conkaia: Cipralex / escitalopram drops taper

[conkaia]

Hi everyone. I’m looking for some advice on two things.

I’m on Cipralex drops 20mg/1ml. I’ve managed to wean myself from 15mg to 2mg. But I need to know how I can safely dilute the drops so that I get the accurate dosage of the active ingredient. 
Also does anyone know why you have to throw away Cipralex drops after eight weeks? If you keep them longer, does this have an impact on the active ingredient?

Thank you so much in advance. 

[Altostrata]

Welcome, @conkaia

 

What is the expiration date on your bottle of Cipralex drops?

 

These topics explain dilution: 

 

How to calculate dosages and dilutions? Spreadsheets and calculators

 

Tips for tapering off escitalopram (Lexapro)  

 

Please summarize your drug and withdrawal history in your signature You may need to use a computer to do this.

[conkaia]

Hi there thanks for replying.  There is a label on the drops saying not to use after eight weeks of opening.  I've since realised that the efficacy of the active substance clearly diminishes after eight weeks.  I've stupidly been using the same bottle for six months and have just endured a month of hell after inadvertently withdrawing from 2mg, as the medicine has clearly become inactive.   Its given me such a fright and I'm really shaken up, although I'm starting to turn a corner after starting a new bottle five days ago.  I want to stabilise and get off this poison but I don't know what to dilute the drops with.  I'm wary of whatever I use diminishing the active substance.  2mg is two drops, which is 0.2mg; there's no syringe small enough so I definitely need to dilute in order to reduce by 10%.  I feel so frustrated that I'm stuck on this medication and would very much appreciate any guidance on what to dilute with.

[Altostrata]

You can dilute the liquid with water. You may wish to use filtered or distilled water. Suggest doing this in small batches or one dose at a time to limit possibility of error. Be sure to keep notes about the dilution so you can replicate your method each time.

[conkaia]

Thank you so much.  I will stabilise on 2mg and embark on a very slow reduction regime using filtered water to dilute as you suggest.  Much love.

[conkaia]

Thank you so much.  I've just one more question, sorry.  I inadvertently caused a withdrawal reaction from 2mg Cipralex due to using expired medication.  I noticed symptoms dating back four weeks and reinstated 2mg six days ago.  I noticed an immediate improvement; however I'm still very shaken and anxious after the whole experience.  After reading the threads on here regarding reinstatement, I'm wondering if I've did the right think reinstating 2mg or if I should have just reinstated 1mg.  But I'm very wary of reducing back down to 1mg after six days on 2mg, in case it destabilises me further.  All the guidance I can see on here (which is so valuable) relates to higher doses of drugs; I was wondering if you could advise me.  Much love.

[Altostrata]

It may take a few weeks for your system to settle down from the error. Please be sure to take the 2mg at the same time each day.

[conkaia]

Thanks so much. This site is literally a saviour ❤️

[conkaia]

Hi just thought I would post an update. It’s been over three months since I inadvertently put myself into withdrawal from 2mg Cipralex. Since then I’ve been in windows and waves, the latter of which I’ve now realised were mainly attributable to alcohol.
 

I feel like such an idiot as I honestly thought I would  be back to normal a few weeks after reinstating to 2mg. Sadly this has not been the case and I believe the Cipralex must have been working it’s way out my body for some time before I started experiencing withdrawal symptoms. 
 

I wondered why I was all of a sudden so unable to tolerate alcohol but put it down to hormones. Thanks to this site, I’ve now learned it’s because my nervous system is still in shock and trying to repair itself. I feel so annoyed with myself for hindering my recovery by drinking alcohol. Obviously now I have stopped drinking completely.
 

I’m so frustrated. I’ve been experiencing horrific mood swings and scary intrusive thoughts. I feel so traumatised by the whole experience, like I’ve completely lost the old me. I’d really appreciate some reassurance, how long is this likely to continue? I just want my life back!

[Altostrata]

Drinking alcohol can set back your stabilization from withdrawal. If you've been drinking intermittently, you'd have to allow some months after you've fully stopped drinking to stabilize.

[conkaia]

Thank you for replying.  I have been drinking socially at weekends; I didn't realise and didn't make the connection.  I thought I was going crazy, I'm so frustrated.

 

I have a question about supplements, as I'm now hypervigilant about anything else interfering with my recovery.  I've listed the supplements I take in my signature, most of which I use to balance my hormones.  I'm a bit worried about the Vitamin B complex after learning this can be activating.  I was wondering if the risk of activation is mainly when starting supplements in withdrawal/tapering? I've been taking this for some time prior to withdrawal, so would my nervous system already be used to it therefore less risk of any adverse effects?

[Altostrata]

B supplements can be activating but drinking alcohol is a far worse interference with recovery.

[Spenitate]

On 9/21/2022 at 11:40 PM, conkaia said:

Hi just thought I would post an update. It’s been over three months since I inadvertently put myself into withdrawal from 2mg Cipralex. Since then I’ve been in windows and waves, the latter of which I’ve now realised were mainly attributable to alcohol.
 

I feel like such an idiot as I honestly thought I would  be back to normal a few weeks after reinstating to 2mg. Sadly this has not been the case and I believe the Cipralex must have been working it’s way out my body for some time before I started experiencing withdrawal symptoms. 
 

I wondered why I was all of a sudden so unable to tolerate alcohol but put it down to hormones. Thanks to this site, I’ve now learned it’s because my nervous system is still in shock and trying to repair itself. I feel so annoyed with myself for hindering my recovery by drinking alcohol. Obviously now I have stopped drinking completely.
 

I’m so frustrated. I’ve been experiencing horrific mood swings and scary intrusive thoughts. I feel so traumatised by the whole experience, like I’ve completely lost the old me. I’d really appreciate some reassurance, how long is this likely to continue? I just want my life back!

Hi there! 
 

I just wanted to check in and say I hope you are hanging in there. I tapered myself down from 75mg to 2mg if sertraline, I too am currently experiencing windows and waves and intrusive thoughts, and totally recognise what you are saying about feeling traumatised and having lost your old self (I have a slightly more convoluted history though as I had to go through all this with paroxetine two years ago!).

 

I just wanted to give you some reassurance that you are not alone and that whilst this is horrible you will get through it and things will improve. I saw huge improvement from my paroxetine withdrawal and although I’m in a bad place with my current withdrawal I know I will survive it because I did last time. And so will you!

 

Try to hang in there - it’s tough but improvement is coming. From what others have written you will get a lot of your old self back when all this is over, although people do say it changes them for the better!

[conkaia]

On 10/1/2022 at 3:36 PM, Spenitate said:

Hi there! 
 

I just wanted to check in and say I hope you are hanging in there. I tapered myself down from 75mg to 2mg if sertraline, I too am currently experiencing windows and waves and intrusive thoughts, and totally recognise what you are saying about feeling traumatised and having lost your old self (I have a slightly more convoluted history though as I had to go through all this with paroxetine two years ago!).

 

I just wanted to give you some reassurance that you are not alone and that whilst this is horrible you will get through it and things will improve. I saw huge improvement from my paroxetine withdrawal and although I’m in a bad place with my current withdrawal I know I will survive it because I did last time. And so will you!

 

Try to hang in there - it’s tough but improvement is coming. From what others have written you will get a lot of your old self back when all this is over, although people do say it changes them for the better!

 

Hello, thanks so much for taking the time to post, I really appreciate it.  The intrusive thoughts are the absolute WORST part of this, really distressing.  I was also experiencing suicidal ideation but I would never act on this as I need to cling on to the hope that things will get better.

 

It's reassuring to hear from people who understand what I'm going through, it literally is hell.  I'm noticing a gradual improvement since cutting out alcohol but I'm still really shaken up by how bad I was, it's been traumatic.  It's also set my tapering right back as I'm too scared to touch the dose for the foreseeable. I wish I'd realised what was going on and I would have reinstated to just 1mg, then at least there would have been some gain from this nightmare.

 

I'm sorry you're struggling too but glad you can remain optimistic.  Feel free to message if you need a listening ear!  Why did you go onto Sertraline after stopping Paroxetine, if you don't mind me asking?

[Spenitate]

23 hours ago, conkaia said:

 

Hello, thanks so much for taking the time to post, I really appreciate it.  The intrusive thoughts are the absolute WORST part of this, really distressing.  I was also experiencing suicidal ideation but I would never act on this as I need to cling on to the hope that things will get better.

 

It's reassuring to hear from people who understand what I'm going through, it literally is hell.  I'm noticing a gradual improvement since cutting out alcohol but I'm still really shaken up by how bad I was, it's been traumatic.  It's also set my tapering right back as I'm too scared to touch the dose for the foreseeable. I wish I'd realised what was going on and I would have reinstated to just 1mg, then at least there would have been some gain from this nightmare.

 

I'm sorry you're struggling too but glad you can remain optimistic.  Feel free to message if you need a listening ear!  Why did you go onto Sertraline after stopping Paroxetine, if you don't mind me asking?

it is one of the great regrets of my life that I went on Sertraline and if I knew then what I know now I would never have touched it. Basically I was so desperate with the Paroxetine withdrawal that when a doctor told me to go on the Sertraline to help manage the symptoms I took their advice. It made everything infinitely worse and then I was stuck taking it because my nervous system couldn’t take any more changes.

 

I rushed my taper of Sertraline this time out of desperation. I am now in a bad place but am luckily being looked after by family. I know I will recover and so will you. I agree with you it is literally hell and so hard to explain even to sympathetic people who haven’t been through it. 
 

take care of yourself and focus on the small improvements!

[conkaia]

6 hours ago, Spenitate said:

it is one of the great regrets of my life that I went on Sertraline and if I knew then what I know now I would never have touched it. Basically I was so desperate with the Paroxetine withdrawal that when a doctor told me to go on the Sertraline to help manage the symptoms I took their advice. It made everything infinitely worse and then I was stuck taking it because my nervous system couldn’t take any more changes.

 

I rushed my taper of Sertraline this time out of desperation. I am now in a bad place but am luckily being looked after by family. I know I will recover and so will you. I agree with you it is literally hell and so hard to explain even to sympathetic people who haven’t been through it. 
 

take care of yourself and focus on the small improvements!

This is why most of us are here - listening to doctors argh. They could at least have put you on Fluoxetine, which is allegedly easier than Sertraline to taper from.  It's awful you're in a bad place but you sound really pragmatic about your situation.  It is absolute hell and you're lucky to have family support.  It is difficult for people to understand just how bad it is unless they've personally experienced it.  I literally would not wish this on my worst enemy.

Thank you for the lovely words, you take care of yourself too.  We will get through this nightmare eventually.

[Spenitate]

18 hours ago, conkaia said:

I literally would not wish this on my worst enemy.

I have used almost exactly these words multiple times to try and explain how bad this is to people. It’s somewhat comforting to know other people out there so know what it feels like! We just have to cling on for the windows - every time I have a good patch however short I write myself a journal entry which I can go back and read during the dark periods. It does help a little bit.

 

Keep fighting it will be worth it in the end.

[conkaia]

On 10/6/2022 at 12:36 PM, Spenitate said:

I have used almost exactly these words multiple times to try and explain how bad this is to people. It’s somewhat comforting to know other people out there so know what it feels like! We just have to cling on for the windows - every time I have a good patch however short I write myself a journal entry which I can go back and read during the dark periods. It does help a little bit.

 

Keep fighting it will be worth it in the end.

I use an app called Daylio to track my moods.  I had a window for a few days this week but back to a wave again now.  The intrusive thoughts are just the worst part of this for me.  I feel like such a freak, like I dont deserve to be happy anymore  .

[Spenitate]

On 10/9/2022 at 1:32 PM, conkaia said:

I use an app called Daylio to track my moods.  I had a window for a few days this week but back to a wave again now.  The intrusive thoughts are just the worst part of this for me.  I feel like such a freak, like I dont deserve to be happy anymore  .

I’m currently in a horrible prolonged wave due to a change in medication brand. I am persistently suicidal and my family are at a total loss. It is awful but I just keep clinging on for the next window. You will get one too!

[conkaia]

8 hours ago, Spenitate said:

I’m currently in a horrible prolonged wave due to a change in medication brand. I am persistently suicidal and my family are at a total loss. It is awful but I just keep clinging on for the next window. You will get one too!

You’re so brave honestly. I literally can’t cope at times. I had similar difficulties due to a change of brand. It was awful, I got GP to prescribe me the branded version. I’m sorry you’re having to go through this. Big hugs. 

[Thorin]

Hi, I just want to say that not long ago I was experiencing horrible intrusive thoughts. I just thought it was a flare up of old trauma but in hind site I’m sure it was withdrawals. I really recommend finding a good therapist if you don’t already have one. Being able to talk about the thoughts helped immensely while I was going through them. Then they slowly stopped as I stabilised. They pop in briefly every now and again but I believe it’s due to withdrawals. Implementing the things I learned in therapy really takes the sting out of the thoughts when they do show up. Good luck!

[conkaia]

3 hours ago, Thorin said:

Hi, I just want to say that not long ago I was experiencing horrible intrusive thoughts. I just thought it was a flare up of old trauma but in hind site I’m sure it was withdrawals. I really recommend finding a good therapist if you don’t already have one. Being able to talk about the thoughts helped immensely while I was going through them. Then they slowly stopped as I stabilised. They pop in briefly every now and again but I believe it’s due to withdrawals. Implementing the things I learned in therapy really takes the sting out of the thoughts when they do show up. Good luck!

Hi thanks so much for your post.  I thought the thoughts were old trauma resurfacing but later realised it was withdrawal.  Its really triggered me, and I'm constantly ruminating and monitoring my thoughts.  I do have a therapist; I stopped going recently as I was so bad I didn't feel I would get any benefit from it.  But I'm seeing him again on Sunday so I will discuss it then.  All my usual strategies don't seem to be effective at all right now.  How long did it take you to stabilise if you dont mind me asking? 

[ChessieCat]

I've moved the post you made to KayC's Intro topic.

[Altostrata]

Hello, @conkaia How is your taper going? Where are you now with it? What withdrawal symptoms are you getting?

[conkaia]

15 hours ago, Altostrata said:

Hello, @conkaia How is your taper going? Where are you now with it? What withdrawal symptoms are you getting?

Hi @Altostratathanks for checking in.  I'm still trying to stabilise at 2mg of the poison that is Cipralex.  I've had a horrific time recently with really disturbing intrusive thoughts and ruminations; this is by far the most debilitating symptom for me.

[Altostrata]

Do these symptoms occur at about the same times each day?

[conkaia]

12 hours ago, Altostrata said:

Do these symptoms occur at about the same times each day?

The rumination starts from the minute I wake most days. The intrusive thoughts come and go during the day but I usually feel more normal in the evenings. I’m starting to get some windows of a couple of days when I can see the thoughts for what they are and dismiss them. They dissipate but then come back with a vengeance and I’m back to square one. My latest strategy is to try allow them to be there whilst telling myself my brain is tricking me etc.    I’d appreciate any other advice on how to manage them, as they’re really vile and upsetting.  Thanks so much. 

[Thorin]

Find a therapist you trust and share the thoughts 

[Altostrata]

@conkaia Are these thoughts characteristic of the way your mind works? Are they connected to typical worries or something that's unusual for you?

 

Letting them fade away is a good way to cope with them.

[conkaia]

@Altostrata I had intrusive thoughts several years ago on a much milder scale than this.  They were trauma related and dissipated after learning techniques to manage them in therapy.  But this time round they are much more severe, disturbing and completely unmanageable.  Basically every taboo topic and dark memories rolled into one.  All previous coping strategies were unsuccessful until recently. So no, they are not typical worries and not characteristic of my mind.

I found a helpful page on intrusive thoughts on the Inner Compass withdrawal project website Obsessive/repetitive thoughts | The Withdrawal Project (theinnercompass.org).  So I continue to try allow them to be there, whilst reminding myself my mind is lying and they are not me.  This seems to be helping, as I felt completely normal yesterday.  I do notice the windows are slowly but surely lasting longer and the waves less severe.💗

[Altostrata]

18 hours ago, conkaia said:

So I continue to try allow them to be there, whilst reminding myself my mind is lying and they are not me.  This seems to be helping, as I felt completely normal yesterday.  I do notice the windows are slowly but surely lasting longer and the waves less severe.💗

 

You are managing them! You should gradually get windows that are longer and more frequent.

[conkaia]

On 11/2/2022 at 4:52 AM, Altostrata said:

 

You are managing them! You should gradually get windows that are longer and more frequent.

I guess I am... I've just had a window lasting the whole of this week.  This is progress!

 

I have two questions, hope that's okay.  Firstly if I remain stable, I will consider tapering down by 10% early next year.  I planned to use filtered water to dilute the Cipralex 20mg/1ml drops.  To make a solution of 1mg/1ml by mixing two 1mg drops into 2ml of water and drawing up 1.8ml.  However I recently came across this thread where a moderator is advising not to use drops, as they are not the same size:  

I'm a bit confused because if the drops weren't the same size, surely everyone taking them would be destabilised?  Anyway, I'd be really grateful if someone could confirm if it would be more accurate to draw up 0.1mg Cipralex in a syringe to mix with water rather than use two drops.

 

The other question is that I'm 48 and have not had a period since this withdrawal nightmare started.  I put it down to peri menopause; however my period has just returned.  After doing a bit of research, I'm coming to the conclusion that the absence of my cycle is due to withdrawal rather than hormonal.  I was wondering if you think this is likely?  I'm going to search the site for similar experiences right now. 

[Altostrata]

The droppers are not as accurate as oral syringes or pipettes.

[conkaia]

Thought I’d update I just had a window lasting a week. However today is back to a wave, which I guess is to be expected. It doesn’t feel as severe and I’m definitely more able to separate from intrusive thoughts and images. Right now I feel anxious and tearful but can’t have a cry because I’m at work. The release of cortisol in tears usually helps. I feel traumatised by how bad the past five months have been, it’s going to take some time to get over this. 

[Altostrata]

Yes, it can be very hard. But signs are that improvement is on the way!

[conkaia]

So I felt better after posting last week and actually felt I was making progress.  Anyway, long story but I ended up in a stressful situation on Friday night, which has tipped me straight back into a wave of doom.  I was crying constantly on Sunday and Monday and am now really anxious and back to horrible intrusive thoughts.  I didn't realise that stress can trigger a wave, although it does make sense.  My nervous system has clearly been shot to pieces; I feel so frustrated.