catmama: Introduction

[catmama]

Hello. I’m a 31 year old female. Straight, single, no kids. From California. I am alcohol-free since 1/1/18 and don’t smoke or use drugs. 
 

I was diagnosed with anxiety in 2001, depression in 2013, and have had moderate to severe emetophobia for as long as I can remember (this contributes to most of my anxiety). My first time being prescribed an antidepressant was at age 12. I was on a low dose of Paxil CR after being hospitalized for mysterious ailments that turned out to be anxiety-related. I’m not sure but I think I was on that med approximately  six months. I don’t remember having any issues coming off it. 

In my last year of college (2013), at age 23, I started experiencing a worsening of anxiety and depression symptoms and ended up back on Paxil. Between then and early 2016 I was on and off Paxil, Zoloft, and Wellbutrin. I gained a lot of weight from the SSRIs which started negatively affecting my health. I was able to get off the combo I was taking (Paxil and Wellbutrin) in 2015(?) with tolerable and brief withdrawal symptoms, and was having great success managing my life with healthy habits and talk therapy. 
 

That all came crashing down when I decided to buy my first house. (A decision I now regret!) The stress of it all made me start having panic attacks at work so I decided to go back on medication. I started with Zoloft but the second time around it gave me terrible side effects. Next was Prozac which was just a week of misery. So I finally tried Lexapro. It worked. But over the course of the next several years I gained even more weight, and along with unhealthy lifestyle choices, ended up with a type 2 diabetes diagnosis. 
 

Along with the type 2 diabetes, my absolute worst struggle is fatigue. I have low energy every single day of my life. It got so bad that I was almost fired from my job for excessive tardiness; I’d sleep though alarms. I actually ended up quitting that job and selling my house because my mental and physical health were sinking to their lowest. I spent over six months on disability and moved back in with my parents. I eventually started working part time. And now I’m back to working full time and recently moved alone in a nice rented apartment.
 

The constant, everyday, debilitating fatigue is still there. I tried everything to remedy it, even had a sleep study done. Nothing. The sleep doctor said that SSRIs can disrupt sleep patterns. So through process of elimination I’ve come to the conclusion that my chronic fatigue is because of the Lexapro. Between that, no sex drive (and thus being single for the past 7 years), and the metabolic issues, I’m determined to get off it. 
 

Which brings me here. I first tried  getting off my 15mg/day dose in summer 2019. I took the bad advice from a homeopathic doctor to taper down 5mg every two weeks. It was hell and even after stretching that out a bit, I had to go back to the full 15 and eventually 20mg dose after six weeks. 
 

I’m now on my second attempt to taper. I easily got back down to 15mg in January 2020. In October 2020 I talked to my psych NP (who’s been managing my medication for several years now) and she prescribe me liquid Lexapro so I can start a slower taper this time. I started off going down 1mg each week, sometimes two weeks if needed. I didn’t have too many issues. The main symptoms were fatigue, nausea, dizziness/lightheadedness, and brain zaps. 
 

January 22, 2021 I got down to 3mg and that’s where I still am because for some reason I’ve been smacked on my a** with symptoms. I’m experiencing all the physical symptoms above, but worse; now along with crying jags, derealization, irritability, intrusive thoughts, and depressive mood. They’re not constant but they’re enough to really mess up my life right now. (Pandemic burn out is definitely a contributing factor as well.) So I’m here on this site to navigate this last leg of my taper. 
 

Feel free to drop a comment, give advice, ask a question, or just say hi. I’m using this site mostly on my phone so I’ll do my best to figure it out and add my signature line ASAP. 

[Shep]

HI, Catmama.

 

Welcome to Surviving Antidepressants. 

 

Quote

 

October 16, 2020 begin taper off escitalopram at rate of 1mg per 1 week (sometimes per 2 weeks) using 1mg/ml liquid from pharmacy 

• January 22, 2021 down to 3mg and holding due to worsening of WD symptoms 

• February 4, 2021 reinstate 4mg dose and holding, with plans to begin 10% standard taper in two-ish weeks 

 

 

From your signature, it looks like you were tapering too fast, but have since figured that out.

 

Instead of doing a 10% taper, you may want to do a micro-taper of, say, 5% a month. Please see:

 

Micro-taper instead of 10% or 5% decreases

 

For information specific to escitalopram, please see:

Tips for tapering off escitalopram (Lexapro)

 

Please note that escitalopram is an extremely potent SSRI. So don't let the low dose trick you into thinking it's mild and won't have an effect. This is a very powerful drug. So the micro-taper is the best path forward. 

 

For now, you may want to hold and give your recent updose time to work. As you hold, check out some of the below information:

 

You may find some helpful information to handle your symptoms here: 

 

Non-drug techniques to cope with emotional symptoms

 

We don't recommend a lot of supplements, as many members report their nervous systems are simply too fragile to handle them. However, magnesium and fish oil tend to be calming to the nervous system and many people report they do help. Please only add in one supplement at a time and at a small dose. For more, please see:

 

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

 

Magnesium, nature's calcium channel blocker

 

Please let us know how you're doing over the coming days. 

[catmama]

Thank you so much for the response @Shep 

I will definitely read up on those links you provided. I didn't know that Lexapro in particular was so potent; no wonder I'm feeling like hell!

I've started a daily symptom tracker on excel. Each symptom is listed and I give it a number rating based on severity for that day. That way I can create a line graph and see how symptoms improve (hopefully) over time. 

 

[Yesyes123]

Hey @catmama welcome!

 

I'm amazed at how fast you tapered Lexapro with manageable symptoms. 1mg per week is super fast from our standards. 

 

How would you describe your symptoms during your taper in this fast rate? Were they moderate? Could you sleep well? 

 

Peace and healing

[Heath]

Hello catmama welcome to SA!! You have come down a long way ! Hopefully the extra updose will help with the symptoms! May hold a little while before continuing taper and they will pass. Yes 1.0 ml lexapro is equal to 1.9 ml Paxil lot stronger!  Hang in there! Slow steady stable!

[catmama]

On 2/8/2021 at 10:34 AM, Yesyes123 said:

How would you describe your symptoms during your taper in this fast rate? Were they moderate? Could you sleep well?

It was quite tolerable before I went down to 3mg. I experienced brain zaps, mild nausea, dizziness/lightheadedness, one or two crying jags. But overall very mild. 
 

I don’t think I’ve ever slept well. I’m always able to fall asleep just fine. But for whatever reason, my sleep isn’t restorative. I do think I have unconscious/nonconscious anxiety or something because there are times when I wake up in the middle of the night with my heart pounding and I’m filled with a sense of dread. It usually passes quickly. I also often wake up with jaw pain from clenching and grinding all night.  
 

I’m always tired. Always. Even before started ADs in college. But I trudged through and I still do. I’m hoping and praying with all my might that maybe once I’m totally off ADs, I can get some real rest and feel energized in the mornings for once in my adult life. 

[catmama]

Thank you so much for the encouragement @Heath! Much appreciated  

[catmama]

Hey it’s been a while since I checked in. Which I suppose is a good thing because it means that for the most part, my tapering journey has been fairly smooth. I’ve been tapering at a steady rate of 10% every 28 days, with a couple 21-day cycles thrown in. But I’m going to stick with the 28 day cycles. My last dose drop was about two weeks ago and I only held the previous dose for 21 days and I’m feeling like hell. Mainly nausea, dizziness, poor sleep, and some depression. Life has been stressful as well (back to in-person work full time, studying for a big licensing exam, and dealing with adrenal fatigue) so I’m sure those are contributing to the withdrawal symptoms being a bit worse than usual. 
 

If anyone has nausea remedies please advise. My appetite is off too, so light foods that I can keep here at work that you recommend would be great too.

 

Thanks all! 

(Also I will update my signature once I’m on my laptop, I’m doing a this update on mobile.) 

[ChromeChinchilla]

Nausea/lack of apatite has been something that seems to crop up every time I have a wave. It's very basic but sipping on ginger tea can often  not only calm my stomach, but stimulate my apatite an hour or so after I've drank it. I make it with thinly sliced, fresh ginger.  You could slice some up in the morning, put it in zip lock and stick it in the office fridge so you could make a cup whenever you felt like it, or just make a at home thermos to take with you. 
 

Another thing that's very basic but is for whatever reason hard to remember when I'm feeling crummy is to make sure I don't fully submit to the "I'm not hungry" sensation. A good number of times I've found that even when I feel like food is the last thing I want, nibbling on a little something will sort of wake my apatite up make me feel more properly hungry. 

[Shep]

15 hours ago, catmama said:

Hey it’s been a while since I checked in. Which I suppose is a good thing because it means that for the most part, my tapering journey has been fairly smooth. I’ve been tapering at a steady rate of 10% every 28 days, with a couple 21-day cycles thrown in. But I’m going to stick with the 28 day cycles. My last dose drop was about two weeks ago and I only held the previous dose for 21 days and I’m feeling like hell. Mainly nausea, dizziness, poor sleep, and some depression. Life has been stressful as well (back to in-person work full time, studying for a big licensing exam, and dealing with adrenal fatigue) so I’m sure those are contributing to the withdrawal symptoms being a bit worse than usual. 

 

A few thoughts: 

 

You may want to slow your taper rate down. Many people find that the lower doses are actually harder to taper than when on a higher dose due to the occupancy rate. Please have a read of at least the first post in this thread. 

 

Why taper? SERT transporter occupancy studies show importance of gradual change in plasma concentration

 

 

You may also want to switch over to the Brassmonkey Slide, as it's gentler on your nervous system due to small weekly reductions, as opposed to one larger monthly reduction. Perhaps even go to 5% instead of 10% each month. The goal is to be as functional as possible, even while still on the drug. Please see:

 

The Brassmonkey Slide Method of Micro-tapering

 

15 hours ago, catmama said:

My last dose drop was about two weeks ago and I only held the previous dose for 21 days and I’m feeling like hell.

 

You may be able to do a very slight updose. I wouldn't increase back up to where you were two weeks ago, but perhaps halfway there and see if that helps. 

 

If you don't feel that would help, you may want to go into a very long hold, especially while you're dealing with so many external stressors. Good luck with your licensing exam. That's great you're out there tackling all of that while you're also dealing with withdrawal, but do take care of yourself. 

 

And like @ChromeChinchillawisely wrote, nibble on something. Please note that low blood sugar can also cause you to have nausea, dizziness, and to sleep poorly. So eating healthy with lots of protein, low sugar, while avoiding caffeine and alcohol, etc. are all important. 

[catmama]

@ChromeChinchilla thank you for the tips. I have some ginger tea here at work but I'll keep some crackers or dry cereal as well to have something to nibble on.

 

@Shep thank you for the tips as well. I'm starting to feel the psychological symptoms of w/d this week as well (like anxiety, intrusive thoughts, and mild depression). In the past, that would have me running back to meds. But I'm determined to get off these meds for GOOD! So I think it would be best if I hold at this dose for a couple months then when I'm ready to resume tapering, I will convert to the Brass Monkey Slide method.

In the meantime I'm going to make more of a point to go the gym - weight lifting does wonders for my depression and gives me such a great mood boost. And also try to get some extra sleep and spend a few minutes meditating every day. 

[Shep]

16 hours ago, catmama said:

So I think it would be best if I hold at this dose for a couple months then when I'm ready to resume tapering, I will convert to the Brass Monkey Slide method.

In the meantime I'm going to make more of a point to go the gym - weight lifting does wonders for my depression and gives me such a great mood boost. And also try to get some extra sleep and spend a few minutes meditating every day. 

 

Sounds like an awesome plan, Catmama. All good stuff to do in the non-drug coping skills category. 

[MrBamse]

Hi Catmama! I just wanted to drop by and say hi.

 

Seems like your all over the withdrawal adventure and have a good plan!
You're building up resilience and a good lifestyle that will serve you well long after withdrawal

[catmama]

(TW) Hey there. It’s been a little while since I provided an update. 
 

After making adjustments after my last update, my taper had been going smoothly. I converted to the Brassmonkey micro taper schedule as suggested by @Shep   It made a significant difference.
 

In July I began the keto diet and had success with lowering my A1c, getting my blood sugar under control, and losing a few pounds. I also started back on Levothyroxine to treat my hypothyroidism and felt a nice little boost in my energy. And I got in a good routine with weightlifting a few times a week. 
 

Things had all been great and I had been enjoying a really nice window. Then suddenly about a month ago a big wave hit me and I’ve been in it ever since. Starting around the holidays and trickling into the new year, my healthy eating and working out went by the wayside, which I’m sure is a contributing factor to some of my withdrawal symptoms. I’ve been experiencing nausea, brain zaps, dizziness and lightheadedness, regular tinnitus and pulsatile tinnitus, fatigue, jaw clenching, and headaches. I’ve also been experiencing an increase in anxiety, intrusive thoughts, and depression. It’s so frustrating. I know there are things I can do to help ease some of these, but with the low energy, it’s hard to even start. 
 

I’m holding at 1.43mg at the moment. I’m just so frustrated. I hate this drug. Hate it. I hate feeling like I’m never going to feel well again. I hate getting these intrusive, upsetting thoughts that say “it would be easier if I was d**d.” I’ve never been s****dal and I know I’m not now. But I hate when those upsetting thoughts pop into my head. 
 

I appreciate this online community. Going through this experience can be so isolating. Especially when I try to explain it to others and have to tell them this is a years-long process. It’s disheartening when well-meaning people say “why don’t you just go back on the medication?” The advice and encouragement on this site is so helpful. And the best part is is that I don’t feel so alone in this journey. 

Edited February 6, 2022 by catmama
Misspellings

[ChessieCat]

Well done on getting your blood sugar under control with diet.  I have recently done the same thing; in 3 months of low carb 7.0 to 5.2 and no diabetes drug, just diet.

 

Getting back on track with your diet might make a difference to how you are feeling.  You don't have to do it all at once, just make gradually changes that are manageable and before you know it you will have made the transition.

 

If getting back on your previous regime does not improve things (I'm thinking that your lapse might have added some stress to your body), then you might consider making smaller reductions.  Many members find that the lower their dose gets the slower they need to go, reducing less and/or holding longer.  Every reduction, whatever the size, is heading towards your goal of being off the drug.  I kept reminding myself that I didn't need the drug but my brain did.

[catmama]

Thank you for the feedback @ChessieCat (another cat-lover it seems!)

 

After reading through some of the comments on the reinstatement thread, I think that is the best course of action for me. The neuro-emotions and dizziness are affecting my ability to do my job and take care of myself. So tonight (I take my dose every evening at 7PM) I will go back up to 1.63mg and see how I feel after a week or so. I was feeling ok at that dose; it's when I went down to 1.49mg, and now 1.43mg, that I'm feeling really crummy. 

 

Any recommendations for how long to hold after reinsating? The thread says "Think in terms of months before you attempt to taper again." I hate the idea of stalling this taper even longer, but I also hate the idea of feeling like crap for who knows how many weeks or months.

[ChessieCat]

1 hour ago, catmama said:

will go back up to 1.63mg and see how I feel after a week or so. I was feeling ok at that dose; it's when I went down to 1.49mg, and now 1.43mg

 

If it was me I would NOT be going to 1.63mg.  I would only go up a small amount, possibly to 1.45mg or 1.46mg, definitely not more than the previous dose of 1.49mg.

 

It takes about 4 days for a dose change to get to full level in the blood and a bit longer for it to register in the brain.  It is better to make small increases than to risk taking too much.

[ChessieCat]

1 hour ago, catmama said:

Any recommendations for how long to hold after reinsating? The thread says "Think in terms of months before you attempt to taper again." I hate the idea of stalling this taper even longer, but I also hate the idea of feeling like crap for who knows how many weeks or months.

 

What you are doing is an updose, not a reinstatement, which is what this statement is about.  See:

 

Stability

 

WDnormal

 

And Brassmonkey talks more about it here:

 

tao-of-the-brassmonkey

[ChessieCat]

You might consider slowing your taper down by making small monthly reductions instead of 10% total.

 

I understand your frustration with wanting to get off your drug, but the goal is to get off with minimal discomfort and disruption to your life as possible. 

 

This topic helps to explain why as you get lower you might need to slow down:

 

Why taper paper: dose-occupancy curves

[catmama]

22 minutes ago, ChessieCat said:

 

What you are doing is an updose, not a reinstatement, which is what this statement is about. 

Yes, an updose. Thank you for clarifying and providing useful links. I will try the tiny updose you recommended. I know what my “WDnormal” is now, so I will work to get back to that again. 

[catmama]

I updosed last night to 1.45 mg. I understand it could take a few days to start feeling any relief. Today is really hard. The worst is the dizziness. I feel off balance and like I will tip over. It makes me feel like I'm carsick, so I feel really queasy. (Which contributes to my anxiety due to my emetophobia.) 

 

I am in-person at work today and I really want to go home. My job started off as 100% remote because I started during 2020, and now we have a hybrid schedule, so it's a job that I can easily do from home with little change. My team has a flexible schedule so I'm thinking of asking to WFH full-time for a few weeks. For some reason, I'm feeling really nervous about asking my supervisor if I can WFH. He's very understanding and easygoing. I think my hesitancy comes from bad experiences from a previous job where I felt the need to hide my struggles with anxiety and antidepressant side effects. Those symptoms led to me being tardy a lot, and other issues, and I eventually had to quit. (Had I not quit, it's very possible I would have been fired.)

 

It's so hard trying to explain this tapering and withdrawal stuff to people on the outside of it. It's hard enough for me to grasp the idea that this little, commonly used pill can cause so much damage and have such a hold on my brain. So I can imagine it's even more baffling to others. I fear judgement from others. 

[ChessieCat]

Many people are struggling to get back to working in the office due to the pandemic and you could tell them that you are finding it harder than you thought it would be and would to try to ease your way into working in the office after having few more weeks working from home.  It would be harder for you because you started the job WFH so you are not going back to something that is familiar, it is all new to you.  Perhaps if you discuss with them how you might do this will take some of the stress off because you will have a plan and know that the management is in the loop.

[catmama]

I just wanted to check in and provide an update.

 

Following the advice provided to me, I held at my dose of 1.45 mg for about 4-5 weeks. Within a couple days I started feeling so much better. I got my energy back, my mood improved, and the dizziness when away. I was able to get back to my keto diet and gym routine, which definitely helps me feel more stable during waves.

 

On March 18 I resumed my taper. I'm following a 2.5% drop per week schedule. I'm now down to 1.34 mg. For the past few days, withdrawal symptoms have set in again. I've been experiencing anxiety, neuro-emotions, night sweats and poor sleep, as well as some dizziness and nausea, both of which are mild thankfully. I'm really bummed out that I feel crummy again. But the window I had while holding gave me hope that when I am eventually off this drug completely, I will be just fine. 

 

I'm trying to just take things one day at a time. Today is a rest day, and I will likely have to skip my gym workout, which really sucks, but I have to listen to my body. When I get to 10% (so four weeks at 2.5% drops), I will hold for two weeks rather than one and see how I feel. Then restart the cycle until I get to just under 1 mg. At that time, I will start the "end game." However I'm having trouble finding guides for the end game taper and jump off points for Lexapro. Does anyone know where those links are?

[catmama]

@ChessieCat thank you for the info. Luckily I have access to liquid lexparo already from my doc/pharmacy. It's a 5gm/5ml solution so measuring doses with an oral syringe is easy.

 

My question is in regards to finally getting to 0. I understand that the end game forum section is under construction. But who knows when it will be completed. Until then I was looking for any info on when to make the jump to 0. Mathematically, I can't keep dropping by a percentage, I know there has to be a "jumping off" point. I recall that the end game suggestion used to be to get to 1 mg then make bigger cuts with longer hold times. But now I'm being told that's no longer recommended. 

[Altostrata]

@catmama, how have you been tapering so far, and what's been your pattern of withdrawal symptoms? When did you last make a decrease? Did you get any withdrawal symptoms from that?

[catmama]

56 minutes ago, Altostrata said:

@catmama, how have you been tapering so far, and what's been your pattern of withdrawal symptoms? When did you last make a decrease? Did you get any withdrawal symptoms from that?

Recently I have been using the micro dose taper schedule, dropping 2.5% every week. I hit a bad wave with symptoms so severe I actually had to miss work, which I hate doing. I was having anxiety, intrusive thoughts, bad dizziness, low appetite, nausea, and fatigue.
 

I did a tiny updose and held for about 6 weeks and it helped tremendously. I felt the best I felt in years during that hold. Like actually forgot I was on a taper most days. 
 

Two weeks ago I resumed my same taper but am now back to experiencing some symptoms again. So I’m going to lengthen my hold times from one week to two weeks and see if that helps. 
 

Here’s a mini breakdown of my last few months: 

Jan 28 - 1.46 mg
Feb 4 - 1.42 mg BAD WAVE

Feb 7 - 1.45 mg (slight updose, and hold)

Mar 11 - 1.41 mg

Mar 18 - 1.37 mg

Mar 25 - 1.34 mg

Today - 1.36 mg (increased symptoms, slight updose, holding until symptoms subside)  

[Altostrata]

If you're getting withdrawal symptoms from tiny dose reductions, simply quitting is likely to cause worse withdrawal. Rather, it may be a good idea for you to hold at one dose for quite a while, maybe months, to let your nervous system settle down before going into the last phase of reductions.

[catmama]

@Altostrata ok that sounds like a good idea. Thank you so much for taking the time to help me out. I really appreciate it!

[catmama]

So, after getting some much-appreciated advice from the mods and site veterans, I have decided to stay on an extended hold at 1.36 mg for a minimum of 4 months. I have come to the realization that is is better to have this taper process last 3-4 years and still be able to feel like a normal person rather than to rush it and feel like hell. I have a life to live and ENJOY and I can still do that while tapering, I just have to go reeeaallllyy slloowww. 

[Altostrata]

Good idea! Please let us know how you're doing.

[Ariel]

@catmama

Thinking of you <3

[Ninabird]

@catmama

Good morning fellow Ca girl. How have you been doing? 🌺🌴

NB

[catmama]

On 6/20/2022 at 3:53 AM, Ariel said:

@catmama

Thinking of you ❤️

 

On 6/20/2022 at 7:06 AM, Ninabird said:

@catmama

Good morning fellow Ca girl. How have you been doing? 🌺🌴

NB

 

Thanks for checking in! I'm doing well. I'm still on my extended hold at 1.36 mg. Once or twice over the last couple months I've experienced a few moments of mild symptoms (mainly dizziness, nausea, and fatigue) but other than that I've been virtually symptom free. I plan to resume my taper the first week of July. I'm nervous about restarting. But I'm also very motivated to get fully off this drug.

Hope you're both doing well!

[Ariel]

@catmama

Great to hear from you, thanks for checking in! 

Sounds like the long hold is paying off. Good on you for the hard, proactive work of doing nothing! 

Best of luck to you resuming your taper. I trust that it will be good. So much healing is already happening <3

 

 

[catmama]

Today is the day I resume my taper. I have been feeling great the past several months --- so I am absolutely dreading the return of WD symptoms. I'm actually in tears as I type this.

 

I'm at 1.36mg. If I follow the micro-taper schedule, it will be another year before I hit my target "jump off" dose of 0.38mg. Part of me wants to just jump to zero now and white knuckle it. But I can't know if I will feel WD for a few weeks or six months. I'm torn.  

[BlushingxPill]

I’m happy to head you’re doing well cat mama! I hope more healing is coming your way. I know this is probably too personal but has your sex drive returned? I’m afraid I fell victim to pssd. And I can’t feel romance. Just looking to find some hope that my feelings return. 🙁