Is Lexapro worth it? Or am I Joan of Arc busily dropping kindling around my feet... ?

History:
I've had anxiety since 5yo. Panic disorder (full blown panic attacks) started twice a day at 15 - until mid twenties.

I've only taken medicine once - when I was 16yo, doc put me on Xanax for a full year. I stopped it as I felt like a zombie, more specifically a sociopath (no emotional reaction to things that should cause emotional reactions).

For the next 30 year (46yo now), I never leave the house without one pretty-pink Xanax pill in my pocket, I primarily ONLY use it if I get a full blown panic attack (they come out of the blue, like bombs), or if I have to fly (hate flying). I drop 0.25 and within an hour I'll be fast asleep.

Today:
Agoraphobia and my quest to visit every country on earth aren't BFF. The drive to travel + fear of stairs, wide open places, narrow places, crowds, strangers, strange places - well... A conflict. 6 months ago I had the bright idea to start taking Xanax (0.25) 4x a day (6am, 12pm, 6pm, 12am). I started taking it before an upcoming 3 month trip through 14 countries. The hypothesis being that keeping myself on a low dose would head-off any building anxiety that comes from travel / agoraphobia. (If you stuff towels under the door to prevent water coming in - you'll never need a rowboat in the basement).

Fast forward 6 months, the trip is long finished (I quit halfway through). I'm back home and all of sudden having massive panic attacks, palps. Of course - off to ER at 3am (multiple times) for my EKG (fine sir). Turns out my body (in finest Borg fashion) has adapted to the 0.25. I upped the dose to 0.50 (4x a day) and I'm back in Wonderland. What anxiety? Fear what?

I desperately want to come off Xanax because it's turned my sex drive into a very deep, very dark, empty void. My junk has gone from an object of enjoyment (at least amusement) to an appendage I only notice when I head to the bathroom (sigh). I want OFF Xanax (please) because I used to enjoy sex, and it's hurting my long term relationship.

My Dr. yesterday prescribed me 10mg Lexapro. The idea being to let it kick in, ride the Lexapro-roller-coaster for a few months (while continuing my 0.5mg Xanax 4x a day) and then SLOWLY come off the Xanax. Then come off the Lexapro (tapered). I'd be back to square one - where I was just 7 months ago (before my bright idea) - carrying around a spare Xanax and dreading flights. I can live with that - as I would probably still keep my girlfriend and might even get erections.. woohoo - sunny days!

WORRIES

Adding an unknown drug to come off an already unwanted drug seems like pouring gas on fire. Lex has a number of negative side effects - weight gain (thanks to Pop Tarts, Cookies and anything with sugar I already have this issue), dizziness, insomnia, lack of sex drive, yada yada.. Also, I'm a writer, I'm wary of any new drugs that may potentially screw with my ability (such as it is) to write.

Happy people rarely bi*ch. So, when I read reviews of Lexapro it's normally the unhappy ones. The ones that go into gruesome detail about how Lexapro turned their lives into car crashes and horror shows.. It's difficult to find really positive reviews about how great it is, because those folks are off riding unicorns that fart rainbows - presumably.

Now, my choices - and where I could really use your sage advice!

1. Take 2.5mg of Lexapro for a week, then up to 5mg, then up to 7.5, then up to 10mg - and see how it goes - if everything is swell; get off the Xanax - and then decide if Lexapro offers or detracts from my existence
2. Drop the Lexapro in the trash can right now (er.. store on shelf with a dozen other drugs I was too fearful to try). Keep taking my 0.5 Xanax for a few weeks to even out, then start a long slow tapering (dropping by 20% every 4 weeks) until I'm off of it - in 5 months.

Advice? Please?

Lexapro has been great for me.
Started on 5 mg and went up to 10 mg after a week.
Never needed any more than 10mg.

Quote:

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Originally Posted by panicface

Drop the Lexapro in the trash can right now (er.. store on shelf with a dozen other drugs I was too fearful to try). Keep taking my 0.5 Xanax for a few weeks to even out, then start a long slow tapering (dropping by 20% every 4 weeks) until I'm off of it - in 5 months.

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The first issue is how are you going to treat the ongoing anxiety once you've quit both the Xanax (alprazolam) and Lexapro (escitalopram)? Have you tried cognitive/behavioural (CBT, REBT), or mindfulness therapy and if so what was the outcome?

Being on an antidepressant (AD) long term is a much, much better bet than Xanax and given your history you may well have to consider remaining medicated for more than a few months. Whether Lexapro works and you can tolerate the side-effects is of course another matter. But with a bit of trial and error there is a good chance you will find an AD that you can live with. Despite what you've read ADs are not the demon spawn some claim. They can be pains in the butt, especially at the beginning, but most do okay on them with tolerable side-effects. Plus, not all the problems people report are necessarily down to the med. The disorders they are treating can create some too. An anxious mind in particular is quite capable of producing the most unpleasant of symptoms.

Trying to wean off Xanax is going to be very difficult in large part because of its very short half-life and forget about 20% reductions, even 10% may be optimistic. The better option would be to switch to an equivalent dose of diazepam (Valium), which has a very long elimination half-life, and weaning off it slowly over some months (it will probably take longer - the downside of that long half-life, but the success rate is much higher).

I only ever took one tab of Xanax.
It was just too good.
It made me feel great but crashed after a short time leaving me craving more.
I can see how people get addicted to it.
I can't speak for others but I had virtually no side effects with Lexapro.
I was on it for 5 years and went off cold turkey with minimal side effects as I was so much better.
Unfortunately life threw me a few problems all at once and 8 years later I ended up back on it.
I'll give it a while longer and go off it again.

Quote:

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Originally Posted by Phill2

I was on it for 5 years and went off cold turkey with minimal side effects as I was so much better.

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Please don't do this the next time. You were lucky, but this is one issue where tempting fate is a bad idea as antidepressants affect more organs than just the brain. Dropping the dose by 2.5mg every 7-10 days is better, less if there are rebound, or withdrawal effects.

Different strokes for different folks :shrug: