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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by moviemom on April 14, 2009, at 9:55:21
Having a tough time finding the right AD. Any thoughts on Prozac vs. Lexapro? Have chronic insomnia that complicates things.
Posted by herpills on April 14, 2009, at 10:51:44
In reply to Prozac vs. Lexapro, posted by moviemom on April 14, 2009, at 9:55:21
> Having a tough time finding the right AD. Any thoughts on Prozac vs. Lexapro? Have chronic insomnia that complicates things.
10mg Lexapro worked great for me as AD, but made insomnia worse. I'm on 5mg now which still helps with depression without side effects. I also take 200mg Lamictal. I have no experience with prozac, but I think a lot of the SSRI can cause insomnia for some people. You could try low dose Prozac or Lexapro, and add something else, like Trazadone. Or low does Lamictal, 100mg?
Posted by moviemom on April 14, 2009, at 10:57:57
In reply to Re: Prozac vs. Lexapro, posted by herpills on April 14, 2009, at 10:51:44
Thanks. How does the Lamictal work? Have you had any negative side effects?
Posted by desolationrower on April 14, 2009, at 11:01:26
In reply to Prozac vs. Lexapro, posted by moviemom on April 14, 2009, at 9:55:21
prozac is usually thought of as more activating than other ssris. however since it antagonises 5ht2c it might actually improve sleep more than the others...i'd probably try it first, it can be had for 4$ a month. take in morning not beofre bed.
are you finding a hypnotic that works?
-d/r
Posted by Phillipa on April 14, 2009, at 11:26:57
In reply to Re: Prozac vs. Lexapro, posted by desolationrower on April 14, 2009, at 11:01:26
Like a benzo? And Luvox is the most sedating of SSRI's. Love Phillipa
Posted by moviemom on April 14, 2009, at 11:38:21
In reply to Re: Prozac vs. Lexapro, posted by desolationrower on April 14, 2009, at 11:01:26
I've tried a number of sleep aids. Klonopin helps but I tend to develop tolerance, plus I think it makes my depression a little worse. Ambien is somewhat helpful but can leave me feeling pretty depressed in the morning and with memory problems. Lunesta doesn't seem to be particularly effective for me. Tried Seroquel once and couldn't function cognitively for two days. Frustrating.
Posted by Alexanderfromdenmark on April 14, 2009, at 14:23:15
In reply to Prozac vs. Lexapro, posted by moviemom on April 14, 2009, at 9:55:21
With insomnia, neither of these might be a very good choice. But I think in general Prozac is probably a better drug because it's less selective. I'd choose prozac over Lexapro.
Posted by moviemom on April 14, 2009, at 15:34:35
In reply to Re: Prozac vs. Lexapro, posted by Alexanderfromdenmark on April 14, 2009, at 14:23:15
Thanks. Thoughts on better ADs where insomnia is a problem, too?
Posted by sowhysosad on April 14, 2009, at 15:52:40
In reply to Re: Prozac vs. Lexapro, posted by moviemom on April 14, 2009, at 15:34:35
As other posters have said, either of those could worsen your insomnia, although perhaps only for the first few weeks. Both of them significantly improved my sleep once my brain had got used to them.
Prozac is definitely more energising but that can easily spill over into anxiety.
Have you considered Remeron in combination with an SSRI/SNRI? It's a really strong antihistamine which helps you sleep and some claim it makes the SSR!/SNRI work better.
Posted by bleauberry on April 14, 2009, at 19:06:07
In reply to Prozac vs. Lexapro, posted by moviemom on April 14, 2009, at 9:55:21
With no knowledge of what meds you've tried, reactions, or history, I would go with prozac because it does more stuff. It is dirtier. That's a good thing. Lexapro does slightly beat prozac in metastudies, but not by much, and those studies have many flaws and biases. My local town doctor has as many patients on prozac as all the others combined, if that means anything.
If you go with prozac, be sure, and I mean it, not kidding, get the brand version. It costs more and is worth it. Absolutely refuse generic. Chances of failure are already high enough in this game. Keep the odds in your favor with the real stuff. My doc sees a big difference between the two. If you do well on it, you can always try a switch to generic a few months later.
Lexapro I think generally has fewer side effects. It is basically weight neutral to weight gain, if that is important, while prozac is generally weight neutral to weight loss. Prozac is usually a bit more energizing by day, more insomnia, while Lexapro is usually a bit more lethargic by day, yet insomnia can be a problem for many people, especially in the early going. With either med, insomnia usually turns into good sleep several months later. It takes a while to get there.
Insomnia. A very low dose of another antidepressant along with your prozac or lexapro is the best bet. While there are a handful of options, I would look no further than these:
5mg-25mg Amitriptyline; 7.5mg Remeron.
A good sleep med meant as a sleep med is Lunesta. Many people use 25mg-50mg of the antipsychotic Seroquel. I would save that option for last.Just my opinions.
Posted by desolationrower on April 14, 2009, at 20:59:36
In reply to Re: Prozac vs. Lexapro » moviemom, posted by bleauberry on April 14, 2009, at 19:06:07
i recommend cyproheptadine and trazadone maybe a zdrug too for insomnia
-d/r
Posted by bearfan on April 19, 2009, at 5:02:14
In reply to Re: Prozac vs. Lexapro » moviemom, posted by bleauberry on April 14, 2009, at 19:06:07
Both are good medications. Lexapro tends to be more tolerable and calming, while Prozac more activating; although both eventually help with anxiety.
This is the end of the thread.
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