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What happens just after dose reduction?


Phil
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Hi guys.

I am wondering if anyone has an idea about whats going on in the brain/body just after a dosage reduction.

I ask because currently the difference for me after taking a tiny bit less is like night and day.

 

After a reduction, I feel like I can't stop thinking, and I feel numb in some way. The world feels different.

I feel like theres nothing I want to do at all. Its like I go 'into my head' or something. Like I can no longer see the world around me properly.

It's quite hard to put into words really.

 

Is it something like a dopamine rebound, or glutamate, or something? (this question is to anyone knowledgeable about that sort of thing)

 

I hate it, because usually it triggers me into ruminating a lot, and I get really depressed. It makes functioning extremely difficult (and I dont do much as it is anyway). I guess I just find it hard to accept the changes in me which I dont want as I dont feel like its "me" at all.

Off Lexapro since 3rd November 2011.

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It's hard to say, Phil.

 

If you can imagine, your serotonin receptors, which had been flooded with serotonin, now have a little bit less to work with. Your brain needs to add more receptors to compensate, to keep the general serotonin level steady. So that's one process.

 

Another is general neural adaptation to the new neurohormonal arrangement. That effects everything in your body.

 

You are clearly a person who is very, very sensitive to changes in these levels.

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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I agree Alto, I think probably due to the fact I had anxiety problems before ssris, and that Ive been exposed to them prior to Lexapro hasnt helped.

 

I keep wondering whether I should switch to another ssri to finish my taper, since Lexapro in itself is quite strong and so any reduction hits harder than the other ssris. Also they might actually come in a liquid form I could use, unlike lexapro.

I just need to gain a little stability so I can work on other things that arent helping my situation right now. Im due to see a psychotherapist soon and in the state I'm in currently I think it would make things worse (since I'm constantly ruminating and unable to bring it under control).

Off Lexapro since 3rd November 2011.

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The only drug to switch to that has any track record of helping withdrawal is Prozac (fluoxetine). This is advice given in many medical journal articles about tapering people off antidepressants.

 

Anecdotally, it has a mixed bag of success -- but the ones who succeed are not likely to be complaining about it on the Web.

 

There's a description of using Prozac to taper off at the end of this post: http://survivingantidepressants.org/index.php?/topic/283-tapering-off-cymbalta-duloxetine/page__view__findpost__p__3034

 

Since you're taking such a tiny amount of Lexapro, I would think the amount of Prozac would be equally tiny or less.

 

Like everything else in this situation, there are no guarantees. But if you hunt you should be able to find a doctor with some experience doing this switch.

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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Thanks for the link Alto. It's certainly something I'm willing to consider, as Lexapro has been an all-round nightmare.

Off Lexapro since 3rd November 2011.

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Hi Phil... I switched to 20mg Prozac when I was down to 5mg of Paxil. The switch was very easy for me and I had no problems. When I decided to taper the Prozac, I found it much easier than tapering Paxil. I know this isn't the case for everyone, but it worked really well for me.

 

 

Charter Member 2011

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That's good to know, summer!

I'm actually surprised to hear a positive story on this as most on the other forum advise against it.

How long did you take to taper off the prozac?

Off Lexapro since 3rd November 2011.

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Hi Phil... I switched to 20mg Prozac when I was down to 5mg of Paxil. The switch was very easy for me and I had no problems. When I decided to taper the Prozac, I found it much easier than tapering Paxil. I know this isn't the case for everyone, but it worked really well for me.

 

 

that really is wonderful news, and now go slowly!

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Yes, I know. Whenever I mentioned it on the other board they were not happy with me!

 

I don't remember exactly how I tapered the Prozac. I did taper slowly, but not as slowly as I should have. Although I felt fine the entire time, about three months after the last dose I started feeling very depressed and told my pdoc that I thought I needed to be on an AD again - hence the Celexa. I thought the original symptoms had returned. I know now that it was withdrawal.

 

Bottom line, if you decide to switch to Prozac, taper really slowly - 10% of your current dose every 3-6 weeks. I tapered faster, which I think caused the spiral 3 months later.

 

 

Charter Member 2011

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Hi summer,, how long did u stay on the prozac? And at ehat milligram? Cause prozac is also te drug i used.

 

Sounds like u went back on celexa and how did that one help u?

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serotonin, please read summer's Intro topic.

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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Just be aware that Prozac has a terrible list of side effects including akathisia, aggression, suicidality, and others. Not that Lexapro's any picnic either.

 

Plus switching from one med to another one has a mixed track record for people. Some people get pretty screwed up by it. I'm not saying don't do it, just be aware of the risks versus benefits thingy.

 

There's no liquid form of Lexapro? That sux.

 

Does it come as a solid pill? I'm tapering Celexa by dissolving the tablet and then measuring out my dose, which I take once every 24 hours. This allows me to taper in very small increments (I cut 0.05 mg at a time).

 

That might be a possibility for you.

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

 

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

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I agree, switching to Prozac has its own risks.

 

Rhi, there is a liquid form of Lexapro available in the US, with a concentration that's convenient for tapering. Phil is in the UK, where for some d*mn reason the concentration is 20:1.

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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Hi Rhi, thanks for the heads up on the side effects. After trying Prozac in the past I recall my main complaint was increased anxiety from it (I was also in ssri w/d at the time).

 

For the moment I've decided to stick with Lexapro. If any effects are too unbearable I take a tiny extra drop of my mixture (I crush tablets and mix with water).

 

I managed to cope with going into town today despite withdrawal symtpoms, so if I can keep learning to cope hopefully I'll be able to get off Lexapro gradually.

Off Lexapro since 3rd November 2011.

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