ikam: tapering escitalopram

[ikam]

No, the doctor asked me to continue with escitalopram despite of adverse response. I also askr her about doxepin, she said to continue with it...

With naratriptan, I just read on line. I was also that time on zolpidem...

I went to A&E and was prescribed yet another medication, but this time I checked on drug interactions and never took this medication...

 

I spoke to somebody who helped me with effexor years ago. She said I was heading in the direction of serotonin syndrom. I was lucky...

[ikam]

 

I am only on my 14th day of decrease. I was told I had an adverse reaction to escitalopram. Somebody who knows about these drugs explained to me:

My problem that began with the higher dose of Escitalopram happened because the person prescribing has little knowledge of drug to drug reactions. Doxepin requires CYP2D6 to properly assimilate. Escitalopram moderately inhibits the CYP2D6 enzyme which allows a build-up of Doxepin. At first, the lower dose still allowed me to manage. But the increase was enough for the problem to show. The sensation i was feeling was from too large of a build-up of serotonin from not being able to process the Doxepin quickly enough.

It is difficult to stay hopeful when symptoms are back...

How long did your paresthesia last?

 

Hi ikam,

 

I hear you about it being hard to maintain hope when symptoms are bothering you. I was hopeless a lot of the time too. Nonetheless, I still have recovered so much even with my feeling like it would never end.

 

My parasthesias cleared up a little while after I got off the drugs that were causing them, if I recall properly.

This was the reason for faster tapper. But I think I need to stay on 2.5mg for some time...

[ikam]

Thank you Ever.

It is my first time when depression returned since decrease...and I seem to be getting lower and lower...i don't feel like doing anything...

 

I went to a nearby park on friday...but again don't feel like getting out, don't want to see anybody...

Unfortunately, my flat is very acoustic, so I can hear people outside or/and upstairs...

 

Maybe I am worse, as I went ro sleep late. And parsthesia has been back...

I have anothet strange problem, which I relate to the nervous system in the pelvic area, I had in times problems with urinating, and I had this last night...

 

I am losing my hope...

[ikam]

You can get serotonin syndrome or serotonin toxicity in varying degrees while you are taking drugs. Only extreme cases are fatal, but it's wise to reduce dosage at any sign of overstimulation.

 

You can get withdrawal symptoms when you are off drugs.

I thought that withdrawal starts when I start decreasing. If yes, it seems I am now at a withdrawl phase...

But, most likely I had some mild serotonin toxicity...

 

What I am unsure about is how to judge my symptoms and plan tappering. I think I need to stay on 2.5mg for some time...but is this still toxic for me?

My paresthesia has been worse last two days...

[ikam]

 

 

What if my body floods itself with serotonin or something now that things are out of whack?

 

 

This is not going to happen for various reasons that if you don't understand all the medical mumbo jumbo it won't do any good to post it. 'Serotonin Syndrome' is a term applied to a specific condition involving taking certain chemicals into your body, not something your body just up and does to you.

 

 

So, it's not possible that my own body could give me serotonin syndrome as levels readjust themselves now that I am off meds?

 

 

No.

 

The reason the ER doc said you did not have it is because of the above statement, the poison control people were misinformed. SS doesn't happen coming off meds, you were getting wd syndrome. Is very hard to accept docs and poison crtl center people as being wrong but that is what we are here for, the reason this board exists. We are documenting with every story how real wd syndrome is.

So, I am in a withdrawal phase now and should follow a withdrawal protocol rather than panicking that I have to stop escitalopram at once?

And, accordingly to this, my symptoms at present are withdrawal symptoms...So, I need to stop panicking...

[cymbaltawithdrawal5600]

Ikam, this is more pertinent to your intro thread because it involves wd and not SS. Could you make a post in your thread and say exactly what is going on with you now? Continuing to talk about it here is drawing the thread off topic.

 

After you make a post in your thread, I will see it, I will put you on my watch list and I'll respond to you there, ok? I'll move these posts over there.

[ikam]

Great, thanks...

[ikam]

Update: this is my 8th day of faster decrease to 2.5mg. I had no paresthesia at all during days 5 and 6. This symptom has returned yesterday...i also had it at night, woke up after three hours with pins and needles in my left arm. Got scared, took painkiller/paracetamol...

 

I take 2.5mg escitalopram in the morning, 75mg doxepin in evening...+ opremazole in the morning and atenolol twice a day 25mg...

 

I have been feeling more low since few days, something as I was before escitalopram, this includes suicidal thoughts (no urge to act upon them)...

But my mood could be situational, no work, very noisy at my flat, living in the area I don't know well...

I tend to stay indoors and don't feel motivated to do anything...

I guess, I concentrate too much on my symptoms...

 

I have been brighter, but easily getting tired...

 

I worry a lot about my future, but do not a lot to secure it...i need to get a job, but I am unsure how able I will be to travel and work...but I must, I cannot afford longer break...

 

it seems I am now at a withdrawl phase at present..

But, most likely I had some mild serotonin toxicity...

 

What I am unsure about is how to judge my symptoms and plan tappering. I think I need to stay on 2.5mg for some time...but is this still toxic for me?

So if I am in a withdrawal phase now I should follow a withdrawal protocol rather than panicking that I have to stop escitalopram at once?

And, accordingly to this, my symptoms at present are withdrawal symptoms...So, I need to stop panicking...

 

As I said I am usure if staying on lower dose of escitaploram for longer is still too toxic for me?

[cymbaltawithdrawal5600]

Ikam, give me some time to read your thread and your update and see if I can say something to help you figure this out, ok?

[cymbaltawithdrawal5600]

When was the last time you took naratriptan?

 

Could you give me a list of every pill (including supplements) you have put in your mouth (including dosages) since you came to this board? I am going to run and post another DI check.

[cymbaltawithdrawal5600]

One thing I am having a bit of difficulty with is the fact that your sig, if I try to use it as a narrative of your drugs, has the current drug at the beginning and the start of your drug odyssey at the end. Be good if you could change it, but you don't have to. I am just having to read slower to get the picture right.

 

How much paracetamol w/codeine do you take per day and is it every day?

 

What dose of Effexor were you on that you tapered from over a 2 year time span?

[ikam]

When was the last time you took naratriptan?

 

Could you give me a list of every pill (including supplements) you have put in your mouth (including dosages) since you came to this board? I am going to run and post another DI check.

Naratriptan- 23rd December, I felt as if I was drunk...

Zolpidem- 24 and 25 December...

Scopolan-24 and 25 December...

 

I am still on 75mg Doxepin in evening (more than two years)

Atenolol, twice a day 25mg

 

Omeprasole 20mg in the morning (i used to be on pantoprasole, changed on 23rd december)

Ranitidine, 150mg in evening

 

HRT/low dose: Utrogestan, 100mg and Sandrena 1.0 gel (in evening, over one year now)

 

Aconitum 30c in the morning, and if needed, but not a lot, maybe twice a day

Passionflower in the morning, 1 pill 425mg extract

 

Paracetamol on few occassions, including last night (i hoped it might help with paresthesia)

 

 

I have not taken naratriptan neither sleeping pill since xmas. I destroyed them...

[ikam]

What is DI check?

[cymbaltawithdrawal5600]

OK. Please bear with me, I am going to move your other posts from the SS thread to your topic where they belong. Please be more specific how often you have taken paracetamol if you can. I'll clean up the thread later. I also have to read up on SS.

 

DI is drugs checker, I will do that this time so the info is all here the way I want it. For now just don't panic and take your drugs as you normally have been. Always remember, if you feel you are becoming seriously ill, please get medical attention. We don't diagnose or give medical advice over the internet, ok?

[ikam]

One thing I am having a bit of difficulty with is the fact that your sig, if I try to use it as a narrative of your drugs, has the current drug at the beginning and the start of your drug odyssey at the end. Be good if you could change it, but you don't have to. I am just having to read slower to get the picture right.

 

How much paracetamol w/codeine do you take per day and is it every day?

 

What dose of Effexor were you on that you tapered from over a 2 year time span?

I don't take anymore paracetamol with codeine, I did in the beginning of las year, even four times a day.

At present I take soluble paracetamol, but not daily...

 

I don't remember effexor dose, it seems as if it was 75mg twice a day. It took me more than two years...

I stopped that time ppi and atenolol. I was then only on supplrments, magnesium, probiotics, systemic enzymes...

[cymbaltawithdrawal5600]

*copying these quotes from the Serotonin Syndrome thread in Symptoms*

 

 

You have been risking serotonin syndrome all along with your combinations of antidepressants, Nikki.
 
You may wish to add any other drugs you are taking to the Drug Interactions checker below.
 
http://www.drugs.com/interactions-check.php?drug_list=1323-0,1698-0&professional=1
 

Interactions between your selected drugs

 MAJOR imipramine ↔ nefazodone

Applies to: imipramine, nefazodone
MONITOR CLOSELY: Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1 receptor agonists, ergot alkaloids, cyclobenzaprine, lithium, St. John's wort, phenylpiperidine opioids, dextromethorphan, and tryptophan may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Symptoms of the serotonin syndrome may include mental status changes such as irritability, altered consciousness, confusion, hallucination, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea.

MANAGEMENT: In general, the concomitant use of multiple serotonergic agents should be avoided if possible, or otherwise approached with caution if potential benefit is deemed to outweigh the risk. Patients should be closely monitored for symptoms of the serotonin syndrome during treatment. Particular caution is advised when increasing the dosages of these agents. The potential risk for serotonin syndrome should be considered even when administering serotonergic agents sequentially, as some agents may demonstrate a prolonged elimination half-life. For example, a 5-week washout period may be advisable following use of fluoxetine and 3 weeks following the use of vortioxetine before administering another serotonergic agent. If serotonin syndrome develops or is suspected during the course of therapy, all serotonergic agents should be discontinued immediately and supportive care rendered as necessary. Moderately ill patients may also benefit from the administration of a serotonin antagonist (e.g., cyproheptadine, chlorpromazine). Severe cases should be managed under consultation with a toxicologist and may require sedation, neuromuscular paralysis, intubation, and mechanical ventilation in addition to the other measures.

Please note there are degrees of excessive serotonergic stimulation, leading to serotonin syndrome. In these situations, rapid reduction in dosage is justified.

 

 

You can get serotonin syndrome or serotonin toxicity in varying degrees while you are taking drugs. Only extreme cases are fatal, but it's wise to reduce dosage at any sign of overstimulation.

 

You can get withdrawal symptoms when you are off drugs.

[cymbaltawithdrawal5600]

 

I don't take anymore paracetamol with codeine, I did in the beginning of las year, even four times a day.

At present I take soluble paracetamol, but not daily...

 

so plain paracetamol now?

 

Why were you taking codeine 4 times a day, for what symptoms?

[ikam]

OK. Please bear with me, I am going to move your other posts from the SS thread to your topic where they belong. Please be more specific how often you have taken paracetamol if you can. I'll clean up the thread later. I also have to read up on SS.

 

DI is drugs checker, I will do that this time so the info is all here the way I want it. For now just don't panic and take your drugs as you normally have been. Always remember, if you feel you are becoming seriously ill, please get medical attention. We don't diagnose or give medical advice over the internet, ok?

Paracetamol, I took last night, before that on 7th january, 31 december...

I used to take it daily. Finished with codeine around half a year ago...

 

I don't feel seriously ill, I panic a lot as I never had such paresthesia before...i tend to catastrophise and think I will become disabled...

And I feel so guilty that I did not see that I was abusing medication...

 

I am going shopping now, will be back soon...

 

Thank you for looking into this for me...my picture seems too complex for me, cannot judge what may be withdrawal, what adverse response...don't know if staying on escitaploram is safe or not...

[ikam]

 

 

I don't take anymore paracetamol with codeine, I did in the beginning of las year, even four times a day.

At present I take soluble paracetamol, but not daily...

 

 

so plain paracetamol now?

 

Why were you taking codeine 4 times a day, for what symptoms?

I was taking paracetamol with codeine to...damp my feelings...to get calmer...

If I had migraine, I used to take naratriptan on top of this...

I also had a very bad habbit (this sounds bad), I would take more doxepin to sleep, slept all day...it used to happen weekly...last tome on 18th December, I took 75mg 3 times during that day...

 

Only plain paracetamol, but rarely...

[cymbaltawithdrawal5600]

Its ok, I just need to know, ok? If you are nervous about it being in your thread, remember we do not know who you are and google can't see you here.

 

Being honest gives me a much clearer picture of what may be happening.

[ikam]

Forgot, I have also been taking charcoal (it is to manage diarohea), I am still on it 3 times a day...

 

I was also taking for almost half a year loperamide, once to three times a day...

 

In 2012 november, I had a major surgery (Benign tumor in my leg), under general and local anastehic, lots of painkillers for over one month...

In 2013, september, october, had a severe infection after dental surgery, on antibiotics for two months, including cipro for two weeks...

[ikam]

I want to be honest...

It seems I am honest to myself for a first time...

 

Sorry, if it is so complex...

[cymbaltawithdrawal5600]

Hey, this is the way we are! It is now becoming clearer to you, as your symptoms are cropping up and you don't know why, that everything you do or have done in the recent past, is important to look at. This is one time my nursing background is coming in handy.

 

What do you think is causing the 'scoots' (diarrhea)?

[ikam]

*copying these quotes from the Serotonin Syndrome thread in Symptoms*

 

 

 

You have been risking serotonin syndrome all along with your combinations of antidepressants, Nikki.

 

You may wish to add any other drugs you are taking to the Drug Interactions checker below.

 http://www.drugs.com/interactions-check.php?drug_list=1323-0,1698-0&professional=1

 

 

Interactions between your selected drugs MAJOR imipramine ↔ nefazodone

Applies to: imipramine, nefazodone

MONITOR CLOSELY: Concomitant use of agents with serotonergic activity such as serotonin reuptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, 5-HT1 receptor agonists, ergot alkaloids, cyclobenzaprine, lithium, St. John's wort, phenylpiperidine opioids, dextromethorphan, and tryptophan may potentiate the risk of serotonin syndrome, which is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors. Symptoms of the serotonin syndrome may include mental status changes such as irritability, altered consciousness, confusion, hallucination, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea.

MANAGEMENT: In general, the concomitant use of multiple serotonergic agents should be avoided if possible, or otherwise approached with caution if potential benefit is deemed to outweigh the risk. Patients should be closely monitored for symptoms of the serotonin syndrome during treatment. Particular caution is advised when increasing the dosages of these agents. The potential risk for serotonin syndrome should be considered even when administering serotonergic agents sequentially, as some agents may demonstrate a prolonged elimination half-life. For example, a 5-week washout period may be advisable following use of fluoxetine and 3 weeks following the use of vortioxetine before administering another serotonergic agent. If serotonin syndrome develops or is suspected during the course of therapy, all serotonergic agents should be discontinued immediately and supportive care rendered as necessary. Moderately ill patients may also benefit from the administration of a serotonin antagonist (e.g., cyproheptadine, chlorpromazine). Severe cases should be managed under consultation with a toxicologist and may require sedation, neuromuscular paralysis, intubation, and mechanical ventilation in addition to the other measures.

 

Please note there are degrees of excessive serotonergic stimulation, leading to serotonin syndrome. In these situations, rapid reduction in dosage is justified.

 

 

You can get serotonin syndrome or serotonin toxicity in varying degrees while you are taking drugs. Only extreme cases are fatal, but it's wise to reduce dosage at any sign of overstimulation.

 

You can get withdrawal symptoms when you are off drugs.

 

I did this drug checker when I realised that something was not quite right. I was trying to tell this to the emergency doctor, but he just prescribed something else which would have interected with my meds, I jever took it...

 

There is also good drug interaction checker on RxISK...

[cymbaltawithdrawal5600]

Good to know. I have to edit the original post and this one too to get the extra words about another poster out of it.

 

Diarrhea?

[ikam]

Good to know. I have to edit the original post and this one too to get the extra words about another poster out of it.

 

Diarrhea?

I have ibs type syndrome, it has been like this since stopping effexor...

[cymbaltawithdrawal5600]

 

There is also good drug interaction checker on RxISK...

 

That is a "side effects' checker, not an interactions checker.

 

OK, so is the charcoal supposed to stop it and does it work? Did the doc give it to you because he suspected SS?

[cymbaltawithdrawal5600]

Keep reading your PM window I have been adding things to it.

[ikam]

 

 

There is also good drug interaction checker on RxISK...

 

 

That is a "side effects' checker, not an interactions checker.

 

OK, so is the charcoal supposed to stop it and does it work? Did the doc give it to you because he suspected SS?

No, I have started it myself around one year ago to manage diarrhoea (it is another use for charcoal). Doctor prescribed me imodium for ibs...

 

I got nothing from emergency doctor to deal with SS, he prescibed me some neuroleptic to deal with dizziness...i never took it...

They sent some letter to my GP about this, I will have an appointment with her on friday...

[ikam]

Hey, this is the way we are! It is now becoming clearer to you, as your symptoms are cropping up and you don't know why, that everything you do or have done in the recent past, is important to look at. This is one time my nursing background is coming in handy.

 

What do you think is causing the 'scoots' (diarrhea)?

The diarrhoea started when I eventually stopped effexor, so I think it must be related to serotonin level...

When I started escitalopram, the diarrhoea stopped...

 

Also, stress contributes a lot...

 

I have to be very mindful what I eat...no diary products, no to most of veg...

I also respond to chemicals, additives in food...

Had to stop probiotics, magnesium...cannot take slippery elm (it would help with acidity in my stomach)...

I also think opremazole contributes to it...

[cymbaltawithdrawal5600]

 

I think it must be related to serotonin level

 

That is not what is happening here and many people think that things have such a simplistic explanation for why they occur. "Serotonin" is not causing this, it is at once more complex and simpler than this and there are a multitude of reasons for the diarrhea. Let's see what the doc says.

 

Stopping one "E" and starting another "E" is not quite the answer, I don't think.

[ikam]

 

 

I think it must be related to serotonin level

 

 

That is not what is happening here and many people think that things have such a simplistic explanation for why they occur. "Serotonin" is not causing this, it is at once more complex and simpler than this and there are a multitude of reasons for the diarrhea. Let's see what the doc says.

 

Stopping one "E" and starting another "E" is not quite the answer, I don't think.

What is "E"?

 

Doctor will not say much more, I was under investigation, they came up with ibs...

[ikam]

Ouch, my hands are becoming quite painful.It is like joint pain, difficult really to explain, it is like arthritis, I guess...my palms also feel kind of weaker and numb...

The pins and needles also feel more sharp...

Getting a bit headachy...

 

I think, I may need to up-dose...would I need to get back to 5mg, the dose I felt better on? If I take it in the morning, will I need to do this at my normal time?

(i take doxepin in evening)...

[Altostrata]

 

When was the last time you took naratriptan?

 

Could you give me a list of every pill (including supplements) you have put in your mouth (including dosages) since you came to this board? I am going to run and post another DI check.

Naratriptan- 23rd December, I felt as if I was drunk...

Zolpidem- 24 and 25 December...

Scopolan-24 and 25 December...

 

I am still on 75mg Doxepin in evening (more than two years)

Atenolol, twice a day 25mg

 

Omeprasole 20mg in the morning (i used to be on pantoprasole, changed on 23rd december)

Ranitidine, 150mg in evening

 

HRT/low dose: Utrogestan, 100mg and Sandrena 1.0 gel (in evening, over one year now)

 

Aconitum 30c in the morning, and if needed, but not a lot, maybe twice a day

Passionflower in the morning, 1 pill 425mg extract

 

Paracetamol on few occassions, including last night (i hoped it might help with paresthesia)

 

 

I have not taken naratriptan neither sleeping pill since xmas. I destroyed them...

 

ikam, I am sorry you are going through a rough patch.

 

It seems to me that you had an adverse reaction from 10mg escilatopram, possibly because of a drug-drug interaction with doxepin, which in EXTREME cases, can lead to serotonin syndrome.

 

You have also intermittently been taking a triptan, which can react with other serotonergics to produce uncomfortable symptoms and in EXTREME cases, can lead to serotonin syndrome.

 

It's only my opinion, but your situation was never an EXTREME case of serotonin toxicity. At this point, it's time to stop ruminating about drugs you have taken in the past and concentrate on giving your nervous system stability now.

 

At 2.5mg escilatopram, it is unlikely you will suffer serotonin syndrome in combination with doxepin or triptans. However, because of the adverse reaction to escilatopram, you may feel drug side effects more intensely.

 

Recently, you also have been changing doses of other drugs here and there. You have also been having waves of symptoms that indicate your nervous system is not comfortable with the drug changes. No need to call them withdrawal symptoms or side effects -- your nervous system is not comfortable.

 

Our nervous systems do best when they are stable. If I were you, I would stop changing any of your drugs for at least 2 weeks. Stop reducing escilatopram. Let your nervous system settle down.

 

Stop taking the occasional drug here and there. Do not add new supplements. Stay in a calm environment as much as possible. If noise bothers you, stay quiet. If light bothers you, don't go out in bright light. Wear sunglasses. Keep lights indoors down.

 

Day 3/2.5mg

 

Hi again, I have been feeling extremely low today. It is the lowest since I started decresing. I am aware that this is a part of this process, but...Nobody likes to feel low...

 

It seems it has started from my conversation with my mother who was crying on a phone that she does not have money, does not take her meds as she does not have money, feels lonely, she may die in her flat and nobody will find her for long...To cut a long story short, my mother often uses me as a container for her feelings. I thought I did handle this well...but...woke up low...I cannot send her money, cannot go there to visit her...Anyway, when she is like this nothing helps, she needs more and more...I am feeling guilty again...My mother does not know about my problems...I have only one friend who knows and I talk here...

 

I woke up not wanting to be alive anymore. Not really suicidal, but tired...This was one of the reasons I started taking esitalopram. I felt so low and tired...

 

I am tired of my life and don't feel today like doing anything. At the same time I feel like a slave of my flat, but this is me who does not go out. And this is not like me. Since I moved to this town, I have problems with going out. I find outside very unfamiliar. Even people seem different, the way they act, talk...So I am finding to face this new reality this extremely difficult. At the same time keep watching builders outside in their machines and get feeling more trapped. I don't understand why instead of detaching myself I get over-tuned to any noises and very upset about them...This was another reason to take meds- as I wanted to cut off from the noises...

 

I had a bit more paresthesia in the morning and my fingers were painful, but it may have been my response to my yesterday's conversation with my mother. When I was talking with her I felt my hands becoming more tense. I guess this is because emotions affect blood flow and have impact on the nerves.

 

Then I had a bit of pelvic pain, which always gets me scared, as I was in pain day by day fir over one year. This was the time when I stopped controling meds with codeine. So when I feel any pain in this area I find it very distressing. I have started worrying that I will need to use painkillers again. How to live with no painkillers? I always tened to use painkillers, or medication for any health problem.

 

I am feeling low and all on my own...

Maybe my "honey moon" has ended?

 

Do you think your low mood and anxiety might have anything to do with your family and ex-husband? Perhaps you should think about this -- that your real-life experiences affect your mood -- and stop focusing on the drugs as cause for everything you feel.

 

The idea that drugs determine your feelings is what takes you back to the doctor over and over for new prescriptions. It's up to you to minimize your interest in and dependence on drugs to manage your thoughts and feelings.

[ikam]

Do you think it would be good to updose?

[ikam]

 

 

When was the last time you took naratriptan?

 

Could you give me a list of every pill (including supplements) you have put in your mouth (including dosages) since you came to this board? I am going to run and post another DI check.

 

Naratriptan- 23rd December, I felt as if I was drunk...

Zolpidem- 24 and 25 December...

Scopolan-24 and 25 December...

I am still on 75mg Doxepin in evening (more than two years)

Atenolol, twice a day 25mg

Omeprasole 20mg in the morning (i used to be on pantoprasole, changed on 23rd december)

Ranitidine, 150mg in evening

HRT/low dose: Utrogestan, 100mg and Sandrena 1.0 gel (in evening, over one year now)

Aconitum 30c in the morning, and if needed, but not a lot, maybe twice a day

Passionflower in the morning, 1 pill 425mg extract

Paracetamol on few occassions, including last night (i hoped it might help with paresthesia)

I have not taken naratriptan neither sleeping pill since xmas. I destroyed them...

ikam, I am sorry you are going through a rough patch.

It seems to me that you had an adverse reaction from 10mg escilatopram, possibly because of a drug-drug interaction with doxepin, which in EXTREME cases, can lead to serotonin syndrome.

 

You have also intermittently been taking a triptan, which can react with other serotonergics to produce uncomfortable symptoms and in EXTREME cases, can lead to serotonin syndrome.

 

It's only my opinion, but your situation was never an EXTREME case of serotonin toxicity. At this point, it's time to stop ruminating about drugs you have taken in the past and concentrate on giving your nervous system stability now.

 

At 2.5mg escilatopram, it is unlikely you will suffer serotonin syndrome in combination with doxepin or triptans. However, because of the adverse reaction to escilatopram, you may feel drug side effects more intensely.

 

Recently, you also have been changing doses of other drugs here and there. You have also been having waves of symptoms that indicate your nervous system is not comfortable with the drug changes. No need to call them withdrawal symptoms or side effects -- your nervous system is not comfortable.

 

Our nervous systems do best when they are stable. If I were you, I would stop changing any of your drugs for at least 2 weeks. Stop reducing escilatopram. Let your nervous system settle down.

 

Stop taking the occasional drug here and there. Do not add new supplements. Stay in a calm environment as much as possible. If noise bothers you, stay quiet. If light bothers you, don't go out in bright light. Wear sunglasses. Keep lights indoors down.

 

Day 3/2.5mg

Hi again, I have been feeling extremely low today. It is the lowest since I started decresing. I am aware that this is a part of this process, but...Nobody likes to feel low...

It seems it has started from my conversation with my mother who was crying on a phone that she does not have money, does not take her meds as she does not have money, feels lonely, she may die in her flat and nobody will find her for long...To cut a long story short, my mother often uses me as a container for her feelings. I thought I did handle this well...but...woke up low...I cannot send her money, cannot go there to visit her...Anyway, when she is like this nothing helps, she needs more and more...I am feeling guilty again...My mother does not know about my problems...I have only one friend who knows and I talk here...

I woke up not wanting to be alive anymore. Not really suicidal, but tired...This was one of the reasons I started taking esitalopram. I felt so low and tired...

I am tired of my life and don't feel today like doing anything. At the same time I feel like a slave of my flat, but this is me who does not go out. And this is not like me. Since I moved to this town, I have problems with going out. I find outside very unfamiliar. Even people seem different, the way they act, talk...So I am finding to face this new reality this extremely difficult. At the same time keep watching builders outside in their machines and get feeling more trapped. I don't understand why instead of detaching myself I get over-tuned to any noises and very upset about them...This was another reason to take meds- as I wanted to cut off from the noises...

I had a bit more paresthesia in the morning and my fingers were painful, but it may have been my response to my yesterday's conversation with my mother. When I was talking with her I felt my hands becoming more tense. I guess this is because emotions affect blood flow and have impact on the nerves.

Then I had a bit of pelvic pain, which always gets me scared, as I was in pain day by day fir over one year. This was the time when I stopped controling meds with codeine. So when I feel any pain in this area I find it very distressing. I have started worrying that I will need to use painkillers again. How to live with no painkillers? I always tened to use painkillers, or medication for any health problem.

I am feeling low and all on my own...

Maybe my "honey moon" has ended?

 

 

Do you think your low mood and anxiety might have anything to do with your family and ex-husband? Perhaps you should think about this -- that your real-life experiences affect your mood -- and stop focusing on the drugs as cause for everything you feel.

 

The idea that drugs determine your feelings is what takes you back to the doctor over and over for new prescriptions. It's up to you to minimize your interest in and dependence on drugs to manage your thoughts and feelings.

Would it be good to updose? I have had some tingly sensation in my legs as well