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samsamsam: Long time anti-depressant user who just tapered off and is now...depressed


samsamsam

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Hi there, 

 

I was diagnosed with GAD and prescribed escitalopram around 6/7 years ago (23/24 years old). They worked great for me! I was able to regulate my worries and never felt any side effects. However, as I think more about having kids I wanted to taper off which I did around 2 months ago (without advising a dr. which I know was bad, but I didn't quit cold turkey). I moved to a new city with my fiance for his work and although I'm really sad about being away from my family and friends (I'm VERY close to my parents and feel guilty for leaving), I was pretty fine when we got here 6 months ago (granted I was on meds).

 

After stopping escitalopram 2ish months ago, I experienced the usual physical withdrawals, but that was it, I felt okay, still sad and missed people but, okay. 

 

However, about 2 weeks ago (so 1.5 months off pills), I became a different person. I'm normally bubbly and excited about everything, now I'm sad and numb. I'm getting married next month and I KNOW I'm excited...I just can't feel it anymore. Nothing excites me, I can't eat. I feel helpless. I'm going to therapy, trying to practice CBT and sometimes it helps but sometimes I think I'll just be like this forever (I suffer from catastrophic thinking, even when on meds, just not this bad).  

 

I'm worried that being on pills for so long has left me unable to regulate my feelings now. I've never been "depressed" before...I know a move can exasperate anyone's emotions, but I feel I am responding unrealistically. I am so tempted to get back on and just being the person that needs SSRIs to function, I don't have a problem with that morally, I just know it's not advisable. 

 

Is this just more withdrawal or did I take pills for so long that this is my new norm. 

 

Thank you all!

  • 2013/14: Diagnosed with GAD and prescribed escitalopram - 10-20mgs (can't recall exact year...could even be earlier)
  • worked great, managed my worries just fine. no side effects - was on 15 mgs for majority of the time
  • 2021: tapered off as I thought about getting closer to having kids. 
  • 5 mgs for ~2 months, 2.5 mgs for ~month
  • fully off June 2021
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  • getofflex changed the title to samsamsam: Long time anti-depressant user who just tapered off and is now...depressed
  • Moderator Emeritus

Hello, and welcome to SA.  We are a peer owned and run forum of people who have been or are getting off of psychiatric drugs.  I'm sorry to hear that you are dealing with this. What you are describing sounds like classic symptoms of withdrawal from antidepressants.  Oftentimes, there is a delayed reaction, and it may take several weeks or even months to feel it. The good news is, given time and proper self care, you will recover. 

 

Here is some information about how these drugs actually work.  This explains why it is important to taper off very slowly and cautiously.

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

 Video on Recovery from Psych Drugs

 

What is Happening in Your Brain

 

What is Withdrawal Syndrome?

 

Also, as we are recovering, we suggest keeping things slow, simple, and stable. This is extremely important. 

 

Keep it Simple, Slow, and Stable

 

 

When we recover, there are times of feeling OK mixed in with times of feeling bad.  This is called windows and waves.

 

Windows and Waves Pattern of Stabilization

 

Here are some techniques to cope with symptoms: 

 

Acknowledge, Accept, Float

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 


Magnesium

 

Omega 3 Fish Oil

 

21 hours ago, samsamsam said:

I am so tempted to get back on and just being the person that needs SSRIs to function, I don't have a problem with that morally, I just know it's not advisable. 

Instead of going back on a full dose of the drug, why not try a small reinstatement?  Going back on a small dose of your drug, which we call reinstatement, is best done very carefully.  This is temporary, and after stabilizing you would then taper gradually off of this.  There is some risk involved, but in your case, since you came off not long ago, and had no adverse effects while on the drug, I feel you would be a good candidate.  Here is some information about reinstatement.  

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

If you decide to do so, I would suggest reinstating at 0.5 mg.  You can get liquid Lexapro from a pharmacy here in the US.  (I'm assuming Vernon is in the USA).  Then you can easily measure it with a 1 ml syringe.  The purpose of the RI is to reduce your withdrawal symptoms and make you more comfortable.

 

Let me know what you decide to do.  In the meantime, hang in there, and take care.  Time and patience are the 2 keys to recovering from this.  

Edited by getofflex

Please do not private message me.  Only tag me for urgent questions about tapering and reinstating - thank you.  

 

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

 

Lexapro   Started Apr 15 2010 - 10 mg;  started taper August 2017, recent taper info: Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08 Aug 16 - 0.07, Oct 6 - 0.06, Nov 21 0.05, Dec. 17 0.04, Jan 14 '22 0.03, Feb 19 0.02, Apr 18 0.01, May 15 0.005,  Jul 8, 0.00.  Psych Drug Free as of July 8, 2022!!  Woohoo!!!

other meds: Levothyroxine 75 mg

magnesium in small amounts at 4 AM, before bed

suppl AM: fish oil, flax oil, vit C, vit E, multivitamin, zinc

suppl 8 PM: magnesium 350 mg, extended release vitamin C, melatonin 2 mg

 

Paxil 2002 - 2010, switched to Lexapro 2010 

Trazodone 50 mg. 2002 - 2019, fast tapered in 2019 

Xanax 0.5 mg as needed 2002 - 2019, up to 3x weekly 

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I so appreciate you taking the time to message me with so much information. It means a lot, really. :)

 

I’m actually in Canada so I take the solid pills of escatalipram. When I was tapering I would just cut the pill into quarters.

 

I guess I’m nervous that going back on, even in small doses, would just drag the inevitable and I would just feel like this again anyways haha. As much as I’m tempted to go back on, it scares me. 

 

I’m trying to discern if my current state is the WD, or it’s just my reaction to moving and having generalized anxiety disorder because I’m not “stable” with drugs right now. I’m hoping it’s just the WD so this isn’t the “new me”. I sleep just fine and wake up with a mini panic attack every morning. I’m so fixated and getting better that it consumes my every thought - Is this just my regular now that i’m off the pills? Or with time, will this pass if I am patient and practicing CBT? 

 

Thank you my friend :)

  • 2013/14: Diagnosed with GAD and prescribed escitalopram - 10-20mgs (can't recall exact year...could even be earlier)
  • worked great, managed my worries just fine. no side effects - was on 15 mgs for majority of the time
  • 2021: tapered off as I thought about getting closer to having kids. 
  • 5 mgs for ~2 months, 2.5 mgs for ~month
  • fully off June 2021
Link to comment

I have another thread in introductions discussing my situation, and the idea of reinstatement was brought up as I had no side effects while on AD and I only stopped using them ~2 months ago. I only have the solid 10mg pills left and want to take the smallest dose possible to reinstate. Does anyone have any suggestions on how to get a small amount from a solid pill? I read you could crush the 10mg ones but I want to be as accurate as possible. Thank you friends! 

 

Side note: I woke up terribly today, heart pounding, scared this is forever, and I now feel like me again a couple hours later. I just want to lean into this positive moment as they come!

  • 2013/14: Diagnosed with GAD and prescribed escitalopram - 10-20mgs (can't recall exact year...could even be earlier)
  • worked great, managed my worries just fine. no side effects - was on 15 mgs for majority of the time
  • 2021: tapered off as I thought about getting closer to having kids. 
  • 5 mgs for ~2 months, 2.5 mgs for ~month
  • fully off June 2021
Link to comment
  • Moderator Emeritus

Previous 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.  

 

There are several ways to measure a very small dose.  One is crushing the pill into a powder and weighing on the scale.  The second is to get or make a liquid, and use that.  I suggest this method, as it is easier and perhaps more accurate.  

 

I'm really glad your sleep is OK.  This is essential, and will help you to recover. 

 

I believe that most of your symptoms are probably from doing a fast taper. The stress of the move could very well be making the symptoms worse, because stress tends to do this.  We at SA suggest a very slow taper of 10% reduction per month, which takes from many months to years, to avoid WD symptoms.  


Here is a thread that will tell you exactly how to measure a very small dose.  

 

Tips for Tapering Lexapro

 

Please do not private message me.  Only tag me for urgent questions about tapering and reinstating - thank you.  

 

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

 

Lexapro   Started Apr 15 2010 - 10 mg;  started taper August 2017, recent taper info: Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08 Aug 16 - 0.07, Oct 6 - 0.06, Nov 21 0.05, Dec. 17 0.04, Jan 14 '22 0.03, Feb 19 0.02, Apr 18 0.01, May 15 0.005,  Jul 8, 0.00.  Psych Drug Free as of July 8, 2022!!  Woohoo!!!

other meds: Levothyroxine 75 mg

magnesium in small amounts at 4 AM, before bed

suppl AM: fish oil, flax oil, vit C, vit E, multivitamin, zinc

suppl 8 PM: magnesium 350 mg, extended release vitamin C, melatonin 2 mg

 

Paxil 2002 - 2010, switched to Lexapro 2010 

Trazodone 50 mg. 2002 - 2019, fast tapered in 2019 

Xanax 0.5 mg as needed 2002 - 2019, up to 3x weekly 

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Thanks @getofflex! I wasn’t sure how to join the 2 convos - appreciate it and you! :) 

 

I would like to reinstate at 0.5mgs as you suggested for a month. Scaling down slowly from there by 10% would mean very small and accurate dosing! Or would 0.5mgs be the last dose before completing the tapering? 

 

Once again thank you for taking the time to help a complete stranger. 

  • 2013/14: Diagnosed with GAD and prescribed escitalopram - 10-20mgs (can't recall exact year...could even be earlier)
  • worked great, managed my worries just fine. no side effects - was on 15 mgs for majority of the time
  • 2021: tapered off as I thought about getting closer to having kids. 
  • 5 mgs for ~2 months, 2.5 mgs for ~month
  • fully off June 2021
Link to comment

Hi again, I’ve been having a couple mild anxiety/ good days recently (praying it’s the journey to a good norm because i’ve been practicing CBT, self talk and exercising etc.) I went to the pharmacy who will compound 0.5mgs of Escitalopram for me Monday but I’m scared of reinstating and causing more issues?

 

It’s a very small amount I know. Could someone let me know if it’s a good idea to reinstate or if it’s one of those “can’t hurt” situations? I read up on kindling etc. so I’m aware of that. 

 

I was recommended reinstating by @getofflex and I read that it might not do anything at all since it’s such a small dose. I guess I’m just wondering if it’s a good precaution to take since I did taper quickly. I stopped taking 5mgs a couple months ago and while on the drugs i had no side effects. 

 

I know the longer you wait to make this decision the less chance it’ll work but I’m hoping to find out if it’s a good precaution and can’t really hurt if i’m care about it. 

 

Thank you!!!!

  • 2013/14: Diagnosed with GAD and prescribed escitalopram - 10-20mgs (can't recall exact year...could even be earlier)
  • worked great, managed my worries just fine. no side effects - was on 15 mgs for majority of the time
  • 2021: tapered off as I thought about getting closer to having kids. 
  • 5 mgs for ~2 months, 2.5 mgs for ~month
  • fully off June 2021
Link to comment
  • Moderator Emeritus

Hello triple Sam.  I'm proud of you for using non drug coping techniques.  This is why we start the reinstatement at a very low dose, to reduce the risk of kindling.  Many people who come in here have been on a drug merry go round with going on and off various psych drugs repeatedly.  You have only been on Lexapro, and haven't gone off and on it in the past.  Plus you have had no adverse effects from it.  I think you would be a good candidate for an RI.  Of course, it is not entirely risk free.  It will be up to you to decide if you would like to reinstate or not.  If yo feel that you can tolerate your WD symptoms, and function with them, then perhaps you would be better off to just soldier on and tough it out.  Have you noticed any improvements at all since you came fully off?  If so, then perhaps it is better to not reinstate.   Please let us know what you decide.  Either way, you will eventually recover from this, give time and proper self care.  

Please do not private message me.  Only tag me for urgent questions about tapering and reinstating - thank you.  

 

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

 

Lexapro   Started Apr 15 2010 - 10 mg;  started taper August 2017, recent taper info: Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08 Aug 16 - 0.07, Oct 6 - 0.06, Nov 21 0.05, Dec. 17 0.04, Jan 14 '22 0.03, Feb 19 0.02, Apr 18 0.01, May 15 0.005,  Jul 8, 0.00.  Psych Drug Free as of July 8, 2022!!  Woohoo!!!

other meds: Levothyroxine 75 mg

magnesium in small amounts at 4 AM, before bed

suppl AM: fish oil, flax oil, vit C, vit E, multivitamin, zinc

suppl 8 PM: magnesium 350 mg, extended release vitamin C, melatonin 2 mg

 

Paxil 2002 - 2010, switched to Lexapro 2010 

Trazodone 50 mg. 2002 - 2019, fast tapered in 2019 

Xanax 0.5 mg as needed 2002 - 2019, up to 3x weekly 

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Hey again! 

 

My apathetic and dark nature is better! However, now it’s replaced with the worry that this is just a window and I’ll hit a wave at any minute. haha I’m working through not having catastrophic thoughts and thinking it’s just me getting better!

 

When you say “you will get better” that means that this depression i never felt before is because of the WD and as I begin to continue stabilizing, that should eventually fade away? :)

 

You’re right, I was only on one drug so perhaps this withdrawal is coming to an end. My anxiety is constant with the move and missing my family and i know my reaction is disproportionate since i do suffer from anxiety and negative thinking. 

 

Reinstating mixed with CBT could ensure I stabilize and am strong. When RI at 0.5, you suggest going down from there to 0.4...0.3...0.2 etc? 

 

 

 

Thanks once again!

Edited by samsamsam
added a sentence for clarity
  • 2013/14: Diagnosed with GAD and prescribed escitalopram - 10-20mgs (can't recall exact year...could even be earlier)
  • worked great, managed my worries just fine. no side effects - was on 15 mgs for majority of the time
  • 2021: tapered off as I thought about getting closer to having kids. 
  • 5 mgs for ~2 months, 2.5 mgs for ~month
  • fully off June 2021
Link to comment
  • Moderator Emeritus
3 hours ago, samsamsam said:

now it’s replaced with the worry that this is just a window and I’ll hit a wave at any minute.

Try not to worry about the future.  The extra worry can contribute to the WD symptoms.  

 

3 hours ago, samsamsam said:

When you say “you will get better” that means that this depression i never felt before is because of the WD and as I begin to continue stabilizing, that should eventually fade away? :)

By that, I meant that eventually, given good self care, and not jumping on other mind altering substances, your nervous system will return to it's original predrug state.  From what you say above, it sounds like depression caused by WD.  I do believe that any issues we had before we went on the drugs will still be there to be dealt with.  However, there are many resources out there for helping us to do this emotional recovery work. I'm working on that myself at this time. 

 

3 hours ago, samsamsam said:

When RI at 0.5, you suggest going down from there to 0.4...0.3...0.2 etc? 

 

No.  That would be a linear taper.  We suggest doing an exponential taper.  The suggested rate is reducing your dose by 10% no more than every 4 weeks, and it's 10% of the current dose, not 10% of the original dose.  So for example, it would be 0.5, 0.45, 0.41, 0.37, and so on.  The basic formula is current dose x 0.9 = new dose.  It takes a long time, but it's especially important to taper very carefully at the very low doses, because even at the low doses, a significant percentage of the serotonin receptors are being down regulated.  At 0.5 mg Lexapro, it is estimated that 29% of your receptors are affected!  Even at my tiny dose of 0.07 mg, 5.8% of my receptors are being affected.  Here are some links that talk about these concepts: 

 

Why Taper by 10% of my Dosage

 

SERT Occupancy Studies SSRI's Affect you Greatly at Low Doses

 

 

Please do not private message me.  Only tag me for urgent questions about tapering and reinstating - thank you.  

 

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

 

Lexapro   Started Apr 15 2010 - 10 mg;  started taper August 2017, recent taper info: Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08 Aug 16 - 0.07, Oct 6 - 0.06, Nov 21 0.05, Dec. 17 0.04, Jan 14 '22 0.03, Feb 19 0.02, Apr 18 0.01, May 15 0.005,  Jul 8, 0.00.  Psych Drug Free as of July 8, 2022!!  Woohoo!!!

other meds: Levothyroxine 75 mg

magnesium in small amounts at 4 AM, before bed

suppl AM: fish oil, flax oil, vit C, vit E, multivitamin, zinc

suppl 8 PM: magnesium 350 mg, extended release vitamin C, melatonin 2 mg

 

Paxil 2002 - 2010, switched to Lexapro 2010 

Trazodone 50 mg. 2002 - 2019, fast tapered in 2019 

Xanax 0.5 mg as needed 2002 - 2019, up to 3x weekly 

Link to comment

Hi again,

 

I received my compounded 0.5mg of escitalopram and am still on the fence to reinstate. As mentioned, I didnt have any bad reactions while on it, and was only ever on the same drug. My weird depression phase of withdrawal is over but replaced with constant worry and anxiety. I wake up in the morning with it, and I'm not even thinking about anything and have trouble eating. I sometimes throw up in the morning too from the anxiety. I was diagnosed with Generalized Anxiety Disorder years back when I was prescribed the escitalopram, but I don't recall it ever being this bad. 

 

I wanted to see if anyone had any inclination if this is another symptom of withdrawal, or a relapse. I'm just so lost on if I should reinstate or not. I dont want to make anything worse, but I want to stabilize if that is whats needed.

 

Thank you!

  • 2013/14: Diagnosed with GAD and prescribed escitalopram - 10-20mgs (can't recall exact year...could even be earlier)
  • worked great, managed my worries just fine. no side effects - was on 15 mgs for majority of the time
  • 2021: tapered off as I thought about getting closer to having kids. 
  • 5 mgs for ~2 months, 2.5 mgs for ~month
  • fully off June 2021
Link to comment
  • Moderator Emeritus
6 hours ago, samsamsam said:

I was diagnosed with Generalized Anxiety Disorder years back when I was prescribed the escitalopram, but I don't recall it ever being this bad. 

That indicates to me that it is from the withdrawal, not a relapse.  

 

6 hours ago, samsamsam said:

I'm just so lost on if I should reinstate or not. I dont want to make anything worse, but I want to stabilize if that is whats needed.

Reinstating will probably help you, but it is your decision.  Just realize that the more time elapses between jumping off the drug and reinstating, the less likely it is to work.  Take care, and hang in there. 

Please do not private message me.  Only tag me for urgent questions about tapering and reinstating - thank you.  

 

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

 

Lexapro   Started Apr 15 2010 - 10 mg;  started taper August 2017, recent taper info: Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08 Aug 16 - 0.07, Oct 6 - 0.06, Nov 21 0.05, Dec. 17 0.04, Jan 14 '22 0.03, Feb 19 0.02, Apr 18 0.01, May 15 0.005,  Jul 8, 0.00.  Psych Drug Free as of July 8, 2022!!  Woohoo!!!

other meds: Levothyroxine 75 mg

magnesium in small amounts at 4 AM, before bed

suppl AM: fish oil, flax oil, vit C, vit E, multivitamin, zinc

suppl 8 PM: magnesium 350 mg, extended release vitamin C, melatonin 2 mg

 

Paxil 2002 - 2010, switched to Lexapro 2010 

Trazodone 50 mg. 2002 - 2019, fast tapered in 2019 

Xanax 0.5 mg as needed 2002 - 2019, up to 3x weekly 

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