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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Keko on October 24, 2004, at 19:18:41
Lexapro is driving me nuts. I am so irritable tonight, wish I could jump out of my own skin and live in the air until it's out of my system and I'm on to something smoother. As Justin says, several hours post-dosing (only about 2 or 3 for him, and 4 to 7 for me), I feel myself getting higher and spacier. It rises and then I'm back to myself a couple of hours later.
Sometimes it takes the form of a touch of hypomania where I'm overly playful, and other times I am so irritable -- same as fighting terrible urges of road rage.
I have been cutting back for a couple of weeks now, from 10mg, to 5mg, and now down to 2.5mg. 2.5mg is still doing a number on my nerves. I can FEEL my nerves, it's like I'm PMSing miserably, but I'm not. I don't want to hurt the people around me by being verbally explosive. I'm trying not to take an ativan or valium, because I don't want to be hooked on anything. Anyone else have a similar reaction to Lexapro? I was on Celexa for a couple of years prior to this, but Lexapro is very agitating to me.
Posted by jboud24 on October 24, 2004, at 19:47:08
In reply to LEXAPRO has driven me nuts! 2.5mg and IRRITABLE, posted by Keko on October 24, 2004, at 19:18:41
Why did you switch from Celexa to Lexapro? Perhaps consider switching back.
Have you taken Zoloft? It feels much smoother than Lexapro/Celexa to me, and is sooo much better for anxiety than those two were.I am highly inclined to believe that we get that irritated/zoned out feeling from lexapro because it is not mixed with the inactive isomer R-citalopram. It would be my guess that whatever pump or diffusion mechanism it is in the stomach/intestines that transports the celexa into the bloodstream, it does so much faster in the abscence of the inactive isomer which probably competes with the S-citalopram for entry into the bloodstream. Thus, with only the S-citalopram present, we feel the effects much quicker since it is the only thing being taken up into the bloodstream via that mechanism.
I really hope all that made sense,
Justin
Posted by Keko on October 24, 2004, at 21:34:03
In reply to Re: LEXAPRO has driven me nuts! 2.5mg and IRRITABLE, posted by jboud24 on October 24, 2004, at 19:47:08
You know, Justin, I really do think I had much better luck with Zoloft (than Celexa OR Lexapro) until it *pooped out.* That's why I went on Celexa, but the added (inactive) isomer in Celexa has antihistamine properties, which caused me incredible fatigue, sometimes to the point that I could barely get off the couch.
It's interesting that you suggested Zoloft, because just last week I talked to my pdoc about returning to Zoloft rather than Celexa. I wondered if Zoloft would be effective again after taking a break for a few years.
I finally gave in and took a valium about an hour ago, so I'm feeling a little better. This anxiety/depression/irritability/ combo is tough. Thanks for responding, Justin, & hope to hear from others as well. We can't be the only ones who have this *high* spaced-out feeling several hours post-dosage -- or the irritability I've been experiencing on this drug.
Posted by sabre on October 25, 2004, at 0:40:16
In reply to LEXAPRO has driven me nuts! 2.5mg and IRRITABLE, posted by Keko on October 24, 2004, at 19:18:41
Hello Keko and Justin
Yes, I can identify with your experiences on Lexapro. At the moment I'm trying 2mg (I dissolved a tablet in a bottle of water and split it into 5).
In the first 2 or so hours I feel like I have had a drink of alcohol...spacy and vague. When that lifts I feel hypomania on 2.5mg and energetic on 2mg. Taking 5mg made me feel flattened, depressed and irritable. I didn't go beyond this dosage. 5mg was foul. I can't help thinking that the whole effect is just like speed. The depression and energy lift because of overstimulation. Can that be healthy?
Does Zoloft help with lagging energy and apathy while at the same time helping panic, anxiety and SA. I'm not asking for too much am I????
sabre
Posted by jboud24 on October 25, 2004, at 11:34:06
In reply to Re: LEXAPRO has driven me nuts! 2.5mg and IRRITABLE, posted by sabre on October 25, 2004, at 0:40:16
Zoloft made me have flattened emotion and a *little* apathy, but for social anxiety/generalized anxiety, it simply blew Lexapro and Celexa out of the water. For me. About the apathy though, several people have experienced success with adding a dopamine agonist, specifically Mirapex, to counteract the apathy. I think some degree of apathy is to be expected when being on an SSRI however.
Justin
Posted by Underhill on October 26, 2004, at 7:26:07
In reply to LEXAPRO has driven me nuts! 2.5mg and IRRITABLE, posted by Keko on October 24, 2004, at 19:18:41
I had similar spaced-out feelings from Lexapro (sold as Cipralex here in Finland). I felt that the level of Lexapro in blood simply went up too much too quickly when I took it. So I decided to try dosing multiple times per day and also slowly (every 2 weeks or so) adjust the dosage.
So now I split 5 mg pills into quarters by cutting them in half using scissors, and then halving the halves again. I take one quarter in the morning, one in the day and one in the evening. Sounds like too much trouble, I know. :) But it works wonders! No spaced-out feelings, no insomnia, no side effects at all, just almost complete relief from depression and anxiety.
I had to experiment with the dosage, too. By trial and error, I found that 3/4 of 5 mg per day is just the right dose for me. Less than that doesn't work (I get depressed in about 1-2 weeks), and more than that causes unnecessary side effects.
Bear in mind, too, that it always takes time to adjust to SSRIs. For the first week or two, you're bound to feel more anxious and irritable. Then the anxiety subsides almost suddenly, and you will start to feel better (if the med works for you, that is).
Posted by sabre on October 26, 2004, at 15:23:43
In reply to Re: LEXAPRO has driven me nuts! 2.5mg and IRRITAB, posted by Underhill on October 26, 2004, at 7:26:07
Hi Underhill
That is an interesting approach. I will try it. Did you find that the gastro/nausea effects were relieved by this method?When I tried 2.5mg of Lex for 5 weeks these effects never went away. Even on 2mg for the past week I get strong GIT effects. Do they eventually go away?
sabre
Posted by Underhill on October 26, 2004, at 17:10:12
In reply to Re: LEXAPRO has driven me nuts! 2.5mg and IRRITAB, posted by sabre on October 26, 2004, at 15:23:43
Hi Sabre,
Actually I didn't have nausea at all when I started Lexapro, so I can't say if it would help with that. I did have slight GIT trouble but it went away within a couple of weeks.
All SSRIs (Lexapro, Zoloft, Paxil, etc.) tend to cause some GI side effects, since the two places in the body where serotonergic nerves are located are the intestine and parts of the brain. I'd imagine that splitting the dosage could help your intestine to adjust to the drug more easily, since the drug level does not fluctuate as much that way. Taking the pills with food probably helps, too.
I mentioned about this method (taking the med in three divided doses) to my psychiatrist, and he said that it makes sense, especially for people very sensitive to medication. Most people don't want (or are too forgetful) to take three doses daily, so the usual recommendation for meds with a moderate or long half-life (>= 24 hours) is once daily. Convenience and ease of use is important.
If you try splitting the dose, please write back to tell how it works for you. I wish you the best of luck!
This is the end of the thread.
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