Posted by bleauberry on June 23, 2009, at 17:28:40
In reply to citalopram vs. escitalopram, posted by linkadge on June 22, 2009, at 19:19:48
I never tried Celexa. But I have been on Lexapro twice. To me it felt like the strongest serotonin action of all the SSRIs, yet the side effects were the mildest in terms of insomnia and sex. After a 6 week trial of it I switched to Zoloft. My biggest symptom at the time as anhedonia, and Lexapro did absolutely squat for that.
Hey, here is an idea though. It pertains to both efficacy and poopout. To increase the odds of a robust effect and longterm efficacy without poopout, consider either Lexapro or Zoloft with a low dose of Nortriptyline. Yeah? Maybe start the Nortriptyline at 5mg for week (half the capsule), increase it by 5mg steps as tolerated. A lot of people say its side effects are actually easier than SSRIs. And people who especially do not do well with SSRIs seem to do well with TCAs or SSRI+TCAs.
It think the whole key lies in the dosing. Start really low. Don't shoot rapidly for some predetermined target. Let the journey guide you as to what is a proper dose. It might be 5mg Lexapro or it might be 20mg. It might be 20mg Nortriptyline or it might be 100mg. It might be 12.5mg Zoloft or it might be 100mg. Your body and your reactions will tell you.
When I switched from Lexapro to Zoloft, it was an overnight switch with no cross taper. I felt immediate benefits of Zoloft over Lexapro the first day. Zoloft did help anhedonia a tiny bit. If I could go back in time I would have asked for a TCA to be added to it rather than saying goodbye to it.
poster:bleauberry
thread:902652
URL: http://www.dr-bob.org/babble/20090620/msgs/902801.html