☼ Pregnog: stopping escitalopram in early pregnancy

[Pregnog]

Hi everyone. This is my first post. I just discovered today that I'm pregnant - and delighted, but in complete shock! Have been trying for years and had given up. I've been taking escitalopram 10mg for 3 months, and need to stop taking it ASAP as it's not good to take while pregnant. I've taken it once before and really struggled to come off it, but managed to eventually by using the liquid and tapering more slowly (although never quite got back to my previous state, but that's another story!). I'm looking for advice on how to come off this drug as quickly and safely as possible. Please help!

[mammaP]

Hi Pregnog, welcome to SA. Congratulations on your news, you must be delighted  .  

 

This is a difficult one, if there are going to be any problems they are usually caused in the first few weeks of

pregnancy. SSRIs are not good in pregnancy but not all babies are affected so it doesn't mean that your baby

WILL be affected.  Tapering..... you have had problems in the past so will no doubt have problems again now,

as you know they are notoriously difficult to get off without withdrawal symptoms.  Can you cope with the

withdrawal?  Can you tell us a bit about your previous experience with withdrawal? That might help us to 

know how fast a taper you may be able to tolerate.  How far along is your pregnancy?   

[Pregnog]

Hi, thanks so much for your reply. The problems I had coming off before were a sudden, intense lowering of my mood, lots of 'electric' shock sensations. I also experienced some intrusive thoughts about self harming, which I'd never had before. That frightened me, as did the intensity of the symptoms. However, I wasn't pregnant then so I had a choice. Now I just want to come off them as quickly as possible, but also as safely as possible.

 

I'm in week 4 of my pregnancy. So very early, but sharing a blood supply now.

 

Are there any actual risks to just suddenly stopping?

[mammaP]

I feel for you so much Pregnog. It is a hard call but is one that only you can make. 

 

If you stop cold turkey that could lead to quite severe withdrawal for you. I just had a thought,

could you contact Dr David Healy? He is a psychiatrist who knows all psychiatric drugs and

their risks, he also knows about withdrawal and is based in the UK. I will find his contact details

for you. He will reply to emails and will see people on the NHS. Some of our members have

contacted him and he is very helpful. He would be better placed to advise you. This suddenly

came to me as I was typing my reply. 

 

His website, http://davidhealy.org/

 

His contact details North Wales

Hergest Unit Ysbyty Gwynedd Tel:  01248 384883

Dr Healy Tel: 01492860926

 

Dr. Healy is one of the few physicians in the world who recognize post-discontinuation syndrome from psychiatric drugs. He also founded Rxisk.org to track iatrogenic damage from pharmaceuticals.

 

Dr Healy is on our list of recommended doctors. http://survivingantidepressants.org/index.php?/topic/988-recommended-doctors-therapists-or-clinics/?p=56135

 

If you contact him will you let us know how you get on? This is so hard, and I wish I had the right answer for you. 

[Pregnog]

Thanks so so much mammaP. I got in touch with Dr Healy straight after reading your message, and he replied within 15 minutes!! 

 

His first reply said this:

 

This is an extraordinarily difficult dilemma.  Its impossible for me to advise you without knowing a lot more about you etc and this isn't possible at the moment.

 

All I can tell you is this.  Withdrawal difficulties of the kind you had before are real and can be terrible - but they might not be so bad if you are pregnant - you have a different body now to the one you had when you tried before.

 

There is a real risk of harm - and this is the critical period for heart defects and things like that - from 2 to about 10 weeks - so the earlier you stop if you are going to stop the better.

 

There is some benefit to stopping anyway even if you do it more slowly in that other problems such as how quickly the baby develops after being born are less likely if you aren't on the meds through the whole pregnancy.

 

Its all complex.  You could remain on treatment the whole way through and your baby would be absolutely fine.  You could stop and their could be problems.  All things being equal, it looks like there is a better chance of things being okay if you stop.  

 

But this is easy for me to say and much more difficult for you to do. I would check with your partner, parents and friends.

 

I then replied and clarified a few things, and asked specifically if there was any harm to me or the baby that could be caused by withdrawal, stopping suddenly, and the symptoms this can cause, and he said no 'If you can handle any withdrawal effects, there is no harm to the baby to just stop - and all things being equal would be better'.

 

So, I've decided to go cold turkey, and I checked this out with my GP as well. I've not taken anything since Wednesday morning, and it's now Friday evening. I've had quite a lot of the 'zaps' (or bojangles as I call them) but to be honest, I don't mind those even though they are very uncomfortable and sometimes disorientating. I've had a few episodes of feeling dizzy but this has been when I've been sitting down. There's been no change in my mood yet, perhaps it's too early for that.

 

Anyway, HUGE thank you for your kind and thoughtful response, it was amazingly helpful of you. I hope someone in the future also finds this thread helpful I'll update if anything changes.

[Meimeiquest]

Good luck!

 

I have read some of women who did well during their pregnancy, but had more issues in the post-partum period. I say that not at all to scare you, but to give you the idea of preparing in advance and maximizing your resilience. Kelly Brogan is a perinatal psychiatrist with an interesting blog you might want to check out, www.kellybroganmd.com.

 

Good luck! Enjoy this time as much as you csn!

[Ever]

Pregnog - so glad you found this site and you are going to stay in touch here.

[mammaP]

I am so glad that he replied right away. He is a great doctor and very helpful. I hope everything goes well for you

and your wee one. Will you let us know how you are and update us of your progress occasionally? And of course 

the announcement when baby arrives 

[Ssriwarrior]

I would also recommend checking out the work of Dr Kelly Brogan. Her specialty is perinatal mood disorders and she helps women get off SSRIs who are pregnant using functional medicine. Unfortunately she's in NYC and not available for Skype consults but still worth checking out Her site:

http://kellybroganmd.com

[Pregnog]

Thank you!! What a kind group you are!!         

[bubble]

Thanks a lot for sharing dr.Healy's reply.

 

It would be great if you could update us on how everything goes. If symptoms ocur we have a great section here in Symptoms and self-care on non drug related ways of coping.

 

The best of luck with everything!

 

Bubble

[Altostrata]

Welcome, Pregnog.

 

Blessings upon Dr. Healy, to be there for you so quickly.

 

If the withdrawal symptoms get worse, you may wish to take a tiny crumb of escilatopram. Incredibly, this sometimes stops withdrawal symptoms. The dosage would be low so less risk to the baby.

[bubble]

yessss! Alto is a genius

 

These symptoms have a delayed onset also so you might be outside the tricky first trimester.

 

We can advise you how to get at a really tiny (but as Alto says, powerful) dose of even 0.5 mg or less if needed. So less to be afraid of!

[Pregnog]

oh wow, that sounds interesting, and potentially really helpful. 

Specifically what kind of symptoms are you referring to, so I know what to look out for?

[bubble]

Although we all have lots of symptoms in common, even in cases where drugs are different, it is still a very, very individual process.

 

You were on the drug much shorter than me, I was on 2 drugs, others had some other different parameters in their history. I wouldn't really bother/scare myself with those. We will deal with them when and if they come.

 

Even with my bad history I managed to stay off for 40 days. It's just important to know that you have a safety net in case you need it.

 

I also expect that pregnancy hormones will buffer a lot of symptoms. Stress free environment and positivity is the best one can do to deal with withdrawal. Pregnancy is that. Just enjoy it. If any symptoms ocur, come here and then we can see together what can be done.

 

In the meantime just be pregnant

[Pregnog]

Ah bless you, what a kind response! 

 

When I came off escitalopram before I'd been on it for about 9 months, and I experienced all the usual zaps, sudden lowering of mood, some intrusive thoughts about self-harm, although these were new and weird, I wasn't concerned I would act on them. Although they did make me wonder really what these drugs do to us! 

 

The longer term effects, which I'm only starting to get my head around now, were more concerning. About 4-6 months after completely stopping, I started getting really intense and overwhelming urges to cry, in situations that wouldn't normally make me cry at all. It was like any tiny bit of stress or anxiety would make me want to cry. Other people noticed and as I was in a relatively new job at the time, people came to think of me as sensitive and emotional. As soon as I started taking escitalopram again, the problem disappeared. There were lots of other things going on as well, that were stressful, however I've been through way more stressful periods and never experienced this. At the time I just couldn't work out what was going on, then eventually I decided to start taking the medicine again. The problem went away within 2 weeks.

 

Maybe I'm veering off topic, but I'd be really curious to know if others have experienced this. I'm really worried about it returning again!

[Ever]

Yes Pregnog - those long-term symptoms you describe are very very common.   I've been there many times.    Always thought that I was just ###'d in the head and needed to go back on the drugs.   So I always did.   Until I discovered they're just withdrawal symptoms.  

 

Mine usually happened about 2 to 4 months out from completely stopping.

[Pregnog]

Oh my goodness. I wish I'd known that! I thought I was going crazy, or going through the early menopause or had thyroid issues or something. Do those symptoms ever completely go away?!

[mammaP]

Yes they can and do go away completely but it takes time. Everyone is different and there is no time scale.

When you feel the worst of the symptoms just a tiny crumb of a tablet can make a difference. Mogfish, one

of our members, tapered pristiq and after she had finished her taper occasionally got some withdrawal symptoms.

She would take a crumb, just a tiny crumb, like if you crushed a tablet it would be one of the smallest pieces. That

helped the symptoms. Hopefully you will be ok but if not just come in here and holler, we will do everything we can

to help. Huge thanks to Alto for mentioning that, I had completely forgotten that! 

[Pregnog]

I just feel completely flabbergasted about this - I wish I had known! I spent from April 2013 to September 2014 experiencing this consistently and relentlessly, it completely ruined a job that I had. I never attributed it to escitalopram. I used to have to leave meetings or just not talk because I felt on the verge of tears so often, it was so humiliating. I have social anxiety anyway and have since I was a child, but it was so much worse during this time. Does this happen with other SSRIs as well? And where can I find information about minimising the chances of this happening again? I like the crumb idea, but there must be some other strategies too?

 

As for how I'm feeling at the moment, the zaps have got a lot worse and I've been feeling quite flat and spaced out. And a bit nauseous, but this could be the pregnancy. Any ideas on how to make the zaps more bearable? 

[bubble]

We have all been there where you were from April to September 2014. The longer you are on these drugs, the more you have changed and so on, the more severe the symptoms are after stopping. This is actually called withdrawal syndrome. Doctors are denying our experiences so that's why we seek advice online. 

 

I've been reluctant to expose you to this information at this point but since you are asking about it here is the link: http://survivingantidepressants.org/index.php?/topic/1008-intro-to-antidepressant-withdrawal-syndrome/

 

Just bear in mind that we are all different and our histories are different so don't get scared.

 

Here is our topic on brain zaps. I hope you will find useful information there: 

http://survivingantidepressants.org/index.php?/topic/288-brain-zaps/

 

Symptoms and self care section has lots of advice on non-drug way of dealing with them. You can google anything that interests you for example surviving antidepressants brain zaps and you will be directed to the information. 

 

keep us posted.

[Pregnog]

Thank you!! Not scary - just very helpful. I'm an information hound, I much prefer to be informed. I've experienced all of these before anyway, just the thought of going through it again is not nice at all. Zaps are so bad today, just going to read the zap link and see if there's anything I can do. Thank you so much!

[ten0275]

Pregnog, hey.

 

Phenomenal attitude towards this - information hound! Knowledge truly IS power here, not just cliche.

 

Also - Pregnog - play on eggnog? If so, one of the best screen names ever.

 

I am sorry you are dealing with withdrawal during pregnancy. I hope you find relief soon. And I wish you, and your little one to be, perfect health and happiness.

 

Hang in there.

 

Dave

[Pregnog]

Yes Pregnog is a play on eggnog!! 

 

Thank you for your well wishes Dave. What would we do without the internet?! I would be feeling so alone right now, and I definitely don't.

 

Just went swimming and had the most awful zaps all through my upper body, arms and hands every time I looked left or right... just reading about this now on the zaps thread, really hope it goes away soon!

 

I'm starting to realise that the meaning we give to these withdrawal symptoms is so important. Right now, every symptom feels like a step forward - the drug is leaving my body, my body is readjusting, it's working out how to be now without the drug. It would be so easy to slip into anxiety (well, I do do that quite a lot tbh!!) and/or anger and I think this would exacerbate things.

 

Probably won't be saying that if these zaps stay this bad for a long time....

[Skylarblue75]

Hi Pregnog, just wanted to stop by and say hi and see how your doing. I too had to do a cold turkey off of celxa that I took for 10 years during my last pregnancy, was never told that I should have been tappered. Here i am in protracted w/d. I did pretty well during the pregnancy, but one month post partum is when all hell broke loose. My little guy will be 2 1/2 yrs on the 20th of this month. Not trying to scare you so please don't think you will have the same issues I'm experiencing.  Congrats to you, just another mom reaching out.

 

Hugs and prayers

[Pregnog]

Thank you! I just want to get through the pregnancy, anything beyond that, my body is or at least can be my own again if I stop breastfeeding. If I need to reintroduce and then taper at that point, I'll be happy to. It's so good to know someone else has been through the same thing, so thank you       

[Pregnog]

I have noticed I've been having lots of problems regulating my body temperature. I'm either boiling and sweating loads, or absolutely freezing with ice cold hands. I can normally be a little bit like this, but not so extreme. Can't work out what's pregnancy, and what's withdrawals! Also very bad night sweats, the bed is literally drenched in the morning (yuck, I know). Any ideas?

[Ever]

Yep - all withdrawal lol.   Not funny I know, but the boiling and sweating, then freezing and night sweats - withdrawal, not pregnancy Pregnog.  

[mammaP]

Do you take fish oil Pregnog? I found it a big help for the brain zaps and dizziness, and as far as I know is ok

in pregnancy. A good quality one is best, I bought some online that were unbranded and very reasonably priced

but I don't think they had any fish oil in them because my zaps came back within a few days of stopping the ones

I had been taking! Now I get the Tesco ones which are fine and not very expensive. 

 

All those strange symptoms are typical of withdrawal and there may be some symptoms from the pregnancy too.

With all my 4 babies I felt very cold and dizzy all the time for the first 3 months. 

 

All the symptoms will pass eventually, and will be worth every minute when you have your precious baby in your arms. 

[Pregnog]

Hi - I do take fish oil, I take the pregnacare vitamins and omega 3s which are designed specifically for pregnancy so I know they're ok. I had thought fish oil would be good for supporting the nervous system in repairing itself, makes sense!

 

Still a bit zappy but nowhere near as bad as last week, thankfully. Hopefully they'll just keep fading. Am feeling very stroppy though, which isn't so good :-(

[bubble]

Stroppy was a new word for me in my English till now but not in the experience after I discontinued Lexapro.

 

I used a more common word: irritability. But the actual feeling was a lot more complex than that. It would get particularly bad in the evening. I would shout at my husband all the time and particularly couldn't bare being touched. However my most pronounced symptom was some kind of sinus inflammation. At least it looked like that or as an allergy. The thing was that a blood vessel in my right nostril was so swollen that when I put my head down to sleep I couldn't breathe. I had no idea it was in nay way related to withdrawal. I learnt about it only when I came here.

 

If you want to check any of experiences you are going through here you just google "surviving antidepressants + hot flushes or night sweats for example.

 

I did it now for you and got this thread. Maybe you will find the experiences of other people helpful. 

 

http://survivingantidepressants.org/index.php?/topic/2752-hot-flushes/

 

We are here for you (and for each other)

[mammaP]

Thinking about you Pregnog and wondering how you are? Hope you are ok and the pregnancy is going well. 

[Pregnog]

Hello! Thanks so much for asking. I'm 11 weeks pregnant now, all going well so far I think. Was zappy for about a month after stopping the meds. Now feel OK, but can definitely notice an instability returning. Sudden urges to cry for no reason, sudden waves of anxiety... I hate it. Is there anything I can do about it?

[mammaP]

That was me when I was pregnant, just the hormones for me at that time.  If you need to cry let the tears go, it is therapeutic to cry sometimes. Like everything else it will pass. I don't really know of anything except mindfulness meditation, which is distracting yourself by focussing on what your body is doing and the things around you. Colours and shapes, how it feels when you breathe, how does the air feel on your skin. It sounds a bit daft but it really does help to take your mind from the feelings of anxiety. Walking is really good exercise that releases endorphins and gets fresh air into your lungs, especially if you can walk in the woods or on the beach. Swimming is excellent too. I like to go to the shopping centre and sit in the cafe upstairs with a cuppa looking down on the Mall with everyone buzzing around. I don't like being IN the crowd but like to watch them from a distance.  Can you knit? Knitting is proved to lower stress, it is the rythmic action and the clicking of the needles and tiny little baby things can be knit up quite quickly. 

[Pregnog]

Hi everyone! Just thought I'd update - 23 weeks pregnant now, a few minor blips with the pregnancy but otherwise all is well! Feeling really good emotionally, was prepared for the worst considering the awful withdrawals I'd had before. Pregnancy is obviously protecting me from this, or something is different anyway. Initially after rh zaps faded I thought the intense anxiety and tearfulness was returning but it didn't last long, maybe a couple of weeks. Now I feel fine - no sudden urges to cry, no waves of panic from nowhere.

 

I've just read through the whole thread again and just wanted to say thanks again for all your kind support and encouragement - it meant I could do this without feeling alone! Thank you!

[Pregnog]

35 weeks now and still generally feeling OK but definitely noticing more emotional instability - sudden urges to cry which feel out of context, like before. Hard to tell what's pregnancy and what's withdrawal. But really amazing to have got this far and to gave felt so well and so stable. Not much longer now til baby is here!