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Tips for tapering off Lexapro (escitalopram)


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#1 Altostrata

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Posted 26 May 2011 - 06:16 PM

aka Cipralex, Seroplex, Lexamil, Lexam

As with all psychiatric drugs, Lexapro must be tapered for safe discontinuation.
 
Lexapro comes in 5, 10, and 20mg tablets and as a liquid suspensiion. It is available as a generic. Its half-life is 27–32 hours http://www.ncbi.nlm....pubmed/17375980

In the UK, Lundbeck's version, Cipralex http://sweden.lundbe...cksedel_ENG.pdf , comes in the same tablet dosages and in liquid form http://xpil.medicine...spx?DocID=21927

In Canada, Lundbeck's Cipralex comes in 5, 10, 15, 20 mg tablets http://www.lundbeck....2_MKT_E_CLN.pdf (PDF).

Official US information:

From http://www.drugs.com...am-tablets.html
The liver enzymes represented by P450 CYP3A4 and CYP2C19 are the primary avenues of metabolization.

Following a single oral dose (20 mg tablet) of escitalopram, peak blood levels occur at about 5 hours. Absorption of escitalopram is not affected by food.

 
From the FDA-mandated US package insert (PDF):
 

Discontinuation of Treatment with Lexapro
During marketing of Lexapro and other SSRIs and SNRIs (serotonin and norepinephrine reuptake inhibitors), there have been spontaneous reports of adverse events occurring upon discontinuation of these drugs, particularly when abrupt, including the following: dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesias such as electric shock sensations), anxiety, confusion, headache, lethargy, emotional lability, insomnia, and hypomania. While these events are generally self-limiting, there have been reports of serious discontinuation symptoms.

Patients should be monitored for these symptoms when discontinuing treatment with Lexapro. 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 [see Dosage and Administration (2.4)].

 
Special considerations
A significant characteristic of Lexapro is that milligram for milligram, it is much stronger than other SSRIs. Chemically, Lexapro is a variation of Celexa; the molecule was re-engineered to be patentable as Celexa's patent was about to expire. The streamlined molecule is a more potent SSRI, 2 to 4 times stronger than others. (Wikipedia has a good explanation of this at https://secure.wikim...ki/Escitalopram.)

However, many doctors are unaware that escitalopram is stronger than other SSRIs and dose it as though it were the same strength. Although the so-called usual starting dose of escitalopram, 10mg, is equivalent to 20mg-30mg or more of, for example, paroxetine (Paxil), your doctor may have moved you to an even higher dose. If you are taking 20mg of escitalopram, you are taking a hefty dose of an SSRI.

If you are taking 5mg, it's not tiny, it's equivalent to 10-20mg Paxil or Celexa.

Consequently, when you taper off escitalopram, you should be careful to decrease by small amounts, as each drop is magnified by escitalopram's extra potency. If you find withdrawal symptoms from a 10% decrease to be too difficult, after 3-4 weeks decrease by a smaller amount.

Cold-turkeying off Lexapro is not a good idea. It's like throwing your brain off a cliff.

Reduce by 10% per month to start
The 10% rule holds for Lexapro, just like other psychiatric drugs: Reduce by 10% per month, calculated on the last dosage. (The amount of the reduction gets progressively smaller.)

See Why taper by 10% of my dosage?

Cutting up tablets
Although 5mg tablets are available, if you are taking 20mg Lexapro, a drop to 15mg would be a 25% decrease. This is a larger decrease than the 10% recommended.

If you wish to try cutting up tablets, they can be cut up with a pill splitter like other medications in tablet form. Keep the pieces you don't use in a clean pill bottle labeled with the dosage for future use.

Reducing with a combination of tablets and liquid
If you are taking, for example, 15mg, and want to decrease by 10% (1.5mg), you can take one 10mg tablet and 3.5mg in the liquid form for a total of 13.5mg.

Titrating using liquid formulation
Using the liquid form is the best way to control the amount of each decrease. The US formulation provides 5 mg per 5 mL (amounting to 1mg of the medication in a milliliter of the liquid, or 1mg:1mL).

From http://www.hipaaspac...es/0456-2101-08
 

Liquid Lexapro
NDC Code 0456-2101-08 <-- this is the order code
Package Description 240 mL in 1 BOTTLE
Proprietary Name Lexapro
Non Proprietary Name ESCITALOPRAM OXALATE
Dosage Form Name LIQUID
Labeler Name Forest Laboratories, Inc.
Substance Name ESCITALOPRAM OXALATE
Strength Number 5
Strength Unit mg/5mL

You can measure out dosages under 10mg by using a 5mL or 10mL oral syringe, see http://survivinganti...ndpost__p__2607

The 10mL oral syringe has markings that enable measuring out amounts as small as .20mL.

If you are at 5mg, for example, use a 10 milliliter oral syringe to measure a 10% decrease, i.e. .5mg. Subtracting .5mg from 5mg would give you a reduced dose of 4.5mg.

If you need to measure an even smaller fraction of a milligram, use a 1 milliliter oral syringe, see http://survivinganti...ndpost__p__2284

NOTE: In the UK, the liquid form is available at a 10mg:1mL or 20mg:1mL concentration -- very inconvenient for tapering. One version of the liquid form is Cipralex from Lundbeck.

To take 1mg of the 10:1 liquid, use the small slim 1mL oral syringe to take 0.1mL (one-tenth milliliter). The 1mL oral syringe has 10 ticks within .1mL, enabling taking .01mL (one-hundreth milliliter) or, given the 10:1 concentration, .1mg (one-tenth milligram) escitalopram.

This information from Lundbeck, a manufacturer of escitalopram drops in Europe, http://www.medicines...rops, solution/ suggests the liquid form can be diluted with water:

Cipralex oral drops, solution: A bottle with dropper applicator or an oral syringe may be used for administration. The oral syringe bears a graduation in mg referring to the escitalopram dose.

Cipralex oral drops, solution can be mixed with water, orange juice or apple juice.

 
Since water is part of the original formulation, it is unlikely additional water will cause the dilution to degrade. However, being exposed to light, etc. may do this, so it is unclear how long a diluted solution will last in potency.

Do-it-yourself liquid
People report that they can make their own liquid from Lexapro tablets and water.

It is soluble in water, see http://www.drugbank.ca/drugs/DB01175 -- stability (shelf-life of dilution) is unknown.

See How to make a liquid from tablets or capsules

Switching to Prozac
The risks of this method may not be worth switching from Lexapro to Prozac. This is usually used for medications with shorter half-lives than Lexapro. If you want to try this, make sure you consult a doctor who has done it many times and knows what he or she is doing.


Edited by Altostrata, 24 May 2014 - 12:34 PM.
updated

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

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#2 turtleboots

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Posted 31 May 2011 - 10:07 AM

THANK YOU for this information! Good to know! It may explain why I have been unable to withdraw from Lexapro (currently at 3 mgs liquid per day). My last arrogant and ignorant psychiatrist (the only kind I've ever known) said I could just bump my dose back up if I started having withdrawal symptoms after a decrease in dosagee, yet doing that led to another slew of new and severe symptoms that took the better part of a year to resolve. WHY don't the doctors that take our health into their hands - and get paid handsomely for it - know these things? WHERE IS THE ACCOUNTABILITY?
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#3 Altostrata

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Posted 31 May 2011 - 05:44 PM

You said it, turtleboots! Welcome. I can tell you're going to be great at DIY Editorials.

When you have a chance, please introduce yourself in the Introductions forum.
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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#4 Altostrata

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Posted 31 May 2011 - 05:53 PM

Updated post #1 with information from UK liquid form of escitalopram.

Edited by surviving, 06 June 2011 - 05:34 PM.
moved info into post #1

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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#5 blackjacklv

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Posted 14 September 2012 - 01:03 PM

Hi everyone, This is my first post here (besides the intro section) and was hoping to pick some of your brains! So I did a ton of research on here and the internet about how I want to taper off my 10 mg of Lexapro (Generic: escitalopram) and have come up with a plan to talk to my Dr. about this afternoon when I go in. I am on 10mg and want to do the 10% taper for a least the first couple of months, but then I had to figure out how I would get to the 9mg initally. It looks like on here there has been the suggestion to use the liquid version to get an exact amount. I figured that I would just do a 5 mg pill and do the liquid to make up the other 4 mg, but talking to my pharmacy and my insurance carrier I have learned that is not allowed. I would have to do all liquid or all pills. I would prefer to do the liquid to be exact, but wanted to find out what others have done? I also got lucky and found out that the generic liquid version of Lexapro (escitalopram) was just released a couple of days ago so this will make the process cheaper if I do the liquid. If I do the pills then I would be having to split a 5 mg pill. Any thoughts or experience? Thanks!
For the management of Postpartum Depression & Anxiety:

Zoloft 25mg - 6/2011 - 4/2012
Tried to taper 12/2011 and went back on 25mg due to withdrawl symptoms
Tried to taper again 3/2012 - 4/2012 and had bad withdrawl symptons & rebounded terribly
Zoloft 50mg - 5/2012
Lexapro 10mg - 6/2012 to Present
9/17/12 - Dropped to 9mg
9/28/12 - Dropped to 8mg
10/12/12 - Dropped to 7mg
10/26/12 - Dropped to 6mg
11/2/12 - Dropped to 5mg
11/14/12 - Dropped to 4mg
11/26/12 - Dropped to 3mg
12/5/12 - Dropped to 2.5mg
12/14/12 - Dropped to 2mg
12/19/12 - Dropped to 1.5mg
12/23/12 - Dropped to 1mg
12/27/12 - Dropped to 0.5mg
1/1/13 - Off Lexapro!!!!

#6 Altostrata

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Posted 14 September 2012 - 02:25 PM

If the liquid is covered, get the liquid. It enables you to very carefully calibrate your tapering.
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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#7 strawberry17

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Posted 15 September 2012 - 12:16 AM

If you can get liquid definately do the liquid, I find I get really accurate consistent measurements with my syringe and it seems so much easier than trying to shave and weigh tablets etc

*** Please note this is not medical advice,discuss any decisions about your medical care with a knowledgeable medical practitioner***





http://prozacwithdrawal.blogspot.com/

Original drug was sertraline/Zoloft, switched to Prozac in 2007.

Tapering from 5mls liquid prozac since Feb 2008, got down to 0.85ml 23/09/2012, reinstated back to 1ml(4mg) 07/11/2012, didn't appear to work, upped to 1.05ml 17/11/2012, back down to 1ml 12/12/2012 didn't work, up to 1.30ml 16/3/2013 didn't work, bumped up to 2ml (8mg) 4/4/2013 didn't work, reinstated Sertraline (Zoloft) 50mg, feeling better now. Been on the antidepressant merry go round since November 1998.


#8 Nikki

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Posted 16 September 2012 - 05:41 AM

Hi... I did taper from Lexapro and was very sensitive to it. In the beginning I did liquid and pills. Then just liquid. Trust me, it is alot more accurate. You do not have to do a 10% taper method. If you are very sensitive you an drop by droplets or in other words much smaller drops than 10%. The pharmaceutical companies and the insurance companies work against us, not for us it seems. Things have changed alot over the years.

Intro: http://survivinganti...ndown-with-ads/

 

Paxil 1997-2004

Crossed over to Lexapro Paxil not available

at Pharmacies GSK halted deliveries

Lexapro 40mgs

Lexapro taper (2years)

Imipramine

Imipramine and Celexa

Now Nefazadone/Imipramine 50mgs. each

45mgs. Serzone  50mgs. Imipramine


#9 bubbles

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Posted 16 September 2012 - 05:56 PM

Hi I agree about the liquid. My experience was with Lexapro, not a generic, but with the liquid Lexapro (10mg) you can get very tiny drops (0.1mg). I started at 20mg and had a sample pack of 10mg pills to go with the liquid get me started with the taper. I did try breaking a 20mg in half but couldn't get the precision I wanted - they didn't break perfectly evenly and I did want to keep the dose uniform so I abandoned that. For me it was easier to just do the liquid and not mess with the pills. Best wishes with your taper Bubbles
Bubbles

Diagnosed Hashimotos 2001
Diagnosed Depression 2006, Lexapro 20mg
2 attempts to discontinue, one too fast, both not successful
29/02/2012 dropped to 18mg
15/03/2012 dropped to 17mg
28/03/2012 dropped to 16mg
07/04/2012 dropped to 15mg
14/04/2012 dropped to 14mg
19/04/2012 dropped to 13mg
23/04/2012 dropped to 12mg
30/04/2012 dropped to 11mg
03/05/2012 dropped to 10mg
10/05/2012 dropped to 9mg
18/05/2012 dropped to 8mg
25/05/2012 dropped to 7mg
29/05/2012 dropped to 6mg
05/06/2012 dropped to 5mg
12/06/2012 dropped to 4mg
19/06/2012 dropped to 3mg
26/06/2012 dropped to 2mg
03/07/2012 dropped to 1mg
10/07/2012 zero

#10 blackjacklv

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Posted 20 September 2012 - 09:11 AM

Thank you everyone! I decided to do the liquid since it sounded like it was much easier from you all and started on Monday. I just dropped 1 mg and have been feeling fine. I haven't noticed anything. How long will it take to notice the drop if I am going to? How long should I stay here before dropping another 1 mg? 4 weeks seems like such a long time. BTW - The liquid tastes horrible! Any suggestions on taking it?
For the management of Postpartum Depression & Anxiety:

Zoloft 25mg - 6/2011 - 4/2012
Tried to taper 12/2011 and went back on 25mg due to withdrawl symptoms
Tried to taper again 3/2012 - 4/2012 and had bad withdrawl symptons & rebounded terribly
Zoloft 50mg - 5/2012
Lexapro 10mg - 6/2012 to Present
9/17/12 - Dropped to 9mg
9/28/12 - Dropped to 8mg
10/12/12 - Dropped to 7mg
10/26/12 - Dropped to 6mg
11/2/12 - Dropped to 5mg
11/14/12 - Dropped to 4mg
11/26/12 - Dropped to 3mg
12/5/12 - Dropped to 2.5mg
12/14/12 - Dropped to 2mg
12/19/12 - Dropped to 1.5mg
12/23/12 - Dropped to 1mg
12/27/12 - Dropped to 0.5mg
1/1/13 - Off Lexapro!!!!

#11 bubbles

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Posted 20 September 2012 - 07:24 PM

Yes, the liquid tastes vile. I wasn't going to mention that... I got used to it after a while. B
Bubbles

Diagnosed Hashimotos 2001
Diagnosed Depression 2006, Lexapro 20mg
2 attempts to discontinue, one too fast, both not successful
29/02/2012 dropped to 18mg
15/03/2012 dropped to 17mg
28/03/2012 dropped to 16mg
07/04/2012 dropped to 15mg
14/04/2012 dropped to 14mg
19/04/2012 dropped to 13mg
23/04/2012 dropped to 12mg
30/04/2012 dropped to 11mg
03/05/2012 dropped to 10mg
10/05/2012 dropped to 9mg
18/05/2012 dropped to 8mg
25/05/2012 dropped to 7mg
29/05/2012 dropped to 6mg
05/06/2012 dropped to 5mg
12/06/2012 dropped to 4mg
19/06/2012 dropped to 3mg
26/06/2012 dropped to 2mg
03/07/2012 dropped to 1mg
10/07/2012 zero

#12 Altostrata

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Posted 21 September 2012 - 11:44 AM

Shoot it into your mouth fast and follow with a swallow of water or fruit juice.
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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#13 Lilu

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Posted 07 June 2013 - 05:12 PM

Why is it that the links on this page don't show up as links, but all show [color=rgb(40,40,40);font-family:helvetica, arial, sans-serif;][url]url]?[/color]

[color=rgb(40,40,40);font-family:helvetica, arial, sans-serif;]Is it my browser or is it just how this page is?[/color]


2000 Reglan - the acid reflux drug that is really a dopamine antagonist and is related to antipsychotics! 

2001 bad reaction to Celexa 1 week/Paxil 2 weeks

2004 Prozac 3 months

2005-2008 Effexor xr

1/2008 - 3/2008 Tapered Effexor for 3 months, then off for 4 months. Reinstated Effexor 7/2008

2008-2009   Effexor xr

2009-3/2013 Pristiq

3/2013 - 5/2013 Lexapro 10mg, then 5mg 1 wk, then cold turkey

5/2013Reinstated 5mg Lexapro for 6 weeks after 2 week withdrawal syndrome

8/2013 Started Liquid Lexapro 5 ml

12/31/13 Held at 1 ml for 1 month; 1/3/14 Reinstated 2 ml dose; 2/1/2014 Resumed Lexapro taper at 5% per week

 


#14 Altostrata

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Posted 08 June 2013 - 08:16 AM

Some kind of coding weirdness that happened in the upgrade.The links seem to be parsing now. Try reloading this page.

 

Thanks for pointing this out.


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.

#15 Lilu

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Posted 22 June 2013 - 08:27 AM

If you are at 5mg, for example, use a 10 milliliter oral syringe to measure a 10% decrease, i.e. .5mg. Subtracting .5mg from 5mg would give you a reduced dose of 4.5mg.

If you need to measure an even smaller fraction of a milligram, use a 1 milliliter oral syringe, see http://survivinganti...ndpost__p__2284

 

Ok, so I did some math, and I get multiple decimal points when I calculate 10% of last dose.  From 5 mg of Lexapro, the first 10% is 4.5. That should be easy enough to measure.  But then the next 10% is 4.05, and the next is 3.645.  How can I possibly measure this with a syringe?  Do I round the numbers off?  Do I use TWO syringes - one at 5 ml and another one at 1 ml?


2000 Reglan - the acid reflux drug that is really a dopamine antagonist and is related to antipsychotics! 

2001 bad reaction to Celexa 1 week/Paxil 2 weeks

2004 Prozac 3 months

2005-2008 Effexor xr

1/2008 - 3/2008 Tapered Effexor for 3 months, then off for 4 months. Reinstated Effexor 7/2008

2008-2009   Effexor xr

2009-3/2013 Pristiq

3/2013 - 5/2013 Lexapro 10mg, then 5mg 1 wk, then cold turkey

5/2013Reinstated 5mg Lexapro for 6 weeks after 2 week withdrawal syndrome

8/2013 Started Liquid Lexapro 5 ml

12/31/13 Held at 1 ml for 1 month; 1/3/14 Reinstated 2 ml dose; 2/1/2014 Resumed Lexapro taper at 5% per week

 


#16 Altostrata

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Posted 22 June 2013 - 09:17 AM

Round off to the lower dose. Combine syringes as you prefer.


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.

#17 Lilu

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Posted 14 August 2013 - 06:54 PM

So, I told my doctor that Lexapro and/or withdrawal is making me very tired and drowsy all the time.  And she told me to take it twice daily instead of once daily.  Do any of you have experience with this?


2000 Reglan - the acid reflux drug that is really a dopamine antagonist and is related to antipsychotics! 

2001 bad reaction to Celexa 1 week/Paxil 2 weeks

2004 Prozac 3 months

2005-2008 Effexor xr

1/2008 - 3/2008 Tapered Effexor for 3 months, then off for 4 months. Reinstated Effexor 7/2008

2008-2009   Effexor xr

2009-3/2013 Pristiq

3/2013 - 5/2013 Lexapro 10mg, then 5mg 1 wk, then cold turkey

5/2013Reinstated 5mg Lexapro for 6 weeks after 2 week withdrawal syndrome

8/2013 Started Liquid Lexapro 5 ml

12/31/13 Held at 1 ml for 1 month; 1/3/14 Reinstated 2 ml dose; 2/1/2014 Resumed Lexapro taper at 5% per week

 


#18 RedTara

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Posted 15 August 2013 - 06:30 AM

Hi Shooting Star,  I don't know the answer to your question about fatigue but do have some information about generic lexapro dosing options

that relates to earlier discussions here.

 

I found that one can buy compounded Lexapro at the compounded pharmacys in the specific dose you / I am on.  I am on 7 mg right now

having tapered down from 10 in the last period of time and when I'm ready I have already a prescription thats filled of 6 mg of compounded

generic lexapro.  Its pretty handy but a little more expensive and its seems most insurance companies do pay for compounding pharmacies.

You just have to call around your area and speak to the various compounding pharmacys.  I think the price can vary as well from compounding

pharmacy to compounding pharmacy.  



#19 findingme

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Posted 21 September 2013 - 11:16 AM

can a 5 mg escitalopram be cut in half ? I've been on 20mg's, and wanted to follow the Harvard guidelines which was a 5mg first taper, but after reading all these posts , I 'm thinking I shouldn't taper by more than 2.5 the first time ? would appreciate any feedback, as I'm starting to get really freaked out about my attempt to do this

#20 Altostrata

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Posted 21 September 2013 - 01:34 PM

Lexapro comes in a liquid, this makes tapering by small amounts such as 10% much easier.


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.

#21 findingme

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Posted 22 September 2013 - 05:39 PM

If I can't get the liquid, can the 5mg pill get cut in half?

#22 Jemima

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Posted 22 September 2013 - 05:57 PM

I wouldn't recommend cutting the 5 mg. pill in half.  At that low a dose, accuracy is really important, plus going from 5 mg. to 2.5 mg. is too big a cut.  (I know from personal experience as this is what I did - on my doctor's advice.)  Here's an article on how to make your own liquid:

 

How To Make Your Own Liquid from Tablets or Capsules


Psychotropic drug history: Pristiq 50 mg. (mid-September 2010 through February 2011), Remeron (mid-September 2010 through January 2011), Lexapro 10 mg. (mid-February 2011 through mid-December 2011), Lorazepam (Ativan) 1 mg. as needed mid-September 2010 through early March 2012

"Never attribute to malice that which is adequately explained by stupidity." -Hanlon's Razor


Introduction: http://survivinganti...oducing-jemima/

 

Success Story: http://survivinganti...r-dickhead-too/

Please note that I am not a medical professional and my advice is based on personal experience, reading, and anecdotal information posted by other sufferers.


#23 findingme

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Posted 23 September 2013 - 11:08 AM

Hi Jemima, I read the explanations about creating your own liquid, and it makes the process seem like a full time job... isn't there some easier way to do this ? I'm getting pretty stressed about this ... thought the dosing reductions would be a lot easier . .. yuck ... now I'm staring to rethink the whole thing... but in my heart I know the antidepressants are messing with my brain ....I've got to keep this simple or I'll never be able to do it ....

#24 Lilu

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Posted 23 September 2013 - 11:47 AM

There's no reason to make your own Lexapro liquid.  I just asked my Doc to prescribe it, and it's available as a generic. Also I asked the pharmacist to color it red so that i can see it better in the syringe.  I also really really didn't want to deal with liquid meds and syringes, but after quitting cold turkey and going bonkers for two weeks, i saw that i had no choice.  Don't worry, once you get the hang of measuring the liquid, it becomes a no brainer.


2000 Reglan - the acid reflux drug that is really a dopamine antagonist and is related to antipsychotics! 

2001 bad reaction to Celexa 1 week/Paxil 2 weeks

2004 Prozac 3 months

2005-2008 Effexor xr

1/2008 - 3/2008 Tapered Effexor for 3 months, then off for 4 months. Reinstated Effexor 7/2008

2008-2009   Effexor xr

2009-3/2013 Pristiq

3/2013 - 5/2013 Lexapro 10mg, then 5mg 1 wk, then cold turkey

5/2013Reinstated 5mg Lexapro for 6 weeks after 2 week withdrawal syndrome

8/2013 Started Liquid Lexapro 5 ml

12/31/13 Held at 1 ml for 1 month; 1/3/14 Reinstated 2 ml dose; 2/1/2014 Resumed Lexapro taper at 5% per week

 


#25 Jemima

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Posted 23 September 2013 - 12:45 PM

Getting the liquid, generic Lexapro is definitely the best way to go if your doctor is cooperative.  Thanks, Lilu.


Psychotropic drug history: Pristiq 50 mg. (mid-September 2010 through February 2011), Remeron (mid-September 2010 through January 2011), Lexapro 10 mg. (mid-February 2011 through mid-December 2011), Lorazepam (Ativan) 1 mg. as needed mid-September 2010 through early March 2012

"Never attribute to malice that which is adequately explained by stupidity." -Hanlon's Razor


Introduction: http://survivinganti...oducing-jemima/

 

Success Story: http://survivinganti...r-dickhead-too/

Please note that I am not a medical professional and my advice is based on personal experience, reading, and anecdotal information posted by other sufferers.


#26 bubble

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Posted 01 October 2013 - 11:08 PM

hm, I posted my first (rather long) post on this thread yesterday and now it's simply not visible ;(

 

Although I did see it after posting it...

 

What might have gone wrong? Should I contact the administrator or just write the whole story again (trying to make it shorter)?

 

thank you!


Amyzol to treat headache in 1996 (19 yrs)
1999. - present Xanax prn up to 3 mg.
2000.-present Prozac, Zoloft
2010-2013 Escitalopram 10 mg
went from 2.5 to zero on 7 Aug 2013, bad crash 40 days after
reinstated to 5 mg Escitalopram 4Oct and holding, significant relief after 2 weeks
Xanax 25.10. 4 x 0.5 mg every 5 hours
9.11. introduced liquid Xanax: 0.4 mg every 5 hours including a night dose
(7.30am, 12.30, 17.30, 22.30,2.30am.)
28 Jan2014 5% drop on Xanax from 2 mg to 1.9
6 March 8 % cut Xan to 1.75 mg (too much), 6 April 4 % Xanax cut to 1.68
26 April 3 day batch 1.66, 12 May 2.5% cut 1.62, 26 May 1.58, 5 June 1.54, 15 June 1.5

5 July 1.46

I'm not a medical professional. Any advice I give is based on my own experience and reading. 


#27 CFSBoomer

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Posted 17 October 2013 - 08:02 PM

I'm planning on obtaining some liquid Lexapro soon,  to begin my taper. I've confirmed that my pharmacy has liquid form. They want $340. a bottle, that's a 1 liter bottle with 1 gram dissolved in it, so 1ml = 1mg as I understand it.  100 mg in a bottle, I believe they said. That's $3.40 a miligram. About twice what my pill price is, but the stuff is priceless when you're addicted to it.  I read above Lilu says it comes in generic. I forgot to ask them. 

 

My question is: Is there a chart showing the 10% reduction doses?  or is there a math diagram that would help me calculate my tapering? 

 

I need to start backwards from 2.5 mg.


14 years on Paxil 5mg (prescribed as an antidote for CFS symptoms (Chronic Fatigue Syndrome)

It worked great for bringing me back to life, and I got over the CFS.

Never could quit Paxil.

Tried it in 30 days, too abrupt, unsupervised.

Had One Bad Year on nothing at all,  (figured I needed to tough it out)

couldn't stand it any longer after a year.

Got back on Lexapro this time, 2.5mg 

That's worked for the last 3 years,

Would like to be free of it,

so am planning a taper. 


#28 Altostrata

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Posted 18 October 2013 - 10:46 AM

If the cost is prohibitive, you can make your own liquid, see instructions in post #1 in this topic.

 

A calculator is handy for calculating 10% decreases, or 90% of current dosage. 10% of 2.5mg is .25mg, resulting in a dose of 2.25mg.


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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#29 Lilu

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Posted 19 October 2013 - 11:16 AM

I'm finding it very tricky to taper once I went past the 1.8 ml mark. Going from 5 ml to 2 ml was a breeze. Especially after my doctor recommended that I divide my dose and take the liquid in the AM and PM.   Even tapering by more than 10% at times. Up to 16% did not cause withdrawal symptoms for me, until... I went past 2ml. 

         Once I went to taking .9 ml in am/pm, all the symptoms of antidepressant withdrawal started: insomnia (not being able to fall asleep at night, no matter how sleepy I am); anger flareups, depression, drowsiness, irritability, blurred vision, and obsessive thinking.  Ugh...I hate to have to go even slower than 10%, as it is, tapering at 10% will put me at the end of May at the finish line.

 

So I decided to go back to taking the full dose in the morning to see if this would offset the insomnia.  It did.  But then I started waking up at 1 or 2 am and unable to fall asleep for a couple of hours.  So, my doctor suggested that I continue to split the dose, but take the larger dose in the morning.  Today is my first day trying this.

         Even though, Lexapro is known to have a 27-32 hour half life, I am led to believe that it is clearing from my body much quicker. Or perhaps after 16 hours or so, the remaining concentrations of the drug are enough to cause withdrawal symptoms.

 

I'm just not sure how I can avoid withdrawal symptoms once I have to go past 1 ml per day...


2000 Reglan - the acid reflux drug that is really a dopamine antagonist and is related to antipsychotics! 

2001 bad reaction to Celexa 1 week/Paxil 2 weeks

2004 Prozac 3 months

2005-2008 Effexor xr

1/2008 - 3/2008 Tapered Effexor for 3 months, then off for 4 months. Reinstated Effexor 7/2008

2008-2009   Effexor xr

2009-3/2013 Pristiq

3/2013 - 5/2013 Lexapro 10mg, then 5mg 1 wk, then cold turkey

5/2013Reinstated 5mg Lexapro for 6 weeks after 2 week withdrawal syndrome

8/2013 Started Liquid Lexapro 5 ml

12/31/13 Held at 1 ml for 1 month; 1/3/14 Reinstated 2 ml dose; 2/1/2014 Resumed Lexapro taper at 5% per week

 


#30 Altostrata

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Posted 19 October 2013 - 03:02 PM

It's possible it's clearing faster at lower dosages.
This is not medical advice. Discuss any decisions about your medical care with a knowledgeable medical practitioner.

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#31 Lilu

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Posted 29 October 2013 - 05:40 AM

My doctors suggestion to take a higher dose in the morning and a smaller one at night, seems to have subsided most of the withdrawal symptoms.  I have noticed that I get very sleepy around 6:30 or 7:30 pm, which I know is one of the withdrawal symptoms.  So, I'm going to start timing the doses closer together, like 8 am and 6 pm.  This also seems to offset the insomnia, and helps me wake up around 7 am instead of in the middle of the night.  

 

Also, instead of doing a 10% drop every week, I tried dropping by 5% on Monday and then by another 5% on Thursday.  This seemed to have worked without any major side effects, so far.  I am currently at 1.32 ml of Lexapro liquid.  Hopefully someone out there also find these techniques helpful.

 

Oh, the other thing I want to point out, is that I suspect that my sudden withdrawal onset also had to do with the fact that after using a 1 ml syringe (for split doses, like .9 and .9) I switched to using a 5 ml syringe to do 1 ml in AM and the rest in PM.  I think the 5 ml syringe was delivering a lot less medication because the liquid left in the tip doesn't come out.  Whereas the 1 ml syringe includes the liquid in the tip, which actually makes it more than 1 ml.  At least that's how the crappy 1 ml syringes I get from Target pharmacy seem to work. They're so bad, they don't even stay inside the cap. I have to apply constant pressure to keep the liquid in the bottle from spilling out!  Ughh  - that happened plenty of times in the beginning!


2000 Reglan - the acid reflux drug that is really a dopamine antagonist and is related to antipsychotics! 

2001 bad reaction to Celexa 1 week/Paxil 2 weeks

2004 Prozac 3 months

2005-2008 Effexor xr

1/2008 - 3/2008 Tapered Effexor for 3 months, then off for 4 months. Reinstated Effexor 7/2008

2008-2009   Effexor xr

2009-3/2013 Pristiq

3/2013 - 5/2013 Lexapro 10mg, then 5mg 1 wk, then cold turkey

5/2013Reinstated 5mg Lexapro for 6 weeks after 2 week withdrawal syndrome

8/2013 Started Liquid Lexapro 5 ml

12/31/13 Held at 1 ml for 1 month; 1/3/14 Reinstated 2 ml dose; 2/1/2014 Resumed Lexapro taper at 5% per week

 


#32 Altostrata

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Posted 29 October 2013 - 09:20 AM

You may wish to get better syringes. See http://survivinganti...ing-techniques/

 

Why did you decide to taper by 10% per week?

 

Sounds like splitting the doses was a good idea. This probably compensates for faster metabolism of the lower dosages. Thanks for contributing it.


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.

#33 Lilu

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Posted 29 October 2013 - 04:54 PM

Why did you decide to taper by 10% per week?

I decided to taper by 10% per week because that is what Dr. Breggin recommends - as per his book, he recommends tapering by 10% every 7 to 10 days.


2000 Reglan - the acid reflux drug that is really a dopamine antagonist and is related to antipsychotics! 

2001 bad reaction to Celexa 1 week/Paxil 2 weeks

2004 Prozac 3 months

2005-2008 Effexor xr

1/2008 - 3/2008 Tapered Effexor for 3 months, then off for 4 months. Reinstated Effexor 7/2008

2008-2009   Effexor xr

2009-3/2013 Pristiq

3/2013 - 5/2013 Lexapro 10mg, then 5mg 1 wk, then cold turkey

5/2013Reinstated 5mg Lexapro for 6 weeks after 2 week withdrawal syndrome

8/2013 Started Liquid Lexapro 5 ml

12/31/13 Held at 1 ml for 1 month; 1/3/14 Reinstated 2 ml dose; 2/1/2014 Resumed Lexapro taper at 5% per week

 


#34 Altostrata

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Posted 29 October 2013 - 05:10 PM

If you get withdrawal symptoms, that means Dr. Breggin's plan is too fast for you, and you need to slow down.


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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#35 Lilu

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Posted 29 October 2013 - 05:43 PM

You may wish to get better syringes. See http://survivinganti...ing-techniques/

 

Very hard to find Baxa (now Baxter), but these look like them: http://www.amazon.co...s=sklar syringe

 

I also found Becton Dickinson syringes for $.16 cents each http://www.vitalitym...ringe-only.html  - do you know anything about this brand?

 

Also, in reading reviews on Amazon, someone suggested a brilliant idea - put a coat of clear nail polish over the numbers!


2000 Reglan - the acid reflux drug that is really a dopamine antagonist and is related to antipsychotics! 

2001 bad reaction to Celexa 1 week/Paxil 2 weeks

2004 Prozac 3 months

2005-2008 Effexor xr

1/2008 - 3/2008 Tapered Effexor for 3 months, then off for 4 months. Reinstated Effexor 7/2008

2008-2009   Effexor xr

2009-3/2013 Pristiq

3/2013 - 5/2013 Lexapro 10mg, then 5mg 1 wk, then cold turkey

5/2013Reinstated 5mg Lexapro for 6 weeks after 2 week withdrawal syndrome

8/2013 Started Liquid Lexapro 5 ml

12/31/13 Held at 1 ml for 1 month; 1/3/14 Reinstated 2 ml dose; 2/1/2014 Resumed Lexapro taper at 5% per week

 


#36 Altostrata

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Posted 30 October 2013 - 11:02 AM

Lilu, these look exactly like Baxa syringes http://www.amazon.co...s=sklar syringe

 

Baxa was purchased by Baxter, which still calls the Baxa-type syringes Exactamed syringes. http://www.baxterbio...ng-devices.html

 

You may be able to get oral syringes locally from a compounding pharmacy, veterinarian, or medical supply store. Ask for a syringe WITHOUT the needle. Tuberculin or insulin syringe with a non-luer tip (aka luer-slip or plain tip) come in the 1mL size.

 

I've bought these in packs of 10 from a medical supply store. They were very inexpensive. Phone the medical supply store first to see what they have.

 

In the US, in  most places you are not required to have a prescription to purchase a syringe.

 

The Becton Dickinson syringes are okay but not as precise as the Exactamed syringes.

 

Here is a source in the UK http://www.ebay.co.u...l-/151114428586

 

It's not clear whether these are Baxa or Becton Dickinson. The photo looks like Becton Dickinson.


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.