Stephygrrl: Need help getting off low dose Lexapro after 2 months

[mammaP]

Feb 2017  

 

zoloft 25mg  

lexapro 10mg

trazodone? 

lexapro 5mg

lexapro 2.5

Lunesta 

klonopin

 

March 2017

 

Lexapro 0 

Seroquel 1 dose

lexaapro 2.5

lexapro 5mg

Lexapro 2.5 

Remeron 7.5 

 

Remeron 15

Lunesta

Klonopin

 

 

The akesthia (sp) I had last night...just need to know if that's a red flag to stop reinstatement. I also had a very bad bloody nose last night and this morning coming out both sides. This was aligned more in timing to the remeron that I took yesterday evening. Need advice on how to stop. Was taking 7.5 for a week and 15 for 3 days. How do I calm my CNS?

I have condensed your history into a list. The problem is not that you took lexapro for pnly 2 months before quitting, it is the whole jumble of drugs that your doctor so recklessly prescribed for you. You are doing your very best to find a way to get stable again and things are getting worse. Note that you doubled the remeron abiut the same time as reinstating lexapro. This is a HUGE increase on an already struggling nervous system. 

Your nervous system will not settle with lots of changes, that is how we all got into this pychiatric mess. Doctors gave us a drug, then when there are reactions, add another drug for the reaction, then another and another until we end up with nervous systems so shook up we are like a bottle of soda that has been shook up, ready to explode! 

 

You really, REALLY need to keep doses stable, if you continue remeron, I would go back to 7.5, and keep to the tiny dose of lexapro. This will take time, imagine it was any other illness. I had septicaemia and was so sick I wasn't expected to get through that first night. I was in hospital for weeks and severely debilitated wjhen I was discharged. There was nothing that could be prescribed to help me get better after discharge. All the antibiotics and drugs saved my life but then my body had to recover in it's own time. This is similar, our bodies have to heal in their own time. The reinstatement will take time to take effect, and the remeron dosage will take time to reduce. You could decide to stop it but if you do you must stick with the decision because changing things is upsetting your nervous system even more.  You will get better, there is no doubt about it, with good self care and try not to panic. Let the symptoms ebb and flow, log them on paper but try not to panic or focus on them. We have been there, some of us are still there and we all know how this feels so can empathise. 

[Stephygrrl]

I will go back to 7.5 remeron for now. I am so scared to take Lexapro again because of the terrible reactions I had to it. Will the insomnia and shakiness get better if I continue even though it was a med I wasn't doing well on in the first place?

[Stephygrrl]

Or would I be better off on 15mg remeron and skip Lexapro? Although lex was the original med causing withdrawal even though my body hated it.

[Stephygrrl]

Just read a post from Alto about the struggle to drop an SSRI when taking a benzo, Is that what is causing all of this? Can we please pull in Alto to give her opinion on how to proceed? Do I reinstate, taper the benzo later or what to do? Stopping the benzo now would cause more disruption, yes? She also mentioned how adding Remeron is bad and that is what I am on now.

[Stephygrrl]

I have also read on here that if you are in a hyper alert stage it may not be wise to reinstate, which is where I am.

[Stephygrrl]

I am not sure if anyone noticed but I experience mild Akathisia after reinstating .5 lex yesterday. It passed but I also was shaking violently this morning. I have not taken another dose. Is that a sign I should steer clear of even low dose reinstatement?

[mammaP]

Stephy you doubled the dose of remeron which is quite strong, and took 2.5 lexapro instead of 0.5 when the pharmacy gave you the wrong figures. 

 

Your nervous system is reacting to the 2 high doses. I would stick with 7.5 remeron and 0.5 lexapro and keep the doses consistent. I know this is so hard for you and I wish I could sit with you to hold your hand and reassure you.  Sadly there is only so much we can do on the internet but we are doing our very best.   

 

Please take care and stick with regular doses so that your brain can adjust. Try not to obsess, searching and searching will bring up conflicting things. What we say to people is based on their specific circumstances and drug history. Every single one is different and some, like yours, are complicated by many changes that we have to unravel. As moderators we have discussed the best way forward for you and are all in agreement after studying the history. 

 

Are you still taking any klonopin or lunesta, any at all? No judgement we just need to know everything that you take in case they interract. 

Try to stay calm, this WILL get better.  

[JanCarol]

Stephy, I don't have much time right now - 

 

Please, stay on the 7.5 Remeron, stay on the tiny dose of Lexapro.

 

Please stay there for a week, and breathe.

 

What you are attributing to a "reaction," may just be rebound from all the drug changes that Mamma so patiently spelled out for you.

 

The only way we will know what is going on, is for you to stay on the same levels long enough for things to settle.

 

Making changes now, just sets you up for more hardship down the track.

 

I'm sorry I don't have more time tonight, but I'm thinking of you.  

 

Breathe.  I know it's happening to you, but we've seen this before - and staying on a stable dose for awhile is the best way we know to fix it.

 

Breathe some more.  It gets better, and patience and breathing will help you survive the tough parts.

[Stephygrrl]

Should a benzo be tapered before an SSRI? I ask because I have been taking .5 klonopin to help with sleep over the past couple of weeks. I would like to get off of it after I stabilize but was wondering the best order of things. I have not been taking lunesta or ambien, but may have to do that on occasion if I withdraw the benzo.

[Altostrata]

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

 

When do you take Klonopin? When you're taking a benzo, it's particularly important to track the time and amount of your doses and your symptoms.

[Shep]

Should a benzo be tapered before an SSRI? I ask because I have been taking .5 klonopin to help with sleep over the past couple of weeks. I would like to get off of it after I stabilize but was wondering the best order of things. I have not been taking lunesta or ambien, but may have to do that on occasion if I withdraw the benzo.

 

 

Stephy, you are moving into a timeframe where you may become dependent on Klonopin to get through this and then have taper off it later. Again, it only takes 2 or 3 weeks to develop a dependency on Klonopin. The same is true of Lunesta and Ambien. They all function in a similar manner in their affect on GABA receptors and the central nervous system. 

 

According to your post here, your daily Klonopin use started on April 15. So you've been using Klonopin daily for 11 days (before that, you mention periodic use for about 5 or 6 weeks at this point). 

 

Your options:

 

1.  Do a very rapid taper off Klonopin now at a rate of 25 - 50% over the next few days.

 

2.   Continue to use Klonopin and taper off it at a later time. Please do NOT add Lunesta or Ambien into the mix. 

 

I'm sorry you're having to deal with these drugs and the type of insomnia they cause, all while tending to a baby and having to work. But I fear your use of benzos and z-drugs is going to cause more problems. 

 

Benzos such as Klonopin, as well as the z-drugs like Lunesta and Ambien, are only meant to be used for a couple of weeks. After that, they can turn paradoxical. This means they will cause insomnia and anxiety, instead of alleviating it. 

 

If I were you, I would stick with that 2 week timeline. 

 

As Alto mentioned, please keep track of the time your take the Klonopin, the dose, and the symptoms. This can help determine if a paradoxical or any other problems are occurring. Please do this for all of your drugs. You may find the format described in this post to be helpful: 

 

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

 

Please keep updating. 

[Stephygrrl]

I take .25-.5 klonopin to sleep at night. My dr wants me taking it during the day too. I wasn't able to continue with the lexapro reinstatement. My reactions were so strong. Complete depersonalization, fog, and about 8 hours after taking that inner restlessness...followed by total body shakes when it was close to time for my next dose the following day.

 

I need to function so I don't lose my job. I know you all are not fond of swapping meds for meds, but would gabapentin be a slightly better option than klonopin? Or kava? I react much the same way to kava as I do to benzos

[Stephygrrl]

In terms of symptoms, it does relax me at night, but I do get morning anxiety, which I had even before using klonopin. the main anxiety I am feeling right now is caused by the lexapro withdrawal...physical tension, stomach tightening...

[Stephygrrl]

I should add I was in such a fog after day 2 of reinstatement that I got into a car accident and could not feel any sort of emotional reaction. It was that night that I had the akasthia and shaking the following morning.

[Stephygrrl]

Please let me know about swapping out klonopin. Again, I understand it's not the most desirable option, but to be able to work, sleep, and care for my baby is essential. My doctor is willing to prescribe gabapentin at low doses (.5ml) but I would prefer kava if it can work.

 

Also, what are your thoughts on the lexapro? Was .1ml too low a dose? The car accident and not feeling a thing from it was worrisome.

[Stephygrrl]

I should say I have continued dyskinesia both on and off lexapro. It's worse off though. Once I stabilize remeron at 7.5, would it be wise to to try reinstatement again or should I abandon? I just want to know what an adverse reaction is. The lack of emotion, and uncontrollable shaking really scared me after I reinstated the low dose. I couldn't care for my baby or think clearly.

[Isabel]

Stepphygrrl,

I cant say for sure but I also have the same uncontrollable shaking at times and I think at least in my case it's nervousness related not so much med related. I notice really being sensitive to body temperature irregularity and shaky from being cold then next could being sweaty. Could this be similar to what you describe?

[Stephygrrl]

I am also very sensitive to temperature. Has it gotten better for you? I have this type of shaking daily, but when I tried a reinstatement, I was shaking uncontrollably after it started leaving my system.

[Isabel]

I think I notice it anytime I make a change in dose. It did get better but I reduced a few days ago and noticed at dose time cold, goosebumps, shaken then had to cover up with blankets and then woke up sweating.

[Isabel]

Ok so I'm confusing you. I think it is caused by meds and nerves now that I think about it. Decreasing or increasing mess disrupts the nerves so of course disregulates temp

[Isabel]

I'm still trying to figure out all the symptoms and reasoning behind them as well! Feel for your situation with having a baby. Its a lot to demand and we put a lot of expectations on ourselves and don't take care of ourselves till this stuff happens.

[Stephygrrl]

Can a moderator advise on my question above about kava, gabapentin and reinstatement of lexapro once I stabilize remeron at 7.5? A genetic test showed I am an ultra rapid metabolized if lexapro which may explain why it hypes me up and then wears off by night. Are my reactions considered adverse (uncontrollable restlessness and shaking) or not? It was pretty scary. I would say I felt better when after I accidentally reinstated too high. I needed to take an Ativan bring me down but felt ok after that. If the reinstatement doesn't work, how will i know and how far back will it set me?

[Stephygrrl]

Oh my gosh, this is exactly what I am going through! Please read this article. How do I proceed????

 

https://www.hormonesmatter.com/kindled-brain-long-term-lexapro-use-reactions/

[Isabel]

This is a great but scary article. Anxious to see what the moderators say about a slow taper when the brain is being exposed to toxins and it seems the best is to get it out quickly.

[brassmonkey]

Please do not take any more Kava, or start to add it to the drug you're already taking.  It is well known to interact badly with psych drugs and we do not recommend its use at any time.

[Stephygrrl]

Has anyone seen a successful reinstatement when one reacted similar to the article I posted? That is my story! What to do?

[Altostrata]

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

 

When do you take Klonopin? When you're taking a benzo, it's particularly important to track the time and amount of your doses and your symptoms.

 

Stephy, we need to know your Klonopin schedule and your symptom pattern.

 

When you take a benzo like Klonopin, it's fairly common to have interdose rebound symptoms, which can be as bad as the shakes, anxiety surges, panic attacks, etc. If your system is already sensitized by other drug misadventures, the interdose symptoms can exacerbate those adverse reactions, too.

 

It's possible your symptoms are not from the Lexapro, but adverse effects of Klonopin. I know I've asked for your drug schedule and symptom pattern several times, yet we still don't have a clear picture of them.

 

You need this information to manage your symptoms. If you keep on going to the doctor begging for drugs, you will get prescriptions. We can't tell you what prescriptions to get, we don't know and we can't take that responsibility.

 

Please use search in the Introductions section to see peoples' experiences with gabapentin. If it was something we see helping people, we would tell you about it.

[Stephygrrl]

I take klonopin .25 at night along with remeron 7.5. I wake up at 3am in a panic and don't go back to sleep. I have anxiety throughout the day. Especially in the morning and late afternoon. Hand tremors and body twitches throughout the day and inability to sit still. My dr thinks I need to take klonopin in the morning too to keep it steady in my blood but I am fighting it.

[Shep]

Hi, Stephy.

 

If you are going to stay on Klonopin for now and taper off it later, than taking it twice a day may help with interdose symptoms. Klonopin's half-life is 18 - 50 hours and it reaches the peak plasma level at anywhere from 2 - 4 hours.

 

So you could be reacting to that from the Klonopin or it could be coming from the Remeron or your Lexapro reinstatement.

 

Also, how often are you taking Ativan? You mention taking Ativan in your post here and in this post here and here. Please note that Ativan is also a benzo and it has an extremely short half life of only 10 - 20 hours.  Alto mentioned interdose rebound symptoms from Klonopin and this is also true of Ativan. 

 

Please list your drugs and your symptoms using this format:

 

 

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

 

 

It's important to write down all of your drugs, the time you take them, and how they make you feel. We need to know when you take ALL your drugs, as it's possible the Ativan is adding to your anxiety with rebound symptoms. 

 

Please do this "daily symptom pattern" list daily according to the example in the link. 

[Stephygrrl]

Shep, I don't typically take Ativan. I used it in that one case when my anxiety was extreme and needed quick relief.

I am really hoping for advice on the lexapro reinstatement after reading that article I posted. I felt the same as he did. My previous experiences were exactly the same as his where I did well with it...but then tried it again and didn't react well but the dr said to keep taking and it it got worse. In instances like these, is reinstatement still appropriate? It seems like it works better when people have not had poor reactions to a drug. However, I don't want to end up in the same boat he is.

[Shep]

Please update your signature to reflect your Lexapro reinstatement. How many days has it been since you reinstated and at what dose? 

 

As JanCarol posted here, you really need to stay consistent and let your mind/body settle from all of the changes you've been through. 

 

Also, you mention taking .25 - .5 mg of Klonopin in this post. Please stay on one consistent dose. 

 

I'm glad you're not taking Ativan regularly. I would dispose of it so it's not tempting, along with the z-drugs you aren't taking any more.

 

I am really hoping for advice on the lexapro reinstatement after reading that article I posted. 

 

 

The article mentions "the kindled brain". All of the changes you've done in the past and the ones you continue to do now (including irregular benzo use) can lead to kindling. 

 

Limbic Kindling -- Hardwiring the brain for hypersensitivity

 

This is why it's very important to be as consistent as you can and not make changes or add in supplements at this point. 

 

Please give your mind and body time to settle down from all of the chemical chaos you've endured. 

 

And again, if you could give a daily list in this format, it will really help and we won't have to keep asking the same questions and can give you better - and safer - feedback. 

 

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

[Stephygrrl]

I reacted very poorly to the initial reinstatement so I did not continue. I even got into a car accident. I only reinstated lex for 2 days. After the second day, I experienced akasthia about 8 hours after my dose and the next morning was shaking uncontrollably. I really do need to sleep to work and care for my child. Jan mentioned trying to keep z drugs to an minimum like twice a week. Is that ok?

[Stephygrrl]

I reinstated at .1ml

[Stephygrrl]

And am i better off taking the klonopin am and pm to keep a steady state then?

[Stephygrrl]

With the reinstatement I keep asking if that was an adverse reaction I had. I literally had no emotion, couldn't think straight, and then had the akasthia 8 hours after the dose and extreme shaking the next day. I read to stop immediately if adverse reaction and didn't know if that was adverse

[JanCarol]

Hey Stephy - 

 

Should a benzo be tapered before an SSRI? I ask because I have been taking .5 klonopin to help with sleep over the past couple of weeks. I would like to get off of it after I stabilize but was wondering the best order of things. I have not been taking lunesta or ambien, but may have to do that on occasion if I withdraw the benzo.

 

Polydrugs? Taper off the Antidepressant First!

 

I need to function so I don't lose my job. I know you all are not fond of swapping meds for meds, but would gabapentin be a slightly better option than klonopin? Or kava? I react much the same way to kava as I do to benzos 

 

Kava hits on the GABA receptors and then some.  Kava is metabolised in the liver and should not be used for more than 2 weeks - JUST like a benzo.  Please listen to Brassmonkey when he says it is not a supplement we recommend!

 

Likewise, Gabapentin is a solution that I am helping other people who are suffering from.  You will need to taper that one, too, regardless of what your doctor says.  Either, your doctor is eager to throw drugs as solutions to your problems, or you are so agitated when you talk to your doctor, he is desperate to try anything that might help (whether it will or not). 

It is important to be calm when in the doctor's office.  To do otherwise is to land on a bunch of drugs - or worse - end up in hospital.  How would you care for your baby and job then?

 

I should add I was in such a fog after day 2 of reinstatement that I got into a car accident and could not feel any sort of emotional reaction. It was that night that I had the akasthia and shaking the following morning. 

 

This was likely a reaction to the large dose of 2.5 mg.  You need to be able to survive symptoms, wait them out, accept them, go through them.  Now, the experiment tells us nothing, other than you reacted to a dose of 2.5 mg.  We don't know if you could've gotten better on a tiny reinstatement - and - every time you go on and off - it makes changes to your brain and body.

 

Here's what Rhiannon says:

Each time the drugs are switched around--whether they are cut, or increased, or changed to other meds, et cetera--whatever processes have already been happening have to try to stop and go the other direction. (Or maybe a couple of other directions.) 

 

This is not simple. This causes more trauma, more chemical chaos, more damage. Processes that cannot be quickly halted and are already out of control, try to counteract themselves using other processes that are very imperfect as well. (Imagine the LA freeway system if all of a sudden everyone had to stop and go the other direction, but there were no lights and no traffic cops. And everybody's brakes and steering were already kind of busted and unstable to begin with.)

 

and then you misquote me:

Jan mentioned trying to keep z drugs to an minimum like twice a week. Is that ok?

 

Nope.  I said Z drugs no more than 2x a month!  Big big difference.  Twice a week can easily get you habituated.

 

I reinstated at .1ml 

 

Please update your signature to show us when you had the 2.5 mg dose, when you quit the 0.5 mg dose, and when you reinstated  the 0.5 mg dose.  Please put the dose in mg's, as different liquids are different strengths.

 

I show that you took:

23-April 2017 - 2.5 mg Lexapro

24-April 2017 - 0.5 mg Lexapro

25-April 2017 - 0.5 mg Lexapro

DISCONTINUED, then

REINSTATED

27-April 2017 - 0.5 mg Lexapro

 

Is this correct?  

 

Please put this information in your signature.

 

Please resist the urge to adjust your doses by how you feel today.  There will be Waves and Windows, and it is vitally important to keep your doses steady and stable.  

 

Same dose, same time, every day for a month!

 

And am i better off taking the klonopin am and pm to keep a steady state then? 

 

If I were you, I would take the smallest possible dose of klonopin at night.  I would not take it in the daytime if you can avoid it.

 

0.25 mg klonopin pm.   Klonopin is long acting, so one dose a day should be fine.

 

I am not a benzo expert, I just know that these are very addictive, very dangerous drugs, and they will increase your cognitive fog, depression, and cause memory issues.

 

I hope you see the sun, and your baby's smile today.