poohstix: Lexapro, possible kindling and attempt at taper

[Altostrata]

To be honest, I don't know what's going on in the early morning, but it seems clear that you have an adverse reaction after taking your dose.

 

Please continue to post daily notes.

[poohstix]

1 hour ago, Altostrata said:

To be honest, I don't know what's going on in the early morning, but it seems clear that you have an adverse reaction after taking your dose.

 

Please continue to post daily notes.

Do you think I should decrease to 4.5 now? I’ve only technically been on 5 for 9 days.

[Altostrata]

You've been on at least 5mg since January 14. Did you get any new symptoms after you went from 7.5mg to 5mg on February 24?

[poohstix]

1 hour ago, Altostrata said:

You've been on at least 5mg since January 14. Did you get any new symptoms after you went from 7.5mg to 5mg on February 24?

I have more diarrhea but otherwise some things have improved: I no longer have moments of fight or flight, and PGAD and fluishness/warm skin seems to be less prevalent. Now I sweat more. 

 

Sleep is maybe marginally worse based on sheer hours tracked by my sleep tracker. But I also feel more rested than I feel I should for the 5-7 hours of sleep I get, but this may also be due to maybe me being asleep at times when I think I’m just resting in bed. 

[Altostrata]

Your description of what happened after you decreased to 5mg indicates you were taking too much before, and 5mg might still be too much. I would decrease to 4.5mg if I were you. This may mean using a liquid.

[poohstix]

3 minutes ago, Altostrata said:

Your description of what happened after you decreased to 5mg indicates you were taking too much before, and 5mg might still be too much. I would decrease to 4.5mg if I were you. This may mean using a liquid.

I will try it. How long should I pursue 4.5, and under what circumstances should I think about going up again?

 

Thank you so much for all your help.

[Altostrata]

You probably would take 4.5mg for at least a month. Please let us know how you're doing.

[poohstix]

16 hours ago, Altostrata said:

You probably would take 4.5mg for at least a month. Please let us know how you're doing.

Should I post daily notes still? 
 

This is from yesterday:

 

3/4:

6:30: wake. Tired. Rapid heartrate. Tight around upper chest and throat. Mild PGAD. Sad/ anxious emotions. Was able to doze until 10. Felt too warm under covers and too cold outside them.

10 am: feel better. Some itching 

11-1pm: dozed more

1pm: took lexapro 5

3pm: massage 

4pm: feel tired and sad, some tongue tightness. Hungry but also upset stomach. Had loose stool.

6:30: ate. No issues 

8pm: upper back and chest discomfort. Feeling emotional. Did some kickboxing. Slightly upset stomach. Tight back of tongue

9pm: ate. diarrhea, upset stomach, poor appetite, sore throat. Fluish. 

11pm: bedtime. 75mg valerian, magnesium foot bath 

4am: woke briefly 

8:30 am: woke and returned to sleep

Slept for 1-2 hours during morning (had a dream)

 

I feel like upset stomach and fluishness are better now. Oddly, I had fluishness when I was getting on lexapro 10 in January. I’m not sure if right now those symptoms are withdrawals or side effects. I’m worried about withdrawal worsening but hopefully 4.5 is a small enough change that it won’t change much. 

[poohstix]

3/5

12: fluishness and upset stomach improved. Thighs still feel warm. Physically tired still.

1pm: ate. Lexapro 4.5 liquid

1:30pm: mild chest pain 

2:40pm: feeling good, eating, no issue

3pm: some stomach upset. Mild face and ear warmth. Feel mildly “off”

5pm: feel good. More energy. Dry throat 

6-7pm: dinner. Moderately good appetite. Mostly no symptoms, just a bit of sore throat

11pm: magnesium foot soak. Still

Somewhat hungry. Snack. 

12midnight: valerian 75mg, bedtime 

4am-5am: woke. Tired but cannot go back to sleep. Sweaty. Took more valerian (75mg)

5-8:30: slept, mostly light 

9-10:45: slept lightly 

[Altostrata]

Yes, please continue with the daily notes.

[poohstix]

3/6:

10:45: woke for the day

1 pm: lexapro 4.5 and ate

1:45pm: mild itch

2pm: warm skin, Bowel movement (soft, not diarrhea)

3pm: mild sore throat, upset stomach, edging toward fluishness, some tiredness 

4pm: temp 99.9

4:30pm: loose stool, suddenly less fluish and broke a sweat 

5:30pm: another loose stool, overall feel good, eating apples

6:00pm: some throat phlegm, mild ear warmth 

7pm: temp 100, not feeling fluish, throat phlegm

8-10pm: feeling somewhat chilled, otherwise ok. Massage

11pm: valerian 75mg, mag foot bath

12midnight: bedtime 

3:44am: woke up, tired

4:15am: fell back asleep

10am: slept, including deep sleep/dreaming

[poohstix]

Note: in post above I meant I slept until 10 am

[Altostrata]

The adverse effects from Lexapro should gradually decrease a bit, but it will take about a week for the reduction to 4.5mg to take full effect.

[poohstix]

3/7:

10 am: mild stomach upset, arms and legs feel sore. Temp 99.3. Ate. Phlegm/soreness in throat

12noon: muscle soreness almost gone, sweats. Throat feels dry 

1pm: lexapro 4.5

2pm: food

2:45pm: loose stool

3pm: temp 100F

6pm: temp 100F

7pm: massage

8:30: dinner. Hungry, no issues. Temp 99F. Magnesium foot soak 

12midnight: bed. Valerian 100mg

5am: woke up. Tired, not anxious, but not able to sleep. Hungry. Mild PGAD. Sweaty. Got under thinner blanket.

7am: took 3 drops valerian tincture (standard dose is 30 drops)

12:30: woke up again for the day. Some deep sleep and some light sleep, no throat or muscle soreness or fever

[Altostrata]

Do you have a virus coming on?

[poohstix]

15 minutes ago, Altostrata said:

Do you have a virus coming on?

Not sure. Today I feel fine: no cold symptoms, not feeling fluish, no fever. If I did have a virus, this would be my second or third one since mid-Jan. I suspect the medication and/or withdrawal process and the sleep deprivation over time has affected my immune system negatively.

[Altostrata]

Suddenly raised temperature would be unusual for withdrawal syndrome.

[poohstix]

3/8:

12:30pm: can feel heartbeat, gone quickly 

1pm:lexapro 4.5

1:30pm: mild PGAD

2:30pm: magnesium glycinate 50mg. Food. Stool (not loose)

3pm: temp 99.7. Don’t feel fever or fluish

3:30: tired, likely from magnesium 

4pm: warm behind ears, dry mouth

4:45 pm: weird skin sensitivity along back, sort of like during a fear response, but not feeling anxious or afraid otherwise 

6pm: food

6:30: mild tightness in mouth and tightness/tingle over chest and back, mildly upset stomach 

8pm: shower. Front of mouth still on and off tight, mild internal tremor, PGAD 1/10. Upset stomach

8:30: meditation. Feel calm by the end 

9pm: eating, no issues 

11pm: mag foot bath, massage, valerian tincture 1/3 serving (10/30 drops)

12midnight: sleep

1am: brief awakening 

6am: wake up for 30 mins, feel chilled 

6:30-10:30am: sleep

10:30-11:30am: RLS, then gone on its own. Nose somewhat congested. Thigh muscles sore.

[poohstix]

21 hours ago, Altostrata said:

Suddenly raised temperature would be unusual for withdrawal syndrome.

Is there a way to tell the difference between withdrawal related flu like feelings and a viral illness?

 

Ever since I started being back on lexapro I keep having viral illnesses, my premenstrual hormonal acne is back and my menses are heavier. I could all be “stress” but it seems there is stress in being on the med and coming off if it. Is it true that SSRIs can affect hormones and immune system?

[Altostrata]

8 hours ago, poohstix said:

10:30-11:30am: RLS, then gone on its own. Nose somewhat congested. Thigh muscles sore.

 

Please describe the RLS. How long did this go on? Have you tried magnesium for this symptom?

 

1 hour ago, poohstix said:

Is there a way to tell the difference between withdrawal related flu like feelings and a viral illness?

 

Not really, except that withdrawal flu probably would not raise your temperature. That is caused by your body fighting a bug.

 

Antidepressants and withdrawal syndrome can affect menses. Women often report worse symptoms at times in their cycle.

[poohstix]

The RLS was in my feet and lower legs and was like a pulling and tense sensation made to feel better by movement. I just had it for about an hour as I was lying down in the morning, drifting in and out of light sleep. Then it went away. I had this symptom a few times when I was on lexapro 10, too.

 

I do magnesium foot soaks at night, so I suspect that helps RLS not occur at night. I am going to try taking magnesium at night to see if it helps with RLS into the morning and sleep generally. I tried mag glycinate before and thought the glycinate was activating me, but I retrospect I dont think that was correct. I am grateful that sleep is improving but the early morning awakening is still there, no matter how relaxed or tired I am when I get to bed.

 

It seems like lexapro is affecting everything in a way it has not done before. Although who knows, maybe it did cause my prior bout of adult acne, but it took years for it to get to that point, and now it’s doing it right away.

[Altostrata]

Magnesium and potassium are good for leg cramps.

[poohstix]

3/9

12:30pm: tight mouth, 1/10 PGAD, a bit restless, mild sore throat and painful thigh muscles 

12:30-1pm: meditation 

1pm: lexapro 4.5

2pm: food. Temp 99.9, mild sore throat. Mag glycinate 50mg

3pm: tight mouth, 1/10 PGAD. Gut does not want to accept food. Mild chest discomfort at bottom of chest and upset stomach, milder than it has been in a while

4pm: feel ok. Soft stool. Temp 99.7

5pm: mild tightness in tongue, hands and feet, and chest and stomach 

6pm: feel ok except for sore throat. Temp 100.

7pm: massage

8pm: dinner, feel ok

10pm: mag foot bath

11pm: valerian 75mg, magnesium glycinate 50

11:30: bedtime. Tired but have had time falling asleep so very light sleep until 12:45am

12:45-2am: tired and frustrated. A little hungry so ate piece of bread. Feel warm so got ice pack 

2am: fell asleep

9am: brief awakening

9-11:30am: some light, some deep sleep with dreaming 

11:30 am: tight throat, hands, and backs of feet. Foot discomfort relieved by moving. Less bad than yesterday. Neuroemotion of sadness 

 

I’m not sure if the magnesium glycinate interfered with falling asleep at all… when I take it during the day it does make me calm and a little tired. But one prior night when I took magnesium glycinate in the late evening I had a really bad night. 

[Altostrata]

I doubt 50mg magnesium glycinate caused your bad night. Magnesium is best taken in small doses throughout the day.

 

I do not see any signs of "RLS" in your daily notes.

[poohstix]

1 hour ago, Altostrata said:

I doubt 50mg magnesium glycinate caused your bad night. Magnesium is best taken in small doses throughout the day.

 

I do not see any signs of "RLS" in your daily notes.

The last time I had restless legs was a few weeks ago, when I was on lexapro 10, which was before I started doing daily notes. I had it for a few days on lexapro 10, only in the morning for an hour or so, and then it went away.

 

Now I had it again the last couple mornings.

[poohstix]

3/9

12:30pm: tight mouth, 1/10 PGAD, a bit restless, mild sore throat and painful thigh muscles 

12:30-1pm: meditation 

1pm: lexapro 4.5

2pm: food. Temp 99.9, mild sore throat. Mag glycinate 50mg

3pm: tight mouth, 1/10 PGAD. Gut does not want to accept food. Mild chest discomfort at bottom of chest and upset stomach, milder than it has been in a while

4pm: feel ok. Soft stool. Temp 99.7

5pm: mild tightness in tongue, hands and feet, and chest and stomach 

6pm: feel ok except for sore throat. Temp 100.

7pm: massage

8pm: dinner, feel ok

10pm: mag foot bath

11pm: valerian 75-100mg, magnesium glycinate 50

11:30: bedtime. Tired but have had time falling asleep so dozing until 12:45am

12:45-2am: tired and frustrated. A little hungry so ate piece of bread. Feel warm so got ice pack 

2am: fell asleep

9am: brief awakening

9-11:30am: some light, some deep sleep with dreaming 

11:30 am: tight throat, hands, and backs of feet. Foot discomfort relieved by moving. Neuroemotion of sadness 

1pm: lexapro 4.5.

3pm: food. Mild sore throat and phlegm in throat. Temp 99.7 but don’t feel warm or fluish, a bit fluish, 

3:30: 1/10 PGAD, very mild chest discomfort, food

4:pm: stool, not loose! Took 2 pills tcm

5pm: warm arms and behind ears, a bit sedated, dry mouth, temp 99.3

6pm: sweats 

7pm: mostly better. Dinner 

8pm: 1/10 PGAD 

9pm: 2/10 PGAD (more like swelling in genital area). Dry mouth

9:30: mag foot bath, feel good 

10pm: massage, valerian tincture 8 drops (working to cut down)

11:30pm: sleep

6:30am: woke for 30 mins, hungry, ate piece of bread 

7:00am-11:30am: slept deeply.

[Altostrata]

Do you ordinarily sleep until noon? What is your sleep schedule?

 

What is your temperature at 1 p.m., before you take Lexapro?

 

If the magnesium foot bath is relaxing, you might rub a little magnesium oil on where it hurts at intervals throughout the day.

[poohstix]

25 minutes ago, Altostrata said:

Do you ordinarily sleep until noon? What is your sleep schedule?

 

What is your temperature at 1 p.m., before you take Lexapro?

 

If the magnesium foot bath is relaxing, you might rub a little magnesium oil on where it hurts at intervals throughout the day.

Ordinarily when I work I sleep midnight to 7 am and by the weekend I have serious sleep debt and sleep 12+ hours, often until noon on later. This was the case before all the business with lexapro induced insomnia (though at the time we didn’t realize it was lexapro induced). I think 9 hours of sleep is what I really need. 

 

Lately I’ve been on medical leave due to all these issues, and until the last week or so I’d sleep midnight to 8-10am, though usually not straight through. There’s often a 4-6 am awakening in there, so I’d truly get only 5-7 hours. Then the last few days my body is letting me sleep longer into the day, my watch is telling me 9-10 hours, and I’m letting it happen because I figure that’s what it needs. The early morning awakening is still happening. Maybe the answer is to go to bed earlier, and to do that I have to break years of night owl tendencies, so it’s definitely a work in progress!

 

I have not checked temp before taking lexapro in morning, but I will do and report back. 

[Altostrata]

34 minutes ago, poohstix said:

Then the last few days my body is letting me sleep longer into the day, my watch is telling me 9-10 hours, and I’m letting it happen because I figure that’s what it needs.

 

This is a good sign. Suggest you get your sleep schedule regularized, go to sleep and wake up at the same times each day. This will assist your normal circadian rhythm to get back on track.

[poohstix]

14 minutes ago, Altostrata said:

 

This is a good sign. Suggest you get your sleep schedule regularized, go to sleep and wake up at the same times each day. This will assist your normal circadian rhythm to get back on track.

Looks like I also just got diagnosed with an ear infection. That might explain the some of the fevers recently. But now I have to take antibiotics and I’m not excited for that now that my system is sensitized. 

[getofflex]

Some antibiotics are better than others.  Please try to avoid the fluoroquinolone antibiotics, which mess with the nervous system.  

 

Antibiotics

[littlebird]

Just now, getofflex said:

try to avoid the fluoroquinolone antibiotics, which mess with the nervous system.  

 

I had no idea antibiotics could mess with the nervous system! Woah, good to know.

[poohstix]

6 minutes ago, getofflex said:

Some antibiotics are better than others.  Please try to avoid the fluoroquinolone antibiotics, which mess with the nervous system.  

 

Antibiotics

Good to know. I was given ampicillin .

[Soup]

Also decline one called Suprax that gave me a big setback . But of course you must take them if you need them . Just sharing my experience 

[poohstix]

3/11

11:30: wake up, mild anxiety, tired (good news, this may mean I need less valerian)

1pm: Lexapro 4.5, food

1:30: acupuncture 

3:30pm: warmth and pins and needles down arms, dry mouth, a bit sad and headachy. Drinking plenty of water.

4:15pm: feel mildly feverish but temp 99.3

5pm: sore throat 

 6pm: anxious, a bit of tearfulness burgeoning, pulling sensation in hands, still feeling fluish. Sore throat more on right side which is where I was told I have ear infection, mild upset stomach with dinner

7pm: feel better. Still a bit fluish and sore throat. Tight front of mouth

8pm: tight in back of hands and feet and front of mouth, neuroemotion that feels like wanting to cry. Sore throat. 99.5 temp

9pm: mild tightness in upper chest. 

10pm: don’t feel feverish anymore, just a bit of sore throat and tight hands and feet 

11:30pm: bedtime. Took valerian 5 drops of tincture (30 drops is standard dose)

1am: wake up briefly, feel warm and feverish 

6:30am: wake up for 30-45 mins, eat and drink water, then fall asleep. Feel warm and feverish, have to be under thinner blanket 

12noon: wake up 

 

 

I think right now feeling on and off fluish is my biggest concern. I have a sore throat on and off and was told I have an ear infection, but I feel barely any ear discomfort: the ear infection was discovered incidentally when I had an earwax plug. I have antibiotics (amoxicillin) but am afraid to take it — this withdrawal/drug reaction changed everything, and taking something that used to be a basic medication now feel scary and fraught. 
 

With sleep, I just recently started being able to sleep a lot, but still have a tendency to wake around 1am and 5-6am, no matter how much I sleep overall. So I lose 1-2 hours of sleep that way. Sleeping through the night has always been an issue throughout this journey. I still am working on anxiety around sleep: that I won’t be able to fall asleep or won’t be able to fall back asleep, which is a barrier to moving bedtime earlier.

[Altostrata]

We  won't be able to interpret your symptom pattern while you're ill and taking antibiotics, your symptoms could be from something else other than withdrawal. Please post your daily symptom pattern after your ear infection is gone.