Im baaaack!

[CanuckGuy42]

Hi all.. I was an active member on this board back in 2011 when I started my adventures with SSRI's for anxiety - namely Cipralex (Lexapro for my American friends)... In 2012 I felt like he stressors that had me turn to SSRI's had been considerable reduced or eliminated so in July 2012 I weened myself off it after being on Lexapro 15 mgs daily for a year. That process went well and all seemed good going forward.

Here I am one year later with a new set of stressors and all the physical symptoms of anxiety that I recognize oh so well from last time have returned and I am about to go back on Cipralex again.

Has anyone every started an SSRI, gotten off it and then found themselves back on it again? Is the ramp up period different when you go back on it a second time? The 6 weeks ramp up I had last time was tough (I chronicled it daily on this board and almost quit several times) but I stuck it out and everyone was right... everything levelled off. Just wondering if my body will recognize it again and it will be less intense.

[Vance2335]

I have been on and off. Both times I noticed a difference within 2 weeks maybe. I didn't really have any ill affects of it.

[CanuckGuy42]

Thanks Vance... i know first hand these meds affect people differently. I won't know until I try...

[JGF25]

You have just joined the community of people that felt good and stopped taking the meds only to find themselves back on them again.  Don't beat yourself up because lord knows we have all done it at one time or another.  I think it helps you to realize that stress is a major trigger for you and that you will never be anxiety free unfortunately.  You will need to build the medication back up but you have the knowledge now that you can feel better, you will feel better, it is just going to take a little bit of time.  Before, you didn't have that knowledge because you hadn't experienced it first hand.  Now you know and having that to fall back on, for me at least, is invaluable.  Take care CanuckGuy!  

[CanuckGuy42]

Thanks JG and nice to see your posts again. I remember you from the last time I was on here. Yeah I know... I'm not really beating myself up about it just wondering if the ramp up process will be the same or as long as last time  realizing that everyone is different.  Yes knowing I will feel better at the outset is a big plus and also knowing these symptoms aren't the result of something more serious healthwise, I know the experience will be different than last time.

[nursegirl6572]

Welcome back my friend!

I think of you often...I remember your journey to adjust to the Lexapro.  

I couldn't agree more with JG, I think it's more common than not for people to at some point come off a med, only to find that the med was really helping to control their symptoms.  I've done it a few times, and kicked myself every time.

I know you had a lot of med anxiety and struggled through the initial start up side effects.  You're right that it's impossible to predict how you will do a second time around.  You may tolerate it even better than you did the first time, and you may have more intense side effects.  I think the important thing is to remember not to psych yourself out about the side effects.  Do you take any anti anxiety meds as needed, like Ativan, or Xanax?  I think you did but cannot recall exactly.  Something like that may be very helpful for you as you adjust to the med again.  I think also it's wise to start out on a low dose and slowly increase it gradually, to minimize the side effects.  I personally feel that's even more important the second around.  

How about therapy?  You know that's SUCH an important part of managing your anxiety.  I recall that you were in therapy before...did you stick with it?   If not, you need to get back in asap.  Just even for the extra support as you will likely have an increased level of anxiety, just about starting the Lexapro again, not to mention as you know that an increase in anxiety is a common start up side effect.

I'm glad you came back to talk to us during this process again.  I think it would be great if you post on your old thread as well (the one where you documented your progress), not to use as an active thread, but just an update.  It's so helpful for people who come accross those old threads to see an update to know how people ended up doing.  I actually have seen your thread bumped many times, I know many people have benefited from reading it, seeing how you went about handling everything starting the med.  My advice would be to start a new thread to document your experience this time around, and then update the old one, explaining where you are, with a link to the new one, for people to follow alone (and also so we don't get a bunch of people posting on the old thread).

I'm anxious to follow along again, and am glad you are sharing your journey with us.  People don't realize just how much it helps OTHERS to put their story out there.

I've got my fingers, toes and eyes crossed that you breeze through this.  If not, you know we'll be here to help you every step of the way.  :0)

[CanuckGuy42]

Wow.. nursegirl so great to hear from you again. To this day I still credit you largely for keeping me from quitting last time as I fought with the side effects during my ramp up on Lexapro. This community support and help is so important and does make a massive difference, at least from my experience.

I am not as hesitant as I was last time to restart the regime. I also will have no doubt as to what the side effects are the result of (something I did not have last time and was obsessed with getting medical test after medical test done)... that is not there this time. I knew what this was the minute it came back....

So I got my script on Friday only this time instead of Clonazapam (Klonopin) to take the edge off the doc gave me Lorazapam - very low dose and only to use if the side effects get bad. It's a long weekend here in Canada and therefore there will be some moderate drinking (yes and I mean moderate) so I figure best time to start is next week.

Once I take that first pill - I will update the old thread and begin a new thread on here chronicling my daily experience again.

Also, no unfortunately I have lost my counselling support system as I moved to a new city last year. I will be looking however to reinstate one here soon.

So wonderful to hear from you all again... I am looking forward to sharing and contributing again in this community.

Best regards :)

[nursegirl6572]

Excellent!  You sound like you're in a good place mentally.  And yes, you're definitely at an advantage this time, as you aren't doing this for the first time, not knowing what to expect!  The Ativan will definitely help if you need it.  What dose are you starting out on?

Thanks for the kind words.  Knowing we help people get through some of their darkest times is what drives me to come back day in and day out.  It truly makes me so happy to hear!  I wish this kind of support system and info would have been available when I started out at 18 struggling to deal with my newly diagnosed panic disorder.

[CanuckGuy42]

DAY 1 - Well hi everyone.. now that I have completed some days of work travel and am on the ground until mid-august I decided this was to be DAY 1 of my return to Cipralex (Lexapro). Starting the ramp up at 5 mg and will see how I respond. Last time I was on this in 2011 I found 5 mg a bit steep of a start in terms of the side effects and cut down to 2.5mg for a while and then up to 5, then to 7.5 then to 10 and then through to 15 which is my prescription dosage. I have some Lorazapam to fall back on if the early side effects show themselves like they did last time.

Will be interesting to see how this ramp up goes. Last time I did not know what to expect and I think the manifesting of some side effects triggered health anxiety and compounded the overall experience. Looking forward to seeing if coming from a position of knowledge this time changes the experience.

Anyway I will post daily as I did last time for those interested in following.

[nursegirl6572]

Good luck!!

Remember, there's a good bit of the side effects that are attributed to anxiety too.  We can psych ourselves out, waiting and worrying for the side effects.  Then, if we DO experience some side effects, we make ourselves more anxious about it.  The best thing you can do is to try not to overthink the process too much, keep yourself busy and distracted.

Fingers crossed that it goes smoothly...definitely keep us updated on this thread.  I'll be anxious (no pun intended, lol) to watch along and see how you do.

[JGF25]

I'm following along too :)  Hopefully your "position of knowledge" will make a big difference this go around.  I know past positive experiences help me tremendously.  

[CanuckGuy42]

DAY 2 - Took my 5 mg dose this morning after a workout at the gym.

Was feeling a bit edgey last night so I went and did an hour of cardio at the gym which at first got me "edgier" but an hour later the edge was off and I slept pretty well last night.

So for now, no Lorazapam. Still got a bit dizzy in the car on the drive in to work this morning but its manageable and not like it was 2 weeks ago when I had the panic attack and had to pull over on the highway. I am avoiding highways for the time being and taking side streets. It's a nicer drive anyway. Less stress and less traffic. That's worth the extra 15 mins on the commute.

Cutting coffee down to 2 cups a day in the morning as I remember from last time coffee is NOT your friend as you ramp up on an SSRI.

Anyway... as I thought this is familiar territory so that is helping BIG TIME
so far. I know what to expect over the next 4-6 weeks....  

[nursegirl6572]

Sounds like you have everything covered, my friend, and are doing well!  Awesome!  Keep up the good work!

:0)

[Paxiled]

There are three theories about this.  First is that mental illness is episodic.  Second is that if you never successfully treated the underlying problem either in therapy or some other modality like that you never solved the problem, you just medicated it.  Third theory is that once you've been on these powerful drugs the brain just has a very hard time functioning without medication anymore.  My suspicion is that each of these happens to some people but not all people, so it's difficult to generalize, but you do have to notice that virtually everyone on these types of forums ends up back on meds.  

[Paxiled]

I should add, as for me, I don't have a clue which theory is correct, so I personally like to believe in number 2 just because the others can't be proven so why not believe in the positive one?

[nursegirl6572]

Good post.

I actually think it's a little bit of all of them, personally....and probably varies from person to person, depending on the amount of work they put in (or not), etc.

I know my panic/anxiety is very cyclic, and I also know that within a few short months of coming off meds each time, my panic returned, often times worse than where it started at.  

Actually, in my case, I'd say that the LEAST likely contributing factor for me was the lack of treatment.  Despite working VERY hard, learning all I could, and pouring myself into getting better, I had a reemergence of my panic each time.   Either the return of the anxiety was severe enough that my normal coping mechanisms just weren't cutting it anymore, or, like you said, I couldn't function without the meds.  Everything I did to control anxious moments while ON the meds was FAR less effective off the meds, without a doubt.

I haven't been on a med (other than an occasional PRN Ativan) for many years, and I haven't done too horribly bad.  I haven't done too horribly well either.  I can say, with confidence, that my anxiety was MUCH better controlled while on meds.  I manage, and I do my best, but I notice a difference for sure.  

For the reasons you mention, and because SO many people find themselves right back where they started (or worse), I always encourage people who post wanting to come off their meds to REALLY give it some thought.  

I honest to God wish I had NEVER gone off the Zoloft I went off to begin with.  And, lol, think I would have learned my lesson, I didn't, I did the same thing with my Lexapro a few years later.  Dumb me!  Every time I see someone post "I want to go off my X med, to see how I do", I cringe and think, "See you in a few months".  Really stinks!!

[Paxiled]

You thing you're sorry, me too.  Although I do believe therapy or spiritual help or whatever is the cure if there is one, nothing ever helped me either except meds, and they didn't solve anything, just made it a little more liveable.  But given what I've been through, I'd stay on that darned Paxil!  Of course, i never intended to necessarily stay off meds, I was just going to experiment and go back on if it didn't work.  All for my writing.  Now I can't write at all.  What you don't know can hurt you, eh?

[CanuckGuy42]

I agree with nursegirl that I believe it is a little bit of everything. But had you told me this two years ago when I was just starting this medication for the first time it would have fueled my fire to stop it and never give it a try for fear of becoming dependant on it for the rest of my life. And I believe this is a concern that plagues many people starting this form of treatment. Now, however, I feel completely different about it. People take medication everyday to regulate and control of plethora of physical issues like cholesterol, heart conditions, diabetes, etc and they do it without any guilt at all. Why should this be any different? The Answer... it shouldn't. There are so many people who suffer through anxiety and depression and are terrified of medication because it is an admission that they can't dig themselves out of it by themselves....I was one of them... but now I ask myself can you dig yourself out of diabetes by yourself??? Can you say "screw those pills, I'm going to control my arrythmia by myself".... If you need medication to "center" your emotional reaction to issues so you have a clear head to address them in whatever way you need to address them... then you should pursue that treatment. And if you go off and go back on again... in my book its ok.... life isn't a flat line.. there will be peaks and valleys...

[CanuckGuy42]

DAY 3 - Definitely felt the edginess all day yesterday.

But again, it was familiar so I didn't let it bother me as much but physically it was definitely there. Best way to describe it - felt like I drank 20 coffees (which I am only guessing because I have never done that!) ...

Anyway if you are just starting Lexapro or another SSRI and reading this and going through the same thing with the initial side effects - DONT FREAK OUT! .... sorry I can't say that enough.. because I did the first time I did this two years ago and it made everything 10 times worse. They DO go away once your body says "ok I get it.. you're gonna keep taking these... alright alright.. I will let it in"..

Anyway I will go to the gym this morning and work off some of this excess energy as a result of this.

[CanuckGuy42]

DAY 4 - Woke up today feeling pretty great.

Of course a bit edgey still but had a massage yesterday and i don't know what they did but the dizziness is pretty much gone. Best guess, the anxiety was causing my muscles in my neck and back to stiffen up so much that it was causing pressure on the muscle tissues in my head and therefore triggering dizziness. Who knows.. but whatever he did it worked... going for one more tomorrow. The weekend is here and the weather is great here in Toronto, Canada... so all is good!

And just as a final comparitive note.. when I did this last time 2011 I didn't make it past day 3 on 5 mgs of Lexapro without having to scale it back to 2.5 and ramp up super slowly. This time definitely not as bad and haven't had to reach once for my Lorazapam.

Have a great weekend everyone!

[JGF25]

I chopped bamboo when I was edgy!  Got any bamboo around?  Sounds like you are doing well.  And count me in with the on meds, off meds, and back on meds and planning to stay on them for the rest of my life if possible.  I like myself much better on meds and I'm sure my family and friends do too!  

[nursegirl6572]

The jittery coffee OD feeling was the one that I had that was most obvious and bothersome.  It was also pretty short lived, thank goodness.  I even had tremors at times, as though I did drink too much coffee.

Sounds like you're doing great...I wouldn't advise changing a thing...you've got this!

[CanuckGuy42]

If everything continues like this I am going to try to go up to 10 MG next week and stay there for a week and then back up to 15 mg where I was and see how that goes.

I understand JG what you say about liking yourself better on the meds. I find I am more centered and able to thing logically about things rather than have that clouded with too much emotional response. Not that I remember being void of emotion, its just that it doesnt creep in to where it shouldnt be when I am on the meds...

Onward and upward!

[CanuckGuy42]

DAYS 5 - 9 ... took a break from posting for a few days. Everything going pretty much the same with the ramp up process on Lexapro however today (DAY 9) I am upping it to 10 mg dose and will stick with that now for a week or so with the goal of getting up to 15 by end of next week (which is my script dosage).

Have not had to take my Lorazapam as yet to counter the side effects. They are there but seem to be more manageable this time for the most part.

Injured my neck by pushing too much at the gym so that has been an added annoyance these pastfew days.

Anyway...hope everyone is doing well.

[nursegirl6572]

AWESOME!!!!!

I think you're going to do just fine.  By this point, if you were going to really struggle with the start-up side effects, you would be.  I know it's not FREE of symptoms, but you're managing well.

Thanks for the update my friend!!