leahbean: Drug mishaps, tapering, illness interference

[leahbean]

Hello everyone.  I wanted to jump on here and hopefully gain some perspective on my situation.
 
I started Lexapro 10 mg in Oct. 2012 for situational depression.  As that situation resolved, I questioned whether I still needed to be on it and began tapering in April 2014.  I went down to 7.5 mg for about a month, then discovered I was pregnant.  I really wanted to wean off Lexapro for the duration of the pregnancy.  Sadly I miscarried at 10 weeks.  I was still on 7.5 mg for a little while.  Felt I processed the miscarriage as much as I could, then went down to 5 mg for awhile. I was doing okay anxiety-wise, I thought. Went down to 2.5 and discovered I was expecting again!  I was overly anxious the whole time, given the outcome of my last pregnancy.  I stayed at 2.5 for pretty much the whole pregnancy, went down slowly from 2.5 as time grew closer to delivery.  I got down to less than 1 mg with liquid, and then stopped right after I delivered.  I was wholly unprepared for what happened next.
 
Three days postpartum, I had an anxious/depressive meltdown, thinking things like, "I shouldn't have had this baby" (even though he was very much wanted), I've ruined my family's life, how am I going to handle caring for two kids instead of one, etc.  I was trying to nurse every 2-3 hours, while fighting through unrelenting panic attacks.  I would even wake up from sleep in the midst of an attack.  It got so that I didn't want to sleep even if someone offered to watch my son because I was so afraid of the panic attacks.  Wild mood swings, couldn't stop crying, suicidal thoughts, feeling hopeless, helpless, the whole nine yards.  I felt like I was losing my mind and went to the ER.  They were pretty much useless, just telling me to go all the way back up to 10 mg of lexapro and everything would eventually be okay.  
 
The panic attacks continued.  On my husband's birthday, I woke up in the worst panic attack I'd ever had.  I knew I couldn't go back to the ER, and checked myself in to a psych ward because I seriously felt like i was going nuts.  They were useless as well, only giving me Vistaril and 10 mg Lexapro.  My husband busted through h*** to get me out of there less than 24 hours later.
 
The anxiety from there continued.  I felt severe DP/DR, and could barely make myself a sandwich to eat.  Changing my clothes and showering was a huge accomlishment.  Continuing to feel desperate to get back to myself, I did arguably the worst thing I think I could have done:
 
I checked into an inpatient treatment program for perinatal mood disorders.  There they proceeded to pump me full of Lexapro, letting me stay at 5 mg for just one night.  It was quickly ramped to 10, then 15, then 20, which I was discharged on a mere two weeks later.  I was given Klonopin and Benadryl as needed for sleep.  I was also advised to take Risperdal, which I adamantly refused.  
 
This was about 10 weeks ago.  I have since come under the care of a reproductive psychiatrist who has continued me on Lexapro 15 mg, Buspar 10 mg, Lamictal 25 mg, and Vistaril for sleep.  She tried augmenting the Lex with Wellbutrin when she wasn't seeing a "quick enough" response.  It made my anxiety worse, and gave me a very frightening moment where I was in the midst of a crying fit, and then suddenly felt like laughing for no reason, so I discontinued it.  
 
I'm yards better than I was.  However, I am having some problems now that I wasn't before and am hoping to taper back off the Lexapro, because I'm thinking (wondering) that I didn't so much have a new episode of depression.  Rather I have a theory that while pregnant, the difficulties of coming off Lexapro were masked by my pregnancy hormones, and after delivery, when those dropped, and my body wasn't getting any Lexapro at all, I crashed and burned.  You should've seen the look on my pdoc's face when i told her this theory...I though she was going to have a heart attack.  
 
Since reinstating lexapro, I've had racing thoughts (sometimes I can't even figure out what I'm thinking about), headaches, vision problems, increased anxiety, difficulty with word finding, lack of concentration (can't even read an easy chapter book with my 9 year old daughter), difficulty focusing on conversations, weight gain, obsessive thinking, songs looping in my head, random movie scenes popping into my head, suicidal thoughts, intrusive thoughts, brain fog, easily triggered by frightening things, etc.  
 
I feel like now, somehow, lexapro is too activating for me.  I've wondered if I've slipped into hypomania or something. Women can sometimes be misdiagnosed with postpartum depression, when they've really converted to bipolar disorder.  those women are at greatest risk for psychosis.  I have no family history of bipolar, though my sister was misdiagnosed with it a few years ago.  She's way more on that spectrum than I ever have been.  
 
So here is my conundrum: I don't want to go back to where i was after I delivered. I CAN'T go back there.  however, I feel that with each pill I swallow, I'm giving myself a chemical lobotomy.  I can't afford to lose any stability trying to care for my children.  I know I can't ask for medical advice here, but I just have two questions:
 
1.  Is my theory about having a really bad reaction to complete withdrawal totally unfounded, or could this have some merit?
2.  Should I even think about tapering off Lexapro right now, feeling that it's too activating for me? I've tried to tell my doctor this many times and she feels that if it's helping even a little, it's worth continuing.  I feel as though I have to continue the Lamictal for now. 
 
Needless to say, these last several months have been extremely traumatizing for my whole family.  I just want to do right by everyone, and remember to include myself in that mix.
 
Thanks for reading.

Edited January 31, 2023 by manymoretodays
language, new title created per members request

[peggy]

oh dear, you poor darling!  I feel so awful for you... what a horrible ordeal you have been through!

 

but to your theory - i think there IS  merit in it..it is not an uncommon story amongst people here - but maybe not in the majority of people - this could be why some doctors don't believe it - they don't see it all the time.   It is common to have a rebound (withdrawal) episode often weeks or months after coming off - ESPECIALLY in light of some kind of trauma - birthing is traumatic - the change in the hormones in the body is enormous in those first few days after delivery, some women are more sensitive to it - throw in a sensitised nervous system from a fairly big drop in lexapro (1mg is considered big here) and it's the perfect storm.

 

Many people report the symptoms of these rebound episodes as being worse than their initial episode, unfortunately sometimes it is treated too aggressively and the drug which once helped becomes too stimulating.

 

i don't know what i would do in your situation - i think i would be inclined to take a small reduction in the lexapro - maybe down 10% to get to 13.5mg and see if that has any effect.. i would get myself some good quality fish oil and some magnesium, i would start a regular practice of meditation - two short (10minutes to start) guided meditations each day. i would also try to get outside every day - take that beautiful baby for a walk in the sunshine - and maybe look into a different doctor... 

 

i think we should always listen to our gut and go with our instincts - we often know what is right for ourselves.  

[Farout]

I agree with your theory.... 

 

Also, day three postpartum is the pits!  It's when all these hormones flood your body and make you feel truly terrible.  It's a well known fact in midwife circles.   I think it's possible that the usual day three hormone rush kick-started your withdrawal symptoms for you and that's where you find yourself now.  

 

I'm glad you found this site.  People here are kind and experienced.  They've really heard it all and will help you taper safely.

Best of luck with it all and congratulations on the new baby!

 

Please always remind yourself that you were prescribed lexapro for situational depression.  This stuff you are seeing now - the anxiety and panic, the horrid, intrusive violent, suicidal and just plain gross thoughts, the endless thought looping, the brain fogs - all drug related and has happened to a lot of us.

 

You will feel better.  It's a bit of a journey but you will get better.

[Petunia]

Welcome leahbean,

I'm so sorry about everything you've been through. From reading your story, with what I've learned working with many people in withdrawal, it seems obvious to me that your symptoms after delivery were withdrawal related. You came off 1mg of lexapro too fast. Lexapro is a strong drug and many people need to taper much lower than 1mg before stopping, especially if you have been taking it for a while.

 

I will give you a few links to read, to help you understand withdrawal and the need for slow tapering.

 

What is withdrawal syndrome?

Why taper by 10% of my dosage?

Why taper? Paper demonstrates importance of gradual change in plasma concentration

Brain Remodelling (Rhi's Description of Brain Healing)

 

I highly doubt you have bipolar disorder or any other mental illness. Your theory sounds correct to me, you're on a high dose of lexapro and its too stimulating. When I was switched to lexapro, originally I was given 10mg, but I couldn't tolerate that high dose and dropped down to 5mg, that's where I stayed for about 6 years until I did my own too fast taper and landed myself in withdrawal.

 

Doctors don't understand withdrawal syndrome. They often want to add or increase drugs, which can make it worse. See: What to expect from my doctor

 

It would help if you would fill in your signature with your drug history and a list the drugs you are currently taking, along with the dose, here are instructions for how to do it:  Please put your withdrawal history in your signature       

 

Please put ALL the drugs you take in the drugs.com Drug Interactions Checker at:

 

Drug Interactions Checker

 

You may post the results here in your thread.

 

I agree with Peggy, that reducing the lexapro is the most likely next move. Here is our lexapro tapering topic to help you get started:

 

Tips for tapering off Lexapro (escitalopram)

 

You can use this thread as your ongoing journal to track progress, write about symptoms, ask questions and communicate with the community, add to it whenever you want. Its a good idea to bookmark it or follow it, so its easy to find again.  I'm glad you found us.

 

Petunia.

[AliG]

Hi Leah. Welcome. I'm sorry for what you've been through. As has been said , it was probably a " perfect storm" , with dropping hormones and withdrawal , all happening simultaneously. If you feel Lexapro is too activating for you , I thinks it's particularly important to think about tapering off, slowly.

We recommend tapering by 10 % , with a hold of between 4- 6 weeks, depending on symptoms.

Why taper by 10% of my dosage?

 

Would you mind filling in your drug and withdrawal history. It appears below each of your posts , and helps us to  understand your context.

Please put your withdrawal history in your signature

 

I think a slow taper off Lexapro is wise. . http://survivingantidepressants.org/index.php?/topic/406-tips-for-tapering-off-lexapro-escitalopram/

 

Ali

 

Edit : posted at same time as Petunia.

[leahbean]

Hi again everyone!

 

Thank you all so much for taking time to respond to my intro.  I should add that I know I have some issues around identity as a mother, mainly who I am apart from that role, that I know will need to be worked out in therapy.  I've always been an introverted, introspective kind of person who tends to ruminate over problems in my life and I'm hoping counseling will help with those tendencies. I struggle with not giving my thoughts too much power over me. Hard to concentrate on therapy, when I feel brain fogged and can't concentrate!  

 

I feel in my gut that tapering the Lexapro is the right thing to do.  I do have some liquid left and will probably combine that with a 10 mg tablet.  As I need to be as stable as I can, I will be taking this extremely slowly (probably more on the 6 week end of things).  In doing this, I know I'm bucking the conventional wisdom around postpartum depression that says to stay medicated for an additional year past the point where I feel stable.  

 

I am supplementing fish oil (Carlson's) liquid, 1 tsp day, vitamin D, and have continued my prenatal vitamin to get my B-vitamins and iron.  My hormones are allegedly normal, except for my thyroid which i understand can take some time to calm down after having a baby. I do have some magnesium and calcium supplements, but I'm wondering what form/amount of each mineral is best?  

 

Thanks again everyone for your replies!  I will keep everyone posted on my progress and be reading the links on withdrawal syndrome.  

[leahbean]

Here are all the drug interactions. Interactions between your selected drugs

Major buspirone  escitalopram

Applies to: BuSpar (buspirone), Lexapro (escitalopram)

Using busPIRone together with escitalopram can increase the risk of a rare but serious condition called the serotonin syndrome, which may include symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhea. Severe cases may result in coma and even death. You should seek immediate medical attention if you experience these symptoms while taking the medications. Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Major hydroxyzine  escitalopram

Applies to: Vistaril (hydroxyzine), Lexapro (escitalopram)

Using escitalopram together with hydrOXYzine can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate buspirone  lamotrigine

Applies to: BuSpar (buspirone), Lamictal (lamotrigine)

Using busPIRone together with lamoTRIgine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate buspirone  hydroxyzine

Applies to: BuSpar (buspirone), Vistaril (hydroxyzine)

Using busPIRone together with hydrOXYzine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate hydroxyzine  lamotrigine

Applies to: Vistaril (hydroxyzine), Lamictal (lamotrigine)

Using hydrOXYzine together with lamoTRIgine may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

Switch to professional interaction data

Moderate lamotrigine  escitalopram

Applies to: Lamictal (lamotrigine), Lexapro (escitalopram)

Using lamoTRIgine together with escitalopram may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. Some people, especially the elderly, may also experience impairment in thinking, judgment, and motor coordination. You should avoid or limit the use of alcohol while being treated with these medications. Also avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medications affect you. Talk to your doctor if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

[leahbean]

I've been reading a little bit about reinstatement.  I'm wondering if I'm having a paradoxical reaction to Lexapro?   I've always had a little bit of health OCD, and tend to overthink things a lot.  However, I've never had anxiety/OCD of this caliber before.  This experience has been a wake-up call to try and find other ways to deal with it.  I never ever felt suicidal or had intrusive thoughts before ramping back up to 15 mg.  It's hard to separate myself from my thoughts.  I know that I'm not a monster, but having sicko, crazy thoughts sure makes me feel like one.

 

I'm starting to feel like my brain has calmed down and accepted the new "normal" of 15 mg. I'm still wanting to taper, however, I'm wondering how long to let my brain rest before messing with my chemistry again by tapering?  Would it make sense to try to change my diet and support my biochemistry with supplements for a while first?  Any advice is appreciated!  Thank you!  

[leahbean]

Okay.  Last night I started my taper!  13.75 mg.  Planning on holding there for awhile.  I'm wondering how I will be able to distinguish withdrawal from monthly mood swings.  Any insight would be appreciated!

[leahbean]

Starting to feel it, I think.  Just feeling really uneasy today, don't know why.  Thoughts are racing.  Intrusive suicidal thoughts that make no sense.  I feel I should be the happiest ever right now and I'm being robbed of the joy of the early months of my son's life.  I freaking hate this!  I'm feeling like I've gotten a kindling reaction going...that Lexapro is causing the things it's supposed to be relieving.....I need some hope!  Any and all encouragement is welcome!!

[leahbean]

Seeing a pattern, I think.  My best two weeks are right before I ovulate.  I can tell almost the minute it happens...the thoughts start getting weird, obsessive, intrusive....I am also wondering if I'm having a harder time due to using a 10 mg pill, with some 6-month old liquid to make my current dose (13.75 mg).  Can people have trouble with this?  I saw a psych NP today who won't rule out bipolar disorder, due to the cyclical nature of my moods.  I hate labels, but I don't know who to trust anymore about all this!  Please help!!!

[Farout]

It's not bi-polar. It's the waves and windows pattern of withdrawal. A lot of us find it gets worse around our cycles. Either the withdrawal messes with our hormone levels while we heal, it normal hormone fluctuations mess with withdrawal.

 

There's a thread in the symptoms forum. Take a look. Sorry, I can't figure out the link in my phone.

[scallywag]

Hi Leah -- I'm popping in while Ali & and Petunia are sleeping/waking up in Aus. I'm sorry that things are still so up and down for you.

 

People can and do react to changes in formulation.  Typically, we suggest that people keep the dose the same for a while when moving to a liquid. It's better to see the symptoms when at the same dose than to risk multiplying the impact by making two changes - dose cut and formulation change.

 

When I look at your signature, I see a drop in both Lexapro (15 mg to 13.75) and Buspar (10 mg to 7.5). Did your Buspar dose drop 2.5 mg n May/June? If so, that could be complicating the situation and intensifying or worsening w/d symptoms.

[leahbean]

It's not bi-polar. It's the waves and windows pattern of withdrawal. A lot of us find it gets worse around our cycles. Either the withdrawal messes with our hormone levels while we heal, it normal hormone fluctuations mess with withdrawal.

 

There's a thread in the symptoms forum. Take a look. Sorry, I can't figure out the link in my phone.

Will search for it, thanks Farout.  I am trying not to be discouraged by the mood swings...it's unacceptable to "feel" suicidal 50% of the month!  Especially while trying to care for two kids.  The other thing the NP suggested was PMDD.  Is it possible that it's the withdrawal pattern, but just happening to line up with my mood swings?

 

Hi Leah -- I'm popping in while Ali & and Petunia are sleeping/waking up in Aus. I'm sorry that things are still so up and down for you.

 

People can and do react to changes in formulation.  Typically, we suggest that people keep the dose the same for a while when moving to a liquid. It's better to see the symptoms when at the same dose than to risk multiplying the impact by making two changes - dose cut and formulation change.

 

When I look at your signature, I see a drop in both Lexapro (15 mg to 13.75) and Buspar (10 mg to 7.5). Did your Buspar dose drop 2.5 mg n May/June? If so, that could be complicating the situation and intensifying or worsening w/d symptoms.

Thanks, Scallywag!  I was wondering why I might be having such a hard time with a 10% withdrawal.  Do you think I should continue what I've been doing?  It's been almost 3 weeks with the pill and liquid combo. I'm not sure when I'll feel ready to try tapering down.  Not anytime soon!!   This sounds silly, but I'm not sure exactly when I went from 10 mg of Buspar to 7.5.  My husband was keeping my meds under lock and key (at my request, when I've felt suicidal) and he was breaking the tablets for me.  It's such a small change visually I didn't really notice the difference...that could definitely be a factor, as I have started taking over my own meds again. 

 

 I don't think Lexapro is working for me beyond not having physical panic attacks.  Is it possible that, even though Lexapro was fine for me the first time around, it's already pooped out?  Can one experience poop-out withdrawal symptoms while still taking the med?  I feel increased depression, anxiety triggered by stuff that never used to bother me, OCD-type thoughts getting somewhat worse, racing thoughts, fixating on weird things.  For example, the old me would have loved to take my daughter to see Finding Dory.  Not knowing what kind of drama there might be (in a KIDS movie!) makes me feel uneasy and want to avoid it.  

 

This stinks to high heaven!

[leahbean]

Also, even though my pdoc says that 25 mg of Lamictal isn't therapeutic, I've continued it in the hope that it would buffer some of the withdrawal.  It's not helping, but I refuse to take more!

[scallywag]

Drugs can stop having the intended effect at any time. Tachyphylaxis (hey I actually spelled it right the first time ) or drug "poop out" is unpredictable.

 

I'll ask more experienced moderators how to taper if a drug has pooped out. It may take a day or two for an answer but I will be back with the information

[Farout]

 

 

 I feel increased depression, anxiety triggered by stuff that never used to bother me, OCD-type thoughts getting somewhat worse, racing thoughts, fixating on weird things.  For example, the old me would have loved to take my daughter to see Finding Dory.  Not knowing what kind of drama there might be (in a KIDS movie!) makes me feel uneasy and want to avoid it.  

This stinks to high heaven!

 

 

I didn't know whether to laugh or cry when I read that.  This was me 20 months ago - but with the Care Bears Movie, of all things!

ETA: I went but found myself on a constant self soothing loop "it's ok...  It's just a movie.. It's all going to be ok......" (because we all know how scary the Care Bears can be).

 

Re PMDD - Personally, I think it's withdrawal. It might be lining up with all sorts but it's still WD.  Frankly though, they can call it what they like as long as they don't try to make you take psych drugs for it.  

[scallywag]

leahbean, if you're getting relief from panic attacks, it's unlikely that the Lexapro has pooped out. The fact that your symptoms are less intense before ovulation is also evidence that the drug is still effective but interacting with hormones in the 2nd 2 weeks, the progesterone-dominant luteal phase.

 

The symptoms are hard to bear. It's hard to know what's going on exactly given that you intentionally reduced Lexapro on June 4 and unknowingly cut Buspar 25% in the last month.  It's probably best to stay at current doses for at least another month.

 

Lexapro is a very potent SSRI. It's possible that you're very sensitive to dose reductions in Lex -- maybe trying a 5% cut next time would yield a smoother transition.

 

Also, "therapeutic" levels are a manufacturer's marketing term. On my first go-round with anti-depressants, I responded DRAMATICALLY to ONE dose of 18.75 mg of Effexor, 25% of the maintenance "therapeutic" dose. For why people respond to "non-therapeutic" doses, check out Why taper paper: dose-occupancy curves. Although Lexapro wasn't one of the 5 anti-depressants the study examined, the researches did include Celexa, a drug very closely related to Lexapro. Celexa's generic name is citalopram; Lexapro's generic is escitalopram.

[leahbean]

Thanks, scallywag.  I'm definitely not doing anything else with meds for a long time.  It's hard to bring myself to take them, because I hate them so much. OTOH, I struggle with suicidal thoughts enough as it is.  This may be TMI, but a new menstrual cycle started for me just 3 days ago and the crying spells and hysteria and catastrophic thinking are not abating at all. The last few morning wake-ups have definitely been "cortisol mornings."  I can't stand feeling so incapable of taking care of my kids because I'm so preoccupied with myself and how I feel.  

[leahbean]

 

 

 

 I feel increased depression, anxiety triggered by stuff that never used to bother me, OCD-type thoughts getting somewhat worse, racing thoughts, fixating on weird things.  For example, the old me would have loved to take my daughter to see Finding Dory.  Not knowing what kind of drama there might be (in a KIDS movie!) makes me feel uneasy and want to avoid it.  

This stinks to high heaven!

 

 

I didn't know whether to laugh or cry when I read that.  This was me 20 months ago - but with the Care Bears Movie, of all things!

ETA: I went but found myself on a constant self soothing loop "it's ok...  It's just a movie.. It's all going to be ok......" (because we all know how scary the Care Bears can be).

 

Re PMDD - Personally, I think it's withdrawal. It might be lining up with all sorts but it's still WD.  Frankly though, they can call it what they like as long as they don't try to make you take psych drugs for it.  

 

My NP recommended stopping the BuSpar and trying Unisom instead of vistaril for sleep.  She also thinks a progesterone IUD could help, but didn't even recommend testing hormone levels first.  Makes me a little leery of the rest of her advice!  i have a feeling she's going to want to tinker with the Lexapro at some point.  

[scallywag]

Ask your NP how many patients she's guided through a multi-drug withdrawal. Her answer will probably make you go

[leahbean]

Yeah...  When she recommended discontinuing Buspar, she spewed the "cut it in half for a week, then every other day, then quit" line.  

 

Sorta off topic:  does Lamictal ever make moods swing instead of stabilize, or otherwise interact with hormones?  I realize it's a reach....

[Altostrata]

Hello, leah.

 

Please keep notes on paper about your daily symptom pattern, when you take your drugs, and their dosages.

 

Does the ramp-up in "anxiety" happen at any particular time of day? What does this feel like?

 

Up above, your drug interactions included

 

Major buspirone  escitalopram

Applies to: BuSpar (buspirone), Lexapro (escitalopram)

Using busPIRone together with escitalopram can increase the risk of a rare but serious condition called the serotonin syndrome....

 

 

 

As you can see by the drug interactions, your psychiatrist put you on a rather volatile combination of drugs. That particular interaction could manifest as periods of "anxiety" or feeling pressured.

 

My take is that you got withdrawal syndrome after giving birth, your system became sensitized to drugs (very common in withdrawal syndrome), and all those drugs you're taking haven't helped much. Not recognizing and overdrugging withdrawal syndrome is very, very common. Just about everyone here has experienced misdiagnosis and mis-medication by medical authorities.

 

The NP being so willing to diagnose "bipolar" when you clearly have female hormone fluctuations is another red flag, as is her inclination to prescribe yet more drugs. More drugs is not better. You need to carefully assess whatever the psychiatrist or NP tell you from now on.

 

It is possible that a decrease in Buspar has thrown you off. You could go back to 15mg Lexapro and see if that helps. You may have to wait a while after to let the Buspar change wear off, then have another go at reducing the Lexapro by 10%.

 

What time of day do you take lamotrigine? Do you feel any differently afterward? You stopped Vistaril, correct? How is your sleep?

[JanCarol]

Hey Leahbean

 

I'm so sorry you are going through this.  All this, and a young life looking to you for - well - everything.

 

Here's what Farout was talking about:  Waves and Windows

 

Another way to look at it:  Healing from Antidepressants: Patterns of Recovery (Toxic Antidepressants)

 

I think you are being wise here:

 

 

Also, even though my pdoc says that 25 mg of Lamictal isn't therapeutic, I've continued it in the hope that it would buffer some of the withdrawal. 

 

And you may wish to go here, and read what others have said about how withdrawal reacts with their monthly cycles:

http://survivingantidepressants.org/index.php?/topic/11767-changes-to-menstrual-cycle-during-withdrawal/

 

Also - you may have your partner look at these, to help understand why things are so wild and wooly right now:

Withdrawal Dialogues - cartoons to encourage you

 

Additionally, while you are holding (please hold, and hold, and hold some more, this is healing and resting your brain before you go again!), it's a great time to learn Non Drug Techniques for Coping with Emotional Symptoms

 

They are difficult to practice while you are thrashing around in the worst of withdrawal, but if, when you feel a little better, you start practicing, and keep practicing, the next time the waves hit - you have a bit of a sandbag wall built up in your practice.  Everyone has different preferences - some like sitting meditation, I like physical things like yoga - others like to walk or dance or sing.  One person rocked and knitted through the worst of her withdrawal!  Many of us take refuge in silly things like games or children's TV shows, or listen to gentle music or guided meditations.  Look through the page, to see what appeals to you.  The best guide at this time, is to follow your pleasure.  Do what you enjoy, follow that for as long as you enjoy it.  If you stop enjoying it, then find out where the pleasure went, and follow it again.

 

You can do this, I'm sorry it's so hard right now.  It does get better, and now that you are on a stable dose, it can get better soon.

[leahbean]

Hello, leah.

 

Please keep notes on paper about your daily symptom pattern, when you take your drugs, and their dosages.

 

Does the ramp-up in "anxiety" happen at any particular time of day? What does this feel like?

 

Up above, your drug interactions included

 

Major buspirone  escitalopram

Applies to: BuSpar (buspirone), Lexapro (escitalopram)

Using busPIRone together with escitalopram can increase the risk of a rare but serious condition called the serotonin syndrome....

 

 

 

As you can see by the drug interactions, your psychiatrist put you on a rather volatile combination of drugs. That particular interaction could manifest as periods of "anxiety" or feeling pressured.

 

My take is that you got withdrawal syndrome after giving birth, your system became sensitized to drugs (very common in withdrawal syndrome), and all those drugs you're taking haven't helped much. Not recognizing and overdrugging withdrawal syndrome is very, very common. Just about everyone here has experienced misdiagnosis and mis-medication by medical authorities.

 

The NP being so willing to diagnose "bipolar" when you clearly have female hormone fluctuations is another red flag, as is her inclination to prescribe yet more drugs. More drugs is not better. You need to carefully assess whatever the psychiatrist or NP tell you from now on.

 

It is possible that a decrease in Buspar has thrown you off. You could go back to 15mg Lexapro and see if that helps. You may have to wait a while after to let the Buspar change wear off, then have another go at reducing the Lexapro by 10%.

 

What time of day do you take lamotrigine? Do you feel any differently afterward? You stopped Vistaril, correct? How is your sleep?

Hi Alto!

 

Thanks so much for jumping in here.  The anxiety is very noticeable in the morning; from the second i open my eyes, I feel "off", like I'm about to give a speech to 5K people.  It does abate as the day wears on.  I take my Lamictal around 0930.  Sometimes it feels like it really slows me down and makes me drowsy; other times, I welcome that effect on my racing thoughts (which aren't always anxious, just fast).  I feel triggered by just about everything.  I can't talk about other people's mental problems, because it makes me uneasy.  I can't look at pictures of the past where I look happy, because it makes me afraid that I won't ever get back to that again. It's awful.  I am not enjoying the window that's starting now, because I know a wave will be coming in a few days, and I hate feeling so defeatist.  I don't think it's coincidence that I feel best at night, just before I take my next dose of Lexapro and Buspar, and my lamictal dose is at its lower concentration.

 

I am definitely wary of adding estrogen or progesterone at this point, even if my hormones are low.  Mainly because I feel that my body is desperately trying to get back to homeostasis, and it's my drugs that are messing with the hormones somehow.  

I have continued the Vistaril, mainly because I don't want to change anything, and I know for sure that I will get some sleep if I take it.  I am so blessed that my husband and parents take turns with night duties with the baby, in order to protect my sleep.  I don't like to take naps during the day; I wake up feeling anxious (I believe on the benzo forum this is called "toxic naps") and I can't shake it for a long time.  I can't stand the increased depression.  

 

This is not to defend my NP by any means, but to her "credit", she said it's too early to say "bipolar", but that she's about 50-50 on it.  She does think I have PMDD given what's been happening with the mood swings.

 

Do you think that reinstating has been a disaster because I went from almost 0 to 20, then 15?  

[Altostrata]

I think you need to address your pre-menstrual symptoms, confer with Dr. Google about diet and supplements.

 

Your pattern is very "normal," your sensitized nervous system is reacting to the usual early-morning cortisol peak.

 

You are taking lamotrigine in the morning? It has a short half-life. You may wish to move half the dose to the evening (it's often taken twice a day). Do this by keeping everything else very regular and moving 12.5mg lamotrigine a couple of hours later each day until your taking the doses 12 hours apart. This may reduce the morning cortisol reaction, you'll have more lamotrigine in your system in the early morning.

 

I don't think your reinstating is a disaster, it seems pretty "normal."

[leahbean]

Hey Leahbean

 

I'm so sorry you are going through this.  All this, and a young life looking to you for - well - everything.

 

Here's what Farout was talking about:  Waves and Windows

 

Another way to look at it:  Healing from Antidepressants: Patterns of Recovery (Toxic Antidepressants)

 

I think you are being wise here:

 

 

Also, even though my pdoc says that 25 mg of Lamictal isn't therapeutic, I've continued it in the hope that it would buffer some of the withdrawal. 

 

And you may wish to go here, and read what others have said about how withdrawal reacts with their monthly cycles:

http://survivingantidepressants.org/index.php?/topic/11767-changes-to-menstrual-cycle-during-withdrawal/

 

Also - you may have your partner look at these, to help understand why things are so wild and wooly right now:

Withdrawal Dialogues - cartoons to encourage you

 

Additionally, while you are holding (please hold, and hold, and hold some more, this is healing and resting your brain before you go again!), it's a great time to learn Non Drug Techniques for Coping with Emotional Symptoms

 

They are difficult to practice while you are thrashing around in the worst of withdrawal, but if, when you feel a little better, you start practicing, and keep practicing, the next time the waves hit - you have a bit of a sandbag wall built up in your practice.  Everyone has different preferences - some like sitting meditation, I like physical things like yoga - others like to walk or dance or sing.  One person rocked and knitted through the worst of her withdrawal!  Many of us take refuge in silly things like games or children's TV shows, or listen to gentle music or guided meditations.  Look through the page, to see what appeals to you.  The best guide at this time, is to follow your pleasure.  Do what you enjoy, follow that for as long as you enjoy it.  If you stop enjoying it, then find out where the pleasure went, and follow it again.

 

You can do this, I'm sorry it's so hard right now.  It does get better, and now that you are on a stable dose, it can get better soon.

Hi Jan.

 

Thank you for your encouragement!  Sometimes I feel so flat, there's not a lot that make me smile right now.  But I try to be upbeat with my newborn especially.  Puzzles and sewing seem to be the go -to activities for now.  It's hard to meditate much when my thoughts race so much!

[leahbean]

I think you need to address your pre-menstrual symptoms, confer with Dr. Google about diet and supplements.

 

Your pattern is very "normal," your sensitized nervous system is reacting to the usual early-morning cortisol peak.

 

You are taking lamotrigine in the morning? It has a short half-life. You may wish to move half the dose to the evening (it's often taken twice a day). Do this by keeping everything else very regular and moving 12.5mg lamotrigine a couple of hours later each day until your taking the doses 12 hours apart. This may reduce the morning cortisol reaction, you'll have more lamotrigine in your system in the early morning.

 

I don't think your reinstating is a disaster, it seems pretty "normal."

Thanks Alto.  I've read that calcium and magnesium are supposed to help PMS.  I will also be getting my trace minerals tested this week to check for copper/zinc levels (Walsh protocol).  Apparently copper can interact with estrogen.  

 

I feel that the Lexapro is exacerbating my anxiety and OCD-type thoughts.  The intrusive thoughts are the worst!  I can't stop seeming to worry about my kids' safety (the fear that someone will molest them), and now that "worry" (a neuro emotion at this point?) is spilling over to other kids as well; for example, when we go to the playground, I see kids running around and think, gosh I hope those kids aren't being abused.  It's ridiculous!  

 

I never ever ever had these kinds of ridiculous worries or anxieties before having my son and reinstating Lexapro.  This is why I feel that reinstating was a mistake.  I wish I would have just stuck through the first two months of my son's life before agreeing to reinstate. I feel triggered by everything.  Any kind of violence or morbidity (even implied in movies) is a trigger for anxiety.   I'm wondering if the panic attacks stopped because I was getting more sleep on a regular basis.   

[scallywag]

Hi leah! How are things going for you?

[leahbean]

Hi leah! How are things going for you?

Hi Scallywag!

 

Thanks for checking in!  Lots of new things happening this week....decided to get genetic testing done.  I realize on this site, it's not necessarily useful as everyone here is trying to get off drugs (myself included), but I was curious to see if an objective set of data would back up my gut instinct that Lexapro is worsening things for me.  And sure enough!  The three ADs that were listed as not good for me, based on my liver's ability to metabolize them, were Lexapro, Celexa and Zoloft. I'm kind of annoyed at myself...I knew deep down that Lexapro isn't right for me.  I didn't HAVE to listen to my psychiatrist telling me that as long as Lexapro was working a little bit that it would be good to stay on it. The report also said that I have the MTHFR "mutation"; I'll call it an idiosyncrasy, since this genetic anomaly, if truly dangerous would have worked itself out through natural selection.  

 

My problem now is, that my NP does agree that I should taper off Lexapro, but she's going to want to try me on something in the "green" column.  That's really not what I want to do.  Reading her email to me, between the lines, she doesn't seem to think that tapering slowly is necessary.  

 

I haven't heard back on my copper/zinc and thyroid function tests yet.  I'm hoping that something there shows up as being off.  My dream scenario would be to work on getting underlying problems back in balance with mineral supplementation, while tapering off Lexapro and eventually Lamictal.  I have a gut feeling that cross tapering to something like Prozac would only cause more confusion to my CNS.  At the same time, I can't be in denial that I have a problem with anxiety, OCD, and suicidal thoughts.  

 

any advice?

[scallywag]

Certainly orthomolecular doctors and practitioners think that zinc/copper imbalances contribute to mental health issues. And a fully functioning thyroid is critical to many of the body's processes.

 

Take a gentle, gradual, one-at-a-time approach to initiating supplementation, similar to the one we recommend with tapering pharma products. I once did a multi-pronged plan to address depressive symptoms and CRASHED after 6 weeks. It was too much too fast for me.  I'm now slowly working my way up to a similar combination of vitamins and minerals, adding only one new supplement every 2 or 3 weeks. It feels much easier and way less "white-knuckle-ride" this way.

 

I'm reading a book that is opening my eyes about my stress-induced situational depressive symptoms, When the Body Says No, by Gabor Mate, MD. Although he looks at what are considered physical illnesses, several of the psycho-social factors seem very true for me. Now I have information, next is action about the insights.

 

What research have you done about the "green" list of ADs?  Is your gut informing you in any way about them?

[Altostrata]

Your plan sounds like a good one, leah. Get fundamental health in order and minimize drugs.
 
Whatever your thoughts are, they are just thoughts. There are many non-drug therapies to deal with them, see
Non-drug techniques to cope with emotional symptoms for suggestions.
 
Tip: No matter what the tests show about your mineral levels, eating more leafy greens seems to be good for almost everyone.

[leahbean]

Certainly orthomolecular doctors and practitioners think that zinc/copper imbalances contribute to mental health issues. And a fully functioning thyroid is critical to many of the body's processes.

 

Take a gentle, gradual, one-at-a-time approach to initiating supplementation, similar to the one we recommend with tapering pharma products. I once did a multi-pronged plan to address depressive symptoms and CRASHED after 6 weeks. It was too much too fast for me.  I'm now slowly working my way up to a similar combination of vitamins and minerals, adding only one new supplement every 2 or 3 weeks. It feels much easier and way less "white-knuckle-ride" this way.

 

I'm reading a book that is opening my eyes about my stress-induced situational depressive symptoms, When the Body Says No, by Gabor Mate, MD. Although he looks at what are considered physical illnesses, several of the psycho-social factors seem very true for me. Now I have information, next is action about the insights.

 

What research have you done about the "green" list of ADs?  Is your gut informing you in any way about them?

I just got back my bloodwork.  My percentage free copper (calculated by the ceruloplasmin levels and serum copper) is in the high zone, according to the Walsh protocol, at 40.6%.  My copper zinc ratio is also imbalanced, at 1.65.  Not sure exactly where I go from here, as there are no Walsh-trained providers in my area.  My TSH level has also swung in the other direction from my last test in April; it is now out of range low, April's was out of range high.  The actual thyroid hormones themselves are within normal limits, and thyroid antibodies were negative.  

 

I have stopped taking Vistaril at night; I was just feeling too sedated.  I have taken Benadryl in its stead, but hope to wean myself off of it psychologically and physically soon.  I have added magnesium glycinate at 75 mg nightly.  Not sure if it's doing anything, but it hasn't upset anything either.  I've also stopped taking a multivitamin that was super-high quality, but did contain copper.  All of these changes, plus adding a supplement called EnBrace (methylfolate, P5P, phosphatidylserine, iron, and a few other things) has really helped this month.  I'm now premenstrual and feel yards better than I did at this time last month.  The Lexapro taper has finally settled down.  

 

I don't want to try any other ADs, even if they are in the green column.  I feel like it would be trading the devil I know for the devil that I don't.  I'm also concerned about the Lamictal.  I've read that it's horrible to go off of, but then again, I've only been at 25 mg for 2.5 months.  I don't want to wait until I've finished a Lexapro taper to start a taper on Lamictal.  I'd be on it for years!  Any advice on this? I just want so badly to be med-free and normal, like we all do!!

 

I think my next Lexapro drop will be soon; I may go at 5% this time, given that I had a rough start to the taper (maybe that was compounded by a drop in Buspar and Lexapro combo pill/liquid, instead of just pills).  My most recent refills are made by different manufacturers, and I'm hoping that doesn't mess things up too much.  

 

You're right; psychosocial/spiritual factors are most definitely in play.  I'm working on addressing those as well!  =)

[scallywag]

leah,

I'm glad you're feeling much better this month. It's amazing how much suffering can be remedied by non-pharmaceutical methods. Adjust a supplement, stop taking nutrient "x".

 

75 mg of magnesium glycinate is a good starting dose to test your ability to tolerate Mg.  You could slowly increase to 300 mg, stopping of course if you have any symptoms. I and others have found magnesium helpful with sleep.  If I recall correctly, it can be helpful with the zinc-copper balance. Warning: I may not have recalled correctly, so do some research to confirm before relying on my previous statement.

[leahbean]

Also....this is a little embarrassing, but I'm noticing some..... er.....increased libido over the last few days?  I mean, more than I'm used to as a part of PMS.  It's gotten a bit distracting, mentally...is this what men have to put up with?  I feel for them if yes!  Has anyone noticed this as a WD symptom?  Or a side effect of Lamictal?  My guess is that something non-pharmaceutical is helping, and the meds are just too much for me.  If I could go down to 5 mg of Lamictal comfortably overnight I would!!

[leahbean]

After seeing my psych NP again, I decided to go for a 10% reduction in Lex this month.  She's excited for me to quit it, and admitted that switching to another AD in the green column isn't a guarantee of anything, so it'd be risky to try to cross-taper.  She's very interested in the free copper issue.  Also found out that my iron stores are extremely low, which I'm not surprised by.  I've always been anemic.  She agrees that meds are making my battle much harder.  She seems to think a month-long taper is no big deal and wanted to know what I'm afraid of by doing it quickly...let's see...um.. feeling suicidal, even if it is a neuro-emotion.  It's scary as hell and I hate it.  Extreme fear and intrusive thoughts.  I don't like having an increased libido either.  It's distracting!!  But taper I must!  gotta soldier on.

 

Jury's out on the Lamictal in terms of what it's doing or not doing for me.  I'm wondering how bad it would be to pause the Lexapro taper after holding this most recent cut, and start tapering Lamictal?  I hope it wouldn't be that bad, given that I'm on a "low" dose and haven't been on it for long.   I wish my brain could just vomit and get it over with so I can move on and feel like I can really live again.  Not just survive and look over my shoulder for the next wave, but really truly relax, live, and THRIVE.