I did a fairly slow taper of my Lexapro from 10Mg to 0 in about 2 months. after being off for 2 weeks I had horrible withdrawal symptoms; High morning anxiety that would increase through out the day to the point I needed Ativan to function. when the Ativan wore off the anxiety would creep back up. It was so bad that I was puking all the time and lost 20lbs. I decided to go back on and would have to do a much longer slower taper. But after being back on for about 2 weeks, there were still the withdrawal symptoms so my doctor upped my dose to 20mg, it has been about 3 weeks since then and I am still as bad as I was. My life was great before this. I am not normally a depressed person, I got on because of a bad breakup that had me not eating and puking all the time. I've been on it for about 2 years. why isn't it working anymore. It has been suggested to me to go on Prozac instead. Can I do that? I was told it is easier to wean off of. right now I just want my mind and body back.
Got off Lexapro then had to reintroduce. Now it's not working.What happened?
Question posted by withdrawalsucks on 31 March 2023
Last updated on 3 April 2023
Answers
"SRIs and SSRIs. The SRIs and SSRIs block serotonin reuptake, increasing the amount of synaptic serotonin; this increase in available serotonin leads to a compensatory decrease in the number of some postsynaptic serotonin receptors (down-regulation).17 When the SSRI is discontinued abruptly, reuptake is reestablished (and possibly enhanced transiently), lowering the amount of available serotonin within the synapse. The resulting reduced concentration of available serotonin, plus the receptor down-regulation, causes clinical signs of serotonin deficiency. Since serotonin interacts with numerous other neurotransmitter systems, its deficiency has the potential to disrupt many other neuronal functions.
SSRI discontinuation symptoms are similar to those of the TCAs, with dizziness, gastrointestinal symptoms, and sleep disorders common. Anecdotal reports have included complaints of “electric shock–like” sensations, flashes, and “withdrawal buzz.”15,17,18,23–26,28–32 The type and severity of the symptoms correlate with the relative affinities of the agents for the serotonin reuptake sites and with secondary effects on other neurotransmitters; with SRIs that also affect cholinergic systems, the symptoms possibly correlate with cholinergic rebound.
Sudden discontinuation is a particular problem with agents that have a relatively short half-life, which include the SSRI paroxetine and the SNRI venlafaxine. With these types of drug, the symptoms can last up to 2 weeks.29 A randomized clinical trial reported that in the 5 to 8 days after discontinuation of an SSRI, symptoms were most common with paroxetine—the most potent SSRI and one with a short half-life—and least common with fluoxetine—an SSRI with a lower serotonin reuptake affinity and a longer half-life.31 Reactions to sertraline were mild and infrequent. However, this trial was designed to simulate intermittent noncompliance and did not attempt to document late-emerging effects that might occur with a drug with a long half-life, such as fluoxetine. There have been reports of symptoms starting 25 days after fluoxetine withdrawal with some persisting as long as 56 days.29 Late reactions to fluoxetine cessation may be reported less often because trials do not follow patients long enough after withdrawal to observe them. Further, the symptoms may be mild and patients may not attribute general symptoms such as flu-like complaints, dizziness, or sleep disturbances to a drug they had stopped taking weeks earlier.29
In addition to its effects on serotonin reuptake, paroxetine affects muscarinic receptors, and its withdrawal could contribute to symptoms of cholinergic rebound, a mechanism usually not attributed to other SSRIs.23 One case report of a patient discontinuing low-dose paroxetine (10 to 20 mg/day) noted symptoms that were very disabling initially and lasted longer than the 5 to 15 days mentioned in the prescribing information. The responses included agitation, anorexia, nausea and diarrhea, vertigo and dizziness, paresthesia, and a shaking chill.30 Sertraline, which like paroxetine is associated with a higher occurrence of discontinuation reactions, is the only SSRI that strongly blocks dopamine reuptake as well as serotonin-reuptake sites.23 Further, discontinuation symptoms with sertraline, although usually mild, may be related to its effect on both dopamine and serotonin reuptake."
Source: National Library of Medicine
It would be a good option after all the time you have restarted Lexapro and as you mention it is not doing its job to make a joint decision with your Psychiatrist to try a different SSRIs.
I get it if i did a sudden discontinuation... i didn't. also, many sites and dr.s say that getting back on should help, but it's been almost a month now and my body still is in withdrawal.
There is something as you are aware that is definitely wrong. If you discontinued Lexapro gradually, then your symptoms returned reinstated the med and it is not working after a month, what logical explanation does your Psychiatrist give you?
I am not a Dr., but you have one who happens to be a trained professional who can not give you a logical medical explanation and you have to turn to the internet to find an answer which by the way do not believe everything you read online and if you come across success stories that are true remember everyone reacts differently to medications, benefits, risks, interactions, side effects, etc..
Another aspect to consider is that your Dr. simply wants you to start treatment with an antidepressant which is in the same drug class as Lexapro, Prozac (fluoxetine)- SSRIs, what if it does not work.
I believe you should seek for a second opinion and find the answer you deserve not online but with an actual Psychiatrist that can truly help you.
All the best and I sincerely wish for you to get back on track and get your life back, masso
And yes, you are right, withdrawal symptoms do suck... been there.
Related topics
lexapro, anxiety, withdrawal, taper, symptom
Further information
- Lexapro uses and safety info
- Lexapro prescribing info & package insert (for Health Professionals)
- Side effects of Lexapro (detailed)
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