[humboldtdan]

I was on paxil before, and it worked much better for me than Lexapro.

[elizabethmaria]

oh, Hi Kimberoo!
No, I haven't had the p450 testing yet - thank you for pushing me - I do really need to do it. I have been putting it off so far in hopes to be a little stronger, as I have to go back to that same doctor to get the order approved, I think - again, those doctors are tough to be around when they don't recognize withdrawal, etc..
I did have seizure testing last week, 4 days worth, and don't have epilepsy, so that is good.. but the doctor said that all my symptoms, movement problems jerking, he thought was some kind of psychologically repressed something or other which nobody knows because he's never heard of a drug reaction like that. How kind of him! He may be a top doctor neurologically, but he even said that CFS that I have is probably psychological -- . That is what made me realize he really doesn't know what he's talking about, as I was clinically diagnosed at a neighboring very excellent hospital - it's a brain disorder, nothing psychological - oh well... anyways, just tired of that whole scene.. and we have so much support here, plus doctors that I've talked to that DO know exactly what's going on with us, and things are improving regardless of their prognosis.. Boy, am I tired of having people ask if I've really been abused, raped, etc. etc.. It's just ridiculous.

Anyways, aside from all that, I've been watching your posts about the calls and everything - I hope that he gets some good info back soon...
thank you again for the important reminder! I just need to recover a bit from the last doctor blow last week ...
Hope your husband begins to feel better very soon at the 15 mg...
you're in my prayers too!
love, EM

[kimberoo]

For Everyone:

I found a site for a UK based company that does the CYP450 testing. It is very informative and might be just what we need to take to our physicians to get them to order the test for us. They don't have to necessarily use this company but it explains what the test is better than we could and explains which type of patient may need the testing.The link on the second page gives an example of a patients results so that your doctor will know what to expect. (My doctor told me that even if he had the test done he wouldn't even know what to do with the results!) It shows how the patient metabolizes medications, lists the patients current meds and what interactions can be expected and gives suggestions as to how to dose them according to the patients genes.

Please visit the following link:



http://www.lab-21.com/lab21/clinical..._drs_guide.pdf


On the second page click on "To view a sample Drug-Gene report please click here"

Here you will find the sample results that your doctor would receive.

I hope this helps, it explains it in layman's terms.

Kimberoo

[SchnauzerTime]

Thanks so much for the comfort and the inspirational message about God..it made me tear up. I don't want to ever come across like I'm not thankful for the people on here who have helped me...and I know there are people worse off than me out there. Like Kimberoo said I know I've been asking so many questions about myself this week and haven't helped others...but if I EVER get through this I DO want to help others learn from my experience also. I was just thinking about that earlier...and I have been praying too that if God helps me through this I will help others.

I know you've been through MUCH more than I have it sounds like...especially the siezures. It amazes me how positive you are and the hope you bring others on this site like myself. You have gone through so much, and like Kimberoo said you still have time to help others.

I switched to Lexapro from Paxil cold turkey because my doctor said it was ok about 5 months ago I think. The first couple weeks I had flu symptoms but it went away and I was ok for a month or so...then ever since I did the fast taper off the Lex and got back on my full dose, I was getting better after a couple weeks on the full dose then I'm sick again.

Anyways, thank you for praying for me...I will do the same for you and I'm happy you are on the right road to recovery and have some doctors that are helping it sounds like. All the doctors around here where I live are idiots, lol.

Take care and thanks again .

[kimberoo]

Aunty

Dr. Black called back himself! I can't believe that! He was very gracious and had absolutely no problem answering my million and one questions. I never mentioned this forum, I just said that I have a friend whose daughter had gone through similar experiences and she referred me to him as he had helped her in the past. (wink, wink Aunty! ) I explained Benny's past SSRI use and told him of my concerns that he possibly had a reaction to the antibiotic in 2005. I told him of his withdrawal in the past 2 months. He said that I am also a psychiatrist and I am aware of what you are talking about but I think that it may be one of two things: 1. He is having a relapse of another psychiatric condition or 2. He may have another condition that possibly the physicians haven't found out about yet.

I told him that my husband was never depressed in the first place that he was given Paxil in 1994 when his father died. He said, regardless, I still believe that he may have an underlying anxiety disorder, not depression, and that having the testing done certainly wouldn't hurt. His only concern was that if it were how he metabolizes the medicine then he should be more bothered by it at higher doses rather than low. I informed him of how Benny had gone up to his full dosage of 20mg for the past 4 days and that he had the same reaction that he had when he was skipping days at 2.5mg. He said that the full dose should have made him feel better, so the testing should help. He did say that the dizziness and vertigo in his case seem extreme even for withdrawal and that is why he thinks it may also be something else. I also told him that I was concerned that he was having an interaction with the Sectral and he said that the test would definitely show that.

He told me to tell my doctor to fill out a lab slip with this written on it:

Cytochrome p450 2D6 & 2C19

He said that the Lexapro metabolizes through the 2C19 and that the Paxil goes through the 2D6 as well as the Sectral. This way it can be seen if he had problems way back when metabolizing even the Paxil. He said that my doctor can call his office and talk to either him or one of his associates and they will help him to interpret the results. The results will come back in one week to 10 days. He said that most all hospitals in the US have a relationship with Mayo's reference lab, all that needs to be done is to get the blood drawn and it will be sent to the Mayo Clinic for testing.

I asked him if he thought that it was possible that the reaction that he had in 2005 could have ruined his pathways where this drug is metabolized and he said no, he really didn't think that was possible, but the antibiotic more than likely did cause the reaction due to a drug to drug interaction.

I asked if the pathway had been damaged, would the test show that and he said no. It shows the persons genes that they were born with and have now and how they metabolize medications, there's no way to know if damage had taken place or if that is even possible.

We called and made an apointment with our Internist for tomorrow morning at 9:00 am. I will come prepared this time with my armory of information, so wish us luck...........no.........please pray that he listens this time.

Benny is a little upset that yet another person thinks that it could be anxiety, but he was only guessing, he doesn't know him personally and he admitted that. By the way, so far so good on the 15 mg, not perfect, never perfect, but he does feel better than he has the last 4 days. Thank you God!!

Em, I hope you're next. I'm so glad that you found out that you don't have epilepsy, that's a blessing. And, thank you for the poem, I really enjoyed it. Hang in there!! I'm rooting for you!!

Aunty, should, I put the number up here or should I just email it to you for you to give it to whomever you think needs it? I don't want to put information on here that you think is too personal or that someone may use in the wrong way. You let me know. Grazie per tutto!! (at least I didn't say thank you )

Kimberoo

[kimberoo]

To SchnauzerTime and anyone else who hasn't gotten tired of hearing from me today

Awwww, SnauzerTime, I certainly meant no inference to you, I was feeling guilty myself, but I can understand how you came to feel that way. It's ok. We all need each other right now and we're definitely doing that. I wish we could all meet each other and talk in person, it would be so amazing. I'm amazed to find people that I've never met have made more of a difference in my life than people that I call "friends", just because I "know" them. You guys are the best and I thank God that I found this group.

Always,

Kimber

[SchnauzerTime]

I'm so glad you are getting the test done...sounds like you are on the right track. And I'm happy to hear Benny is feeling a little better, that's great! I'll be thinking of you both and hope everything goes ok with the test tomorrow.

I don't know if you read my post on the previous page...I was just wondering how long it took for you to get accepted into the Withdrawal and Recovery group and if Catherine answered your emails promptly once you got in? I'm wanting to figure out what's wrong with me so I can go ahead and at least know what I'm dealing with.

Thanks Kimberoo and good luck tomorrow .

[elizabethmaria]

Hello again,
I'm glad that post helped you too - it helped me today a bunch as well! I love quotes like that, and I am going to try and post some more more frequently just to keep spirits up, if it helps anyone..
It sounds like you've had the ups and downs of paxil withdrawal, and then the lex-- and as Aunty says, it seems like a combination of both, and hopefully it will stabilize... I'm so sorry! that is NO fun.. but I bet they will really be able to help (Catherine, etc.)..
Don't worry about feeling like you aren't helping - every post you write helps others who read this forum not feel alone, and compare their experiences and symptoms. As things begin to stabilize, then you'll feel more able to help out in other ways - I've been a total mess for months, my family can attest to that! Until things even out, it's tough to even know who you are!
take very good care, EM

I just found a bit of info on movement disorders - caused by drugs often.. so I'll post it here...

Tardive dyskinesia is a neurological disorder caused by the long-term or high-dose use of dopamine antagonists, usually antipsychotics. These neuroleptic drugs are generally prescribed for psychiatric disorders. Other dopamine antagonists that can cause tardive dyskinesia are drugs for gastrointestinal disorders (for example metoclopramide) and neurological disorders. Some drugs that are not intended to affect dopamine, such as SSRI antidepressants, may also cause tardive dyskinesia. While newer atypical antipsychotics such as olanzapine and risperidone appear to have less dystonic effects, only clozapine has been shown to have a lower risk of tardive dyskinesia than older antipsychotics.[1]


The term tardive dyskinesia was introduced in 1964. Dyskinesia refers to an impairment of voluntary movement. The resultant tics and other movements are often referred to as dyskinesias. Dyskinesia is sometimes caused by long-term use of anti-psychotic drugs or other dopamine antagonists like the antiemetic metoclopramide. The effect of these drugs can be tardive, meaning the dyskinesia continues or appears even after the drugs are no longer taken. As far as treatment of iatrogenic tardive dyskinesia is concerned, neuroleptic drugs should be withdrawn for a period of 3-6 months to see if this resolves the issue, but the problem may fail to improve or may even exacerbate. In this situation, it would be sensible to trial the patient on tetrabenazine 25-50 mg/8h PO. (Oxford Handbook of Clinical Medicine).

In context of Parkinson's disease, dyskinesias are often the result of chronic levodopa (L-dopa) therapy. These motor fluctuations occur in more than half of PD patients after 5 to 10 years of levodopa therapy, with the percentage of affected patients increasing over time.[2]

Dyskinesias most commonly occur at the time of peak L-dopa plasma concentrations and are thus referred to as peak-dose dyskinesias. As patients advance, they may evidence diphasic dyskinesias, which occur when the drug concentration rises or falls.

The use of MDMA has been shown to enhance the effects of L-Dopa while reducing the associated dyskinesia in primates with simulated Parkinson's disease.[3] There have also been many anecdotal reports that chronic concurrent abuse and co-administration of the sedative-hypnotic GHB in conjunction with amphetamines, or their acute conjunction in large doses, induces a transient manifestation of tardive dyskensia and more enduring akathisia. Both conditions are also associated with GHB withdrawal syndrome following prolonged heavy round-the-clock administration over months or years. [4]

Contents [hide]
1 Features
2 Cause
3 Treatment
4 Epidemiology
5 Controversy
6 See also
7 References
8 External links



[edit] Features
Tardive dyskinesia is characterized by repetitive, involuntary, purposeless movements. Features of the disorder may include grimacing, tongue protrusion, lip smacking, puckering and pursing of the lips, and rapid eye blinking. Rapid movements of the arms, legs, and trunk may also occur. Impaired movements of the fingers may appear as though the patient is playing an invisible guitar or piano. Patients with Parkinson's disease have difficulty moving, while patients with tardive dyskinesia have difficulty not moving.

Other closely related neurological disorders have been recognized as variants of tardive dyskinesia. Tardive akathisia involves painful feelings of inner tension and anxiety and a compulsive drive to move the body. In the extreme, the individual undergoes internal torture and can no longer sit still. Tardive tourettism is a tic disorder that can closely mimic Tourette Syndrome, sometimes to the point where the two can only be distinguished by the details of their onsets.


[edit] Cause
The cause of tardive dyskinesia appears to be related to damage to the system that uses and processes the neurotransmitter dopamine. It is thought that postsynaptic dopaminergic receptors become supersensitive to stimulation as a result of the use of neuroleptic drugs and that this supersensitivity causes the symptoms of tardive dyskinesia. The available research seems to suggest that the concurrent prophylactic use of a neuroleptic and an antiparkinsonian drug is useless to avoid early extrapyramidal side-effects and may render the patient more sensitive to tardive dyskinesia. Since 1973 the use of these drugs have been found to be associated with the development of tardive dyskinesia (Crane, 1973). Since some of the symptoms of tardive dyskinesia can be interpreted as schizophrenia by doctors, they may prescribe additional neuroleptic drugs to treat it, leading to increased risk of more prevalent tardive dyskinesia. Several studies have indicated that long-term neuroleptic use is associated with both cognitive deterioration and atrophy of the brain.[5][6]


[edit] Treatment
Primary prevention of tardive dyskinesia is achieved by using the lowest effective dose of a neuroleptic for the shortest time. If tardive dyskinesia is diagnosed, the causative drug should be reduced or discontinued if possible. Tardive dyskinesia may persist after withdrawal of the drug for months, years, or even permanently. There is no known cure for tardive dyskinesia, but preliminary research suggests that the atypical neuroleptic clozapine (Clozaril®) may improve the state of the patient.[citation needed] Improvements are also seen in some cases, if the high potency benzodiazepines - lorazepam (Ativan®), diazepam (Valium®), or clonazepam (Klonopin®)--are used.[citation needed] The findings about the effects of natural substances, such as vitamin E (Alpha-Tocopherol) or melatonin, are inconclusive.

Natural remedies are unproven, since they are seldom tested in a controlled setting such as a drug trial. Preliminary research indicates that alternating rest, and regular exercise also negate the symptoms of tardive dyskinesia,[citation needed] necessary for all mental health outpatients who maintain anti-psychotic neuroleptic drug regimes, for on-going 'wellness'. Switching to a newer drug with fewer side effects might be an option for a patient in a controlled or monitored environment.[citation needed]


[edit] Epidemiology
Tardive dyskinesia most commonly occurs in patients with psychiatric conditions who are treated with antipsychotic medications for many years. Some estimates suggest that it occurs in 15-30% of patients receiving treatment with antipsychotic neuroleptic medications for 3 months or longer.[citation needed] “A study being conducted at the Yale University School of Medicine has estimated that 32% of patients develop persistent tics after 5 years on major tranquilizers, 57% by 15 years, and 68% by 25 years.”[7] Other estimates suggest that with each year of neuroleptic use, 5% of the patients will show signs of tardive dyskinesia, i.e., 5% after one year, 10% after two years, 15% after three years with no clear upper limit.[8] Eventually, according to these estimates, if on the drugs long enough, the majority of patients will develop the disorder.[9] The incidence of tardive dyskinesia varies with the type of neuroleptic (e.g., haloperidol (Haldol®) more often than perphenazine (Trilafon®)), daily dose and duration of treatment (the higher the daily dose and the longer the duration of treatment, the higher the risk).

[SchnauzerTime]

No! I didn't mean you were referring to me and only me...I knew you were talking about people in general but it just hit home. I know I've been self-centered lately and it made me feel bad knowing that your hubby and others are going through a tough time too. I just didn't want to come off that way...like I don't care about what anyone else is going through too. I just get really whiny when I'm sick...especially when I've been sick for 6 months straight. But I know other people have been too.

Anyways, I didn't mean to sound like I was blaming you...was meaning to say that you made me think of how I've been sounding. Some days I just feel like dieing and yesterday was one of those days! Anyway, sorry again...I hope everything goes ok for your hubby tomorrow .

[elizabethmaria]

The elderly and female patients are more prone to develop tardive dyskinesia.[citation needed] Cigarette smokers also have a higher prevalence of tardive dyskinesia.[citation needed] Children and adolescents are much more sensitive to the early and late extrapyramidal side-effects of neuroleptics than adults.[citation needed] Because of this, treatment of youngsters with neuroleptics may be contraindicated, and many authorities believe that they should be initiated only as a last resort, using the lowest dose regime possible and the shortest duration of treatment in accordance with good patient management.[citation needed]

Tardive dyskinesia can become a social handicap. Patients and/or their families (guardians and/or caregivers/nurses) should receive full information about the neuroleptic before starting treatment (informed consent). The benefits need to be weighed by the individual patient/guardian and their physician.


[edit] Controversy
Peter Breggin has discussed tardive dyskinesia in the context of his criticism of biological psychiatry. However, his hypotheses are not widely accepted by mainstream psychiatric professionals. [10][11][12][13]


[edit] See also
Primary ciliary dyskinesia
Athetosis
Asterixis

[edit] References
^ Craig & Stitzel; Modern Pharmacology (6th ed) pp. 401.
^ Obeso JA, et al. The evolution and origin of motor complications in Parkinson's disease. Neurology. 2000;55 (suppl 4):S13-S20.
^ Iravani, M., Jackson, M., Kuoppamäki, M., Smith, L. & Jenner, P. (2003). 3,4-Methylenedioxymethamphetamine (Ecstasy) Inhibits Dyskinesia Expression and Normalizes Motor Activity in 1-Methyl-4-Phenyl-1,2,3,6-Tetrahydropyridine-Treated Primates, Journal of Neuroscience, 23, 9107–9115
^ Miotto, Karen. MD, & Roth, Brent. MD; UCLA Integrated UTSW Toxicology, ‘GHB Withdrawal Syndrome’ Texas Commission on Alcohol and Drug Abuse, March 2001
^ Breggin, P. R. (1990) Brain damage, dementia and persistent cognitive dysfunction associated with neuroleptic drugs. Evidence, etiology, implications. Journal of Mind and Behavior, 11, 425 64
^ Gualtieri, C. T. and Barnhill, L. J. (1988) Tardive dyskinesia in special populations. In M. E. Wolf and A. D. Mosnaim (eds) Tardive dyskinesia. Washington DC: American Psychiatric Press.
^ Glenmullen, Joseph. Prozac Backlash. ©2000 by Joseph Glenmullen. Simon & Schuster, Inc. New York. page 38. [1]
Referring to W. M. Glazer, H. Morgenstern, and J. T. Doucette, "Predicting the Long-Term Risk of Tardive Dykinesia [tics] in Outpatients Maintained on Neuroleptic [major tranquilizer] Medications," Journal of Clinical Psychiatry 54 (1993): 133-139. [2]
^ Jeste D, Caligiuri M. (1993) Tardive dyskinesia. Schizophr Bull. 1993;19:303-316. PMID 8100643
^ Whitaker , Robert - Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill, Perseus Pub., c2002
^ Breggin, P. R. (1983) Psychiatric drugs. New York: Springer
^ Breggin, P. R. (1991) Toxic psychiatry. New York: St. Martin's Press
^ Psychiatrist and Psychiatry Critic, Peter Breggin, On Tardive Dyskinesia
^ Psychiatrist and Psychiatry Critic, Peter Breggin, On Neuroleptics

[elizabethmaria]

More information about movement disorders - - hmmm.. why doesn't my doctor know this!!?? From University of Kansas Medical Center website... (I have tardive dyskinesia/dystonia symptoms, so thought it would be good to post for any others...)

Tardive Syndromes
Tardive (meaning "late onset") dyskinesia (meaning "abnormal involuntary movement") is a term used to describe a syndrome occurring as a result of treatment with medications that block the receptors for the neurotransmitter dopamine in the brain. Dopamine is involved in producing movement. If the receptors are blocked over a period of time, some individuals may develop uncontrolled involuntary movements. Onset of symptoms can range from a few months to several years after initiation of drug therapy. In contrast to a tardive syndrome (which as the name implies occurs only after extended exposure to a causative agent), symptoms may also occur within a few hours to days after initiation of drug therapy. This is called an acute reaction. Acute reactions are more easily managed and usually completely resolve within a few days.

Tardive dyskinesia was first described in the 1950s in patients treated with antipsychotic medications. The tardive syndromes can affect anyone exposed to medications that block dopamine receptors; however, women, the elderly and persons with psychiatric disorders (particularly affective disorders) are at increased risk. The incidence is difficult to estimate as symptoms and severity can vary widely and many cases are probably undiagnosed, but it is believed that up to 50 % of persons with prolonged exposure to medications that block dopamine receptors will develop a tardive syndrome. The tardive syndromes include classic tardive dyskinesia, tardive dystonia, and tardive akathisia.

Classic tardive dyskinesia most commonly appears as repetitive, somewhat rhythmical involuntary movements. Typical involuntary movements include tongue thrusting, lip smacking, lip pursing, grimacing and chewing movements, rocking of the trunk, pelvic thrusting, rotation of the ankles or legs, marching in place, irregular respirations, and repetitive sounds such as humming or grunting.

Tardive dystonia may also be seen as part of the tardive syndrome. Dystonia is characterized by sustained muscle spasms causing involuntary movement and abnormal postures of the affected area. Some examples include torticollis (the head and neck are turned to the side), retrocollis (the head and neck are pulled back between the shoulder blades) and blepharospasm (the eyelids are squeezed forcefully shut). It can also cause excessive arching of the back. Tardive dystonia clinically appears identical to idiopathic or primary dystonia (meaning "of unknown cause") but is classified as a secondary dystonia since it is the result of a known agent.

Tardive akathisia is the third type of tardive syndrome. Akathisia refers to a feeling of restlessness often accompanied by anxiety. In milder cases, the individual may complain of a sensation of inner restlessness and be unable to sit quietly without fidgeting . In more severe cases, the individual may actually be unable to remain seated and must pace or march around the room. Their sense of anxiety increases if they are unable to move about.

While the above tardive syndromes are characterized by excessive movements, individuals may also experience a drug-induced parkinsonism which appears clinically like Parkinson’s's disease. With drug-induced parkinsonism, there is an absence of movement. Individuals have slow movements with rigid or stiff muscles and tremor. When walking, a shuffling gait is present with a stooped posture and diminished arm swing. Facial expression is blunted causing a very solemn appearance. Of all the tardive syndromes, drug-induced parkinsonism is the most reversible. It resolves after the medication is stopped, but this may take up to 18 months.

Some medications that are known to cause tardive syndromes include:

Medications for gastrointestinal problems

metoclopramide (Reglan)
prochlorperazine (Compazine)
Medications for cough

promethazine (Phenergan)
Medications for depression

amoxapine (Ascendin)
perphenazine/amitriptyline (Triavil)
Antipsychotics or Neuroleptics

chlorpromazine (Thorazine)
thioridazine (Mellaril)
trifluoperazine (Stelazine)
perphenazine (Trilafon)
fluphenazine (Prolixin)
thiothixene (Navane)
haloperidol (Haldol)
pimozide (Orap)
Diagnosis is based on the patient's history and a thorough clinical examination. The criteria for diagnosing a tardive syndrome can vary but is generally agreed to be exposure of an individual to a dopamine receptor blocking agent within 6 months of onset of symptoms which persist at least 1 month after stopping the offending drug. There is no laboratory test or x-ray to confirm the diagnosis; although, such tests may rule out other conditions if the diagnosis is questionable.

The longer the drug is taken, the greater the chance of developing a tardive syndrome. Once the symptoms are noticed, the best course of action is to stop the medication if possible. Your physician will work out a tapering schedule to discontinue the drug as most should not be abruptly stopped. With chronic psychiatric conditions, this may not be an option and in these instances the medication should be kept at the lowest possible dose.

Symptoms may temporarily worsen after the medication is stopped, but avoiding this type of medication offers the best hope for a remission. Symptoms may lessen or even disappear if the medication is restarted or the dose is increased, but movements will eventually break through with an increase in severity and be more resistant to treatment.

For some, symptoms may first be noticed after the medication has been stopped (withdrawal emergent tardive dyskinesia). Once again, the best course of action is to remain off the offending drug.

Tardive dyskinesias are challenging both to the patient and medical profession. The best treatment may simply be to withdraw the offending medication and allow the symptoms to resolve on their own. If symptoms are intolerable to the patient, oral medications may be used. Some studies suggest vitamin E may hasten the resolution of symptoms. Benzodiazepines such as clonazepam (Klonopin) may provide some relief of involuntary movements and anxiety. The main side effect seen with this type of drug is drowsiness. Dopamine depleting drugs are probably the most effective medications used to treat tardive dyskinesia. Two commonly used drugs in this class are reserpine and methyldopa. These medications have side effects including depression, apathy, lowered blood pressure and parkinsonism.

Tardive akathisia may be treated with beta blockers such as propranolol (Inderal). Side effects can include slowed heart rate, lowered blood pressure and depression. It should be used cautiously in persons with certain types of heart and respiratory diseases.

Tardive dystonia may be relieved with anticholinergics such as trihexyphenidyl (Artane) or benztropine (Cogentin). If is important to note that these medications (while beneficial in some cases of tardive dystonia) will typically worsen tardive dyskinesia. Certain types of tardive dystonia may also be treated effectively with local injections of botulinum toxin.

Treatment may require trials of different medications at different doses and a great deal of patience. Just as each individual is unique, so must the medication regimen be tailored to their specific needs. While some tardive syndromes are persistent, most individuals gain some degree of relief with oral medications and the natural resolution of symptoms as time off the offending agent increases. Some experts believe the time an affected individual was exposed to the causative medication can be correlated to the length of time needed for symptoms to resolve.

Research is currently underway in both the treatment and prevention of tardive syndromes. As our understanding of the neurochemistry of the brain increases, new medications are being developed that spare the dopamine receptors involved in syndromes such as tardive dyskinesia

[SchnauzerTime]

How were you when you switched from Paxil to Lexapro years ago? You said you were on Paxil before...did you just switch cold turkey or did you taper? I switched cold turkey from Paxil to Lexapro myslef 5 months ago and DID get withdrawals from it for a couple weeks. They were really bad withdrawals too...I was in bed for 2 weeks.

But think back to when you went from Paxil to Lexapro and it will probably be the same doing it vice versa...from Lex to Paxil. I am just GUESSING though...and the SAFEST way would be to not switch cold turkey and do a slow tapering EVEN though the doctor says it's ok. Alot of doctors also say it's ok to quit taking these meds cold turkey or a very fast taper and most people end up pretty sick that way.

I'm not a doctor and am just giving my opinion.

[HelpMe58]

Originally Posted by tavee

Helpme- Do U Feel At All Like U Are Depressed? Like U Are Not Ureself??
I Have Noticed A Big Difference In Me. I Have A Lot Of Anxiety, I Get Irritated Easily(this Is How I Was Before Lex). My Real Self Is Back.

I Dont Want To Say That I Am Depressed, But I Know It Doesnt Feel Like I Was When I Was On Lex. I Get Sad.
I Am Just Worried That If I Am Done Completely That I Will Be Depressed Especially When We Decide To Get Pregnant Again.
Sometimes I Wish That I Would Be Able To Take The Lex Without Any Side Effects In The Future. It Is Such A Bad Drug And With All The Things That It Has Done To Us Who Knows If It Is Longterm.

That Is Another Thing I Am Dealing With Is Worry. I Always Worry. I Worry About Dying, About Pains That I Have, Etc..... I Worry That I Will Die In The Car When I Am Driving. I Seriously Can Feel The Weight On My Chest From The Anxiety. I Am Sooooooooooo Not Patient. Go Figure. I Dont Know How I Taught For 11 Years!!!!!

So Thats Pretty Much It On My End.

How Is Ure Mother Doing? How Are U Doing????

Keep Me Posted
Tavee

Tavee,
I have always been a rather depressed and worried person and it is all back. I think it is amplified because I am still in some type of withdrawal. I worry about being alone with my son leaving for college and my mother being so ill. She is maintaining on medication but that will not last forever. I feel like I have lost everyone, my grandparents, my father, ,my husband, all in the last few years. On the Lexapro I did not think back to the old days and I did not get depressed in the way I do now. Now I find all the memories are flooding back when all these people were alive.
I wish the Lexapro was not so horrible and did not make me gain so much weight. It really took the edge off my personality so I could cope.
Did any of that make sense?
HelpMe

[elizabethmaria]

Dear Tavee,
I'm sure your worries will go away - those sound like total lex worries - the pains, the fear of dying, etc etc.. I had that so bad in the beginning, it was WEIRD.. especially about dying. I've read lots of people have that too - I even think there is a name for it. Some people get super afraid of cancer or some other illness. This will definitely pass though, it was just in the beginning, so I bet it will go away quickly, well, soon. It was a really strange feeling, but it's not really real, it's not how you'll normally think..
just don't worry about it? ok, that was a bad pun.. sorry!
love, EM

[JBS]

I have just joined this group because I've decided to quit Lexapro after being on it and Celexa for the past 7 years. I had tried to quit several times before, but unsuccessfully. Each time in the past, I felt a return of what I thought were depression symptoms: anger, sadness, and extreme irritability. I now think these were withdrawal related. I am determined to go off!
I have been down from 10 mg to 7.5 mg for the past 6 days- my eyes feel like they have cotton in them, I feel like they are swollen. My stomach hurts, I have the sweats, and I am sooooo tired all the time.
Here's why I am so determined: in the past 7 years I have gained about 40 pounds, I have no sex drive, and I could sleep 16 hours a day if I didn't have to go to work.
I am so scared that this is going to last a long time and/or get worse.
I need words of encouragement.
How slow a taper should I do?
Thanks!!!!

[auntybiotic]

Now how many doctors would take the time and make a long distance call to someone that was not even their patient. I am so impressed with DR. Black's compassion.

I am hoping the testing will go thru fine, and Dr. Black will actually do a consulation with your doctor over the phone and explain all the results, at no cost.....how rare is that!!!!

Catherine is so well informed as she has delt with thousands in crisis over these medications. I hope the 15 Mg works out for your husband.

You are such a great wife, going out on every limb to find answers. I know you will find the reasons other then withdrawal why your husband is so ill. I don't know your husband but ANYONE that went thru the nightmare your husband has been thru would be anxious. I am anxious just reading about his experiences.

I would not post the number. Almost 700,000 hits to this thread.....can you imagine how often their phone may ring with questions. LOL!!! May be overwhelming. Send it to me and I will provide it to whomever may need it or they can go thru the channels as you did with the numbers that are posted here.

Schnauzer Time,

Draminine or Bonnie may help the dizziness, emetrol may help the naseau also benadryl helps the dizziness and zaps but don't think you are having those. It may also help with sleep.

Your period brings on hormonal changes which makes PMS and lexapro withdrawal 100 times worse. Give it a few days and you should feel better. Drink bottled water with fresh lemon squeezed into it to help you detox. Take a hot 20 minute bath/soak in two cups epsom salts and a bottle of hydrogen peroxide in the water to help relax you and also help detox. You will get better............it most likely is withdrawals and side effects of reinstating. Try and stop worrying.

Go out and get Dr. Bach's Flower Essence in Rescue Remedy and Cherry Plum and take it as directed on the bottle for the next 4 days........this will get you thru the crisis. Does the body Calm help you?

I am not a doctor, so please research what you have read and check with your physician. Can anyone see you to possibly doe the P 450 genetic testing? Most insurances pay for this and it may provide answers. I know Dr. Black would help your physician interpert the results also.

[humboldtdan]

I actually quit paxil cold turkey back then, then started on lexapro, so needless to say it was hell.

I have a question, if you are on Lexapro, and it is so hard to get off of, and I know it is, I tried, and even with a 6 week taper I ended up back on it. Anyways, would it make sense, to switch to prozac, which is said to be the easiest ssri to kick, take that for a bit, then taper off of that. That way you avoid the lexapro withdrawal by using prozac as a replacement. Any thoughts? Also how does prozac work for anxiety?

[SchnauzerTime]

Going from 10mg to 7.5 may be too fast. You will have to see in the next week or 2 if you come out of withdrawals and stabilize. It is BEST to do not more than a 10 percent taper each time from your CURRENT dose. Normally, people do best on 5 to 10 percent tapers.

So if you start at 7.5mg , 10 percent of that is .75mg which is subtracted from 7.5mg so you get 6.75mg. So 10 percent of your CURRENT dose of 7.5mg would be 6.75mg for your next taper. Only taper every 2 to 3 weeks or until you stabilize and all your withdrawals have gone away. Do NOT taper if you are still having withdrawals. The best way is to get liquid Lexapro so you can get EXACT dosages. Pill splitting does not work because when you get down to smaller dosages in the 2mg mark or 1mg marks it is impossible to do without it being liquid.

Then your next taper after 6.75mg would be 10 percent of that dose.

Going from 10mg to 7.5 is more than 10 percent...but usually the withdrawals aren't too bad until the lower levels so you may be o.k. Just watch it and if the withdrawals don't go away in 2 weeks at the most then reinstate back up to at least 9mg until you stabilize then start the 10 percent tapers.

Good luck.

[SchnauzerTime]

If you switch to ANYTHING off your Lexapro you will more than likely get withdrawals...so even if you do switch to Prozac you will still have withdrawals and since it is like stopping cold turkey it will probably not be pleasant. I have actually thought of that myself...switching to something that would be easier to get off of. But what would happen is it would still be taking the Lexapro out of your system all at once and would essentially be like stopping cold turkey...even though you are adding another SSRI into your system. You would have side effects from starting the other SSRI in addition to Lexapro withdrawal also. It's not just Lexapro that is hard to quit...ALL the SSRI meds have bad withdrawals if you stop them cold turkey. If you want to get off them altogether the best thing would be to do the 10 percent tapering off of the Lexapro you are on since your body is already used to that medicine.

I'm not a doctor and this is only my opinion.

[SchnauzerTime]

I am already feeling a tad better tonight it seems. I am eating a little more and being able to sit up some. I will try the bath and the Bach Flower Essence...can I get that at any drugstore?

Also, why do you think I may need a P450 test? I don't think I'm a slow metabolizer like Kimber's hubby. When I reinstate doses I don't get really sick...I just get the normal side effects for a couple days.

And I'll try to quit worrying . You've been a HUGE help to me and I really really appreciate it.

Oh and yes the Body Calm seems to help...I'm not having anxiety really but I do get jittery , shaky sensations through all this and today I took regular Body Calm throughout the day about every 4 to 5 hours. It REALLY helped alot...tonight to sleep I'm going to take 2 of the Body Calm Supremes.

[JBS]

thank you to Schnauzertime for your reply about tapering.
Just to know that someone out there cares feels like I am not taking this scary journey alone. I will ask my doctor about Liquid Lexapro as she has not mentioned this in the past. I thought I had to go from 10 to 7.5 to 5, but now I see that I can do a slower taper. Even though I want this drug out of my system asap, I don't want to suffer along the way.
Thanks again!
JBS

[tavee]

Schnauzer- Can U Tell Me What Body Calm U Are Taking For The Anxiety??

Can I Get A Number Cuz That Site Is Confusing???

I Know It Is The Bach Essence But Which One Is It??


Thanks
Tavee

[kimberoo]

Aunty

Today was much better. He took the 15 mg and never took a Klonopin!! We even went to Walmart and he stayed with me for the whole 30 minutes! Of course, he did have on sunglasses, a hat and looked at the floor the whole time.....all he needed was a trench coat and he could've passed for a flasher! He still has some effects but nothing like the past 4 days!!

I know, I was totally surprised that he called me back. I was expecting a call from his associate. What an amazing person. I thanked him for his research and let him know that his work is helping so many people. My husband couldn't believe it either. He used the same word as you, compassionate, to describe him. I must say, today was a GOOD day! I was so excited and couldn't wait to let you know how everything went, I felt like I was bringing home a report card with all A's !

I will email the info to you and you use it accordingly. I'm glad that I hesitated on that one! I had to research it with your cues. The most important thing is to understand what you're talking about before you make that phone call, if you don't have a good general idea of the concept any information that is given to you will make no sense. Thank you for your kind words, you & Catherine have helped me so much, I can't take full credit for anything that has transpired. Without your guidance and her expertise I would be so lost right now. I've learned more in the past 2 months than I've known in the 13 years of his antidepressant use. Your words about the anxiety gave Benny peace, he thanks you too!! God Bless!!

SchnauzerTime

I didn't think that you blamed me, I just didn't want you to think that I was talking about anyone in particular other than myself. You have absolutely nothing to apologize to me about. I love to read your posts and follow your recovery. You have had the kindest words for so many people, including myself, so don't come down so hard on yourself.....you're already a helper. I'm hoping to help people at this point through following our experiences and my research (that seems to be all that I do anymore). Someday I hope that I too can be of more assistance, but until my husband gets through this "abnormal" withdrawal, unfortunately for Aunty, I'll be hanging onto her every word. That is why most of my posts are directly to her. As for the Withdrawal & Recovery...I signed up I think on a Wednesday and Catherine answers the list on Thursdays ONLY. The site allows her to post responses only one time a week. Therefore, for me I got a response rather quickly. If you joined on a Friday or Saturday, you will have to wait until Thursday to see a response. Most importantly though, did you post an introduction of yourself on the site? Catherine needs an introduction with all, and I mean ALL information that you can give her. Doses, dates, how you felt at a certain dose, EVERYTHING!! She wants a lot of information because otherwise she may have to ask you menial questions that are really just a waste of her time and yours. Be thorough, believe me she doesn't mind. If you haven't posted an introduction yet then maybe that is why you haven't heard anything. She needs to know you before she can address your problems. She is blunt and to the point with her responses, but not in a bad way, she makes you understand what you are doing wrong and what you need to do in order to fix your situation. I had written her probably a 1000 word post and she wrote me back in one sentence exactly what needed to be done and why.....it worked too! And....she's funny as heck. I told her that I was sorry for driving her nuts and she told that I was too late for that :-) Aunty is right, Catherine has much experience and she is quick to resolve issues. The forum is different from here and takes getting used to, but if you need help with it, just post me lol!!

Goodnight All!

Kimberoo

[kimberoo]

Aunty

I sent the webmaster a message to notify you that I need to contact you via email. I requested to either send it via them or to notify you with my email so that you could send me one that I could reply to. That way I don't have to ask for your email here, otherwise you may have 700,000 new messages lol!!! However you want to handle it is fine with me. Thanks!

Kimberoo

[auntybiotic]

Tavee,

Body Calm and Body Calm Supreme are from THE ROAD BACK, they are NOT Bach Flower Essences. They are for anxiety and sleep issues. They can be ordered from THE ROAD BACK and the link is a page or two back under one of my posts.

Schnauser Time,

You are welcome. I thought possibly that when you said you were becoming more dizzy after reinstating and feeling terrible that possibly you were having issues being a slow metabolizer that's why I recommended the P 450 testing but if not, no need for it.
I am so proud of your recent posts, you have learned SO MUCH and your advice to others is so precise and helpful...................I know it must be difficult to share your knowledge when you are still feeling bad.........WOW GOOD JOB!!

I am sure your recent steps backward is due to your your period. My daughter is expecting hers in a day or two and she has been SO IRRITABLE and GROUCHY!!

Kimbertoo,

You are becoming an expert!!! That's great........... when I am too busy to answer posts you will have all the information to help others! You are right without knowledge of the P 450 cytochrome system....it will be like Dr. Black was speaking a foreign language.

Tell Benny that his anxiety, in my opinion, is like a post tramautic stress reaction, God only knows the stress he has been under thru this ordeal. When he becomes stable and tapers properly........Benny will be on here doing the posts and sharing his recovery with others.

Tell Benny I am very intuitive and I know he will be feeling better in about two months! Of couse he will have improvements up till then but will notice a great improvement in a few months.

You both are a great team......................with you as a advocate..........he is so lucky. I know you will not sleep until you understand this entire SSRI thing. Seriously purchase Dr. Anne Blake Tracy's Book...............it is eye opening and written so any lay person can understand......................it is a MUST HAVE!!!!

She also has a series of tapes called HELP I CAN"T GET OFF MY ANTIDEPRESSANTS. I had a copy but they are so scratched up from my failure to put them back into the CD case, that I cannot listen to them anymore. Every fifth word is audible!! They are GREAT ALSO!

My best wishes to you both. Benny, remember the POWER OF POSITIVE THINKING. Everyday repeat that "I will feel better today and safely taper off of lexapro with little or no withdrawals".. Say this a hundred time a day. It may sound silly but the subconscious mind will heal you.

Remember Benny.....write it on your bathroom mirror........"I will feel better today and safely taper off lexapro with little or no withdrawals !" It will work!!! Trust Me!!!!

Benny if you can pick up some CD's on Ebay on The power of the Subconscious mind and Positive Reinforcements...............and listen to them right before bed...........I think you will experience a noticible improvement.

Remeber Smile even if you do not have a reason to and after smiling several times thruout the day......................YOU WILL FEEL HAPPY...............the mind is amazing!!! Benny that is your homework.......Listen to these type of CD or cassette tapes for the next month!! The body will do whatever the mind instructs it to..................so you BENNY are going to tell your body that you will be calm and peaceful because you are on the road to recovery!!!!

[HelpMe58]

Aunty,
What is the normal time period for withdrawal to begin after getting off Lexapro and how long does it last? In your experience what are the normal withdrawal symptoms?
HelpMe

[butchy yost]

after stopping lexapro cold turkey and suffering insane emotional withdrawl I got back on to prozac and feel much better, I was on prozac before the lex and didnt think it was doing much...stopped with no problems...waited a while and then tried the lex...and then HELL.

almost as soon as I took the first prozac I started feeling much better, have been back on for 3 weeks and feel 100% better...so I would definitely recommend that switch for anyone who wants to try getting off the lex...dont go cold turkey!! its not worth it, trust me...

[carolleah]

Hi! I am new to joining this forum but have been reading posts for almost four months. It has been amazingly helpful to read what others have been going through since I too have suffered as many have here with bizarre and debilitating withdrawals. I would not have been able to cope without this forum. I feel like I am part of a family here trying to struggle for wellness. The encouragement, kindness and support in this forum is overwhelming. I plan on telling my story in my next post, so I too can contribute and possibly be a part of it all. Thank you all for being such wonderful people. It truly has made a difference in my life.

[auntybiotic]

Are antidepressants taking the edge off love?
<
http://www.latimes. com/features/ health/la- he-antidepressan ts30jul30, 1,5710039. story?coll= la-headlines- health>

By Susan Brink
Los Angeles Times -- July 30, 2007

Sure, we know about the sexual side effects of SSRIs. But researchers now
wonder if that's the only aspect of romance the drugs can influence.

LOVE'S first rush is a private madness between two people, all-consuming
and, if mutually felt, endlessly wonderful.

Couples think about the other obsessively -- on a roller coaster of euphoria
when together, longing when apart.

"It's temporary insanity," says Helen Fisher, an evolutionary anthropologist
at Rutgers University.

Now, from her studies of the brains of lovers in the throes of the initial
tumble, Fisher has developed a controversial theory. She and her
collaborator, psychiatrist J. Anderson Thomson of the University of
Virginia, believe that Prozac, Zoloft, Paxil and other antidepressants alter
brain chemistry so as to blunt the intense cutting edge of new love.

Fisher and Thomson, who describe their theory in a chapter in the book,
"Evolutionary Cognitive Neuroscience, " aren't talking just about the
notorious ability of the drugs to damp sexual desire and performance,
although that, they believe, plays its part. They think the drugs also sap
the craving for a mate -- perhaps even the brain's very ability to fall in
love.

And that would be bad news, given the widespread use of antidepressants in
this country -- about 10% of adult women and 4% of adult men take the drugs,
according to a 2004 report by Centers for Disease Control and Prevention's
National Center for Health Statistics.

Though they still lack solid evidence that more Americans are having trouble
falling in love these days, the scientists do have animal and laboratory
science along with some human studies to whet their research appetites.

For one thing, there's brain chemistry. The chemicals involved in the
heart-pounding fall over the cliff into another's life, including dopamine,
norepinephrine and serotonin, are the very chemicals altered by many
anti-depressants.

Fisher cites animal studies showing, for example, that female prairie voles,
naturally loyal to one mate, lose interest in him when dopamine is
suppressed. The early human version of mate-pairing -- romantic love -- is
also associated with increased activity in dopamine pathways. And SSRI
antidepressants suppress that activity.

SSRIs are also known to curb obsessive thinking, the kind of focused state
that is central to the first blush of romance.

For both these reasons, Fisher suggests that SSRIs could jeopardize intense
romantic love.

There are few studies on the effects of antidepressants on aspects of love
beyond libido and sexual performance. But in an intriguing experiment, one
Canadian psychologist, Maryanne Fisher (no relation to Helen), reported
evidence in a small 2004 study of what she termed "courtship blunting" in
women taking antidepressants.

Asked to rate the attractiveness of men's faces, women taking the drugs
rated the men more negatively, and breezed through the pictures faster than
women not on antidepressants.

There is also anecdotal evidence -- and although such stories may be
anathema to hard science, they can provide the basis for research questions.
Thomson collects them.

A 20-year-old man who had been on antidepressants from the ages of 15 to 18
was reluctant to take them again, despite feeling depressed. "No one told
him about the sexual side effects. In retrospect, he realized he had the
sexual side effects and that might have contributed to his not dating,"
Thomson says.

Any drug that has sexual side effects, Thomson says, could well blunt other
chemicals the brain uses to intently focus on one person or to work up the
obsession necessary to fall in love in the first place.

Then there was the 42-year-old single woman who had not been on a date in
the eight years she had been taking an antidepressant. "She had not felt any
desire [to date] for at least that period of time," he says.

Jerry Frankel, a urologist from Plano, Texas, who's been married for more
than 40 years, was so conflicted about his experience on antidepressants he
wrote to a national newspaper.

"My usual enthusiasm for life was replaced by blandness," he wrote. "My
romantic feelings for my wife declined dramatically. " He was willing to risk
depression again in order to regain his old zest for romantic depth.

Fisher and Thomson's theory is new enough that many therapists say they've
never heard it discussed.

But Richard Tuch, psychoanalyst at the New Center for Psychoanalysis, says
he has long been concerned, especially for adolescents, that if
pharmaceuticals interfere with sexuality, they may also be interfering with
a basic system that teens require to learn about the opposite sex. Still,
he's cautious about sounding an alarm. "Antidepressants can save a person's
life," he says.

Mental health experts like him already fear that, with recent publicity
about suicidal risks in adolescents taking antidepressants, people whose
lives could be improved or even saved with medications won't take them.
Prescriptions for antidepressants for people 18 and younger fell by 20%
since the Food and Drug Administration issued a warning in March 2004 that
the drugs may increase the risk of suicide, according to research published
in the Sept. 2, 2005, issue of Psychiatric News.

If people think the drugs will hamper their ability to find Mr. or Ms.
Right, psychiatrists say, even more might avoid the potentially life-saving
medications.

Fisher doesn't quarrel with the drugs' benefits for many with chronic,
severe depression. But she worries about people who take the drugs to get
through a break-up, a death or a job loss, then keep taking them.

"I'm concerned about well-adjusted men and women who go through a crisis and
start taking antidepressants, " she says. "They continue taking them, not
realizing they may be suppressing these other systems."

Physicians, she says, aren't asking enough of the right questions when they
ask their patients about side effects. Lack of awareness of a potentially
troubling side effect -- becoming blase about romance -- is reminiscent of
the years immediately after the first SSRI, Prozac, was approved in 1988.

At that time, reports were that only about 6% of patients suffered sexual
side effects, but the low rate is now understood to have resulted because
doctors failed to ask questions about sex and patients were reluctant to
bring it up. A later analysis put that figure at about 30%, and a 2001 study
at as high as 73%. It is one of the top reasons that people stop taking the
drugs.

Doctors may be getting savvier about warning patients about the potential
for sexual side effects. But most probably are not asking patients if they
feel a blunted drive to search for love.

So far, there is no evidence that a dulling of romantic interest is a
universal antidepressant side effect. And when it does appear in people who
need the drugs to live and function, doses might be adjusted, or medications
changed, Fisher says.

Some scientists dismiss Fisher and Thomson's theory. "Antidepressants tend
to tone down the emotions. But they don't interfere with the ability to fall
in love. No," says Otto Kernberg, director of the Personality Disorders
Institute at the New York Presbyterian Hospital and author of six books on
love.

But Tuch says the theory is challenging. "I think it's a call to the
psychiatric community to study this. She's raised the question. Now it's our
responsibility to look into it," he says.

Until more is known, Thomson has some suggestions for people on
antidepressants.

"Regularly ask, 'Do I still need to be on them?' If you're having sexual
side effects, ask if everything is being done to mitigate them, because
those responses might also be linked to unconscious romantic desires.

"And ask yourself, 'How is this affecting my relationships? ' "



__._,_.___

[auntybiotic]

It usually takes about 7 days after stopping Lexapro to feel the withdrawal. They can last anywhere from 6 months to 18 depending on how fast you tapered off. The faster the taper the more intense and longer the withdrawal will last.

The typical withdrawals are Moodiness, Rage, Crying spells, Inability to sleep, Anxiety, Nightmares, Stomach Cramping, Diziness, and Zaps if you tapered too quickly.

There are hundreds more in alist I have previously posted but these are the normal that almost everyone will experience. I one is taking another antidepressant such as Wellbutrin with the lexapro then the effects will be more subtle but withdrawls will still be there.