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Dr. Bob is Robert Hsiung, MD,
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Posted by mills on October 14, 2002, at 14:19:17
In reply to Re: dosing info » mills, posted by pharmrep on October 14, 2002, at 14:07:17
I used to be on Paxil (worked my way slowly up to 40 mg, and it was a perfect dose), and I weaned my way slowly off (auditory "swooshes" and all) several months ago; started on 10 mg of Lexapro 6 weeks ago; jumped to 20mg the second week, and stayed there for 4 weeks, and then went down to 15 mg one week ago
> > yes, i have had flu-ey symptoms for the last few weeks trying to find the right dose of lexapro; i am confident it is depression and not the flue; i think i went up to 20 mg too fast, and have gone down to 15, taking 10 in the morning and the other 5 in the evening; the jury is still out for me even after 6 full weeks on lexapro; my head fees dull and i feel disoriented somewhat; an hour to 3 hours after i take my morning dose, i feel depressed, and i know it is the lexapro; i am going to give it more time though, because it took Paxil a long time to level out my experience, actually much longer than the six weeks everyone says; i wish i knew more about the proper dosing of lexapro; i seem to be hearing some conflicting reports from people's experiences and information
> >
> ***** what was your dose and of which med before? 10mg is the starting dose, and if you go higher, go to 15mg 1st, 20mg is a big jump. if you have a very low tolerance to meds...(ie 10mg of paxil/prozac/celexa seemed strong to you) then try 5mg of lexapro 1st, wait a couple weeks, then see what adjustments are needed (if any)
>
>
Posted by pharmrep on October 14, 2002, at 16:01:01
In reply to Re: dosing info, posted by mills on October 14, 2002, at 14:19:17
*** why did you go to 20mg? you only gave 10mg 1 wk...it might be enough...if not, 15mg should be...if you can, try going back to 10mg and give it a fair chance (2 weeks) before going up. (the flu stuff might be from going to the higher dose so fast) good luck and keep us posted
Posted by mills on October 14, 2002, at 16:29:29
In reply to Re: dosing info » mills, posted by pharmrep on October 14, 2002, at 16:01:01
my reason for going to 20 mg is I badly need the full effect of whatever medication I am on, and the doctor recommended I increase my dosage to 20 mg; my reason for going back to 15 a week ago or so is the depressed/fluey feeling from the 20; I find it hard to believe that 10 is enough considering I needed 40 of Paxil, but if I continue to feel depressed from the 15 mg, I will definitely go down to 10; if I don't get a sense of Lexapro clearing up my head within another month, I'm going back to Paxil, sexual side effects and all (although I SURE don't want to)
> *** why did you go to 20mg? you only gave 10mg 1 wk...it might be enough...if not, 15mg should be...if you can, try going back to 10mg and give it a fair chance (2 weeks) before going up. (the flu stuff might be from going to the higher dose so fast) good luck and keep us posted
Posted by meow mary on October 14, 2002, at 19:03:40
In reply to Re: dosing info, posted by mills on October 14, 2002, at 16:29:29
I saw my doctor today. He said he's been getting a lot of disappointed responses from his patients who have been at 10mgs, and thinks there is a certain amount of "hype" about that dosage being effective--especially in the case of OCD where a higher dosage is usually required. He doubled my dosage, although he said it would be fine to start with 15 at first.
Posted by Caydi on October 14, 2002, at 20:35:15
In reply to Re: Anyone switched to Lexapro?, posted by mills on October 14, 2002, at 12:58:54
> My head is cloudy after 6 weeks on this stuff; is anyone else experiencing something like that? Seems like it is dulling my memory or something; i'll do things like go to the refrigerator to get a glass, or go to a room and forget why I went in, that sort of thing, and I feel thick-headed or something; hard to label the feeling really. Please let me know if anyone is having this same experience. It's pretty troubling.
i had a problem with that for a while too when i started on lexapro. i was taking it in the morning since it seemed that most people were having problems with insomnia and i already have a little trouble getting to sleep. but the lexapro made me kind of nauseous, sleepy, and gave me that same sort of dulled feeling, like i was just all doped up. so i started taking it just before i go to bed and all of those symptoms went away (or i guess i'm really just sleeping through it). so if you're taking them in the morning, try switching to night.
Posted by emmalie on October 14, 2002, at 20:35:58
In reply to Lexapro Dosing Info--My Doctor's Opinion, posted by meow mary on October 14, 2002, at 19:03:40
Lexapro was WAY too intense for me. I felt like a complete zombie, and sort of had this weird semi out of body experience this morning lying in bed at 4 am. I'm going back to Celexa tomorrow!
Posted by shakingoscar on October 15, 2002, at 1:21:41
In reply to Re: Lexapro Dosing Info--My Doctor's Opinion, posted by emmalie on October 14, 2002, at 20:35:58
Hi
I am also having problems finding the correct lexapro dose.I have been on lex for 7 weeks now and I have just gone up from 15mg to 20mg because my old symptoms have been returning.
Unfortunately 20mg feels really INTENSE and Im not sure if I can take it.
If I cant, I am going back to my trusty 60mg celexa again.
I also wish the dosing of this med was clearer to understand.
Cheers
Posted by shakingoscar on October 15, 2002, at 5:56:44
In reply to Anyone switched to Lexapro? « ggrrl, posted by Dr. Bob on June 11, 2002, at 7:52:48
Hi,
I have a question which has not been answered by any doctor I have visited.Has anyone actually been cured of Anxiety?
I have had this illness now for 2 years and am just wondering when it might go away.
When will I be able to drink coffee again without becoming a nervous wreck after just one single cup???
Im just looking for some hope that I might be free of this affliction some time soon!
Cheers
Posted by Abacus on October 15, 2002, at 9:02:42
In reply to Re: Anyone switched to Lexapro?, posted by Caydi on October 14, 2002, at 20:35:15
I, too, had that feeling, but like you I changed to taking the lex at night. Being a zombie when I am asleep is not a bad thing. :) I'm only at 5 mg. of lex (and 150 mg. of Wellbutrin once a day -- in the morning), but it seems to be enough for me. Things are looking so much better now -- especially since I've been able to sleep at night. (and last night -- no night sweats -- yay!)
Posted by mills on October 15, 2002, at 9:18:13
In reply to Re: Anyone switched to Lexapro?, posted by Caydi on October 14, 2002, at 20:35:15
now why didn't I think of that? thanks, caydi
> > My head is cloudy after 6 weeks on this stuff; is anyone else experiencing something like that? Seems like it is dulling my memory or something; i'll do things like go to the refrigerator to get a glass, or go to a room and forget why I went in, that sort of thing, and I feel thick-headed or something; hard to label the feeling really. Please let me know if anyone is having this same experience. It's pretty troubling.
>
> i had a problem with that for a while too when i started on lexapro. i was taking it in the morning since it seemed that most people were having problems with insomnia and i already have a little trouble getting to sleep. but the lexapro made me kind of nauseous, sleepy, and gave me that same sort of dulled feeling, like i was just all doped up. so i started taking it just before i go to bed and all of those symptoms went away (or i guess i'm really just sleeping through it). so if you're taking them in the morning, try switching to night.
Posted by maririp on October 15, 2002, at 9:23:25
In reply to ANXIETY - Anyone cured?, posted by shakingoscar on October 15, 2002, at 5:56:44
> Hi,
> I have a question which has not been answered by any doctor I have visited.
>
> Has anyone actually been cured of Anxiety?
>
> I have had this illness now for 2 years and am just wondering when it might go away.
>
> When will I be able to drink coffee again without becoming a nervous wreck after just one single cup???
>
> Im just looking for some hope that I might be free of this affliction some time soon!
>
> Cheers
>Hi. I had my first panic attack in 1989 and it was a long road..I can't answer you if there is a cure for it . I went through allot of therapy to try and over come it. I learned tips on how to deal with it. I can say that i have an easier time with it now because i have learned so much. It never goes completely away for me but i deal with it and it does get better. Coffee, chocolate any thing high in caffeine would send me through the roof. I still have xanax on hand but dont have to take it often. The more you learn about anxiety and how to deal with the symptoms as they come the easier it will get for you to get through the symptoms..fear is the worst. I think for me that learning to control my breathing was the key to limiting the severety of the attacks...good luck
Posted by maririp on October 15, 2002, at 9:41:59
In reply to Re: A question for Anxiety Ann, posted by ANXIETY ANN on October 14, 2002, at 10:10:00
> > Hi - I too suffer from anxiety/panic attacks. I have used benzo's only when needed, but find that instead of taking them I will often just avoid a situation (usually regarding traveling outside my comfort area.) Thus, I don't have panic or anxiety on a daily basis, but I have unnecesarily restricted my life and activities. Have you experience agoraphobia as well? If so, do you find that taking the benzo's on a daily basis helps you to do the things you would normally avoid?
> > Any experiences you can share would be appreciated.
> > Thanks
>
> *****
>
> Hi
>
> Unfortunately the dose of xanax that I was on did not keep me from avoiding going places I feel un comfortable about. Everytime I have to go somewhere, that dreaded feeling of anxiety hits me. I know how you feel, its been six years of this. With my therapist I am learning to plug along through all this. I'm hoping that Lexapro will help. Hang in therehi. I also went through agoraphobia. I wouldnt go outside my comfort zones either. My worst fear was driving in a car because thats where i had my fist full blown panic attack. Then one christmas I was taking my kids to get pictures made and I became so overwhelmed I had to go back home. I hated that. What I did to overcome it was set small goals for myself making it from one point to the next sayin ok I did that I got this far. I still get overwhelmed when i have to drive long distances but I refuse to give in to panic and limit my life. If I feel anxious I wont pull over, I turn up the radio and sing. I open windows and keep going and most of all I control my breathing. Keep at it. Set small goals and go further and further, its so satisfying to beat these feelings and limits.
GOOD LUCK
Posted by celesteloveage on October 15, 2002, at 13:33:26
In reply to Re: Lexapro treatment status at 4 weeks...., posted by emmalie on October 13, 2002, at 17:27:42
> It's day 4 for me on Lexapro.
>
> I was in a total zombie state for much of today (I take it in the morning when I wake up). I feel less anxious but it's at the expense of feeling TOTALLY out of it. Perhaps this will go away with time . . .It only took me two days to feel relief from my physical tension and excessive worry. I'd say within two weeks my depression had lifted considerably. For me Lexapro has brought back color to my life. Until I started this medication everything in life seemed gray, gloomy, and hopeless. What I am most amazed with is how quickly Lexapro started working at first I thought it was psychological but it wasn't. To go from a slow progression into depression and be able to come out of it that quickly for me really made me see how truly depressed I was...very scary! As for side effects... my libido has been definitely lowered which I don't like but I'd rather have that then the depression. Other then that I've really not noticed any other bothersome problems really only positive side effects like feeling refreshed upon waking in the morning. I really could just go on all day about Lexapro but I won't...not yet! I'm soooo glad to have my life back!
Posted by mills on October 15, 2002, at 13:55:33
In reply to Re: Lexapro treatment status at 4 weeks.... » emmalie, posted by celesteloveage on October 15, 2002, at 13:33:26
i hate you, celesteloveage; no, seriously, it's nice to hear some encouraging stories on this anxiety/depression ridden bulletin board; hope it lasts for you
.
>
> It only took me two days to feel relief from my physical tension and excessive worry. I'd say within two weeks my depression had lifted considerably. For me Lexapro has brought back color to my life. Until I started this medication everything in life seemed gray, gloomy, and hopeless. What I am most amazed with is how quickly Lexapro started working at first I thought it was psychological but it wasn't. To go from a slow progression into depression and be able to come out of it that quickly for me really made me see how truly depressed I was...very scary! As for side effects... my libido has been definitely lowered which I don't like but I'd rather have that then the depression. Other then that I've really not noticed any other bothersome problems really only positive side effects like feeling refreshed upon waking in the morning. I really could just go on all day about Lexapro but I won't...not yet! I'm soooo glad to have my life back!
>
Posted by discoduck on October 15, 2002, at 15:14:28
In reply to Anyone switched to Lexapro? « ggrrl, posted by Dr. Bob on June 11, 2002, at 7:52:48
I took l0 mg daily for two weeks and then drank four beers. I seemed totally out of control
and super-duper drunk. My typical motor skills
were severely affected. Anyone else have this
problem? Suggestions/advice?
Posted by Cletus2 on October 15, 2002, at 15:44:08
In reply to lexapro and alcohol, posted by discoduck on October 15, 2002, at 15:14:28
I currently take 25mg of Lexapro daily (about 3 weeks now) for OCD and have had no problems with alcohol. I had about four or five beers the other night and felt fine. In the past I took 100mg of Celexa (for about a year) and drank socially with no problems at all. However, each person reacts to these meds differently so if it causes problems for you, you probably need to cut down the drinking. You are fairly new on the drug so your body still may need some time to adjust. Good luck.
Posted by johnj on October 15, 2002, at 16:02:51
In reply to lexapro and alcohol, posted by discoduck on October 15, 2002, at 15:14:28
Stop drinking.
Posted by Milla on October 15, 2002, at 16:55:08
In reply to Re: Anyone switched to Lexapro? « ggrrl, posted by Ippopo on October 13, 2002, at 22:20:02
My doctor switched me to Lexapro from prozac almost a month ago. The first two days I experienced nausea, dizziness, and I felt disassociated from reality like nothing was real. I was in a very complient mood and it was like nothing seemed to matter including all that I care about deeply. I haven't taken Lexapro since then. I was diagnosed with depersonalization disorder with derealization traits. My illness is disassociative, so those with another illness may experience Lexapro differently and may have positive results.
I find that eating incredibly healthy, getting adequate sunshine and excercise combined with Cognitive Therapy and being attuned to who you are is far better for me than any pill that I've taken (and I have tried them all).
It should be encouraged that medication is not always necessary. Unless there is a severe chemical imbalance present, it is possible to succeed without medicine. Often individuals on medication don't have a chemical imbalance, and are just going through a hard time from a stressful and negative environment. It is true for those with post traumatic stress disorder and disassociative disorders to have a disfunction with the hippocampus but have a normal level of seratonin.
Regardless of severity of any illness, healing can be influenced for the better with Cognitive Therapy and taking good care of ones self by understanding what makes you happy and what triggers a negative response. Be attuned to who you are and what your body is telling you. No doctor can tell you better than what your own body and mind have to say.
Posted by ZeeZee on October 15, 2002, at 18:58:31
In reply to Re: A question for Anxiety Ann, posted by maririp on October 15, 2002, at 9:41:59
Thank you for your support. Over the course of the past 16 years since my first panic attack (although my anxiety disorder has been since childhood) I have done all that you've mentioned. I've had zillions of hours of therapy (am also a retired therapist) read all the books, listened to all the tapes, had biofeedback, learned "proper breathing", did the desensitizaion programs, pushed myself to take steps to keep expanding my "territory" - and yet here I am - back at square one. I have never gotten over the fear of the panic, although for very long periods of time have been much less fearful, I have never lost the fear of the fear completely. I plan on continuing to plug away however tiring this task appears. I am doubtful of any significant change without the right medication. The 5 yrs on MAOI's followed by another nearly 4 yrs symptom free were made possible by the medication. Within 3 weeks of starting the drug there was more improvement and return to normalcy than any small fleeting change noted as a result of many, many, many years of therapy. I wish all I had to do was apply what I have learned to be better, however it doesn't seem to be working that way for me. I am glad you have found success and hope you hold on to it.
Regards,
Lisa
Posted by Micki on October 15, 2002, at 20:31:32
In reply to Re: A question for Anxiety Ann » maririp, posted by ZeeZee on October 15, 2002, at 18:58:31
This press release was on a wire service today.
UCLA Neuroscientists Examining Biology of Learning Discover Distinct
Molecular Key to Overcoming FearATTENTION: Medical editorsLOS ANGELES, Oct. 15 (AScribe Newswire) - In a discovery with implications
for treatment of anxiety disorders, UCLA Neuropsychiatric Institute
investigators have identified a distinct molecular process in the brain
involved in overcoming fear. The findings will be published in the Oct. 15
edition of the Journal of Neuroscience.The study of how mice acquire, express and extinguish conditional fear shows
for the first time that L-type voltage-gated calcium channels (LVGCCs) - one
of hundreds of varieties of electrical switches found in brain cells - are
required to overcome fear but play no role in becoming fearful or expressing
fear. The findings suggest that it may be possible to identify the cells,
synapses and molecular pathways specific to extinguishing fear, and to the
treatment of human anxiety disorders.''Brain plasticity, or the ability of the central nervous system to modify
cellular connections, has long been recognized as a key component to
learning and memory,'' said Dr. Mark Barad, the UCLA Neuropsychiatric
Institute's Tennenbaum Family Center faculty scholar and an assistant
professor in-residence of psychiatry at the David Geffen School of Medicine
at UCLA. ''The discovery of a distinct molecular process in overcoming fear
bodes well for development of new drugs that can make psychotherapy, or talk
therapy, easier and more effective in treating anxiety disorders. More
broadly, the findings also suggest that distinct molecular processes may be
involved in the expression and treatment of other psychiatric disorders.''Both the acquisition and extinction of conditional fear are forms of active
learning. The acquisition of conditional fear requires a unique pairing of
an initially neutral conditional stimulus with an aversive unconditional
stimulus. In this research, the conditional stimulus was a tone and the
unconditional stimulus was a mild foot shock.Although extinction, the reduction of conditional responding after repeated
exposures to the conditional stimulus alone, might initially appear to be a
passive decay, or erasure of this association, many studies indicate that
extinction is new inhibitory learning, which leaves the original memory
intact.In examining this process, UCLA researchers used injections of two LVGCC
inhibitors - nifedipine and nimodipine - to test whether LVGCC activity is
required for the 1) acquisition, 2) expression and 3) extinction of
conditional fear. Results showed that blocking LVGCC activity had no effect
on the acquisition or expression of fear, but effectively prevented
extinction.The research was supported by a National Alliance for Research on
Schizophrenia and Depression Young Investigator Award, and by the Forest
Award of the West Coast College of Biological Psychiatry.Other investigators involved in the project were Chris Cain of the UCLA
Interdepartmental Program in Neuroscience and Ashley Blouin of the UCLA
Department of Psychiatry and Biobehavioral Sciences. Barad also is
affiliated with the UCLA Brain Research Institute.The Tennenbaum Family Center at the UCLA Neuropsychiatric Institute was
created earlier this year with a four-year, $1 million gift from Michael E.
and Suzanne Tennenbaum. Michael Tennenbaum is managing member of Tennenbaum
and Company, a private Los Angeles-based investment firm he founded in 1996.In addition to the faculty scholar program, the center is encouraging
research into brain plasticity by providing seed money to promising research
projects and offering graduate student and post-doctoral fellowship support.The UCLA Neuropsychiatric Institute is an interdisciplinary research and
education institute devoted to the understanding of complex human behavior,
including the genetic, biological, behavioral and sociocultural
underpinnings of normal behavior, and the causes and consequences of
neuropsychiatric disorders.Online Resources:- UCLA Neurospychiatric Institute: www.npi.ucla.edu/- UCLA Brain Research Institute: www.bri.ucla.edu/index.htm- David Geffen School of Medicine at UCLA: www.medsch.ucla.edu/- Journal of Neuroscience: www.jneurosci.org/-30-
Posted by ZeeZee on October 15, 2002, at 20:46:24
In reply to New anxiety research, posted by Micki on October 15, 2002, at 20:31:32
Fascinating! I'll be first in line to try it, if and when they actualize these findings into an anxiolytic. I'll cross my fingers, but won't hold my breath.
Posted by bonnie_ann on October 15, 2002, at 21:05:04
In reply to Lexapro Dosing Info--My Doctor's Opinion, posted by meow mary on October 14, 2002, at 19:03:40
Posted by Charles carter on October 15, 2002, at 22:06:05
In reply to Lexapro side-effects , posted by dr dave on August 28, 2002, at 3:15:33
The primary advancement with respect to Lexapro resides in its increased selectivity for serotonin reuptake (100 x greater) and its increased potency (2 x more potent) versus Celexa....NOT some quantum leap in tolerability.
I would argue that Celexa was already one of the better tolerated SSRI's, if not the best of the bunch, with respect to side effects across all patient types and dosages.
The discontinuation rates with Lexapro in clinical trials are comparable to placebo at the starting dose of 10mg. In the comprehensive database, the only adverse event that occurred greater than 10% versus placebo AT BOTH DOSES was nausea, which occurred at a rate of 15%. In addition to that, the drop-out rates during the clinical trials including all patients AT BOTH DOSES was 6% versus 2% on placebo. I would suggest that most prescribers would be ecstatic if 94% of their patients on SSRI therapy not only were responders,but did not discontinue due to adverse events.
Comparing PI to PI is not an apples-to-apples; however, reps and physicians still do it to identify trends. The three most commonly reported adverse events with Celexa were nausea (21%), somnolence (18%) and insomnia (15%). Lexapro checks in at 15%, 6% and 9% respectively.
Indeed, there may not be conclusive data to suggest that Lexapro is some great leap forward versus Celexa on tolerability; however, it's not too hard to make the case that Lexapro appears to be AT LEAST as well tolerated as what many consider to be the best tolerated SSRI in the class in Citalopram.
Finally, there certainly is data to suggest efficacy, increased potency and earlier onset of action with Lexapro versus Celexa. The fact that the s-isomer is twice as potent as its racemate and still has a side effect profile that compares favorably to ANY other SRI on the market is a leap forward in and of itself.
Respectfully,
Carter
Posted by pharmrep on October 15, 2002, at 22:30:31
In reply to Anyone know the half life of Lexapro? (nm), posted by bonnie_ann on October 15, 2002, at 21:05:04
celexa is 35 hrs...lexapro is 27-32 (most 1/2 lifes are measured in ranges now...dont know why)
why did you want to know?
Posted by pharmrep on October 15, 2002, at 22:38:58
In reply to Re: Anyone switched to Lexapro? « ggrrl, posted by Milla on October 15, 2002, at 16:55:08
> My doctor switched me to Lexapro from prozac almost a month ago. The first two days I experienced nausea, dizziness, and I felt disassociated from reality like nothing was real. I was in a very complient mood and it was like nothing seemed to matter including all that I care about deeply. I haven't taken Lexapro since then. I was diagnosed with depersonalization disorder with derealization traits. My illness is disassociative, so those with another illness may experience Lexapro differently and may have positive results.
> I find that eating incredibly healthy, getting adequate sunshine and excercise combined with Cognitive Therapy and being attuned to who you are is far better for me than any pill that I've taken (and I have tried them all).
> It should be encouraged that medication is not always necessary. Unless there is a severe chemical imbalance present, it is possible to succeed without medicine. Often individuals on medication don't have a chemical imbalance, and are just going through a hard time from a stressful and negative environment. It is true for those with post traumatic stress disorder and disassociative disorders to have a disfunction with the hippocampus but have a normal level of seratonin.
> Regardless of severity of any illness, healing can be influenced for the better with Cognitive Therapy and taking good care of ones self by understanding what makes you happy and what triggers a negative response. Be attuned to who you are and what your body is telling you. No doctor can tell you better than what your own body and mind have to say.
>
** your'e right...you probably know yourself better than anyone else...but you gave a new med in your body only 2 days... I have heard the same s/e you mentioned in dozens of people and doctors so far (many here on this site)...and after the 1st week or so... the same people said most of the s/e lessen to being barely noticeable. You might want to give yourself a "fair" trial of a couple weeks or so to give your body a chance to adjust to lexapro (or any new med for that matter)
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