Quitting Lexapro - insomnia and scary thoughts

[candyapple]

Hello all. I hope someone can relate to what I'm going through or give me some sort of advice. I am going to call my doctor tomorrow for an appointment but I need to get this off my chest.

I had been on lexapro for 10 years (since I was 16), originally prescribed for panic attacks that seeemed to start out of the blue, although I've always been an anxious person. I stayed on the medication for this long bc of depression. I haven't had any major panic attacks in several years and I felt like my depression was better, so 3 months ago my doc said it was ok to start tapering off lexapro.

I reduced my dose gradually over the course of approximately 8 weeks but I still got withdrawal side effects, mostly severe nausea, chills and crying spells. Around week 8 my doctor had me quit lexapro altogether and take prozac 10mg for a week, and then quit that too.

Its been about 4 weeks since I've been completely off SSRIs and I've been having serious insomnia. At first I ignored it because I also had a bad cold for two weeks so I thought that could be the cause, but I still cannot sleep. I went two days without any sleep and the other days I have lay awake for up to 5 hours, tossing and turning. A lot of the time I feel like I'm halfway between consciousness and unconsciousness. When I finally fall asleep its for 2-4 hours and poor quality.

My general practice doctor gave me Ambien a few days ago and I was able to sleep with it but I am worried about dependence, I really don't want to take it. OTC sleep aids, warm baths, hypnosis/subliminal message stuff hasn't worked either. I am afraid that I would just be switching from an SSRI to a sleep aid and I don't want to do that.

Also when I can't fall asleep and I'm just lying here, I start to have strange thoughts. Like I will imagine I see a face on the wall, or hear a noise, or I will picture something violent and scary in my head like a car crash. This is really worrying me, I don't know if these thoughts are because I'm so tired, or if I am having them because I'm no longer on an SSRI. I'm worried that I'm "going crazy" or that I have a serious mental illness that means I need to get back on an SSRI forever. Again these thoughts are almost always at night, when I'm alone in bed. However I have had flashes of scary and/or violent thoughts during the daytime too. Like I will be doing the dishes or something mundane and then randomly picture myself falling off a cliff or something.

Sometimes I also feel like my body is full of energy, like negative energy, and I need to expend it. Like I can't sleep and I feel like I need to go run a few miles or scream really loud to get the energy out. I don't know if this is just anxiety bc it doesn't feel like any anxiety I remember having before. But again I've been on Lexapro since I was 16 so how can I remember?

I'm sorry this is so long, I just needed to vent. If anyone wants to share experiences of quitting SSRIs or has any input on whether my experiences are normal/typical then that would be helpful. Do these scary/strange thoughts sound like normal SSRI withdrawal or do I need to get back on Lexapro? Ugh.

[EclecticJoe]

A couple of options you may try are ADs that double as sleep aids: Trazadone and Remeron, which had anti anxiety properties for me. There are some downsides to Remeron, like wanting to eat the house, but you may at least consider it.

Some of the other TCAs help promote sleep too.

[insights]

Do these scary/strange thoughts sound like normal SSRI withdrawal or do I need to get back on Lexapro?

I suspect the scary thought have more to do with your insomnia than withdrawal. You could try Benadryl, a sedating antihistamine available over-the-counter. The effect tends to wear off after a few weeks, so you may need to switch to a sedative that doesn't have tolerance problems if the Benadryl fixed your problems. The antidepressant trazadone (Desyrl) would be a good choice as, unlike hypnotics such as Ambien, it doesn't reduce REM sleep, indeed often increases it. A lack of REM sleep can produce weird thoughts. At low doses - <100mg - trazodone doesn't have antidepressant properties.

If you still have scary thoughts after a few nights of good sleep then you may need to consider either returning to antidepressants or trying psychotherapy.

Ian