Stephygrrl

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

139 posts in this topic

No i stopped the reinstatement after two days. First day I took 2.5mg second day I took .5. I was so scared by my reaction I stopped after that. I am on 7.5 remeron, and .25-.5 klonopin at night (need to decide one dose or another). Neither is helping me sleep at this point. I know the anxiety I am experiencing is the lexapro withdrawal. I have felt it before. Since I stopped the reinstatement, is it wise to just steer clear now?

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I will update my signature tonight, can't while at work

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What is considered an adverse reaction to a reinstatement? Reading the info said to stop immediately if adverse reactions. The akasthia, major trembling, and complete inability to feel emotion seemed adverse to me. Was it not?

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It could be, Stephy. Many people are prescribed benzos or even an antipsychotic when they go on an antidepressant if they present with severe anxiety or akathisia. And some people are even labeled with schizophrenia or bipolar disorder due to this reaction. The antidepressant revolution has created an epidemic of bipolars because doctors don't understand these types of reactions. 

 

Please consider yourself very lucky to have found this site and all of this information so early in your psychiatric drug experience. I would do everything possible to get off these drugs safely over the coming weeks / months, so you can have a wonderful life without having to go through this for decades like many of us. 

 

Try to learn some ways of self soothing, such as mindfulness or gentle yoga. This is a very unfortunate experience for you and I'm sorry you're having to deal with it while also caring for a new baby, but these symptoms will pass. 

 

I just googled some mindfulness meditations for new moms and found this one:

 

Postpartum Meditation from Mama and Baby Love

 

If you don't like this one, there are many others out there. The more you can surround yourself with calming experiences, the more your nervous system will heal. 

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I am still so scared to reinstate again after my initial reactions that caused me to stop the reinstatement on Sunday. My current symptoms are nausea (mainly morning) shakes (all day) inner restlessness (first half of day-gets better at night) anxiety, waves of panic throughout the day (gets better in evening, then restarts in the middle of the night), and insomnia. Will these go away if I don't reinstate lexapro? It was poison to me from the start and I forced myself to keep going on it for a month before stopping. That's why I am so hesitant.

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I hear your fear about a possible adverse reaction. That's totally understandable. Unfortunately, the first few days of a start-up for a reinstatement can come with a lot of symptoms that may not settle down for at least 4 days to a week. And since these symptoms include anxiety and insomnia, it's very hard to tell if what you're going through is an adverse reaction or if your nervous system will eventually adjust to the drug and allow you to do a slow and moderately comfortable taper.

 

And to make it even more confusing, you've been using varying doses of Klonopin, which makes it harder to know exactly how you were adjusting to the reinstatement. Not only could the Klonopin be masking an adverse reaction to the Lexapro, but at the same time, Klonopin may be contributing to the anxiety and insomnia due to rebound Klonopin symptoms. 

 

My advice is if you do decide to reinstate again, to give yourself a full week to adjust and to keep your benzo use very consistent so you can gauge your symptoms more accurately. 

 

But if you feel the symptoms on Lexapro are too severe, then reinstatement may not be a good option for you. 

 

Please do work on some ways of self-soothing, such as the video I linked in my previous post. Whether you reinstate or not, it's good to have ways of calming down your very sensitive nervous system. 

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What will happen if I don't reinstate? I have been off now for about 4 weeks with these symptoms. The remeron has masked some, but they are still in the background.

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Ok Stephy - 

 

you didn't give the reinstatement enough time.

 

What will happen if you don't reinstate?

 

I don't know.  What will happen if you reinstate?  I don't know.

 

In my experience, you will have a rougher ride if you don't reinstate.  Reinstatement (if you can survive the first week) gives you the chance to control your symptoms somewhat before you taper.

 

Are you breastfeeding?  This could be important in the decision to reinstate.  While 0.5 mg Lexapro is still a very low dose of the drug (and doctors would laugh and say "No worries,") - you still would be feeding your baby some of the Lexapro, as all of these drugs pass through the milk.

 

Same with the klonopin, and the remeron.

 

1.  Please tell us how much klonopin you take, and when.

2.  Please revise your klonopin dosage so that you take the same dose at the same time every day.  Klonopin has a half life of over 24 hours, so one dose a day should be fine, especially since you aren't a long term user.

3.  Keep notes of your symptoms and patterns.  If you take klonopin at night, when are you most anxious?  Do you take it at the same time as the remeron?

4.  Please do not bounce doses - do not change doses of klonopin and remeron.

5.  It is still not too late to reinstate.  After you have taken the klonopin at the same time, same dose, every day for a week, you can try to reinstate the Lexapro again, which seems to be your main problem.  It may be exacerbated by uneven doses of klonopin, but Lexapro is very strong, and it is probably what your body is craving.  If you are afraid of 0.5 mg, can you take 0.25 mg?  If you do reinstate, you may have to be uncomfortable for a week before you settle.  Some people didn't settle into their reinstatement for a month, because they were so destabilized by multiple drug changes.

 

You are asking the same questions over and over.  We can only give the same answers so many times.

 

If you feel anxious, if you feel you are asking the same question again, re-read your thread to see if we have already answered it.  Re-read the links, and see if there is something new that helps you understand the same questions from a different angle.  

 

You've gotten a look in from Alto, and she said the same things Shep and Mamma and I are saying:  we need to know your klonopin is taken at a stable dose, at the same time, every day.  We need to know when your symptoms are hitting in relation to when you take your doses. 

 

The problem is caused by drugs - the answer will not be found in more drugs, so please resist new prescriptions, and resist tampering with supplements.  All of these are potentially destabilising.  The only supplements we recommend are:  Magnesium and Omega-3 fish oil.  The answers to your anxiety are in yourself, your perceptions of your anxiety.

 

Atlantic: I am Excited! Turn Anxiety into Excitement

 

You can do this, and it does get better!  You will need to be patient, and learn to accept and mindfully examine your symptoms - with curiosity.  Breathe, and you can do this.

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Currently I am taking klonopin .25 at 8pm and remeron at 9:30 pm. It is not enough to help me sleep though. I also take melatonin.

 

To help me sleep through this ride, would it be ok to increase klonopin to .5 and then taper that later?

 

At night my anxiety hits and wakes me at 3:30am almost on the dot. I have read a lot about cortisol and was wondering the best way to control those surges. I have good sleep hygiene and a dark room.

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Where I am struggling is the whole kindled theory. My brain is kindled that's for sure. Wouldn't another reinstatement be a recipe for disaster?

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Hey Stephy - 

 

How much melatonin are you taking?  We often find that the 5 mg (common dose) is too high.  Melatonin is a trigger, not a "drug," or herb or even amino.  It's a hormone.  All you need to take is enough to trigger sleep.  Too much can cause side effects and paradoxical reactions.  Some people do quite well on 0.25 mg.   http://survivingantidepressants.org/index.php?/topic/189-melatonin-for-sleep/

 

Also, it is important to take your melatonin and lie down in the dark.  No last minute things to get done before bed. No phone.  No computer.   Lie down.  In the dark.   This gives the "trigger" effect of melatonin a chance to work.

 

There are a lot of things to help with sleep, you can read here:

Important Topics about Symptoms Including Sleep Problems

http://survivingantidepressants.org/index.php?/topic/53-sleep-problems-that-awful-withdrawal-insomnia/

 

Okay.  Kindling.  I'm not the brightest tool in the shed, so mostly all I can say is that it's complicated.

 

Rhiannon said it like this:

Rhi's description of healing the brain

 

 

A lot of people, including healthcare practitioners; in fact, I guess, most people-- are operating from entirely the wrong paradigm, or way of thinking, about these meds. They're thinking of them like aspirin--as something that has an effect when it's in your system, and then when it gets out of your system the effect goes away.

 

That's not what happens with medications that alter neurotransmitter function, we are learning.

What happens when you change the chemistry of the brain is, the brain adjusts its chemistry and structure to try to return to homeostasis, or biochemical and functional balance. It tries to restabilize the chemistry. 

For example: SSRI antidepressants work as "serotonin reuptake inhibitors." That is, they cause serotonin to remain in the space between neurons, rather than being taken back up into the cells to be re-used, like it would be in a normal healthy nondrugged brain.

So the brain, which wants to re-establish normal signaling and function, adapts to the higher level of serotonin between neurons (in the "synapse", the space between neurons where signals get passed along). It does this by removing serotonin receptors, so that the signal is reduced and changed to something closer to normal. It also decreases the amount of serotonin it produces overall. 

To do that, genes have to be turned on and off; new proteins have to be made; whole cascades of chemical reactions have to be changed, which means turning on and off OTHER genes; cells are destroyed, new cells are made; in other words, a complex physiologic remodeling takes place. This takes place over time. The brain does not grow and change rapidly. 

This is a vast oversimplification of the amount of adaptation that takes place in the brain when we change its normal chemistry, but that's the principle.

When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay.

When the drug is removed, the remodeling process has to take place in reverse.

SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. 

It's a matter of, as I describe it, having to grow a new brain. 

I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long. 

With multiple drugs and a history of drug changes and cold turkeys, all of this becomes even more complicated. And if a person is started on these kinds of drugs at an early age before the brain has ever completely established normal mature functioning--well, it can't be good. (All of which is why I recommend an extremely slow taper particularly to anyone with a multiple drug history, a history of many years on meds, a history of past cold turkeys or frequent med changes, and a history of being put on drugs at a young age.)

This isn't intended to scare people, but hopefully to give you some idea of what's happening, and to help you respect and understand the process so you can work with it; ALSO, because you are likely to encounter many, many people who still believe these drugs work kind of like aspirin, or a glass of wine, and all you need to do is stop and get it out of your system. 

Now you can explain to them that no, getting it out of your system is not the issue; the issue is, you need to regrow or at least remodel your brain. This is a long, slow, very poorly understood process, and it needs to be respected.

 

 

That goes along quite well with my understanding, too.  (that's pretty much where I learned it, too.  Rhiannon is awesome!)

 

Tapering too fast ripped your roses right off the lattice and they are in a tangled heap on the ground (withdrawal, kindling).  A reinstatement puts back a small piece of lattice so that your roses can reshape themselves while they heal, without all of the pressure of the tangled heap.

 

Your 2.5 mg reinstatement was probably too much lattice and stirred things up.  So it is impossible to tell if you would have had a successful 0.5 mg reinstatement or not.

 

What you do with a kindled brain, is keep it stable, simple.  (KISS, SA style):  3 KIS's Keep It Simple, Slow, Stable

 

If you can survive on just the mirtazapine and the klonopin, then - awesome.

 

But what I'm hearing from you is that your symptoms are still quite strong, and that you might benefit from a slow, stable, tiny reinstatement.

 

Same doses, same time, every day.  (and careful with that melatonin!)

 

I hope you see the sun (and your baby's smile!) today.

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I know everyone says stay put on remeron now but it appears I am not doing well on it anymore. Akathisia in the evening, no sleep, headaches, earaches. What do I do? I don't want to be going through 2 withdrawals but this is unbearable. I have had to rely more on klonopin now because the akathisia gets so bad.

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It feels like my brain is burning all day, then finally let's up about 22 hours after I took the last dose

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I am sure I made it all worse when i updosed on the remeron last week...following drs orders...hoping it would mitigate the lex withdrawal and make me feel better. It did not. Now that I am back on 7.5 and holding I feel horrible. On 15mg my head ached and i felt like my ears were going to explode so I really could not stay there.

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However, I think my body grabbed onto the 15mg dose and habituated quickly. I suffered less physically on it but was worried about how it was making my head feel. I do think I am feeling some withdrawal from bringing that dose back down to 7.5. I didn't have akathesia with just the lex withdrawal and the night panic has become horrible.

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I am considering going to the hospital just to stabilize but I am afraid they will not understand what delicate shape my brain is in. Are there any programs where they won't force you to go back on more drugs or will at least work with you on managing symptoms?

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I truly feel like the remeron is killing me, all it is doing is making me feel like a zombie. Should i updose to 12.5mg to try to reduce symptoms? No idea what to do now. Now that I feel what mirt withdrawal is like (forgot to add achy muscles, sore throat, panic) I am totally scared but this med does nothing good for me.

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I have only been on rem 4 weeks. Only 5 days at 15mg. Such a mess...

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The best way to describe the way remeron makes my head feel is like someone hit me on the left side with a bat and now there is a hole in my head....

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The akathisia starts early afternoon

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I can't even think of reinstating lex before I get off this garbage. Any advice for remeron after being on just 4 weeks?

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Hey Stephy - 

 

I know everyone says stay put on remeron now but it appears I am not doing well on it anymore. Akathisia in the evening, no sleep, headaches, earaches. What do I do? I don't want to be going through 2 withdrawals but this is unbearable. I have had to rely more on klonopin now because the akathisia gets so bad. 

 

How do you know it is the Remeron?  Remeron would not "cover" Lexapro withdrawal in any way.

 

This sounds like withdrawal from Lexapro.  it could be bumps from your 2.5 mg dose of Lexapro.  Your Lexapro use was recent enough so as to be still affecting you for awhile yet.

 

Please do not ramp up your klonopin use.  This is a dangerous drug.

 

Akathisia ramping up in the afternoon - when do you take your klonopin?  It could be the klonopin wearing off.  Klonopin doesn't "cover" Lexapro withdrawal either, but makes you numb for awhile.  The periods of numbness will get shorter and shorter, and the klonopin will get less effective - the more you take it.  Please take the same doses at the same time every day.  If that has to be 2x a day, then you may need to do that.  But do not take "extra."

 

Please take same doses at same time every day.  Until you've done this for at least a week (I'd prefer a month) there is little we can do because changes in dose - any dose - is destabilising.

 

If you want to reinstate 0.5 mg Lexapro, or even a smaller amount, you are free to try that.

 

I'm sorry you are struggling.  Please follow the links about withdrawal, and watch the cartoons and the video over and over until you understand better how these things work.  You're still treating the drugs like aspirin, you take a drug, you get an effect.  That is not what the long term effects of these drugs are.  You take a drug, and it takes time to change what it has done to you.

 

Also - please study Non-Drug Techniques for dealing with emotional symptoms.  I know that chemical-emotional symptoms are very hard to deal with, and challenge even the best Non-drug techniques - but you have to try.  It's the best way out of this.

 

Patience.  It can get better - staying at the same dose at the same time every day is key.

 

I really believe that a reinstatement might help.  

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The side effects of the remeron I can't take. The headaches come on shortly after I take it and remain with me most of the day. It leaves me feeling like a zombie all day. It feels like my brain is burning. I can't imagine staying on this while reinstating and trying to function.

I have been trying to limit my klonopin usage as much as possible. Staying on remeron scares me more than anything.

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I do think I feel the akathisia more as the klonopin wears off (I take it at night). However, I didn't have akathisia before remeron, or muscle aches, or blurred vision.

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I feel like the remeron is really impacting me negatively. I feel like it has given me a lobotomy. I have been on for a month. Do I really need to taper 10% at this point or can I go a tad faster since I haven't been on long? I know we want to keep things steady but I don't feel it's safe to stay on this drug.

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Posted (edited)

Hi all, I have been on remeron for 5 weeks. Mostly at 7.5mg. I went up to 15 for 5 days about 3 weeks in but the headaches were too intolerable so I reduced to 7.5 again. A few days later, I experienced a panic attack and akathisia. I had to take a klonopin to calm down. My body must have quickly acclimated to the 15mg. I am holding at 7.5 and need off this drug. I feel like it's given me a lobotomy. The muscle aches and blurry vision are crazy and it didn't even help me sleep. With short term use like this, please tell me I can get off a little faster?!

Edited by scallywag
moved from Remeron topic: individual situation

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I met with my dr today. He prescribed lamictdal to help level me out and could help withdrawal sysmptoms. I asked if lithium orotate would be comparable, but he couldn't speak to it since it is not a prescription. Would it be possible to take lithium orotate and a low dose of lamictdal together? Any experience?

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Also, I will be needing to come off remeron because he thinks I may have more bipolarish symptoms which I agree too. I will likely stay away from lexapro reinstatement too. The remeron has been an aweful for me. Of course he thinks I can just take 3.75mg for a few nights and stop. Argh...

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Lithium orotate can cushion some of the blows, but it also is a toxic salt - you will need blood tests to check for toxicity.  It just gives you another complication in your cocktail.  You are on 3 - no 4 - drugs now, why add another one?  Adding drugs does not treat symptoms of drug withdrawal!

 

I have liver and kidney damage from lithium carbonate, and I lost my thyroid because of lithium.  I am still taking a tiny amount, but it may be time for it to go away, as I still have trouble with thyroid conversion.

 

Read more about Lithium Orotate here:  http://survivingantidepressants.org/index.php?/topic/7040-lithium-orotate/

 

What you think is the Remeron - is probably Lexapro withdrawal.

 

Look at it like this.

 

Lexapro is strong and big - like a T-Rex or Godzilla.

Remeron is more the size of a taxi, or at worst, an army tank.  At the dose you are on, it is only a little stronger than a benadryl (OTC).  Remember, Godzilla eats army tanks for breakfast!

 

Lamictal is kind of like using a fire extinguisher on Godzilla.  It might calm him down a little bit - what DOSES?  Please update your signature!

 

Klonopin is like a sleeping shot.  It "puts him down" for a little bit, but each time you use it, it gets a little weaker, a little less effective.

 

But Lexapro is the big, bad monster - and that's why I continue to keep suggesting reinstatement. 

 

Please:  Non Drug Techniques for Coping with Emotional Symptoms

 

and

Change the Channel

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I do think I feel the akathisia more as the klonopin wears off (I take it at night). However, I didn't have akathisia before remeron, or muscle aches, or blurred vision.

 

Exactly when do you feel this "akathisia"? Does it happen about the same time each day?

 

What is your Klonopin schedule, how much are you taking in each dose?

 

How much Lamictal are you taking, and when? How does it affect you?

 

You may notice we are always asking you for schedules, symptom patterns, and dosages. This is important. So far, you haven't given us enough information for us to suggest anything. We need the schedules, symptom patterns, and dosages.

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Hey Stephy - how's it going?

 

Let us know, and please update your signature with your current cocktail.

 

Just thinking of you.

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