savedflower: currently tapering Lexapro - intrusive thoughts, OCD

[savedflower]

First off, I am so grateful for this site. I don't know if I would have had the strength to start the weaning process without this site and all the wonderful information and success stories. It has truly made such a difference in my recovery. I wanted to write a post as soon as I found this site but I waited until I was farther into the withdrawal process.

 

I was diagnosed with Generalized Anxiety Disorder and late onset Obsessive Compulsive Disorder in 2015 at 19 years old, and the anxiety turned my world as I knew it upside down because I'd never dealt with it's level of intensity before. I was suffering badly from OCD obsessions of all kinds including POCD, HOCD, ROCD, and the list goes on. I think it was at it's worst when I had no idea what I was suffering from or why it was happening (seemed to have come out of the blue).

 

I was extremely frightened of my suicidal thoughts, so after a hospital visit, I was started on 5 mg of Celexa and 10 mg of Buspirone at the end of 2015. The antidepressant did help a little with the fear but gave me random panic attacks (something I'd never experienced pre-medication).

 

I switched to Luvox for only a few months because it made me more depressed than before.

 

I switched to Zoloft which did pretty well for a while except for the intense tiredness all day, despite how much I slept, and depression at night. It destroyed my sleep schedule because I would sleep for 14 hours some days to try and get rid of the tiredness and depression.

 

In 2017, my symptoms alleviated a lot when I started going to the gym regularly and I cut the Zoloft cold turkey because I thought I didn't need it anymore and had never heard anything about a withdrawal. After a month, I had some of the worst anxiety and panic I've ever experienced and ended up in the hospital again.

 

After reading about antidepressant withdrawal syndrome, I gradually reinstated my Zoloft back to 75 mg over the next week.

 

I was also given Xanax for the panic and told by my psychiatrist to only take the smallest amount possible, only when I need it badly, and not often.

 

In November 2018, the Zoloft stopped working. I knew because no matter how much I increased the dose (with the help of a psychiatrist), it wouldn't work anything like before and I was experiencing the same withdrawal symptoms that I had when I cut the Zoloft cold turkey.

 

I learned about tachyphylaxis during that time and gradually tapered onto Lexapro at 10 mg. I was hoping to stay there, but had to raise it to 15 mg in the beginning of 2020 because the withdrawal symptoms wouldn't calm down, and I didn't know how to combat them.

 

I was tired of going back and forth from marijuana, to Xanax, to Vistaril (which was giving me strange racing heart symptoms) and using medication to run from the anxiety. I had become apathetic and unemotional, unable to cry or feel as much empathy which was really unusual for me. I remember making excuses about it to stay on my medication by telling myself that I didn't need and couldn't handle "overactive" emotions anyway. 

 

When I found this site, I knew this medication wasn't good for me and I became determined to get off of it even though I was terrified of myself and my anxiety pre-medication.

 

I've been doing the 10% taper every approximately every 4 weeks for the past 9 months and I'm finally at a point (almost 5 mg Thank God) that I never thought I would get to in the past. It has been a huge learning process that has changed my life ultimately for the better and I'm excited to keep going to the end. 

 

I definitely will try and keep this account updated as much as possible as I go, but for anyone who sees this, please know that you are capable of so much more than you could ever imagine.

 

Much Love ❤️

 

 

Edited November 7, 2021 by ChessieCat
added spacing for easier reading

[ChessieCat]

Hello savedflower and welcome to SA,

 

There are many members of SA who had no idea that psychiatric drugs could/would cause withdrawal symptoms, including me.  However, when I think back, I did get brain zaps when I missed a dose (one I missed 2) but I didn't even consider that reducing my Pristiq 100mg to 50mg would cause any issues.  Sorry, just a bit of musing going on.

 

Thank you for creating your drug signature.

 

I am really pleased to see that you have been doing a 10% taper about every 4 weeks.  Please be aware that as your dose gets lower you might have to reduce by less and/or hold for longer.  If this happens you might consider changing over to the

 

thebrassmonkey-slide-method-of-micro-tapering

 

This topic explains why: 

 

why-taper-sert-transporter-occupancy-studies-show-importance-of-gradual-change-in-plasma-concentration

 

 

Post #1 of this topic has printable and computer versions of Dr Joseph Glenmullen's Withdrawal Symptom Checklist:

 

dr-joseph-glenmullens-withdrawal-symptom-checklist

 

Q:  Is there any information in particular that you would like us to provide?

 

Post #1 of this topic has links to some helpful topics.  And there is a link to the Tips for Tapering Lexapro if you need to know how to get non standard doses. 

 

important-topics-in-the-tapering-forum-and-faq

 

Please update your drug signature whenever you make a change so that it remains current.  This allows the staff to see your drug history at a glance and not have to read back through your posts to get the information.  The following link goes directly to it:

 

Account Settings – Create or Edit a signature
 

This is your Introduction topic.  Each member has only one.  Your Introduction topic is the best place to ask questions specific to your own situation and where you can journal your progress.  This keeps your history in one place and means that you do not have to repeat your story.

 

There are many existing topics on SA where members discuss their symptoms (these are general topics; please remember to post in your Introduction topic as explained above, staff regularly check the Introductions forum but because the site is very busy with a lot of members, they may not see posts made elsewhere).  You can try using the site search function.  Or you can use an internet search engine and add site:survivingantidepressants.org  to the search term.

[ChessieCat]

39 minutes ago, savedflower said:

 

I was diagnosed with Generalized Anxiety Disorder and late onset Obsessive Compulsive Disorder in 2015 at 19 years old, and the anxiety turned my world as I knew it upside down because I'd never dealt with it's level of intensity before. I was suffering badly from OCD obsessions of all kinds including POCD, HOCD, ROCD, and the list goes on. I think it was at it's worst when I had no idea what I was suffering from or why it was happening (seemed to have come out of the blue).

 

 

One thing that is very important to understand is that when we go off our psychiatric drug we may still experience the issues that we initially went on the drug for.

 

If you haven't or aren't already doing so, it is generally recommended to see a counsellor to help you to cope with the original issues.  You might also ask that they teach you general life coping skills too.  This seems to be especially helpful for members who started a psychiatric drug as a younger person and before they ventured out into the big wide world!

 

This is SA's topic:

 

Non-drug techniques to cope

[savedflower]

I had some trouble in my weaning journey recently. 2/21/22 I was hit with a train of withdrawal symptoms after reducing to below 5 mg. I don't know the cause exactly if I had foolishly skipped a dose (which could of happened because I was stressed) but the severity of the symptoms made me reinstate 10 mg to stabilize and I started feeling better within the week gradually. But over the course of 2 months, I've been taking the 10 mg every day at the same time and recording it all my symptoms and I've noticed I have some "bad" weeks were my panic and anxiety returns very strong and it feels like the familiar withdrawal symptoms from before but less intense. It will usually come in waves. One week, it'll be gone for the most part and then the next week, it'll come back. I was wondering if it's normal to experience this? Or if the on and off symptoms are just my nervous system stabilizing? I read on the "reinstatement" section that I shouldn't continue weaning for a couple months so I'm on stand-by right now, but I guess because I increased the dose, I had this expectation that my withdrawal symptoms would dissappear or something. 

 

I also wanted to say I recented got a therapist to help me with coping with the original anxiety so thank you for the advice and I'll update my timeline on my profile soon. 

[Altostrata]

Hello, @savedflower Are you female? Do the bad patches coincide with points in your menstrual cycle? Many women experience this.

 

Or, are there triggers for the bad patches? Do you drink alcohol, have an irregular sleep schedule, or take another drug occasionally, such as allergy medication?

[savedflower]

Hi, yes I'm a 25 year old female and my menstrual cycle definitely could have an affect since I've noticed my negative emotions spike around that time when it starts. But I'm not on any allergy medication and I don't drink alcohol because it doesn't agree with me, but my sleep schedule is irregular because I work at night so sometimes I'll sleep through the day.

[Altostrata]

An irregular sleep schedule can affect overall quality of sleep, which can greatly affect your general wellbeing. Is there a way you can keep regular hours?

[savedflower]

Doing an update from the earlier post. I've been on 10 mg of Lexapro since 2/22/2022 trying to restabalize. I take the medication at 8:30 pm every day and record my symptoms. I went back to therapy for my OCD and I got a new job and have been sleeping normal hours.

My intrusive thoughts are stable but I have these very bad somatic panic attacks almost every day, sometimes a couple times a day. (Heart palpitations, painful tingles, breathing shallow, feeling of dying, bowel movement, nausea, and powerful shaking and sometimes crying spells afterwards). Because of these panic attacks, the idea of weaning when I'm not necessarily stable is making me apprehensive even though I want to get back to it.

I've had Zoloft "poop out" on me in the past and cross tapered to Lexapro almost 3 years ago, so I've been considering maybe doing a cross taper to Prozac in an effort to stabilize because I believe that same "poop out" is happening again.

I found the equivalent dosage of Prozac to the dosage of Lexapro on this site (which is 10 mg of Lexapro = 22.2 mg of Prozac) and I've read the "Prozac Switch or "Bridging" with Fluoxetine."

I'm trying to figure out if a cross taper to 22.2 mg of Prozac would be a good idea for me. Any advice would help. Thank you!!

[ChessieCat]

Q:  Are you still taking Ativan?

 

Q:  Are you taking it every day?

 

Q:  Are you taking it once or twice a day?

 

Q:  If you are not taking it every day how often do you take it and when was the last time you took it?

[savedflower]

Thank you for the quick reply,

I only take Ativan is crisis situations:

2/22/2022 I took 1 mg, 2/23 - 0.5 mg, 2/24 - 0.5 mg, 2/25 - 0.25, 2/26 - .125 because of bad WD symptoms after weaning past 5 mg of Lexapro. After that the only time I've ever taken it was 6/17/2022 when I was on vacation and had a horrible panic attack, it was 1 mg of Ativan because I threw up the first dosage of 0.5 mg. 

That week of 2/22 - 2/26 and 6/17 are the only dates I've taken it since it was prescribed in 2/22/2022.

 

I wanted to add, I'm going to make a psychiatrist appointment tomorrow. A month ago, when I brought up the adverse effects to the Lexapro, she said we can either add a drug or increase my dosage. I didn't like those options so I just refilled the Lexapro.

[ChessieCat]

Thank you for answering my question about the Ativan.  I was concerned that it might be the cause of the issue.

 

I have asked the other staff for their assistance.

 

Before taking/changing anything that the psychiatrist recommends, please wait until another staff member has responded.

 

Q:  What was the last dose of Lexapro you took?  Was that 5mg on 30 Jan 2022?  If yes, please add the phrase last dose to your drug signature, or if it was different then add that information please, ie date, last dose ??mg.

 

You reinstated 10mg Lexapro?.  That is a high dose because Lexapro is a very strong drug.  You stopped at 5mg(?) and then started back on 10mg?  When reinstating, SA suggests starting with a small dose (generally the longer you have been off the smaller the reinstatement dose) and then if needed to increase gradually in small increments.

 

Q:  Have you looked up the side effects of Lexapro?  I suggest you do.

 

Q:  Are you taking any other drugs or supplements?

 

When talking to your doctor it is a good idea to be careful of the way you act (try not to get emotional) and how you say things.  It is important to remember that you will need a doctor (not necessarily a psychiatrist) to keep prescribing your drug so that you can taper it carefully.  Examples of the way to word things:  I would like to research that, I would like to try this first.  And of course ask questions; possible side effects, what would be the process to get off if that happens, drug interaction (this is very important if they are suggesting adding a drug), if switching to a different drug ask for the plan of how that will be done.

 

how-to-talk-to-a-doctor-about-tapering-and-withdrawal-what-to-expect

 

[Altostrata]

Hello, @savedflower

 

Please post daily notes of times of day you take your drugs, their dosages, and your symptoms throughout the day. Post 24 hours of notes at a time in this topic, in a simple list format with time of day on the left and notation (symptom or drug and dosage) on the right. This can show if your symptoms are adverse effects from one of your drugs.

[savedflower]

I tried to update the drug signature to better reflect that change. 30 Jan 2022 was the last time I decreased the medication and I was on 5 mg daily until the bad WD symptoms on 2/22/2022 caused me to have extreme panic and consult a psychiatrist. Unfortunately I think my panic drove me to, like you said, follow her advice and reinstate a higher dosage of Lexapro than I should. I also foolishly thought maybe it would take my withdrawal symptoms away quicker or something. 

 

Not yet I think. I found a list of Lexapro symptoms and looked them over just now, thank you. 

 

No other drugs and supplements as of 6/17/2022 to now.

Before 6/17/2022, I was taking flaxseed 1000 mg, Magnesium Gycinate 350 mg, B12 500, Turmeric 900 mg, Zinc Picolinate 50 mg daily. I tried NAC 600 mg for a few weeks too because it used to work wonders with my intrusive thoughts when I was on Zoloft but it gave me horrible migraines this time around so I stopped quickly.

 

Thank you for the attachment I will check that out. I was definitely very emotional when talking to the psychiatrist on 2/22 when she upped my dosage. 

 

[savedflower]

This is yesterday's log and how I format recording my daily symptoms:

 

11/6 Took meds at [8:30 pm] [65]
Woke up at 11:45 am, anxiety upon waking up felt better after 10 min

1:10 panic,

1:30 - 2:03 panic,

2:06 relief,

2:10 panic back,

2:25 relief,

peak of panic 2:30,

crying spells until 2:41,

3 - 4:10 felt better, 
Anxiety returns at 4:52 when leaving the house,

7 pm anxiety about dreamlike state? That's a first, small fluctuations at 8 but anxiety was pretty good after that

 

[65] is the number of pills that should be in the pill bottle after I take that dosage at 8:30 pm, it how I keep track that I'm not accidently skipping dosages or something so I can always go back and count. 

[savedflower]

Also there were some days that I didnt take the medication at 8:30 pm exactly, I will put these below since it might have an effect since I've noticed I'm very sensitive.

 

8/30 Took meds at [11:00 pm]

9/27 Took meds at [10:30 pm]

9/30 Took meds at [9:45 pm]

10/2 Took meds at [9:30 pm]

10/31 Took meds at [9:55 pm]

 

[savedflower]

Oh and these are the symptoms I experience that match the Lexapro Symptoms list online:

 

Abnormal dreams,
decreased sex drive,
yawning,
ringing in the ears, 
decreased concentration,
racing thoughts, 
headache, 
nausea, 
fast or uneven heartbeat,
confusion,
tremors

 

I didn't see anything about panic. But I never had panic attacks until I started antidepressants.. now I've been diagnosed with panic disorder and I've had the worst panic attacks of my life on Lexapro. I don't know if that's unrelated. 

[ChessieCat]

1 hour ago, savedflower said:

30 Jan 2022 was the last time I decreased the medication and I was on 5 mg daily until the bad WD symptoms on 2/22/2022 caused me to have extreme panic and consult a psychiatrist. Unfortunately I think my panic drove me to, like you said, follow her advice and reinstate a higher dosage of Lexapro than I should.

 

Just to clarify the terms we use here at SA:

 

Reinstatement - if you went off the drug completely and then started taking it again.

 

Updose - if you did not go off the drug completely but increased the dose.

[ChessieCat]

1 hour ago, savedflower said:

[65] is the number of pills that should be in the pill bottle after I take that dosage at 8:30 pm, it how I keep track that I'm not accidently skipping dosages or something so I can always go back and count. 

 

You might find an easier/better way to do this.  It is very easy to mis-count the tablets, or even drop one out of the bottle without noticing.

 

tips-to-remember-to-take-your-dose-reminder-ideas

 

[ChessieCat]

1 hour ago, savedflower said:

Also there were some days that I didnt take the medication at 8:30 pm exactly

 

It is important to take you drug at about the same time every day.

[savedflower]

Oh I used the word wrong, sorry. I did updose not reinstate.

 

Thank you for the link.

 

I can be forgetful sometimes so I'm definitely trying to be better at taking it at exactly the same time. Thank you.

[Altostrata]

On 11/7/2022 at 10:52 AM, savedflower said:

11/6 Took meds at [8:30 pm] [65]

 

What meds? Please specify drug and dosage in your daily notes.

 

On 11/7/2022 at 11:04 AM, savedflower said:

8/30 Took meds at [11:00 pm]

9/27 Took meds at [10:30 pm]

9/30 Took meds at [9:45 pm]

10/2 Took meds at [9:30 pm]

10/31 Took meds at [9:55 pm]

 

This is quite a range. Depending on the drugs you're taking, this could be a problem.

[savedflower]

Each day I took Lexapro 10 mg, I'll change it in my notes.

 

[Altostrata]

It is important that you take your drugs on a consistent daily schedule. A variation of an hour or two is too much.

[savedflower]

Hi, so I've been on a consistent schedule for the past month and my panic attacks have stopped. I only have typical daily anxiety. I was wondering if now is an appropriate time to begin weaning again? Of course I'll be going a lot slower this time [because I seem to be very sensitive to change].

 

I have a psychiatrist appointment for the end of December. 

[Heath]

@savedflower Glad the panick attacks have passed!

How is the sleep schedule?

when was the last panic attack , 2 weeks? 

 

You have updosed a good bit, still having panic attacks 5 months later.  And no panic attacks for 2 or 3 weeks. So   I would continue to hold same dose same time daily for a few more months maybe 3 or more and then see how things are. Continue to learn and practice self help for the daily anxiety and any other symptoms during this time. This will help get you ready to taper in the future. 
These are only my thoughts from my experience & research. I am NO dr or moderator. 

[Altostrata]

On 11/27/2022 at 4:39 PM, savedflower said:

I only have typical daily anxiety.

 

Hello, @savedflower, what does this mean?

[savedflower]

To respond, daily anxiety to me is OCD intrusive thoughts that might fluctuate in severity throughout the day, but no panic attacks. 

Update: I stabilized to a point with the 10 mg where basically wasn't experiencing anxiety daily at all. 

On 4/13/23, I switched to liquid and began my taper again. I'm going to do the brass monkey slide but a 1% decrease for 4 weeks and hold for 2 weeks, because I think I'm too sensitive for the 2.5%. I looked through my notes and I think I went too fast and it was inaccurate because I was shaving pills. I think I was in denial about being sensitive to changes and yet wanting it to be over in a year. I plan on taking it slow this time. Thank you so much for the helpful responses.

[Altostrata]

On 4/19/2023 at 6:19 PM, savedflower said:

Update: I stabilized to a point with the 10 mg where basically wasn't experiencing anxiety daily at all. 

 

Good to hear. Stabilized on what?

 

Since what date have you taken 10mg (Lexapro?)? (Please clarify your signature.) You reduced from 10mg (Lexapro?) to 9.60mg (4% reduction) on 4/13/23? Please clarify the 4/13/23 entry in your signature.

 

If you believe you're very sensitive, if I were you, I'd give your nervous system more time to get used to that 4% decrease.

[savedflower]

I stabilized on 10 mg of Lexapro. I took the 10 mg Lexapro from 2/21/22 to 4/13/23. On 4/13/23 I reduced the 10 mg of Lexapro to 9.60 mg. I realized that was too big of a drop after a couple days, so from now on I will do a 1%. I agree that I should give more time to stabilize after the big drop. 

[Altostrata]

On 4/22/2023 at 2:18 AM, savedflower said:

I took the 10 mg Lexapro from 2/21/22 to 4/13/23.

 

You probably are tapering prematurely. You had a bad withdrawal reaction only 2 months ago. If I were you, I'd allow your nervous system more time to stabilize on 10mg Lexapro.

[savedflower]

An update, so I'm currently still on 9.6 mg of liquid Lexapro (taking liquid so I can wean more accurately). After holding on 10 mg of Lexapro for about a year, I decreased my dose to 9.6 mg on 4/13/23. I've had a lot of ups and downs since that point but recently, it's been a lot of downs. I thought I was stable enough to wean again a week ago, but then the last three days I've been experiencing heavy panic and anxiety. Yesterday, the bad symptoms persisted for 12 hours with very little windows.

I know that I'm weaning in "poop out" and I've been experiencing tolerance withdrawal for about two years now. It's been very mentally hard for me to wean further on the Lexapro because of that and I've considered either switching to Prozac or bridging Prozac because of this.

In the past, I've successfully switched SSRI's with no adverse effects or weird side effects because this isn't the first time an SSRI has pooped out on me, I just didn't know about withdrawal back then.

I'm hoping that I can maybe make an appointment and speak to my psychiatrist about the possible switch, but I value the information on this site as well. I've read the thread about Cross Tapering or Bridging Prozac on this site and what I've come to understand is that the cross taper has to be completed no later than 2 weeks?

 

My hope is to switch to Prozac to stop the tolerance withdrawal so I can continue to wean the dosage. I know that I will continue to experience withdrawal after and I'm okay with that. Just the tolerance withdrawal with the actual withdrawal symptoms have been a nightmare together. 

 

Any advice about my next steps would be very appreciated and thank you for all the information!!

[Altostrata]

Why do you think you're in "tolerance withdrawal"?

 

It appears you worsened your symptoms with a dosage reduction, which suggests they are withdrawal symptoms from events in February.

 

Please keep daily notes of times of day you take your drugs, their dosages, and your symptoms throughout the day. Post 24 hours of notes at a time in this topic, in a simple list format with time of day on the left and notation (symptom or drug and dosage) on the right. We need to know how you feel before and after each dose. This can show if your symptoms are adverse effects from one of your drugs.