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Wanting Advice for Treating Severe Muscle Tension (in Back) Following Lexapro Taper Completion


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In early September of 2020, I successfully completed my taper off of nearly 20 years of using Lexapro. (4 months drug free!) As I got closer to zero, my overall general anxiety level rose and I began developing extreme upper back, neck and shoulder muscle tension. It has continued and gives me some almost debilitating headaches when it's at its worst. The muscle tension and anxiety go hand in hand, (they tend to increase and decrease in unison), so I can't tell which one is the cause and which one is the symptom. I imagine it goes both ways, and they feed off of each other. Chiropractic visits help a little bit, and so does DIY massage therapy, but they don't seem to be healing me. On my best days, I feel like I've got the constant ache of pulled or torn muscles in my neck and upper back. Like a constant tooth ache. When headaches set in, it actually makes me physically ill / nauseous. My physical symptoms match those associated with GAD (General Anxiety Disorder). My anxiety matches up with GAD pretty well too.

 

Will this go away in time? As my body continues to heal, I realize it's a possibility that this will resolve its self over the next year or two.

 

Are there any supplements or vitamins that anyone recommends? I'm not on any medications and don't want to ever go back on any, but am willing to take supplements and vitamins. I have some Ashwagandha and 5-HTP on hand, but have been reluctant to take either of them.

 

Any advice for helping me relieve my general anxiety and especially my muscle tension would be greatly appreciated. Thank you all in advance, Iowan
 

1999: Paxil ?? mgai (Paroxetine Hydrochloride) - stopped cold turkey
2001-03: Celexa ?? mgai (Citalopram Hydrobromide) - switched to Lexapro
2003-August 2015: Lexapro 20 mgai (Escitalopram Oxalate) - rapid 5 mgai increment taper down to 0 mgai
December 2015 - January 2016: Short hospital stay for unknown acute AD WD due to rapid taper
January 2016-February 21, 2016: Prozac ?? mgai (Fluoxetine Hcl) and Wellbutrin ?? mgai (Bupropion Hcl) - switched to Lexapro
February 21, 2016-July 22, 2018: Lexapro 10 mgai  - rapid 5 mgai increment taper down to 5 mgai
July 22, 2018-March 17, 2019: Lexapro 5 mgai - endured horrible waves due to rapid taper
March 17, 2019-April 7, 2019: Lexapro 3.226 mgai - endured horrible wave due to rapid taper
April 7, 2019-April 28, 2019: Lexapro 3.548 mgai - updosed to level out
April 28, 2019: Implemented Brass Monkey Slide taper method (2.5% weekly reduction) - IT’S WORKING!!!
September 2, 2020: Lexapro 0.000 mgai / 0 mgpw / 100% Taper COMPLETE!

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ChessieCat

If you muscle tightness is being caused/worsened by anxiety then I suggest that learn and do relaxation exercises throughout the day as well as general, all body exercise, strengthening and stretching.

 

These are by one of SA's members:

 

 

I injured my lower back in June 2020 and my rehabilitation has included doing hydrotherapy, strengthening exercises (pilates), stretching, several remedial massages, and walking and I've recently started doing some light (0.5kg) seated weight exercises for the upper body.  I'm noticing an overall improvement in my pre-existing tense muscles and aches and pains.  One thing I have noticed during the last 6 months is that as I've focused one area there is a domino effect so I then have to work on that.  As an example I recently had muscle pain just below the back of my knee and I researched it and learned that it was most probably caused by weak hamstrings, so I found hamstring strengthening exercises and since doing those the muscle pain has abated.

 

I found it very helpful learning about muscles.  Here are some youtube channels (no affiliation) I have found helpful:

 

This guy is a teacher and has created videos for his students:

 

https://www.youtube.com/c/SamWebster/playlists

 

https://www.youtube.com/user/physicaltherapyvideo/playlists

 

Exercises:

 

https://www.youtube.com/c/MoreLifeHealth/playlists

 

https://www.youtube.com/c/Eldergym/playlists

NEW!!!     INTERVIEW with Altostrata, SA's founder    NEW!!! 

 

REMINDER TO SELF:  I don't need the drug now, but my still brain does.

Current from 9 Jan 2021:  Pristiq 0.405 mg

ADs since ~1992:  25+ years - 1 unknown, Prozac (muscle weakness), Zoloft; citalopram (pooped out) CTed (very sick for 2.5 wks a few months after); Pristiq:  50mg 2012, 100mg beg 2013 (Serotonin Toxicity)  Tapering Oct 2015 

My tapering program   My Intro (goes to my tapering graph)  My website

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

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Thank you @ChessieCat. Lots of great info here. I do find that working out on a regular basis helps. Being sedintary for long periods of time is what really makes my back sing. Due to the constant stress/anxiety I have in the background, I fall into using bad posture and my back muscles are constatly under strain. When my anxiety spikes, my already fatigued muscles get strained even more, in turn, nearly locking me up completely. Sleep is still intermitant, but occasionally, I get a more normal full night of rest, and it makes a world of difference. I'll try to implement some/all of these and see if I make any progress. I don't have any new injuries that I can think of, that may be contributing. I can't say I've treated my body well in my youth either, but I don't believe this is injury related. Just age, fatigue and constant high stress levels wearing me down.

1999: Paxil ?? mgai (Paroxetine Hydrochloride) - stopped cold turkey
2001-03: Celexa ?? mgai (Citalopram Hydrobromide) - switched to Lexapro
2003-August 2015: Lexapro 20 mgai (Escitalopram Oxalate) - rapid 5 mgai increment taper down to 0 mgai
December 2015 - January 2016: Short hospital stay for unknown acute AD WD due to rapid taper
January 2016-February 21, 2016: Prozac ?? mgai (Fluoxetine Hcl) and Wellbutrin ?? mgai (Bupropion Hcl) - switched to Lexapro
February 21, 2016-July 22, 2018: Lexapro 10 mgai  - rapid 5 mgai increment taper down to 5 mgai
July 22, 2018-March 17, 2019: Lexapro 5 mgai - endured horrible waves due to rapid taper
March 17, 2019-April 7, 2019: Lexapro 3.226 mgai - endured horrible wave due to rapid taper
April 7, 2019-April 28, 2019: Lexapro 3.548 mgai - updosed to level out
April 28, 2019: Implemented Brass Monkey Slide taper method (2.5% weekly reduction) - IT’S WORKING!!!
September 2, 2020: Lexapro 0.000 mgai / 0 mgpw / 100% Taper COMPLETE!

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Hello fellow back pain sufferer! I'm currently going through pain due to muscle tension in the exact regions you describe. No fun!

 

For me a hot water bottle seems like it works best on decreasing muscle tension. In addition, I try to massage as many triggerpoints as I can find. Works okay for the back and shoulders, but I'm less successful with the neck and head currently. I have had great success with the neck in the past, though. I think this is the English version of my go-to triggerpoint massage book: https://www.amazon.com/gp/product/1572243759

 

Although I'm a fan of the water bottle and massage, they seem to be treating symptoms rather than causes. I'm currently pondering about the role of cortisol. I read something about cortisol and muscles somewhere on this forum yesterday and I was trying to find it again when I found your post. Searching online just now, I found that cortisol increases the reuptake of serotonin (https://pubmed.ncbi.nlm.nih.gov/12467090/). I wish I could do some more thorough reading, but some muscle tension somewhere is leading to pain behind my eye and slight nausea, so I'm having trouble concentrating.

 

Before my brain melted I also read this web page: https://www.livestrong.com/article/521720-how-to-get-cortisol-out-of-your-system/

It recommends omega-3 and magnesium for lowering cortisol, two supplements that are often recommended on this website as well. I use them both, and was thinking about adding a vitamin B complex after reading that page.

 

 

2006 - Paroxetine, 20 mg

2008 / 2018 - Several mostly unsuccessful attempts at tapering, without knowledge of withdrawal

2019 - Decrease from 20 mg to 15 mg (June), from 15 mg to 10 mg (December)

2020 - Switch to 10 mg liquid citalopram (February), decrease to 8 mg (April), 6 mg (June), 4 mg (July) without symptoms. 3.2 mg (September 9), 3 mg (September 23), 2.8 mg (October 10), 2.6 mg (October 26), 2 mg (November 13).  Tapered to 1.68 mg in steps of 0.16 mg (December 3). Withdrawal kicked in.

2020, December - Increase to 1.8 mg (December 8), increase to 1.92 mg (December 18)

2021, January - Increase to 2.2 mg (January 1)

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Hm, apparently many people react strongly to vitamin B on this forum:

 

I usually don't respond much to anything, so I'm not opposed to trying, but I figured you might wanted to know that piece of information. The topic mentions probiotics (Bifidobacteria) as an alternative, might be worth a shot. :)

 

2006 - Paroxetine, 20 mg

2008 / 2018 - Several mostly unsuccessful attempts at tapering, without knowledge of withdrawal

2019 - Decrease from 20 mg to 15 mg (June), from 15 mg to 10 mg (December)

2020 - Switch to 10 mg liquid citalopram (February), decrease to 8 mg (April), 6 mg (June), 4 mg (July) without symptoms. 3.2 mg (September 9), 3 mg (September 23), 2.8 mg (October 10), 2.6 mg (October 26), 2 mg (November 13).  Tapered to 1.68 mg in steps of 0.16 mg (December 3). Withdrawal kicked in.

2020, December - Increase to 1.8 mg (December 8), increase to 1.92 mg (December 18)

2021, January - Increase to 2.2 mg (January 1)

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4 hours ago, Jolene said:

apparently many people react strongly to vitamin B on this forum:

Here's a link:

 

Hypersensitive to B Vitamin or B-Complex  

 

Gridley Introduction

 

Lexapro 20 mg since 2004.  Begin Brassmonkey Slide Taper Jan. 2017.   

End 2017 year 1 of taper at 9.25mg 

End 2018 year 2 of taper at 4.1mg

End 2019 year 3 of taper at 1.0mg  

Oct. 30, 2020  Jump to zero from 0.025mg.  Current dose: 0.000mg

3 year, 10 month taper is 100% complete.

 

Ativan 1 mg 1986-1991 CT, soon reinstated.  CT 2000. RI 1 mg 2011-2016.  Sept. 2016  0.625mg X 3

Nov.27, 2020 Begin 7-week Ativan-Valium crossover and change from 3 daily doses to one 18.75mgai dose (0.311mgpw). Jan. 11, 2021 begin hold at current bedtime 18.75mgai dose.

 

Imipramine 75 mg daily since 1986.  Jan. 2016 began every 3-weeks 10% taper, down to 16mgai (0.44mgpw).  Aug 2016, discovered SA, holding at 16mg.  Taper is 78% complete.  

  

Supplements: omega, vitamins E and D3, magnesium glycinate, probiotic, melatonin .3mg


I am not a medical professional and this is not medical advice, but simply information based on my own experience, as well as other members who have survived these drugs.

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HopeToHeal

Muscle tension is one of my primary anxiety symptoms and I have become especially sensitive to it since my escitalopram adverse reaction and its aftermath. While it is a symptom, it also causes further anxiety for me, so it’s a feedback loop.

 

I have been reading about self myofascial release and ordered a soft foam roller that should be arriving tomorrow. I have also been watching videos on YouTube on ways to self-treat tension (mine is in my upper back and my legs and also just generally) and doing some of the exercises that are taught by physical therapists on there. I have had a bit of improvement, but think getting the roller will help more as well. I have used the harder rollers that you can get in stores and they were just too painful to be helpful, so I am looking forward to using this softer density one and trying some of these techniques.

2014 & 2017 - 25mg sertraline for postpartum depression

Late May ‘20 - Early June ‘20: 7.5mg buspirone 2x/day (adverse reaction)

Mid-June ‘20 (six days total): 5mg escitalopram (adverse reaction)

 

currently taking: vitamin D, magnesium, omega 3, occasional melatonin.

 

no alcohol, no caffeine.

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@Jolene Thank you for your feedback. This upper back muscle tension is not pleasant. It's not the worst thing I've been through, but it's constant and builds, and builds throughout the day. The headaches are no joke.

 

I get frustrated treating the symptoms, only to provide slight and temporary relief. I believe this is serotonin related. It makes the most sense. I no longer have SSRIs in my system to bounce serotonin around until it's accepted/absorbed, or whatever. I'm also certain my personal production of serotonin is really low as well, from taking SSRIs for so long. I will look into trying to lower and rid myself of cortizol. I took a ton of supplements during the 1st half of my taper, but didn't feel that they were helping, and they were $$$. I'll research and look to reimplement omega-3 and magnesium. I am sensitive to B vitamin and know the proper stuff to take because of it. I'll look at reimplementing that one as well. I've still got probiotics onhand, so I'll look into that one as well.

 

@HopeToHeal Thank you for your feedback as well. It sounds like we share the same story with this anxiety, muscle tension feedback loop. I have performed self myofascial release on my mid back up through my neck. It makes me sweat almost uncontrollably, my head feels like it's going to pop, and I nearly vomit for 30 to 60 minutes following. It's so intense for me that I can't force myself to do it often. I need to do it more. I think it is pushing toxins out of my tight muscles into my system and my system is being forced to deal with them. No pain, no gain, right? I imagine over time, this will get better and more plesant to perform.

 

I just received my Pettibon System portable cervical neck traction device. Chiropractors use them a lot, before they provide adjustment service. I used it last night for the first time. My head felt like it was going to pop for about 10 minutes following, but then I felt pretty dang good for the rest of the evening after that. I'll continue to use it and see if I get any real improvements from it. I'll try to use the foam roller more too, and just push through the icky hour following.

 

Thanks again, Iowan

1999: Paxil ?? mgai (Paroxetine Hydrochloride) - stopped cold turkey
2001-03: Celexa ?? mgai (Citalopram Hydrobromide) - switched to Lexapro
2003-August 2015: Lexapro 20 mgai (Escitalopram Oxalate) - rapid 5 mgai increment taper down to 0 mgai
December 2015 - January 2016: Short hospital stay for unknown acute AD WD due to rapid taper
January 2016-February 21, 2016: Prozac ?? mgai (Fluoxetine Hcl) and Wellbutrin ?? mgai (Bupropion Hcl) - switched to Lexapro
February 21, 2016-July 22, 2018: Lexapro 10 mgai  - rapid 5 mgai increment taper down to 5 mgai
July 22, 2018-March 17, 2019: Lexapro 5 mgai - endured horrible waves due to rapid taper
March 17, 2019-April 7, 2019: Lexapro 3.226 mgai - endured horrible wave due to rapid taper
April 7, 2019-April 28, 2019: Lexapro 3.548 mgai - updosed to level out
April 28, 2019: Implemented Brass Monkey Slide taper method (2.5% weekly reduction) - IT’S WORKING!!!
September 2, 2020: Lexapro 0.000 mgai / 0 mgpw / 100% Taper COMPLETE!

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Hi Iowan,

 

Good to hear the neck traction device gave you a pleasant afternoon. I hope it continues to do so!

 

Regarding the myofascial release: that sounds intense. How enthousiastically did you do it? Perhaps you can build the intensity up more slowly? Starting with massaging just a few minutes, or using less pressure? I never get such symptoms from self-treatment, only when I go to a massage therapist.

 

I also think the symptoms are serotonin-related. The line of thinking with cortisol would be: anxiety/stress increase cortisol levels. Cortisol increases the reuptake of serotonin. SSRI's (selective serotonin reuptake inhibitor) normally inhibit this reuptake. So not taking SSRI's anymore already leads to less serotonin available, and cortisol leads to even less serotonin being available.

 

To lower cortisol, your best bet would be to lower anxiety/stress. Easier said than done, I know. But it would mean that relaxation exercises and meditation really can have an impact. I usually have trouble motivating myself to do those long term, but this becomes easier if I know the theory of why and how they help.

 

2006 - Paroxetine, 20 mg

2008 / 2018 - Several mostly unsuccessful attempts at tapering, without knowledge of withdrawal

2019 - Decrease from 20 mg to 15 mg (June), from 15 mg to 10 mg (December)

2020 - Switch to 10 mg liquid citalopram (February), decrease to 8 mg (April), 6 mg (June), 4 mg (July) without symptoms. 3.2 mg (September 9), 3 mg (September 23), 2.8 mg (October 10), 2.6 mg (October 26), 2 mg (November 13).  Tapered to 1.68 mg in steps of 0.16 mg (December 3). Withdrawal kicked in.

2020, December - Increase to 1.8 mg (December 8), increase to 1.92 mg (December 18)

2021, January - Increase to 2.2 mg (January 1)

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@JoleneI'm kind of a heavy guy and I put all of my weight on my feet and the roller under my back, as I slowly roll up and down on it. I don't think this would phase pre SSRI withdrawal, but it almost feels like torture when I do it now. I literally think my muscles in my upper back are getting loaded up with toxins throughout the day and when I do this, it squeezes them out, to be circulated. I don't think I've ever experienced anything like it.

 

Yes, serotonin related, almost guaranteed. Lowering my stress is impossible, with what's required of me at work. The anxiety however continues to improve slowly, but does flare up from time to time, especially during periods of elevated stress. 2020 was FULL of stress. 2021 hasn't changed much... The gym is my friend, and I will contiue to roll out my back and use my neck traction device. Relaxation just puts me to sleep, so I just go to bed when I want to relax. I'll be working on assembling a supplement and vitamin reginine too.

 

Thanks, Iowan

1999: Paxil ?? mgai (Paroxetine Hydrochloride) - stopped cold turkey
2001-03: Celexa ?? mgai (Citalopram Hydrobromide) - switched to Lexapro
2003-August 2015: Lexapro 20 mgai (Escitalopram Oxalate) - rapid 5 mgai increment taper down to 0 mgai
December 2015 - January 2016: Short hospital stay for unknown acute AD WD due to rapid taper
January 2016-February 21, 2016: Prozac ?? mgai (Fluoxetine Hcl) and Wellbutrin ?? mgai (Bupropion Hcl) - switched to Lexapro
February 21, 2016-July 22, 2018: Lexapro 10 mgai  - rapid 5 mgai increment taper down to 5 mgai
July 22, 2018-March 17, 2019: Lexapro 5 mgai - endured horrible waves due to rapid taper
March 17, 2019-April 7, 2019: Lexapro 3.226 mgai - endured horrible wave due to rapid taper
April 7, 2019-April 28, 2019: Lexapro 3.548 mgai - updosed to level out
April 28, 2019: Implemented Brass Monkey Slide taper method (2.5% weekly reduction) - IT’S WORKING!!!
September 2, 2020: Lexapro 0.000 mgai / 0 mgpw / 100% Taper COMPLETE!

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  • 2 weeks later...

Update: Omega D3 and Ashwagandha seem to be working for me. Slowly, I am recognizing improvements in my neck and back tension and pain. I've increased my daily water intatke too. I'm struggling on getting back into a steady gym routine, but try to get physical activity daily, even when I can't make it to the gym. I am very pleased with the progress! I believe my overall anxiety is improving as well!

1999: Paxil ?? mgai (Paroxetine Hydrochloride) - stopped cold turkey
2001-03: Celexa ?? mgai (Citalopram Hydrobromide) - switched to Lexapro
2003-August 2015: Lexapro 20 mgai (Escitalopram Oxalate) - rapid 5 mgai increment taper down to 0 mgai
December 2015 - January 2016: Short hospital stay for unknown acute AD WD due to rapid taper
January 2016-February 21, 2016: Prozac ?? mgai (Fluoxetine Hcl) and Wellbutrin ?? mgai (Bupropion Hcl) - switched to Lexapro
February 21, 2016-July 22, 2018: Lexapro 10 mgai  - rapid 5 mgai increment taper down to 5 mgai
July 22, 2018-March 17, 2019: Lexapro 5 mgai - endured horrible waves due to rapid taper
March 17, 2019-April 7, 2019: Lexapro 3.226 mgai - endured horrible wave due to rapid taper
April 7, 2019-April 28, 2019: Lexapro 3.548 mgai - updosed to level out
April 28, 2019: Implemented Brass Monkey Slide taper method (2.5% weekly reduction) - IT’S WORKING!!!
September 2, 2020: Lexapro 0.000 mgai / 0 mgpw / 100% Taper COMPLETE!

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Great to hear, Iowan!

2006 - Paroxetine, 20 mg

2008 / 2018 - Several mostly unsuccessful attempts at tapering, without knowledge of withdrawal

2019 - Decrease from 20 mg to 15 mg (June), from 15 mg to 10 mg (December)

2020 - Switch to 10 mg liquid citalopram (February), decrease to 8 mg (April), 6 mg (June), 4 mg (July) without symptoms. 3.2 mg (September 9), 3 mg (September 23), 2.8 mg (October 10), 2.6 mg (October 26), 2 mg (November 13).  Tapered to 1.68 mg in steps of 0.16 mg (December 3). Withdrawal kicked in.

2020, December - Increase to 1.8 mg (December 8), increase to 1.92 mg (December 18)

2021, January - Increase to 2.2 mg (January 1)

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