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- Sat Sep 13, 2008 9:35 am
I'm a 30 yo, male and I've been experiencing some Lexapro withdrawals and am concerned about being short of breath the last two days. Not sure if it's just anxiety or what. I've been dealing with GAD for the last 11 years, so I'm well versed in anxiety and panic attacks. I'm giving some history here, so bare with me.
I've been on and off anti-depressants for ten years. At diagnosis (1999), I was put on Celexa and Buspar. I'd prefer not to take these drugs, so I'll be on them for a while and then stop because of how they make me feel and the fact that it really just addresses the symptoms and not the root cause. A year earlier I was diagnosed with Acid Reflux/Gurd with some h. pylori and went through the regiment of high dose antibiotics. I took Prilosec OTC for years until recently due to it maybe being linked to heart issues and have been getting by on Pepcid Complete chewables as needed.
In 2006, I was going through some wicked panic attacks and my PCP tried to put me on Cymbalta. I refused to take it after reading about it. We compromised on Lexapro and it actually did wonders for my anxiety, but not so much for my weight. I have gained 30 pounds in the last couple years.
In 2005, I had a stress test due to complaints of chest tightness. After I was done, I was sitting there recouperating (I'm a big guy, 6'4" 330 pounds) and the nurse starts going into emergency mode. Well, here I am, sweating like a pig, but otherwise feeling fine and within 20 seconds, there were 12 doctors and nurses packed into a tiny stress test room. They thought I was in Vtach. After 4 days of hospitalization and numerous tests (echo, angio, EP study, blood work) they concluded it was an electrical issue, no heart attack or Vtach - it was PSVTs and was told it was benign, I had nothing to worry about. They put me on Toprol XL - 25mg to control the PVCs which caused the tach. One notable about that whole experience. My BP was always good, like 110/70...until I had that EP study done, when I came out it was high and has been every since. Granted, I've only had it check when I'm at the cardio (and I'm not much for doctors offices - white coat syndrome, lol) and it has been running like 130/88. The cardio doesn't seem concerned as '90' is the magic number and even then, it has to be constant. I chalk it up to some doctor's office anxiety too. Weight gain from the two drugs (30 lbs) is helping either. The nurse told me last time, lose that 30 pounds and you'll see the difference.
So, I've been on both the Toprol and the Lexapro (I can't remember the dose, but it was nothing obscene, I *think* it was around 10 or 20mg) since 2006. I was okay at first, but the longer I was on these two, the more and mroe I felt....well, like a slug. I became more and more lethargic and withdrawn. It got to the point where I didn't want to do anything or even leave the house.
I started doing some reseach a couple months ago about these two drugs. Turns out other people were experiencing the same thing and feeling the same way I was. I always felt like I was being...dragged down...like I was just carrying 50 pounds on my back. Everything was an effort.
About 2007, the pharm (via my insurance) switched me over to the generic Toprol (metro-soemthing er other)...this is when all the lethargy and whatnot really started.
I did a little experiment. First, I started cutting the Toprol in half, taking 12.5. My cardio said it was such a low dose, even if I just quit it, it wouldn't have any effects on me (I was asking if I needed to carry a script, just in case I was travelling and they lost my luggage or something like that). He said if I did have to stop taking it, that a couple days of weaning off and I'd be fine. So I figured that just cutting back wasn't going to hurt (I see him in a month or two for an annual visit). Within a week I noticed my energy levels were increased and I generally felt better. I stated cutting back about two months or so ago.
Next was the lexapro. I started cutting those in half too and was doing okay with only mild anxiety occasionally (I can control them pretty well, I'm a veteran at these things now). I was taking the half dose for about a month or so and just stopped when I ran out on Labor Day weekend.
I was fine for the first week, but this past week, I started having the classic withdrawal symptoms. At first, I didn't really know what was going on. I had the cold shivers and sweats, shakiness. I didn't think too much of it as it only lasted a few hours and then subsided. But then the dizziness and wooziness started. On Tuesday I felt in other world almost. I couldn't even turn my eyes in my head without feeling woozy. I had some waves of nausea, but never got sick. I did a little house cleaning and was okay while doing so (didn't feel like I was gonna pass out, just a little woozy)...it wasnt' until after I sat down that I felt bad. After a couple hours the dizziness subsided.
Today, it's not too bad, still a little woozy (it's still early though!) but I know have been having shortness of breath the last two days. Especially when sleeping. It's really affecting my ability to sleep and be comfortable. I even had a dream last night that I was being intubated.
Basically, what happens is, as soon as I start to get into a deeper sleep, I wake up, gasping for breath and palps, so I've not really been able to get past that 'light sleep.' I also have spasms in my right leg (I've also been dealing with a gout issue in my right foot this week too). I noticed they almost coorelate, of course, it could be coincidence. My leg will spasm (starts in calf and shoots up leg) which then wakes me up, taking a gasp and having my heart pounding. Needless to say, this is not condusive to a good nights sleep.
Last night I tried sitting up when I went to bed. It was better, but not 100%, just not as bad gasping. I wasn't having the spasms in my leg. I thought I was actually going to get a decent nights sleep. Wrong. Sitting up while sleeping isnt' exactly comfortable, so about an hour in, I laid all the way down (with two pillows). That's when the spasms and gasping started again...and I didn't sleep well again.
Now, I am a web developer and have been working 15-16 hours a day on a website, sitting in this computer chair. I did some more house cleaning yesterday, for about two hours and legs felt good. I do try to get up every couple hours and stretch out, but that proves difficult, especially when time flies by, before I know it, it's been 3 hours. I think the chair is cutting into my hamstrings and causing the spasm issue. Also, along with the gout and my body tensing up for the pain that comes along with it. Oh, and I did take two Advil Wednesday and Thursday to help deal with the gout pain - which has susbsided, I didn't take any Advil last night.
I have had this shortness of breath issue before (the gasping when sleeping), but it's few and far between. The last time I had this issue was about two years ago and it only lasted a few days before subsiding. Maybe it's just allergies or stress, could just be the change of seasons.
I also have neuropraxia of the branch of nerves on my left collarbone. I forget their name. This causes tigthness in my jaw, shoulder and pains/tingling in my left arm and pinky/ring fingers. Sitting at a computer all day typing doesn't help either. If I turn my head to the right, from my jaw down to my elbow is all one big pull.
My question is, is this shortness of breath anxiety related because of the Lexapro withdrawal or is it possibly something else? I am under a lot of stress with this site and my financial well being is heavily tied to it. Is it because I'm coming off the Lexapro, couple with some other things? I'm comfortable it's not a heart issue (my big anxiety issue) since I was checked 7 ways to Sunday a couple years ago. Even cutting back on the beta blocker I don't have to take (and it's been about two months, I figure I would have seen symptoms before now). I knew that I would probably have some anxiety issues getting off the Lexapro, and breathing issues and anxiety go hand in hand. I haven't had a drink in a week, nor have I smoked marijuana (which I had been doing for years) for the past week and I have stopped for good. These were my two vices that kept me calm...even if the marijuana did cause some anxiety issues on its own. I havne't had any coughing really, but I feel like I have a tickle or 'dirt' in the back of my throat. I feel that little...knot of excitement, is what I call it, in my chest....typical for anxiety me thinks.
Maybe it's sleep apnea? I was supposed to have a sleep study done the same week as the last stress test, but didn't make it due to my little vacation in the hospital.
Should I be concerned about all this or just ride it out and chalk it up to the lexapro withdrawal? Wait and see? I'm not going back on it, going on three weeks now, so why start the cycle over? Maybe I bit off too much when quitting all my vices and the Lexapro at once? Should I just throw back a beer and try to relax some? I don't have an alcohol problem, I don't HAVE to drink, but it does relax me and I find my mood elevates if every few days I have a couple drinks.
Sorry for the long post, but when you go the doctor, I always feel rushed, like I have to spit everything out in 1 minute or less because they need to get onto the next person...maybe it's just been the doctors I've seen. I'm also trying to give a big picture instead of just saying, yeah, I have this problem, what is it.
| Dr. E. Seigle
- Sun Oct 12, 2008 8:49 pm
The issues that you present are certainly multiple and complex, but the following seems clear: your shortness of breath could be due to your heart, or to anxiety, or to withdrawal from the Lexapro. The serotonin discontinuation syndrome can last for quite a while. To be on the safe side, you might return to taking it at one-fourth of a tablet per day for 3 weeks, one-eighth tablet for three weeks, then stop. Also, I would consult your cardiologist or internist right away to make sure this isn't cardiac related. Finally, the shortness of breath being related to anxiety is also possible. Try these other things and see what happens; most important, being safe is the focus of my suggestions. Good luck!
-Eliot Seigle MD