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Isabel

Its just really hard with all these symptoms. Withdrawal from hydroxzine, not stable on lexapro, Don't know how long these symptoms are here for.

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Isabel

I guess I'm trying to figure out if what I'm having is withdrawal why can't I just stop the 3.75 if it isn't stable anyway and get into actual withdrawal rather then this pseudo withdrawal reinstatement mess

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scallywag

When we start taking a neuroactive medication, any psychiatric medication including Lexapro, our brain and CNS (central nervous system) react and make changes to neurotransmitter chemicals and the cells that send and receive neurotransmitters. When we stop taking the medication or decrease dose, our CNS has to undo changes it made earlier. The content at these two links provide helpful explanations about this:

How your brain responds to psychiatric drugs - aka "Brain remodeling"

Youtube video, 4 minutes: Healing from antidepressants

 

What do you mean when you wrote, "this pseudo withdrawal reinstatement mess"?

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Isabel

I don't know if my symptoms are from withdrawal or reinstatement not working.

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Isabel

If I'm going to have to go through all these symptoms again if I'm in withdrawal why am I even on the med if its not doing anything

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Isabel

Any info about reinstating hydroxzine and tapering.

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Isabel

This is getting complicated and I need advice. I'm waiting on test results to see if I have a kidney infection. If my kidney isn't processing the lexapro and eliminating it can it get toxic and lead to serotonin syndrome?

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scallywag

Lexapro is metabolized almost entirely by your liver; your kidney function would have a minimal impact on your ability to process and eliminate this medication.

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Isabel

Ok thanks.

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Isabel

I'm feeling the effects of nearly 4 weeks with her very little sleep. I'm needing some help or I feel things will go downhill fast. I'm sure my cortisol is off, adrenals, hormones, etc..... is a sleep aid ever recommend for such extremes. Again, I'm feeling I need to decrease my 3.75 but I'm not stable yet but I can't wait to try something different to see if anything helps!

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Happy2Heal

hi Isabel,

I am sorry you are going thru this, it's really hard.

sadly no one can tell you how long the symptoms will last and adding more drugs is unlikely to make things better (and usually make things worse, or at the very least, complicate things)

 

for now the best you can do is find non drug coping skills to deal with the symptoms.

 

many of us have insomnia as an issue. It can sometimes help to listen to relaxing music, or a relaxation tape, learn how to meditate, esp. A nice soothing bath, esp with epsom salts, can be helpful

 

I am coming off lexapro too and while I hope that things are different for you ( I was on a much higher dose and for a lot longer!!) I've had insomnia since last Sept/Oct. It's improving but it's been very slow.

 

for some people things turn around fairly quickly, for others, it takes longer.

 

it's best not to have too many expectations on when things will improve, and just try to take each day as it comes. Be assured, thought, that you WILL heal, it mostly just takes some time.

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Isabel

Thanks for the advice. Are you completely off? With no sleep, I think my cortisol is elevated especially at night. How does epsom salt work?

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Happy2Heal

Thanks for the advice. Are you completely off? With no sleep, I think my cortisol is elevated especially at night. How does epsom salt work?

 I am not off lexapro yet, I am taking 0.22 mgs per day, and will be slowly VERY slowly tapering off at approx 5% per month.

 

 

espom salts are a form of magnesium and magnesium can help a LOT with anxiety and cortisol spikes.

 

http://survivingantidepressants.org/index.php?/topic/8321-epsom-salts-baths-another-way-to-relax-with-magnesium/

 

many of us also take magnesium in tablet, capsule, liquid, powder or even spray on or lotion forms. there's a whole thread about it; it really helps a LOT:

 

http://survivingantidepressants.org/index.php?/topic/1300-magnesium-natures-calcium-channel-blocker/

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Isabel

After each reduction, i notice feeling better for a few days then worse after a week. Is 7 days typical to notice changes or would it be by the next day. Likewise, if I have to increase again , I thought I read it should take away the symptoms

After a day?

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ChessieCat

After any dose change 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.

 

It is suggested that you hold on a new dose for 2 weeks after decreasing or increasing and keep daily notes on paper of what symptoms improve / worsen / stay the same, unless symptoms become unbearably worse.

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Isabel

I'm trying to correlate what was recommended for me. Dropping from 5mg to 3.75 is greater than 10%. Why was this recommended? Also I'm trying to make sense of the occupancy % that was provided in the tapering forum. Is there a big drop going from 5 to 4 but not between 4 to 3

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Isabel

I cant interpret what the % occupancy is of 5 vs 4 vs 3

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ChessieCat

Hi Isobel, welcome to SA. Reinstating at 2.5 was too high after being on 1mg for a year. Doctors rarely understand this and often increase a dose when a smaller dose would be better. I would take 3/4 of a 5mg tablet for 2 weeks, then half for 2 weeks, then 1/4  and see how you feel.  How long have you been taking hydroxine? Does it help at all? 

 

Lexapro is available in liquid which would be better for getting the very low dose. When you have stabilised you can start to taper, even very small doses need tapering, lexapro is a very strong drug and 1mg is more powerful than most people realise. 

 

Thank you for filling in your signature, it is very helpful  :)

 

http://survivingantidepressants.org/index.php?/topic/406-tapering-off-lexapro-escitalopram/

 

Things will settle down again but try and hold off switching, it is possible to stabilise on a small dose, maybe even smaller than1mg if necessary! 

 

The reason that it has been suggested that you reduce by more than 10% is that you were reinstated at what we believe was too high a dose.  You had been on 5mg for about 5 weeks so the brain would have made some adaption to the higher dose.  Please see the quote above which provides the suggestion of how to get back to a lower dose quickly, but hopefully in a "safer" way than jumping from 5mg down to 1.25mg in one go.

 

The dose occupancy information is referred to as a guide (not a rule) to help members understand why it is better to taper.

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Isabel

Thanks for the reply. I'm still not comfortable switching to liquid or even 1/2 and 1/2. From what I understand there is s big drop in occupancy from 1mg to 0. But I'm wondering if I'm cutting pill to what I believe to be 3.75 but may vary in the .10 hundredths is the occupancy affected drastically with this variance?

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Kittygiggles

Hi Isabel,

 

Sleep: I'd like to echo that magnesium may help relax you enough to sleep; once you know if your kidneys are okay (I'm not sure what effect magnesium has on your kidneys but it may be worth checking before taking it), you could try a little (maybe a quarter pill) each day to see how you go. I take mine with a meal and it seems to help.

 

Stabilization: This is so variable from what I can tell. I am not stable yet BUT I am hands down better than I was before I reinstated. Once I reinstated things got better within hours, then of course waves came back but overall things were getting better and better with each week. 

 

Liquid: I tried to transition to liquid and it can be done but you may be sensitive to it, as I was. If you can do it accurately, then you could try as low a percentage liquid and do the rest solid and slowly increase it from there. A moderator could help you work out a realistic pace to do this. I can't think of a more accurate and easy way to divide tiny doses than with liquid. If I could go back in time, I would have reinstated using liquid to make things easier when I get to lower doses in the future. Anyway, I will probably need to transition to liquid in the future but for now I am sticking to solid until I am more stable. 

 

I hope you are doing a little better today.

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Isabel

Thanks for the suggestions!

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Isabel

So it'll be 2 weeks that I am at 3.75. I'm not sure what to think. I read about others that reinstate and feel better right away, But because I reinstated at too high of a dose I'm still waiting to stabilize. Is it better to hold at this dose and see if I do, or drop to 2.5 as suggested. I'm weary of this big of a drop. Is my brain still wanting to be at 1 mg where I was when I stopped? Or has it adapted to the current dose. I've read others have to stay x 6 weeks at current dose before dropping. Symptoms are ear pain, headache, burning in head feeling.

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Isabel

Thank-you. Yes I have read the posts but at what point do you decide the stabilization isn't happening. I've read so many conflicting things. In one of Alto's posts she said she noticed most people stabilize in four days. I know I haven't stabilized yet so will it be more damaging to go down again from 3.75 to 2.5 or wait this out to see if I stabilize.

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mammaP

Isabel you reinstated at a dose that is too high and your body is not coping very well with it. Also when cutting the tablets you are not getting a consistent dose. You could try to go down to half a tablet now you have been on 3.75 for 2 weeks. Are your tablets scored so the halves would be even? We are only recommending such big cuts because you are reacting to the high dose. 

Hopefully you will start to feel a little better. 

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Isabel

What I struggle with is that I wasn't mentally prepared for this battle. I feel thrown into withdrawal not by choice and not look forward to the worst to come. For those that went through years of withdrawal and protracted withdrawal, would you taper the same? I have had a couple windows so now not sure if I should hold at current dose? The awful withdrawal stories make me question if its worth it?

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Isabel

Advice......? Anyone reinstate lexapro at too high a dose and feel better after a decrease? I'm debating going from 3.75 to 2.50. If this hits me as the wrong thing I don't know what to do. Cant tell dr. No one knows I'm tapering cause no one understands. Can I take something for headache?

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Happy2Heal

Advice......? Anyone reinstate lexapro at too high a dose and feel better after a decrease? I'm debating going from 3.75 to 2.50. If this hits me as the wrong thing I don't know what to do. Cant tell dr. No one knows I'm tapering cause no one understands. Can I take something for headache?

hi

I'm sorry you are still struggling. I can't really help you with your question about reinstating at too high a dose and decreasing, as I did the opposite (reinstated low and went up- and am now tapering)

hopefully someone can answer that question for you.

 

as far as the headache, I think taking tylenol or ibuprofen is safe. I take pain meds occasionally (generic celebrex) and am on lexapro and have not noticed any adverse effects from it. celebrex is an NSAID

 

hope you feel better real soon!

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Kittygiggles

Hi Isabel,

 

As a newcomer here I think I can speak for everyone when I say: we all want you to feel better as soon as possible and want you to avoid any more suffering if at all possible! What I've understood about Alto mentioning '4 days' is usually to do with an SSRI reaching a stable level in your blood, which is separate from brain stability. The latter part is what requires more scientific research. From what I can tell, SA (survivingantidepressants.org) is the best place to help you guess how your SSRI withdrawal is affecting you, how to recover, and how long this will take. Sadly though, they are still guesses, albeit educated ones. 

 

Getting to 1mg

If I understand your signature, you managed to taper to 1mg in March 2014, then held that dose until February 2017. If that is the case then my best guess is that yes, your brain really does want to return to 1mg. But you can only do that at a safe pace. By reinstating at 2.5mg in February, your brain had to adapt to a higher dose, then higher again still at 5mg, then following hydroxine, you are now at 3.75mg. Each change does something to the brain, I only wish I knew all the science around this. As bad as all those changes are, they happened over a short period so it follows, hopefully, that you won't need too long to go down to 1mg. However, tapering to 1mg is the safest course of action right now. 2 weeks at 3.75mg may be long enough but before you decide think hard about it some more and hold on until a moderator can get to you!

 

Rating symptoms helps you decide when to change a dose

If you're not doing it already and if you feel you have the motivation, you could list your symptoms and then try to categorize them per drug and whether they are adverse reactions or withdrawal. Then from now on, you can rate them throughout the day, when you remember, or even at the end of the day, out of 10 for severity. This kind of data will be so useful to you in measuring progress and helping you decide whether a drop is too steep or too sudden. 

 

Take note of the ones you feel challenge you the most. We all have ones we feel are unbearable at times otherwise we wouldn't be here! I can tell withdrawal is affecting you badly so it is good to for you to target the symptoms you really cannot handle. Sometimes it is our response to the symptoms that causes the most distress. Really question which ones can be tolerated, so you can then see which ones are just unbearable. When you identify those, try to think about options you can take if they ever become unbearable or happen too often or for too long. Having someone to talk to, a safe place, a favorite activity, reducing obligations, anything you can think of.

 

I did the above and I now have a wealth of data on what I can do with certain symptoms. Although my waves can be awful, seeing the data I've gathered really helps me to keep pushing forward. To refine my coping strategies I search other threads here and other places online for non-drug methods for dealing with symptoms. 

 

What will happen if you decide to drop to 2.5mg?

I wish there was a way to predict this but the science isn't there yet. One thing that may reassure you but it is based on my experience and some of what I've read regarding others' experience: the symptoms you get when withdrawal first hits tend to be the ones you're stuck with for the duration, which diminish as your brain heals. From what I understand, the brain heals with time, whether you are reinstating, stabilizing, or tapering, as long as things are slow and steady, your brain is adapting and therefore healing. 

 

So, if you drop to 2.5mg, you may not be surprised with new symptoms but the ones you have may get worse. If, having listed all the symptoms and you have a plan in place if things get worse, you can make the decision whether you want to take the risk. The good news is that the drop to 2.5mg may be tolerated quite well and some of your symptoms (if they are adverse reactions to your reinstatement and updose) may diminish. 

 

I hope this post was helpful in some way but I am sorry if it wasn't :S I am sorry you are going through this though. When I found out I had withdrawal, I was terrified and had a lot of things to accept. It's awful, it really is, but I am happy to say that today and yesterday have been good days for me: something I never thought possible in the beginning. 

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Isabel

Thanks for the replies! I have a lot to think about. Would like more information on what physiologically happens when reinstatement is too high. There's been so many changes in dose I don't know how to know if CNS is adapting to 3.75. How do you know if its adverse reaction or withdrawal?

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Isabel

So the last few days have noticed tingling in hands. Is this overactive CNS or nerve damage cause of lexapro

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Isabel

Thank you! There is just so much information it's a lot to take in. Again, I hate to be redundant, But I'm in such uncertainty about reducing from 3.75 to 2.5. If I sleep decent then I feel slightly better so hard to know what to do I just don't want to cause more instability. However I realize reinstatement at too high a dose might be causing the issues in which case would I feel better going down. Thoughts?

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Isabel

Can anyone explain the difference between adverse reaction to reinstatement at a high dose or withdrawal? I'm trying to determine if I should cut to 2.5 from 3.75mg to alleviate reaction but will I also be getting withdrawal symptoms? Emotionally ok but feel "shaky" in hands and head has burning and "busy" feeling that's hard to describe. Is this glutamate? I'm not taking my other supplements cause I'm afraid of reaction to those.

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Isabel

there is sooo much information on this sight it's hard to know what info applies to myself and I'm trying to make the best informed decision. One moderator said to taper 3.75 to 2.50 because of adverse reaction to reinstatement. but on the other hand, everyone tapers slow it seems. Could someone explain, If I have tolerance to the lexapro after being on 1mg for years, or if I'm hypersensitive, Receptors doenregulated.... etc. I don't understand what all of it means! If I continue taking 3.75 to see if I stabilize is this causing more harm. It seems so scary to think I'll be in withdrawal for years.

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