Reducing from 20mg to 10mg - help!
Posted , 4 users are following.
I've been taking 10mg of escitalopram for over a year now. During that time i had to start taking steriods. Everything fine for the first 6 months, tablets side by side then disaster! Felt awful and almost suicidal! Hospital dropped steriods down thinking it was those and gp increased escitalopram at the same time up to 20mg. I felt much better but now again feel terrible. I really feel like the piggy in the middle caught between hospital consultant and Gp. Anyway i have made a decision, i need to go back to 10mg escitalopram for starters and thats where you helpful people come in!! Having only been on the increase (10 to20mg) for 6 weeks how should i make the reduction, can it be done quickly or again a much slower route. Maybe I should tackle a drop to 15mg first, how do i do that?
Any help/advice would be great. Thank you
0 likes, 15 replies
matts4912 Sooboo
Posted
Going down, then back up and then back down again will have caused a lot more sensitivity to your system, so you must absolutely go slow here - more than you would have done in the first instance.
In order to drop to 15mg, you will need to get pills of the right dose. They do come in 15mg or you can get 10mg and split on in half to get the 5mg.
Sooboo matts4912
Posted
thanks for that matts4912 any idea of how i should go about the reduction?
matts4912 Sooboo
Posted
Just re-read your message and just realised you didn't go down first, and that you have just gone up to 20mg and now need to go back to 10mg having stopped the steroids.
Steroids are known to exacerbate depression in those prone to having episodes, so I think your GO was wrong to increase the dose - stopping the steroids would have made sufficient difference. Even so, 6 weeks is enough to have made sufficient changes to your brain chemistry, so I would advise that you go to 15mg for at least 2 weeks, you may need a third week, but your body will tell you this.
Ideally we would drop by 2.5mg but this would mean breaking tablets into pieces that may have different amount of the med in them, so water titration would have to be used, which is too complex for this unless you are really sensitive. So, go with 15mg for 2 weeks and see how you feel.
Sooboo matts4912
Posted
thanks again Matts4912 I'll make drop down to 15mg from today. Big problem i have is i need the steriods because i have a lung condition and this is the treatment, i am still taking them as re my consultant just a lower dose. What ive been trying to do is desipher which tablets has caused the grieve....i now think it must be the steriods in which case i need to speak with the consultant and not the GP. THANKS
matts4912 Sooboo
Posted
What is the name of the steroids you are taking?
Sooboo matts4912
Posted
predisilone I was on 10mg but when i mentioned 'my head' they dropped to 7 1/2mg which means i take 2 x 5mg one day then 1 x 5mg the next day etc.
matts4912 Sooboo
Posted
This is known to exacerbate depressive symptoms. In tests as many as 50% have shown such effects. I also had the same when I took them. I would say it is almost certainly the steroids causing the issue here.
Sooboo matts4912
Posted
thanks again Matt. i totally agree with your thoughts on steriods.
i shall do the drop on escitalopram down to 15mg and possibly to 10mg then hopefully by the time i have done this my hospital appt will be due to discuss steriods with lung consultant mid February 2020.
Shall i do it like this? :
Monday 15mg
Tuesday 20mg
Wednes 20mg
Thurs 20mg
Friday 20mg
Satur 20mg
Sund20mg
Monday 15
Tuesd 15
Wed 20mg
Thur 20mg etc etc
or can i just do the whole week at 15mg and hold at that for say a month to see how i go before i drop further?
This has become such a difficult time, effecting marriage, friendship et al! I feel between Gp and consultant no one wants to take full responsibilty. You are helping more than either of them with you advice. THANK YOU SO MUCH for the time you have given me.
matts4912 Sooboo
Posted
No - this is not a good taper pattern. You need to keep it as level as possible. The closest thing you can do is 20mg day 1, 15mg day 2 for a couple of weeks, then 15mg for a couple of weeks, then 15mg day 1, 10mg day 2 for a couple of weeks etc. It has a relatively long half-life to do this, but the way you are suggesting, the system will be all over the place. This way is never the right way to taper, and the way I have described should only be done with anti-depressants that have a half-life of longer than 24 hours. If you feel the need, you can always put the brakes on at any of the above intervals. Escitalopram is usually OK until you get lower than 10mg, then things need to go slower. Listen to your body and it will tell you what needs to be done and when.
Professionals rarely want to take responsibility. A p-doc once ended me up in hospital due to an incorrect withdrawal, which is why I started learning myself. You never really know who to trust... but that said...
I am an admin on a long-standing withdrawal site, so please do not worry about credentials!! I have been helping people for a while now. My passion is in helping people get through these times with minimal problems.
Sooboo matts4912
Posted
so Matt once last time, lets see if ive got this right....
monday 20mg
tues 15mg
wed 15mg
thurs 15mg etc for 2 weeks
2 weeks at 15mg
monday 15mg
tues 10mg
wed10mg
thurs 10mg etc
then ill stick at 10mg which will put me back where i started 6weeks ago!
I'll then take on the consultant and steriods, lord only knows what the answer there will be but at least ive proved they are the tablets causing my problems. hopefully early in the new year i can let you know how the Ad reduction has gone, fingers crossed! Sue
matts4912 Sooboo
Posted
Apologies - I'm not being clear enough...
Weeks 1/2
Mon 15mg
Tue 20mg
Wed 15mg
Thur 20mg
Fri 15mg
Sat 20mg
Sun 15mg
Weeks 3/4
Mon-Sun 15mg
Weeks 5/6
Mon 10mg
Tues 15mg
Wed 10mg
Thur 15mg
Fri 10mg
Sat 15mg
Sun 10mg
Week 7 on
Mon-Sun 10mg
Sooboo matts4912
Posted
GOT IT! THANK YOU
Kittykitty Sooboo
Posted
hi do you have any advice on how to taper off from 10mg? i also dont trust GP advice.
thank you
kelly58470 Sooboo
Posted
Hi!
I'm I right in reading that you've only been on 20 mg for 6 weeks? If that's the case, instead of dropping back down to 10 mg (which it sounds like wasn't working for you any longer?), I would stick with the 20 mg for another six weeks. Otherwise, say you decrease to 10 mg and don't find any improvement. You're then faced with either bumping up again, or having to switch to something else altogether. It would be easier to just stick with the 20 mg another six weeks, see how you feel, and the decide what to do.
matts4912 kelly58470
Posted
Valid point, but if the op has been doing fine for 6 months prior to this stage, which happened to coincide with steriods, then I argue for a foregone conclusion. Too much Escitalopram will give its own issues - anxiety for one is a known issue of bumping up too high. This is why I have recommended that she stay put for longer than a week at each interval. If the depression was caused by a poop out, an increment of 5mg would wise rather than a increase of 100%.
But again, I do see your logic, and this may well be the case and dropping up and down is not a wise idea. A tough call, but again given the interaction between SSRI and steroids, I would favour the above.