1 hour ago, Steve1 said:

So its unlikely that escitalopram will ever have a positive impact in the long term? I.e. if I stay on 5mg for months?

If you choose to stay at 5 mg, it's likely that it will take several months or longer to stabilize, i.e. for your symptoms to improve significantly.

If by "positive impact in the long term" you mean addressing any underlying mental health concerns you may have, I don't think you'll find anyone on here who will advocate for using a psychotropic drug to treat a mental health issue. The evidence that any of these drugs are effective for addressing mental health concerns is sparse to non-existent, and really only shows some slight potential benefit in the very short-term. Long-term, these drugs often do much more harm than good, as you'll see for yourself if you look around this forum.

Edited September 7Sep 7 by SarahMc

"Seversl months or longer" worries me. Would I be better doing a faster taper?

2 hours ago, Steve1 said:

"Seversl months or longer" worries me. Would I be better doing a faster taper?

No most certainly not @Steve1 , your nervous system is destablised, getting off this quickly now would not be a good move.

I would either:

1. Reduce your dose further to try to reduce your hypersensitivity to the drug

2. Hold the dose at 5mg until things have settled down

Once you are stable you can consider tapering very carefully off the drug, with some help from us,

Sarah is 100% right, stablity can take some time. We have to accept this. There is no quick way out of this. Your nervous system has a little injury now, we have to just do our best to reduce further harm and then allow your system some time to settle down.

Acceptance and time are your friend, we all get it, we are all here to help you through this.

Thanks for the kind words.

If I was to reduce down further, what would be a reasonable trial dose?

8 minutes ago, Steve1 said:

Thanks for the kind words.

If I was to reduce down further, what would be a reasonable trial dose?

Pleasure

I would be tempted to look at the reductions in Recptor occupancy terms rtaher than % of the mg.

So looking at the chart I sent you before:

Stage	Approx. RO	Lexapro dose	Weeks at this stage
Start	80%	10 mg	3.25 weeks
Drop 1	65%	4.22 mg	3.25 weeks
Drop 2	50%	1.78 mg	3.25 weeks
Drop 3	35%	0.75 mg	3.25 weeks
End	20%	1 mg	—
Total		10 → 1 mg	13 weeks

I would think around 2mg would be a good dose change for you, 15% RO reduction which is 25% of the total RO difference between 10mg and 1mg. We can't know how you will react, hopefully it will reduce any hypersensitivity you are having to the dose. If things get significantly worse returning to 5mg would be best, if there is no obvious change then hang there for 7/10 days and observe how things go.

How are you making your dose? Do you have scales?

Thanks for the reply...

At the moment I'm just taking 5mg tablets (day 30ish now). Previously to this I was on 10mg for 9 weeks

Just now, Steve1 said:

Thanks for the reply...

At the moment I'm just taking 5mg tablets (day 30ish now). Previously to this I was on 10mg for 9 weeks

To make other doses up you'll need a set of scales, Gem-20 would be the cheapest option.

Thanks...

Silly question perhaps but is the active ingredient evenly distributed across the pill

8 minutes ago, Steve1 said:

Thanks...

Silly question perhaps but is the active ingredient evenly distributed across the pill

Yes it is.

When using the scales we weigh 10 pills and divide that weight by 10 to get an average pill weight. We always use that going forwards. Perhaps divide that in half to give you 2.5mg

Makes sense thanks....

Torn at what to do attempt to stabilise at 5mg or drop to 2.5mg.

I may be wrong, but I currently believe I'm still experiencing activation and withdrawal from dropping to 5mg.

I'm so mad with myself for putting up with 10mg for 9 horrific weeks. Worried I've done permanant harm to myself.

3 minutes ago, Steve1 said:

I may be wrong, but I currently believe I'm still experiencing activation and withdrawal from dropping to 5mg.

I'm so mad with myself for putting up with 10mg for 9 horrific weeks. Worried I've done permanant harm to myself.

You could be. Its possible you benefited from reducing the dose, but then are now having WD symptoms from the drop. It is so hard to know what is best in situations like this. My hypothesis is to try to get cases like you down in dose as quickly possible and undo the 'too higher RI' before things get worse.

However if you feel what you are dealing with now is WD from the reduction than for the minute it may be best to hold. You have to trust your instincts on this and listen to your body.

When would you expect withdrawal from moving down to 5mg to resolve? I was only on 10mg for 9 weeks

1 minute ago, Steve1 said:

When would you expect withdrawal from moving down to 5mg to resolve? I was only on 10mg for 9 weeks

They will resolve in time. Wd is very confusing and it’s often hard to know what is causing what. Generally holding is a good idea. It allows the brain time to let things settle.

There are not many exceptions to that but being hyper sensitive to the dose/ri would be one of them. Working out if that is your biggest problem now is tricky. You definitely were at 10mg from what I’m reading. Now you need to try to judge if the reaction to the dose is more tolerable atm and if you think you are mainly experiencing wd or not.

Do symptoms worsen after the dose for example?

We can’t know 100% and you have to choose for yourself to get you thinks best.

Yes 10mg was far too strong and never settled. I noticed symptons would ramp up shortly after taking dose each morning.

At 5mg it is an unclear picture. My gut instinct is there is still residual activation and withdrawal overlapping. Perhaps the prudent thing to do at the moment therefore is to hold and hope both settle down concurrently.

Perhaps this is wishful thinking!

Edited September 8Sep 8 by Steve1

4 minutes ago, Steve1 said:

At 5mg it is an unclear picture. My gut instinct is there is still residual activation and withdrawal overlapping. Perhaps the prudent thing to do at the moment therefore is to hold and hope both settle down concurrently.

I wouldn’t ignore your gut but you should decide for yourself. You could try an even smaller reduction to test the water.

What would be a suggested trial length for a smaller dose?

Thanks

35 minutes ago, Steve1 said:

What would be a suggested trial length for a smaller dose?

Thanks

I’d just see how you react initially. Again as before if it’s not immediately bad hold for 7/10 days and reassess

I'm 90% my new symptons are predominantly driven from withdrawal.

9 weeks on 10mg was non stop activation.

Then did 4 days at 7.5mg

Last 30 days at 5mg.

My concern is withdrawal symptons seem to be ramping up, rather than stabilising.

Ideally I want to hold at 5mg and ride the wave. Do you think I'm very close to turning the corner?

Thanks

39 minutes ago, Steve1 said:

I'm 90% my new symptons are predominantly driven from withdrawal.

9 weeks on 10mg was non stop activation.

Then did 4 days at 7.5mg

Last 30 days at 5mg.

My concern is withdrawal symptons seem to be ramping up, rather than stabilising.

Ideally I want to hold at 5mg and ride the wave. Do you think I'm very close to turning the corner?

Thanks

Thanks Steve it's good to get that clarity from you. So you felt better and better initially as you dropped?

Yes I feel like activation is gradually easing, whilst withdrawal is gradually ramping up?

What do people recommend?

Just now, Steve1 said:

Yes I feel like activation is gradually easing, whilst withdrawal is gradually ramping up?

What do people recommend?

It's a balance. You were reacting to the dose, you reduced the dose, this has helped that. Unfortunately WD is a reality of the large dose reductions. I would suggest at this point you should hold and wait for things to settle down. You could updose a little and see if there is a half way house dose here, but that might cause more activation which you have just gotten down, plus your system is now very sensitive and moving doses might not be a good idea. That would be your only other choice Im afraid.

People do stablise, it can take some time and happens non-linearly in windows and waves.

Sorry this is so tough mate, we all empathise and are right there with you.

I know nobody can really predict, but what is everyones guesstimate of when this withdrawal will peak.

As a reminder I did:

9 weeks 10mg

4 days 7.5mg

Last 30 days 5mg

Thanks

Edited September 9Sep 9 by Steve1

15 minutes ago, Steve1 said:

I know nobody can really predict, but what is everyones guesstimate of when this withdrawal will peak.

As a reminder I did:

9 weeks 10mg

4 days 7.5mg

Last 30 days 5mg

Thanks

Hey Steve. There is no way to say unfortunately. Everyone is so different. What I can say is the body is amazing and the key to all this is time. Your job is to cope and buy it that time. Coping skills are the way to do this best. Distraction. Acceptance. Finding some peace as best you can whilst things settle for you.