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Veritas: Introduction


Veritas

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Hi everyone,

 

I'm here for help and support with WD symptoms. I've been on an SSRI for about 13 years now. Started using for mild depression. Was not told it should be short term use, or told anything about it being hard to stop taking them if I wanted. They helped at first but I got sick of the side effects. I tried a couple of times to come off with doctor instructions (4 weeks I think?) and felt terrible. Thought it was "relapse" so went back on. Thinking about coming off again, I found this website and realized what happened the other times. So I tried a really slow taper and using a different drug with a longer half life but I think the lower doses were too fast and I hit WD again but worse than the other times.  
 
Symptoms: akathisia, low appetite, weight loss, brain fog, trouble being social, insomnia, cortisol surges, tremors, apathy, low motivation.

I'm stabilizing after going up in mg. Most of above symptoms are less severe; some are gone. My husband doesn't really understand whats happening. We have kids (older but still) and that makes stuff harder. Working with a therapist who is good but I am needing support from people who understand WD and this group seems great.

 

I have a couple of questions:

1) Does it sound like my updose is working and, if so, will I continue to see slow, incremental improvements in my WD symptoms?

2) Considering my history of WD episodes (four of them) and the messing around with doses/drugs the last few months, am I even a candidate to taper again in the future?

3) If I attempt another taper (which would literally be the slowest of slow...), how would I assess my body's readiness to begin?

 

Veritas

 

Edited by Karma
Edited for privacy

2008  fluoxetine 10mg (brief), then escitalopram 20 mg

2011 - 2012 - escitalopram too fast taper once each year; reinstate

2012-2017  escitalopram 20 mg

2018 (May)  started "Prozac bridge" - 40 mg fluoxetine; hold

2018 (Nov) to 2019 (Sep) - fluoxetine slow taper to 10 mg - no issues

2019 (Sep-Nov) fluoxetine taper to 4 mg; too fast; crashed

2019 (Dec) - updose to 10 mg fluoxetine; stabilized

2020 - resume taper in Apr; down to 2.1 mg fluoxetine in Apr 2021

2021 (Apr) - switch to liquid fluoxetine; WD symptoms creep in

5/14/21 - switch back to fluoxetine tablets 2.1 mg; WD worsens

6/15/21 - updose to fluoxetine 10 mg; WD worsens

7/16/21 - switch to escitalopram 10 mg; HOLDING to stabilize

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  • Moderator

Dear Veritas, I am so sorry to read of how much you have suffered on these drugs and trying to get off of them. 

 

I am glad that you are seeing improvements on your switch. It's not ideal that you had to switch but as long as that is working, I would stay there. Your trajectory seems to be towards improvement. Once you are stabilized you can resume a very slow taper. 

 

The reason your symptoms ramp up when you are at the lower doses is that the majority of these drugs' effects occur at the lower doses, hence it's important to start slowing your taper at those doses.

 

We recommend going no faster than 10% of the previous dose a month but some of us have to go even slower than that. 

 

Since you've had such a hard time with the taper so far, I'd give it a few months after being stable before attempting to taper again. In case any lingering symptoms might come back. By now you have heard about the windows and waves pattern of withdrawal, so you might see an uptick occasionally and easier days so you might want to see how these might go.

 

Making changes sensitizes our system so that makes subsequent tapers even more challenging but there is no reason why you can't do it successfully at a slow rate holding when things get difficult. 

 

Your job now is to stabilize and we can help you prepare and start tapering when you feel stable. You might want to read the topics in the tapering and the symptoms and self care Forums.

 

we are here for you when you have more questions and feel free to chime in on other people's boards as well.

 

Wishing you some respite soon

 

OMW

Edited by Karma
Updated user name

I am not a doctor and this should not be considered medical advice. You can use the information provided in whatever way you want and all decisions on your treatment are yours. 

 

If you would like to get a response from me directly please type @Onmyway some place in your message so I get notified of your post. I am not able to follow all of the threads all the time.

 

Aug  2000 - July 2003 (ct, 4-6 wk wd) , citalopram 20 mg,  xanax prn, wellbutrin for a few months (don't remember dates), trazodone prn 

Dec 2004 - July 2018 citalopram 20 mg, xanax prn (rarely used)

Aug 2018 - citalopram 40 mg (self titrated up)

September 2018 - January 2019 tapered citalopram - 40/30/20/10/5 no issues until a week after reaching 0

Feb 2019 0.25 xanax/day, then 0.5/day (3 weeks) over to klonopin 0.25 once a day to manage severe wd

March 6, reinstated citalopram 2.5 mg (liquid), klonopin 0.25 mg for sleep 2-3 times a week

Apr 1st citalopram 2.0 mg (liquid), klonopin 0.25 once a week, 

citalopram (liquid) 4/14/19 -1.8 mg, 5/8/19 - 1.6 mg,  7/27/19 -1.5 mg,  8/15/19 - 1.35, 2/21/21 - 1.1 (smaller drops in between), 6/20/21 - 1.03 mg, 8/7/21- 1.025, 8/11/21 - 1.02, 8/15/21 - 1.015, 9/3/21 - 0.925 (fingers crossed!), 10/8/21 - 0.9, 10/18/21 - 0.875

Supplements: magnesium citrate and bi-glycinate

 

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Veritas, my heart goes out to you . I’ve had a similar story  to yours and I understand how different it is to endure this when you have children. I’m happy your having some relief and staying with your sister, its great your focusing on yourself. My husband sounds like yours , they will never understand , you have to put yourself first and get better nosed you will.  Hospitals are a waste of time they don’t know what we’re dealing with and can’t help, everyone here can. Your lucky you have found a therapist that understands you , I’m still looking for one . Keep us posted and listen to the mods, there angels . 

Edited by Karma
Updated username

1995 started Paxil 20mg slowly increasing to 50mg until 2014

-2014 I decided to tapper myself not knowing how too and crashed , DR added 50mg Seraquel

-2015 tried tapering again and crashed

Seroquel Taper

2/11/16 43mg  1/09/17  37.5mg  10/03/10 36.25mg. 17/3/19 35mg 26/3/19 33.75mg  4/4/19 32.5mg  21/4/19 30mg

16/7/19 28.75mg  5/8/19 27.5mg. 19/8/19 25mg   4/8/20 23mg 18/8/20 22.5mg  12/10/20 18.25mg  10/1/21 15mg  3/8/21 UPDOSE 16mg

Paxil Taper

2/11/16 40mg 12/10/17 37mg  28/10/17 36mg  10/1/18. 35mg  24/05/18 33mg  28/8/18 31mg 16/12/18 30mg 20/10/19 29mg  17/11/19 28mg 7/1/20  27mg 12/2/20  26mg 7/3 /20 25mg  11/4/20 24mg 4/5/20 23mg  5/6/20 22mg 23/6/20 21mg 15/7/20 20mg

Untitled.rtf

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@Onmyway Thank you for the advice about stabilizing. I can’t imagine doing it with my nervous system being so fragile. I’m thinking of waiting to get stable and then remaining stable for multiple months. 
 

@Cheeky Thank you for your kind words. Yes, dealing with WD while caring for children takes things to another level. I’m sorry to hear you face the same struggle, and that your husband isn’t super understanding. It’s so lonely, isn’t it? How is your taper going?

 

I do need some advice. I switched over to escitalopram one month ago. Weeks 3 and 4 showed progress toward stability. However, I just had to refill my Rx at a local pharmacy (not my usual; I’m staying with my sister 3 hours from my home). This new bottle is a different manufacturer from what I had been on those 4 weeks. I’ve been logging any symptoms since starting and feel like I may be reacting:

 

DAY 1: no different

DAY 2: worsening of equilibrium problems; started bounding my leg up and down during dinner - the leg bouncing is what I was doing a lot back in June and July when I was way worse (akathisia?) but it had gone away. 
DAY 3: more leg bouncing, but mild

DAY 4: (today) woke up to a cortisol surge through my arms - another symptom that was there in June/July but had gone away. 
 

Does this sound like being sensitized and thus sensitive to different manufacturers? How long do I let it play out? How hard do I search for another pharmacy that carries the other manufacturer? 

2008  fluoxetine 10mg (brief), then escitalopram 20 mg

2011 - 2012 - escitalopram too fast taper once each year; reinstate

2012-2017  escitalopram 20 mg

2018 (May)  started "Prozac bridge" - 40 mg fluoxetine; hold

2018 (Nov) to 2019 (Sep) - fluoxetine slow taper to 10 mg - no issues

2019 (Sep-Nov) fluoxetine taper to 4 mg; too fast; crashed

2019 (Dec) - updose to 10 mg fluoxetine; stabilized

2020 - resume taper in Apr; down to 2.1 mg fluoxetine in Apr 2021

2021 (Apr) - switch to liquid fluoxetine; WD symptoms creep in

5/14/21 - switch back to fluoxetine tablets 2.1 mg; WD worsens

6/15/21 - updose to fluoxetine 10 mg; WD worsens

7/16/21 - switch to escitalopram 10 mg; HOLDING to stabilize

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  • Moderator

I spoke to my husband who is a recently retired pharmacist. Due to FDA standards, a drug can be certified a generic equivalent if it is within 15% bioavailability of the original product.  This means that the generic could be up to 15% stronger, or 15% weaker than the brand name Lexapro.  Two generics could therefore be 30% different in their bioavailabilities.  This can definitely cause a ramping up of symptoms.  If it were me, I would request that the new pharmacy order the same brand of escitalopram that you were on previously, and go back on that.  Or find a pharmacy that sells your old brand.   How long ago did you start using this new brand? 

Edited by getofflex

***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 '02 - 10 mg;  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

Ibuprofen 800 mg, or Tylenol 1000 mg as needed

other meds: Levothyroxine 75 mg

Trazodone nightly, stopped in late 2019

Xanax on occasion, stopped in late 2019

magnesium in small amounts at breakfast, 3 PM 

suppl AM: fish oil, flax oil, vit C, vit E, calcium

suppl PM: magnesium 350 mg, GABA 750 mg, Estroven, melatonin 2.5 mg

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  • Moderator
On 8/14/2021 at 6:05 PM, Veritas said:

I can't bear to think of the gossip ramping up around the neighborhood.

Try your best not to worry about that.  Other people have no idea what you are dealing with.  I think you are doing the right and best thing to take care of yourself.  

 

On 8/14/2021 at 6:05 PM, Veritas said:

1) Does it sound like my switch/updose from fluoxetine 5 mg to escitalopram 10 mg has been successful, and, if so, will I continue to see slow, incremental improvements in my WD symptoms?

It does sound successful, as you have been reporting that you are feeling better each day.  However, it is common to have downturns too.  This link explains about that:  

 

Windows and Waves Pattern of Stabilization

 

On 8/14/2021 at 6:05 PM, Veritas said:

2) Considering my history of WD episodes (four of them) and the messing around with doses/drugs the last few months, am I even a candidate to taper again in the future?

I believe that yes, you can taper in the future, but I would suggest a very long stabilization period, as in at least a year or two.  Then, you can taper off very slowly and carefully.  This link explains how to taper safely:  

 

 Why Taper by 10% of my Dosage  

On 8/14/2021 at 6:05 PM, Veritas said:

3) If I attempt another taper (which would literally be the slowest of slow...), how would I assess my body's readiness to begin?

If it were me, I would wait until all my WD symptoms had completely resolved.  Your nervous system has really been through it with all the drug changes in the past, and needs a good long rest in order to recover and go back to equilibrium.  Read this links, it explains why this is so.  

 

 

How Psychiatric Drugs Remodel Your Brain

 

 Video on Recovery from Psych Drugs

 

What is Happening in Your Brain

 

What is Withdrawal Syndrome?

 

I'm very sorry you have been through this ordeal.  I'm praying for you.  The good news is, there is hope for the future, and you can eventually get off of these drugs.  It just takes a lot of time, and patience. 

Edited by Karma
Updated username

***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 '02 - 10 mg;  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

Ibuprofen 800 mg, or Tylenol 1000 mg as needed

other meds: Levothyroxine 75 mg

Trazodone nightly, stopped in late 2019

Xanax on occasion, stopped in late 2019

magnesium in small amounts at breakfast, 3 PM 

suppl AM: fish oil, flax oil, vit C, vit E, calcium

suppl PM: magnesium 350 mg, GABA 750 mg, Estroven, melatonin 2.5 mg

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@getofflex I started taking the new brand on Friday. Uptick in WD symptoms started on day 2. Thank you for explaining about the 15% difference in bioavailability allowed by FDA. That is frightening for sensitive folks like me. And really explains why a change in manufacturer could be significant. 
 

I was able to find another pharmacy that has the brand I need. My psychiatrist called it in there for me. Now hoping insurance will cover it since I just refilled last week. Even if it doesn’t, I feel like I can’t risk going on taking the other brand. 
 

Thank you so much for your kind words of support. 
 

Veritas

2008  fluoxetine 10mg (brief), then escitalopram 20 mg

2011 - 2012 - escitalopram too fast taper once each year; reinstate

2012-2017  escitalopram 20 mg

2018 (May)  started "Prozac bridge" - 40 mg fluoxetine; hold

2018 (Nov) to 2019 (Sep) - fluoxetine slow taper to 10 mg - no issues

2019 (Sep-Nov) fluoxetine taper to 4 mg; too fast; crashed

2019 (Dec) - updose to 10 mg fluoxetine; stabilized

2020 - resume taper in Apr; down to 2.1 mg fluoxetine in Apr 2021

2021 (Apr) - switch to liquid fluoxetine; WD symptoms creep in

5/14/21 - switch back to fluoxetine tablets 2.1 mg; WD worsens

6/15/21 - updose to fluoxetine 10 mg; WD worsens

7/16/21 - switch to escitalopram 10 mg; HOLDING to stabilize

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@Cheeky I thought I had found a therapist but it fell through. She lives in Indiana and I’m not, so she can’t treat me, even with tele-health; she’s not licensed to practice in my state. I’m so disappointed. Back to the drawing board…

2008  fluoxetine 10mg (brief), then escitalopram 20 mg

2011 - 2012 - escitalopram too fast taper once each year; reinstate

2012-2017  escitalopram 20 mg

2018 (May)  started "Prozac bridge" - 40 mg fluoxetine; hold

2018 (Nov) to 2019 (Sep) - fluoxetine slow taper to 10 mg - no issues

2019 (Sep-Nov) fluoxetine taper to 4 mg; too fast; crashed

2019 (Dec) - updose to 10 mg fluoxetine; stabilized

2020 - resume taper in Apr; down to 2.1 mg fluoxetine in Apr 2021

2021 (Apr) - switch to liquid fluoxetine; WD symptoms creep in

5/14/21 - switch back to fluoxetine tablets 2.1 mg; WD worsens

6/15/21 - updose to fluoxetine 10 mg; WD worsens

7/16/21 - switch to escitalopram 10 mg; HOLDING to stabilize

Link to comment
  • Moderator
On 8/17/2021 at 11:17 AM, Veritas said:

@getofflex I started taking the new brand on Friday. Uptick in WD symptoms started on day 2. Thank you for explaining about the 15% difference in bioavailability allowed by FDA. That is frightening for sensitive folks like me. And really explains why a change in manufacturer could be significant. 
 

I was able to find another pharmacy that has the brand I need. My psychiatrist called it in there for me. Now hoping insurance will cover it since I just refilled last week. Even if it doesn’t, I feel like I can’t risk going on taking the other brand. 
 

Thank you so much for your kind words of support. 
 

Veritas

If it were me even if it cost money out of my own pocket I would go on your previous brand. A 15 or 30% difference in the strength can have a major impact on your withdrawal symptoms if you are sensitized.  This could take months to resolve.

Edited by Karma
Update username

***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 '02 - 10 mg;  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

Ibuprofen 800 mg, or Tylenol 1000 mg as needed

other meds: Levothyroxine 75 mg

Trazodone nightly, stopped in late 2019

Xanax on occasion, stopped in late 2019

magnesium in small amounts at breakfast, 3 PM 

suppl AM: fish oil, flax oil, vit C, vit E, calcium

suppl PM: magnesium 350 mg, GABA 750 mg, Estroven, melatonin 2.5 mg

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  • Karma changed the title to Veritas: Introduction

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