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PrayingForRestoration Trying To Get Back To Normal / Need Rx Sequence and Tapering Advice (and support)


PrayingForRestoration

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PrayingForRestoration

New Member: A therapist/GP put me on Celexa in 2002 to help with occasional bouts of anger (not sadness). Then around 2014, my Celexa prescription transitioned to Lexapro/Escitalopram (20mg). This was my only prescription for many years as I was blessed with a healthy life until I decided near the beginning of 2020 to stop taking Escitalopram as I was feeling pretty good and wanted to be pharmaceutical free. Unlike myself, I didn't research the tapering process or ask for medical supervision. I took 20mg tablets when the headaches got bad. The times between headaches got further and further apart until I had not taken Escitalopram for about three-months. 

 

Then at the end of May or beginning June (2020), anxiety started to build more each day. At first I didn't understand it. Granted, this is when Covid hit and the world turned upside-down but I don't normally get too anxious about world problems. Then it hit me that this might be a reaction/withdrawal from Escitalopram. I restarted taking Escitalopram (20mg) and made a doctor's appointment. My recollection is that the anxiety was retreating for the few days I had gone back to it and I was still sleeping eight-plus hours each night. 

 

Upon my doctor's visit toward the beginning of June (2020), I told her that anxiety had kicked in a little but I was taking my Escitalopram again (I don't remember if I told her it was bringing down the anxiety). At this point she scrolled through an (Rx) app on her iPad and told me to stop taking Escitalopram and start Zoloft/Sertraline. Without questioning her I did as I was prescribed.

 

Shortly after starting Sertraline my brain went berserk - I was getting anywhere from zero to six-hours sleep, shakes, "twitches," throbbing headaches, screaming tinnitus, severe anxiety, hours of pacing inside the house and unable to take naps. I used to be a productive person then I became a hermit rarely leaving the house. 

 

When I contacted my doctor to tell her what was going on, she seemed to minimize the urgency (my pain and agony). Usually she would just double the dosage or put me on a different prescription or tell me "she's got this."  She had me take so many tests because she didn't believe it was mis-prescribing (her advice) causing the issue. She had me endure several blood tests, two CT scans (head and abdomen), a neurologist appointment (who did nothing but check if I could walk a straight line) and a hospital hosted overnight sleep study. This went on for almost five-months. I think all of the medicines can be seen somewhere on my profile.

 

At some point, it seemed she - my general practitioner/internest -  figured out that she had no idea what to do then recommended a psychiatrist to help with medicine management. He, the psychiatrist, told me stay on Escitalopram (20mg) and put me on Bupropion, Quetiapine and Lithium. At this point I'm taking four prescriptions. This is about the time my spouse found this site and learned I was not the only one going through this horrible experience. The notes and advice we found on this site seemed to make much more sense then what the doctors are/were saying or doing. 

 

At the moment, I am taking the following prescriptions:

1. Escitalopram (20mg), June 2002 - January 2020 (18-years), then back again August 2020,

2. Bupropion (300mg), Since October 2020,

3. Quetiapine (200mg), Since November 2020,

4. Lithium (300mg), Since November 2020, CURRENTLY TAPERING (down from 900mg).

 

I want to reduce my reliance on prescription(s) as much as possible. Note that I still have the aforementioned symptoms; although, I am getting a little more sleep with a prescription (Quetiapine), that I wish to quit taking. Large parts of most days I am basically non-functional and spend time in bed with a pillow on my head. 

 

My questions include:

1. In which order should the medications be tapered? The "app" on this site wasn't much help.

2. How quickly may the medications be tapered? I see that 10% per month is common advice. Is this true for all medicines regardless of time taking?

3. Based on a few write-ups on this site, it appears going back to Escitalopram - full dosage - is "kindling" the withdrawal symptoms.  So should I still slowly taper (10%) off of the Escitalopram or just get off of it quickly to stop the kindling?

4. Is there a doctor near me that has REALLY worked with someone in my predicament? My GP and Psychiatrist claimed to be experienced, but they weren't. Instead, they were experimenting with me and made it worse.

5. What should be my reaction if withdrawal or other symptoms begin - gut it out, restart the med(s) at a low dosage, high dosage, or other advice?

 

Thank you for reading my long message and for any help you can provide.

2002 - 2014 Celexa, 20mg; 2014 - 2020 Lexapro/Escitalopram, 20mg;
06/01/2020 - 08/10/2020, Sertraline/Zoloft, 50mg;
07/10/2020 - 07/13/2020, Amitriptyline, 20mg;
07/14/2020 - 08/05/2020, Trazodone, 50mg;
08/10/2020 - 08/10/2020, Temazapam, 15mg;
08/11/2020 - Present, Lexapro/Escitalopram, 20mg;
10/15/2020 - Present, Quetiapine/Seroquel, 200mg;
10/17/2020 - 10/17/2020, Paroxitine/Paxil, 40mg;
10/21/2020 - 10/23/2020 Bupropion, 75mg; 10/24/2020 - 11/17/2020 Bupropion, 150mg; 11/18/2020 - Present, Bupropion, 300mg,
12/02/2020 - 12/14/2020, Lithium, 300mg; 12/15/2020 - 12/28/2020, Lithium, 600mg; 12/28/2020 - 01/14/2021, Lithium, 900mg;
01/27/2021 - 02/09/2021, Lithium, 600mg; 02/10/2021 - 02/23/2021, Lithium, 300mg; 02/24/2021, Lithium, 150mg; 03/10/21 - 03/25/21, Lithium, 0mg;

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  • Altostrata changed the title to PrayingForRestoration Trying To Get Back To Normal / Need Rx Sequence and Tapering Advice (and support)
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Altostrata

Welcome, @PrayingForRestoration

 

It sounds like your most troublesome current symptom is sleeplessness?

 

Why did you decide to go off lithium first? How are you tapering it? What time of day are you taking buproprion, and why are you taking it?

 

Doctor who know anything about tapering are few and far between. See 

 

 

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.

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PrayingForRestoration

Thank you for your reply, @Altostrata.

 

It's difficult for me to order my symptoms by most troublesome to least. At the beginning of the Escitalopram withdrawal, at least that's what I think it (withdrawal) was, sleep was the most troublesome. My spouse believes I am getting more sleep now; although, we're unsure how much of it is aided by Quetiapine/Seroquel. And I've gotten little to no relief from the other symptoms listed in the first message. And I forgot to mention other symptoms: loss of memory and vocabulary, inability to focus, hearing phantom noises, racing thoughts, OCD-like symptoms (never had this (OCD) before this mess), and probably more symptoms that I don't remember.

 

We (I and my spouse who I trust more than the doctors with whom I consult) decided to wean off Lithium first because I had only taken it for a few months, it didn't seem to be helping, and the psychologist "allowed" us to do so at our last visit/discussion because I said I wanted to wean off as much medicine as possible. Weaning off any medicine was not his recommendation. The psychiatrist is convinced I was/am suffering for "discontinuation syndrome with depression." Therefore, he's pushing (hard) ECT (Electric Convulsive Treatment) and TMS (Transcranial Magnetic Stimulation). Both "therapies" take many weeks, are very expensive and are not covered by my insurance as many/most psychiatrists in my area do not accept insurance.  

 

The psychiatrist said to drop the Lithium dosage by 300mg every week. I am weaning a little slower then the doctor's instructions based on reading recommendations on this site; however, it is still fast compared to the 10% per month rule as we thought being on it for only a few months would safely allow it. That said, I dropped Lithium from 900mg to 600mg and held for two-weeks. Then dropped Lithium from 600mg to 300mg and held for two-weeks. This is where I am right now. I think the plan after being on LIthium (300mg) for two-weeks, is to cut the Lithium pill in half after two-weeks so that I am taking 150mg for two-weeks, then off of it completely. 

 

I take the Bupropian in the morning with the Escitalopram. The psychiatrist prescribed the Bupropian as a "booster" to the Escitalopram. 

 

Yes, I had seen the "Recommended Doctors, Therapists and Clinics" forum but found no doctor close to me. Maybe I can find a doctor who will allow remote visits. If anyone knows of a doctor that really did help patients wean off these prescriptions, I'd be grateful to know his/her contact information. 

2002 - 2014 Celexa, 20mg; 2014 - 2020 Lexapro/Escitalopram, 20mg;
06/01/2020 - 08/10/2020, Sertraline/Zoloft, 50mg;
07/10/2020 - 07/13/2020, Amitriptyline, 20mg;
07/14/2020 - 08/05/2020, Trazodone, 50mg;
08/10/2020 - 08/10/2020, Temazapam, 15mg;
08/11/2020 - Present, Lexapro/Escitalopram, 20mg;
10/15/2020 - Present, Quetiapine/Seroquel, 200mg;
10/17/2020 - 10/17/2020, Paroxitine/Paxil, 40mg;
10/21/2020 - 10/23/2020 Bupropion, 75mg; 10/24/2020 - 11/17/2020 Bupropion, 150mg; 11/18/2020 - Present, Bupropion, 300mg,
12/02/2020 - 12/14/2020, Lithium, 300mg; 12/15/2020 - 12/28/2020, Lithium, 600mg; 12/28/2020 - 01/14/2021, Lithium, 900mg;
01/27/2021 - 02/09/2021, Lithium, 600mg; 02/10/2021 - 02/23/2021, Lithium, 300mg; 02/24/2021, Lithium, 150mg; 03/10/21 - 03/25/21, Lithium, 0mg;

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Altostrata

You went off sertraline in August, then it looks like you were taking drugs for sleep problems. Did any of them work?

 

When you reinstated 20mg escilatopram, did your sleep improve? What benefit have you seen from buproprion?

 

Do you feel any withdrawal after the lithium reductions?

 

On 2/16/2021 at 10:01 AM, PrayingForRestoration said:

The psychiatrist is convinced I was/am suffering for "discontinuation syndrome with depression." Therefore, he's pushing (hard) ECT (Electric Convulsive Treatment) and TMS (Transcranial Magnetic Stimulation).

 

^This is stupid.

 

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.

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PrayingForRestoration

No, my recollection is Amitryptyline and Trazadone did little to nothing to improve sleep. The sleep aid I'm on now, Quetiapine/Seroquel 200mg, seems to be helping but I'm unsure how much. 

 

No, my recollection is that my sleep did not improve going back onto Escitalopram. 

 

My spouse and I are not aware (don't see or "feel") of any benefit(s) of Bupropion.

 

I don't sense Lithium withdrawal but my brain/CNS are out of whack - screaming tinnitus, throbbing brain, etc. -  so perhaps there is a chance that I cannot distinguish withdrawal from the other symptoms. But, again, I don't sense Lithium withdrawal.

 

By the way, my psychiatrist told me this week that he is out of ideas to help me improve other than trying ECT, TMS and/or checking into an in-patient program at the Menninger Clinic in Houston. Remember I live in South Florida. 

2002 - 2014 Celexa, 20mg; 2014 - 2020 Lexapro/Escitalopram, 20mg;
06/01/2020 - 08/10/2020, Sertraline/Zoloft, 50mg;
07/10/2020 - 07/13/2020, Amitriptyline, 20mg;
07/14/2020 - 08/05/2020, Trazodone, 50mg;
08/10/2020 - 08/10/2020, Temazapam, 15mg;
08/11/2020 - Present, Lexapro/Escitalopram, 20mg;
10/15/2020 - Present, Quetiapine/Seroquel, 200mg;
10/17/2020 - 10/17/2020, Paroxitine/Paxil, 40mg;
10/21/2020 - 10/23/2020 Bupropion, 75mg; 10/24/2020 - 11/17/2020 Bupropion, 150mg; 11/18/2020 - Present, Bupropion, 300mg,
12/02/2020 - 12/14/2020, Lithium, 300mg; 12/15/2020 - 12/28/2020, Lithium, 600mg; 12/28/2020 - 01/14/2021, Lithium, 900mg;
01/27/2021 - 02/09/2021, Lithium, 600mg; 02/10/2021 - 02/23/2021, Lithium, 300mg; 02/24/2021, Lithium, 150mg; 03/10/21 - 03/25/21, Lithium, 0mg;

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Altostrata
On 2/20/2021 at 9:12 AM, PrayingForRestoration said:

I don't sense Lithium withdrawal.

 

No changes in your symptom pattern after you reduce lithium?

 

Did you get any distinct adverse effects when you introduced lithium?

 

Bupropion can cause tinnitus and sleeplessness. It's not a good drug for someone having trouble sleeping.

 

On 2/20/2021 at 9:12 AM, PrayingForRestoration said:

By the way, my psychiatrist told me this week that he is out of ideas to help me improve other than trying ECT, TMS and/or checking into an in-patient program at the Menninger Clinic in Houston. Remember I live in South Florida. 

 

Your psychiatrist is utterly clueless about adverse effects of drugs. If I were you, I would not keep this person on my 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.

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PrayingForRestoration

Much of the "brain throbbing" went away following the Lithium reduction. That said, my brain has been throbbing since the beginning; around May/June 2020, so I don't know Lithium's part in this given that I didn't start Lithium until I started seeing this psychiatrist around October 2020. Either today or tomorrow the plan is to reduce from 300mg (full pill) to 150mg (half-a-pill) and hold for about two-weeks. I don't know what the plan is two-weeks from now. Perhaps one option is to cut the 150mg (half-pill) in half to 75mg (quarter-pill). We're continuing to pray for no symptoms. 

 

No, I don't remember any adverse effects when introduced to Lithium in October 2020, which might help explain in part why the psychiatrist started with 300mg, then quickly increased to 600mg, then quickly (in my opinion) increased to 900mg. 

 

Yes, my spouse and I have lost confidence in this psychiatrist but the nearest recommended doctor on the list is about three-hours from home. 

2002 - 2014 Celexa, 20mg; 2014 - 2020 Lexapro/Escitalopram, 20mg;
06/01/2020 - 08/10/2020, Sertraline/Zoloft, 50mg;
07/10/2020 - 07/13/2020, Amitriptyline, 20mg;
07/14/2020 - 08/05/2020, Trazodone, 50mg;
08/10/2020 - 08/10/2020, Temazapam, 15mg;
08/11/2020 - Present, Lexapro/Escitalopram, 20mg;
10/15/2020 - Present, Quetiapine/Seroquel, 200mg;
10/17/2020 - 10/17/2020, Paroxitine/Paxil, 40mg;
10/21/2020 - 10/23/2020 Bupropion, 75mg; 10/24/2020 - 11/17/2020 Bupropion, 150mg; 11/18/2020 - Present, Bupropion, 300mg,
12/02/2020 - 12/14/2020, Lithium, 300mg; 12/15/2020 - 12/28/2020, Lithium, 600mg; 12/28/2020 - 01/14/2021, Lithium, 900mg;
01/27/2021 - 02/09/2021, Lithium, 600mg; 02/10/2021 - 02/23/2021, Lithium, 300mg; 02/24/2021, Lithium, 150mg; 03/10/21 - 03/25/21, Lithium, 0mg;

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  • 2 weeks later...
PrayingForRestoration

@Altostrata: Today I reduced my Lithium intake from 150mg to 75mg (a quarter pill) after being on 150mg for two-weeks. My prayer is that I can taper off Lithium fairly quickly and safely as I've been on the Lithium (900mg at highest dosage) only for about four or five-months. Perhaps this is wishful thinking. That said, if withdrawal symptoms appear, is the advice to kick back up to the previous dosage (150mg) for a while? Or is there another recommendation?

 

Additionally, the new psychiatrist, who I don't plan to seek instruction from anymore, put me on Quetiapine/Seroquel and Bupropion in October, 2020. Is it also wishful thinking that because it's only been a few months that I've been on these prescriptions that I can taper these, too, at the same time even as I taper off Lithium? I ask because it concerns me that it may take months to years to taper off the first and/or second and/or third and/or prescription(s) if the 10% rule is applied but this will also significantly increase time on these prescriptions which would seem to cause a greater dependency on them and, thus, much longer to taper. Maybe the 10% rule could be applied to all of them at once so as to reduce dependency time and then tapering time. I've read the recommendation to taper off one drug at a time which definitely makes sense if the prescription has been used for quite some time (I have no idea where this time line is - months, years). Maybe there's information as to how quickly the brain becomes dependent on these prescriptions. For some reason, I have four to eight months on the brain, so I might already be in that dependency trap. 

 

Lastly, I think I've read where Magnesium, Omega-3 (fish oil) and B12/complex are recommended. Is this (taking these supplements) true for all people/scenarios? Thank you for your service.

2002 - 2014 Celexa, 20mg; 2014 - 2020 Lexapro/Escitalopram, 20mg;
06/01/2020 - 08/10/2020, Sertraline/Zoloft, 50mg;
07/10/2020 - 07/13/2020, Amitriptyline, 20mg;
07/14/2020 - 08/05/2020, Trazodone, 50mg;
08/10/2020 - 08/10/2020, Temazapam, 15mg;
08/11/2020 - Present, Lexapro/Escitalopram, 20mg;
10/15/2020 - Present, Quetiapine/Seroquel, 200mg;
10/17/2020 - 10/17/2020, Paroxitine/Paxil, 40mg;
10/21/2020 - 10/23/2020 Bupropion, 75mg; 10/24/2020 - 11/17/2020 Bupropion, 150mg; 11/18/2020 - Present, Bupropion, 300mg,
12/02/2020 - 12/14/2020, Lithium, 300mg; 12/15/2020 - 12/28/2020, Lithium, 600mg; 12/28/2020 - 01/14/2021, Lithium, 900mg;
01/27/2021 - 02/09/2021, Lithium, 600mg; 02/10/2021 - 02/23/2021, Lithium, 300mg; 02/24/2021, Lithium, 150mg; 03/10/21 - 03/25/21, Lithium, 0mg;

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Crochet

Hi Praying, 

 

I'm so sorry that you have been going through this.  I'm a fellow Lexapro-taker that got off the medication too quickly.  I hope that you find peace and healing in this community.

 

Take care,

 

Crochet

 

2012 - Lexapro 10mg
2017 - Lexapro 5mg (fast taper but stabilized)
11/1/20 - Stopped Lexapro 5mg cold turkey

1/13/21 - present - Reinstated Lexapro 2.5, then 5, then 10, currently 7.5

2/7/21 - present - Hydroxyzine 50mg per night

 

No longer take:

2011 - Zoloft (3 months?  Dosage unknown.  CT/fast taper?)

2011 - Wellbutrin (1 week, Dosage unknown. CT)

1/16/21 - 2/4/21 - Ativan .5:  Took 13.5 pills over the course of 22 days and stopped

2/5/21 - Mirtazipine 7.5 (only took once)

2/24/21 - 3/8/31 - Propranolol 5mg

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PrayingForRestoration
2 hours ago, PrayingForRestoration said:

For some reason, I have four to eight months on the brain, so I might already be in that dependency trap. 

 

I meant to write that I've read that the brain becomes dependent on meds after about four to eight weeks (not months) usage.

 

My spouse and people with whom I spend the most time have said that my personality is largely back. From their perspective I seem to be healing. But I still believe that I need to get off these meds. And I presume it won't be easy. 

 

Thank you for your service.

2002 - 2014 Celexa, 20mg; 2014 - 2020 Lexapro/Escitalopram, 20mg;
06/01/2020 - 08/10/2020, Sertraline/Zoloft, 50mg;
07/10/2020 - 07/13/2020, Amitriptyline, 20mg;
07/14/2020 - 08/05/2020, Trazodone, 50mg;
08/10/2020 - 08/10/2020, Temazapam, 15mg;
08/11/2020 - Present, Lexapro/Escitalopram, 20mg;
10/15/2020 - Present, Quetiapine/Seroquel, 200mg;
10/17/2020 - 10/17/2020, Paroxitine/Paxil, 40mg;
10/21/2020 - 10/23/2020 Bupropion, 75mg; 10/24/2020 - 11/17/2020 Bupropion, 150mg; 11/18/2020 - Present, Bupropion, 300mg,
12/02/2020 - 12/14/2020, Lithium, 300mg; 12/15/2020 - 12/28/2020, Lithium, 600mg; 12/28/2020 - 01/14/2021, Lithium, 900mg;
01/27/2021 - 02/09/2021, Lithium, 600mg; 02/10/2021 - 02/23/2021, Lithium, 300mg; 02/24/2021, Lithium, 150mg; 03/10/21 - 03/25/21, Lithium, 0mg;

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Altostrata
On 3/10/2021 at 12:33 PM, PrayingForRestoration said:

That said, if withdrawal symptoms appear, is the advice to kick back up to the previous dosage (150mg) for a while?

 

Yes. You are tapering rapidly, in a way we usually wouldn't do.

 

On 3/10/2021 at 12:33 PM, PrayingForRestoration said:

Is it also wishful thinking that because it's only been a few months that I've been on these prescriptions that I can taper these, too, at the same time even as I taper off Lithium?

 

Yes, it is wishful thinking that you can taper quickly off 3 drugs at the same time. We do not advise this. If you do this and it goes wrong, we don't have any way to put Humpty Dumpty back together again.

 

We recommend tapering only one drug at a time, to protect your nervous system. I'm sorry if this will take longer than you'd like. 

 

On 3/10/2021 at 12:33 PM, PrayingForRestoration said:

if the 10% rule is applied but this will also significantly increase time on these prescriptions which would seem to cause a greater dependency on them and, thus, much longer to taper.

 

No, you would taper according to your tolerance for dosage reductions. We don't have any way to assess degree of dependency. As you lower the dosage, your system should adjust and the effect of the drug should reduce.

 

On 3/10/2021 at 12:33 PM, PrayingForRestoration said:

Maybe there's information as to how quickly the brain becomes dependent on these prescriptions. For some reason, I have four to eight months on the brain, so I might already be in that dependency trap. 

 

The rule of thumb is risk of withdrawal increases after about 1 month on the drug.

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.

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