BigSun: Liquid solution from Lexapro

[BigSun]

Hi there,

 

I am not sure the best way to start, and the answer to my question may already be buried in one of the many other excellent responses, but here is the question anyway.

 

I take 2.5 mg Lexapro by cutting in half the 5 mg pill, and want to taper to 0.   I tried this before by going to 1.25 mg by cutting the 5 mg tablet into 1/4ths and was OK, but then tried using a compound pharmacy to get smaller doses to get to 0.  However, about 3 days after starting to take 2 what were supposed to be 0.5 mg doses (to go from 1.25 to 1.0) of the compound pharmacy doses, I had a major crash, tons of anxiety and panic.  I dont have any idea what happened, except maybe the compound doses were screwed up some way or another.  Things got so bad I had to go back to 7.5 mg. 

 

Now I am back down to 2.5 mg and doing well, and want to find a reliable way to taper to 0. 

 

I think the liquid works well, but dont like the preservative chemicals in the commercial liquid version of Lexapro, for example there are 2 different parabens, and I dont know at what level since they consider that "propietary" information.   Nice, huh. 

 

So I would like to make my own liquid from the tablets.   This FDA report says lexapro is soluble in an isotonic saline solution. 

https://www.accessdata.fda.gov/drugsatfda_docs/label/2003/21323se1-003,se8-007,21365se8-001,se1-004_lexapro_lbl.pdf

 

So my plan is to just dissolve the tablet in an isotonic saline solution and then take the proper amount for the proper tapering dose. 

 

My questions are:

 

1.  Does anyone have any knowledge about dissolving Lexapro in an isotonic saline solution and does this really work, and will it be well distributed in the solution, maybe better than a suspension in water?

 

2.  Is there any reason not to do this?

 

3.  If I only take a percentage of the slef-made solution, how long will the other portion be good, say in the refrigerator, so the remainder can be taken as doses on other days?

 

thank you  🙂

 

Big Sun

 

 

 

 

 

Edited January 19, 2021 by manymoretodays

[Sunnyday]

Hi @BigSun and welcome,

 

I apologise we couldn't get back to you sooner. Would you mind writing a signature? We ask that all new members do this. Here's how to:

 

How to write a sginature

 

 

This topic below, if you haven't already seen it, might be helpful. It also mentions dissolving the Lexapro in an isotonic saline solution a bit further down. It will supposedly keep for up to a week with the drug added in. Without the drug in it, it can last for a month or so in the fridge:

 

Tips for tapering off escitalopram (Lexapro)

 

We recommend to taper by no more than 10% of the current dosage.

 

Why taper by 10% of my dosage

 

 

If you have more questions, feel free to ask. In this introduction topic you can ask questions, give updates and get support from others. I'm glad to hear you are feeling better right now.

 

 

Edited January 22, 2021 by Sunnyday

[manymoretodays]

Hi BigSun,  and welcome aboard,

And that's good, you've stabilized on the 2.5 mg of Lexapro/escitalopram.

 

And most definitely go slow now, with continued tapering.

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

Why taper by 10% of my dosage?

And then often when getting to the lower dosages, it is apparent, that it makes sense to taper much more cautiously, and slowly, and then some, will even taper by less than 10%, a microtaper, or do what is known as the brassmonkey slide method

   

*Tips for tapering off Lexapro

^ more information about your drug, and getting the smaller doses need for proper tapering

 

*How to make a liquid from tablets or capsules

more about this method

 

And then always good to do some form of crossing over to liquid, whether it's homemade or pharmacy grade:

Starting with this formula, or adapting it, as needed:

When shifting to liquid, do not taper at the same time.

Day 1-3  Same dose, 1/4 dose in liquid and 3/4 dose in solid form

Day 4-6  1/2 liquid and 1/2 solid

Day 7- 10 3/4 liquid and 1/4 solid

And then on to your dose in all liquid.  Again, you may adapt this to your needs.  Sometimes the change in formulation will result in some bumps.

 

And yes, good idea to start, if you make your own liquid, with a saline solution.  There is a bit more on that in the Tapering Lexapro topic too.

 

Yes, and apologies, on the late approval and getting started.

 

This is your introduction/journal page where you have now introduced yourself to the community, you can ask questions here regarding your tapering, give updates, and just keep a record of your journey.

 

And yes, do attend to the signature, that will enable us to see at a glance, where you are at, and where you might be coming from as well.

This is a bit different from your profile information, and will appear below all your posts after you've completed it.

Are you on any other drugs right now?  Please include all drugs in the signature.

 

Welcome again and best, Love, peace, healing, and growth,

moderator manymoretodays(mmt)

 

 

[BigSun]

OK, signature added  🙂

[BigSun]

Thank you.  Any idea how long a home made solution made with an unpreserved isotonic saline solution would last in the refrigerator?

 

thanks again

 

PS Congratulations on getting off the meds!

Edited January 26, 2021 by manymoretodays
name removed at members request

[manymoretodays]

Hey BigSun,

And what a great user name, especially for this time of year!

To be on the safe side, I sure wouldn't go longer than 3-7 days, and protect it from light, even the light in the refrigerator.  An amber colored storage bottle with a lid is great.  I went all simplistic with my last drug, and kept it in a paper bag and used a sterile urine container.  Glass is best though.

You can also, go to further links from the tapering topic, to find out more.  PubMed often is great, with all kinds of information.  And then I also lucked out, with finding a friendly pharmacist who gave me some guidance and reassurance, and seemed to approve of what I was doing.  My last drug off was not Lexapro, however.

 

I did not mention the microtaper methods, beyond the brassmonkeyslide, I see.

So- Micro-taper instead of 10% or 5% decreases

And, honestly, I do think, that with Lexapro you should consider going with less than 10% total, every month or 6 weeks. 

That you've gotten to 2.5 mg, and can still type is great.  I pretty much lost my brain for awhile, when I attempted to get below 5 mg, and much too quickly, I might add.

 

You might want to just sit with the 2.5 mg, or HOLD now.  And give it 3 to 6 months before going back to tapering.  Me, that's what I would do.  You just got off Trazodone too!  So congratulations on that!

 

Be a turtle, in other words.  No great prizes for going too fast, and it takes quite awhile to recover from too fast tapers.

 

The rule of 3KIS: simple, slow, stable

 

And thank you for the congratulations!  No one, absolutely no one, on the ground really gets it........all I went through, with these stupid drugs and all, so.......much appreciated.  I am enjoying the free of meds/drugs, me now, and excited about the future.  What.....a.......long........haul.......it has been.  I've sure met a lot of people and learned a lot though, that just would not have been, otherwise.  So.......an interesting journey adventure anyway.

 

And thank you for the signature.  So helpful.

 

Best, L, P, H, and G,

mmt

Edited January 25, 2021 by manymoretodays

[BigSun]

Thanks MMT, I do think going slow is definitely the way to be.  I was down to 1.25 mg previously, and doing OK and then started with a compounded version at 2 * 0.5 = 1 mg (in theory) and had an unbelievable crash within days, with disabling, off the charts, anxiety like nothing I had ever experienced before.   I will always wonder what was really in that compounded Lexapro. 

 

The trick is to find a good way to control the dose for small reductions. 

 

I have been on the 2.5 mg for 5 months, but planning on waiting a few more months before reducing more (springtime!), but in the meantime for fun, I put a Lex tablet in unpreserved saline solution for eyes (just saline, boric acid and borate) but after 8 hours it still seems to be suspension instead of solution.  Not sure why. 

 

Another option would be to use the commercially prepared solution which is  1 mg/ml which is good because it is a fairly high dilution so easy to measure out small doses, but the US version has 2 parabens preservatives which is not considered even good on skin, so I prefer not to eat that each day.  

 

There is also a Canadian/European commercial prepared solution version without parabens, but it is 20 mg/ml so pretty concentrated so more difficult to measure out small amounts of Lex.  I thought maybe using that diluted with water would work.    Any thoughts about that?

 

Thanks again and I envy your drug freeness!

 

 

[manymoretodays]

Hey, I think Frogie used the prescription solution.  Here's their main thread, you could go over there and ask if they further diluted.  I would think you would have to, at the smaller dosages, or get a syringe with very small calibrations.   And then other considerations might be cost, and how often you would need to get a refill.  They usually dispense more than one needs, while tapering, and most of the time the solution expires after so much time has passed.

 

Frogies main Introduction

 

And again, be cautious and careful when crossing over to liquid too!  That's where I really blew it.

Probably others who might comment on the liquid as well.  You could search from your main browser, just put in survivingantidepressants and then Lexapro and some more members who have or are tapering that should appear.  Then you can browse their Introductions to see, and post there too.

 

[BigSun]

Thanks MMT  🙂

[Heath]

Hello BigSun Welcome to SA !!

 I see you have experience in ssris as many of us do unfortunately 🤪.  I take liquid lexapro 1 to 1 . Like you I definitely do not like the taste! I  have gotten used to it. I have to take in a few shots instead of one big gulp. I did not know about the parebens in it  interesting . I do advise to hold and transfer slowly when you change to liquid form. I wished I would have held a month or so after.  There are great moderators on here that will help your calculate and get to your liquid solution! Again welcome and good luck with your taper ! 

[BigSun]

Thanks Heath  🙂    I wish you well on your ongoing taper! 

 

I didnt realize there wold be an issue stabilizing when switching from the tablet to liquid (and maybe vice versa) but others and now you have mentioned it, so I guess it can be an issue.   

 

The US version has the parabens, the Canadian does not, so maybe it is possible to get it from there.  It can be cheaper too but it depends on ones insurance. 

 

The US version is 1 mg/ ml which makes it easy to measure it out well because a ml = 20 drops, so 20 drops per mg.

 

The Canadian version is 20mg/ml per ml, so 1 drop per mg which means if you dont get the drops exactly right, there could be big difference in dosage. 

 

I am wondering if it is possible to simply dilute the Canadian version with water to get similar ratio's to the US version making it easy to control the dosage?  Hopefully someone may know.

 

take it easy

 

 

 

 

[BigSun]

MMT,

 

By the way, you said you had a problem switching to liquid.   Do you mind elaborating?  I remembered that before my big crash, I switched from liquid to compounded pills.....

[manymoretodays]

Hi BigSun,

I think my biggest problem with my switch from 5 mg Lexapro solid tablet to liquid, might have been:

 

1. my timing, I had lost a friend, a loved one, to suicide in the preceeding months and of course, was struggling a lot, with that.

Also, had come off Seroquel sometime prior to this, and perhaps just needed more time adjusting to that

2.  when I switched to liquid, I, at that time, had no idea what I was doing and just did a straight switch over along with dropping my dosage by a full 1 mg.  And then a few days later dropped down to 3 mg.  And oh my, that was just plain ignorance, out of lack of knowledge.

 

*oh and hey, editing in here- I may have also needed more time to let my previous drops in Lexapro/excitalopram settle.  I found, in review of some of my notes, and records that I had been on 20 mg at one time, and then dropped to 10- likely shortly after, as I may have experienced adverse effects at the high dose.  And then, had likely jumped down at some point, precipitously, I might add, to 5 mg.

And as, I now know, for me, and many others, getting below 5 mg, should really be done, much more cautiously........as should getting down from the higher dosages.  I just really believe we have to wait, and listen to our bodies responses, to the changes, as well as be aware of the various saturations, and dose effects on these.  You'll see more about that in the Why taper by 10% topic:

  

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

For scientific data supporting very gradual tapering, see Horowitz, 2019 Tapering of SSRI treatment to mitigate withdrawal symptoms 

 

This paper is based on the concepts discussed in our topic Why taper? Paper demonstrates importance of gradual change in plasma concentration referring to Meyer, 2004 and other research into SERT transporter occupancy.

 

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

 

The bolded statement above.  And see Horowitz, and Meyer's works too!  Took me awhile to take it all in and understand.

Sometimes.......I think it's a wonder, that I have managed to come through it all, as well as I have.

 

I only had the slightest idea of tapering, nothing like what I know now.  I had not arrived here.  And really had only glanced Will Hall's, the Icarus project, Guide for Coming off Psychiatric drugs.  I had one of the first editions printed off even, yet had not really done a good read through, or my own research.

 

And so, both timing, and ignorance really for me. 

That false belief that if I just came off my medication, I would feel better. 

The impact of suicide is quite awful, on those left behind.   And although I thought I was going on okay......obviously.......it takes time, and the emotions that come up can be very difficult. 

 

And so yah, for me, it wasn't just a switch in forms of Lexapro, it was also a rapid, way too rapid of a taper, as well as perhaps needing to readjust, give my nervous system more adjustment time, after a previous WD. 

And then, the life stressors........  😞 Best, if at all possible to wait until some of the other aspects of life are going a bit more smoothly......or it would have been for me.  Grieving takes time, this I know.  It deserves time and space.  My friend, my loved one lost to suicide........well, I've long suspected that his own drug use, and I mean prescribed psychotropics, played a part too, in their death.  And so, I try, try, try.......to be a part of changing this whole landscape of prescribing, and deprescribing(what little exists).......for the Love of Scott.

 

And phew...... thanks for the space.  All about me, eh?  ❤️

 

Ah, and best BigSun.

 

L, P, H, and G,

mmt

 

 

Edited January 29, 2021 by manymoretodays

[BigSun]

Hi BigSun,

I think my biggest problem with my switch from 5 mg Lexapro solid tablet to liquid, might have been:

1. my timing, I had lost a friend to suicide in the preceeding months and of course, was struggling a lot, with that.

Also, had come off Seroquel sometime prior to this, and perhaps just needed more time adjusting to that

Wow, those are 2 major stressors at nearly the same time that would affect anyone.

2.  when I switched to liquid, I, at that time, had no idea what I was doing and just did a straight switch over along with dropping my dosage by a full 1 mg.  And then a few days later dropped down to 3 mg.  And oh my, that was just plain ignorance, out of lack of knowledge.

I only had the slightest idea of tapering, nothing like what I know now.  I had not arrived here.  And really had only glanced Will Hall's, the Icarus project, Guide for Coming off Psychiatric drugs.  I had one of the first editions printed off even, yet had not really done by own research.

Wow #2,  I hadn’t seen the Icarus project, that looks really good.  I am looking forward to reading it!  Thanks for mentioning it.

And so, both timing, and ignorance really for me. 

Well, if the highly paid doctors who prescribed these medicines had a clue what they were prescribing, you should have been informed….but alas…

That false belief that if I just came off my medication, I would feel better. 

The impact of suicide is quite awful, on those left behind.   And although I thought I was going on okay......obviously.......it takes time, and the emotions that come up can be very difficult. 

 I have not experienced that with any close relations….it must be very destabilizing…

And so yah, for me, it wasn't just a switch in forms of Lexapro, it was also a rapid, way too rapid of a taper, as well as perhaps needing to readjust, give my nervous system more adjustment time, after a previous WD. 

And then, the life stressors........  😞 Best, if at all possible to wait until some of the other aspects of life are going a bit more smoothly......or it would have been for me.  Grieving takes time, this I know.  It deserves time and space.

Thanks for all the feedback, and the fact that you are off all the meds and apparently doing well enough is very inspirational!