Tips for tapering off escitalopram (Lexapro)

[Cipramillion]

Im on a ultra low dose of escitalopram. It is possible to taper If you dilute in water. Switching could be a very risky move. If you dont succeed, your symptoms might worsen and your CNS desentisized. At this point, i would take no chances.

[Junglechicken]

Thank you all for your comments, they are much appreciated.

 

I will do some further mulling and probably come back with questions.

 

Best,

JC x

[Junglechicken]

What if I was do the shaving off technique with high precision scales and a razor blade?  My plan is to do 10% cuts every 4-6 weeks, however (like many members) I am dealing with TINY amounts of pill.

 

I'm VERY nervous about diluting the 1ml / 20mg liquid Lexapro because the dose drops are so small, and my start point is already very small.  Because of this, I have VERY little faith in my ability to do an accurate titration, and don't want to go down the chemistry lab route.

 

Potentially I could dissolve the pill in purified water and then syringe up the correct dose - this could work out ok.

 

Thanks,

JC

[ChessieCat]

So you don't want to be a mad scientist?

 

None of us here at SA expected to be in the situation we are in.  I've actually got it fairly easy compared to a lot of other members.  Very thankful that my compounding chemist is fairly close by, is a reasonable price and can do them in a day.  The "fun" I have is using an excel spreadsheet to calculate how what capsules I need to make up my doses, how many of each capsule dose I need and how many tablets I need to provide to be compounded.

 

Good luck with the method you decide to use.

[Junglechicken]

Chessie,

 

I'd love to be a mad scientist, just not in this subject area, lol  

 

The spreadsheet is done with my dose drops, its just a question of "how/which/what/when" I guess.

 

Am trying to reach a decision on how I can safely get from 2.5mg to 0mg and its taking a while to make that decision because I need all the facts I can get.

[ChessieCat]

Well you are in the right place!

[Junglechicken]

Not too mad then, lol!

[Altostrata]

Junglechicken, if you dilute the escilatopram liquid, you would be drawing a LARGER amount into your syringe, and you would be able to measure the tiny decreases more accurately.

[TroubledThoughts]

Just curious as to what I should do.

 

I am thinking about reinstating but I would be at under 1mg of Lexapro a day. I'm not sure how I can measure that out since I've been told the liquid Lexapro does not exist by more than one pharmacy. My only choice is to use 5mg tablets dissolved, but I have no idea how I would get a .25mg dose using that method. Does anyone have any suggestions?

[Frogie]

1 hour ago, TroubledThoughts said:

Just curious as to what I should do.

 

I am thinking about reinstating but I would be at under 1mg of Lexapro a day. I'm not sure how I can measure that out since I've been told the liquid Lexapro does not exist by more than one pharmacy. My only choice is to use 5mg tablets dissolved, but I have no idea how I would get a .25mg dose using that method. Does anyone have any suggestions?

I just wanted you to know I live in the US. I am using liquid Escitalopram Oxalate (generic liquid Lexapro) to taper. It is manufactured by CAMBE if that helps.

 

I live in a town of 600 people and have to drive 16 miles to a town of 3,000 people to a family owned pharmacy. They order it for me monthly.

 

Take care,

Frogie xx

[TroubledThoughts]

1 hour ago, Frogie said:

I just wanted you to know I live in the US. I am using liquid Escitalopram Oxalate (generic liquid Lexapro) to taper. It is manufactured by CAMBE if that helps.

 

I live in a town of 600 people and have to drive 16 miles to a town of 3,000 people to a family owned pharmacy. They order it for me monthly.

 

Take care,

Frogie xx

Thank you Frogie! 

 

I will see if I can find this anywhere. My pharmacy told me they did not make liquid Lexapro.

[Frogie]

1 hour ago, TroubledThoughts said:

Thank you Frogie! 

 

I will see if I can find this anywhere. My pharmacy told me they did not make liquid Lexapro.

This is generic, but I know a lot of people on here use it.

 

Good luck!

 

Take care,

Frogie xx

[Altostrata]

https://www.drugs.com/pro/escitalopram-oral-solution.html

 

Quote

 

Oral Solution:

5 mg/5 mL, peppermint flavor (240 mL bottle)
NDC# 54838-551-70

 

The NDC number is the ordering number for US pharmacies.

[Frogie]

1 hour ago, Altostrata said:

https://www.drugs.com/pro/escitalopram-oral-solution.html

 

The NDC number is the ordering number for US pharmacies.

Thank you so much Altostrata for the information on the Lexapro. I use the generic and that's all that's on my label.

 

Take care,

Frogie xx

[TroubledThoughts]

7 hours ago, Altostrata said:

https://www.drugs.com/pro/escitalopram-oral-solution.html

 

The NDC number is the ordering number for US pharmacies.

Thank you very much!!

[nolongeranxiousbut]

Has anyone with Gerd issues been able to use the US liquid lexapro with natural peppermint flavoring with no gerd issues?

Just wondering. I was so disappointed to see that as an ingredient.

[JLex1981]

Hi Guys !

 

Question for the taper... If I have 10 ML of Liquid Lexapro and I add 9 ML of water to it have a effectively made a 1/10 GRAM to ML solution , or is water not a good solution to mix and will not distribute the medicine ?

 

Thanks!

JLEX

[Altostrata]

Please read this topic from the beginning. If you have a question about your taper, please put it in your Introductions topic.

[nologic1986]

I didn't see this mentioned in the thread, but has anyone had difficulties transitioning from tablets to the liquid Rx version? 

[Gridley]

2 hours ago, nologic1986 said:

I didn't see this mentioned in the thread, but has anyone had difficulties transitioning from tablets to the liquid Rx version? 

 

Yes, I recall a member a while back who found the liquid (I don't remember if it was homemade or Rx liquid) didn't agree with her and she had to do a crossover back to tablet then do her taper with the tablet.  The body reacts differently to the liquid than to the tablet, including faster absorption.  

 

It's better to post your questions in your main Introduction topic so that all your information is in one place.

[Annala]

Has anyone made a liquid from Lundbeck's Cipralex tablets? I tried to dissolve it in water but there is a white residue on the bottom...Is it just the pill shell and the active ingredient is dissolved? I'm not sure if it is save.

[brassmonkey]

Cipralex is sparingly soluble in water, meaning that not all of the active ingredient will dissolve.  So It is very important that the bits that settle to the bottom be fully mixed in the water when you draw out your dose.  Adding enough salt to the water (make it taste like sea water) will help the solubility.  Using a suspension media such as "oraplus" will make it a lot easier to get a smooth evenly distributed suspension.

[Katy398]

On 5/27/2011 at 12:16 PM, Altostrata said:

significant characteristic of Lexapro is that milligram for milligram, it is much stronger than other SSRIs

Hi Alto

Do you know of a link that I can give my doctor. She says it’s no stronger than most other ADs 

Thank you Kx

[Altostrata]

On 5/26/2011 at 7:16 PM, Altostrata said:

A significant characteristic of Lexapro is that milligram for milligram, it is much stronger than other SSRIs. Chemically, Lexapro is a variation of Celexa; the molecule was re-engineered to be patentable as Celexa's patent was about to expire. The streamlined molecule is a more potent SSRI, 2 to 4 times stronger than others. (Wikipedia has a good explanation of this at https://secure.wikimedia.org/wikipedia/en/wiki/Escitalopram.)

 

[Gilla999]

Hi all - hope i'm posting this in the right place as I seem to keep getting it wrong! I've just purchased the Cipralex liquid in the UK so that I can do a 10% taper off of Escitalopram. However.... and apologies if this question has already been asked, I'm sure it has.... the bottle is not like the Mirtazapine liquid that I have, it's in "drops" with "1 drop = 1mg". I can't take the stopper off the bottle to get a syringe in there, and even if I managed to break it off I still wouldn't know what the dose equivalent is for ml - ie. I don't know how many ml is "one drop" of the bottle dosage and therefore can't convert it into mg.

 

Can anyone help? If I drop from my current 6 drops (eg 6mg) right down to 5 drops (5 mg) that's already a 16% drop

[Gridley]

1 hour ago, Gilla999 said:

 

Can anyone help? If I drop from my current 6 drops (eg 6mg) right down to 5 drops (5 mg) that's already a 16% drop

If one drop is 1mg, you don't need to convert.  You're basing your calculations in mg anyway.

 

I'm not sure what a "drop"is or how it comes out of the bottle.  Can you put 1 drop in a small bowl and use a syringe to measure half, giving you 0.5mg and take 5 1/2 drops which is an acceptable 8% decrease.  Save the the other 1/2 drop for the next day.  If this works you can divide further into quarters as you go lower.

Edited February 11, 2020 by Gridley

[Gilla999]

Thanks @Gridley for the reply. I've managed to work out that 1 drop = 1ml and I've also rammed the bottle neck off so I can get a 0.5 syringe in there. Trouble is there is no plastic stopper inside so I can't lift the bottle up to draw it back, but it will do. 

 

However I had a massive migraine yesterday morning which is really unusual for me and then had the "jumping awake when trying to sleep" thing all night - only managed 3 hours. I don't ever usually get migraines and I'm wondering if it's connected to my medication in some way. I've decided to stop taking the liquid (only took it for two days) and go back to my Lexapro pills for now until I feel better and stabilise. Wondering if anyone else has experienced migraines as part of WD or maybe it's just a co-incidence. But last night definitely felt like WD with anxiety and sleep jumps!!

[Gridley]

3 hours ago, Gilla999 said:

o back to my Lexapro pills for now until I feel better and stabilise.

Good idea.

 

Many members have reported migraines connected to withdrawal.

Migraines, headaches, neck ache / pain and head pressure ...

 

Headaches, which I know aren't migraines, are #45 on the withdrawal symptom checklist.

 

Daily Checklist of Antidepressant Withdrawal Symptoms (PDF) 

[Gilla999]

Interesting! Thanks very much for sharing @Gridley. Think maybe i'm accepting I need to try and taper off one thing at a time - otherwise it's really hard to know what is WD and if so what's it connected to etc

[Gridley]

5 minutes ago, Gilla999 said:

Think maybe i'm accepting I need to try and taper off one thing at a time - otherwise it's really hard to know what is WD

We definitely recommend one drug at a time for the reasons you gave.

[Andie]

19 hours ago, Gilla999 said:

Thanks @Gridley for the reply. I've managed to work out that 1 drop = 1ml and I've also rammed the bottle neck off so I can get a 0.5 syringe in there. Trouble is there is no plastic stopper inside so I can't lift the bottle up to draw it back, but it will do. 

 

 @Gilla999 Are you using the 20mg per ml solution? 

 

Can you transfer all the contents over to another bottle with a stopper that can be used with a syringe? 

 

Ive just had to do this, and purchased a couple of amber bottles with stoppers and syringes from a compounding Pharmacy. 

[Gilla999]

@Andie that's a great idea - and yes that's the one I have  - I'm not sure where to buy the empty bottles from (I'm in the UK, not sure we have compounding pharmacies here) but I'm sure they can't be hard to find - I shall have a Google

[Victor3]

I am now concerned if the powdered form of Lexapro in the water can have a different impact on the absorption of the drug in the blood. There are many manufacturers for Lexapro and depending on the type of coating material used, it might have slow and proper rate of absorption when consumed as a whole tablet. The powdered form might not act and react the same way it is supposed to be acting. Any thoughts on this?

[Altostrata]

Please read this topic and the topic about making your own liquid from the beginning. A do-it-yourself liquid is not perfect but it is good enough. We have many people who have successfully tapered with homemade liquids made from tablets. Lexapro, by the way, is available in liquid form by prescription.

[Victor3]

Thank you Altostrata for the info.

I have another question. Is it possible that we might need more serotonin and dopomine and other neurotransmitters when we are completely withdrawn from these drugs? How do we produce those required neurotransmitters naturally if your body and brain can't produce it anymore.? What if we are naturally deficient from these neurotransmitters right from birth or through hereditary? Can exercise, proper nutrition, support group and natural supplements balance all the hormones and neurotransmitters?

Please advise.

[Altostrata]

The neurotransmitter imbalance theory has no validity. Don't worry about your neurotransmitter balance. You already are producing all the neurotransmitters you need naturally.

 

Withdrawal syndrome is not a deficiency in neurotransmitters, it arises from the difficulty the nervous system and the rest of the body have in adjusting to a big change in internal biochemistry.