Beekeeper: 6 weeks off lexapro, withdrawal symptoms getting worse?

[beekeeper]

Hello, thank you to those who create and maintain this forum. 
I’m 27-years-old, female. I’m interested in learning more about people’s experiences with withdrawal AFTER getting down to 0mg. 

I was on 10mg generic lexapro for 4.5 years. I tapered off of it over the course of 7 months. I’m now 6 weeks out from 0mg and experiencing worsening withdrawal symptoms: shakiness, depressive episodes, digestive issues, hard time sitting still, can’t sleep because of shakiness. These all come throughout the day but come in “waves,” as this site has explained to me. The worst of it began 4 days ago, after rock climbing (which was a mistake). 
I actually didn’t have too much difficulty with the taper—would feel bad for a few days after I dropped a dose, but even when I was on 2.5 and 1.25 mg I was feeling good. 

 

Background

Prescribed it after college for obsessive/intrusive thoughts, panic attacks, depression. It gave me my life back, though in retrospect I would have benefited a lot from talk therapy. (At the time I didn’t know anything about the mental health care system, so I just visited one counselor who mis-diagnosed me big time, and that made me wary of social workers for awhile.) So I stayed on it because it really improved my quality of life (I had dealt with depression and obsessive thought throughout high school and college without knowing that I had a mental health problem.) 

Last summer I decided to try to switch meds because I noticed that the Lexapro wasn’t working as well. Tried 10mg of Prozac for 9 days, made my whole body go numb and caused major sexual dysfunction (now I have PSSD). I try to see this as a blessing in disguise because it prompted me to do more research about SSRIs and I realized that they weren’t safe. 
I’m not on any other drugs. 
I’m wondering if others out there have experienced this —easy taper, bad withdrawal after 0mg?

Edited June 23, 2021 by Gridley

[beekeeper]

And also if anyone has suggestions for symptom mitigation, especially the shakiness?

[Gridley]

Welcome to Sa, beekeeper.

 

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 be sure to include the rate at which you tapered, the dose you were on before you stopped the Lexapro and the date you stopped.

 

Account Settings – Create or Edit a signature.

 

The symptoms you describe are typical of antidepressant withdrawal, the effects of which can be delayed.  So that you have a better idea of what you're experiencing, here is some information on withdrawal.

 

What is withdrawal syndrome.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

 

The Windows and Waves Pattern of Stabilization

 

When we take psychiatric medications, the CNS (central nervous system) responds by making changes over the months and years we take the drug(s). When the medication is discontinued, the CNS has to undo all the changes it made. Rebuilding the neurotransmitter production and reactivating the receptor and transporter cells takes time -- during that rebuilding process symptoms occur.  

 

You asked about mitigation of symptoms.  You have, from our perspective, basically two choices.

 

1.  Wait it out.  Your system is working constantly to repair itself, as described in the paragraph above about the rebuilding of neurotransmitters.  The damage is not permanent and your system will heal itself.  We can't give you a timeline.  Some recover fairly quickly; others take longer.

 

2.  The second choice is to reinstate a very small dosage of your previous drug, in your case generic Lexapro.  Reinstatement in the only known method to mitigate withdrawal symptoms.  You're still within the time period when reinstatement works (within 3 months after your last dose).  Please read:

 

About reinstating and stabilizing to reduce withdrawal symptoms. -- at least the first page of the topic

 

If you're interested in reinstating, let us know and we can suggest a dose after you're competed your drug signature with information about your taper and the dose at which you stopped taking the drug.  Do not reinstate without letting us suggest a dosage.  Reinstating too much can overwhelm your system and destabilize you further.  If you reinstate, you would wait to stabilize then taper very slowly off to zero at the rate of 10% of current dose every four weeks (much more slowly than your previous taper).

 

Why taper by 10% of my dosage?

 

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.

 

 

 

 

 

 

 

 

 

[beekeeper]

Thank you, Gridley. I appreciate all the resources. I would be interested to know your suggestion for reinstating Lexapro at a low dose. I want to be drug free but right now symptoms prevent me from sleeping/functioning. I had been taking a bunch of vitamins a few days leading up to worsening symptoms so I'm wondering if those played a role. Not going to take them anymore.

[beekeeper]

I also know that I am very sensitive to drugs. I needed to go back on Lexapro after trying to switch to Prozac last fall, and reinstating Lexapro then had to go slowly because I was very sensitive to the drug again.

[Gridley]

On 6/23/2021 at 11:22 AM, beekeeper said:

I would be interested to know your suggestion for reinstating Lexapro at a low dose.

Sorry for the delay in responding; I didn't see your post.  To tag me so I'll be sure to see your posts, type @Gridley and when the rectangle with@Gridley appears, click on it.

 

Since your final dose was very low, I'd suggest a reinstatement of 0.25mg (1/4mg).  Prescription liquid Lexapro would be the most convenient and accurate way to reinstate.  A compounding pharmacy is another method for getting your doses.  How were you measuring your doses during your taper?

 

This link contains information about getting non-standard doses of Lexapro.

 

Tips for tapering off escitalopram (Lexapro)

 

It takes 4 days for the reinstated dose to reach full strength in your bloodstream and a few days longer for it to register in the brain.  It is very important not to reinstate too much because too much can overwhelm your system and make things worse (this is especially so since as you write that you're very sensitive to drugs).  Be patient and allow the reinstatement to work.  If you need to increase very slightly after allowing the 0.25mg time to work, this will be a simple matter with the liquid.

 

Reinstatement doesn't always work.  If you are worse after reinstating, stop the reinstatement immediately.  The purpose of reinstatement isn't to elmininate symptoms entirely (though it does for some) but rather to make them tolerable.

 

 

 

 

Edited June 28, 2021 by Gridley

[beekeeper]

Thank you, @Gridley. So is the idea to go back up on a minimal dose until I feel alright, then hold that and taper more slowly from that? 

I wonder if you could direct me to any posts about someone having success reinstating lexapro at a low dose and tapering off more slowly?

 

Right now the worst part is the mornings. I wake up early panicky, depressed, racing thoughts. Waves of shakiness and depression and racing thoughts throughout the day. Half the time I think it is relapse, half the time I think it is withdrawal. The frequent shakiness makes me think it's WD.

 

I also wonder if there is any information about counseling that helped people during withdrawal? What I've noticed is that I'm dealing with PTSD symptoms from a situation years back, now that I'm off the drugs. I thought I had worked through it with CBT but without the drugs I feel like I need more healing. I am in such a fragile state I don't know if starting EMDR right now would help with the racing thoughts and panic.

[Gridley]

@beekeeper

 

43 minutes ago, beekeeper said:

So is the idea to go back up on a minimal dose until I feel alright, then hold that and taper more slowly from that? 

 

Yes, that is exactly the idea.

 

There are several posts about reinstating Lexapro.  Here's one.  For more, Google SurvivingAntidepressants.org reinstating Lexapro.

I didn't search for specific success stories, but reinstatement with Lexapro can work just as it can with other psychiatric drugs.  The important factors are (1) to reinstate soon after stopping the drug (at 2 months you're ell within the time frame of 3 months during which reinstatement most predictably works) and (2) not reinstating too much.

Paul22: should I reinstate escitalopram / Lexapro ...

 

43 minutes ago, beekeeper said:

 

Right now the worst part is the mornings. I wake up early panicky, depressed, racing thoughts

 

Increased symptoms in the morning is very common in withdrawal.  This is caused by the increased amount of cortisol in your body at this time.  Again, it is a very typical part of withdrawal.

Early-morning waking - managing the morning cortisol spike ...

43 minutes ago, beekeeper said:

 

I also wonder if there is any information about counseling that helped people during withdrawal?

 

Many members have been helped by therapists.  The question is IF (and it's a big "if") you can find a therapist who is knowledgeable about or at least open to the idea of withdrawal.  If you go to a therapist who isn't sympathetic to withdrawal problems, they can be worse than useless. Psychiatrists in general would fall into the "worse than useless" category here, as their tools are drugs and more drugs and they do not believe in withdrawal.  Any therapist who tells you that it's impossible to have withdrawal symptoms after stopping at a low dose or that "it's all in your head" fall into the worse than useless category.

 

I just saw this post by Shep, one of our administrators, about therapy.

 

"Even if you can't find a therapist who's educated in withdrawal, target your search for a therapist for one who can teach you certain skills, such as mindfulness or even skip therapy altogether and go to a beginner's yoga or Tai Chi class. You can even start out on your own using YouTube videos for beginning skills in these areas. Whatever you need to do to feel more comfortable inside your own skin."

 

From the same post from Shep:

 

"Having spent 30 years starting as a teenager using psychiatric drugs to regulate my emotions and to sleep at night meant having to do a lot of work to learn those skills I never had to learn before. Please  spend some time here:

 

Non-drug techniques to cope with emotional symptoms

 

Simply learning to breathe through uncomfortable symptoms can get you through a lot of difficulties. This is one of many videos available on YouTube to get you started:

 

 

The Breathing Space by Jon Kabat Zinn video (4 minutes)

 

 

 

Edited July 5, 2021 by Gridley

[beekeeper]

I am 2 months and 10 days since my last dose of lexapro, which was 1.25mg. I tapered 10mg over the course of 6.5 months, and I now realize I should have gone much slower. 
Withdrawal symptoms: shakiness, restlessness, trouble sleeping, anxiety, weepiness, obsessive thoughts, waves of depression, occasional dizziness and nausea. These hit the worst 6 weeks after my last dose.

Last week I had a period of 4 days where I felt pretty solid, but now I am on the 5th day of a bad wave. 
 

I am concerned that that things will get worse before they get better? So I am wondering if my chances of a quicker, less painful recovery are better if I get back on the drug, restabilize, and taper much more slowly. 
 

***Please don’t post anything overly negative. I just need help thinking through this objectively.***

[Go2zero]

Hello Beekeeper,

 

Welcome to this support site. Sorry that you are suffering this much from withdrawal. Is is quite common that people quit at a low (but too high) dosage. Escitalopram is a very strong SSRI. So withdrawal can be even stronger than with some less potent SSRI's.

 

To give an idea what your last dosage of 1,25mg still did:

The occupancy of the serotonine receptors at a full dosage of 10 mg is around: 80%

At a dosage of 1,25 mg this is still around 50% !!!

 

Most of us do not know this and quit at a too low dosage. Since the withdrawal effects of escitalopram could even get worse or stay for a longer time, it might be useful to reinstate I guess. Before you do so, I will discuss your case with other moderators.  So please wait until I come back to you.

[beekeeper]

Thank you, @Go2zero. I also wanted to note that this bad wave has been while I’m on my period. Just trying to share as much info to make the best decision. 

[Go2zero]

OK, thanks for the extra info. We will take that into account as well. How have you been feeling lately when not having your periods?

 

By the way I have moved your post to the forum "Introductions and updates" . This is the right place for these posts.

[beekeeper]

@Go2zero For 4 days a few days out from my period I was feeling solid. Before that I had been dealing with similar symptoms that I’m feeling now. The symptoms began to get bad 6 weeks after my last dose. 
 

another question I have is, at what point generally do people get past the worst symptoms? I understand that this can persist for a long time, but it would be helpful to know whether ai can expect a general but slow improvement.

[Go2zero]

25 minutes ago, beekeeper said:

another question I have is, at what point generally do people get past the worst symptoms? I understand that this can persist for a long time, but it would be helpful to know whether ai can expect a general but slow improvement.

Unfortunately I cannot answer this question. We all react differently. As said, you jumped at a very high SERT level to zero. Must of us have done things like that without knowing. I did the same 3 times, without knowing. Most doctors don't know or do not believe in slow tapering.

 

The last part is the most important and difficult part, since the SERT levels drop so extremely fast when we taper the last 10-20 % of the original dose. I do not want to scare you, but be very much aware how you feel and how everything develops. In my case (and I know with several others as well) the real hammer came after 3-4 months after stopping. 

 

Therefor reinstating might be a thing to overthink. I will come back to you when the other moderators have reacted to my question about reinstating .

[getofflex]

@beekeeperPrevious post moved to your intro topic to keep your history all in one place.  Please post questions and discussion about your situation in this one thread, to avoid confusion and duplication of efforts.  Thank you.  

[Go2zero]

Hi Beekeeper,

 

I discussed your case with other moderators and we think that reinstating could be a good way to go. However, everybody can react differently to reinstating. A reason to do RI is to prevent WD to become worse. A too high RI might cause kindling. So we suggest that if you choose to reinstate, that you will do so on a very low dose of 0,125mg. Hold on that for at least 2 weeks and see what happens. Keep us informed what happens. Let us know when things get worse or better.

 

See hereunder a link how to make a liquid from tablets. In such a way it is quite easy to make very precise extreme low dosages

 

 

[Altostrata]

Hello, @beekeeper

 

You may wish to get a prescription for liquid escitalopram in order to take a very small dose with an oral syringe. 0.125mg might be enough to see if this will work for you, or you may need a little more. You'd taper off by minuscule amounts later. Please let us know how you're doing.