RealityCheck: I thought coming off a low dose of Lexapro would be no big deal

[RealityCheck]

Hey everyone, new participant here, freshly off a 3 year course of Lexapro at a dose of 7.5 mg for most of that time. It's been 2.5 weeks since my last dose after a one-month taper and I am amazed at how sick I have been feeling. Stomach issues, dizziness, some spikes of anxiety... those are the main ones. Head is clearing a tiny bit but I feel there's a long way to go. Any encouraging words would be appreciated. I'm grateful to have found this forum!

[alex]

Hi RC;it would be good if you put your medication history in your signature.

Antidepressants change the brain chemical structure, and it takes some time to go back to normal.But it will.

Stick around, and be patient.

[RealityCheck]

Thank you, I added a signature... on my phone... My poor eyes! Did I do it correctly?

[Altostrata]

Yes, it looks fine.

 

Welcome, RealityCheck.

 

As you suspect, you are suffering withdrawal syndrome from going off Lexapro too fast. In such situations, we've seen that going back on a very small amount, 1mg for example, can stop the withdrawal symptoms. After stabilizing for a month or so, you can then taper off by very tiny amounts.

 

Lexapro comes in a liquid that makes such titration easy, or you can make your own, see http://survivingantidepressants.org/index.php?/topic/406-tips-for-tapering-off-lexapro-escitalopram/

 

Given you've been on and off drugs a number of times, if I were you, I'd assume from now on your nervous system is sensitized and be very, very cautious about taking any more psychiatric drugs.

[Jemima]

I went off of Lexapro 10 mg. over a three and a half month period, according to my doctor's advice, and was sick for over two years, so I hope you'll take Alto's advice and reinstate a small amount.  It will save you a great deal of illness and mental anguish. It seems counter-intuitive, but getting off the lower doses is more difficult than the initial cuts.  I went from 10 mg. to 5 mg. with no problems, and then to 2.5 mg, which is where the antidepressant withdrawal syndrome started and settled in for a long stay. I wish I had known how reinstatement could help back then, but I think I was too whacked out to grasp the idea.

 

Welcome to the forum.  You'll find lots of good information and friendly support here.

[Petunia]

Hi RC,

I'm another one who is suffering protracted withdrawal from coming off Lexapro too fast.  I hope you consider reinstatement and then a slow, safe taper.  Lexapro is actually a much stronger SSRI than many doctors realize, have a look at our Lexapro topic here:

 

http://survivingantidepressants.org/index.php?/topic/406-tips-for-tapering-off-lexapro-escitalopram/?hl=%2Btips+%2Bfor+%2Btapering+%2Boff+%2Blexapro

 

Here is some information about reinstatement, which will explain more about it:

 

http://survivingantidepressants.org/index.php?/topic/3079-about-reinstating-and-stabilizing-to-stop-withdrawal-symptoms/

 

Petu.

[RealityCheck]

Thank you all greatly. I'm willing to reinstate 1 mg. will do my best to eyeball a faction of a quarter tablet or may try DIY liquid as you all suggest. Reinstatement feels like a setback, but I tend to be a black & white thinker about things, which is so typical of the depressive/anxious persona I want to transcend.

[Jemima]

Liquid is your best bet for an accurate amount, which is especially important at low doses. Give it at least four full days to take effect, and please let us know how you're doing.

[Rhiannon]

If it helps, instead of thinking of it as a setback, think of it as a course correction.

 

The "no reinstatement" course generally leads to crashing into a wall head-on followed by, usually, one to three years of misery (often unable to work, losing marriages, etc.) before getting back to health, or, commonly, ending up back on full doses or even multiple meds. The "small reinstatement" course won't completely stop the withdrawal but it will cushion it and allow you to stabilize and avoid crashing head-on into a wall (more like riding bumpily over some rough terrain before settling down, shaken and maybe with a few teeth loose, but not crushed.)

 

Your course correction will allow you to continue to move forward and reach your goal without disaster. And you will become one of the many people we actually DO know, here, who have successfully gotten off meds after many years of use.

 

See how much better that sounds? :-)

[Pokeshaw]

If it helps, instead of thinking of it as a setback, think of it as a course correction.

 

The "no reinstatement" course generally leads to crashing into a wall head-on followed by, usually, one to three years of misery (often unable to work, losing marriages, etc.) before getting back to health, or, commonly, ending up back on full doses or even multiple meds. The "small reinstatement" course won't completely stop the withdrawal but it will cushion it and allow you to stabilize and avoid crashing head-on into a wall (more like riding bumpily over some rough terrain before settling down, shaken and maybe with a few teeth loose, but not crushed.)

 

Your course correction will allow you to continue to move forward and reach your goal without disaster. And you will become one of the many people we actually DO know, here, who have successfully gotten off meds after many years of use.

 

See how much better that sounds? :-)

I gotta say, Rhi -

 

you really nailed it. really nailed it. i needed to read this today - me at 0.5 mg and riding bumpily over some rough terrain but with splendidly glorious days here and there -  but oh so grateful not to be on the verge of disability as i was 2 yrs ago. that was a nightmare i wouldnt wish on anyone.

 

Welcome RealityCheck - you are in the right place! Truly ~~

 

[Bellisimo]

Hello & welcome to this wonderful forum

 

I tried like you did taper my celexa for a short time and then quit, got very sick, i always reinstarted it and the last time i reinstarted it i tapered it for around a year, then i could get over it, but withdrawal hit me anyway but im fighting and it has been much better than it was a few months ago.

[RealityCheck]

Thanks everyone and yes, Rhi, "course correction" sounds a whole lot better.  After just a couple of doses at 1 mg, I don't feel like I'm in crisis, and that's really good.  Is it the placebo effect?  Maybe -- but the more I read about SSRI's and this one in particular, the more I am starting to understand how powerful these drugs are, so who's to say that 1 mg would not change anything? 

 

One thing I'm noticing is that certain situations that used to cause me anxiety on my full dose of Lexapro, like freeway driving, are actually causing LESS anxiety now that my dose is almost at nothing.  I had sometimes suspected that the medication wasn't really doing what I signed up for it to do and that it actually might be causing some problems that hadn't been there before.  Either that or I have actually learned some tools to deal with anxiety instead of relying on a drug to do it for me.  Of course this isn't true across the board, and I had some very upsetting, panicky moments over the weeks of withdrawal... my hope is that the withdrawal was causing that imbalance, and it's not the new (or for me, old) normal in the post-Lexapro years. 

 

I'm trying to be selective about what I show up for and how hard I push myself, but it's a fine balance that I definitely don't always get right.  Maybe some of you all have tips about this... and I am looking forward to delving deeper into some of the message boards about self-care and emotional management techniques.  When I'm on meds I don't have to work as hard to be in harmony with reality, and I can push myself really hard and not really feel the pain.  The whole system is more fragile now and needs almost constant oversight to keep it in balance.  It's easy to see how insurance companies love these meds -- they keep their workers productive!  Brain-damaged, perhaps, but they don't take as many of those pricey sick days... until they try to quit.

[RealityCheck]

Just wanted to check in after a week at 1 mg. overall I've felt a little better than before I reinstated. I'm still having some GI issues like frequent indigestion and diarrhea. The dizziness has improved somewhat. My energy is quite low. I had a couple of good days during the last week but just not as stable as at a full dose. Emotions running very "big" and the negative ones have more staying power than they did before. I got so angry the other day and it just took hours to let it go. But when I feel centered it's really nice and I love knowing that it's natural. Head is clearing too and my access to my vocabulary seems to be returning.

 

Any suggestions for the digestive issues? I'll look at the symptoms pages too.

 

Honestly sometimes wonder if it would be easier just to ease the dose up a little to 2.5... ? Don't want to give up too soon though. And really don't want to go thru withdrawal again!

 

Thanks

RC

[mammaP]

Hi RC, just read through your thread and I'm glad that you reinstated and are feeling much better.

I would hold at 1mg for a while and allow your nervous system to settle. There will be days when 

you get odd symptoms, it's all part of the healing process. It can take a while to stabilise, months

for some people but generally they are able to get on with life while stabilising.

 

Many of us have found that a good probiotic helps a great deal with gastro problems.  You'll find

lots of suggestions in the symptoms and self care topics. Personally my gut is better  since I

started using psyllium husk with live yogurt in my oats.  

[Jemima]

Given that you're still feeling some pretty strong withdrawal symptoms after a week, if I were you, I probably would updose to 1.5 or 2.0 mg. Please consider making your pills into a liquid or getting liquid Lexapro prescribed, though.  Even a little inaccuracy can make a difference.  Also consider that I'm a ninny and don't tolerate discomfort very well.  If you're satisfied with your progress at 1.0 mg., just ignore me.

 

Glad to see that reinstatement is working for you.

[Altostrata]

RC, you may be running into problems with varying dosage since you're cutting tablets.

 

Please at least make your own liquid so you can be more consistent in your dosing.

 

....

Lexapro comes in a liquid that makes such titration easy, or you can make your own, see http://survivingantidepressants.org/index.php?/topic/406-tips-for-tapering-off-lexapro-escitalopram/

 

Given you've been on and off drugs a number of times, if I were you, I'd assume from now on your nervous system is sensitized and be very, very cautious about taking any more psychiatric drugs.

 

It's up to you if you wish to nudge the dosage up. If I were you, I'd do this gradually with a liquid, maybe by increments of .25mg not more often than every 4 days. You can see how the increase affects you.

 

I would be very gradual because you probably will feel terrible if you accidentally take too much. A sensitized nervous system is very, very sensitive.

[RealityCheck]

Okay, I will try mixing up some liquid solution tonight. I don't want to up the dose and hadn't considered that I might have been doing so by accident. I picked up some Culturelle today... maybe it will work better than the probiotic pearls I was taking before... it certainly costs more.

 

I'm having a good day today, and two days ago was also good -- by that I mean that mood and energy were both okay after the usual nausea and existential angst in the morning. So two of the last three days were okay. I would say that's moving in the right direction.

 

Thanks so much for your kind support everyone!

[Jemima]

Your "existential angst" may be due to high cortisol levels rather than any sort of philosophical-psychological crisis. This is another nasty feature of withdrawal. I found I could control my morning dread by keeping the bedroom as dark as possible, wearing a sleep mask, and mentally bracing myself before sliding the sleep mask off. I also found wearing sunglasses in the house on bright days until 1:00 PM or so was very helpful, and I always wore sunglasses outside during daylight hours. I did my shopping at twilight for the first several months of withdrawal, after the sun was setting but before most drivers turned on their headlights.  I wasn't aware of why I was doing my shopping at that hour at first, but after finding out about the cortisol connection it made sense.  Bright light can cause some nasty headaches and high anxiety due to light sensitivity in early withdrawal.

[RealityCheck]

Ugh! Hey everyone! I haven't checked in here in so long. Still holding on to 1.25 mg escitalopram by my fingernails, since May. Have had major upheaval in the last few months and am just not bouncing back from it. Considering another updose to 2.5 mg if it doesn't resolve soon. MD found a vitamin D insufficiency so I'm supplementing that, plus fish oil, cal/mag, meditation and a (lame) attempt at regular exercise. Oh yeah I tried to start on birth control pills to see if that would help matters, but I abandoned them after a few weeks because I just didn't want to go on that ride. Even my husband is kind of like, why don't you just take a little more?

 

If anyone has experience with a depressive relapse/situational depression after tapering, I'd sure appreciate some feedback. It's kind of hard for me to function right now, barely getting by at work and have basically stopped doing anything that used to give me pleasure.  Thanks, Liz

[Altostrata]

RealityCheck, I moved your post here, as an update to your topic.

 

It can take some time for supplementation to raise low vitamin D. Vitamin D is an extremely important vitamin.

 

A psychiatric drug cannot substitute for a nutritional deficiency. Hang in there, do what you can, it will get better.

[Rhiannon]

RC, it seems to be common with AD withdrawal for people to get through the initial acute withdrawal period and feel some improvement, and then to get hit three to nine months (five or six is most common) later with a blast of WD symptoms. I call it delayed postacute withdrawal. Very common and Lexapro is a frequent culprit.

 

I don't know what causes it, but I think it must have something to do with how the brain has to remodel itself when the drugs are reduced/removed. There must be something in that process that causes renewed instability some months out. Since most doctors don't know anything about withdrawal, this is the point where people are told they are having a return of their "underlying condition" and is the trap that often drags people into lifelong psych drug use, usually escalating to multiple drugs over time with an overall course of increasing dysfunction and disability. (If you haven't yet read Anatomy of an Epidemic, I recommend it.)

 

So this is probably not your new normal, but a temporary setback that will pass in a few months. You may need to go back to being extra careful about taking care of yourself (diet, sleep, gentle exercise, regular routine, reduce stress, etc.) Be very gentle with your nervous system.

 

I would be cautious about updosing at this point. You're far enough out that you're probably quite sensitive to small changes in dose. If you do choose to updose, I would go with very small increments only, start with going to 1.5 at most. You can ratchet it up gradually over many weeks if you choose to go that route. But at this point the increased instability caused by ANY change in your brain's chemistry (induced by changes in drugs) can just paradoxically make the symptoms worse rather than better.

[Rhiannon]

It sounds like you're experiencing "depressive" type symptoms, very common at this stage. Ride it out if you can. Get plenty of light, either sunshine (sounds like you could use some with the vitamin D thing too) or those artificial therapy lights (10,000 lux minimum) for S.A.D. Get some kind of gentle exercise daily, doesn't have to be much. Even if you don't feel like it, make sure you are getting social experiences and social support. Stay away from alcohol, caffeine, sugar, refined carbs. These are all things that have seemed to help folks. Given the time of year I would particularly address the light thing right away. You'd be surprised how fast that can help.

[jprez562]

Reality Check,

 

how ow are you doing ? I am in a similar situation and been holding a dose of Lexapro of 0.7 mg. My main issue and symptom is depression which I never had before my panic attacks started. Updosing has crossed my mind because I get frustrated with the cycle of feeling better and then depressed again.

 

hope all is well

[Bonzee]

Jprez and everyone else, were you able to get off completely? I titrated 10 MG Lexapro from 10 to 5 with no issues until about a month after I started 5 every other day. I went back on 5 daily, then titrated down to 2.5 daily and then off. Severe withdrawal starting about 1 week after being off completely. I reinstated 1ML (1mg) daily per Altostrata's recommendation and I'm feeling better but I still have bad dizziness. Will stabilize at 1mg for a month then go down in increments. Probably will stop after I get to .3mg and feeling ok.

[jprez562]

Hi Bonzee,

 

I have stayed on 0.7 mg and have been holding and I have pretty much stabilized. It was rough. I have started a new job and want to get acclimated before I continue my taper. I will reduce 10% and hold for a month or two and take it from there. I am determined to get off and see if I can function