lex1989: escitalopram / Cipralex and clonazepam / Rivotril / Klonopin

[lex1989]

@Frogie I've read the topic, I recommended a 2 hour shift instead of 1 hour and the dose split should be 12 hours appart.

 

The actual question is : Should I split the dose for Lexapro ? as I am a ultra-rapid metabolizer, would this help ?

Considering I take it at 13 PM and usually I have symptom's during the day and it lessens in the night. Moving half of dose before sleep, would help, how ?

 

Or should I split the doze of Clonazepam ? Or both ? What do you think ?

[Frogie]

18 minutes ago, lex1989 said:

@Frogie I've read the topic, I recommended a 2 hour shift instead of 1 hour and the dose split should be 12 hours appart.

 

The actual question is : Should I split the dose for Lexapro ? as I am a ultra-rapid metabolizer, would this help ?

Considering I take it at 13 PM and usually I have symptom's during the day and it lessens in the night. Moving half of dose before sleep, would help, how ?

 

Or should I split the doze of Clonazepam ? Or both ? What do you think ?

I would split the clonazepam dose. Don’t split the Lexapro. I always took my Lexapro in the morning, but I know a lot that take it at night because it’s sedating to them. What does the Lexapro do for you after you take it? Maybe you should consider moving the time you take it?

[DataGuy]

14 hours ago, lex1989 said:

Now related to the most important topic : How should I split and what ? I guess we are talking about the Lexapro and not the Clonazepam as me and @Frogie thought it should be split for the inter-dose withdrawal.

 

 

Yes, was talking about the lexapro because you are an ultrarapid metabolizer. Your proposed schedule looks good. 

[lex1989]

4 minutes ago, Frogie said:

I would split the clonazepam dose. Don’t split the Lexapro. I always took my Lexapro in the morning, but I know a lot that take it at night because it’s sedating to them. What does the Lexapro do for you after you take it? Maybe you should consider moving the time you take it?

 

I used to take it in the morning while I was at the first psychiatrist, for 2 months.

The second psychiatrist put me to take it before sleep together with the Clonazepam, this was for the next 3 months.

At the 5th month I decided things are way worse then before medicine and started to taper.

 

Did a fast taper from 0.5 to 0.3 Clonazepam in 3 weeks (did not knew benzo buddies or SA back then) while Lexapro was still before sleep together with Clonazepam. All hell broke loose and from that point and the daily symptoms started to be even worse during the day until the night when things calm down.

 

Found BB and SA and asked for advices, stopped tapering and stabilized for a bit and moved Lexapro in the morning / afternoon. Starting from that point things got a little better, but I am not sure if because I stopped the rapid tapper and stabilized and slowed my taper and moved to taper Lexapro instead, I am still not sure, that's why keep asking questions.

 

After a long discussion with @getofflex and @Altostrata we came to the conclusion that Lexapro is doing more harm (I also got some liver damage because of the medicines and it seems the Lexapro might be the one, also bad reaction from Lexapro when I started to take it in the first place and while trying to lower Clonazepam or up dosing Lexapro things always got worse.)

 

6 minutes ago, DataGuy said:

 

Yes, was talking about the lexapro because you are an ultrarapid metabolizer. Your proposed schedule looks good. 

 

Shall I split then Lexapro together with Clonazepam, would this help ?

 

I am almost certain I am in withdrawal from both medicines and also adverse reaction from Lexapro. Happy me

[DataGuy]

Yes, I would do as @Frogie advises with the clonazepam. If it doesn't help you can always go back. It's also recommended you only try one thing at once, so it's easier to differentiate what is causing what change in symptoms. 

[Frogie]

As @DataGuy recommends, only change one medication at a time so we know what is going on.  I would move 1/2 of your clonazepam dose one hour until you are taking them about 10-12 hours apart.

 

We suggest that you stabilize on this, then start the Lexapro taper. Clonazepam is a brake and will help (hopefully) with the Lexapro taper when you start that. Lexapro is an accelerator. 

 

After you are done with your Lexapro taper, then you should wait a good couple of months to see how you feel before starting the clonazepam taper.

[Greatful]

@lex1989

I am confused.  I am an altra fast metallizer with the lex too as you know.  My doc suggested to split the dose to see if that would help me stabilize and I was told not to by a mod here.  Now you are being told to do so.  This is so confusing.  Can you explain it to me what you are trying to do.

[lex1989]

3 hours ago, Frogie said:

As @DataGuy recommends, only change one medication at a time so we know what is going on.  I would move 1/2 of your clonazepam dose one hour until you are taking them about 10-12 hours apart.

 

We suggest that you stabilize on this, then start the Lexapro taper. Clonazepam is a brake and will help (hopefully) with the Lexapro taper when you start that. Lexapro is an accelerator. 

 

After you are done with your Lexapro taper, then you should wait a good couple of months to see how you feel before starting the clonazepam taper.

Ok will do. Won't make any more changes to the Lexapro tapper until I split the dosage for Clonazepam.

 

I know that the benzo acts like a brake, unfortunately for me it does not do it anymore haha.

 

I would assume this will take ~ 12 days to do so, will see how I am then and continue with the 0.8 mg taper of Lexapro.

 

Thanks a lot for the support.

[Frogie]

Unfortunately it will take that long to move it, but hopefully it will help then.

 

After you split the dose and get it where you want it I’d hold 2-3 weeks before you start the Lexapro taper to make sure everything is smoothing out.

[Frogie]

@lex1989

 

I was mistaken when I read @DataGuy's response. He was referring to the splitting of the Lexapro.

 

Can you start splitting your dose of Lexapro into 2 doses, getting them 12 hours apart by moving one to say 8 am and one to 8 pm (or whatever time you feel comfortable taking it, that is just an example). You'll have to move each one 1 hour each day until they are 12 hours apart.

 

Don't mess with the Clonazepam at this point.

 

Sorry for the confusion, but glad we got it worked out.

 

Thanks!

[lex1989]

14 hours ago, Frogie said:

@lex1989

 

I was mistaken when I read @DataGuy's response. He was referring to the splitting of the Lexapro.

 

Can you start splitting your dose of Lexapro into 2 doses, getting them 12 hours apart by moving one to say 8 am and one to 8 pm (or whatever time you feel comfortable taking it, that is just an example). You'll have to move each one 1 hour each day until they are 12 hours apart.

 

Don't mess with the Clonazepam at this point.

 

Sorry for the confusion, but glad we got it worked out.

 

Thanks!

 

@Frogie Ok I understand, but knowing that during the day I have my usual withdrawal symptoms and knowing that at 1 PM I take the Lexapro, how would help moving half of Lexapro dose at night when I feel better ? Just trying to make sense.

 

As @DataGuy mentioned, being ultra-fast metabolizer, splitting the dose would help, but how ? Maybe moving it a bit later in the afternoon like 5-6 PM ? When I still have symptoms (usually they can start at that point or become worse sometimes). But I won't see any sense moving it before sleep when I am fine.

 

The goal of this topic and my recent question where related to the fact that I did not understood very well why I have the pattern where the w/d symptoms are present during the day, while in late evening and night I am much better, but @DataGuy confirmed it's related to the fact of the cortisol levels during the day and also blood pressure and body temperature (body get's ready to sleep) and that is why w/d lessens a lot.

 

I wanted to be sure if it's not inter-dose w/d as well, moving half of the benzo in the day would make sense as I feel worse then, but how would help moving the Lexapro before sleep ?

 

[Frogie]

@lex1989

 

You can take it any time of day that you feel most comfortable with. I was only giving you an example.

 

@DataGuy suggests the lexapro splitting and see how you do because you are such an ultra-fast metabolizer

 

You could try splitting it every 8 hours and see if that would relive some of your symptoms.

 

After you get the doses moved, you could hold for a few days to see if you get any symptoms (more than you already have) and then we could certainly split the benzo and see if that helps also.

 

Let me know what you think about that.

Edited January 9, 2022 by Frogie

[lex1989]

@Frogie Ok. I will split the Lexapro like these : 1 PM 55% and 5-6 PM 45% (I can't scale exactly 50% of current dose).

 

Will try it like this. Then leave a few days, than maybe split the benzo as well.

 

Thank you !

[Frogie]

@lex1989

 

That sounds like a great plan.

 

Crossing my fingers it helps and we can go on to the benxo.

 

 

[Frogie]

@lex1989

 

Just checking in on you?

[lex1989]

Hi @Frogie,

 

I'm functional, grateful for that :).

 

Still splitting the dose of Lexapro.

[Frogie]

@lex1989

 

Well, that's a good thing that you are functional lol...

 

Hopefully splitting the Lexapro will bring some relief pretty soon.

[lex1989]

@Frogie Functional almost let's say, with all the symptoms .. hah, at least I get a small break during the night.

 

I hope so as well, if not then maybe the Clonazepam split will do the trick.

[lex1989]

This is day 2 of splitting and feel worse after I took second dose today.

I have a hunch that splitting a drug that I have adverse reaction to won't help, but make it worse, we'll see I guess.

[Frogie]

@lex1989

 

I hope by splitting the dose it will make it easier since you are a fast metabolizer. It's going to take 4 days at least to see the outcome.

 

 

We can always work with the Clonazepam.

 

Keep me posted please.

[lex1989]

I’m not sure if splitting Lexapro helps, it does seem worse.

 

Maybe split just the benzo, will think about it until tomorrow

[Frogie]

@lex1989

 

Let me know what you think as it's only been a couple of days.

 

 

[Frogie]

@lex1989

 

Just wondered how you are doing?

[lex1989]

@Frogie 

Thank you for checking. I am doing bad, regretting splitting the Lexapro dose. Was somehow stable and could tapper before this.

[Frogie]

@lex1989

 

It's only been 3 days, you could go back to one dose if you want to try it.

 

We could try splitting the Clonazepam, that might help.

[lex1989]

I would give few days to recover or see if I can recover with the Lexapro dose being split, if I'm not feeling any better in 3-4 days will go back to full dose at 13 and split Clonazepam.

[Frogie]

@lex1989

 

I just wouldn't wait much longer to go back to a full dose, or you might have another unexpected wd symptom.

 

I think you are safe for a couple more days, then you'll have to change back if that's what you think is best for you.

 

Then hold on everything for a couple of weeks at least. Then we can work on splitting the Clonazepam.

[lex1989]

Yes, we'll see in a couple of days.

 

I waited 6 weeks after my last cut, stabilized then started  to tapper 0.08 Lexapro each 3/4 days like Alto recommended.

Would not wait many more weeks as my liver gets damage because of Lexapro.

[Frogie]

@lex1989

 

I totally understand about tapering. If you go back to taking one dose a day, I'd give it a couple of weeks to let your body settle and then if you feel better, start tapering again as you were.

[lex1989]

I decided today to go back to full dose 3.76 mg Lexapro at 1 pm, it was hellish moving and splitting the dose. 
 

Maybe the fact that I am very sensitive to it , got bad adverse reaction to it since day 1 I took it, beeing ultra rapid metabolizer, all of this made a bad response doing the split.

 

I will stay here stabilizing, hope as soon as possible then considering splitting the Clonazepam.

[Frogie]

@lex1989

 

That sounds like a good idea. You are still in the safe zone to move it all back as you only did this for 4 days.

 

Get stable on it again and we can try splitting the Clonzepam. Hopefully that will bring you some relief.

[Greatful]

@lex1989

That sounds rough.  Hang in there you will adjust again.  I am watching how this goes for you before I split.  

Do you think some of your increase in symptoms could be from the resent cuts?

 

Take it easy, rest and be kind to yourself............

[lex1989]

1 hour ago, Greatful said:

@lex1989

That sounds rough.  Hang in there you will adjust again.  I am watching how this goes for you before I split.  

Do you think some of your increase in symptoms could be from the resent cuts?

 

Take it easy, rest and be kind to yourself............

 

Will do @Greatful, I did (like always..) more than 1 change :

- Started to tapper 0.08 every 4 days

- Skipped a dose of Lexapro by mistake

- Split the dose of Lexapro

- Re-adjusted my sleep time (from very late 4-5 AM in holiday)

- Issues with my fiancée

 

Don't take it for granted that the split was the problem, it just probably put the cherry on top, to many changes at once for my body to handle, back to 1 dose now, wait to stabilize and will resume with the 0.08 mg taper.

[Greatful]

@lex1989  How are you doing?

[lex1989]

21 minutes ago, Greatful said:

@lex1989  How are you doing?

Yesterday seemed that I was recovering / stabilizing, today I was kind of horrible (like losing it, depersonalization and anxiety) haha. Going forward. What can we do?

[Frogie]

Would you think adding like 0.2 mg of Clonazepam during the day would help? As I got in tolerance with it 5 months ago And fast tapper from 0.5 to 0.3, would this still help the daily horrible simptoms? 

I have also Bromazepam and Buspar (I heard it s a benzo with less dependency, if there is such thing) frm previous docs presciptions, that I never took, could I try them instead of Clonazepam? Or adding a new drug will confuse my CNS even more? 
I also have CBD oil, I told you it got me some good relief, but found out that would interefe with Lexapro having the same enzymes almost.

Which one is the lowest bad thing to do in this situation? I am not saying I will take any of it, but I felt like I can t take it anymore these last 2 days and seems to get even worse, just wating to know what to do if I feel I can’t handle it anymore, instead of going to the er, which would be a bad thing to do.

I know probably the best thing to do is wait couple of days until it regulates into the bloodsream and register to the brain, but idk if I can do it.

 

You could try an updose of 0.2 Clonazepam and see if that helps since you did a relatively fast taper on it.

 

I wouldn't suggest adding Bromazepam or Buspar to the mix. You would have to taper off of those also,

 

I don't know much about CBD, other than it is legal in the state I live in. I have not tried it. I found this topic on it here.

 

 

Windows and waves are very common and especially when you change/updose/taper a drug.

 

Windows and Waves Pattern of Stabilization