MomOf5: Hello, would love input

[MomOf5]

Hi all.  My story feels long and a bit like a train wreck, even though it has all happened in the last year.  I'll try to summarize.

1) I had a baby in Jan 2013, at home with midwives, all natural, wonderful birth.

2) shortly thereafter I started waking up with jaw pain and intermittent pain when chewing

3) in June 2013 it got really bad and I went to the dentist, who found that one tooth acted cracked but he couldn't see anything.  Suggested that maybe I needed a pain doctor.  I panicked.  Postpartum hormones, pain and a big old mystery sent me right off the edge. 

4) went to an endodontist who couldn't see anything either.  More pain, more panic.

5) sought a second opinion from a dentist who said, oh, this is cracked tooth syndrome.  sent me to a different endodontist who did a root canal.

6) was not prepared for the ongoing pain that came with the procedure. was trying desperately to keep nursing my baby and not take heavy duty drugs.  Eventually panic overtook (bit I didn't know that is what it was) and I caved to the pain meds.  BROKE MY HEART to stop nursing.  At this point my hormones are a mess, I am still in pain and now not sleeping b/c of the pain meds (didn't know that narcotics keep me from sleeping).

7) At a loss, the dr gives me steroids.  Again, I didn't know what those do to me.  Now I do.  ANXIETY.  Ended up passing out, going to the hospital, getting no help.

8) the pain starts shooting up the back of my head.  dr sends me to hospital where they pump me full of who knows what.  it helps but I'm a mess.  Had an anxiety attack in the hospital and came to the first realization that my problem is more than just pain.  They gave me Ativan and it helped.  I had no idea what kind of drug it was, all I knew was that it worked.  That's when I stopped using pain meds and started using Ativan.  They also put me on Zoloft.

9) at home I'm using Ativan twice a day and a muscle relaxer to sleep.  Waking up with unbelievable anxiety, so confused and upset.  Non-functional.  My mother-in-law graciously stays with us and takes care of my baby. 

10) one week after I my hospital stay, I manage to take my 2 yo to the ped for strange symptoms, we end up on an ambulance to the hospital, she has type 1 (formerly "juevenile") diabetes.  In the hospital with her for a week, whole lives turned upside down.  Have to start giving my dd a shot whenever she eats.  BTW, my dad died from diabetic complications.  Major trigger.  (Isn't this crazy??)

11) I am having a rough time, major nausea.  My dr switches me from Zoloft to Cymbalta.  Nausea gets better.  Still crying all the time.  I try twice to get off Ativan per my doctor's instructions, fail both times.  I lost about 25 pounds.

12)  I fight with insurance company to get in to a psychiatrist.  He adds Remeron to the mix.  Finally I can sleep and eat.  I start to feel a bit better. 

13) Try to come off Ativan again, slower.  Do okay until take away the last quarter pill and my body goes crazy.  Pain.  Dr. says "huh, you werent' on it that long, go back on and try again in a week."  I switch doctors.

14) New psychiatrist doesn't use Ativan and wants me to stick it out.  I do, but am doing poorly.  She is conviced the Cymbalta isn't cutting it.  Wants to switch me to Lexipro.  In one week's time:  removes the Remeron, reduces Cymbalta, adds Lexipro.  Not a good time.  I end up back on the Remeron b/c I am waking up with panic attacks.  I am also still having jaw pain.

15) Several dental specialists try to help, make mouth guards, give me injections in the tendon.  That seems to help.  Also having head and neck pain.

16) I am still having bad anxiety, so dr adds Klonopin.  Seems to help, with pain too.  I kind of stabilize on Lexipro, Remeron and Klonopin.

17) Try to get off Remeron, according to dr. instructions.  Go from 7.5 to zero and feel l might die.  End up back on it 6 days later.

17) New stragtegy:  taper the Klonopin and get off.  Have short term memory problems for a few days, which scare me, but they pass.

18) In all of this have been to several neurologists to rule out other things (MS, trigeminal neuralgia), and I seem to check out okay.  The latest one I see puts me on 1 week of Prednizone.  What awful timing!  Fresh off the Klonopin, on Prednizone.  It did help my neck pain but not my headache, that's for sure.  I feel like the Remeron saved me b/c it allowed me to sleep.

19) Got through the Prednizone, decided it was time to get off Remeron so that I'd be on only one med.  Decide to cut it up much smaller this time.  Have major crying spells, headaches, but stick it out.  I took my last bit of Remeron last Friday.  It was going okay until I went to the neurologist on Monday.  He gave me injections to try to help my neck and head.  I didn't think it through that the injections contain steroids, again.  I feel great for the rest of Monday but can't sleep Monday night b/c I'm wired.  I even try the muscle relaxer he gave me and can't sleep.  Tuesday (yesterday) I crash.  My head hurts SO BAD.  I did sleep better last night, took the muscle relaxer again.  I am missing the Remeron and wondering if I should get back on.  My pdoc also wonders if the Lexipro could be causing the headache.  She is willing to help me get off, but I feel so unstable as it is.  If I weren't in so much head pain I might be able to think it through better.  I called the neurologist and he said the steroids should wear off in several days.  Should I stick it out?  Did I taper the Remeron too quickly?  All I know is that I feel like I've been hit by a truck.  I have 5 kids under 10 and I can barely care for them.  One has a chronic illness that requires daily, hourly vigilance. 

 

Please, any input is appreciated.  Thank you for having me here.

[Altostrata]

Welcome, Momof5.

I'm sorry you're going through all of this.

1) It sounds like you originally may had some kind of musculoskeletal issue that initially caused jaw pain, clenching, and tooth pain. You might look into Temporomandibular disorders (TMD) http://www.webmd.com/oral-health/guide/temporomandibular-disorders

 

It's possible this has traveled into your neck and back. If this seems to fit, acupuncture, chiropractic, or osteopathic manual treatment may help reduce the pain. Wearing a mouth guard at night may help to gradually correct the jaw misalignment.

 

You should discuss this with the best dentist you can find. My guess is the ones you've seen have misdiagnosed you.

 

2) It sounds like you may have adverse reactions to steroids, for example http://www.drugs.com/pro/prednisone.html
 

Psychiatric derangements may appear when corticosteroids are used, ranging from euphoria, insomnia, mood swings, personality changes, and severe depression, to frank psychotic manifestations. Also, existing emotional instability or psychotic tendencies may be aggravated by corticosteroids.

 

 

You should make all your doctors aware of this.

 

3) It sounds like you may have adverse reactions to Ativan and other benzodiazepines. They often cause depression as a side effect and, when they wear off, rebound anxiety that's worse than the original anxiety.

 

You should make your psychiatrist aware of this. She's not very sharp, so you'll have to guide her along so she'll be of help to you.

 

Even though the Ativan may have caused many of your problems, it needed to be tapered to discontinue it.

 

No wonder adding Klonopin relieved some of your symptoms, you probably were suffering benzo withdrawal. If you stabilize, you can go off by tapering much, much more slowly.

 

For tips about managing benzo dependency, see http://survivingantidepressants.org/index.php?/forum/29-members-only-benzo-tapering-discussion/

 

4) You may also be suffering from adverse effects of drug switches. Our nervous systems are not made of rubber. The more different neurologically active drugs you take, including psychiatric drugs, the more likely your nervous system will be sensitized and do a lot of complaining. This may include symptoms that mimic chronic pain or fatigue syndromes.

 

5) You had an adverse reaction to Zoloft.

 

6) On Cymbalta, you may have been crying because of the adverse effect of the benzo, or withdrawal from Zoloft.

 

7) When your psychiatrist took you abruptly off Remeron, reduced Cymbalta, and added Lexapro, she triggered another round of withdrawal reactions (from Remeron and Cymbalta) and possibly adverse reaction to Lexapro, though it's hard to tell because of all the drug changes.

 

So it's no surprise that you "kind of" stabilized on Lexapro, Remeron and Klonopin.

 

8) The head pain may very well be from going off Klonopin. Or Remeron. Or it could be an adverse reaction to Lexapro.

 

9) Yes, you probably also went off Remeron too quickly.

 

All of the above could exacerbate the head and neck pain.

 

Unfortunately, it's not unusual for people to end up on a psychiatric drug cocktail they don't need as a result of a medical condition and adverse reactions to other drugs. It sounds to me -- and I am not a doctor -- like that's what happened to you.

 

What were the dosages of Klonopin, Remeron, and Lexapro you were taking?

[MomOf5]

Thanks for your reply.  It is a mess, isn't it?  If I hadn't been post-partum, it might have turned out differently.  Yet here I am.  I felt the best when I was on Cymbalta, Mirtazapine and Ativan.  I really thought I was going to be fine.  Until I got off the Ativan.  Fast forward...I landed on 1 mg Klonopin, 7.5mg Remeron and 20mg Lexipro.  I am currently on 20mg Lexipro.  The only things that have helped the pain are Ativan and Klonopin.  Oh, I also was on Gabapentin for a little while too,.  Sigh.  Quite the laundry list.  Not sure what to do from here either....

 

Thanks again.

[Altostrata]

It's no surprise that the benzos eased the pain. They're muscle relaxants.

[MomOf5]

Yes, that is what I thought too.  Sadly, actual muscle relaxants don't seem to help much.

 

So, it was a week ago yesterday that I took my last bit of Remeron (just under 2mg, smallest I could cut it up).  Then Monday I had the steroid injections.  At this point I am feeling pretty bad.  I am not sleeping well, waking up with major nausea, anxiety, can't eat, headaches, bowels are messed up.  I feel myself wanting to go back to the Remeron b/c I know that at least I would sleep and have an appetite.  I just wish I knew the root cause.  I was having headaches before stopping.  Can Lexipro cause headaches or nausea even after having been on it several months?  I also feel like I'm in a fog.  It is so hard to concentrate.  I know Lexipro makes many people tired, but doesn't seem to do that to me.  I wish it did at this point!  Here are what I see as my options:

 

1) continue on as is, Lexipro 20 mg, pray things improve as the steroids leave my system

 

2) add back the Remeron, try weaning again later

 

3) add back the Remeron, wean off the Lexipro instead to see if it helps alleviate negative symptoms

 

Any thoughts?  And thanks, Altostrata, for you detailed responses and links.  I have seen two of the best dental specialists here and have several different bite guards to wear at night.  At this point I wonder if the bite guard is contributing to the headache.  I'm obviously grasping at straws.  I hate this headache .  The neurologist offered me Cymbalta, Gabapentin, Lyrica or Topamax.  Ugh.  I really do not want another drug. 

 

Thanks again for having me here.

[Skyler]

Yes, that is what I thought too.  Sadly, actual muscle relaxants don't seem to help much.

 

So, it was a week ago yesterday that I took my last bit of Remeron (just under 2mg, smallest I could cut it up).  Then Monday I had the steroid injections.  At this point I am feeling pretty bad.  I am not sleeping well, waking up with major nausea, anxiety, can't eat, headaches, bowels are messed up.  I feel myself wanting to go back to the Remeron b/c I know that at least I would sleep and have an appetite.  I just wish I knew the root cause.  I was having headaches before stopping.  Can Lexipro cause headaches or nausea even after having been on it several months?  I also feel like I'm in a fog.  It is so hard to concentrate.  I know Lexipro makes many people tired, but doesn't seem to do that to me.  I wish it did at this point!  Here are what I see as my options:

 

1) continue on as is, Lexipro 20 mg, pray things improve as the steroids leave my system

 

2) add back the Remeron, try weaning again later

 

3) add back the Remeron, wean off the Lexipro instead to see if it helps alleviate negative symptoms

 

Any thoughts?  And thanks, Altostrata, for you detailed responses and links.  I have seen two of the best dental specialists here and have several different bite guards to wear at night.  At this point I wonder if the bite guard is contributing to the headache.  I'm obviously grasping at straws.  I hate this headache .  The neurologist offered me Cymbalta, Gabapentin, Lyrica or Topamax.  Ugh.  I really do not want another drug. 

 

Thanks again for having me here.

Steroid injections come with a lot of baggage. Does the pain you have originate in trigger points? If so, you could have steroid injections directly into them and have minimal to no side effects. I have fibro with severe flares, and local injections were very effective.

 

Your headache sounds absolutely dreadful and I'm sorry you are having so much pain.

[Meimeiquest]

What did the dentists think about your TMJs? This may be way overreaching, but one thing pregnancy hormones do is loosen joints, it is part of what causes the "pregnancy waddle." The purpose is to loosen the symphysis pubis. Anyway, if your TMJ came out of alignment through the loosening and retightening, that could be your root cause. Or not. I have found chiropractic to be a big help for pain in the lower head, neck, upper shoulders. Good luck!

[Altostrata]

How long have you been on the Lexapro? How long, all together, have you been on antidepressants (Lexapro, Zoloft, Cymbalta, Remeron).

[MomOf5]

Thanks for all your replies. I agree that I started with a musclo-skeletal problem.  Lack of sleep plus post-partum hormones plus intense pain led to the mood issues.  Now I am stuck on the medication merry-go-round. Let me try to summarize better:

 

Way back in 2000: I took Wellbutrin for depression for about 1.5 years after my father died, no troubles, weaned easily. 

 

This go around it has been more about pain and anxiety than depression.  I was in a great place when all of this started.  Here goes...

July 2013: Zoloft for 3 weeks, Ativan 1 mg 2x day

August 2013: switch to Cymbalta 60mg, still taking Ativan

September 5, 2013: add Mirtazapine 15 mg - feel much better with sleep and appetite

Start Ativan taper Sept 19, 2013.  Take last Ativan October 23, 2013

Early November, 2013: start Gabapentin to try to help with anxiety

November 6, 2013: cut Mirtazapine to 7.5 mg

November 11, 2013: cut Mirtazapine to 0

November 14, 2013: Cymbalta to 30mg, Lexapro to 5mg

November 15, 2013: Cymbalta 30mg, Lexapro 10mg

November 18, 2013: Cymbalta to 0, Lexapro 10mg, Gabapentin at 300mg, 3x day

November 19, 2013: add back Mirtazapine 7.5 mg b/c of anxiety attacks while sleeping

November 26, 2013: add Klonopin .5mg, Mirtazapine to 0 again

December 2, 2013: Klonopin to 1mg

December 4, 2013: add back Mirtazapine 7.5mg, again feel better

December 17, 2013: Increase Lexipro to 20mg

December 19, 2013: start Klonopin taper

Decembr 23, 2013: start Gabapentin taper

January 3, 2014: last Gapapentin

February 4, 2014: last Klonopin

February 19, 2014: start Mirtazapine taper

March 7, 2014: Mirtazapine to 0 (again)

Current: Lexapro 20mg, neurologist offering switch to Cymbalta or adding Lyrica, Gabapentin or Topomax for pain

 

And that's the story.  It is a mess, I know, and all at doctor's instructions.  I feel like I am living in a fog.  I think the Lexapro is too much at 20 mg, but I dread tapering it at all.  Yet, my dr thinks it could be causing the headache.  I also feel like  I could sit and stare at the walls all day.  My eyelids feel so heavy but I can't fall asleep.  I am so sad that I am "missing" such special parts of my kids lives, especially the baby.  I just want my brain back!!

 

Thanks again for the support.  Not many other people get it, including the doctors, it seems.

[Rhiannon]

We do get it. For what that's worth.

 

I'm not sure where I would go now if I were you, except I would continue to resist the doctors' suggestions of new meds. You've been on and off so many things in less than a year, it makes my head spin to read over it! I'm not sure how much trust I would place in the doctors who came up with that program.

 

It seems likely there's some benzo withdrawal in the mix, but I don't know that I'd try to do anything about that at this point.

 

Are you taking only Lexapro now? Can you just stay on that for a while, until you've had some time to recover from all that other craziness? It would be pretty hard at this point right now to figure out how much of what you're experiencing is due to the presence of the Lexapro, and how much is due to the resonating aftereffects of all the other ons and offs and ups and downs of meds over the past eight months or so.

 

It seems like just not changing anything for a while, until you settle down and can figure out what your baseline is, might be one way to approach it.  But if Alto thinks a reduction in the Lexapro might be helpful, listen to her, she knows way more about that than I do.  I do seem to recall that Lexapro can be pretty activating for some people.

[Altostrata]

Please, guys, I only make semi-informed guesses. I'm not a doctor, I'm not omniscient, and I can't tell the future.

 

.....

July 2013: Zoloft for 3 weeks, Ativan 1 mg 2x day

August 2013: switch to Cymbalta 60mg, still taking Ativan

September 5, 2013: add Mirtazapine 15 mg - feel much better with sleep and appetite

Start Ativan taper Sept 19, 2013.  Take last Ativan October 23, 2013

Early November, 2013: start Gabapentin to try to help with anxiety

November 6, 2013: cut Mirtazapine to 7.5 mg

November 11, 2013: cut Mirtazapine to 0

November 14, 2013: Cymbalta to 30mg, Lexapro to 5mg

November 15, 2013: Cymbalta 30mg, Lexapro 10mg

November 18, 2013: Cymbalta to 0, Lexapro 10mg, Gabapentin at 300mg, 3x day

November 19, 2013: add back Mirtazapine 7.5 mg b/c of anxiety attacks while sleeping

November 26, 2013: add Klonopin .5mg, Mirtazapine to 0 again

December 2, 2013: Klonopin to 1mg

December 4, 2013: add back Mirtazapine 7.5mg, again feel better

December 17, 2013: Increase Lexipro to 20mg

December 19, 2013: start Klonopin taper

Decembr 23, 2013: start Gabapentin taper

January 3, 2014: last Gapapentin

February 4, 2014: last Klonopin

February 19, 2014: start Mirtazapine taper

March 7, 2014: Mirtazapine to 0 (again)

Current: Lexapro 20mg, neurologist offering switch to Cymbalta or adding Lyrica, Gabapentin or Topomax for pain

 

....

 

 

I don't see where Lexapro was added.

 

I strongly suspect benzo withdrawal. Rather than mucking about with Lyrica, Gabapentin or Topomax, I would go back on a very low dose of Valium (Diazepam), the longest-acting benzo. I'd take the lowest dosage that's effective to reduce symptoms and stabilize. It's important to start very low because your system may have become sensitized and if you start too high, you might get a paradoxical effect, not to mention adverse effects. By a low dose, I mean 0.25mg. Take at night.

 

Be prepared for staying on Valium for quite a while because you need to get the other drugs straightened out, plus deal with the pain. Then you can taper off Valium.

 

Yes, you are physically dependent on benzos. This is not full-fledged addiction. Reinstating a benzo may be the key to getting you out of this mess.

 

Make sure your doctors understand this. The neurologist might be most helpful.

 

At the same time, focus on non-drug treatments for the pain: Acupuncuture, chiropractic, osteopathic manipulation, massage, etc. Taking drugs for the pain is going to confuse the issue further.

 

Hopefully, the benzo will help you sleep.

 

My guess is the Lexapro dosage is too high. The last thing you need is stimulation from an SSRI. A week after adding the benzo, I would start reducing Lexapro at 10% every 2 weeks, down to 10mg. Monitor for withdrawal symptoms, if they occur, slow down.

 

At 10mg Lexapro, let's see how you're doing. It may be you need to add in a little mirtazapine for sleep, then taper the rest of Lexapro at 10% per month, then go off the mirtazapine, then the diazepam.

[MomOf5]

Thank you, thank you!  I hope someday I will be in a place to give back as much as you've already given to me.  Alto, I think your insights are spot on.  The Lexipro was added on Nov. 14, but I don't think it changes anything you wrote.  I like your proposed plan, but I'm not sure I can convince my doctor that my problem is benzo w/d, since the medical community would say it's out of my system by now (ack).  I am going to try though.  I have bottles of Ativan, Klonopin and Valium, but not enough of any to do a long-term tapering plan.  I called my dr yesterday b/c I felt so awful and her suggestion was to go back on the Mirtazapine for now to alleviate symptoms.  Sleep is not going well and I am waking up very nauseous with intestinal issues.  I didn't add it back last night, but I don't know how much more I can take.  As I've learned by reading here, just sticking it out doesn't help.  If I do add back the Mirtazapine, I'd do 3.75 mg.  If I can't get anyone to go along with a benzo, perhaps I can lower the Lexapro while keeping the Mirtazapine at 3.75. 

 

Again, thank you so very much.  I can't believe what a mess can come of these meds.  It's scary.

[MomOf5]

Oh, I meant to mention that I am already doing acupuncture and chiropractic.  I was doing massage too but the place closed and I have to find somewhere else.  I am open to anything "natural."  I've even been trying essential oils.  It's worth a shot!

[Altostrata]

If you add mirtazapine, I suggest you reduce Lexapro by 10% starting a few days later. My guess is you don't need the Lexapro at all, mirtazapine alone would be sufficient.

 

However, you will still be suffering benzo withdrawal syndrome, which can include a lot of physical pain.

 

You need to make your case to your doctor, and possibly a new doctor. Phone all the psychiatrists in your area and see if any knows anything about benzo withdrawal syndrome. They should be familiar with something called the Ashton Manual.

[MomOf5]

I assume there is no way to tell how long benzo withdrawal syndrome might last?  As I look back over my calendar, it is true that the only times I've felt well were on Ativan or Klonopin. 

 

I've already left a message with my current doctor.  It will be hard to find another in the area...I found that out when I first went looking.  There is one that is a possibility, but it takes several months to get in.  I even had my insurance company do a search for me and they came up with this same one.  I pay my current doctor out of pocket, but she charges reasonably and does a lot of extra over the phone.  It is quite a frustrating situation.  I wonder if an integrative medicine doctor might be able to help me.  There is a practice like that around here.  Worth asking.

 

Oh, and thanks, Rhi for your support.  I'm glad you get it.

[Altostrata]

Any MD can do the prescribing.

 

Benzo withdrawal can last a very long time, months or years. There are several benzo support groups on Facebook.

[MomOf5]

Well, not getting anywhere with doctors for benzo w/d help. 

 

I did add back 3.75mg mirtazapine.  I'm not doing as well as before the steroid shot, but I'm trying.  So much crying going on, mostly because I feel so stuck and I'm tired of my head hurting.  Alto, you suggested cutting the Lexipro if I added back the mirtazapine.  I'm preparing to do this.  It was one option my doctor suggested too.  I tried cutting the pills I have and I can get a somewhat reasonable 17.5mg dose, which is a bit more than 10% down from 20mg.  I have 20mg tablets and 5mg tablets.

 

The mornings are just so yucky.  I perk up around 1pm and feel best late in the evening. 

 

I am so mad and sad to be on these meds.  I need to look around for some success stories so that I know it is possible to get off.  It is, right????

[rickoshea]

Hi MomOf5 ... so sorry to hear about your problems and trauma. From the point of view of your teeth (I'm a dentist) I think from what you have said that the diagnosis of Cracked Cusp Syndrome was correct. It's very rarely we can actually see any fracture line on the tooth and the diagnosis is made by testing (usually pain on release of pressure, but also pain on biting and cold/hot sensitivity can be evident). I assume the endodontist would have noticed a root fracture during his treatment of the tooth. Teeth can often be painful and sensitive for a few weeks after endo treatment. If the tooth is still painful and the endo has been well done then there may be lateral canals that are impossible to fill, or a root fracture. Sometimes root canal treatments just don't work unfortunately (usually due to lateral canals) and the tooth has to be removed. A root fracture can be seen on CT, only occasionally if its subtle can it be seen on a regular radiograph.

 

TMJ syndrome is actually easy to diagnose. Palpation over the joint gives tenderness, the big muscle that lies on the side of your jaw (the masseter muscle) is generally tender as are some that can be palpated intra orally. It is usually tender on opening and the jaw may deviate to one side on opening as well (causing stress on the opposite TMJ which can cause or exacerbate the problem). Treatment is a strict soft diet, not opening wide hence not stressing the joint, local heat and anti inflammatories such as Ibuprofen ... all this over at least 3 weeks. 

 

Sorry I cant help much with the medication side of things (believe me I know how horrendous the difficulties are) but maybe this may help with your dental problems

 

take care,

 

Richard

[Altostrata]

I would let the mirtazapine take effect for a week before reducing Lexapro.

 

Please be more careful about reducing Lexapro. It comes in a liquid for tapering, see http://survivingantidepressants.org/index.php?/topic/406-tips-for-tapering-off-lexapro-escitalopram/

[MomOf5]

Thank you both.  Richard, I appreciate your professional opinion.  I neglected to mention that I had the tooth removed in November, amidst all the other craziness.  I clearly remember sitting in the waiting room with terrible Ativan w/d symptoms.  The tooth was, indeed, cracked.  I can now chew again normally.  I believe the jaw pain I was having was a combination of the cracked tooth, referred pain from it, and irritated muscles/ligaments from the root canal procedure.  Thankfully, my mouth and jaw are doing much better.  I still wear the mouth guard at night.  I am a clencher/grinder.  The main problem now is my head pain and ongoing anxiety symptoms.

 

Alto, how would this look for a tapering schedule?  (I think I can do this with pill cutting.  I left a msg for my dr about the liquid.) 

Current: 20mg

Cut 1:18.75mg

Cut 2: 17.5 mg

Cut 3: 16.25 mg

Cut 4: 15 mg

Cut 5: 13.75 mg

Cut 6: 12.5mg

Cut 7: 11.25mg

Cut 8: 10mg

Cut 9: 8.75mg

Cut 10: 7.5 mg

Cut 11: 6.25 mg

Cut 12: 5mg

Cut 13: 3.75 mg

Cut 14: 2.5mg

Cut 15: 1.25mg

Cut 16: zero

 

As you suggested, I would start with a cut every 2-3 weeks, hoping to alleviate head pains.  As they improve (hopefully), I would slow down to once a month.

 

Thank you again so much for your support.  So very much.

[Altostrata]

How are you going to do that with pill cutting? Please read the link I gave above.

[MomOf5]

Yes, I read the link, thank you for your work in putting the information together.  I am working on getting the liquid.  If that proves difficult, I thought I could cut the 5mg tablet into quarters and do the schedule above.  I could use a jeweler's scale to get the quarters right.

 

I do wish I could get my body to stop registering anxiety though.  It just goes to show me that the Lexipro isn't doing what it is supposed to, even at a high dose.  It's like the first thing I feel when I wake up is anxiety.  Of course, today I woke up to the startling alarm of my daughter's glucose monitor, which isn't the most gentle way to wake.  I talked to my doctor about it and, of course, she offered to add something (Buspar).  It's possible that the headaches are from anxiety, in which case decreasing the Lexipro isn't going to help with that, other than alleviating the anxiety I feel from being on it.

 

Thanks again.

[Altostrata]

With these drugs, more is not necessarily better. It could be the dosage of Lexapro is too high and it's adding to your anxiety.

 

When do you take it and what is your symptom pattern?

[Petunia]

Hi MomOf5,

 

I'm glad you found this site and are starting to get some help now.  If you put your drug and withdrawal history in your signature, it would help us to easily see your situation when replying to posts.  Instructions for how to do that are here:

 

http://survivingantidepressants.org/index.php?/topic/893-please-put-your-withdrawal-history-in-your-signature/

 

Petu.

[MomOf5]

Ack.  I'll write more later, but just wanted to share that I just talked to my doctor and she won't call in the liquid Lexapro because "it is for people who can't swallow pills and that's not your problem."  She feels it would be feeding into my anxiety to go along with my desire to titrate small amounts when she feels I can handle "normal" decreases.  She wants me to go from my current 20mg to 15mg and hold.  Sigh...

[Rhiannon]

Do you have the option of "doctor shopping"? I think there must be a doctor out there who would be more cooperative with a patient who wants to taper by smaller increments.

 

Is Lexapro one of the meds that you can make your own liquid of? I can't remember, but I'm sure it says somewhere in the Tapering section, either under the thread on Lexapro or the one on making your own liquid. 

[Altostrata]

I think you will need to speak more firmly to your doctor. Politely, but firmly -- and insist on the liquid Lexapro.

 

Tell her you'll take responsibility for your tapering method. (Her response was patronizing and stupid, but not unusual.)

 

Yes, you can make your own liquid from Lexapro, see http://survivingantidepressants.org/index.php?/topic/406-tips-for-tapering-off-lexapro-escitalopram/

[MomOf5]

Hello again.  I thought I'd check in since it has been a little while.  I added a signature, thanks Petu for the help.  I also met with my doctor and she refuses to give me liquid Lex at this point.  She is more willing when I get down to smaller amounts.  For now she feels it would be "collaborating with my anxiety."  I looked into a different doctor, the only other one I knew of, and he's no longer taking new patients. He will probably be taking them again come June or July.  I read about making my own liquid and that seems easy enough.  I have plenty of syringes around (5 kids)!

 

For now, I am feeling discouraged and stuck and frustrated.  My head/face/arms feel tingly, kind of like a burning, and I don't know if/when it will ever end.  It seemed better when I had lowered the mirtazapine, but not sleeping was not an option either.  I think the steroids are slowly leaving my system, so perhaps I could try lowering the mirt again.  However, my doctor is on board with tapering the Lex, so maybe I'll start there, try to get to 10mg as Alto suggested, and then think about the mirt again.  It kills me that I've been on Lex only 4 months but it could take a year or more to get off it.  I'd love to know how others keep up hope of feeling good again one day.  I feel like my life has been stolen away and I can't get back to it.  We had hoped for one more child (yes, I know 6 kids sounds crazy, but they are my life), but I am 40 and don't have tons of time left.  I know people who have been pregnant on AD's, but I won't do it.  I can't put a baby through this. 

 

Thanks for listening.

[MomOf5]

I forgot to add that I take the Lex at 6pm and the Mirtazapine at bedtime, so both at night.  I've wondered if I moved the Lex to the AM if it might go better for me.  I hate the nightmares, which could be from either med or the combo. 

[Altostrata]

Many people find Lexapro activating. You might gradually take the Lexapro a couple of hours early every day until you move it to the morning.

 

Was the mirtazapine added after you started taking Lexapro?

[MomOf5]

Thanks, Alto.  I was on the mirtazapine before the Lexipro.  Started mirtazapine September 2013 (while on Cymbalta) and started Lexapro November 2013.

[MomOf5]

Alto, do you have an opinion on which drug to taper first, Lexapro or mirtazapine?  I have been thinking to get down to 10mg Lex and then try the mirtazapine again, but I'm wondering if the mirtazapine could be causing some of the constant tingling/burning feelings I have in my face and head.  From my reading, it sounds like a more common mirtazapine side-affect. 

 

Thank you!

[Altostrata]

If I were you, I'd start on the Lexapro. Reduce by 10%, see how you do.

[MomOf5]

I have just spent some time reading others' threads and I want to say thank you to all of you who put so much of yourselves into helping others.  Some of the posts are so very helpful.  When I first started reading here (before I registered and posted), I found many of the threads scary.  Now I am starting to see the upside instead.  There is HOPE!  Many of you who are further along keep saying things like "you CAN get off these drugs forever if you do it right" and "things WILL get better," even if they have been really really bad.  I appreciate this so much.  My greatest fear has been that I will never get off the drugs and never get better.  I am starting to see that this kind of thinking is distorted and just another facet of anxiety.   I also followed a link to find a doctor who doesn't push drugs and I found one a couple of hours from me.  I sent an email and will see what she says about working with someone from out of town.

 

Anyway, I just wanted to say thank you.  Oh, and I have made my first cut in Lexapro!  The road ahead feels awfully long, but at least I am getting started.  I am going to keep telling myself "you can get off this forever if you do it right." 

 

Kids are home, better run.

[wulfgar]

Hi MomOf5,

There is hope for sure! This site is full of good wisdom and kind hearts. Good luck!

/Wulfgar

[arwen]

MomOf5: things do get better! There are obstacles in the road, sometimes you are pushed back, and it feels that it is the same place where you started, or even worse, but it doesn't last. It gets better!

 

Sometimes, in my darkest moments, I am suffering, but instead of taking it as it is, I amplify it! My anxious mind is thinking: "It is so bad now, I feel so sick, but this is nothing compering with how bad I will feel tomorrow". And guess what, tomorrow comes, and I feel great, and I forget the misery, the pain, until next time... And the yesterday pain was bigger because I amplified it so much!