David Bishop4 said:Hi everyone—I’m 22 years old. About two years ago, I was prescribed Paxil, primarily to manage panic attacks, but I stopped taking it after my very first pack because I didn't realize I was supposed to continue the course. Since then, things have been mostly manageable; if I felt a surge of anxiety, I’d just take some Xanax and everything would settle down. However, lately, I haven't been doing very well... I have some Lexapro at home that I tried taking for just a few days as a preventative measure, but it didn't sit right with me, so I stopped since I was feeling relatively okay at the time. To be clear, I actually attempted the Lexapro nearly a year ago. Yesterday, I took just a quarter of a pill after lunch (previously I had been taking it in the morning and it made me feel terrible), and I didn't experience horrible nausea until this morning. Today, I took another quarter. My plan is to gradually increase to half a tablet after about a week. I didn't reach out to my psychiatrist this time because she had originally prescribed this specific medication herself. Will these nauseous feelings eventually subside? Is it even possible for such a tiny dose to cause such intense side effects? Or should I just try to push through it? Please, I really need some advice... I have to head back to college in a month, and I am terrified of being in this state when classes start. I've already taken a full year off... help me please.
It is quite unclear whether you are currently taking Lexapro under medical supervision or if you are simply deciding to self-medicate. If you are acting on your own, you absolutely must notify your psychiatrist immediately; they need to guide you through the entire process and monitor how your body reacts to the medication. Looking back, you have made several significant errors—antidepressants aren't something you take "preventatively" as you suggest, but rather a medication intended to be taken for at least nine months to a year, or even longer, and tapering off must always be done gradually and methodically, never abruptly. And you should never deviate from the plan without a doctor's oversight.
The psychiatrist is the only one qualified to decide when it is appropriate for you to stop the medication, whether that occurs in one year or two.
Ultimately, the most dangerous thing you can do is stop an antidepressant the moment you notice the first sign of improvement—that is precisely when symptoms tend to relapse, often more severely than they were before treatment began.
With Lexapro, the standard approach is often starting with a quarter tablet for the first three or four days. After those initial days, you might move to half a tablet. You can certainly remain at a half-dose for longer if the side effects are intense. Then, you might transition from half to a quarter for another few days before finally moving to a full 10 mg tablet. At that point, you really ought to consult your psychiatrist to report how you feel on the 10 mg dose so they can determine if adjustments are necessary. You simply cannot play games with antidepressants; it isn't something to mess around with. Furthermore, it is generally advisable to supplement with B vitamins while on an antidepressant.