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Thread: 15mg Lexapro - but how long until positive or any effects?

  1. #51
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    Re: 15mg Lexapro - but how long until positive or any effects?

    What medications are you on now PDU? What have you found most effective for anxiety?

  2. #52
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    Re: 15mg Lexapro - but how long until positive or any effects?

    Quote Originally Posted by Windywel View Post
    What medications are you on now PDU? What have you found most effective for anxiety?
    I can't tolerate SSRIs/SNRIs, so have only taken MAOIs, imipramine and for the last 25 years, dosulepin, aka dothiepin. The MAOIs were the most effective, but back in the late 1980s the dietary restrictions were an issue for me. Modern food preparation techniques have apparently significantly reduced the risk, so should I need to stop taking dosulepin, which is probably inevitable as my heart ages, then tranylcypromine (Parnate) is at the top of my list.
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  3. #53
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    Re: 15mg Lexapro - but how long until positive or any effects?

    Interesting. Why can’t you tolerate SSRIs/SNRIs? Do they give you awful side effects? Is dusolepin a TCA? Do you have depression as well as anxiety?

  4. #54
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    Re: 15mg Lexapro - but how long until positive or any effects?

    Quote Originally Posted by Windywel View Post
    Interesting. Why can’t you tolerate SSRIs/SNRIs? Do they give you awful side effects?
    They make me manic.

    Is dusolepin a TCA? Do you have depression as well as anxiety?
    Yes, and no, only panic disorder.
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  5. #55
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    Re: 15mg Lexapro - but how long until positive or any effects?

    Another week, another med....

    So Clonidine didnít really work out due to my already low bp. Next stop Pregabalin. Still on 10mg Escitalopram until and if P works. Iíve been on 25mg for a week and feel so drowsy and dizzy, which is expected - just really hoping it wears off.

    Still kind of want to come off everything and start again. Not a huge fan of now taking 2 brain altering medications. Iíll go another week and see how it goes....

    Hope everyone else doing ok! NervousKel?

  6. #56
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    Re: 15mg Lexapro - but how long until positive or any effects?

    Quote Originally Posted by LisaS View Post
    Still on 10mg Escitalopram until and if P works. Iíve been on 25mg for a week and feel so drowsy and dizzy, which is expected - just really hoping it wears off.

    Still kind of want to come off everything and start again. Not a huge fan of now taking 2 brain altering medications.
    Agreed on the two meds. If escitalopram isn't working at a dose you can tolerate then, imho, it isn't worth taking, but it is best left until you're stabilized on pregabalin as changing two med doses will just create confusion. Also, 25mg pregabalin is a very low dose. I wouldn't expect much from it until you're taking well into triple figures.
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  7. #57
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    Re: 15mg Lexapro - but how long until positive or any effects?

    Hi All,

    Merry Christmas to you all and a quick update.
    I started levelling out on the 25mg of pregabalin but felt slight anxiety creeping back so upped it to 50mg. My psychiatrist is under the impression that I will not need to go into the triple figures.
    I've also come down to 5mg of escitalopram and looking to drop to 2.5mg in the next few days.
    It definitely seems to take a while for the pregabalin to settle - I feel pretty dreamy for a couple of weeks before starting to feel 'normal' again which can be a little odd and dreamlike and disconcerting.
    My psych loves chatting about meds and also mentioned Reboxetine and Brintellix - I'm sure you'd enjoy talking to her PDU! She also was keen on a 'sprinkle' of dexamphetamine! What are your views on these ones!?

    I mean I'm happy to just be on the pregabalin tbh if it turns out to be effective, and if it doesn't I'm not sure I'm up for guinea pigging these random ones and would rather go for Effexor, Pristiq or Duloxetine/Cymbalta...

    Question for you about the SNRI's - I know that effexor is basically an SSRI until the higher doses, but is this the same story for Pristiq and Cymbalta too? (I know pristiq is a v similar drug to Effexor..)

    Thanks!
    P.s. I am overall feeling much better - I'd say around 75% there....

  8. #58
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    Re: 15mg Lexapro - but how long until positive or any effects?

    Quote Originally Posted by LisaS View Post
    My psych loves chatting about meds and also mentioned Reboxetine and Brintellix - I'm sure you'd enjoy talking to her PDU! She also was keen on a 'sprinkle' of dexamphetamine! What are your views on these ones!?
    Neither reboxetine or vortioxetine (recently rebranded to Trintellix because of potential confusion of Brintellix with another med of a similar name) haven't really set the world on fire. Reboxetine is a weak noradrenaline (NA), aka norepinephrine, reuptake inhibitor. The NA inhibiting TCAs nortriptyline (Pamelor), or desipramine (Norpramin) would be better bets. Vortioxetine is just another SSRI. It may be a better fit to your biology than other SSRIs so might be worth trying, but as a generalisation it hasn't proved significantly more effective than the others.

    I know that effexor is basically an SSRI until the higher doses, but is this the same story for Pristiq and Cymbalta too?
    Even at the maximum 375mg dose venlafaxine (Effexor) is still only a weak NA reuptake inhibitor. Its active metabolite desvenlafaxine (Pristiq) is a little better and duloxetine (Cymbalta) more potent again. However, I don't recommend any of them because of their very short half-lives which can make starting and stopping them difficult, exacerbated with duloxetine by the limited range of doses it come in. The serotonin+noradrenaline reuptake inhibiting TCAs are a much better bet, imho. They usually produce fewer initial side-effects aided by being available in very low dose tablets, are arguable more effective than SSRIs and SNRIs, especially for depression, and are also usually easier to wean off. OTOH, they do tend to have more ongoing side-effects, mostly nuisance ones such as dry-mouth and constipation which can usually be managed.

    She also was keen on a 'sprinkle' of dexamphetamine
    Or maybe the AD bupropion (Wellbutrin) which is quite stimulating. Too stimulating as a primary AD for most with anxiety, but very useful for depression. At low supplemental doses it may also counter some SSRI/SNRI side-effects.
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  9. #59
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    Re: 15mg Lexapro - but how long until positive or any effects?

    Well after saying I was feeling much better, today I feel worse than I have in ages.
    Woke up with a panic at 4am and have been anxious/nervous and shaky ever since.. I've just taken a propanolol to see if it helps as it seems to be purely physical. Why this is happening, I don't know.
    I can't imagine it would be anything to do with coming off escitalopram as I've been on 5mg for 2 weeks and haven't had any other side effects while coming off.
    It's been just over a week at 50mg pregabalin and I am not keen on how weird it makes me feel sometimes - so could be that. Otherwise its the after effects of Christmas. Either way this is a journey I am on that I didn't buy a ticket for!
    My clinical psychiatrist is lovely and well versed in her field but its as much a minefield in relation to meds as it is for the GP. It's basically pick one and see how you go.

    PDU you mentioned Effexor and the half life - I took the extended release version around 15 yrs ago and although it was a hideous start up, I do vaguely remember it helped... I was on it about 18 months before I came off as I was pregnant. I remember a few head shocks but don't remember it being hugely traumatic coming off, so could be a potential for me to try again! I think you can now get an ER version of pristiq too?

    Anyway... onwards I go....

  10. #60
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    Re: 15mg Lexapro - but how long until positive or any effects?

    Quote Originally Posted by LisaS View Post
    I can't imagine it would be anything to do with coming off escitalopram as I've been on 5mg for 2 weeks and haven't had any other side effects while coming off.
    Withdrawal symptoms usually start before the reduced dose stabilizes to a steady-state again, so in under a week for escitalopram. However, very occasionally I have heard from people who have had delayed onset. Unlikely, but not impossible.

    Otherwise its the after effects of Christmas.
    Christmas can be the most stressful time of the year so a likely candidate, imo.

    PDU you mentioned Effexor and the half life - I took the extended release version around 15 yrs ago and although it was a hideous start up, I do vaguely remember it helped... I was on it about 18 months before I came off as I was pregnant. I remember a few head shocks but don't remember it being hugely traumatic coming off, so could be a potential for me to try again! I think you can now get an ER version of pristiq too?.
    Extended release versions don't change the half-life, just release the med over 24 hours instead of immediately. That provides a smoother ride while taking it, but doesn't help when weaning off. The amount in your system still drops off the cliff soon after the dose if cut back. It also adds a further complication because there are only a few extended-release dose options so often people need to switch to and cut immediate-release tablets instead to shave the dose down by small steps. That said, trying to wean off venlafaxine directly is the heroic way of doing it. Usually the easier option is to switch to fluoxetine (Prozac) for a while and then weaning off it. A lot of hassle for an AD that doesn't have any real advantage over SSRIs and a couple of significant disadvantages. Desvenlafaxine is a little easier, but I still don't see the point
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