Rudolph: Can you safely reduce by .5mg of liquid lexapro every 4 weeks?

[Rudolph]

Hi There!

 

I'm new to this forum.  I have been on lexapro for about 6 years. The last two years I have been slowly weaning off lexapro.

 

At first I went from 20mg to 15mg to 10mg every 2 weeks no problem. Then once I hit 10 mg I had to slow it down even more.

 

I went from 10 mg to 7.5mg with a pill cutter. After that I discovered liquid and I went down .5mg every 4 weeks and went all the way down to 2.5mg but then a death happen in family and I went back up to 5mg and stayed on that dose for almost a year. 

 

Once spring started I began reducing by .5mg every 2-4 weeks and now I'm down to 2mg.

 

I have noticed I get withdrawal symptoms for the first 3-5 days and then I balance out. 

 

I wonder is it safe for me to continue to go down .5mg every 4 weeks?

Edited May 19, 2021 by Gridley

[Gridley]

2 hours ago, Rudolph said:

I wonder is it safe for me to continue to go down .5mg every 4 weeks?

 

It is much safer to do a percentage taper such as the 10% every four weeks taper rather than the linear taper you describe.  With a percentage taper, as you get lower and lower the amount of your taper gets smaller and smaller, which makes it easier on the nervous system.  By contrast, with the straight linear taper, the amount of your drop in relation to your dose get larger and larger just at the time (the low doses) when you should be slowing down.

 

We recommend tapering no more than 10% of current dose every four weeks.  The following link explains why, as well as giving information on whether you can go faster and how to do it if appropriate for you.

 

Why taper by 10% of my dosage?

 

In your case, dropping .5mg from 2 to 1.5 is a 25% reduction.  From 1.5 to 1 is a 33% reduction.  From 1 to .5 is a 50% reduction.  Using this method, you'd be jumping to zero from 1mg after only 8 weeks.  It took me 11 months to go from 1mg Lexapro to zero.  

 

One reason we suggest a percentage taper (which results in cutting the dose by smaller amounts as we taper and especially as we get to the low doses) is because there is a high rate of receptor occupancy at low doses of the drug.  That is to say, even on low doses of the drug, it is still having a major effect on the brain.  Please see this link: 

 

SERT Transporter Occupancy Studies

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.

 

Account Settings – Create or Edit a signature.

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Add in one at a time and at a low dose in case you do experience problems. Get supplements that are single ingredient (not mixed with other types of supplements).

 

This is your Introduction topic, where you can complete your drug signature, ask questions and connect with other members.  We're glad you found your way here.

 

 

 

 

 

 

 

 

 

[Rudolph]

Wow! Thank you for your reply. I will definitely go a lot slower and reduce by 10%. Also, I’ll get supplements you have suggested:):)

[Rudolph]

(topic title before merging with original introduction topic:  Rudolph: Trazodone and Escitalopram)

 

I'm very slowly weaning off escitalopram and I'm down to 3mg after 6-7 years of being on this medication.  

 

I'm also on 50mg of trazodone as a sleep aid to escitalopram. I have been taking trazodone for 2-3 years.

 

I'm wondering if I should stop weaning off escitalopram and start weaning off trazodone?

 

I have noticed I'm constantly exhausted and my memory is not what it use to be.

 

Edited September 7, 2021 by ChessieCat
added topic title before merging into Intro topic

[Gridley]

Welcome to SA, Rudolph.

 

To start:

 

To give members the best information, we ask them to summarize their medication history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-24 months particularly.  Please include the date you started the Escitalopram, the starting dosage, your taper rate and the date you started tapering.

 

Account Settings – Create or Edit a signature.

 

We recommend tapering acivatings drugs (such as SSRI's like Escitalopram) first and leaving sedating drugs like trazodone in place to aid with sleep to be tapered later.  I would taper down to zero on the Escitalopram first before tapering the Trazodone.  I would also wait at three months, perhaps longer, after you finish the Escitalopram taper before starting tapering the Trazodone.  

 

How fast are you tapering?  If your symptoms of exhaustion and poor memory are severe, that is an indication of that you're tapering too fast and suffering antidepressant withdrawal.

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

You might consider holding at 3mg for a while to see if these symptoms improve before continuing your taper.  Escitalopram is the most potent SSRI on the market, and it is especially important to go slowly in your taper of the small doses, which continue to have a strong effect on your brain.  3mg of Escitalopram is still a considerable dose of Escitalopram.  We recommend tapering down to a very low dose before jumping to zero, somewhere in the low .00's.  You can see from my drug signature that I jumped to zero from 0.025mg.  I'm now 7 months off the drug and doing fine.

 

We recommend tapering no faster than 10% of your current dose every four weeks.  

 

Why taper by 10% of my dosage?

 

A slightly slower but more gentle tapering method than the 10%/4 week taper is the Brassmonkey slide taper, which consists of four weekly 2.5% reductions from current dose with a 2-week hold. It's the methodI used to taper Escitalopram from 20mg to zero, and I recommend it.

 

The Brassmonkey Slide Method of Micro-tapering

 

What method are you using to get your taper doses?  Prescription liquid is a convenient and accurate taper method.  Other methods include making your own liquid and weighing powder made from tablets on a digital scale, such as the Gemini-20, available on Amazon.  These methods are described in the following link, which is specifically about tapering Escitalopram.

 

Tips for tapering off escitalopram (Lexapro)

 

 

We don't recommend a lot of supplements on SA, as many members report being sensitive to them due to our over-reactive nervous systems, but two supplements that we do recommend are magnesium and omega 3 (fish oil). Many people find these to be calming to the nervous system. 

 

Magnesium, nature's calcium channel blocker 

 

Omega-3 fatty acids (fish oil) 

 

Add in one at a time and at a low dose in case you do experience problems. Get supplements that are single ingredient (not mixed with other types of supplements).

 

This is your Introduction topic, where you can complete your drug signature, ask questions and connect with other members.  We're glad you found your way here.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

[Rudolph]

I’m currently very slowly weaning off of liquid escitlopram(I’m down to 3mg). 
 

I take 50mg of trazodone to help me sleep due to escitlopram. 
 

Weaning off of escitlopram has been hell.

 

I just want to know if trazodone is just as bad to wean off of?

 

Thank you

[manymoretodays]

Hi Rudolph, @Rudolph and welcome aboard,

I've got your latest question and post moved into your main topic here, your Introduction, which is the best place for questions, updates, etc. around your specific case.  That way all your pertinent information is together too, very useful for us moderators, yourself, and other members.

 

How have you been tapering your Lexapro?

Any WD(withdrawal) symptoms?

 

You'll now see Gridley's reply above, with more information for you too, as to WD, and then to some of our harm reduction guidelines to tapering.

 

When tapering multiple medications, we often suggest leaving the more sedating or "brakes" until last, as insomnia is so often encountered while tapering, and sleep can be so important or helpful in the healing process.  In your case, as Trazodone is often prescribed for sleep, that would be your brake.

How is your sleep right now?

And more about tapering, when more than one drug is involved:

Taking multiple psych drugs? Which drug to taper first?

 

7 hours ago, Rudolph said:

Weaning off of escitlopram has been hell.

 

I just want to know if trazodone is just as bad to wean off of?

 

You may not find trazodone to be as bad to wean off of, at a later date.

How often and by how much have you been tapering the Lexapro?

 

You can help us out too, by doing a drug signature, it's the portion you'll see under others posts.

Here are some guidelines for doing that:

How to list drug history in signature

this is best done from a PC, and then allows us all to get an idea of where you are at, at a glance, when you ask questions, and does save staff time

 

Okay, and welcome aboard again.  Tell us a bit more, get your signature done, and we may be able to help guide and support you out of hell.  😇

I hope so.   I'm sure we can at least empower you with education and information, and coping skills.  And lend support.

 

And best.

Love, peace, healing, and growth,

moderator manymoretodays (mmt)

Edited June 24, 2021 by manymoretodays

[Rudolph]

I’m down to 2.7mg escitlopram and I’m stable. 
 

I just move into a new place with a new roommate. 
 

My boyfriend and I are on the fence to

stay together or break up. 
 

I’m wondering if I should stay at the dose or continue to lower my medication? 

[hayduke]

Hi @Rudolph

 

Please help us out by filling out your signature with your drug history. 

 

How to Summarise Drug History in Signature

 

Someone here (apologies, I've forgotten who) wisely said "Any reason you can think of to hold is a good one".  It's hard to go wrong with that adage.

 

In short, when you're experiencing stress, difficult or challenging situations, and life changes, holding is a great idea.

 

Once things are steady again it makes sense to look at resuming your taper.

 

Cheers

[ChessieCat]

I have merged your new topic with your original Introduction topic.  This keeps your history is all in one place.

[Rudolph]

Does long term use of antidepressants cause vertigo?

 

Hi There!

 

I'm just wondering if anyone else has had vertigo from long term use of antidepressants?

 

Edited February 6, 2022 by ChessieCat
added topic title before merging with intro topic

[ChessieCat]

SA's topic:

 

dizziness-vertigo-light-headedness-rocking-or-swaying-sensations

 

Q:  Have you checked blood pressure recently?  Low blood pressure can cause dizziness.

 

Q:  Have you missed any doses recently or been taking them at irregular times?

 

Q:  Or have you recently made a reduction and it started after that?

 

Dizziness is a withdrawal symptom:

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

Q:  How long have you had the vertigo?  Generally unwanted side effects are dose related so if it is a side effect I think you would have experienced it on a higher dose.
 

From https://www.drugs.com/sfx/lexapro-side-effects.html

 

Quote

 

In Summary

Common side effects of Lexapro include: diarrhea, drowsiness, ejaculatory disorder, headache, insomnia, nausea, and delayed ejaculation. Other side effects include: anorgasmia, constipation, dizziness, dyspepsia, fatigue, decreased libido, diaphoresis, and xerostomia.

 

 

[Rudolph]

Does trazodone cause low blood pressure???

 

 

I wonder if antidepressants long term use cause low blood pressure???

 

Edited June 11, 2022 by ChessieCat
added topic title before merging with intro topic

[ChessieCat]

Q:  What prescription drugs and other supplements are you currently taking?  Anything over the counter that you take regularly?