MirandaN: Severe Escitalopram withdrawal after too fast tapering, is reinstatement an option?

[MirandaN]

Hi everyone!

 

My background is that in the summer of 2020 I was still a normal, functioning person - I enjoyed time with my family and friends, was often jogging in the forest, swimming, doing daily yoga, gardening etc. besides my work. I did not have any special health issues that needed attention or medication. Then I got sleeping problems in Oct 2020 mainly because of stress at work and physical injuries in my back, which prevented me from sleeping well. In Nov 2020 I was prescribed Imovane (zopiclone) for my sleep, but I still slept only 3 hours a night due to pain in my back and was very exhausted. I was diagnosed with fatigue syndrome in Dec 2020. In the middle of Dec 2020 I began having fever and could not sleep at all. I also got symptoms such as breathing problems and a feeling of "burning legs" and I quickly got anxiety due to the frightening symptoms. My normal doctor did not know what to do and sent me on to a psychiatrist, who prescribed Mirtazapin for my sleep, declaring I had general anxiety disorder. I was also advised to take fast walks outdoors for my anxiety. I started out on a high dose (30 mg). The drug did not help me sleep more than 5-6 hours per night at most. My breathing problems got worse and the fever came back. I was extremely fatigued and the walks outdoors made me extremely sick, but the psychiatrist still advised me to exercise "to keep my anxiety down". Eventually the tests for covid-19 finally returned (after more than a week) and I realized I had been sick all along in covid-19. I was now instead prescribed to rest and not exercise. However, my breathing problems got worse and I was eventually hospitalized for a while. Also, after two weeks on Mirtazapine I developed severe tinnitus (which I had not had before in my life) and immense sensitivity to all sounds inlcuding my own internal sounds (like swallowing). 

 

In the beginning of Jan 2021 I got a new doctor (while my doctor was on leave), who took me off Mirtazapine cold turkey ("this is not a problem after just a few weeks"). After 3 days I got severe anxiety. The good news was that my tinnitus disappeared and I was very happy about that part. However, the anxiety was not like anything I had ever before experienced in my life so I returned to the doctor after 5 days. The doctor now diagnosed me with depression and prescribed Sertraline. For my sleep I was prescribed Olanzapine 5 mg. After two days I got back tinnitus, but now much worse than before. After 3 days I got numbness in my arms and strange feelings in my skin. Also after 3 days I felt as if I were "drugged" and outside of my body. After 4 days I got permanent dizziness, that has not got away ever since then. My doctor advised me to "keep pushing through". At least I slept well now and was slowly recovering, but I was extremely foggy and tired all the time. I could hardly chew my food. After 1 week I discovered that my eye sight had changed, I had trouble focusing and I had got very light sensitive. 

 

The symptoms described above did not vanish, so my doctor let me quit olanzapine after a few weeks. Cold turkey was not a problem, she said, because you have only taken it for a few weeks. After 4 days of stopping olanzapine the dizziness got much worse and I felt numbness in my face and my scalp in addition to all the other problems. The doctor explained that it was impossible to be related to olanzapine. Another doctor examined me and declared that the dizziness and eye problems came from taking Sertraline. He decided that I was to immediately quit Sertraline cold turkey. After a few days I got really sick - more dizzy, paresthesia etc. The doctor explained that it was impossible to be due to taking the prescribed medications. Instead the doctor suggested that I suffered from post covid symptoms. 

 

For two months I was taken on and off olanzapine a few times by different doctors. For example one doctor thought it was a great sleep aid medication to take, while another thought I should quit because it was not suitable for someone with my problems. Every time I quit I would feel great for two days and then develop severe anxiety, paresthesia, chills, insomnia and severe dizziness. 

 

I was eventually referred to a doctor specialized in post covid symptoms (neurologist), who made a very thorough examination. But she declared that my symptoms were not at all typical of post covid. She instead suggested that my symptoms were due to fatigue and anxiety problems, but also said that she was not an expert on this. She had not idea whether my symptoms could be caused by medication and did not comment on that. 

 

My normal doctor was now back from his leave and said that he belived all my symptoms to be related to fatigue. He prescribed Escitalopram and I started taking it on 30 March 2021. At the same time I took olanzapine for another two weeks. I felt relatively OK on 5 mg escitalopram, although I had some side effects with cramps, insomnia and tight jaws. After two weeks I was taken off olanzapine and at the same time the Escitalopram dose was increased to 10 mg (which according to my doctor is the lowest therapeutic dose). My anxiety returned with vengeance, the dizziness got much worse and I felt thoroughly sick. This lasted for a couple of weeks. I got some new side effect: hand tremor, different parts of the body would shake involuntarily when I wanted to sleep, my eyes did not function properly anymore (extremely hard to focus), very light sensitive and the colours were all "wrong" (a yellowish kind of colour). So my doctor decided to up the dose to 15 mg, because in his experience this would help. However, it did not. I felt more foggy, the tremor in my hands was so bad I could not hold a fork, I was extremely dizzy and barely managed going to the bathroom - and I had horrible anxiety. After 3 weeks the dose was decreased to 10 mg and I felt somewhat better. My doctor advised me to stay on this dose for at least 6 weeks, but after a couple of weeks I decrease my dose to 7.5 mg and I felt even better. However, "better" is a relative term - I still had permanent dizziness, light sensitiveness, eye problems, tinnitus, tremor and involuntary shakes. But the anxiety was much better, which my doctor thought was very strange. Also, I could take walks and enjoy a little bit of things in my daily life again. My doctor now belived that I am very sensitive to all kinds of medication and we agreed to try to stop taking escitalopram. However, when going down to 5 mg I developed severe physical withdrawal symptoms - paresthesia, chills, headaches, worse eye problems, worse tinnitus, and severe dizziness. According to the guidelines my doctor was following, withdrawal only lasts for 1-2 weeks (at most 6 weeks). I got a new doctor, because my previous doctor quit his job. My new doctor told me that it was obvious the medication never gave me any positive effects, which I agreed on. So I stopped the medication from 5 mg and after two days experienced extreme symptoms. I was entirely incapable of anything at all for weeks. My family was and is taking care of me. 

 

Now it has been more than 6 weeks. To be specific it has been 9 weeks and 2 days. My doctor tells me it is impossible to have withdrawal symptoms after 6 weeks so I really feel I am on my own here. I strongly belive I have been having withdrawal symptoms and side effects all along. Being fatigued (and also covid-19) has probably made my whole system more sensitive to all kinds of medication in the first place. I have now finally found this great forum. Unfortunately, a bit late. 

 

My withdrawal symptoms are the following: Constant dizziness (like being on a rocking boat), cramps in the scalp, pressure over the temples (which I associate with cramps in the head muscles), paresthesia (numbness/tingling) in my face, scalp, hands and feet, eye problems (extremely sensitive to lights, difficulties with focusing, floaters), feeling foggy in my head, memory problems, extreme fatigue, severe tinnitus, feeling "swollen" in my body and limbs and ears, occasional "brain zap" (although this symptom has got much better lately). Also after I quit Escitalopram I cannot eat anything with sugar, I cannot drink coffee or tea, because these all make me much more sich within minutes. A few times a week I also experience bouts of anxiety, but they usually last for only around 30 minutes at a time. My main problems are the physical symptoms. I do feel rather worried about my physical symptoms, which is understandable. Will they pass? Did I "destroy" my nervous system by quitting from 5 mg to 0 mg? I realize that my nervous system is over-sensitized now. 

 

Since my withdrawal symptoms are still severe I wonder if I should reinstate medication? My doctor suggests taking 5 mg again (although he does not acknowledge that I should experience these symptoms at all after 6 weeks), but reading through some of the information in this forum makes me believe that 5 mg may be much too high for me. Also, I understand from your information that after 1 month of quitting (I am currently at more than 9 weeks after quitting) there are no guarantees that my system will react well to reinstatement. I also understand from the information here that reinstatement may even make me more sick. But I also understand that there IS a chance that I might feel somewhat better with reinstatement at a low dose. 

 

To sum things up, I would happily receive some experienced thoughts about different options in my situation. My days are extremely limited right now and I am entirely taken care of by my family. I manage some meditation, qigong breathing exercises, a short outdoor walk per day and making my own breakfast - that is more or less all due to the physical withdrawal symptoms. If I want to attempt a reinstatement - how much and how should I do it? Is it the same drug (escitalopram) or should I try to get citalopram instead and why so? 

 

Many thanks in advance! I am so glad I eventually found this forum!

[getofflex]

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.  You have come to the right place.  I'm sorry you have been on such a merry go round.  Many doctors tend to over rely on drugs to treat people, and end up causing a lot of problems for many people.  

 

Thank you for providing a clear and concise drug signature.  I take it you are still on the zopiclone 3.75 mg, and nothing else? If so, please don't make any changes to this drug, and keep taking it as you have been regularly and consistently. 

 

Here is some information about how these drugs actually work.   This explains why we get symptoms from going off of these medications, and why it's so important to taper so slowly and carefully, and be very cautious about changing our doses: 

 

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

 

Windows and Waves Pattern of Stabilization

 

 

Also, as we are recovering, we suggest keeping things slow, simple, and stable. 

 

Keep it Simple, Slow, and Stable

 

Considerations About Stability - Stop Jumping Around

 

 

Here are some techniques to cope with symptoms: 

 

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

 

Finally, 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, you have only been off the Lexapro for 2 months, so you still have a chance of being helped by reinstatement.  If you want to you could try to reinstate to 0.5 mg Lexapro, and see if this helps to lessen your symptoms.  It is best to reinstate to the same drug you recently got off of.  

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

I would suggest that you make or buy the liquid, as it will be easy to get a precise dose using a syringe.  This link will explain more about the practical ways of how to do this: 

 

Tips for Dosing and Tapering Lexapro

 

It will take a minimum of a week to feel the effects of this.  It may take a month or even 2 for the reinstatement to fully settle in your system.  Stay on this reinstatement for a long time, unless you have an immediate severe reaction to the reinstatement.  After all the various drugs you have gone on and come off of, your system desperately needs stability, which means staying on the same drugs, at the same dose, for a long time, so that your nervous system can adjust, and find homeostasis.  Please be very careful to take the precise dose, at the same time each day.  Don't miss or skip doses.  Don't increase or decrease it, until and unless advised by a staff member here.  

 

I suspect you may also be experiencing withdrawal from going off the other meds as well in 2021 (mirtazapine, sertraline, olanzapine). So the reinstatement may not take all your symptoms away, but it will hopefully help to reduce them.  

 

If it were me, and a doctor told me again to go back on any psych meds, I would refuse to do it.  Realize that it's your body, and you have every right to make your own choices about what goes in your body.  The doctor doesn't have to experience the pain like you do.  Unfortunately, most doctors have no idea of the consequences of what happens to their patients when they casually put their patients on drugs, and take them off drugs.  

 

I've given you quite a bit of information here.  Please read through it, and mull it over, and we will take it from there. In the meantime, take care of yourself, and take heart.  We in this forum have been through this, and we understand first hand the pain and discomfort you are going through.  Please know that the brain is amazing in it's healing abilities.  It takes time, but healing can and will happen.   Please let us know how you are doing.  

Edited October 2, 2021 by getofflex

[getofflex]

You might find this video interesting:  

 

Frustrated by the Dismissive and Invalidating Attitude of Your Doctor

[MirandaN]

Thanks a lot for your reply!

 

Yes, I am currently still taking 3.75 mg zopiclone. I plan to stay on this dose for a while, although my doctor told me it is possible to quit entirely within a few weeks. I have realized he doesn't have a clue what he is doing. I am also taking 5 mg melatonin every night, which really helps a lot for sleep. I have now added that in my signature. I sleep around 6-7 hours, unless my back pain prevents me from sleeping. Also, I already take the magnesium bisglycinat and fish oil. 

 

I am considering the escitalopram liquid part you suggested. I am not sure the liquid form will work for me. I realized I forgot to mention in my narrative that I tried the liquid (name: Cipralex) for 6 days in July. I had been on 7.5 mg escitalopram tablets (name: Escitalopram Krka) for a few weeks and felt relatively OK. After seeing my doctor, who agreed I should continue taper down, I requested the liquid form to make things easier. So I switched to 7 drops (=7 mg), but got terrible symptoms, especially terrible brain zaps in my head that prevented me from sleeping. So after 6 days I switched back to the tablets. Now after 9 weeks off the drug I rarely have any brain zaps anymore, so I am concerned they will return if I take the liquid. Do you have any thoughts on this? I am still not sure what happened there in July. I think Cipralex is the only liquid form of escitalopram available in my country. Would you say it is very difficult to weigh out 0.5 mg escitalopram from tablets?

 

 I am also not sure about drug reinstatement vs. "hold on as it is". My current situation is really debilitating, but some small things have changed for the better. For example the colours are more "real" and not as "yellowish" anymore, which I am thankful for. It is very beautiful to see the coloured leaves on the trees in autumn. Also, I feel slightly less "drugged" and slightly less "outside of my body", although it is still really bad. Also, as mentioned, the brain zaps only happen rarely now. I am very afraid all this will change for the worse again if I take 0.5 mg escitalopram. I suppose 0.5 mg escitalopram still blocks a fairly large amount of receptors? Any thoughts on this?    

 

Thanks again for sharing your experience and knowledge. 

[MirandaN]

Hi again, 

So I double checked and the only liquid form available in my country is Lundbeck's Cipralex (20 mg/ml), which is the same liquid I tried in July. So 1 drop is equal to 1 mg escitalopram according to the medicin description. How would I go about to achieve 0.5 mg? What kind of syringe should I use. Would it be easier with cutting tablets? This all feels very difficult. Also, I am afraid of adverse reactions. How would I know if I got an adverse reaction and not another wave?

 

 

[MirandaN]

OK, I have done some more research now and asked around a little bit. It seems the best way is to dissolve a 5 mg tablet in 100 ml water and then extract 10 ml (to achieve 0.5 mg), since we do not have the other liquid options in my country that you do in the US. The difficult thing will be to have the tablet dissolve evenly in the water. Also, later on I will need to increase the total amount of water in order to be able to accurately extract the right dose, since the available syringes here only come in 1 ml and 5 ml. Do you foresee any other difficulties with this way of doing it?  

 

Also, I found out that some people do react negatively when switching from tablets to the liquid (as I did in July) so I am not sure the liquid would have been a good idea anyway. 

[MirandaN]

@getofflexHi again. I am now having another bad wave with twitching in the muscles of the head, cramps, really stiff arm/leg/back muscles and joints (I feel like I am a hard rubber tire), heavy head, severe tinnitus, bad sleep, very dizzy, very worried and extremely sad about all these symptoms. So I am really considering the reinstatement option. I am only afraid that all the really bad side effects of Escitalopram will become worse/return too if I reinstate - such as not seeing real colours (instead everything becomes "yellowish" just as in an old photograph), red and dry eyes, feeling extremely "drugged" and looking through the world from an "out of the body" perspective etc. Also, I have not had any brain zaps for a week now and before that only twice in two weeks. I am so afraid all that will return if I reinstate. What is your experience with this? If I do not get better from the reinstatement (or even get worse), should I stop again? How long should I wait before I stop again if it gets worse? I am really concerned about this...

 

I still have another 2 days to make up my mind, since I am waiting for the equipment I have ordered to arrive (equipment to be able to accurately dissolve tablets and extract 0.5 mg escitalopram, as mentioned above I see no other way of doing this). I am also wondering if it would be wise to reinstate an even smaller dose, such as for example 0.25 mg escitalopram. Would that be even less severe on my nervous system? What do you think? I am really SO sensitive now to everything - so no sugar, no coffee or tea, no gluten, no lactose etc. I could eat all those things before. 

 

[getofflex]

On 10/3/2021 at 5:49 AM, MirandaN said:

Yes, I am currently still taking 3.75 mg zopiclone. I plan to stay on this dose for a while, although my doctor told me it is possible to quit entirely within a few weeks

Doctors are notorious for giving bad advice like this. I strongly suggest you don't do this.  You would run a significant risk of worsening your situation.  

 

On 10/3/2021 at 5:49 AM, MirandaN said:

I have realized he doesn't have a clue what he is doing

I agree! 

 

On 10/3/2021 at 5:49 AM, MirandaN said:

I had been on 7.5 mg escitalopram tablets (name: Escitalopram Krka) for a few weeks and felt relatively OK. After seeing my doctor, who agreed I should continue taper down, I requested the liquid form to make things easier. So I switched to 7 drops (=7 mg), but got terrible symptoms, especially terrible brain zaps in my head that prevented me from sleeping. So after 6 days I switched back to the tablets.

But your symptoms may have been from dropping the dose, or from switching suddenly to liquid.  You made 2 drug changes all at once.  I doubt that your symptoms were causes by the fact that it was the liquid rather than the tablet.  However, you can also taper using tablets, if you wish.  The link above on dosing and tapering Lexapro will tell you how to do that.  We also suggest when people go from tablet to liquid, they do a gradual crossover for a month from the table to the liquid. 

 

On 10/3/2021 at 5:49 AM, MirandaN said:

I am also not sure about drug reinstatement vs. "hold on as it is". My current situation is really debilitating, but some small things have changed for the better. For example the colours are more "real" and not as "yellowish" anymore, which I am thankful for. It is very beautiful to see the coloured leaves on the trees in autumn. Also, I feel slightly less "drugged" and slightly less "outside of my body", although it is still really bad. Also, as mentioned, the brain zaps only happen rarely now. I am very afraid all this will change for the worse again if I take 0.5 mg escitalopram. I suppose 0.5 mg escitalopram still blocks a fairly large amount of receptors? Any thoughts on this?    

It is really great that you are seeing some improvements!  If you can tolerate the symptoms, then by all means, don't reinstate.  Yes, there is always a risk with reinstatement. The longer it is between the time you went off the drug, and the time you reinstate, the greater the risk.  

 

 

[getofflex]

On 10/3/2021 at 3:16 PM, MirandaN said:

How would I go about to achieve 0.5 mg? What kind of syringe should I use.

Get 1 ml syringes.  They are available on amazon.com.  Measure out 0.5 ml of the liquid in the syringe.  Of course, remove and dispose of the needle before you do this. 

 

On 10/3/2021 at 3:16 PM, MirandaN said:

Would it be easier with cutting tablets? This all feels very difficult.

It will be easy if you use the liquid, especially since it is 1 mg/1 ml.  That is what I've been doing.  

 

On 10/3/2021 at 5:49 AM, MirandaN said:

So I switched to 7 drops (=7 mg),

Please say mg instead of drops, thanks.  The word drops can be confusing and vague. 

 

On 10/4/2021 at 5:46 AM, MirandaN said:

It seems the best way is to dissolve a 5 mg tablet in 100 ml water and then extract 10 ml (to achieve 0.5 mg), since we do not have the other liquid options in my country that you do in the US.

Personally, I would use the commercial liquid.  You don't have to worry about making a mistake, and the homemade liquid only lasts a short time.  I don't believe there is anything wrong with liquid Cipralex, I think it was the fact that you reduced your dose and switched from tablet to liquid all at once that gave you symptoms.  

 

 

[getofflex]

23 hours ago, MirandaN said:

So I am really considering the reinstatement option. I am only afraid that all the really bad side effects of Escitalopram will become worse/return too if I reinstate

The trick is to choose the lesser of 2 evils.  You had an adverse reaction to the higher doses of Lexapro, such as 10 mg and 7.5 mg.  Usually people can tolerate a very low dose like 0.5 or 0.25, even if they had an adverse reaction to the higher doses.  Yes, I think trying a reinstatement of 0.25 would be good just to test the waters.  It would be less severe on the nervous system.  If that goes OK, you can always increase the dose slightly.  However, give the 0.25 mg dose some time to work.  Stay in close touch here, so we can monitor how you are doing.  Don't jump off, or increase the dose, until you run by us first.  

[MirandaN]

@getofflex

I have now started reinstatement of 0.25 mg escitalopram today Thursday 7 Oct 2021. I dissolved a 5 mg tablet in 200 ml of saline solution. It still took a few hours for the tablet to dissolve properly and I had to stir quite a lot. There were still some granules floating around, but I stirred before extracting 10 ml (which should equal 0.25 mg). I did my best, hopefully it is good enough. Now I wait. 

 

I really hope the bad side effects will not return with reinstatement (such as anxiety, "wrong colours" eye problems, feeling "drugged", brain zaps etc.). I have really enjoyed seeing my kid and my husband in "real colours" lately and also not through "drugged eyes". I took a short walk in the forest before attempting the reinstatement in order to see the beautiful colours of autumn. At least I know these side effects are (hopefully) reversible (again) should they happen again. 

 

I guess an adverse reaction, if it happens, will happen within hours, right?

 

Needless to say, I am worried. But I can only wait now. 

[getofflex]

 Yes I would think it would happen with an hours or even a day or two.  Most people who have adverse reactions to doses of Lexapro like 5 mg don’t have a bad reaction to very low dose is like what your on now. I don’t think it’s likely that you will have an adverse reaction to 0.25 mg.

 

Please keep in mind that you have come off of many other psych meds so you may still have some symptoms from that as well.  
 

I see you made a recent significant reduction to your dosage of zoplicone. Did you have any symptoms after this recent dose reduction?

Edited October 7, 2021 by getofflex

[MirandaN]

1 hour ago, getofflex said:

Most people who have adverse reactions to doses of Lexapro like 5 mg don’t have a bad reaction to very low dose is like what your on now. I don’t think it’s likely that you will have an adverse reaction to 0.25 mg.

OK, let's hope so, but I stay observant on how I feel. I never really qualified as "most people" from the start, since I never ever got any beneficial effect from any of these drugs. 

 

1 hour ago, getofflex said:

I see you made a recent significant reduction to your dosage of zoplicone. Did you have any symptoms after this recent dose reduction?

I am not sure. Should such symptoms be distinguishable from the other symptoms? If I have symptoms from zopiclone withdrawal, they are not very different from the ones I have from escitalopram withdrawal. Perhaps the mini-spasms in the head may come solely from reduction of zopiclone. Otherwise, I cannot distinguish any different symptoms than I already had, although the intensity of the withdrawal symptoms has varied a lot recently (mostly increased). As discussed, I will stay on 3.75 mg zopiclone for now.   

[getofflex]

After you reduced your dose of zoplicone did you notice an uptick in symptoms?  That is how you would know.  

[MirandaN]

Well, if we are talking about the same symptoms but intensified, then yes I did notice that. However, I kept a daily log as from 28 July (when I ended escitalopram) and it has been really rough all along with only brief windows. During this period I also took my second covid-19 vaccine (and felt really ill for a couple of weeks) as well as caught a bad cold. All these things may have affected the escitalopram withdrawal symptoms negatively (at least that is how I feel). Personally, I attribute most of my symptoms to the escitalopram withdrawal, but you are the experienced one here. So I suppose the worsening of symptoms could be partly attributable to the reduction of zopiclone. Does that, in your opinion, change anything significantly about what I am currently attempting? I highly appreciate your thoughts! My plan is otherwise to keep it at 0.25 mg escitalopram as well as keep the 3.75 mg zopiclone until it, hopefully, feels a bit better. 

[getofflex]

You’ve had quite a lot to deal with! Sorry you’ve had to deal with the other issues as well.
 

I don’t think it changes anything about what you are currently attempting as far as doing the reinstatement of Lexapro and staying on the zoplicone. However it may mean that even with the right reinstatement dose of Lexapro you may still have some significant symptoms from the effects of the other drug changes.   But let’s wait and see what happens.  No matter what’s causing what as long as you stay off of these drugs and taper slowly you should gradually begin to feel better as time goes on.

Edited October 7, 2021 by getofflex

[MirandaN]

@getofflexThanks for your kind reply! I'll let you know if anything interesting happens. 

[MirandaN]

@getofflexHi, I am worried now. After two reinstatement doses (0.25 mg) I do feel some difference, i.e. the following: 

- some kind of chemically induced energy although I am in fact really tired (it feels as if one has had too many cups of coffee too late in the evening)

- great difficulties to fall asleep last night (I am not sure I slept at all, which has not happened since I stopped the drug in July, because I have been super tired  all the time - not even after I reduced the zopiclone dose did I fail to sleep)

- increased overall anxiety and feeling of hopelessness (will I ever get well, play with my kid again? etc.)

 

If this continues (i.e. no sleep) I am afraid I will crash again. I have not noticed any positive difference yet. Any thoughts? The chemically induced energy scares me and I recognize it from when I took escitalopram in April-July. My body told me it was SO tired, but I could not rest. Not good. Not even my qigong breathing exercises helped last night - and they always did. 

 

 

[getofflex]

@MirandaNIf I were you, I would quit the reinstatement.   It sounds like your system is just not going to tolerate any more Lexapro.  What time did you take the 0.25 mg Lexapro?   At one point you said you were getting 6-7 hours of sleep. How was your sleep before you reinstated the 0.25 mg Lexapro?  

 

If you want, you may wish to try reinstating a very small amount of Lexapro's milder cousin, citalopram.  It's up to you. 

 

The other option is to tough it out, and wait. In time, your brain and body will very gradually heal. Consider trying some magnesium and omega 3 supplements (fish oil or flax seed oil). 

 

I don't suggest you make any changes to your zopiclone at this time.  You need as much stability as you can get, after the many drugs you have gone off and on in the recent past.  

 

Edited October 8, 2021 by getofflex

[MirandaN]

Yesterday I took the dose at 5 pm, but today I switched to taking it at 1.30 pm (I realized it would be better with an earlier time). Right now it is 9.30 pm and I am tired in my body but SO awake in my head. Not good. Will try some qigong to calm the system. It feels as if I had lots and lots of cups of coffee. Damn!!! I really hoped I could do the reinstatement on this tiny dose. The WDS are really so hard to endure. 

 

Citalopram - I need to ask my doctor about that. Cannot do that until next week and may not get an appointment any time soon. Also, I will need to convince him that I have withdrawal symptoms (which he doesn't seem to believe). 

 

 

[MirandaN]

45 minutes ago, getofflex said:

At one point you said you were getting 6-7 hours of sleep. How was your sleep before you reinstated the 0.25 mg Lexapro?  

That has been the case before the reinstatement, i.e. usually 6-7 hours, although sometimes a bit less, especially because of back and knee pain. It has of course not been very good quality sleep (a lot of waking up because of the tinnitus, back pain, nightmares etc.) but still something. And I always had to rest after lunch for around 2 hours because of fatigue. Today I got no rest after lunch - felt artificially awake. So something definitely happened with this tiny dose. 

[MirandaN]

51 minutes ago, getofflex said:

The other option is to tough it out, and wait. In time, your brain and body will very gradually heal. Consider trying some magnesium and omega 3 supplements (fish oil or flax seed oil). 

Yes, I take these supplements already since August (fish oil I have taken for years). 

[Altostrata]

On 10/3/2021 at 3:49 AM, MirandaN said:

I sleep around 6-7 hours, unless my back pain prevents me from sleeping.

 

This and other improvements you reported 5 days ago indicate your nervous system was settling down from drug changes.

 

What did you intend to treat with reinstatement of Lexapro?

[MirandaN]

9 minutes ago, Altostrata said:

What did you intend to treat with reinstatement of Lexapro?

I hoped to get some reduced symptoms: I have severe constant dizziness (like being on a rocking boat in a storm), muscle pain, pressure over my head (which I attribute to cramps in head muscles), numbness/paresthesia in face, scalp, hands, feet and shins, blurry vision, difficulties to focus with my eyes, very light sensitive, migraines, headaches, severe tinnitus, stuffed nose, extreme fatigue, twitching in my head, twitching of other muscles in my body, muscles feel like hard rubber (difficult to move), memory problems, swollen hands and feet etc. 

 

While I still took escitalopram (i.e. before I stopped in the end of July) I "only" had the dizziness (not as severe as now), tinnitus (not as severe as now), stuffed nose and muscle pain - but it was all not as severe as now. And yes - I also had the "wrong colours" side effect (yellowish) and felt more like I was "outside of my body". 

 

I agree I have had some minor improvements lately, although the general situation was still very debilitating. 

[Altostrata]

You've been on and off drugs for a year. When did the dizziness start?

[MirandaN]

@AltostrataThe dizziness started on the 15th of January 2021 at around 6 pm (yes, it was rather precise!). I had just started taking sertraline and olanzapine for 3-4 days when it happened, so I very much suspect those drugs. After that specific time I have been constantly dizzy (day and night, regardless of what I do), but the dizziness has become more severe anytime I have quit drugs (any drugs) and somewhat less severe while on drugs (but always there, unfortunately). So I somehow attribute the dizziness to the system being in constant change. The dizziness is my most severe withdrawal symptom. The first few months I was extremely afraid all the time, since the dizziness never passed. Now I have learnt to partly master my fear most of the time, but the dizziness still affects me a lot, especially at night when I try to sleep. Do you have any experience with this kind of dizziness?

 

One of the reasons I started escitalopram was because my doctor told me dizziness can be cured by taking SSRI. While I very much suspected the drugs, the doctors kept telling me it was unlikely so I decided to give it a shot. Also, I was very fatigued at that time so I was not in a condition to think things through about starting escitalopram. Now escitalopram did not work for me for many reasons (side effects, se above) and it never helped with the dizziness either (although the dizziness was somewhat less severe when I was on 7.5 mg). 

[Heath]

MirandaN welcome to SA! you are in the rt place! I just stopped by to encourage you and you are not alone. I am sorry you are in a bad place rt now.  That covid and this at same time woo. I can’t imagine. I too started out with a back injury and was given these drugs. I have had many of the symptoms that you speak of. 
About 3 or 4 months after starting lexapro from being swapped from a different one I started having the brain fog dizziness, sensitive to other medications, one time I about passed out, I have since learned it happens every year in spring to fall allergy season for me. The lower in dose I go it gets less every year. Along with this I have really dry sinuses dry mouth, dry eyes. I had fear when it first started. 
 

the withdrawal of feeling wired up but tired physically I have had that too! Actually a few months ago. It usually happens when I reduce dose and goes away in about a week. 
 

ive had several of the others you mentioned too. Once I figured out these were side effects and withdrawals I just kinda let them be. I do hate them it’s frustrating but I do feel a little calmer knowing what they are. And they will go away!  You will get better ! the moderators will guide you along 
 

[Altostrata]

You went cold-turkey off 3 weeks of 30mg mirtazapine January 7.

 

On 10/2/2021 at 4:54 AM, MirandaN said:

After 3 days I got severe anxiety. The good news was that my tinnitus disappeared and I was very happy about that part. However, the anxiety was not like anything I had ever before experienced in my life so I returned to the doctor after 5 days.

 

You had mirtazapine withdrawal.

 

How did you feel when you added sertraline? Why was olanzapine added?

 

 

[MirandaN]

9 hours ago, Altostrata said:

You had mirtazapine withdrawal.

 

How did you feel when you added sertraline? Why was olanzapine added?

You attribute the dizziness to mirtazapine withdrawal? My own feeling is that the dizziness was caused by the new drugs I had started taking - sertraline and olanzapine. After two days on those drugs my tinnitus returned (that had previously disappeared after discontinuing mirtazapine) and after 3 days I felt "drugged" and "not in my body". On the 4th day I got the dizziness. But that is of course just my own interpretation. 

 

Will the dizziness eventually pass and should I expect it to stick around for many years? 

 

I was prescribed olanzapine to help with sleep, because I could not sleep at all due to mirtazapine withdrawal. I remember I asked the doctor "Will I become psychotic if I take an anti-psychotic medicine?" but she assured me people get olanzapine for sleep issues  and that I should not fear getting a psychosis. Well, she did not lie - I have not had a psychosis and it seems many people do get these medicines for sleep issues etc. However, I wish she would have told me the rest too - all that would happen instead. 

[MirandaN]

9 hours ago, Heath said:

MirandaN welcome to SA! you are in the rt place! I just stopped by to encourage you and you are not alone.

Thank you @Heath, you are very kind! 

[MirandaN]

Last night I could not sleep despite doing qigong for 40 minutes and getting head massage from my husband. None of the things that previously (before the reinstatement) have worked fine worked now. My anxiety spiked and it was getting very late. I still felt like I had had many cups of coffee. So I decided to take 25 mg of Propiomazine for one night (along with my usual 5 mg melatonin and 3.75 mg zopiclone). We also fetched the cat and let her purr in my bed for a while. And suddenly I got tired enough to sleep. So I have slept (most likely with the help of Propiomazine). 

 

After waking up today I still feel more chemically energized than before. I attribute that to the reinstatement of escitalopram. 

 

@getofflexI will not continue with the reinstatement. It does not seem to work for me. 

[MirandaN]

@getofflex But now I become very hesitant. When I did my usual morning exercises (very simple exercises), I noticed my muscles do not hurt as much as before. And the muscles do not feel like hard rubber either, but instead more "light" as they should feel. And since I do not feel as fatigued (because of the "chemical energy") I could actually focus better on the movements. On the downside are of course the increased anxiety and difficulty sleeping. But what if the increased anxiety and trouble sleeping will pass? So difficult to know what is the best decision for my body. 

 

Sorry to trouble you with my thoughts. I know it is my own decision to make. I just wanted to share my thoughts a bit, I hope that is ok. I know I must not jump on and off things, so I need to decide whether to continue with the reinstatement or not. 

[MirandaN]

@getofflexJust to let you know, I took the reinstatement dose (0.25 mg) again today. So it's the third day. If it continues to be bad (anxiety and not able to sleep) I will discontinue tomorrow. However, I noticed some more things that may be for the better - a little less tingling in my head and less numbness in my feet. So something is happening. 

[getofflex]

23 minutes ago, MirandaN said:

@getofflexJust to let you know, I took the reinstatement dose (0.25 mg) again today. So it's the third day. If it continues to be bad (anxiety and not able to sleep) I will discontinue tomorrow. However, I noticed some more things that may be for the better - a little less tingling in my head and less numbness in my feet. So something is happening. 

I would do the same if it were me.  Sleep is important.  I'm glad that some things have improved.  

[Altostrata]

11 hours ago, MirandaN said:

You attribute the dizziness to mirtazapine withdrawal? My own feeling is that the dizziness was caused by the new drugs I had started taking - sertraline and olanzapine. After two days on those drugs my tinnitus returned (that had previously disappeared after discontinuing mirtazapine) and after 3 days I felt "drugged" and "not in my body". On the 4th day I got the dizziness.

 

11 hours ago, MirandaN said:

I was prescribed olanzapine to help with sleep, because I could not sleep at all due to mirtazapine withdrawal.

 

You reported withdrawal symptoms before you started taking sertraline and olanzapine. Withdrawal symptoms can continue even though you added other drugs, or you might have had adverse effects from the new drugs. But dizziness is a very common antidepressant withdrawal symptom.

 

Your doctor couldn't tell you anything about withdrawal because they don't know much about it.

 

If I were you, I would stop the escitalopram. It's more likely you have mirtazapine withdrawal. I would get a liquid preparation of mirtazapine, if available by prescription, and take 1mg to start. If a prescription is not available, this topic explains how to make one yourself Tips for tapering off mirtazapine (Remeron)

 

Please let us know how you're doing.

[MirandaN]

9 minutes ago, Altostrata said:

If I were you, I would stop the escitalopram. It's more likely you have mirtazapine withdrawal. I would get a liquid preparation of mirtazapine, if available by prescription, and take 1mg to start. If a prescription is not available, this topic explains how to make one yourself Tips for tapering off mirtazapine (Remeron)

 

Please let us know how you're doing.

Actually I would like to try the reinstatement of escitalopram for another day or so instead of rushing off into something new. After all, some of my current withdrawal symptoms are from quitting escitalopram. Something is happening for the better. My back and neck muscles suddenly do not feel like hard rubber anymore, but somewhat lighter and more flexible. My other muscles do not hurt as much as before. My nose is not as stuffed as before so I can smell things a bit more. Still very much awake though, but maybe that will pass. 

 

As for mirtazapine - I am not sure I want to jump on that drug again after 9 months off. Also, I thought you cannot reinstate after such a long time. We cannot know for sure taking that drug again will help my dizziness. And it does not explain why my dizziness has been slightly better while on escitalopram and much worse when stopping. As I understand, serotonin affects the balance system. If I can keep things stable for a longer while, the dizziness might eventually get better. Don't you think so?