more help

[alwaysanxious]

hello i posted a note earlier in the week about coming off meds, well this is my second week and 4 oclock this morning i woke up with pounding heart hot sweats and that electrical zaps in my head continuos, the feeling and sound in my ears and head is like that light saber from star wars to some people will laugh but thats the only way i can describe this feeling and electric shocks at same time. i cant go on tablets now its been 2 weeks without them but does any 1 know how long this scary feeling will last. its been a while scince i felt like this and i just want to be normal again i know its my brain reacting to the chemical thats not there now from the tablet but for gods sake i could have gotr out of bed and stuck my head in the oven its all in ur ears the sound drive u nutty ( pardon the expression) its so bad u cant run away from ur head can u or sounds in ur ears.. the racing heart and hot sweats i can handle but this brain zap thing it makes me rock backwards and forwards and cry please help or can some 1 send me advice about where i can look about withdrawel symtoms so i can understand bit more.
thanku desperately seekingh lisa x

[ElizabethJane]

Hi Lisa I withdrew from mirtazapine last year and the withdrawal was horrendous. It would help me to know what drug you were on previously? Did you taper slowly? ( that is what is recommended to minimalise withdrawal) Did you go 'cold turkey'? Different anti depressants have different half lives ie the time that a drug takes to leave the body. My worst withdrawals took about two to three weeks. If you can I would make an appointment for you to see your GP after the Bank Holiday. I hope you begin to feel better soon.

[happyone]

Hi there,
I had a little look back and I gather it is cipralex you are coming off? Like other posters have said, it is not really advisable to go cold turkey. I have done the same with a similar drug and it was not nice. Withdrawal should not be done without a doctors advice.
Happyone

[nomorepanic]

I replied to your other post and said it was a bad bad idea!

I am sorry you are suffering but you should never never go cold turkey on meds like that.

[alias_kev]

The common advice with Cipralex (Escitalopram) is to reduce the dosage in 5mg per day amounts AND to stay at each dosage for several days (atleast) or until you feel OK after atleast a few days. Even the manufacturer says in the Summary of Product Characteristics (http://emc.medicines.org.uk/medicine/9360/SPC/Cipralex++5%2c+10+and+20+mg+Film-Coated+Tablets+and+10+mg+ml+oral+drops%2c+solution ./#POSOLOGY) with my added emphasis:


Discontinuation symptoms seen when stopping treatment
Abrupt discontinuation should be avoided. When stopping treatment with escitalopram the dose should be gradually reduced over a period of at least one to two weeks in order to reduce the risk of discontinuation symptoms (see section 4.4 and 4.8). If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered. Subsequently, the physician may continue decreasing the dose, but at a more gradual rate.
and with my added emphasis
Discontinuation symptoms seen when stopping treatment
Discontinuation of SSRIs/SNRIs (particularly when abrupt) commonly leads to discontinuation symptoms. Dizziness, sensory disturbances (including paraesthesia and electric shock sensations), sleep disturbances (including insomnia and intense dreams), agitation or anxiety, nausea and/or vomiting, tremor, confusion, sweating, headache, diarrhoea, palpitations, emotional instability, irritability, and visual disturbances are the most commonly reported reactions. Generally these events are mild to moderate and are self-limiting, however, in some patients they may be severe and/or prolonged. It is therefore advised that when escitalopram treatment is no longer required, gradual discontinuation by dose tapering should be carried out (see section 4.2 and 4.4).
As nomorepanic said before its unfortunate that you (or your GP) has gone down this rapid cold turkey route. Even ignoring your (our) original illnesses underlying all of this expecting the brain and mind to cope with huge sudden changes in seratonin function is pretty harsh! I've included the above partly as reminder that you could/should ask for some tablets to taper off with (even now) and as a flag to anyone reading this thread later.

If your symptoms persist I really would suggest getting some more and slowly reducing the dose. That means over days or weeks.

From my reading Escitalopram is perhaps one of the kinder medications during withdrawal and even its manufacturer says taper 1-2 weeks or longer. The only times it would be appropriate to go faster would be due to other adverse reactions to the medication - usually during the early doses - or where other medications supporting the seratonin cycle are in use.

I myself am just dropping rather fast off of Esc' as my GP was loath to give me more since the PCT in Southend have written telling him that he must prescribe citalopram instead as "its the same". I think the consensus here and on other forums is that there are big differences - atleast for some patients. Anyway I'm going onto Buspirone at the same time and that supports the other end of the seratonin cycle - so far most symptom changes have been improvements/natural except for some unusual headaches and periods of poor coordination. I've got a thread on this.

[alias_kev]

I should have said that a good way to understand any uk medication is to go to: Electronic Medicines Compendium (http://emc.medicines.org.uk/default.aspx) and type the brand or generic name into the search box at the top. This will give you a search for two document types:

PIL = Patient Information Leaflet. This is like you get in the packet.

SPC = Summary of Product Characteristics. This usually has more detail and uses far more medical jargon and terminology. It also has the best info (sometimes) as Doctors and Pharmacists need to know this.
The search will give you a list of available documents. These will open in either a normal web document (HTML) or in Adobe Reader (PDF).

The other thing is not to allow the details to scare you - especially health anxiety sufferers - these days the UK PILs tell you all about rare side effects as well as common ones. Pay special attention to the frequency of the side effects, this is how common they are ranging from very common to rare. There is also often a list of unproven and presumably rare symptoms that have been correctly or incorrectly linked to treatments.

On dosage there may be different information for different conditions and its important to find the one most closely related to your illness(es).

In practice a well informed patient can know more about what's in those leaflets than many GPs. Its quite common to hear of GPs leaving people on an initial dose (which is expected to rise in most patients) or dosing at strange levels.