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Dr. Bob is Robert Hsiung, MD,
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Posted by JLM on October 4, 2002, at 2:34:59
In reply to Re: about insomnia side effect/bottom » samenewme, posted by pharmrep on October 4, 2002, at 0:19:46
> > I just saw this. I'm on 30 mg. Remeron and 20 mg. Celexa. Yes, I'm one of the special people who are wakeful on as little as 30 mg. Remeron. Ambien doesn't work for me.
> >
> > I take 3 mg of melatonin at night for sleep and it helps a bit. Sometimes I have to stack it with Sonata.
> >
> > I used to take 1000 mg L-Tryptophan for sleep when I was on nortriptylene, but because I'm on an SSRI now we're avoiding it. Your doctor may be willing to discuss this with you (it's still available by prescription from compounding pharmacies).
> >
> > > Hi pharmrep,
> > >
> > > Saw the note about Phil's combo, can't resist asking a question. For me Celexa is activating and causes insomnia. I take 10mg in the morning, and can't sleep at all unless I take something sedating at night. For now the sedating med is neurontin, but even with that I'm awake til 3am. Do you know of any better way to deal with the insomnia side effect from celexa?
> > >
> > > Also, how does lexapro compare on insomnia? Sorry if you've answered this elsewhere, I didn't read the entire thread.
> > >
> > > -Tabitha
> >
> > *** tough call, celexa can cause both insomnia and somnolence...usually people are tired...you are doing the right thing in taking early in day, but you still stay up at night. Lexapro doesnt have the somnolence, but a little insomnia for some (9% in the studies...same suggestion...take in morning) When do you take the remeron?
Ummm, I think its a little premature to say conclusively that Lexapro doesn't cause somnolence, based upon limited clinical experience with it. Prozac didn't cause sexual side effects either, or akathisia for that matter. Hardy har har har ;)
You should disclaimer that statement with 'in our limited clinical experience'. Which, at this point, IS limited.
Posted by Phil on October 4, 2002, at 6:35:39
In reply to Re: schwing » Phil, posted by pharmrep on October 3, 2002, at 23:51:46
Oh, what a lucky man, he was...bummer.
I hope your #'s are right but as far as Paxil goes, I don't remember posts about it here w/o sexual S/E. Wonder if I could do an informal poll?
Thanks, pharmrep
Posted by JLM on October 4, 2002, at 7:10:35
In reply to Re: Lexapro side-effects, posted by dr. dave on June 19, 2002, at 4:41:27
>
> The research shows Lexapro has no significant benefit over Celexa in terms of side-effects. People taking Lexapro 20mg report side-effects at the same rate as those on Celexa 40mg (86%).
>
> In the same study more people stopped taking Lexapro 20mg because of side-effects than those taking Celexa 40mg (10.4% vs 8.8%), but this difference was not statistically significant.
>
> The reason for this is that Lexapro is to all intents and purposes the same thing as Celexa but re-branded and re-patented. There is no evidence of the R-citalopram component they have removed doing anything of significance pharmacologically. To understand this 'new' drug you have to understand that the patent on Celexa just ran out, but the manufacturers can effectively renew the patent by isolating the active component and re-branding it.
>
> See more at http://www.guardian.co.uk/Archive/Article/0,4273,4434943,00.html
>
> The critical comments in the article are mine.Dr. Dave,
I've been meaning to ask you this. What do you think of David Healy's work? What about Teicher, Cole, or Glenmullen?
Its interesting to note that Teicher claimed in the patent for r-fluoxetine 'Pure R(-) fluoxetine functions as an effective antidepressant with a shorter half life and shorter duration of action than the racemic mixture or the S(+) isomer of fluoxetine. Having a shorter half life and shorter duration of action results in less accumulation of R(-) fluoxetine in a patient's body. This in turn results in decreased adverse effects including headaches, nervousness, anxiety, insomnia, inner restlessness (akathisia), nausea, diarrhea, drowsiness, decreased libido and/or sexual dysfunction, suicidal thoughts and self mutilation.'
Some of these things, namely suicide induced by akathisia, have been vehemently denied by Lilly, Glaxo, and damn near everyone else that makes AD's, and its my understanding that they even tried to discredit Teichers earlier work on akathisia. On the one hand they say he's nuts, and on the other hand they pay tens of millions for r-fluoxetine, which he helped develop. Maybe they are just bipolar or schizophrenic?
Some intellectual consistensy, and honesty about SE's would be nice for change from some of these folks. People need to KNOW what might happen to them, in terms of risks vs. benefit. I have no doubt that these drugs do benefit some people, just as David Healy has no doubt. But its time that things are cleaned up a bit, and its time that GP's stop overprecribing psychoactive agents to people when they don't need them.
Posted by maririp on October 4, 2002, at 7:49:56
In reply to Re: Paxil to Lexapro--Let's see, salvation or sex?? » mills, posted by pharmrep on October 4, 2002, at 0:07:30
ggrrl...when i first started on lexapro i felt some of your symptoms for days...felt fuzzy headed like i was just going through the motions. The worst symptom i had was waking up feeling even more depressed for a few days. Give it some time because within a week i was feeling so much better. I was on paxil for a long time as well and it wasnt worth the sexual side effects for me or the night sweats. Give lexapro a chance, i know how hard it is to wait it out.
Posted by mills on October 4, 2002, at 9:15:18
In reply to Re: schwing » pharmrep, posted by Phil on October 4, 2002, at 6:35:39
appreciate the responses; i fully intend to give lexapro more time, but it is just discouraging, you know, to have something that worked so well for me, even with the side effects, and this not work as well; maybe it will, and I'll probably lower the dose if this fluey/depressed feeling doesn't subside
Posted by Stacey69 on October 4, 2002, at 9:29:49
In reply to Re: Anyone switched to Lexapro? « ggrrl, posted by norml on September 30, 2002, at 20:40:51
Everyone here seems to be ripping on Lexapro. Many of you who are doing so are simply looking at the statistics and are not on it yourselves to really know the difference. I have panic disorder/mild depression, and I had been on Celexa for 7 or 8 months before switching to Lexapro. (10 mg.) I am also on 15 mg. of Buspirone, and I found myself unable to function with this combination due to the extreme drowsiness I experienced. Since making the switch (prescribed from my psychiatrist) I am now able to get up and do productive things around the house, visit friends, and hold a job, without sleeping until 4:00 or 5:00 in the afternoon. I also have a very strong sex drive, which is supposedly "not typical" for being on an SSRI. All of this after only 1 month on Lexapro. 5 or 10 mg. of Lexapro should be sufficient in treatment, possibly along with another medication. The reason I say this is because, 20 mg. of Lexapro IS a higher dose, and if you're taking a higher dose of any medication, you're almost always going to experience unwanted side effects. Most people on a typical dose will experience the minimum. All in all, it depends on the person's weight and body chemistry, everyone will respond to a drug differently. But don't be so skeptical of every new medication to hit the market. If it will help you get better, it's worth a try!!
Posted by kathyj on October 4, 2002, at 11:25:16
In reply to Re: about insomnia side effect, posted by samenewme on October 3, 2002, at 21:56:35
I am a chonic insomnia sufferfor the last 8 months, since my depression began.I suffered without any a/d medication for all of those months. I have been taking lexapro for one week and find that I still cannot sleep without the Restoril 30 mg. I tried one night without the restoril and I was up until 5am. Is the Lexapro increasing my insomnia?
Posted by kathyj on October 4, 2002, at 11:31:54
In reply to Re: lexapro 10mg » kathyj, posted by pharmrep on October 4, 2002, at 0:02:08
> > This is my first time on anti-depressants. I took 5 mg for 2 days and then went to 10mg which I have been taking for 5 days now. Prior to the Lexapro I was taking sleeping pills. I hoped that the lexapro would eliminate the sleeping pills. I take the dosage at 5pm and I don't get sleepy. I still have to take my sleeping pill. Does lexapro increase insomnia? On a brighter note, I was more depressed the first couple of days but now I feel much less depressed.
>
> * glad to hear its working...i would suggest taking it in the morning so as to avoid the possibility of insomnia (occurred at 9% in studies)I staret taking it in the mornig tomorrow so as not to miss my dose today. I'll keep you informed.
kj
Posted by Ippopo on October 4, 2002, at 12:28:48
In reply to Pharmrep: A Week On Lexapro..., posted by Alice Anne on October 3, 2002, at 12:38:59
> Hello Pharmrep, I've managed a week now at 10 mgs. Lexapro. I started at 2.5 for a week and then went to 5 for a few days. Most of the side effects (queasiness, muscle tension-- although I'm still a little spacey feeling) are dissipating, but my depression is not. My question for you is when do the anti-depressant, anxiety effects "usually" kick in? Thanks for the info.
Hi Alice, I'm glad you posted. I've been going through the same thing but because of all the hype Lexapro has recieved my Dr doesn't believe I still have symptoms after 2 wks. Within the past week I've called and also went to see him to ask when I'll stop crying. He just tells me to give it time...he'll see me in a month. In the mean time I've slashed up my arms(I'm a cutter) and am in process of losing my job because of poor performance. Please keep me posted as to your recovery. Best wishes!
Ippopo
Posted by maririp on October 4, 2002, at 13:10:20
In reply to Re: Pharmrep: A Week On Lexapro..., posted by Ippopo on October 4, 2002, at 12:28:48
Ippopo...are you takin any other meds besides lexapro? for those who have been taking sleeping pills too..i can imagine that trying to just stop is not the way..why not cut the dose on the sleeping meds? Id also consider another doctor. I would not go to a doctor that dismisses my feelings and tells me to return in a month..he should help you with other alternative meds or a stradegy plan.
Posted by Ippopo on October 4, 2002, at 13:39:21
In reply to Re: Pharmrep: A Week On Lexapro... » Ippopo, posted by maririp on October 4, 2002, at 13:10:20
Hi, I'm not on sleeping pills I'm being treated for ADD and on adderall. I sleep like a log when I finally get to sleep. I keep getting disconnected so I'm writting very short responses now.
Posted by Alice Anne on October 4, 2002, at 14:09:16
In reply to Re: Pharmrep: A Week On Lexapro..., posted by Ippopo on October 4, 2002, at 12:28:48
I'm so sorry to hear you're having such a hard time. Does your doctor know you're cutting and still dismiss what you're telling him? I agree, it sounds like you might be better off finding someone who will take you more seriously and be of more help during critical times. I know that's easier said than done. In the meantime maybe you could ask if there is anything you could take with the lexapro to get through the next few weeks, or to avoid cutting. (I'm not a therapist, but I've heard that some people can avoid cutting by putting ice on those areas.) I hope at least you have someone to talk to, and I'm glad you posted here. I'm really going to try and give the Lexapro a chance. But it's so much more involved for some of us actual people adjusting to medication than it is in theory.
Posted by johnj on October 4, 2002, at 14:51:24
In reply to Lexapro is much better than Celexa! *read!*, posted by Stacey69 on October 4, 2002, at 9:29:49
Hi,
Hope you can answer a few questions for me about your med combo? Did you say now you are only on lexapro? or buspar too? or did changing to lexapro make the combination tolerable? I am interested in something for my depression and anxiety. I am not sure which one is worse but anxiety and worrying seem to be a big trait in my illness.
Also, did you ever get any worsening of anxiety when starting an ssri? That is my fear, but I need some changes so I can excercise since my current TCA impedes that. Thank youjohnj
Posted by nmk on October 4, 2002, at 18:29:59
In reply to Re: Three weeks on Lexapro » nmk, posted by pharmrep on October 4, 2002, at 0:00:03
It was my doctor's idea. He thought I was weaning too rapidly off the effexor and suggested I stay at 16 mg for the next week (I have been on 16 mg for over one week now). He suggested that today, I stop the Lexapro to see if it is causing the nausea. Needless to say, today I feel more depressed AND nauseous. I will get his ok to stop effexor asap and remain solely on the Lexapro. Have many patients experienced nausea with Lexapro 10 mg beyond three weeks or does it usually subside?
Posted by ZeeZee on October 4, 2002, at 19:30:31
In reply to Lexapro is much better than Celexa! *read!*, posted by Stacey69 on October 4, 2002, at 9:29:49
I too have panic disorder but also with agoraphobia. I've been reluctant to try Lexapro because I've had terrible experiences with other SSRI's, such as greatly increased anxiety and panic. If you don't mind my asking did your anxiety and panic increase initially? also, do you have agoraphobia as well and has it helped with that also? I would be very interested in hearing more about your experience.
Thanks
Posted by CindyLou on October 4, 2002, at 20:10:15
In reply to Re: What is the best time to take » kinikia, posted by cody on October 2, 2002, at 15:46:00
I just started taking 5 mg. Lexapro today, and felt very agitated -- had to take double my Klonapin dose to offset the irritablity. Is this a common side effect, and will it subside?
Thanks for any information you can give me!
cindy
Posted by pharmrep on October 4, 2002, at 21:05:16
In reply to Re: Three weeks on Lexapropharmrep, posted by nmk on October 4, 2002, at 18:29:59
> It was my doctor's idea. He thought I was weaning too rapidly off the effexor and suggested I stay at 16 mg for the next week (I have been on 16 mg for over one week now). He suggested that today, I stop the Lexapro to see if it is causing the nausea. Needless to say, today I feel more depressed AND nauseous. I will get his ok to stop effexor asap and remain solely on the Lexapro. Have many patients experienced nausea with Lexapro 10 mg beyond three weeks or does it usually subside?
* i am hearing the headach/nausea subsides in 1 wk....now that you are done w/ effexor...tell us how the lexapro is in 1 wk
Posted by pharmrep on October 4, 2002, at 21:11:01
In reply to Lexapro and agitation, posted by CindyLou on October 4, 2002, at 20:10:15
> I just started taking 5 mg. Lexapro today, and felt very agitated -- had to take double my Klonapin dose to offset the irritablity. Is this a common side effect, and will it subside?
>
> Thanks for any information you can give me!
>
> cindy** you are not experiencing a s/e...you are experiencing the changes a new med can have on your body. 1 day is not enough time...you will notice headache/nausea and some others (as you would on any new med) i am hearing it lasts for about 1 wk...try not to change any other meds doses, wait 1 wk, and keep us posted
Posted by pharmrep on October 4, 2002, at 21:16:23
In reply to Re: Lexapro » Stacey69, posted by johnj on October 4, 2002, at 14:51:24
> Hi,
> Hope you can answer a few questions for me about your med combo? Did you say now you are only on lexapro? or buspar too? or did changing to lexapro make the combination tolerable? I am interested in something for my depression and anxiety. I am not sure which one is worse but anxiety and worrying seem to be a big trait in my illness.
> Also, did you ever get any worsening of anxiety when starting an ssri? That is my fear, but I need some changes so I can excercise since my current TCA impedes that. Thank you
>
> johnj********* lexapro will help w/ anxiety...not hurt (1-2 weeks for most)...ask your dr (perhaps just the 1 med...lexapro will work)
Posted by JLM on October 4, 2002, at 21:31:15
In reply to Lexapro and agitation, posted by CindyLou on October 4, 2002, at 20:10:15
> I just started taking 5 mg. Lexapro today, and felt very agitated -- had to take double my Klonapin dose to offset the irritablity. Is this a common side effect, and will it subside?
>
> Thanks for any information you can give me!
>
> cindySeveral researchers such as David Healy feel that the incidence of severe agitation, allthou rare, can be incredibly serious.
To me there is a difference between 'anxiety' and 'agitation'.
Can you not sit still, or do you feel like you have to constantly move about? If so, it may be akathisia. Both Prozac and Zoloft did this to me, and to a less degree Celexa and Paxil. With the Zoloft and Prozac, it was severe. I was highly agitated/hysterical and couldn't sit in the same spot for more than 2 minutes, for about a week. When I stopped the drugs, the reaction stopped. It was 10x more anxiety then I have ever experienced at any point in my life. Quite frankly it scared me.
For years, the makers of SSRI's have tried to deny that in a very small majority of people, the drugs produce akathisia. Which is rather ironic, considering the US Patent document for the failed r-fluoxetine claims that it REDUCES akathisia, thoughts of suicide, and thoughts of violence compared to the original Prozac. It claims to reduce these SIDE EFFECTS of the Prozac, which Lilly has vehemently denied.Maybe this will help you clarify what akahtisia is:
http://abcnews.go.com/onair/2020/2020_000621_prozac_feature.html
Posted by maririp on October 4, 2002, at 22:23:32
In reply to Re: Lexapro is much better than Celexa! *read!* » Stacey69, posted by ZeeZee on October 4, 2002, at 19:30:31
ZeeZee ..I also suffer from panic disorder and did go through agoraphobia. I took xanax for that. I am on lexapro now and have been for about two weeks..I have noticed my anxiety level is way down..I didnt take any antidepressants for 3 years..but i know how you feel. I feel lexapro has helped me so much i dont need the xanax. try to stay with it...it took me about a week to really adjust
Posted by shakingoscar on October 5, 2002, at 5:13:37
In reply to Lexapro is much better than Celexa! *read!*, posted by Stacey69 on October 4, 2002, at 9:29:49
I AGREE WITH YOU TOTALLY!!!
Now that I have changed my dose from the over-prescribed 30mg (doctors mistake) down to 10mg of lexapro, I am feeling the best I have felt in 2 years since I became ill with anxiety and depression.
And my sex drive (and ability) has returned to almost normal too.
I am very happy.
Cheers
Posted by shakingoscar on October 5, 2002, at 6:03:27
In reply to Re: Lexapro is much better than Celexa! *read!*, posted by shakingoscar on October 5, 2002, at 5:13:37
I want to ask a question about coffee.
I suffer with anxiety and depression and am now on lexapro 10mg which is brilliant. I was taking 60mg celexa before and have suffered for around 2 years.
My question is this.
If I drink one single cup of coffee I start to sweat HEAVILY and I get tremors which last maybe 2 hours, longer if I have 2 cups of coffee.
Is this really anxiety? I thought caffeine affected Nor-adrenaline and dopamine. Why am I now so sensitive to coffee and why does this happen when I am feeling perfectly ok?
I also take trazodone at night which I have noticed reduces this problem. Before taking trazodone, I could not drink ONE cup of coffee without nearling "losing it" because of the tremors and sweating (almost like Parkinsonian-type symptoms).
Is this anxiety or should I go back to my doctors?
Thanks
Posted by maririp on October 5, 2002, at 9:30:50
In reply to A SINGLE CUP OF COFFEE, posted by shakingoscar on October 5, 2002, at 6:03:27
shakingoscar ...coffee...hi..i can tell you when i first had panic attacks the thing i first noticed was when i drank coffee it sent me through the roof..same with chocolate..loaded with caffeine...those things triggerd my anxiety badly..try decaff..and give meds a time before you start with caffeine. It only took one cup of coffee to send me flying same with a candy bar.
Posted by ZeeZee on October 5, 2002, at 9:33:47
In reply to A SINGLE CUP OF COFFEE, posted by shakingoscar on October 5, 2002, at 6:03:27
Hi, I too am very sensitive to caffeine NOW! Used to have a cup or two before my relapse with no problem but now avoid all forms of caffeine. Even one cup of coffee has been shown to increase muscle tension and thus anxiety. I don't think it's worth it, but that's my opinion. I find that increased fluids such as OJ and water plus a protein breakfast works just as well to help me start the day - don't miss the caffeine at all.
Good Luck.
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