DonnaR: Cipralex side effects and withdrawal

[DonnaR]

Hi there, I started taking Ciprolex in Feb 2012, I almost immediately got a severe case of chapped lips. I went to my dr and she said she has never heard of anyone getting chapped lips as a side effect so to keep taking the pills, the chapped lips must be from something else. I continued taking the pills (10mg which I know isnt alot) and have suffered with these painful itchy lips non stop since, I have also gained about 15 lbs since starting. I understand from research that weight gain is not normal with this drug, could be just my aging metabolism???... anyway the chapped lips were bad enough but then the back of my throat and upper palet started feeling funny, numb/itchy so I went back to the Dr, I thought it could be an alergy to this medication. She did think it peculiar that I have had chapped swollen lips (my husband thinks are kinda sexy but I say NOT!!) She and I both figured that I was not needing to be on the pills any longer so she told me to go to half a pill for one week then stop...

 

WELL... I have been off for one week now and what I am feeling is just plain weird, just want to get some advice and see how long these symptoms will last. I did check with my doctor and she basically said that there are zero withdrawl symptoms or side effects from this medication... I am extremely light headed and dizzy, have this really loud and very high pitched buzzing in both of my ears. I am nausiated, and I am unable to sleep through the night, when I do manage to fall asleep I suffer extreme night terrors to the point where my husband has to wake me up because he knows what is happening in my dream state is scaring the crap out of me... my question, how long will these withdrawl sysptoms last? it is very yard to work and have been unable to go to the gym or walk because of the dizziness and feeling like I will keel over from fainting... also, has anyone else gained weight from these? if so, does it go away when you come off the medication?

 

btw... the chapped lips disappeared within two days of stopping this med...

 

signed: head buzz in Ontario

[Jemima]

Hello, Donna -

 

I moved your post here because it's your introduction to the forum. When you want to add anything to your experiences with Cipralex, just click on the "Add Reply" button at the bottom of the page. Your intro topic functions very much like a journal.

 

First of all, your doctor is sadly misinformed about withdrawal from Cipralex, which is nothing unusual. Most doctors are not familiar with antidepressant withdrawal syndrome and give bad advice regarding getting off the drugs. This is largely because they get all their education about drugs from the drug companies which downplay side effects and twist research data to suit their own purposes. You might want to read my introductory posts as I "tapered" off of Lexapro a year ago according to my doctor's instructions and went through a hellish withdrawal. I am still not quite myself after ten months off the drug.

 

Weight gain is a very common side effect of antidepressants and usually goes away after getting off the drug.

 

Coming off of these drugs abruptly is not a good idea! Since you've only been off for a week, please consider going back on your Cipralex at maybe 2.5 to 5 mg., and then tapering very slowly from there. Your symptoms indicate that abruptly stopping the drug has destabilized your central nervous system, which is never a good thing. These symptoms can continue for months or even longer, so your best bet is to go back on a dose where you are comfortable and then taper very slowly from there. Here's a specific topic on withdrawing from this drug:

 

http://survivingantidepressants.org/index.php?/topic/406-tips-for-tapering-off-lexapro-escitalopram/page__p__4142__hl__cipralex__fromsearch__1#entry4142

 

Please consider reinstating at a low dose. I would hate to see anyone go through what I did unnecessarily.

[DonnaR]

Thank you so much Jemima for replying to my note and moving it to the appropriate area, I am such a newbie here to this site and have never been a member of any forum before lol...

I will definitely look at your blog, I am sure it will help.

I have thought about going back onto the Ciprolex as you suggest below but the chapped lips were so extreme and uncomfortable and the fact that I started showing signs of alergic reaction kind of makes me wary...

 

am I reading you correctly when you say the withdrawl side effects can last months?? this is unbelievable!!

[Georgia]

Thank you so much Jemima for replying to my note and moving it to the appropriate area, I am such a newbie here to this site and have never been a member of any forum before lol...

I will definitely look at your blog, I am sure it will help.

I have thought about going back onto the Ciprolex as you suggest below but the chapped lips were so extreme and uncomfortable and the fact that I started showing signs of alergic reaction kind of makes me wary...

 

am I reading you correctly when you say the withdrawl side effects can last months?? this is unbelievable!!

 

Allergies that affect the throat and lips can be serious, so I agree you should be very cautious. So sorry this happened to you. There used to be a long thread on drugs.com site about lexapro withdrawal... it's still there but not active anymore. Weight gain from lexapro was a very frequently reported problem on that thread, and was one of the reasons people said they wanted to get off the drug.

[lexhex]

As I understand it, Cipralex is like Lexapro. Withdrawal symptoms can last for years depending on how long you've been on the medication. I was on Lexapro for 6 years. Did an almost cold turkey taper back in July and my symptoms are exactly the same as yours, loss of appetite, nausea, racing heart with the night terrors, stomach upset, wierd vertigo and dizziness. I can barely leave the house. I had my last dose back in August after trying a failed reinstatement. Its been 6 weeks of hell with little reprieve. I have met with 3 psychiatrists, none of whom understand withdrawal syndromes, and who all claim that I have become "hypomanic" which they assume is my natural state. I have never wanted to smash someone in the face more than when I hear this come out of their mouths. Even my family practitioner had the same opinion. I am trying again with a FOURTH psychiatrist on Tuesday. My goal is to get back on the meds safely because I simply refuse to tolerate a protracted withdrawal. It takes too much time and robs me of a life I once I enjoyed. I also suggest that you get back on the meds while you still can. Don't wait much longer. If the generic version is giving you the wierd lip thing, ask for the REAL brand of the drug. Sometimes the inert ingredients in the generics can cause allergic reactions in some people and the name brand won't.

[Altostrata]

Donna, welcome to our community.

 

It sound like what you suffered was an allergic reaction to Cipralex. From official FDA information at http://www.drugs.com/pro/escitalopram-tablets.html

 

....

3. Severe allergic reactions:

• trouble breathing
• swelling of the face, tongue, eyes or mouth
• rash, itchy welts (hives) or blisters, alone or with fever or joint pain

  ....

Yes, Cipralex has withdrawal difficulties. http://www.drugs.com/pro/escitalopram-tablets.html

....

If the decision has been made to discontinue treatment, medication should be tapered, as rapidly as is feasible, but with recognition that abrupt discontinuation can be associated with certain symptoms....

....

Discontinuation of Treatment with Escitalopram Tablets

 

Symptoms associated with discontinuation of Escitalopram Tablets and other SSRIs and SNRIs have been reported [see Warnings and Precautions (5.3)]. Patients should be monitored for these symptoms when discontinuing treatment. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose but at a more gradual rate....

 

Your doctor acted incompetently on both counts. She should have immediately taken you off the drug when you had allergic symptoms. Since she kept you on the drug, you became at risk for withdrawal symptoms when you quit. Your doctor knows nothing about Cipralex or its risks.

 

10mg Cipralex is a normal dose, not a small dose.

 

If I were you, I'd find a new doctor and file a complaint against this doctor.

 

Given that you had an allergic reaction, it's hard to suggest going back on Cipralex. But withdrawal symptoms can get worse, and last for months. In a liquid form of Cipralex, you might be able to take a very low dose, perhaps 2mg or so, for a few weeks to alleviate the withdrawal symptoms without triggering the allergic reaction. Then you can taper off the liquid gradually.

 

The link Jemima posted for you contains information about how to make a liquid yourself if you can't get a prescription for liquid Cipralex.

 

Do you have any tablets left?

[Jemima]

Thank you so much Jemima for replying to my note and moving it to the appropriate area, I am such a newbie here to this site and have never been a member of any forum before lol...

I will definitely look at your blog, I am sure it will help.

 

It isn't a blog, it's my introductory topic, and there's a link in the signature area of my posts. Sometime when you have a moment, it would be a good idea to flesh out this area in your own signature. Here are the instructions:

 

http://survivingantidepressants.org/index.php?/topic/893-please-put-your-withdrawal-history-in-your-signature

 

I have thought about going back onto the Ciprolex as you suggest below but the chapped lips were so extreme and uncomfortable and the fact that I started showing signs of alergic reaction kind of makes me wary...

I'm not sure what to say about that. Personally, I would rather put up with a mild allergic reaction than go through withdrawal, but I don't know if that allergic reaction could become worse, which is a consideration. There are a number of drugs that are chemically similar to Cipralex so it may be possible that one of them would not give you the allergic reaction.

 

am I reading you correctly when you say the withdrawal side effects can last months?? this is unbelievable!!

 

Withdrawal can actually turn into years, although there's no way to predict who will suffer or for how long. (The worst of mine went on for about three months, if I remember right, but I had my last dose of Lexapro December 14, 2011, and as I said, I'm still not quite myself.) That alone is good reason - to me - to get off the drugs very slowly. What happens is that these drugs change the way a person's brain works by both destroying old neurotransmitters and growing new neurotransmitters, so even though the drug may be completely out of one's system, the brain is changed and it takes quite a while to re-normalize. Stopping the drug abruptly leaves the brain without the chemical support it has become used to and withdrawal symptoms appear to come from the brain repairing itself here and there unpredictably. The withdrawal symptoms range from uncomfortable to outright disabling. As you read through other forum member's introductions and subsequent posts, you'll get a better idea of what happens and how much variation there is.

[DonnaR]

Hi there, thanks for the info and the welcome!! the alergic reaction was getting worse, and I was definietly getting worried about continuing with the pills... I had just renewed my prescription for 3 months so yes I do have tables at home, good thing I didnt flush them lol... it could have been hives that were on my lips and not chapped, they would swell to double their size... pretty unsightly for sure. She did say that I was on a low dosage and seeing as this is the first long term medicine I have ever been on I had nothing to gauge this amount on...

 

the more I am reading on this and the more posts that are coming up on here, I wish I would never have gone on this drug in the first place, I am sure that I could have battled my depression on my own without all the issues... I must say though that aside from the lip/mouth issue, I did feel really good while taking the cipralex.

 

I will try the liquid form, thanks for the info and hope this works.

 

Donna

[peggy]

Welcome Donna,

I agree with Alto - find another doctor and file a complaint...

 

Perhaps lexapro may not cause an allergic reaction? Lexapro is more refined version of cipralex and perhaps the component that you are allergic to is not present in the same form...but you would need to find a competent doctor to prescribe it. Otherwise, maybe a smaller dose of cipralex would be ok.

 

Your symptoms may get better in a few weeks/months - or they may get worse, it is not possible to predict. Some fish oil would probably help you in the meantime.

[Altostrata]

Lexapro is Cipralex!

 

peggy, you are thinking of citalopram (Celexa). This is a milder sibling of escilatopram (Lexapro, Cipralex).

 

I guess a little citalopram might be an option for you, Donna. If I were you, I might try a little liquid Cipralex first. If you get an allergic reaction from it, you'd have to get a prescription for citalopram to try that.

 

Do you have another doctor you can talk to about this? You might want to get a potential citalopram prescription lined up right away.

 

(I think we had someone else here describe an allergic reaction to an SSRI; her early symptoms were in her mouth, too.)

[Georgia]

Hi there, thanks for the info and the welcome!! the alergic reaction was getting worse, and I was definietly getting worried about continuing with the pills... I had just renewed my prescription for 3 months so yes I do have tables at home, good thing I didnt flush them lol... it could have been hives that were on my lips and not chapped, they would swell to double their size... pretty unsightly for sure. She did say that I was on a low dosage and seeing as this is the first long term medicine I have ever been on I had nothing to gauge this amount on...

 

the more I am reading on this and the more posts that are coming up on here, I wish I would never have gone on this drug in the first place, I am sure that I could have battled my depression on my own without all the issues... I must say though that aside from the lip/mouth issue, I did feel really good while taking the cipralex.

 

I will try the liquid form, thanks for the info and hope this works.

 

Donna

 

Please get medical advice, preferably from an allergy doctor, before going back on a drug that caused your lips to swell. Your lips were swollen to double their size (that does not sound like "chapped lips"; it sounds like angioedema/hives) and you also had allergy symptoms in your throat? Yes, withdrawal is terrible, but you don't want your throat to close up. Your physician doesn't sound very helpful, but you need medical advice about how to handle an allergic reaction if you reinstate. (such as carrying antihistamines or an epipen) Withdrawal is worse than a mild allergic reaction, that's true in my opinion, but what you have described doesn't sound like a mild reaction. Ask a doctor who is knowledgable about allergic reactions before you make a decision.

[DonnaR]

night terrors, stomach upset, wierd vertigo and dizziness

 

not sure how to do the quote thing but this is from Lexhex... Vertigo is the perfect word to describe what is happening.... and the withdrawl seems to be worse today than yesterday etc etc... I will definitely try the liquid dose and get back to everyone... thanks so much for the advise, I am very grateful to have found this site, I was kind of feeling all alone with this...

[DonnaR]

 

Hi there, thanks for the info and the welcome!! the alergic reaction was getting worse, and I was definietly getting worried about continuing with the pills... I had just renewed my prescription for 3 months so yes I do have tables at home, good thing I didnt flush them lol... it could have been hives that were on my lips and not chapped, they would swell to double their size... pretty unsightly for sure. She did say that I was on a low dosage and seeing as this is the first long term medicine I have ever been on I had nothing to gauge this amount on...

 

the more I am reading on this and the more posts that are coming up on here, I wish I would never have gone on this drug in the first place, I am sure that I could have battled my depression on my own without all the issues... I must say though that aside from the lip/mouth issue, I did feel really good while taking the cipralex.

 

I will try the liquid form, thanks for the info and hope this works.

 

Donna

 

Please get medical advice, preferably from an allergy doctor, before going back on a drug that caused your lips to swell. Your lips were swollen to double their size (that does not sound like "chapped lips"; it sounds like angioedema/hives) and you also had allergy symptoms in your throat? Yes, withdrawal is terrible, but you don't want your throat to close up. Your physician doesn't sound very helpful, but you need medical advice about how to handle an allergic reaction if you reinstate. (such as carrying antihistamines or an epipen) Withdrawal is worse than a mild allergic reaction, that's true in my opinion, but what you have described doesn't sound like a mild reaction. Ask a doctor who is knowledgable about allergic reactions before you make a decision.

 

I was planning on going to my pharmacy tonite on way home from work, the pharmacist may have more insight...

[Altostrata]

That's excellent advice, Georgia. I agree completely. But few doctors understand the adverse effects of these drugs. Finding someone to discuss an allergic reaction to one might be like looking for a needle in a haystack.

 

In the meantime, what should Donna do? Reinstating is most effective when done quickly.

 

Donna, read this about making a liquid http://survivingantidepressants.org/index.php?/topic/2693-how-to-make-a-liquid-from-tablets-or-capsules/

 

If you get an allergic reaction to 2mg, stop immediately.

[peggy]

Lexapro is Cipralex!

 

peggy, you are thinking of citalopram (Celexa). This is a milder sibling of escilatopram (Lexapro, Cipralex).

 

sorry - i was thinking of cipramil (that is the name here)

[Georgia]

 

In the meantime, what should Donna do? Reinstating is most effective when done quickly.

 

 

 

I understand and agree about withdrawal issues and reinstatement sooner rather than later; Donna's in a difficult position. I still haven't recovered from taking lexapro several years ago. I never found a single doctor who understood the drug withdrawal issues, or whose advice I felt I could trust on SSRIs (or any of the other drugs they offered to me).

 

I don't know what Donna should do, but I do know that mouth and throat reactions can be serious. I hope the pharmacist can give her some helpful advice, or that she can quickly find a physician who can help.

[peggy]

Also, agreed about the mouth/throat issues - perhaps Donna you could ask the pharmacist if taking phenergan or another generic antihistamine may help prevent the allergic reaction?

[Altostrata]

I would test to see if the lower dose causes an allergic reaction first, then figure out what to do.

 

If you take an antihistamine at the same time, you won't know what's going on or what side effects are caused by.

[Brandy]

Also, agreed about the mouth/throat issues - perhaps Donna you could ask the pharmacist if taking phenergan or another generic antihistamine may help prevent the allergic reaction?

 

I just want to mention a warning about phenergan because it's actually a phenothiazine. I'm severely allergic to phenothiazines and you may be allergy-prone as I am, Donna. Phenergan is an antihistamine, but in a different family than others. Phenothiazines are prescribed not only for their antihistamine properties, but as antipsychotics (very common before the newer generation of antipsychotics being prescribed nowadays were invented), and also to control nausea. A sort of "Renaisance man" drug.

 

It was for the latter reason (nausea) that I took a combination medication that contained a small amount of phenothiazine. (I was not on SSRIs etc. at that time - it was more than forty years ago and SSRIs hadn't even been invented.) The brief version is that my tongue swelled up so badly it was cutting off my breathing. Intramuscular benadryl did nothing, but just in time, IV benadryl reduced the swelling and I was able to start breathing normally again.

 

Re your description of your symptoms:

 

I never associated my extremely "chapped lips" with the med during my many years on paxil, but I'm more than six years off paxil and the problem went away after I went off paxil and never returned. Even though I have dry lips, probably from another condition I have (Sjogren's Syndrome).

 

But while on paxil, the skin on my lips would dry in very large patches. My lips looked like a drought-stricken parched desert. The large patches of dry skin would peel off even when lightly wiping my mouth with a napkin. In spite of very frequent use of various kinds of lip balm (all natural, but different substances).

 

But my lips certainly didn't swell to twice their normal size, and I don't recall their being itchy. That does sound like a possible allergic reaction that calls for a cautious approach.

 

I agree with Alto that taking an antihistamine simultaneously with a trial reinstatement would not be a good idea because it could mask an allergic reaction you would need to know about if it occurred. But given the nature of the reaction you've had to the cipralex, I do think it's a good idea to work with a pharmacist (or maybe a better doctor - not the one who's been giving you such misinformation!) on selecting an antihistamine to have readily available while taking even a low-dose trial reinstatement, just as a precaution. Perhaps something on the order of benadryl. (Personally I don't like the side effects I get from those antihistamines, especially post-SSRI, but they were quite mild and as far as I know any side effects would likely be transitory and not dangerous.)