Machinehead: Should I go back?

July 9, 2016

Hello everyone. I hope you all find the strength needed to successfully archive your goals towards a better self.

I am really torn about what to do next. My story, short: I was on benzo from 1999-2012 and on SSRI from 2002-February this year (2016). The underlying diagnose is anxiety/panic disorder.

The journey has been hell (you know what I mean) and I'm not going to repeat what all of you already know...you know how hard it is and how many symptoms one can feel. From feeling like going crazy to extreme hopelessness. From insomnia to jaw pain...

Where I am now is as follows: the first two months after my last dose Lexapro were hell but I was nevertheless able to go to work, don't know how actually.
Months 3-4 were surprisingly stable I went to work and lived quite normally. I smiled to myself and thought I was archiving victory, as I previously did with benzo.
...but sadly now some weeks ago, in my 5th month things are getting quite nasty. Symptoms are coming back, specially strong anxiety, panic attacks (not every day), nightmares, mood swings and specially muscle ache (jaw and back).
I don't know what's happening. I have read everywhere symptoms after 3 months are "yourself" and not withdrawal, same as my doctor says.
I really, really don't want to go back. Leaving the medicine was a titanic task...I don't want to go back,l but at the same time I refuse living in this constant pain. This is not life worth living for me.

I daily do everything in my power to get better, as I've done this far when tapering both benzo and SSRI; I run 5km each other day, hit the gym, eat healthy, meditate, get lots of rest, have changed my life away from stress, I have no great financial problems, I have this wonderful wife, a wonderful life really...and I can't enjoy it.

My question for you, experienced people is: what should I do? I have an appointment with my doc this Monday and I'll have to make a decision by then.

Should I hold on and wait for better days (will they come?) or should I take a low dose Lexapro?
Even 2,5-5mg were enough for keeping me stable. I mainly got of SSRI to show "that I could", a decision I'm beginning to regret.

Is it possible this still could be withdrawal?

Thanks a lot
Love to you all
/Machinehead

Edited July 19, 2016 by scallywag
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July 9, 2016

Machinehead -- Welcome to Surviving Antidepressants (SA)

I hope you'll find the information in the SA forums enlightening and helpful for your taper. I'm sorry that you are in the position that you need the information, but am glad that you found us.

You were originally prescribed psychoactive drugs for anxiety and panic. Did you also have nightmares, mood swings, and muscle tension and pain then? If not, it's almost certain that your CNS (central nervous system) is adjusting, re-wiring so to speak, to the absence of Lexapro. Withdrawal symptoms can start within days of the last dose or build over weeks becoming noticeable after 2+ months.

Doctors, even psychiatrists, rely almost solely on information and research produced by drug manufacturers. "Big Pharma" has an interest in maximizing market share, profit, and shareholder value, not in the negative effects of their products. The information they provide to medical professionals is therefore significantly skewed to make the drugs look effective and harmless; a drug that causes adverse ("side") effects or that people have difficulty stopping doesn't look good. Your doctor, like many other MDs, is woefully undereducated and ill-informed about this.

Introduction to antidepressant withdrawal syndrome

What is withdrawal syndrome

Questions for you:
You said that the SSRI you last took is Lexapro. About your time on the Lexapro bus:

How long were you taking Lexapro?

What was your "maintenance" dose?

How did you taper lexapro?

What was your last dose and what date (an approximation is fine) did you take it?

When do your symptoms occur during the day? For each of them, please post whether it

- intensifies and what time of day that happens

- disappears and what time of day that happens

or

- stays fairly constant throughout the day.

Were you working out at the same level -- running 5k every other day and going to the gym -- when you were on Lexapro?

--- end of questions ---

What have you read about reinstating an SSRI? Here's our topic on that:

About reinstating and stabilizing to reduce withdrawal symptoms

Many people find that magnesium and omega-3 fatty acids help with symptoms of CNS destabilization. We've posted information about each in their own topics:

Magnesium, nature's calcium channel blocker

Omega-3 fatty acids (fish oil)

A request: Would you summarize your history in a signature -- drugs, doses, dates, and discontinuations & reinstatements, in the last 12-18 months particularly? Any drugs prior to that can just be listed with start and stop years. Please put your withdrawal history in signature

A tip: You may way want to follow this topic so that you get notifications when someone posts in your thread. Click the gray "Follow this topic" button. A dialog box appears: select one of the notify options, then click follow this topic in the dialog box.

That's probably enough reading and posting assignments. For now. Please have a look at the linked topics I've posted. Come back here and ask questions.

July 9, 2016

Questions for you:

You said that the SSRI you last took is Lexapro. About your time on the Lexapro bus:

How long were you taking Lexapro?

What was your "maintenance" dose?

How did you taper lexapro?

What was your last dose and what date (an approximation is fine) did you take it?

When do your symptoms occur during the day? For each of them, please post whether it

- intensifies and what time of day that happens

- disappears and what time of day that happens

or

- stays fairly constant throughout the day.

Were you working out at the same level -- running 5k every other day and going to the gym -- when you were on Lexapro?

--- end of questions ---

Hello and thank you so much for your detailed and concerned answer. This site is really a treasure for people in this kind of pain. Ill do my best to answer:

a) I was specifically on Lexapro from around 2008 until February this year. On SSRIs from 2002 (tried everyone I think, escitaloram worked the best)

b ) I took 15mg when the dose was at the highest but didn't tolerate it (Im really sensitive; bad drinker, get psychosis with pot, dizzy with tobacco etc...). Most of the time my dose was "only" 10mg. And I felt relatively well then. I also felt relatively well with 5mg.

c) I tapered first from 10mg to 5mg at once for like 2 years ago. (I went of benzo 2012 so that year was really hard and I had no plan on leaving SSRI close to that event). Stayed on 5mg during a year then down to 2,5mg for a month. Then 2,5mg each other day for a month. Then nothing.

d) My last dose Lexapro was 2,5mg the 15th February 2016.

My symptoms have varied (a lot) from the time I stopped the SSRI. Its lika reading the diagnosis table for GAD/Depression or something. But they rarely lasted more than a couple of weeks each at the beginning...and they were most intense pretty exactly when two months had past. Right now I could say:

-Feelings of surreality; this symptom is one that bothers me the most and is (I think) an indicator of anxiety. It may follow me throughout the day even though I otherwise feel calm. It intensifies and transforms into a panic attack eventually. Its like being without being there. Im really not present, almost like depersonalization (?).

-Muscle pain; specially in the back (shoulder blade area) and jaw. The jaw pain is causing problems with the hearing too (it "scrambles, rattles" within my left ear). I have been to the dentist for this and getting botox injection in September to relax the muscle.

-Tiredness; i usually feel immensely fatigued around lunch (this is the least of my concerns, it isn't painful).

-Hopelessness is pretty intense throughout the day, specially when symptoms show.

-Mood swings are also persistent, I can go from miserable to ok within minutes. Apparently for no reason. I can be doing the most pleasurable activities and feel miserable, anxious anyway. Its like the feeling is not connected to my reality.

-Anxiety; usually stronger in the evening, gets softer towards the night.

-Fatal thoughts; I often experience fatal thoughts when going to bed. I see my wife (she always goes to bed earlier than me) and imagine horrible things happening to her. I see her die. I see her in pain...its really hard to escape these thoughts. They fill me with terror.

-Difficulty falling asleep during the night, sometimes nightmares and a couple of panic attacks have occurred this last bad month. I sometimes choke in my sleep (wakens me up). This is really intense. I believe Im losing my mind when it happens. It luckily doesn't happen every day though, I would say it happens roughly each other day.

-Hyper sensitivity; this one is often linked to anxiety and makes lights and specially sounds feel as if they were super strong and annoying.

-Tremors in face (nerves twitching), happens sometimes.

I have worked out as much as Ive managed to during hard periods with have been mostly during my tapering phases. So yes, Ive worked out even with Lexapro.

I just wanted to add that everything isn't bad. Some good things that lighten up my day is my heightened sensitivity to beauty in all its forms, something that simply wasn't there with medication; I feel and appreciate nature, art, literature, music and people on a different level now. The sex is better and I'm a far more empathic person. I could be really cynical and cold blooded with the medicine.

I guess I'm a real human now but I simply don't possess the tools to manage life painlessly. Im 37 years now and I began taking pills when I was 21. I guess it will take time but...when will I be "me" and when will the withdrawal end? Everything would be so much easier If I only knew!

I also want to add that Im right now on vacation. I do exactly what I want everyday and "should" be feeling great. This is extremely frustrating because I felt better when I was all stressed out at work! WTF!

PS: English is not my native language so sorry if it is somewhat strange sometimes.

July 10, 2016

Machinehead,

Thank you for completing your signature. It would go from excellent to super-star by including both the date and the dose of your last bit of Lexapro.

The feeling of surreality you describe is also called depersonalization and/or derealization. It's unfortunately common in withdrawal from psych drugs.

More links to discussion topics about a few of the symptoms you've listed:

Depersonalization and derealization (DP/DR)

Self-help for Muscle pain

Face and jaw muscle pain and tension

The pain, the pain!

Sleep related issues:

Tips to help sleep

Severe Fatigue

Your nightmares and waking up could be surges of cortisol, an adrenal hormone. The CNS has many interconnections with the endocrine system (thyroid, adrenals, pituitary, ovaries/testes, etc.) Waking with anxiety or panic -- managing cortisol spikes

Your posts show an understanding of how forums work. You can find information about your other symptoms by

browsing the Symptoms and self-care forum
searching the boards' search function the top corner of every page. I generally use the advanced search that's available by clicking the wheel next to the search entry box because it allows me to specify to look only in topic titles and in particular forums.
using google or another web search tool and entering your symptom and "survivingantidepressants" as search terms

Thanks for posting what's going better for you since you discontinued. There's much more improvement in your future. Make the most of your vacation however that looks; if you can, just accept it exactly the way that it is.

P.S. I would never have guessed that you weren't a native English speaker, until you mentioned it. I had to scroll up to see where you live.

July 10, 2016

Thank you so much again, I'll read the information today.

About my original question; I guess you think I should not go back to a low dose Scallywag? You think this is still withdrawal (5 months after quitting)?

Thanks

July 10, 2016

It's definitely withdrawal. I'd wait for a mod to get back to you on the specifics of reinstatement as the chances of it being successful at 5 months off vary, but if they recommend reinstating a low dose it may well be worth giving it a try.

July 10, 2016

It's definitely withdrawal. I'd wait for a mod to get back to you on the specifics of reinstatement as the chances of it being successful at 5 months off vary, but if they recommend reinstating a low dose it may well be worth giving it a try.

You are probably right my friend though I've had a hard time finding information here about when YOU as an individual come in the picture. There is a lot of victimizing and self pity (feelings) but our main concern should be a logical/pragmatical one: how do I get better and suffer the least?

I mean; there was a reason we began with these things in the first place. We should not forget that. What we are experiencing is a withdrawal PLUS our original, bad state (if we haven't healed)...and how would we know if we are not still sick? We had the medicine dampening our original struggle so I guess the real deal breaker here is:

How do we know when the WS stops and our diagnose starts? It's impossible to make an informed decision about taking AD or not without knowing that.

I (we) need to know the answer before making decisions.

July 10, 2016

I can only speak for myself, but the only real symptom I had before starting medication was mild depression and a bit of social anxiety (I was shy, basically). Now I've got a list of symptoms as long as my arm, that I never had before starting on antidepressants. So for me, I'm sure that this is withdrawal, or more correctly, my brain trying to rebalance itself and function without the daily dose of fluoxetine it's become used to for 13 years.

I think there's quite a few threads/topics on withdrawal vs original symptoms/relapse so you may want to have a search of the site.

Alto has collated a lot of good info here: W hat is withdrawal syndrome?

July 10, 2016

Hi Machinehead, my story is similar to yours. I'm 38 yrs old and have been on Lexapro since I was 23 yrs old. I got off in March 2016 after a 6 month taper(which I know realize was not long enough nor done correctly). The first 3 months were hell for me. Everything hit me like a ton of bricks. Anxiety, heart palpitations, shaking, burning skin feeling, numbing and tingling in my left foot, fatigue, brain fog and then came the pain all over my body but remains constant on my right side. The last month I've noticed a few of my symptoms have completely gone away, some have gotten a little better but I'm still left with muscle and nerve pain. I almost feel like the pain has gotten worse and not better. I still sometimes think it's not related to withdrawal and maybe I have something seriously wrong with me. However, I've gotten an MRI and a ton of blood tests all saying I'm fine. So the pain must be withdrawal right? I'm like you and sometimes think I can't do this anymore and would rather be on a pill and live a normal life than in this hell. However, what if we are so close to feeling even better than before and are withdrawal symptoms are even closer to getting better? I would hate to think we went through that hell only to get right back on Lexapro. I don't know, just something to think about. Is your muscle pain everyday?

July 10, 2016

Machinehead,

Reinstatement is an something to try if your symptoms are unbearable and works some of the time. Some people experience relief from symptoms; some people experience no change; for others whose CNS are seriously destabilized, symptoms worsen. Regrettably no one can predict which group you'll be in.

About the original symptoms that initiated the prescriptions:

Modern medicine and psychiatry in particular has been hypnotized by pharmaceutical solutions. Got a symptom? Here's a prescription.

There are many situations where the drugs alleviate the original symptoms within weeks or months. Each time I've taken a psycho-neuro-active drug, I've seen noticeable improvement. What we should receive once we have improved and stabilized is counselling and coaching so that we develop of self-care skills and routines, identify the causes of stress in our lives to decrease stressors and increase our coping skills. Then when we're ready we should be guided to taper slowly off the drug by people educated about the possibility, symptoms and treatment of psych drug withdrawal. As you know, the second and third phases rarely occur in a coordinated manner.

A book, Mad in America, summarizes the modern history (1950s onward) of psychiatry and psychiatric medicines. (Author is Robert Whitaker) Prior to the discovery of a synthesized substance (drug) that appeared to relieve symptoms grouped and called "psychosis," most patients recovered from their symptoms called "depression" and "psychosis" with time and rest, and never had a recurrence.

... editing to add more

July 10, 2016

Thank you for your words everyone. I am considering what to do and will get back to you with my decision.

Going back to the AD is really my last choice, it's like a personal triumph but I also feel one should not suffer in vain. If only a fairy or something could tell me; "- Hey, this is withdrawal, you'll feel like **** during a whole year but you'll be better in time" ...my decision would be easy. I'd take the blows and wait but I don't have this fairy and life is so short. What if it isn't the meds?

I certainly feel more symptoms now than when I began with the meds, but isn it possible that my diagnose has evolved? It's been 17 years after all.

A last thing I forgot to tell you is that I began smoking a month ago and that I began to feel the relapse from withdrawal around the same time. I refuse to believe nicotine could have such a strong effect on neurotransmitters...could I be wrong? Could it really be the smoking that's destabilizing my withdrawal curve? I smoke around 5 cigs a day...I should maybe stop.

July 10, 2016

Hi Machinehead, my story is similar to yours. I'm 38 yrs old and have been on Lexapro since I was 23 yrs old. I got off in March 2016 after a 6 month taper(which I know realize was not long enough nor done correctly). The first 3 months were hell for me. Everything hit me like a ton of bricks. Anxiety, heart palpitations, shaking, burning skin feeling, numbing and tingling in my left foot, fatigue, brain fog and then came the pain all over my body but remains constant on my right side. The last month I've noticed a few of my symptoms have completely gone away, some have gotten a little better but I'm still left with muscle and nerve pain. I almost feel like the pain has gotten worse and not better. I still sometimes think it's not related to withdrawal and maybe I have something seriously wrong with me. However, I've gotten an MRI and a ton of blood tests all saying I'm fine. So the pain must be withdrawal right? I'm like you and sometimes think I can't do this anymore and would rather be on a pill and live a normal life than in this hell. However, what if we are so close to feeling even better than before and are withdrawal symptoms are even closer to getting better? I would hate to think we went through that hell only to get right back on Lexapro. I don't know, just something to think about. Is your muscle pain everyday?

I know the feeling and you have a strong point there...what if we are close? I wonder sometimes if there really isn't a way to tell what is what? A scan or something?

My muscle pain is everyday but goes in waves, today it's somewhat better.

July 10, 2016

I can only speak for myself, but the only real symptom I had before starting medication was mild depression and a bit of social anxiety (I was shy, basically). Now I've got a list of symptoms as long as my arm, that I never had before starting on antidepressants. So for me, I'm sure that this is withdrawal, or more correctly, my brain trying to rebalance itself and function without the daily dose of fluoxetine it's become used to for 13 years.

I think there's quite a few threads/topics on withdrawal vs original symptoms/relapse so you may want to have a search of the site.

Alto has collated a lot of good info here: W hat is withdrawal syndrome?

You obviously have a good argument there. My only doubt would be around the fact that sickness sometimes mutate. We are not the same people as back then. But again, your point is valid. Question is still; how can we know for sure?

July 10, 2016

Welcome, Machinehead.

We don't have a way to directly examine the nervous system, so there's no way to know for sure what's going on there, or whether it's going in a better direction or a worse direction.

As your symptom pattern is is not like any other psychiatric disorder and so very much like withdrawal syndrome, and follows going off the drug, the reasonable inference is that the nervous system dysregulation is related to going off the drug.

Here are your choices as I see them:

- Reinstate a small amount of escilatopram (perhaps 1mg-2mg), stabilize, and taper off by tiny amounts later.

- Another drug option: Many doctors would treat withdrawal syndrome with benzodiazepines. These are drugs that are addictive and require careful tapering later, with additional risk of withdrawal symptoms (since your nervous system is now susceptible to them).

- Wait and see, cope with symptoms. This could take months or years, there's no way to predict.

One thing you can do for the jaw ache is use a night guard to protect your teeth and ease the tension in your jaw. See our Symptoms and Self-care forum http://survivingantidepressants.org/index.php?/forum/8-symptoms-and-self-care/for suggestions about how to cope with symptoms.

July 10, 2016

Welcome, Machinehead.

We don't have a way to directly examine the nervous system, so there's no way to know for sure what's going on there, or whether it's going in a better direction or a worse direction.

As your symptom pattern is is not like any other psychiatric disorder and so very much like withdrawal syndrome, and follows going off the drug, the reasonable inference is that the nervous system dysregulation is related to going off the drug.

Here are your choices as I see them:

- Reinstate a small amount of escilatopram (perhaps 1mg-2mg), stabilize, and taper off by tiny amounts later.

- Another drug option: Many doctors would treat withdrawal syndrome with benzodiazepines. These are drugs that are addictive and require careful tapering later, with additional risk of withdrawal symptoms (since your nervous system is now susceptible to them).

- Wait and see, cope with symptoms. This could take months or years, there's no way to predict.

One thing you can do for the jaw ache is use a night guard to protect your teeth and ease the tension in your jaw. See our Symptoms and Self-care forum http://survivingantidepressants.org/index.php?/forum/8-symptoms-and-self-care/for suggestions about how to cope with symptoms.

Thank you so much. Your answer makes a lot of sense.

- First alternative is my first option if I don't get better soon...if I don't get convinced this is withdrawal only.

- Benzos are out of the question as they're nearly prohibited here in Sweden and since coming of them was hell on earth.

- Coping is my option if I get convinced this is only withdrawal, sadly, as you say, there's no way of knowing it.

I actually have a night guard, it helps somewhat but is far from enough because the muscle pain is there even without closing the jaw.

July 10, 2016

Machinehead, I think it's withdrawal but I know it's hard to believe it sometimes. I go back and forth a lot too. When I'm having a decent day I say to myself "I can get through this." When I'm having a bad day like today "I want to give up." Hopefully, we can all get through this with each others support.

Alto, is it natural in w/d to have muscle and nerve pain all over the body and can it get worse while other symptoms have gotten better?

July 10, 2016

It's as "natural" as any other symptom cluster is in withdrawal. Many people suffer the tension and pain in different parts of their bodies.

Machinehead, even if it is purely withdrawal, we frequently recommend trying a very small reinstatement of the drug to ease the symptoms. Otherwise, you could be in for a very long time coping with the symptoms.

As scallywag noted, fish oil and magnesium can be helpful. Magnesium in particular can ease tense muscles, as in Epsom salts baths or magnesium oil.

July 11, 2016

Hi everyone, I was at the doc today and this is what she said:

-Its definitely NOT withdrawal. The medicine is completely out of my system after 5 months (strange logic, withdrawal is just that...when the drug is out of the system, duh).

-This probably me experiencing the world and all its harshness without the medicine, the brain is learning how to cope.

-Its me relapsing but after all this time everything is different, hence the symptoms are different.

...well, for what its worth she agrees on not getting back and understood my dilemma.

Her solution:

Wait and see how you feel within the next 2-4 weeks. If symptoms persist/worsen; take a small dosage SSRI. She suggested Fluoxetine 10mg to begin with.

What do you think? I can't do more than be really surprised about how different docs think than you people here. They almost laugh at the thought of having withdrawal past 3 months. They claim theres no way such a serious characteristic of a medicine (withdrawal problems larger than 3 months as in Benzo i.e.) could get past national health controls, at least not here in Sweden.

July 11, 2016

Hi Machinehead-- The trick is these drugs don't work in the same manner as say pain killers. With painkillers and the like, yes it is a matter of getting the drug out of your system. But with ADs it's different. Ads work by making physical changes to the brain and nervous system. It only takes about a month for these changes to become established. Once established the the brain requires the presence of the drug to function properly. Remove the drug quickly, the changes remain but the brain can't control them because it doesn't have the drug it requires to do so. The entire purpose of a slow taper is to let the brain sort out those changes and repair them without causing it too much grief.

Because of your long term use and rapid taper you now have a good case of withdrawal syndrome. That is causing the symptoms you are feeling. There may be a small amount of your original condition showing up, but that would be overshadowed by the withdrawal. We have found through years of painful experience that the longer one waits to reinstate the trickier it is to do. We have found that a very small dose (i.e. 1-2mg) of the same medication is frequently effective. To change to a much larger dose of a different medication gives a very high risk of an adverse reaction, which will make WD syndrome seem like a walk in the park.

I suggest that you reread the thread on reinstating, About reinstating and stabilizing to reduce withdrawal symptoms

Doctors may laugh at our methods but we have a very good track record at undoing the messes they have created through their lack on knowledge.

July 11, 2016

Hi Machinehead-- The trick is these drugs don't work in the same manner as say pain killers. With painkillers and the like, yes it is a matter of getting the drug out of your system. But with ADs it's different. Ads work by making physical changes to the brain and nervous system. It only takes about a month for these changes to become established. Once established the the brain requires the presence of the drug to function properly. Remove the drug quickly, the changes remain but the brain can't control them because it doesn't have the drug it requires to do so. The entire purpose of a slow taper is to let the brain sort out those changes and repair them without causing it too much grief.

Because of your long term use and rapid taper you now have a good case of withdrawal syndrome. That is causing the symptoms you are feeling. There may be a small amount of your original condition showing up, but that would be overshadowed by the withdrawal. We have found through years of painful experience that the longer one waits to reinstate the trickier it is to do. We have found that a very small dose (i.e. 1-2mg) of the same medication is frequently effective. To change to a much larger dose of a different medication gives a very high risk of an adverse reaction, which will make WD syndrome seem like a walk in the park.

I suggest that you reread the thread on reinstating, About reinstating and stabilizing to reduce withdrawal symptoms

Doctors may laugh at our methods but we have a very good track record at undoing the messes they have created through their lack on knowledge.

Hello!

-My taper wasn't fast! I went from 10mg escitalopram to 0 in like 2 years. Last 5mg were relatively fast, like 6 months, being the last dose of 2,5mg cold turkey after like one month.

-You recommend me to reinstate the same drug? Thanks for the tip. 10mg fluoxetine is not a high dose though, it's a child's dose.

Is there any study supporting the thesis that reinstating a different SSRI would give a nightmarish reaction? I mean, people would not be able to change meds if that was the case...

I must say I thought you would recommend not taking AD again...is it really true reinstating is harder if I wait more? Isn't it always better to give the brain a chance to heal?

July 11, 2016

Hi everyone, I was at the doc today and this is what she said:

-Its definitely NOT withdrawal. The medicine is completely out of my system after 5 months (strange logic, withdrawal is just that...when the drug is out of the system, duh).

-This probably me experiencing the world and all its harshness without the medicine, the brain is learning how to cope.

-Its me relapsing but after all this time everything is different, hence the symptoms are different.

...well, for what its worth she agrees on not getting back and understood my dilemma.

Machinehead,

If I were given a vote I would say your doc is (a) wrong and (b ) an idiot.

The medicine being out of your system is not relevant to withdrawal. What happens is the changes the medicine creates in the brain, i.e., the modification of the serotonin and dopamine receptor activity that has to be "undone" after you get off the medicine. She does not understand even the most basic neurochemistry of the brain and, therefore, is not worth listening to.

We recommend you using the same drug you were on to reinstate (if you do) because it is NOT to deal with some underlying issue but to deal with the withdrawal that is being experienced. Introducing a new drug to the mix can create new symptoms and make it more difficult to understand what is really going on.

While reinstatement does not work for all, it is frequently successful, and we see the most success with the same med. The longer you wait the more we have seen the brain react badly to meds in general as the CNS can get destabilized from the withdrawal process.

5 months is hard to judge and results will vary to some degree. If, however, you remain uncomfortable, I would view it as a chance worth taking.

Best,

Andy

July 11, 2016

Hi everyone, I was at the doc today and this is what she said:

-Its definitely NOT withdrawal. The medicine is completely out of my system after 5 months (strange logic, withdrawal is just that...when the drug is out of the system, duh).

-This probably me experiencing the world and all its harshness without the medicine, the brain is learning how to cope.

-Its me relapsing but after all this time everything is different, hence the symptoms are different.

...well, for what its worth she agrees on not getting back and understood my dilemma.

Machinehead,

If I were given a vote I would say your doc is (a) wrong and (b ) an idiot.

The medicine being out of your system is not relevant to withdrawal. What happens is the changes the medicine creates in the brain, i.e., the modification of the serotonin and dopamine receptor activity that has to be "undone" after you get off the medicine. She does not understand even the most basic neurochemistry of the brain and, therefore, is not worth listening to.

We recommend you using the same drug you were on to reinstate (if you do) because it is NOT to deal with some underlying issue but to deal with the withdrawal that is being experienced. Introducing a new drug to the mix can create new symptoms and make it more difficult to understand what is really going on.

While reinstatement does not work for all, it is frequently successful, and we see the most success with the same med. The longer you wait the more we have seen the brain react badly to meds in general as the CNS can get destabilized from the withdrawal process.

5 months is hard to judge and results will vary to some degree. If, however, you remain uncomfortable, I would view it as a chance worth taking.

Best,

Andy

Thank you. I'm right now experiencing one of the worst anxiety bursts since I stopped. I feel like I'm losing it. For real. I'll call them tomorrow and will begin with 2,5mg escitalopram again.

I really tried and I cry because I feel this as a defeat. I thought my brain would be able to heal....and I've been able to hold on for five months, why doesn't this work?...why?

Why does this happen? My god this is terrible.

PS; just a last question, what if I just hold on to this (not taking)? I will suffer, I know...but isn't there a chance I WILL overcome this monster?

July 12, 2016

Hi MH-- 2 years isn't fast, but it's the last 5mg in 6 months and the ct from 2.5mg that are causing the problem. We have some charts around here somewhere that show that the majority of the effectiveness of these drugs happens in the first 7-8 mgs. This is why you're being hit so hard by the last bit of your taper and CT. A "baby dose" is a marketing ploy from the manufacturers.

We usually recommend reinstating the same drug because each of the drugs is just a little different and by switching between them a person frequently ends up with WD symptoms from the first and start up symptoms from the second. There is a process called a prozac bridge which crosstapers a person from their original drug to prozac, but the results are unpredictable and often unsatisfactory. If you read through many of the threads here you will find that very few people successfully changed from one drug to another. It gives us one of our biggest challenges for helping get people off of them.

Although we are very against ADs, because we have seen the pain and suffering that they cause, many times it is necessary to use them to minimize that pain. There are no studies to show our results, but we have thousands of case files that show a long slow taper is more successful and much lest painful than a fast taper or CT. Reinstating needs to be viewed as a strategic move to decrease suffering and not as a defeat.

If you were to just hold on as you are now, yes, eventually you would recover, but it would be a very long and painful journey. I have been tapering off of paxil for over four years now, it will be almost exactly five years by the time I finally get to "0". During my taper I have held my job as a Research Engineer, traveled, perused my hobbies and within limitations lived my life. The first several years were very symptomatic but there have been stead improvement the entire time. In contrast I have several friends who CTed from the same dose at the same time, they are still suffering debilitating symptoms.

I'm so glad you're going to try the 2.5mg RI. It will not by an instantaneous fix. It will take your body a minimum of four days just to realize that things have changed, then it could take up to several months for the symptoms to sort them selves out and settle down, but it will happen given time.

July 13, 2016

Machinehead,

Here's the paper that brassmonkey mentioned.

The paper is linked in the first post.

Why taper paper: dose-occupancy curves

The first SERT occupancy curves are on page 4 of the paper. The research looked at 4 SSRI drugs: Prozac (fluoxetine), Zoloft (sertraline), Celexa (citalopram) and Paxil (paroxetine). The researchers also studied the effect of Effexor (venlafaxine). As you might guess from the generic names, Lexapro (escitalopram) is closely related to Celexa (citalopram), so you can look at that one to understand what happens with citalopram, a weaker drug than escitalopram.

At any rate, the graphs in the paper that's linked in this topic show a very different patterns in neurotransmitter occupancy below and above what we call the "uh-oh" dose. Above the uh-oh dose, transmitter occupancy decreases with a very gentle slope as the dose decreases, it's like a beautiful beach gradually sloping to the sea. Below the uh-oh dose, transmitter occupancy drops off like a edge of a fjord, a cliff where there's just a vertical drop straight down to the ocean.

Using the analogy, your first 18 months you walked along the gentle slope leading to the cliff. You scaled down the top half of the cliff using ropes and good safety practices. Then you jumped from half-way down (2.5 mg) and hit the ocean HARD!

July 13, 2016

Machinehead,

Here's the paper that brassmonkey mentioned.

The paper is linked in the first post.Why taper paper: dose-occupancy curves

The first SERT occupancy curves are on page 4 of the paper. The research looked at 4 SSRI drugs: Prozac (fluoxetine), Zoloft (sertraline), Celexa (citalopram) and Paxil (paroxetine). The researchers also studied the effect of Effexor (venlafaxine). As you might guess from the generic names, Lexapro (escitalopram) is closely related to Celexa (citalopram), so you can look at that one to understand what happens with citalopram, a weaker drug than escitalopram.

At any rate, the graphs in the paper that's linked in this topic show a very different patterns in neurotransmitter occupancy below and above what we call the "uh-oh" dose. Above the uh-oh dose, transmitter occupancy decreases with a very gentle slope as the dose decreases, it's like a beautiful beach gradually sloping to the sea. Below the uh-oh dose, transmitter occupancy drops off like a edge of a fjord, a cliff where there's just a vertical drop straight down to the ocean.

Using the analogy, your first 18 months you walked along the gentle slope leading to the cliff. You scaled down the top half of the cliff using ropes and good safety practices. Then you jumped from half-way down (2.5 mg) and hit the ocean HARD!

Still, medicine wanted me to taper even faster than i did. Doctor told me to go CT from 5mg because that dose was so low.

What should I tell my doctors when I visit them? Should I tell them they're lying because of a site on the web? What would you do? I am really thankful this site exists with all the help, information and support but at the same time it puts me as a sufferer in the displeasure of choosing between you and medicine as the one offered by the system. It's really not a nice anxiety to add. I have no one to trust anymore I feel.

July 13, 2016

Hi MH,

Here are a couple of things you might like to read before speaking to your doctor:

What should I expect from my doctor about withdrawal symptoms?

How do you talk to a doctor about tapering and withdrawal?

July 13, 2016

Machinehead: I'm really sorry that you're suffering because of doctors' advice.

My doctors advised me to skip days. That was bad advice. I was essentially dropped from the cliff and to land on a trampoline 90 % of the way down every 4 days. I wrote them a letter telling that I was going back to a daily dose which I would be tapering at 10% per month and asked that if they wanted to talk with me about doing this to have the assistant call me to schedule an appointment.

More recently I printed the linked research study and delivered it to my doctor, with a note letting her know that I wanted her thoughts about it. I took the approach that "Hey, I came across this information and think it means that I should reduce my dose very slowly especially as my dose gets lower. Does it mean what I think it means?" At my next appointment we discussed it and I was pleasantly surprised by her positive reaction to learning about this research.

Your sense of your doctor(s) is infinitely better than mine so you're the best judge of whether you can have a similar conversation.

July 13, 2016

What should I tell my doctors when I visit them? Should I tell them they're lying because of a site on the web? What would you do? I am really thankful this site exists with all the help, information and support but at the same time it puts me as a sufferer in the displeasure of choosing between you and medicine as the one offered by the system. It's really not a nice anxiety to add. I have no one to trust anymore I feel.

Machine,

Doctors by and large are not "lying". Rather, they simply don't know. The difference between "good" doctors and "not so good" doctors is their willingness to learn new information. Only you can judge whether yours are open or closed-minded on this subject. I printed out and gave that study to my pdoc and she has a new appreciation for the issue.

Best,

Andy

July 13, 2016

Thank you for your words Scallywag and apace

I must confess I haven't reinstated yet. The symptoms have now mutated (as they did with benzo wd) and are now mainly panic/anxiety episodes. Yesterday night when trying to sleep I woke up at least 8 times choking PRECISLY when sleep was taking over.

Today morning I've already had a strong anxiety episode...it ended when I cried over my state. It's really hard not feeling self pity when panicking.

Does anyone know why this symptom migration happens? It has proven to last around 2weeks-1 month for me and the symptoms don't come back later. It's like the brain attacking me with different weapons begging me to reinstate. I'm just hoping the "panic weapon" doesn't last....it's really the most debilitating to me. It's the reason I began with medication in the first place back in 1999.

PS: I'll see my doctor this Friday.

July 13, 2016

Another question; what's the option if reinstatement doesn't work?

July 15, 2016

Hello everyone

I reinstated 2,5mg yesterday evening after several weeks in hell. Doctor told me I now probably was getting depressed and that my brain simply need the medicine as a diabetic needs insulin. He told me to go as fast as I wanted to, so here I am.

I reached the state where I feel taking a shower is scary and that I need my wife by my side all the time. That's when I "woke up".

This far I don't feel anything special. I'm somewhat calm because I see some kind of light at the end of the tunnel but quite anxious about the reinstatement. We will see how this develops. I feel very fragile.

July 15, 2016

I reinstated 2,5mg yesterday evening after several weeks in hell.

As we have all said, reinstatement will hopefully be a good option for you and you will find your footing once again. It can be really scary when you in the throes of withdrawal.

Note my emphasis, please.

Doctor told me I now probably was getting depressed and that my brain simply need the medicine as a diabetic needs insulin.

I hope you have read enough and know enough from this site to know that THIS is total and unmitigated bullsh*t.

60 years of effort by the psychiatric and pharmaceutical machinery has been conclusively unable to demonstrate any validity to the serotonin myth. Please do not believe the line of hooey coming from your doctor.

Getting off the meds is not easy and can take a long time. It is not without it's horrific struggles for some. The problems that are felt are not a result of the lack of medicine, except to the extent the brain has become acclimatized to having it and screams when it is taken away.

Hope you feel better soon, Machine.

Best,

Andy

July 15, 2016

Hello Machinehead....I hope your reinstatement works for you...I myself and trying to stabilize myself. It sounds like you were wise to not let things get any worse. Best wishes!

July 15, 2016

Hello Machinehead....I hope your reinstatement works for you...I myself and trying to stabilize myself. It sounds like you were wise to not let things get any worse. Best wishes!

Thank you and remember to reinstate if your struggle gets completely unbearable!

July 15, 2016

Are you doing better today?

July 15, 2016

Are you doing better today?

I would say I'm definitely not worse, witch means a lot right now. Just took my second 2,5mg I'll report tomorrow.

I have lots of nerve twitching around the jaw/mouth area...(?)

Machinehead: Should I go back?

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