View Full Version : My lexapro diary
Hello Everyone,
This is the continuation of my paroxetine thread which I am discontinuing. Dr has started me on escitalopram.
I am starting lexapro and will keep a little journal here to track my progress and ask any questions along the way. My conditions are depression and GAD with panic.
I was taking paroxetine 10mg for almost 3 months. The last week I went down to 5mg without too much trouble and now completely stopped the paroxetine and have started lexapro at 5mg.
Yesterday was the first day of the switch and was easy enough. Today is the second day and a fair bit more rough. Low mood namely.
The next week or two will be interesting as I will not know what effects I am getting from starting lexapro and what is the discontinuation of the paroxetine?
Dr wants me to stay on 5mg for 5 weeks before checking back in with her.
As I mentioned in my previous thread I took lexapro over 4 years ago when I was in a very dark place. I only took it for about 6 weeks and remember it was good for depression but average for anxiety. Too be honest I do not believe I was on it long enough for it to make a difference and I had so much stress at the time I would of been surprised if anything would of worked.
Anyway feel free to add any input and wish me luck!
Regards
John
G'day mate
I found Lexapro a life saver
I've been on it for 5 yrs and found it pretty gentle compared to others.
6 weeks isn't long enough to feel any major difference
I started on 5mg for a week then went to 10mg and have stayed there ever since.
Gday Phil
I hope I get the same relief you got. Pretty scared about having to start from scratch again but will try to remain optimistic.
You're not starting from scratch though in terms of your management of anxiety and depression. Medication is only a part of that and not the be all and end all. Therapy-either self-taught or professional-plays a big part in management. If you put all your faith in medication you will heap more pressure on it to "succeed" and that could be counter-productive.
Thanks pulisa
Just trying to be productive today without putting too much pressure on myself.
Had a mini panic attack today which I have not had for while.
You'll be on alert due to starting the lexapro. A mini panic attack is insignificant so don't overthink it. Just take things slowly and steadily and try not to worry about how you are feeling?
Pulisa is right
Just try to forget you're taking it and you'll be fine.
Yep, I am on high alert at the moment. My teeth grinding seems to be worse as is my anxiety. I know a lot of this is in my head.
Taking this week off work as I feel I will have a major panic attack. The paroxetine threw a blanket over the panic but it also left me not feeling myself.
How long do the start up jitters usually last on this medication?
I didn't really have any jitters.
I just sort of calmed down without realising it if you get what I mean.
Sposed to be 6 weeks before it kicks in properly that's why I can't understand why the doc has you on half dosage for so long.
Wow I wish I have a response like you! Maybe the jitters is the other medication leaving my system? Who knows.
I am pretty sensitive to medication so dr is being cautious. She said I am a slow metaboliser and 5mg might be enough for me.
I tried paroxetine before this and going from 10mg to 20mg was like being hit by a Mack truck. I could not do it.
Started exercising and going for walks to keep myself active.
Now I understand the reasoning.
When are you taking yours?
I found taking it with breakfast works best for me.
I take mine straight after breakfast.
5mg is enough for me.
I think that these jitters are psychological. Don't over-analyse what you think is "going on". Walking is a good stress-reliever and will burn off any excess adrenaline from your anxiety.
That's kind of you to say that, Phill. Advice is only any good if it helps a little bit though so I hope things have been a bit more manageable for you today, John.
I take mine after breakfast too.
Have been feeling pretty rough the last couple of days. Sleepy with headaches and actually fearful like something bad is going to happen.
Hope this is just the other stuff leaving my body and it resolves itself. Time will tell.
It's just anxiety symptoms, John. Try not to work out what's "happening" re the meds. Keep busy and limit the monitoring if you can.
Thanks pulisa
Had to take some clonazepam last night as I felt too activated. A lot of teeth grinding and anxiety. Think I better start a cbt course before this gets the better of me.
Found my old Dialectic Behaviour Therapy Skills Workbook from ten years ago.
Quite a few of my anxieties from back then no longer trouble me, I seem to have developed NEW anxieties. How weird!
Unfortunately that's the nature of the beast.:shrug:
It certainly is. It's not weird at all.
Have a look back over your DBT material. The principles remain the same even if your anxiety issues have changed.
You are changing meds and are naturally worried about potential side effects. If you read all the accompanying literature on lexapro you will fill your head with panic and "what if" scenarios. You need to give the lexapro a chance by trying to manage your anxiety more effectively. Keep up with the walking and keep occupied with stuff which isn't entirely MH related.
At day 10 and nothing much to report except tiredness/sleepiness. Went to work on Saturday and anxiety was very present. Only early days still.
Good for you sticking to it :yesyes:
Should I bite the bullet and just go to 10mg or stick with the 5mg like the doc said? I seem to be tolerating it better than other medications.
panic_down_under
06-09-21, 11:42
At 10 days escitalopram will have reached a steady-state level in blood plasma so you could increase the dose now, John. Whether you should is another matter as I think psychology was a factor in some of the issues you had with paroxetine. It comes down to how comfortable you are mentally with raising the dose.
I agree. It's early days as you say. Don't rush it and regret it. You're doing well so keep stable and your stress levels as low as possible.
I'd talk to your Dr. before doing anything just in case had a particular reason for the long lead up.
So I seem to be going ok-ish with the lexapro. Main things to report are a bit of mental fog and lethargy and headaches which I have had since before starting the pills.
Yesterday I woke up really positive and was doing ok but by about 2pm I needed to lie down as I was exhausted.
I am sleeping very well at night unlike on the paroxetine which completely stuffed up my sleep.
Today I have woken up with a big headache which has put me in a bad mood.
I will speak with my dr regarding upping my dose if I can get through to her today and let you know what she says.
My dr was a bit ambivalent about increasing my dose but thought we could try it out and see how it goes.
So the last 3 days at 10mg have been pretty crap. Feels like my head is puffy and I am a little anxious. Plus a lot of teeth grinding.
I have to go in to work tomorrow (only working Saturdays at the moment) and am full of dread. Probably psychological not the medication.
How long for things to settle after a dose increase?
There have been moments where I have felt fine but then I sink back into anxious feelings/thoughts.
It's probably a bit of over thinking on your part.
I did much the same on Arpoax.
Try to find something to distract yourself and it should settle down.
I find work a great distraction.
Got to work today and did all my tasks. Anxiety still present. By the afternoon I was totally wiped out. Namely tired and trouble concentrating. I took a 2mg Valium and had a rest and feel a bit better this evening.
Am having some stomach pains since going to 10mg. Nothing too serious but definitely noticeable.
Also had my second Pfizer covid injection yesterday so that might have contributed to my feeling crap today.
Lets hope next week gets better.
Well done at work :yesyes:
It will get better
Just give it time
So today was pretty awful. Anxiety and headaches all day long. Spent most of the day on the couch. Took 2mg Valium before dinner.
Yesterday I actually had a good day and was quite productive so I was hopeful that I was turning a corner.
I think it is my 8th day at 10mg. Is this normal?
panic_down_under
14-09-21, 12:17
So today was pretty awful. Anxiety and headaches all day long. Spent most of the day on the couch. Took 2mg Valium before dinner.
Yesterday I actually had a good day and was quite productive so I was hopeful that I was turning a corner.
I think it is my 8th day at 10mg. Is this normal?
At this early stage escitalopram won't be having a positive impact even factoring in whatever residual benefit may have accumulated from the small paroxetine dose, but, as with all ADs at the beginning, it could be making anxiety worse because of the increased serotonin activity. It is early days so I wouldn't read too much into it, or the better previous day, John.
I'm on day 7 of this journey. I'm on it for GAD, at the moment I'm super stressed about my bowels so trying to determine if it's the drug that's making them weird or something else. Other than that I can feel kinda spacey at times. Hope it kicks in soon !
Good luck!
Thankfully I have not had any trouble in the bowel department.
However I can say that I officially feel worse now than when I started. Killer headaches, jaw clenching, anxiety much worse and no attention span.
Just feel like lying down on the couch all day. Forcing myself to go for a walk now with my clenched jaw.
panic_down_under
15-09-21, 12:10
at the moment I'm super stressed about my bowels so trying to determine if it's the drug that's making them weird or something else.
Serotonergic ADs can trigger a range of bowel issues at the beginning including diarrhoea and/or constipation. The gut is by far the most serotonergic organ of the body, making about 50 times as much serotonin as the brain. The brain is only a minor player making and using less then 2% of the body's total.
The gut is controlled by its own mini brain, the enteric nervous system (http://www.nytimes.com/2005/08/23/health/23gut.html) (ENS), which is replete with serotonin receptors which can be as affected by ADs as those of the brain. The ENS is is also a significant force in manifesting anxiety and depression. It is directly linked to the brain via the vagus nerves and seems to be the more dominant partner with most of the data flow originating from it (it is also connected to the heart and lungs via the vagus which allows it to trigger anxiety symptoms such as rapid pulse and shortness of breath in addition to gut related anxiety symptoms). It is arguably the tail wagging the brain 'dog'. Electronic vagus nerve stimulators which inhibit the ability of the gut to communicate with the brain have proven to be effective for treatment resistant depression, though much less so for anxiety disorders.
In turn the ENS is influenced (https://www.apa.org/monitor/2012/09/gut-feeling) by the gut microbiome. How you feel emotionally can literally be effected by your poop! Gut microbes also have (https://institute.progress.im/en/content/microbes-and-brain-share-neurochemistry) binding sites (receptors) targetted by ADs so may also be affected by them. In addition to their direct impact on the ENS, there is also evidence that ADs can alter the mix (https://www.medicalnewstoday.com/articles/326299.php) of gut flora. All of which makes a strong argument for us being merely the life support system for the bugs in our guts who can lead us on a merry chase at times. They outnumber the cells of our bodies by about 10:1 so we don't stand a chance if they turn on us! :scared15:
See also:
Gut microbiota plays a role in brain function and mood regulation (Article (https://www.sciencedaily.com/releases/2020/12/201211115507.htm?) | Study (https://www.nature.com/articles/s41467-020-19931-2))
How your gut might modify your mind (https://cen.acs.org/biological-chemistry/microbiome/gut-might-modify-mind/97/i14?PageSpeed=noscript)
Gut bacteria, the vagus nerve and the brain (PDF (http://www.old-herborn-university.de/wp-content/uploads/publications/books/OHUni_book_26_article_4.pdf))
Gut bacteria and the brain: Are we controlled by microbes? (https://www.medicalnewstoday.com/articles/312734)
Gut communicates with the entire brain through cross-talking neurons (https://www.sciencedaily.com/releases/2020/04/200402155733.htm)
Gut microbes may talk to the brain through cortisol (https://news.aces.illinois.edu/news/gut-microbes-may-talk-brain-through-cortisol)
Nutrition and mental health: Is there a link? (https://www.medicalnewstoday.com/articles/nutrition-and-mental-health-is-there-a-link)
What bowel issues do you have?
panic_down_under
15-09-21, 12:16
However I can say that I officially feel worse now than when I started. Killer headaches, jaw clenching, anxiety much worse and no attention span.
Unfortunately, these are fairly typical initial SSRI side-effects. All you can do is treat the symptoms until the body adjusts.
Just feel like lying down on the couch all day.
If that is what you need to do to get through another day then so be it, though doing things which distract you from what you're feeling will help.
What bowel issues do you have?
Don't want to hijack the thread but I've posted in the IBS/bowel forums.
Thanks for the write up, very informative!
All good Balt. We are all here to help each other.
So I am at day 13 on 10mg and all symptoms still persist as before.
Last night I was so stirred up I took 0.25mg clonazepam.
Psychologically I feel very nervous as I have to go into work pretty much everyday next week.
Probably still have a long way to go till I feel any relief.
Went to work today. Another diazepam and paracetamol day. Totally wiped by the time I got home. Hope this starts levelling off soon. Do not feel relaxed in any sense of the word. :-(
Hang in there jon.
You'll get there :yesyes:
You can always go back to 5mg if you would feel psychologically better doing that? After checking with your psych of course. You did appear to be more comfortable on that dose?
Hey pulisa,
I am not feeling anything positive from the lexapro yet.
Headaches, fatigue, anxiety and mental fog all still present.
I am seeing my psych next Thursday and will discuss whether I stick to the current dose or reduce back to 5mg.
PDU mentioned a blood test that can determine how much lexapro is floating around your system. Maybe I ask for one if I still feel crap next week.
John
What would you most like to get rid of with any medication? Chronic headache? General lethargy? What distresses you most?
It is not just one thing unfortunately.
The headaches and mental fog probably give me the most trouble.
It is hard to do any sort of psychology or thought challenging for anxiety when I am mentally spent and in pain.
panic_down_under
22-09-21, 10:33
I am seeing my psych next Thursday and will discuss whether I stick to the current dose or reduce back to 5mg.
If you can't tolerate taking 10mg then you might as well not take it, imho. Taking less than the minimum therapeutic dose is something you've done with just about every med you've tried and none of then have subsequently worked. I know you believe you're a slow metaboliser John, but if that were really the case the meds would have been effective at the lower doses.
PDU mentioned a blood test that can determine how much lexapro is floating around your system. Maybe I ask for one if I still feel crap next week.
I would/should have suggested that for TCAs, not SSRIs. As far as I know there is no readily available commercial blood test for SSRIs and SNRIs.
The headaches and mental fog probably give me the most trouble.
'Mental fog' is a fairly common potential initial side-effect of most ADs and also an anxiety symptom. My understanding is headaches are an issue even when you're not taking ADs. They probably need further investigation to determine whether there is an organic problem, or if they are driven by anxiety.
It is not just one thing unfortunately.
The headaches and mental fog probably give me the most trouble.
It is hard to do any sort of psychology or thought challenging for anxiety when I am mentally spent and in pain.
It's hard but not out of the question. I have a chronic pain condition and am a carer for my 2 adult autistic children who both have complex MH issues. I have to work on my anxiety al the time.
It's hard but not out of the question. I have a chronic pain condition and am a carer for my 2 adult autistic children who both have complex MH issues. I have to work on my anxiety al the time.
Oh pulisa I cannot imagine how difficult it must be for you. If I had half your strength I would be so grateful.
At the moment I am about 2 1/2 weeks into my dose increase and feel all I have is side effects and no benefits.
How did you settle on 5mg of lexapro? Did you ever try increasing your dose?
'Mental fog' is a fairly common potential initial side-effect of most ADs and also an anxiety symptom. My understanding is headaches are an issue even when you're not taking ADs. They probably need further investigation to determine whether there is an organic problem, or if they are driven by anxiety.
Hey Ian
I used to get Botox injections into my scalp and neck for headaches last year with mixed success and might have to try that again.
The mental fog is really bad at the moment.
I looked back at my paroxetine notes and found i did not see any improvement until the seven week mark which means I have another month before this medication does its thing. My God that feels like a long long way away right now.
Oh pulisa I cannot imagine how difficult it must be for you. If I had half your strength I would be so grateful.
At the moment I am about 2 1/2 weeks into my dose increase and feel all I have is side effects and no benefits.
How did you settle on 5mg of lexapro? Did you ever try increasing your dose?
I've got a history of not being able to tolerate "therapeutic" doses of psych meds (hospitalised twice) so I am treated very cautiously by docs! I've been on 5mg in the past and that has helped with agitation (very different from anxiety) and also I don't feel so low. For me it's a safe and good choice.
Hey Ian
I used to get Botox injections into my scalp and neck for headaches last year with mixed success and might have to try that again.
The mental fog is really bad at the moment.
I looked back at my paroxetine notes and found i did not see any improvement until the seven week mark which means I have another month before this medication does its thing. My God that feels like a long long way away right now.
Have you tried physio? The sternocleidomastoid muscle caused a lot of my headache issues. Active trigger points can cause a lot of chronic pain.
I see.
I believe anxiety is largely learnt behaviour and highly treatable with behavioural therapy.
Agitation is a constant nagging condition for no apparent reason that I am yet to figure out how to control.
For example driving on the freeway might give me anxiety but I will not have anxiety lying on the couch.
Agitation on the other hand lies on the couch with me. :-(
No I have not tried physio for headaches
panic_down_under
23-09-21, 12:34
I used to get Botox injections into my scalp and neck for headaches last year with mixed success and might have to try that again.
Have you seen a specialist about the headaches? If no, then maybe it's time your GP referred you to one.
The mental fog is really bad at the moment.
It often is at the beginning partly because of a direct impact on the hippocampi which process memory and also from interrupted sleep. It usually eases after a few weeks.
I looked back at my paroxetine notes and found i did not see any improvement until the seven week mark which means I have another month before this medication does its thing. My God that feels like a long long way away right now.
When AD kick-in times are plotted the top of the bell curve is usually around 6 weeks, plus I'd add a week or two to allow for the med switch and the longer escitalopram half-life, however, it may occur even earlier. The only predictable thing about ADs is their unpredictability. :ohmy:
Agitation is a constant nagging condition for no apparent reason that I am yet to figure out how to control.
For example driving on the freeway might give me anxiety but I will not have anxiety lying on the couch.
Agitation on the other hand lies on the couch with me.
Is your psychiatrist aware of the agitation, John?
Yes psychiatrist has been aware of agitation for sometime. That is probably why I tried some of those Seroquel type medications that did not agree with me at all. My issues are really bad GAD with the depression and then intrusive thoughts.
Whenever I have done the mental health questionnaires I score middle of the range for depression but very high for anxiety and stress.
When my anxiety and headaches are not present the depression melts away immediately.
Friday I took 0.25mg clonazepam with the lexapro in the morning and had a terrific day at work. I believe the benzo kept the anxiety in check enough so that I did not get a cracker headache and depression dissolved. Lexapro probably helped too but I know it is still early days.
I do not want to go down the daily benzo path so I am hoping the ssri kicks in soon.
I have seen a neurologist for headaches and after trying a few different medications we settled on the Botox treatment.
Sorry for the long post. At the moment jaw clenching, anxiety and mental fog still present.
The benzo will be acting as a muscle relaxant too re the jaw clenching. What does your dentist say about the TMJ?
The benzo will be acting as a muscle relaxant too re the jaw clenching. What does your dentist say about the TMJ?
My dentist made me a splint which I wear at night.
It does not solve the problem but prevents me from wearing down my teeth.
So yesterday I saw my psychiatrist who said I should stick with the 10mg lexapro and should continue to see benefits over the next few weeks as I have only been on the current dose for 3 1/2 weeks.
I think I am at the stage where I am having good days and bad days. Yesterday was great. Today was terrible. Bad teeth grinding and anxiety off the scale together with mental fog.
I did go to work today but must admit it was a struggle.
Is it normal to have totally crap days at this stage? I was hoping I would be past that by now.
Also does anyone have any idea how to stop the jaw clenching and teeth grinding? I just took 0.25mg clonazopam.
John
panic_down_under
01-10-21, 12:09
Is it normal to have totally crap days at this stage? I was hoping I would be past that by now.
Yes, the snake and ladders one step forward, two or more back tango is fairly common, John. It is usually a good sign because it shows the good days probably aren't the placebo effect at work as it sometimes is when there is a straight line progression.
Also does anyone have any idea how to stop the jaw clenching and teeth grinding? I just took 0.25mg clonazopam.
Teeth clenching and/or grinding, bruxism, is a fairly common initial SSRI side-effect though it tends to occur more often with fluoxetine, sertraline and venlafaxine. When it comes to the mouth escitalopram is more (in)famous for the 'Lexapro yawn'. Buspirone (Buspar) is often effective at doses between 5-30mg/day in 3 split doses. Buspirone may also resolve, or at least moderate other SSRI induced side-effects too and also increase the effectiveness of the AD. It takes about 2-3 weeks to become fully effective. You could also try magnesium supplements.
Did you ask the psychiatrist about the teeth grinding and if so what was the response?
I did mention the teeth grinding and she said it was a side effect of the lexapro and more evidence that I am medication sensitive.
I do not want to throw more medications (Buspar) into the mix but have some magnesium supplements that I will begin taking.
The anxiety I have now feels more heightened than before. Is this normal?
I am 26 days at 10mg.
There is no 'normal" as such because everyone is different but many do suffer heightened anxiety before the meds kick in.
panic_down_under
02-10-21, 12:25
I did mention the teeth grinding and she said it was a side effect of the lexapro and more evidence that I am medication sensitive.
One that basis 80% of the population is 'medication sensitive'.
The anxiety I have now feels more heightened than before. Is this normal?
ADs, particularly the serotonergic ones, often make anxiety worse at the beginning.
Another bad day. Anxiety and brain fog.
Changed the oil in my wife’s car and got out of the house for a bit to feel productive but ready to crash now.
Am trying magnesium at night for jaw clenching. It upsets my bowels a little bit but it’s manageable.
I am still at the ‘one day at a time’ stage.
panic_down_under
03-10-21, 09:46
Am trying magnesium at night for jaw clenching. It upsets my bowels a little bit but it’s manageable.
Magnesium hydroxide, oxide and sulphate have low bio availability. Magnesium citrate is probably the most popular, but it can also have laxative effects in some as may the aspartate, carbonate, chloride, gluconate, oxide and lactate forms. Magnesium glycinate supposedly is the most bio available form, be least likely to have laxative properties and the most calming, but it can be expensive. Whether it is worth the extra I can't say. Fwiw, I take magnesium for muscle cramps and I usually alternate between magnesium chelate and mag. taurate depending on which is cheaper at the time. They seems to work well enough without upsetting my gut, but it is cast iron anyway so YMMV.
Don't go overboard on dosing as too much can cause imbalances with other minerals, especially calcium. <=300mg elemental magnesium daily should be okay long term, but check with your GP the next time you see him/her. Note: supplements will/should state two doses, the quantity of the magnesium type and also how much elemental magnesium this is equivalent to which should be a lower figure. The two doses are often printed on different areas of the label, presumably to confuse and confound us mere mortals for marketing purposes. :unsure:
If all else fails then loperamide (Imodium) available at all good supermarkets is usually very effective for diarrhoea.
I am still at the ‘one day at a time’ stage.
Unfortunately, you probably still have a few weeks to go before escitalopram kicks-in. :sad:
I have magnesium diglycinate which I believe is the same as magnesium glycinate. The lower number is 150mg and I take one pill at night. I am also making a conscious effort not to grind my teeth.
Doing my best to stay positive at the moment but agitation and anxiety is still high.
Also still have brain fog and difficulty concentrating which can be a symptom of anxiety and depression.
Took 2mg Valium yesterday afternoon.
panic_down_under
04-10-21, 09:15
Doing my best to stay positive at the moment but agitation and anxiety is still high.
Also still have brain fog and difficulty concentrating which can be a symptom of anxiety and depression.
Unfortunately, you're likely still a few weeks off seeing any significant improvement from the med, John. :weep:
Took 2mg Valium yesterday afternoon.
Cool. Take diazepam if you really need it, but try and avoid taking it 'just in case' as it may inhibit the AD.
Anxiety has been building and building for the last 5 days. Actually it is the worst it has been for quite sometime. Have taken the day off work as I feel horrible and took 2mg Valium. Wasn’t expecting this after a month. Not happy :-(
I'm sorry you feel like this. It's a horrible feeling. How do you get through the hours if you don't go to work though? Do you feel better being at home and not having to put on a performance at work?
panic_down_under
05-10-21, 08:19
Anxiety has been building and building for the last 5 days. Actually it is the worst it has been for quite sometime. Have taken the day off work as I feel horrible and took 2mg Valium. Wasn’t expecting this after a month. Not happy :-(
It is still early days, John. Most begin to see an improvement at around 6 weeks and it can take up to 12. Given your med history I suspect it will take longer than 6 weeks to kick-in. :weep:
I'm sorry you feel like this. It's a horrible feeling. How do you get through the hours if you don't go to work though? Do you feel better being at home and not having to put on a performance at work?
I actually prefer going to work but I feel totally brain dead. Not like myself at all. I managed to do some housework, exercise and read a book but then I crashed out on the couch like I had run a marathon.
And it isn’t a just a bad day but rather a series of bad days.
I actually felt better two weeks ago. Isn’t the medication meant to level off rather than ramp up?
Not clenching my jaw as much today which is a small win.
Brain fog, fatigue and anxiety still hanging around :-(
You'll get there jon :hugs:
Anxiety is still building up and have not been able to go into work this week.
Feel like throwing in the towel on this and I’m only at week 5 on 10mg.
Please tell me this gets better…
Give it one more week and see what happens.
6 weeks is normal for some people.
Do you still have benzos to help?
Yes, I took 2mg Valium but it doesn’t seem to be doing anything.
The anxiety stuffs up my concentration and makes it impossible for me to get things done. Work, etc
I take 2 x 5mg daily.
Maybe try taking 4mg?
Can you function on 5mg? Doesn’t it make you drowsy? I need to drive to work and work with power tools.
Nope not drowsy and function well I'm all good.
Been taking the same dose for years.
So what time do you take the Valium? Are you still on lexapro or any other antidepressant?
I take em when I wake up and before bed.
Still on 10mg Lexapro.
Can you function on 5mg? Doesn’t it make you drowsy? I need to drive to work and work with power tools.
I'd be very cautious as you're working with power tools but maybe when you are at home and the agitation is very marked you could take 5mg?
Did you feel better on just 5mg lexapro?
My GP prescribed it to help with the Lexapro.
Works well.
I'd be very cautious as you're working with power tools but maybe when you are at home and the agitation is very marked you could take 5mg?
Did you feel better on just 5mg lexapro?
If I tried higher dose benzodiazepines it would be at home for sure. I find benzodiazepines help anxiety but worsen depression so that is why I haven’t used higher doses. Again unlucky with medications. :-(
I did feel better on the 5mg lexapro but that was only for 10 days so probably placebo effect.
Then I went to 10mg and felt ok-ish (up and down) for a few weeks BUT these last 5 days things have gone pear shaped.
My unanswerable question is:
Are these last 5 days a passing side effect or a hump?
Or………
Are the last 5 days exactly what the medication is meant to do and I am just not suited to it?
panic_down_under
07-10-21, 12:25
My GP prescribed it to help with the Lexapro.
Works well.
So the 10mg escitalopram isn't adequately effective on its own? If so it would be better to increase the dose rather than relying on benzodiazepines to paper over the cracks as they *inhibit ADs.
* see:
Boldrini M (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4374628/), 2014; Nochi R (https://www.ncbi.nlm.nih.gov/pubmed/23963779), 2013; Sun Y (https://www.ncbi.nlm.nih.gov/pubmed/23639432), 2013; Song J (https://www.kurzweilai.net/how-the-brains-stem-cells-find-out-when-to-make-new-neurons/comment-page-1#comment-96481), 2012; Wu X (http://www.biologicalpsychiatryjournal.com/article/S0006-3223(09)00106-1/abstract), 2009; Stefovska VG (https://www.ncbi.nlm.nih.gov/pubmed/18991352), 2008); Benzodiazepines: The Good, The Bad, and the Ugly (https://journalofpsychiatryreform.com/2016/11/20/benzodiazepines-the-good-the-bad-and-the-ugly/)
panic_down_under
07-10-21, 12:33
My unanswerable question is:
Are these last 5 days a passing side effect or a hump?
Or………
Are the last 5 days exactly what the medication is meant to do and I am just not suited to it?
Or.......
Is escitalopram not working yet and what I'm experiencing is the anxiety I'm taking it for in full flight.
The answer to the first question is escitalopram is almost certainly not working yet. For the second, its hard to say, but it is likely just underlying anxiety exacerbated by the stress of current circumstances.
Too old for increase.
I'm over 65 so 10 mg is the limit
So the 10mg escitalopram isn't adequately effective on its own? If so it would be better to increase the dose rather than relying on benzodiazepines to paper over the cracks as they *inhibit ADs.
* see:
Boldrini M (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4374628/), 2014; Nochi R (https://www.ncbi.nlm.nih.gov/pubmed/23963779), 2013; Sun Y (https://www.ncbi.nlm.nih.gov/pubmed/23639432), 2013; Song J (https://www.kurzweilai.net/how-the-brains-stem-cells-find-out-when-to-make-new-neurons/comment-page-1#comment-96481), 2012; Wu X (http://www.biologicalpsychiatryjournal.com/article/S0006-3223(09)00106-1/abstract), 2009; Stefovska VG (https://www.ncbi.nlm.nih.gov/pubmed/18991352), 2008); Benzodiazepines: The Good, The Bad, and the Ugly (https://journalofpsychiatryreform.com/2016/11/20/benzodiazepines-the-good-the-bad-and-the-ugly/)
Sorry jon I can't answer that one.
My experience was nothing like yours.
If I tried higher dose benzodiazepines it would be at home for sure. I find benzodiazepines help anxiety but worsen depression so that is why I haven’t used higher doses. Again unlucky with medications. :-(
I did feel better on the 5mg lexapro but that was only for 10 days so probably placebo effect.
Then I went to 10mg and felt ok-ish (up and down) for a few weeks BUT these last 5 days things have gone pear shaped.
My unanswerable question is:
Are these last 5 days a passing side effect or a hump?
Or………
Are the last 5 days exactly what the medication is meant to do and I am just not suited to it?
Well I haven’t even finished week 5 so I shouldn’t be expecting much. I went through my paroxetine notes and didn’t see any real improvement till week 7 so I am trying to be patient but Christ it’s hard.
Do not want to muck around with dose without talking to dr and my next appointment is in a month.
Sometimes I read lexapro reviews online and most people see benefits at 4-6 weeks.
There are no hard and fast rules for response though, John and maybe it's best to just take each day as it comes, hard as that may be? Then report back to your doctor who can make an assessment based on how things are in a month for you. I think you are putting additional pressure on yourself by searching for a timeline for "improvement" which is a natural thing to do but may be unhelpful with anxiety?
There are no hard and fast rules for response though, John and maybe it's best to just take each day as it comes, hard as that may be? Then report back to your doctor who can make an assessment based on how things are in a month for you. I think you are putting additional pressure on yourself by searching for a timeline for "improvement" which is a natural thing to do but may be unhelpful with anxiety?
Lol I must of asked myself the question when will I feel better a million times.
Please excuse the pun but going backwards whilst on medication is a bitter pill to swallow.
Wow I made a joke.
Medication certainly doesn't help everyone and medication alone isn't the "answer" and "cure" for anxiety.
If you feel significantly more anxious and depressed then I would contact your psychiatrist and ask for advice.
Well I do feel worse but I really want to try to hang in there for at least 2 months to say I have it a go.
Well I do feel worse but I really want to try to hang in there for at least 2 months to say I have it a go.
That's a very sensible approach. It's helpful to have a plan and to stick with it without ruminating too much on physical symptoms which are annoying but harmless. Don't let them drag you down?
Thank you for the support pulisa.
I hope you are doing well :-)
I can still function, John and I find that the periods of agitation pass more quickly now that I'm on lexapro. The med has definitely helped with the depression symptoms. Anxiety-wise I prefer to rely on self-help.
I like your approach. In those moments where the depression and brain fog have lifted I find I still have anxiety but it’s more like an annoyance. I can use my self-talk to allow the symptoms to pass without trying to fix anything.
It is still early days for me. Headaches, brain fog still present but will continue on the 10mg. Only just finished week 5.
Pretty low mood the last couple of days. Depression and anxiety hanging around most of the day. Have to go into work on Saturday and not looking forward to it.
Hi people, another bad day.
Went into work for a few hours but have had bad brain fog all day. Also physical anxiety symptoms like feeling my heartbeat hard but not fast.
Really hoped to start getting some relief but not today.
Can you describe what you mean by brain fog, John? You said you worked with power tools so it must be very hard to maintain concentration.
I guess the best way to describe it is as a lack of concentration. It could be depression?
Cannot gather my thoughts and anxiety hits 11 out of 10.
Into week 6 now and still nothing positive to report.
Trying to be patient.
Actually anxiety is worse and my mood is worse too. Will speak with psych tomorrow…
Spoke with my psych yesterday.
I told her that I’ve had increased anxiety and low mood and poor concentration for the last two weeks. In other words I am not getting any benefits from the 10mg lexapro even though it has been over 6 weeks.
She now has me on 15mg for 2 weeks with the objective of getting me up to 20mg.
She said that I am likely not getting any benefits from my current dose and this is the way to go.
Are you happy with that plan? Do you have faith in her?
I take it there is no concern about your sensitivity to these meds?
Are you happy with that plan? Do you have faith in her?
I take it there is no concern about your sensitivity to these meds?
I am very frightened.
She said 10mg is only for elderly patients and the rest of her patients are on 20mg.
I specifically asked her if my current symptoms are medication related or mental health and she is adamant the drugs are not causing my heightened anxiety etc. I think it is more 50/50.
I have taken 15mg for the past 2 days. Spent most of today on the couch. Don’t think I will be able to go to work and pretend everything is fine when I feel like crap.
Personally I would question her theory re the 10mg dosage.
Does she think that you are actually fit to go to work and use power tools?
Hi pulisa
I'm 68 and on 10mg.
More than that is not recommended for over 65s.
Hello Phill
Yes I appreciate that but I thought that 10mg was a therapeutic dose for all adults not necessarily only for those over 65?
Isn't the range 10-20mg daily?
I'm 37 and on 10mg, and it's been fairly effective for me.
I have been taking the 15mg for a few days now and the anxiety is still up where it was. Also headaches which are probably related to the anxiety.
I managed to do a few hours at work yesterday which was good.
Will just have to trust her judgement for now and continue on the increased dose.
Hello Phill
Yes I appreciate that but I thought that 10mg was a therapeutic dose for all adults not necessarily only for those over 65?
Isn't the range 10-20mg daily?
Hi Pulisa
This is the advice in the leaflet
"10 mg/day is the recommended dose for most elderly patients"
The max dose for younger people is 40mg but I'd be hesitant about going that high.
In the UK that's the dosage for citalopram/cipramil but it's 10-20mg for escitalopram/lexapro.
I wonder why the dosage criteria is so different in our countries?
No idea Pulisa.
I've just been diagnosed with pre diabetes and the levels for that in the UK are higher than here too :shrug:
I'm sorry to hear that, Phill. Can you manage that through diet alone?
I reckon your healthcare system is superior to ours which is all over the place at the moment!
I'm unsure at the moment Pulisa.
I'm still learning about it.
Our health system isn't doing so well at the moment.
Lots of Drs and nurses unable to work due to Covid iso etc.
So 6 days at 15mg as per doctors instructions.
Anxiety not any better.
A lot of brain fog and fatigue.
Went for a full round of blood work today.
Do you magically feel better at some point? Because there is no gradual improvement in my opinion. :-(
I think you are expecting a lot from a medication alone, John. See whether your bloods come up with anything which could explain the physical symptoms but it won't help to focus on how you are feeling every day. Has your psychiatrist not suggested any form of therapy to complement the meds?
No you don't magically feel better at a specific time. Improvement is something which comes once you stop analysing your feelings and coming up short.
It seems the lexapro is making my headaches worse. I always had anxiety headaches but they’re worse now.
I am seeing my neurologist tomorrow morning for Botox injections which treats the headaches.
I have read that increasing the dose of any antidepressant resets the clock on when they start to work. If that is true I won’t see any improvement until December. So so so disappointed
I hope the Botox helps. I live with chronic pain too and it can really drag you down..if you let it. I had psychological therapy to help me manage my pain. There is no doubt that anxiety heightens pain perception and some days are obviously better than others but if you feel/perceive less pain you are going to feel better physically and psychologically and this won't be down to lexapro dosage so don't pay too much attention to dates and "rules" re potential efficacy?
Since going up in dose I have experienced a really big increase in fatigue.
It has been 1 week at the increased dose and lately all I can do is lie on the couch.
I tried a strong coffee this morning to get me going but that causes my anxiety increase.
Anyone else had this bad fatigue reaction on this medication?
Journey so far:
10 days at 5mg
45 days at 10mg
7 days at 15mg
Actually felt BEST the first two or three weeks and have gotten WORSE as this medication has built up in my system.
In particularly since starting week 5 on 10mg things have gone south. Then going up to 15mg anxiety and brain fog almost 24/7! Also depression rearing it’s ugly head too.
Hoping my psychiatrist calls me back today to discuss my options. Her secretary said she doesn’t work fridays so will see…
You know best how you are feeling. I've always found that less is more but that goes against the therapeutic dose guidance, I know.
Have any of these meds actually helped you though?
You know best how you are feeling. I've always found that less is more but that goes against the therapeutic dose guidance, I know.
Have any of these meds actually helped you though?
10 years ago I had luck with Pristiq and stayed on it for 3 years. Then came off it without any dramas and felt well for another 3 years.
This time it didn’t help me at all. Just made anxiety worse.
Psychiatrist called and said I can go down to 10mg thank god.
Psychiatrists prescribe massive doses of anti depressants well above the therapeutic dose. Why wouldn’t the opposite be true for some people?
Anyway my blood work revealed some thyroid problem I need to see my GP about.
The thyroid anomaly could be very significant. Either hypo or hyperthyroidism. You need to get that looked at because it could be having an effect on how you are feeling mentally.
So thyroid turned out to be nothing. Doctor recommended to eat less salt and have another round of bloods in six months.
Decided to give 20mg lexapro a try as I am only working one day a week and if I don’t try it now I never will.
So have been on 20mg for 5 days now and obviously too early to see any improvement but will try to stick it out. Jaw clenching and headaches still lingering as are anxiety/depression symptoms.
Seeing psychiatrist in 2 weeks. Hopefully I get some relief by then or we will probably stop.
Good on you for sticking it out jon.:yesyes:
Hope you see some improvement soon.
Doesn’t look like I’ll be sticking to the 20mg. Have had smashing headaches like I’ve never had before.
That's really strange.
I never had a headache with it.
Maybe talk to your GP about a change of meds?
I take it the botox injections haven't helped? Why not look into getting a physio to assess your neck and shoulders as to active trigger points?
Do you still have faith in your psychiatrist?
I take it the botox injections haven't helped? Why not look into getting a physio to assess your neck and shoulders as to active trigger points?
Do you still have faith in your psychiatrist?
Hey pulisa I feel the Botox does help long term.
However trying to increase the lexapro dose has been a failure. I guess SSRI meds aren’t for me. Especially at higher doses. I have experienced nasty headaches, jaw clenching and fatigue without any real benefits to mood and anxiety.
I am at 10mg now after trying the 20mg which made things SO much worse. Will stick to 10mg for a few more days and then reduce to 5mg and see how things go.
I still believe my psychiatrist has my best intentions at heart but I just don’t respond well to some meds. Her original instructions were to stay at 5mg for 6 weeks but I jumped to 10mg after a couple of weeks.
You know that I have always thought that less is more for me and therapeutic dosage is down to the individual's response as opposed to what the doctors say it should be.
Hope you feel more settled on the lower dose. At least you tried the 20mg.
Yep I am glad I tried the higher dose but now I just want to get it out of my system lol.
Have been at 10mg for a few days now and hope to go down to 5mg soon.
It’s going to be a rough ride but I keep reminding myself that I had to give it a try.
The higher dose was a strange mixer of agitation and fatigue. Yuck!
I remember when Pristiq worked for me many years ago things got better and better the longer I stayed on it and had full remission after 6-8 weeks.
Is Pristiq not an option for you now? Sorry if you've already elaborated on this..
Is Pristiq not an option for you now? Sorry if you've already elaborated on this..
Unfortunately the pristiq made the anxiety worse this time around :-(
I asked why this happened and the answer I got was “your brain chemistry has changed”.
I am down to 5mg lexapro and will see my psychiatrist in a couple of days. We have pretty much tried everything so I don’t know where we will go from here.
The only SSRI I haven’t tried is Zoloft but I don’t see why that would work when everything else has failed.
I was on Zoloft ans switched back to Lexapro
Are you prepared to try another med or are you just fed up of the whole process of antidepressant trial and error? I suppose it depends on how convincing your psychiatrist is? That's why I asked you whether you still have faith in her and her ability to prescribe appropriately.
Psychiatrist said I should stay on 5mg lexapro for 6 weeks as originally planned.
She does not want to prescribe another anti depressant.
She believes the lexapro at low doses will help me but it will not be a 100% cure.
I find low dose lexapro helps me deal with the worst of the agitation but I have never expected a "cure", more a better quality of life and an ability to get through each day. That means a lot to me but I understand that you want more and maybe therapy in addition to meds may be the next step?
I haven’t seen my psychologist for a while now. Maybe time to revisit her or someone new.
I have been on 5mg for 12 days.
A strange thing has happened these last few days. I get to sleep ok but I am wide awake from 3am for an hour and then get back to bed. I think my body is still adjusting to the dose change.
Also agitation is all over the place. One minute I’m fine and next minute I’m crawling out of my skin.
Hope I settle soon.
Let's hope so Jon :yesyes:
I think it might be a good idea to look into therapy again. The right meds can help but they're aren't a chemical "fix". Were you happy with your psychologist last time?
Will be calling my psychologist tomorrow to book in an appointment.
Not going to continue on the lexapro, even at this low dose for the last 2 1/2 weeks I’m getting more side effects than benefits. Constant headaches/head sensations and doesn’t allow me to relax just like I’m on a dirty street drug.
Maybe my mind is still adjusting after being on the higher doses?
Went to work yesterday and managed to do 6 hours but felt brain dead the whole time.
Seeing psychologist next Friday.
Coming off SSRIs is harder than coming on. :-(
I think you will benefit from trying another course of therapy. Even from the point of view that you will be able to talk through what is really bothering you and what could be the root cause. I think you've had enough of ADs for the time being and need a fresh approach? Psychologically it could help even if only to take the edge off your distress.
Hey Pulisa hope you’re well. Haven’t seen PDU around for a while and hope he’s ok.
Talk therapy sometimes loses effect if there is no clear goal in mind. That is why I didn’t do it for the last 6 months or so. However if I feel really low it is good just to talk about anything. I do think there are some problems I have been sweeping under the rug that need airing.
As for medication I won’t say never again but I am happy to have a break from it. I still take valium or clonazepam from time to time.
I have booked in for knee surgery in January and although going under frightens me I am looking forward to getting some relief from the pain and swelling I have been putting up with for the last year.
panic_down_under
05-12-21, 10:41
Haven’t seen PDU around for a while and hope he’s ok.
Was slacking in hospital for a few weeks. I apparently have an incurable illness, stupidity, which may end up being fatal one of these days. Tried doing something that would have been unwise at half my age and paid the price. Still have quite a hole in one leg as a reminder of my folly. :wacko:
Was slacking in hospital for a few weeks. I apparently have an incurable illness, stupidity, which may end up being fatal one of these days. Tried doing something that would have been unwise at half my age and paid the price. Still have quite a hole in one leg as a reminder of my folly. :wacko:
I noticed you hadn't been on too PDU, hope you're in the mend.
Sounds extremely painful, PDU and really sorry to hear that you've been in hospital. It must have been really bad luck and not "folly".
Hey Pulisa hope you’re well. Haven’t seen PDU around for a while and hope he’s ok.
Talk therapy sometimes loses effect if there is no clear goal in mind. That is why I didn’t do it for the last 6 months or so. However if I feel really low it is good just to talk about anything. I do think there are some problems I have been sweeping under the rug that need airing.
As for medication I won’t say never again but I am happy to have a break from it. I still take valium or clonazepam from time to time.
I have booked in for knee surgery in January and although going under frightens me I am looking forward to getting some relief from the pain and swelling I have been putting up with for the last year.
Living with chronic pain certainly adds to low mood and really drags you down. Hopefully the op will bring benefits both physically and mentally.
I understand what you mean about therapy "goals". I suppose you have to weigh up whether you are prepared to talk about issues which you have kept hidden for a while? That can be a big step.
panic_down_under
06-12-21, 11:06
I noticed you hadn't been on too PDU, hope you're in the mend.
Thanks. I am. It looked grim for a while, but the only issue now is a sizeable hole that will take another month or so to heal.
Sounds extremely painful, PDU and really sorry to hear that you've been in hospital. It must have been really bad luck and not "folly".
It wasn't that painful, pulisa. The real problem was the antibiotic resistant infection that followed. And it was folly. I knew it was stupid and that I'd likely hurt myself, but did it anyway to save time. As it turned out the damage was minimal, just took the surface layer of skin off a shin so I thought I'd gotten off lightly until the leg blew up to twice its normal size and turned a very deep red 3 days later. There's no fool like an old fool!! :emot-fail: :redface:
You didn't know that you'd get such a severe infection...Just goes to show how dangerous these things can be. I'm glad you're home now but take it easy whilst you are healing!
Glad to hear you are on the mend Ian. Infections can be a pain to treat and thankfully most doctors take them very seriously.
Wishing you a speedy recovery.
Yes pulisa I pushed my injured knee too far at work for a couple of days climbing ladders and what not and it has really stuffed me up. Think I’ll have to go back to half days for a while until I have the operation.
Problem I have had is I can’t really relax (anxiety) so when I am at work I go at a fast pace and end up injuring myself.
Seeing psychologist tomorrow afternoon to see if she has some strategies to slow me down and just talk through some issues in general.
Also stopping the lexapro has been harder than I thought. Depression and anxiety plus fatigue and prickly sensations on my face. Looks like 3 months was long enough for it to get into my system.
Hope you got some helpful strategies to try out from the psychologist..and that you believe that they will be worth trying regardless of how you are feeling mentally and physically.
Mentally feel very weird. My energy levels are all over the place! Think there might be a little bit of benzo withdrawal going on as well as SSRI discontinuation. Not sure but I am just trying to ride out the next week and hope things settle.
The psychologist and I agreed I was doing my best when I was physically fit and working steady hours and not on medication.
I lost a lot of work due to covid restrictions and as I was employed as a casual I didn’t qualify for government assistance.
At the moment I have to go easy on my bad knee till I get the surgery and from there on I hope to start feeling better a little bit at a time.
It is a slow recovery but I have to accept it.
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