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

[LisaS]

If I've done the calculation right you've now been on 15mg for 30 days which is still a little early to draw a firm conclusion, imho. I'd give it at least another 2 weeks.
It’s been 5 weeks on 15mg. 12 wks since I started 10mg..


Given you've needed to take 20mg in the past I don't think you're on an excess dose now. Agitation tends to occur a little more often with escitalopram than the parent compound citalopram, so if it continues to be a problem switching to the older med might resolve it. As they share the same active drug (citalopram also contains a mostly inactive isomer of it) there should be few if any side-effects.

I did take 20mg a couple of years ago but I was in a much more debilitating state than I am this time.

If I were to switch to Citalopram, is it a straight switch or do I have to come off ESC than back on Cit?

[panic_down_under]

If I were to switch to Citalopram, is it a straight switch or do I have to come off ESC than back on Cit?

A straight overnight switch should present few, if any problems. The active drug in both is exactly the same, the S-enantiomer of citalopram, aka escitalopram, the difference is citalopram also contains a mostly inactive form of the drug, the R-enantiomer, which produces some minor differences in how the drug interacts with biology, but most won't notice any difference except maybe in side-effects. There can be subtle differences which is actually what you'd be hoping for with respect to the agitation. I can't guarantee it'll work, but there is usually little downside in giving it a shot. It is just as easy to switch back if you choose to.

[LisaS]

Hey PDU,
Before you referred to the amount of time I'd been on 10mg but now you mention the 15mg. FWIW, it's now been 13 weeks since I started the 10mg and almost 6 weeks on the 15mg.
I probably had one of my worst days yesterday and was back to the diazepam and propanolol. Today I feel a bit spaced out and down in the dumps (fed up).. I'm so disappointed. I am seeing my GP on Tuesday and see what he thinks.

Part of me wants to keep going, part of me wants to come off and reset and start again and part of me wants to go to 10mg ... I hate how there is no quick fix to this.

thanks for your support this far though.

[panic_down_under]

FWIW, it's now been 13 weeks since I started the 10mg and almost 6 weeks on the 15mg.

If the 15mg is going to work then from now on would be when it is most likely too. That said, I suspect it'll take 20mg.

Part of me wants to keep going, part of me wants to come off and reset and start again and part of me wants to go to 10mg

There are good arguments for the first two, but I doubt 10mg will work, Lisa.

[LisaS]

I saw a new GP yesterday who said he didn’t think meds would work for me at all which was not the best thing to hear! He’s doing full blood work up and then go from there. He thinks I need to work more on my psychology, which I have been actively doing for years.
After waking at 4am today with a major panic, I think I’ve made me own decision to come off. I’ve given it a damn good go.
I’ll prob go down to 10mg for a while and take it slow from there.

He mentioned Valdoxan but I’m keen to try Pristiq..

[panic_down_under]

I saw a new GP yesterday who said he didn’t think meds would work for me at all

Based on what? Escitalopram worked for you in the past so obviously you can and do respond to ADs. The fact it hasn't this time can probably be attributed to the loss of efficacy after discontinuation and restart hoodoo, but this doesn't mean no ADs will work and this would be true even if SSRIs were the only ADs available, which isn't the case. There are many other ADs acting on a range of different pathways.

BTW-have you been treated by a psychiatrist in the past? If not, now might be a good time to ask for a referral.

He’s doing full blood work up and then go from there. He thinks I need to work more on my psychology, which I have been actively doing for years.

Blood work is always a good idea as there are some conditions which can produce similar symptoms as the anxiety disorders, though they are uncommon. As for therapy, it too could be worth while doing a formal refresher.

After waking at 4am today with a major panic, I think I’ve made me own decision to come off. I’ve given it a damn good go.
I’ll prob go down to 10mg for a while and take it slow from there.

I'd be tempted to ask for a small dose of buspirone (Buspar) to be added. It is a GAD specific med which works very well for a few and not at all for most and then only for GAD and maybe social anxiety. However, it has a pretty good track record for increasing the effectiveness of SSRIs and SNRIs and/or reinvigorating those that are/have failed. It may also ease some of the common SSRI/SNRI side-effects. If it is going to work you can expect to see positive indications within 2-3 weeks, though it may take another few to hit peak efficiency.

He mentioned Valdoxan

Valdoxan (agomelatine) is a unique melatonin acting AD which doesn't seem to be prescribed much, possibly because it wasn't able to gain FDA approval due to indifferent trial results and some doubts about its affect on the liver. It took several attempts before the TGA approved it in AU too (PDF). It might prove to be a very effective med for you, but it is well down my to try list. It does reportedly usually produce few initial side-effects and appears to be easy to discontinue.

but I’m keen to try Pristiq..

Any reason?

[LisaS]

Hi PDU

I appreciate your response and totally agree with you regards to the efficacy of SSRIS and me. I have had success with Effexor and Escitalopram in the past so I’m not immune.

I have seen a psychiatrist last year when I was having excessive twitching from Sertraline and my plan was to come off and restart Pristiq. But when I came off I felt great so didn’t restart anything which has led to anxiety creeping back again.
Pristiq came up as a recommendation from a DNA test I did due to the fact it is independent of pharmacogenetic status, apparently.. plus being an offshoot of Effexor that has worked for me in the past.
I will try and see the psych again but I’m aware there is a long wait list....

[Quinn1]

I am on Valdoxan,along with Lyrica.Thinking about asking my psychiatrist about changing the Valdoxan it is so expensive.

[panic_down_under]

I am on Valdoxan,along with Lyrica.Thinking about asking my psychiatrist about changing the Valdoxan it is so expensive.

How many kidneys do you have to sell each month?

If it was working well then it might be worth the price, but that you're also taking Lyrica (pregabalin) suggests it isn't.

[Quinn1]

How many kidneys do you have to sell each month?

If it was working well then it might be worth the price, but that you're also taking Lyrica (pregabalin) suggests it isn't.

The GP prescribed Lyrica for nerve pain 3yrs ago,my psych put me on Valdoxan 6mths ago and I have been ok on them,
I take a few more meds for HIV,so far so good as in no interactions.

I already sell a lot of kidneys on the black market.