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Gridley: introduction

imipramine escitalopram lorazepam

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#1 Gridley

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Posted 22 October 2016 - 08:58 AM

In 1986 I was prescribed a tricyclic antidepressant, 75 mg Imipramine PM, to slow bowel function and to relieve pain resulting from ulcerative colitis.  I was also put on 1 mg Lorazepam.  In 1991 I went CT off both the Imipramine and the Lorazepam, resulting in a terrible colitis flare-up.  After a few months I reinstated with success.   However, these medications, and everything else I did for the colitis ceased work about three years ago, and in January, 2015, I underwent surgery to remove my colon and replace with an internal J-pouch, which cured the colitis.  But that left me with the 30-year-long Imipramine situation.  In January, 2016, I began tapering the Imipramine 10% every three weeks, which went fine until I got down to 19 mg, then 12 mg, at which point I began experiencing severe anxiety as well as dizziness.  Realizing I had tapered too quickly, I updosed to 25 mg a month ago but have not as yet stabilised at this dose, as I am still experiencing considerable anxiety as well as insomnia.  Until September 23, my tapers were approximate percentages as I hadn't yet bought a scale.  I use the supplements Theanine and Nature's Balance Happy Camper to help with the anxiety, along with magnesium glycinate.  It's only been a month, but I'm a little worried that I am never going to stabilise at 25 mg.
 
In 2004, due to depression, I was put on a succession of SSRIs, in addition to the Imipramine, including Zoloft, Prozac and Effexor.  Lexapro 20 mg seemed to finally work and I remain on it at this time.
 
In 2011 I was prescribed 1 mg Lorazepam for insomnia, now 1.5 mg.

Edited by scallywag, 04 March 2017 - 03:11 PM.
tags

Gridley Introduction

 

Lexapro 20 mg. since 2004 for depression.  January 6, 2017, began 2.5% taper per week for four weeks with 2-week hold. Jan. 6 19.5 mg, Jan 13 19 mg, Jan. 20 18.5 mg, Jan. 27 18 mg, Feb. 3 two-week hold, Feb. 18 17.5  mg, Feb. 25 17.1 mg, Mar. 4 16.7 mg, Mar. 11 16.3mg, Mar. 18 two-week hold, April 1 15.9 mg, April 8 15.5 mg, April 15 15.1 mg, April 21 holding at 15.1 mg

 

Lorazepam 1 mg for colitis-related stress 1986.  CT 1992, reinstated a few months later.  CT approx. 2000 with no difficulty.  Since 2011 1mg for insomnia at bedtime. Decreased to .75 mg mid-2015 with no difficulty.  September 28, 2016, increased to 1.5 mg in a split dose of .5 mg, morning, afternoon and bedtime to alleviate anxiety.  April 21 old brand no longer available, began crossover to locally available brand, .5mg new brand AM dose, old brand PM and night dose

 

Imipramine 75 mg daily since 1986, prescribed for ulcerative colitis pain.  CT 1991, experienced bad flare-up of colitis, reinstated a few months later.  Jan. 27, 2016, began every-3-weeks 10% taper.  At 30 mg began experiencing dizziness; at 25 mg experiencing anxiety as well as insomnia; at 19 mg - more anxiety; at 15 mg - more anxiety; August 30 discovered SA, updosed to 25 mg and holding there.    

 

Supplements: theanine, fish oil, vitamin E, magnesium, Natural Balance Happy Camper, VSL3DS probiotic, vitamin D3, digestive enzyme, zinc, fo-ti.  50 mg Enerphos at bedtime, 50 mg when I wake in the the night. 


#2 Shep

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Posted 22 October 2016 - 10:15 AM

Hi, Gridley.

 

Welcome to SA.  I'm sorry for all you've gone through with colitis, but I'm glad the surgery cured it. We can help you set up a strategy for getting off the drugs that may be causing undue symptoms and give you better overall health. 

 

From your post and signature, this is what I have of your current situation:

 

Imipramine - 25 mg

 

Lexapro - 20 mg

 

Lorazepam - 1.5 mg

 

I'm wondering if your recent anxiety and dizziness may be a combination of imipramine withdrawal mixed with the side effects of Lexapro. As you decrease drugs that are more sedating, it can unleash side effects such as anxiety from more stimulating drugs like Lexapro.

 

Please read this thread, as it explains the concepts of "brakes" for sedating drugs and "accelerators" for stimulating drugs:

 

Taking multiple psych drugs? Which drug to taper first?

 

Please let us know if there is any reason you decided to come off the imipramine first.

 

For your reference here are the threads to coming off imipramine and Lexapro:

 

Tips for tapering off imipramine (Tofranil)

 

Tips for tapering off Lexapro (escitalopram)

 

Why taper by 10% of my dosage?

 

We don't have a thread specific to lorazepam. However, lorazepam is a benzodiazepine, and we have a members-only benzo forum where you can get more information:

 

Members only benzo forum

 

And here are some links to basic information about withdrawal:

 

 

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

 

Please start taking notes of your drug use and symptoms as described in this post:

 

Keep notes on paper about your drug dosages and daily symptom pattern

 

By writing down your symptoms after each dose, you may be able to tell a pattern of which drug may be causing which symptom, as well as a pattern of the "brakes" and "accelerators" as described in the first link I posted on which drug to taper first. 

 

It may be time to hold the imipramine and taper the Lexapro, but let's get a list of symptoms first.

 

This is your thread to document your symptoms and to ask plenty of questions. I'm glad you found us for support and information. 

 

 


Locked up and forced onto drugs as a teenager - misdiagnosed manic depressive.
Developed dependency and stayed on cocktails of drugs for nearly 30 years.

My Intro: Shep's Journey

Last drug cocktail: Seroquel, Halcion, Klonopin, Sonata, Vibrydd, and Dexetrine

After 30 years of polydrug use, completely med free May 22, 2015.

Remaining symptoms: dp/dr with memory problems and insomnia

 

I am not a medical professional, and this is not medical advice, but simply information based on my own experience, as well as other members who have survived these drugs. 

 

 


#3 Shep

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Posted 22 October 2016 - 10:31 AM

As a follow up, I placed all of your drugs in the drug interaction checker. Please see the report below:

 

https://www.drugs.co...1488-0,1013-565

 

Interactions between your selected drugs
Major imipramine  escitalopram

Applies to: imipramine, Lexapro (escitalopram)

Using escitalopram together with imipramine 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 contact your doctor immediately if you experience these symptoms during treatment. In addition, combining these medications 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 lorazepam  imipramine

Applies to: lorazepam, imipramine

Using LORazepam together with imipramine 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 lorazepam  escitalopram

Applies to: lorazepam, Lexapro (escitalopram)

Using LORazepam 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.

Switch to professional interaction data

No other interactions were found between your selected drugs.
Note: this does not necessarily mean no interactions exist. Always consult with your doctor or pharmacist.

 

 


Locked up and forced onto drugs as a teenager - misdiagnosed manic depressive.
Developed dependency and stayed on cocktails of drugs for nearly 30 years.

My Intro: Shep's Journey

Last drug cocktail: Seroquel, Halcion, Klonopin, Sonata, Vibrydd, and Dexetrine

After 30 years of polydrug use, completely med free May 22, 2015.

Remaining symptoms: dp/dr with memory problems and insomnia

 

I am not a medical professional, and this is not medical advice, but simply information based on my own experience, as well as other members who have survived these drugs. 

 

 


#4 Gridley

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Posted 22 October 2016 - 11:31 AM

**  moved from:  About reinstating and stabilizing to reduce withdrawal symptoms  **

 

After tapering the tricyclic imipramine from 75 mg over a nine month period, I began to experience severe anxiety at 19 mg but continued down to 12 mg before discovering this site and updosing to 25 mg exactly a month ago.  It was then that I bought a scale so that my doses are more precise.  I still have the anxiety but, I think, not as bad as when I had tapered too fast to 12 mg.  

 

1. I know this varies, but how long might it take before I stabilise at 25 mg?  

 

2.  How will I know I have stabilized?  Total lack of anxiety?  I had no anxiety at the beginning of my taper, a small amount at 25 mg, much more at 19 and   12 mg.

 

3.  Does updosing from 12 mg up to 25 seem too large a jump?  That is to say, did I mess up?

 

Finally, I'd love a bit of encouragement on this updose and my chances of stabilizing  I was doing so well at the higher doses of the taper and thought I'd be one of the lucky ones.  I live in South America and have no medical support.


Edited by ChessieCat, 22 October 2016 - 01:26 PM.

Gridley Introduction

 

Lexapro 20 mg. since 2004 for depression.  January 6, 2017, began 2.5% taper per week for four weeks with 2-week hold. Jan. 6 19.5 mg, Jan 13 19 mg, Jan. 20 18.5 mg, Jan. 27 18 mg, Feb. 3 two-week hold, Feb. 18 17.5  mg, Feb. 25 17.1 mg, Mar. 4 16.7 mg, Mar. 11 16.3mg, Mar. 18 two-week hold, April 1 15.9 mg, April 8 15.5 mg, April 15 15.1 mg, April 21 holding at 15.1 mg

 

Lorazepam 1 mg for colitis-related stress 1986.  CT 1992, reinstated a few months later.  CT approx. 2000 with no difficulty.  Since 2011 1mg for insomnia at bedtime. Decreased to .75 mg mid-2015 with no difficulty.  September 28, 2016, increased to 1.5 mg in a split dose of .5 mg, morning, afternoon and bedtime to alleviate anxiety.  April 21 old brand no longer available, began crossover to locally available brand, .5mg new brand AM dose, old brand PM and night dose

 

Imipramine 75 mg daily since 1986, prescribed for ulcerative colitis pain.  CT 1991, experienced bad flare-up of colitis, reinstated a few months later.  Jan. 27, 2016, began every-3-weeks 10% taper.  At 30 mg began experiencing dizziness; at 25 mg experiencing anxiety as well as insomnia; at 19 mg - more anxiety; at 15 mg - more anxiety; August 30 discovered SA, updosed to 25 mg and holding there.    

 

Supplements: theanine, fish oil, vitamin E, magnesium, Natural Balance Happy Camper, VSL3DS probiotic, vitamin D3, digestive enzyme, zinc, fo-ti.  50 mg Enerphos at bedtime, 50 mg when I wake in the the night. 


#5 Gridley

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Posted 22 October 2016 - 12:26 PM

Thanks, Shep.  That's very helpful.   I began tapering the Imipramine first because after the colectomy I felt I no longer needed it, since it had been prescribed for colitis issues.   I had also read about a linkage between tricyclics and dementia.  In addition, I was fearful of depression returning if I tackled the Lexapro.  As for the benzo, lorazepam, I had gone off it completely a couple of times in the past with little difficulty and so wasn't as concerned with it.

 

The Imipramine is an antidepressant, so wouldn't it be a brake?  Or are tricyclics different?  If so, it does seem I should have started with the Lexapro, since it's an accelerator.  However, I'm ten months in now on the imipramine.  As I said, I updosed from 12 mg to 25 mg a month ago and, as best as I can tell, have not stabilized--which brings me to my current symptoms.

 

The two worst symptoms are anxiety and insomnia, both of which began as I got below 25 mg. 

 

Regarding the insomnia, at bedtime I take .5 of my 1.5 lorazepam plus the imipramine and the lexapro, as well as 300 mg theanine and am able to get to sleep without difficulty.  However, I awaken after about 5-6 hours sleep and can't get back to sleep due to anxiety.  (I have a PS called Enerphos on order from the States to see if that helps the insomnia).  

 

Regarding the anxiety, I get up, take a walk, take my next .5 lorazepam, 300 more mg of theanine and a passionflower-kava supplement called Natural Balance Happy Camper.  This take the edge off the anxiety and sometimes totally eliminates it for a time.   The anxiety is not as extreme as when I was down to 12 mg imipramine but is, of course, unpleasant.  Mid-PM I take my other .5 lorazepam and more thiamine.  The anxiety seems more acute when

we go down to the village (we live in isolation on top of a mountain, a good place to deal with WD if you have to).  

 

One other symptom is occasional dizziness, which I read can accompany imipramine withdrawal.  This is not a big problem.

 

You mentioned stopping the imipramine taper and starting the lexapro.  Two things give me pause: I haven't stabilised on my updose of imipramine and also lexapro has a strong anti-anxiety component.

 

That's my story at the moment.  Any advice and guidance are welcome.  Thanks for taking the time to write.


Gridley Introduction

 

Lexapro 20 mg. since 2004 for depression.  January 6, 2017, began 2.5% taper per week for four weeks with 2-week hold. Jan. 6 19.5 mg, Jan 13 19 mg, Jan. 20 18.5 mg, Jan. 27 18 mg, Feb. 3 two-week hold, Feb. 18 17.5  mg, Feb. 25 17.1 mg, Mar. 4 16.7 mg, Mar. 11 16.3mg, Mar. 18 two-week hold, April 1 15.9 mg, April 8 15.5 mg, April 15 15.1 mg, April 21 holding at 15.1 mg

 

Lorazepam 1 mg for colitis-related stress 1986.  CT 1992, reinstated a few months later.  CT approx. 2000 with no difficulty.  Since 2011 1mg for insomnia at bedtime. Decreased to .75 mg mid-2015 with no difficulty.  September 28, 2016, increased to 1.5 mg in a split dose of .5 mg, morning, afternoon and bedtime to alleviate anxiety.  April 21 old brand no longer available, began crossover to locally available brand, .5mg new brand AM dose, old brand PM and night dose

 

Imipramine 75 mg daily since 1986, prescribed for ulcerative colitis pain.  CT 1991, experienced bad flare-up of colitis, reinstated a few months later.  Jan. 27, 2016, began every-3-weeks 10% taper.  At 30 mg began experiencing dizziness; at 25 mg experiencing anxiety as well as insomnia; at 19 mg - more anxiety; at 15 mg - more anxiety; August 30 discovered SA, updosed to 25 mg and holding there.    

 

Supplements: theanine, fish oil, vitamin E, magnesium, Natural Balance Happy Camper, VSL3DS probiotic, vitamin D3, digestive enzyme, zinc, fo-ti.  50 mg Enerphos at bedtime, 50 mg when I wake in the the night. 


#6 Shep

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Posted 22 October 2016 - 01:07 PM

Thanks for this well written post, Gridley. I'm going to respond to some of what you wrote. 

 

I had also read about a linkage between tricyclics and dementia.

 

A lot of these drugs can cause cognitive problems, not only the tricyclics, but also the benzodiazepines such as lorazepam.  However, many people find that once they come off the drug and give their mind and body time to heal, their memories and cognitive functioning return. 

 

As for the benzo, lorazepam, I had gone off it completely a couple of times in the past with little difficulty and so wasn't as concerned with it.

 

I'm glad you mentioned this, as many people experience something called "kindling" that can be quite severe with these kinds of prescription drugs. Many people find they are able to come off them once or twice, but each subsequent taper is harder because your CNS becomes more and more destabilized. 

 

This thread on limbic kindling explores this. Please note that adding and subtracted medications, supplements, certain foods, and even stress can cause kindling. Once your CNS is destabilized by these drugs, it's best to nurture your CNS by not subjecting it to too many substances or too many changes.

 

Limbic Kindling -- Hardwiring the brain for hypersensitivity

 

Regarding the anxiety, I get up, take a walk, take my next .5 lorazepam, 300 more mg of theanine and a passionflower-kava supplement called Natural Balance Happy Camper. 

 

I would be very cautious with the use of supplements during withdrawal and well into recovery. While some people do okay with them, others have setbacks. 

 

Please see this thread on Kava, as there is an interaction between kava and benzodiazepines:

 

Kava-Kava (Piper Methysticum)

 

While many (if not most) supplements cause problems during withdrawal, many members report success with the use of Omega 3 (fish oil) and magnesium, as they calm the CNS. Because some members do have problems with these, we recommend you only try one at a time at a low dose in case there are problems. These links will give more information:

 

King of supplements: Omega-3 fatty acids (fish oil)

 

Magnesium, nature's calcium channel blocker

 

My CNS is too sensitive to use supplements, but I get Omega 3 by eating fish almost every day and taking Epsom Salt baths for magnesium. Epsom salt baths are a way of getting magnesium that is gentler on the stomach. 

 

 

You mentioned stopping the imipramine taper and starting the lexapro.  Two things give me pause: I haven't stabilised on my updose of imipramine and also lexapro has a strong anti-anxiety component.

 

I'm going to ask the other moderators to weigh in because I'd like to get their feedback.  In the meantime, please take a look at the links and feel free to ask more questions. 

 

Two more questions for you - when did you add Kava into your drug cocktail? And did you add any other supplements into your cocktail that coincided with the recent increase in symptoms? It may just be imipramine withdrawal, but it's best to rule out anything else that may be going on. 

 

Thanks for your patience and for answering all our questions. 

 


Locked up and forced onto drugs as a teenager - misdiagnosed manic depressive.
Developed dependency and stayed on cocktails of drugs for nearly 30 years.

My Intro: Shep's Journey

Last drug cocktail: Seroquel, Halcion, Klonopin, Sonata, Vibrydd, and Dexetrine

After 30 years of polydrug use, completely med free May 22, 2015.

Remaining symptoms: dp/dr with memory problems and insomnia

 

I am not a medical professional, and this is not medical advice, but simply information based on my own experience, as well as other members who have survived these drugs. 

 

 


#7 Altostrata

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Posted 22 October 2016 - 01:48 PM

Hello, Gridley.

 

That waking and "anxiety" you experience after taking lorazepam at night is rebound anxiety from the benzo. This is a common adverse effect.

 

The anxiety might persist into the day.

 

I note you increased your lorazepam dosage to 1.5mg. This indicates you are at least physiologically dependent on the lorazepam. It is an addictive drug. You may have difficulty going off it. Dependency on benzos puts people between a rock and hard place -- staying on them and going off them can both be difficult.

 

Also, you should know "depression" is another common side effect of benzos. It is possible the "depression" that caused you to be prescribed Lexapro is another adverse drug effect. Or it could be connected to your illness. At any rate, it was 11 years ago and your internal ecology has changed. You may no longer "need" the Lexapro for "depression."

 

As you can see, the Lexapro-Imipramine combination is risky. Doctors are universally warned not to combine these two types of antidepressants but your doctor apparently didn't get the memo.

 

Given all of this, if I were you, I would consider reducing Lexapro rather than imipramine first. Lexapro is more likely to disrupt sleep.

 

On the other hand, because you seem to be having an adverse reaction to lorazepam, you may wish to deal with that first. Benzo balancing can be tricky. Please see  http://survivinganti...ing-discussion/
 

 

As you have been on these drugs for so long, very careful tapering is required.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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#8 Gridley

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Posted 22 October 2016 - 02:47 PM

Thanks, Shep and Alto,

 

Shep:  Two more questions for you - when did you add Kava into your drug cocktail? And did you add any other supplements into your cocktail that coincided with the recent increase in symptoms? It may just be imipramine withdrawal, but it's best to rule out anything else that may be going on. 

 

I've been on the Kava and Theanine on and off for a couple of years, well before the current anxiety.  I also added magnesium recently, but this was after the anxiety began.  I seem to be tolerating these well and they do cut the anxiety and help me get through the day.  I've been on omegas for 12 or 14 years now with no negative effect that I'm aware of.  By the way, Shep, my sincere congratulations for being drug-free!  You did great! 

 

Alto: I note you increased your lorazepam dosage to 1.5mg. This indicates you are at least physiologically dependent on the lorazepam. It is an addictive drug. You may have difficulty going off it. Dependency on benzos puts people between a rock and hard place -- staying on them and going off them can both be difficult.

 

I was doing fine on the .75 lorazepam taken at bedtime, but became so enervated with the anxiety that I split it into three doses of .5 each so I'd get some benefit during the daytime anxiety spells.  Probably it was unwise but I was desperate for relief.

 
Alto: Given all of this, if I were you, I would consider reducing Lexapro rather than imipramine first. Lexapro is more likely to disrupt sleep.
 
I am certainly willing to give the Lexapro tapering a shot.  However, I had no anxiety until I got to around 30 mg on the imipramine taper, with increasing anxiety until I got down to 12 mg.  My current continuing anxiety makes me wonder if the cause is that I haven't stabilized at the 25 mg updose I began a month ago.  Would it be wise to start in on the Lexapro taper with the imipramine taper still unstable at 25 mg?
 
Are you talking about staying at 25 mg or reinstating to the full 75 mg imipramine? If staying at 25, would you wait until I feel I have stabilized?   I guess it is a question of what is causing the anxiety.
 
 Let me add, Alto, what a great site this is.  I was in the Dark Ages, fumbling and guessing and messing up, before I discovered it.  You are providing a great service.

Gridley Introduction

 

Lexapro 20 mg. since 2004 for depression.  January 6, 2017, began 2.5% taper per week for four weeks with 2-week hold. Jan. 6 19.5 mg, Jan 13 19 mg, Jan. 20 18.5 mg, Jan. 27 18 mg, Feb. 3 two-week hold, Feb. 18 17.5  mg, Feb. 25 17.1 mg, Mar. 4 16.7 mg, Mar. 11 16.3mg, Mar. 18 two-week hold, April 1 15.9 mg, April 8 15.5 mg, April 15 15.1 mg, April 21 holding at 15.1 mg

 

Lorazepam 1 mg for colitis-related stress 1986.  CT 1992, reinstated a few months later.  CT approx. 2000 with no difficulty.  Since 2011 1mg for insomnia at bedtime. Decreased to .75 mg mid-2015 with no difficulty.  September 28, 2016, increased to 1.5 mg in a split dose of .5 mg, morning, afternoon and bedtime to alleviate anxiety.  April 21 old brand no longer available, began crossover to locally available brand, .5mg new brand AM dose, old brand PM and night dose

 

Imipramine 75 mg daily since 1986, prescribed for ulcerative colitis pain.  CT 1991, experienced bad flare-up of colitis, reinstated a few months later.  Jan. 27, 2016, began every-3-weeks 10% taper.  At 30 mg began experiencing dizziness; at 25 mg experiencing anxiety as well as insomnia; at 19 mg - more anxiety; at 15 mg - more anxiety; August 30 discovered SA, updosed to 25 mg and holding there.    

 

Supplements: theanine, fish oil, vitamin E, magnesium, Natural Balance Happy Camper, VSL3DS probiotic, vitamin D3, digestive enzyme, zinc, fo-ti.  50 mg Enerphos at bedtime, 50 mg when I wake in the the night. 


#9 Shep

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Posted 22 October 2016 - 04:18 PM

Hi, Gridley.

 

Thanks so much for your thorough answers.

 

I wouldn't increase your imipramine dose, but instead consider decreasing the Lexapro.  There may be two things going on - 1. the rebound anxiety coming from the lorazepam and 2. you may be getting some kind of "stimulating" effect from the Lexapro which is now more noticeable because the sedating effects of the imipramine are not as great because the dose has been lowered. 

 

The entire time you've been on Lexapro, you've also been on two sedating drugs. Even though imipramine is an antidepressant, it's a tricyclic antidepressant and many people find it sedating. So it's possible the imipramine was covering the stimulating effect of Lexapro. And as you've lowered the imipramine dose, you felt the stimulating effects of the Lexapro more. 

 

I've asked our benzo moderator, Wellness, to stop by your thread when she's online again to take a look at your Lorazepam use. 

 

In the meantime, here are some great non-drug coping skills. I used mindfulness and it really helped me a lot. A lot of our members find it helpful for sleep and anxiety.  You'll find information about that and many other non-drug coping skills in these links:

 

Sleep problems - That Awful Withdrawal Insomnia

 

 

Non-drug techniques to cope with emotional symptoms

 

If you are getting a stimulating effect from the Lexapro, you may want to move your Lexapro dose to earlier in the day to see if that will help with sleep. If you do this, please keep the dose the same for all your meds. It's best to make only one change at a time so you know what change is causing what symptom. 

 

Shep, my sincere congratulations for being drug-free!  You did great! 

 

Many thanks, Gridley. I did it after 30 years of drug use, and I'm sure you can come off your drugs, too. If you find some non-drug coping skills you like, such as mindfulness or yoga or whatever works for you, your experience coming off these drugs will be a much smoother ride. 

 

Wishing you much luck with your tapers. 


Locked up and forced onto drugs as a teenager - misdiagnosed manic depressive.
Developed dependency and stayed on cocktails of drugs for nearly 30 years.

My Intro: Shep's Journey

Last drug cocktail: Seroquel, Halcion, Klonopin, Sonata, Vibrydd, and Dexetrine

After 30 years of polydrug use, completely med free May 22, 2015.

Remaining symptoms: dp/dr with memory problems and insomnia

 

I am not a medical professional, and this is not medical advice, but simply information based on my own experience, as well as other members who have survived these drugs. 

 

 


#10 Gridley

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Posted 23 October 2016 - 05:50 AM

Thanks, Shep.  I appreciate your help.  

 

As long as I have your "on the line" could you tell me how to access my thread, "Gridley introduction."  Do I do it via "Introductions and Updates"?  This works fine as long as I have made a recent post and I appear near the top.  But I seem to disappear if I haven't made a post recently.  Is there some way to search "Introductions and Updates" for my name?  Or do I have to keep scrolling through page after page until I turn up?  As you can see, I'm not very computer literate.


Gridley Introduction

 

Lexapro 20 mg. since 2004 for depression.  January 6, 2017, began 2.5% taper per week for four weeks with 2-week hold. Jan. 6 19.5 mg, Jan 13 19 mg, Jan. 20 18.5 mg, Jan. 27 18 mg, Feb. 3 two-week hold, Feb. 18 17.5  mg, Feb. 25 17.1 mg, Mar. 4 16.7 mg, Mar. 11 16.3mg, Mar. 18 two-week hold, April 1 15.9 mg, April 8 15.5 mg, April 15 15.1 mg, April 21 holding at 15.1 mg

 

Lorazepam 1 mg for colitis-related stress 1986.  CT 1992, reinstated a few months later.  CT approx. 2000 with no difficulty.  Since 2011 1mg for insomnia at bedtime. Decreased to .75 mg mid-2015 with no difficulty.  September 28, 2016, increased to 1.5 mg in a split dose of .5 mg, morning, afternoon and bedtime to alleviate anxiety.  April 21 old brand no longer available, began crossover to locally available brand, .5mg new brand AM dose, old brand PM and night dose

 

Imipramine 75 mg daily since 1986, prescribed for ulcerative colitis pain.  CT 1991, experienced bad flare-up of colitis, reinstated a few months later.  Jan. 27, 2016, began every-3-weeks 10% taper.  At 30 mg began experiencing dizziness; at 25 mg experiencing anxiety as well as insomnia; at 19 mg - more anxiety; at 15 mg - more anxiety; August 30 discovered SA, updosed to 25 mg and holding there.    

 

Supplements: theanine, fish oil, vitamin E, magnesium, Natural Balance Happy Camper, VSL3DS probiotic, vitamin D3, digestive enzyme, zinc, fo-ti.  50 mg Enerphos at bedtime, 50 mg when I wake in the the night. 


#11 Shep

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Posted 23 October 2016 - 06:04 AM

Hi, Gridley.

 

It's okay, we can help you learn how to navigate the forum. Even those of us who are computer literate can have lots of trouble during withdrawal. 

 

Up at the top right of the screen, there's a box that says "Follow this topic". Click on the box and you'll see where it says "Receive notification". Click that box and then click "Follow this topic".

 

If you're receiving notifications via email, you'll receive an email. You can also easily locate your thread anytime someone has responded by clicking "View new content," which is located on the upper right corner of your screen. 

 

It may also help if you bookmark this Intro page on your computer. 

 

I also keep the link to my intro in my signature, and when I was first starting out on the forum, it helped me locate my thread. If you would like to do this, too, here is the link to your thread, which you can copy and paste in your signature:  

 

Gridley Introduction

 

Please let us know if you have any other questions. 

 

 


Locked up and forced onto drugs as a teenager - misdiagnosed manic depressive.
Developed dependency and stayed on cocktails of drugs for nearly 30 years.

My Intro: Shep's Journey

Last drug cocktail: Seroquel, Halcion, Klonopin, Sonata, Vibrydd, and Dexetrine

After 30 years of polydrug use, completely med free May 22, 2015.

Remaining symptoms: dp/dr with memory problems and insomnia

 

I am not a medical professional, and this is not medical advice, but simply information based on my own experience, as well as other members who have survived these drugs. 

 

 


#12 Gridley

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Posted 23 October 2016 - 06:29 AM

Thanks, Shep.  

 

I am going to shift my Lexapro to the morning, as you suggested, to see if that helps with sleep.  I'll do 10 mg this morning and 10 tonight, then 20 mg tomorrow morning and thenceforth.  I won't change the dosage at this point.  That will leave me taking the .5 mg lorazepam and the 25 mg imipramine at bedtime.  Then we can see about tapering the Lexapro.  If I do taper the Lexapro, would you suggest I stay constant at 25 mg imipramine?  I read in this site that it can be good to let the brain rest for perhaps three months after an updose.

 

I think I understand what you and Alto are saying: that the anxiety and insomnia may not be caused by lack of stabilization of the updose a month ago from 12 to 25 on the imipramine, but rather from effects of the Lexapro.


Gridley Introduction

 

Lexapro 20 mg. since 2004 for depression.  January 6, 2017, began 2.5% taper per week for four weeks with 2-week hold. Jan. 6 19.5 mg, Jan 13 19 mg, Jan. 20 18.5 mg, Jan. 27 18 mg, Feb. 3 two-week hold, Feb. 18 17.5  mg, Feb. 25 17.1 mg, Mar. 4 16.7 mg, Mar. 11 16.3mg, Mar. 18 two-week hold, April 1 15.9 mg, April 8 15.5 mg, April 15 15.1 mg, April 21 holding at 15.1 mg

 

Lorazepam 1 mg for colitis-related stress 1986.  CT 1992, reinstated a few months later.  CT approx. 2000 with no difficulty.  Since 2011 1mg for insomnia at bedtime. Decreased to .75 mg mid-2015 with no difficulty.  September 28, 2016, increased to 1.5 mg in a split dose of .5 mg, morning, afternoon and bedtime to alleviate anxiety.  April 21 old brand no longer available, began crossover to locally available brand, .5mg new brand AM dose, old brand PM and night dose

 

Imipramine 75 mg daily since 1986, prescribed for ulcerative colitis pain.  CT 1991, experienced bad flare-up of colitis, reinstated a few months later.  Jan. 27, 2016, began every-3-weeks 10% taper.  At 30 mg began experiencing dizziness; at 25 mg experiencing anxiety as well as insomnia; at 19 mg - more anxiety; at 15 mg - more anxiety; August 30 discovered SA, updosed to 25 mg and holding there.    

 

Supplements: theanine, fish oil, vitamin E, magnesium, Natural Balance Happy Camper, VSL3DS probiotic, vitamin D3, digestive enzyme, zinc, fo-ti.  50 mg Enerphos at bedtime, 50 mg when I wake in the the night. 


#13 Shep

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Posted 23 October 2016 - 08:14 AM

Shifting the Lexapro to the morning while keeping everything else steady sounds like a good plan. 

 

Then we can see about tapering the Lexapro.  If I do taper the Lexapro, would you suggest I stay constant at 25 mg imipramine?  I read in this site that it can be good to let the brain rest for perhaps three months after an updose.

 
Yes, keeping at 25 mg imipramine sounds like a good plan. Also, it's best to only taper one drug at a time, so keeping the Lorazepam steady is also important. 
 
I'm not sure you'll need three months after an updose, or any other change, but it really depends on how you're doing. This is why it's best to limit your supplements and to eat a clean diet. There are many factors that can cause changes in mood, sleep, appetite, etc, so the fewer variables in the equation the better.
 
I think I understand what you and Alto are saying: that the anxiety and insomnia may not be caused by lack of stabilization of the updose a month ago from 12 to 25 on the imipramine, but rather from effects of the Lexapro.
 
Yes, and I'll add the possibility of some rebound issues with the Lorazepam, as Alto discussed in her post above.
 
You've got a great game plan here, Gridley. Please let us know how you're doing as you move the Lexapro dose to earlier in the day. I really hope that helps.
 

Locked up and forced onto drugs as a teenager - misdiagnosed manic depressive.
Developed dependency and stayed on cocktails of drugs for nearly 30 years.

My Intro: Shep's Journey

Last drug cocktail: Seroquel, Halcion, Klonopin, Sonata, Vibrydd, and Dexetrine

After 30 years of polydrug use, completely med free May 22, 2015.

Remaining symptoms: dp/dr with memory problems and insomnia

 

I am not a medical professional, and this is not medical advice, but simply information based on my own experience, as well as other members who have survived these drugs. 

 

 


#14 Altostrata

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Posted 23 October 2016 - 09:30 AM

If I were you, I'd move the 10mg Lexapro maybe 2 hours earlier each day instead of the less gradual change in schedule.

 

It's also possible you got anxiety from withdrawal when you reduced the imipramine.

 

Lexapro is not an anti-anxiety drug. Most people find it activating, but everyone's different. Some people find Celexa, Lexapro's sibling, makes them sleepy.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

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#15 Gridley

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Posted 23 October 2016 - 10:12 AM

Many thanks.


Gridley Introduction

 

Lexapro 20 mg. since 2004 for depression.  January 6, 2017, began 2.5% taper per week for four weeks with 2-week hold. Jan. 6 19.5 mg, Jan 13 19 mg, Jan. 20 18.5 mg, Jan. 27 18 mg, Feb. 3 two-week hold, Feb. 18 17.5  mg, Feb. 25 17.1 mg, Mar. 4 16.7 mg, Mar. 11 16.3mg, Mar. 18 two-week hold, April 1 15.9 mg, April 8 15.5 mg, April 15 15.1 mg, April 21 holding at 15.1 mg

 

Lorazepam 1 mg for colitis-related stress 1986.  CT 1992, reinstated a few months later.  CT approx. 2000 with no difficulty.  Since 2011 1mg for insomnia at bedtime. Decreased to .75 mg mid-2015 with no difficulty.  September 28, 2016, increased to 1.5 mg in a split dose of .5 mg, morning, afternoon and bedtime to alleviate anxiety.  April 21 old brand no longer available, began crossover to locally available brand, .5mg new brand AM dose, old brand PM and night dose

 

Imipramine 75 mg daily since 1986, prescribed for ulcerative colitis pain.  CT 1991, experienced bad flare-up of colitis, reinstated a few months later.  Jan. 27, 2016, began every-3-weeks 10% taper.  At 30 mg began experiencing dizziness; at 25 mg experiencing anxiety as well as insomnia; at 19 mg - more anxiety; at 15 mg - more anxiety; August 30 discovered SA, updosed to 25 mg and holding there.    

 

Supplements: theanine, fish oil, vitamin E, magnesium, Natural Balance Happy Camper, VSL3DS probiotic, vitamin D3, digestive enzyme, zinc, fo-ti.  50 mg Enerphos at bedtime, 50 mg when I wake in the the night. 


#16 Wellness

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Posted 25 October 2016 - 04:44 AM

Gridley,

 

welcome to SA.

 

I'm mostly a benzo person and so the information I have often doesn't include the use of other medications, so please filter my opinions accordingly.

 

Your symptoms are very commonly associated with benzodiazepine tolerance or withdrawal.  Although you experienced increased anxiety and insomnia with a decrease in imipramine, you also made changes to the lorazepam shortly afterwards and that may have contributed to your increased anxiety.

 

Your description mentions the following lorazepam use:

 

1986   1mg Ativan

2011 1 mg Lorazepam

2016 1.5 mg Lorazepam 3 x 0.5 mg

 

You also mention that you were taking 0.75 mg at bedtime, which you changed to 0.5 mg.

 

It's not clear what your use of lorazepam has been over the last year, were you taking 1 mg or 0.75 mg?   Were you taking all of the lorazepam at bedtime ( 1 mg or 0.75 mg?) and none during the day?  When did you change to 1.5 mg - 3 x 0.50 mg?

 

Regardless of your exact recent usage of lorazepam, here are my opinions:

 

By splitting your lorazepam doses, you decrease the peak concentration in your blood.  Although the total amount of lorazepam that you are taking has increased, the peak has decreased.  For example, if you were taking 1 mg at bedtime, your peak concentration would still be higher than if yIou take 3 times 0.5 mg throughout the day.  If you are in tolerance from lorazepam, which you are almost certainly since it only takes a few weeks to become tolerant, then by splitting your dose you are effectively decreasing the peak concentration in your blood.  That is almost the same as a decrease in total dosage.

 

Although the imipramine may have triggered the initial anxiety and increased insomnia, by splitting the lorazepam dose, you decreased the lorazepam and metabolites available to your CNS. You are probably feeling withdrawal symptoms from the decreased lorazepam.  That may be the reason why the anxiety and insomnia did not get better and that one month later after the updose, the anxiety is still not better.  

 

I agree with Alto's opinion that you may be waking up in withdrawal because taking 0.5 mg lorazepam at bedtime just doesn't cover your CNS need for lorazepam and you wake up.   Since it takes about 2 hours for lorazepam to reach peak concentration, it explains why, in time after taking your second dose, you can get back to sleep.  Taking 0.5 mg twice in rapid succession allows you to manage until the your CNS needs the afternoon dose.  I also agree that benzodiazepine use, and benzodiazepine withdrawal typically cause depression. 

 

I've included a link to the Ashton Manual below, if you haven't read it yet, it is well worth the time it takes to read it.  Professor Ashton was a pioneer on benzodiazepine symptoms and withdrawal and remains relevant today. The only two points which are a bit dated are the use of antidepressants to help with benzo withdrawal.  Since writing the manual, antidepressants have not been shown not to help.  The other point is that her withdrawal taper protocol are often too rapid, especially for people who are currently experiencing withdrawal symptoms.

 

Link to the Ashton Manual:  http://www.benzo.org.uk/manual/

 

Regarding escitalopram, it has been shown to increase GABA (in rats, poor things), so it is GABAergic as are benzodiazepine. If it helps with anxiety, you can bet that you will get rebound anxiety from coming off of it.  Here is a random link that established a link between escitalopram usage and increase GABA in rats' brain.  

 

https://www.ncbi.nlm...pubmed/21383885


I do not have a medical background, any opinions are my own.

I took zopiclone ( z-drug) for situational insomnia. Three weeks later I was having panic attacks. I was given Benzos, A/D, anti-psychotics, "mood stabilizers" and I kept getting worse and worse. I got very sick.

I have been off all drugs now for over 5 years and I'm healing nicely.

#17 Gridley

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Posted 25 October 2016 - 06:59 AM

Hi, Wellness (and Alto and Shep, please feel free to add your thoughts),

 

Thanks for writing.  Here's what's happening lately.  In 2011, I was prescribed 1 mg Lorazepam for insomnia, taken at bedtime.  In mid-2015 I decreased the dosage to .75 with no noticeable problem.  

 

In January, 2016, I began a taper of 75 mg of the tricyclic antidepressant Imipramine, 10% every three weeks.  I did fine, with no noticeable adverse effects, until I got down to 19 mg then 12 mg, at which point I began experiencing anxiety and insomnia.  On September 23 I updosed to 25 mg.  Now a month later I am still experiencing anxiety and insomnia.

 

On September 28, I increased my Lorazepam dose from .75, which I was taking solely at bedtime, to 1.50 and split it into three .5 mg doses, one taken upon arising, one in mid-afternoon and one at bedtime.  My reasoning was that I was wasting the effect of the dose, since I wasn't sleeping anyway, and might as well try to get some anti-anxiety benefit during the day.  I had also read since Lorazepam has a short span it is best to take split doses.  As to my increasing the dose, I probably shouldn't have and should've just stayed at .25 X 3but I was desperate for relief from the anxiety.  I have found that taking the morning Lorazepam with theanine and a supplement called Natural Balance Happy Camper and the afternoon dose with just theanine reduces my anxiety considerably and often totally.

 

On the Lexapro front, Alto and Shep suggested I slowly move my 20 mg Lexapro to morning. This Sunday, October 23, I shifted 10 mg to morning and moved the other mg 2 hours earlier than bedtime.  I had the best night's sleep in quite a while, waking at 6:00 instead of 2:00 or 3:00.  It wasn't a deep sleep but it was uninterrupted and I felt great all day yesterday (still taking my .5 Lorazepam in am and pm with theanine.)  I was very encouraged.  In fact I felt so restful that I enjoyed two lovely naps, which may be the reason that last night I slept less well, awakening at 3 am.

 

The plan at this point is, after I've completed totally shifting the Lexapro to morning, to see how that works.  Then I will hold at 25 mg Imipramine and see how I feel.  If I'm feeling solid, I can begin a very slow taper of the activating AD, Lexapro.

 

That brings me back to the Lorazepam.  Should I hold with what I'm doing with the .5 split dose, which seems to be helping?  Should I shift it all back to one dose and, if so, taken when?  Should I cut back to the previous .75 from the current 1.50? 

 

Thanks, Wellness.


Gridley Introduction

 

Lexapro 20 mg. since 2004 for depression.  January 6, 2017, began 2.5% taper per week for four weeks with 2-week hold. Jan. 6 19.5 mg, Jan 13 19 mg, Jan. 20 18.5 mg, Jan. 27 18 mg, Feb. 3 two-week hold, Feb. 18 17.5  mg, Feb. 25 17.1 mg, Mar. 4 16.7 mg, Mar. 11 16.3mg, Mar. 18 two-week hold, April 1 15.9 mg, April 8 15.5 mg, April 15 15.1 mg, April 21 holding at 15.1 mg

 

Lorazepam 1 mg for colitis-related stress 1986.  CT 1992, reinstated a few months later.  CT approx. 2000 with no difficulty.  Since 2011 1mg for insomnia at bedtime. Decreased to .75 mg mid-2015 with no difficulty.  September 28, 2016, increased to 1.5 mg in a split dose of .5 mg, morning, afternoon and bedtime to alleviate anxiety.  April 21 old brand no longer available, began crossover to locally available brand, .5mg new brand AM dose, old brand PM and night dose

 

Imipramine 75 mg daily since 1986, prescribed for ulcerative colitis pain.  CT 1991, experienced bad flare-up of colitis, reinstated a few months later.  Jan. 27, 2016, began every-3-weeks 10% taper.  At 30 mg began experiencing dizziness; at 25 mg experiencing anxiety as well as insomnia; at 19 mg - more anxiety; at 15 mg - more anxiety; August 30 discovered SA, updosed to 25 mg and holding there.    

 

Supplements: theanine, fish oil, vitamin E, magnesium, Natural Balance Happy Camper, VSL3DS probiotic, vitamin D3, digestive enzyme, zinc, fo-ti.  50 mg Enerphos at bedtime, 50 mg when I wake in the the night. 


#18 Altostrata

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Posted 25 October 2016 - 04:32 PM

Good to hear.

 

It's best not to change two drugs at once. I would put off any changes in the benzo until you've finished moving the Lexapro.

 

What time of day do you take imipramine? Best to take it apart from Lexapro.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

"It has become appallingly obvious that our technology has surpassed our humanity." -- Albert Einstein

All postings © copyrighted.

#19 Shep

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Posted 26 October 2016 - 02:47 AM

Hi, Gridley.

 

I'm so glad to hear that you are sleeping better. 

 

Please let us know your drug timing and symptoms using this format:

 

Keep notes on paper about your drug dosages and daily symptom pattern

 

Knowing your symptoms in the context of the drugs taken throughout the day will help us guide you through the withdrawal process. Please also list your supplements. 


Locked up and forced onto drugs as a teenager - misdiagnosed manic depressive.
Developed dependency and stayed on cocktails of drugs for nearly 30 years.

My Intro: Shep's Journey

Last drug cocktail: Seroquel, Halcion, Klonopin, Sonata, Vibrydd, and Dexetrine

After 30 years of polydrug use, completely med free May 22, 2015.

Remaining symptoms: dp/dr with memory problems and insomnia

 

I am not a medical professional, and this is not medical advice, but simply information based on my own experience, as well as other members who have survived these drugs. 

 

 


#20 Gridley

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Posted 26 October 2016 - 05:37 AM

Hi, Alto and Shep,  

 

What time of day do you take imipramine? Best to take it apart from Lexapro.

 
I take the Imipramine before bed, around 10.  In two more days I will have finished moving the Lexapro to morning, so they will be at totally different times.
 
Please let us know your drug timing and symptoms using this format:

 

Will do.

 

Many thanks.


Gridley Introduction

 

Lexapro 20 mg. since 2004 for depression.  January 6, 2017, began 2.5% taper per week for four weeks with 2-week hold. Jan. 6 19.5 mg, Jan 13 19 mg, Jan. 20 18.5 mg, Jan. 27 18 mg, Feb. 3 two-week hold, Feb. 18 17.5  mg, Feb. 25 17.1 mg, Mar. 4 16.7 mg, Mar. 11 16.3mg, Mar. 18 two-week hold, April 1 15.9 mg, April 8 15.5 mg, April 15 15.1 mg, April 21 holding at 15.1 mg

 

Lorazepam 1 mg for colitis-related stress 1986.  CT 1992, reinstated a few months later.  CT approx. 2000 with no difficulty.  Since 2011 1mg for insomnia at bedtime. Decreased to .75 mg mid-2015 with no difficulty.  September 28, 2016, increased to 1.5 mg in a split dose of .5 mg, morning, afternoon and bedtime to alleviate anxiety.  April 21 old brand no longer available, began crossover to locally available brand, .5mg new brand AM dose, old brand PM and night dose

 

Imipramine 75 mg daily since 1986, prescribed for ulcerative colitis pain.  CT 1991, experienced bad flare-up of colitis, reinstated a few months later.  Jan. 27, 2016, began every-3-weeks 10% taper.  At 30 mg began experiencing dizziness; at 25 mg experiencing anxiety as well as insomnia; at 19 mg - more anxiety; at 15 mg - more anxiety; August 30 discovered SA, updosed to 25 mg and holding there.    

 

Supplements: theanine, fish oil, vitamin E, magnesium, Natural Balance Happy Camper, VSL3DS probiotic, vitamin D3, digestive enzyme, zinc, fo-ti.  50 mg Enerphos at bedtime, 50 mg when I wake in the the night. 


#21 Shep

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Posted 29 October 2016 - 07:17 AM

How are you doing now, Gridley? 

 

How is your sleep with the Lexapro moved to the morning? 


Locked up and forced onto drugs as a teenager - misdiagnosed manic depressive.
Developed dependency and stayed on cocktails of drugs for nearly 30 years.

My Intro: Shep's Journey

Last drug cocktail: Seroquel, Halcion, Klonopin, Sonata, Vibrydd, and Dexetrine

After 30 years of polydrug use, completely med free May 22, 2015.

Remaining symptoms: dp/dr with memory problems and insomnia

 

I am not a medical professional, and this is not medical advice, but simply information based on my own experience, as well as other members who have survived these drugs. 

 

 


#22 Gridley

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Posted 29 October 2016 - 11:58 AM

Shep,

 

Thanks for writing.

 

Today was the first day with the Lexapro totally moved to the morning.  Overall, my sleep is slightly better than before the move.  Curiously, the first two 

nights, when I had moved the Lexapro just two hours back, then four, I had more uninterrupted sleep than later on in the process.  The first night I slept from 10:00 until 6:00 and the second night from 9:20 until 5:30.  The next night I awoke at 4:00 but was able without difficulty to get back to sleep until 5:30.  The next night I awoke at 2:00 but got back to sleep until 5:30 and last night was about the same.  I have no idea why the length of my solid sleep decreased as the Lexapro got moved father and farther toward the morning.  I was going to give it three of four more nights with the Lexapro totally in the a.m. just to see before I introduced another change with the Lexapro taper.

 

Except for the sleep aspect, I am doing pretty well and have mostly peaceful days and even some days when I do a bit of gardening. There is some anxiety, of course, especially if there is a stress factor like too much socializing in the village (I know I have some social phobias).  I do wake up with anxiety.  I do a gentle walk, then take my .5 mg Lorazepam pus 600 mg theanine and three capsules of Natural Balance Happy Camper, which is an herbal supplement including passion flower.  I then meditate.  About an hour and a half later, the anxiety fades and, barring some stressor, this carries me fine into the mid-afternoon, when I take another .5 mg Lorazepam and 600 mg more theanine.  This is a high dose of theanine, but lower doses don't work for me and I am tolerating it well.  That is to say, it works in controlling the anxiety.  I have read that theanine and passion flower potentiate Lorazepam but can't say if it is true.  The evidence is my case would seem to point that way.  

 

The plan as we left it was that once I'd seen how the morning Lexapro affected my sleep, I would begin a slow taper of the 20 mg Lexapro, with the first taper being 2 mg less.  I would leave the divided dose of .5 mg Lorazepam in place, as well as the 25 mg Imipramine.  I don't have access to liquid Lexapro, recommended by Alto, and am not confident in making my own.  I do have a Gemini milligram scale that I read about on this site and have been using it with my imipramine taper.

 

 

I've read Alto's post on tapering Lexapro and had a question.  She says:

"If you find withdrawal symptoms from a 10% decrease to be too difficult, after 3-4 weeks decrease by a smaller amount."

Does this mean that if it is too difficult, I should updose, perhaps by 5% to 19 mg and hold there for approx. 4 weeks and then, if I'm doing okay, I can go down another 5% and thereafter decrease only by 5%, not 10%.

 

(One technical question: if I post something here, such as this reply to you, does Alto also see it?)

 

I have four days of my drug timings and symptoms log since you requested.  Do you want me to continue or go ahead and post it before I begin my Lexapro taper?

 

I just received a shipment from the States of Enorphos PS, to see if it will help with the insomnia.  I will hold off on using it so as to avoid too many changes at once.

 

Thanks again for your help.  This site is a lifesaver.

 

(One anecdote: a very good chiropractor just arrived in our little Ecuadorian village.  When I told him I was on antidepressants, he set about working on my adrenals, fearing they were nonfunctioning due to longtime AD us.  The next morning, I awoke with Cortisol anxiety through the roof.  I guess my adrenals are still functioning.)

 

Gridley


Gridley Introduction

 

Lexapro 20 mg. since 2004 for depression.  January 6, 2017, began 2.5% taper per week for four weeks with 2-week hold. Jan. 6 19.5 mg, Jan 13 19 mg, Jan. 20 18.5 mg, Jan. 27 18 mg, Feb. 3 two-week hold, Feb. 18 17.5  mg, Feb. 25 17.1 mg, Mar. 4 16.7 mg, Mar. 11 16.3mg, Mar. 18 two-week hold, April 1 15.9 mg, April 8 15.5 mg, April 15 15.1 mg, April 21 holding at 15.1 mg

 

Lorazepam 1 mg for colitis-related stress 1986.  CT 1992, reinstated a few months later.  CT approx. 2000 with no difficulty.  Since 2011 1mg for insomnia at bedtime. Decreased to .75 mg mid-2015 with no difficulty.  September 28, 2016, increased to 1.5 mg in a split dose of .5 mg, morning, afternoon and bedtime to alleviate anxiety.  April 21 old brand no longer available, began crossover to locally available brand, .5mg new brand AM dose, old brand PM and night dose

 

Imipramine 75 mg daily since 1986, prescribed for ulcerative colitis pain.  CT 1991, experienced bad flare-up of colitis, reinstated a few months later.  Jan. 27, 2016, began every-3-weeks 10% taper.  At 30 mg began experiencing dizziness; at 25 mg experiencing anxiety as well as insomnia; at 19 mg - more anxiety; at 15 mg - more anxiety; August 30 discovered SA, updosed to 25 mg and holding there.    

 

Supplements: theanine, fish oil, vitamin E, magnesium, Natural Balance Happy Camper, VSL3DS probiotic, vitamin D3, digestive enzyme, zinc, fo-ti.  50 mg Enerphos at bedtime, 50 mg when I wake in the the night. 


#23 scallywag

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Posted 30 October 2016 - 04:38 AM

I've read Alto's post on tapering Lexapro and had a question.  She says:

"If you find withdrawal symptoms from a 10% decrease to be too difficult, after 3-4 weeks decrease by a smaller amount."

Does this mean that if it is too difficult, I should updose, perhaps by 5% to 19 mg and hold there for approx. 4 weeks and then, if I'm doing okay, I can go down another 5% and thereafter decrease only by 5%, not 10%.

 

(One technical question: if I post something here, such as this reply to you, does Alto also see it?)

 

Gridley -- welcome from me too.

 

Your responses in your introduction thread or any thread on the forum are visible to site members. Alto will see your reply.

 

What's important in tapering is stability. If symptoms after a dose reduction are difficult, we suggest holding until they subside and making the next dose reduction smaller. We generally don't suggest updosing because updosing would be a second medication change in a short time period and because symptoms often diminish with time at the same dose.


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results
Cymbalta (brand name), 60 mg 2012 - 2015; 20 mg to 7 mg in 2016, exact doses and dates in this post;
2017: 6.3 (58 beads) Feb. 1; 5.6 mg (52) Feb. 22; 5.4 mg (50) Mar. 15; 5.1 mg (47) Mar. 25; 4.9 mg (45) Apr. 5; 4.5 mg (42) Apr. 14;
Current dose: 3.5 mg (32) 2017-Apr-26
+ Supplements: fish oil (1500 mg EPA/500 mg DHA), Vitamins: D3, K2, C; Minerals: Mg, Se, Cr, I, V
scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet


#24 Gridley

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Posted 30 October 2016 - 07:09 AM

Thanks, Scallywag.

 

Next week I'll start my taper of Lexapro 20 mg, which I've been on for some 14 years after a career-based (I think) major depressive episode.  It did seem to pull me out of it.  But now I'm ready to be free of it and the other drugs I'm on (but will be doing it slowly, slowly--I learned my lesson on a too-fast taper of Imipramine).  

 

I've had good results using the Gemini scale to reduce doses.  


Gridley Introduction

 

Lexapro 20 mg. since 2004 for depression.  January 6, 2017, began 2.5% taper per week for four weeks with 2-week hold. Jan. 6 19.5 mg, Jan 13 19 mg, Jan. 20 18.5 mg, Jan. 27 18 mg, Feb. 3 two-week hold, Feb. 18 17.5  mg, Feb. 25 17.1 mg, Mar. 4 16.7 mg, Mar. 11 16.3mg, Mar. 18 two-week hold, April 1 15.9 mg, April 8 15.5 mg, April 15 15.1 mg, April 21 holding at 15.1 mg

 

Lorazepam 1 mg for colitis-related stress 1986.  CT 1992, reinstated a few months later.  CT approx. 2000 with no difficulty.  Since 2011 1mg for insomnia at bedtime. Decreased to .75 mg mid-2015 with no difficulty.  September 28, 2016, increased to 1.5 mg in a split dose of .5 mg, morning, afternoon and bedtime to alleviate anxiety.  April 21 old brand no longer available, began crossover to locally available brand, .5mg new brand AM dose, old brand PM and night dose

 

Imipramine 75 mg daily since 1986, prescribed for ulcerative colitis pain.  CT 1991, experienced bad flare-up of colitis, reinstated a few months later.  Jan. 27, 2016, began every-3-weeks 10% taper.  At 30 mg began experiencing dizziness; at 25 mg experiencing anxiety as well as insomnia; at 19 mg - more anxiety; at 15 mg - more anxiety; August 30 discovered SA, updosed to 25 mg and holding there.    

 

Supplements: theanine, fish oil, vitamin E, magnesium, Natural Balance Happy Camper, VSL3DS probiotic, vitamin D3, digestive enzyme, zinc, fo-ti.  50 mg Enerphos at bedtime, 50 mg when I wake in the the night. 


#25 Gridley

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Posted 31 October 2016 - 08:22 AM

I'm confused and could use some help.

 

Yesterday was the second day of taking my entire 20mg Lexapro in the morning, separate from my nighttime dose of Imipramine, in an effort to improve sleep.  I have gained a hour of unbroken sleep, waking at 3:00 a.m. instead of 2:00, but today I awoke with more extreme anxiety than usual. Also, when I was in the early stages of moving the Lexapro dose, with 10 mg in the morning and the other 10 only 2-4 hours earlier, I could get back to sleep after waking

at 2 a.m. but now with 20mg in the morning, I can't.

 

As I said in my introduction, beginning in January, I tapered Imipramine from 75 mg over a nine-month period. I was fine throughout but I began to experience severe anxiety at 19 mg but continued down to 15 mg before discovering this site and updosing to 25 mg 5 weeks ago.  I theorized that I continued to have the anxiety and insomnia because I tapered too fast and have not yet stabilised on my updose to 25 mg.  My plan was to wait it out until I stabilised on the updose

 

Alto and Shep had a different explanation:

(Shep) I'm wondering if your recent anxiety and dizziness may be a combination of imipramine withdrawal mixed with the side effects of Lexapro. As you decrease drugs that are more sedating, it can unleash side effects such as anxiety from more stimulating drugs like Lexapro.

Thus, the insomnia and anxiety may not be caused by the lack of stabilization of the Imipramine updose but rather from the activating effects of the Lexapro and the possibility of rebound issues with the Lorazepam.  Under this view, I might never stabilise on my Imipramine update.
 
Wellness added:
Although the imipramine may have triggered the initial anxiety and increased insomnia, by splitting the lorazepam dose, you decreased the lorazepam and metabolites available to your CNS. You are probably feeling withdrawal symptoms from the decreased lorazepam.  That may be the reason why the anxiety and insomnia did not get better and that one month later after the updose, the anxiety is still not better.  
 
Based on Shep's suggestion, my plan was to begin to taper the Lexapro to reduce its accelerating effect, once the move to morning Lexapro was complete.
 
Here's my conundrum.  Everything I read about Lexapro is that it is prescribed for depression AND anxiety.  If, for me, it's helping with the anxiety, I'd be reluctant to reduce it (and to put another med into play).  Are you sure Lexapro is an accelerator?    I know everyone is different.  I just don't know if it's an accelerator for me.  I do know that this morning the anxiety was more intense when I awoke and that my sleep has only slightly improved after the move to A.M Lexapro.  On the other hand, if it is an accelerator for me, I might never stabilize on my Imipramine updose.
 
It seems to my I have these possible courses of action:
 
1. Go with the Lexapro-as-accelerator approach and begin my taper of Lexapro after a few more days of morning-only Lexapro.  No change to the Lorazepam.
 
2. Make no changes to the Lexapro and wait it out, hoping my Imipramine updose will stabilize, then continue the imipramine taper.  I know there are different views about the advisability of updosing on this site and that updosing is something of a crap-shoot. If I go this route, how long might it take before I stabilise at 25 mg?  Does "stabilise" mean symptom-free, no anxiety, as I was at the beginning of the taper?   Does updosing from 15 mg up to 25 seem too large a jump?  That is to say, did I mess up?  

  

3.  One further possibility with either course is that I begin to take Enorphos (successor to Seraphos) phosphatidylserine to lower cortisol and aid sleep.
 
I know we're in murky territory here, but any guidance would be appreciated.
 

 

 

 

 

 

My plan was once I had stabilised on the morning Lexapro, I would 

 

 

Given all of this, if I were you, I would consider reducing Lexapro rather than imipramine first. Lexapro is more likely to disrupt sleep.

 

I think I understand what you and Alto are saying: that the anxiety and insomnia may not be caused by lack of stabilization of the updose a month ago from 12 to 25 on the imipramine, but rather from effects of the Lexapro.

 
Yes, and I'll add the possibility of some rebound issues with the Lorazepam, as Alto discussed in her post above.
 

 

 

 

 

 

It's also possible you got anxiety from withdrawal when you reduced the imipramine.

 

 

 

I'm wondering if your recent anxiety and dizziness may be a combination of imipramine withdrawal mixed with the side effects of Lexapro. As you decrease drugs that are more sedating, it can unleash side effects such as anxiety from more stimulating drugs like Lexapro.

Please read this thread, as it explains the concepts of "brakes" for sedating drugs and "accelerators" for stimulating drugs:

 

 

Although the imipramine may have triggered the initial anxiety and increased insomnia, by splitting the lorazepam dose, you decreased the lorazepam and metabolites available to your CNS. You are probably feeling withdrawal symptoms from the decreased lorazepam.  That may be the reason why the anxiety and insomnia did not get better and that one month later after the updose, the anxiety is still not better.  

 

 

ou need to bring some order to the chaos. If you hold at one level (of all your drugs), you are at least giving your nervous system some stability. Given the constants -- which still may be causing adverse effects, etc. -- your nervous system will regroup over time.

 

 

Although the imipramine may have triggered the initial anxiety and increased insomnia, by splitting the lorazepam dose, you decreased the lorazepam and metabolites available to your CNS. You are probably feeling withdrawal symptoms from the decreased lorazepam.  That may be the reason why the anxiety and insomnia did not get better and that one month later after the updose, the anxiety is still not better.  

 

Regarding escitalopram, it has been shown to increase GABA (in rats, poor things), so it is GABAergic as are benzodiazepine. If it helps with anxiety, you can bet that you will get rebound anxiety from coming off of it.  Here is a random link that established a link between escitalopram usage and increase GABA in rats' brain.  


Gridley Introduction

 

Lexapro 20 mg. since 2004 for depression.  January 6, 2017, began 2.5% taper per week for four weeks with 2-week hold. Jan. 6 19.5 mg, Jan 13 19 mg, Jan. 20 18.5 mg, Jan. 27 18 mg, Feb. 3 two-week hold, Feb. 18 17.5  mg, Feb. 25 17.1 mg, Mar. 4 16.7 mg, Mar. 11 16.3mg, Mar. 18 two-week hold, April 1 15.9 mg, April 8 15.5 mg, April 15 15.1 mg, April 21 holding at 15.1 mg

 

Lorazepam 1 mg for colitis-related stress 1986.  CT 1992, reinstated a few months later.  CT approx. 2000 with no difficulty.  Since 2011 1mg for insomnia at bedtime. Decreased to .75 mg mid-2015 with no difficulty.  September 28, 2016, increased to 1.5 mg in a split dose of .5 mg, morning, afternoon and bedtime to alleviate anxiety.  April 21 old brand no longer available, began crossover to locally available brand, .5mg new brand AM dose, old brand PM and night dose

 

Imipramine 75 mg daily since 1986, prescribed for ulcerative colitis pain.  CT 1991, experienced bad flare-up of colitis, reinstated a few months later.  Jan. 27, 2016, began every-3-weeks 10% taper.  At 30 mg began experiencing dizziness; at 25 mg experiencing anxiety as well as insomnia; at 19 mg - more anxiety; at 15 mg - more anxiety; August 30 discovered SA, updosed to 25 mg and holding there.    

 

Supplements: theanine, fish oil, vitamin E, magnesium, Natural Balance Happy Camper, VSL3DS probiotic, vitamin D3, digestive enzyme, zinc, fo-ti.  50 mg Enerphos at bedtime, 50 mg when I wake in the the night. 


#26 Gridley

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Posted 31 October 2016 - 09:56 AM

I forgot to erase my notes on the previous post.  The post should end at "I know we're in murky territory here, but any guidance would be appreciated."

Sorry.


Gridley Introduction

 

Lexapro 20 mg. since 2004 for depression.  January 6, 2017, began 2.5% taper per week for four weeks with 2-week hold. Jan. 6 19.5 mg, Jan 13 19 mg, Jan. 20 18.5 mg, Jan. 27 18 mg, Feb. 3 two-week hold, Feb. 18 17.5  mg, Feb. 25 17.1 mg, Mar. 4 16.7 mg, Mar. 11 16.3mg, Mar. 18 two-week hold, April 1 15.9 mg, April 8 15.5 mg, April 15 15.1 mg, April 21 holding at 15.1 mg

 

Lorazepam 1 mg for colitis-related stress 1986.  CT 1992, reinstated a few months later.  CT approx. 2000 with no difficulty.  Since 2011 1mg for insomnia at bedtime. Decreased to .75 mg mid-2015 with no difficulty.  September 28, 2016, increased to 1.5 mg in a split dose of .5 mg, morning, afternoon and bedtime to alleviate anxiety.  April 21 old brand no longer available, began crossover to locally available brand, .5mg new brand AM dose, old brand PM and night dose

 

Imipramine 75 mg daily since 1986, prescribed for ulcerative colitis pain.  CT 1991, experienced bad flare-up of colitis, reinstated a few months later.  Jan. 27, 2016, began every-3-weeks 10% taper.  At 30 mg began experiencing dizziness; at 25 mg experiencing anxiety as well as insomnia; at 19 mg - more anxiety; at 15 mg - more anxiety; August 30 discovered SA, updosed to 25 mg and holding there.    

 

Supplements: theanine, fish oil, vitamin E, magnesium, Natural Balance Happy Camper, VSL3DS probiotic, vitamin D3, digestive enzyme, zinc, fo-ti.  50 mg Enerphos at bedtime, 50 mg when I wake in the the night. 


#27 Shep

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Posted 31 October 2016 - 10:11 AM

Hi, Gridley.

 

Thanks for the update. I've listed your questions. 

 

It seems to my I have these possible courses of action:

 

1. Go with the Lexapro-as-accelerator approach and begin my taper of Lexapro after a few more days of morning-only Lexapro.  No change to the Lorazepam.

 

It can take 4 days to a week for your CNS to settle down after making dose and / or timing changes, so it's really too soon to see where you're at. 

 

Please take careful notes using this format: 

 

Keep notes on paper about your drug dosages and daily symptom pattern

 

These notes will help guide your course of action. If you are having symptoms of anxiety, restlessness, etc in the morning and afternoon, that's an indication that Lexapro is activating. If it's making you calm and sleepy, then you'll want to note that, too. But again, give yourself at least a week to gauge your symptoms. 

 

 

2. Make no changes to the Lexapro and wait it out, hoping my Imipramine updose will stabilize, then continue the imipramine taper.  I know there are different views about the advisability of updosing on this site and that updosing is something of a crap-shoot. If I go this route, how long might it take before I stabilise at 25 mg?  Does "stabilise" mean symptom-free, no anxiety, as I was at the beginning of the taper?   Does updosing from 15 mg up to 25 seem too large a jump?  That is to say, did I mess up?  

 

 

Please take notes over the next few days to see how your sleep is.

 

"Stabilize" does not mean symptom-free, but more like a state where your symptoms are manageable with non-drug coping skills such as meditation, yoga, or distractions such as video games, gardening, or whatever you feel up to doing. For many of us, it's a lot of work. But by practicing these non-drug coping skills again and again, it sets the stage for how we need to live when we're off these drugs. Many of us (myself included) never learned how to self-soothe. It was only in the process of getting off drugs that I learned. 

 

 

3.  One further possibility with either course is that I begin to take Enorphos (successor to Seraphos) phosphatidylserine to lower cortisol and aid sleep.

 

I'm not familiar with Enorphos, but this thread may be helpful:

 

Phosphatydilserine, aka phosphatidyl serine (Seriphos or Cortiphos)

 

A caution with supplements - if you do add in supplements, start with a very small dose and only one supplement at a time. It's best to give your CNS 4 days to a week to stabilize.

 

With the number of drugs you're dealing with, please keep in mind that adding supplements will complicate things. It will be very hard to know if it's the drugs or the supplements that are causing problems, so please be cautious and keep good notes on your symptoms. 

 

My advice is to keep it as simple as possible. Before adding supplements, ask what can you subtract? For example, are you eating foods with caffeine or sugar? Are you eating small meals throughout the day in order to keep your blood sugar level?  

 

I hope this information is helpful. 


Locked up and forced onto drugs as a teenager - misdiagnosed manic depressive.
Developed dependency and stayed on cocktails of drugs for nearly 30 years.

My Intro: Shep's Journey

Last drug cocktail: Seroquel, Halcion, Klonopin, Sonata, Vibrydd, and Dexetrine

After 30 years of polydrug use, completely med free May 22, 2015.

Remaining symptoms: dp/dr with memory problems and insomnia

 

I am not a medical professional, and this is not medical advice, but simply information based on my own experience, as well as other members who have survived these drugs. 

 

 


#28 Gridley

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Posted 31 October 2016 - 10:53 AM

Shep,

 

Many thanks for your prompt and helpful response.

 

It can take 4 days to a week for your CNS to settle down after making dose and / or timing changes, so it's really too soon to see where you're at. 

That's very helpful.

 

Keep notes on paper about your drug dosages and daily symptom pattern

These notes will help guide your course of action. If you are having symptoms of anxiety, restlessness, etc in the morning and afternoon, that's an indication that Lexapro is activating. If it's making you calm and sleepy, then you'll want to note that, too. But again, give yourself at least a week to gauge your symptoms. 

 

I've been doing this for the past several days and will continue.  Thus far, the results have been all over the map, one day calm, the next not.  However, the results thus far may not be meaningful since, as you said, I'll need four days to a week for my CNS to settle down to the timing change.  My first day of 20mg Lexapro all in the morning was Saturday.  Of course, how I feel could be complicated by the fact that I take .5mg Lorazepam in the morning upon arising, with the Lexapro dose a bit later after breakfast, and another .5 Lorazepam in the afternoon--all of which, including the wearing off of the effects of the Lorazepam, could affect my anxiety level.  Then there's the possible withdrawal anxiety based on the changes to the Imipramine and to the Lorazepam. But I will continue to take careful notes.

 

A caution with supplements - if you do add in supplements, start with a very small dose and only one supplement at a time. It's best to give your CNS 4 days to a week to stabilize.

 

I will hold off until things stabilize.

 

For example, are you eating foods with caffeine or sugar? Are you eating small meals throughout the day in order to keep your blood sugar level?  

 

I consume no caffeine or sugar.  No, I'm not eating small meals throughout the day to keep my blood sugar level--but I will.

 

Gridley


Gridley Introduction

 

Lexapro 20 mg. since 2004 for depression.  January 6, 2017, began 2.5% taper per week for four weeks with 2-week hold. Jan. 6 19.5 mg, Jan 13 19 mg, Jan. 20 18.5 mg, Jan. 27 18 mg, Feb. 3 two-week hold, Feb. 18 17.5  mg, Feb. 25 17.1 mg, Mar. 4 16.7 mg, Mar. 11 16.3mg, Mar. 18 two-week hold, April 1 15.9 mg, April 8 15.5 mg, April 15 15.1 mg, April 21 holding at 15.1 mg

 

Lorazepam 1 mg for colitis-related stress 1986.  CT 1992, reinstated a few months later.  CT approx. 2000 with no difficulty.  Since 2011 1mg for insomnia at bedtime. Decreased to .75 mg mid-2015 with no difficulty.  September 28, 2016, increased to 1.5 mg in a split dose of .5 mg, morning, afternoon and bedtime to alleviate anxiety.  April 21 old brand no longer available, began crossover to locally available brand, .5mg new brand AM dose, old brand PM and night dose

 

Imipramine 75 mg daily since 1986, prescribed for ulcerative colitis pain.  CT 1991, experienced bad flare-up of colitis, reinstated a few months later.  Jan. 27, 2016, began every-3-weeks 10% taper.  At 30 mg began experiencing dizziness; at 25 mg experiencing anxiety as well as insomnia; at 19 mg - more anxiety; at 15 mg - more anxiety; August 30 discovered SA, updosed to 25 mg and holding there.    

 

Supplements: theanine, fish oil, vitamin E, magnesium, Natural Balance Happy Camper, VSL3DS probiotic, vitamin D3, digestive enzyme, zinc, fo-ti.  50 mg Enerphos at bedtime, 50 mg when I wake in the the night. 


#29 Gridley

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Posted 03 November 2016 - 10:26 AM

I am on a divided dose of .5 mg Lorazepam three times daily, one dose upon arising, one in early afternoon and one at bedtime.  Could anyone please tell me how important it is to take these doses at the same time each day?  Also, should the doses be the same number of hours apart.  How much leeway do I have in terms of varying the times? I ask about leeway because I find I do better taking them on an empty stomach and my meal times differ most days.

 

Does anyone have experience with whether taking Lorazepam on an empty or full stomach makes any difference?


Gridley Introduction

 

Lexapro 20 mg. since 2004 for depression.  January 6, 2017, began 2.5% taper per week for four weeks with 2-week hold. Jan. 6 19.5 mg, Jan 13 19 mg, Jan. 20 18.5 mg, Jan. 27 18 mg, Feb. 3 two-week hold, Feb. 18 17.5  mg, Feb. 25 17.1 mg, Mar. 4 16.7 mg, Mar. 11 16.3mg, Mar. 18 two-week hold, April 1 15.9 mg, April 8 15.5 mg, April 15 15.1 mg, April 21 holding at 15.1 mg

 

Lorazepam 1 mg for colitis-related stress 1986.  CT 1992, reinstated a few months later.  CT approx. 2000 with no difficulty.  Since 2011 1mg for insomnia at bedtime. Decreased to .75 mg mid-2015 with no difficulty.  September 28, 2016, increased to 1.5 mg in a split dose of .5 mg, morning, afternoon and bedtime to alleviate anxiety.  April 21 old brand no longer available, began crossover to locally available brand, .5mg new brand AM dose, old brand PM and night dose

 

Imipramine 75 mg daily since 1986, prescribed for ulcerative colitis pain.  CT 1991, experienced bad flare-up of colitis, reinstated a few months later.  Jan. 27, 2016, began every-3-weeks 10% taper.  At 30 mg began experiencing dizziness; at 25 mg experiencing anxiety as well as insomnia; at 19 mg - more anxiety; at 15 mg - more anxiety; August 30 discovered SA, updosed to 25 mg and holding there.    

 

Supplements: theanine, fish oil, vitamin E, magnesium, Natural Balance Happy Camper, VSL3DS probiotic, vitamin D3, digestive enzyme, zinc, fo-ti.  50 mg Enerphos at bedtime, 50 mg when I wake in the the night. 


#30 Shep

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Posted 04 November 2016 - 12:26 PM

Hi, Gridley.

 

Could anyone please tell me how important it is to take these doses at the same time each day? 

 

Yes, t's best to take your doses at the same time each day. It's less confusing to your CNS that way.

 

Also, should the doses be the same number of hours apart.  How much leeway do I have in terms of varying the times?

 

This depends. With Lorazepam, the half life is very short, so some people like to take 4 - 6 divided doses a day, sometimes more than that, sometimes less. I've known people to take a larger amount at night to help with insomnia, and then they use non-drug coping skills to handle symptoms such as anxiety during the day.

 

So there are some "best practice" guidelines, and then you can tweak it according to your symptoms.

 

HOWEVER, it's best not to mess around with your doses and the timing, as any change - whether it's a dose amount or the time you take it - can cause symptoms. 

 

Being as consistent as possible is key.

 

Does anyone have experience with whether taking Lorazepam on an empty or full stomach makes any difference?

 

I don't have any scientific articles about using benzos on an empty stomach, but I used to take Klonopin on an empty stomach, and I've known quite a number of people coming off benzos who also took it on an empty stomach. 

 

I would take it consistently the same way every day, though - if you want to take it on an empty stomach, then ALWAYS take it on an empty stomach.

 

I hope this helps. 


Locked up and forced onto drugs as a teenager - misdiagnosed manic depressive.
Developed dependency and stayed on cocktails of drugs for nearly 30 years.

My Intro: Shep's Journey

Last drug cocktail: Seroquel, Halcion, Klonopin, Sonata, Vibrydd, and Dexetrine

After 30 years of polydrug use, completely med free May 22, 2015.

Remaining symptoms: dp/dr with memory problems and insomnia

 

I am not a medical professional, and this is not medical advice, but simply information based on my own experience, as well as other members who have survived these drugs. 

 

 


#31 Gridley

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Posted 04 November 2016 - 01:05 PM

That's very helpful, Shep.  Thanks.  And thanks for reminding me about being consistent.


Gridley Introduction

 

Lexapro 20 mg. since 2004 for depression.  January 6, 2017, began 2.5% taper per week for four weeks with 2-week hold. Jan. 6 19.5 mg, Jan 13 19 mg, Jan. 20 18.5 mg, Jan. 27 18 mg, Feb. 3 two-week hold, Feb. 18 17.5  mg, Feb. 25 17.1 mg, Mar. 4 16.7 mg, Mar. 11 16.3mg, Mar. 18 two-week hold, April 1 15.9 mg, April 8 15.5 mg, April 15 15.1 mg, April 21 holding at 15.1 mg

 

Lorazepam 1 mg for colitis-related stress 1986.  CT 1992, reinstated a few months later.  CT approx. 2000 with no difficulty.  Since 2011 1mg for insomnia at bedtime. Decreased to .75 mg mid-2015 with no difficulty.  September 28, 2016, increased to 1.5 mg in a split dose of .5 mg, morning, afternoon and bedtime to alleviate anxiety.  April 21 old brand no longer available, began crossover to locally available brand, .5mg new brand AM dose, old brand PM and night dose

 

Imipramine 75 mg daily since 1986, prescribed for ulcerative colitis pain.  CT 1991, experienced bad flare-up of colitis, reinstated a few months later.  Jan. 27, 2016, began every-3-weeks 10% taper.  At 30 mg began experiencing dizziness; at 25 mg experiencing anxiety as well as insomnia; at 19 mg - more anxiety; at 15 mg - more anxiety; August 30 discovered SA, updosed to 25 mg and holding there.    

 

Supplements: theanine, fish oil, vitamin E, magnesium, Natural Balance Happy Camper, VSL3DS probiotic, vitamin D3, digestive enzyme, zinc, fo-ti.  50 mg Enerphos at bedtime, 50 mg when I wake in the the night. 


#32 Gridley

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Posted 08 November 2016 - 12:23 PM

DRUG TIMING AND SYMPTOMS

 

Since October 23, I've been slowly shifting my bedtime 20mg Lexapro to morning to see if this helps with insomnia and also to try to see if Lexapro has an activating or sedating effect on me.  Prior to this shift, I was able to get to sleep without difficulty but awoke after 5-6 hours and was unable to get back to sleep due to anxiety.  

 

October 23 

7:00 am   .5 mg Lorazepam plus theanine plus Natural Balance Happy Camper supplement

10:00 am  10 mg Lexapro

10:00 am   supplements: omega (with each meal), D3, E, B12, 200 mg magnesium glycinate, digestive enzyme with each meal, VSL3DS probiotic 1/2 packet after breakfast and dinner

No anxiety all morning

diarrhoea throughout day

2:00 pm     .5 mg Lorazepam plus theanine

No anxiety all afternoon

8:00 pm     10 mg Lexapro

10:00 pm    25 mg Imipramine, .5 mg Lorazepam, 200 mg magnesium.  Went to sleep.

Slept without interruption until 6:00

 

October 24

6:30 am      .5 mg Lorazepam plus theanine plus Natural Balance Happy Camper

10:00 am    10 mg Lexapro

10:00 am     supplements: same 

no anxiety all morning

diarrhoea throughout day

12:00 anxiety probably due to social interaction in village (generally there's much less anxiety when I stay on the mountain)

3:30 pm       .5 Lorazepam plus theanine

some anxiety continues in afternoon

6:00 pm        10 mg Lexapro   

10:00 pm       25 mg Imipramine, .5 mg Lorazepam, 200 mg magnesium.  Went to sleep.

Slept with some interruption until 5:30; no anxiety

 

October 25

Sorry, no notes except that I awoke at 3:00 with anxiety

 

October 26

7:10 am   .5 mg Lorazepam plus theanine plus Happy Camper

9:00 am   .10 mg Lexapro

10:00 am   supplements: same

no anxiety all morning

continued diarrhoea

12:00        .5 Lorazepam plus theanine

4:45 pm    10 mg Lexapro

no anxiety all afternoon and evening

9:20 pm    25 mg Imipramine, .5 Lorazepam, 200 mg magnesium.  Went to sleep.

Awoke at 4:00 am, got back to sleep until 5:30, awoke with more anxiety than yesterday

 

October 27

6:50 am   .5 Lorazepam plus theanine plus Happy Camper

no anxiety 

9:30 am   supplements same except eliminated 200 mg magnesium (diarrhoea soon abates)

10:00   10 mg Lexapro

12:00   calm returns

1:00    .5 mg Lorazepam plus theanine

2:45    anxiety returns

2:45 pm   10 mg Lexapro

9:45 pm   25 mg Imipramine, .5 Lorazepam.  Cut magnesium to 100 mg.  Went to sleep.

Awoke at 2:00 am but returned to sleep until 5:30.  Awoke with mild anxiety

 

October 28

7:05   .5 Lorazepam plus thiamine plus Happy Camper

9:45   no anxiety

9:45   supplements: same

10:15  10 mg Lexapro

12:00   anxiety (was in village)

12:45  10 mg Lexapro

1:15 pm  anxiety ceased once I returned home

no more diarrhoea

2:05 pm   .5 Lorazepam plus theanine

no anxiety all afternoon

9:40    25 mg imipramine, .5 Lorazepam, 100 mg magnesium

Awoke at 2:00, got a little more sleep after.  More anxious than yesterday.

 

October 29  First day with 20 mg Lexapro all in one morning dose

7:10   .5 Lorazepam plus theanine plus Happy Camper

Calm all morning in village

2:00 pm .5 Lorazepam plus theanine

10:30 pm   .5 Lorazepam, 25 mg Imipramine, 100 mg magnesium.  Went to sleep

Calm all day.

Slept until 3:00.  Less anxious upon arising.

 

October 30   Day 2 of morning Lexapro 

7:25 am   .5 Lorazepam plus thiamine plus Happy Camper

10:40 am   supplements: same

More anxiety than earlier today

10:40 am   20 mg Lexapro.  

12:00   Anxiety continues.

2:00 pm   .5 Lorazepam plus theanine

3:00 pm   anxiety continues

10:10  pm   25 mg imipramine, .5 Lorazepam, 100 mg magnesium.  Went to sleep.

Awoke at 3:00 am very anxious.

 

October 31   Day 3 of morning Lexapro

6:45 am   .5 Lorazepam plus theanine plus Happy Camper

9:00 am    no anxiety

11:00 am   20 mg Lexapro

11:00 am   supplements: same

Fairly calm

1:30 pm    .5 Lorazepam plus theanine

2:00 pm      some anxiety

2:15 pm       calm

2:55 pm     very calm

4:15 pm     calm and sleepy

6:00 pm   still calm

8:30 pm   PEACE

9:35 pm   25 mg Imipramine, .5 Lorazepam, 100 mg magnesium.  Went to sleep.

Slept until 1:30 pm, back to sleep until 5:00 am.  Awoke with anxiety but less than yesterday.

 

November 4   Day 4 of morning Lexapro

6:50 am   .5 Lorazepam plus thiamine plus Happy Camper

9:00 am   mild anxiety (going to village today?)

9:30 am   20 mg Lexapro

10:30 am   continued anxiety

11:45 am   (in village) worse anxiety

12:30 pm   .5 Lorazepam plus theanine 

12:50 pm   anxiety less (back home)

2:10 pm   calm returns

2:30 pm   sleepy

4:00 pm   ate yogurt with mangos - immediate anxiety

6:00 pm   anxiety fades

9:20 pm   25 mg Imipramine, .5 Lorazepam, 100 mg magnesium

Awoke at 2:00 am but went back to sleep until 6:45 am (7 3/4 hours sleep!)  Awoke with no anxiety

 

November 2   Day 5 of morning Lexapro

7:20 am   .5 Lorazepam plus theanine plus Happy Camper

9:00 am   supplements: same

9:00 am   20 mg Lexapro

10:25 am  calm

11:05 am  sleepy

2:00 pm  still calm

3:10 pm   .5 Lorazepam plus thiamine.  Still calm.

9:40 pm   25 mg Imipramine, .5 Lorazepam. Went to sleep.

Slept until 2:00 am, then a little more until 4:00 am.  Awoke with some anxiety.

 

November 3   Day 6 of morning Lexapro.

6:20 am   .5 Lorazepam plus thiamine plus Happy Camper

8:10 am   anxiety continues

9:30 am   calm

10:15 am  received news that friends may visit - anxiety ensues

10:15 am  supplements: same

10:15 am  20 mg Lexapro

anxious all morning

1:00 pm   .5 Lorazepam plus theanine

Anxiety all afternoon and evening after reading Dr. Shipko on SA about how some never recover

10:00 pm 25 mg Imipramine, .5 Lorazepam, 100 mg magnesium.  Went to sleep.

Awoke at 2:00 with worse anxiety

 

November 4   Day 7 of morning Lexapro

7:00 am   .5 Lorazepam plus theanine plus Happy Camper

9:15 am   calm

10:00 am   20 mg Lexapro

10:15 am   anxiety (going to town?)

10:40 am   mild yoga in town no help with continued anxiety

1:30 pm    same yoga pose at home brings peace

2:00 pm  .5 Lorazepam plus theanine

10:00 pm  25 mg Imipramine, .5 Lorazepam, 100 mg magnesium.  Went to sleep.  Peaceful most of day.

Slept until 6:00 am.  

 

November 5   Day 8 of morning Lexapro

7:05 am   .5 Lorazepam plus theanine plus Happy Camper

9:30 am   mild anxiety

10:00 am  20 mg Lexapro

10:00 am  supplements: usual

11:20 am  still mild anxiety

12:30 pm  anxiety gone

1:50 pm   still calm

2:05 pm   .5 Lorazepam plus theanine

a good day

9:45 pm   25 mg Imipramine, .5 mg Lorazepam, 100 mg magnesium.  Went to sleep.  Awoke with some anxiety.

 

November 6   Day 8 of morning Lexapro

7:00 am   .5 Lorazepam plus theanine plus Happy Camper

9:00 am   anxiety better

10:00 am  supplements: usual

11:20 am  (in village) mild anxiety

12:00       (returning from village) calm

2:00 pm   .5 Lorazepam plus less theanine

3:00 pm   ate mango--very sweet, anxiety

6:30 pm   no anxiety

9:15 pm  25 mg Imipramine, .5 Lorazepam, 100 mg magnesium

Slept solid until 6:45.  Awoke with no anxiety.

 

November 7   Day 9 of morning Lexapro

7:00 am   .5 Lorazepam plus theanine plus Happy Camper

10:15 am  supplements: same

10:15 am  20 mg Lexapro

no anxiety

12:00  anxiety (repairman on property and had to deal with renters)

1:00 pm no anxiety

2:00 pm TOTAL PEACE

2:00 pm  .5 Lorazepam and less theanine

A good afternoon with better appetite than usual

10:15 pm   25 mg Imipramine, .5 Lorazepam, 100 mg magnesium.  Went to sleep.

Slept until 5:30.  Awoke with some anxiety (trip planned to neighbouring city to deal with citizenship issues)

 

November 8   Day 10 of morning Lexapro.  

7:00 pm   .5 Lorazepam plus theanine plus Happy Camper

9:15 am   Calm despite journey

Calm continues as we lean in village that the road is closed due to bicycle race

11:00  20 mg Lexapro

2:00 pm   .5 Lorazepam plus theanine

calm

3:00  calm continues as I write this.

 

I'm still unclear whether the Lexapro is activating or sedating for me.  I googled "SSRI activating sedating" and got answers all over the map on Lexapro,with one site saying it was very activating and another two saying it was neutral, with both activating and sedating qualities.  And who know if they know anything anyway?  I do think my sleep is a bit better, but I can't tell whether the Lexapro is activating me in the morning and afternoon since there are so may other things going on.

 

That leaves me with the question of where to go from here.  I could continue my hold at 25 mg Imipramine and wait until I stabilise more there (I do think I'm better on that front) before doing anything.  I could begin a taper of Lexapro if it seems to be activating me.  Any guidance would be appreciated.


Gridley Introduction

 

Lexapro 20 mg. since 2004 for depression.  January 6, 2017, began 2.5% taper per week for four weeks with 2-week hold. Jan. 6 19.5 mg, Jan 13 19 mg, Jan. 20 18.5 mg, Jan. 27 18 mg, Feb. 3 two-week hold, Feb. 18 17.5  mg, Feb. 25 17.1 mg, Mar. 4 16.7 mg, Mar. 11 16.3mg, Mar. 18 two-week hold, April 1 15.9 mg, April 8 15.5 mg, April 15 15.1 mg, April 21 holding at 15.1 mg

 

Lorazepam 1 mg for colitis-related stress 1986.  CT 1992, reinstated a few months later.  CT approx. 2000 with no difficulty.  Since 2011 1mg for insomnia at bedtime. Decreased to .75 mg mid-2015 with no difficulty.  September 28, 2016, increased to 1.5 mg in a split dose of .5 mg, morning, afternoon and bedtime to alleviate anxiety.  April 21 old brand no longer available, began crossover to locally available brand, .5mg new brand AM dose, old brand PM and night dose

 

Imipramine 75 mg daily since 1986, prescribed for ulcerative colitis pain.  CT 1991, experienced bad flare-up of colitis, reinstated a few months later.  Jan. 27, 2016, began every-3-weeks 10% taper.  At 30 mg began experiencing dizziness; at 25 mg experiencing anxiety as well as insomnia; at 19 mg - more anxiety; at 15 mg - more anxiety; August 30 discovered SA, updosed to 25 mg and holding there.    

 

Supplements: theanine, fish oil, vitamin E, magnesium, Natural Balance Happy Camper, VSL3DS probiotic, vitamin D3, digestive enzyme, zinc, fo-ti.  50 mg Enerphos at bedtime, 50 mg when I wake in the the night. 


#33 Shep

Shep

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Posted 12 November 2016 - 04:43 PM

Hi, Gridley.

 

I'm still unclear whether the Lexapro is activating or sedating for me.

 

From what you've posted, you're sleeping better and it looks like you're anxiety is less. Does this sound right? If so, than you're on the right path. Try not to overthink it, which is easy to do during withdrawal. 

 

I would go by the improvements in sleep as being a good indication that you're taking it at the right time and channel your non-drug coping skills to help with the daytime anxiety. It's much easier to handle day time anxiety after you've gotten some sleep. Your post sounds good.

 

That leaves me with the question of where to go from here.  I could continue my hold at 25 mg Imipramine and wait until I stabilise more there (I do think I'm better on that front) before doing anything.  I could begin a taper of Lexapro if it seems to be activating me.  Any guidance would be appreciated.

 

Yes, I would hold and stabilize more. Now is a good time to continue working on your non-drug coping skills and let them become more "habit" so you'll be ready for any discomfort from a reduction.

 

I would taper the Lexapro before the imipramine. It's likely the imipramine is helping with sleep, so let's not mess with that just yet.

 

Please keep us updated. 


Locked up and forced onto drugs as a teenager - misdiagnosed manic depressive.
Developed dependency and stayed on cocktails of drugs for nearly 30 years.

My Intro: Shep's Journey

Last drug cocktail: Seroquel, Halcion, Klonopin, Sonata, Vibrydd, and Dexetrine

After 30 years of polydrug use, completely med free May 22, 2015.

Remaining symptoms: dp/dr with memory problems and insomnia

 

I am not a medical professional, and this is not medical advice, but simply information based on my own experience, as well as other members who have survived these drugs. 

 

 


#34 Gridley

Gridley

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Posted 13 November 2016 - 05:48 AM

Thanks, Shep.  As you suggest, I will hold at 25 mg Imipramine and stabilize more at present dosages.  That seems to be the prudent course


Gridley Introduction

 

Lexapro 20 mg. since 2004 for depression.  January 6, 2017, began 2.5% taper per week for four weeks with 2-week hold. Jan. 6 19.5 mg, Jan 13 19 mg, Jan. 20 18.5 mg, Jan. 27 18 mg, Feb. 3 two-week hold, Feb. 18 17.5  mg, Feb. 25 17.1 mg, Mar. 4 16.7 mg, Mar. 11 16.3mg, Mar. 18 two-week hold, April 1 15.9 mg, April 8 15.5 mg, April 15 15.1 mg, April 21 holding at 15.1 mg

 

Lorazepam 1 mg for colitis-related stress 1986.  CT 1992, reinstated a few months later.  CT approx. 2000 with no difficulty.  Since 2011 1mg for insomnia at bedtime. Decreased to .75 mg mid-2015 with no difficulty.  September 28, 2016, increased to 1.5 mg in a split dose of .5 mg, morning, afternoon and bedtime to alleviate anxiety.  April 21 old brand no longer available, began crossover to locally available brand, .5mg new brand AM dose, old brand PM and night dose

 

Imipramine 75 mg daily since 1986, prescribed for ulcerative colitis pain.  CT 1991, experienced bad flare-up of colitis, reinstated a few months later.  Jan. 27, 2016, began every-3-weeks 10% taper.  At 30 mg began experiencing dizziness; at 25 mg experiencing anxiety as well as insomnia; at 19 mg - more anxiety; at 15 mg - more anxiety; August 30 discovered SA, updosed to 25 mg and holding there.    

 

Supplements: theanine, fish oil, vitamin E, magnesium, Natural Balance Happy Camper, VSL3DS probiotic, vitamin D3, digestive enzyme, zinc, fo-ti.  50 mg Enerphos at bedtime, 50 mg when I wake in the the night. 


#35 Gridley

Gridley

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Posted 22 November 2016 - 07:50 AM

A couple of questions about insomnia.   Ten days after I completed the switch of Lexapro from bedtime to morning (Nov. 8), the number of hours I was  sleeping started out great, with 7 1/2 and 8 hour nights predominating.  Since November 14, though, the hours I'm able to sleep has been diminishing, down to three to five hours a night.  Can anyone offer an explanation?  Nothing has changed in my regimen.

 

To try to help with the insomnia, I want to start Neesby Enorphos (the new version of Seriphos).  I've read all the SA posts on Seriphos.  I'm going to start out with 100mg a night and see how that goes for 4 or 5 days.  When do you recommend I take it, at bedtime or when I wake up in the middle of the night?

 

Thanks to all for any thoughts you can offer.


Gridley Introduction

 

Lexapro 20 mg. since 2004 for depression.  January 6, 2017, began 2.5% taper per week for four weeks with 2-week hold. Jan. 6 19.5 mg, Jan 13 19 mg, Jan. 20 18.5 mg, Jan. 27 18 mg, Feb. 3 two-week hold, Feb. 18 17.5  mg, Feb. 25 17.1 mg, Mar. 4 16.7 mg, Mar. 11 16.3mg, Mar. 18 two-week hold, April 1 15.9 mg, April 8 15.5 mg, April 15 15.1 mg, April 21 holding at 15.1 mg

 

Lorazepam 1 mg for colitis-related stress 1986.  CT 1992, reinstated a few months later.  CT approx. 2000 with no difficulty.  Since 2011 1mg for insomnia at bedtime. Decreased to .75 mg mid-2015 with no difficulty.  September 28, 2016, increased to 1.5 mg in a split dose of .5 mg, morning, afternoon and bedtime to alleviate anxiety.  April 21 old brand no longer available, began crossover to locally available brand, .5mg new brand AM dose, old brand PM and night dose

 

Imipramine 75 mg daily since 1986, prescribed for ulcerative colitis pain.  CT 1991, experienced bad flare-up of colitis, reinstated a few months later.  Jan. 27, 2016, began every-3-weeks 10% taper.  At 30 mg began experiencing dizziness; at 25 mg experiencing anxiety as well as insomnia; at 19 mg - more anxiety; at 15 mg - more anxiety; August 30 discovered SA, updosed to 25 mg and holding there.    

 

Supplements: theanine, fish oil, vitamin E, magnesium, Natural Balance Happy Camper, VSL3DS probiotic, vitamin D3, digestive enzyme, zinc, fo-ti.  50 mg Enerphos at bedtime, 50 mg when I wake in the the night. 


#36 scallywag

scallywag

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Posted 22 November 2016 - 08:56 AM

I wish I could give you an explanation of this particular change in your symptoms.
 
You may want to search the site for others taking seriphos with a web search tool. Use the search terms:
seriphos site:survivingantidepressants.org


This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.
1997-1999 Effexor; 2002-2005 Effexor XR 37.5 mg linear taper, dropping same #beads/week with bad results
Cymbalta (brand name), 60 mg 2012 - 2015; 20 mg to 7 mg in 2016, exact doses and dates in this post;
2017: 6.3 (58 beads) Feb. 1; 5.6 mg (52) Feb. 22; 5.4 mg (50) Mar. 15; 5.1 mg (47) Mar. 25; 4.9 mg (45) Apr. 5; 4.5 mg (42) Apr. 14;
Current dose: 3.5 mg (32) 2017-Apr-26
+ Supplements: fish oil (1500 mg EPA/500 mg DHA), Vitamins: D3, K2, C; Minerals: Mg, Se, Cr, I, V
scallywag's Introduction
Online spreadsheet for dose taper calculations and nz11's THE WORKS spreadsheet






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