this process along, but many people find fish oil and magnesium supplements helpful, see
https://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/
https://survivingantidepressants.org/topic/15483-magnesium-natures-calcium-channel-blocker/

 

You might try a little bit of one at a time to see how it affects you.

 

I would save my money regarding Amen SPECT scan, it doesn't do anything useful.

 

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Victor3

Thank you Altostrata for the quick response. The last time I took rexulti was like12 months back.

I just ordered a digital scale online to measure the tapered dose exactly. I would do 10% lower dose now. And thank you for clearing my doubts about SPECT scan. I would not do it anymore. It's expensive too. I have always been a vegetarian since birth and now became vegan recently and gluten free and no junk food, which might help with Lexapro withdrawal.

I really appreciate your help.

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Altostrata

Making a liquid or getting the prescription liquid may be more convenient for tapering.

 

Are you taking vitamin B12 supplements? This is essential for people who do not consume animal products.

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Victor3

My psychiatrist might not agree to prescribe liquid form. But I will try.

I just started multi vitamins which includes b12 and vitamin d3.

I just saw your YouTube video. And it was very helpful and informative. Thank you for everything you are doing. I am going to support you in any way that I can. 

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jozeff

Hi Victor,

 

If you had such a bad reaction to a 15% reduction i would definitely not try 10% now. Why not try 2,5,% and see how that feels for a week?

 

I have tried a lot of tapering things for citalopram and now I find even 1,25 ,% per week too fast.

 

Better take it slow and go faster than the other way around. Trust me and many people before me on that.

 

 

Good luck!!!

 

Cheers

 

Jozeff

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Victor3

Thank you jozeph for this advice. Would definitely take into consideration. BTW how are you measuring such a small dose?

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Caroline16

Hi Victor!

 

I started tapering off Lexapro with the Brassmonkey method, it is really smooth. I feel no withdrawal symptoms at all! You can read about it here: https://www.survivingantidepressants.org/topic/17671-the-brassmonkey-slide-method-of-micro-tapering/

 

I started measuring my doses with a balance too, but it didn't go well for me. What I do now is to measure 10ml of water in a free syringe my pharmacist gave me. My Lexapro 10mg dissolve in it, I shake well and then, I discard the quantity I need, be it 0,25ml, 0,5ml, etc.

 

You can read about this here: https://www.survivingantidepressants.org/topic/2693-how-to-make-a-liquid-from-tablets-or-capsules/

 

I wish you the best of luck and go slowly, it is worth it for your health! :)

 

Caroline

 

 

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Victor3

Thank you so much Caroline. I went through the brass monkey method and seems very practical. And syringe will be better option too. I now have clear path and process for tapering my Lexapro dose of 20mg.

Thanks again. God bless you.

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Victor3

I am now concerned if the powdered form of Lexapro in the water can have a different impact on the absorption of the drug in the blood. There are many manufacturers for Lexapro and depending on the type of coating material used, it might have slow and proper rate of absorption when consumed as a whole tablet. The powdered form might not act and react the same way it is supposed to be acting. Any thoughts on this?

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Caroline16

It may have an impact on the absorption. If so, it may take you several days to adjust. If it is too difficult for you, you may take half your dosage in pill and the other half as the dilution, to get used to it.

 

You can ask your pharmacist if your Lexapro has a special coating regulating the absorption. But as far as I know, with all that I've read on this forum, it is not the case with Lexapro.

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manymoretodays
14 hours ago, Victor3 said:

I am now concerned if the powdered form of Lexapro in the water can have a different impact on the absorption of the drug in the blood. There are many manufacturers for Lexapro and depending on the type of coating material used, it might have slow and proper rate of absorption when consumed as a whole tablet. The powdered form might not act and react the same way it is supposed to be acting. Any thoughts on this?

 

Hi Victor3,

I went right from tablet to liquifying without any real problems myself.  Not with the Lexapro.  Mainly I think, you might get a little bit quicker absorption with liquid......I didn't notice much.  If/when switching from pill form to liquid form we usually ask members to do a bit of a cross over too:

 

Day 1-3-   no change in dose, 1/4 new form with 3/4 old form

Day 4-7-  1/2 new with 1/2 old

Day 8-11  3/4 new with 1/4 old

Day 12-  full dose using new form

 

Also including:

How to make a liquid from tablets or capsules

Using an oral syringe and other tapering techniques

 

Are you still on the 20 mg dose of Lexapro?

Also, please put your medication and tapering history in your signature -- that's the information you see at the bottom of someone's post. This will help people understand your situation no matter where you post on the site. See instructions in this topic:

https://www.survivingantidepressants.org/topic/18343-please-put-your-withdrawal-history-in-your-signature/(Please note that, while your identity is protected by a screen name, your topic can be read by anyone who visits the site, including Google, and do not post sensitive identifying information.)

 

What you could consider doing, is doing part of your dose liquid and then part of it with the tablet, and then later going to full liquid.  You'd just have to get a prescriber to write specifics for you on doing that, on the prescription.  If the pharmaceutical liquid is too expensive or something, you could make your own liquid with a half tablet, or get 10 mg tablets to work with.

Tips for tapering off Lexapro(escitalopram)

Cutting up tablets
Although 5mg tablets are available, if you are taking 20mg Lexapro, a drop to 15mg would be a 25% decrease. This is a larger decrease than the 10% recommended.

If you wish to try cutting up tablets, they can be cut up with a pill splitter like other medications in tablet form. Keep the pieces you don't use in a clean pill bottle labeled with the dosage for future use.

Reducing with a combination of tablets and liquid
If you are taking, for example, 15mg, and want to decrease by 10% (1.5mg), you can take one 10mg tablet and 3.5mg in the liquid form for a total of 13.5mg.

Titrating using liquid formulation
Using the liquid form is the best way to control the amount of each decrease. The US formulation provides 5 mg per 5 mL (amounting to 1mg of the medication in a milliliter of the liquid, or 1mg:1mL).

 

Welcome aboard, and hope that helps.

 

L, P, H, and G,

mmt

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Victor3

Thank you manymoretodays for the input.

I added info on my signature like you suggested. 

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Victor3

Thank you Caroline for the info and suggestions.

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Victor3

I have another question. Is it possible that we might need more serotonin and dopomine and other neurotransmitters when we are completely withdrawn from these drugs? How do we produce those required neurotransmitters naturally if your body and brain can't produce it anymore.? What if we are naturally deficient from these neurotransmitters right from birth or through hereditary? Can exercise, proper nutrition, support group and natural supplements balance all the hormones and neurotransmitters?

Please advise.

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manymoretodays

Hi Victor3,

And thank you for getting your signature done.  How are you doing today?

 

I'm going to give you some links today too, to some of the general information here, on tapering, and WD(withdrawal). 

The 10% taper recommendation is a harm reduction approach to going off psychiatric drugs.
 
 
 

 

22 hours ago, Victor3 said:

I have another question. Is it possible that we might need more serotonin and dopomine and other neurotransmitters when we are completely withdrawn from these drugs? How do we produce those required neurotransmitters naturally if your body and brain can't produce it anymore.? What if we are naturally deficient from these neurotransmitters right from birth or through hereditary? Can exercise, proper nutrition, support group and natural supplements balance all the hormones and neurotransmitters?

Please advise.

 
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. And sleep is really important during withdrawal.
 
So, in partial answer to your question there about natural deficiency of neurotransmitters.........I don't believe that the answer is in neurotransmitters, or ever was, or a lack somehow of them, leading to various states.  I don't think it's that simple.   Take a look at this:
 
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) 

 

You'll see, from the main page, or Home page, all the forums lined up.  And so you can begin to get a feel for, how to use the site now.

Hope today is a good one for you.

 

L, P, H, and G,

mmt

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Victor3

Thank you manymoretodays for the explanation. Most of my doubts about the neurotransmitters are getting cleared now. 

I have made changes to my diet, became vegan and gluten free. And no junk or processed foods. Taking omega 3 dha and epa, and multivitamins. Since I am working from home these days, I don't have that stress from office coworkers and social anxiety. My Lexapro dose has reduced to 10mg since 10 days. I was able to trick my mind believing that 20mg was too high of a dose. I am starting p90x3 home workout from tomorrow as well. This support group is extremely helpful. 

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manymoretodays
11 hours ago, Victor3 said:

My Lexapro dose has reduced to 10mg since 10 days. I was able to trick my mind believing that 20mg was too high of a dose. I am starting p90x3 home workout from tomorrow as well. This support group is extremely helpful. 

 

Hi Victor3,

Wait.  You did a 50% decrease in your Lexapro dose 10 days ago?  That's a huge decrease.  Sometimes, symptoms of WD are delayed.  Your body and nervous system will really appreciate some stability.  And once the instability sets in, it can take a long time to recover.  How are you doing now? 

 

I'm not sure that tricking your mind, is the best option for taking a harm reduction approach now to tapering Lexapro.  The key to a successful withdrawal is a gradual approach.  This is not a gradual approach, at all.  You might be able to get away with a little bit of a faster taper, while decreasing from the higher dosages, of Lexapro, but still........use your head and brain here. 

A much better approach, might be doing the 10% only tapers, from each previous dose, and carefully observing for the first 4 weeks.  If doing well, at that point, you might be able to do your tapers at more frequent intervals, to a certain point.  Please take caution when you get to the lower dosages too.  I mean once WDsyndrome sets in badly, it could be months or years to recover from that.

 

Do withdrawal symptoms always show up right away? Delayed onset.

 

What is p90x3?  I'm thinking, possibly some exercise program.  Victor3, please pay attention now, and go slow, ease your way into exercise.  Listen to your body, if you can.  This isn't a sprint, or a race, or some competitive sport........tapering and getting free of medications/drugs.  It's more like a marathon........slow and steady wins every time.

 

Exercise.....Do more, do less, do nothing, what worked for you?

 

The rule of 3KIS: Keep it simple, slow, and stable

 

 

On 3/25/2020 at 3:10 PM, Victor3 said:

i tried to lower the dose by 15% (approx) 3 weeks back for 3 days and had severe withdrawal symptoms like fever, headache, muscle pain, sore throat, brain zaps, loss of control. I went back to my original 20mg dose and doing fine now since this week. Is it a good idea to take fish oil, multi vitamins, and other natural herbs while tapering off Lexapro so brain can produce new neurotransmitters?

 

I think you might be playing with fire, a bit here.  So after 2 weeks of stabilization.......you then went on to do a 50% reduction???  What were you thinking?  Your poor nervous system.  Often the more ups and downs you do like this, will lead to kindling.......and you may not bounce back like you did the first time.

 

Oh Victor3.  Please study the links, especially the starred ones, in my first post.  And keep us updated.

 

 

Best, L, P, H, and G,

mmt

 

 

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Victor3

Hi mnymoretodays.

In all these years, whenever I lowered my dose by 50%, I feel the Withdrawal symptoms after 2 days. I get brain zaps, electric shock feeling, loss of control and headache. But this time I don't feel any withdrawal symptoms. It's been 10 days already. I feel that strong belief, some supplements and proper diet plays an important role as well. We put toxins everyday in our body by eating fast foods and processed foods which can worsen the withdrawal symptoms.

But I will be monitoring my symptoms very closely. May be I should go to 15 mg instead of 10mg if I see any slightest of the withdrawal symptoms.

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manymoretodays
Posted (edited)

Hi Victor3,

Just caution, caution please.  And urgha, I can't find the charts, I want you to look at.

Why taper by 10% of my dosage?

^, take a really good look at the first post, and then the Meyers, et. al article https://www.ncbi.nlm.nih.gov/pubmed/15121647

That next link is the abstract only, further along in the why taper by 10% the actual charts may be linked to or posted. Unfortunately, I don't think there is one for Lexapro, but there might be one for Celexa/citalopram, it's kinder, gentler cousin of sorts.

 

The charts give you a visual to demonstrate:  From correspondence with Dr. Horowitz: "...all pharmacological relationships are hyperbolic so the pattern of exponential reduction that you recommend is likely to apply to any target no matter what it is."

 

You can look up hyperbolic and exponential reduction definitions, if you'd like.  I had to.  Basically though, with many of the AD's, at the higher dosages, changes in the plasma concentration(determined by dosage) that then relate to the serotonin transporter occupancy, are not quite as much, as with the lower doses.  You have to take into account too, how long it might take, after a change in dose, to get to steady state as well.

 

So yah, going to 15 mg might not be a bad idea.  And then just sitting it out, and HOLDING, for a good stretch, while planning out your next steps.

I mean this is great that you ARE doing okay thus far.  And your confidence and attitude, as well.  I sure don't want to see you get hit hard though, if possible, with WD symptoms.  This all takes time, and a ton of patience.  Be the turtle......as in the story of the race between the turtle and the hare.

 

Please add the date of your recent change to your signature too.  Just go to AccountsSettings/signature

And then update with any subsequent changes.

 

Update here too.  Thank you.

 

L, P, H, and G,

mmt

 

Edited by manymoretodays
3rd section, redid a sentence, edited!

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Victor3

Thank you manymoretodays. This information is very helpful. Still trying to understand hyperbolic and exponential reduction. I updated my signature.

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Caroline16

Hi Victor!

 

It is not really complicated to calculate how much you should decrease your dose. If you start from 20mg you have to substract 10% which is 2mg, so you should take a 18mg dose for about a month.

The next month, you calculate 18mg-2%= you should take 16,2mg (because 10% of 18mg is 1,8mg).

 

Do you understand better? I am not sure my explanations are clear!

 

Caroline

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Victor3

The time Since I lowered my dose to 10 mg Lexapro on March 22, I haven't experienced any withdrawal symptoms. In fact I am feeling even better. (Seems like healthy diet and lifestyle is working for me). 

Has anyone felt like this?

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Victor3

The time Since I lowered my dose to 10 mg Lexapro on March 22, I haven't experienced any withdrawal symptoms. In fact I am feeling even better. (Seems like healthy diet and lifestyle is working for me). 

Has anyone felt like this?

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Altostrata

Since you had withdrawal symptoms before when you lowered the dose, we cannot explain why you tolerated a 50% decrease so well this time around.

 

As you started this topic March 25 saying you were taking 20mg Lexapro, please explain why you posted today saying you were taking 10mg on March 22.

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Victor3

Yes. I was going to alternate my dose between 10 and 20 mg on March 25. But I continued 10 mg instead of 20mg. I have done this before many times when I would skip a complete dose for a day or 2 and then jump back to 20 mg. But this time I continued on 10mg dose.

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Happy2Heal
On 3/31/2020 at 9:29 AM, manymoretodays said:

I think you might be playing with fire, a bit here.  So after 2 weeks of stabilization.......you then went on to do a 50% reduction???  What were you thinking?  Your poor nervous system.  Often the more ups and downs you do like this, will lead to kindling.......and you may not bounce back like you did the first time.

@Victor3 Please please please listen to MMT!!! this is not a smart move. 

 

On 4/11/2020 at 9:40 PM, Victor3 said:

The time Since I lowered my dose to 10 mg Lexapro on March 22, I haven't experienced any withdrawal symptoms. In fact I am feeling even better. (Seems like healthy diet and lifestyle is working for me). 

Has anyone felt like this?

 

yes Unfortunately what you are doing is very similar to what I did- and the results were NOT good.

Healthy diet and lifestyle won't change the fact that lexapro is a VERY powerful drug. 


Many of us have tried to do what you are trying to do and it WON"T WORK.  You almost surely will suffer for it if you don't slow down.

 

You've already gone up and down in your dose several times, this is NOT GOOD

please, learn from my mistake and from the mistakes and experiences of others who have come before you!
your brain needs stability!! that means only tiny changes done very very slowly.

 


My signature is an abbreviated version of what I went thru with lexapro. (it also shows all other drugs I've been on and got off of, and none of them was as hard to get off of as lexapro was)

I went on and off lexapro several times(with doses as high as 30 and 40 mgs)  The symptoms of WD were just awful, but I thought I was "relapsing" (and that's what my drs said) so I'd go back on the lexapro, often at an even higher dose.


I didn't know anything about WD- then I found this forum

 

but even when I found out I was going too fast, I had a false sense of security from being able to get off the other drugs without a lot of problems (plus I had a stupid feeling that I was going to be "different" from everyone else and just coast right thru WD easily) I thought I was special. LOL 

 

I too didn't feel much when going down from 20 mgs to 10 mgs to 5 even-

but when I got down below that, It was HORRIBLE. I can't even describe how awful it was.

So I went back to 2.5mgs with the intention to hold at that dose til I stabilized.

 

(thinking back I should have known this would happen: I'd fast tapered or CTed off the lexapro several times previously and had to go back on because the symptoms were so bad. I didn't know they were WD symptoms though, I thought at the time that I was sick and "really needed" the drug!)

 

I stayed at 2.5mg for about 6 mos but I was believing what the drs said, that 2.5mgs is "nothing"- it can't be doing anything, they laughed and said it was stupid to take that low a dose

so I jumped off at 2.5mg

Not exactly intentionally, I just forgot it for a few days and felt "ok", so I decided I'd be ok.

 

I was NOT OK.

about 3 mos later, I started to notice that I was having intrusive scary thoughts and was sweating a lot, day and night and unable to sleep.

that got worse and worse over the course of a few weeks til I was in a terrible terrible place where I was slammed with over 30 horrendous withdrawal symptoms, severe and utter terror, panic attacks, severe insomnia, vomiting, depersonalization, derealization, ringing in my ears, odd pains and physical sensations, massive cortisol spikes,  emotional spirals, anxiety thru the roof, and so much more. It was terrible

I did reinstate at tiny tiny dose but by then it was really too late, I was in severe delayed protracted withdrawal. I was most likely "kindled" (although I dont' fully understand that term I think it's the right one)

I suffered terribly for not following the advice of the moderators on this forum

 

I pray that you won't make the same mistakes.

it's really really bad Victor3

 

you've already had a small taste of how bad it can be, now imagine that being 10 or 100 times worse.

 

 

I too, eat a mostly very healthy diet. It has helped me lose weight, it reversed multiple physical issues, reversed non alcoholic fatty liver disease, hypertension, GERD, IBS, severe joint pain, high cholesterol, prediabetes (I just found out, no one told me but I found my blood test results, I was prediabetic a few years ago)

It might help your withdrawal go a little bit easier but a healthy diet will NOT prevent withdrawal symptoms

Just like it will improve your immune system, to eat well,  it will NOT prevent you from getting a cold or the covid19 virus

it might make the symptoms less severe if you do get a cold or whatever but it will not prevent you from getting one

 

same with drug withdrawal. Your brain does things very slowly, it needs time to adjust to being off these drugs

 

eat well, exercise and keep good sleep hygiene but do not count on your good habits to save you from withdrawal symptoms because it won't work

 

I pray that you take this advice very seriously. I went thru a solid year of hell and a few less hellish but not fun years after that. If I can help just one person avoid that kind of hell, maybe it will all have been worth it

 

please slow down and dont go up and down in your dose.

 

 

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Happy2Heal
On 4/11/2020 at 10:20 PM, Victor3 said:

Yes. I was going to alternate my dose between 10 and 20 mg on March 25. But I continued 10 mg instead of 20mg. I have done this before many times when I would skip a complete dose for a day or 2 and then jump back to 20 mg.

please please do not do this anymore!!!
 

 

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Altostrata
On 4/11/2020 at 7:20 PM, Victor3 said:

Yes. I was going to alternate my dose between 10 and 20 mg on March 25. But I continued 10 mg instead of 20mg. I have done this before many times when I would skip a complete dose for a day or 2 and then jump back to 20 mg. But this time I continued on 10mg dose.

 

This very well may explain why you got withdrawal symptoms. Alternating or skipping doses is an excellent way to bring on severe symptoms.

 

As Happy2Heal said, please do not do this any more, for any drug.

 

This is why we advocate a smooth, slow taper -- to avoid large variations in blood level of the drug.

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Rosetta

Skipping doses started the whole disaster for me.  My two cents.

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