Dock1480: Tapering off of a 3-4 month treatment

[Dock1480]

Hi everyone.  I'm pretty new to SSRI medication and medication in general.  I apologize for the initial block of text below but I figured I'd share my own brief, (doesn’t feel brief at all), history with anxiety and depression.  Second block explains my medication treatment, my subsequent tapering and the question I have for the group. 

 

I'm 32 now and prior to Dec 2013, I hadn’t had to take any medication of any kind save for the occasional ibuprophen for joint and muscle pain.  Starting in the summer of 2013, I noticed that I was periodically waking up in the middle of the night with 'loud mental noise' , (what I called it, didn’t know anything about anxiety), and intrusive thoughts which was causing quite a bit of distress.  Compounding my anxiety was the ever-present thought that 'I am going crazy.  This is what it must feel like to loose your mind.  How long will it be before I loose complete control of myself and hurt someone'.  These feelings were made all the more real by the fact that my aunt has been battling schizophrenia for many years and things like hearing voices, killing family pets and self-immolation are all things that have resulted from her condition. 

Apart from the occasional sleepless, distressful night, around mid Aug 2013 I had what I later would find out was a panic attack which shook me up.  Nothing particular seemed to trigger it.  Was just eating lunch at work when it came on.  Had no idea what it was happening to me and thought I was dying.  During the attack, my heart was racing which seemed to be the one symptom that alarmed my doctor.  After an ER checkup which found nothing out of the ordinary, I was told that if it happens again, they will put me on a heart monitor.

I've always been a very physically active person, which looking back, probably helped me cope.  Around mid Oct 2013, I injured myself during a workout and had to stop my daily exercise routine for 2 months.  It was in the middle of this period, (a few days before Thanksgiving), that I got really bad.  I experienced a constant thick, fog-like state of mind.  It took considerable effort try and follow one-on-one conversations.  Very little of the experiences around me were being absorbed, (left me with very little memory of what was going on).  I was aware of how abnormal my condition was which brought back my anxiety and crippling fears of going insane.  Soon after Thanksgiving, I broke down and sought help from my doctor who agreed to see me the following day.  Taking the step to seek help was immediately good and bad.  The good was that it gave me hope that I was getting on a path to get better.  The bad was that seeking help made it 'real' and all the more scarier to try and process.  There was no longer the chance that I could deal with it and get through it on my own without anyone else having to know.  That night, I had the worst anxiety attack of my life.  Mental torture every second is the best way to describe it and it lasted for hours.  The next day my doc diagnosed me with depression and prescribed me 10mg of Lexapro per day and 1mg of Lorazepam as req.

 

My medication started on 12/01/13 with 10mg of Lexapro per day.  After 4 weeks, I still was experiencing lingering anxiety and intrusive thoughts so my prescription was upped to 20mg a day starting 01/01/14.

The higher dose made me feel about as normal as I could hope for.  It proved to be difficult to try and differentiate between the effects of the drugs vs effects of the condition that let me to the drugs.

Around mid-March, I was still dealing with the effects of the drugs but i had been feeling stable for a while.  I consulted my doc about when I could start tapering off.  He said 4 to 6 weeks so starting 04/01/14, I began to take my 20mg Lex on M,W,F only.  Then from May 1st to May 9th, I took 10mg every M,W,F.  Around May 12th, I started to experience dizzy, lightheadedness.  I would turn my eyes and/or my head to one side and would get vertigo for a second.  I took one more 10mg on May 16th and it took the dizzy feelings away pretty quick but they started to come back a day or so later.  I consulted my doc again and he confirmed that I was experiencing SSRI withdrawals and that if they got too severe, I could go on Prozac for a while since its half-life is much longer than Lex.

FF a couple weeks to today.  The dizzy, lightheaded feelings are all but gone.  I am experiencing waves of 'junk' which bring feelings of utter hopelessness with life, anxiety, horrible night sweats (I sleep on towels now), and some waking up in the middle of the night with crap feelings.  Overall, these waves have been manageable and since my the initial dizzy symptoms are now gone, I have hope that the others will eventually fall off as well. 

After reading various threads in this blog, I am concerned that I could be unknowingly heading for a crash given how quickly I tapered off my meds compared with a 10% taper.  It seems like my relatively short treatment period might allow a more aggressive taper but I don’t know.

I'm now caught between the option of going back on the drug and attempting a more gradual taper or staying off and seeing how the withdrawals play out.

Has anyone had any experience with or knowledge of short SSRI treatment periods and then quick tapers?

 

 

[Lexy]

Welcome

Please be careful...I was on effexor for 8 weeks only when I cut my dose by 50%. And have endured wds since oct 2012.

There will be other offering advice with more experience.

 

You should post on the introduction where more people are able to see your story.

[Petunia]

Hi Dock1480, and welcome.

 

I moved your post here to the introductions section, you can use this thread as your ongoing journal, updating your progress by adding posts.

 

Thank you for sharing your story in detail, it makes it easy to understand what may be going on in your situation.  I'm sorry you are feeling so unwell at the moment.  It sounds very much like you are experiencing withdrawal symptoms from discontinuing Lexapro too fast.  Your method of tapering by missing doses has probably contributed to added symptoms.

 

If I'm understanding it right, you took your last 10mg dose on the 16th May, which is two and a half weeks ago.  It would be helpful if you added your drug and withdrawal history, including dates and dose, to your signature, instructions for doing that are here:

 

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

 

Being on 20mg of Lexapro for 6 months is long enough to cause withdrawal symptoms for quite a while, everyone is different, but some people do have more serious problems and the fact that you are suffering already, gives an indication that you may possibly be struggling with withdrawal for some time.

 

In general, would you say you now feel worse, better or about the same?  Is there any daily pattern to your symptoms?

 

As Lexi mentioned above, some people have serious problems after only being on medication for a very short time.  We generally recommend reinstatement and then a much slower taper.  Because you have only been off the drug for under 3 weeks, you are well inside a time frame where reinstatement usually works well to reduce symptoms.

 

To help you decide, please read through our information about reinstatement:

 

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

 

If I were in your situation, I would probably reinstate at 5mg and see if it helped.  Then you could hold for a few more weeks, and then begin a proper taper.  It sounds like you are familiar with the 10% recommendation.  Information specific to tapering from Lexapro is here:

 

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

 

You will find a lot of friendly help and support here.

 

Petu

 

 

[Rhiannon]

Some people are able to taper off quickly after short usage (although I usually think of short usage as 3 months or less). Some people are able to taper off in about the same amount of time that they were on the drug. And some people find they end up tapering for longer than they were actually on the full dose.

 

We do find that a minority of people can't go off meds fast after any period of use. 

 

It's impossible to predict which category people will fall into in advance. Nobody can tell you how it's going to go for you from here out. Since the stakes are so high (given that minority of people who end up with huge suffering) we, here on this forum, are going to go with conservative advice, which in this case would be to reinstate at a small dose, stabilize, and then taper off slowly.

 

However, the ultimate decision is yours. I wish I could tell you what's going to happen but there's no way for me to know.

 

I would like to add that the taper method you used (alternating days) we have found is almost always rockier and more disruptive to the CNS than a regular daily taper (taking the med every day but at slowly reducing dosages).  We don't recommend it.