Wrangles783: Hi all - need help (thanks in advance!)

[Wrangles783]

I'll keep this brief, and thank you to anyone who offers some support and guidance. The truth is, I'm in dire straits. 

 

I've been on Lex (10mg) for 5 years, and decided it was time to get off at the end of last year. I took it slow, or so I thought, but I realise now I've really done a number on my nervous system. I went through the usual modes of withdrawal: anger/irritability, some anxiety, returning OCD/intrusive thoughts, but there were also waves of pleasant emotions - some that I hadn't experienced for years. Fast forward to a week or so ago, and it all came crashing down. Horrible despair, wanting to die etc. 

Now, I have looked at the restabilisation thread, and there seems to be mixed results. I reinstated 5mg of lexapro, which immediately relieved a fair amount of symptoms for a few days (I read this is a good sign), but the despair began again after day 3. At day 5 (yesterday) I bumped up my lex dosage to 7.5mg and am planning to stay here until my nervous system can gain traction. The re-onboarding process is really, really rough - lots of waves of anxiety and panic, and I guess I'm just looking for reassurance that I need to stay the path and wait for my brain and body to recalibrate. I'm also looking for success stories of restabilisation on lexapro after around a month off the drug. I've noticed the dread has gone, but the panic/anxiety remains. I guess that's progress?

I'll add my drug history signature now.

Please help - thank you...

Edited May 21, 2023 by manymoretodays
name to topic title, tag

[Onmyway]

Hi @Wrangles783, 

how are you feeling now? Would you say you are at a better place after upping your dose to 7.5?

 

OMW

[Wrangles783]

Thanks so much for the reply, Onmyway!

I am in the process of stabilising, and there is a steady incline towards being in a better place. The 'waves and windows' pattern is certainly at play, and there are beautiful moments where the stars align neurologically, and I feel my old self again. The waves are dark and tough, but I am tougher. Today the wave of despair was significantly shorter than yesterday, which is a good sign. From your experience, does this sound like a typical pattern of stabilisation? I'm just looking for some reassurance that the medication is indeed picking up the slack after 1-month of being off it completely.

Thank you!

W

[LostInCanada]

@Wrangles783 glad you found SA. It is a good sign that some of your withdrawal symptoms have lessened. You are definitely on the right path. Just be patient and kind to yourself. Look under self care, try some CBT and check out Claire Weekes. She is a bit outdated but the overall approach to anxiety is spot on. Stabilizing now is the key.👍

[Onmyway]

That is great news @Wrangles783, 

it takes a while for the drug to reach steady state in the body so the fact that you are seeing improvements is good news. I am still trying to wrap my head around the feelings of the windows and waves myself as well - we want to believe that when we feel good it's done and when we feel bad we go back into despair. But I need to remind myself that it is the natural way in which we heal. And heal we will. 

 

The thing to do right now is to manage the difficult moments and I love the suggestions by @LostInCanada. In the Symptoms and Self Care Forum there are a number of pinned topics on dealing with emotional symptoms. Use them. And hold for a good 4-5 months now before you start tapering again. It took me about 4-5 months to get to some level of withdrawal normal after reinstatement. 

 

Take good care of yourself. I am a huge fan of Claire Weekes and Kristen Neff self-compassion.org

Please keep us updated on how you are feeling and feel free to tag to ask questions. Interacting with others on their intro topics may help as well to help you get a sense of community

 

OMW

[Emonda]

 

On 5/11/2023 at 10:00 AM, Wrangles783 said:

I guess I'm just looking for reassurance that I need to stay the path and wait for my brain and body to recalibrate

 

Hi @Wrangles783

Your story resonates with me. I did something similar, although with a different AD.

 

Over a similar time frame to you, I dropped from 15mg to 7.5mg of Vortioxetine/Brintellix without a hiccup. When I tried to drop from 7.5mg to ~3.5mg, it got a bit ugly, and I experienced the things you describe.

 

I reverted back to the last dose I felt 'ok' (7.5mg) and held it there for 5 or 6 months. After a few months, I felt 'normal' again but just held the dose out of fear.

 

After finding this site and adopting the 'brass monkey slide', I'm now sitting at 3.65mg. It's taken 17 months to get here.

 

I hope that gives you some reassurance to stay the path and wait for your body to recalibrate.

 

Keep reading this site...there's heaps of very helpful information, and I've found some very kind and encouraging members, too!

[Wrangles783]

Apologies for the delay in thanking and replying - I was enjoying the peace of a lengthy window!

Unfortunately a wave hit last night, and is enduring through today - it is much more manageable as compared to how things were 2 weeks ago, so I'm thankful for that. Thank you to all who commented offering their insights and supports, it really means a lot. This forum is a real wellspring of 'faith in humanity = restored' (cringe, I know!).

As for the wave, it's like there are tears behind my eyes that just can't flow, and a milder form of the withdrawal despair - I've read through the checklist that is often circulated here, and both 'symptoms' are listed. The worst part about waves is the sense that they are eternal, but I know that this is not true in the slightest.

 

It frustrates me that I had to return to the Lex to stabilise, but sometimes a tactical retreat and regrouping is required to win the war. And win the war we will.

Thanks again,

W 

 

[Emonda]

3 hours ago, Wrangles783 said:

it is much more manageable as compared to how things were 2 weeks ago

Celebrate any positive, even in a wave. That's great that it's more manageable.

 

3 hours ago, Wrangles783 said:

The worst part about waves is the sense that they are eternal

Yep, when I'm in a wave, I think it'll never pass and that it's a relapse...but they do pass, and a window will return.

 

3 hours ago, Wrangles783 said:

sometimes a tactical retreat and regrouping is required to win the war. And win the war we will.

What a great way of describing it! We will win the war...one foot in front of the other.

[Wrangles783]

Hey Edmonda,

It's a strange thing celebrating feeling crap, but it's absolutely warranted. Bearable crap beats unbearable crap any day of the week!

Are your waves similar to mine? Depression, teary, and despairing? I feel I'm certainly past the anxiety/panic and jitters of restabilising, and the only waves I experience now are of the more depressive variety.

W

[Emonda]

3 minutes ago, Wrangles783 said:

It's a strange thing celebrating feeling crap, but it's absolutely warranted. Bearable crap beats unbearable crap any day of the week!

 

You still have a sense of humour, too! Another reason for celebrating 😜

 

5 minutes ago, Wrangles783 said:

Are your waves similar to mine?

 

I start with ruminating, anxiety, despair, teary and a hint of depression. A 5km run helps me, but exercise has always been my friend. I've also found a few drops of lavender oil in my peppermint tea helps with anxiety (I read about lavender oil somewhere on this site).

[Wrangles783]

Luckily, my sense of humour is the last thing to go - and the first thing to return  

Same for me - I've been weight training for 7-years, and it's a powerful thing. I unfortunately learned about gut health too late in the game (non-celiac gluten sensitivity and childhood antibiotics), and I reckon I could have avoided ever jumping on Lex if I knew then what I do now.

How is your wean going overall? Also, I think we're both in AUS, and are in similar spots wean-wise, so feel free to PM me (absolutely no pressure).

W

[Emonda]

1 hour ago, Wrangles783 said:

How is your wean going overall?

 

Yeah, we are at a similar spot, taper-wise and down in Aus. I've had two 6-week, very rough patches this year. I was so close to up-dosing both times, but this site, an encouraging member (thanks @LostInCanada), and my wife got me through. Enjoying the current window ☺️

[Wrangles783]

Well done for holding the line and pushing through - it will be worth it, and the fact you're currently in a window pit-stop is reassuring and relieving!

I have re-read your message about reinstatement eventually working a number of times, and it continues to give me hope as I move through this wave - so thank you again.

W

[Wrangles783]

Hi everyone,

 

Really struggling in this wave - depression is heavy, and I'm at a loss as to how to proceed. Do I go up to 10mg lex (my original dose), or push through to stabilisation at 7.5mg?

 

Please advise, even though I know you can't give medical advice etc.

 

W

[Johni]

Hello . I'm reading your thread now. Your situation is exactly the same as what I experienced. Also with Escitalopram. Be patient as others have said before me. Recovery and stability may take time. It took me 6 months to get back to normal. What are your current main symptoms? what appeared first and what passed? sending peace and comfort from Hungary.

[Wrangles783]

Thanks @Johni - your message couldn't have come at a more helpful time.

 

Current symptoms include minor pockets of neuroanxiety, which are not really a problem. It's the depression that hits the hardest, and the worst part is that I never went on Lexapro for depression.

 

Exercise helps immensely - I know my brain is hungry for serotonin.

 

I sincerely appreciate it.

 

W

[Johni]

 

I just wanted to suggest training. Although in this situation I was not able to do anything other than cycling for 1 hour every evening. What is the nature of your depression? is he present all day? or only at certain times of the day? How functional are you with your current symptoms? 😊 haven't you tried relaxation meditation? I wish you patience. If you have any questions, feel free to write.

[Wrangles783]

Yeah - weight training has been an absolute lifesaver. It pulled me out of hell today, and sort-of levelled me out.

 

For this present wave, it's been present for most the day, but it's settled since training today. It's purely physical (i.e. neuroemotion) - there are no thoughts or anything tied to it. Just a physical dread, if that makes sense?

[Wrangles783]

In terms of functionality, I'm hanging in there. I just hope there's some reprieve on the horizon - but as you say, patience.

 

Is what I've described similar to your experience?

[Johni]

our situation is very similar. as you said, just patience 😊 interestingly, this depression thing disappeared for me almost overnight. But he was present non-stop for about 2 months.

[Altostrata]

On 5/11/2023 at 1:00 AM, Wrangles783 said:

The re-onboarding process is really, really rough - lots of waves of anxiety and panic, and I guess I'm just looking for reassurance that I need to stay the path and wait for my brain and body to recalibrate.

 

Hello, are you still getting these waves? Do they occur at any particular times of day? What times o'clock do you take your drugs, with their dosages?

[Emonda]

How are you doing @Wrangles783

[Wrangles783]

Hey everyone,

 

Apologies for ducking out without replying. In the end, I successfully at 7.5mg (down from 10mg) with a lot of hard work.

 

I have since started a gut healing protocol (3 weeks in), and am having amazing results with that so far. Unfortunately, I got a little greedy and attempted to move down to 6.75mg, but after day 4 I decided to resume the 7.5mg as I will he starting a new job soon and need my wits about me. It's also impossible to cut pills into 8ths accurately.

 

It's clear that my only choice for successfully weaning off for good is the liquid approach, so I'll be starting that once I restabilise and finish this gut protocol.

 

All in all, I'm grateful I'm no longer in the dark place I was in when I made my intro post.

 

Thanks again, and I hope you're all well.

 

W

[Emonda]

5 minutes ago, Wrangles783 said:

I'm grateful I'm no longer in the dark place I was in when I made my intro post

 

Excellent news @Wrangles783, and good to hear from you.

 

6 minutes ago, Wrangles783 said:

It's also impossible to cut pills into 8ths accurately

 

Totally. I make my own liquid with a different AD. It is the way to go, in my experience. I've purchased 0.5ml syringes to get the dose as accurately as I can.

 

Given you are starting a new job, I'd hold the 7.5mg. There is no rush. Before considering the next cut, wait until you feel settled in the new job. You may find the brass monkey slide (2.5% per week for 4 weeks + a 2-week hold) more tolerable than dropping 10% to 6.75mg.

 

Wishing you well

[LostInCanada]

@Wrangles783please share what you are doing for your gut. Thanks

[Wrangles783]

19 hours ago, Emonda said:

 

Excellent news @Wrangles783, and good to hear from you.

 

 

Totally. I make my own liquid with a different AD. It is the way to go, in my experience. I've purchased 0.5ml syringes to get the dose as accurately as I can.

 

Given you are starting a new job, I'd hold the 7.5mg. There is no rush. Before considering the next cut, wait until you feel settled in the new job. You may find the brass monkey slide (2.5% per week for 4 weeks + a 2-week hold) more tolerable than dropping 10% to 6.75mg.

 

Wishing you well

 

That's great to hear, @Emonda. Did you make your own liquid by dissolving pills into a saline solution? I just looked at your med history, and it looks like you're able to go super slow, which is awesome. How have your withdrawal symptoms been going this slow?

Given Lexapro does come in a prescription liquid form, I'll switch over to that when ready. Did you notice any adjustment period required when switching to your homemade liquid?
 

Just waiting to stabilise at the 7.5mg again - it's amazing how much even a 1.5mg drop for only 4 days can require time to level out after returning to the starting dose (7.5mg)...

 

Thanks!

W

[Wrangles783]

7 hours ago, LostInCanada said:

@Wrangles783please share what you are doing for your gut. Thanks

Sure thing! I'm putting together an eBook on gut health as it pertains to OCD, but the principles are applicable to almost all 'mental illness', which I now see is better termed as 'brain health'.

Here's the chain of 'pathology': dysbiosis (imbalance in gut flora/the microbiome) + leaky gut (the intestinal wall is not sealed, leading to food particles filing into the bloodstream) - leads to 'food intolerances' (which are just food particles in the blood) + activation of the immune system + proinflammatory cytokines are released, leading to autoimmune reactions (white blood cells attack the organs, including the brain, where systemic inflammation is present) + cytokines downregulate dopamine and serotonin, leading to mood disturbances and 'mental illness' symptoms. Interestingly, SSRIs do have an antimicrobial/anti-inflammatory effect, which could be one reason why they 'work'. I understand the chemical imbalance hypothesis has little concrete evidence, and my thoughts are that it's not about have too little serotonin, but more about having too little in circulation relative to the needs of your particular nervous system to achieve homeostasis (balance).

So, if physical issues (gut issues) are leading to a downregulation of serotonin, it stands to reason that SSRIs may help to increase the circulation of available serotonin - which (I think) is why Lexapro worked well for me (with side effects, of course). But, if you can remedy the root cause of the downregulation of serotonin, hypothetically there should be a reduced need for medication.

My nutritionist and I are working through her protocol - which is not fun, but it's resulting in the expulsion of A LOT of parasites.

I hope this helps

W

[LostInCanada]

@Wrangles783very interesting. I deal with alot of nausea which paroxetine is notorious for casing when you go on it and come off it. Thanks 👍

[Emonda]

6 hours ago, Wrangles783 said:

Did you make your own liquid by dissolving pills into a saline solution

 

 I crush the tablet into tiny, tiny pieces and mix it/shake it vigorously in water, extracting what I don't need with a syringe.

 

6 hours ago, Wrangles783 said:

How have your withdrawal symptoms been going this slow?

 

I still notice WD, but it is generally manageable. Around two or three days after a reduction, I feel dizzy, irritable, tight in the chest, and a bit of insomnia. 

 

6 hours ago, Wrangles783 said:

Did you notice any adjustment period required when switching to your homemade liquid?

 

Great news that you can buy Lexapro in liquid form in AUS. I didn't notice a change with my homemade liquid, but it was almost a year ago now, so maybe I have forgotten.

 

6 hours ago, Wrangles783 said:

Just waiting to stabilise at the 7.5mg again - it's amazing how much even a 1.5mg drop for only 4 days can require time to level out

 

100%! Take your time, don't rush it, be patient, and slow down when your body tells you to.

 

Go well...

 

 

[catmama]

On 5/20/2023 at 7:41 PM, Wrangles783 said:

The worst part about waves is the sense that they are eternal, but I know that this is not true in the slightest.

THIS right here. I’m currently in a wave and I’m having to continuously remind myself IT WILL PASS. Thank you for reminding me of that. 
 

I’m also tapering off Lexapro so I’m trying to connect with other active Lexapro taperers here. I hope things smooth out for you. My one bit of advice that I can share (that I wish I’d followed!) is go SLOW. Being in a rush won’t help, and it will actually do more harm. Trust your body to heal and guide you. 

[Wrangles783]

Hey Catmama!

 

I'm sorry to hear you're in a VERY TEMPORARY wave. You'll pull through the other side as you always have in the past. What are you feeling?

 

And by what amount are you reducing?

 

Lex is a b**** to kick - but once I'm consolidated I will be going ultra slow via liquid form. I think, at least for me, it's the only way.

 

Feel free to DM me at any time.

 

W

[Wrangles783]

Hey all,

 

Hope you're doing well just a quick question - is it normal to encounter wave periods even 2 weeks after just a 1.5mg drop for only 4 days before returning to original dose (7.5mg)?

 

Usual symptoms: a sense of tears building behind the eyes that rarely come, low mood, feeling emotionally brittle, some anxiety.

 

Thank you!

 

W

[Emonda]

Hey @Wrangles783,

I wondered the same thing 4 or 5 months back, in the midst of a wave, and found this diagram that might answer your question, taken from the following article:

 

(https://www.cambridge.org/core/journals/bjpsych-advances/article/distinguishing-relapse-from-antidepressant-withdrawal-clinical-practice-and-antidepressant-discontinuation-studies/AE99BDE4435521CE9F3D626AE14D1962).

 

I experienced the start of a wave perhaps three weeks after a 2.5% reduction and feared it was a relapse. The article/diagram suggests that two weeks after a reduction, it would be normal to experience a spike in symptoms (feelings of a wave, perhaps).

 

I appreciate you up-dosed four days later, but that may have destabilised you. Time and patience are your friends.

 

I hope this helps.

[Wrangles783]

I appreciate the reply, Edmonda!

 

I'm also considering the idea that I'm splitting unscored pills, which makes it really tough to get consistent dosages in my system. It seems that lexapro pills can be split, but I'm just not sure if it's worth me going back to 10mg while I work out the transition to liquid to get exact dosages. I need consistency more than anything at the moment.

 

In fact, I think that's what I might do. Regroup at 10, plan the liquid transition, and begin to ween off from there when ready.

 

W

 

[Emonda]

19 minutes ago, Wrangles783 said:

splitting unscored pills, which makes it really tough to get consistent dosages in my system

 

Agree entirely, @Wrangles783. Eighteen months ago, I was splitting un-scored teardrop-shaped pills, and I was mindful it was wildly inaccurate. Did I subsequently fall apart because my dose was inconsistent/inaccurate, or was it because I dropped too fast, or was it both? I'm guessing it was both.

 

As to increasing from 7mg to 10mg, I'd seek the wisdom of a moderator on this. It sounds like a significant increase to me. They say to reduce by at most 10% per month. I'm assuming the reverse rule applies for up-dosing...no more than a 10% increase, but I've never actually read that (hopefully someone wise will shed some light on my assumption 😜).

 

I keep in my mind: "Keep it Simple, Slow and Stable". Going from 5mg to 7mg to 10mg could be destabilising.

 

43 minutes ago, Wrangles783 said:

plan the liquid transition

 

As I crush my tablet and make my own liquid, I can't shed any light on the transition to a pre-made liquid version. I am sure someone will respond who has done this.

 

Keep fighting, Wrangles.

[Wrangles783]

Sorry to hear that was your experience, but I'm also glad I wasn't the only one thinking this. For a strained, sensitive system, I imagine even the smallest of deviations from consistency are magnified, which is why I think I've felt so rocky.

 

Regarding the jump from 7.5 to 10, its actually not a big increase in terms of the mechanism of the drug - if you check out the way the SERT is affected at certain dosages there isn't a massive difference. I'm more reaching for consistency of dosage - which I think is vitally important right now.

 

I start this new job monday, so I'm hoping my system, which functioned remarkably well on 10mg, kicks back into gear over the next few days.

 

W