ikam: tapering escitalopram

[KarenB]

Moving house is a very big stress-inducer.  It takes time to recover from, so don't be too hard on yourself.  The feelings and stresses will keep working through and away from you, and gradually you'll notice you're feeling a bit more like yourself again.  Keep on soothing, accepting, giving yourself love - you deserve good things Ikam. 

 

Karen

[ikam]

Possibly I shall wait a bit with tampering, until I feel a bit better...

I don't know anymore...

I don’t know if the pain is from stress or wd? Or both...

It strangely kicks in around 5, 6am...

[KarenB]

The pain will be from w/d, and the w/d will be made worse by the stress.  The reason it starts at that time of the morning is because that is when cortisol naturally runs higher in order to wake people up for the day.  But for us in w/d, it causes extra problems as our systems are not regulating properly, so it ramps up too much.  This is also why people in w/d often feel better towards the end of the day. 

 

It's probably best to wait a while before tapering again - good idea.

[ikam]

Thanks for the explanation, it makes sense. I always wake up with the pain around 6am, although I may not have any pain during the night. I am always very low in the morning as well...

 

Looks I need to hold; but when will be a good time? My life is a bit more settled at present, but far from stability. I will need to start my divorce proceedings + my job related situation is not really safe (as there are many changes in the nhs service)...

But,

it is not a good time, I know, I do need to deal with after-stress symptoms...and dealing with stress and wd means that I don't recover as well as people with well functioning nervous system...

[ikam]

Hmm...My "depressive" mood continues and I am reaching the darkness I have not known it existed...

I feel so low, so empty...

Have "zero" motivation...

[ikam]

How to deal with a physical pain? Today is my jaw, as if pain in the teeth I don't have anymore.

Last night it was my foot, stabbing pain, waking me up...

I am worried that one day I will not be able to get up...

[KarenB]

I don't know much about coping with physical pain, but we have some discussion here:  http://survivingantidepressants.org/index.php?/topic/7713-non-drug-techniques-for-dealing-with-physical-pain/ and http://survivingantidepressants.org/index.php?/topic/10992-eckhart-tolle-the-pain-body-and-mental-suffering-during-withdrawal/

 

As for mental suffering - I have certainly been there.  There's no single answer.  It's a combination of time, and continuing to add supportive or good things into your life, no matter how tiny or insufficient they may seem.  Eventually they build up into something bigger, and you start to get through it.  You can have a look at my blog if you want more details on how I've coped (and not coped) over the years (see signature). 

 

I'd say that there is reason to hope, (although I do remember how it's nearly impossible to believe that when you are in that black place).

 

Karen 

[ikam]

Thank you Karen. I seem to be in "the impossible" at the moment...Feeling so depressed...I don't understand this feeling as I seem to be in "the best" place, after long term stress...and I have everything I need...

Yet, my house is the mess, I never had before...my bike is standing...my work- I do minimum...

I don't understand...so low, so miserable, exhausted...

And in a trap of impossible puzzle related to my meds, I don't know if and where and when to start??? One affects another, the side effects...possibly my depression relates to them, definitely exhaustion...

I isolate totally, don't want to see anybody...don't do much...

[ikam]

Additionally to the above, I have had this strange "immobility" sate. I could just sit and do nothing...this is something new for me...

[KarenB]

I was just writing this on another thread - psych meds cause depression.  Ironic huh? 

 

I still think that what I wrote earlier makes sense:  Tapering Omeprazole first would make sense in that it's quicker to taper, and you could then start tapering your next drug.  (This would also knock out one of your moderate interactions).  However, you have a major interaction between Escitalopram and Doxepin, which can cause serotonin syndrome.  That said your dose of Esc. is relatively low at 2.5mg, so you might be okay to wait, and then taper Escitalopram after you've done Omaprazole.

 

I know it is hard to make a decision when your brain just won't co-operate.  It's a difficult cycle to be in. 

 

Karen

[ikam]

Karen, I also blame myself that I got myself to this stage...that I "wanted" meds to be fixed...I truly believed that they were helping me...

 

I have been better today, just normal...

[KarenB]

That's not so uncommon, to blame yourself.  Truth is though, we are living in a culture of drug-taking, and of drug-pushing by the 'professionals' we have been taught to trust since our childhoods.  Turns out the big bad wolf wasn't out in the woods - it was in a white coat in a doctor's office.  And with a school system designed to makes us into good, compliant citizens - wow!  We didn't stand a chance because we don't exist in a vacuum.  

 

Acceptance, forgiveness, letting go - that's the way forward.  

[ikam]

Additionally, my father was a psychiatrist...he was also addicted to drugs and alcohol...

I was treated with various meds since childhood, mostly antibiotics...I was made to believe, to trust doctors...

[ikam]

I have been more settled...feels so good...less tired, more relaxed...less phisical pain...

 

It is sad that I will have to upset this balance when I decide tappering again...

 

If I start with escitalopram, I think I need to start very, very slowly...I take 10ml syringe (2.5mg)...I was thinking about decreasing 0.5ml, using 1ml syringe...Would it be slow enough?

[KarenB]

If I'm reading this right, 0.5ml would be a 5% reduction of your escitalopram dose?  That sounds like a wisely cautious dose to begin with.  If you want to be extra sure you could always start by reducing 0.25ml for this first time, and then if that goes well try a 0.5ml reduction next time round. 

 

That said, if things have started to settle, allow yourself some time in that place - don't rush in to tapering. 

[ikam]

Thank you Karen. I feel caught up in between a need to rush and hold...oscillate between two and actually taking no decision at all...it feels good to feel more stable...

 

As per your answer I will start at some point with 2.5%...

[ikam]

I have days when I feel better, almost "myself", whatever it means...actually more and more often I feel rested...But I am never free of physical pain...

I often think what I would say to a doctor if they would really listen? That I regret that I did listen to them and believed their suggestions for treatment (so I often suffer of the consequences in the form of side effects), believed in nhs free treatment (that is only led by polices), that this is very sad for me that only now I see that certain medication is dangerous (e.g. ssri, antidepressants, prolonged use of proton pomp inhibitors or beta-blockers)...

I believed in everything they suggested...I see my mother struggling, as the medication is just added in order to deal with side effects of another medication...she swallows at least 20 pills a day! She trusted doctors...

And I did trust them...I don't anymore...

Of course, I am not completely blind, as I know that without their intervention I would not have a surgery I needed...But, still I think that the amount of painkillers is miss-used...I was completely drugged after my surgery...

I would ask a doctor to really listen to me, as I know my body far better that they do...I would request all the tests prior to any medication given...

Hmm, my father was a doctor, I would tell him to stop medicating me with each sore throat or a cold, I did not need antibiotics twice a year...I did not need all these injections (oh, I was so brave!), tinctures (so bitter, but I was so good in swallowing them with no complaints!)...

At least, I was good in something (???)...

I would tell them to "be with me" (my mother and father), rather than treat me and panic that I may get worse...

And now, it seems all to late for a change...my body seems damaged...I need special probiotics, iron supplements, etc.. All due to the treatment I received, never resisted, never complained, completely trusted...

The physical pain I mentioned above, it is largely due to oversensitivity of my nervous system, as it does not work "normally"...What does not affect others so much, affects me...e.g. I am very sensitive to any additives in food, I may buy apples in Tesco, and in organic shop...I cannot eat "Tesco ones" as I will have symptoms...but organic food is much more expensive...

It feels too late for anything...

There are aspects of life I have just discovered (e.g. that it is good to have a pension plan), that I should have known about long time ago...

Yesterday I woke up anxious, that when I eventually retire (I wish to be retired, I am tired of working, cannot get enthusiastic anymore, as my work has been "spoilt" by polices...), that I will have not enough money to afford a decent rented accommodation, and that I will have no money to have my place properly heated, I will have no money for some supplements I need to take, etc....

Doctors? They have training in quick fixes and they have "delusions of power"...and they often corrupted by "Big pharma"...

And I know this today, but it is too late to reject some treatments I received in the past that affected my life here and now and will affect my future...

I would never tell doctor what I really think...I understand that they have to follow guidelines, but this only means that they stopped listening to their patients...and they will never do, as the anxiety of failing a policy is much greater than failing a patient...As long as they follow the policy, it is (sorry) not important that patient died or developed serious symptoms as a consequence of treatment...

[ikam]

This is weird. I used to be able to read psychology/psychotherapy books with no emotions. Read as a something scientific rather than emotional...

 

Now, reading affects me so much. I read half of a book about psychosomatic disorders yesterday, and I am so affected by the content. I even had a nightmare last night...

 

I tried to read some of the topics here, but I always get overwhelmed with anxiety and hopelessness...So I don't read, but then I don't contribute to anybody's problems, neither get any "tips" to my problems...

 

I feel so low today (Sunday)...

The dream was really vivid, I dreamt about having a surgery to my arm...it was healing well, the scar was forming...I went to see a nurse for another wound on my back that had some stiches to be removed...She touched the scar on my arm and the puss started coming out of it...I woke up terrified that "I cannot heal"...

It reminded me about some dental surgery that went wrong, and I had two months of hell, with a severe infection and antibiotics treatment lasting for two months...

[KarenB]

When they mess with people's lives, they mess with the sacred.  That's why we hurt so much.  However, they cannot affect our essence, the real core of who we are. 

 

JanCarol bumped this thread yesterday, with a short video about dealing with this deep level of pain:  Melt into your own life  I watched it last night, and I know it'll be one I go back to.  Hope you also get something out of it Ikam, because I can really hear the hurting in your words.

 

Karen

x

[ikam]

Additionally, I dont know if I have done something wrong (again). I added something called Hemo-Lyph https://www.pureformulas.com/hemolyph-60-tablets-by-nutri-west.html

It does not affect my stomach, but I have not been sleeping too well, have more anxiety...Feeling generally more active, but also more anxious...

[ikam]

Could Probiotic make a difference when taking "the drugs"...I think it may affect assimilation process? Hence, alter the amount of "drug"...???

[scallywag]

Oh, ikam. People react to all kinds of things, even probiotics.  A healthy friend of mine had a horrific reaction to a new supplement. She was off work, saw her doctor and went at least once to a hospital emergency department (A&E).  It turns out she and a coworker at a supplement company both had extreme reactions to a new product the both had sampled.

 

As always, start with a small amount -- ¼ of the lowest recommendation on the bottle or less -- to test and then increase slightly and slowly over days and weeks.

[ikam]

Can probiotics have a negative effect, e.g. mess up with metabolism...

 

I have started some 5 days ago and feel strange...

[LexAnger]

I tried once two yrs back, got new symptoms so stopped.

I feel once our systems are over sensitized, they tend to over react to basically everything new. So I quit thinking to take anything for hope of feeling better.

[ikam]

I stopped them. Have done some research today and I found stated below side effects- I put "+" in the symptoms I experienced.
Most common side effects for patients taking VSL 3:

HEADACHE +
NIGHT SWEATS +
BACK PAIN
CHILLS
CROHN'S DISEASE +
DIZZINESS
DYSPNOEA
ILEITIS
INFLUENZA LIKE ILLNESS +
IRRITABLE BOWEL SYNDROME
URINARY TRACT INFECTION
ABDOMINAL DISTENSION
ABDOMINAL PAIN +
ALOPECIA
ANXIETY +
ARTHRALGIA
COLITIS ULCERATIVE
CONSTIPATION
DIARRHOEA
DRUG DOSE OMISSION
DRY MOUTH +
DYSPEPSIA +
FATIGUE +
INFLAMMATORY BOWEL DISEASE
NAUSEA
OROPHARYNGEAL BLISTERING
SLEEP DISORDER +
SYSTEMIC LUPUS ERYTHEMATOSUS
TRANSAMINASES INCREASED


Additionally: http://www.mommypotamus.com/popular-probiotic-strain-may-induce-neurotoxicity/

[brassmonkey]

Hi Ikam-- I got your PM asking about the Brassmonkey Slide Method and thought it best to answer here in your intro thread. The BSM is a variation of the standard 10% taper. To do it you do 4 slides of 2.5% each, one a week for four weeks and then hold an additional two weeks.  This give a total drop of 10% every 6 weeks. Some people have opted to do a total of 5% by sliding 1.25% each week for four weeks and then holding the additional two weeks. The thinking is to spread the impact of the WD symptoms out over the smaller cuts instead of having them hit all at once.

[ikam]

Sounds like a good idea. I think with escitalopram the cuts need to be small...

Thank you for your answer. I will try to do it your way...

 

I have a big problem with starting. I constantly postpone it...

But I need to be wise with my life...

I know that escitalopram is toxic for me...

[Junglechicken]

I am curious as to why you would need to taper Omeprazole.

 

This was a medication I took for 6 weeks, and then stopped taking abruptly a couple of weeks ago. I found out my mother is also taking it.

[ikam]

I have been on PPI for years, when I try to lower my dose I get reboud acid and other symptoms.

Also, decreasing PPI makes absorption of other meds different.

[Altostrata]

You need to lower the dosage of omeprazole gradually or risk getting rebound reflux, your gut has to accommodate to working again.

[Junglechicken]

Thanks Ikam and Alto.

[ikam]

I am not brave enough...will I ever be brave enough to expose myself to symptoms I dont want to feel????

[ikam]

I don't understand this ongoing pain, I don't know is this WD or real problem... I am so tired of this. There is no day with no pain, mostly my joints...

[ikam]

i have done it again, over-dosed with 150mg doxepin...woke up today with various phisical pains...had enough, wanted to detach completely...

i have lost any hope I will ever get better...

whatever I do I end up with physical pain...

also, emotional pain, complete loneliness...

I don't want to be alive...

[scallywag]

Aw, ikam, I wish we or somebody knew how to take away the pain. You've done so much work to decrease your doses. Keep hanging on.

 

Was this an unintential updose? Or a regular dose that your body responded to as "too much"?

[ikam]

I intentionally took 150mg doxepin...just to shut down, forget....it is similar to drinking alcohol...kind of binge drinking or drugging...I don't drink alcohol at all...

I am so tired of this constant pain; I have not had a day free from pain for very long...

Struggling at the moment...