Bert: need Lexapro advice

[Bert]

Hello, new member here

 

I started Lexapro (10mg) on 12 October  together with xanax. Took the xanax for 2 weeks then tapered it down successfully. Today I am exactly 3 weeks off benzos, only had withdrawal symptoms for 2 days.

I was sleeping well until last Tuesday, I started having insomnia for no reason. I wasn't stressed, anxious and wasn't worrying. I didn't have any pain either. That's what I mean with "for no reason".

 

I also want to start tapering the Lexapro since I hate meds (This is the first time ever that I've been on meds). The capsules that I'm taking are 10mg and they can only be split in 2. I also can't grind them down or anything like that since I simply do not have access to these tools. What option should I go for?

 

Also, is it possible that the Lexapro is causing my insomnia?

 

Thanks for the help, stay well! 😀 😉

[Gridley]

Welcome to SA, Bert.

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.

 

Account Settings – Create or Edit a signature.

 

I need to know more about the 10mg capsules you're taking?  Are they capsules or tablets?  If they are capsules, what is inside them?

Lexapro tablets (and likely whatever is inside the capsule) don't require special tools to grind them to powder.  All you need is two spoons to grind the drug into powder.  

 

We recommend tapering by no more than 10% of your current dose every four weeks.

 

Why taper by 10% of my dosage?

 

This link is specifically about tapering Lexapro, including the various methods you can use to get the nonstandard doses you'll need for a 10% taper.  These include weighing powder with a scale, making your own liquid and using a compounding pharmacy.  Once you've answered my questions about the form your Lexapro comes in, we'll be in a better position to advise you.

 

Tips for tapering off escitalopram (Lexapro)

 

Lexapro, like all SSRI's, is activating and could be a factor in your insomnia.  What time do you take the Lexapro?  If at night, you could move it backward one hour a day until you reach a point in the morning when it's convenient to take the drug.  This could help with your insomnia.

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Add in one at a time and at a low dose in case you do experience problems. Get supplements that are single ingredient (not mixed with other types of supplements).

 

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

 

 

 

 

 

 

 

 

 

[Bert]

I take the escitalopram at 9 in the morning.

They are capsules, not tablets. I don't have anything to weigh the doses

.

I saw a therapist for the first time ever Friday, he's awesome. He knew AD can be dangerous and recommended me to not quit the escitalopram yet unless there's a medecal reason for it.

I also read multiple times that escitalopram is ultimately supposed to improve insomnia (I've been taking them for almost 2 months). 

What do you guys think, is the escitalopram just not a fit for me or will this go away? I also sometimes have muscle jerks when I'm laying in bed.

 

 

[Gridley]

@Bert

Bert, we're a site for going off psychiatric drugs.  If you want to stay on the drug, that's a decision between you and your doctor.  If you want to taper off the Lexapro, the best way would be to switch to prescription Lexapro liquid.  More information is available from the link I provided in my first post, Tips for Tapering off Lexapro.

 

We can't predict whether the insomnia will go away.  

59 minutes ago, Bert said:

I don't have anything to weigh the doses

Many members use the Gemini-20 digital scale, available on Amazon, to weigh their doses.  If you don't want to use the liquid, you could switch to the Lexapro tablet, which is very easy to weigh.

Edited December 6, 2020 by Gridley

[Lilu]

Lexapro doesn't come in capsules. I checked on Google. Brand or generic is always a tablet.  Not sure what it is that you're really taking. 

 

Lexapro (escitalopram oxalate) is available as tablets or as an oral solution. Lexapro tablets are film-coated, round tablets containing escitalopram oxalate in strengths equivalent to 5 mg, 10 mg, and 20 mg escitalopram base. The 10 and 20 mg tablets are scored.

 

I've had bad experiences with generic Escitalopram and only take the brand.  It is possible to get your doctor and insurance to approve it. However, the liquid version only comes in generic, and also can vary in potency.

 

The insomnia and jerks that you are experiencing is most likely from Benzo withdrawal. Those are classic benzo withdrawal symptoms.

 

As to whether or not to stay on Lexapro depends on why you started taking it in the first place.  The longer you stay on it, the harder it is to quit.

[ChessieCat]

11 hours ago, Lilu said:

Lexapro doesn't come in capsules.

 

I'm wondering if Bert is talking about the oval shaped tablets.

[ChessieCat]

On 12/4/2020 at 9:08 PM, Bert said:

The capsules that I'm taking are 10mg and they can only be split in 2.

 

Is this what they look like?  The lettering/numbering may be different.

 

[Bert]

On 12/6/2020 at 5:23 PM, Lilu said:

The insomnia and jerks that you are experiencing is most likely from Benzo withdrawal. Those are classic benzo withdrawal symptoms.

 

As to whether or not to stay on Lexapro depends on why you started taking it in the first place.  The longer you stay on it, the harder it is to quit.

The jerks are gone but still have some insomnia, it's not that bad anymore though.

I started the escitalopram for anxiety, I was doing fine on it until the insomnia worsened my symptoms again.

My therapist recommended me to not quit the meds yet. This seems to be the standard here to start therapy in combination with a drug. I'm just here to get the information I need for when I'm going to get off it.

 

But let's say I want to get off it tomorrow. I have then almost taken it for 2 months. Can I just start halving my dose or do I need to do a 10% taper every month?

This seems a little bit exaggerated to me since I've been on them for such a short time.

 

 

On 12/7/2020 at 4:42 AM, ChessieCat said:

 

Is this what they look like?  The lettering/numbering may be different.

 

Yes! This is exactly what they look like. I take a generic lexapro called escitalopram.

Sorry for the confusion :P

[ChessieCat]

9 minutes ago, Bert said:

But let's say I want to get off it tomorrow. I have then almost taken it for 2 months. Can I just start halving my dose or do I need to do a 10% taper every month?

This seems a little bit exaggerated to me since I've been on them for such a short time.

 

It can take as little as 1 month for the brain to fully adapt to a psychiatric drug.  You've also been on Xanax recently.

 

Reducing your dose by 50% would be too much. 

 

If you decided to get off the drug now than you might be able to go faster than 10% but you would need to listen to your symptoms and hold longer and/or reduce less as needed.  It is better to go slower than to go too fast and end up with bad withdrawal symptoms.  It would be better to reduce by no more than 25%.

 

If you decide to stay on for longer then you will need to taper more slowly.

[Bert]

3 hours ago, ChessieCat said:

 

It can take as little as 1 month for the brain to fully adapt to a psychiatric drug.  You've also been on Xanax recently.

 

Reducing your dose by 50% would be too much. 

 

If you decided to get off the drug now than you might be able to go faster than 10% but you would need to listen to your symptoms and hold longer and/or reduce less as needed.  It is better to go slower than to go too fast and end up with bad withdrawal symptoms.  It would be better to reduce by no more than 25%.

 

If you decide to stay on for longer then you will need to taper more slowly.

Okay, thanks. Once my therapist says I can come off it, I will come back here.

I still got some questions though:

• If I want to switch AD, will I have to taper my original AD? For example: Tomorrow I started taking mirtazapine at night, will I still have to taper escitalopram?
• Will I get withdrawal symptoms if I decide to go with the 10% of original dose taper every month? If yes, about how long could they last?

Thanks!

Bert

[Heath]

@Bert Welcome to SA !!!

if you want to stop taking this medicine you are in the right place! Listen to the moderators here and you will be fine !!

[Bert]

Hi, it's Bert again.

 

I think I'm gonna stay on the lexapro for another month, after my exams are over since there will be less stress. 

I'll be 3 months on it then and I'm thinking of tapering 25% every 2 weeks, maybe a month? (7.5mg -> 5mg -> 2.5mg -> jump)

I'd like your thoughts on this but staying on them for another year (while tapering) is not really an option for me.

 

Also, any natural/non-addictive sleep aids/meds recommendations?

 

Thanks!

[ChessieCat]

It only takes about 1 month for the brain to fully adapt to the drug.  Tapering by 25% every 2 weeks is much too fast.

 

It is the brain which dictates how fast we can get off the drug.  It has nothing to do with how disciplined or determined we are.

 

My suggestion would be to do a test reduction of 10% reduction and see how you feel.  If after 2.5 or 3 weeks your symptoms are at WDnormal then you could reduce try reduction by another 10%.

 

Stability

 

WDnormal

 

 

And the percentage reduction is calculated on the current dose, not the starting dose.

 

We have members here who have tried to go too fast and it has ended up taking them longer to get off than if they had done a steady and careful taper and some have ended up on an additional drug which then needs to be tapered.  The idea is to get off with minimal withdrawal symptoms.

 

Please carefully read the following:

 

  

On 5/27/2011 at 12:16 PM, Altostrata said:

Special considerations
A significant characteristic of Lexapro is that milligram for milligram, it is much stronger than other SSRIs. Chemically, Lexapro is a variation of Celexa; the molecule was re-engineered to be patentable as Celexa's patent was about to expire. The streamlined molecule is a more potent SSRI, 2 to 4 times stronger than others. (Wikipedia has a good explanation of this at https://secure.wikimedia.org/wikipedia/en/wiki/Escitalopram.)

However, many doctors are unaware that escitalopram is stronger than other SSRIs and dose it as though it were the same strength. Although the so-called usual starting dose of escitalopram, 10mg, is equivalent to 20mg-30mg or more of, for example, paroxetine (Paxil), your doctor may have moved you to an even higher dose. If you are taking 20mg of escitalopram, you are taking a hefty dose of an SSRI.

If you are taking 5mg of Lexapro, it's not tiny, it's equivalent to 10-20mg Paxil or Celexa.

Consequently, when you taper off escitalopram, you should be careful to decrease by small amounts, as each drop is magnified by escitalopram's extra potency. If you find withdrawal symptoms from a 10% decrease to be too difficult, after 3-4 weeks decrease by a smaller amount.

Cold-turkeying off Lexapro is not a good idea. It's like throwing your brain off a cliff.

 

 

 

[Bert]

Okay, I'll take it slow then.

Why do people decide to go off after x years if it'll cause so many problems even after a 10% taper?

Is it possible that AD control our thoughts in some ways? Lately I've been thinking about suicide and death a lot and I just can't picture myself 10 years from now. I'm not depressed or suicidal or anything like that, I don't wanna die but these thoughts scare me.

 

Edited December 11, 2020 by ChessieCat
removed quote

[ChessieCat]

We have a topic here:

 

why-and-when-did-you-decide-to-come-off-drugs

 

For me personally, I tried to reduce my drug by 50% because of mild serotonin syndrome and the drug only being available in 100mg and 50mg and supposedly not able to be cut the tablet.  After 2 weeks of very bad cog for I was unable to type.  Because I am a professional typist I knew that something was wrong.  SA suggested updosing, which I did, and after about 4 hours (not days) my brain fog was clearing and I was able to type again.  I knew it was because of the drug due to the fact that I had a benchmark.

 

Originally I was only going to reduce my drug to get rid of mild serotonin syndrome.  My psychologist, in 2012, had told me that "you need the drug for life like a diabetic needs insulin".  After joining SA I learned that this was the chemical imbalance myth and it had been debunked at least 20 years ago.  I then decided to keep reducing to see how low I could get, and I've just continued and am now down to 0.45mg Pristiq after starting at 100mg.  And during this time I've only experienced mild withdrawal symptoms.

 

again-chemical-imbalance-is-a-myth-stop-the-lies-please

 

I suggest that you read the book Your Drug May Be Your Problem by Dr Peter Breggin.

 

Sometimes after being on a psychiatric drug for a long time (no particular timeframe though) the drug can reach tolerance, poop out, tachyphylaxis.  This is when the drug no longer works at the same dose and usually the medical professional will increase the dose, and then poop out might be reached again and the dose again increased. 

 

My previous drug reach tolerance.  I did not know about this at the time.  I had several major life stressors over a short period of time and had a massive breakdown.  Because the drug hadn't stopped the breakdown and I wasn't feeling good on it I decided to cold turkey the drug.  I felt the best I had done for a long time (which may have been because the drug was no longer working) for about 2 months and then became bed bound for 2.5 weeks with what seemed like the flu but I was sure it wasn't, and I lost 8kgs because I was unable to eat.  After joining SA I realised that it was withdrawal.  It was then that the psychologist recommended Pristiq and I was told I needed a drug for life.

 

SA's taper method is a harm reduction approach.  It is a guideline, a starting point.  Some people may be able to go faster than 10% and others need to go slower.  However, there is no way to know this.  For people who get withdrawal symptoms that are more than minimal by taking note of your symptoms you can usually work this out and adjust your taper accordingly and reduce by less and/or hold for longer.

 

Although for some people it may be possible to get off a drug with no withdrawal symptoms, it is unlikely that many do.  Some people may get symptoms and not realise that they are related to reducing the drug.  However, the idea is to keep withdrawal symptoms to a minimum.  I have managed to do that throughout my taper.  There have been times when I have held for longer because my body has been under additional stress, eg dental issues, back injury, having a cold.

 

The idea is to sneak the drug away.  The brain is always trying to maintain homeostasis.  When we add a drug the brain adapts to getting the drug.  When we take the drug away the brain has to adapt to not getting the drug.  If we do this in small amounts, then the brain doesn't have to make as many changes like it does if the drug was taken away in one go.

 

I suggest that you check out Brassmonkey.  He did a slow and careful taper off Paxil and was able to work and travel during this time.  It wasn't a symptom free taper and post 0 recovery, but it was manageable.

 

One think to be aware of is that many members find that as their dose gets lower they might need to slow down their taper, reducing less and/or holding longer.  I won't try to explain it here but this topic might help you to understand why this is the case:

 

Why taper paper: dose-occupancy curves

 

When I started learning about the pharmaceutical industry and history of psychiatric drugs I started to understand that there is very little science behind it all.

 

Interview:  Confessions of an Rx Drug Pusher (51 minutes Gwen Olsen - ex pharmaceutical representative)
 

Video:  Ex-Big Pharma Rep:  We’re Trained To Misinform -The Drugs ARE Dangerous (6 minute video)
 

Video:  Ex-Big Pharma Rep:  Manipulating Doctors to Sell More Drugs (10 minute video)

 

 

Approval Criteria Used by the FDA

Antidepressants and the Placebo Effect by Irving Kirsch (link to full article)

Abstract:

Antidepressants are supposed to work by fixing a chemical imbalance, specifically, a lack of serotonin in the brain.  Indeed, their supposed effectiveness is the primary evidence for the chemical imbalance theory.  But analyses of the published data and the unpublished data that were hidden by drug companies reveals that most (if not all) of the benefits are due to the placebo effect.  Some antidepressants increase serotonin levels, some decrease it, and some have no effect at all on serotonin.  Nevertheless, they all show the same therapeutic benefit.  Even the small statistical difference between antidepressants and placebos may be an enhanced placebo effect, due to the fact that most patients and doctors in clinical trials successfully break blind.  The serotonin theory is as close as any theory in the history of science to having been proved wrong.  Instead of curing depression, popular antidepressants may induce a biological vulnerability making people more likely to become depressed in the future.

Excerpt:

How Did These Drugs Get Approved?
....
The FDA requires two adequately conducted clinical trials showing a significant difference between drug and placebo.  But there is a loophole:  there is no limit to the number of trials that can be conducted in search of these two significant trials.  Trials showing negative results simply do not count.  Furthermore, the clinical significance of the findings is not considered.  All that matters is that the results are statistically significant.
....
(NB:  emphasis in abstract and excerpt are mine)

 

[ChessieCat]

SA strongly encourages members to learn and use:

 

Non-drug techniques to cope

 

Post #1 of this topic contains links to a withdrawal symptom list in different formats.  Printable and computer versions.  Includes a rating key.

 

Dr Joseph Glenmullen's Withdrawal Symptoms

[Nomansland]

Hello Bert, just a few thoughts from my side.

 

You are in the comfortable situation that your nervous system seems stable right now.

I can only encourage you that (if you want to taper) to do it with the advices from the moderators here.

Once the system got sentisized, you will feel uncomfortable (well thats a nicer word for "hell") ...thats something you cant imagine when you

havent experienced it (and nearly all docs will not diagnose it right). And it can take time to feel stable again.

 

So go from a stable position and dont taper too fast....would be my advice!

 

Greetings

[Heath]

@Bert I agree with above posts! You have a chance that many folks did not have . If I would have had support and knowledge from SA 15 years ago I would not be in this position now ! Before I would try to taper off and I always thought it was me and I would have to take it forever and I didn’t want to think about it. That was wrong thinking. One dr told me same exact thing as chesscat it’s like insulin for diabetic blah blah! It just amazes me for so long drs prescribing these drugs and still do not know or will not acknowledge withdrawals from this meds !  I also learned if I miserable with withdrawals don’t call the dr or you will end up worse on a cocktail of drugs. That’s all they know how to do! Since I have learned that it’s best to learn all about these drugs we are taking . My goal became to know more than the drs. And that didn’t take long.  Learn all you can SA is filled with tons of info and support! Slow and Steady!!! Literally time gets your nervous system steady . Patience is key! Hang in there !!

[Bert]

12 hours ago, ChessieCat said:

I then decided to keep reducing to see how low I could get, and I've just continued and am now down to 0.45mg Pristiq after starting at 100mg.  And during this time I've only experienced mild withdrawal symptoms.

This actually made me less scared of withdrawal, thank you.

If I may ask you ChessieCat, how have you been feeling overall emotionally throughout your taper over the years?

I'm not really scared of the physical symptoms such as flu like symptoms, but what scares me the most is the suicidal, depressive and anxious thoughts.

 

But if I get it right someone who has been on an AD for only 2-3 months and tapered too fast (or went with the 10% on current dose) or CT'ed would have the same WD period and symptoms as if he were on the drug for several years? (same person, I know it may be confusing) I can't think of anything less fair.

If the answer to that question is yes than I'll have to wait for 2 years or so to start my 5%-10% taper since I still have 2 years left on my bachelor.

 

[ChessieCat]

Brassmonkey successfully got off Paxil several years ago and was able to keep working at job that required him to use his brain.

 

He created his own gentler taper method which divides the 10% by 4 and you reduce each week and then hold for an extra two weeks.  It gives you a bit more control over your taper because if you still have symptoms when it's time to reduce again, then you hold for longer.  Of course it would take longer than the SA 10%/4 week taper, but the idea is to be able to continue living your life as normally as possible.

 

Brass Monkey Slide

 

And remember that any reduction in the amount of drug you are taking is heading in the right direction and you will get off eventually.

 

This topic might help you to understand things better:

 

are-we-there-yet-how-long-is-withdrawal-going-to-take

 

[ChessieCat]

10 hours ago, Bert said:

If I may ask you ChessieCat, how have you been feeling overall emotionally throughout your taper over the years?

I'm not really scared of the physical symptoms such as flu like symptoms, but what scares me the most is the suicidal, depressive and anxious thoughts.

 

If you have experienced these in the past when you tapered too quickly it is understandable that you are scared that it will happen again.  However, if you taper slowly then there is less chance of them being so bad and/or lasting as long.

 

And it's good to understand that people who have never taken an antidepressant have times when they have a low mood.  It's just a part of life and we need to learn ways to get through it.  Learn and practise different non drug coping techniques.  I found it helpful to learn CBT, acceptance and mindfulness.  I also found this statement helpful:

 

"It's only a feeling and feelings change."

 

It was in a book called How I Stayed Alive When My Brain Was Trying to Kill Me by Susan Rose Blauner.

[Heath]

@Bert even though you are in college you can still taper very slowly and may not notice much at all. I tapered about 5 times at 10 % with very little noticeable effects, I still work work pay bills, laugh, family ,kids in college and all life stress. So basically I went slow enough that it didn’t cause a destabilizing nervous system. But by the 6th taper and changing to liquid and bladder infection it was too much for nervous system so I’m holding a bit and going to the brass monkey slide. What I’m trying to say is I was like you the only tappers I knew were hell and reinstatement took 6 to 12 months. Brutal! So I was scared to try this 10% taper from here . But once I started I’m more confident now at tapering. I mean you could do 1% . There is no set rule under 10 % just slow and steady!