estilopram question from a newbie

[martin_paes]

hi guys
newbie here
i am suffering from depression and insomnia since 2 yrs a, a feeling of loneliness and worthlessness.
i visited a doc and he put me on flupenthixol 0.5mg and estilopram 5mg and then after a week 10 and after 2 weeks 20mg
for insomnia he put ativan 1mg
felt good at the start

after 2 months i start feeling worthless and lonely again and not in any mood to do my day to day work
he stopped my flupenthixol and tried lowering my dose to 10 mg and its been 3 weeks and i still feel like shit specially in the morning,so he put
armodanafil 50 mg in the morning. but im reluctant to take so many pills
i was wondering can i up the dose to 20mg for some weeks?
please help

[Bigboyuk]

Hi Martin we cant advise to change your dose only your dr can and should do this. Meds just don't start working over night either some say up to 2 months! Can relate to your depression, loneliness and self worth mate :) had this feeling for years now. ATB

[martin_paes]

Hi Martin we cant advise to change your dose only your dr can and should do this. Meds just don't start working over night either some say up to 2 months! Can relate to your depression, loneliness and self worth mate :) had this feeling for years now. ATB
my doc used to call me every week and its 2 months but i just felt relief in the 1st two weeks rest all same
i was considering stopping it as its not showing any results
but am confused over it if to shop or slowing taper

[AntsyVee]

Most docs advise dosage increases before you quit. You need to speak with your doc.

[martin_paes]

i have started 5 mg morning and 5 mg at night and feel better than straight 10 mg at night

[AntsyVee]

Good. I’ve been on escitalopram for 3 years now. I can’t live without it. I love it.

[martin_paes]

Good. I’ve been on escitalopram for 3 years now. I can’t live without it. I love it.
is it safe to take it long so much??

[AntsyVee]

Yes. If it weren't safe, it wouldn't be prescribed. In fact, the MINIMUM to stay on such drugs is a year.

[martin_paes]

thank you

[Bigboyuk]

My stance on this is always try a combination of both meds and therapy where ever possible the 2 can go hand in hand and compliment each other :) ATB

[MyNameIsTerry]

i have started 5 mg morning and 5 mg at night and feel better than straight 10 mg at night

That means you aren't getting 10mg anymore. The peak periods of the med will be too far apart to overlap resulting in a peak of over 5mg now as opposed to 10mg if you took the 10mg in the same sitting.

However the way you are taking it, which is unconventional for a SSRI, will result in a top up effect that prevents the med dropping as low as it would if you were taking 5mg once a day.

So, perhaps you were on too much? Or perhaps you started increasing the dosage too quickly making the side effects much more intense?

[martin_paes]

That means you aren't getting 10mg anymore. The peak periods of the med will be too far apart to overlap resulting in a peak of over 5mg now as opposed to 10mg if you took the 10mg in the same sitting.

However the way you are taking it, which is unconventional for a SSRI, will result in a top up effect that prevents the med dropping as low as it would if you were taking 5mg once a day.

So, perhaps you were on too much? Or perhaps you started increasing the dosage too quickly making the side effects much more intense?
this is really confusing to me as i m firts time on such med but since i have 5/5 split i feel much better than taking 10 mg only at night

[AndreiSH]

Hi. I take cipralex 10mg for a little over 3 weeks. I take it after lunch around 2pm. Did you guys have nausea like all the time, even the next day? And does it ever go away?

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[MyNameIsTerry]

this is really confusing to me as i m firts time on such med but since i have 5/5 split i feel much better than taking 10 mg only at night

Yes, I appreciate it's complicated, I was the same and it's only from reading professional reference material that I now understand how they work. Basically, like all drugs they have a half life and at that point the med is 50% of what it was at it's peak period (the peak builds up quickly after taking the med and lasts for a time) so it is reduces through the hours leading up to the half life time.

Think about taking a pain killer. If you take say 500mg of paracetamol your body starts getting 500mg as it is absorbed and hits it's peak period. Then it declines as it reaches the half life, and then it declines further beyond the 50% it was at the half life. If you split that pill into two 250mg ones and take them AM/PM, your body receives a maximum peak of 250mg during the peak periods of each of these doses. Now, if the peak periods don't overlap then the drug has started reducing below that 250mg max so in reality when you come to take the next 250mg you add that on to what is left of the first.

10mg Escitalopram = 20mg Citalopram. Starting on 20mg of Cit can be a hard experience and so many doctors taper upwards by going to 10mg first as it helps reduce the sudden side effects and gets the body more used to having the drug in there. So, it may be that you went on too high a dose at first but you may find it easier going up as this settles.

[martin_paes]

Yes, I appreciate it's complicated, I was the same and it's only from reading professional reference material that I now understand how they work. Basically, like all drugs they have a half life and at that point the med is 50% of what it was at it's peak period (the peak builds up quickly after taking the med and lasts for a time) so it is reduces through the hours leading up to the half life time.

Think about taking a pain killer. If you take say 500mg of paracetamol your body starts getting 500mg as it is absorbed and hits it's peak period. Then it declines as it reaches the half life, and then it declines further beyond the 50% it was at the half life. If you split that pill into two 250mg ones and take them AM/PM, your body receives a maximum peak of 250mg during the peak periods of each of these doses. Now, if the peak periods don't overlap then the drug has started reducing below that 250mg max so in reality when you come to take the next 250mg you add that on to what is left of the first.

10mg Escitalopram = 20mg Citalopram. Starting on 20mg of Cit can be a hard experience and so many doctors taper upwards by going to 10mg first as it helps reduce the sudden side effects and gets the body more used to having the drug in there. So, it may be that you went on too high a dose at first but you may find it easier going up as this settles.

thank you sir

[martin_paes]

update
i have been on 5 mg for now and feel good yet
will plan to stop it from 01 jan2018
then lets see how things go

[AntsyVee]

will plan to stop it from 01 jan2018

That should be based on how you are feeling and your doctor. Don't set yourself up with predetermined deadlines.