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

  1. #61
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    Re: 15mg Lexapro - but how long until positive or any effects?

    Thanks PDU.

    Out of interest what is the difference between Nortriptyline and Reboxetine. You said before the TCA would be a better bet so how is their action different? My psych quite happily handed me a script for Reboxetine with 5 repeats on it, just incase.... plus a long list of other meds to try.. and of course the Trintellix but tbh I think the meds just aggravate my anxiety. I want to ditch the lot of them (don't worry, I won't)

    I'm losing patience with Pregabalin - I just feel so drowsy and spaced out (not to mention anxious).. I just can't function properly and I need to be able to.

    It's possible I may just stay on 5mg escitalopram for now and reset. I've started up yoga again and getting more organised and eating healthier. I've told myself I will only improve if I take meds but I don't think this is always the case if you can make lifestyle changes.

  2. #62
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    Re: 15mg Lexapro - but how long until positive or any effects?

    Quote Originally Posted by LisaS View Post
    Out of interest what is the difference between Nortriptyline and Reboxetine.
    Reboxetine is a weak inhibitor of noradrenaline (NA), aka norepinephrine, reuptake, nortriptyline is a more potent NA inhibitor and also inhibits serotonin reuptake.

    You said before the TCA would be a better bet so how is their action different?
    That's complicated because unlike SSRIs, they don't all the the same thing. Some, only inhibit serotonin reuptake, others both serotonin and NA and others only NA.

    The dual action TCAs generally inhibit NA reuptake much more than the SNRIs, with the exception of milnacipran and levomilnacipran, have longer half-lives so are less likely to trigger severe withdrawal symptoms and because they are available in low dose tablets relative to their therapeutic range, starting at a low dose and ramping it up by small amounts to reduce the severity of initial side-effects is much easier than with SNRIs. Plus, as a generalisation, TCAs are often more effective, both for anxiety and especially depression. The SSRIs/SNRIs didn't replace TCAs because they were more effective, but because they are safer in overdose, and even that isn't true for all of them.

    I'm losing patience with Pregabalin - I just feel so drowsy and spaced out (not to mention anxious).. I just can't function properly and I need to be able to.
    I'm not a fan either. I could understand the rationale for prescribing it instead of BZDs before it became clear it (and the similar gabapentin) have the same tolerance issues as the BZDs, but now why not just prescribe a BZD. They are usually more effective anxiety meds with fewer side-effects.

    It's possible I may just stay on 5mg escitalopram for now and reset.
    If you want to keep taking it then please take no less than 10mg, or quit it completely to avoid increasing the risk of it pooping out entirely. Long term sub therapeutic dosing is not a good idea according to a number of studies.

    I've started up yoga again and getting more organised and eating healthier. I've told myself I will only improve if I take meds but I don't think this is always the case if you can make lifestyle changes.
    Cool. It's worth a shot. If cognitive, behavioural, or mindfulness therapy is an option then I urge you to also try it.
    __________________
    The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.

  3. #63
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    Re: 15mg Lexapro - but how long until positive or any effects?

    Update from me

    Nearly off escitalopram. I was at 2.5mg and felt almost normal. When I started alternating 2.5mg with nothing I’ve really felt an uptick in my anxiety. In fact last night was pretty awful. I’m not sure this is withdrawal or anxiety returning...

    Still really not sure if to go med free or start on the vorioxetine.. psych said to start vorioxetine at 5mg and increase to 10mg as tolerated. So thinking I may go 2.5mg for a few days first.
    Obviously I’m concerned about side effects knowing my history but then I feel maybe I should give it a try....

    ugh ��

  4. #64
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    Re: 15mg Lexapro - but how long until positive or any effects?

    Quote Originally Posted by LisaS View Post
    Nearly off escitalopram. I was at 2.5mg and felt almost normal. When I started alternating 2.5mg with nothing Iíve really felt an uptick in my anxiety. In fact last night was pretty awful. Iím not sure this is withdrawal or anxiety returning...
    Not a fan of weaning off ADs by missed doses, Lisa. It just sets up a roller-coaster at small doses which can become more disconcerting than any withdrawal symptoms from simply quitting.

    psych said to start vorioxetine at 5mg and increase to 10mg as tolerated. So thinking I may go 2.5mg for a few days first.
    The most common vortioxetine side-effects are mild headache and nausea. Any of the common painkillers should fix the first, although paracetamol (aka acetaminophen) rather than aspirin, or another of the NSAIDs, such as ibuprofen, is preferable because it isn't an anticoagulant, and ginger and/or vitamin B6 supplements for the nausea.

    Ideally, stay on whatever starting dose you decide on for 14 days before increasing. Upping the dose earlier may increase side-effects severity (however, delaying the increase for longer won't significantly reduce their severity no matter how long the delay).
    __________________
    The opinions expressed above are based on my observations and, where applicable, interpretation of cited data and are general in nature. Consult your physician before acting on anything stated.

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