Jump to content

LRuthC: Did I go too fast? Or should I weather the withdrawal symptoms?


Recommended Posts

Hi!

 

Have read through a few posts across this amazing online community, and Alto's publication in Therapeutic Advances in Psychopharmacology.

 

I've completed a signature so won't go through the basics, but really hoping to get off the escitalopram at some point, I have been taking it for a year and its the first time ever on ADs. I went on them after a relatively traumatic 2 years. But now that my life is on track, I want my motivation/zest back! And I also would like to shift the 10kg I've accumulated in the last 6 months. I'm just ready to be me again.

 

I read through the literature to come up with my tapering plan (had yet to come across this site) and settled on the reduction regime outlined in Horowitz, M. A., & Taylor, D. (2019). Tapering of SSRI treatment to mitigate withdrawal symptoms. The lancet. Psychiatry, 6(6), 538-546. https://doi.org/10.1016/S2215-0366(19)30032-X.

 

The first step of this regime was to reduce my dosage from 20mg to 15mg. I bought a small medicine weighing machine and got cracking (well, splitting- I split up the tablets and weighed them). What I didn't think of doing though was weighing the whole tablet first, I assumed one whole tablet weighed 20mg (even though splitting it in unequal halves resulted in one half being approx 16mg, and then other being 11mg). So effectively, in the first week of taper I went from taking a 27mg tablet to a 16mg tablet.

 

WS started 3-5 days in. Flu like symptoms, aching body, jaw clenching and general tightness in the throat/tongue/neck region. Similar symptoms to when I first started the escitalopram. These more extreme symptoms lessened over the 2 weeks and so I went down to 14mg, and then after 2 weeks, down to 12mg (did I say I was going to spare the details?).

 

WS are still here- although not like those initial symptoms- however I'm lethargic, I no longer have the strength to do my normal gym routine (which was weights). Now, if I do go to the gym, I do some cardio- it's a slog, I find it rathr sickening but I do try to stick to a routine, and I would like to shift this weight. I need more sleep than I ever did before. I don't have any zest, and I still have this general tightness in the throat/tongue/neck region as well as a feeling of permanent buzzing in the brain (?) I know its WS, I've never had anything like it until I started tapering. Each day is a bit of a struggle.

 

I'm wondering, do I go back up to 14mg? Upon retrospect while I thought I was going from 20mg to 16mg I went from 27mg to 16mg (how does that work meanwhile? Why are the tabs actually 27mg? Is it 20mg of escitalopram with 7mg of filler? Or is my tablet weighing machine just off?) Did I drop too much too quickly and is there any way back? Is it possible to actually avoid WS anyway? Should I just stick it out given it's not horrendous and I can still work/be a parent (albeit, with more struggle)?

 

Any advice would be greatly appreciated (should I be posting this elsewhere? If so, sorry!)

 

Take care everyone, and thanks for making it this far!

 

 

LRC

 

 

 

2021 March started escitalopram 10mg

2021 May increased escitalopram 20mg

2022 March 18th cut escitalopram down to 16mg (weight)

2022 April 1st: 14mg; April 15th: 12mg; April 25th: 11mg.

current 11mg (weight).

 

2022 April Also trying to cut out alcohol (which escalated during 2021-2022)

 

2022 March: 10mg Doxylamine succinate each night to aide sleep

Link to comment
  • ChessieCat changed the title to LRuthC: Did I go too fast? Or should I weather the withdrawal symptoms?
  • Moderator

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  We suggest a very slow taper, much slower than what you have been doing.  

 

It sounds as though you may be confusing tablet weight with the weight of how much drug is in the tablet.  The tablets have fillers, so a 20 mg tablet will weigh more than 20 mg.  Weigh about 7 pills, and then get an average tablet weight.  Take the total weight of 7 tablets and divide this by 7.  That is your average pill weight.  It's confusing, because both are measured in milligrams.  I personally think it would be easier to taper using the liquid - that is what I have been doing.  More on all this later.  

 

Are you on any other drugs/supplements besides Lexapro and doxylamine succinate?  

 

Here is some important information about how these drugs actually work.  This explains why we get symptoms from going off of these medications, and why it's so important to taper slowly and carefully, and be very cautious about changing our doses: 

 

How Psychiatric Drugs Remodel Your Brain

 

 

This helps you understand what withdrawal syndrome is: 

 

Video on Recovery from Psych Drugs

 

Windows and Waves Pattern of Stabilization

 

 

Tapering is best done extremely slowly, and we generally taper by 10% of the current dose no more than once every 4 weeks, so that the reduction becomes exponentially smaller.

 

 Why Taper by 10% of my Dosage  

 

Tips for Tapering Escitalopram/Lexapro

 

Here is a link with checklists of common WD symptoms: 

 

Dr Joseph Glenmullen Withdrawal Symptom Checklists

 

 

Here are some techniques to cope with symptoms: 

 

Non Drug Ways to Cope with Withdrawal Symptoms

 

Stability is really important when we are tapering off psych meds.  Please read the link about stability:

 

Keep It Simple, Slow, and Stable

 

 

We don't suggest many supplements, but 2 that many of us find helpful are magnesium and omega-3 fish oil. Here are the links for info about those. It is suggested to add one at a time, and start with a low dose to see how it affects you. 


Magnesium

Omega 3 Fish Oil

 

Finally, going back on a small dose of your drug, or increasing your dose, which we call reinstatement, is best done very carefully.  This is temporary, and after stabilizing you would then taper gradually off of this.  There is some risk involved, but in your case, I think it would be reasonably safe to updose back to 12 mg Lexapro, because you only dropped to 11 mg a few days ago.  Give it at least a week, which is how long it takes for an updose to fully register in your system.  Then, if things are going OK, I would stay on this dose for a while, and allow your system to have a break, and get a chance to fully adjust to the drug changes.  Here is some information about reinstatement.  

 

About Reinstating and Stabilizing to Reduce Withdrawal Symptoms

 

You don't want to updose to much, because you probably have a sensitized nervous system from the fast taper, and this could cause you to get worse instead of better.  I've given you a lot of information, so let us know if you have any questions.  Please let us know how you are doing. 

Please do not tag me, unless it is a question about tapering or withdrawal.

 

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

 

Lexapro   Started Apr 15 '02 - 10 mg;  Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08 Aug 16 - 0.07, Oct 6 - 0.06, Nov 21 0.05, Dec. 17 0.04, Jan 14 '22 0.03, Feb 19 0.02, Apr 18 0.01, May 15 0.005 

Ibuprofen 800 mg, or Tylenol 1000 mg as needed

other meds: Levothyroxine 75 mg

Trazodone on occasion, stopped in late 2019

Xanax on occasion, stopped in late 2019

magnesium in small amounts at 4 AM, breakfast, 3 PM, before bed

suppl AM: fish oil, flax oil, vit C, vit E, calcium

suppl PM: magnesium 350 mg, GABA 750 mg, Estroven, melatonin 2.5 mg

Link to comment
  • Moderator

This post explains the issue of tablet weight versus weight of active ingredient in the tablet:  

 

Using a Scale to Weight and Measure Doses

Please do not tag me, unless it is a question about tapering or withdrawal.

 

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

 

Lexapro   Started Apr 15 '02 - 10 mg;  Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08 Aug 16 - 0.07, Oct 6 - 0.06, Nov 21 0.05, Dec. 17 0.04, Jan 14 '22 0.03, Feb 19 0.02, Apr 18 0.01, May 15 0.005 

Ibuprofen 800 mg, or Tylenol 1000 mg as needed

other meds: Levothyroxine 75 mg

Trazodone on occasion, stopped in late 2019

Xanax on occasion, stopped in late 2019

magnesium in small amounts at 4 AM, breakfast, 3 PM, before bed

suppl AM: fish oil, flax oil, vit C, vit E, calcium

suppl PM: magnesium 350 mg, GABA 750 mg, Estroven, melatonin 2.5 mg

Link to comment
  • Moderator

In your signature you said "2022 April Also trying to cut out alcohol (which escalated during 2021-2022)".  

 

Drinking, and any other mind altering substances can significantly impact withdrawal for the worse.  You will have a much easier time if you completely abstain from these things.  

Please do not tag me, unless it is a question about tapering or withdrawal.

 

***Please note this is not medical advice.  Discuss any decisions about your medical care with a doctor who understands psych meds and how to withdraw from them, if you can find one.

 

Lexapro   Started Apr 15 '02 - 10 mg;  Apr 2 '20  0.18 mg; Jul 16  0.17 mg, Aug 23  0.16 mg, Oct 7  0.15 mg, Nov 8 - 0.14, Jan 16 '21 - 0.13, Feb 7 - 0.12, Feb 22 - 0.11, Mar 26 - 0.10, May 21 - 0.09, June 15 - 0.08 Aug 16 - 0.07, Oct 6 - 0.06, Nov 21 0.05, Dec. 17 0.04, Jan 14 '22 0.03, Feb 19 0.02, Apr 18 0.01, May 15 0.005 

Ibuprofen 800 mg, or Tylenol 1000 mg as needed

other meds: Levothyroxine 75 mg

Trazodone on occasion, stopped in late 2019

Xanax on occasion, stopped in late 2019

magnesium in small amounts at 4 AM, breakfast, 3 PM, before bed

suppl AM: fish oil, flax oil, vit C, vit E, calcium

suppl PM: magnesium 350 mg, GABA 750 mg, Estroven, melatonin 2.5 mg

Link to comment

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
×
×
  • Create New...

Important Information

Terms of Use Privacy Policy