Jump to content
Shelton

Shelton: withdrawal from short term amitriptyline and nortriptyline use, Celexa previously

Recommended Posts

Shelton

Please help!

 

I was on 30mg of Celexa for 3 months for generalized anxiety. After coming off of Celexa, I developed PGAD which I’m learning is unfortunately happening to people a lot. My doctor put me on 10mg Amitriptyline for 9 days and I had terrible side effects - brain fog, heightened anxiety, no appetite. Day 10 they switched me to Nortriptyline at a low dose of 2mL (liquid it’s such a small dose). Took it for 3 days and felt angry/mood swings, emotional, extremely depressed, agitated (couldn’t handle any mental stimulation or it made me so anxious - none of this is like me!) on the 4th night, I was going to stop Nortriptyline altogether. I fell asleep for an hour and woke up with the worst withdrawals - nausea, flu symptoms, agitation, insomnia, heart racing. I then got out of bed and lowered the Nortriptyline dose to 1mL. My withdrawals calmed down a tad and I was able to sleep for a couple hours. Woke up with anxiety, nausea, flu-like symptoms, fatigue. 
 

I was on low doses for such a short period of time, I can’t believe I’m dealing with withdrawal symptoms. Should I stop the Nortriptyline cold turkey now since it’s only been 3 nights and just suffer through the side effects?


Paxil 20mg - 2013-2015 (tapered to Lexapro)

Lexapro 20mg 2015 - May 19th, 2020

Celexa 10mg - May 19-May 26; Celexa 20mg - May 26-June 25; June 25-July 22; Celexa 30mg - 2 weeks leading up to July 22 - Caused adverse reactions/mild serotonin syndrome. CT’d Celexa July 22.

Developed PGAD August 13th - brutal; Buspar added 5mg twice a day for withdrawal anxiety - August 14th-15th but didn’t help PGAD (HELPED ANXIETY)

Nortriptyline 1mL liquid - August 19th-Sep 3 - HELPED PGAD

Sep 4 -Lexapro 1.25mg Sep 5 -Lexapro 2.5mg helped withdrawal symptoms but caused muscle pain so I knew I messed up

Sep 6-Sep 9 - Lexapro 1.25mg (helped flu like symptoms - severe “cortisol anxiety” at all hours of the night and day. No relief unless I take ativan which I tried so hard to avoid - severe nausea (too much med)

Sep 11-Now - Celexa .5mg (liquid .25ml)

2010-Now - Dexilant 30mg for acid reflux
May 2020 - Ativan .25mg as needed for anxiety - now on schedule at .125mg 3 x’s a day (September 13-15th or so, 2020)

(Vaginal Valium as needed for PGAD) - Used twice since August 13th - Stopped

Share this post


Link to post
Shelton

 

Altostrata,


I was on Celexa 30mg for 3 months. After discontinuing successfully, I developed PGAD which I'm learning happens a lot coming off of SSRI's.

My doctor prescribed Amitriptyline 10mg for PGAD, it worked. I was on it 9 days with awful side effects - heart racing, chemical anxiety, no appetite, shakiness. She switched me to Nortriptyline but at a tiny dose of 2mL (liquid). I took it for 3 days but felt VERY irritable, mood swings, angry and anxious which is not like me at all. I tried to stop cold turkey and lasted 3 hours before I couldn't stand the withdrawals I was feeling (Insomnia, extreme irritability, flu like symptoms, nausea) so I took 1mL of Nortriptyline and it calmed me down. I am now experiencing insomnia, flu like symptoms, nausea. Should I stop cold turkey since I was only on them a total of 12 days? Not sure what would be best at this point.

 

Edited by manymoretodays
removed quote that had been from another members topic

Paxil 20mg - 2013-2015 (tapered to Lexapro)

Lexapro 20mg 2015 - May 19th, 2020

Celexa 10mg - May 19-May 26; Celexa 20mg - May 26-June 25; June 25-July 22; Celexa 30mg - 2 weeks leading up to July 22 - Caused adverse reactions/mild serotonin syndrome. CT’d Celexa July 22.

Developed PGAD August 13th - brutal; Buspar added 5mg twice a day for withdrawal anxiety - August 14th-15th but didn’t help PGAD (HELPED ANXIETY)

Nortriptyline 1mL liquid - August 19th-Sep 3 - HELPED PGAD

Sep 4 -Lexapro 1.25mg Sep 5 -Lexapro 2.5mg helped withdrawal symptoms but caused muscle pain so I knew I messed up

Sep 6-Sep 9 - Lexapro 1.25mg (helped flu like symptoms - severe “cortisol anxiety” at all hours of the night and day. No relief unless I take ativan which I tried so hard to avoid - severe nausea (too much med)

Sep 11-Now - Celexa .5mg (liquid .25ml)

2010-Now - Dexilant 30mg for acid reflux
May 2020 - Ativan .25mg as needed for anxiety - now on schedule at .125mg 3 x’s a day (September 13-15th or so, 2020)

(Vaginal Valium as needed for PGAD) - Used twice since August 13th - Stopped

Share this post


Link to post
Shelton

Short Time Span on Amitriptyline & Nortitriptyline

 

I developed PGAD from coming off of Celexa 30mg for 3 months. Seems to be a theme with coming off of antidepressants. 

My doctor started me on 10mg Amitriptyline 2 weeks to help the PGAD. It took it away but gave me awful side effects (heart racing, high BP, agitation, increased anxiety).


After 9 days, doctor switched me to 2mL of Nortriptyline. The PGAD symptoms stayed away at the low dose but was having severe mood swings/anger (not me at all!) and heightened anxiety.
 

After 3 days on 2ml, I lowered my dose last night to 1ml of Nortriptyline and am feeling absolutely terrible. I had no idea I could get withdrawals from such low doses over a span of 2 weeks?

My question - do I stay on 1ml, go back to 2ml or stop altogether?

Withdrawal symptoms now: nausea, flu like symptoms, anxiety, agitation

How long will the withdrawals last if I’ve only been on the medications for 2 weeks?

 

Edited by ChessieCat
added topic title before merging with intro

Paxil 20mg - 2013-2015 (tapered to Lexapro)

Lexapro 20mg 2015 - May 19th, 2020

Celexa 10mg - May 19-May 26; Celexa 20mg - May 26-June 25; June 25-July 22; Celexa 30mg - 2 weeks leading up to July 22 - Caused adverse reactions/mild serotonin syndrome. CT’d Celexa July 22.

Developed PGAD August 13th - brutal; Buspar added 5mg twice a day for withdrawal anxiety - August 14th-15th but didn’t help PGAD (HELPED ANXIETY)

Nortriptyline 1mL liquid - August 19th-Sep 3 - HELPED PGAD

Sep 4 -Lexapro 1.25mg Sep 5 -Lexapro 2.5mg helped withdrawal symptoms but caused muscle pain so I knew I messed up

Sep 6-Sep 9 - Lexapro 1.25mg (helped flu like symptoms - severe “cortisol anxiety” at all hours of the night and day. No relief unless I take ativan which I tried so hard to avoid - severe nausea (too much med)

Sep 11-Now - Celexa .5mg (liquid .25ml)

2010-Now - Dexilant 30mg for acid reflux
May 2020 - Ativan .25mg as needed for anxiety - now on schedule at .125mg 3 x’s a day (September 13-15th or so, 2020)

(Vaginal Valium as needed for PGAD) - Used twice since August 13th - Stopped

Share this post


Link to post
manymoretodays

Hi Shelton and welcome,

This is your introduction page now, and the best place to put your questions specific to your case.

 

How many milligrams of a dose is 1 mL of your present Nortryptiline(corrected from Amitryptiline originally, mmt)?

How long were you on Celexa? 3 mos?   How did you come off of it and when?

 

Also:

 

*Please summarize your withdrawal history in your signature

pretty clear instructions on how to do this ^

 

*Why taper by 10% of my dosage?

especially the very first post there

I'm including an excerpt from that first post in the above link that should help your understanding:

  

On 8/5/2011 at 2:43 PM, Altostrata said:

According to the medical journal literature on antidepressant withdrawal syndrome, anyone who has been taking a drug for a month or more is at risk.

 

Chances are that you are suffering from Celexa WD and then your doctor chose to treat that with amitrytiline, then nortryptiline.  Interesting.  Your not quite dependent on the amitryptiline or nortryptiline.....yet, at only 2 weeks usage.,

The mood swings and increased anxiety quite likely are due to WD(withdrawal) symptoms from Celexa breaking through now.  

 

Dr. Joseph Glenmullen's withdrawal symptom checklist

 

*What is withdrawal syndrome?

 

@Shelton  You've now introduced yourself to the community, and should continue to post specific question around your specific case right here.  It really helps to have all your information in one place.  I moved your first post from another members introduction, removed the quote of Altostrata's that was in response to them, and got you approved and started.  Here's a link to the post that you had partially quoted, talking more about the properties and pharmacokinetics of amitryp and noritryp, to Honingbij, in their introduction:  https://www.survivingantidepressants.org/topic/9973-honingbij-tapering-off-amitriptyline-again/?do=findComment&comment=481832 

 

We have individual tapering topics on many of the AD's as well.  You'll find them here:

Important topics in the Tapering forum and FAQ's

just scroll on down in the first post ^, and you'll find topics on all 3 of your drugs that you've tried to date.

 

 

 

Best,

Love, peace, healing, and growth,

moderator manymoretodays(mmt)

Edited by manymoretodays
a bit more for clarity, correction, links

Started with psycho meds circa 1988 I think 27 or 28 total.

AD's, antpsychotics, antiseizure mood stabilizers. Lithium, lamictal ,benzos, and stimulants. Some med. for narcolepsy once(Provigil,) Gabapentin........probably more.  Ask me?......I probably was on it.  Haphazard W/D's by Dr. recommend or uneducated self.

10/2014- off Lexapro--had been on highest dose 10 mg. then 5 mg. for a couple of years, went from 5 mg. to 3 mg. liquid and then CT in hospital(voluntary).  I got out of the hospital on a combination of low dose adderal salts x1/day and trileptal 150mg. x2/day.

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!

 

3/21/2016---I did some unwise updosing of trileptal/oxcarbazepine with some stressful stuff......doubled the above dose x2 during this last wave but began liquifying again and on approximately 68mg. starting today.  11/12//2016 24 mg. oxcarbazepine  12/9/2016 off oxcarbazepine/trileptal!!!! :) optimistic  2016 December 9- completely off all medications!!!!!

Omega3's,EPA +DHA= 1800 mg/day. Magnesium complex, orally, diluted in a liter of H2O(that I can shake up.....it usually dissolves more completely as the water gets down to room temperature) and/or Epsom salt baths prn.   Vit. C, D3, and E.  B12, melatonin tapered to 1mg., and bioidentical hormones sublingually.  Trace mineral drops.  L-lysine.  L-methylfolate=400 mcg plus daily spinach. Totally ready for a good long window to hit soon and getting better strings of full days and partial days along the way.  Definite improvement overall since I first arrived on the SA survivor ship.  Herb and alcohol free since 5/15/2016.  None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider. manymoretodays

 

Share this post


Link to post
Shelton
On 9/1/2020 at 9:26 PM, manymoretodays said:

Hi Shelton and welcome,

This is your introduction page now, and the best place to put your questions specific to your case.

 

How many milligrams of a dose is 1 mL of your present Nortryptiline(corrected from Amitryptiline originally, mmt)?

How long were you on Celexa? 3 mos?   How did you come off of it and when?

 

Also:

 

*Please summarize your withdrawal history in your signature

pretty clear instructions on how to do this ^

 

*Why taper by 10% of my dosage?

especially the very first post there

I'm including an excerpt from that first post in the above link that should help your understanding:

  

 

Chances are that you are suffering from Celexa WD and then your doctor chose to treat that with amitrytiline, then nortryptiline.  Interesting.  Your not quite dependent on the amitryptiline or nortryptiline.....yet, at only 2 weeks usage.,

The mood swings and increased anxiety quite likely are due to WD(withdrawal) symptoms from Celexa breaking through now.  

 

Dr. Joseph Glenmullen's withdrawal symptom checklist

 

*What is withdrawal syndrome?

 

@Shelton  You've now introduced yourself to the community, and should continue to post specific question around your specific case right here.  It really helps to have all your information in one place.  I moved your first post from another members introduction, removed the quote of Altostrata's that was in response to them, and got you approved and started.  Here's a link to the post that you had partially quoted, talking more about the properties and pharmacokinetics of amitryp and noritryp, to Honingbij, in their introduction:  https://www.survivingantidepressants.org/topic/9973-honingbij-tapering-off-amitriptyline-again/?do=findComment&comment=481832 

 

We have individual tapering topics on many of the AD's as well.  You'll find them here:

Important topics in the Tapering forum and FAQ's

just scroll on down in the first post ^, and you'll find topics on all 3 of your drugs that you've tried to date.

 

 

 

Best,

Love, peace, healing, and growth,

moderator manymoretodays(mmt)


 

Thank you so much for your response! I’m trying to add my history. 
 

I was on Lexapro 20mg for 6 years. After having a baby, my doctor switched me to Celexa. I did okay on Celexa for 3 months until she increased me to 30mg. When that happened, I got serotonin syndrome and had to abruptly stopped. I was dealing with the withdrawals but then PGAD hit. Since I couldn’t reinstate Celexa due to serotonin syndrome, they gave me Amitriptyline 10mg. It stopped the PGAD but the side effects were awful (heart racing, chest pains, brain fog). After 9 days, doctor switched me to 2ml Nortriptyline. It kept pgad away but was feeling angry, agitated, moody (not like me at all) so I stopped cold turkey and it got worse? 

 

i was thinking it was withdrawals from Amitriptyline/Nortriptyline but now I’m thinking it’s all withdrawals from Celexa and the Nortriptyline is keeping some of the withdrawal symptoms at bay?

 

What should I do?


Paxil 20mg - 2013-2015 (tapered to Lexapro)

Lexapro 20mg 2015 - May 19th, 2020

Celexa 10mg - May 19-May 26; Celexa 20mg - May 26-June 25; June 25-July 22; Celexa 30mg - 2 weeks leading up to July 22 - Caused adverse reactions/mild serotonin syndrome. CT’d Celexa July 22.

Developed PGAD August 13th - brutal; Buspar added 5mg twice a day for withdrawal anxiety - August 14th-15th but didn’t help PGAD (HELPED ANXIETY)

Nortriptyline 1mL liquid - August 19th-Sep 3 - HELPED PGAD

Sep 4 -Lexapro 1.25mg Sep 5 -Lexapro 2.5mg helped withdrawal symptoms but caused muscle pain so I knew I messed up

Sep 6-Sep 9 - Lexapro 1.25mg (helped flu like symptoms - severe “cortisol anxiety” at all hours of the night and day. No relief unless I take ativan which I tried so hard to avoid - severe nausea (too much med)

Sep 11-Now - Celexa .5mg (liquid .25ml)

2010-Now - Dexilant 30mg for acid reflux
May 2020 - Ativan .25mg as needed for anxiety - now on schedule at .125mg 3 x’s a day (September 13-15th or so, 2020)

(Vaginal Valium as needed for PGAD) - Used twice since August 13th - Stopped

Share this post


Link to post
DataGuy

Hi @Shelton,

 

You said in another post that you tried the lowest dose of Celexa, can you remember exactly that that dosage was? Sometimes the lowest dose of a drug available is actually not very low and has substantial pharmacological action. 

 

It might be best to get rid of the ami/nortriptyline and try and reinstate a small amount of Celexa. 


Remeron - 2004-2005 (bad withdrawal)

Clonazepam - 2005-2018 (jumped around March)

Many drugs in between including Lexapro, other benzos and z-drugs, and olanzapine.

Still suffering post-withdrawal from Clonazepam (Klonopin), Olanzapine and Domperidone. 

Share this post


Link to post
Shelton

My doctor lowered my Nortriptyline to .5ml 2 nights ago and tried me on 2.5mg of Lexapro yesterday morning and I had the serotonin syndrome like symptoms again - an adverse reaction. 
 

I just fixed my signature because before I was put on Amitriptyline, I was on Buspar 5mg twice a day. It calmed my anxiety/withdrawal symptoms but didn’t touch PGAD so that’s when they prescribed Amitriptyline.

 

My next question -

Should I do the low dose of Buspar and the low dose of Nortriptyline - calming my nervous system then gradually taper both?


Paxil 20mg - 2013-2015 (tapered to Lexapro)

Lexapro 20mg 2015 - May 19th, 2020

Celexa 10mg - May 19-May 26; Celexa 20mg - May 26-June 25; June 25-July 22; Celexa 30mg - 2 weeks leading up to July 22 - Caused adverse reactions/mild serotonin syndrome. CT’d Celexa July 22.

Developed PGAD August 13th - brutal; Buspar added 5mg twice a day for withdrawal anxiety - August 14th-15th but didn’t help PGAD (HELPED ANXIETY)

Nortriptyline 1mL liquid - August 19th-Sep 3 - HELPED PGAD

Sep 4 -Lexapro 1.25mg Sep 5 -Lexapro 2.5mg helped withdrawal symptoms but caused muscle pain so I knew I messed up

Sep 6-Sep 9 - Lexapro 1.25mg (helped flu like symptoms - severe “cortisol anxiety” at all hours of the night and day. No relief unless I take ativan which I tried so hard to avoid - severe nausea (too much med)

Sep 11-Now - Celexa .5mg (liquid .25ml)

2010-Now - Dexilant 30mg for acid reflux
May 2020 - Ativan .25mg as needed for anxiety - now on schedule at .125mg 3 x’s a day (September 13-15th or so, 2020)

(Vaginal Valium as needed for PGAD) - Used twice since August 13th - Stopped

Share this post


Link to post
manymoretodays

Hi Shelton,

 

Here's our PGAD topic:  Persistent genital arousal disorder(PGAD)

Also: Serotonin Syndrome or Serotonin Toxicity

And a more basic WebMD article too:  https://www.webmd.com/depression/guide/serotonin-syndrome-causes-symptoms-treatments#1

I like the WebMD one because it has a symptom list right at the start.  Can you identify which symptoms you got, when you acutely got it? 

 

The other thing is that, you have had a 7 year history of AD's(antidepressants).  And  a really rapid WD(withdrawal) from the last high dose of Celexa and must be experiencing WD symptoms now too.  Some do get PGAD, like you.  Check out that link, meanwhile, stay real hopeful too. 

 

On 9/1/2020 at 7:26 PM, manymoretodays said:

How many milligrams of a dose is 1 mL of your present Nortryptiline(corrected from Amitryptiline originally, mmt)?

I found the answer to the above here:  Drugs.com Nortriptyline Oral Solution

The liquid comes in 10 mg(the dose) per 5 mL(the amount of liquid that dose is in)

So 1 mL is going to give you a 2 mg dose.  And we already know that, it's parent compound, at a full dose......here I'm referring to the Amitriptyline did help the PGAD but then all heck broke loose.

And then 0.5 mL is going to give you a 1 mg dose.  That's what you are on now, correct?

 

5 hours ago, Shelton said:

My next question -

Should I do the low dose of Buspar and the low dose of Nortriptyline - calming my nervous system then gradually taper both?

Boy, I love Drugs.com.  If I were you I think that I might get familiar with checking any and all drugs that are given to you now, before even taking them.  You can search for any drug singularly AND check for drug interactions too.

 

So then.......here's the Drug Interaction Report for the combination of Buspar and nortriptyline

 

Gasp!!

 

I think if I were you, I'd ditch the Buspar now.  And wouldn't try any other drugs just yet.   You were only on it for 2 days.

 

Less is often more, is why...... I personally, might do the above.  And then I would just HOLD tight with it, the dose of nortriptyline that doesn't send you skyrocketing into anxious confusion and feeling like you are coming apart at the seams.  It might help a little with WD symptoms.  If you can just stay with one drug, small reinstatement........that may be best for now. 

 

Let me know how that sounds to you.

And then keep us updated too.

Are you on any other medications or supplements?

 

Non-drug techniques to cope

 

BASIC SUPPLEMENT TOOLKIT

King of supplements: Omega-3 fatty acids (fish oil)

Magnesium, nature's calcium channel blocker

 

I might try some magnesium.  You can take it orally or topically or even some in the bath in the form of Epsom salts.  Take a look at the link.  It can be very calming.

 

And best. 

L, P, H, and G,

mmt

 

 

 

 

 

 


Started with psycho meds circa 1988 I think 27 or 28 total.

AD's, antpsychotics, antiseizure mood stabilizers. Lithium, lamictal ,benzos, and stimulants. Some med. for narcolepsy once(Provigil,) Gabapentin........probably more.  Ask me?......I probably was on it.  Haphazard W/D's by Dr. recommend or uneducated self.

10/2014- off Lexapro--had been on highest dose 10 mg. then 5 mg. for a couple of years, went from 5 mg. to 3 mg. liquid and then CT in hospital(voluntary).  I got out of the hospital on a combination of low dose adderal salts x1/day and trileptal 150mg. x2/day.

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!

 

3/21/2016---I did some unwise updosing of trileptal/oxcarbazepine with some stressful stuff......doubled the above dose x2 during this last wave but began liquifying again and on approximately 68mg. starting today.  11/12//2016 24 mg. oxcarbazepine  12/9/2016 off oxcarbazepine/trileptal!!!! :) optimistic  2016 December 9- completely off all medications!!!!!

Omega3's,EPA +DHA= 1800 mg/day. Magnesium complex, orally, diluted in a liter of H2O(that I can shake up.....it usually dissolves more completely as the water gets down to room temperature) and/or Epsom salt baths prn.   Vit. C, D3, and E.  B12, melatonin tapered to 1mg., and bioidentical hormones sublingually.  Trace mineral drops.  L-lysine.  L-methylfolate=400 mcg plus daily spinach. Totally ready for a good long window to hit soon and getting better strings of full days and partial days along the way.  Definite improvement overall since I first arrived on the SA survivor ship.  Herb and alcohol free since 5/15/2016.  None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider. manymoretodays

 

Share this post


Link to post
Shelton
3 hours ago, manymoretodays said:

I like the WebMD one because it has a symptom list right at the start.  Can you identify which symptoms you got, when you acutely got it? 


So here’s the strange part - I was on 30mg of Celexa for a month and did great. It was a quick increase from 10 to 20 and then to 30 - still unsure why my doctor did that ☹️ I was fine for a month on 30mg then had my first postpartum cycle - day after period ended I started having severe anxiety, irritability, tremors, heart racing. It stayed that way for 2 weeks (doc thought it may be hormonal) then it came to a head and I started getting body shakes. I never had to go to the hospital, my doctor thought I had some symptoms of serotonin syndrome so she had me C/T. Still not 100% sure of serotonin syndrome I just know my body all of a sudden did NOT like the Celexa?

 

3 hours ago, manymoretodays said:

So 1 mL is going to give you a 2 mg dose.  And we already know that, it's parent compound, at a full dose......here I'm referring to the Amitriptyline did help the PGAD but then all heck broke loose.

And then 0.5 mL is going to give you a 1 mg dose.  That's what you are on now, correct?


Since I’m having awful side effects to the Nortriptyline (racing heart - high resting heart rate, extreme fatigue) doc is suggesting stopping the 1mg Nortriptyline and reinstating Lexapro at 2.5mg to try and reverse PGAD and lessen withdrawal symptoms. Get me stable, then VERRRYYY slowly try to wean down. What do you think of this? 

 

I am on Dexilant for acid reflux (been on it for years) and a stomach probiotic that I’ve been on for years. No other supplements. I have ativan as needed for severe panic attacks. 
 

Can magnesium make things worse? Terrified now of taking any medication (as I’m sure we all are!)

 

Thank you so much for responding! 


Paxil 20mg - 2013-2015 (tapered to Lexapro)

Lexapro 20mg 2015 - May 19th, 2020

Celexa 10mg - May 19-May 26; Celexa 20mg - May 26-June 25; June 25-July 22; Celexa 30mg - 2 weeks leading up to July 22 - Caused adverse reactions/mild serotonin syndrome. CT’d Celexa July 22.

Developed PGAD August 13th - brutal; Buspar added 5mg twice a day for withdrawal anxiety - August 14th-15th but didn’t help PGAD (HELPED ANXIETY)

Nortriptyline 1mL liquid - August 19th-Sep 3 - HELPED PGAD

Sep 4 -Lexapro 1.25mg Sep 5 -Lexapro 2.5mg helped withdrawal symptoms but caused muscle pain so I knew I messed up

Sep 6-Sep 9 - Lexapro 1.25mg (helped flu like symptoms - severe “cortisol anxiety” at all hours of the night and day. No relief unless I take ativan which I tried so hard to avoid - severe nausea (too much med)

Sep 11-Now - Celexa .5mg (liquid .25ml)

2010-Now - Dexilant 30mg for acid reflux
May 2020 - Ativan .25mg as needed for anxiety - now on schedule at .125mg 3 x’s a day (September 13-15th or so, 2020)

(Vaginal Valium as needed for PGAD) - Used twice since August 13th - Stopped

Share this post


Link to post
Shelton
10 hours ago, DataGuy said:

Hi @Shelton,

 

You said in another post that you tried the lowest dose of Celexa, can you remember exactly that that dosage was? Sometimes the lowest dose of a drug available is actually not very low and has substantial pharmacological action. 

 

It might be best to get rid of the ami/nortriptyline and try and reinstate a small amount of Celexa. 


It was 10mg Celexa which I’m learning now is super high. Doc wants me to stay away from Celexa, get rid of Nortriptyline and do 2.5mg Lexapro to try and reverse PGAD and calm withdrawal symptoms. What do you think?


Paxil 20mg - 2013-2015 (tapered to Lexapro)

Lexapro 20mg 2015 - May 19th, 2020

Celexa 10mg - May 19-May 26; Celexa 20mg - May 26-June 25; June 25-July 22; Celexa 30mg - 2 weeks leading up to July 22 - Caused adverse reactions/mild serotonin syndrome. CT’d Celexa July 22.

Developed PGAD August 13th - brutal; Buspar added 5mg twice a day for withdrawal anxiety - August 14th-15th but didn’t help PGAD (HELPED ANXIETY)

Nortriptyline 1mL liquid - August 19th-Sep 3 - HELPED PGAD

Sep 4 -Lexapro 1.25mg Sep 5 -Lexapro 2.5mg helped withdrawal symptoms but caused muscle pain so I knew I messed up

Sep 6-Sep 9 - Lexapro 1.25mg (helped flu like symptoms - severe “cortisol anxiety” at all hours of the night and day. No relief unless I take ativan which I tried so hard to avoid - severe nausea (too much med)

Sep 11-Now - Celexa .5mg (liquid .25ml)

2010-Now - Dexilant 30mg for acid reflux
May 2020 - Ativan .25mg as needed for anxiety - now on schedule at .125mg 3 x’s a day (September 13-15th or so, 2020)

(Vaginal Valium as needed for PGAD) - Used twice since August 13th - Stopped

Share this post


Link to post
manymoretodays
On 9/4/2020 at 10:14 AM, Shelton said:

My doctor lowered my Nortriptyline to .5ml 2 nights ago and tried me on 2.5mg of Lexapro yesterday morning and I had the serotonin syndrome like symptoms again - an adverse reaction. 

 

Are these the symptoms of "serotonin like symptoms" that you refer to above?

 

16 hours ago, Shelton said:

day after period ended I started having severe anxiety, irritability, tremors, heart racing. It stayed that way for 2 weeks (doc thought it may be hormonal) then it came to a head and I started getting body shakes.

 

16 hours ago, Shelton said:

Since I’m having awful side effects to the Nortriptyline (racing heart - high resting heart rate, extreme fatigue) doc is suggesting stopping the 1mg Nortriptyline and reinstating Lexapro at 2.5mg to try and reverse PGAD and lessen withdrawal symptoms. Get me stable, then VERRRYYY slowly try to wean down. What do you think of this? 

 

I think 2.5 mg Lexapro is too high of a reinstatement dose for you, given that you do seem to be so very sensitive now.  And a little bit of citalopram might be a wiser choice, but I don't know Shel......I wish I did, and am so sorry that you are having to go through all this while you should be just enjoying your new little one.

 

Here's more on reinstatements:

About reinstating and stabilizing to reduce withdrawal syndrome

 

We take a harm reduction approach here, and start low with reinstatements, much lower than what your doctor has been trying.   And you've been trying so many things.  I'm going to put you in for further input.

 

So 2 days now of nortryptiline .5mL equivalent to a 1 mg dose? 

Can you give us an idea of what a day looks like simply:  daily notes  - please just look at the first post and the sample note there and try to do one of those and post it. 

 

You've done good with piecing more of your recent history together here and getting your signature done.  Appreciated. 

17 hours ago, Shelton said:

I am on Dexilant for acid reflux (been on it for years) and a stomach probiotic that I’ve been on for years. No other supplements. I have ativan as needed for severe panic attacks. 

 

Have you used any of the ativan recently.  And if so, when and how much(dose)?

 

Best to you and the little one.

L, P, H, and G,

mmt

 


Started with psycho meds circa 1988 I think 27 or 28 total.

AD's, antpsychotics, antiseizure mood stabilizers. Lithium, lamictal ,benzos, and stimulants. Some med. for narcolepsy once(Provigil,) Gabapentin........probably more.  Ask me?......I probably was on it.  Haphazard W/D's by Dr. recommend or uneducated self.

10/2014- off Lexapro--had been on highest dose 10 mg. then 5 mg. for a couple of years, went from 5 mg. to 3 mg. liquid and then CT in hospital(voluntary).  I got out of the hospital on a combination of low dose adderal salts x1/day and trileptal 150mg. x2/day.

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!

 

3/21/2016---I did some unwise updosing of trileptal/oxcarbazepine with some stressful stuff......doubled the above dose x2 during this last wave but began liquifying again and on approximately 68mg. starting today.  11/12//2016 24 mg. oxcarbazepine  12/9/2016 off oxcarbazepine/trileptal!!!! :) optimistic  2016 December 9- completely off all medications!!!!!

Omega3's,EPA +DHA= 1800 mg/day. Magnesium complex, orally, diluted in a liter of H2O(that I can shake up.....it usually dissolves more completely as the water gets down to room temperature) and/or Epsom salt baths prn.   Vit. C, D3, and E.  B12, melatonin tapered to 1mg., and bioidentical hormones sublingually.  Trace mineral drops.  L-lysine.  L-methylfolate=400 mcg plus daily spinach. Totally ready for a good long window to hit soon and getting better strings of full days and partial days along the way.  Definite improvement overall since I first arrived on the SA survivor ship.  Herb and alcohol free since 5/15/2016.  None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider. manymoretodays

 

Share this post


Link to post
DataGuy

I agree with @manymoretodays, 2.5mg of Lexapro sounds too high for you. I think this already induced serotonin syndrome type symptoms for you?

 

I would try reinstating 1mg or lower. Better to start too low than too high. If you can't tolerate any dose of Lexapro, you may just have to stay away from meds for awhile while your body heals. 

 

Please add ativan and any other drugs (like antibiotics) or supplements you have taken to your drug signature.


Remeron - 2004-2005 (bad withdrawal)

Clonazepam - 2005-2018 (jumped around March)

Many drugs in between including Lexapro, other benzos and z-drugs, and olanzapine.

Still suffering post-withdrawal from Clonazepam (Klonopin), Olanzapine and Domperidone. 

Share this post


Link to post
Shelton

I made a mistake I think @DataGuy & @manymoretodays - Yesterday, I took 1.25mg Lexapro and handled it well (had some increased anxiety) so my doctor said increase it to 2.5mg (after a day) - my withdrawal symptoms immediately started to feel better and I was starting to feel more like myself but later on I started having bad muscle aches so I knew I probably messed up. I woke up this morning with shakes and nausea and felt bad so I knew I couldn’t handle 2.5mg. So this morning I took 1.25mg of Lexapro. Now I have severe nausea, muscle aches, flu like symptoms.


My question now - do I continue taking 1.25mg or less tomorrow morning or have I ruined chances of reinstatement since I’m having a bad reaction to 2.5mg and now 1.25mg? 

 

Honestly, being off all meds is not an option because with PGAD and severe withdrawal symptoms, I don’t think I can handle it 😭 if I can’t handle Lexapro, I previously tried Buspar for 2 days and it helped withdrawal symptoms with no side effects, just not sure if it helps PGAD. Would a low dose of Buspar be okay for reinstatement since SSRI’s themselves are making me so sick?

 

I am fixing my signature now.

 

@Altostrata - do you have any suggestions on my reinstatement? I am desperate and need help. 


Paxil 20mg - 2013-2015 (tapered to Lexapro)

Lexapro 20mg 2015 - May 19th, 2020

Celexa 10mg - May 19-May 26; Celexa 20mg - May 26-June 25; June 25-July 22; Celexa 30mg - 2 weeks leading up to July 22 - Caused adverse reactions/mild serotonin syndrome. CT’d Celexa July 22.

Developed PGAD August 13th - brutal; Buspar added 5mg twice a day for withdrawal anxiety - August 14th-15th but didn’t help PGAD (HELPED ANXIETY)

Nortriptyline 1mL liquid - August 19th-Sep 3 - HELPED PGAD

Sep 4 -Lexapro 1.25mg Sep 5 -Lexapro 2.5mg helped withdrawal symptoms but caused muscle pain so I knew I messed up

Sep 6-Sep 9 - Lexapro 1.25mg (helped flu like symptoms - severe “cortisol anxiety” at all hours of the night and day. No relief unless I take ativan which I tried so hard to avoid - severe nausea (too much med)

Sep 11-Now - Celexa .5mg (liquid .25ml)

2010-Now - Dexilant 30mg for acid reflux
May 2020 - Ativan .25mg as needed for anxiety - now on schedule at .125mg 3 x’s a day (September 13-15th or so, 2020)

(Vaginal Valium as needed for PGAD) - Used twice since August 13th - Stopped

Share this post


Link to post
DataGuy

@Shelton, your doctor sounds like he doesn't know what he is doing. It takes around 5 days for lexapro to get up to full strength when taken daily. 

 

Ok, we are going to go real low. Try 0.25mg for a few days. I think what happened is that your neurons got sensitized by rapid withdrawal, making them hyper-responsive to any stimuli. Going on and off tends to make things worse, so we are going to try and stop going up and down. If the 0.25mg does nothing after a few days, we can increase to 0.5mg. Serotonin syndrome symptoms are very bad, so you want to avoid those even more than the PGAD. Make sure these are all gone before you take anymore lexapro. 

 

Sometimes people become too sensitized by kindling to reinstate any dose, so there is no guarantee this will work. 


Remeron - 2004-2005 (bad withdrawal)

Clonazepam - 2005-2018 (jumped around March)

Many drugs in between including Lexapro, other benzos and z-drugs, and olanzapine.

Still suffering post-withdrawal from Clonazepam (Klonopin), Olanzapine and Domperidone. 

Share this post


Link to post
Shelton

@DataGuy okay so symptoms today are nausea, flu like symptoms, shakes, high anxiety. Should I wait until the shakes go away to start back on .5 or start back at .5 tomorrow? Also, I only have a 5mg tablet so I have been cutting it into 4’s to get the 1.25. How do I get .5mg? 
 

If this doesn’t work (I always have to have a back up plan or I get more anxious), would a low dose of Buspar work for reinstatement since I had no adverse reaction to it previously during withdrawal?


Paxil 20mg - 2013-2015 (tapered to Lexapro)

Lexapro 20mg 2015 - May 19th, 2020

Celexa 10mg - May 19-May 26; Celexa 20mg - May 26-June 25; June 25-July 22; Celexa 30mg - 2 weeks leading up to July 22 - Caused adverse reactions/mild serotonin syndrome. CT’d Celexa July 22.

Developed PGAD August 13th - brutal; Buspar added 5mg twice a day for withdrawal anxiety - August 14th-15th but didn’t help PGAD (HELPED ANXIETY)

Nortriptyline 1mL liquid - August 19th-Sep 3 - HELPED PGAD

Sep 4 -Lexapro 1.25mg Sep 5 -Lexapro 2.5mg helped withdrawal symptoms but caused muscle pain so I knew I messed up

Sep 6-Sep 9 - Lexapro 1.25mg (helped flu like symptoms - severe “cortisol anxiety” at all hours of the night and day. No relief unless I take ativan which I tried so hard to avoid - severe nausea (too much med)

Sep 11-Now - Celexa .5mg (liquid .25ml)

2010-Now - Dexilant 30mg for acid reflux
May 2020 - Ativan .25mg as needed for anxiety - now on schedule at .125mg 3 x’s a day (September 13-15th or so, 2020)

(Vaginal Valium as needed for PGAD) - Used twice since August 13th - Stopped

Share this post


Link to post
DataGuy

@Shelton do you have a scale that can weigh the pill? If not, you may just have to eyeball it. 

 

Also, you are taking 0.25mg at first, not 0.5mg. You do not want to sensitize yourself further.

 

So do what you can to take 1/5 of 1.25mg, if you do not have a scale. That is probably going to be pretty difficult. If you determine that this is impossible, you can try to make a liquid. See tips for tapering escitalopram (lexapro). You would dissolve 1.25mg of lexapro in the solution and then take 1/5 of the resulting product. You could also get a compounding pharmacy to make you a liquid with 0.25mg of lexapro per ml, but I'm not sure if they could make it quickly enough. Someone else may want to weigh in on making the liquid, if that is the route you want to go.

 

The backup plan is Celexa, because the pharmacology of this drug is much closer to that of Lexapro. But if you cannot tolerate 0.25mg, then I would not recommend trying any other SSRI type drugs for a long time. 


Remeron - 2004-2005 (bad withdrawal)

Clonazepam - 2005-2018 (jumped around March)

Many drugs in between including Lexapro, other benzos and z-drugs, and olanzapine.

Still suffering post-withdrawal from Clonazepam (Klonopin), Olanzapine and Domperidone. 

Share this post


Link to post
DataGuy

Here is the link to the serotonin syndrome / toxicity thread. You might want to take a look at it if you haven't already: 

 


Remeron - 2004-2005 (bad withdrawal)

Clonazepam - 2005-2018 (jumped around March)

Many drugs in between including Lexapro, other benzos and z-drugs, and olanzapine.

Still suffering post-withdrawal from Clonazepam (Klonopin), Olanzapine and Domperidone. 

Share this post


Link to post
DataGuy

You should wait until all of your symptoms are gone before taking anymore lexapro. By this, I mean all of the symptoms that were caused by the excessive reinstatement dose of lexapro. 


Remeron - 2004-2005 (bad withdrawal)

Clonazepam - 2005-2018 (jumped around March)

Many drugs in between including Lexapro, other benzos and z-drugs, and olanzapine.

Still suffering post-withdrawal from Clonazepam (Klonopin), Olanzapine and Domperidone. 

Share this post


Link to post
Altostrata

Hello, Shelton.

On 9/3/2020 at 6:53 PM, Shelton said:

I did okay on Celexa for 3 months until she increased me to 30mg. When that happened, I got serotonin syndrome and had to abruptly stopped.

 

What were these symptoms?

 

On 9/4/2020 at 9:14 AM, Shelton said:

My doctor lowered my Nortriptyline to .5ml 2 nights ago and tried me on 2.5mg of Lexapro yesterday morning and I had the serotonin syndrome like symptoms again - an adverse reaction. 

 

What were the symptoms?

 

It seems to me what happened was 30mg Celexa was too much for you and your doctor doesn't know any more about serotonin syndrome than he or she knows about withdrawal syndrome and reinstatement.

 

You are having adverse reactions to the subsequent drugs because your nervous system has been sensitized by withdrawal. All the dosages you tried are too high for you.

 

If I were you, I would stop experimenting with escitalopram, it's related to but much stronger than citalopram -- another essential fact your doctor doesn't know. I would get the liquid form of Celexa and try a reinstatement of 0.5mg citalopram. Let us know how you're doing.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Share this post


Link to post
manymoretodays

Yes, all of what Dataguy is saying above is true.  Switching drugs on a daily basis(almost, from what I can see) is never helpful at all.

 

We do really need some notes too.  Especially if you would like Alto's opinion.

"What we need to see for every single day over several days is what symptoms you get before and after you take your drugs. If you're not taking any drugs and have withdrawal symptoms, we still need to see your symptom pattern throughout the day"

 

Here's the link again:  Keeping daily notes

Time on the left, then any drug or supplement by name, with dose on the right

Time on the left continues for 24 hours(in increments of that), note symptoms when noticed on the right.

Sample note:

And so forth. A diary, in chronological order, looking something like this:
 
6 a.m. Woke with anxiety
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
10:00 p.m. Took 50mg Seroquel
10:20 p.m. Feeling dizzy
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

 

37 minutes ago, Shelton said:

Should I wait until the shakes go away to start back on .5 or start back at .5 tomorrow? Also, I only have a 5mg tablet so I have been cutting it into 4’s to get the 1.25. How do I get .5mg? 

 

For right now, you are going to have to cut one of the 1/4's into 1/5 or less. O.25 mg.  It's probably just be a crumb by then.  Stick with the same size crumb.  Take at same time each day.  Stay with it and the notes for a minimum of 4 days.

And okay.....deferring to Alto, I'm one of the slowest posters around.....

  

6 minutes ago, Altostrata said:

If I were you, I would stop experimenting with escitalopram, it's related to but much stronger than citalopram -- another essential fact your doctor doesn't know. I would get the liquid form of Celexa and try a reinstatement of 0.5mg citalopram. Let us know how you're doing.

 

 

Do notes!  Post a 24 hour segment just like the sample but with your information.  Include Ativan if you use it with the dose please. 

 

I don't know that Buspar is going to be any great save from the WD symptoms or PGAD.  I've never seen that to be the case.  It's certainly not one of our go to's for reinstatement, unless that was the drug you originally went off of.

 

It is really hard to know what's what, while you make the changes in other medications almost daily.  We need to see patterns, over time, like a few days........without further changes.  What happened on August 13th, was WD, in my opinion, including the PGAD.  It often does have a delay.......we see this frequently.  There aren't often quick fixes once it has set in.   Don't be desperate.  You can handle this.   One day at a time.  Take advantage of all the calm moments you get right now!  Cuddle with cute new baby!

 

L, P, H, and G,

mmt

 

 

 

Edited by manymoretodays
revised after Alto's post

Started with psycho meds circa 1988 I think 27 or 28 total.

AD's, antpsychotics, antiseizure mood stabilizers. Lithium, lamictal ,benzos, and stimulants. Some med. for narcolepsy once(Provigil,) Gabapentin........probably more.  Ask me?......I probably was on it.  Haphazard W/D's by Dr. recommend or uneducated self.

10/2014- off Lexapro--had been on highest dose 10 mg. then 5 mg. for a couple of years, went from 5 mg. to 3 mg. liquid and then CT in hospital(voluntary).  I got out of the hospital on a combination of low dose adderal salts x1/day and trileptal 150mg. x2/day.

5/28/2015-off Adderal salts 2.5mg. (I had been on that since hospital 10/2014)

12/2015---just holding, holding, holding, with trileptal/oxcarb at 75 mg. 1/2 tab at hs.  My last psycho med ever!

 

3/21/2016---I did some unwise updosing of trileptal/oxcarbazepine with some stressful stuff......doubled the above dose x2 during this last wave but began liquifying again and on approximately 68mg. starting today.  11/12//2016 24 mg. oxcarbazepine  12/9/2016 off oxcarbazepine/trileptal!!!! :) optimistic  2016 December 9- completely off all medications!!!!!

Omega3's,EPA +DHA= 1800 mg/day. Magnesium complex, orally, diluted in a liter of H2O(that I can shake up.....it usually dissolves more completely as the water gets down to room temperature) and/or Epsom salt baths prn.   Vit. C, D3, and E.  B12, melatonin tapered to 1mg., and bioidentical hormones sublingually.  Trace mineral drops.  L-lysine.  L-methylfolate=400 mcg plus daily spinach. Totally ready for a good long window to hit soon and getting better strings of full days and partial days along the way.  Definite improvement overall since I first arrived on the SA survivor ship.  Herb and alcohol free since 5/15/2016.  None of my posts are intended as medical advice.  Please discuss any decisions about your medical care with a knowledgeable medical provider. manymoretodays

 

Share this post


Link to post
DataGuy

I endorse @manymoretodays and @Altostrata's plans. 0.5mg of Citalopram is likely pretty similar to 0.25mg of Lexapro.


Remeron - 2004-2005 (bad withdrawal)

Clonazepam - 2005-2018 (jumped around March)

Many drugs in between including Lexapro, other benzos and z-drugs, and olanzapine.

Still suffering post-withdrawal from Clonazepam (Klonopin), Olanzapine and Domperidone. 

Share this post


Link to post
Shelton
4 minutes ago, Altostrata said:

 

Hello, Shelton.

On 9/3/2020 at 9:53 PM, Shelton said:

I did okay on Celexa for 3 months until she increased me to 30mg. When that happened, I got serotonin syndrome and had to abruptly stopped.

 

What were these symptoms?

 


Started as severe agitation, insomnia, muscle weakness, nausea - she thought it was hormonal (3 months postpartum) so had me wait it out. By the end of the 2nd week “waiting it out” I was SEVERELY anxious and shaking. Woke up in the middle of the night and had to pace the floors, insomnia. She said it sounded like serotonin syndrome. I stopped cold turkey per her recommendation and those symptoms went away within 2 days.

 

7 minutes ago, Altostrata said:
On 9/4/2020 at 12:14 PM, Shelton said:

My doctor lowered my Nortriptyline to .5ml 2 nights ago and tried me on 2.5mg of Lexapro yesterday morning and I had the serotonin syndrome like symptoms again - an adverse reaction. 

 

What were the symptoms?


I started at 1.25 mg Lexapro on Friday and just had heightened anxiety and depression - no effects to withdrawal symptoms. Dr had me increase to 2.5mg Saturday (yesterday) - for 4 hours, withdrawal symptoms calmed down a lot and I was feeling more like myself. Then, my muscles started aching BAD all over. I had to take an ativan 5mg to go to sleep. I woke up with morning with shakes, agitation, muscle weakness, nausea. I took 1.25mg Lexapro this morning instead of 2.5 like yesterday and that made me feel worse. Nausea, agitation, shaky, flu symptoms (body weakness and aching).

 

12 minutes ago, Altostrata said:

It seems to me what happened was 30mg Celexa was too much for you and your doctor doesn't know any more about serotonin syndrome than he or she knows about withdrawal syndrome and reinstatement.

 

You are having adverse reactions to the subsequent drugs because your nervous system has been sensitized by withdrawal. All the dosages you tried are too high for you.

 

If I were you, I would stop experimenting with escitalopram, it's related to but much stronger than citalopram -- another essential fact your doctor doesn't know. I would get the liquid form of Celexa and try a reinstatement of 0.5mg citalopram. Let us know how you're doing.


She is off today and tomorrow. Earliest I could get would be Tuesday. Should I skip tomorrow? What if she won’t give me liquid form of Celexa and will only do Lexapro? 


Paxil 20mg - 2013-2015 (tapered to Lexapro)

Lexapro 20mg 2015 - May 19th, 2020

Celexa 10mg - May 19-May 26; Celexa 20mg - May 26-June 25; June 25-July 22; Celexa 30mg - 2 weeks leading up to July 22 - Caused adverse reactions/mild serotonin syndrome. CT’d Celexa July 22.

Developed PGAD August 13th - brutal; Buspar added 5mg twice a day for withdrawal anxiety - August 14th-15th but didn’t help PGAD (HELPED ANXIETY)

Nortriptyline 1mL liquid - August 19th-Sep 3 - HELPED PGAD

Sep 4 -Lexapro 1.25mg Sep 5 -Lexapro 2.5mg helped withdrawal symptoms but caused muscle pain so I knew I messed up

Sep 6-Sep 9 - Lexapro 1.25mg (helped flu like symptoms - severe “cortisol anxiety” at all hours of the night and day. No relief unless I take ativan which I tried so hard to avoid - severe nausea (too much med)

Sep 11-Now - Celexa .5mg (liquid .25ml)

2010-Now - Dexilant 30mg for acid reflux
May 2020 - Ativan .25mg as needed for anxiety - now on schedule at .125mg 3 x’s a day (September 13-15th or so, 2020)

(Vaginal Valium as needed for PGAD) - Used twice since August 13th - Stopped

Share this post


Link to post
Altostrata
12 minutes ago, Shelton said:

I started at 1.25 mg Lexapro on Friday and just had heightened anxiety and depression - no effects to withdrawal symptoms. Dr had me increase to 2.5mg Saturday (yesterday) - for 4 hours, withdrawal symptoms calmed down a lot and I was feeling more like myself. Then, my muscles started aching BAD all over. I had to take an ativan 5mg to go to sleep. I woke up with morning with shakes, agitation, muscle weakness, nausea. I took 1.25mg Lexapro this morning instead of 2.5 like yesterday and that made me feel worse. Nausea, agitation, shaky, flu symptoms (body weakness and aching).

 

Lexapro is closely related to but, milligram for milligram, much stronger than Celexa.

 

You might as well work with the Lexapro liquid you have.

 

It takes several days for Lexapro or Celexa to ramp up in your bloodstream. What happened was you initially felt pretty good from the amount of Lexapro that got into your system the second day, but as it ramped up and you increased it, it got to be too much for you -- just like increasing to 30mg Celexa was too much for you.

 

Your nervous system is now sensitized by going on and off drugs and having adverse reactions to them. A little goes a long way.

 

The 1.25mg Lexapro you took today, roughly equivalent to 3.75mg-5mg Celexa, added to whatever was left in your system from the prior 2 days. It's too high a dose of the drug. This should wear off over the next few days -- you should be feeling a little better each day (but don't expect to get back to normal soon, that may take months).

 

If I were you, I'd plan on taking 0.25mg Lexapro at the same time each day. This may be enough for the withdrawal symptoms you developed when you cold-turkeyed Celexa in July. This change probably will take a week to settle in. Please let us know how you're doing.

 

Your doctor may be a good doctor in many ways but is not knowledgeable about psychiatric drugs.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Share this post


Link to post
Shelton
1 minute ago, Altostrata said:

Lexapro is closely related to but, milligram for milligram, much stronger than Celexa.

 

You might as well work with the Lexapro liquid you have.


I don’t have liquid form of either right now. Right now I just have a 5mg tablet of Lexapro. I have been cutting it into 4’s.

 

2 minutes ago, Altostrata said:

It takes several days for Lexapro or Celexa to ramp up in your bloodstream. What happened was you initially felt pretty good from the amount of Lexapro that got into your system the second day, but as it ramped up and you increased it, it got to be too much for you -- just like increasing to 30mg Celexa was too much for you.


This makes SO much more sense than any doctor saying “you’re just so sensitive!” And I always looked and serotonin syndrome symptoms but the only one I really had was shaking badly, agitation and stomach aches. My other side effects (flu symptoms, body aches, weakness) weren’t on there.
 

5 minutes ago, Altostrata said:

If I were you, I'd plan on taking 0.25mg Lexapro at the same time each day. This may be enough for the withdrawal symptoms you developed when you cold-turkeyed Celexa in July. This change probably will take a week to settle in. Please let us know how you're doing.


Should I skip tomorrow and start Tuesday when these flu-like symptoms calm down or take it tomorrow regardless?


I emailed my doctor and left an on call message hoping to get either liquid form of Celexa (preferably) or liquid form of Lexapro. Until then, should I just kind of guess .25mg with the Lexapro tablet? I will let you all know what she gives me.

 

You guys seem to be on the same page and SO knowledgeable and helpful - I could literally cry. Holding my 3 1/2 month old baby sobbing because I can’t believe this is happening to me. I’m so grateful I found you guys or I have no idea what would happen. 

 

@DataGuy @Altostrata @manymoretodays


Paxil 20mg - 2013-2015 (tapered to Lexapro)

Lexapro 20mg 2015 - May 19th, 2020

Celexa 10mg - May 19-May 26; Celexa 20mg - May 26-June 25; June 25-July 22; Celexa 30mg - 2 weeks leading up to July 22 - Caused adverse reactions/mild serotonin syndrome. CT’d Celexa July 22.

Developed PGAD August 13th - brutal; Buspar added 5mg twice a day for withdrawal anxiety - August 14th-15th but didn’t help PGAD (HELPED ANXIETY)

Nortriptyline 1mL liquid - August 19th-Sep 3 - HELPED PGAD

Sep 4 -Lexapro 1.25mg Sep 5 -Lexapro 2.5mg helped withdrawal symptoms but caused muscle pain so I knew I messed up

Sep 6-Sep 9 - Lexapro 1.25mg (helped flu like symptoms - severe “cortisol anxiety” at all hours of the night and day. No relief unless I take ativan which I tried so hard to avoid - severe nausea (too much med)

Sep 11-Now - Celexa .5mg (liquid .25ml)

2010-Now - Dexilant 30mg for acid reflux
May 2020 - Ativan .25mg as needed for anxiety - now on schedule at .125mg 3 x’s a day (September 13-15th or so, 2020)

(Vaginal Valium as needed for PGAD) - Used twice since August 13th - Stopped

Share this post


Link to post
Shelton
35 minutes ago, DataGuy said:

I endorse @manymoretodays and @Altostrata's plans. 0.5mg of Citalopram is likely pretty similar to 0.25mg of Lexapro.


Thank you so much @DataGuy !

 

I am hoping she will call me in liquid form of Celexa. If not, I hope she will give me liquid form of Lexapro. Have you seen such small doses end up helping withdrawal symptoms? 
 

I will update you guys on how I am and what she will prescribe for me!

 

@manymoretodays @DataGuy @Altostrata


Paxil 20mg - 2013-2015 (tapered to Lexapro)

Lexapro 20mg 2015 - May 19th, 2020

Celexa 10mg - May 19-May 26; Celexa 20mg - May 26-June 25; June 25-July 22; Celexa 30mg - 2 weeks leading up to July 22 - Caused adverse reactions/mild serotonin syndrome. CT’d Celexa July 22.

Developed PGAD August 13th - brutal; Buspar added 5mg twice a day for withdrawal anxiety - August 14th-15th but didn’t help PGAD (HELPED ANXIETY)

Nortriptyline 1mL liquid - August 19th-Sep 3 - HELPED PGAD

Sep 4 -Lexapro 1.25mg Sep 5 -Lexapro 2.5mg helped withdrawal symptoms but caused muscle pain so I knew I messed up

Sep 6-Sep 9 - Lexapro 1.25mg (helped flu like symptoms - severe “cortisol anxiety” at all hours of the night and day. No relief unless I take ativan which I tried so hard to avoid - severe nausea (too much med)

Sep 11-Now - Celexa .5mg (liquid .25ml)

2010-Now - Dexilant 30mg for acid reflux
May 2020 - Ativan .25mg as needed for anxiety - now on schedule at .125mg 3 x’s a day (September 13-15th or so, 2020)

(Vaginal Valium as needed for PGAD) - Used twice since August 13th - Stopped

Share this post


Link to post
Altostrata

Please don't skip any doses. This topic contains instructions for making a liquid from your tablet: Tips for tapering off escitalopram (Lexapro)

 

You will need a container to measure some milliliters of water and a small oral syringe, preferably 1mL, which you can get from a pharmacist or veterinarian -- they're used to give drugs to children and animals.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Share this post


Link to post
Shelton

@Altostrata @manymoretodays @DataGuy,

 

I woke up several times throughout the night with flu like symptoms, shakes, insomnia, nausea and this morning had diarrhea. 
 

Still take .25mg this morning?


Paxil 20mg - 2013-2015 (tapered to Lexapro)

Lexapro 20mg 2015 - May 19th, 2020

Celexa 10mg - May 19-May 26; Celexa 20mg - May 26-June 25; June 25-July 22; Celexa 30mg - 2 weeks leading up to July 22 - Caused adverse reactions/mild serotonin syndrome. CT’d Celexa July 22.

Developed PGAD August 13th - brutal; Buspar added 5mg twice a day for withdrawal anxiety - August 14th-15th but didn’t help PGAD (HELPED ANXIETY)

Nortriptyline 1mL liquid - August 19th-Sep 3 - HELPED PGAD

Sep 4 -Lexapro 1.25mg Sep 5 -Lexapro 2.5mg helped withdrawal symptoms but caused muscle pain so I knew I messed up

Sep 6-Sep 9 - Lexapro 1.25mg (helped flu like symptoms - severe “cortisol anxiety” at all hours of the night and day. No relief unless I take ativan which I tried so hard to avoid - severe nausea (too much med)

Sep 11-Now - Celexa .5mg (liquid .25ml)

2010-Now - Dexilant 30mg for acid reflux
May 2020 - Ativan .25mg as needed for anxiety - now on schedule at .125mg 3 x’s a day (September 13-15th or so, 2020)

(Vaginal Valium as needed for PGAD) - Used twice since August 13th - Stopped

Share this post


Link to post
DataGuy

I will let @Altostrata give the final answer, but I would not if you still have symptoms of the adverse reaction. 


Remeron - 2004-2005 (bad withdrawal)

Clonazepam - 2005-2018 (jumped around March)

Many drugs in between including Lexapro, other benzos and z-drugs, and olanzapine.

Still suffering post-withdrawal from Clonazepam (Klonopin), Olanzapine and Domperidone. 

Share this post


Link to post
Altostrata
2 hours ago, Shelton said:

@Altostrata @manymoretodays @DataGuy,

 

I woke up several times throughout the night with flu like symptoms, shakes, insomnia, nausea and this morning had diarrhea. 
 

Still take .25mg this morning?

 

These sound like withdrawal symptoms. Yes, I would take 0.25mg consistently.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Share this post


Link to post
Shelton
18 minutes ago, Altostrata said:

 

These sound like withdrawal symptoms. Yes, I would take 0.25mg consistently.


 

@Altostrata


At this point, I think it is withdrawal symptoms. 


Here are my notes so far:


(Spoke to psychiatrist Wednesday (at this point, was only on 1ml Nortriptyline - told her I was feeling agitated, angry/irritable, high anxiety, couldn’t handle a lot of stimulation at one time, body aches, flu like symptoms, dizzy. I thought this was side effects of Nortriptyline but now learning it was the beginning of withdrawal. She told me to continue Nortriptyline Friday night and do 2.5mg Lexapro)

 

Thursday 09/03

2.5mg Lexapro in the morning - within 30 minutes felt it was too much with heart racing, shortness of breath, restless, chest heavy

 

(couldn’t get in touch with psychiatrist, thought this was serotonin syndrome ((now learning I probably never had)) and didn’t take it Friday morning)

 

Friday 09/04

Nighttime - WORST SEVERE anxiety I’ve had so far. Very close to panic attack - Almost like electric currents running through my body, shakey, flu like symptoms, achey and nauseous
Took 1/2 ativan 8:30, calmed down just a tad. Had to take another 1/2 to go to sleep
 
(Spoke to psychiatrist, she said lower dose to 1.25mg starting TOMORROW and if PGAD starts to come back, increase to 2.5mg)
 
Night -
.25ml Nortriptyline
PGAD : 0/10
Sleep : HORRIBLE. Woke up with severe anxiety, body aches, nausea and flu like symptoms at 12am. Fell back asleep and woke up at 1:30am with the same feelings. 
 
Saturday 09/05
Woke up with : horrible anxiety, jolted with anxiety, weakness in arms and legs, nausea
PGAD : 1/10
 
Late Morning -
1.25mg Lexapro
 
After taking Lexapro -
Symptoms : heightened or “different” anxiety but about the same overall 
PGAD : 1:00 2/10
 
2:15pm took 1/2 ativan for anxiety and PGAD more noticeable so took additional 1.25mg Lexapro per doc’s recommendation 
 
Symptoms after additional Lexapro were same - wave of panic at 3:45
Gradually calmed down to more of an internal agitation/anxious feeling - body aches especially in legs - had some confusion with my words which was scary?
NOTE- for about 4 hours after taking it, i felt more like myself! Thennnn symptoms hit bad. 
 
PGAD during afternoon/evening: 0/10
 
Night time -
NO Nortriptyline
5mg Ativan
Sleep : Slept great but woke up around 6 with body shaking/restless/sweats/confusion with words/nausea
Immediately took 1/2 ativan and knew I messed up with 2.5mg with instructions from psychiatrist.
 
Sunday 09/06
Woke up with : body shaking/restless/sweats/confusion with words/nausea
immediately took 1/2 ativan.
PGAD : 0-1/10
 
Late Morning -
1.25 Lexapro 
 
After taking Lexapro:
Symptoms: After about an hour, flu like symptoms, nauseous (almost vomited), weak, muscles hurt - had to lay down it was so bad (CANT TELL IF WITHDRAWAL SYMPTOMS OR ADVERSE REACTION?)
PGAD : 1/10
 
(After talking to you and discovering all of this, I emailed my psychiatrist - thinking too much Lexapro - could possibly benefit from liquid LOW (.25mg-5mg dose of Celexa or Lexapro?) Celexa may be better since not as strong)
 
Night time:
Symptoms: flu like symptoms calmed down some, no nausea, weak and muscles still ache some - extremely emotional/slight anxiety
Took .25mg ativan
PGAD : 2/10
NO Nortriptyline
Sleep : Woke up 11:15 feeling awful, high anxiety - took other half (.25 ativan) - woke up again 2:20pm feeling terrible. PGAD 3/10, sweating, nausea, flu symptoms, shaking
 
Monday 09/07
Woke up with : diarrhea, nausea, weakness, can’t lift head off my pillow, shaking/shivering, sweaty
PGAD : 2/10
 
Took what I think is .25mg Lexapro until I can get in touch with psychiatrist for liquid!
 
So...stay on .25mg and see if I feel better in a week? If I don’t, what do I do next? These withdrawal symptoms are so bad. Do you think I still have hope with reinstatement with everything I’ve done and psychiatrist has recommended?
 
Psychiatrist keeps wanting me to go on Buspar - I have another appt with a different psychiatrist but can’t see her until October!

Paxil 20mg - 2013-2015 (tapered to Lexapro)

Lexapro 20mg 2015 - May 19th, 2020

Celexa 10mg - May 19-May 26; Celexa 20mg - May 26-June 25; June 25-July 22; Celexa 30mg - 2 weeks leading up to July 22 - Caused adverse reactions/mild serotonin syndrome. CT’d Celexa July 22.

Developed PGAD August 13th - brutal; Buspar added 5mg twice a day for withdrawal anxiety - August 14th-15th but didn’t help PGAD (HELPED ANXIETY)

Nortriptyline 1mL liquid - August 19th-Sep 3 - HELPED PGAD

Sep 4 -Lexapro 1.25mg Sep 5 -Lexapro 2.5mg helped withdrawal symptoms but caused muscle pain so I knew I messed up

Sep 6-Sep 9 - Lexapro 1.25mg (helped flu like symptoms - severe “cortisol anxiety” at all hours of the night and day. No relief unless I take ativan which I tried so hard to avoid - severe nausea (too much med)

Sep 11-Now - Celexa .5mg (liquid .25ml)

2010-Now - Dexilant 30mg for acid reflux
May 2020 - Ativan .25mg as needed for anxiety - now on schedule at .125mg 3 x’s a day (September 13-15th or so, 2020)

(Vaginal Valium as needed for PGAD) - Used twice since August 13th - Stopped

Share this post


Link to post
Shelton

@Altostrata @DataGuy 

 

also note, haven’t had severe panic like I had Thursday (day of not taking Lexapro) since then - is this a good sign or is my reinstatement doomed since I have moved my dosage so much and didn’t take one Thursday?


Paxil 20mg - 2013-2015 (tapered to Lexapro)

Lexapro 20mg 2015 - May 19th, 2020

Celexa 10mg - May 19-May 26; Celexa 20mg - May 26-June 25; June 25-July 22; Celexa 30mg - 2 weeks leading up to July 22 - Caused adverse reactions/mild serotonin syndrome. CT’d Celexa July 22.

Developed PGAD August 13th - brutal; Buspar added 5mg twice a day for withdrawal anxiety - August 14th-15th but didn’t help PGAD (HELPED ANXIETY)

Nortriptyline 1mL liquid - August 19th-Sep 3 - HELPED PGAD

Sep 4 -Lexapro 1.25mg Sep 5 -Lexapro 2.5mg helped withdrawal symptoms but caused muscle pain so I knew I messed up

Sep 6-Sep 9 - Lexapro 1.25mg (helped flu like symptoms - severe “cortisol anxiety” at all hours of the night and day. No relief unless I take ativan which I tried so hard to avoid - severe nausea (too much med)

Sep 11-Now - Celexa .5mg (liquid .25ml)

2010-Now - Dexilant 30mg for acid reflux
May 2020 - Ativan .25mg as needed for anxiety - now on schedule at .125mg 3 x’s a day (September 13-15th or so, 2020)

(Vaginal Valium as needed for PGAD) - Used twice since August 13th - Stopped

Share this post


Link to post
Altostrata

Yes, I would keep taking 0.25mg Lexapro. You may need to increase it. How are you measuring your dose?

 

Any doctor can prescribe the liquid form of Celexa or Lexapro. You might ask your GP to  do it because you have withdrawal. There's no reason to keep a psychiatrist on your payroll.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Share this post


Link to post
Shelton
17 minutes ago, Altostrata said:

Yes, I would keep taking 0.25mg Lexapro. You may need to increase it. How are you measuring your dose?


What should I increase it to? This morning I cut my 5mg tablet into 20 pieces. I don’t have a scale and was hoping and praying my doctor would call in liquid by tomorrow.

 

20 minutes ago, Altostrata said:

Any doctor can prescribe the liquid form of Celexa or Lexapro. You might ask your GP to  do it because you have withdrawal. There's no reason to keep a psychiatrist on your payroll.


I am at my parents house 2 hours away from my home/doctor because I’m so sick. I literally cannot get out of bed - diarrhea, nausea, flu like symptoms, body aches, noise sensitivity - I just started having a symptom of shakiness/anxiety and had to take a 1/2 ativan. I will send a message to my GP but she’s going to be so confused - I haven’t seen her since all of this happened and I can’t drive there right now. 
 

 

I do not want to keep having to take ativan - do you recommend magnesium for me at this point? If so, what kind/how much? I tried to follow along the thread and there was so much back and forth about different kinds/how to take. 
 

My mom has 400mg soft gels (attached photos) - is that too much?

F6FFF1C6-3AA2-46F4-8882-A5F8765E5451.jpeg

50671D75-45FC-4DF2-938A-BEEDA3C30A44.jpeg


Paxil 20mg - 2013-2015 (tapered to Lexapro)

Lexapro 20mg 2015 - May 19th, 2020

Celexa 10mg - May 19-May 26; Celexa 20mg - May 26-June 25; June 25-July 22; Celexa 30mg - 2 weeks leading up to July 22 - Caused adverse reactions/mild serotonin syndrome. CT’d Celexa July 22.

Developed PGAD August 13th - brutal; Buspar added 5mg twice a day for withdrawal anxiety - August 14th-15th but didn’t help PGAD (HELPED ANXIETY)

Nortriptyline 1mL liquid - August 19th-Sep 3 - HELPED PGAD

Sep 4 -Lexapro 1.25mg Sep 5 -Lexapro 2.5mg helped withdrawal symptoms but caused muscle pain so I knew I messed up

Sep 6-Sep 9 - Lexapro 1.25mg (helped flu like symptoms - severe “cortisol anxiety” at all hours of the night and day. No relief unless I take ativan which I tried so hard to avoid - severe nausea (too much med)

Sep 11-Now - Celexa .5mg (liquid .25ml)

2010-Now - Dexilant 30mg for acid reflux
May 2020 - Ativan .25mg as needed for anxiety - now on schedule at .125mg 3 x’s a day (September 13-15th or so, 2020)

(Vaginal Valium as needed for PGAD) - Used twice since August 13th - Stopped

Share this post


Link to post
Altostrata

That's probably not the right magnesium.

 

Do you have the tools make a liquid? If you have pets there may be an oral syringe in the house. Otherwise, please take a piece every day, let us know how you're doing.

 

You need to be able to measure your dose. If we don't know how much you're taking, we can't say what an increase might be. It appears about 1mg might be right for you, since 2.5mg was too much.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

Share this post


Link to post
Shelton

Okay! I’m going to do 1mg tomorrow morning. So stay on 1mg for 4 days and see how I’m feeling?

 

Is this magnesium okay? Figured I could try 25mg and see how I do but I’ll wait to see how I do on 1mg Lexapro first. 

 

I will definitely keep you posted to see the next step. You are saving lives @Altostrata, you are truly a godsend during this time! 

208B3682-D459-41F4-9E55-D36B04B7F1D4.jpeg

7842B415-2E89-47AC-B432-AF6BA6DDD4B0.jpeg


Paxil 20mg - 2013-2015 (tapered to Lexapro)

Lexapro 20mg 2015 - May 19th, 2020

Celexa 10mg - May 19-May 26; Celexa 20mg - May 26-June 25; June 25-July 22; Celexa 30mg - 2 weeks leading up to July 22 - Caused adverse reactions/mild serotonin syndrome. CT’d Celexa July 22.

Developed PGAD August 13th - brutal; Buspar added 5mg twice a day for withdrawal anxiety - August 14th-15th but didn’t help PGAD (HELPED ANXIETY)

Nortriptyline 1mL liquid - August 19th-Sep 3 - HELPED PGAD

Sep 4 -Lexapro 1.25mg Sep 5 -Lexapro 2.5mg helped withdrawal symptoms but caused muscle pain so I knew I messed up

Sep 6-Sep 9 - Lexapro 1.25mg (helped flu like symptoms - severe “cortisol anxiety” at all hours of the night and day. No relief unless I take ativan which I tried so hard to avoid - severe nausea (too much med)

Sep 11-Now - Celexa .5mg (liquid .25ml)

2010-Now - Dexilant 30mg for acid reflux
May 2020 - Ativan .25mg as needed for anxiety - now on schedule at .125mg 3 x’s a day (September 13-15th or so, 2020)

(Vaginal Valium as needed for PGAD) - Used twice since August 13th - Stopped

Share this post


Link to post
ChessieCat
6 minutes ago, Shelton said:

Is this magnesium okay?

 

It contains calcium.  Calcium cancels out the calming effect of magnesium.  Calcium and magnesium are better taken 2 hours apart.

 

Also be aware that some magnesium tablets/capsules contain B vitamins (which can be activating, especially B6).

 

Magnesium


Being very patient.  I'll get there - slowly.  ETA mid 2021

ADs:  25 years - 1 unknown, Prozac (caused muscle weakness), Zoloft/sertraline; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after)

Pristiq:  50mg 2012, 100mg beg 2013 (mild Serotonin Toxicity)

Began tapering Oct 2015  Current from 12 Sept 2020:  Pristiq 0.625 mg (compounded)

My tapering program

My Intro (goes to my tapering graph)

My website - includes my brief history + links to videos & information on the web

PLEASE NOTE:  I am not a medical professional.  I provide information and make suggestions.

Share this post


Link to post

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
×
×
  • Create New...

Important Information

Terms of Use Privacy Policy