Need help weaning off meds

[kesha16]

I've been on Propranalol 80mgs for about 10 yrs. for chronic migraines and panic attacks.  I was placed on Lexapro 10 mgs and then bumped up to 20mgs for better results for depression.  I am trying to wean myself off of both and my doctors (family and psychiatrist) want me to stay on them.  I have talked to both about the 30 lbs. I've gained recently and they both act as if it's not a big deal.  My depression had pretty much gone away, but now it seems to be coming back because I've gotten so fat and have absolutely no energy at all.  I need to know how to safely get off these meds.  I haven't taken the lexapro for about a week and a half and my appetite has decreased immensely.  Should I continue this way and how can I get off the propranalol?

[elyssa]

Hello,

I need some help please.My husband just had an MRI of the cervical spine.c3-c4 Disc Osteophyte complex with effacement of the ventral thecal sac and no cord deformity.
c4-c5 Disc Osteophyte complex with effacement of the thecal sac and no cord defoformity. There is mild netural forsminal narrowing.
c5-c6:Disc osteophyte complex with minimal effacement of the ventral thecal sac and no cord deformity. No neutral forminal narrowing.
C6-C7: Negative.
C7-TI: Negative.
Impression: Limited study due to patient motion. Mild miltilevel degenerative disc disease as detailed above.
My husband has  a lot of neck pain and shoulder pain.
Lately  a lot of headaches.High presure job,stress.He is 43 years old.Non -smoker Non- drinker.
He worked closely with at and during 911 and continued to work in the 911 area.The rum.MD says some kind of athric dx. going on probable RA.I also notice signs of sleep apena. I am conserned with the headaches.I do not want anything to be over looked.He is always tired, has a lot of pain,hard to sleep,What should be his next step? Besides PT? Thank you!
lyssa

[Abhijeet Deshmukh, MD]

Hello.

Yours is a tricky situation. You are taking Propranol for migraines and panic! If you have frequent panic attacks, you may be diagnosed as having a panic disorder. There are good medicines specific for panic.

Now, propranol causes clinical depression. It is a known side effect. Decreased or increased appetite can occur in depression. Hence, we can not be sure if the decreaed appetite is due to Lexapro, or depression. Also, the gained weight could have been a part and parcel of depression. All these things are confounders.

But there is one piece of advice. Please continue Lexapro, even if you have decreased symptoms of depression. It may be transient, and you may again go into depression after stopping Lexapro. As per guidelines, we have to continue an antidepressant for a significant period of time to have its long lasting effect.

Regards

[DrBhumikaMD]

Hi,
You are doing  good with the lexapro it seems. That is a positive sign. The major part of your weight gain must be due to lexapro. Now what you need to do is try n remain off lexapro for about 2 more weeks. Eat a healthy diet and exercise regularly. Once you have stopped taking lexapro for about 4 weeks, try and decrease the dose of propranolol to 60 mg. You need to remember that since you have been taking these medications for almost 10 years now your body might not accept their abrupt withdrawl. After being on 60 mg propranolol for 2 weeks decrease it to 40 mg. This again needs to e taken for 2-4 weeks till your body feels comgortable. And similarly the dose can be decreased again. If you have migraine attacks during withdrawl, take some OTC painkillers and remain at that dose for 4 weeks and then decrease.