Pharmageddon emergency, help! terrified, must reinstate: what dosage?

[Pharmageddon]

Hello everyone,

 

New here, terrified, desperate and doing everything in my power to fend off suicide. I just exchanged several emails with Dr Shipko who first agreed to consult with me, but then said my polypharmacy history was too complicated for him to help me. The pattern, as i have experienced it, is quite straightforward though: 

 

I have been on Lexapro, the drug that destroyed my brain, for approx 13 years. 80-90% of that time I was on 10 mg. I have stopped the drug three times, and each of those times a very similar pattern occurred:

 

Mar. 2006 rapid wean-1.5 months post-WD severe melancholic depression with insomnia, appetite loss and dysautonomic symptoms emerged--1 month later reinstated 10 mg--symptoms rapidly resolved but became impulsive and manic, made some very self-destructive decisions and took 2 years to regain balance. I was not fully functional until 2009.

 

Jun 2012 rapid wean-again, 1.5 months post-WD severe melancholic depression, same dysautonomic symptoms. Waited again to reinstate until a little past 2.5 months post W/D. Right around the 2.5 month mark (before reinstatement), I developed EXTREME akathisia, insomnia, dyskinesia and other bizarre symptoms. I had recently weaned off of a benzo and opioids, but this was definitely not the cause of this syndrome as reinstating them even at much higher doses did not help (I had been on benzos and painkillers a couple times before while ON Lexapro, and it was quite easy to wean off); also, this akathisia syndrome felt very continuous with the "Lexapro depression"--it was a smooth and inexorable degeneration down from the depression into the neurological syndrome. Unfortunately I had not yet known that SSRI withdrawal could cause such extreme symptoms so I was on a merry-go-round of neurologists, infectious disease specialists etc, wondering if I had a prion disease or a rare brain infection. Bashed my head into a wall several times, episodes of weakness, twitching, screaming, nearly constant violent shaking. I had to give up my life  and move back in with an ex-boyfriend I didn't like because it was the only way I could get the 24/7 care I needed to survive.

 

(Jun 2012 cont'd) After reinstating the Lexapro 10 mg approx 2.5 months post-WD, I did not notice any particular change (there was so much going on I don't recall; my memory is damaged and there may have been a change I don't remember) 

 

However, by 3 months post-reinstatement (late 2012) the severe symptoms were completely gone (whew!) and I was able to start on the long road back to finding a "life" again, albeit with some disabling symptoms which seemed quite tolerable in comparison: GERD, hot and cold flashes, hypersomnia, intermittent depression, memory loss. 

 

In summer 2013 I started treatment with Xyrem (a strong sleep medication, for my hypersomnia) and Klonopin. This rid me of all of my residual health problems but I felt the combo of 3 drugs was dulling my mind so I began to wean down Lexapro slowly, by 1 mg every 2 months. I was OK during this time; in Dec. 2014 I stopped Xyrem. I was on a low dose of 3 mg Lexapro at this time, and my only other psych med was 1.5 mg Klonopin. I felt great, clear, better than ever. A rapid taper of Klonopin (to 0.25 mg within 3 weeks) made me very ill. Reinstating Klonopin at 1 mg worked and I was feeling good again by Feb. 2015.

 

I very gradually tapered Klonopin to 0.75 mg, held the dosage, and continued weaning Lexapro. I discontinued my last 1 mg of Lexapro on May 18. I was doing well until that same 1.5 month point when depression emerged, but it was not as severe as in 2012. I also noticed some mild autonomic instability--HR and BP went high easily. But it was all manageable until that dreaded 2.5 month mark which I have just now passed. 1.5 weeks ago a mild surgery sent me into a severe episode of hypertension and ever since, I've been on the fast track back to the worst parts of 2012. I've had attacks of severe akathisia, screaming, twisting and uncontrollable violent behavior. My BP and HR go through the roof at the slightest notice, I can't eat or sleep. The scariest part is that I have become INSENSITIVE to all sedatives--the Ambien that helped me sleep in 2012 barely gives me 2 hours now, my tolerance to any sedative med goes up instantly. So while I am super-sensitive to anything stimulating, and super-sensitive to any delay in getting my Klonopin, I am not at all sensitive to sedative meds, it's like my nervous system is on fire.  In 2012 I was in a similar state but a couple months after reinstating 10 mg Lexapro, the benzos and Ambien became much more effective.

 

The best times of my life were when I was on a LOWER dose of Lexapro, say 3-5 mg, not the 10 mg I reinstated to before...and of course, the times before I started the $#@&ing drug! But I know I can't even live through another week of this if it becomes chronic, so it seems like my best chance is to reinstate the Lexapro.

 

Since I have only one prior experience to go on and even then I don't know whether the akathisia would have been better or worse had I reinstated lower (or higher? Dr. Shipko mentioned sometimes having to increase from the original dose), I am terrified that this time reinstatement won't work, especially if I pick the wrong dose. It is also different than before in that I weaned slowly and was very stable and happy on a 3 mg dose last winter.

 

So what do people think? What dose should I try to reinstate at, and how soon should I increase it if symptoms do not improve? It's so scary thinking that if I make the wrong move I could be condemned to an agonizing death, because that's what will happen if anything worse than 2012 happens (or for that matter, even if 2012 were to start again and become permanent).

 

Sorry the message is so long. I'm having a very hard time controlling/calming my thoughts and it is hard to think calmly so this is the best I can do. I really appreciate your help!!

 

 

 

 

[Altostrata]

Welcome, Pharmageddon.

 

It's difficult to predict what will help. Going on and off psychiatric drugs sensitizes the nervous system. It will not react to drugs the way it used to, even that same drugs you were taking in 2012.

 

To be very cautious with your sensitized nervous system, you might try 1mg Lexapro and stabilize for a good long time. Please see

 

What is withdrawal syndrome?
 
The Windows and Waves Pattern of Stabilization

About reinstating and stabilizing to reduce withdrawal symptoms

 

To take small amounts of Lexapro: It comes in a liquid or you can make your own, see Tips for tapering off Lexapro (escitalopram)

[Pharmageddon]

Thanks Altostrata for answering. I read the links and unfortunately am very familiar with the liquid lexapro (awful taste).

 

Well, that's 3 votes for "low dose,"

 

Dr. Shipko simply said "try a low dose and go higher if necessary," you said 1 mg and another member here reported success with 1 mg from a very similar taper. Somehow my intuition is telling me 2-3 mg will be best but on the other hand if I start with 1 mg now at least I can increase if I need to (vs risking a bad reaction at a higher dose).

 

I will be getting the liquid tomorrow and probably starting at 1 mg. 

 

Another scary thing that confuses me is the definition of "sensitivity." Since I am hypersensitized to stress and stimulation but desensitized to relaxing stimuli and sedative drugs (the "alerting" syndrome you describe is EXACTLY what I have, to the extreme--wow that's scary) I am afraid that Lexapro could be one of the "sedative" drugs that I will under react to--then again maybe not, since it is the drug that CAUSED the alerting to begin with!

 

I have had nothing but statistically unbelievably bad luck for ten years (I'm 34 and lost my youth to Lexapro, illness and family tragedies),  I'm not really ready to die just yet, I mean if I had a functioning nervous system I'd be totally ready to start a new life, but like anyone else I have my limits to what I can tolerate. It's really scary going through this again and having to make this decision when you've already had a several month episode of severe akathisia. It would be really nice if once--just once I could get a break and I'm praying that will be tomorrow!! Has anyone else here had the severe akathisia more than once (as in two separate WDs and reinstatements) and recovered?

 

BTW Shipko is right, that level of akathisia is NOTHING to play around with. I was finally vindicated when I read (I think it was in Mad in America) that Soviet interrogators would use specific antipsychotics to deliberately induce intense akathisia in their prisoners, as a form of torture.

 

I'm so glad this forum is here, at least I don't have the added torture of thinking this is some rare unknown disease. Now if the medical community could figure it out and find effective treatments, I'd actually feel safe.

[bluebalu86]

I don't know about having akathisia twice, but we have a lot of members dealing with akathisia. It's survivable, supposedly. And people recover from it. Don't lose hope. I hope you manage to stabilize on your reinstatement. Best of luck honey

[Altostrata]

You're welcome, Pharmageddon. I'm very sorry that you and everyone else on this site have to be in this position.

[chicken]

I've had it twice. Well I should say just the severe anxiety that makes you pace the floors and want to kill yourself. I'm not sure about akathesia since I didn't have the  physical pain, just the inner restlessness.

 

My first time was when I tried to use prozac again after I had been off it for about two years. The 2nd time was when I quit remeron too quickly, reinstated and took a floroquinolone antibiotic during that  same time.

 

Ended up on three drugs to bring it under control. I've managed to taper off all of them and I'm on the home stretch with the last one.

 

I think Fresh had a severe case of it and she is also doing well now.

 

It's different for everyone. Luckily bridging to a different drug helped me but does not for a lot of people. I agree that reinstating at the lowest dose possible is probably the best way to go.

[nz11]

I was finally vindicated when I read (I think it was in Mad in America) that Soviet interrogators would use specific antipsychotics to deliberately induce intense akathisia in their prisoners, as a form of torture.

 

Welcome Pharmageddon wow are you able to reference this with a page number ...no pressure of course. Im off to the library to try to get it.

Why does this not surprise me I just new these drugs could be used for torture....if the army know this how come they do this to their own!!

[Minny]

Hi Pharmageddon,

 

I can't offer you any advice as I am in a similar position at the moment.  I have managed to get down to 3mg of Cipramil.  It makes me scared to go any further.  I just wanted to wish you luck and hope you find some peace and relief soon.

 

xoxo

[Pharmageddon]

Here comes another long rant...trying to be as concise as my fried brain can manage.. Thanks everyone for your support!! It really means a lot to me especially since I lost my family before I started Lexapro and I am single, so the only face-to-face social support I have is my uncle and one friend--hah, I lost the rest of them to the numbing that the Lexapro caused, or the 2012 w/d. Ironically, it was the loss of my parents that led me to Lexapro.

 

Altostrata, I know, right? And even worse, this condition interferes with treatment for other medical problems, since our destabilized CNS can't handle surgery, drugs etc. This is a real problem for me because I have a family risk of thoracic aortic aneurysm and I can't risk regular spikes in BP. Really constrains my options dealing with the discontinuation syndrome, this is right now the scariest part for me. I saw my mother die from complications for her very risky aortic arch surgery, it was an agonizing 9 months after her surgery and I decided if I developed it I would probably let it take its course and skip the surgery, depending on the situation at least. Withdrawal is NOT the right situation for surgery, so I'm more concerned about stabilizing than becoming drug-free although that would be ideal, in a perfect world. (I don't have an aneurysm yet--it's just that months or years more of spiking BP have a non-trivial chance of causing one; so that adds an unwelcome dose of reality to the "neuro-emotional" fear that these symptoms are damaging me). 

 

So, update--I reinstated yesterday, and I compromised with a 1.25 mg dose because it felt like I had reached the tipping point where every day I delayed things could get more dangerous, and all I had was a dropper with 2.5 ml increments so I cut in in half, heh. Almost immediately I felt a relaxation and for the rest of the day up through bedtime, I felt MUCH better (not GOOD mind you, just able to stand without getting dizzy and sit without planning suicide)... I was really shocked that this little dose could have such an effect. The only problem was I continued to feel like I had insomnia (this run of insomnia has been my worst ever), and when I am on a run of insomnia I can "sense" it even when I'm not trying to sleep. So last night I was scared I might not sleep well. 

 

My doc prescribed a short course (5 tabs) of Ambien 10 mg and when I first started it I got 2 hours from the whole tab, this time I took 3/4 tab and got 4 hours, but I woke up with my heart pounding. I took my regular midnight dose of 0.25 mg Klonopin, and a half dose of Benadryl (I am trying to stop all of my non-regular meds for simplicity and stability's sake, so taking smaller amounts each time) and fell asleep--yay! 

 

The weird part was that this "sleep" was basically uninterrupted nightmares. This is exactly what I had in 2012, every night for months. This time it was worse w/ heart pounding each time I woke up. Once I woke up and took my Klonopin, I felt better. I followed the Klonopin with another 1.25 mg Lexapro and instantly felt mild-moderate akathisia return.

 

Here's the weird part: I don't think this is bad. And here's why: First, I have been able to get out of bed and talk to people, exercise, and function for the first time since this started, and everyone says I seem better. And second, before I started the 1.25 mg, my akathisia this summer was extremely severe (think dangerous hypertension and ambulance rides), but came in increasingly frequent "attacks." The akathisia I had in 2012 after reinstating 10 mg was not quite THAT intense but still intolerable, however it came in a very stable pattern of worse in the morning and improving almost to normal at night. The akathisia this morning somehow felt more "stable," as well as feeling much milder than 2012. My theory is that it may have been some sort of interaction between either the Benadryl/lexapro (antihistamines can cause akathisia), or it may have had something to do with the time of day I took it. Already the akathisia is very mild, so I am back to my 2012 pattern but not so intense, which is a relief. Somehow I think "stable in frying pan" is worse than "unstable and back and forth between the slow cooker and the fire."

 

Tomorrow morning I'm going to skip the Benadryl and wait until 1 pm again to take the lexapro, and see if anything changes. 

 

Minny, so sorry to hear you're going through this too. Best of luck to you as well and please remember you can always hold your dose if things get into an emergency; I would have done so if I'd known this was the cause of my symptoms (the delay from my WD made me think it was some rare neurological disease!) 

 

If I had known about this problem before--ANYTIME before last month, I would have reinstated since I don't have much leeway to play around with my health. The other thing I would have done a long time ago is withdrawn from the Klonopin and all PRN drugs BEFORE I tapered Lexapro, not vice-versa. Dr. Shipko recommends this as well.

 

nz11--I will find it as soon as I have a chance

 

I am going to hold this dose for the four days and then re-evaluate my situation--considering either up dosing again, up dosing Klonopin or starting clonidine patch as my primary concern is the spiking vitals (BP meds and clonidine are not ideal either as my vitals are sometimes low and this wouldn't be good--I need some way to stabilize and unfortunately it looks like psych meds are easiest, but I'm not going to make a move until I get more information)

[Altostrata]

Pharmageddon, are you taking 1.25mg Lexapro once a day or twice a day?

 

Try to take all your drugs on a regular schedule. This can help identify adverse reactions.

 

The stimulation you felt might be the startup effect of Lexapro.

[Pharmageddon]

Altostrata, thanks, that is good advice and reassuring. Yes, I am slowly eliminating the "as needed" (unscheduled) meds; the other ones are on a regular schedule. I'm experimenting, trying to establish the best time to take the Lexapro now, it should be, I think, sometime between 9 am and 1 pm. I took it at 1 pm on Monday which was later than I'd planned, because I couldn't get the prescription filled sooner.

 

I am on 1.25 mg once a day.

[LoveandLight]

Your an inspiration. I just read the other post you just wrote in finding meaning

[Pharmageddon]

Thank you Love and Light, I might fight a little longer if I know I can be of help to others   I don't know how long, or if, I'm going to last through this but I'm feeling this weird sense of peace, whether it's healing or death coming on I don't know. Feels like a bit of both. I write a lot clearer than I feel, my body right now is shaking and burning and screaming at me "Kill me, please," I am resisting it for now.

 

The symptoms I have now after reinstatement (4 days on 1.25 mg lexapro): slightly improved sleep, much improved cognitive ability; less violent attacks and overall more stable, but increased and stabilized morning/daytime akathisia, this is increasing. More physical suicidal impulses...not planning, not conscious, my body just saying "enough, I'm done fighting." I've also been developing this intense burning electric/nuclear meltdown feeling in my spine. Horrifically painful. I will not stop the increased dose though, I do NOT want another up-and-down. People who reinstate and then quickly stop from increased symptoms don't seem to do well from what I've read here.

 

Emailed Dr Shipko again because from everything I have read (I've been reading like crazy this past week)!, PLUS from my own personal experience, it just seems like a better bet to do what's already worked for me--reinstatement--even if it temporarily makes things worse, I think the shock of full-dose reinstatement in 2012 actually forced my body to stabilize a lot faster than otherwise. Because of the slow taper this time, I think reinstatement at the original 10 mg will be too much, but my intuition still keeps nagging at me to go up--somewhere between 3 and 6 mg now, after what I've read so far. (I say 3 and 6 for a reason: 3 mg was the last time in my taper that I was asymptomatic; 6 mg is the lowest dose I've been stable on longer than a few months).

 

I hope he responds, I'm trying to get his perspective on the timing of updoses in reinstatement: how long to wait between updoses? For tapering I think low doses are great but another of the many concerns i have about REINSTATING and holding at only 1.25 is that the info from rxlist claims "the single and multiple dose pharmacokinetics of escitalopram are linear and dose-proportional ***in a dose range of 10 to 30 mg/day***. This seems to imply the stated half-life of 27-32 hours may be unreliable for doses under 10 mg. If anyone has further info on this please let me know! I found this article that might help: http://www.ncbi.nlm.nih.gov/pubmed/17375980but don't have access to the full text. (I realize this implies ANY dose under 10 mg has an unknown half-life, but I'd feel much more comfortable with this issue at 3-6 mg than 1.25) Has anyone experienced lower doses "washing out" before 24 hours?

 

It could be that the more stable diurnal rhythm of my symptoms now is corresponding with the med flushing out of my system completely after a certain period of hours, which means more instability. Don't want that...

 

I'm pretty resolved to updose tomorrow to 2.5 mg, unless anyone thinks it's a really bad idea (keep in mind my priority now is NOT getting off the drug, it's doing whatever has the best chance of keeping the extreme symptoms limited to the shortest time frame possible)...after that I'm not sure. I was pretty resolved to updose to 6 mg last night and this morning but not sure now. But based on how these drugs work it seems that the higher the dose, the quicker my body will adapt and reverse the symptoms (of course, with side effects and diminishing returns at too-high doses which is why I don't want to reinstate the total original dose).

 

I read a story of someone with very similar symptoms to mine who had stabilized after a few months on 2/3 her original dose, and having already had this happen this is probably the source of my intuition. I also fear I may need to add more benzos as I did in 2012 bc I would not have survived it without them. But I will try to hold off on that until I get to whatever Lexapro dose I hold at. Anyone with similar experiences have any feedback? I read some of Nadia's posts, and she mentioned success reinstating. Specific ideas on most effective time frame to updose a reinstatement?

 

Thanks so much for your help.

[raul]

Hello pharmaggedon, i reinstated 5 mg lexapro, after 6 months fast taper (please, read it in signature) and after 15 days i can say that my mood improved, even some days i am glad  BUT i still have at least one day in a week that i burst into tears and feel depressed. The days i feel better is the ones that i sleep good, and they are only 1 or 2 in a week, the worst is high cortisol that not makes me a good quality sleep and makes me very tired and finally i explode. I do not know how much time i will spend to stabilize, but sometimes i think that if i get stable,not to taper anymore and continue with the drug forever, i am really very tired to suffer. Sorry, but today is not a good day for me. I wish you recover and i am sure you will do it.

[Pharmageddon]

Thanks Raul, very helpful and I appreciate the encouragement. Best wishes for your recovery!

 

My body is practically screaming at me now to reinstate at a higher dose, I'm further out from my taper than you but I did recover from very severe symptoms in 2012 after reinstating. I think I should listen to my body and intuition because it's been very loud talking to me for the past few months--first when I stopped it said "please reinstate," haha, now it is telling me to updose now before things get too far. Every time I have ignored it, and each time I have gone further into hell from ignoring it and staying off the med. I just need to get some sort of handle on the specifics: when to updose (body is telling me soon!) and how much. It's interesting, I felt a lot better for the first two days after the updose and then deteriorated. I think it's at least partly that the low dose is not controlling the syndrome progression (my symptoms are most similar to Dr. Shipko's "tardive akathisia"). I'll clearly need a benzo to get through the readjustment, I'm already on Klonopin 0.75 mg and also trying to research whether to use more Klonopin or add Valium for my symptoms.

[Fresh]

Hi Pharmageddin , welcome.  

 

It sounds like you're on the right track - the fact that you felt less bad for 2 days is a very good sign.  Listen to your gut - you've got this.

 

I'd be trying to find any other way to get through this than increase Klonipin or add valium.   If you look at the Member's Only Benzo Forum , you'll see you might be setting yourself up for another long-term complication.  Have you ever tried melatonin?   It's safe to try and can be very sedating.

 

Re chicken's post: " the severe anxiety that makes you pace the floor and want to kill yourself".    

Those symptoms are hallmarks of akathisia - you've had it chicken.  Congratulations on another diagnosis (sorry honey)

 

Best wishes ,  Fresh

 

(If you click FOLLOW at the top right , you'll receive an email each time someone posts)

[Altostrata]

Pharmageddon, you're overthinking.

 

No, these small doses have not been tested -- or the data regarding them have not been published -- and they most certainly have NOT been tested in sensitized nervous systems.

 

Sensitization increases the effects, good and bad, of very low doses.

 

If you feel you should updose, your guess is as good as mine or as Dr. Shipko's. Please keep in mind that it takes at least 4 days for any dosage change to fully take effect. The effect gets stronger over those 4 days. So if you had a good result for 2 days and then it gradually becomes unpleasant, it could be the dosage is too strong for you, not that you need more.

 

It is a misunderstanding by many doctors that higher dosages of psychiatric drugs are more effective. More is not better when it comes to psychiatric drugs in a sensitized nervous system.

[Pharmageddon]

Thanks Fresh, yeah I have no idea what to do but to go with my gut and instinct on this. As for the benzos yes, yes I understand the problems they pose, but I'd be dead if i hadn't taken them in 2012 and I'm reaching that point now.

 

And thanks Alto, I agree about the guessing for sure. Overthinking aside, I just have a strong feeling that the 6 mg is the right way to go...I'm waiting for a couple other answers before I go ahead with it though. I'm really interested in gathering as much information as I can since that's all I can really do at this point other than go on my gut...do you have any examples of other cases where increasing a reinstatement made someone worse (long-term) so I could take a look? Thanks!

[Pharmageddon]

btw just wanted to add something weird I noticed--I still feel a lot better for about an hour after taking the 1.25 mg, then it starts wearing off--

[Altostrata]

Well, maybe you need more. If I were you, I'd go up by 0.5mg at a time, allowing a week each time to see what happens.

 

Jumping up in dosage is the way a lot of people get into trouble.

[Pharmageddon]

Thanks Alto, what you say makes a lot of sense and I've read over some stories of people who reinstated higher with bad results.

 

I wish I could follow your advice but when things are as severe as they are now (my friend was trying to call an ambulance for me yesterday morning, and I have severe hypertension, nausea, sweating, diarrhea, akathisia, skin and bone pain, intense burning skin, lightheadedness, confusion and lost 10 pounds in 1 week I felt like I was dying) I just had to make a decision and the safest best for me seems to be to do what worked before. Talked to my dr last night and we discussed everything you, Dr Shipko, and other members reported (he's a very open-minded doc and thanking me for bringing this issue to his attention) we decided to increase Lexapro to 5 mg/day. I trust my experience with my own body more than anyone else's and I know this has allowed me to recover before so I'm going for it and I'm sticking with it until the end of the year (first time the updose took 1 month to work, second time it eliminated akathisia by 3 months, but both times it got worse before it got better, so we are premedicating with extra Klonopin.) Stopped Ambien, propranolol, and acetaminophen, looking for a different BP med. So far definitely improved but only 2nd day.

 

I have no idea where this is going to go but I'm doing what my instincts tell me and going to stick with it, give it all I've got until the end of the year. I've been through it once before I can do it again and if I can't I'm simply finished. If I come out of this alive though it could be good, I'll still be at only half my original dose, and I am DEFINITELY following Dr. Shipko's advice about tapering off other meds before SSRIs. Not even going to touch the Lexapro until I'm weaned off other drugs.

 

Thanks so much for your advice and I'm sorry I can't participate more in the forums now, I'm putting all of my energy in trying to get through daily functioning. Hope to be back soon with something helpful to contribute!

[chicken]

Pharma,

Sometimes you have to go with your gut. There were times I went against all advice from this board and other times I went against all advice from the doctor. I too tapered my benzo and AP first, though most recommended the AD go first.

 

I had to go with my gut. So far it has worked. I'm on a low dose of the AD now.

 

Wishing you the best with your taper.

[Altostrata]

Please let us know how you're doing.

[Pharmageddon]

12 days into my updose. Sorry I've been away so long but things have been gradually evolving and I wanted to have some time to see what direction they were going in. I am taking 3 mg Lexapro in the AM and 2 mg at night; and 1.25 mg Klonopin split into two 0.625 mg doses.

 

Well, I am LUCKY...two rounds of intense akathisia with dysautonomia survived, and I learned my lesson big-time: if you have a strong and generally accurate sensitivity/intuition into your own body, LISTEN to it when it is shouting a serious message at you! 

 

I am mostly stabilized, almost all symptoms are gone except some daytime fatigue (no biggie) and occasional mild itchiness, which is par for the course for me on Lexapro. I'd originally gone from 0.75 to 1.5 mg Klonopin but found it to be too much and went down to 1.25 mg. I plan to hold the dose of Lexapro and Klonopin until the end of the year, begin weaning Oxycodone now (not much choice--but have done this before with little issue) and begin tapering Klonopin next year, and follow with an extremely slow lexapro taper--like 1 mg per year.

 

It seems that for most it is best to taper the SSRI first but in my case I have been on the Lexapro much longer than the Klonopin, and I tend to have much greater difficulties tapering Lexapro than benzos.

 

Thank you everyone for your support, I'd probably be dead without you! 

[Altostrata]

That's very good news, PG.

 

Given the Lexapro makes you itch, I hope you will be able to taper it after you go off oxycodone.

 

Are you getting a good amount of sun or taking vitamin D? Vitamin D affects the skin.

[Pharmageddon]

Thanks Alto! Yes I am very relieved and also trying to look at the positive side of this: instead of a failed 18 month taper from 10 mg, I'm looking at it as a successful SLOWER taper--I got down to 5 mg after 2 years 

 

The itching has been a periodic thing for me, it has always waxed and waned and never lasted more than a few months so I think I'll be OK. I notice it more in the fall too. It's interesting, I think I recall you or a mod here saying that SSRIs can cause histamine release, which gets worse when exposed to allergens. I always had hay fever in the fall until I started Lexapro and then it sort of morphed into a different form. I'd be surprised if it was around in the winter.

 

I am taking Vit D because my levels tend low, but recently lowered my dose after my labs came back mid-normal... I'll try going back up and see what happens, thanks!

[Pharmageddon]

Marmite, thanks for stopping by! I noticed we both have really prominent cardiac and autonomic symptoms and I can see why you got the pacemaker, I probably would have ended up on one too if I hadn't reinstated. Sorry to hear you had to go through that.

 

Fortunately I'm doing pretty well right now--I can say I enjoy my life even, well at least about half the time   The question is how I will feel after I get into my tapering--tapering oxycodone now and the symptoms have been manageable so far. I just feel so lucky to be out of hell, I'm willing to go as slow as necessary...

[Altostrata]

Pharmag, how much of everything are you taking now? Please update your signature.

 

"Out of hell" -- well, that's good news!

[JanCarol]

Hey PG - wow.  You have been through the wringer!  Congratulations at finding a low dose of Lexapro which doesn't kill you!

 

And congratulations on starting your oxycodone taper - I was going to point out a few things about oxy:  it increases itchiness, Something about the way the opiate receptors interface with the skin.  Additionally, the main issue with opiates of any kind (and oxy is a strong one) is rebound pain - when you have been taking the drug for awhile, your body actually produces pain in order to get you to take more.  It's why the darned things are so addicting.

 

How low have you gotten the oxycodone to?  How are you going?

[btdt]

Could you give me your thoughts on the drug xyrem?