Thanks all.....

Things are getting worse by the day which really worries me.

Now 45 days holding at 5mg.

As I'm unsure if its ongoing activation or withdrawal that is the predominant factor I feel like I have no choice but to hold at 5mg.

In reality I feel like I have a combination of both activation and withdrawal. Is this possible?

Surely if it is withdrawal it settles down soon as was "only" oon 10mg for 9 weeks and there isnt a massive difference in sert occupancy between 10mg and 5mg?

32 minutes ago, Steve1 said:

In reality I feel like I have a combination of both activation and withdrawal. Is this possible?

Completley possible Steve.

32 minutes ago, Steve1 said:

Surely if it is withdrawal it settles down soon as was "only" oon 10mg for 9 weeks and there isnt a massive difference in sert occupancy between 10mg and 5mg?

No one knows mate, I know you want an answer to this question, there isn't one. Im sorry. In WD we have to make what small choices we have and then stick to our guns and trust our bodies. You can either reduce a little and see if that helps matters, like a test. Or keep holding and wait to stablise which could be some time. What I would try to not do is add to the distress by agonising over the choice. Pick a route and stick to it. Acceptance is key - Why does acceptance feel impossible?

I think the problem I have is when people say "hold and you will stabilise eventually" there is no suggested timescales.

Obviously you'd like to think you will stabilise in a couple of years, but adjusting dose might be the quicker option?

31 minutes ago, Steve1 said:

I think the problem I have is when people say "hold and you will stabilise eventually" there is no suggested timescales.

Obviously you'd like to think you will stabilise in a couple of years, but adjusting dose might be the quicker option?

Im not sure what to say Steve, You asked for advice and you have recieved it. If it isnt what you want to hear I am sorry. You ask for advice and then choose to do what you will with it. No one is offering you timescales as that is impossible to do. No one can tell you 100% holding is the right route, especially in your case where the dose has obviously been high for you, and you reacted well to reducing.

It isn't about one route is quicker than the other. If you think you are mainly dealing with WD than holding makes sense. If this is you reacting to the dose still then reducing makes sense, potentially....... You are not immune to WD just because you are reacting to the dose, you can get WD from dropping and benefit from making that reduction too all at the same time, so it is a balancing act between the two.

Thanks @Chippy please don't think I'm criticising you or others, I'm just expressing my frustration with the situation I face.

I had hoped I would slowly gradually get better on 5mg, but gone majorly backwards in the last 10 days or so.

1 hour ago, Steve1 said:

Thanks @Chippy please don't think I'm criticising you or others, I'm just expressing my frustration with the situation I face.

I had hoped I would slowly gradually get better on 5mg, but gone majorly backwards in the last 10 days or so.

No I know where it comes from. An absolute frustration. We have all felt it. I think there is an element of grieving before accepting can take place. I suspect this is what it looks like for you.

Linear recovery is like rocking horse teeth round these parts mate.

1 hour ago, Steve1 said:

Thanks @Chippy please don't think I'm criticising you or others, I'm just expressing my frustration with the situation I face.

I had hoped I would slowly gradually get better on 5mg, but gone majorly backwards in the last 10 days or so.

We’re here for you! There’s really no right or wrong answer for your individual situation.

Your body might love another reduction. Or it might not. A tiny reduction could let you test the waters.

I wish our bodies could give us a print out of what actions would be best.

❤️

Yep its so confusing.....!

Within 2 mins I go from getting what I class as activating symptons (thinking the dose is too high) to what I class as withdrawal symptons.

4 minutes ago, Steve1 said:

Yep its so confusing.....!

Within 2 mins I go from getting what I class as activating symptons (thinking the dose is too high) to what I class as withdrawal symptons.

Do you feel activation after you take your dose? Oh really I think I meant to ask is there a certain time of day when you feel more activated than others?

Edited September 23Sep 23 by Finni

Hi @Finni I definitely got intense activation after taking dose of 10mg. 5mg is a bit more confusing as I feel like when I wake up the body is desperate for some more of the pill

28 minutes ago, Steve1 said:

Hi @Finni I definitely got intense activation after taking dose of 10mg. 5mg is a bit more confusing as I feel like when I wake up the body is desperate for some more of the pill

Sounds like a bit of both Steve. Which is worse?

I would say the "activation" side effect is more painful

Hi @Steve1 I had a quick read of your thread. I suggest that you reread it as well. I really heard you saying escitalopram never has been good from the start. IMO you would not want to increase due to activation.

The drop to 5 mg was only in August....45 days isn't much time to.undo the mess of 9 weeks unfortunately. Give it time, acceptance is huge at this point.

There are some members like @j1290 that held for some time and never felt better. They had to taper off and finally felt relief as the dose lowered. But they gave it time to see if stability would come.

Maybe posting a daily hourly log with symptoms would help give a clearer picture...rate symptoms 1-10.

❤️🙏

Were you constantly increasing and decreasing, or stopping and restarting your drugs?

@LostinCanada thanks for the response.

Yes sensible thing seems to be to hold at 5mg. The thing that concerns me is things are getting worse not better.

I'm not familiar with @j1290 exeperience. Is there a post I can read?

Many thanks

19 minutes ago, Steve1 said:

not familiar with @j1290 exeperience. Is there a post I can read?

Maybe he can chime in. His story is on SA.

20 minutes ago, Steve1 said:

The thing that concerns me is things are getting worse not better.

This is quite normal because the full WD often takes a few months to fully manifest. I'm most cases it would make sense to slowly updose to prevent this but you are also dealing with activation so this would make things worse. It is very hard to deal with the 2 things at once, WD and activation, at the same time but being patient now will lessen further issues.

I would reassess in another month but a daily log here will help. 😊

Ok will hold for the foreseeable!

Thanks again

Edited September 23Sep 23 by Steve1

On 9/21/2026 at 5:18 AM, SarahMc said:

If this is a consistent pattern where you feel like you’re getting interdose withdrawal in the evening/overnight, but you’re reacting to the dose when you take it, one thing you could consider is splitting your dose. So you’d be taking 2.5 mg twice a day instead of 5 mg once a day. We generally recommend moving the doses apart slowly, so start by taking them an hour apart, then two, then three, until you’re taking them 12 hours apart.

The hope would be that this would keep the level of the drug in your body more consistent, and since you would be taking a smaller amount of the drug each time you’d experience less activation right after taking it.

I looked up when escitalopram reaches daily peak plasma levels...it is 3-5 hours.

I think @SarahMc has made something worth considering. I think for both you and @Finni this might be the answer if things don't start settling down.

Because activation and withdrawal are such opposites, I can see this as being a viable solution because it lowers the dose and lessens the drop in plasma levels from interdose withdrawal by spreading it out.

Hopefully the next couple weeks will tell us more.

Hi @Steve1 a just read through your thread and from what I have read you say you went from 10mg to 5mg of escitalopram. So back when I was tappering citalopram which is the older of the two , escitalopram is more potent and double the strength of citalopram, so let's say if back then if I were to drop from 10mg to 5mg of citalopram, in hind sight that would be the equivalent 20mg to 10mg of escitalopram, which is a huge drop, just remember I'm using the above as just an example. My Doctor had this discussion with me during my tapering. So yes it is very understandable why your CNS got so disrupted and unstable. So as others have said holding is probably a good option. When I hit 5mg of tapering citalopram my Doctor did split my dose, I did take 2.5mg at 8:00am and the other at 8:00pm. It definitely dispursted the amount out more evenly throughout the day. I can only say this is what worked for my system and also when I was at 5mg I started taking liquid form to be percice. @SarahMc did give you the suggestion, it may help, but remember everyone is different. So what works for one may not necessarily means it works for all, but do listen to your body. It definitely sounds like your CNS just needs more time to stabilise, no need to rush it further.

Hugs my friend

Thanks @Bernadette . I made the big drop to 5mg as 10mg gave me akathasia.

And these drugs are meant to help us.....!

Ok, that makes sense why you dropped so fast, for the time being I would say holding is probably a very good idea until your body stabilizes. I realize as uncomfortable as the symptoms can be it's not forever, it's just till you stabilize. Another thing to remember as we all have learned is the lower you go in dosage the slower you go as to minimize and disruption. You are doing great and things will get better. As for me my excitement is reaching my 24 month/2 year mark and just excited to see the changes. And take it from me, healing is happening, even as unpleasant, or uncomfortable as it is, it is necessary for the process. I used to be minute by minute, then hour by hour, then day to day. But now I see the progress weekly and the transformation I've gone through and it has been worth it. And I will NEVER let another psyc med ever pass my lips.

8 hours ago, Steve1 said:

I'm not familiar with @j1290 exeperience. Is there a post I can read?

I have a thread in the success stories that I think tells the tale.

Long story short, I'd been on Bupropion(wellbutrin) for 20 years, and I later read that if you're on a med for that long and begin tapering, it can sometimes break and no longer work properly again, even if you reinstate. That's what I think happened to me, because I never stabilized despite reinstating to the last stable dose and time release.

It wasn't the easiest, I was in WD the entire time tapering, but I eventually got to zero and started feeling better as the months rolled on.

I hear you about the confusing symptoms. It took me the better part of a year to come to the conclusion the med wasn't working how it used to in my case, and I made the decision to taper through it and hope for the best when I got to zero.

I really encourage you to find the AD daily withdrawal checklist and track your daily symptoms. That helped me so much. I came to realize they weren't nearly as baffling as I thought they were, and in fact quite predictable while tapering.

15 hours ago, Chippy said:

No one knows mate, I know you want an answer to this question, there isn't one.

This is some of the most honest advice I've ever read in tapering forums. We collectively are in my opinion one of the best sources of tapering info, and we still know only a little. Tests and charts and graphs are one part of the equation, but in my experience the brain works however it wants to and doesn't care about what we think 😆

Thanks @j1290 so you never actually stabalised despite holding?

6 hours ago, j1290 said:

but in my experience the brain works however it wants to and doesn't care about what we think

This is very important. I think we all have a bias based on our previous experiences, however everyone is different, there is so litle research. I agree collectively this is the place to get the best advice, certainy of outcome, absolutley not.

13 hours ago, LostinCanada said:

I looked up when escitalopram reaches daily peak plasma levels...it is 3-5 hours.

I think @SarahMc has made something worth considering. I think for both you and @Finni this might be the answer if things don't start settling down.

Because activation and withdrawal are such opposites, I can see this as being a viable solution because it lowers the dose and lessens the drop in plasma levels from interdose withdrawal by spreading it out.

Hopefully the next couple weeks will tell us more.

@Steve1 I agree with LIC mate, it may be you need to reduce at some point, however WD can be and seems like for you delayed, so everything you are experiencing could simply just be WD, or it could be both. Id set a note in your diary for say 1 month, hold and don't question your choice till then, will give you some peace of mind rather than daily questioning yourself which can be painful. Just observe. A Diary is a good idea too. Then you can decide based on that month, hold longer, test drop, or split dose (which could be a very good idea).