Pokeshaw: tapering off Lexapro

[brassmonkey]

Hi Pokeshaw-- if each of the .01 capsules was off by 5% it would be the same as 1 of the .1 capsules being off by 5%.  If some of the .01 capsules were off by only 2% then you would actually be getting just a bit more medication by using them.  But the amount would be so small it shouldn't make much difference. Just remember that each time you switch methods you need to let things settle for six to eight weeks before going any further.

[Pokeshaw]

@brassmonkey

 

You're right! 

 

So, I guess I will stay where I am for now (10 caps of .01 mg) and wait to see if I reach the level of stability that I have reached before (using individual caps rather than the aliquot) when dealing with a bad wave.  Seems to be working so far, just slow. I certainly dont want to make any unnecessary changes after what I have been thru these past months. 

 

 - When the time does come to resume taper -

An engineer friend created a spreadsheet for me to assist with the 2.5% redux calculations using the aliquot caps and diluting. 

 

As below, for instance at first 2.5% reduction I would drop down from taking 10 caps of .01 mg to 9 caps of .01 mg and then 75% of one .01 mg capsule.

 

The question is - which is better, diluting in water or using scale?  I think i lean toward diluting because it seems easier thing to do daily -  do you think Ok to go with that?

 

Thanks again!

Pokeshaw

 

 

Num of whole capsules to take	ml of solution with 1 capsule dissolved in 100ml	Capsules (whole + fraction)	Total mg of powder to take	Reduction fraction
10	0.0	10.00000	0.10000
9	75.0	9.75000	0.09750	0.975
9	50.6	9.50625	0.09506	0.975
9	26.9	9.26859	0.09269	0.975
9	3.7	9.03688	0.09037	0.975
8	81.1	8.81096	0.08811	0.975

[brassmonkey]

Hi Pokeshaw-- that sounds like a good plan. Looks like a useful spread sheet too. Diluting in water should work fine.

[Pokeshaw]

@brassmonkey

 

Hi Brass - Happy New Year to you!

 

I has been awhile since I checked in here. Things have been fairly up and down so I was hoping to get your advice on next step.

 

You will see from our conversation thread that I had to switch last spring from compounded indiv caps (was at .1 mgs and needed to reduce) 

to aliquot  (.01 mg caps)

At the time I was not thinking that the change of delivery in the compounding would be a problem and I made too large a reduction by going to .09 mg (9 caps of .01)

When i reached out here you suggested that the multiple reductions I had made in the weeks before changing to the aliquot and then making that change and reducing at the same time from .1 to .09 was too much and probably the cause of the setback.

So, after 3 months at .09 mgs of the aliquot caps and in bad w/d I up dosed on 7/22/18 from .09 mgs (9 caps of the aliquot .01 mgs each) 

to .1 mgs (10 caps) to see if I would stabilize. 

I stayed at that dose until 9/30 (9 wks) and felt I was gaining some stability and was def starting to experience the side effect symptoms that usually prompt a reduction so I went down to .095 but after 2 weeks things got wavy again so I went up to .0975 and have been there since.

Here is what I am taking - 

9 of the .01 mg caps

1 cap of .005 which pharmacist makes as a separate aliquot script

Then I carefully split one of the .005 caps to get .0025.

Totaling .0975 mg or close.

 

so I have just hit 90 days at this dose. Unfortunately shortly after I made the updose in Sept I got a urinary tract infection and had to take an antibiotic for a few days which I think really threw my system off. I cannot take any supplements or meds without some kind of reaction. Then I got sick with a virus/flu that knocked me out for a couple of weeks. Plus dealing with challenges around stress.

 

My concern is that I am just not getting stable.  I am in a withdrawal state most of the time with some good days or spells here and there.

The worst symptoms are the digestive (loose stool and diarrhea) vertigo, nausea, reflux, and the most frightening - terrible intrusive thoughts/memories and dread/panic. These are the withdrawal symptoms that were even worse when I first stopped the lexapro too quickly 8 yrs ago.

 

I suppose I could say that the trend is ever so slightly up, maybe. But just not sure what to do at this point.  And perhaps after updosing to .1 (10 caps) I should have stayed longer than 9 weeks before making a reduction.

 

I am not sure what to do here.  These are the 3 options I mull over (and over and over!)

 

1 - Stay at this dose and delivery method a bit longer to see if I stabilize  

2 -  Updose again to 10 caps of the aliquot to get back to .1 mgs

3 - Go back to getting  .1mg caps compounded (which is what I was using before pharmacist had to change to the aliquot) and when the time comes to taper try diluting in liquid (a bit tricky since the filler in the caps is hard to dissolve)

 

I am one of those people who came off the medication too quickly and got very very sick but did not reinstate until many months later (8) and then was all over the map for a yr or so until I found this site and started having the medication compounded. I have been on this path now since 2011. Who knew that I would have so much trouble the closer I get to the end!  

 

As usual, I appreciate any feedback you might offer!

 

Best,

 

Pokeshaw in Brooklyn

[brassmonkey]

Hi Pokeshaw-  I'm sorry to hear that the last several months have been so rough.  It does sound like things are improving a little bit at a time though.  Unless your symptoms are totally overpowering then an updose is not a good idea. For right now I think that a hold is a good idea.  It may seem that a 90 day hold would be a good long one, but often times that is not enough.

 

Here is part of a post I made to Nike1990 about intrusive thoughts.  His situation is a bit different, but the information is applicable to both of you.

 

With more and more receptors starting to work there will be a slow increase in mental clarity, ability to do things and adapt to situations.  It can also drag up a lot of things from your past some true, some false and some that never even happened and magnify the heck out of them.  This is a variation on the wave theory, and can be handled by remembering about spiral thinking and neuroemotions.  With practice these types of thoughts respond very well to AAF and CBT.  For recurring baggage from the past I got to the point where I would say "I've been through this all before, thought it through and accepted my conclusion, there is no need to do it all again".  I would follow up with changing the channel and some distraction and the thoughts would leave me alone. In the beginning the trick is to recognize the spiral before it can get a foot hold.  That takes some vigilance, practice and having to go through several spirals but pretty soon some patterns and triggers will show themselves and you can get down to work.

 

Getting sick during ADWD sure doesn't help things either.  It will really slow down the process, but things will eventually get back on track.

 

I'm a bit scattered today, but I hope that helps.

 

Brass

[Pokeshaw]

Hi Brass,

 

Thanks so much for getting back to me so quickly.  I appreciate it for sure. And thanks for the bit on intrusive thoughts. Good to read.

 

I will try holding longer to see if things improve. Some days the symptoms are pretty overpowering and then some days not so bad. I keep a diary with brief notes on each day and so I do see that there are some good days. I am hoping that the most severe symptoms will slow down to the level they were at in the yrs past which was a bit more manageable!

Thank you!

Pokeshaw

 

[Pokeshaw]

Hi Brass,

 

Questions of course!

 

- It has been since last March that I have been trying to work with the aliquot of compounded lexapro and I am just not stabilizing the way I used to on the individual caps after a wave. And I did not have such severe waves on a regular basis as I am now. Usually when things got wavy a hold of a few weeks would even things out.   

 

Question - is it common when down to such low doses to have an increase in waves?

 

I am now taking 9 of the .01 mg caps

1 cap of .005 which pharmacist makes as a separate aliquot script

Then I carefully split one of the .005 caps to get .0025.

Totaling .0975 mg or close.

 

I am considering switching back to getting .1 mg caps and dissolving in water to taper.

 

Question - If I do this, what would be the safest way to do it? You had suggested that I not updose unless w/d symptoms are too unbearable.

If I switch would it be best to keep dose same - .0975

 

That way I could see if the aliquot is contributing to the very uncomfortable ups and downs of the past yr.

 

Thanks so much!

 

Poke

 

[Pokeshaw]

@Altostrata

 

Hi Alto -

 

I have been posting on BrassMonkey's Tapering thread over the past few months but hoping you might see this and weigh in as well. I need all the help I can get!

 

I have been tapering Lexapro using a compounding pharmacy for several yrs after cold turkey stop of Lexapro as you may recall. 

 

Last March I got down to 0.1 mg compounded (individual caps) and the pharmacist said he couldn't go any lower on individual caps so he started making an aliquot. 

 

This meant that I would get caps at .01 mgs each. 

 I had made several reductions over the weeks (Feb/March) leading up to this change and so when I got the aliquot I went from .1 mg of individual cap to 9 caps at .01 mgs each - so .09 mg. 

This was too large a reduction, clearly. Looking back now I am not sure why I did that. I had been making aprox 10% redux per month but not all at once.

 It didnt go so well and I started having bad w'd symptoms but stayed on that dose hoping it would even out. After almost 4 months I finally gave in and updosed to 10 caps of .01 mgs, so back to .1 mg. 

I started to stabilize and after about 9 weeks I tried to reduce to .095 but that didnt go well so I went up to .0975 which is where I have been for 3 months.

 

I am now taking 9 of the .01 mg caps

1 cap of .005 which pharmacist makes as a separate aliquot script

Then I carefully split one of the .005 caps to get .0025.

Totaling .0975 mg or close.

 

Around the same time as I updosed as above I also got a UTI and had to take antibiotics for a few days. Then I got a bad virus. So I was sick for the first month of the updose and have been in a wave ever since with a few windows here and there. Mainly vertigo,nausea, loose stools and diarrhea,bad panic/anxiety, intrusive thoughts.  All the worst symptoms I experienced when I originally went off the lexapro too fast yrs ago. Not quite as severe but still pretty awful.

 

 It has been since last March that I have been trying to work with the aliquot of compounded lexapro and I am just not stabilizing the way I used to on the individual caps after a wave. And I did not have such severe waves on a regular basis as I am now. Usually when things got wavy a hold of a few weeks would even things out.   

Currently 90 days and holding - but not sure how much longer I can tolerate this. There has been a small improvement I think but I seem to be going up and down. And I cant understand why.

 

Question - is it common when down to such low doses to have an increase in waves?

 

I am considering switching back to getting .1 mg caps and dissolving in water to taper.

 

Question - would it be unwise to switch delivery method at this point?

 

If I did switch, what would be the safest way to do it? Should I updose to .1 or should I take same dose as I am now, .0975? 

I would have to dissolve the caps in water and measure off the reduction.

 

I am thinking that if I switch back to individual capsules from the aliquot I could see if the aliquot is contributing to the very uncomfortable ups and downs of the past yr.

 

Any suggestions would be much appreciated!

 

Thanks ever so much!

 

Pokeshaw

 

 

 

[Altostrata]

Pokeshaw, you must have a very patient and creative pharmacist!

 

Why are you not using Lexapro liquid? It's available by prescription, and you (or your pharmacist) can dilute it, as LexAnger described. With a 1mL or 0.5mL oral syringe, you can control your tiny decrements fairly precisely.

 

Sometimes one's nervous system needs a break from tapering, to recalibrate on a very low dosage. An antibiotic can throw your nervous system for a loop, too.

 

It's also possible you are at such a low dose, your system is processing it very quickly and it might make sense to take some of your daily dose earlier in the day and some later. What time of day do you take Lexapro? After you take your dose, what effect does it have on you?

[Pokeshaw]

Hi Alto,

 

Thank you so much for responding.

 

Yes I do have a very good pharmacist!

 

I am not sure why I did't go with the liquid lexapro. I think my dr was concerned that it would be absorbed too fast. I cant recall now.  Wouldnt it be a bit difficult to transition to liquid? 

 

I take the Lexapro with breakfast.  I am not sure what effect it has exactly. Especially since it has the slow release ingredient.

 

The compounded ingredients are 

Lexapro

microcrystalline cellulose

methocel E4M  - which is what makes it slow release

 

But mornings are usually difficult for me. Especially after a bowel movement. It seems that gut activity really activates all my symptoms.  When in W/D symptoms it is fast gut and reflux. When I have been on a dose a while my gut slows down and i get constipated. Then I make a reduction.

 

Just been having such a hard time of it lately. Confused about what to do.

 

Pokeshaw

[Altostrata]

My sense is you need a break from tapering. Depending on your symptom pattern over the next couple of weeks, a small updose to 0.1mg might be in the offing. Please let us know how you're doing.

 

Please consider using liquid Lexapro for the rest of your taper.

[Pokeshaw]

@Altostrata

 

Thanks, Alto. I will see how things go over the next couple of weeks. If not improving I will updose to .1 mg

 

One more question

If I were to switch to liquid would you suggest I do it with the updose or - updose on the aliquot first and after stable make the transition to the liquid?

 

Thanks, 

Pokeshaw

[Altostrata]

3 minutes ago, Pokeshaw said:

If I were to switch to liquid would you suggest I do it with the updose or - updose on the aliquot first and after stable make the transition to the liquid?

 

Good question. I would take part aliquot and part liquid for a gradual transition.

[Pokeshaw]

On 1/19/2019 at 6:07 PM, Altostrata said:

 

Good question. I would take part aliquot and part liquid for a gradual transition.

@Altostrata  Hi Alto - A week since last post.

Gut started to slow a bit which gave me hope but then a backslide now.

Just seems since I switched to the aliquot (multi caps) that I just cant seem to get stable. Up and down. Even after holding for 3-4 months. Maybe I need to hold here a bit longer. You had said try another couple of weeks.

So I will do that in spite of the nasty symptoms.

If things dont improve I feel I should updose from .0975 to .1 mg. I am thinking of going back to the individual capsules which the pharmacist can do at 0.1 mg. That way if I stabilize on that method of delivery I will know that the aliquot was just not working. And then after a good hold I would consider transitioning to the liquid. I am a bit afraid to make such a big change from capsules to liquid right now while in a wave and after the last 10 months of instability.

[Altostrata]

I am concerned about the accuracy of the aliquot. I would convert to liquid now.

[Pokeshaw]

12 hours ago, Altostrata said:

I am concerned about the accuracy of the aliquot. I would convert to liquid now.

@Altostrata  I agree about the accuracy of the aliquot. Though the pharmacist assures me it is within 5%. 

If I convert to the liquid that is a whole new thing for me. I am not quite sure how to do it.

If I  get the doc to write a script and get from a pharmacy then I would have to dilute and figure that out myself.

If I ask the pharmacist to do it then I am dependent on his services til this taper is done. 

Can the liquid lexapro from a pharmacy (I think lowest dose is 5 mg) be diluted with water?

You had suggested that if I do convert to liquid that I do a gradual transition using some of the aliquot and some of the liquid.

Wondering how best to do the transition. Would you suggest that I try to consult with BrassMonkey for advice on exactly how to proceed?

I feel I need a bit of hand holding on this!

Thanks ever so much,

 

Poke

[Pokeshaw]

On 7/20/2018 at 3:39 PM, LexAnger said:

Oh, I used 5ml synrige for all my measures

Hi Lex,

 

Hope it is ok to message you. 

I see that you have completed your taper. I hope you are doing ok?

 

I wonder if you can help me?

I am having trouble with my current delivery method of compounded lexapro and Alto suggests that I switch to liquid.

I am at such a low dose .0975 mg so I am a bit confused about how to do that. Also a bit hesitant since I have been in a pretty wavy place these past months and am afraid to make any changes that might make things worse.

I know you have experience with diluting the liquid for low accurate doses.

Can you tell me how you did that? I know the lowest it comes is 5mg. Is that what you worked with?

It would help me to know how you did it exactly. What tools you used and how you measured etc.

 

Many thanks,

 

Poke

[LexAnger]

Hi pokeshaw,

 

I'm sorry you are having a difficult time lately. It's insane how these drugs injured so many in such a way as I know you have been tapering so slow.

 

I used 5mg/5ml liquid for most of my taper all the way down to 0.0004mg before jumping. 

 

I only started diluting  after I reached 0.2mg lex in my taper.

 

So I would add 100ml water to 0.2ml lex, that way I can reduce 0.002mg by taking out 1ml solution. 

 

Soon I transitioned to dilute drops of lex liquid rather than measuring by synrige as I found synrige can't be as accurate for micro cut. There are about 5 drops in each 0.2ml lex liquid if I remember correctly, so I started using drops to make solution. I used 5ml synrige all the time. if you can use 1ml synrige to measure lex liquid, it'll be much easier without using drops.

 

 

So For your current dose and tapering goal, if you measure 1ml (1mg)  lex liquid and add 99 ml water to make 100 ml solution , you can get 0.01mg easily by taking 1ml solution. If you dilute only 0.1ml lex in 100 ml water, you can get 0.001mg easily by taking 1ml solution, or 0.0001mg by taking 0.1ml solution by using a 1ml synrige.

 

The nice thing about the 5mg/ml lex is easy math and the even solution in water. I found it very accurate even for cut like 0.0004mg. Also, you can use the solution for many days so you don't have to make it everyday when you get down to tiny doses.

 

 

Please let me know if you want to talk it over the phone. 

 

I'm unfortunately in the worst situation, not from lex WD though. I was doing better and functional  a few months after getting off lex, then hit by a serious back injury causing sciatic rotation, cauda ewuino, fybromygia and complete disability, to make thigs even worse, stupidly I started valium for the muscle problem caused by the back injury, which threw me into an unbelievable hell trying to get off of valium on top of the deadly back injury. 

 

 

Lex.

 

 

 

 

[Pokeshaw]

4 hours ago, Pokeshaw said:

@Altostrata  I agree about the accuracy of the aliquot. Though the pharmacist assures me it is within 5%. 

If I convert to the liquid that is a whole new thing for me. I am not quite sure how to do it.

If I  get the doc to write a script and get from a pharmacy then I would have to dilute and figure that out myself.

If I ask the pharmacist to do it then I am dependent on his services til this taper is done. 

Can the liquid lexapro from a pharmacy (I think lowest dose is 5 mg) be diluted with water?

You had suggested that if I do convert to liquid that I do a gradual transition using some of the aliquot and some of the liquid.

Wondering how best to do the transition. Would you suggest that I try to consult with BrassMonkey for advice on exactly how to proceed?

I feel I need a bit of hand holding on this!

Thanks ever so much,

 

Poke

@Altostrata I have emailed my doctor about this since I am really not sure how to proceed exactly.   Wondering if I should updose to .1 mg of the aliquot to get out of this bad wave before transitioning to liquid? 

[Altostrata]

On 1/19/2019 at 3:07 PM, Altostrata said:

 

Good question. I would take part aliquot and part liquid for a gradual transition.

 

[Pokeshaw]

@Altostrata 

 

Hi Alto,  I have been having such a hard time of it and feeling an urgency to do something, so I have decided to make an updose from .0975 mg of the aliquot to .1 mg of the aliquot to try to regain some stability.

 

was taking as

 9 of the .01 mg caps

1 cap of .005 which pharmacist makes as a separate aliquot script

Then I carefully split one of the .005 caps to get .0025.

Totaling .0975 mg or close.

 

Since Feb 1,  now taking 10 caps of .01 mg. 

 

I needed to do something, the symptoms are becoming intolerable.

I had been at .1 (10 caps of .01) of the aliquot 4 months ago and was alot more stable than I am now.

I think the above mixture of the aliquot was just not working.

So I decided to start with this and then look into switching to liquid at some point as you suggest.  I emailed the pharmacist and my doctor about it. She defers to him. He is concerned about accuracy trying make a liquid suspension at .1 mgs for me to work with.  

I havent asked him about using the regular liquid lexapro that folks here use and dilute themselves. I imagine he would not condone that. 

But it seems to work for people so I will consider it. 

My doctor is away this week but I will see her middle of Feb. 

Do you think it best that I wait a while at this new dose via aliquot before trying to transition to liquid that I dilute myself?

 

Thanks so much,

Poke

[Pokeshaw]

@Altostrata

 

I am at day 9 of this updose from .0975 to .1 mg of the compounded Lex brand aliquot.  I know it will take time to regain a bit of stability but I am really having a rough time. I know the only thing to to is hold and wait but the gut symptoms are really intense. and the anxiety/panic/dread and intrusive thoughts. 

I dont remember symptoms worsening last time I updosed. 

Poke. 

 

[Pokeshaw]

Day 12 of updose. Gut symptoms a bit better. Diarrhea has stopped. Anxiety and reflux are still intense. hoping more time will calm these symptoms.

 

Poke

[bubble]

Just stopping for a quick hello. I'm following your journey (in total disbelief at how vicious this drug is...). The doses are incredibly low but their impact is so strong...

 

Happy to hear the updose is helping!

[Pokeshaw]

On 2/13/2019 at 12:57 AM, bubble said:

Just stopping for a quick hello. I'm following your journey (in total disbelief at how vicious this drug is...). The doses are incredibly low but their impact is so strong...

 

Happy to hear the updose is helping!

Hi Bubble,  Good to hear from you. Yes, this has been a rough time. Now day 15 on updose. Had a couple of decent days. Not so good today but I suppose to be expected. I will hold and hope for more stability.

I hope all went well with your move?

Best,

Poke

[Pokeshaw]

Day 37 of updose. Some improvement for sure. Dealing with UTI and now having to take Macrobid antibiotic. So far not too bad. 

[Pokeshaw]

In a bad place for past few weeks.

 

Second round of antibiotic (Macrobid) for UTI and still not resolved. Waiting for culture results. Antibiotics sent me into a bad wave. Afraid I will need to take another one. Unfortunately I do not handle D-Mannose powder very well. it really messes with my gut and brain.

 

60 days at updose back to .1 mg of aliquot form of delivery for compounded Lexapro. Planning to switch back to the individual caps of .1 mgs then when time ever comes for needing to taper I will dissolve in water. I discovered that if I use very warm water the filler (microcrystalline cellulose) does not clump up.

Was going to transition by taking aliquot one day and indiv cap next day. so .1 cap every other day for awhile then after couple weeks go to daily.

But that will have to wait until UTI issue is resolved i think./

 

Poke

[bubble]

Nice to hear from you Poke although it is totally not nice you are struggling. ATBs hit me badly too so it is the most likely culprit. I hope it resolves soon. Real pity about Mannose because I haven't really had UTI since I started using it...

 

I hope spring gives you some comfortand this resolves soon. Did you see my news on my benzo thread?

[Pokeshaw]

Hi Bubble,

 

Good to hear from you. Do you take Mannose daily?

 

I did not see your news on your Benzo thread. How do I find that?

 

Poke

[bubble]

I take Mannose at the first signs of burning and discomfort and can feel how it stops it from progressing.

 

Here is my benzo thread 

 

[Pokeshaw]

Hello!

 

Been awhile since I have posted.  I am in need of some advice!

 

I have been doing my taper by having Lexapro (brand) compounded but once I got down to .1mg and needed to get .095 mg the pharmacist said he could not make individual capsules below .1 mg so he offered me an aliquot of .01 mg each but I was never able to get stable on them. I just dont think it was accurate enough.

 

I  am back to individual capsules of  .1 mg  and am stabilizing finally.

The problem is that when I need to make a reduction it is not possible to dissolve the contents of the capsule in water because it is made with  methocel E4M which is a slow release form of Methocrystalline cellulose and it clumps up in water unless it is very hot which may affect the Lexapro.

I asked the pharmacist if he could make me a liquid to work with but he wasnt confident about the accuracy. something to do with making it from the tablets rather than the generic which comes in a format used for liquid  (I cannot tolerate the generic)

The option is to have it compounded in lactose which is water soluble, BUT that would be a change away from slow release.

I am wondering how to make this transition from the slow release caps to the  non slow release caps?  I need to do it  so that I can eventually make reductions by dissolving in water. 

Does anyone have any experience with this?  I would very much appreciate any feedback before i embark on this.

 

Thanks as always!

Pokeshaw

[Altostrata]

Hi, Pokeshaw. How about the prescription escilatopram liquid? The pharmacist can dilute this if necessary.

[Pokeshaw]

Hi Alto, I know that would be easier for the pharmacist but I am a bit nervous about switching from Lexapro brand to the generic (escilatopram ) since I recall earlier in my taper when the doc mixed up the script and wrote it for generic and I had a bad response to it. It really heightened certain symptoms like the neck clench. So I have steered clear of it ever since.

[Pokeshaw]

Hi all - 

 

I havent been on this site much over the last year or so but thought it might be good to check in now and then so that I am not so alone with this. Any long time micro tapering folks out there who can offer guidance or a pat on the head would be much appreciated! I do have a therapist and somewhat of a network but folks who arent going through this kinda dont quite get it, if you know what I mean!

 

2.5 months since I made the switch away from aliquot delivery method back to individual capsule of .1 mg Lexapro. The vertigo/nausea is much less so I am very grateful for that. Not going to make any changes until I absolutely feel I have to. Then I will figure out how to continue the taper. Seems one option is to have the caps compounded in lactose which will be water soluble as opposed to the methocel currently being used which only dissolves in very hot water.

 

I had a very bad spell from summer 2018 until just recently - so many things went sideways including having to take antibiotics which really messed me up. I was in such a bad place and could barely function. I am not sure how I got thru it. Luckily I was able to work from home a lot. It was pretty upsetting considering that I had been tapering along for many years without anything quite that severe.

I think it was a combo of stress around having to move in the summer of 2018 and having just switched to taking the medication by aliquot made by the compounding pharmacist (he couldnt make individual caps below .1 mg.)

I tried to stick with it thinking things would even out but they didnt, and then I had what I thought was a UTI and was put on antibiotics. That is when things really went bad. after 2 rounds of antibiotics I saw a uro-gynecologist who told me after a catheter urine test that there was no infection but that I had pelvic floor muscle tension that was causing me the severe pain and what felt like a uti from hell!  Anyway...you get the picture!

 

 I feel like I am JUST starting to regain a bit of traction. But then a month ago I had to have a root canal and that was a bit triggering of symptoms except not as bad as a previous one since this time I made sure to have the anesthesia without norepinephrine. But what did happen was that it was a difficult root canal and some of the sealant used in the process was pushed out beyond the tip of the root into the tissue. Usually this will dissolve over time and cause no issues in most patients. It is causing me some inflammation and discomfort. The doctor says there is no infection and it will just take time. I of course am living in complete terror of having to have some surgical procedure to resolve this where I have to take an antibiotic. I will go to a specialist for a second opinion next week and hopefully this will calm my anxiety. I am just too distracted by this!

 

I also recently started making kefir water as a way to get probiotics. I have been very sensitive to most all supplements over the years and I cannot eat dairy so I thought maybe it would be tolerable. I think the small amount I am taking may be making me a bit anxious. It's the intrusive spinning thoughts that really tell me when something is aggravating. I spent most of the past yr in that state along with severe vertigo and nausea so i think I am dealing with a bit of PTSD! Going to stop it for a couple days and see how that goes.

 

So....after all that, I want to say that I am truly grateful that this site is here!

 

Blessings to all of us!

 

Pokeshaw in Brooklyn

[Pokeshaw]

Hi all - I posted this in another topic about how to make liquid from tablets or capsules but thought I would post here as well since i am not sure who sees what!

 

on my long slow micro taper I have  been having brand Lexapro compounded. I cannot tolerate the generic.The compounding pharmacy uses a slow release filler - Methocel E4M.  I am down to  0.1 mg and they cannot make capsules at lower doses. They offered an aliquot (10 caps of 0.01 mg ea) which I tried and my brain went sideways for months. I switched back to the individual capsules of 0.1 mg.  I have gained some stability but seem to be experiencing both w/drawal and side effect symptoms.  Over the yrs of my taper the side effect symptoms were always what prompted me to make a reduction.  And i feel i will need to do that soon.

Unfortunately the filler Methocel E4M is not water soluble. it clumps up and really sticks to the side of the glass.  Very hard to make a suspension. it only dissolves in very hot water but I dont want to do that.

So I had the pharmacy make me 0.1mg caps in Methocrystalline cellulose which they suggested because it dissolves nicely in water but is fast release. I am trying to transition over by taking it every 3 days (capsules for now with the idea of dissolving in water later when I am stable on it) but already feeling w/drawal aggravation.  Not sure how to do this safely? I seem to be so very sensitive. should I go more slowly with the transition from the slow release to fast release capsules?

Or - Is there a way to make a suspension with the slow release Methocel E4M filler?

 

Any ideas would be very helpful!

Thank you as always!

Poke

[brassmonkey]

Hi Pokeshaw-  If you are at 0.1mgai this puts you in the realm of the Endgame Taper.  I just happen to be doing a write up on this subject, not quite ready for publication but it's coming soon. The Endgame Taper can be very problematic because of the very small amounts concerned and this changes how tapering needs to be approached.  Quite often a person has to do visual divisions of a known amount to get their new doses.  If you start with the powder from one of your 0.1mgai capsules carefully divide that in half, divide that in half and then in half again each of the 8 little piles would be roughly 0.085mgai.  You would be working with a powder that is tolerable to you and still be able to get fairly small reductions.  Using this approach you could get 8 more reduction cycles which would leave you at a dose of about 0.015mgai which is a very acceptable place to make the jump to "0".