poohstix: Lexapro, possible kindling and attempt at taper

[poohstix]

Hello everyone!

 

I recently found this website, and suddenly my last few weeks of experience with lexapro have begun to make a lot of sense! I am so grateful for all this community does to help people dealing with the adverse effects of antidepressants and withdrawal. Here is my story. I am hoping for any insights on how to proceed. I do have a psychiatrist, but unfortunately this is not a very well understood phenomenon in the medical community. I am also struggling with self blame and worry that I will become a person who has gotten messed up irreversibly, and I know those are cognitive distortions, but any positive vibes in those departments would still be great!

 

Backstory

I’ve been on lexapro twice in my life for several years at a time for GAD, did great, had nausea upon first starting out and some irritability on tapering but overall found it quite helpful and with minimal side effects. I never cold turkeyed - both times I weaned over months if not years under medical supervision. I was also always a good sleeper: could sleep 9+ hours easy.

 

Fast forward to this holiday season. I’m not on lexapro, stable for 6 months. Then I start getting random heart pounding throughout the morning and trouble falling asleep—every time I would try my heart pounded. Got medical workup, all good. Over the course of a week, I tried several sleep meds, including valerian root, Trazodone up to 100 mg, Benadryl and gabapentin up to 400 mg, which helped sleep minimally and only messed me up more: caused daytime anxiety or disinhibition or over tiredness. Some nights I took both trazodone and benadryl. In the end I took a 150mg dose of Benadryl in a desperate attempt to sleep. At about that time I resumed lexapro because my doc figured it was underlying anxiety causing sleep trouble, though in retrospect I don't think I was really that anxious.

 

Kindling?

Then I had weird symptoms for 2 weeks, including ongoing insomnia (troubles staying asleep), inappropriate sexual arousal that felt like a pain in my genitals, restlessness, a sense of fight or flight including trouble breathing and a sense of urgency and discomfort in your own skin, sometimes with shortness of breath and chest tightness, oftentimes after eating which I know makes very little sense, poor appetite, lots of stools though not diarrhea, random itching including itching that woke me in the middle of the night). None of the above is my regular old GAD, by the way. My usual anxiety is more mental: turning over worst case scenarios in my head and all that. I had never had any of the above symptoms before, so I chalked it up to withdrawal from my overuse of sleep meds. My doctor, too, told me that sometimes anxiety can morph into other forms, but I was skeptical, feeling like "this is chemical."

 

I also wondered if I was histamine intolerant and started a low histamine diet, which by the way sucks, but I doubt hurts anything because I can still eat enough of a variety of foods.

 

Most of the above symptoms evened out over 2-3 weeks except for upset stomach and fatigue whenever I ate, and I could get unbroken sleep only every other night. So my doc and I decreased lexapro to 5 mg after about a month of being on 10mg, since we thought 5 mg would be more tolerable.

 

Taper

First week into the taper, appetite declined so I have to count calories just to make sure I get enough. I itched at times but that’s a minimal issue. There were flutters of restlessness and “monkey mind” here and here and there, and a bit of genital swelling, but overall manageable. The second week sleep got worse: before I would wake and just not be able to resume sleep, but now I would wake with ragged breathing and struggle to resume sleep and be anxious about it. Before that I would just wake up and be awake. I take valerian root for sleep in tiny doses: 1/4 of the 500mg caps per night. I don’t want to take it, but worry about going back to a time when I slept 4 hours per night if that at the beginning of this journey.

 

(Re)-Increase

So then on 2/15 doc and I figured I should try a slower taper and do 7.5mg. I did that for 2 days and on day 2 (2/16) the fight or flight returned: restless, uncomfortable in my skin, a swelling sensation in my genitals. I took an extra 2.5 mg (for a total of 10 mg) and later that day felt like my skin had a sunburn for about an hour. I went down to lexapro 5 mg for a day, then back up to 7.5 mg and have been on that dose for the past 4 days. Well, sure enough the "chemical" feeling anxiety did decline and is almost gone, the skin warmth increased and then declined (I also had cold-like symptoms but not objective fever), and inappropriate arousal has also improved (except for today, when it seems worse). I also had some looser stools and the jury is still out on whether that's getting better or worse.

 

 

[TL;DR]

If you got this far, thank you :). My questions are as follow:

-- Does it seem like I might be dealing with kindling (or re-kindling)? I'm not sure I fully understand kindling... When it occurs, does it decline? Or do medication side effects sometimes look a lot like a kindling phenomenon?

-- re: kindling: if I kindled myself as I backtracked on my lexapro taper, what now? Is it best to hold steady, or to taper? Should I wait and see? There's been a couple days of back and forth but overall I've been on lexapro 7.5 mg for less than a week. If I taper again I will ask my doc for liquid lexapro and decrease very slowly, as I have learned from this site.

 

TIA for reading and for any insights! Keep fighting the good fight. 

[getofflex]

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  Thank you for giving us your drug history.  Let me give you some basic information first, then go into specific on your situation.  

 

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 about recovery from psychiatric drugs: 

 

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 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 links 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

 

It may be that you have kindled after you first reinstated Lexapro on Jan. 10.  However, when you increased your dosage to 10 mg. you say that kindling symptoms declined, which doesn't make sense, because if your were kindled, you would have felt worse at the 10 mg dosage.  It looks like what you are trying to do is cure your symptoms by changing your Lexapro dose.  It is important that you stop doing this.  This puts you at risk of worsening your symptoms, instead of improving them.  Changing your dose frequently will further confuse and destabilize your nervous system.  You also indicate using trazodone, valerian, and gabapentin, so it could be that your system is reacting to those drugs/supplements.  Were you using these prior to your reinstatement of Lexapro on Jan 10?  When there are multiple substances being used that impact the nervous system, it is hard for us to know what is causing the problem.

 

How are you feeling on the current dose of 7.5 mg of Lexapro?  Are there any other drugs or supplements you are using?  

 

 

[getofflex]

The fallacy many people believe, is that they think these drugs are like an Advil pain killer, where the drug works while it is in your system, and once it's out of your system, there is no effect.  This is not true of these psychiatric drugs.  These drugs make profound changes to the nervous system, and become dependent on a specific dose of the drug.  So, when we make frequent dose changes, the nervous system becomes confused and destabilized, and this causes symptoms.  Our nervous system must change and adjust each time we change our dose, and this takes time.  It can take 4-8 weeks for our nervous system to adjust to even a very small change in the dosage. Please read:

 

 

 

Stop Jumping Around

[poohstix]

1 hour ago, getofflex said:

Hello, and welcome to SA.  We are a volunteer-run community of people who have been or are getting off of psychiatric drugs.  Thank you for giving us your drug history.  Let me give you some basic information first, then go into specific on your situation.  

 

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 about recovery from psychiatric drugs: 

 

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 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 links 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

 

It may be that you have kindled after you first reinstated Lexapro on Jan. 10.  However, when you increased your dosage to 10 mg. you say that kindling symptoms declined, which doesn't make sense, because if your were kindled, you would have felt worse at the 10 mg dosage.  It looks like what you are trying to do is cure your symptoms by changing your Lexapro dose.  It is important that you stop doing this.  This puts you at risk of worsening your symptoms, instead of improving them.  Changing your dose frequently will further confuse and destabilize your nervous system.  You also indicate using trazodone, valerian, and gabapentin, so it could be that your system is reacting to those drugs/supplements.  Were you using these prior to your reinstatement of Lexapro on Jan 10?  When there are multiple substances being used that impact the nervous system, it is hard for us to know what is causing the problem.

 

How are you feeling on the current dose of 7.5 mg of Lexapro?  Are there any other drugs or supplements you are using?  

 

 

Thank you so much for answering. I know now it’s not the best aides to jump around, and it’s a hard impulse to resist.

 

Right now I only take lexapro 7.5mg and valerian <100mg/night. I would like to add omega 3 since a I’ve had good luck with them before.

Prior to Jan 10, I did not take anything except the occasional valerian root about once a week if I was having a hard time falling asleep.

 

To clarify, week 1 I took the sleep aids trazodone, gabapentin, valerian, and Benadryl, along with lexapro 5. The next week I took no sleep aids and increased lexapro to 10mg, and things got worse with anxiety and agitation and such, but they did even out over the course of 1-2 weeks, week 3 I felt fluish and tired, and by week 4 I was just getting inconsistent sleep and post eating discomfort/brain fog. If it were kindling, would the bad feelings have persisted? It’s true it’s hard to know what was going on because that first week I took so many things but things clearly got worse after the night I took too much Benadryl.

 

At this time on lexapro 7.5, I feel warm, usually in the morning without objective fever, and my thigh muscles, which I worked out a week ago, hurt. On a good night I sleep 6 hours, and on a bad night I wake every 2-4 hours and get a total of 6. It is hard to eat: I feel full too soon and sometimes just undefinably bad after eating. Fight or flight sensations and genital pain have gone, thank goodness.

 

My only concern and why I might want to change doses is that when I increased from lexapro 5 to 7.5, I did in retrospect have an almost immediate bad reaction (meaning within 2 days) with anxiety/fever, and the ongoing warm feelings, loose stools etc could point to serotonin excess if not serotonin syndrome, and I know that is not safe.

I am sad that this medication seems to be making things worse but I can’t get off of it quickly and if I were to do it the right way, I’d have to stay at the current dose which I feel like is poisoning me for another 4 weeks. 

 

 

 

[poohstix]

One thing I’m curious about is, when I increased from 5 to 7.5, I may have had an almost immediate bad reaction. But now I’m a week out from when that occurred, so I’m not sure I’d I’m still in the window of being able to reverse that change. The bad reaction symptoms declined some but are still there to an extent, notably warm skin and flulike feeling. I also have some cold symptoms but they are minimal and out of proportion with the warm skin.

[poohstix]

I feel like I’m having bad reactions to being on lexapro and it might be causing me harm to be on it (feeling like I have the flu and a fever, early on when I started it’s not impossible I had mild akathisia, now gone, which can be evidence of damage to the nervous system), but going off of it slowly means I have to have this drug in my system for months yet and it’s likely to continue to exert its harmful influences.

 

I guess I’m struggling with how do you balance it if you’re actively having side effects but also trying to minimize harm of withdrawal.

 

Everything says avoid stress and be gentle with yourself… But I have a job to return to and financial responsibilities and there is nothing non-stressful about that. I see stories of people who had to quit their jobs, who lost careers. I worry this will destroy my life. Are there discussions on how one *can* maintain responsibilities and a semi normal life while going through this process? Right now I am home on medical leave and my home is a paradise or relaxation: healthy food, baths, light exercise, meditation, funny movies, books with pages, massages from my spouse every day, acupuncture visits. And I’m still sick with a dysregulated nervous system and doing 8 hours of thinking and dealing with other humans feels like a formidable task. 

[getofflex]

3 hours ago, poohstix said:

One thing I’m curious about is, when I increased from 5 to 7.5, I may have had an almost immediate bad reaction. But now I’m a week out from when that occurred, so I’m not sure I’d I’m still in the window of being able to reverse that change.

I'm thinking about that, too.   However I will need to see a clearer and more concise drug history before I can determine this.  I'm not sure what dose of Lexapro you were on between Jan 21 to Feb 5.   I need you to give us the details of your drugs in a concise vertical list (no symptoms), only specific dates, include the day (as best you can say for example early March if you don't recall the day), drug names, and dosages of each and every medication decrease or increase. Here is an example: 

 

March 12, ’22: Lexapro 5 mg, Xanax 0.5 mg, Trazodone 50 mg

March 29, ’22: Lexapro 4 mg, Xanax 0.5 mg, Trazodone 50 mg

April 17, ’22:  Lexapro 3.8 mg, Xanax 0.5 mg, Trazodone 50 mg

May 19, ’22:  Lexapro 3.8 mg, Xanax 0.5 mg, Trazodone 25 mg

 

Please eliminate descriptions, explanations, symptoms, etc. That information is already in your intro post.  Thank you.  

[poohstix]

45 minutes ago, getofflex said:

I'm thinking about that, too.   However I will need to see a clearer and more concise drug history before I can determine this.  I'm not sure what dose of Lexapro you were on between Jan 21 to Feb 5.   I need you to give us the details of your drugs in a concise vertical list (no symptoms), only specific dates, include the day (as best you can say for example early March if you don't recall the day), drug names, and dosages of each and every medication decrease or increase. Here is an example: 

 

March 12, ’22: Lexapro 5 mg, Xanax 0.5 mg, Trazodone 50 mg

March 29, ’22: Lexapro 4 mg, Xanax 0.5 mg, Trazodone 50 mg

April 17, ’22:  Lexapro 3.8 mg, Xanax 0.5 mg, Trazodone 50 mg

May 19, ’22:  Lexapro 3.8 mg, Xanax 0.5 mg, Trazodone 25 mg

 

Please eliminate descriptions, explanations, symptoms, etc. That information is already in your intro post.  Thank you.  

I’ll do my best. The first week I don’t remember everything as it was so chaotic. I wish I could recall exactly when lexapro was increased: below is my best guess. I started keeping a diary Jan 24 so from that date on everything is accurate. 

 

June 30 2022 (approximate): last dose of lexapro 5

2023:

Jan 9: valerian 300mg, Benadryl 12.5

Jan 10: lexapro 5, trazodone 50, valerian 100-200mg

Jan 11: lexapro 5, trazodone 50, Benadryl 25, gabapentin 100 or 200

Jan 12-13: lexapro 5, gabapentin dose unknown, Benadryl dose unknown 

Jan 14: Benadryl 150mg. Lexapro either 5 or 10, don’t recall 

Jan 15-17 (approximate)-Feb 5: lexapro 10

Feb 6-14: lexapro 5, 1/8 cap of 500mg valerian 

Feb 15: lexapro 7.5, ditto valerian

Feb 16: lexapro 10, ditto valerian

Feb 17: lexapro 5, ditto valerian

Feb 18: lexapro 7.5-present, ditto valerian

 

[getofflex]

Beautiful job on the signature - thank you!  I will copy and paste this into your signature box to replace the info from June 2022 on.  

 

I suggest you go ahead and drop your Lexapro dose back down to 5 mg, and stay on this dose for a while.  Your nervous system needs some stability, which means, taking the same doses of drugs and supplements each and every day, at the same time of day each time.  The trick is, we need to balance the adverse reaction with the withdrawal.  We want to lessen the ADR (adverse reaction), but don't want to taper off so fast that the withdrawal becomes worse than the adverse reaction.  Stay on this 5 mg dose for a while, at least 4 weeks, and we will take it from there.  There may be days where you feel worse, and times when you feel better (windows and waves).  We don't want to react, and change the dosage based on that.  Please work on non drug ways to cope with these symptoms as they come up.  

[poohstix]

Thank you. By the way I looked back at the signature and realized that there may have been some confusion about symptom timeline, so I updated it. 
 

Basically, I don’t think the signature made clear that things worsened after Jan 14, though they did get better by the time January was up. Jan 14 correlates with both a lexapro increase and the Benadryl bomb/withdrawal from prior sleep meds. But the next time I increased the lexapro dose there was a mini version of a similar adverse reaction. 
 

I also sense that lexapro 5 mg is the right target for now. Would it be too fast a drop though? I know this site advocates decreases of 10 percent or less. 

1 minute ago, getofflex said:

Beautiful job on the signature - thank you!  I will copy and paste this into your signature box to replace the info from June 2022 on.  

 

I suggest you go ahead and drop your Lexapro dose back down to 5 mg, and stay on this dose for a while.  Your nervous system needs some stability, which means, taking the same doses of drugs and supplements each and every day, at the same time of day each time.  The trick is, we need to balance the adverse reaction with the withdrawal.  We want to lessen the ADR (adverse reaction), but don't want to taper off so fast that the withdrawal becomes worse than the adverse reaction.  Stay on this 5 mg dose for a while, at least 4 weeks, and we will take it from there.  There may be days where you feel worse, and times when you feel better (windows and waves).  We don't want to react, and change the dosage based on that.  Please work on non drug ways to cope with these symptoms as they come up.  

 

[getofflex]

On 2/24/2023 at 5:12 PM, poohstix said:

I also sense that lexapro 5 mg is the right target for now. Would it be too fast a drop though? I know this site advocates decreases of 10 percent or less. 

Yes, that is true, we suggest only 10% drops.  I thought long and hard about this.  Since you were all over the place with your dosing, going up and down between 5, 7.5, and 10, I figured that it would be OK to drop to 5 mg.  However, I will run this by the other staff, and see if they concur.  

 

How are you feeling now that you have been on the Lexapro 7.5 mg since Feb 18?  

 

Please keep a daily journal, to see what your symptom pattern is.  This will help determine if you are indeed having an adverse reaction.  Please do a daily drug and symptoms journal.  Keep track of taking your drug, symptoms, eating, sleeping, etc.  Write the time on the left, and describe the event on the right.  Pay attention especially to how you feel before, and then after, you take your drug. Please do this for 24 hours, and post an entry in here for each 24 hour period.  Here is an example: 

 

January 31, 2023

6 AM woke with anxiety

8 am took 2.5 mg lexapro

10 am stomach is upset

10:30 am ate breakfast

11:35 am got a headache, lasted one hour

12:35 ate lunch

4 pm feel a bit better

5 pm took 2.5 mg lexapro

6 pm ate dinner

9:20 pm headache 

10:00 pm took 50 mg Seroquel

10:30 pm feeling dizzy

10:30 pm fell asleep 

2:30 am woke, took 3 mg Ambien

2:45 am fell asleep

4:30 am woke, but got back to sleep 

 

 

Edited February 26, 2023 by getofflex

[poohstix]

Well, I did decrease lexapro to 5 on 2/24 per your advice. 
 

While I was on lexapro 7.5 from 2/18 to 2/23, I dealt with sleep that was broken up and 6-7 hours per night, flu like feelings with subjective fever and muscle pain, pounding heart, genital pain, dry throat, loose stools/poor appetite, and occasional panic or sense of fight or flight. 
 

I want to say in the last couple days some things have improved, notably the loose stools, dry throat, and genital pain, but that may just be a window. It is hard to know if the updosing to 7.5mg did in fact lead to a worsening via the emergence of warm skin and “fight or flight” feeling but rather those symptoms were an ongoing part of withdrawal and were going to

occur anyway. 
 

I do already keep detailed diaries of my symptoms, though not quite as detailed as the example. Here are my diaries for last couple days. I will post more as time goes on. 

 

2/24:

Prior night: Slept soundly 6 Hours 12-6 am. Came close to falling back asleep in morning but can’t.

9-12 am: 

No/minimal genital pain 

Sore legs/feverish

Sad, tightness in upper throat. 

Feverish sensation gone by noon.

Noon: lexapro 5

 

2-3 pm: eating and reading anxiety inducing stuff. Tight throat and roof of mouth, some increase in heart rate

 

Genital pain did not start until later PM.  Feels like a very localized pain at 3/10. Otherwise good evening 

 

12-6 am: Broken sleep, 5-6 hours. Took valerian to get to sleep and stay asleep (1/8 to 1/4 of 500 mg cap at bedtime and again middle of night). Overnight weird full body zap

2/25: 

9 am: Pounding heart in morning, some tightness in mouth and tongue (want to press it on the roof of the mouth), tightness in backs of feet, want to stretch them. Lasted 1 hour.

Noon: lexapro 5

1 pm: Pounding heart recurred in acupuncture. Also tight throat and some unevenness in breathing, feeling downcast and withdrawn. NO sense of fight or flight-todays symptoms were qualitatively different. Lasted 2 hours.

3-6 pm: Afternoon to early evening fluish.

7pm: Mild genital discomfort 2/10 pain. Otherwise symptom free in evening. 

8 pm: Tried magnesium glycinate (50 elemental magnesium) and felt relaxed 

11 pm: took valerian 1/2 of 500 mg cap. Slept unbroken 8 hours. 

[getofflex]

19 minutes ago, poohstix said:

Well, I did decrease lexapro to 5 on 2/24 per your advice. 

Good to know, thank you.  Please update your signature accordingly. 

 

If you are getting 6-7 hours of sleep, this is very good for a person in withdrawal.  How is your anxiety, panic, sense of fight or flight since you reduced the dose to 5 mg Lexapro?  

 

Would you say that overall, in just one word, do you feel 1) better 2) the same 3) worse in the few hours after you take your Lexapro at noon?  

 

Please continue to post your daily drug and symptom notes here.  Thank you.  

[poohstix]

2 hours ago, getofflex said:

Yes, that is true, we suggest only 10% drops.  I thought long and hard about this.  Since you were all over the place with your dosing, going up and down between 5, 7.5, and 10, I figured that it would be OK to drop to 5 mg.  However, I will run this by the other staff, and see if they concur.  

 

How are you feeling now that you have been on the Lexapro 7.5 mg since Feb 18?  

 

Please keep a daily journal, to see what your symptom pattern is.  This will help determine if you are indeed having an adverse reaction.  Please do a daily drug and symptoms journal.  Keep track of taking your drug, symptoms, eating, sleeping, etc.  Write the time on the left, and describe the event on the right.  Pay attention especially to how you feel before, and then after, you take your drug. Please do this for 24 hours, and post an entry in here for each 24 hour period.  Here is an example: 

 

January 31, 2023

6 AM woke with anxiety

8 am took 2.5 mg lexapro

10 am stomach is upset

10:30 am ate breakfast

11:35 am got a headache, lasted one hour

12:35 ate lunch

4 pm feel a bit better

5 pm took 2.5 mg lexapro

6 pm ate dinner

9:20 pm headache 

10:00 pm took 50 mg Seroquel

10:30 pm feeling dizzy

10:30 pm fell asleep 

2:30 am woke, took 3 mg Ambien

2:45 am fell asleep

4:30 am woke, but got back to sleep 

 

 

If this helps, here is my diary from  2/15 and 2/16 when I first updosed to 7.5. Not hour by hour but does have a chronology to it.

 

2/15

Some itch in morning before food even.

noon: lexapro 5

Mild cold symptoms and burning behind ears post eating lunch 

Feel a bit cold with tiredness 

Feeling a bit emotional even though rationally more or less made piece with the bad night last night 

Some post eating brain fog for first time in more than a week

More stomach discomfort - early satiety and some evidence of acid reflux (a bit of throat acid taste)

Some itch after dinner when I went out 

Easily full with dinner

4 pm: Took extra lexapro 2.5mg and omega 3 

Night: Woke up at 12 after an hour of sleep and at 4 am for 1-2? Hours. Overall 6 hours broken sleep with 1/2 pill of valerian. Was anxious albeit tired during awakenings.

 

2/16

Feel awake, just tired post eating. Some stomach pain with lexapro 5 dose at 8 am. Passed in 1-2 hours, not severe. But overall appetite better than expected 

Took several sips of coffee

Took lexapro 2.5mg 10 am

11 am—tried to take nap but felt viscerally anxious (sort of like my old anxiety), then it randomly went away 11:30

1 pm post Acupuncture: feel calmer. Ongoing odd dry throat despite water consumption. Some acidity likely due to reflux in mouth. Still some skin itch post acupuncture though it improved during the treatment

2 pm: Random fight or flight moment with skin tingling and restlessness and genital sensation. Began before eating. Want to cry but cannot

3:30 again: visceral anxiety again, sense of being uncomfortable in skin, sensation in genitals, tingling sensation in feet. Then some itching.

Tingling and genital sensation come in waves, but milder now 

5 pm: Took lexapro 2.5mg 

Above symptoms on and off in evening and night

Dry throat 

Felt like skin has a sunburn 

Was very tired going into bedtime

Sweats at night 

slept 11-1, 1-4, 6-8:30, total 7.5 hours

No anxiety in middle of night, just awake. Needed extra valerian to return to sleep

[getofflex]

In the future, please put the times with the events, thank you.  

[poohstix]

42 minutes ago, getofflex said:

How is your anxiety, panic, sense of fight or flight since you reduced the dose to 5 mg Lexapro?  

 

Would you say that overall, in just one word, do you feel 1) better 2) the same 3) worse in the few hours after you take your Lexapro at noon?  

I can’t say that I feel better or worse post taking my noon lexapro, so I’ll just say the same. However, evenings tend to be the best.
 

Anxiety, panic, fight or flight has changed a bit since going down to lexapro 5. I no longer feel that sense of fight or flight or discomfort in my skin, where I just want to shut down and doing anything feels like too much, like I did on 7.5. I do get a pounding heart and uneven breathing at times, more often in the morning or after eating. I also get tight muscles in the hands, face, mouth and feet.

[poohstix]

1 hour ago, getofflex said:

In the future, please put the times with the events, thank you.  

Will do. Thank you so much for taking all the time to think and advise on my situation.

 

Even without time markers looking back over 2/15 and 2/16 when I first updosed to 7.5, I probably had a bad reaction because I had not previously felt like my skin “had a sunburn” and the fight or flight/restlessness/genital issues came back, and the last time those

things had been a part of my experience was when I was *getting on* lexapro 10 in January. So maybe there is something about higher doses when they are first implemented that does not agree with me.

[getofflex]

20 hours ago, poohstix said:

Anxiety, panic, fight or flight has changed a bit since going down to lexapro 5. I no longer feel that sense of fight or flight or discomfort in my skin, where I just want to shut down and doing anything feels like too much, like I did on 7.5.

Excellent, this means it was the right thing to drop to 5 mg.  Please stick with this for a while, to give your system some stability.  Continue to keep the post the daily notes.  Eventually, when you have stabilized more, you could start to do a gradual 10% taper as described previously.  

 

19 hours ago, poohstix said:

So maybe there is something about higher doses when they are first implemented that does not agree with me.

Yes, evidently 7.5 mg was too high of a dose for you.  

[poohstix]

2/26: 

Prior night 11 pm: took valerian 250 mg and magnesium 50. Slept unbroken 8 hours. Woke up refreshed. 

9-10 am: rapid heartbeat, warmth in arms and legs, behind the ears. Pain in thigh muscles. 

11 am: took magnesium 25mg (I take it in the form of magnesium glycinate, all values in elemental magnesium)

11:30: genital discomfort 1-2/10 qualitatively different from last few days: rather than localized pain or nerve pain, more like a diffuse swelling, traveling pains. By 2 pm mostly gone.

1 pm: lexapro 5 (late)

1 pm-2pm: lunchtime. Appetite good. Very mild increase in heart rate, warmth behind ears, mild sore throat. This often happens with eating

2:30 pm: mood lower (neuroemotion?), can feel my heartbeat. felt a bit of pain in upper back and like my food was going to come up. Feel hungry for a second then not. Had bowel movement (large, on soft side), brief mouth tension and then fine. Cold hands for a few minutes 

3pm: magnesium 25m. 

Warm behind ears, warmth over the back. Overall feel just a bit off, breathing a bit off. Some tightness in throat and stomach (I dont think the magnesium caused this, it’s too soon to tell). Starting to feel more warm, stomach does not want to accept anything new, even water

4: feel good, free of essentially all symptoms except 1-2/10 genital pain 

7 pm: meditating but get an anxiety spasm toward end, shiver down arms

Took magnesium 50mg

8 pm: dinner. Some tightness in chest. Appetite good.

11 pm:  prison salt foot bath (night ritual) and massage from spouse. took melatonin 5 and valerian 250. However, struggled to fall asleep until 3 am. Never felt all the way asleep. Tried cold water, ice packs. Felt warm, leg muscles sore and rapid heartbeat 

3 am: took valerian 100mg and magnesium 50. Dozed off, but never felt all the way asleep 

5 am: woke up, feeling warm and rapid heartbeat. Had bowel movement, soft. Feel a bit dehydrated in throat. Drank a large bottle of water. 

6-7 am: dozed

7 am: woke up hungry, had two pieces of bread 

8-9 am: slept relatively deeply and actually had a dream. Woke up with rapid heart beat 

 

I'm not sure what happened to sleep last night. Maybe I overdid the magnesium, since U read glycinate can disinhibition some people. All night I felt tired but just could not sleep, but I actually felt more tired in morning than overnight.

[poohstix]

Overall daily patterns:

I have a tendency to wake at midnight, 4 am and 6 am. I also have a tendency to have heart palpitations prior to noon. I did not have any major sleep issues before my most recent stint on lexapro. I’m sad that it took me a month or more to figure out that the lexapro was the problem, and now I am stuck on lexapro and will need to wean over many months. And weaning also seems to be adding to sleep problems. 
 

last night I could not even get to sleep, which is a new problem. I’m hoping it’s just a bad reaction to magnesium glycinate.

[poohstix]

2/27:

5 am: woke up, feeling warm and rapid heartbeat. Went #2, soft. Feel a bit dehydrated in throat. Drank a large bottle of water. 

6-7 am: dozed

7 am: woke up hungry, had two pieces of bread 

8-9 am: slept and actually had a dream. Woke up with rapid heart beat 

1pm: lunch and lexapro 5

2-4: tight throat and upper chest. Feel not tired per se but disconnected. Hungry but throat does not want to accept food. But feel better when I do eat 

5-5:15: hands tingling and feel overall sort of warm. Neuroemotion of sadness

6pm-7pm: feel warm  and low grade feverish 

8pm: dinner. Some tingling in extremities, warmth behind ears.

9pm: fluish/feverish feeling gone. 1-2/10 genital pain. Took bath. Mildly restless.

10pm: massage from spouse 

11pm: took valerian 250mg. Tired but hard time falling asleep until about 1:30 am. Rapid heart rate. Frustrated by noises. But did sleep soundly until 8 am. Feel relatively rested. 

[poohstix]

2/28: 

8am: trying to go back to sleep but rapid heartbeat and hungry. Had piece of bread. Some tightness in legs that compels them to move (RLS?). Some other muscle groups tight. 

10 am: chest discomfort, despairing mood

12: above symptoms gone. 

1:30: lump in lower chest again. Eating and lexapro 5. 

1:30-2:30: meditation, helpful, made me almost fall asleep 

3:00: psychotherapy. Feel warm, mostly in legs. Dry throat, mild pain in ears

4pm: tightness in mouth and some muscles. Now cold feet 

6-7: exercise by walking. Had snack during. Toward end some chest tightness and uneven breathing, throat tightness, reflux 

8 pm: dinner, no major symptoms except tingling in arms 

11: restorative yoga, massage, valerian 250

12-1:30: slept

1:30-2?: brief awakening

2-5: slept

5-7: awake, struggled to sleep though tired. Ate slice of bread, got ice pack. Some sweating and warmth 

7-9:30: slept 

[poohstix]

Titled:  Confused about what is withdrawal and what is adverse effects

 

I am confused. I resumed lexapro (likely unnecessarily, in retrospect) after several months of doing relatively well but having some stressors and minor getting-to-sleep insomnia, and the symptoms I had after resuming lexapro included worse insomnia (trouble staying asleep), restlessness, PGAD, evidence of dysautonomia such as fight or flight symptoms after eating and subjective fever that never really registered on a thermometer, poor appetite, diarrhea. Most of these symptoms went away after a couple weeks but insomnia was still on and off as well as being tired post eating. As I have tapered down on lexapro, I’ve had insomnia worsen, and I have had those subjective fevers even more, poor appetite and diarrhea still, occasional PGAD. I did not have any of these issues before resuming lexapro and had previously been on lexapro without a problem for several years. Now, I did probably destabilize my body by trying a bunch of sleep meds when I first started having trouble staying asleep, but at this point I’m probably having both side effects and withdrawals and feeling hopeless that any of it will end anytime soon. 

 

There is more info in my intro post, including symptom logs.

Edited March 6, 2023 by manymoretodays
merged from S and SC

[Altostrata]

Please be sure to take 5mg Lexapro at the same times each day and indicate when you take it in your daily notes. Inconsistent dosing can cause odd symptoms.

[poohstix]

1 minute ago, Altostrata said:

Please be sure to take 5mg Lexapro at the same times each day and indicate when you take it in your daily notes. Inconsistent dosing can cause odd symptoms.

Will do. I take lexapro at 12-1pm every day, so close to same time. I forgot to include it in my most recent entry, but I believe I had it in the others.

[poohstix]

3/1

5 am-warm skin, feeling of low grade flu, tired.

5-10 am: PGAD 2-3/10

11am: meditation 

12 noon: brief improvement in fluishness

1pm: lunch and lexapro 5. 

1:30: cold hands and feet, then warm again

2pm: tightness in throat, upper chest

4pm: warm magnesium bath. Relaxing but made heartrate go up, ongoing tightness in throat and a twinge of pain in upper chest. 

5 pm: bath over, heartrate down. Throat still tight. Warm skin/fluishness improved 

6pm: feel almost asymptomatic 

7pm: upset stomach again, don’t really want to eat dinner. Tightness in back of mouth and discomfort in upper chest 

7:30pm: yoga 

8pm-8pm: eating slowly, throat and upper esophagus feel tense, some tightness in chest and uneven breathing 

10: massage

11: feel hungry and have a large snack. No issues. Take valerian 250mg

12: bedtime. Hard time falling asleep until 3. 

1-2 am: sweats 

3-8:30 am: slept 

[Altostrata]

When you started Lexapro again in 2019, did you have any startup symptoms?

 

How are you measuring 5mg Lexapro?

[poohstix]

33 minutes ago, Altostrata said:

When you started Lexapro again in 2019, did you have any startup symptoms?

 

None. It just helped with anxiety.

 

33 minutes ago, Altostrata said:

 

How are you measuring 5mg Lexapro?

 

I have the 5 mg tablets. 
 

Of note, spouse told me that I was in fact asleep 12-1 am last night as I was heard grinding my teeth which I only do when asleep. I did not think I did more than doze 12-1 am last night. I use a sleep tracker watch but it is not a perfect system. So maybe I sleep more than I think I do.

[Altostrata]

Please continue to post daily notes.

[poohstix]

3/2:

8:30: woke up. Feel more rested than expected. Loose stool.

(Of note, spouse told me that I was in fact asleep 12-1 am last night as I was heard grinding my teeth which I only do when asleep. I did not think I did more than doze 12-1 am last night)

12 noon: tight sensation in upper left chest, upper back, neck and radiating to head

1 pm: lexapro 5, small breakfast 

1:30-2:30: acupuncture, relaxing

2:45: loose stool

3 pm: tight throat, upper chest and back tightness. Began before eating. When I ate, throat was tight and food seemed reluctant to go down

4pm: exercise by biking 

5pm: psychotherapy

6pm: symptoms that began around 3 pm almost gone. Eating ok but breathing somewhat uneven, heaviness in bottom of chest. Loose stool. Cold hands and feet.

6:30 pm: more exercise by cycling, 30 mins

7:30 pm: mini cortisol spike with PGAD moment, tongue tightness, feeling of internal tremor 

8:30 pm: dinner. Breathing somewhat uneven, tongue tightness. Pinprick sensation under ribs

9:30 pm: continuing to eat, warm behind ears and sore throat. Gut gladly accepting food

11pm: massage, breathing exercises, took valerian 160mg, magnesium foot bath 

12:30am: slept 

5:30: brief awakening 

8:30: woke for the day, dozed until 9 am 

 

 

(Of note, I had I had autonomic symptoms such as heart rate going up, shortness of breath, panicky/false urgency feelings, restlessness, particularly post eating and particularly in the afternoon when I was first *getting on* lexapro 10 mg in early January 2023. I always took lexapro at noonish. So it’s confusing that I’ve had some recurrence of hyper autonomic symptoms now that I’m tapering. I’ve also had PGAD with initially getting on and tapering the drug).

[poohstix]

I also had warm skin once on my first week of lexapro 10, fluish feelings all of my third week on lexapro 10. I had some warm skin on updosing from 5 to 7.5 and fluishness that re-emerged with that updose and has been on and off since.

[poohstix]

16 hours ago, Altostrata said:

Please continue to post daily notes.

One other thing to consider is that on prior trials of lexapro I had a different manufacturer of pills. But at this point I am concerned trying to change manufacturers or to start taking liquid lexapro (which I do have for the future when I start decreasing doses) would introduce additional confounding variables.

[poohstix]

I made a chart of what I think is an adverse drug reaction and what is a withdrawal symptom, based on my daily analysis and my week by week analysis. Some symptoms are between columns, because they don’t seem to fit neatly into any column but seem to be more ADR than withdrawal—for example, restlessness was definitely more prominent with starting the drug but has cropped up in a minimal way on withdrawal too. But I would love to know what others think based on my daily logs. 

[poohstix]

3/3

9 am: woke up feeling sore leg muscles, fluish, sore throat

9:30 am: going to an appointment, still feel fluish, mild PGAD, upper chest discomfort radiating to back, tight throat and want to press tongue to roof of mouth, and an overall undefinable “off” feeling m, not actually feeling anxious or like I have fight or flight 

10:30 am: fluishness mostly gone, feel urge to fidget with hands as I talk to doctor. This is not usual for me and I don’t feel mentally anxious at all.

11 am: some tightness in arms and legs 

11:30: no more muscle soreness. 

12:30: feeling fluish again. 

1 pm: Took Lexapro 5 and had lunch. Hands and feet cold, and overall chilled and can feel my heartbeat

1:30: fluishness now minimal 

3pm: chest tightness followed by mildly upset stomach, muscle tightness in hands and feet, minimal PGAD. All symptoms mild 

4pm: meditation

5:30: almost asymptomatic, skin just feels a bit warm and some ear pain

6-7pm: light aerobic exercise by biking. Mild sore throat only 

7:30 pm: eating, very mild upper chest and back sensations, warm behind ears. Tightness in front of mouth and extra salivation. Cold hands

10pm: magnesium foot bath

11pm: massage, valerian 150. Feeling tired

12: bedtime. Hungry, had snack. Somehow unable to sleep until 1:30. Slept until 6:30 am.

[Altostrata]

It appears that you experience activation from a dose of Lexapro for several hours after taking it each day. If I were you, I'd reduce it to 4.5mg. Please let us know how you're doing.

[poohstix]

13 minutes ago, Altostrata said:

It appears that you experience activation from a dose of Lexapro for several hours after taking it each day. If I were you, I'd reduce it to 4.5mg. Please let us know how you're doing.

IThat’s an interesting insight. I also do get alerting symptoms in the morning (pounding heart, chest tightness) that seem to resolve on their own before I ever take my lexapro dose. I wonder if that a mini withdrawal every day or just hyper responsiveness to cortisol whether due to the med or as part of withdrawal.
 

I will try the 4.5. Not going to lie, I’m eager to try and take less of this med.