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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Joslynn on September 19, 2005, at 10:56:28
To make a long story short, most of the time for the past couple years I have been on 10 mg lexapro, and sometimes Remeron during rough months. This summer, some things went on that triggered a mini episode, and I went up to 15 mg Lexapro and 15 Remeron.
So now, I would like to go back to my usual 10 mg Lex, and I will keep taking the Remeron for now, and reasses towards the end of the year. I am not anti-meds, but I also want to be on the lowest dose of something I need.
So, I am now on 12.5 (by carefully cutting the pills) of LEx. What would be a good schedule for getting back down to the usual ten? I have been on 12.5 for a little less than a week.
thanks. P.S. If it's relevant, I weigh 128 pounds and age is mid 30s. I have discussed with pdoc but I want other opinions too, thanks.
Posted by Phillipa on September 19, 2005, at 18:04:11
In reply to schedule for lex 15 to 10?, posted by Joslynn on September 19, 2005, at 10:56:28
Have you posted this on the withdrawal Board? But if you're down that low already and feel okay I would think you could try the l0mg. How long have you been on l2.5mg? Fondly, Phillipa
Posted by Glydin on September 19, 2005, at 19:46:46
In reply to schedule for lex 15 to 10?, posted by Joslynn on September 19, 2005, at 10:56:28
I'm just basing this on my expereince with hitting the time frame of "kickin" on Lex when starting or increasing dose...... I would think about two - three weeks at a given dose. Since you're at 12.5 mgs now, I would think after 2-3 weeks you could decrease to 10 mgs. You can always return to the previous dose for a time if it seems to be too quickly for your body.
I would be interested to know what your doc suggests if you would share that....
Posted by Joslynn on September 20, 2005, at 9:00:32
In reply to Re: schedule for lex 15 to 10?, posted by Glydin on September 19, 2005, at 19:46:46
My pdoc actually said he would prefer if I stay on the 15, but it's ultimately my decision and that some people like me who like to be on the lowest amount do have to do some trial and error. The thing is, I am not saying I am going to toss my meds, just that I want to get back to my usual dose of 10, so I don't quite understand his concern. I am not going lower than my usual dose, just getting back down to my usual dose. But I understand that pdocs are cautious and I guess that is better than the other way.
He recommended a couple weeks on the 12.5 and said that if I really wanted to be cautious, he could give me a liquid to go down super gradually with an eye dropper, but at a certain point it's splitting hairs. I said I would skip the liquid because I had just refilled the pills and they are not cheap, even on a health insurance plan. So I will carefully slice them.
I have one of those pdocs who can be discursive and will come out and say, "You know, it's not an exact science and everyone is different. " While I appreciate the honesty, sometimes don't you want to hear someone say, it is an exact science and this is exactly what you should do.
Well, I can overthink anything, including meds....
I will see pdoc in about 3 wks. I guess I could just stay on 12.5 until then. Also, I am also on the Remeron so I have the boost from that.
Posted by Glydin on September 20, 2005, at 10:28:21
In reply to Re: schedule for lex 15 to 10?, posted by Joslynn on September 20, 2005, at 9:00:32
> My pdoc actually said he would prefer if I stay on the 15, but it's ultimately my decision and that some people like me who like to be on the lowest amount do have to do some trial and error. The thing is, I am not saying I am going to toss my meds, just that I want to get back to my usual dose of 10, so I don't quite understand his concern. I am not going lower than my usual dose, just getting back down to my usual dose. But I understand that pdocs are cautious and I guess that is better than the other way.
~~~ Yes, I think your doc just is being careful with you. I'm sure you'll do fine and you can always return to a higher dose if 10 mgs doesn't work out for you. Overall, I'm very pleased with my response to Lex and it's turned out to be a good med choice for me.
I hope your plan works out for you.
Posted by tiffanywp on September 20, 2005, at 10:33:25
In reply to Re: schedule for lex 15 to 10? » Joslynn, posted by Glydin on September 20, 2005, at 10:28:21
i really dont know - why not try a 10 and if you feel weird you can go back up to 12.5. i am not a patient person so i would prob do it that way - its not a comittmnet - can always go back up.
i just started taking lex yest. she gave me a sample - i bit the 10 in 1/2 b/c i want to try a VERY low dose and they dont make 5's. my question to you is why do you have to carefully cut it? do you think biting it is too random?
also have you gained weight on lex?
sorry to highjack -thanks if you have any input!
Posted by Joslynn on September 20, 2005, at 10:42:30
In reply to Re: schedule for lex 15 to 10?, posted by tiffanywp on September 20, 2005, at 10:33:25
Regarding biting, half of a half of ten is too small to bite, it really is a tiny little chip, so I have to use the pill cutter.
I did gain about 8 lbs on meds, but I think that was because of the other med I took, (Remeron), not the SSRI. There is no way to say for sure though because I took the two at the same time. Also, being less depressed made me be more social, which leads to more eating, I find. Also as I get into my mid 30s, I can't eat as much as before.
Posted by Bill LL on September 20, 2005, at 11:11:09
In reply to Re: schedule for lex 15 to 10? » tiffanywp, posted by Joslynn on September 20, 2005, at 10:42:30
Unless you are getting sexual side effects from the 15 mg, I would recommend staying on it. I think it's amazing that you have been able to stay on 10 mg for such a long time. I personally have taken 40 mg for a long time. Because of sexual side effects, I recently went down to 35 with the gradual addition of Lamictal.
> Regarding biting, half of a half of ten is too small to bite, it really is a tiny little chip, so I have to use the pill cutter.
>
> I did gain about 8 lbs on meds, but I think that was because of the other med I took, (Remeron), not the SSRI. There is no way to say for sure though because I took the two at the same time. Also, being less depressed made me be more social, which leads to more eating, I find. Also as I get into my mid 30s, I can't eat as much as before.
Posted by Emily Elizabeth on September 20, 2005, at 12:08:41
In reply to schedule for lex 15 to 10?, posted by Joslynn on September 19, 2005, at 10:56:28
Could your doc be concerned that 10 was not enough to prevent a relapse of depression? I'm not sure, just throwing it out there.
As for decreasing, my experience is that it can be really hit or miss. It depends on your general sensitivity to meds, how long you have been on it, etc. Also, it probably will be easier since you are not completely stopping, just lowering. My pdoc has always said things to the effect of drop down every few days and if you have too many side effects from discontinuation, go back up. So, my guess (I haven't done it myself) would be about a week at 12.5 and then try 10 and see how it goes.
Best,
EE
Posted by Joslynn on September 20, 2005, at 12:42:57
In reply to Re: schedule for lex 15 to 10?, posted by Emily Elizabeth on September 20, 2005, at 12:08:41
I think yes to question about relapses. Snce I first went on meds I have gotten situational mini-episodes, if you could call them that, on average about once a year, always after some sort of relationship conflict or loss. I think my depression/anxiety has been more situational than "organic." The mini-episodes clear up after a week. I can function in those episodes, but it does disrupt sleep and eating, and I cry more often and get "what if" thinking. It was during one of those episodes that my doc recommended going up to 15.
It's so hard to decide what to do! But I seem ok on the 12.5 Lex and the 15 Remeron. I felt a little icky Monday morning, but I think that was because I didn't get enough sleep Sunday night and ate too much sugar over the wknd. I have learned that I have to be so very vigilant about sleep and eating when it comes to my moods.
Well, thanks so much for everyone's input!
Posted by blueberry on September 20, 2005, at 20:42:02
In reply to schedule for lex 15 to 10?, posted by Joslynn on September 19, 2005, at 10:56:28
Years ago I had similar pattern with Paxil. 20mg worked most of the time, but every now and then I had to go up to 25mg or 30mg for a few weeks. Then I wanted to get back down to 20mg. And I did, and it was fine. But the best way for me to do it was in super tiny steps.
Cutting the pills is a good way to do it. But, instead of taking exactly a 1/4 pill or whatever, just shave a little bit off of that 1/4. You know, maybe it's just 1/2 a gram or so that you shave off. Stay at each new dose for about 4 to 7 days before shaving more off and then keep going like that. The trick is to just do it in super tiny steps, and stay at each step for a few days. That worked for me on paxil.
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