Lexapro Withdrawal????
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Lexapro Withdrawal????
| Sun, 03-13-2005 - 11:32am |
Has anyone ever had withdrawal symptoms when going off of lexapro or any other SSRI? I'm at the point where I'm only taking 10mg every other day but yesterday which should have been an off day I was forced to take one. My hands were ice cold and tingly so I took 10mg of lexapro and it went away within a couple of hours. Of course my dr (PA)

Sorry to hear this, Danielle. I lifted this from the AD board. Alot of talk about this very subject. When I went off Effexor XR, I experienced the flu like symptoms, an occ. electrical shock in my body & I cried almost constantly for 6 weeks. Bear in mind that we are all different & have different reactions. Let us know how you're doing. I hope it gets better very soon. (((hugs))) jan
Harvard Mental Health Letter
February 2001
Symptoms That Start When an Antidepressant Stops
Stopping a drug is not always easier than starting it. Antidepressants may cause uncomfortable, if transient, symptoms when patients quit taking them. Although these symptoms can reasonably be described as a withdrawal reaction, “discontinuation syndrome” is in some ways a preferable term. The word “withdrawal” has certain connotations that do not apply to antidepressants. For many people, it suggests addiction — craving, drug seeking, desire for a specific sensation, physical tolerance, and a need for higher doses to get the same desired effect. A complex pattern of behavior, along with physical symptoms, undermines the effort to relinquish an addictive drug. Patients taking antidepressants generally do not contend with these problems. They may be dependent on their medication, but only in the way that a person with hypertension is dependent on blood pressure medicine.
The three major classes of antidepressant drugs are tricyclics, including imipramine (Tofranil) and amitryptiline (Elavil); selective serotonin reuptake inhibitors (SSRIs) like fluoxetine (Prozac); and monoamine oxidase inhibitors like phenelzine (Nardil). Each has its own typical discontinuation syndrome.
Patients who stop taking tricyclic antidepressants may develop gastrointestinal symptoms, including appetite loss, nausea, vomiting, or diarrhea; flu-like symptoms such as a runny nose, sweating, muscle aches, or fever; and neuropsychiatric symptoms like tingling, restlessness, insomnia, dizziness, lightheadedness, anxiety, or agitation. These drugs are anticholinergic (they decrease the activity of the neurotransmitter acetylcholine), and a cholinergic rebound may account for some of these symptoms.
The symptoms of SSRI discontinuation (which are also precipitated by the discontinuation of clomipramine, a tricyclic drug with strong effects on serotonin) may include dizziness, trouble with balance or coordination, headaches, nausea, fatigue or lethargy, tingling, electric shock–like sensations, insomnia, and vivid dreams. Less common reactions are gastrointestinal discomfort and flu-like symptoms. Sometimes there are also mood changes — irritability, sadness, anxiety, agitation, and crying spells. The SSRI discontinuation syndrome may be due to a sudden decrease in the availability of serotonin in the space between neurons along with changes in the sensitivity of serotonin nerve receptors. The neurotransmitters dopamine, norepinephrine, and gamma-aminobutyric acid (GABA) may also be involved.
The SSRIs most likely to cause these symptoms are the ones that leave the body rapidly — paroxetine (Paxil) and fluvoxamine (Luvox). Fluoxetine and its major breakdown product remain in the body for a long time, so it is less likely to cause this problem. One way to help a patient who is having trouble stopping one of the shorter-acting SSRIs is to switch to fluoxetine and then gradually lower the dose. Sertraline (Zoloft) and citalopram (Celexa) persist in the body longer than paroxetine and not so long as fluoxetine; they create a moderate risk of discontinuation symptoms.
Monoamine oxidase inhibitors can produce the potentially most disturbing discontinuation effects. In some ways they resemble stimulants like amphetamine, and abrupt discontinuation may cause reactions that resemble amphetamine withdrawal — anxiety, agitation, sleeplessness, and sometimes a psychosis with hallucinations or paranoid ideas. The more dramatic symptoms are unlikely to occur if the dose is reduced gradually.
Some newer antidepressants belong to none of the three major categories. Venlafaxine (Effexor), with a mixture of serotonin and norepinephrine effects, is eliminated from the body fairly quickly and therefore often causes a discontinuation syndrome which may be quite severe. Discontinuation symptoms similar to those caused by tricyclics and SSRIs have been reported by patients taking trazodone (Desyrel), nefazodone (Serzone), and mirtazapine (Remeron).
Because the discontinuation syndromes may include emotional states like depression and anxiety, they are sometimes confused with a relapse or recurrence of the original illness. The best way to tell the difference is to wait for a while. The discontinuation symptoms will almost always disappear within several days or a few weeks.
The symptoms that develop when patients stop taking antidepressants are rarely, if ever, dangerous, but they can be distressing. Patients should be informed about the subject, since a significant number of them (perhaps a third) stop taking antidepressants on their own in the first month of treatment. That information may guide the process of discontinuation, helping patients to tolerate any mild symptoms that emerge as the dose is gradually reduced and avoid interruptions in work or other activities. Unfortunately, many physicians are unfamiliar with these syndromes. In one recent study, more than 25% of psychiatrists and almost 75% of general practitioners responding to a questionnaire were not aware of the problem. With better education and preparation and active management, patients and doctors will be able to avoid many of the discomforts of antidepressant discontinuation.
—Michael Craig Miller, M.D.
Hugs & Prayers,
Danielle
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Hope tomorrow as well--- take care Judy