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Dr. Bob is Robert Hsiung, MD,
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Posted by yeltom on October 3, 2002, at 18:03:58
In reply to Re: Paxil to Lexapro--Let's see, salvation or sex??, posted by mills on October 3, 2002, at 17:06:25
I still say try a lower dose. You never gave 10 mg much chance or 15 mg any chance. It is possible to take too much
Posted by JLM on October 3, 2002, at 18:10:48
In reply to Re: Logic and evidence » pharmrep, posted by dr dave on October 3, 2002, at 2:53:09
>
> I wonder if you could let us know what the evidence is that r-cit 'can attach to receptor sites not allowing the s-cit to attach, therefore inhibiting metabolization'. The only relevant site with respect to SSRI activity is the serotonin re-uptake transporter, and r-cit has only 1/30th the affinity for it that s-cit has, not enough to significantly compete. I am also not sure why s-cit would have to be bound to a receptor to be metabolised, or what receptor that would be. It sounds like you've seen some important new data, and would be very grateful for details.
>
>
> > ** hi there...there are studies that show r-cit doesnt work...(sanchez study). the r-cit can attach to receptor sites not allowing the s-cit to attach, therefore inhibiting metabolization.
> > ps...i dont know where this 4-to-1 ratio thing is coming from...its not forest. Lexapro is twice at potent as celexa (or any other AD). so yes..10mg lexapro is at least as efficacious as 40mg of celexa. does this mean 15mg=60 or 20mg=80? not necessarily...the math seems that way, but patients so far dont always need more...i know of many 80mg celexa pts doing fine on 10mg lexapro, (or higher doses fo prozac, paxil, zoloft, effexor as well)
>
>
I'd like to see this evidence as well.The silence seems deafening thou, doesn't it? ;)
Posted by cody on October 3, 2002, at 18:15:21
In reply to Re: lexapro 10mg, posted by kinikia on October 3, 2002, at 15:15:11
> I'm glad to hear you're feeling less depressed. I started 5mg on Monday and I am totally depressed, but that started on Sunday. I would also be interested to know when I should start to feel better. Don't know if it's the lexapro but I am definitely feeling more anxious. It never really stops. Took some xanax but it doesn't really help so I just have to take more. I used to take half of a .25mg xanax and be fine, now no amount seems to help. I'm getting quite despondent. If anyone has anything positive to say about lexapro or anything, It would definitely be appreciated. Thanks,
> - kinikia
>
>
> > This is my first time on anti-depressants. I took 5 mg for 2 days and then went to 10mg which I have been taking for 5 days now. Prior to the Lexapro I was taking sleeping pills. I hoped that the lexapro would eliminate the sleeping pills. I take the dosage at 5pm and I don't get sleepy. I still have to take my sleeping pill. Does lexapro increase insomnia? On a brighter note, I was more depressed the first couple of days but now I feel much less depressed.
>
>
I know what you mean about the anxiety. This is my third day. First two were fine (think I still had some Remeron in my system). Had a really hard time sleeping last night. This morning I woke up really wired. Been taking ativan all day. It seems to help some, but I can really tell when it's wearing off. Is Lexapro supposed to help anxiety (my main problem)? I really don't want to be popping ativan all day. Has the Lex helped anyone with anxiety problems? Please let me know.
Posted by yeltom on October 3, 2002, at 19:46:53
In reply to Paxil to Lexapro--Let's see, salvation or sex??, posted by mills on October 3, 2002, at 15:49:53
Have you read the ealier part of this thread dealing with shakingoscar's post, "I take 30 mg of Lexapro." It appears that his doctor didn't know what s/he was doing and had prescribed too much. He tried 10 mg and felt a million times better. Take a look
> So far (one month) on Lexapro, and I am disappointed, but it wasn't until literally after the sixth full week on Paxil that I started feeling less depressed/disoriented (demenitia-like symptoms [anyone else ever experience that? god, i hope so for my sake, hope not for yours)] ocd/panicky/generally angst ridden/socially anxious (let's see, did I cover them all? yep); Paxil saved my life; it was hell getting on, and hell getting off, but while on it, it literally gave me hope to live, especially with the thick-headed/demenitia/inability to focus-concentrate symptoms; the sexual side effects, however, were so bad that I had to try to get off and find something else; I got on Luvox for awhile, until Lexapro came on the market; I was on 10 mg for a week, and was chronically depressed, so, went up to 20, and have been at 20 for 3 more weeks; so far, i've got a chronic medium grade depression, with the other things still hanging on, including the weird thick-headed sense, or like a distortion in my perception (see, that's one of my problems, not being able to identify/articulate what's wrong); oh well, this is my story, and I'm sticking to it; anyone relate? should I hang with Lexapro or go back to Paxil?
Posted by corrina on October 3, 2002, at 20:33:05
In reply to Re: lexapro 10mg, posted by cody on October 3, 2002, at 18:15:21
this is Day 4 on the lexapro and I have to say I was still a little dizzy today but my feeling sick to my stomach has halted and Dont feel as dizzy as yesterday, I also notice that im doing things a bit slower then I use to, if this is the way im gonna be feeling without the dizziness Im really gonna like these meds, it has me more relaxed and not rush, rush like I am use to doing.
Corrina
Posted by samenewme on October 3, 2002, at 21:56:35
In reply to Re: about insomnia side effect » pharmrep, posted by .tabi.T.ha. on August 3, 2002, at 3:28:08
I just saw this. I'm on 30 mg. Remeron and 20 mg. Celexa. Yes, I'm one of the special people who are wakeful on as little as 30 mg. Remeron. Ambien doesn't work for me.
I take 3 mg of melatonin at night for sleep and it helps a bit. Sometimes I have to stack it with Sonata.
I used to take 1000 mg L-Tryptophan for sleep when I was on nortriptylene, but because I'm on an SSRI now we're avoiding it. Your doctor may be willing to discuss this with you (it's still available by prescription from compounding pharmacies).
> Hi pharmrep,
>
> Saw the note about Phil's combo, can't resist asking a question. For me Celexa is activating and causes insomnia. I take 10mg in the morning, and can't sleep at all unless I take something sedating at night. For now the sedating med is neurontin, but even with that I'm awake til 3am. Do you know of any better way to deal with the insomnia side effect from celexa?
>
> Also, how does lexapro compare on insomnia? Sorry if you've answered this elsewhere, I didn't read the entire thread.
>
> -Tabitha
Posted by pharmrep on October 3, 2002, at 23:46:53
In reply to Pharmrep: A Week On Lexapro..., posted by Alice Anne on October 3, 2002, at 12:38:59
> Hello Pharmrep, I've managed a week now at 10 mgs. Lexapro. I started at 2.5 for a week and then went to 5 for a few days. Most of the side effects (queasiness, muscle tension-- although I'm still a little spacey feeling) are dissipating, but my depression is not. My question for you is when do the anti-depressant, anxiety effects "usually" kick in? Thanks for the info.
** 1-2 wks is the response time for most, but that time starts with the 10mg...so you have 1 wk it sounds like...even then, a fair trial would be 1 month. hang in there and keep us posted.
Posted by pharmrep on October 3, 2002, at 23:51:46
In reply to pharmrep, posted by Phil on October 3, 2002, at 12:56:20
> Does your company offer chemist a huge bonus if they can cure the sexual SE or do they really believe their numbers?
> I'm at 15 mg and my unit only does one function..it ain't the fun one. I'll wager at least 50% will run into this. Too bad, pretty good drug otherwise.** sorry bro...it is a class effect...it seems paxil is the worst, then prozac/zoloft/celexa in descending order...I dont think 9% is accurate since it is derived from "volunteered" info...i dont think 50% is right either...even paxil is around 35%...Lex will probably be somewhere in the teens.
Posted by pharmrep on October 4, 2002, at 0:00:03
In reply to Re: pharmrep: Three weeks on Lexapro, posted by nmk on October 3, 2002, at 13:29:24
> This is my 3rd week of 10 mg Lexapro and the nausea has not let up. I am also weaning off Effexor xr (am down to 16 mg) simultaneously so I don't know which is the culprit. If it is the Lex, shouldn't the s/e's have lessened at this point. I don't want to give up so soon on this but I am losing weight fast. Please help.
** with 2 AD's in your system...I'm not surprised. Is this your idea or you Dr's? There would still be a serotonergic effect in your body with the addition of Lexapro so as to lessen the effexor discontinuation effects. Can you stop the Effexor completely now?..you will do much better on just Lexapro.
Posted by pharmrep on October 4, 2002, at 0:02:08
In reply to Re: lexapro 10mg, posted by kathyj on October 3, 2002, at 13:49:12
> This is my first time on anti-depressants. I took 5 mg for 2 days and then went to 10mg which I have been taking for 5 days now. Prior to the Lexapro I was taking sleeping pills. I hoped that the lexapro would eliminate the sleeping pills. I take the dosage at 5pm and I don't get sleepy. I still have to take my sleeping pill. Does lexapro increase insomnia? On a brighter note, I was more depressed the first couple of days but now I feel much less depressed.
* glad to hear its working...i would suggest taking it in the morning so as to avoid the possibility of insomnia (occurred at 9% in studies)
Posted by pharmrep on October 4, 2002, at 0:07:30
In reply to Paxil to Lexapro--Let's see, salvation or sex??, posted by mills on October 3, 2002, at 15:49:53
> So far (one month) on Lexapro, and I am disappointed, but it wasn't until literally after the sixth full week on Paxil that I started feeling less depressed/disoriented (demenitia-like symptoms [anyone else ever experience that? god, i hope so for my sake, hope not for yours)] ocd/panicky/generally angst ridden/socially anxious (let's see, did I cover them all? yep); Paxil saved my life; it was hell getting on, and hell getting off, but while on it, it literally gave me hope to live, especially with the thick-headed/demenitia/inability to focus-concentrate symptoms; the sexual side effects, however, were so bad that I had to try to get off and find something else; I got on Luvox for awhile, until Lexapro came on the market; I was on 10 mg for a week, and was chronically depressed, so, went up to 20, and have been at 20 for 3 more weeks; so far, i've got a chronic medium grade depression, with the other things still hanging on, including the weird thick-headed sense, or like a distortion in my perception (see, that's one of my problems, not being able to identify/articulate what's wrong); oh well, this is my story, and I'm sticking to it; anyone relate? should I hang with Lexapro or go back to Paxil?
** of course im biased, but i would still stay on lexapro...fewer s/e, less sexual s/e, no drug to drug interactions w/ lex...many with paxil, lower protein binding w/ lexapro, and lexapro isnt associated with the discontinuation problems you mentioned you had with paxil. (lex costs less too) there are other benefits...but these are the obvious ones.
Posted by pharmrep on October 4, 2002, at 0:14:31
In reply to Re: lexapro 10mg, posted by cody on October 3, 2002, at 18:15:21
****** yes, lexapro will help with anxiety...within 2 wks or so for most to notice a difference.
> > I'm glad to hear you're feeling less depressed. I started 5mg on Monday and I am totally depressed, but that started on Sunday. I would also be interested to know when I should start to feel better. Don't know if it's the lexapro but I am definitely feeling more anxious. It never really stops. Took some xanax but it doesn't really help so I just have to take more. I used to take half of a .25mg xanax and be fine, now no amount seems to help. I'm getting quite despondent. If anyone has anything positive to say about lexapro or anything, It would definitely be appreciated. Thanks,
> > - kinikia
> >
> >
> > > This is my first time on anti-depressants. I took 5 mg for 2 days and then went to 10mg which I have been taking for 5 days now. Prior to the Lexapro I was taking sleeping pills. I hoped that the lexapro would eliminate the sleeping pills. I take the dosage at 5pm and I don't get sleepy. I still have to take my sleeping pill. Does lexapro increase insomnia? On a brighter note, I was more depressed the first couple of days but now I feel much less depressed.
> >
> >
> I know what you mean about the anxiety. This is my third day. First two were fine (think I still had some Remeron in my system). Had a really hard time sleeping last night. This morning I woke up really wired. Been taking ativan all day. It seems to help some, but I can really tell when it's wearing off. Is Lexapro supposed to help anxiety (my main problem)? I really don't want to be popping ativan all day. Has the Lex helped anyone with anxiety problems? Please let me know.
>
Posted by pharmrep on October 4, 2002, at 0:19:46
In reply to Re: about insomnia side effect, posted by samenewme on October 3, 2002, at 21:56:35
> I just saw this. I'm on 30 mg. Remeron and 20 mg. Celexa. Yes, I'm one of the special people who are wakeful on as little as 30 mg. Remeron. Ambien doesn't work for me.
>
> I take 3 mg of melatonin at night for sleep and it helps a bit. Sometimes I have to stack it with Sonata.
>
> I used to take 1000 mg L-Tryptophan for sleep when I was on nortriptylene, but because I'm on an SSRI now we're avoiding it. Your doctor may be willing to discuss this with you (it's still available by prescription from compounding pharmacies).
>
> > Hi pharmrep,
> >
> > Saw the note about Phil's combo, can't resist asking a question. For me Celexa is activating and causes insomnia. I take 10mg in the morning, and can't sleep at all unless I take something sedating at night. For now the sedating med is neurontin, but even with that I'm awake til 3am. Do you know of any better way to deal with the insomnia side effect from celexa?
> >
> > Also, how does lexapro compare on insomnia? Sorry if you've answered this elsewhere, I didn't read the entire thread.
> >
> > -Tabitha
>
> *** tough call, celexa can cause both insomnia and somnolence...usually people are tired...you are doing the right thing in taking early in day, but you still stay up at night. Lexapro doesnt have the somnolence, but a little insomnia for some (9% in the studies...same suggestion...take in morning) When do you take the remeron?
Posted by shakingoscar on October 4, 2002, at 1:19:17
In reply to Re: Paxil to Lexapro--Let's see, salvation or sex? » mills, posted by yeltom on October 3, 2002, at 16:16:57
I agree totally that 20mg is too high a dose. I have come down from 30mg to 20mg (because my stupid doctor over-prescribed), but still, I feel 20mg is too high. I was on 60mg celexa which was fine.
BTW, I was on Paxil, and it was brilliant for anxiety/depression, but in my view celexa was much better in that it was ALMOST as good for the illness, but ten times better for the lack of side effects.
Good luck
Posted by shakingoscar on October 4, 2002, at 1:25:04
In reply to Re: Paxil to Lexapro--Let's see, salvation or sex?? » mills, posted by yeltom on October 3, 2002, at 19:46:53
Hi all,
Yes, I am dropping from 30MG lexapro, and each day I am feeling much MUCH better... This is my second day, and Ive dropped to 20mg (I took 10mg yesterday and felt really good) but I dont want to drop too suddenly, so I am taking 20mg for a few days before going down further.The point is, I felt TERRIBLE on too high a dose of lexapro, but am starting to feel great now the dose has dropped.
Also, and I dont wish to be crude, my orgasms have improved significantly the last two days (in fact, they work!!! WOW)
Good luck all
Posted by JLM on October 4, 2002, at 2:34:59
In reply to Re: about insomnia side effect/bottom » samenewme, posted by pharmrep on October 4, 2002, at 0:19:46
> > I just saw this. I'm on 30 mg. Remeron and 20 mg. Celexa. Yes, I'm one of the special people who are wakeful on as little as 30 mg. Remeron. Ambien doesn't work for me.
> >
> > I take 3 mg of melatonin at night for sleep and it helps a bit. Sometimes I have to stack it with Sonata.
> >
> > I used to take 1000 mg L-Tryptophan for sleep when I was on nortriptylene, but because I'm on an SSRI now we're avoiding it. Your doctor may be willing to discuss this with you (it's still available by prescription from compounding pharmacies).
> >
> > > Hi pharmrep,
> > >
> > > Saw the note about Phil's combo, can't resist asking a question. For me Celexa is activating and causes insomnia. I take 10mg in the morning, and can't sleep at all unless I take something sedating at night. For now the sedating med is neurontin, but even with that I'm awake til 3am. Do you know of any better way to deal with the insomnia side effect from celexa?
> > >
> > > Also, how does lexapro compare on insomnia? Sorry if you've answered this elsewhere, I didn't read the entire thread.
> > >
> > > -Tabitha
> >
> > *** tough call, celexa can cause both insomnia and somnolence...usually people are tired...you are doing the right thing in taking early in day, but you still stay up at night. Lexapro doesnt have the somnolence, but a little insomnia for some (9% in the studies...same suggestion...take in morning) When do you take the remeron?
Ummm, I think its a little premature to say conclusively that Lexapro doesn't cause somnolence, based upon limited clinical experience with it. Prozac didn't cause sexual side effects either, or akathisia for that matter. Hardy har har har ;)
You should disclaimer that statement with 'in our limited clinical experience'. Which, at this point, IS limited.
Posted by Phil on October 4, 2002, at 6:35:39
In reply to Re: schwing » Phil, posted by pharmrep on October 3, 2002, at 23:51:46
Oh, what a lucky man, he was...bummer.
I hope your #'s are right but as far as Paxil goes, I don't remember posts about it here w/o sexual S/E. Wonder if I could do an informal poll?
Thanks, pharmrep
Posted by JLM on October 4, 2002, at 7:10:35
In reply to Re: Lexapro side-effects, posted by dr. dave on June 19, 2002, at 4:41:27
>
> The research shows Lexapro has no significant benefit over Celexa in terms of side-effects. People taking Lexapro 20mg report side-effects at the same rate as those on Celexa 40mg (86%).
>
> In the same study more people stopped taking Lexapro 20mg because of side-effects than those taking Celexa 40mg (10.4% vs 8.8%), but this difference was not statistically significant.
>
> The reason for this is that Lexapro is to all intents and purposes the same thing as Celexa but re-branded and re-patented. There is no evidence of the R-citalopram component they have removed doing anything of significance pharmacologically. To understand this 'new' drug you have to understand that the patent on Celexa just ran out, but the manufacturers can effectively renew the patent by isolating the active component and re-branding it.
>
> See more at http://www.guardian.co.uk/Archive/Article/0,4273,4434943,00.html
>
> The critical comments in the article are mine.Dr. Dave,
I've been meaning to ask you this. What do you think of David Healy's work? What about Teicher, Cole, or Glenmullen?
Its interesting to note that Teicher claimed in the patent for r-fluoxetine 'Pure R(-) fluoxetine functions as an effective antidepressant with a shorter half life and shorter duration of action than the racemic mixture or the S(+) isomer of fluoxetine. Having a shorter half life and shorter duration of action results in less accumulation of R(-) fluoxetine in a patient's body. This in turn results in decreased adverse effects including headaches, nervousness, anxiety, insomnia, inner restlessness (akathisia), nausea, diarrhea, drowsiness, decreased libido and/or sexual dysfunction, suicidal thoughts and self mutilation.'
Some of these things, namely suicide induced by akathisia, have been vehemently denied by Lilly, Glaxo, and damn near everyone else that makes AD's, and its my understanding that they even tried to discredit Teichers earlier work on akathisia. On the one hand they say he's nuts, and on the other hand they pay tens of millions for r-fluoxetine, which he helped develop. Maybe they are just bipolar or schizophrenic?
Some intellectual consistensy, and honesty about SE's would be nice for change from some of these folks. People need to KNOW what might happen to them, in terms of risks vs. benefit. I have no doubt that these drugs do benefit some people, just as David Healy has no doubt. But its time that things are cleaned up a bit, and its time that GP's stop overprecribing psychoactive agents to people when they don't need them.
Posted by maririp on October 4, 2002, at 7:49:56
In reply to Re: Paxil to Lexapro--Let's see, salvation or sex?? » mills, posted by pharmrep on October 4, 2002, at 0:07:30
ggrrl...when i first started on lexapro i felt some of your symptoms for days...felt fuzzy headed like i was just going through the motions. The worst symptom i had was waking up feeling even more depressed for a few days. Give it some time because within a week i was feeling so much better. I was on paxil for a long time as well and it wasnt worth the sexual side effects for me or the night sweats. Give lexapro a chance, i know how hard it is to wait it out.
Posted by mills on October 4, 2002, at 9:15:18
In reply to Re: schwing » pharmrep, posted by Phil on October 4, 2002, at 6:35:39
appreciate the responses; i fully intend to give lexapro more time, but it is just discouraging, you know, to have something that worked so well for me, even with the side effects, and this not work as well; maybe it will, and I'll probably lower the dose if this fluey/depressed feeling doesn't subside
Posted by Stacey69 on October 4, 2002, at 9:29:49
In reply to Re: Anyone switched to Lexapro? « ggrrl, posted by norml on September 30, 2002, at 20:40:51
Everyone here seems to be ripping on Lexapro. Many of you who are doing so are simply looking at the statistics and are not on it yourselves to really know the difference. I have panic disorder/mild depression, and I had been on Celexa for 7 or 8 months before switching to Lexapro. (10 mg.) I am also on 15 mg. of Buspirone, and I found myself unable to function with this combination due to the extreme drowsiness I experienced. Since making the switch (prescribed from my psychiatrist) I am now able to get up and do productive things around the house, visit friends, and hold a job, without sleeping until 4:00 or 5:00 in the afternoon. I also have a very strong sex drive, which is supposedly "not typical" for being on an SSRI. All of this after only 1 month on Lexapro. 5 or 10 mg. of Lexapro should be sufficient in treatment, possibly along with another medication. The reason I say this is because, 20 mg. of Lexapro IS a higher dose, and if you're taking a higher dose of any medication, you're almost always going to experience unwanted side effects. Most people on a typical dose will experience the minimum. All in all, it depends on the person's weight and body chemistry, everyone will respond to a drug differently. But don't be so skeptical of every new medication to hit the market. If it will help you get better, it's worth a try!!
Posted by kathyj on October 4, 2002, at 11:25:16
In reply to Re: about insomnia side effect, posted by samenewme on October 3, 2002, at 21:56:35
I am a chonic insomnia sufferfor the last 8 months, since my depression began.I suffered without any a/d medication for all of those months. I have been taking lexapro for one week and find that I still cannot sleep without the Restoril 30 mg. I tried one night without the restoril and I was up until 5am. Is the Lexapro increasing my insomnia?
Posted by kathyj on October 4, 2002, at 11:31:54
In reply to Re: lexapro 10mg » kathyj, posted by pharmrep on October 4, 2002, at 0:02:08
> > This is my first time on anti-depressants. I took 5 mg for 2 days and then went to 10mg which I have been taking for 5 days now. Prior to the Lexapro I was taking sleeping pills. I hoped that the lexapro would eliminate the sleeping pills. I take the dosage at 5pm and I don't get sleepy. I still have to take my sleeping pill. Does lexapro increase insomnia? On a brighter note, I was more depressed the first couple of days but now I feel much less depressed.
>
> * glad to hear its working...i would suggest taking it in the morning so as to avoid the possibility of insomnia (occurred at 9% in studies)I staret taking it in the mornig tomorrow so as not to miss my dose today. I'll keep you informed.
kj
Posted by Ippopo on October 4, 2002, at 12:28:48
In reply to Pharmrep: A Week On Lexapro..., posted by Alice Anne on October 3, 2002, at 12:38:59
> Hello Pharmrep, I've managed a week now at 10 mgs. Lexapro. I started at 2.5 for a week and then went to 5 for a few days. Most of the side effects (queasiness, muscle tension-- although I'm still a little spacey feeling) are dissipating, but my depression is not. My question for you is when do the anti-depressant, anxiety effects "usually" kick in? Thanks for the info.
Hi Alice, I'm glad you posted. I've been going through the same thing but because of all the hype Lexapro has recieved my Dr doesn't believe I still have symptoms after 2 wks. Within the past week I've called and also went to see him to ask when I'll stop crying. He just tells me to give it time...he'll see me in a month. In the mean time I've slashed up my arms(I'm a cutter) and am in process of losing my job because of poor performance. Please keep me posted as to your recovery. Best wishes!
Ippopo
Posted by maririp on October 4, 2002, at 13:10:20
In reply to Re: Pharmrep: A Week On Lexapro..., posted by Ippopo on October 4, 2002, at 12:28:48
Ippopo...are you takin any other meds besides lexapro? for those who have been taking sleeping pills too..i can imagine that trying to just stop is not the way..why not cut the dose on the sleeping meds? Id also consider another doctor. I would not go to a doctor that dismisses my feelings and tells me to return in a month..he should help you with other alternative meds or a stradegy plan.
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