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Dr. Bob is Robert Hsiung, MD,
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Posted by pharmrep on November 3, 2002, at 10:23:14
In reply to Re: differences in SSRI's/see bottom » pharmrep, posted by dr. justin on November 2, 2002, at 18:33:33
> pharmrep,
>
> I have 2 questions. 1) Has Lexapro been shown to have any advantages over Celexa where anxiety or SAD's are concerned?, and 2) It sounds from other posts that the sexual side-effects are similar; so, if that is your chief concern, is there any reason to switch from Celexa to Lexapro?
**** For some reasons to use Lexapro over Celexa (or other SSRI's) see the end of my post "sexual s/e" i sent to cannoli..Thank you.**** yes...Lexapro studies (Lydiard specifically) showed a statistically significant improvement in 2 weeks for treating anxiety (there is a placebo arm and a 40mg Celexa arm too).
Posted by johnj on November 3, 2002, at 10:37:34
In reply to Re: Does anyone notice they are never thirsty?, posted by Phyl on November 3, 2002, at 8:58:53
I have been on lexapro (2.5 mg) for a few days. I have a headache, hangover feeling and some very different anxious feelings I have never had before. Does anyone have this? and did it go away at a certain dose. I am starting low to titrate up slowly since I am med sensistive. I have depression with anxiety/GAD type symptoms. I am wondering if it would be best to jump to 5 or 10 mg and ride this feeling out(if it does go away), I started low so my body would adjust slowly. Thanks
johnj
Posted by Dkk1040 on November 3, 2002, at 11:52:24
In reply to Re: Does anyone notice they are never thirsty?, posted by Phyl on November 3, 2002, at 8:58:53
> I've always been a person who doesn't seem to need to drink water (I actually don't like it), but since I have been on Lexapro, I'm never thirsty at all. Even after having salty foods, like pizza or chili, I don't seem to have the need to drink water. Every morning, I need to drink 8 ounces of water with Fosomax and for the rest of the day, I never even think about taking in any liquid. At dinner, I sometimes take just a couple of small sips of wine and that's about it. Have any of you noticed this?
> I also have "Stephen King" type dreams very often.
>RE: Thirsty
On the contrary I am thirstier then when I was not taking anything.
The SSRI drugs can produce vivid dreams but may dissipate in the future
Posted by Dkk1040 on November 3, 2002, at 11:59:11
In reply to Hangover feeling.....strange anxious, posted by johnj on November 3, 2002, at 10:37:34
> I have been on lexapro (2.5 mg) for a few days. I have a headache, hangover feeling and some very different anxious feelings I have never had before. Does anyone have this? and did it go away at a certain dose. I am starting low to titrate up slowly since I am med sensistive. I have depression with anxiety/GAD type symptoms. I am wondering if it would be best to jump to 5 or 10 mg and ride this feeling out(if it does go away), I started low so my body would adjust slowly. Thanks
> johnjYou are on a very low dosage of Lexapro, you should consult with your physician about upping your dose so he or she can help you determine the correct dose or try something else.
This was from one of my previous posts:
I've switched to Lexapro from two years on Celexa. Celexa gave me dry mouth and headaches Lexapro does not! I am very very grateful for Lexapro and wouldn't want to live life without it.
To the people that post on the board, a question.... What is your life like without this drug, is it better or worse? Some of the SE I'd rather live with than live life without the replacement of the brain chemical I lack, namely seratonin. Of all the side effects people state on this board MOST are treatable, tolerable, and improve over time. Give it a chance! Some take weeks to months, NOT just one dosage, or a day, or a week. This is not a "make me feel better now" drug. Best wishes to everyone, and if this drug does NOT work for you please don't give up hope, but be persistent and try something else.
Posted by bridgette on November 3, 2002, at 12:35:39
In reply to Anyone switched to Lexapro? « ggrrl, posted by Dr. Bob on June 11, 2002, at 7:52:48
Has anyone ever tried Ritalin w/an SSRI to alleviate the sexual side effects. I read in a book that either of these Buspar, Gingko, Wellbutrin or Ritalin could alleviate the sexual problems. I zeroed in on Ritalin because I also have ADD.
Posted by Alan on November 3, 2002, at 16:07:42
In reply to New idea, posted by bridgette on November 3, 2002, at 12:35:39
To add perspective re: comparative statistics....
Differences in *individuals'* reactions to antidepressants are so big that it is difficult to state meaningful generalizations about the statistical difference between one drug and another.
In other words, an *individual's* reaction far outweighs the "statistical" response.
Posted by cannoli on November 3, 2002, at 16:58:32
In reply to New idea, posted by bridgette on November 3, 2002, at 12:35:39
> Has anyone ever tried Ritalin w/an SSRI to alleviate the sexual side effects. I read in a book that either of these Buspar, Gingko, Wellbutrin or Ritalin could alleviate the sexual problems. I zeroed in on Ritalin because I also have ADD.
I'm sorry to say my own experiences don't provide much reason for optimism. I nver tried Buspar, but I was on various SSRI/Wellbutrin combos and one SSRI/Ritalin combo, and also tried Gingko with SSRIs, and none of these combinations helped with the sexual side effects. Some of the combinations were good in other ways, but the sexual problems seemed to be inescapable as long as I was taking an SSRI.
Posted by ANXIETY ANN on November 3, 2002, at 17:57:39
In reply to Question for Pharmrep, posted by ANXIETY ANN on November 2, 2002, at 23:18:10
Pharmrep,
Glad your back, did you see my question earlier? Any suggestions?
Anxiety Ann
Posted by pharmrep on November 3, 2002, at 19:55:32
In reply to My Experience with Lexapro, posted by MarathonMom on November 2, 2002, at 21:01:13
> I have followed this message board for several weeks now and am ready to join in. I was diagnosed with major depression back in 2000 and was prescribed Prozac. That worked well, but then I got the bright idea to go off meds to see if I was really "cured." Big mistake. I crashed and burned within 2 months and at that point began taking Celexa.
>
> I found Celexa to be very effective in clearing the depression and negative thoughts. Things were going along fine and I felt great, but alas the sexual side effects creeped in. As if we haven't suffered enough, one of the few things that bring us pleasure is no longer fulfilling. To alleviate this my Dr. suggested a switch to Lexapro.
>
> I have been taking Lexapro for 2 weeks, and am quite disappointed with the results. I often feel blue, like I am sinking back underneath the surface. I am very tired and sweat much more as well. And the sexual side effects are still there.
>
> Judging from the comments on this post, many others are also experiencing disappointing results as well. I am seriously considering switching back to Celexa. I am questioning my rationale for changing in the first place.
>
> My questions:
>
> 1--Has anyone found an effective remedy to counter the sexual side effects?
>********* I often see Wellbutrin added in.
> 2--Has anyone switched back to Celexa? How long before you felt human again?
>********* Why did you switch to start with?
> 3--Does Lexapro take longer than 2 weeks to kick in?
********* it seems to work in 1-2 weeks for most, but a fair trial is 4-6 wks
Posted by pharmrep on November 3, 2002, at 20:28:29
In reply to Question for Pharmrep, posted by ANXIETY ANN on November 2, 2002, at 23:18:10
> Welcome Back!
> I've been on Lexapro for about a month now (10MG). I was prescribed it for GAD and Panic. My question is this: sometimes I have dizzy spells (usually in the evenings and mornings)and was wondering if the was a s/e of the Lexapro or just anxiety? It seems I may have had them before but it was kind of hard to tell because I had other symptoms of panic and anxiety as well. I also take Norvasc (5mg) for high Bp and adivan to help with the anxiety. What do you think? Thanks Ann
** Hi Ann...I have heard of the dizziness before...it seems this is not an uncommon s/e for a new drug in your body...particularly an AD (antidepressant)...nausea and headaches are also up there...but dizzinessis is not big on the Lexapro profile...the Dr's I have talked to about it said that it's normal to see this during "adjustment" period...and can go away in a couple weeks to a couple months....the norvasc and adivan shouldnt be a problem with Lex as it has a very clean "drug interaction" profile
Posted by sadie evans on November 3, 2002, at 20:42:07
In reply to Anyone switched to Lexapro? « ggrrl, posted by Dr. Bob on June 11, 2002, at 7:52:48
I started Lexapro a few days ago and started slowly. 2.5 mg for two days, now today 5 mg. After another day at 5, I will go up to 10. I have been hypersensitive to other SSRI's, but so far things have been better with Lexapro. Sweating and flushing has been a big problem, along with insomnia and fatigue and sometimes agitation. So far only insomnia with Lexapro, but I'm not up to a regular dose either. I did have a strange headache the first day, and a sort of dissociated feeling, but they both passed after just one day.
I will post about my response again later, after I've been on 10 mgs for a while. In spite of the insomnia I am still feeling refreshed in the morning and have a reasonable amount of energy. If the insomnia continues, I will probably end up on a sleep med in addition to the Lexapro, which has happened with other SSRI's.
So far I am pleased, and am hopeful I can manage to take a theraputic dose of this one.
> [Posted by ggrrl on June 11, 2002, at 1:19:51]
>
> > Seems like there are a lot of people on here who have talked about Lexapro's improved side-effects, specifically that it has less tiredness and sexual side effects than Celexa. Some have said that it has the same side effects as Celexa. However most people are quoting from press releases - does anyone here know from experience (theirs or others')?
>
>
Posted by pharmrep on November 3, 2002, at 20:42:46
In reply to Hangover feeling.....strange anxious, posted by johnj on November 3, 2002, at 10:37:34
> I have been on lexapro (2.5 mg) for a few days. I have a headache, hangover feeling and some very different anxious feelings I have never had before. Does anyone have this? and did it go away at a certain dose. I am starting low to titrate up slowly since I am med sensistive. I have depression with anxiety/GAD type symptoms. I am wondering if it would be best to jump to 5 or 10 mg and ride this feeling out(if it does go away), I started low so my body would adjust slowly. Thanks
> johnj*** 2.5mg is very low...but only you know your own sensitivity (compared to other drugs and doses)...the nausea/dizziness/headache s/e I see and hear occurs in the 1st week or so, and the same people say it goes away around the 2nd week or so...this was for people taking the normal 10mg starting dose. I have seen some people who tried lower doses have this too, and when it went away and they titrating up...it happened again for a few days...depending how bad it is for you...maybe "toughing it out" once is better...you will have to decide for yourself. good luck and keep us posted.
Posted by pharmrep on November 3, 2002, at 20:47:10
In reply to Re: Anyone switched to Lexapro? « ggrrl, posted by sadie evans on November 3, 2002, at 20:42:07
> I started Lexapro a few days ago and started slowly. 2.5 mg for two days, now today 5 mg. After another day at 5, I will go up to 10. I have been hypersensitive to other SSRI's, but so far things have been better with Lexapro. Sweating and flushing has been a big problem, along with insomnia and fatigue and sometimes agitation. So far only insomnia with Lexapro, but I'm not up to a regular dose either. I did have a strange headache the first day, and a sort of dissociated feeling, but they both passed after just one day.
>
> I will post about my response again later, after I've been on 10 mgs for a while. In spite of the insomnia I am still feeling refreshed in the morning and have a reasonable amount of energy. If the insomnia continues, I will probably end up on a sleep med in addition to the Lexapro, which has happened with other SSRI's.
>
> So far I am pleased, and am hopeful I can manage to take a theraputic dose of this one.
>
>
>
*** glad to hear its working for you....if you arent already...try taking it in the morning to avoid the insomnia you have...good luck and keep us posted
Posted by Alan on November 3, 2002, at 20:59:06
In reply to Hangover feeling.....strange anxious, posted by johnj on November 3, 2002, at 10:37:34
> I have been on lexapro (2.5 mg) for a few days. I have a headache, hangover feeling and some very different anxious feelings I have never had before. Does anyone have this? and did it go away at a certain dose. I am starting low to titrate up slowly since I am med sensistive. I have depression with anxiety/GAD type symptoms. I am wondering if it would be best to jump to 5 or 10 mg and ride this feeling out(if it does go away), I started low so my body would adjust slowly. Thanks
> johnj
=========================================
The standard known proceedure is for docs is to prescribe a benzodiazapine such as ativan,xanax, valium, or klonopin to counteract the start-up side effects you're describing (anxiousness) during that period.Then there are those that will find the effect of AD's to be ultimately too "stimulating" or create a kind of "hyperarousal" (euphemistically to *them* anyway, referred to as "activating").
Alan
Posted by JLM on November 4, 2002, at 4:43:36
In reply to Re: Citalopram pharmacology » SLS, posted by dr. dave on October 31, 2002, at 8:26:26
I too get a bit tired of the ad nauseum claims of Lex's lower incidence of SE 's and efficiacy over Celexa.
We hear a lot about how 'the published studies' demonstrate both things clearly, even thou the data is contradictory at best.
Know what I would like to see? The UNPUBLISHED studies that would have had to have been submitted to the FDA for the approval of Lexapro. They can be obtained thru the Freedom of Information Act for those brave enough to do so. I would NOT be surprised to see several studies that show NO greater effect than either placebo or Celexa for that matter.
All we have so far are the studies done by paid Forrest consulants, which may not be all that objective.
Perhaps I will take the time to learn how to submit a FOIA request for the unpublished studies submitted to FDA. I bet there are some real gems in there.
Like Dr. Dave, I have yet to hear a remotely plausible explaination for the claims of less SE's with Lexapro.
Posted by Jaycee on November 4, 2002, at 5:01:38
In reply to Re: New idea, posted by cannoli on November 3, 2002, at 16:58:32
I took paxil prior to lex and my migraines were not as bad. I like lex but can't deal with these migraines. I have been reading about topamax for migraines, anyone taking it with lexapro?? This is my 6th week on lexapro.
Posted by sjb on November 4, 2002, at 8:26:48
In reply to Re: Does anyone notice they are never thirsty?, posted by Phyl on November 3, 2002, at 8:58:53
Yes! That is so weird that you mentioned that because I was just realizing how much less I'm drinking even when working out. At first I thought it was the cooler weather (that's some of it), but I used to drink a lot of water year round.
Also have the VERY weird, vivid dreams that I seem to be able to remember better. In fact when I wake up, I'm kinda shook up for a while and I have to remind myself it was just a dream, but they stay with me longer and seem more real, like they really happened. Also seems like I'm dreaming a lot more.
Posted by colin wallace on November 4, 2002, at 9:16:15
In reply to Hangover feeling.....strange anxious, posted by johnj on November 3, 2002, at 10:37:34
Hi there John,
Good to see you've finally ditched that nasty tricyclic!! You may get some exercise in soon if you're lucky.
My experience of ssri's is that I went through at least 4 or 5 weeks of increased anxiety and a highly strung/jittery type feeling(and a tendancy to blurt out silly, unguarded comments!) before they suddenly kicked in with a therapeutic effect- stick with it and take it easy.(still on lithium too??)All the best,
Col.
Posted by Alan on November 4, 2002, at 9:34:43
In reply to Re: Citalopram pharmacology, posted by JLM on November 4, 2002, at 4:43:36
> I too get a bit tired of the ad nauseum claims of Lex's lower incidence of SE 's and efficiacy over Celexa.
>
> We hear a lot about how 'the published studies' demonstrate both things clearly, even thou the data is contradictory at best.
>
> Know what I would like to see? The UNPUBLISHED studies that would have had to have been submitted to the FDA for the approval of Lexapro. They can be obtained thru the Freedom of Information Act for those brave enough to do so. I would NOT be surprised to see several studies that show NO greater effect than either placebo or Celexa for that matter.
>
> All we have so far are the studies done by paid Forrest consulants, which may not be all that objective.
>
> Perhaps I will take the time to learn how to submit a FOIA request for the unpublished studies submitted to FDA. I bet there are some real gems in there.
>
> Like Dr. Dave, I have yet to hear a remotely plausible explaination for the claims of less SE's with Lexapro.
>
>
>
============================================
Until the FDA has better oversight of the test results, the pharm. co.'s are allowed to cherry pick test results and throw out the undesired test results after having changed the test criteria until they get the result that they want - which the FDA never sees before adjudicating the drug's acceptance. Fox guarding the chicken coop.Alan
Posted by johnj on November 4, 2002, at 11:06:50
In reply to Re: Hangover feeling.....strange anxious » johnj, posted by colin wallace on November 4, 2002, at 9:16:15
Hey Colin,
How are things going? Still on the lamactal? I hope it is holding up for you.
My doc wants me on a thearaputic dose of lexapro before he will lower my TCA. I actually didn't take my lexapro dose last night and feel so much better. I see my doc this Friday and we need to talk about how to do this. I may jump to 5 mg and see how that is and just tough it out. I want off the TCA, but man that ssri felt horrible. Not as spaced out as remeron, but I did feel like you did (thinking I was goingto say or do something totally out of place). Where the hell does that come from? Lexapro..no s/e, yeah right.
I have two major stresses solved in my life right now, 1)my wife found a job, and 2) that engineering test is over!. So, I dropped down my benzo a bit and started lexapro the next day....probably not the wisest choice. I don't know what benzo withdrawl was so that may have played a part in my feeling so horrible this past weekend. Sometimes our meds give us a tough trade off. One thing I did notice is that the ssri did NOT affect my sex drive, it seemed to improve it.
Not sure where to proceed next, but sometimes I think I should get off the TCA no matter what and just start excercising and see if that holds.
Yes, I am still on the lithium. However it makes me sleepy in the morning so the morning of the test I didn't take it and was more alert. Sometimes I wonder if I need it?? The lithobid is the only type of lithium I can tolerate.
How is excercising going for you? Still biking? Take care
johnj
Posted by bridgette on November 4, 2002, at 15:14:15
In reply to Re: Citalopram pharmacology » JLM, posted by Alan on November 4, 2002, at 9:34:43
My Dr said he would add Wellbutrin to the Luxapro as a way of enhancing it and hopefully heping w/the sexual side effects. What does everyone think about that.? Anyone have any experience w/Wellbutrin. Actually, I hve been pleased w/what I've heard.
Posted by Brandymac26 on November 4, 2002, at 15:30:37
In reply to Re: answers » ANXIETY ANN, posted by pharmrep on November 3, 2002, at 20:28:29
Just started lexapro 4 days ago, any suggestions on the best time to take it, and how long it actually takes to work? Thanks
Posted by Brandymac26 on November 4, 2002, at 16:15:56
In reply to Re: Does anyone notice they are never thirsty?, posted by Dkk1040 on November 3, 2002, at 11:52:24
Have any of you noticed that it seems that people taking ssri's or med's in general for anxiety have worse side effects? I was a memeber of the celexa group at yahoo for about 8 months, and it also seemed to me that people taking it for anxiety had worse side effects than people taking it for depression? Weird!
Brandy
Posted by ANXIETY ANN on November 4, 2002, at 16:36:18
In reply to Luxapro and Wellbutrin, posted by bridgette on November 4, 2002, at 15:14:15
> My Dr said he would add Wellbutrin to the Luxapro as a way of enhancing it and hopefully heping w/the sexual side effects. What does everyone think about that.? Anyone have any experience w/Wellbutrin. Actually, I hve been pleased w/what I've heard.
Hi Bridgette
My doc also told me that he might add the wellbutrin with my Lexapro too. I am hesitate to add more drugs to what I already take (lexapro, adivan ) but if it helps the anxiety I guess its worth a try. I go see him tomorrow. Do you take Lexapro fro anxiety? If you do, do you notice that sometimes you get very anxious? I do especially in the mornings and evenings. It seems as though we all have some sort of s/e from these damned drugs!
Ann
Posted by syringachalet on November 4, 2002, at 16:45:45
In reply to Re: Anyone switched to Lexapro? « ggrrl, posted by dr. justin on November 1, 2002, at 12:32:24
I have been on lexapro for about five weeks now after being on Celexa for four years. I had severe PTSD related to severe prolonged childhood sex abuse that returned after a counselor inappropriately sexually tocuehd me and I fell apart.
The thing I notice most about the Lexapro is that my thought processses are clearer and my daily decision maing is better. I also dont miss the nightly changing my night shirt from profound sweating around the head and neck every night partly from the meds and partly from the stress of the flashbacks while I was sleeping. I also noticed I sleep 5-6 hours in a block vs 3-5 hours at night with none of the hang over I have had from so many ofthe other psych meds I have been on over the years.
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