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Thread: cannot get up the courage to start

  1. #1
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    Sep 2017
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    cannot get up the courage to start

    hi
    i have gone so far as to cut my pills in quarters, starting at 2.5mg of lexapro, per my therapist's suggestion. but i cannot find the courage to start the pill even though i really need to get some relief from my anxiety. i'm just so scared. the pandemic is really burdensome and my bucket is full. i

    do you think that 2.5mg is going to have any side effects? I am not sure what time of day to take it either. I like to have a couple of glasses of wine at night, which my therapist is fine with, but I don't want it to interact with the meds. should I take it in the morning? does it really matter?

    help me get up the courage. I need to do this.

  2. #2
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    Re: cannot get up the courage to start

    I'd probably be dead without Lexapro. I'm on 20 mg a day and I love it. I find that the people who are worried about side effects are the ones most likely to have them...they create a psychosomatic reaction in their bodies. In other words, it's their brain that cause their own physiological response with worry.

    Here's a schedule I would suggest: 1 week on 2.5 mg, then the second week go to 5 mg, then third week if you're doing okay, bump it to 10 mg. 10 mg is the lowest effective dose. You're not going to see much of a difference in yourself if you keep it too long on a substandard dose.

    It doesn't matter what time of a day you take it. I take mine at dinner. If you find it keeps you up at night, switch to taking in the morning. If it makes you sleepy, take it before bed.

    Here are some other things to keep in mind:

    1) They work by building up in your system. You can't just pop them like an aspirin for a headache. You need to be on them for at least a year, and it often takes 6 to 8 weeks to see the full effects of any dosage.
    2) For some people, as your body gets used to them, have some start up anxiety in the first 4-6 weeks or so. This is normal. Just keep taking them and power through it; it'll even out. Gradually upping the dosage helps with this a lot.
    3) You have to find the right dosage that works for you. You may need to up the AD after the first few weeks. Again this is normal, and finding the right dosage is a trial and error process, so be patient.
    4) They don't replace therapy to deal with your issues. They make you less likely to dwell on your issues, but you still have to do the work to change your thinking.

    Good luck!

    Vee
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  3. #3
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    Re: cannot get up the courage to start

    Quote Originally Posted by cofo View Post
    do you think that 2.5mg is going to have any side effects?
    Side-effects may still occur but they will likely be mild. The two things to keep in mind about side-effects is that they don't indicate harm, ADs do not usually cause physical harm, and side-effects are not necessarily caused by the med. An anxious mind is quite capable of producing our worst nightmares if given the chance.

    I am not sure what time of day to take it either. I like to have a couple of glasses of wine at night, which my therapist is fine with, but I don't want it to interact with the meds. should I take it in the morning? does it really matter?
    it doesn't matter. After you've ben on a dose for 2 weeks plasma levels will stabilise to a steady-state and then not vary much across 24 hours.

    However, go easy on the wine, especially when first taking an AD. The AD+alcohol combination can be unpredictable. Some days you may be able to drink a herd of alcoholic elephants under the table without raising a sweat, on other a small glass of wine could turn legs to rubber. be careful until you work out how the combination affects you.

    The second issue is that alcohol can inhibit the mechanism by which ADs work. They stimulate the growth of new brain cells (neurogenesis) to replace cells killed, or prevented from growing by high brain stress hormone levels, mostly of cortisol (PDF). The therapeutic response is produced by these new cells and the stronger interconnections they forge, not the meds directly.

    The problem is alcohol has the same affect on hippocampal neurogenesis as cortisol. Even moderate drinking can reduce hippocampus neurogenesis by nearly half (see also: Morris SA, 2010; Crews FT, 2003).
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  4. #4
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    Re: cannot get up the courage to start

    I've been on 10mg for years (max dose for my age) and find it great.
    It's one of the gentler ADs so the side effects aren't too bad.
    I started on 5mg for a week and then went up to 10mg.
    Like Antsy I found it to be a life saver.
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  5. #5
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    Re: cannot get up the courage to start

    thank you all...this really helped

  6. #6
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    Re: cannot get up the courage to start

    Have you begun taking the escitalopram? If so, how is it going?
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    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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