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Gridley

Thanks, Shep and Scallywag.

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Gridley

I'm in week 8 off my Brassmonkey slide off 20 mg Lexapro, down to 17.1 and doing well  Some anxiety but tolerable. I'm keeping a journal and looking for patterns in symptoms after a drop.  Sleeping well most nights with the help of Enorphos.  Day after tomorrow another 2.5% cut, ojala, as they say here in Ecuador ("God willing").  No physical symptoms except lack of energy.  Too much exertion and anything other than mild exercise gets me agitated.

 

Though I was never gluten-sensitive before WD, I have pretty much eliminated it.  However, I had pasta two nights in a row and noted increased anxiety and worse insomnia.  I think I can take a little gluten but not too much.

 

I've been doing a lot of reading on SA and finding much help and encouragement.

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brassmonkey

Excellent update Gridley, keep up the good work.

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Gridley

I just read Chessiecat's very helpful post of today, which led me to Claire Weeks and he concept of accepting the anxiety.  A great help to me.  Thanks, Chessie!

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Gridley

I am working on myself.  I've always been prone to regret and second-guessing and if-only-I had/hadn't.  I found this post from Healing very helpful. 

 

We are designed to learn from our experience. We're not born knowing everything. There is an infinite amount to learn. We can only ever act based on incomplete knowledge. We have strong feelings and strong needs. And so we do things that we later regret. This cannot be avoided. It is a part of being human.  ...  

And then, you add the fact that *our* particular illness involves temporary neurological damage that makes these feelings even worse. It may be that the prefrontal cortex, which makes us temperate in our assessments, is under-performing. And the amygdala, which is reactive and negatively biased, is over-performing. Whatever you felt bad about before you took meds is now amplified.

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Gridley

Jemima wrote this in Cybaltawithdrawal's thread a while back:

 

I'm 67 myself, and as you wrote in another post, "There is nothing in front of me except this journey", so I may as well just plod along and do the best I can. I've finally, finally accepted that there is a place for distractions in my life, that I don't have to be doing something difficult and noble most of my waking hours. What a relief! 

 

What a relief is right.  I've always pushed myself to accomplish and be a success and even now in retirement I tend to feel I should be accomplishing something.  Well, with going off Lexapro, Imipramine and Lorazepam, I think I have a pretty worthwhile project that even I can't fault.  "There is nothing in front of me except tis journey."  It feels good to let myself off the hook.

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Shep

You're finding some great quotes, Gridley. I'm glad you're doing so well with the Brassmonkey slide and finding inspiration. I like the line - "There is nothing in front of me except this journey."  Very true.  :) 

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Gridley

Update at week 10 of my Brassmonkey taper of Lexapro, down from 20mg to 16.3mg.  I have felt no negative symptoms.  I still have anxiety (tolerable), especially in the morning, which is helped by a 10-minute walk and the legs-on-chair yoga pose for 20 minutes, during which I do my meditation (silent chanting of tones).  So, the Lexapro taper is going well.  After this week is a 2-week hold.  I plan to hold longer after I get to 10 mg.

 

Likely (as suggested by Alto, Shep and Wellness) the anxiety is due either (or both) to my Imipramine cut over 8 months from 75 mg to 25 mg and/or Lorazepam withdrawal caused by my tinkering (pre-SA) with my Lorazepam dosage.  Ah, well.  I'm glad I found SA when I did.  

 

Out of curiosity, I googled "minimum effective dosage Lexapro" and found one psychiatrist who said 30 or 40mg was good.  I'm glad I didn't go to him.

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Gridley

Additional update: I have had two nights in a row of increasing insomnia and I believe the anxiety is increasing.  It may be that 2 1/2mg per week is too much for me or that I need longer holds.  I have a two-week hold coming up after this week and will be better able to decide after that.

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Gridley

I meant, 2 1/2% per week, not mg.

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Rose9975

Hi Gridley,

 

I am tapering from Lexapro also & I wish to say you are not alone. My tapering process is much slower than yours. I am doing 5% drop & holding for two months to see any delayed withdrawal symptoms. It like is taking away bricks from a house & then all of or sudden the brain collapses.I feel it is good to increase the holding time to allow the circuit/neurons rewire & repair.How long have you been practising Yoga?

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Gridley

Hi, Rose,

 

Thanks for writing.  So far, so good on my taper, but I will be monitoring my symptoms to see if I have to slow down.  If I do, I will.  Everything I read on SA says to go slow.  I agree with you totally about the value of holds and waiting for delayed WD symptoms.  That's a good analogy, taking away bricks from the house.  As I wrote on my post yesterday, I will be reevaluating the % of my drop and the length of my holds during my two week hold coming up next week.

 

I've been doing yoga off and on for maybe 30 years, but all I can do now is the gentlest of poses, like the feet up the wall pose, which does wonders for anxiety.  Any kind of strenuous exercise gets me agitated.  That's just me though.  I've read on the forum of others who prosper on strenuous exercise.

 

I think your tapering protocol is very prudent. 

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Gridley

Week 11 update: last week I was at 16.3 mg Lexapro and now will hold there for two weeks before tapering again.  I am starting to notice a pattern that anxiety hits on the fourth day of my weekly 2 1/2% drop, then resolves.  I think this level of taper is working for me.  Anxiety, when present, has been tolerable.  

 

I've found that, for now at least, anything more than a gentle 15-minute walk outside raises cortisol and produces anxiety.  I focus on the beauty of the surrounding mountains and all the flowers growing in your yard.  I do not focus, as I used to, on all the imperfections in the garden but rather the near-perfections.  A small but huge shift for me.  Reading this site and being on lower doses has, I think, contributed to this shift in attitude.

 

In other news, I read on a local expat board that the owners of a 12-year old Yorkshire terrier in a city 8-hours away were unable to care for her and the dog, who had some untreated medical issues, was quite despondent.  A Good Samaritan delivered her to us and we are in the process of getting our two other callejero (street dog) rescues to accept her.  She weighs all of nine pounds.

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Shep

Wow, Gridley, what a beautiful update!

 

So happy you've had a mind-shift and are seeing the beauty in the world.

 

And congratulations on your newly adopted Yorkie. What a wonderful thing to take in an older dog with health issues. I think you will both be good for each other. 

 

I wish you and your dog much healing and happiness.  :)

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Gridley

Could any of you help me with clarifying what “stabilizing withdrawal symptoms” means in terms of being ready for your next taper?

 
I’m on week 12 of my BrassMonkey Slide taper of Lexapro, in my second week of holding at 16.3 mg.  My next 2 1/2% taper will be this Friday.  The reason I’m asking about “stabilizing” is that I want to make sure I’m not tapering too fast.  Over the twelve week taper thus far, I continue to have some symptoms of anxiety.  Some days it is mild and fades by early afternoon.  Other days it is moderate and lingers into the afternoon.  Non-drug methods help.  My sleep is not great but okay.  Some night I get 5 1/2 hours, others (with the help of Enorphos) 7-8.  By rough count, not factoring in days that are just middling, I had 39 good days over the taper and 23 not-so-good.  There is discomfort but it is manageable. I am not debilitated.  However, on only two days have I had no symptoms whatsoever. That brings me to some definitions I read on a 2012 SA thread about “stabilizing” in the context of being ready for the next drop. 
 
One member wrote:
 
Stabilizing withdrawal symptoms in this context means getting to the point that withdrawal symptoms hopefully disappear completely between cuts. …  Stable means few or no withdrawal symptoms, whether physical or emotional. 
 
Similarly:
 
Hmm, I thought stable was when you had zero withdrawal symptoms. The presence of withdrawal symptoms indicates your nervous system is unstable, so isn't it best to hold until they go away completely? Even if they are manageable, surely reducing the dose, even by tiny amounts, could cause debilitating symptoms in the future?
 
Though at the end of some weeks most—not all—symptoms have resolved; other weeks they have not.  SinceI have almost no days without some symptoms, under this definition it appears I have been tapering without having stabilized.  
 
One member stated a looser standard:
 

To me, it means not being debilitated by your withdrawals, so that activities of daily life are disrupted.  

 
Another member agreed:
 
That's pretty much how I see it too. Plus, having it be like that not just on occasional good days, but on more days than not. Ideally all the time with maybe occasional small wobblies. When I get to where I feel about 80% steady and not symptomatic, I consider that pretty stable. 
 
I am pleased with the progress I’ve made, but I want to do this right and not too fast.  On the other hand, I’ve read on SA that a drop can lessen WD symptoms.  With an activating and strong drug like Lexapro, this might be applicable in my case.  I have noted some weeks when I am tapering are no more (or even less) symptomatic than holding weeks.  I am eating healthily, doing gentle walks, doing some gardening and lots of reading (I’m an old-fashioned bookworm.)
 
I know much of this is individual, but your thoughts and suggestions would be appreciated.
 
Gridley 
 
 

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Gridley

Thanks very much, Chessie.  The quotes are from "Stabilizing After a Reduction - What does it Mean?"  Sorry I didn't specify.  I'll read the other link you sent,"Withdrawal Normal Description."

 

Complicating matters is the possibility that my symptoms may not be due to the Lexapro taper but rather, as Alto, Shep and Wellness wrote a while back, coming from Imipramine withdrawal or Lorazepam tolerance or withdrawal.  Ah, so many drugs.

 

I hope you are doing well.

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Gridley

Update:  I completed my two-week hold at 16.3 mg Lexapro and today I dropped another 2 1/2 % to  15.9 mg.  I’m tolerating this schedule pretty well.  I still have some morning and occasional afternoon anxiety, which is manageable, and some middle-of-the-night insomnia (the Enrophios works some nights, some nights no).   

 

Our mountain road washed out due to incessant rain, and we had to take a rigorous hour-long hike to survey the damage.  Though I was exhausted afterward, I was pleased it didn't trigger any cortisol anxiety. 

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Shep

Hi, Gridley.

 

Thanks for the update. Sounds like you're handling everything and taking it in stride.

 

I hope your road is clear soon from the rain damage.  Getting through an hour-long hike without any extra symptoms is quite impressive. 

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Gridley

Last week at 15.9 mg Lexapro went well, some anxiety, manageable, on a few days but a couple of days with no anxiety at all.  I do have apathy and little energy but this too is manageable.   The only physical symptoms I have are mild intermittent tinnitus (which began when I was doing my Imipramine taper last year) and occasional burning sensations in my feet at night.

 

I'm now two days into my drop to 15.5 mg with no problems.  

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Gridley

I need some benzo advice.  As my signature says, I take Lorazepam .5 mg X 3 daily.  I have had no difficulties with it.  My problem is that Ecuador no longer imports Lorazepam.  I can get Lorazepam from Colombia but have just read (one person's opinion) that the quality of the Colombian-made Lorazepam is questionable; there is no way for me to tell except by taking it.  I can probably get a few more bottles of 30 from the States but my connection with my doctor there is tenuous, as I rarely get to the U.S.  As of today I have 75 days worth of American Lorazepam plus several months' worth of the Colombian-made, which I can get indefinitely.

 

I haven't calculated but I'm probably two years away from finishing my Lexapro taper.  Then there would be a rest period before I started tapering the 25 mg Imipramine.  Following SA guidelines I would taper the benzo last.  So we're looking a few years down the road that I will need the Lorazepam.

 

Ecuador has available Diazepam (Valium) and Clonazepam (Klonopin) and, I think, Xanax (No!)  There is no guaranty that they will continue to import them.

 

As I see it, my options, none good, are:

1.  When I run out of American Lorazepam, switch over to the Colombian;

2. Do a crossover to Valium if I have enough Lorazepam left to do this.  I know the half-life of Valium is longer, making a taper easier.

3.  Stop the Lexapro taper and taper the Lorazepam (I'd really prefer not to do this)

 

This is one of the little wrinkles of living in Ecuador.  My Lexapro taper is going so well.

 

My desire is to Keep It Stable.  My feeling is to go with the Colombian Lorazepam. I know that switching manufacturers can cause problems but possibly this is the lesser of evils.

 

Your advice would be very much appreciated.

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Shep

Hi, Gridley.  I'm sorry you're having to deal with this.

 

I don't have any experience or knowledge of Colombian-made Lorazepam, so I'm afraid I don't have any advice for that aspect.

 

But here are some thoughts.

 

1.  If you do decide to do a Valium crossover, you would still have to stop the Lexapro taper because it won't be safe to taper an AD while switching to another benzo. It's best to only change one drug at a time. 

 

2.  The Valium crossover does carry some risks. Some people find Valium to be very sedating and can cause depression. However, some people find the sedation to help with sleep and if they can sleep, they are able to cope better. This is a thread over in the members-only benzo section of the forum that may provide some additional information.

 

Crossover to diazepam (Valium)? Re: Ashton Manual

 

Ideally, it's best to taper from the drug you're currently on, unless you're having problems. But due to circumstances beyond your control, you're not in an ideal situation. 

 

My feeling is to go with the Colombian Lorazepam. 

 

 

 

You've been doing great so far, Gridley, so I really trust your judgement. 

 

Perhaps do some more research, but if your gut feeling is to stick with the Lorazepam and to try the Colombian version, that may be the way to go.

 

If you do decide to go with the Columbian version, I would stop the AD taper. That way, if there is a problem with the Columbian version, it will be recognized and not confused with the withdrawal symptoms from an AD reduction. 

 

Please let us know what you decide to do. I hope this goes smoothly for you. 

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Gridley

Shep,

 

I've decided to go with the Colombian Lorazepam when my American-made Lorazepam runs out.  It's my feeling that this will be the least disruptive course.

I'll continue my taper of Lexapro until that point and then hold, as your suggested, so if there are reactions from the new Lorazepam, ithey won't be confused with the Lexapro taper.

 

My question is: how long should I let the new Lorazepam settle before I can resume my Lexapro taper?

 

Doing pretty well at this end.  Tomorrow I taper another 2.5% for a week.  A bit of stress this afternoon as two giant cows we're pasturing for a friend broke down the gate and came within munching distance of our lettuce garden.  We drove them off, barricaded ourselves in, and an epsom salt footbath calmed me down.

 

Thanks, as always, for all your help.

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brassmonkey

You might try alternating days when switching between the manufacturers. Every other for a couple of weeks, every third day for a couple of weeks etc, until you've made the switch. Then a couple of weeks to let things settle out and resume your taper.

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Gridley

Thanks, Brass.  

 

My brain's a little foggy this morning,  Point of clarification: are you saying make the switch after two weeks of U.S. Lorazepam every other day + two weeks of U.S. Lorazepam every third day (four week crossover) ?  Or are you saying to continue with the crossover with a U.S. Lorazepam every fourth day for two weeks, then every fifth day for two weeks, every sixth day for two weeks, every seventh day for two weeks?  

 

That is, how many 2-week periods should I stretch it out? 

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Shep

Hi, Gridley.

 

I'm going to offer up another idea regarding switching from the US brand to the Columbian brand of Lorazepam. 

 

You may wish to switch it out as following:

 

.5 mg morning Columbia brand

 

.5 mg afternoon US brand

 

.5 mg evening US brand

 

And gradually get used to it. After a week or so, switch out another Columbian dose for the US. 

 

This is similar to the method we recommend for switching from the tablet form to the liquid, as it gently lets the nervous system adjust with only a partial daily dose being switched up. 

 

So it may be a good method for switching from one brand to another brand. You'll gradually build it up. 

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Gridley

Many, many thanks, Shep.  And thanks for keeping an eye on me!

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Shep

Hi, Gridley.

 

No problem. I enjoy working with you, as you've had a very stoic and resilient vibe throughout this process. 

 

Do you have a thread set up in the members-only benzo forum yet? If not, if you'd like to do this during your transition from US to Columbia brand, please feel free to do so and post any questions. 

 

Members-only benzo area

 

I hope this is an easy transition. 

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Gridley

Thanks, Shep.  I'll set up the thread.

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brassmonkey

Hi Gridley-- it would all depend on how you react to the changes. If everything is going well after US every fourth day then there shouldn't be any problems just to switch.  If you're noticing a difference between the pills then continuing it out to every seventh day would be best.  The method Shep talks about would be a good way also.

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Gridley

Thanks, Brass.  Welcome home.

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Gridley

Saturday I will begin my crossover from American-made Lorazepam (no longer available in Ecuador) to Colombian-made.  For the first week, I will switch out my morning .5mg dose for the new brand.  At the end of the week, I'll see how I'm doing, If no problems, I'll switch out my afternoon .5mg dose for a week.

If things are rocky, I'll hold another week with just one dose of the new brand. If all is going well, in the third week, I'll be taking all three doses of the new brand.

 

I will hold on my Lexapro taper until I've finished making the switch plus another two weeks to let things settle out before beginning again my Lexapro taper.

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Gridley

Update on Lorazepam manufacturer switch:  I'm two days in on my gradual switchover from American Lorazepam to Colombian.  By coincidence, at the same time I started the switch, I ran out of the Lorazepam from the manufacturer I'd been using for years and started in on a bottle I'd recently gotten from a different pharmacy.  Noting that I felt different (more irritable) after taking the new American, I compared the two American Lorazepams and saw that the new one was larger, indicating a different manufacturer.

 

Rather than getting used to two new versions, I'm inclined to make the switch to the Colombian version for all three daily doses.  At the end of the week, I would hold for two weeks to let things settle down then resume my Lexapro taper.

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Gridley

Tomorrow will be 13 days since I switched from my American-manufactured Lorazepam (which I can no longer obtain) and a South American version.  I wasn't able to do the switch gradually (ran out of old pills) and as a result, perhaps, the first week of the switch was marked by increased anxiety.  However, things have stabilized in this second week of the switch, and though the new version may not be quite as effective as the old, it does work and has the great advantage of being available.  (Though I don't have Health Anxiety, I do sometimes have Taper Anxiety, as in "am I doing this right?" and for a while I worried that the South American Lorazepam might be causing an adverse or paradoxical effect.)  So I'm happy to say that the new Lorazepam does work for me and I have returned to WD normal, which means some anxiety, some insomnia, fatigue and dizziness, all manageable.  I do some yoga and a good bit of meditation, as well as gentle walks in nature. Lots of distraction, mostly fiction reading. I also practice Claire Weeks' acceptance of anxiety technique.  So my WD normal is pretty ok.  

 

Tomorrow I will resume my Lexapro Brassmonkey taper, going from 15.1 mg to 14.7 mg.

 

I have a question.  Before I discovered SA, I tapered Imipramine on a 10% of current dose every three weeks basis from 75 mg to 25 mg.  I also, in effect, reduced my dose  of Lorazepam by splitting it from one to three doses.  Moderators wrote that I was likely in Lorazepam withdrawal and possibly Imipramine withdrawal.   I would guess this is the source of my symptoms, not the Lexapro taper, which has been very gradual. I am long past the window of opportunity for updosing, nor do I wish to.   I will not be getting around to tapering either the Lorazepam or Imipramine until I've finished the Lexapro taper, perhaps two years off.  

   

My question, at last: Is it possible that my brain will acclimate at some point to my current doses of Imipramine and Lorazepam and that I will come "out of" withdrawal, resulting in an abatement or lessening of WD symptoms? 

 

Thanks as always for your help.

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Gridley

I'm continuing my 2 1/2% week drop of Lexapro, now down to 14.3 mg from 20.  Some days there's a low-level underlying anxiety much of the day,  Other days I have virtually no WD symptoms at all.  I don't yet see a pattern.  My guess is that many of my WD symptoms stem from my regrettable pre-SA taper of the sedating Imipramine plus continuing Lorazepam WD.

 

Lately I've been feeling more apathy-anhedonia, not much interest in doing anything.  I still enjoy reading and our three dogs (the 13-year-old Yorkie just underwent very successful surgery and has bounced back like a puppy).  I do still have feelings, though perhaps a bit blunted.

 

The switchover to the local brand of Lorazepam was successful, though a little rough initially.

 

The Enerphos (phosphoserine) seems to have stopped working and my insomnia has worsened.  I fall asleep easily around 9:30 but awaken around 2:00 and can't get back to sleep.  I was taking 50 mg Enerphos at bedtime, 50 mg when I woke up.  Last night I increased it to 60 mg and slept a bit better.  I'll see how it goes.

 

I continue to do my meditation, mild yoga and gentle walking, as well as Claire Weeks' technique of acceptance of the anxiety.

 

I confess to feeling a little daunted by the length it's going to take to get off all three drugs, but what is, is.  I feel no inclination whatever to hasten the process.  All things considered, including the length of time I've been on these drugs, I'm doing pretty well.  It's a long-term project with a goal.

 

I derive great comfort from the forum.  Thanks to all of you.

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Gridley

After a year and a half of tapering, I had my first window today, and it was lovely.  Usually my best days are blah, relatively symptom-free WDnormal.   But this morning I awoke (after an unusually good night's sleep) feeling tranquil and with energy (not a lot but enough to undertake projects).  It was a break from the grinding "Groundhog Day" feeling of another day to get through until I get well.  It only lasted two hours (plus whatever might have been part of my sleep) but it was enormously encouraging to see that there is bliss in the old boy yet.

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