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TXoilman: Reinstate or not?


TXOilman

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I'm a husband posting on behalf of my wife:

 

My wife was on Lexapro (5mg) for 4 years.  She cut back to 2.5mg a couple of years ago, then dropped to 1.25mg, then to 0.625mg over a 2- month period before stopping altogether after a dose on April 29 , 2014.  Withdrawal began within 6 days of the final dose, mostly physical in nature, but some anxiety.  Six tough weeks passed and some of the symptoms went away, but then she had a week with heavy "brain fog", was too weak to hardly stand up, and was very dizzy.  She kind of panicked, thinking it was about to get really bad, and took a 0.2mg. dose on Wed., June 11.  She didn't like how it made her feel that day and the next (mostly brain fog).  She also had some restless anxiety on Thursday night, but doesn't know if that was caused by the Lexapro or the fact that she did not repeat the dose.  Fri. through Sun. after taking the 0.2mg dose were horrendous (like a mini withdrawal), but the next 2 weeks the withdrawal symptoms were much less pronounced other than bad anxiety like she had not experienced before.   

This last week, however, the restless, chemical anxiety has progressed, and at times caused her to claw at her legs, bite the knuckles of her fingers, kick walls, etc.  Besides this anger, she is also dealing with depression that wasn't there before taking the 0.2mg dose.  The nausea has progressively gotten worse during this last week (which wasn't present before), and she believes she is starting all over again with withdrawal and is not sure she can survive doing it all again, especially with possibly worse symptoms to come.  As a result, she is in anguish over whether or not to reinstate, possibly at a much reduced dose at first.

 

Here are the questions we have:

1.  Did she have a bad reaction to the 0.2mg dose based on Fri., Sat., and Sun. which were horrendous, or was that related to cold-turkey withdrawal from that dose?

2. Following those very tough days, is it possible for the dose to have kicked in and helped starting day 6 and for a couple of weeks after that, to some extent?  It seems very strange that 3 days of bad withdrawal symptoms could become 2 weeks of diminished withdrawal symptoms resulting from taking 1 dose, much less a small dose.

 

All along since early May, she has been anguishing over whether or not to reinstate for real.  She is worried about potential side effects with getting back on (kindling effect?), but also worried about what could be coming down the road if she doesn't reinstate.  She has so much to live for NOW, and needs to be healthy again, but doesn't want to have a bad reinstatement and then have to withdraw all over again.   Your thoughts would be much appreciated. Thanks!!

2006    Ativan, Ambien as needed to cope with breast cancer treatment - very small doses

2008    Lexapro 5mg "to control hot flashes"

2012    Lexapro 2.5mg - no problems noted with that drop

2014    Feb. Lexapro 1.25mg

2014    Mar-Apr Lexapro 0.625mg, eventually dropping frequency to twice weekly

2014    Apr 29 Final Dose of Lexapro

6/2014     Lexapro 0.2mg single dose

7/15/14    Lexapro 0.05mg reinstatement

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  • Moderator Emeritus

Hi TX, I've moved your thread to introductions and updates, this will be your thread to update

and ask questions about your wife's experience and progress. 

 

Can you tell us a bit more about how your wife tapered and how long she was at 1.25? 

I'm sorry I can't help right now, I'm having a bad day myself and can't concentrate but someone will be 

along very soon who can offer some advice.  

 

I'm sorry your wife is in this situation but I am so pleased she has you by her side to get her through this nightmare.

**I am not a medical professional, if in doubt please consult a doctor with withdrawal knowledge.

 

 

Different drugs occasionally (mostly benzos) 1976 - 1981 (no problem)

1993 - 2002 in and out of hospital. every type of drug + ECT. Staring with seroxat

2002  effexor. 

Tapered  March 2012 to March 2013, ending with 5 beads.

Withdrawal April 2013 . Reinstated 5 beads reduced to 4 beads May 2013

Restarted taper  Nov 2013  

OFF EFFEXOR Feb 2015    :D 

Tapered atenolol and omeprazole Dec 2013 - May 2014

 

Tapering tramadol, Feb 2015 100mg , March 2015 50mg  

 July 2017 30mg.  May 15 2018 25mg

Taking fish oil, magnesium, B12, folic acid, bilberry eyebright for eye pressure. 

 

My story http://survivingantidepressants.org/index.php?/topic/4199-hello-mammap-checking-in/page-33

 

Lesson learned, slow down taper at lower doses. Taper no more than 10% of CURRENT dose if possible

 

 

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  • Moderator Emeritus

Hi TXOilman and welcome,

 

I'm sorry to learn that your wife is suffering like this, but its great that she has you to help her, I'm sure its a real comfort.

 

As MammaP wrote, it would be helpful if we could get the details of the taper a little clearer.  Please would you put the taper details, doses and dates in your signature, here is how you do it:

 

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

 

Here are the questions we have:

1.  Did she have a bad reaction to the 0.2mg dose based on Fri., Sat., and Sun. which were horrendous, or was that related to cold-turkey withdrawal from that dose?

2. Following those very tough days, is it possible for the dose to have kicked in and helped starting day 6 and for a couple of weeks after that, to some extent?  It seems very strange that 3 days of bad withdrawal symptoms could become 2 weeks of diminished withdrawal symptoms resulting from taking 1 dose, much less a small dose.

 

 

 

Its impossible to know exactly what happened, our brain and nervous system is complex and doctors don't even know the full effects of how these drugs work, even in a stable nervous system.  I doubt that your wife is having an ongoing adverse reaction to one 0.2mg dose taken almost a month ago.  Its more likely that she is experiencing the 'normal' windows and waves pattern of withdrawal, see this thread for more information:

 

http://survivingantidepressants.org/index.php?/topic/82-the-windows-and-waves-pattern-of-recovery/

 

In your wife's situation, we most likely would have suggested trying a reinstatement at a dose similar to what she tried, but reinstatement needs to be tried for a minimum of 4 - 7 days to find out if its going to help.  Taking the same small dose over the course of several days, and then tracking symptoms can give a good indication of if its helping or making symptoms worse.  From what you have written, its difficult to know if what she experienced from one small dose was an adverse reaction or just the normal fluctuations of ongoing withdrawal.

 

It has to be your decision if you want to try a proper reinstatement.  Here is our reinstatement thread, which may help:

 

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

 

Others may offer more opinions, if you do decide to give reinstatement another chance, we will be able to help with that.

 

Petu.

I'm not a doctor.  My comments are not medical advise. These are my opinions based on my own experience and what I've learned. Please discuss your situation with a medical practitioner who has knowledge of tapering and withdrawal...if you are lucky enough to find one.

My Introduction Thread

Full Drug and Withdrawal History

Brief Summary

Several SSRIs for 13 years starting 1997 (for mild to moderate partly situational anxiety) Xanax PRN ~ Various other drugs over the years for side effects

2 month 'taper' off Lexapro 2010

Short acute withdrawal, followed by 2 -3 months of improvement then delayed protracted withdrawal

DX ADHD followed by several years of stimulants and other drugs trying to manage increasing symptoms

Failed reinstatement of Lexapro and trial of Prozac (became suicidal)

May 2013 Found SA, learned about withdrawal, stopped taking drugs...healing begins.

Protracted withdrawal, with a very sensitized nervous system, slowly recovering as time passes

Supplements which have helped: Vitamin C, Magnesium, Taurine

Bad reactions: Many supplements but mostly fish oil and Vitamin D

June 2016 - Started daily juicing, mostly vegetables and lots of greens.

Aug 2016 - Oct 2016 Best window ever, felt almost completely recovered

Oct 2016 -Symptoms returned - bad days and less bad days.

April 2018 - No windows, but significant improvement, it feels like permanent full recovery is close.

VIDEO: Where did the chemical imbalance theory come from?



VIDEO: How are psychiatric diagnoses made?



VIDEO: Why do psychiatric drugs have withdrawal syndromes?



VIDEO: Can psychiatric drugs cause long-lasting negative effects?

VIDEO: Dr. Claire Weekes

 

 

 

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@TXOilman

Thanks very much for responding to my post!

 

I wish I could supply more details relative to her taper.  Unfortunately, she was not doing a planned taper, and therefore was not tracking the exact dose amounts by calendar day.  The Dr. that originally prescribed the Lex never prepared her for getting off of it, and then died a year or two ago.  A different Dr. was refilling the prescription, but also gave her no advice.  It is a miracle that she somehow instinctively knew to taper off at all.  She originally started the drug at 5mg in 2008, then cut back to 2.5mg about 2 years ago.  In Feb. this year she cut the dose to 1.25mg (not sure how long at that level), then to 0.625mg (also not sure how long), then started skipping days until she was only taking the 0.625mg dose a couple of times each week.  Her last dose was 4/29 until the single dose of ~0.2mg on 6/11. 

2006    Ativan, Ambien as needed to cope with breast cancer treatment - very small doses

2008    Lexapro 5mg "to control hot flashes"

2012    Lexapro 2.5mg - no problems noted with that drop

2014    Feb. Lexapro 1.25mg

2014    Mar-Apr Lexapro 0.625mg, eventually dropping frequency to twice weekly

2014    Apr 29 Final Dose of Lexapro

6/2014     Lexapro 0.2mg single dose

7/15/14    Lexapro 0.05mg reinstatement

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  • Moderator Emeritus

Hello and welcome from me, another Lexapro victim here.

 

As you will see from my signature, I'd been on several other ADs together with a benzo before I was put on Lexapro which are only some of the things that will make our experiences different. Was your wife on any other medication prior to taking Lexapro?

 

Also I was put on 10 mgs Lexapro and without knowing about taper I cut to 5 mg without (too noticeable) consequences. (I didn't follow my doctor's advice because she maintained that ADs are not addictive and that I can just stop taking them from one day to the other!).We established that 95 % of psychiatrists are not aware of the withdrawal symptom and just ascribe the symptoms to the return of the "illness". Of course pharmaceutical companies aren't interested in funding research that would reveal the true nature of these drugs and compromise their profit coming from advertising them as completely harmless. That's why there are no instructions on how to come off them.

 

I didn't have too many problems with cutting from 5 to 2.5 mg but I discontinued that after 2 weeks thinking it was such a small dose that I'd be ok. I had symptoms immediately but hoped they would go away. Contrary to that they were intensifying as the time went by and I reinstated 5 mg after 45 days. 

 

What I see as a mistake that your wife made was skipping doses and taking the drug a couple of times per week. This destabilises CNS very much. It's like  you didn't eat for a few days and then you ate everything there is in the fridge. It's a bad simile but the thing is that the brain is trying to adjust to the situation without a drug and changing its doses is battering it badly.

 

I don't even won't to imagine what would've happened to me had I not reinstated.I would've prob have the same symptoms as your wife. I actually reinstated before coming here and was too scared of what was happening to me so went to 5 mg thinking more was better. But in any case I felt as if I was a cart sliding down a steep slope at an increasing speed that suddenly stopped sliding. The relief was obvious but it took me 4 months of very slow climbing out of the deep pit I was in. 

 

What I've learnt here is that it's best to reinstate or even updose if we are still tapering as soon as possible after the first symptoms occur because they are sign that CNS can't keep up with the changes. I would say that your wife's instinct to reinstate and reinstate at such a small dose was good. If I'm reading it right, it did give her relief. So in response to your second question, I'd definitely say yes: even that tiny dose stopped withdrawal and provided relief of 2 week of diminished symptoms. As Petu says, I also don't think it's  to blame for her present condition which I also see as original withdrawal that that small dose temporarily stopped.

 

With my other AD, Zoloft I lasted off longer (3 months). In the course of those 3 months my symptoms progressively deteriorated to the situation where I also sank in the deepest depression ever. So these drugs definitely have a potential to make us deteriorate even after a very long time. 

 

I'm very sorry about what your wife is experiencing. I really sounds horrible. It's hard to say where to go from here. As we say, more than 2 months off all bets are off too. However, following my experience of being dragged out of a precipice by reinstatement, I would always try it.Even if it doesn't work, things can hardly be as bad as they are now. Also reinstating a very small amount makes it easy to stop if there is an adverse reaction without consequences.

 

Reinstating doesn't stop all the symptoms especially not immediately or even soon as I described. But if one experiences the slightest of relieves as I did, it's all it takes to bring hope and then see windows and waves of recovery. 

 

Check this thread, especially the graphs displayed to see why such small doses are so powerful.http://survivingantidepressants.org/index.php?/topic/6036-why-taper-paper-demonstrates-importance-of-gradual-change-in-plasma-concentration/

 

I believe you will get more opinions, i would especially wait for our main expert Alto before deciding what to do. I'm glad you found this site and your wife is very lucky to have such support in you.

 

She will be fine, we all recover. we just have to find a way and then allow time to heal.

 

best,

bubble

Current: 9/2022 Xanax 0.08, Lexapro 2

2020 Xanax 0.26 (down from 2 mg in 2013), Lexapro 2.85 mg (down from 5 mg 2013)

Amitriptyline (tricyclic AD) and clonazepam for 3 months to treat headache in 1996 
1999. - present Xanax prn up to 3 mg.
2000-2005 Prozac CT twice, 2005-2010 Zoloft CT 3 times, 2010-2013 Escitalopram 10 mg
went from 2.5 to zero on 7 Aug 2013, bad crash 40 days after
reinstated to 5 mg Escitalopram 4Oct 2013 and holding liquid Xanax every 5 hours
28 Jan 2014 Xanax 1.9, 18 Apr  2015 1 mg,  25 June 2015 Lex 4.8, 6 Aug Lexapro 4.6, 1 Jan 2016 0.64  Xanax     9 month hold

24 Sept 2016 4.5 Lex, 17 Oct 4.4 Lex (Nov 0.63 Xanax, Dec 0.625 Xanax), 1 Jan 2017 4.3 Lex, 24 Jan 4.2, 5 Feb 4.1, 24 Mar 4 mg, 10 Apr 3.9 mg, May 3.85, June 3.8, July 3.75, 22 July 3.7, 15 Aug 3.65, 17 Sept 3.6, 1 Jan 2018 3.55, 19 Jan 3.5, 16 Mar 3.4, 14 Apr 3.3, 23 May 3.2, 16 June 3.15, 15 Jul 3.1, 31 Jul 3, 21 Aug 2.9 26 Sept 2.85, 14 Nov Xan 0.61, 1 Dec 0.59, 19 Dec 0.58, 4 Jan 0.565, 6 Feb 0.55, 20 Feb 0.535, 1 Mar 0.505, 10 Mar 0.475, 14 Mar 0.45, 4 Apr 0.415, 13 Apr 0.37, 21 Apr 0.33, 29 Apr 0.29, 10 May 0.27, 17 May 0.25, 28 May 0.22, 19 June 0.22, 21 Jun updose to 0.24, 24 Jun updose to 0.26

Supplements: Omega 3 + Vit E, Vit C, D, magnesium, Taurine, probiotic 

I'm not a medical professional. Any advice I give is based on my own experience and reading. 

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  • Moderator Emeritus

Well Petu and Bubble have pretty much covered it all. I'd just like to reiterate that although she was wise to taper at all, the alternating doses thing actually is just as bad as CT.

 

We find that the nervous system does best with stability, and I suspect that's because every time we perturb the biochemical mileu, the nervous system reacts by attempting to re-establish homeostasis.

 

When a person takes the same dose every day, the brain remodels itself around the new chemistry (removing receptors, adding others, growing new cells, destroying others, turning on some genes and turning off others). Then when we change doses or meds it has to try to re-adapt to the new chemical environment. None of these changes are fast, and the ability of the brain to do them is very imperfect since we've never had the chance during evolution to develop the necessary mechanisms since we've never been exposed to these drugs before.

 

Every time we perturb the system by taking doses just intermittently, all those poorly-adapted compensatory mechanisms get triggered on and off and on and off, and the result doesn't seem to be good.

 

So I'm not surprised she's quite symptomatic now and her symptoms are chaotic. Things will probably be that way for a while.

 

I agree that a very low dose reinstatement would probably be a good idea, and give it a few days unless she has an obvious terrible reaction to it. Reinstatement is not a cure, however. She will still be symptomatic. It just takes the edge off and makes it less like crashing into a wall and more like riding with no shock absorbers over a very bumpy road.

 

Also, given the history, it's important not to be changing doses around any more. Try the reinstatement at 0.1 mg or 0.2 mg, give it four days. If she has a strong bad reaction and she chooses not to reinstate, that should be the last time she tries it. Her brain needs stability now. If it does seem to improve some of her symptoms, then she needs to stay on that exact dose, taken the same time every day, regardless of how the withdrawal symptoms come and go (and they will, because they do.)

 

How is she measuring her doses (the 0.2 mg and the 0.625 mg)? It's important to make sure the doses are precise and consistent every day, either by using a scale or by using a liquid. At such a small dose if you're just cutting pills it's easy to end up with a lot of variation.

 

Take a look at our Symptoms and Self Care section for ideas on how to cope with the symptoms.

 

When she's well enough, maybe she can post here herself and let us give her our regards. She will probably find it comforting to see that many other people have experienced the things she is experiencing now and into the future. It's not just the physical symptoms. The kinds of emotions and thoughts that withdrawal causes can be very disorienting to our sense of who we are, and it can be helpful to know that other people have gone through the same stuff and come out the other side.

 

Let her know that she has lots of support here. She's going to be fine, it's just going to take a while. And give her my congratulations on the wise choices she made, to taper down to a small dose and to reinstate at a very small dose, both of which I'm sure her doctor was no help with.

Started on Prozac and Xanax in 1992 for PTSD after an assault. One drug led to more, the usual story. Got sicker and sicker, but believed I needed the drugs for my "underlying disease". Long story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything. Amitryptiline, Prozac, bupropion, buspirone, flurazepam, diazepam, alprazolam, Paxil, citalopram, lamotrigine, gabapentin...probably more I've forgotten. 

Started multidrug taper in Feb 2010.  Doing a very slow microtaper, down to low doses now and feeling SO much better, getting my old personality and my brain back! Able to work full time, have a full social life, and cope with stress better than ever. Not perfect, but much better. After 23 lost years. Big Pharma has a lot to answer for. And "medicine for profit" is just not a great idea.

 

Feb 15 2010:  300 mg Neurontin  200 Lamictal   10 Celexa      0.65 Xanax   and 5 mg Ambien 

Feb 10 2014:   62 Lamictal    1.1 Celexa         0.135 Xanax    1.8 Valium

Feb 10 2015:   50 Lamictal      0.875 Celexa    0.11 Xanax      1.5 Valium

Feb 15 2016:   47.5 Lamictal   0.75 Celexa      0.0875 Xanax    1.42 Valium    

2/12/20             12                       0.045               0.007                   1 

May 2021            7                       0.01                  0.0037                1

Feb 2022            6                      0!!!                     0.00167               0.98                2.5 mg Ambien

Oct 2022       4.5 mg Lamictal    (off Celexa, off Xanax)   0.95 Valium    Ambien, 1/4 to 1/2 of a 5 mg tablet 

 

I'm not a doctor. Any advice I give is just my civilian opinion.

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  • Administrator

Welcome, txoilman.

 

It sounds like your wife felt a little better after taking 0.2mg, but not taking it consistently caused her nervous system to complain about the changes.

 

If I were your wife, I would try 0.1mg for at least a week to see if it helps. If it does, stay on for several months, then go off by tiny amounts. See this topic about titrating Lexapro (it comes in a liquid): http://survivingantidepressants.org/index.php?/topic/406-tips-for-tapering-off-lexapro-escitalopram/

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Thanks very much to all of you who have posted responses to my initial post!  We had not really considered the impact of spreading 0.625mg doses out over several days, then doing that for several weeks before stopping altogether.  My wife has been thinking of all that as tapering rather than like a C/T withdrawal, so that concept throws a new wrinkle in our thinking.  The consensus seems to be that the single 0.2mg dose taken on 6/11 did not impact her overall process that much, and that her current symptoms were on their way anyway.  The consensus also seems to be that she should reinstate at a low dose (0.1mg) and stay on it at least 7 days to see what impact it has.  Of course, she has read a lot about "kindling effect" and is very scared that reinstating again at any dose may cause that to occur.  Would be interested in your opinions on that.

 

One thing that has puzzled her:  in Feb. and March, the primary symptom of the "tapering" was shortness of breath which caused serious anxiety at times, loss of sleep, and indirect weight loss due to the fact that she believed the shortness of breath was related to bloating caused by eating certain foods, swallowing air, etc.   That period was compounded by an injury to her sacroiliac joint caused by chiropractors.  Is it possible for the first symptom of Lex W/D to be shortness of breath?

2006    Ativan, Ambien as needed to cope with breast cancer treatment - very small doses

2008    Lexapro 5mg "to control hot flashes"

2012    Lexapro 2.5mg - no problems noted with that drop

2014    Feb. Lexapro 1.25mg

2014    Mar-Apr Lexapro 0.625mg, eventually dropping frequency to twice weekly

2014    Apr 29 Final Dose of Lexapro

6/2014     Lexapro 0.2mg single dose

7/15/14    Lexapro 0.05mg reinstatement

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Need to answer some of the questions from responders:

 

My wife had not been on any AD's before Lexapro.  She had been taking very small doses of Ativan since 2006 and still uses this med though not every day, same dose.  She also uses Ambien to help with sleeping, and has for quite some time although not every day.  Insomnia is a very bad symptom that she is dealing with - often only gets a few hours of sleep, and that only in short snatches.  I worry about the effect on brain's ability to recover/repair.

 

As to how we would measure a 0.1mg dose: dissolve a 5mg tab in 100 milliliters of water, then use a syringe to pull out 2 milliliters containing a total of 0.1mg of the Lex.

2006    Ativan, Ambien as needed to cope with breast cancer treatment - very small doses

2008    Lexapro 5mg "to control hot flashes"

2012    Lexapro 2.5mg - no problems noted with that drop

2014    Feb. Lexapro 1.25mg

2014    Mar-Apr Lexapro 0.625mg, eventually dropping frequency to twice weekly

2014    Apr 29 Final Dose of Lexapro

6/2014     Lexapro 0.2mg single dose

7/15/14    Lexapro 0.05mg reinstatement

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  • Administrator

Yes, it is possible the first noticeable symptoms of withdrawal might be shortness of breath, but your wife's other symptoms -- serious anxiety at times, loss of sleep, and difficulty eating -- might also have been withdrawal symptoms.

 

Her use of benzos and Ambien may be adding to her symptoms. Rebound effects and interdose withdrawal symptoms are common with those drugs. We recommend people keep notes on paper about their daily symptom pattern, when they take drugs, supplements, etc., and their dosages. Is she taking any other drugs, such as antihistamines and stomach acid blockers?

 

Since she didn't get a kindling reaction when she took 0.2mg, she shouldn't when she takes 0.1mg. There are no guarantees, however. It takes about 4 days for a drug to reach steady-state in the bloodstream; if kindling occurs, she can quit immediately. There's a chance that she might have to cope with a riled nervous system if that happens and be patient while it settles down.

 

Lexapro comes in a liquid form, have you considered that?

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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She only rarely uses antihistimine, although I picked up some Dramamine for her yest. to possibly help with nausea. She uses something called Astepro daily that is a nasal steroid to manage allergies.

 

We have not considered the liquid form of Lexapro but will look into it. If she tries to reinstate again, we might do it the way I described until we see if it will be an extended reinstatement before acquiring the liquid form. I think the dissolve/dilute method will be even more accurate than weighing grains, the only question is shelf life. Though about freezing each dose in an ice tray where "cubes" are actually small half-spheres. She could just drop one in a cup of water, let it melt, and drink the whole cup.

 

Thank you so much for your input!!!

2006    Ativan, Ambien as needed to cope with breast cancer treatment - very small doses

2008    Lexapro 5mg "to control hot flashes"

2012    Lexapro 2.5mg - no problems noted with that drop

2014    Feb. Lexapro 1.25mg

2014    Mar-Apr Lexapro 0.625mg, eventually dropping frequency to twice weekly

2014    Apr 29 Final Dose of Lexapro

6/2014     Lexapro 0.2mg single dose

7/15/14    Lexapro 0.05mg reinstatement

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  • Administrator

Please read the links given up above for your information.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • 2 weeks later...

Hi All,

 

Sorry for absence.  My wife reinstated Lexapro on 7/15 at 0.05mg.  Followed that with another dose on 7/16 and again today.  Within a few hours the first day she experienced more of that detached feeling, heart pounding, "foggy" vision, tunnel vision, shakiness, and the feeling that she was having to think about breathing (though she had been dealing with the last two since Feb.).  That first night her Ambien did not work and she only got 1 hr. of sleep (as opposed her normal 3-4 hrs.).  The next morning she was angry, anxious, nauseous (though she had already been dealing with nausea before the RI).  Some of these symptoms seemed to improve about the time to take another dose. Ativan helped the anxiety some last night and she enjoyed having our kids and grandson over to celebrate her birthday.  We all took a pretty long walk during the evening, which is something she has been doing for several weeks now.  She slept more last night, and her nausea wasn't as bad this morning, but her breathing was worse.  The nausea got a little worse this afternoon, but she has able to eat anyway.  We took another walk tonight. 

 

Here are her questions:  1) is this considered an adverse reaction?   2) since she very much needs the WD symptoms to diminish or go away, how long should she stay at 0.05mg before increasing the dose, and by how much when she does?   3.) How long should she expect it take before she can know if this dose is helping to offset WD?

 

If she can get the WD symptoms under control or get rid of them altogether, she will put weight back on and get healthy before begin a much slower taper off of it.

 

As always, thanks so very much for your input!

2006    Ativan, Ambien as needed to cope with breast cancer treatment - very small doses

2008    Lexapro 5mg "to control hot flashes"

2012    Lexapro 2.5mg - no problems noted with that drop

2014    Feb. Lexapro 1.25mg

2014    Mar-Apr Lexapro 0.625mg, eventually dropping frequency to twice weekly

2014    Apr 29 Final Dose of Lexapro

6/2014     Lexapro 0.2mg single dose

7/15/14    Lexapro 0.05mg reinstatement

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  • Moderator Emeritus

Hi TXO,

 

it takes at least 4 days for the change to register but it is great you are monitoring the symptoms closely. It's also very good that she is able to go for walks and at least briefly experience joy. 

 

As we said before, if the reinstatement works, she will feel at least some symptoms diminishing but not all of them and not at once. It's very gradual and slow process. Stability is the only thing that help and changing doses in an attempt to find the one that works makes things work.

 

It would help us if you could put her drug history in the signature so that we don't have to look for the information about the changes in your thread.http://survivingantidepressants.org/index.php?/topic/893-please-put-your-withdrawal-history-in-your-signature/

 

She is not getting worse and many things are better so that's a very good sign.

 

best,

bubble

Current: 9/2022 Xanax 0.08, Lexapro 2

2020 Xanax 0.26 (down from 2 mg in 2013), Lexapro 2.85 mg (down from 5 mg 2013)

Amitriptyline (tricyclic AD) and clonazepam for 3 months to treat headache in 1996 
1999. - present Xanax prn up to 3 mg.
2000-2005 Prozac CT twice, 2005-2010 Zoloft CT 3 times, 2010-2013 Escitalopram 10 mg
went from 2.5 to zero on 7 Aug 2013, bad crash 40 days after
reinstated to 5 mg Escitalopram 4Oct 2013 and holding liquid Xanax every 5 hours
28 Jan 2014 Xanax 1.9, 18 Apr  2015 1 mg,  25 June 2015 Lex 4.8, 6 Aug Lexapro 4.6, 1 Jan 2016 0.64  Xanax     9 month hold

24 Sept 2016 4.5 Lex, 17 Oct 4.4 Lex (Nov 0.63 Xanax, Dec 0.625 Xanax), 1 Jan 2017 4.3 Lex, 24 Jan 4.2, 5 Feb 4.1, 24 Mar 4 mg, 10 Apr 3.9 mg, May 3.85, June 3.8, July 3.75, 22 July 3.7, 15 Aug 3.65, 17 Sept 3.6, 1 Jan 2018 3.55, 19 Jan 3.5, 16 Mar 3.4, 14 Apr 3.3, 23 May 3.2, 16 June 3.15, 15 Jul 3.1, 31 Jul 3, 21 Aug 2.9 26 Sept 2.85, 14 Nov Xan 0.61, 1 Dec 0.59, 19 Dec 0.58, 4 Jan 0.565, 6 Feb 0.55, 20 Feb 0.535, 1 Mar 0.505, 10 Mar 0.475, 14 Mar 0.45, 4 Apr 0.415, 13 Apr 0.37, 21 Apr 0.33, 29 Apr 0.29, 10 May 0.27, 17 May 0.25, 28 May 0.22, 19 June 0.22, 21 Jun updose to 0.24, 24 Jun updose to 0.26

Supplements: Omega 3 + Vit E, Vit C, D, magnesium, Taurine, probiotic 

I'm not a medical professional. Any advice I give is based on my own experience and reading. 

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  • Moderator Emeritus
Here are her questions:  1) is this considered an adverse reaction?   2) since she very much needs the WD symptoms to diminish or go away, how long should she stay at 0.05mg before increasing the dose, and by how much when she does?   3.) How long should she expect it take before she can know if this dose is helping to offset WD?

 

 

You may find answers to your questions in the thread on reinstatement here:

 

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

 

  • After reinstatement, the amount of time needed to alleviate withdrawal symptoms (stabilizing) varies according to the individual. Relief can be felt immediately, after some weeks, or after some months.
  • Once you feel withdrawal symptoms are reduced after reinstatement, give your nervous system time to stabilize before attempting dosage reduction. Think in terms of months, not days.
  • Be patient after you reinstate. Reinstatement may not immediately eliminate all withdrawal symptoms. You may still experience waves of symptoms, which usually lessen as time goes on.
  • The dose needed for effective reinstatement varies according to the individual.
  • Sometimes reinstatement does not work. The nervous system has taken such a hard hit from withdrawal, it's destabilized beyond whatever effect the drug might have had.
  • Sometimes reinstatement not only does not work, it causes an adverse reaction from a nervous system sensitized by withdrawal. If you have an immediate bad reaction, reduce or stop taking the drug.

She might not need to increase the dose, .05mg may be enough to settle the symptoms down.  As Alto suggested, a few posts up, keep notes on paper about daily symptom pattern, when she take drugs, supplements, etc., and their dosages. Rate symptoms on a scale of 1 -5, so you can see if they are decreasing.

 

If I were you I would give it at least a month before making a decision. As Bubble wrote - stability is important and changing doses too quickly is not a good idea.  If after a month, there has been no improvement or slight improvement, then you could increase to .1mg

 

Her use of benzos and Ambien may be adding to her symptoms. Rebound effects and interdose withdrawal symptoms are common with those drugs.

 

This is important, when you fill out your signature, please include all medications, doses and times taken.  If there are rebound effect from benzos, the dose can be spread out more evenly through the day.

 

I agree with Bubble, there have been a few positive changes and that's a good sign.  Please work on the signature and let us know how your wife is doing.

I'm not a doctor.  My comments are not medical advise. These are my opinions based on my own experience and what I've learned. Please discuss your situation with a medical practitioner who has knowledge of tapering and withdrawal...if you are lucky enough to find one.

My Introduction Thread

Full Drug and Withdrawal History

Brief Summary

Several SSRIs for 13 years starting 1997 (for mild to moderate partly situational anxiety) Xanax PRN ~ Various other drugs over the years for side effects

2 month 'taper' off Lexapro 2010

Short acute withdrawal, followed by 2 -3 months of improvement then delayed protracted withdrawal

DX ADHD followed by several years of stimulants and other drugs trying to manage increasing symptoms

Failed reinstatement of Lexapro and trial of Prozac (became suicidal)

May 2013 Found SA, learned about withdrawal, stopped taking drugs...healing begins.

Protracted withdrawal, with a very sensitized nervous system, slowly recovering as time passes

Supplements which have helped: Vitamin C, Magnesium, Taurine

Bad reactions: Many supplements but mostly fish oil and Vitamin D

June 2016 - Started daily juicing, mostly vegetables and lots of greens.

Aug 2016 - Oct 2016 Best window ever, felt almost completely recovered

Oct 2016 -Symptoms returned - bad days and less bad days.

April 2018 - No windows, but significant improvement, it feels like permanent full recovery is close.

VIDEO: Where did the chemical imbalance theory come from?



VIDEO: How are psychiatric diagnoses made?



VIDEO: Why do psychiatric drugs have withdrawal syndromes?



VIDEO: Can psychiatric drugs cause long-lasting negative effects?

VIDEO: Dr. Claire Weekes

 

 

 

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  • Administrator

Tx, we need to see what her daily symptom pattern is, particularly in relation to when she is taking ANY drug, and their dosages.

 

Also, she should take the Lexapro at the same time every day. Do the symptoms get worse after she takes the Lexapro? If you can't tell because she's taking other things at the same time you need to separate the Lexapro, take at a different time.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Alto,

 

I wish I could fully answer your first question. My wife has kept a fairly detailed diary of her symptoms, but has not paid a lot of attention to what symptoms might be related to taking Ativan or Ambien. She takes those only sporadically, also, and at much reduced doses.

 

Since reinstating last Tuesday at 0.05mg, she has experienced side effects that are very similar to the WD symptoms that she has been dealing with off and on since May. They were worse within the first few hours after taking the Lex, although that seems to fluctuate as well. She is very concerned that she is not noticing any positive benefits as of yet from the RI, and worried that her system may not respond to the drug by minimizing, much less stopping the WD symptoms. At that point she feels that she might have wasted all the time she was going through the WD process and actually improving in some ways, and would therefore be back to square one, or worse, because now she will have to taper off and suffer with the side effects for a long time. She is a very disheartened gal at this point.

 

My feeling is that it is still too early to know. The saturation level in her system will not actually peak until Thursday, and her CNS may need a few more weeks to recover from the upset caused by the RI.

 

I am working on a signature, but just have not gotten it done yet.

2006    Ativan, Ambien as needed to cope with breast cancer treatment - very small doses

2008    Lexapro 5mg "to control hot flashes"

2012    Lexapro 2.5mg - no problems noted with that drop

2014    Feb. Lexapro 1.25mg

2014    Mar-Apr Lexapro 0.625mg, eventually dropping frequency to twice weekly

2014    Apr 29 Final Dose of Lexapro

6/2014     Lexapro 0.2mg single dose

7/15/14    Lexapro 0.05mg reinstatement

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Hi ALL,

 

This is day 11 of my wife's reinstatement at 0.05mg/day of Lexapro. It is hard to imagine that such a small dose would cause a return of some of the WD symptoms that had gone away, plus cause new and different symptoms, but it has, without question. The WD symptoms could be related to her original WD, but many of those had gone away or improved, including burning, puffy eyes, burning mouth and throat, "chemical" anxiety, shortness of breath, detached feeling, brain fog, blurry vision, & shaking/shivering. New symptoms include dizziness, "a different kind of nausea", face hot & flushing. These get worse 4-5 hours after taking the dose, then improve for a bit just before she takes the next dose.

 

Our questions right now:

  • Is it normal for RI symptoms to take this long to subside?
  • Is there still hope that they will at some point?
  • Is it normal to see some of the old WD symptoms come back during RI, and can she expect them to go away again?
  • If the RI symptoms hang on this long, is there still room for hope that her system will adjust and still use the drug to stop the WD process?

She is regretting the RI, realizing that she had made so much progress to that point that she should hold off and give it some more time. She is wondering now if it is already obvious that her system will not tolerate Lexapro any more, and she should go ahead a taper back off.

Thanks so much for your patience with us and your input! It helps so much to bounce all this off of someone who has seen many cases and has a feel for how these things generally go. There doesn't seem to be anyone in the medical community in our area (north Texas) that has a clue or even wants to try to help her.

By the way, she is holding her own with her weight, and sleeping has improved a little.  Still doesn't get enough and what she gets is sporadic, but we are not as concerned about her short-term well-being right now.  If the shortness of breath and almost constant underlying anxiety were gone, she could tolerate everything else much better.

Thanks again!!!
TXOilman

2006    Ativan, Ambien as needed to cope with breast cancer treatment - very small doses

2008    Lexapro 5mg "to control hot flashes"

2012    Lexapro 2.5mg - no problems noted with that drop

2014    Feb. Lexapro 1.25mg

2014    Mar-Apr Lexapro 0.625mg, eventually dropping frequency to twice weekly

2014    Apr 29 Final Dose of Lexapro

6/2014     Lexapro 0.2mg single dose

7/15/14    Lexapro 0.05mg reinstatement

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  • Administrator

This is not a good sign. I would stop trying reinstatement.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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She raised some concern today about serotonin syndrome, and she definitely has several symptoms.  They do seem to lessen after the dose has "worn off" some.  If she stops the reinstatement, will that now either exacerbate her original withdrawal, or start an all-new withdrawal since she has been back on the med long enough to reach max saturation?

2006    Ativan, Ambien as needed to cope with breast cancer treatment - very small doses

2008    Lexapro 5mg "to control hot flashes"

2012    Lexapro 2.5mg - no problems noted with that drop

2014    Feb. Lexapro 1.25mg

2014    Mar-Apr Lexapro 0.625mg, eventually dropping frequency to twice weekly

2014    Apr 29 Final Dose of Lexapro

6/2014     Lexapro 0.2mg single dose

7/15/14    Lexapro 0.05mg reinstatement

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  • Moderator Emeritus

Its impossible to predict what will happen. 

 

Because of what you have written, its clear that your wife's symptoms are getting worse since reinstatement.  If a reinstatement was going to work, and be beneficial, symptoms would improve or at the very least, not change over the course of 4-7 days.

 

There seems no point in continuing with something which is not working, and is making her feel worse.  She reinstated such a small amount, its unlikely to have any impact long term on the course of her 'previous' withdrawal, this is one of the reasons we recommend only reinstating by a small amount at first, to protect from potential adverse effects on a sensitized nervous system.

 

Is your wife taking any other medications? 

 

Please would you fill out your signature with details of your wife's drug and tapering history so we don't have to read back through your entire thread to get the details every time we try and offer suggestions.

 

 Please would you put the taper details, doses and dates in your signature, here is how you do it:

 

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

 

 

If I were in your wife's situation, I would conclude that my nervous system was now destabilized and sensitive to psychotropic drugs.  She could look through our section on symptoms and self care to find non-drug ways to manage symptoms as she recovers, which she will, it may take some time though.  The link is here:

 

http://survivingantidepressants.org/index.php?/forum/8-symptoms-and-self-care/

 

If your wife wanted to come to this site herself, we could offer her support and understanding directly, which may help to eliminate some of her anxiety, concern and confusion.  Many of us here are in a similar situation and have experienced the same symptoms, being able to connect with other people who understand what its like, can provide some comfort.

 

Petu.

I'm not a doctor.  My comments are not medical advise. These are my opinions based on my own experience and what I've learned. Please discuss your situation with a medical practitioner who has knowledge of tapering and withdrawal...if you are lucky enough to find one.

My Introduction Thread

Full Drug and Withdrawal History

Brief Summary

Several SSRIs for 13 years starting 1997 (for mild to moderate partly situational anxiety) Xanax PRN ~ Various other drugs over the years for side effects

2 month 'taper' off Lexapro 2010

Short acute withdrawal, followed by 2 -3 months of improvement then delayed protracted withdrawal

DX ADHD followed by several years of stimulants and other drugs trying to manage increasing symptoms

Failed reinstatement of Lexapro and trial of Prozac (became suicidal)

May 2013 Found SA, learned about withdrawal, stopped taking drugs...healing begins.

Protracted withdrawal, with a very sensitized nervous system, slowly recovering as time passes

Supplements which have helped: Vitamin C, Magnesium, Taurine

Bad reactions: Many supplements but mostly fish oil and Vitamin D

June 2016 - Started daily juicing, mostly vegetables and lots of greens.

Aug 2016 - Oct 2016 Best window ever, felt almost completely recovered

Oct 2016 -Symptoms returned - bad days and less bad days.

April 2018 - No windows, but significant improvement, it feels like permanent full recovery is close.

VIDEO: Where did the chemical imbalance theory come from?



VIDEO: How are psychiatric diagnoses made?



VIDEO: Why do psychiatric drugs have withdrawal syndromes?



VIDEO: Can psychiatric drugs cause long-lasting negative effects?

VIDEO: Dr. Claire Weekes

 

 

 

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Thanks for the responses!   Looking back since she reinstated almost 2 weeks ago, several of the symptoms she has been experiencing are common to Serotonin Syndrome, and they seemed to be getting worse as time progressed.  Interestingly enough, however, her shivering and nausea improved after taking the dose yesterday.  In addition to that, she slept a little better last night.

 

  • Is it possible for her system to adjust to excess serotonin?
  • Should she consider the RI to have failed in spite of symptoms improving slightly, and move to get off?
  • Should she just simply stop taking and risk another CNS upset-related period of shortness of breath, bad anxiety, etc., or do some kind of taper?

2006    Ativan, Ambien as needed to cope with breast cancer treatment - very small doses

2008    Lexapro 5mg "to control hot flashes"

2012    Lexapro 2.5mg - no problems noted with that drop

2014    Feb. Lexapro 1.25mg

2014    Mar-Apr Lexapro 0.625mg, eventually dropping frequency to twice weekly

2014    Apr 29 Final Dose of Lexapro

6/2014     Lexapro 0.2mg single dose

7/15/14    Lexapro 0.05mg reinstatement

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  • Administrator

Have you been keeping notes of her daily symptom pattern? Which symptoms have improved and which have worsened?

 

Is she taking other drugs? Please put ALL her drugs the Drug Interactions Checker http://www.drugs.com/drug_interactions.html and post the results in this topic.

 

It's unlikely she has serotonin syndrome from Lexapro 0.05mg unless another drug is involved.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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It all depends on the time of day as to what is worse and what is better.  What was getting worse right after taking the dose is now getting worse before taking it.  There doesn't seem to be any pattern that makes any sense.

 

In your experience, is shivering, elevated temperature, or joint stiffness a potential side effect during reinstatement?

2006    Ativan, Ambien as needed to cope with breast cancer treatment - very small doses

2008    Lexapro 5mg "to control hot flashes"

2012    Lexapro 2.5mg - no problems noted with that drop

2014    Feb. Lexapro 1.25mg

2014    Mar-Apr Lexapro 0.625mg, eventually dropping frequency to twice weekly

2014    Apr 29 Final Dose of Lexapro

6/2014     Lexapro 0.2mg single dose

7/15/14    Lexapro 0.05mg reinstatement

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  • Administrator

What I need is to see how symptoms correlate with when she takes this drug or other drugs, and patterns throughout the day. Your notes should include the time of day. Keep them every day to see patterns.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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  • Moderator Emeritus

Part of what makes this all so complicated is that in withdrawal, symptoms often (or even usually) tend to come and go and wax and wane, unfolding over time, without any direct or obvious connection to an instigating factor. People in withdrawal on no meds at all or in withdrawal but after reinstatement all find this same pattern--symptoms will come and go no matter what you do or do not do.

 

So we often end up assigning blame for a symptom or a group of symptoms to something we associate with it that isn't really causative at all, they just happen to both be happening, if that makes sense.

 

That's why if you're going to try to trace a cause and effect relationship it's important to take very careful and precise notes over a long enough period of time to tell if the patterns are actually real patterns, or just coincidence.

 

It kind of sounds to me like your wife is getting some improvement from the reinstatement but also having some reaction to the med as well. This happens often and is a tricky situation. You have to decide where the balance is for you. She's on a very low dose and I agree with Alto that it's unlikely she's having serotonin syndrome unless there are other meds in the picture. But withdrawal can produce such a range of effects (because these drugs affect our entire nervous and neurohormone systems) that it can imitate almost anything.

 

Since she's getting some relief from the small dose, if it were me I would probably stick it out for a few more weeks, but keep those very detailed and precise notes and if it becomes clear that she's having a deleterious effect clearly associated with taking her dose, and that bad effect is worse than the benefit she's getting, then it would be time to make a decision about that.

 

I agree too that at this point it would probably be helpful for your wife to actually come here herself and interact with us directly. She would get better care, too. It's just hard to work with someone through someone else.

Started on Prozac and Xanax in 1992 for PTSD after an assault. One drug led to more, the usual story. Got sicker and sicker, but believed I needed the drugs for my "underlying disease". Long story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything. Amitryptiline, Prozac, bupropion, buspirone, flurazepam, diazepam, alprazolam, Paxil, citalopram, lamotrigine, gabapentin...probably more I've forgotten. 

Started multidrug taper in Feb 2010.  Doing a very slow microtaper, down to low doses now and feeling SO much better, getting my old personality and my brain back! Able to work full time, have a full social life, and cope with stress better than ever. Not perfect, but much better. After 23 lost years. Big Pharma has a lot to answer for. And "medicine for profit" is just not a great idea.

 

Feb 15 2010:  300 mg Neurontin  200 Lamictal   10 Celexa      0.65 Xanax   and 5 mg Ambien 

Feb 10 2014:   62 Lamictal    1.1 Celexa         0.135 Xanax    1.8 Valium

Feb 10 2015:   50 Lamictal      0.875 Celexa    0.11 Xanax      1.5 Valium

Feb 15 2016:   47.5 Lamictal   0.75 Celexa      0.0875 Xanax    1.42 Valium    

2/12/20             12                       0.045               0.007                   1 

May 2021            7                       0.01                  0.0037                1

Feb 2022            6                      0!!!                     0.00167               0.98                2.5 mg Ambien

Oct 2022       4.5 mg Lamictal    (off Celexa, off Xanax)   0.95 Valium    Ambien, 1/4 to 1/2 of a 5 mg tablet 

 

I'm not a doctor. Any advice I give is just my civilian opinion.

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Thanks very much for your input, Rhi! I wish she felt like doing her own posting, but she is just too weak, nauseated, and shaky right now to do that. Plus, she has a tendency to surf the site and read other horror stories, which just makes her anxiety worse. There is no doubt that she is suffering significant side effects, even from the 0.05mg doses, and quite possibly serotonin syndrome, based on the episodes of elevated body temp, shivering (different from the shaking she experienced prior to reinstating), stiff muscles, etc. She feels terrible today and is scared about what to do now, whether to stay with this a little longer, simply stop the reinstatement totally, or begin some kind of taper off of the 0.05mg dose. She went through hell for several weeks after she took the single 0.20mg dose in June, including severe anxiety with suicidal "ideation", and she is scared to go through that again if she stops the reinstatement. We want to make the right decision but there doesn't seem to be anyone who can predict whether stopping now, either abruptly or with tapering, will cause the same extreme WD symptoms that she endured after the June single dose. Or is there a reasonable possibility that her system will still stabilize if she stays with it? HELP!!!

2006    Ativan, Ambien as needed to cope with breast cancer treatment - very small doses

2008    Lexapro 5mg "to control hot flashes"

2012    Lexapro 2.5mg - no problems noted with that drop

2014    Feb. Lexapro 1.25mg

2014    Mar-Apr Lexapro 0.625mg, eventually dropping frequency to twice weekly

2014    Apr 29 Final Dose of Lexapro

6/2014     Lexapro 0.2mg single dose

7/15/14    Lexapro 0.05mg reinstatement

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  • Administrator

TX, we need to see that daily symptom pattern AND the drug interactions report!!!!

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Alto,

 

We are working on that, but in the meantime we are trying to determine whether or not she is suffering from serotonin syndrome enough for it to be critical for her to get off of the 0.05mg dose immediately. The shivering has gotten a little better the last couple of days, but her muscle/joint stiffness and outright muscle pain began getting worse yesterday and was very bad today. She has bouts of hot, flushed face and her temperature goes from normal to 99.1deg during them. If these symptoms are just the normal reinstatement-related symptoms that will likely subside, she can hang in there and give it more time, but if in fact she has serotonin overload that could get worse at some point, that is a different matter and we need to figure out how to get off the drug without kicking off another horrendous round of WD hell.

 

She is using 1/4 of an Ativan on an as-needed basis, but they don't seem to help her like they did at one time. None of these other symptoms get worse with the Ativan, other than sometimes she feels like her shortness of breath gets worse after taking it. She also is using tiny pinches of an Ambien to help her sleep, but it only keeps her alseep about an hour at a time. It does not affect the RI, SS, or SE symptoms other than it seemed to take the edge off of the muscle pain today.

 

It would be nice to hand you the detailed outline you are requesting, but she has honestly not really felt like keeping such detailed records 24 hrs. per day, and I am an executive in a corporation and have a full-time plus work schedule. I am doing the very best I can to balance the two, even though I would much prefer to be at her side 24 hrs. per day.

 

Thanks,

TX

2006    Ativan, Ambien as needed to cope with breast cancer treatment - very small doses

2008    Lexapro 5mg "to control hot flashes"

2012    Lexapro 2.5mg - no problems noted with that drop

2014    Feb. Lexapro 1.25mg

2014    Mar-Apr Lexapro 0.625mg, eventually dropping frequency to twice weekly

2014    Apr 29 Final Dose of Lexapro

6/2014     Lexapro 0.2mg single dose

7/15/14    Lexapro 0.05mg reinstatement

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  • Administrator

In that case, your guess is as good as mine about whether she should stop trying a little Lexapro. If it is increasing her symptoms, she should go off.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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If she gets off, do you think she is starting all over with WD process?  Would you recommend a 2-step taper?

2006    Ativan, Ambien as needed to cope with breast cancer treatment - very small doses

2008    Lexapro 5mg "to control hot flashes"

2012    Lexapro 2.5mg - no problems noted with that drop

2014    Feb. Lexapro 1.25mg

2014    Mar-Apr Lexapro 0.625mg, eventually dropping frequency to twice weekly

2014    Apr 29 Final Dose of Lexapro

6/2014     Lexapro 0.2mg single dose

7/15/14    Lexapro 0.05mg reinstatement

Link to comment

Hi TX,

 

I have an amazingly supportive husband who has been, and continues to be, there for me through thick and thin. I applaud your courage and generosity. Please be sure to look after yourself and your own health, while you are caring for your wife.

 

I can't offer much here, except on the subject of ativan. I take lorazepam (another benzo) and was shocked to learn here that there can be inter-dose withdrawal symptoms between even tiny doses. When I arrived here, I was taking a single .5 mg tablet once a day, with the occasional "extra" pill "as needed."

 

I have since cut that tiny pill into two .25 mg doses at regular 12-hour intervals, and I truly believe this has helped relieve my morning anxiety. (I'm going through a bad "wave" at the moment, so the a.m. anxiety has returned, but I believe this will improve as the wave subsides.)

 

Others here will speak much more knowledgably on the subject, but I wonder if the "as-needed" dosing of ativan isn't causing more harm than good by illiciting withdrawal anxiety when it wears off. Would perhaps be better to take a very small dose at regular, daily intervals?

04/2013 diagnoses: severe insomnia, major depressive disorder, anxiety disorder, agoraphobia. PTSD (my diagnosis)

Original scripts: 30 mg mirtazapine (Remeron) (1x day), 75 mg Bupropion HCL (Wellbutrin) (2x day), and 0.5 lorazepam (1x day or as needed)

05/05/14: Onset of acute Wellbutrin withdrawal symptoms after haphazard "taper" of 6-8 wks.

05/10/14: Joined this site.

05/11/14: Reinstated approx. 25 mg Wellbutrin (1x day)

05/14/14: Switched to 12.5 mg Wellbutrin (2x day)

06/28/14: Changed lorazepam dosing to .25 mg 2x a day - seems to be reducing anxiety flare-ups

07/28/14: Dosing Wellbutrin in a (home made) solution form 12.5 mg (2x day) 08/15/14: Remeron 28 25.2 22.7 20.5 18.5 16.7 15.1 13.6 mg (home made) solution

05/16/15: Have been dosing lorazepam at .5 mg in the morning, .25 mg in the afternoon, and .25 mg at bedtime. Anxiety has increased somewhat, possibly due to tolerance.

 

 

 

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  • Administrator

I suppose she could go off in 2 steps about 4 days apart. 0.05mg is truly a very small amount.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

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Others here will speak much more knowledgably on the subject, but I wonder if the "as-needed" dosing of ativan isn't causing more harm than good by illiciting withdrawal anxiety when it wears off. Would perhaps be better to take a very small dose at regular, daily intervals?

 

Thanks very much for your comments, although I'm no hero by any means. I will continue to do all I can for her because I love her very, very much and I need her back!!!!

 

That's a very interesting idea you have there. I will definitely bring that up and do some research on it myself. She has always taken incredibly tiny amounts of the Ativan because she has always felt that her system didn't need much to "take the edge off". Wouldn't it be bizarre if some of these symptoms we have thought were totally related to Lexapro WD was actually related to Ativan "withdrawal".

 

Thanks again!!!

2006    Ativan, Ambien as needed to cope with breast cancer treatment - very small doses

2008    Lexapro 5mg "to control hot flashes"

2012    Lexapro 2.5mg - no problems noted with that drop

2014    Feb. Lexapro 1.25mg

2014    Mar-Apr Lexapro 0.625mg, eventually dropping frequency to twice weekly

2014    Apr 29 Final Dose of Lexapro

6/2014     Lexapro 0.2mg single dose

7/15/14    Lexapro 0.05mg reinstatement

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  • Administrator

Adverse, paradoxical, or rebound reactions from Ativan are another reason we need the record of daily symptom patterns. But if you'd like, you can keep guessing about what's causing her symptoms.

This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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  • Moderator Emeritus

Ativan is lorazepam, by the way.

 

It's called "interdose withdrawal."

Started on Prozac and Xanax in 1992 for PTSD after an assault. One drug led to more, the usual story. Got sicker and sicker, but believed I needed the drugs for my "underlying disease". Long story...lost everything. Life savings, home, physical and mental health, relationships, friendships, ability to work, everything. Amitryptiline, Prozac, bupropion, buspirone, flurazepam, diazepam, alprazolam, Paxil, citalopram, lamotrigine, gabapentin...probably more I've forgotten. 

Started multidrug taper in Feb 2010.  Doing a very slow microtaper, down to low doses now and feeling SO much better, getting my old personality and my brain back! Able to work full time, have a full social life, and cope with stress better than ever. Not perfect, but much better. After 23 lost years. Big Pharma has a lot to answer for. And "medicine for profit" is just not a great idea.

 

Feb 15 2010:  300 mg Neurontin  200 Lamictal   10 Celexa      0.65 Xanax   and 5 mg Ambien 

Feb 10 2014:   62 Lamictal    1.1 Celexa         0.135 Xanax    1.8 Valium

Feb 10 2015:   50 Lamictal      0.875 Celexa    0.11 Xanax      1.5 Valium

Feb 15 2016:   47.5 Lamictal   0.75 Celexa      0.0875 Xanax    1.42 Valium    

2/12/20             12                       0.045               0.007                   1 

May 2021            7                       0.01                  0.0037                1

Feb 2022            6                      0!!!                     0.00167               0.98                2.5 mg Ambien

Oct 2022       4.5 mg Lamictal    (off Celexa, off Xanax)   0.95 Valium    Ambien, 1/4 to 1/2 of a 5 mg tablet 

 

I'm not a doctor. Any advice I give is just my civilian opinion.

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