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frignuts: short bad trip with Lexapro (and ativan)


frignuts

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Hi all,

 

I have a history of life long anxiety with some panic and a little bit of depression. I took paxil in 2008 or so and had a good psychiatrist to help me with the difficult withdrawal. I've been mostly free of meds with the exception of the occasional ativan .5-1mg to help me when I really needed it to sleep. I maybe used it once or twice per month. jobs, family, and health stuff crept up on me and i found myself feeling anxious and having greater difficulty sleeping. I tried to deal with it behaivorally but i felt it getting worse. In addition to counseling i thought some meds might help. My primary doc put me on lexapro 5 mg on 5/22. since then my sleep problems have worsened. despite trying to take the med in the AM and PM I have a lot of trouble drifting off and wake up as im falling asleep. for the past couple days i have had to use .5mg ativan to help with that. I want to get off of the lexapro. I started to taper myself by taking 2.5mg instead of the 5 this morning. I know that is much more abrupt than the normal taper recommended here but I have only been on 5mg for 13days. Am I doing it too quickly? How can i tell? Any other advice. 

 

the site looks like a great resource and I am glad to be able to get some help from folks who care and seem to know what its like. 

 

cheers

5/22/2015- 5mg lexapro AM tired during day

5/23/2015- 5/28 5mg lexapro PM diff sleeping

5/29-5/31 back to AM 5mg

6/1 took 5mg PM

6/2-6/4 5mg AM

6/5 started taper at 2.5mg

 

 

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  • Moderator Emeritus

Hi frignuts, welcome to SA.

 

Because you have only been on a fairly low dose of lexapro (5mg) for just 13 days, you should be able to stop taking it fairly fast.  If I were you I would take 2.5mg for 2 - 3 days. Then 1.25mg for another 2-3 days then stop. You may experience some uncomfortable symptoms for a little while and your sleep may be irregular, but this shouldn't last too long.

 

Because you have been taking it for less than 2 weeks, I'm almost tempted to tell you to just stop taking it, but by doing this short taper, it may be a slightly smoother process.

 

Be careful with your Ativan use, its possible to become dependent on it in as little as 2 weeks if taken regularly, try and restrict your use to no more than 2 - 3 times a week.

 

It sounds like you and SSRIs don't get along, I would avoid them from now on if I were you.   Have a look through this topic for some ideas of how to manage sleep issues naturally:

 

Important topics about symptoms, including sleep problems

 

Scroll down a bit for the sleep section.  Something else which some people find calming is magnesium, also fish oil can be helpful for some, see King of Supplements: Omega 3 Fatty Acids (Fish Oil) and Magnesium, Nature's Calcium Channel Blocker

 

I'm glad you found us.

 

Petunia.

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 so much for your response, Petunia, and for the welcome. It's nice to have some support. I don't think I slept a wink last night. I kept wincing awake every time as I was drifting off. Did this all night. I didn't use the ativan though, although I'm not sure how long I'm going to be able to hold off. I'm really hoping that my sleep will improve after coming off the lexapro (it's actually escitalopram). Should that be the case? When I told my psychiatrist that I was not sleeping on the escitalopram he told me to taper but did not explain exactly how.  He then prescribed me vybriid (replacement AD), belsomra (hypnotic i think), Nuvigil (something to keep you awake), and deplin (something to do with folic acid). I haven't taken any of these yet but was thinking of trying the belsomra just to get some sleep and avoid taking the ativan. Does that make sense?

 

I do plan on checking into melatonin and magnesium. 

 

What are people's thoughts on clonidine?

 

I really just want to sleep. 

5/22/2015- 5mg lexapro AM tired during day

5/23/2015- 5/28 5mg lexapro PM diff sleeping

5/29-5/31 back to AM 5mg

6/1 took 5mg PM

6/2-6/4 5mg AM

6/5 started taper at 2.5mg

 

 

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  • Administrator

Welcome, frignuts.
 
Does it seem odd to you that you go to this psychiatrist with occasional sleep problems, have an adverse reaction to escilatopram, and end up with 4 prescriptions to take every day?
 
Both Vibryd and Belsomra are fairly new drugs that not many people have taken, why is this doctor experimenting on you?
 
http://www.thecarlatreport.com/free_articles/belsomra-new-hypnotic-don’t-get-too-excited-free-article
 

Belsomra: A New Hypnotic? Don’t Get Too Excited [Free Article]
Talia Puzantian, PharmD, BCPP
October, 2014

....

Suvorexant, which will be marketed by Merck & Co. under the brand name Belsomra, was approved by the FDA in August 2014. It truly is a new chemical entity with a first-in-kind mechanism of action. Unlike currently marketed hypnotics, suvorexant does not exert its hypnotic effects via activity at receptors for GABA, histamine, or melatonin. Considered a “DORA” or dual orexin (OX1 and OX2) receptor antagonist, suvorexant alters the signaling of orexins. Orexins are neurotransmitters that regulate the sleep-wake cycle by promoting wakefulness through excitement of brain regions involved in arousal and attention.

But what does this mean clinically? Does it work? Is it safe? What about long-term use?

What Studies Show
Several pre-clinical trials have examined the efficacy and safety of suvorexant in 1,784 patients with insomnia, with 160 patients taking the drug for one year or longer. Compared to patients taking placebo, those taking suvorexant tended to go to sleep more quickly (depending on the study and the dosage used, an average of about two to 22 minutes faster) and spent less time awake throughout the night (on average, about 20 minutes more total sleep time). In general, the higher doses (30 mg to 40 mg) tended to be more effective than the lower doses (15 mg to 20 mg). These studies all compared suvorexant with placebo, so unfortunately there is no data allowing us to compare it with the hypnotics currently in use.

The most common side effects were somnolence, headache, abnormal dreams, and dry mouth, which were reported in about 2% to 8% of patients in the studies. There were also some rare side effects (reported in less than 1% of patients) that could become quite problematic. These include sleep paralysis (inability to speak or move for up to a few minutes during the sleep-wake transition), cataplexy (leg weakness for seconds up to a few minutes, reported both in the nighttime and daytime), and hypnagogic hallucinations (including vivid and disturbing perceptions).

The Fight for FDA Approval
An interesting part of the history of this drug is that Merck expected to gain FDA approval in the summer of 2013. However, the FDA expressed concerns about safety with the 30 mg to 40 mg dosing range Merck was proposing and denied approval. The approval finally came in August with the newer, lower dosing range of 10 mg to 20 mg nightly. The next-day driving tests requested by the FDA showed that even those who took the 20 mg dose were impaired in the morning. For this reason, the recommended dose is 10 mg nightly....

Suvorexant will be available as 5, 10, 15, and 20 mg tablets by late 2014 or early 2015. It will be a schedule IV controlled substance (same category as zolpidem (Ambien) and temazepam (Restoril), among others) although the data thus far have not shown withdrawal and rebound upon discontinuation.

TCPR’s Verdict: Other than a new mechanism of action, there’s not much to recommend suvorexant. It likely works just fine as a sleeping pill, but there’s no reason to expect it to work better than the many hypnotics already on the market. We’re concerned that next-day impairment is a potential side effect at the highest approved dose of 20 mg, particularly since sleepless patients may decide on their own to take even higher doses. Be very clear to patients about the potential dangers of driving the next morning. Suvorexant also will likely be expensive, and only a couple of thousand people have been exposed thus far, mostly in short-term trials. This is definitely not a first line medication—nor even a second line.

 

 

It is possible your recent sleeplessness was caused by overstimulation from escilatopram or rebound effects from the benzo. It may take some time for your nervous system to settle down.

 

We can't advise you on the other drugs. Generally, prescribing psychiatric drugs to counter adverse effects of other psychiatric drugs does not end well. There are many people here who were drawn into a merry-go-round of polypharmacy after an adverse reaction to a psychiatric drug, which continued until they said "enough" and went off all of them.

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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I've gotten off of that junk and am feeling better. I will not be returning to that psychiatrist. Thanks for the advice!

5/22/2015- 5mg lexapro AM tired during day

5/23/2015- 5/28 5mg lexapro PM diff sleeping

5/29-5/31 back to AM 5mg

6/1 took 5mg PM

6/2-6/4 5mg AM

6/5 started taper at 2.5mg

 

 

Link to comment
  • Administrator

Good to hear you're feeling better. Please let us know how you're doing.

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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