sicksagittarius: Lexapro/escitalopram withdrawal

[Sicksagittarius]

On 4/30/2021 at 8:50 PM, Sicksagittarius said:

 

 

Lexapro/escitalopram: 

2014: 10 mg (1 year)
2015-2021: 20 mg (6 years)
2021: slowly weened from 20 to 15 mg (1 mg at a time for months for 3 months)

 

*advised by doctor to wean off lexapro due to chronic stomach pain, diarrhea, weight loss, dizziness, brain fog:

diagnose ideas: Celiac Disease, potentially microscopic colitis, irritable bowel disease, ulcerative colitis*

*followed advice of pharmacist, psychiatrist, and primary care physician*

 

April 2021: decreased to 10 mg - 11 days
April 2021: decreased to 5 mg - 8 days
April 2021: 5 mg lexapro + 30 mg duloxetine or cymbalta (took cymbalta once)

 

Cold turkey next day after trying 5 mg of lexapro+cymbalta

 

3-6 days after cold turkey, extreme withdrawal symptoms:
-vertigo, pressure in head, headaches, spinning ,dizzy, blurry spots in vision, sensitivity to light, sensitivity to sound, sweating, nausea, fatigue, heart racing, burning on skin, crying, anxiety, and anger increased

 

reinstated: 2.5 mg 6 days post cold turkey - helped symptoms
reinstated: 5 mg next day - worsened symptoms

 

went back to 2.5 mg currently - last 7 days, use bonine to help assuage withdrawal symptoms

I also want to make a note of the change in my signature bc I didn't add the other drugs I was taking: I need to know the side effects of theses other medications and how to properly wean off of them to try more natural things because I am seeing all the awful side effects they have on healing, especially omeprazole. In addition, I need to know what supplements or foods to add in slowly. Is taking 1280 of omega 3 enough or too much? I ordered magnesium tautrate as well but it comes it says 3 pills is 1500, so one is 500 and i think thats too much to start off with. I got it from amazon double wood supplements as I need it to be dairy free and gluten free for stomach issues. 

 

• 2014: Lexapro/escitalopram 10 mg
• 2015-2021: Lexapro/escitalopram 20 mg
• November 2020 - March 2021: decreased 20 mg to 15 mg, 1 mg a month
• April 2021: decreased to 10 mg, stayed on this for 11 days 
• April 2021: decreased to 5 mg, stayed on this for 8 days
• April 2021: 5 mg lexapro + 30 mg duloxetine or cymbalta (took cymbalta once) 
• April 2021: stopped both lexapro and cymbalta next day after trying 5 mg of lexapro+cymbalta once
• April 2021: 3-6 days after quitting lexapro/cymbalta, withdrawal symptoms so reinstated 2.5 mg
• April 2021: over 4 days, tried 2.5 mg, then 5 mg, then 2.5, then 5 again
• May 2021: 2.5 mg, starting to stabilize

 

drugs for stomach issues:

• hyoscyamine: .375 mg, twice a day, every 12 hours 
• mesalamine: 1.2 GM, 3 times a day, now weaned to only 1 in morning and 1 at night 
• omeprazole: 20 mg daily, now 40 mg daily
• zofran: 4 mg, 3-4 times daily, now only as needed stopped zofran, only as needed 

allergy medications:

• montelukast or singular: 10 mg once daily
• zyrtec: 10 mg once daily 

supplements:

• omega 3 fish pill: 1280 mg, Nordic Naturals Ultimate Omega

multivitamins: (vitafusion gummy)

• A, C, D and E and 6 B vitamins
• Calcium plus D3 

[Yesyes123]

43 minutes ago, Sicksagittarius said:

Okay that's good to hear. I cannot get more of the 5 mg pill because I ordered the liquid lexpro and didnt know you had to taper onto that so my insurance won't cover me ordering more pills until next week. I only have halves of the 5 mg pill from attempting to split it and I have whole 20 mg pills. How would I go about weighing the 2.5 mg out if I dont have a full 5 mg pill to measure them all and average it to make sure its the right dose? Can I crush up 20 mg of lexapro the same way I would crush of 5 mg of lexapro and weigh it out?

 

OK so firstly are you going to switch from pills to liquid to taper?

 

I personally don't recommend this. I have read about people who run into problems when switching from solid to liquid and could not stabilize, having to go back to solid.

 

Personally, I don't think it's worth the risk. 

 

For my taper I chose to stick to crushed pills. I have never heard of crushing pills causing problems as long as it's measured properly.

 

45 minutes ago, Sicksagittarius said:

How would I go about weighing the 2.5 mg out if I dont have a full 5 mg pill to measure them all and average it to make sure its the right dose? Can I crush up 20 mg of lexapro the same way I would crush of 5 mg of lexapro and weigh it out?

 

It's simple... you'll need to weight 10 pieces of the 2.5mg pill you have and take the average weight. 

 

2.5mg = Xg pill weight (your average goes here in the X)

2.3mg (or whatever value you want to measure) = Y

 

Then you use that simple calculator I sent earlier to find out the pill weight of 2.3mg (or intended value) that you'll measure in the scale.

 

[Yesyes123]

Are you still confused about what method to use for your taper?

Some people will say that it's much easier to use the liquid but I chose to use the crushed pill + digital scale method for my taper to be safer.

 

- I didn't have to make a transition to liquid

- I didn't risk running into problems during that transition

- I can make the custom pills for about 3 weeks in advance and then I only have to make more when they run out.

[Sicksagittarius]

 

2 minutes ago, Yesyes123 said:

 

OK so firstly are you going to switch from pills to liquid to taper?

 

I personally don't recommend this. I have read about people who run into problems when switching from solid to liquid and could not stabilize, having to go back to solid.

 

Personally, I don't think it's worth the risk. 

 

For my taper I chose to stick to crushed pills. I have never heard of crushing pills causing problems as long as it's measured properly.

 

 

It's simple... you'll need to weight 10 pieces of the 2.5mg pill you have and take the average weight. 

 

2.5mg = Xg pill weight (your average goes here in the X)

2.3mg (or whatever value you want to measure) = Y

 

Then you use that simple calculator I sent earlier to find out the pill weight of 2.3mg (or intended value) that you'll measure in the scale.

 

I was going to do the liquid but I think I am deciding against it due to tedious tapering process that I dindt realize you had to do. the pills I have split from a 5 mg are roughly 2.5, so they're uneven and thats where Im worried about weighing out the average and doing the math because I dont have the proper dosages within each pill

[Yesyes123]

11 minutes ago, Sicksagittarius said:

I was going to do the liquid but I think I am deciding against it due to tedious tapering process that I dindt realize you had to do. the pills I have split from a 5 mg are roughly 2.5, so they're uneven and thats where Im worried about weighing out the average and doing the math because I dont have the proper dosages within each pill

 

You're already on a low dose of 2.5mg

 

If I were you I'd stay on the 2.5mg pills until you are able to get more pills and do the crush & weight method.

 

You need to be very careful tapering off this last 2.5mg as the lower you get the harder it is to make reductions.

[Yesyes123]

If you want to be safe it will take you a long time to taper off this last 2.5mg making very small reductions with an interval of 3-4 weeks between them.

Possibly over a year, and at least a few months before you reach 0.

[Yesyes123]

I think it's key to hold longer at the smaller doses as they are the most potent ones and do most of the job. 

[Sicksagittarius]

On 5/12/2021 at 6:23 PM, Gridley said:

Yes, that's the right scale.  The first link is for the scale I'm using now and may be a later version than the second link.

 

There is no way to predict symptoms.  I would take the attitude of assuming you will be fine.  This attitude is not a pollyanna approach (I'm the last thing from pollyanna) but assuming the best result increases the likelihood that it will happen.  Your body reads your thoughts and mirrors them.  Give your body good, positive thoughts to mirror.

 

Digestive problems are common in withdrawal, but there is no way for us to tell whether yours are caused by WD or not.  

I was wondering about PPI omeprazole. I read that it can increase or potentially double the amt of escitolopram in my system. If I wean off of omeprazole, will it cause me to have more intense withdrawal symptoms since it will decrease the amt of lexapro in my system? Is there a thread I can go to to ask about each specific drug I am on and how they interact with eachother or what side effects they cause? 

[Yesyes123]

There is an online website tool for checking drug interactions. Look up on the site search "drug interactions" or "drug interaction tool" and you should find it. Someone will probably have the link for you as well.

[Gridley]

7 hours ago, Sicksagittarius said:

On 5/11/2021 at 5:25 PM, Gridley said:

 

Does this scale also work for small amounts? I'm at 2.5 mg right now, and I've read that they arent very accurate with low doses

When using the scale, there are two measurements you'll be dealing with: pill weight (the weight of the pill), abbreviated as mgpw, and active ingredient (the dosage), abbreviated as mgai.  In your case at this point you're at 2.5mgai.  I explain in the last paragraph how you would calculate your pill weight.

 

The scale is accurate to at least 4mg pill weight.  Pill weight is much higher than active ingredient due the the fillers in the pill.  Every drug and brand of drug is different.  In my case when I tapered Lexapro, my brand's ratio of pill weight to active ingredient was 10:1, so accuracy down to 4mg pill weight meant it was accurate down to .4mg active ingredient.

 

I was able to get much lower than 4mgpw with the scale.  At the very low doses when the scale started giving varying readings, I added the 10 gram weight that comes with the scale.  That put me back in the range of the scale's competency and allowed me to weigh very, very low doses accurately, all the way down to 1mg pill weight, which is as low as the scale can go.  In my case, at 1mg pill weight I was at .1mg active ingredient.  I wanted to get lower before I jumped to zero, so at that point I would get a 1mg pill weight dose of powder and eyeball it to split the powder in half to get .5mgpw, which gave me a dose of .05 mgai, a low dose indeed.  I did this one more time, to get myself down to 0.025mgai.  At this point I jumped to zero.

 

In your case, to arrive at your pill weight, you would weigh ten pills (since the weight of each pill in a bottle differs a little) and then calculate the average.  That is your pill weight.  You would then calculate what weight you'd need to get a 2.5mgai dose.  For example if you're weighing using a 5mgai pill, it would be half the weight of the 5mg pill.  If you're using a 20mg pill, it would be 1/8.   I kept a handwritten chart with the date, mgai and mgpw.

 

This sounds complicated because these are likely new concepts but it's not difficult (and I'm no math whiz).  

 

 

Edited May 14, 2021 by Gridley

[Gridley]

5 hours ago, Sicksagittarius said:

Am I going to have more damaging, long standing withdrawal symptoms

There's no way to predict how withdrawal would go, but I wouldn't worry about it.

 

4 hours ago, Sicksagittarius said:

How would I go about weighing the 2.5 mg out if I dont have a full 5 mg pill to measure them all and average it to make sure its the right dose? Can I crush up 20 mg of lexapro the same way I would crush of 5 mg of lexapro and weigh it out?

Until you get the scale, there's no way to get it more accurate except to be as careful as you can.  It's going to be a matter of cutting the pill and eyeballing it until the scale arrives.  You can crush a 20mg pill just as you would a 5mg pill and then weigh the powder.  There would be no difference.  I was working with a 20mg Lexapro pill.  I crushed it to powder then, using tweezers or a little powder weighing spoon (available on Amazon) I would place the powder on the scale to get the weight I wanted.  As I got to the very low doses, one 20mg pill made many days' doses.

Edited May 14, 2021 by Gridley

[Gridley]

2 hours ago, Sicksagittarius said:

I was wondering about PPI omeprazole. I read that it can increase or potentially double the amt of escitolopram in my system. If I wean off of omeprazole, will it cause me to have more intense withdrawal symptoms since it will decrease the amt of lexapro in my system? Is there a thread I can go to to ask about each specific drug I am on and how they interact with eachother or what side effects they cause? 

This link leads you to links about each drug but doesn't address interactions.  If the Omeprazole isn't causing any problems, you could stay on it until you've finished your Escitalopram taper to avoid the problem you raise.  In any case, we advise tapering off only one drug at a time.

 

Important topics in the Tapering forum and FAQ  

 

This link allows you to check the interactions between your two drugs.

 

Drug Interactions Checker

 

Here's what I found.  I'm afraid it isn't very helpful in that it tells you what you already know. 

 

Interactions between your drugs

Moderate

omeprazole  escitalopram

Applies to: omeprazole, escitalopram

Talk to your doctor before using escitalopram together with omeprazole. Combining these medications may increase the blood levels and effects of escitalopram. You may have an increased risk of developing side effects, including irregular heart rhythm and a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. You should contact your doctor immediately if you experience these symptoms while taking the medications. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

 

 

Edited May 14, 2021 by Gridley

[Willfinish]

How are you @Yesyes123? Do you have symptoms ?

[Sicksagittarius]

2 hours ago, Gridley said:

This link leads you to links about each drug but doesn't address interactions.  If the Omeprazole isn't causing any problems, you could stay on it until you've finished your Escitalopram taper to avoid the problem you raise.  In any case, we advise tapering off only one drug at a time.

 

Important topics in the Tapering forum and FAQ  

 

This link allows you to check the interactions between your two drugs.

 

Drug Interactions Checker

 

Here's what I found.  I'm afraid it isn't very helpful in that it tells you what you already know. 

 

Interactions between your drugs

Moderate

omeprazole  escitalopram

Applies to: omeprazole, escitalopram

Talk to your doctor before using escitalopram together with omeprazole. Combining these medications may increase the blood levels and effects of escitalopram. You may have an increased risk of developing side effects, including irregular heart rhythm and a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. You should contact your doctor immediately if you experience these symptoms while taking the medications. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

 

 

 

Thank you so much! I went on omeprazole bc I am having extreme stomach issues i believe due to withdrawal from lexapro and I read within a PPI forum on here that omeprazole works against you healing your GI issues. 

[Gridley]

16 hours ago, Sicksagittarius said:

Thank you so much! I went on omeprazole bc I am having extreme stomach issues i believe due to withdrawal from lexapro and I read within a PPI forum on here that omeprazole works against you healing your GI issues. 

I'm afraid that omeprazole is beyond the scope of our knowledge here.  Another possibility is that you could go off the Omeprazole before tapering your Lexapro further so that you would know your baseline on Lexapro without the possible influence of the omeprazole.

 

I noticed in your signature that your gummy supplement contains B vitamins.  Just for your information, B vitamins are too activating for many people in withdrawal.

 

Hypersensitive to B Vitamin or B-Complex  

 

Edited May 15, 2021 by Gridley

[Sicksagittarius]

On 1/17/2021 at 2:05 AM, Altostrata said:

You have described acute withdrawal syndrome followed by protracted withdrawal syndrome.

 

You might consider reinstating a very low dose of amitriptyline, such as 1mg, stabilizing for a while, then tapering off using the liquid form of the drug. See 

 

What is withdrawal syndrome? 
 
About reinstating and stabilizing to reduce withdrawal symptoms 
 
The Windows and Waves Pattern of Stabilization 

 

 

To help us out, follow these instructions Please put your drug and withdrawal history in your signature You may need to use a computer to do this.

 

 

Hi @Altostrata

 

I have had stomach issues a month after I started weaning off Lexapro. I'm still dealing with them 6 months later as I believe I tapered too fast and screwed myself up. I am now trying to stabilize at 2.5 mg. Is it more beneficial for my stomach to get back on the lexapro, should I stay on 2.5 mg for a few months, or will getting off of it eventually be the cure? I have stomach burning, pain, diarrhea, and gluten, dairy, and inflammatory food intolerances. What type of doctor can I go to (naturopathic/homeopathic?) to get advice on what natural, non damaging things I can do or take to heal my gut? My Gastroenterologist gave me hyocyamine and mesalamine to help with diarrhea and pain and they do, but they have awful side effects of nausea and many others. I am learning how pharm drugs just mask or bandaid the issue with bad side effects instead of healing the root of the issue. I'm also nervous because i've cut my pills w pil splitters all this time, meaning my dosage has not been 100 percent accurate for months as I wean off. Will this mean the healing of my stomach will take longer? I was on 20 mg of lexapro for 6 years, which makes me worry that ive done so much damage to myself. Can you point me in the right direction of threads with others who have healed their gut issues from SSRI withdrawal? Thanks!!

[Altostrata]

I cannot tell if your gastrointestinal problems are from withdrawal or something else.

 

Do you feel better or worse after taking 2.5mg escitalopram every day? What times of day do you take it?

 

See 

 

Eating as an activating factor

 

Elimination or exclusion diets for reactions to food (food intolerance)

 

Histamine intolerance

 

SCD/GAPS/Paleo Diets

 

Cut down on sugar to improve mental health

 

and other topics about diet in the Symptoms and Self-Care forum.

[Sicksagittarius]

On 5/11/2021 at 6:25 PM, Gridley said:

We recommend reinstating as low a dose as possible.  Your system is very sensitized from your fast taper, and reinstating too much can destabilize it further, something that can take a long time to recover from.  The fact that you're feeling a lot better is a sign that the reinstatement is working, and I wouldn't tinker with success.

 

That would be the way I would recommend.  I crushed the tablet into a fine powder between two spoons, gave it a stir with a toothpick to make sure the active ingredient was evenly distributed, then weighed powder using a Gemini-20 scale available on Amazon.  I then used a bent Post-it to pout the weighed powder into a size 0 or 00 gelatin capsule, also available on Amazon, and saved the remainder for another dose.  It takes a little practice to do the pouring and at first you may spill some powder but it becomes easier as you get used to the process.  I've never seen Escitalopram/Lexapro with a coating but if it does have a coating it doesn't matter because it is not time-release.

 

How do you use a bent post it note to get the fine powder from the scale into the capsules? Do you use the post it note to scoop it up in between the two folds of the paper? I have tweezers to manuever it from the paper to the pill. 

[Gridley]

2 hours ago, Sicksagittarius said:

How do you use a bent post it note to get the fine powder from the scale into the capsules? Do you use the post it note to scoop it up in between the two folds of the paper? I have tweezers to manuever it from the paper to the pill. 

Once I get the correct dosage on the scale, I pour the dosage from the scale onto the bent Post-it, then tap the powder from the Post-it into the capsule.  Using the tweezers would be more difficult and likely would result in some powder being left on the Post-it.   I use the tweezers to add or subtract powder while the powder is still on the scale to get the correct weight.

[Yesyes123]

5 hours ago, Sicksagittarius said:

How do you use a bent post it note to get the fine powder from the scale into the capsules? Do you use the post it note to scoop it up in between the two folds of the paper? I have tweezers to manuever it from the paper to the pill. 

 

I bend the sides of my piece of paper kinda like a paper airplane and then slide the powder directly into the empty gelatin capsule.

[Sicksagittarius]

On 5/14/2021 at 12:32 PM, Yesyes123 said:

Are you still confused about what method to use for your taper?

Some people will say that it's much easier to use the liquid but I chose to use the crushed pill + digital scale method for my taper to be safer.

 

- I didn't have to make a transition to liquid

- I didn't risk running into problems during that transition

- I can make the custom pills for about 3 weeks in advance and then I only have to make more when they run out.

Thanks so much! Could I experience withdrawal-like symptoms once i make the transition from just cutting my pills in half to crushing them into a powder, weighing on scale, and putting them into capsules? I did it for the first time tonight and I feel floaty in my head now. I made sure to double check my equation to measure out the pill and was super careful but I know it will take time. What are some other tips to make sure I get the exact dosage within the crushing pills/weighing on scale journey? I read its important to mix the powder thoroughly, making sure to use gloves when weighing so the oils from your hands don't impact the weight, crushing up 5-10 pills in one session in order to get the most precise dosage... etc. I ordered a pill crusher because crushing 20 mg lexapro pills is difficult to do and the powder goes everywhere and sticks to things. 

[Sicksagittarius]

10 hours ago, Gridley said:

Once I get the correct dosage on the scale, I pour the dosage from the scale onto the bent Post-it, then tap the powder from the Post-it into the capsule.  Using the tweezers would be more difficult and likely would result in some powder being left on the Post-it.   I use the tweezers to add or subtract powder while the powder is still on the scale to get the correct weight.

Thanks so much for the advice! Could I experience withdrawal-like symptoms once i make the transition from just cutting my pills in half to crushing them into a powder, weighing on scale, and putting them into capsules? I did it for the first time tonight and I feel floaty in my head immediately. I was cutting 5 mg pills in half to get 2.5 mg but I ran out. I just got my scale in and only have 20 mg left so I crushed a single 20 mg pill and weighed it out on my scale and put it into capsule to be 2.5 mg. Could the amt of the drug not be evenly dispersed or somehow different?

[Yesyes123]

23 minutes ago, Sicksagittarius said:

Could I experience withdrawal-like symptoms once i make the transition from just cutting my pills in half to crushing them into a powder, weighing on scale, and putting them into capsules?

 

I don't think so. I don't remember having any problems switching from solid pill to powder. I think it's pretty much the same, you're not adding water or any other component. @Gridleyprobably knows more about this.

[Yesyes123]

54 minutes ago, Sicksagittarius said:

I read its important to mix the powder thoroughly, making sure to use gloves when weighing so the oils from your hands don't impact the weight, crushing up 5-10 pills in one session in order to get the most precise dosage...

 

It's good to mix the powder to make sure the active ingredient is well mixed. 

 

I never wear gloves, I never touch the powder with my hands only move it around with utensils.

[Yesyes123]

55 minutes ago, Sicksagittarius said:

I ordered a pill crusher because crushing 20 mg lexapro pills is difficult to do and the powder goes everywhere and sticks to things. 

 

I want to try a pill crusher as well,  but I still use spoon method. I use a small glass bowl and crush the pills between two spoons or press the pill with the spoon against the bowl.

 

47 minutes ago, Sicksagittarius said:

I did it for the first time tonight and I feel floaty in my head immediately. I was cutting 5 mg pills in half to get 2.5 mg but I ran out. I just got my scale in and only have 20 mg left so I crushed a single 20 mg pill and weighed it out on my scale and put it into capsule to be 2.5 mg. Could the amt of the drug not be evenly dispersed or somehow different?

 

I think it could maybe be an effect from changing it to powder, but that should be mild far as I know. I didn't feel any that I remember during that transition. Don't exclude the possibility of placebo since you know you did something different!

 

How did you crush the pill? And did you do the rule of three correctly?

[Sicksagittarius]

7 hours ago, Yesyes123 said:

 

I want to try a pill crusher as well,  but I still use spoon method. I use a small glass bowl and crush the pills between two spoons or press the pill with the spoon against the bowl.

 

 

I think it could maybe be an effect from changing it to powder, but that should be mild far as I know. I didn't feel any that I remember during that transition. Don't exclude the possibility of placebo since you know you did something different!

 

How did you crush the pill? And did you do the rule of three correctly?

I needed to equate a 20 mg pill to 2.5 mg. I crushed the 20 mg pill by using my pill cutter to chop it into tiny pieces then put it in a small bowl and used an icecream scooper to crush it into a fine powder. My equation I did was:

 

20 = 0.257 (2.57/10) - weighed 10 pills and averaged out

2.5 = x

 

x = 0.032 

 

I thought it was placebo too at first but I woke up this morning and I'm still feeling floaty in my head and so nauseous. This is exactly how I felt when I was trying to learn was dose I would stabilize from with reinstatement and I tried 5 mg at first and felt this feeling until about noon the next day.  I'm so angry about this because it was so difficult to figure out how to properly crush the pills and transfer them into a capsule I was crying all afternoon trying to do it. Now I feel more discouraged than ever because I'm scared this will mess up my stabilization now because I went off track one day. 

[Gridley]

9 hours ago, Sicksagittarius said:

Could I experience withdrawal-like symptoms once i make the transition from just cutting my pills in half to crushing them into a powder, weighing on scale, and putting them into capsules?

It's not likely.  I never have.  It's the same form of the drug and the delivery to your system would be the same.  If you noticed a difference, it may be that your dose was different from splitting pills due to uneven distribution of the active ingredient in the cut pill.

It's important to stir the powder thoroughly (as with a toothpick or powder mixing spoon (available on Amazon; also good for adding/subtracting powder from scale to bent Post-it/paper).

8 hours ago, Yesyes123 said:

I want to try a pill crusher as well, 

A problem with the pill crusher is that powder can cling to the sides of the crusher.  In my experience the spoon method is better because you can easily get all the powder onto the scale.  Of course, do whatever works for you.  The 2-spoon method was always effective for me.  

 

1 hour ago, Sicksagittarius said:

 I'm so angry about this because it was so difficult to figure out how to properly crush the pills and transfer them into a capsule I was crying all afternoon trying to do it.

I'm sorry you're having this difficulty.  Please try to relax about the process.  Just give yourself some time to get used to doing it.  It becomes second-nature with a little practice.

[Gridley]

10 hours ago, Sicksagittarius said:

making sure to use gloves when weighing so the oils from your hands don't impact the weight

My hands never touch the powder.  I've never worn gloves.

 

I do one pill at a time.  That lessens the chance of too much powder to handle and your losing control and it flying all over the place.

 

If you have weighed 10 pills and found the average, that will give you a sufficiently exact dose.  The variance in active ingredient from pill to pill (due to the  much greater amount of filler) will be negligible.

 

Just a possibility: is there someone you're sufficiently close to that can crush your pills and pour the powder into capsules?  

Edited May 20, 2021 by Gridley

[Sicksagittarius]

1 hour ago, Gridley said:

It's not likely.  I never have.  It's the same form of the drug and the delivery to your system would be the same.  If you noticed a difference, it may be that your dose was different from splitting pills due to uneven distribution of the active ingredient in the cut pill.

It's important to stir the powder thoroughly (as with a toothpick or powder mixing spoon (available on Amazon; also good for adding/subtracting powder from scale to bent Post-it/paper).

A problem with the pill crusher is that powder can cling to the sides of the crusher.  In my experience the spoon method is better because you can easily get all the powder onto the scale.  Of course, do whatever works for you.  The 2-spoon method was always effective for me.  

 

I'm sorry you're having this difficulty.  Please try to relax about the process.  Just give yourself some time to get used to doing it.  It becomes second-nature with a little practice.

Thank you for the quick response! Thats a great point about the powder sticking to sides. I couldnt crush the 20 mg pill with a spoon it was so difficult bc its large but I'm getting more 5 mg pills today. Another thing I thought about was using the 20 mg pill opposed to the 5 mg could cause this reaction but what you said about cutting the pill and it has uneven distribution of active ingredients make sense. How do you recommend I move forward to help my body get the most accurate dose? tonight when I take my lexapro im going back to cutting the 5 mg in half so I can stabilize because I feel misreable right now. Weighing the cut in half pill on the scale help or no because its about the active ingredient more so than the weight of the pill? I'm so upset that I messed it up somehow and feel so awful right now and am scared its going to take me a few days to go back to stabilizing because who knows how much of an increase in dose I gave myself. I'm also on 40 mg of omeprazole which I have found can double the amount of lexapro in your system which scares me knowing I may have given myself a higher dose of lexapro than intended. 

 

omeprazole journal article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4297217/

 

"Escitalopram concentrations were significantly higher in patients treated with omeprazole (+93.9%; P < 0.001),"

 

"When omeprazole or esomeprazole are used in combination with escitalopram, a 50% dose reduction of the latter should be considered. Omeprazole or esomeprazole was combined with escitalopram, causing an almost 2-fold increase in the escitalopram levels"

 

[Sicksagittarius]

1 hour ago, Gridley said:

My hands never touch the powder.  I've never worn gloves.

 

I do one pill at a time.  That lessens the chance of too much powder to handle and your losing control and it flying all over the place.

 

If you have weighed 10 pills and found the average, that will give you a sufficiently exact dose.  The variance in active ingredient from pill to pill (due to the  much greater amount of filler) will be negligible.

 

Just a possibility: is there someone you're sufficiently close to that can crush your pills and pour the powder into capsules?  

Im back at home with my mom due to me being sick and she is a nurse and is of course on western medicine doctors sides and doesnt believe in anything I'm doing. We have been fighting because every time I try to do something to benefit my health she thinks its unnecessary. She tried to come help me bc I was sobbing trying to crush the pills and I told her its hard to get all of the powder in one bowl and not stick to various things so I had to start over because if you lose a lot of the powder it could screw up the dose and she thinks im being too tedious and crazy. evidently not because I did my best last night to do this and I'm still having awful side effects even by being as accurate as possible and spending hours doing it.

 

I don't have the energy to fight her about this anymore and it sucks bc I live with her. I cant heal in an environment where she is constantly arguing the cause of my illness. She is on my case about getting better and thinks I'm not doing anything to help myself. she straight up said to me "you're a smart, productive, hard working girl, I miss that version of you" as if it's my fault that im not this version of myself that allows her to feel better about herself. I'm still that person and I'm already struggled with feeling like im losing my identify to this illness and her saying that was like twisting a knife in my back.

 

I swear she just wants me to get better so she isnt embarrassed of me living at home, not working so she can brag to her friends about my accomplishments and look good for superficial reasons in society. Idgaf about any of that I just want to heal and will do exactly what I need to do in order for this to happen despite what anyone says. its going to take months/years to get 100 percent and she thinks thats dumb and i should just go off the meds cold turkey bc she thinks ill feel normal in a few days.... as we all know going cold turkey is the worst thing you could ever do. 

 

She thinks this can be fixed in a few weeks by some magic pill. Why would I listen to her advice when everytime I tell her symptoms I have, she doesnt believe the cause? Last night I told her how sick I felt from trying to crush and scale the pills and said its just due to stress. I tried to wean off of my stomach medication and my throat felt like it was closing and she didnt believe that.

 

I told the dr i started getting a significant amt of grey hairs in a short period of time, and im in my twenties so this is a new thing for me, and the dr, my mom, and his associates laughed. I started crying because i was trying to explain how I think all the meds he put me on are making me worse and not allowing me to absorb vitamins bc im also bruising way too easily. He also said i need to stop sitting around and focusing on being sick and exercise and live life as normal as possible which I agree, but some days I physically or mentally cannot do it and I think its okay to rest. 

 

I recently went to my gastroenterologist and his suggestion was to put me on a tricyclic to replace the lexapro to help slow down stomach issues. I obviously said no because why would I add any more psych meds to my system when Im destabilized. He said its a low dose so it wont be for psych issues just stomach. I think it will still impact me. I said is there any other thing I can do besides adding that for the pain and he said tylenol which was so rude. He's not open minded to trying something else or listening to me.

 

I have a feeling my mom was talking to this doctor before my appt because they work together. He seemed to know a lot about what ive been doing without telling him. He lectured me about "googling" and said "you can google xyx, it will tell you what im saying." so condescending when they say googling... no im looking at peer reviewed, credible journal articles and peoples first hand experiences with this. I'm a smart, college educated person who knows how to read journal articles and whats credible and they totally blew me off.

 

My mom said "you don't like what the dr has to say/won't listen to them." Ive listened to what they told me to do for 8 months! Its not that i dont like what they said its an actual real life experience of having adverse effects from doing what drs told me to do. Im in this position because I listened to my doctors to take lexapro for years and to ween off way too fast by their orders. 

 

I'm dealing with heavy mental issues like panic attacks and anxiety and racing heart and thoughts all day as I'm stabilizing so its hard for me to get things done without sitting there and overthinking every move i make. she doesnt understand mental illness at all. She thinks when I feel sick I need to "push through it" but after learning from this site, you need to take it easy when you're feeling your worst because it will only make you feel sicker.

 

I'm tired of no one being on my side and me having to work 10 times harder to get better when anyone else with any different illness would have so many doctors and people on their side helping them get better. no one understands what im going through besides this site and i'm struggling so much to keep it together. I also went off of my birth control a few months ago and I think thats impacting a lot of my issues as well with having an excess of estrogen that can cause stomach issues and hormone issues for my mental struggles. 

[Yesyes123]

5 hours ago, Sicksagittarius said:

I'm so angry about this because it was so difficult to figure out how to properly crush the pills and transfer them into a capsule I was crying all afternoon trying to do it. Now I feel more discouraged than ever because I'm scared this will mess up my stabilization now because I went off track one day.

 

I'm not sure what could have caused your head floating symptom. 

 

Did you have any other symptom other than "floating in your head"? Is it like dizziness?

 

Doing the crushed pill method is actually easy. At least it has been for me and has been effective. 

 

I will try to make a video explaining exactly how I do the entire process soon.

[Yesyes123]

Since it hasn't been long since you started to stabilize on 2.5mg escitalopram, it's probably best that you hold on 2.5mg for a while before tapering. Maybe you should stick to the half 5mg pill while you learn more about the crushing pills method.

[Gridley]

4 hours ago, Sicksagittarius said:

He said its a low dose so it wont be for psych issues just stomach. I think it will still impact me.

We would not recommend a switch from Lexapro to a tricyclic.  Tricyclics and SSRI's such Lexapro are totally different, and a switch very likely would result in significant withdrawal symptoms from Lexapro.  

 

Making pills can be a painstaking  job, especially if you're feeling stressed.  There's nothing wrong with the pill crusher if it makes it easier for you.  One of our mentors, Frogie, used a pill crusher for her taper, and it worked well for her.  You could tag her using the @ plus Frogie (no space between the @ and Frogie).  I'm sure she'll be happy to tell you about her experience with the pill crusher.

 

4 hours ago, Sicksagittarius said:

Another thing I thought about was using the 20 mg pill opposed to the 5 mg could cause this reaction but what you said about cutting the pill and it has uneven distribution of active ingredients make sense. How do you recommend I move forward to help my body get the most accurate dose? tonight when I take my lexapro im going back to cutting the 5 mg in half so I can stabilize because I feel misreable right now. Weighing the cut in half pill on the scale help or no because its about the active ingredient more so than the weight of the pill?

 

Weighing the cut pill cut in half is better than not weighing at all because you can scrape some pill off or add a little piece of pill to get your exact weight.  However, weighing powder is better because you can stir to distribute the active ingredient.  There is no way to know how well the manufacturer of your pill distributes the active ingredient throughout the pill.

 

That's fine to go back to your old method until you feel comfortable with the powder.  Wait until your crusher comes in and see if that makes it easier.  Don't worry, you will get this worked out.

 

 

 

 

 

 

 

Edited May 20, 2021 by Gridley

[Formykids1220]

 From a fellow Sagittarius 🙂 I'm an RN currently going through lexapro withdrawal after rapid taper(March 28th was last dose). I am on long term disability and right now and I couldn't work while going through this. I also have stomach and digestive issues. I'm on my 4th week of omeprazole because I believe taking diclofenac with lexapro gave me an ulcer. I would ask your Mom to watch medicating normal they have web screenings and some in person screenings. When I watched it there was a Mother (that was also an RN) watching it for her son who was currently going through withdrawal. My view of medicine has completely changed since I developed adverse reactions and my psychiatrist kept changing my meds at every 4 week appointment. The medical community is in the dark about this. I hope it is beginning to change. 

[Yesyes123]

I made a video today showing the entire method and process of how I weigh my escitalopram powder and put the desired amount in gelatin capsules (crushing pills method).

 

I need to edit it and make the cuts and I'll upload it and post it here soon.

[Altostrata]

Thanks, @Yesyes123, that will be very helpful.