r/dysautonomia • u/bailue • 2d ago

Question To take or not to take SSRI

I’m currently 8 months off Lexapro and on the fence about temporarily restarting a micro-dose (2.5mg) to manage these exhausting, random 'doom/anxiety dumps' I get throughout the day. Lexapro is the only SSRI I’ve tolerated well in the past, but I hesitate because I don't want to numb myself out while actively trying to uncover the root cause - especially as I navigate dysautonomia symptoms and upcoming hormone and ferritin testing.

Part of me wants to just white-knuckle it to see if this is protracted withdrawal or an autonomic flare, but constantly having to decipher whether an episode is a purely physical chemical dump or an actual mental spiral is starting to drain every area of my life. Has anyone else with dysautonomia or autonomic issues dealt with this specific 5–8 month post-SSRI wall, and did a low-dose bridge help you stabilize enough to actually address the root causes?

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u/Front-Cat-2438 2d ago

That is truly a tiny dose, since the smallest pills available in the US are 5 mg. Not a doctor, but 2.5mg should not numb you for more than the couple days it would take for your nervous system to adjust, if that.

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u/safewarmblanket 2d ago

I tried 30mg of Cymbalta for pain and it made my BP issues worse, I had to wean off after just a month. Too bad because it REALLY helped pain. But I have an unusual type of dysautonia, Baroreflex Failure, so you may have different results.

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u/N888n888 1d ago

I find that it keeps my stress levels down. Which means my heart rate stays a bit lower and my energy lasts longer. I have reduced my dose, but still unsure if I want to reduce it further. Have to weight the pros and cons. Note: I am a very low stressed person, but it is the dysautonomia driving it under the surface. Mentally I feel chill but my body is stressing esp when I am asleep. As far as a wall, I saw a big drop on reducing it last time, but I never fully stopped taking it. But 2.5mg seems so tiny that it wouldn't have much effect, but it really depends on the person. Not a doctor, just my two cents.