Mars11: Seeking improvement

[Mars11]

I have always been anxious, but it was manageable. Until I started working in 2000. I was 1st put on blood pressure meds (perindopril). Then around 2002 I had my 1st panic attack and was put on benzodiazepines, which I of course needed more of as time went by. Then in 2005 escitalopram was added. I managed to stop the benzodiazepines in 2007 cold turkey (severe withdrawal for about 3 months). I am still on escitalopram 10mg, but it feels like it stopped working. Reading this site I am 100% sure I should not increase the dosage and is considering tapering off, but I have seen many horror stories (although there are some succeses), so fairly scared, even though I do think the meds are not doing anything for me( may even be the reason for my sleep issues and health anxiety). I am the UK and as far as I know we only have the tablets (20mg, 10mg and 5mg). Any suggestions in how I should taper?

[ChessieCat]

Hi Mars11 and welcome to SA,

 

Because you have been on escitalopram since 2005 there is a possibility that the drug has stopped working.  This is called by several names:  tachyphylaxis, poop out and reaching tolerance.  The general medical professional response to this is the increase the drug, add a new drug or switch drugs.  If the drug is increased due to poop out, there will most likely come a time when the drug reaches tolerance again, and then the process is repeated, increase, add or switch.

 

What can happen when tapering out of poop out is that after a reduction you start to feel a bit of improvement, and then gradually the symptoms start to worsen.  Tapering when not in poop out can be different in that after making a reduction you might get mild withdrawal symptoms and then those symptoms resolve over a few weeks.  You can read more about it here:

 

Tachyphylaxis, Reaching Tolerance or as It's Lovingly Known “Poop-Out”

 

tolerance-or-poop-out-or-tachyphylaxis

SA usually recommends tapering by no more than 10% of the current dose followed by a hold of about 4 weeks to allow the brain to adapt to not getting as much of the drug.  The idea is to keep withdrawal symptoms to a minimum.  If you experience bad withdrawal symptoms after a reduction, or the symptoms last for too long after a reduction that is a sign that you have reduced too much.  The 10% every 4 weeks is only a guide.  You need to listen to your body/symptoms and taper according to them and not the calendar.

 

Why taper by 10% of my dosage?

 

Tips for tapering off escitalopram (Lexapro)

 

Dr Joseph Glenmullen's WD Symptoms Checklist

 

WDnormal

 

And Brassmonkey wrote more about it here:

 

tao-of-the-brassmonkey

 

Some members do a different taper making their reduction over a 6 week period.  Brassmonkey, who has successfully tapered off Paxil (now about 3.5 years off) whilst experiencing poop has posted about this tapering method here:

 

brassmonkey-talking-about-myself

 

the-brassmonkey-slide-method-of-micro-tapering

 

Please create your drug signature following these instructions:

 

Instructions:  Withdrawal History Signature

 

This link goes straight to where you create your signature.

Account Settings – Create or Edit a signature

 

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

[NeDaytoDayMJ]

Hi, I think the escitalopram has led to my sleep issues.  I feel as though I never get enough sleep.  I have periodic arm movements.  I wish you the best in your decision.