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

[Altostrata]

21 hours ago, Wrangles783 said:

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.

 

If you're taking 7mg, as your signature says, you could take 5mg in tablet form and 2mg in liquid form. Taper from the liquid.

[Wrangles783]

Thanks @Altostrata,

 

For better or worse, I jumped back up to 10mg (day 3).

 

Awful, awful experience - I'm really struggling here. Very concerned that I'm experiencing the kindling response.

 

I have no other choice but to ride this out and hope that restabilisation occurs, but I'm in dire straits.

 

Any advice would be greatly appreciated. Hold at 10mg? Or revert back to 7.5mg?

 

Thanks,

 

W

[Altostrata]

On 7/7/2023 at 2:09 AM, Wrangles783 said:

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.

 

It's quite a jump. Receptor occupancy isn't the whole story. How did your theory and experiment work out?

 

Not sure what you're trying to do here. You were stabilizing at 7mg. Do you believe more is better?

 

Quote

Or revert back to 7.5mg?

 

Common sense suggests this would be a good idea. Stop playing with your drugs.

[Wrangles783]

Thanks @Altostrata.

 

I think I'm too far into 10mg (day 4) to risk what would happen shocking my system reverting back to 7.5mg.

 

In your experience, would going back to 7.5mg now be dangerous?

[LostInCanada]

@Wrangles783

2 hours ago, Altostrata said:

Quote

Or revert back to 7.5mg?

 

Common sense suggests this would be a good idea. Stop playing with your drugs

Your system would have more issues going back up to 10 mg. 

[Wrangles783]

It definitely has had more issues, that's for sure. I think I encountered an unexpected wave, and freaked out.

 

I will revert back to 7.5mg and deal with the consequences - I appreciate everyones guidance.

 

One more ? -  on the question of pill splitting, I've read that it's okay to split the unscored circular pills into 1/4s provided they're relatively even. Lex has a long half-life, so it all sort of evens out. Is this similar to what you understand?

 

Thanks again,

 

W

[LostInCanada]

@Wrangles783I had similar questions about even distribution of drug in pills. I think it was Brassmonkey who posted alot of information showing how there is no need to worry about this. They are highly regulated in this regard. The more important part is weighing the pill accurately so your dose is consistent.

[Wrangles783]

Thanks @LostInCanada - I've been trying to find a scale small enough for my needs, but no luck. Do you have any links to any that are suitable for measuring .5mg?

W

[Wrangles783]

Nevermind - I think I found one

[LostInCanada]

@Wrangles783on a scale .5mg looks like .0005 g. Also your pill will not weigh 10 mg, it has filler added to it. You need to weigh say 10 pills. Add the weights together and divide by 10. That will be the pill weight to use moving forward as the standard for 10 mg. So my 10 mg pill of paroxetine weighs 118.4 mg, a dose of 5 mg weighs 59.2mg and so on. Make sure you stick with the same manufacturer if possible as filler composition and quality varies. If you have to use a new manufacturer then you have to determine pill weight again. I have a good scale that goes to .0001g but it was a few hundred $$$. You don't need that good of a scale if you are eventually transitioning to liquid.

 

[Emonda]

1 minute ago, LostInCanada said:

You don't need that good of a scale if you are eventually transitioning to liquid.

 

Always a source of knowledge @LostInCanada. I was thinking the same thing. If the end goal is to transition to liquid, it may be quicker (not waiting for a scale to arrive), simpler and cheaper to follow the suggestion from Altostrata:

 

On 7/8/2023 at 7:22 AM, Altostrata said:

you could take 5mg in tablet form and 2mg in liquid form. Taper from the liquid.

 

I'm sorry to hear things got a bit rough after the up-dose, Wrangles. I was worried about that as I read about a similar experience only recently from another member. They dropped back after a few days, and things improved.

 

If the suggestion from Alto works for you, a nice long hold would be in order from this point...especially with your new job.

 

Take care.

[Wrangles783]

Thanks for your guidance and support.

 

I'm sticking with 7.5mg in pill form for now - I spent some time yesterday ensuring my pill splits were clean and even, so I should be okay on that front.

 

Things have settled somewhat, so I'm just waiting to fully even out. I will be holding until at least the start of next year where I'll assess the liquid option for further weaning.

 

Thanks again,

 

W

[Wrangles783]

Just posting an update.

 

Ended up somewhat restabilising mid-last week, and I'm in the midst of a manageable wave at the moment. The OCD returned with a vengeance, but I'm getting that back under control now.

 

I know I just need to be patient and hold out for as long as it takes to settle. Despite all this, I have a stubborn, new found appreciation for life.

 

I appreciate everyone's support and help.

 

W

[Altostrata]

16 hours ago, Wrangles783 said:

I know I just need to be patient and hold out for as long as it takes to settle. Despite all this, I have a stubborn, new found appreciation for life.

 

Good attitude. Hang in there!

[Emonda]

17 hours ago, Wrangles783 said:

Ended up somewhat restabilising mid-last week

 

Great news, Wrangles 🎉

 

17 hours ago, Wrangles783 said:

I know I just need to be patient and hold out for as long as it takes to settle

 

100%...as you said a few posts ago, "a tactical retreat and regrouping is required to win the war....and win the war we will".

 

Be patient, give yourself a nice long hold before any reduction...then small accurate reductions as per the advice of the moderators.

 

[Wrangles783]

Honestly, with the hell that has been the last 16-months, I don't know if I'll even bother to wean again.

 

I have OCD - I know that now, and for all side effects of the 10mg Lex, which actually weren't all that bad, it actually helped me considerably. I was 'normal', for the most part. I fell into the trap of complacency, and I forgot how life was before the medication. I have been reminded.

 

I'll be honest - I'm frightened that I won't stabilise to the extent that I can sufficiently enjoy life again, but I have no choice but to push on.

 

I know no one can guarantee anything, which is the terrifying part. It's been just over 2-weeks, and while there has been improvement, these 'waves' just suck. I love life and I have so much to live for, but this hurts. Real bad.

 

Thanks again for the words of encouragement.

 

W

[Altostrata]

Have you tried psychotherapy or other coaching for what you call OCD?

[Wrangles783]

I have, many times, but the wrong sorts - ACT/ERP is the best approach for OCD, and instead I went for the talk therapy route, which only made things worse.

 

My brain feels like its on fire - I think I did some damage jumping up to the 10mg for those few days. Any insights @Altostrata?

 

I'm sorry to be pestering you all - it's just tough at the moment.

 

W

[Altostrata]

Didn't you go back to 7.5mg? How do you feel before and after you take your dose of Lexapro? Are these symptoms better or worse at any particular times of day?

[Wrangles783]

Hey @Altostrata

 

I am on 7.5mg, you're right - I was referring to the weekend a couple of weeks back where I stupidly went up to 10mg for 3 days. I've been on 7.5mg since (just over 2 weeks).

 

I don't feel any worse after taking the medication in the mornings. I'm just generally dysregulated with respect to mood - emotionally brittle and experiencing urgent fear with intrusive thoughts. Generally elevated stress and a sense that something 'isn't right'.

 

The emotional brittle-ness and urgent fear associated with the intrusive thoughts has improved over the last couple of days, which gives me some hope that I'm stabilising/evening out.

 

Mornings are the hardest. I hope this sounds like a regular, non-kindling response, and that I just have to be patient. This is the longest it's taken for me to gain traction.

 

W

[Altostrata]

Is this urgent fear more intense or better at certain times of the day?

[Wrangles783]

Hey @Altostrata

 

It's worse immediately upon waking up, and around later afternoon. I spoke to my GP last night and he doesn't believe I've done permanent damage, and that I need to I just wait for my nervous system to restabilise. He prescribed very low dose beta blockers which I'm reluctant to take.

 

There is less urgent fear per se, and just more of this heavy block in my chest. My mind is calmer, but I'm still feeling everything physically.

 

Does this sound like kindling?

 

Thanks

 

 

[Altostrata]

Please keep daily notes of times o’clock you take your drugs, their dosages, and your symptoms throughout the day. We need to know how you feel before and after taking each drug, and any significant symptoms in between. Post 24 hours of notes at a time in this topic, in a simple list format with time o’clock on the left and notation (symptom or drug and dosage) on the right. This can help identify symptoms that are adverse effects from one or more of your drugs.

[Wrangles783]

7:30am - 7.5mg lexapro + magnesium citrate + fish oil.

 

5:00pm - magnesium citrate.

 

Symptoms don't appear to be fluctuating around medications/supplement intake. They occur at random. 

 

I just feel like my serotonin system is not online, and I'm getting very scared. Do I hang on?

[Wrangles783]

Because there isn't worsening of symptoms around medications/supplement intake I'm hoping this means I just need to fight and wait.

 

Please guide me asap.

[Wrangles783]

The acute stress has subsided.

 

I just feel this heavy block in my head.

[Emonda]

Hey @Wrangles783

9 hours ago, Wrangles783 said:

The acute stress has subsided.

 

Sounds like a small step in the right direction.

 

Has it been three weeks at 7.5mg now? When I took Lexapro 10+ years ago, I recall it took 4-6 weeks for some stability.

 

On the previous page, you said, "Bearable crap beats unbearable crap." Given the acute stress has subsided, are you now sitting on the bearable side of things?

 

Still exercising (I think you said you do weights). Are you avoiding alcohol and coffee?

 

Keep fighting Wrangles.

 

[LostInCanada]

@Wrangles783 any improvement shows your body is settling down. It took me a solid 6 months to somewhat stabilize...it wasn't perfect but way better. Kindling happens when you keep changing the dose. Best to just keep that consistent and more healing will come. You are doing great. 👍

[Altostrata]

In your daily notes, please show your symptoms throughout the day. We need to know how you feel before and after taking each drug, and any significant symptoms in between. Post 24 hours of notes at a time in this topic.

[Wrangles783]

Any explanations for agonising depression? Not sure how much longer I can hold on.

 

Still weight training. No coffee/alcohol.

[LostInCanada]

@Wrangles783 Alto asked for daily notes. That will help her help you. Just a simple format. Any msg, artificial sweeteners, nitrates. Try to stay away from processed foods.

 

[Wrangles783]

This is for yesterday:

 

6am – woke up: free-floating anxiety

7am – took 7.5mg Lexapro and 10mg propranol

8am – ate eggs (organic)

9am – throughout the day: severe physical depression. Feels as though my brain is not online

1pm – ate organic burgers

Still feeling as depressed

4pm – went to gym (alleviated depression somewhat – makes me think my serotonin system isn’t working and these micro boosts from exercice give me temporary relief)

5pm – ate chicken and salad

6pm – felt okayish for the rest of the night (ruminative thoughts, but was able to float through them.

10pm – went to bed

As you can see, I'm eating very clean - no alcohol and coffee. I don't know why my brain is struggling so hard to get back online.

Please help me.

[Wrangles783]

I just found this:

 

https://pubmed.ncbi.nlm.nih.gov/2463453/#:~:text=These results indicate that propranolol,the regulation of blood pressure.

"These results indicate that propranolol decreases central serotonergic activity and suggests a possible role for central serotonergic pathways in the antihypertensive action of propranolol."

Could this be it?

[Wrangles783]

https://pubmed.ncbi.nlm.nih.gov/2140288/#:~:text=The relationship between propranolol and,whether propranolol can cause depression.

"Propranolol was found to cause depression as a side effect with a statistically greater frequency than the control medications used in these trials. As other side effects of propranolol include fatigue, diminished energy, decreased libido, anorexia and poor concentration, it is suggested that propranolol is a cause of organic mood disorder, depressed type."

[Emonda]

Hey @Wrangles783

I'm sorry to hear things are rough at the moment. 

 

22 minutes ago, Wrangles783 said:

Propranolol was found to cause depression as a side effect with a statistically greater frequency than the control medications used in these trials. As other side effects of propranolol include fatigue, diminished energy, decreased libido, anorexia and poor concentration, it is suggested that propranolol is a cause of organic mood disorder, depressed type

 

This is very interesting. I look forward to reading the response from someone with knowledge of this. I'm sure Alto will drop by with some wisdom soon.

 

Keep fighting, Mate.

[Altostrata]

Why are you taking propranolol at the same time as Lexapro?

 

1 hour ago, Wrangles783 said:

https://pubmed.ncbi.nlm.nih.gov/2140288/#:~:text=The relationship between propranolol and,whether propranolol can cause depression.

"Propranolol was found to cause depression as a side effect with a statistically greater frequency than the control medications used in these trials. As other side effects of propranolol include fatigue, diminished energy, decreased libido, anorexia and poor concentration, it is suggested that propranolol is a cause of organic mood disorder, depressed type."

 

Do you think propanolol might be causing your depression?