Africandude: Looking for help and guidance for side effects with Lexamil (escitalopram)

[Africandude]

Hi all,

 

I am a 37 year old male from South Africa. For the second time in my life I started suffering with an anxiety disorder a few months ago (about 3 months) and my psychiatrist (who I have used before) put me on 30mg Lexamil (escitalopram). This very quickly helped bring my anxiety under control but I started struggling with a few challenging side effects, specifically distorted vision and a feeling of depersonalisation. I have been speaking to my psychiatrist and we then started splitting the dose up 10mg in the morning, 10mg at lunch and 10mg at night. This helped to a degree but the side effects were still there.

 

He then recommended that I taper down to 25mg, 10 in the morning, 5 at lunch and 10 at night. I did this and started to notice some improvements but I was/am still struggling with the distorted vision and depersonalisation.

 

Following a chat with him last week Wednesday we agreed to cut the dose down to 20mg, 5 in the morning, 5 at lunch and 10 at night. I have however started feeling quite emotional, want to cry a lot and if anything my distorted vision and depersonalisation has gotten even worse the last few days and this is causing me a lot of distress.

 

I am also really struggling to get out of bed in the mornings, feeling very lethargic and sleepy and this is quite unlike me.

 

I just thought I would find out if anyone else out there has suffered from distorted vision and depersonalisation from Lexamil (escitalopram) and if anyone had any advice how to get through this time. I know that the side effects are from the drugs but I need to find a way to get rid of them as quickly as possible.

 

For what its worth my anxiety is largely under control still, I am actually more anxious about the side affects I am suffering than I am about anything else.

 

​Thanks for any help/comments in advance.

 

Africandude

[Africandude]

Also, if anyone can help with any advice on how to minimise or overcome these side effects I would be hugely grateful.

 

Thanks in advance.

[clearday]

Welcome -

 

Lexapro is a powerful drug even at the standard dose of 10 mg.

 

Lexapro is also very powerful at half the standard dose, 5 mg.

 

It is not surprising that your nervous system is rejecting a huge dose of 30 mg; your nervous system is under assault from an overdose of Lexapro, three times the standard dose.

 

Make no mistake about it: average psychiatrists still don't understand how powerful these SSRI drugs are, and the damaging effects they have on our nervous systems.

 

Good thing you are on this potent drug for only a couple months.

 

We recommend a 10% taper off these drugs in order to minimize withdrawal effects:

 

http://survivingantidepressants.org/index.php?/topic/1024-why-taper-by-10-of-my-dosage/

 

Since you are only on these drugs for a couple months, maybe you can stabilize at a lower dose and then taper from there -

 

A moderator should be along to better guide you as to how to proceed from here -

[Africandude]

Thanks for the quick reply Clearday, I just checked and I started the Lexamil on12 April 2015, just over 6 weeks ago. If I can stabilise at a lower dose and get rid of these side effects that would be awesome. I hope a moderator can help.

[Africandude]

Clearday, do you think that only being on Lexamil for 6 weeks means I can get to a lower dose quickly and taper from there? How do I find out?

 

Thanks.

[Altostrata]

Welcome, AfricanDude.

 

As you have experienced, you can get withdrawal symptoms from reducing your dosage too fast. Having taken Lexamil for only 6 weeks still puts you at risk for withdrawal syndrome.

 

Please see

 

Tips for tapering off Lexapro (escitalopram)

[clearday]

Clearday, do you think that only being on Lexamil for 6 weeks means I can get to a lower dose quickly and taper from there? How do I find out?

 

Thanks.

 

Sounds like Lexapro is not a good drug for you since you've been having side effects all along, and now withdrawal effects after cutting from 30 mg to 20mg. 

 

Perhaps you may want to stabilize at 20 mg for awhile and then do a slow taper from there.

 

Or go back up to 25 mg, stabilize, and do a slow taper from there.

 

Better yet, maybe someone with a lot of tapering experience can help give you more advice.

 

I had almost no side effects while on Lexapro for 5 years from the day I started taking it.

 

When I dropped from Lexapro 10 mg to 5 mg, I had two weeks of fatigue, then stabilized for a long time, no problems.

 

When I dropped from Lexapro 5 mg to zero (cold turkey), I went into full blown acute withdrawal for 2 months, then protracted, severe, delayed withdrawal at 7 months then again hit hard at 10 months until 16 months out, finally starting to get better.

 

Others on here same long-term Lexapro nightmare, even worse for some.

 

You sure you want to be married to this Lexapro? 

[Altostrata]

AfricanDude, how much are you taking now? If you're not taking 25mg, I 'd go back to that as soon as possible.

 

Hold at that level for several weeks to give your nervous system a rest, then start tapering at 10%.

[Africandude]

Hi Altostrata,

 

I only went to 20mg 3 days ago. I have gone back up to 25mg today and hope that things will stabilise there. I will then start the 10% taper in a few weeks time.

 

Thanks for the assistance, it is appreciated.

 

Is there anything I can do for this distorted vision and depersonalisation in the meantime or do I just need to ride it out? Can I change to another SSRI?

 

Thanks.

[Africandude]

Hi Clearday,

 

Thanks for the comments. I definitely don't want to be married to this Lexapro but I'm not sure how to get off it as quickly as possible without doing more harm... Any ideas?

[clearday]

Hi Clearday,

Thanks for the comments. I definitely don't want to be married to this Lexapro but I'm not sure how to get off it as quickly as possible without doing more harm... Any ideas?

 

Our motto for getting off these drugs is "keep is slow, simple, and stable".

 

Doing a slow taper will increase the amount of time that you are on the drug, and will increase the amount of drug you take in the long run.

 

But that is better than going "cold turkey" - stopping the drug altogether - or doing a fast taper.

 

Getting off the drug too fast causes a shock to our nervous systems which can extend recovery time. By slowly tapering, we are providing a "crutch" for our nervous system to stand on as it slowly readapts to life off the drug, rather than pulling the rug out from under it and letting the whole nervous system collapse. I've been through that, it is a disaster, and it takes a long time to heal. 

 

There is no easy answer. But experience has shown that overall, a slow taper gets better results than going off too fast.

 

When people go off too fast, withdrawal is often so difficult that they wind up going back on the drug weeks or months later in order to reduce withdrawal, and that is the last thing people want to wind up doing.

 

In the long run, the best chance for successfully getting off the drug with the least difficulty is by doing the slow taper.

 

Many of the regulars on here are in the process of a long, slow taper. They compare notes, posting often, get feedback when they run into difficulties. They get good advice from "those who have been there" when they have questions on dosing etc.

 

Many of them had gone off too fast, ran into severe difficulty, had to go back on ("reinstate"), and now have learned to go SLOW. 

 

But of course, you decide how to proceed, based on how you feel, and how much withdrawal symptoms you want to tolerate. Each individual case is different. We only give suggestions based on our experience. You're in charge of your own recovery.

 

Best of luck to you -

 

Here is the tapering recommendation again:

 

http://survivingantidepressants.org/index.php?/topic/1024-why-taper-by-10-of-my-dosage/

[Africandude]

Hi Clearday,

 

Thanks for that, I really do appreciate the comments.

 

Does that mean I just have to live with the current side effects (i.e. distorted vision and depersonalisation) for as long as it takes for me to get to a level on these drugs where I don't suffer from these side effects?

 

Does the fact that I have only been on it 6 weeks mean that I am now committed to the long term taper?

 

Is there anything I can do for these side effects in the interim? Can I switch to another medication?

 

Thanks for the help, I really do appreciate it.

[clearday]

In general, we don't recommend other medications. That is for your doctor to decide.

 

In general, everyone agrees that the only way to eliminate withdrawal effects from a medication is by going back (reinstating) on that medication. That's why we reinstate, to reduce the severity of withdrawal.

 

Other than that, we taper off as as stable as possible. Even then, there will usually be some kind of withdrawal that we must put up with if we want to get off the drug.

 

All of us have to "tough it out", or "ride it out" to some degree at various times in our recovery.

[clearday]

As far as side effects -

 

I really can't say. Seems like you had these side effects early on, which seems to me like your body doesn't like these medications. We see that often.

 

We try to help people get off these drugs and minimize withdrawal effects as you get off these drugs.

 

In general, we don't recommend how to reduce side effects of a drug that may not be good for you in the first place; that is for your doctor to decide.

 

In your case, it's already murky as far as what is side effects and what are withdrawal effects.

 

Your doctor put you on such a high overdose of Lexapro, it's hard to tell what is going on.  

 

Until you stabilize, it's all unclear. Side effects are often similar to WD effects.

 

Best you can do is take Alto's advice in her most recent post above. This is a long process that takes a lot of patience.

[Africandude]

Hi Clearday,

 

You are absolutely correct, the side effects and withdrawal effects seem to be the same although I've only tried withdrawal for 3 days. If one reacts badly to a medication (as in my case) how does one typically make a change? I understand you can't give specific advice.

 

Thanks.

[clearday]

I could only respond with what you probably already know -

 

Doctors usually get the person off that particular medication and try another -

 

They put us on the "SSRI Merry-Go-Round" until we find a med that has the least side effects for the individual.

 

That involves "cross-tapers" and "bridging" from one med to another.

 

We usually don't get involved with bridging from one drug to another. That would be for your doctor to help you with.

 

Honestly, I would steer clear of any doctor that was comfortable putting you on 30 mg of Lexapro. He sounds unusually dangerous and reckless. Lexapro is an unusually powerful SSRI, it is very strong even at 5 mg dose.

[Africandude]

Thanks Clearday,

 

I am already trying to find another psychiatrist who can help, will keep you posted.

 

Thanks again.

[Africandude]

Hi Altostrata,

 

Thank you so much for the help already. I was wondering if I could ask you a few specific questions as you clearly seem to have some experience in this area.

 

1. Is there anything I can do about the depersonalisation and distorted vision in the short term? Can I swap medication considering I've only been on it for 6 weeks?

 

2. Is a 10% taper my only way out of this?

 

3. Any other advice on dealing with these symptoms, they are causing me a lot of distress.

 

Many thanks in advance

[Altostrata]

Swapping drugs has risks: The swap may not work, you might still get withdrawal from Lexamil, plus you might get equally distressing side effects from the new drug.

 

We talk about a 10% taper because we believe that's the safest way to go off drugs for most people. Some people need a 5% or less taper.

 

If there were other good options, we would tell you.

 

Many people do better with fish oil and magnesium supplements, see
http://survivingantidepressants.org/index.php?/topic/36-king-of-supplements-omega-3-fatty-acids-fish-oil/
http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/

 

Also see other topics in the Symptoms and Self-Care forum for ways to deal with symptoms.
 

[Africandude]

Thank you.