For most 5mg is a sub therapeutic dose and taking less than the recommended minimum dose for such a long time may have be unwise.Originally Posted by AnnieLopez
Antidepressants have no direct effect on anxiety, or depression in the way say aspirin has on a headache. They work by stimulating the growth of new brain cells (neurogenesis) to replace cells killed, or prevented from growing by high brain stress hormone levels. The therapeutic response is produced by these new cells and the stronger interconnections they forge, not the meds directly and this requires a minimum level of the med in the system to initiate and sustain.
The problem with taking sub/borderline therapeutic doses is neurogenesis may be interrupted whenever plasma levels drop below the amount needed to sustain it which may lead to the second issue, the growing evidence antidepressants become progressively less effective every time they are stopped and restarted. Two studies, Amsterdam JD, 2016 and Amsterdam, 2009 found the likelihood of antidepressants working after each restart drops by between 19-25% (see also: Amsterdam JD, 2009; Leykin Y, 2007). This applies whether returning to a previously taken antidepressant or a different one. Taking a low escitalopram dose for 9 months may have often created a similar situation as stopping and restarting it. While the neurogenesis interruptions will only have be of short duration, they will would have been much more frequent.
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