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Foggyhead

Foggyhead: Reinstatement of Lexapro after 2.5 months off

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Foggyhead

Hello,

 

I did a relatively quick taper from Lexapro using 1 mg per week water titration from 10mg with my final dose mid-November. Acute withdrawals lasted a couple weeks then subsided. Around Christmas the weeping and depression set in with a vengeance. At the same time insomnia started. I could not sleep unless I took 50mg of Seroquel. i am still battling the insomnia but ironically last night I slept 7 hours without having to take meds. Today is my 5th day of reinstatement on 5mg of Lexapro. Seroquel as stopped a week ago and replaced with Ambien, which I have not taken for 2 days. 

 

The insomnia is taking it's toll on me. My T3 thyroid is starting to go low, I am having cold temperature intolerances, hair is falling out, strange "feelings" in my hands and legs from time to time, and inability to relax or make myself comfortable. It's like I am always in a restless state.

 

Since I have reinstated the weird feeling in my hands and legs are subsiding and are more flair up in nature. I felt relaxed when I woke up this morning and when I layed down last night. 

 

I do have the typical startup anxiety/tiredness that is all too familiar. the head fog is very bad also. 

 

How long will I know whether or not this reinstatement is going to work? Also, how long should I stay at 5 mg before I go to 10 mg and plan to hold there? 

 

I did not want to reinstate but the insomnia will put me to an early grave if I do not get it under control. Dr. Shipko's blog also scared the crap out of me. If I would have read that back at the end of last year, I would have never goin off in the first place.   

 

 

Edited by scallywag
highlight medications, added tags

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ChessieCat

Hi Foggyhead and welcome to SA,

 

The first thing we ask all new members to do is to Please put your Withdrawal History in Signature.  Please include details for the last 12-18 months of  all drugs, dates, doses and discontinuations & reinstatements.  If you can't remember dates, please write it as "early March" or "mid-August".  Please provide a summary of any drugs prior to that which can just be listed with start and stop years. Please include all prescription, non-prescription drugs and supplements you are currently taking. If you are using a phone there are instructions in Posts 9 & 10.

 

It sounds like your reinstatement is working because your symptoms have already started to improve.  The idea of reinstating is to bring the withdrawal symptoms to a bearable level, not necessarily to get rid of them completely.  It takes about 4 days for the drug to get to a steady state in the blood and a bit longer for it to register in the brain.  After having been off the drug since mid-November I doubt that you will need to return to 10mg.  The lower dose you can reinstate at the better.  Please read the link below to find out more.

 

Here are links which I suggest you read and then you can ask questions here in your Intro/Update topic, where you can also journal your progress.  Click "Follow" top right and you will be notified when someone responds.

 

About reinstating and stabilizing to reduce withdrawal symptoms

 

Why taper by 10% of my dosage?

 

These helped me to understand SA's recommended 10% taper of the previous dose followed by about a four week hold to allow the brain to adapt to not getting as much of the drug:

 

Brain Remodelling


Video:  Healing From Antidepressants - Patterns of Recovery

 

These links may also be helpful:

 

Keep it Simple, Slow and Stable


Keep Notes on Paper

Rate Symptoms Daily to Check Patterns and Progress


Stabilising After a Reduction - What Does That Mean?

 

Withdrawal Normal Description

 

Once you have stabilised, which may take anything from 3-4 months, you can then taper the recommended way.

 

Tips for tapering off Lexapro (escitalopram)

 

It's also suggested that you learn Non-drug techniques to cope

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Foggyhead

Thanks for responding. I will include my history in my profile. 

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Altostrata

Welcome, foggyhead.

 

How long did you take the Seroquel, how often, and how did you go off it?

 

How long were you taking 5mg Lexapro before you went off the Seroquel?

 

 

The insomnia is taking it's toll on me. My T3 thyroid is starting to go low, I am having cold temperature intolerances, hair is falling out, strange "feelings" in my hands and legs from time to time, and inability to relax or make myself comfortable. It's like I am always in a restless state.

 

 

 
When did these symptoms start?

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Foggyhead

I was on Seroquel 100mg for first week of January, then backed down to 50mg for two weeks then down to 25mg for a week then off. I noticed the cold intolerance after a couple nights of no sleep. My GP told me the low T3 and other symptoms are my body's reaction to sleep deprivation. I have decided no more sleep aids. I am enrolled in a CBTI group with my local hospital

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KarenB

Hey Foggyhead,

 

If you could put your signature so it appears on each of your posts, that would be very helpful to anyone responding to your questions. 

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Foggyhead

What is your sleep schedule? Do you sleep at all? If so, when?

 

When do you take Lexapro?

 

See  Important topics about symptoms, including sleep problems

 

You might also consider taking a little melatonin Melatonin for sleep: Many people find it helpful

 

 

Before I "lost the ability to sleep", I was usually in bed by 10-10:30 and up around 6-6:30, never had a problem with sleep before and I have been riddled with anxiety for years. Now I try to stay up later so I do not get up so early. Last night I woke up at 4AM, feel asleep at 12:30PM. The night before it was 6AM when I got up. I have been taking melatonin, 1mg sublingual. I am enrolled in a weekly CBT-I group with our local hospital. The next step will be sleep restriction which will be hell at first. I have my hopes on it providing relief. Does the withdrawal actually affect the neurotransmitter aspect of sleep or the circadian rhythm? 

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Foggyhead

I have noticed tinnitus since I reinstated last week which is making me reconsider stopping. 

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Happy2Heal

I have noticed tinnitus since I reinstated last week which is making me reconsider stopping. 

I had tinnitus while on the drug and now during WD, so I'd say that's not a good reason to stop taking it. there's no way to know if it's going to go away if you stop the lexapro, and it could actually get worse :/

 

I am going off lexapro too, as you can see below in my signature. I messed up my taper before finding this forum. And even since finding this place and getting GREAT advice, I ignored it a couple of times(thinking I would be different)  and I REALLY regretted it

 

Ppl here will give you good suggestions, esp the mods, please listen to them.

 

the thing you don't want to do, which is what I did, so learn from my BAD example!! is jump around, up and down in doses.

 

it's very bad for your central nervous system, which craves stability. You want to keep the dose stable, as well as the time you take it etc

 

sleep problems are common.  Mine are pretty bad but I know eventually they will get better. I might not have such a bad time IF I'd been smart and not made so many changes, so please!! think carefully before you stop or start any med OR supplement ok?

 

wishing you speedy healing!

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Foggyhead

Thanks catnapt for the info. The sleep loss is brutal amplifying everything. Thankfully I am physically doing ok. I still run 4 times a week for 30 minutes. All of my symptoms are mental. I am also still working and will continue unless things get real bad.

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Happy2Heal

Thanks catnapt for the info. The sleep loss is brutal amplifying everything. Thankfully I am physically doing ok. I still run 4 times a week for 30 minutes. All of my symptoms are mental. I am also still working and will continue unless things get real bad.

 

oh so sorry you're going thru this too, it's rough, eh?

 

I hope you can get some sleep soon. I find the ringing in my ears gets worse if I get upset or angry; otherwise I only notice it at night or when it's quiet.

It sometimes helps to listen to soft music to distract you from it..

That's great that you are able to keep running!!  that should help a lot. I read a book that says that running is VERY good for the brain, for helping with depression and all sorts of other things!

 I wish I was able to run, but walking is more my speed.

 

things will get better,

soon, for our sakes, I hope!!

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Foggyhead

 

Thanks catnapt for the info. The sleep loss is brutal amplifying everything. Thankfully I am physically doing ok. I still run 4 times a week for 30 minutes. All of my symptoms are mental. I am also still working and will continue unless things get real bad.

 

 

oh so sorry you're going thru this too, it's rough, eh?

I hope you can get some sleep soon. I find the ringing in my ears gets worse if I get upset or angry; otherwise I only notice it at night or when it's quiet.

It sometimes helps to listen to soft music to distract you from it..

 

That's great that you are able to keep running!!  that should help a lot. I read a book that says that running is VERY good for the brain, for helping with depression and all sorts of other things!

 I wish I was able to run, but walking is more my speed.

 

things will get better,

soon, for our sakes, I hope!!

as horribly tired as I may be, when I jump on that treadmill it perks me right up. I only notice the tinnitus in a quiet room also. I always had it low grade, it just stepped up a notch this week.

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Foggyhead

I had to stop my reinstatement. Not sure if it is related but this tinnitus just popped up on Thursday. I am not taking anything else so I can only pinpoint it to the Lexapro. It did not case tinnitus when I took it regularly. I have a constant zinging in both ears and it is driving me crazy. Not how much of this tinnitus, insomnia and withdrawal I can endure with no end in site.

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KarenB

Foggyhead, please write a signature.  It is very hard to help you without all the details summarised - and we'd really like to help :).

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Foggyhead

I do not know if I am heading into protracted withdrawal but it sure seams that way. When I lay down I am not even close to being relaxed. I get the feeling that I need to get up. it's a torturous feeling. Sleep is really getting bad. I just started sleep restriction therapy three days ago and it is hell on earth. My sleep timeframe is 1AM to 6AM. I take at least an hour to fall asleep and wake up by 5AM with that God awful restless feeling. It is like I lost my ability to rest. It resembles the tardive symptoms that Dr. Shipko talks about which scares me.

 

Should I re-reinstate and hold or just ride it out and see what drug free brings me? Last week my sleep did start to improve when I reinstated. The tinnitus is still there so I doubt that it is from the Lexapro since I did not have it before.

 

Although today even though I only had 3 hours of sleep, I notice a certain clarity that I did not have before and my eyesight is incredibly sharp. Anxiety today is very low but the depressive symptoms are very bad with suicidal idealization and weeping. maybe the weeping is helping my eyes since they are usually dry.         

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scallywag

Foggyhead:

 

Have you tried Magnesium? Some people find that an epsom salts bath helps with relaxation and sleep.

 

Epsom Salts Baths -- another way to relax with magnesium
 
Here is the topic on magnesium where there are posts about Epsom salts baths:
Magnesium, nature's calcium channel blocker.

 

Once you've got that topic open, search for "epsom" using the search tool in the top right corner of the page.

 

Here is a list of posts from around the entire site that mention epsom salts: Search results.

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Foggyhead

I do take two forms of Magnesium. I take the powdered CALM at night and I take Magnesium L-Threonate which really gets into the brain. It calms and makes me as smart as I can be with only 3-4 hours of sleep.  I also take .5 melatonin sublingual. I drink Chamomile Tea before bed also. I will try the Epsom salt baths and see how that goes. 

 

I did go to the doctor about the tinnitus. My left ear had wax buildup around the eardrum. They cleaned it out and the doctor said that it may take 3 weeks to subside. It is on and off in intensity today. 

 

Other than the intense depersonalization today, I was acting like myself. I went to lunch with coworkers, joked around and made people laugh and held conversations with people. In the back of mind I think about the hell that may relinquish itself upon me if I am heading into PAWS.

 

I have an appointment with a new psychiatrist on Thursday. I cannot wait to hear her when I talk to her about my PAWS concerns. The office that I am going to is starting to lean heavier on MAOIs but I will not go down that route. I actually do not know why I just do not cancel the appointment knowing that she will more than likely want to start an MAOI or poly drug me.  

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Foggyhead

I reinstated approximately 3 weeks ago and do not like the way I am feeling. I feel very drugged and have pretty severe depersonalization. I have steadied my dose to 2mg using water titration mix that I made. To stop the reinstatement, how would be the best to taper since it has been such a short duration being back on? I just have a hunch that I may be better off going completely back off. I have been getting at least 5 hours sleep which is a plus but the tinnitus have come on with a vengeance. Thanks in advance for the help.

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scallywag

Foggyhead, The 5 mg reinstatement may have been too much for you, even with the subsequent reduction to 2 mg. Since you've been taking the reinstatement dose of 2 mg Lexapro for only 3 weeks, I would try a 25% reduction to 1.5 mg for 5 days. If symptoms improve, hold there for another week. Symptoms easing is THE sign that you've found a workable reinstatement dose.

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Foggyhead

Thanks Scallywag. If symptoms do not improve, should I jump off completely?

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scallywag

I don't know. It depends how your CNS (central nervous system) responds to the reduction. Please keep notes on paper of your symptoms and the times of your dose(s). This post has a useful format for a daily log:

Take notes of doses and symptoms.

 

If you post your notes here in your intro topic, that information will help us help you sort out the next step.

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Foggyhead

Well I hope I did not "shoot myself in the foot". I completely stopped my reinstatement yesterday. So that is yesterday and today without any Lexapro. My anxiety is through the roof. My tinnitus and strange hearing sensations have let up though which is a good sign. the strange sensations in my arms and hands has also let up.  

 

Did I set myself up for disaster? I am pretty sure that the reinstatement was causing more harm than good. Will I stabilize somewhat in a few days, weeks? 

 

I have been fully functional, at work yesterday and today, slept 4 hours last night, and ran 4 miles yesterday. As far as the sleep goes, my brain will absolutely not let me sleep more than 4 or 5 hours no matter how tired I am. I have been taking Hydrozine to help with the anxiety. It does help some but comes with a price of a drug-induced haze. 

 

I am on my own from here on out... I need to press forward and not sit and fear that I will be in protracted withdrawal for years although it is a grim possibility. 

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ChessieCat

Have you tried Magnesium.  It may help with the anxiety.  There are several ways in which you can use magnesium.  Some members dissolve it in water and sip it throughout the day.  You can have epsom salts bath or foot soak.  Or you can buy or make a lotion containing magnesium to rub on your skin.  I take half a tablet morning and night and I have found that it takes the edge off my anxiety.

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Foggyhead

I will keep this as succinct as possible since so much has taken place in the last several months. Please let me story be a lessen to those that are considering tapering after a long history on these drugs. I finished a fairly rapid taper from Lexapro back in November. I have been on an SSRI since approx 1995, the most recent being Lexapro. My intent is to be drug free.

 

I also finished a taper off of Clonazepam last April after being on it for over 3 years straight. I still had protracted withdrawal symptoms when I started my Lexapro taper.  

 

The week of Christmas I fell into a horrendous bout of chronic insomnia that I have started to see some relief from. When it started I went 4 days with no sleep. I now get between 3 and 5 hours. It takes me 2 hours to fall asleep and I wake up at 4:30AM every morning like clockwork. 

 

I was hospitalized the week after New Years, afraid that the insomnia was going to cause harm. They started me on Effexor and after 3 days I was in a state of inner restlessness that was unbearable. I stopped as soon as I returned home. A short time later I attempted to reinstate a small dose of Lexapro which yielded the same results.

 

Now the interesting part:  

 

At the beginning of February I had two low-dose Ketamine infusions, on right after the other. That was a horrible experience that had no positive results for me. I thought I was going to die. It also did nothing for my insomnia.

 

At the beginning of April things took a turn for the worst. I started to have serious suicidal ideations that lead to a planned attempt. Horrid crying spells, relentless anxiety and depression. This landed me back in the hospital. I refused anti-depressants. They called me "treatment resistant" and told me that my only choice was an MAOI which I also refused. I did start taking Ambien to help with sleeping. It did help me fall asleep. I needed something as the restlessness still had a stronghold. They then suggested ECT which I decided on. I then had a total of 5 treatments.

 

The ECT knocked the depression and suicidal ideation completely out of me. I was able to sleep at least 8 hours a night but the DP/DR and anxiety was still present. About 2 weeks later the insomnia came back which I still struggle with. The first couple weeks after the ECT I had some short-term memory loss but that has since gotten better.

 

I currently take half a 3mg Lunesta only a couple times a week and am working on cutting it out all together. I never had a sleep problem before, even through benzo withdrawal. My symptoms wax and wane, DP/DR, insomnia, tinnitus, waves of relentless anxiety and the loss of enjoyment in activities that I used to enjoy. I cannot even sit and watch a TV show that I used to enjoy. My home, work and surroundings seem foreign to me which is a very strange feeling. I also went through an Insomnia group therapy session back in March. We tried sleep restriction but it did not work for me. I do not think that the therapist understood that the insomnia was related to withdrawal. 

 

Even though the insomnia is my biggest complaint, the sleep I get is straight through. When I get 5 hours, it is uninterrupted. I haven't had that in all my years on meds. It seams as if my system is trying to re-regulate my circadian rhythm.  

 

My current p-doc said that I had a manic episode and that I am bipolar. I mentioned that I am in a protracted withdrawal and he was not buying it. He said that I tapered the Lexapro way slower that he would have recommended and that any protracted withdrawal from the benzo was far fetched since it has been over a year. He wanted to put me on an antipsychotic med. Nope, not this guy.

 

Here is what I currently do to try and help the healing process:

 

- Cryotherapy at least two times a week

- Acupuncture at least once every other week

- Strength train and run at least 5 days a week

- Eat as healthy as possible

- Rest as best as I can even though I only sleep 3 to 5 hours a night,(when will it get better?)

- Fish oil, vitamin D, Zinc, one baby Aspirin a day and Magnesium  

- Talk therapy although I am currently looking for a therapist who can fit me in at least once every 2 weeks. There is a shortage of therapists in our area so it is tough to get in frequently. 

- Spend time with my children and try and do the things that I used to enjoy

 

Any further suggestions? I have tried various supplements, most of which seamed to aggravate my symptoms. Even antihistamines have an adverse affect. I have to be careful what I take.

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Blondiee1915

Hi Foggyhead - 

 

I am also trying to get off lexapro.  I was on it for about 9 years on and off with a few medications in between.  I was mostly on 20 mg.  During summer of 2016 I switched to vibyid stayed on it for about a month or two and then withdrew within a month.  So basically cold turkey.  My hair also started falling out like a month later.  Acute symptoms lasted a few weeks but were not too bad.  Then 3 months later I was hit with severe dp/dr, fatigue, and intense dizziness.  Like you I reinstated to 5 mg lexapro but still was not doing too good on it.  It is crazy what these medications can do to us.  I then switched from lexapro to luvox (another SSRI) and tried to stabilize (still trying to).  It is so difficult.  I have dizziness DP/DR and extreme fatigue.  Oh and I actually got tinnitus after I reinstated lexapro and then switched.  It was pretty bad for 2 months or so and now it is pretty much gone.  It does happen when I get too stressed.   So this is definitely WD symptom. 

You healing plan sounds good.  The only thing is be careful about doing too much of an exercise.  It is better to start gentle and go from there

 

Hopefully you are doing okay 

 

B

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Foggyhead

I have hit the seven month mark since taking my last taper dose. I have been crippled with chronic insomnia since the end of December, 2016. I just cannot get a feeling of relaxation, I always feel restless. Any ideas on when the insomnia will abate? I never had sleep problems before as I was always able to get at least 7 hours of sleep or more if I wanted. Now I fluctuate between zero sleep and maybe 6 hours on a very good night. It is starting to take a toll on me. If I do not sleep, I will not continue to heal, correct assumption or are the sleep issues a part of the re-calibration process?  I am in it for the long haul. I know recovery could take years. On a positive note I have noticed that my eyesight has become very crisp recently, like when you leave the eye doctor with a new pair of glasses. 

Edited by scallywag
merged topics, "Sleep problems after Lexapro"

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Foggyhead

Hello All,  I do not post much here, I guess I might just need some encouragement. I have been dealing with insomnia for 10 months now and it seams to be getting a bit worse the last few weeks. I get a good 8 hours one night and then the next two nights zero to maybe 2 or 3 hours. I get up and go to work every day, tend to my family and try and be as normal as possible. My tinnitus is also a but louder the last few weeks as well. I am doing a 10 week Skype Session with a Sleep Specialist and we are working on behavioral methods to help with the insomnia. I just do not think that he is taking into consideration that my sleep issues are more than likely part of my protracted withdrawal. When did others start to see light at the end of the tunnel? I am also suffering from persistent DP and the lack of feeling joy in activities that I once enjoyed as well as bouts of depression the mornings that I do not get any sleep. I am trying to stay positive but and getting worn thin. On a positive note on the days that I get good sleep, I feel pretty good throughout the day. I have tried several supplements as mentioned here with no luck. They seam to rev me up.  I do try and eat well and exercise 6 days a week which includes 3 to 4 days when I jog for 30 minutes. The last thing I want to do is go back on meds and I need to persevere. 

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FarmGirlWorks

I am not even as far out as you (just passed 7 months) but think that 11 months is not a protracted withdrawal. It is just a slooooow process. Wishing you support and good vibes from another sufferer.

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Foggyhead

Thanks. I can say I am slowly getting better. The sleep issues are the worst when all you want to do is sleep but you cannot.

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Petunia

Hi Foggyhead, I'm sorry you are dealing with insomnia, unfortunately its a common symptom many of us have to endure as we slowly recover. Normal sleep routines usually resolve over time, but it can take a while depending on the person. Have you seen the sleep section of this topic, you may find some helpful ideas here:

 

Important topics about symptoms, including sleep problems

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Foggyhead
20 minutes ago, Petunia said:

Hi Foggyhead, I'm sorry you are dealing with insomnia, unfortunately its a common symptom many of us have to endure as we slowly recover. Normal sleep routines usually resolve over time, but it can take a while depending on the person. Have you seen the sleep section of this topic, you may find some helpful ideas here:

 

Important topics about symptoms, including sleep problems

Yes, that section has been a big help. Thankfully the 7-8 hour nights are starting to become more frequent, twice a week. Its those zero nights that are horifying. The CBT related task that has helped the most is to get out of bed if you do not fall asleep within 30 minutes. It takes away the dread and anxiety of laying there and getting frustrated. 

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