Sunnyhope: Lexapro withdrawal - adverse effect - need advice

[Altostrata]

6 hours ago, Sunnyhope said:

Cons
- I’m in WD. Maybe I react differently now

- I’ve reinstated Paxil 2 months ago. 
- I didn’t feel 5 mg Prozac did much for my ocd and anxiety so maybe it’s not strong enough to help with the wd mess I’m in. 
- my insomnia has improved on Paxil. It may come back , maybe even worse?

 

You've done a good job outlining the pros and cons. The decision is up to you. Please let us know how you're doing.

[Sunnyhope]

Thanks!

@Altostrata  @Kiasofia

 

It’s a tough decision! 

 

1. stay on the current dosage 1.5 mg for some months or more to stabilise the WD I’m in ( and suffer the unwanted side effects of Paxil)

 

2.  Keep tapering by 10 percent and see how it goes

 

3. Bridge to Prozac. 
 

IF I eventually do that:  what is the best way?

 

 I read the SA thread on this, got a little confused by the different options. So I borrowed the “recipe” from Erells signature on bridging, and downsized to my dosage. It seems she landed on a dosage of fluoxetine that was 75% of her paxil dosage. 
 

Would this be a possible way?

 

Day 1:   

1.5mg Paroxetine + 0.15 mg Fluoxetine

Day 4 : 1.5mg Paroxetine + 0.30 mg Fluoxetine

Day 6 to day 18: drop 0.3 mg Paroxetine every 4 days, add 0.15 mg Fluoxetine every 4 days

= Day 18:  0.3 mg Paroxetine + 0.9 mg Fluoxetine

 

Day 23:  0.15 mg Paroxetine + 1 mg Fluoxetine

Day 27: 0.08 mg Paroxetine + 1.1 mg Fluoxetine 

Day 40  1,1 mg  Fluoxetine   (STOP PAROXETINE)

 

Day 40- day 140.

 

I see that ERELL in the next 100’days added back small amounts of paroxetine (0.06 to toothpick size and also added 1 mg diazepam). So going to zero Paxil will be hard…

 

thanks again. 

 

 

 

 

[Altostrata]

If I were you, I'd plan to crossover to fluoxetine in 10 days:

 

Day 1 1.5mg paroxetine + 1mg fluoxetine (observe effect)

 

Day 4 1.0mg paroxetine + 1mg fluoxetine (observe effect)

 

Day 7 0.5mg paroxetine + 1mg fluoxetine (observe effect)

 

Day 10 1mg fluoxetine

 

Often, less fluoxetine is sufficient. The effect of fluoxetine will continue to ramp up over weeks.

 

[Sunnyhope]

A little update!

 

Thank you altostrata for the crossover plan. 

 

I struggle a lot with physical and mental withdrawal symptoms from the adverse reactions and quitting Lexapro.  (and with coping that I am in this situation)  

 

The physical symptoms are getting worse. Numbness ALL over, and even more swollen brain. Now I get tightness in the head, feels like a headache with no pain (I’ve seen this better explained, don’t remember the words for it). 
 

At the moment I feel trapped. I hate the metabolism side effects from the misinformed reinstating of Paxil, which makes an unbearable situation even worse. But I don’t dear to risk getting worse at the moment. 
 

At the moment I’m doing nothing, but constantly thinking of whether to continue to taper Paxil by 10 percent, doing the Prozac crossover, OR - doing a citalopram crossover in hope that this can lessen some of the lexapro induced numbness.  (I will consult you before this) 

 

 

I just told doctor I needed extended sick leave. In doing so, I realised the absurdity of this situation. 
 

She thinks in her heart that I’m a mental case, but I know that the doctors treatment did this to me!  




 

[Sunnyhope]

@Kiasofia

 

Hi, I am severely suffering.
 

Is it anything I can do? Just need to discuss my options. 
 

It seems to me that those who reinstate a small amount of the offending drug are doing better. 
 

I already reinstated Paxil, which was not the offending drug for reasons explained earlier, so it’s not like I can choose freely…

 

How  do I know if the offending drug is Prozac or lexapro?

 

(I cold switched from Prozac to lexapro) 

 

I suspect the suffering is from the lexapro since I have all the extreme lexapro-typical symptoms: swollen brain/head squeezing, numbness ALL over my body  etc etc in addition to the mental torture. Each time I read about someone with those symptoms they almost always have lexapro in the mix. 
 

I didn’t reinstate lexapro because the severe symptoms came while I was on it. So I reinstated Paxil instead in hope of alleviating some of the wd symptoms.  

 

The numbness and swollen brain keeps getting worse. Same with tinnitus and genital pain. 

The  insomnia that got a little better after starting Paxil, is getting worse again.

 

It seems that the  lexaproers that has similar symptoms as me still suffers the same after longer time than this.

 

I read bellatrix reinstated and got better. I am starting to think about cross tapering to citalopram.

Anyone with swollen brain/ head squeezing got better after reinstating the offending drug? 

 

I’m not thinking about getting back on drugs, just wondering if I can alleviate symptoms on citalopram and taper slowly from there. 
 

Cons:  

The severe jaw/teeth problems came while on lexapro, (but has gotten worse after quitting. ). So clearly I had a severe adverse reaction. 
 

 

 

 

[Kiasofia]

I'm so sorry you are suffering❤️ There is no way of knowing which drug you are in withdrawal from (and it could be both). These drugs are unpredictable so what course of action will give the best results just isn't possible to know. I wish I had a better answer. You have made a good pro and con list before and need to decide based on that.

[Altostrata]

Quote

2015-2021 : 5 mg prozac (and 5 mg valium as needed )

 

You took Prozac for 6 years. How did you feel while you were on it? When did you use Valium while taking Prozac?

[Sunnyhope]

@Kiasofia@Altostrata

 

Hi there. 
quick recap

May 2021:  Extreme adverse effects/wd from cipralex   Still suffer. ongoing. 
 

 

Oct 23 : reinstated 1.7 mg Paxil (in panic). Didn’t help. Got side effects. 

 

Nov 30: decrease  to 1.5 mg

jan 1: decrease to 1.4

no negative effects of this. 

HOLD. 
may-June:  slowly slide down to 1.3 (no negative effects of this)

 

july 1: down to 1.2

 

Suddenly, after a week I’m hit with increased anxiety for no reason. It keeps increasing. Feeling I’m soon back to accute that hit me hard September last year. 
 

recognize a typical “Paxil” taste to the anxiety, chemical, anxiety down my arms, inner escalating restlessness. Afraid to get akathisia.  
 

I decided to stay on 1.2 but it’s been 5 weeks and getting worse. 
 

is there a point in getting back to 1.3?

 

devastated-  I’m stuck on this forever?

 

 

 

 

[Sunnyhope]

Also. I’ve had some improvements from January. My sleep is better, I’m not so agitated. 
 

The reinstatement of Paxil May have helped sleep a bit, can’t be sure. Mostly I feel it’s time that did the work. 
 

im starting to get more agitated and wake up early again so this last reduction took a turn to the worse. 

[Sunnyhope]

On 1/31/2022 at 11:09 PM, Altostrata said:

You took Prozac for 6 years. How did you feel while you were on it? When did you use Valium while taking Prozac?

sorry @Altostrata  didnt see your last question there. I decided based on your advise back then not to risk the prozac bridge. I also took a break from the forum not to scare myself. 
 

 

Its so hard to describe  how i felt on Prozac . Knowing what i know now i realise i was in paxil witddrawal all those 6 years. The intrusive thoughts. The regret ocd. The impending doom knot in my stomach. The terrible mornings but nice evenings.  The waves. 
 

My understanding while on it was that it didn’t “help” as much as Paxil, but I didn’t have any side effects. 

 

I used Valium 5 mg once or twice a week in tough situations. (Job presentation, emotionally challenging events etc) 

 

those six years still were the best - much better than being fat and tired on paxil. I felt i was getting my life back, except for the heavy emotional knot in my stomach. 

[Altostrata]

12 hours ago, Sunnyhope said:

Oct 23 : reinstated 1.7 mg Paxil (in panic). Didn’t help. Got side effects. 

 

I don't understand what happened. You went back on 1.7mg Paxil, which didn't help, then you've been tapering it since then? Did it eventually "help", or have you had the same symptoms since October?

[Sunnyhope]

On 11/30/2021 at 10:19 PM, Kiasofia said:

Since Paxil isn't helping withdrawal I think starting with a 10% reduction and going from there is a good idea. If it was celexa or prozac you had reinstated and you didn't have side effects we could have considered a slight dose increase. But with Paxil I think going off is better than going up.

Yes, that’s what happened. 
 

i started paxil to see if it could help. I got annoying side effects and regretted reinstating. 
 

I didn’t notice any immediate help, except maybe some tiny improvement on my sleep. 

 

I got the advise to start tapering, so I did, 

 

Did it eventually help? 
 

Its hard to say 
 

I had some improvement on my sleep and I got less agitated. 

the sleep improved some when I started it and got better and better, especially this spring. 
 

i don’t know if it’s the Paxil or the time That caused the improvement. 
 

@Altostrata

 

[Altostrata]

Do you feel better or worse now?

[Sunnyhope]

@Altostrata
 

short answer:  

I feel increasingly worse again after the drop. Much more anxiety, increasing still, now I’ve started to wake up again with cortisol rush anxiety and I’m chemically anxious all the time. Have to restrain myself from spiralling into panic, avoiding things I managed to. 
 

long answer: 


- I quit cipralex in May 2021

- in august 2021  I suddenly got so agitated and afraid and couldn’t sleep. I couldn’t stop talking, i couldn’t stop pacing I was behaving like a maniac. Akathisia?  SI thoughts. I committed myself voluntarily to a psych ward. (Never been this ill)
 

I was far worse than the other patients. I paced and couldn’t sit still. I had to constantly distract, I did obsessively solve sudoku. I slept maximum 4 hours. I paced the halls at night. I made plans to end it all. 

In October, after a strong SI urge, I started a small dosage of Paxil.  I didn’t notice any immediate difference, but after a month I noticed my sleep improved. In stead of waking up at 4 am it would be 5 am. 
 

My hospital stay was  ended in the end November after the maximum allowed two months.

 

looking back:  

I’ve been much better since those terrible hospital days.  The extreme agitation is gone, and I sleep better.  This happened gradually from November, and especially from around February. This could very well be because of Paxil. Also time. Or a combination. 
 

still, I struggle every day; 
lots of physical pain, weird numbness, head pressure, intrusive thoughts, anxiety, flashbacks, extreme emotional pain. 
 

now I feel worse again. Like a new a accute wd started/ is in the making. 

1 july made the drop

July 7. Noticed something was different. Like I was more afraid in the background. I couldn’t pinpoint it, just a weird uneasy feeling. Then it grew. I Started to feel even more anxious. I suspected the drop, but thought to my self, it will pass. 
 

july 14 I was much more stressed.  Cancelled a dinner at a friends house I would have managed before the drop. Noticed that I had a weird anxiety feeling down my arms, which I haven’t had since I quit Paxil in 2014.  Got more restless legs, more inner restlessness. Was anxious all the time again. 
 

july 21: so anxious I can’t stop talking about it. My husband says he notice a difference, im behaving worse.  Cancelling things I have managed to do before. Constant anxious and that chemical, “typical” Paxil anxiety ( hard to explain- but I recognise it from my wd in 2014) 
 

feeling anxious all the time for no reason. 
 

From july 28:  feel I want to pace and must restrain myself from not spiralling into panic. Waking up in cortisol rush anxiety again, that gradually subsided from March this year. 
 

what to do now?

my intuitive plan has been to “sit still” and hope this pass. And then after that don’t do any more drops, for as long as it takes. 
 

but would it help/be wiser to go back to 1.3 mg?

 

(it seems crazy that so small amounts actually can make a difference. But here I am..)

 

 

[Altostrata]

If your withdrawal symptoms were not completely gone in November, I don't understand why you're decreasing Paxil at all.

[Sunnyhope]

2 hours ago, Altostrata said:

 

If your withdrawal symptoms were not completely gone in November, I don't understand why you're decreasing Paxil at all.

 

I understand why you ask. 
 

It was the advise i got from Kiasofia  back in November, when I asked what to do.  
 

The reason I wanted off Paxil is because I get terrible side effects from it. 

I chose the wrong drug to reinstate. Paxil was not the offending drug. Ideally (if I had known this site then) I would have reinstated Lexapros milder sibling. 
 

Earlier in my thread it’s the whole discussion what to do based on this. 

Paxil didn’t help with any of the physical wd symptoms. We had a discussion wether I should cross taper to Lexapro, to Prozac or what. 
 

@Altostrata

[Sunnyhope]

@altostrata 

 

Thanks again for your kind help:)
 

I’m thinking I maybe misunderstood something back in november/January. 

 

it seems I would be wiser not to decrease  Paxil as long as I have withdrawal symptoms. 

 

That seems like the best plan after this recent negative experience. 
 

 

 

 

 

 

 

 

[Altostrata]

 

We do know that your tapering Paxil has brought on a resurgence of symptoms, so it probably did help you stabilize up until you started tapering November 30, 2021. If I were you, I'd go back to 1.3mg and see if that helps.

[Sunnyhope]

@altostrata 

 

Ok thanks. 
 

I will try that. 

[Sunnyhope]

@Kiasofia
 

Could you please PM me contact info on the psychiatrist that you mentioned?

 

Trenger kontakt med, eller bli sendt videre av, en fagperson som kan WD. 

 

Translation: 

 

Need contact with, or be passed on by, a professional who knows WD

 

Edited September 7, 2022 by ChessieCat
added translation

[Sunnyhope]

@Altostrata

 

11 august:  I went back on 1.3 paxil from your advice.
 

I got better. But still much worse than before the drop. 
 

now it’s getting worse. It feels like it is about to spin out of control. 

 

Feels like Im now in a paxil wd - on top og the Lexapro wd. 

I did this all wrong. 

 

[Sunnyhope]

@altostrata 
 

I reread my thread again.  I see that I have failed to 

1. Make myself clear. 

2. Properly pick up on the advise I get (because of fear. )
3. Ask further questions when you say something has a risk. 

4. Chose the best option for my self. 
 

example: .

 

back in 27 november when i first contacted you.
 

I had used Paxil - which I regretted - only 34 days when I contacted you. But that information is just mentioned in a small sentence among my detailed story. Not intentionally. But i fail to make it clear. 

 

Kiasofia says:  at this point not sure if it’s worth the risk to try reinstatement of lexapro which is what we would have suggested had you not started Paxil. 
 

 I should have asked further. Clarified that it was  only 4 days more than a month.
 

Back then I took it literally. I felt terrified and doomed. 

 

so I interpreted the answer from kiasofia as:  at this point ( 4 days over the safe zone) it’s not worth the risk. 

 

my conclusion was:  now I have to taper this for years and I don’t get to try the better reinstatement. 

Same with my further questions. I don’t get your hints and suggestions it seems. I get scared and fail to follow up. 

 

 

I really want to be better at understanding my options from now on. 
 

 

[Altostrata]

9 hours ago, Sunnyhope said:

I got better. But still much worse than before the drop. 
 

now it’s getting worse. It feels like it is about to spin out of control. 

 

What got better, for how long, and what got worse? 

[Sunnyhope]

@Altostrata

 

this happened after the drop

 

- increased chemical anxiety

- constant inner restlessness. Inability to feel calm

- started waking up again with cortisol anxiety at

- faster thoughts

-agitated behaviour 

-not calming down in the evening

- a feeling of a burnt smell (like my brain has fried) 

 

This got better after the up
 

- less waking up early , and able to calm down and sleep again most nights

- less chemical anxiety (but still more than before the drop)

-less restlessness,

-felt confident that this would get better and better 

 

This got worse again (but not as bad as before the upping)  started 1 week ago

 

- more early cortisol anxiety again, harder to fall back to sleep

- sudden random bouts of very strong anxiety - 

- an alarming feeling that this is spinning out of control. It seems similar to the build up I felt before I crashed from the Lexapro. But I’m not there yet. 

 

This is new from the last week:
-increased head pressure and head ache

- sudden burning in scalp, brain, (areas that are numbed from the lexapro-wd) 

-sudden burning in joints (knees, wrists, toes)

- extreme sweating at night (I had also this the first months after lexapro wd kicked in) 
 

 

[Altostrata]

Of any of your drugs, have you skipped any doses, taken any off-schedule, had any alcohol in the last 2 weeks? When was the last time you had your thyroid treatment checked? That can change when you change other drugs.

 

What times o'clock do you take your drugs, with their dosages?

[Sunnyhope]

@altostrata 

 

I have not skipped doses or taken off schedule. 
I don’t drink alcohol anymore

Thyroid checked last time in end of august. 
The dosage was lowered in January (75 to 50 mcg levothyroxine, I will update my signature. 

 

I take Paxil at 06 pm 

 

The other drugs I take at 10 am. 

 

[Altostrata]

Are you taking immediate-release nifedipine? Please check the package. 

 

Please put ALL your drugs in this Interactions Checker and post the report or a link to it in this topic. While you're on drugs.com, read up on adverse effects of each of your drugs.

[Sunnyhope]

@altostrata 

 

nifedipine is slow release. 
 

here is the Drug interavtions report. 
https://www.drugs.com/interactions-check.php?drug_list=1717-0,974-0,1463-0,1912-0,1800-1156&consumer=1&types[]=major&types[]=minor&types[]=moderate&types[]=food&types[]=therapeutic_duplication
 

There is one major interaction. A little bit surprising for the high dose of potassium chloride was added by the doctor due to enalapril lowering the levels significantly.  
 

i regularly monitor potassium levels and it’s always on the low side and sometimes below suggested values. 
 

 

I’ve used these medication since 2003 with no side effects that I could detect!

 

I had side effects on Paxil that went away when I quit in 2014 (that are now back). 

 

I suspect Paxil is the culprit og high blood pressure and low thyroid. 

I got high blood pressure in 2003. 
I may mistakenly got diagnosed with low thyroid in 2009.   I had low levels but within the levels. I had slow metabolism and other symptoms that made the diagnosis. I now believe these were side effects from Paxil. 

 

 

 

[Altostrata]

You'll have to discuss your blood pressure treatment with your doctor.

 

Yes, we would not have recommended reinstatement of Paxil because it is so very difficult to go off. These do sound like withdrawal symptoms:

 

On 9/7/2022 at 2:13 PM, Sunnyhope said:

This is new from the last week:
-increased head pressure and head ache

- sudden burning in scalp, brain, (areas that are numbed from the lexapro-wd) 

-sudden burning in joints (knees, wrists, toes)

- extreme sweating at night (I had also this the first months after lexapro wd kicked in) 

 

I am hesitant to suggest increasing Paxil. Your best option now might be to convert to citalopram, escitalopram's milder sibling, by adding 0.5mg now, increasing to 1.5mg after a week and, after giving that a week, stopping Paxil. The principle is similar to The Prozac switch or "bridging" with fluoxetine
 

[Sunnyhope]

@altostrata 

 

Thank you for your continuing support! 

 

On 9/9/2022 at 2:30 AM, Altostrata said:

 

I am hesitant to suggest increasing Paxil. Your best option now might be to convert to citalopram, escitalopram's milder sibling, by adding 0.5mg now, increasing to 1.5mg after a week and, after giving that a week, stopping Paxil. The principle is similar to The Prozac switch or "bridging" with fluoxetin

 

This is a tough descision. I will have to dig deep both for more information and try to listen to my gut

I will reflect on different angles. 
 

I feel that I am in two different wd s now. 
1) LEXAPRO-wd with physical body and genital  numbness, swollen brain, head pressure, head ache, and extreme bruxism.

 

2). PAXIL-wd  - with renewed extremely strong anxiety, it feels if possible deeper than the one from lexapro.

 

question 1

Will this actually be a choice of which “wd “ will get better?

 

meaning. If I stay on  (or increase) the Paxil, I will have a chance to relieve this newly increased anxiety , but not get relief from the physical “lexapro “ wd symptoms?

 

And if I choose citalopram, I will have a chance for relief in the numbness and head pressure?  But also risk coming in a full CT WD from Paxil? 
 

Question 2

what happens if I do the switch and get worse/ go into a severe Paxil wd?  Can I change back?  
 

Question 3

can one be on both drugs?  (Not that I want to)

 

 

 

[Altostrata]

As explained before, we would never have advised you to start Paxil because it can cause the problems you're experiencing now. Unfortunately, there is no easy way to go off Paxil. Doctors often will switch to Prozac to do this. However, you have rejected a switch to Prozac.

 

No one can predict the future, but it is possible a citalopram reinstatement will both reduce escitalopram withdrawal and substitute for Paxil enough to enable you to go off. 

 

Reinstating escitalopram would also be a possibility, but it's stronger than citalopram and you had an adverse reaction to it before. Taking Paxil with citalopram has less risk of this than taking Paxil with escitalopram.

[Sunnyhope]

@altostrata

 

On 9/10/2022 at 11:54 PM, Altostrata said:

However, you have rejected a switch to Prozac.

 I think this is a misunderstanding on my part. 
I never rejected a switch to prozac, I wanted to do the switch!!   I honestly interpreted your answers as you were advising against it.

 

Before even asking my state of mind was;  they’ll probably say it can’t be done. I see I constantly answer. Yes that’s  what I thought. I wont do any changes then. 

 

so when you tell me -you have done a great job outlining the pros and cons - the decision is up to you. 
 

I read my cons and think. That’s what I thought. It can’t be done. 

 

I realise now I was constantly catastrophizing. Expecting the worst.
 

Thats what i mean by

I see that I have failed to 

1. Make myself clear. 

2. Properly pick up on the advise I get (because of fear. )
3. Ask further questions when you say something has a risk. 

4. Chose the best option for my self. 
 

[Altostrata]

Still your decision about what you want to do.

[Sunnyhope]

@altostrata 

 

I know. 
 

At the moment I have such a terrible headache. It feels like my brain is on fire. And the chemical  anxiety is still thru the roof from the failed drop. So that needs to settle before  i can decide anything. 

Even thinking of changing anything makes my head hurt. 
 

 

[Sunnyhope]

@Altostrata

 

On 9/10/2022 at 11:54 PM, Altostrata said:

No one can predict the future, but it is possible a citalopram reinstatement will both reduce escitalopram withdrawal and substitute for Paxil enough to enable you to go off. 

 

if I do the bridge and get intolerable wd from Paxil: what are my options?

1.  Will it help to updose the new drug

 

2. If that fails,  can I quit the new drug and go back to Paxil?

 

3. Some other options that I don’t know about?

 

 

stablise  before doing a bridge?

 

I’m still having wd symptoms from the drop from 1.3 mg to 1.2 mg paxil, then back to 1.3 

 

This scares me. I seems it’s very likely that I will get a wd reaction when doing the bridge, since such a small change affected me so much. 

will it help to wait til this has improved?

 

thanks for your patience and kind help!!!!

 

 

[Altostrata]

Please review your topic from the beginning. We're not going to answer the same questions over and over.