TheCircle: burnout and withdrawal symptoms - escitalopram

[TheCircle]

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 November 9, 2021 by ChessieCat
added spacing

[Kiasofia]

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.

 

[TheCircle]

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.

[Kiasofia]

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.

[TheCircle]

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.

[TheCircle]

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

 

[Blossom71]

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.

[TheCircle]

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

[TheCircle]

Hi all.

I have been having withdrawal symptoms like edginess and then dysphoric mood, (alhtough they come and go in waves, 50% of time ok, 50% not ok) for a month roughly. And that is probably due to faster tapering recently: every week from mid december 2022 to end of january 2023 when I was doing every 2 weeks and was fine before.

 

I have been holding on the 0.65mg per day since early february when the symptoms started to appear.

 

Do you recommend uptaking and by how much? Or holding on my current 0.65mg dosage and for how long?

 

Please let me know! Cheers.  

[TheCircle]

Hi all.

 

I have been having symptoms like edginess and then dysphoric mood, (alhtough they come and go in waves, 50% of time ok, 50% not ok) for a month roughly while tapering.

 

That is probably due to faster tapering recently: every week from mid december 2022 to end of january 2023 when I was doing every 2 weeks and was fine before.

 

I have been holding on the 0.65mg per day since early february when the symptoms started to appear.

 

Would you recommend increasing dosage and by how much? Or holding on my current 0.65mg dosage and for how long?

 

I am not too keen on seeing my psychatrist as she will just advise to increase back to a much higher dosage. 

 

Please let me know! Cheers.  

[Gridley]

On 3/1/2023 at 4:07 AM, TheCircle said:

 

Do you recommend uptaking and by how much? Or holding on my current 0.65mg dosage and for how long?

Please post all questions about your situation here in your Introduction topic rather than starting new topics in other site forums.  That keeps all your posts in one place.

 

You could try a very small updose to .67 or at most to .7mg  It takes 4 days for an updose to reach full strength in the bloodstream  and a bit longer for it to register in the brain.  If that helps, I'd hold there for at least a month before tapering further.  If you feel worse, go back to .65mg and hold.

 

I'm sure you're aware of our recommendation to taper no more than 10% every four weeks.  

 

Why taper by 10% of my dosage?

 

Some can go faster, and apparently you've been able to do so up to now  The symptoms you're experiencing are an indication that you're going too fast.  Often withdrawal effects are cumulative and can catch up with you. Once you've stabilized on your updose and are ready to resume tapering, I'd slow down.  

 

You're probably aware that we strongly recommend against every other day tapering.  This causes the amount of the drug in your blood stream to go up and down, battering the nervous system.  

 

 

[TheCircle]

Thank you @Gridley!

 

One question though: If increasing to 0.7mg from 0.65mg does not help, why not increasing further? Instead I understand you would recommend going back to 0.65 which is surprising since I am not well at the moment.

 

Please let me know

 

 

 

[Gridley]

21 minutes ago, TheCircle said:

 

One question though: If increasing to 0.7mg from 0.65mg does not help, why not increasing further? Instead I understand you would recommend going back to 0.65 which is surprising since I am not well at the moment.

 

Please let me know

You can increase further.

 

If you are worse after the updose, then I would recommend going back to .65.  

 

If you haven't improved after around 8 days, you could increase a little more and wait to see how you are after 8 days. The important thing is to increase little by little so you don't overwhelm your system by increasing too much.

 

It's a good idea to keep written notes for yourself to keep track day by day how the updose is doing.

[TheCircle]

@Gridley thank you very much, this is precious advice! 🙏

I am starting on 0.7 today for 8 days and will adjust accordingly.

I wish you a fine day.

[TheCircle]

@Gridley, Hi!

Just wanted to thank you very much as I have been feeling great since increasing to 0.7mg from your advice.

Without your help, I would probably have gone much higher on the dosage and lost a lot of time and go through more pain as well.

 

This is just brilliant and unvaluable help.

 

🙏

 

Will stick there for a month or month and a half then resume tapering in slow mo.

[Gridley]

2 hours ago, TheCircle said:

I have been feeling great since increasing to 0.7mg from your advice.

That is really great news.

 

2 hours ago, TheCircle said:

Will stick there for a month or month and a half then resume tapering in slow mo.

See how you feel at a month and a half.  It might be a good idea to hold longer at 0.7mg before tapering again.

[TheCircle]

Hi @Gridley

 

Held at 0.7 for 2 months as discussed with you, so march and april I was feeling good.

Then from 8th May resumed tapering to 0.63 for 4 weeks, then from 8th June to 0.57.

 

I have been having dysphoric mood symptoms since end of may. Not feeling great some days while some other days I am fine.

 

I have had external stressors coincidently: from mid may broke up with a recent but intense relationship so felt down for a few weeks, and I am looking for a job, so not the best time of my life. So I am thinking that it is not entirely due to too fast tapering.

 

Overall have been much less tolerant to stress from end of may, and so started to experience more insomnia events.

 

Will go up a notch to 0.60 for a week and see what happens. Please let me know if you would advise something else.

 

Thank you