Annelle: tapering off escitalopram after long term treatment

[annelle]

Hello again!

 

I just have an additional question. I am currently taking 2 mg = 2 mg = 2 drops of Cipralex a day. I take it at the same time every day.

 

But reading about other people dividing their daily dose into two or more, I just wondered if it would be better for me to split the daily dosage in two - take one drop of 1 mg twice a day? Or would that not work for escitalopram?

 

Thanks again!

[annelle]

Hello again!

 

I have a question to Altostrata and Alexejice.

 

I have reinstated Cipralex after 7 months without it after a very quick taper - after reinstating I have felt hypersensitive to Cipralex, so I have gone from initially 5 mg to 2,5 mg to now 2 mg (liquid) which I have been on for 5 days now.

 

Now, my concern is that I still feel very sensitive to the drug - as if it were a stimulant - and in addition I am having very strong alcohol cravings - which I have kept abay for appr 7 years. The alchol cravings came on when I stopped taking Cipralex last October, and again now on reinstating. Sometimes I give in to them, sometimes I do not. 

 

But just the fact that I having them is very upsetting, after having 7 years of sobriety. 

 

So my question is - could they be a sign that I have become too sensitive to Cipralex after 7 months after almost c/t - and do I need to quit right away before it gets worse - or do I stay on it and hold for one or more months? I feel very strange, almost psychotic I think - or maybe it derealisation and depersonalisation?

I definitely do not feel like myself right now.

[annelle]

Thank you so much Marmite for your response!

 

It really helped a lot.

 

I have also been hospitalized for heart issues twice - they found an ischemic heart condition and hypertrophy of my left ventricle - but they did not think that that could explain the symptoms I was hospitalized for - which was difficulty breathing when I was laying down on my left side to sleep. I had to sit up again right away just catch my breath.

 

This difficulty actually started right after I stopped taking Cipralex, which I did not at all put together until just recently, after finding this site. 

 

It is just amazing how many symptoms - also physical symptoms you would never think were related to AD's - these drugs cause, in the form of adverse effects when still on them and then in the form of withdrawal symptoms when tapering or after quitting them. 

[annelle]

Hello Marmite!

 

I have and have had many of the same symptoms you described. I have numbness in my hip too, which I never thought could be related to any drugs - but now I think it may be. I also have chronic pain in my left hip and leg - it was because of this I had to take tramadol. The pain is still bad some days, but I do not want to take strong pain killlers. I use paracetamol for the pain, when it is bad.

 

I also have had excessive sweating for quite some time now - almost debilitating. I hate to be around other people in the shops, and even my own family sometimes, because of it.

 

I also often have the feeling that my intestines have stopped moving completely, as well as my esophagus and stomach. For a while I thought this due to hypokalaemia, but my GP said the level of potassium in my blood was not low enough to give these symptoms. I guess he was right, and it was the AD - and perhaps seroquel and tramadol as well.

 

I also have anxiety, especially at night between 2 and 5 a.m., but also sometimes in the day time. And sometimes more than just anxiety, almost fear, I feel really scared - this is worse since reinstating Cipralex.

 

Sleep is very difficult to come by - I generally sleep 3-4 hours a night, if I a lucky, sometimes only 1-2 hours. I think that that makes the anxiety worse. I also feel almost psychotic sometimes - like I am not myself, and the world is a strange and scary place which I don't know.

 

Yes, I had an X-ray of my lungs when I was in hospital last November - they were fine. So that is one good thing!

 

I am sorry that you had such a bad experience with the AD's also - even though it is very nice to hear from someone who has been through a lot of the same things.

 

Thank you!

[annelle]

Hello everyone!

 

I just wanted to give an update.

 

Today I am having what I think is a window - I slept 4 hours in a row last night and felt almost normal when I woke up. My mood is better than it has been for the last few weeks - so maybe reinstating is working for me, even if I did after 7 months off AD.

 

I realize that it is probably just a window, and that it very well be followed by one or several waves - but at least it is nice to have just one window - gives a little bit of hope.

 

I am very grateful that I found this site - the advice in the symptoms and self-care section has helped me - especially I think magnesium citrate and fish oil is doing me good. 

 

So thank you everybody who posted the great advice!

[Nikki]

Thank you Altostrata!I will try that - today I am getting the liquid form of Cipralex - I hope that will make it easier to measure doses accurately, which I think is important, especially if one is hypersensitive to the medication.I have noticed in the past few months that I have had some OCD-like (I think) symptoms - they manifest as certain songs or tunes always playing in my mind - also when I am thinking of something else, it seems to always be playing in the background - strange and a little unnerving and unpleasant. I wonder if it is another withdrawal symptom?Also I am rather sensitive to sunlight and daylight - I try to get some daylight every day because I think it is helpful in terms of getting into a healthy sleep pattern, - but sometimes it feels like it is too much for me - too intense.I am also very easily tired - almost exhausted - when I try to exercise - just walking - and it takes very little - maybe just a phone call or discussion with somebody - to make me feel extremely stressed - with heavy sweating and heart palpitations. This seems to have gotten worse since reinstating.Does anybody else recognize these symptoms?I hope everybody is having a good day!

 

Hi Annelle - everything you have mentioned I have had as part of WD and tapering.  The OCD type is very frustrating because for me I felt a lack of control.  Sunlight is tough for alot of people.  I livei in Florida so I am accustomed to it and miss it very much from rain. Exhaustion, stress and perspiration along with the palpitations have all happened to me.  If you read thru the posts of others who are tapering Cipralex you will see you are not alone.

 

I have never had an issue with reinstatment.  Alot do.  Alto said it is sensitivity and I believe it.  I also believe it's like a burn out on a drug. There are people who have had to wait a week or two to see improvement.

 

I hope youi feel better soon.

[annelle]

Hi everyone!

 

I have now been on 2 mg of Cipralex (escitalopram) for 2 weeks, and I think reinstating is helping me. I am having a good day today, which I usually have after  being able to sleep ok. Last night I slept appr 6 hours, and dreamt quite a bit - which I have not done for some time now. I like getting my dreams back - I have missed being able to remember my dreams for the last few months. 

 

All in all, I think i am getting a little better. But am careful not to get too optimistic too soon - some waves are probably still to come. I guess I can say that I am cautiously optimistic

 

I wanted to update, because it may give hope to other people struggling with WD from escitalopram - and other drugs as well.

 

Best wishes to everyone!

[areyouthere]

Wow!!! This is all GREAT news!!!! Good for you Annelle!!!

[annelle]

Hello again!

 

This time my update is not so positive, unfortunately - but that was to expected, and I did. I guess I am in a wave today - feeling blue, heavy in body and mind, tired, sad, weepy. 

 

I think it may in part be due to the weather we are having today here in Denmark - it is grey, rainy, and thunder is coming, the weather girl said.

 

I have noticed a few times lately that I am now very sensitive to changes in weather - both thunder and strong sunlight. But I think that must be part of the withdrawal syndrome.

 

I am also sensitive to too much exercise, which I did yesterday. I walked a little more than usual, and as a result I could not relax and get to sleep last night - had terrible restless legs and trunk and burning and hurting feet for about 2 hours - so all in all not a very good night.

 

I suppose the best thing to do is to try and learn from that experience and moderate my exercise whenever possible - it is not always possible, of course - and be very careful with stimulating experience (I had a massage yesterday too which I think also may be a factor with regard to restless legs and maybe also burning feet).

 

Also I took a bit more vitamin C yesterday than I usually do, because I thought it might help me sleep - but perhaps it had an adverse effect.

 

That it is one of the problems when you are in withdrawal - it is so difficult to know exactly what the problem is - it may be something you did, something you ate, a supplement you took - you can make yourself crazy trying to figure it out.

 

Today I am trying to keep everything at a very low level, so to speak - not taking any supplements, not overdoing anything exercisewise, not getting too much sun (which is easy since it is raining today!)

 

But I am still largely optimistic and consider this a wave, and am hoping for a new window tomorrow or in the next few days

[annelle]

Hi again!

 

I was just wondering about something - maybe you, Alto, know the answer to my question:

 

I am sometimes having great trouble falling asleep at night because of restless legs. I try to stick it out and wait till it subsides and I can fall asleep, but sometimes I just can't stand it, when it goes on for hours. My doctor has prescribed pramipexole for this, but I am reluctant to take it, because I am afraid it will in some way interfere with my healing from withdrawal (from escitalopram).

 

Do you know if taking this drug, which I think has an impact on dopamine in some way, will interact negatively with withdrawal syndrome and healing from this?

 

Thank you.

[Altostrata]

I would avoid taking more drugs for this symptom. I would take fish oil, magnesium, and maybe potassium for this. Many people find magnesium alone eliminates the symptoms. See the magnesium topic in Symptoms and Self-care.

[annelle]

Thank you Alto,

 

I do take magnesium citrate and fish oil, but sometimes it is not enough - and unfortunately you cannot get potassium as a supplement without a prescription here. But I do sometimes eat a banana late at night to see if it helps - but sometimes nothing works. 

 

I guess I have to go in trying to suffer through it when I can, and only take pramipexole when it is absolutely unbearable. I only hope that I am not making things worse by taking it once in a while.

 

It is unbearable when it is at its worst, because it is not only restless legs, but also pelvis/lower back and shoulder/arms that just can't lie still! Thank God it is not every night!

 

Thanks for replying so quickly!

[Altostrata]

Can you get magnesium oil to apply to your legs? It can be absorbed through the skin and go right to the muscles.

[annelle]

Thank you, Alto,

 

I will try that instead of taking magnesium capsules. I do not think I can buy magnesium oil here, but I will try making my own with the help of the symptoms and self-care forum.

 

Even without the restless legs syndrome bothering me I do have great difficulty getting a good night's sleep. I have been taking Phenergan (promethazine) tablets 25 mg on and off for a couple of years for insomnia. I don't take it very often now that I am in withdrawal, but sometimes I feel desperate to get some sleep, and I take one.

 

Do you think that is unwise with regard to healing from withdrawal? I do feel that my movements are somewhat slow the day after I take it, and that is probably not a good sign. But it is the only thing that it is making me sleep.

 

Do you have any suggestions with regard to sleep?

 

Thank you!

[Altostrata]

Try to take as little medication as possible, as it may cause your nervous system to react. Perhaps half or a quarter of a tablet would do just as well.

 

The homemade magnesium oil wasn't as good as the manufactured one, but it does get magnesium onto your skin, and you might find the light massage to be helpful, too.

[annelle]

Thank you, Alto - great suggestion about the Phenergan - I have in fact noticed lately that it seems to have a greater effect than earlier - I feel a little more groggy the next day than before withdrawal started.

 

I will try that.

[annelle]

Hello again,

 

Alto,

 

I was wondering if you have any knowledge as to why vitamin B12 levels are too HIGH - especially with regard to being on AD for a long time, and also on Omeprazol for 7 years.

 

I think it usually goes the other way. I have been reading about PPI's making it difficult to absorb nutrients like vit B12.

 

I had a blood test recently to check B12 levels among other things, and it came back HIGH, above normal. It said 1160. (I don't know if the measuring unit is the same in the US).

 

This surprised me quite a bit. My doctor was surprised, too, but said that it was a good thing.

 

But it is a little strange, since I rarely eat meat.

 

Do you have any thoughts regarding HIGH levels of vitamin B12? 

 

Thank you!

[Rhiannon]

Annelle, regarding the high B12 level, I think it's most likely that you are eating something that has added B12 in it and perhaps you didn't realize it. That would be my first guess. If you take a vitamin then that would do it too. I've never heard of any condition where someone accumulates too  much B12 from just foods in their diet.  But I'm not a doctor or anything like one!

[annelle]

Hi Rhi!

 

Thanks for your reply.

 

I have up till recently been taking a multivitamin that has B12 in it, but only the recommended daily intake, but maybe that is the explanation. (I don't think we have any foods here that are B12 enriched).

 

The high level of B12 just surprised me because I have heard so much about the dangers of proton pump inhibitors with regard to this, plus I had paresthesia in hands and especially feet (but that could be due the withdrawal itself I suppose). And also because I have been a vegetarian for about 7 years.

 

But I guess it was worse if my levels were too low! So that is a good thing anyway.

 

Thanks!

[annelle]

Oh boy,

 

it never ends, does it? 

 

I just called my aunt, and she told me that my other aunt who is 86 just died the day before yesterday ;( I am so sad because I loved her very much, and I was just trying to call her, but no reply - which is why I called my other aunt, who the told me the sad news ;(

 

It us just one trigger after another isn't it - but of course, that is just life. It is just so sad as now there is only one one of my mothers' siblings left  

 

this may seem trivial to many people - I mean, that is just how life goes, right? But somehow - maybe because I am in AD withdawal - it impacts me so strongly.

I am devastated

[Karma]

Hi Annelle

 

Perhaps the high B12 reading is a lab error.  I have had that happen to me twice in the last 2 years with iron tests in the States.

 

I actually like to keep my B12 up around 1200-1300 pg/mL ... but I've seen normal ranges that only go up to 835 pg/mL.  They usually define the normal range based on the population in your region.

 

Karma

[annelle]

Hello everyone,

 

I had a great day yesterday after a couple of rough weeks. I was able to go out to a local event together with my wonderful daughter and her wonderful daughters - it was so great to be out and feel, well, at least almost, normal in the company of many other people, listening to a little music.

 

And to top it all, I am still feeling ok today. I was, as I often am, expecting to feel somewhat crappy the day after an eventful day, but so far I am feeling good, although maybe just a little tired. Slept only about 3 hours. But did not have any restless legs or anything else, or not too much pain in legs and lower back, which I usually get the night after too much excitement and/or exercise.

 

I am feeling grateful that this happened, and of course I hope it is a window that will stay open for a while.

 

Hope everybody is getting windows as well!

[Altostrata]

Good to hear, Annelle. May you have ever more and longer windows....

[annelle]

Thank you so much, Alto!

 

Today I am still very tired, but not as wiped out as I usually am after too much excitement, so I consider that progress. I don't think I could have participated in the event a few months ago, at least not without feeling absolutely exhausted afterwards. It is so nice to feel closer to normal (whatever that is?! Lol)

 

I have been wondering about something. I have stopped taking almost all supplements except omega-3 and magnesium citrate. I had been taking a lot of vitamin B complex for several years, but about stopped about 4-5 months ago, because I felt they affected me badly (I would probably never have known that vit B could be a culprit here if not for the advice on this site, because I have always believed strongly in taking those).

 

But lately I have been thinking, if maybe too little vit B, maybe even creating a deficiency, can have a negative impact on withdrawal, not to mention health in general? But currently my concern is, of course, withdrawal, and what helps or harms it?

 

Do you, Alto, have any experience with regard to vit B deficiency impacting withdrawal?

 

Thank you!

[Altostrata]

If you feel you need B vitamins, you might try cutting up a supplement and taking a very small portion to see if it helps you.

[annelle]

Hi again,

 

Thank you, Alto, for the suggestion about vit B. I tried to take a small dose of B-complex yesterday and today, and I feel that my muscle weakness in particularly my arms is getting a little better, and I had (so far) no adverse reactions to it.

 

I have been reading other people's stories on this site, and although I know that everyone is different, it strikes me that I have not seen anybody mention the sometimes almost unbearable symptoms (it makes me cry, sob, sometimes) I am having in my hands, feet and breasts. The last few weeks the worst of it is in my fingers, especially the tips of the fingers. It is so bad that I can hardly bear to touch anything, I have to make sure that when I lie in bed, for instance, that my fingers do not touch each other or the sheets. I even have trouble touching very smooth things, like the screen of my IPhone.

 

I have seen this as paresthesia or dysesthesia caused by withdrawal from escitalopram, but I am beginning to get worried that it may be something else, something that may need treatment (although I really do not want to take any new drugs for it!).

 

I was just wondering, if anybody can relate to this symptom, and whether you think it is related to withdrawal, or something else entirely?

 

Thanks!

[Altostrata]

If the skin hypersensitivity showed up with the other withdrawal symptoms, it's probably withdrawal.

 

Be patient, it will lessen with time.

[annelle]

Thank you, Alto - yes, it did show up at the same time as the other symptoms, about 3 months after my too fast taper, so I guess it is 'just' withdrawal. I think I just needed a little reassurance. And I need to be more patient.

 

Thank you!

[annelle]

Hello again,

 

I just noticed something about these paresthesia sensations in my hands, fingers, feet, toes and breasts: They always seem to get worse around 4-5-6 p.m.

It seems to be a pattern.

 

I just had the thought that maybe the paresthesia could be related to the time at which I ingest my escitalopram drops. I always take them at 11 a.m. And I read here that it takes about 5 hours for the drug to get into your bloodstream. 

 

Do you, Alto, think that there could be a connection there, could the paresthesia be a reaction to the drug. Maybe I am so highly sensitive to it that it manifests this way in my peripheral nervous system? Have you ever heard about this as a possibility?

 

Thanks again!

[Altostrata]

Yes, it could be a side effect. Good detective work.

 

If it is a side effect, it should decrease as you decrease dosage.

[annelle]

Hello again,

 

Sorry to keep bothering you, Alto, but I just last night realized that I have been making the most stupid mistake with regard to the dosage of escitalopram. I am really beating myself up about it (but I guess that does not really help the situation!)

 

I have been taking what I thought to be 1,80 mg of Cipralex oral drops for 30 days now, and was beginning to think about dropping by 10%.

 

But somehow, I don't know how I could have made this stupid mistake, I have only been taking 1,20 mg/ml instead of 1,80 mg/ml!! I think it must be due to not thinking clearly, having diminished cognitive ability due to withdrawal itself - ironic! This seems a very big drop in dosage!

 

Now, of course, the big question to me is - do I now updose the what I thought i was taking, 1,80 mg? Or stay at 1,20 mg and try to stabilize? I tend to go with the last option, since I have been on this low dose for about a month already. I do have some withdrawal symptoms, i.e. difficulty getting enough sleep, I get on average 3-4 hours a night, and the terrible paresthesia and skin sensitivity in hands, fingers, feet, toes and breasts. The latter is by far the worst symptom for me.

 

Please, Alto, do you agree with me that it would be best to stay at 1,20 mg/ml for some time instead of updosing? Even if I inadvertently made such a big reduction in dosage?

 

Thank you!

[Altostrata]

You might want to try 1.30mg, a slight updose, since the withdrawal symptoms are such a problem.

[annelle]

Thank you very much, Alto, I will try that.

 

I guess this silly mistanke at least partially explains the symptoms I have. I hope so, anyway, although some of them are likely due to withdrawal as such.

 

But it gives a little more hope.

 

Thank you for your help!

[annelle]

Hello everyone,

 

Today is the first day in months that I have virtually no paresthesia/dysesthesia/skin sensitivity!

 

It feels so amazing to be able to touch things and have normal sensations in hands, especially. I never thought it would happen, I am just so happy about it - and at the same time careful not to think that I am 'healed' now.

 

I would just be setting myself up for disappointment in thinking that. But it is very encouraging, and hopefully this window will last several days/weeks/months ... dare I say years?

 

And of course this improvement also gives my mood a lift.

 

Thank you to Alto for good advice regarding dosing of escitalopram!

[Altostrata]

Very good to hear. I hope your window continues.

 

Please allow time to stabilize on the increased dose before trying another very tiny taper.

[annelle]

Hello again everyone,

 

Today I am having my third good day with regard to paresthesia in fingers etc. It is amazing to have almost normal feeling in hands, fingers, feet, toes and breasts again. It feels like I am recovering from a looong illness - and I suppose in a way I am.

 

I have been wondering for a while why it is that my withdrawal symptoms are almost exclusively physical. Or at least I notice the physical symptoms a lot more than any emotional ones. Maybe I have gotten used to feeling just a little bit low - I see it as a part of my personality

 

I have never had any brain zaps, which seem to be one of the most common symptoms reported from other people.

 

I do not feel actually depressed - of course there are days or moments where I feel a little low or blue, but not what I would call depressed, just a normal variation in mood like most people feel in life.

 

I suppose it is a good thing that I only have symptoms in the physical category. I am grateful that I am not depressed (I should mention, though, that I was very depressed right after almost cold turkeying escitalopram).,

 

My most prominent symptoms have been paresthesia (or skin sensitivity) and insomnia. And both seem to be getting better. I slept 6-7 hours last night, albeit broken sleep (I rarely sleep more than an hour and a half at a time).

 

Now I just hope that I won't be hit with a lot of emotional symptoms, since it seems that this withdrawal/healing is so non-linear, and it seems that one symptoms lessens, others pop up!

 

But maybe it won't happen - so why worry? Worrying is not helpful, I know.

 

I am very grateful for the improvement that I seeing in my symptoms. Grateful to Alto for advice and for starting this site to begin with!

 

I shutter to think where and how I would be without it!

 

So thank you!