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TheCircle: burnout and withdrawal symptoms - escitalopram


TheCircle

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Hi everyone, I started to take AD in Jan 2019 further to what was diagnosed as a burn-out.  My symptoms were mostly insomnia ahead of anything which was out of a quiet routine. For instance, planning to see a friend or planning a week end with family or friends. It was just too much and that would stress me out and impossible to go to sleep until the event would go away. Had other symptoms like some pains etc... These insomnias had started back in 2016.

 

After putting my life on order (sold my business , sought divorce which went rather peacefully with ex-wife, and a few years of therapy which still continues) in November 2020 started to reduce escitalopram to 5mg from 10mg and that was fine, did not see much difference at all. Had ups and downs but big up from June to july 2021 still on escitalopram 5mg so from August decided to taper every other day. September I was fine so psychatrist advised to switch to 5mg every 3 days.

 

Then september 2 stressors came up, one of which was a crush which was short-lived but nonetheless disturbing. Rollecoaster emotions for 3 weeks and then felt depressed and anxious and felt like something I had not experienced before.  Had to end the relationship. Would be curious on what you guys think and whether this is withdrawal symptoms or too much emotions causing these depressing and anxiety symptoms? I am back not to escitalopram 5mg every other day and might increase more before tapering but much slower.

 

Also I still feel emotionally sensitive and still experience insomnia ahead of some event when there is some kind of commitment. I think burn out is very long to overcome and even though I feel my body has recovered somewhat, I am still very vulnerable to emotions. I can still afford not to work (since nov 2020) and rest more but tend to want to do new things everytime I feel better which bottom line is not helping as impairing the healing. 

 

Thank you for reading and your thoughts are welcome!

 

 

Edited by ChessieCat
added spacing

01-2019 / 07-2019 Mirtazapine for burn out symptoms (insomnia mostly)
07-2019 / 12-2020 Escitalopram 10mg
12-2020 / 07-2021 Escitalopram 5mg, fine overall
08-2021 Escitalopram 5mg every other day start tapering and fine
09-2021 Escitalopram 5mg every 3 days tapering continue and ok
10-2021 Escitalopram 5mg every 3 days tapering and starting to feel tiredness and also depressed
11-2021 Back to Escitalopram 5mg every other day. Improving

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  • ChessieCat changed the title to TheCircle: burnout and withdrawal symptoms - escitalopram
  • Moderator

Welcome @TheCircle

Medical professionals often advise skipping doses (take every other day) to taper. The experience here is that this causes withdrawal symptoms, sensitizes the central nervous system (CNS) and makes tapering even harder. Please do not do this. Either start taking 5mg every day. Or you can consider taking 2.5mg every day. It is very important to take the same dose, at the same time, every day.

 

What is withdrawal syndrome?

Dr. Joseph Glenmullen's withdrawal symptom checklist

 

My next advice:

Keep it simple, slow and stable

Tips to help sleep -- so many of us have that awful withdrawal insomnia

 

Once you are feeling stable:

Why taper by 10% of my dosage?

Tips for tapering off escitalopram (Lexapro)

 

To give members the best information, we ask them to summarize their medication history in a signature.

How to List Drug History in Signature

 

This is your Introductory topic, where you can ask questions and connect with other members.  We're glad you found your way here.

Please stay in touch and let us know how you are doing.

 

These are my opinions based on my own experience and what I have learned, not medical advice.

 

Drug history

2002-2019 Citalopram/Escitalopram, Lamictal
2019 April Escitalopram, quit at 10mg (withdrawal), Oct Escitalopram 10mg reinstated, quit after a few days (adverse reaction)

2019 Oct Lamictal cut from 200mg to 100mg
2019 Dec Lithium 83x2 mg

2020 Aug-Nov Lamictal tapered to 50 mg

2020 Nov 24 Lithium taper started, 30 Jan off Lithium

2021 15. March-31. May Lamictal tapered to 32.5 mg (holding)

2022 10. Jan started taking 25mg+5mg+2mg+0.5 liquid, 22. Jan went back to taking 25mg+5mg+half 5mg

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Thank you very much @Kiasofia for your message and useful tip about taking a daily dosage. I will do that going forward. Saw my psychiatrist yesterday and we decided to be back to 2.5mg daily for 2 or 3 months before tapering again, also told her that I would like to taper much slower next time with 10% off each month. I will have to split pills as there is no liquid escitalopram in France according to her. I have been feeling better the last couple of days and thanks to your website I have realized how important it is to be very careful with tapering! I don't want to feel as bad as I did the last  few weeks ever again. Thank you again.

01-2019 / 07-2019 Mirtazapine for burn out symptoms (insomnia mostly)
07-2019 / 12-2020 Escitalopram 10mg
12-2020 / 07-2021 Escitalopram 5mg, fine overall
08-2021 Escitalopram 5mg every other day start tapering and fine
09-2021 Escitalopram 5mg every 3 days tapering continue and ok
10-2021 Escitalopram 5mg every 3 days tapering and starting to feel tiredness and also depressed
11-2021 Back to Escitalopram 5mg every other day. Improving

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  • Moderator

So glad we could help! Getting back to taking the same daily dose is the most important for now. Make sure you are feeling stable for minimum 4 weeks before reducing more. You will have gone from 5mg to 2.5mg and this is a 50% cut which is very big for some people's brains to handle:

How Psychiatric Drugs Remodel Your Brain

 

Going from 10mg to 5mg is easier on the brain than going from 5mg to 2.5mg:

Why taper? Importance of gradual change in plasma concentration

 

It is possible to make your own liquid:

How to make a liquid from tablets or capsules

 

Or weigh pills:

Using a scale to weigh and measure doses

 

The search function on this site doesn't work very well.  The best way to search this site for specific information  is to use your favorite search engine. Type in survivingantidepressants.org then the symptom, treatment, supplement or information you wish to search for.

 

To make sure someone sees your post write @ and then start typing their username so it becomes blue like this @Kiasofia.

 

We appreciate very much if you come back and update on how it is going.

These are my opinions based on my own experience and what I have learned, not medical advice.

 

Drug history

2002-2019 Citalopram/Escitalopram, Lamictal
2019 April Escitalopram, quit at 10mg (withdrawal), Oct Escitalopram 10mg reinstated, quit after a few days (adverse reaction)

2019 Oct Lamictal cut from 200mg to 100mg
2019 Dec Lithium 83x2 mg

2020 Aug-Nov Lamictal tapered to 50 mg

2020 Nov 24 Lithium taper started, 30 Jan off Lithium

2021 15. March-31. May Lamictal tapered to 32.5 mg (holding)

2022 10. Jan started taking 25mg+5mg+2mg+0.5 liquid, 22. Jan went back to taking 25mg+5mg+half 5mg

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Dear @Kiasofia,  thank you for your message and again precious info.

Yes I will stay on 2.5mg per day for 2 to 3 months before anymore tapering. I have just bought a pill splitter to take it daily.

I felt well after 4 weeks of switching from 5 to 2.5mg (end of August) but things started to get messy below (5mg every 3 days...). Next time will be 10% from there and meds taken daily. I will probably make my own liquid thanks to your tutorials. Again thank you for making the time for me and following up. I hope you are keeping well too.

01-2019 / 07-2019 Mirtazapine for burn out symptoms (insomnia mostly)
07-2019 / 12-2020 Escitalopram 10mg
12-2020 / 07-2021 Escitalopram 5mg, fine overall
08-2021 Escitalopram 5mg every other day start tapering and fine
09-2021 Escitalopram 5mg every 3 days tapering continue and ok
10-2021 Escitalopram 5mg every 3 days tapering and starting to feel tiredness and also depressed
11-2021 Back to Escitalopram 5mg every other day. Improving

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  • 4 months later...

Dear @Kiasofia

 

I hope you are well? I went back to 5mg in December and have felt much better since. I am thinking about starting tapering in April or May by 10% as per your recommandation. I had 2 questions though:

1) Regarding dilution: I will mix my 5mg tablet with 5ml of water. If I need 4.5mg of medecine I will therefore withdraw 4.5ml of mixed liquid (water and tablet mixed together). I could also mix 5mg tablet with 10ml of water. I would therefore withdraw 9ml of mixed liquid if I were to take 4.5mg of medecine.  Is that correct?

2) From that dilution ratio my second question is that by diluting 5ml of water with 5mg of medecine, surely the resulting liquid is more dense (heavier) than the 5ml of water alone. Does that not play a role in distorting the ratio of dilution and should we not take into account the density?

Thank you again for your help.

Kind regards

 

01-2019 / 07-2019 Mirtazapine for burn out symptoms (insomnia mostly)
07-2019 / 12-2020 Escitalopram 10mg
12-2020 / 07-2021 Escitalopram 5mg, fine overall
08-2021 Escitalopram 5mg every other day start tapering and fine
09-2021 Escitalopram 5mg every 3 days tapering continue and ok
10-2021 Escitalopram 5mg every 3 days tapering and starting to feel tiredness and also depressed
11-2021 Back to Escitalopram 5mg every other day. Improving

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Hi @TheCircle

 

I am on a different med and quantity but I dissolve a 50mg in 50ml of water a couple of hours before my dose.   I put it in a jar and shake it to make sure it's equally distributed.

I am taking 37.5ml so I remove 12.5ml and then just drink the rest.   As 5ml is such a small amount of water for yours, I would probably dissolve 5mg in 10ml water, remove 1ml then drink the rest to equal 9mg.

 

Density shouldn't will play a role as you're taking the med by volume.

Sertraline (Lustral):  2014. Sept 50mg. Oct 100mg. Dec 150mg. 2015-2019. 150mg. 2019  Apr-May 0mg. Beg May 150mg. End May 100mg. Late June 125mg. Late Aug 100mg. 2020 Jan 75mg. April 50mg.

2022  50mg. 1Jan 45mg. 1Feb 40.5mg. Water T24Feb 39.5mg. 3Mar 38.5mg. 18Mar 38mg. 25Mar 37.5mg. 22Apr 37mg. 5May 36.5mg. 18May 36mg. 1Jun 35.3mg. 15Jun 34.5mg.  30Jun 34mg. 15Jul 33.5mg. 22Jul 33mg. 5Aug 32.5mg

Promethazine:  2016 25mg. 2022  25mg. 26Jan 22.5mg. 3Apr 20mg.  17Jun 18mg. 20Jun 16.25mg

Desogestrel:  2014 -  present:  75mcg

Supplements: Introduced gradually between April and June 2022.  Magnesium. 400mcg  Folic acid.  400mcg. Vitamin D. 10mcg.  Multivit/min. 1 tab

 

 Omeprazole.:  2016 20mg. 2022  20mg.  15Jan 15mg. 9Feb 10mg. 25Feb 6.5mg. 15Mar 3mg. 3Apr 1.5mg.  15Apr 0mg 🎉

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Hi @Blossom71, thank you very much for taking the time to answer!

 

This is very useful. I will proceed in a couple of weeks.

 

Have a good week end and hope your tapering is going as expected or without too much trouble.

 

Kind regards

01-2019 / 07-2019 Mirtazapine for burn out symptoms (insomnia mostly)
07-2019 / 12-2020 Escitalopram 10mg
12-2020 / 07-2021 Escitalopram 5mg, fine overall
08-2021 Escitalopram 5mg every other day start tapering and fine
09-2021 Escitalopram 5mg every 3 days tapering continue and ok
10-2021 Escitalopram 5mg every 3 days tapering and starting to feel tiredness and also depressed
11-2021 Back to Escitalopram 5mg every other day. Improving

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