Debby: tapering off 10mg Escitalopram

[Debby]

Hello everyone!

 

I was on Citalopram 10mg for about 17 years (with a couple of breaks - one for a year and one for 6 months - both of which ended up with me back on it) then about a year ago my GP switched me to Escitalopram 5mg (as an equivalent dose) as my anxiety got bad and I felt like the medication wasn't working any more. This was soon increased to 10mg Escitalopram which is where I am now and I'm hoping to get down to 5mg (and maybe even taper off completely in future - but 5mg is my goal for now!)

 

I've been prescribed Cipralex 20mg/ml oral drops and I'm planning to switch to the drops at the same dose as I'm currently on (so 10 drops = 10mg) and hold that for a month to stabilise before decreasing by 10% for the next month.

 

I'll let you know how I get on and thank you very much for being here! The last time I tapered off I did it over a year and was doing really well until the end when I was down to 2 drops (so 2mg) and then stopped suddenly as I went away and forgot the drops and thought 'I'm so close now I'll just stop' - six months of hell and I was back up to 10mg again! So your advice and support will be hugely appreciated.

 

Thanks everyone! x

[mammaP]

Hi Debby, welcome to SA. That is exactly what I did, tapered effexor for a year, forgot it when I went away for a few days and thought it was low enough to stop anyway. I was wrong too and had to reinstate but I reinstated a very tiny dose, waited to stabilise then started to taper again much wiser! 

People usually find it better to take part of the dose in tablet form and part in liquid, upping the liquid while lowering the tablet so that the brain can get used to it. People often have to do this when changing brands too. They are the same drug but made by different companies. If I use my mums recipe for something it never turns out exactly the same and it is the same with drugs. You could find your nervous system struggling a bit doing a straight switch. Maybe do 7.5 tablet, 2.5 liquid, then 5 T+ 5L and start tapering the liquid part.  Good on you for getting the liquid, it is much easier to taper. 

 

We recommend tapering 10% of the CURRENT dose, with 4 weeks or more between drops. This takes a long time but is sneaking the drug away so that the brain doesn't notice. 

 

Tapering lexapro

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

 

Why taper 10%

 

http://survivingantidepressants.org/index.php?/topic/1024-why-taper-by-10-of-my-dosage/

 

The 3 KIS

http://survivingantidepressants.org/topic/6632-the-rule-of-3kis-keep-it-simple-keep-it-slow-keep-it-stable/

 

[Debby]

Hello mammaP and thank you so much for your reply!

 

Your advice on taking part of the dose in tablet form and part in liquid makes sense, and thank you for the explanation! I've read the info you point to on splitting tablets and titrating drops. I'm a bit nervous about it - maths isn't my strong point and I don't want to make any mistakes! I'm not sure I'll be able to accurately measure 7.5mg of tablet and 2.5mg of liquid - or is it easier than it sounds? I've been given a 1ml syringe. So I guess that a full syringe = 20mg so to get 2.5ml I'll need to measure 0.125 in the syringe? Is that right?

 

I like the idea of sneaking the drug away so that the brain doesn't notice!

 

I know nobody can really answer this but do you think I'll be able to actually get off the meds without having a horrible anxiety crash and then continue drug-free without anxiety? It seems impossible at the moment. I'm convinced that I'll always need them and always struggle with anxiety. 

 

Thanks again for your helpful advice x

[mammaP]

If the tablets are scored you could cut them in half then half again to get 7.5.  Escitalopram oral solution is 1ml to 1mg. (Check your bottle for confirmation). You could use an oral syringe to get 2.5 . 

Or you could go straight to 5 tablet and 5 solution but you might get some side effects, they will not last though and you will stabilise again. Are you sure the syringe is 1ml and not 10ml?  1ml syringe is tiny. If it is 10ml you could measure 2.5 in it. Yoy can absolutely get off without the anxiety if you go sowly enough. Any sign of withdrawal that is more than a little bit uncomfortable means the drop is too big, or too soon. You will get to know your body and know when to slow down. It's also good to have a long hold sometimes. Again your body will tell you and when you are used to tapering the urgency will go and you will be fine with tapering however slow it has to be.

 

As you get the dose down you will need to learn coping skills so that you don't feel the need to go back. 17 years of drugs that dampen your natural responses means that you will be facing new challenges.  When you get upset about something you will really feel it, but you need to go through it. Dealing with things is part of life. We get angry, we get upset, we grieve for lost loved ones and they are all normal human emotions that drugs change. We have a forum on non drug techniques. Put them in place as you taper and there will not be any surprises once you are off, and we will all be here for you cheering you on. 

 

[Debby]

Thank you mammaP for the advice and encouragement!

 

I bought a pill cutter this morning but I'm still a bit confused about the liquid. I've definitely got Cipralex 20mg/ml oral drops and a 1ml syringe. The drops are 1mg PER DROP not per ml. Does that make sense? So my (admittedly terrible) maths tells me that a full 1ml syringe = 20mg so 1mg would be 0.05ml. Is that right? 

 

Man, this is a faff!

 

Thanks again x

[Debby]

Just an update: Today I started taking 7.5mg of Escitalopram in tablet form and 2.5mg in liquid. I also started taking Magnesium Citrate 300mg per day.

 

I'll keep updating! Thanks x

[Debby]

Another update: Feeling fine. Today started B12 1000ug sublingually and 4000mg of Omega 3 fish oil 1000mg.

[Debby]

I've just asked a question on a different thread but thought it might be better here:

 

Could I please ask for your advice? I'm currently shifting from 10mg tablet to liquid and I've been advised to take 7.5mg as tablet and 2.5mg as liquid with a view to getting to 5mg tablet/5mg liquid then start decreasing the drops. I started on the 7.5mg/2.5mg last Thursday so it's only been a few days and I feel fine so far - should I stay here for a month do you think? Or could I move to 5mg/5mg a bit quicker as I'm not actually decreasing my dose, just switching the form of it? Any advice from anyone would be helpful! 

 

Thank you x

Edited August 15, 2017 by scallywag
merged topics

[mammaP]

On 09/08/2017 at 3:48 PM, Debby said:

Thank you mammaP for the advice and encouragement!

 

I bought a pill cutter this morning but I'm still a bit confused about the liquid. I've definitely got Cipralex 20mg/ml oral drops and a 1ml syringe. The drops are 1mg PER DROP not per ml. Does that make sense? So my (admittedly terrible) maths tells me that a full 1ml syringe = 20mg so 1mg would be 0.05ml. Is that right? 

 

Man, this is a faff!

 

Thanks again x

That makes perfect sense. There are so many brands and thay can vary so I am glad you checked!  It takes 4 days to get a steady concentration in the blood so you could go to 5+5 if you are doing ok after 5 days of starting the liquid.  I am rubbish with numbers and get myself in a pickle but we have some mods aho are great and can do the maths in a jiff if you get stuck. I have some 0.5 insulin syringes for tiny doses but had to remove the needles with pliers. It was easy, just gripped the whole cap and pulled them off with the cap. I got them from ebay, good old ebay! Just letting you know in case you need them for smaller doses when tapering.   

 

[apathetic]

Hi Debby.

Welcome to the forum. I'm on escitalopram as well, 10mg, so I'll be following your topic.

I'm so glad that there are people who are firstly trying to inform themselves on how to taper, unlike me. I made a big mistake there.

Sending you support and wishing you a good recovery & tapering process

[Debby]

Thanks mammaP, this is so helpful! I'm doing fine at the moment so I think I'll go over to 5+5 next week. Thanks for the info on 0.5 insulin syringes too! x

[Debby]

Hello apathetic and thanks so much for your message! Sending support to you too, let's hope we can help each other. I hope you're doing well x

[scottly9999]

Hi Debby

You posted on my thread the other day.

Thanks for that!

Just wondering why you're doing part tablet and part liquid?

Are you having trouble measuring the liquid amounts?  Or the cost of the liquid?

I think I read with your posts, that you're on the Lexapro 20mg/ml?

 

Also from your post - I remember you saying, you tapered down to 1.5mg - and due to some reason just stopped taking it at that dose.

THat is still a HUGE dose - that has a huge effect on you.

Lexapro (Escitalopram) is a very potent SSRI - and most are prescribed way higher than they should be in the first place.

I'd say most of your problems were from that jump-off point.

 

Heck - even with my slow-ish taper, I still have had (still having) horrific acute W/D symptoms...

that was nearly a year of tapering from 1mg .8 .6 .4 .2 0  I did notice stuff starting to flare up at the lower doses - and if I had my time again - I'd probably have tapered even more gradually and slower.

I was on 0.2mg for about 2-3 months from memory - and then stopped..

AND I suddenly lost my Mum right in the middle of all this.

Mum was my last parent - and was very sick.

I'm an only child, so have been thrown into a LOT of painful emotions on top of the neuro-emotions from withdrawal.

It's an opportunity to grow and learn more about myself.  You don't grow if you're comfortable!

 

Anyway - ENOUGH about me - and more about you!

 

How are you?????

Hope you're doing well.

[scallywag]

On 2017-08-14 at 9:33 AM, Debby said:

I've just asked a question on a different thread but thought it might be better here:

 

Could I please ask for your advice? I'm currently shifting from 10mg tablet to liquid and I've been advised to take 7.5mg as tablet and 2.5mg as liquid with a view to getting to 5mg tablet/5mg liquid then start decreasing the drops. I started on the 7.5mg/2.5mg last Thursday so it's only been a few days and I feel fine so far - should I stay here for a month do you think? Or could I move to 5mg/5mg a bit quicker as I'm not actually decreasing my dose, just switching the form of it? Any advice from anyone would be helpful!

 

Debby, it's best to post questions about your situation in your introduction topic because the Introductions forum is where moderators look first for member questions. I've moved your post/question to your introduction topic so that all your information, questions and answers are in one place.

 

We're cautious about changes -- even formulation changes when the dose is constant -- so recommend taking the tablet to liquid crossover slowly. As an absolute minimum, I'd give it a week at each 25% step.

 

 

[Debby]

Hello scottly! Thank you so much for checking on me! Yep, I jumped off too quickly last time and hopefully I can avoid doing that again. I'm sorry to hear about your mum, it's very hard isn't it? Especially when the real emotions get muddled with the neuro ones. Or get exacerbated and exaggerated by the w/d perhaps. Hope you're feeling better.

 

I've been advised on here to switch only part of my dose to liquid to start off with to avoid a sudden switch and possible side effects. As scallywag says above, I'll be giving it at least a week before I go to 5mg tab/5mg drops.

 

And scallywag, thank you so much for moving my post - I'll continue to update and ask any questions in this thread. And thanks also for the advice to take the switchover slowly - I'll do that!

 

Hope everyone is doing ok, and thanks for being here x

[Debby]

Hi all - just a little update. I moved to 5mg tablet and 5mg liquid on Saturday 26th August. Fine so far, no zaps or anything. Still taking the vitamins! x

[LexAnger]

hi Debby,

 

just scaned led your thread quickly to understand your situations, like everyone said, you are luck to find this forum at this early stage before tarring! I Amy sorry though about what you went through the last unsussceeful taper. 

 

Just to share my thoughts about the lexapro liquid you are taking. As strange as it is to up make such a high concentration liquid, you can dilute by adding water in your future taper for easier and more accurate measuring. That's the only good thing about the liquid form of lex, allowing you to taper as slow as possible with very tiny reduction. You can see from my signature how small my doses are--0.0004 mg is piece of cake and it's very accurate.

 

wish you best luck in your forward journey!

lex

[Debby]

Hello Lex!

 

Thank you so much for your message! It's a relief to know that I can reduce to very small doses - I've been wondering how I can do that when I get to the end! So thank you for the advice. How are you doing now on just 0.03mg? I hope you're well and not suffering withdrawal x

[LexAnger]

Hi Debby,

 

thank  I you for your kind wishes!

im still in great pain unfortunately. My original plan was to taper the 4.5 mg in 7 years, but got severe reaction in the middle due to couple accidental updoses so had to drop faster. As everyone says my case is exceptional so not everyone will be like me thank goodness.  As long as you have the option to hold long, going slow is the way to avoid the WD agony. lexapro is a very potent Ssri so be extra gentle to yourself. It's a long journey, but with patience and careful approach, you will make it to the other side.

 

best,

lex

 

 

[Debby]

Hi Lex!

 

I've read through your story and oh my goodness, I'm so sorry you've had such a bad time. The pain sounds terrible. You are so strong to have got so far. 

Thank you for your advice, I will go as slow as I possibly can, I'm in no hurry at all. I think I might do 5% drops just to be on the safe side. We'll get there eventually!

 

Thank you so much for being there, it's making a HUGE difference to know there are other people out there who understand. One of the worst things about both anxiety and withdrawal is feeling alone in it. SA is an amazing place so thank you all x

 

Lex, I wish you all the best and hope that your pain eases soon x

 

[Debby]

Hi everyone

 

I haven't made any changes since switching to 5mg tablet/5mg liquid but I did talk to my GP yesterday and found it very frustrating! I explained why I was tapering so slowly which she appreciated but she said that a lot of people just need to stay on SSRIs forever because I what I describe as withdrawal is actually a chemical imbalance and a return to the original anxiety. I didn't want to argue with her but I mentioned having a look at this website. She didn't seem very interested but it seems criminal that GPs are so misinformed about SSRI withdrawal! I want to make anyone who prescribes SSRIs read this forum! Is there anything we can do? I completed the survey that was linked to here a while ago, but unless GPs have this information there will be more and more people like us, suffering horribly when trying to get off the meds. Are there any academic medical papers written on this topic? She might be more inclined to look at that rather than a forum.

 

I don't have any answers, just wanted to vent! Thanks x

[Debby]

While I'm here, I have a question. When I tapered last time, to avoid having to measure tiny amounts of liquid (and do any complex maths), I did this:

 

Month one: 10 drops daily

Month two: 10 drops one day then 9 drops the next, continuing with 10 and 9 alternately

Month three: 9 drops daily

Month four: 9 drops one day then 8 drops the next alternately

Month five: 8 drops daily

 

And so on...

 

I seem to remember it worked ok until the end when I jumped off too soon. Is this a silly plan? Has anyone else done it like this? I really want this taper to go smoothly so if I need to do a 5% or 10% taper and measure it accurately then I will. Thanks for any advice people! x

[mammaP]

Hi Debby, we don't recommend alternating doses, it can destabilise the nervous system. It will be best to dilute the drops if needed to get the lower doses. I am no good with the complex stuff either and taper by miniscule amounts.  People tend to get quite inventive with tapering and working out how to get the doses! 

 

I had trouble telling my doctor when I was tapering. He said I was making it worse by tapering slowly! They haven't a clue, and STILL believe the chemical imbalance THEORY that was cooked up by the drug companies to sell their drugs.

Alto has done a ton of research and posted some of it here that can be printed and handed to GPs

 

 

[Debby]

Thanks for advice mammaP - looks like I'm just going to have work out those complex numbers and try some diluting!

 

And thanks for the link, I'll have a read and see if there's anything I can pass on to the GP x

[JS11]

Hi Debby, Scotty999, LexAnger, Apathetic, MammaP and Scallywag,

I hope I didn't miss anyone.

I just wanted to introduce myself and say hello.  New to S.A.

 

I am on Escitalopram both the liquid and tablet form too.  Thank you all for all the helpful information you have provided.  I am trying to stabilize on my current dose and do find the math rather confusing as well.  

 

I have appreciated reading your stories.   So many things you have gone through.  It does help to not feel so all alone out there.  

take care and I hope the day treats you well.

 

JS

 

[Frogie]

On August 14, 2017 at 11:22 AM, apathetic said:

Hi Debby.

Welcome to the forum. I'm on escitalopram as well, 10mg, so I'll be following your topic.

I'm so glad that there are people who are firstly trying to inform themselves on how to taper, unlike me. I made a big mistake there.

Sending you support and wishing you a good recovery & tapering process

Are you still taking escitalopram? I'm sorry I couldn't understand your signature if you have tapered off congrats! If not, can we follow each other's progress? I'm currently on 6.4 (I think, I'll have to look at my signature), I just have it marked on an oral syringe and take it every morning. When I'm off that, I'll be tapering Xanax, then done! Thanks in advance for answering me.

 

Take care,

Frogie xx

[LexAnger]

That's so kind of you JS11 saying those words!

wish you a pain free and peaceful day!

lex

[Frogie]

3 minutes ago, LexAnger said:

That's so kind of you JS11 saying those words!

wish you a pain free and peaceful day!

lex

Hi Lex:

 

I read your signature and it looks like you are almost to zero.

 

I just wanted to say congrats!

 

Take care,

Frogie xx

[LexAnger]

Hi Frogie,

glad we MET again here:)

yeah, that's the only thing giving me hope. Although I'm not feeling better at all at the low dose. I hope once I'm off, things will improve naturally and quickly as my situation is super complicated by the drug reaction ever since 2 years ago.

 

i have been following you silently. I hope steady and slow tapering works well for you.

 

will talk more on your thread.

 

appology Debby for hi- jacking your thread a bit.

lex

 

[Frogie]

3 minutes ago, LexAnger said:

Hi Frogie,

glad we MET again here:)

yeah, that's the only thing giving me hope. Although I'm not feeling better at all at the low dose. I hope once I'm off, things will improve naturally and quickly as my situation is super complicated by the drug reaction ever since 2 years ago.

 

i have been following you silently. I hope steady and slow tapering works well for you.

 

will talk more on your thread.

 

appology Debby for hi- jacking your thread a bit.

lex

 

I apologize Debby too. Maybe we can track each other, I'm not too far ahead of you. You are at 10 and I'm at 6.4.

 

Lex, follow me, and talk to me. It would help a great deal to know how you are doing. Post on my thread all you want.

 

Take care,

Frogie xx

[Debby]

Hello to JS and welcome - I hope you're doing ok and hope we can support each other!

 

Hi Lex and Frogie - no worries about the hijack! Maybe you can help with how to measure the smaller amounts? Glad we're all in this together! x

[Frogie]

42 minutes ago, Debby said:

Hello to JS and welcome - I hope you're doing ok and hope we can support each other!

 

Hi Lex and Frogie - no worries about the hijack! Maybe you can help with how to measure the smaller amounts? Glad we're all in this together! x

I would love to help you, if you can help me! Team effort.

 

Nice to meet you by the way! Hopefully we can be there for each other. These meds are horrible!

 

Take care,

Frogie xx

 

 

[LexAnger]

3 hours ago, Debby said:

Hello to JS and welcome - I hope you're doing ok and hope we can support each other!

 

Hi Lex and Frogie - no worries about the hijack! Maybe you can help with how to measure the smaller amounts? Glad we're all in this together! x

Hi Debby,

 

i used drops as my reduction measure when at lower doses as I think it is more accurate.

so far you I think it should work as well. Just like you did last time, but not alternating doses. Basically you stick the new dose/ drops once you make the reduction.

 

lex

[JS11]

8 hours ago, LexAnger said:

That's so kind of you JS11 saying those words!

wish you a pain free and peaceful day!

lex

I have felt such kindness here, Lex.  It is of great comfort.  When you have had a taste of those lovely moments when everything is going well, you so want more and wish others an equal measure.  Such a precious thing. 

take good care,

JS

[JS11]

5 hours ago, Debby said:

Hello to JS and welcome - I hope you're doing ok and hope we can support each other!

 

Hi Lex and Frogie - no worries about the hijack! Maybe you can help with how to measure the smaller amounts? Glad we're all in this together! x

Oh hello Debby and thank you.  Yes, support is always so greatly appreciated and hopefully I can return some as well.

 

Maybe I'm hijacking your thread too?  I am trying very hard to learn the proper etiquette.  I think whenever I see anything related to Escitalopram, Lexapro or the British one Citoprex?  I instantly am drawn.  Have been reading so much and attempting to respond as I must admit, my brain ohhhh.  Comes and goes.  

 

Oh Debby I wanted to ask, I think we are on just about same or similar dose.  I take liquid and tablet as well.  Do you notice any adverse reaction with the liquid?  I was all over the place with my dose and then added some more medications to the fire, but it seems my anxiety skyrockets shortly after taking it.  

 

I spoke with Lex about this as well.  And hi Frogie.  I have been meaning to properly introduce myself to you as well.  

 

take care all, I hope you have peaceful sleep whatever continent you may be on or time zone for that matter...

JS

 

[JS11]

5 hours ago, Frogie said:

I would love to help you, if you can help me! Team effort.

 

Nice to meet you by the way! Hopefully we can be there for each other. These meds are horrible!

 

Take care,

Frogie xx

 

 

Teams are good!!!!

take care,

JS