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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 merpmerp on November 10, 2010, at 20:18:54
Hi all, first post here, will probably be long. I will state my question up front then give background so you don't have to read the background if you don't want to.
I am on Lexapro 5 mg and having great difficulty with anxiety. Does Lexapro indirectly increase norepinephrine? Note: I've been on meds predominantly for pure depression and not had a real problem with anxiety before the episodes described below.
I know Lexapro is an SSRI, but! I found a post here http://forum.mesomorphosis.com/mens-health-forum/adrenal-fatigue-getting-worse-134249714.html where in the second post, Dr. Marianco says, "Excessively increasing serotonin levels, however, will reduce dopamine production from dopamine neurons. This will further *increase norepinephrine production* from norepinephrine neurons - since a tract from the dopamine neurons helps control norepinephrine production. The reduction of dopamine and increase in norepinephrine creates a side effect called akathisia." (emphasis mine).
Okay now comes the background, y'all can skip it if you're bored :)
Feb. 2009-Sept. 2009: was on Prozac at varying doses, 10, 20, or 30 mg. Prozac worked great for me in the past, but this time around, awful. Terrible, terrible muscle jerks and twitches along with rock hard muscles that would not relax, violent, intrusive thoughts (never in life had them before then), feeling of impending doom, occasional panic attack.
Sept. 2009 tried to increase Prozac dose for the winter, got worse, told my doctor, she switched me to Lexapro 10 mg.
Sept. 2009-April 2010 10 mg Lex. Felt okay, but tired/apathetic all the time (dopamine depletion?)
April 2010: Decreased to 5 mg Lex for the summer. Felt less apathetic/sluggish.
Sept. 2010: Increased to 10 mg Lex for the winter. Had a recurrence of the EXACT SAME symptoms that the Prozac was giving me. (And yes, I increased the dose SLOWLY.) Doc allowed me to return to 5 mg, which is where I've been for a little bit, waiting for my blood levels to settle and my brain return to normal.
Today has been a very rough day with mini panic attacks all the time, so I apologize if the post is a little scattered. I was just wondering, since I've had such problems with extreme panic during this period of changing Lex dose, is this a norepinephrine effect? I've never felt anything like these panic attacks before being on this med.
Thank you.
Posted by maxime on November 12, 2010, at 21:22:09
In reply to Lexapro and Norepinephrine?, posted by merpmerp on November 10, 2010, at 20:18:54
I can't answer your questions, but I wanted to welcome you to Psycho Babble!
Posted by merpmerp on November 15, 2010, at 7:40:38
In reply to Re: Lexapro and Norepinephrine? » merpmerp, posted by maxime on November 12, 2010, at 21:22:09
Thank you!
I guess I sort of have my answer. Ever since decreasing the dosage of Lexapro back to 5 mg, I do feel better. So for whatever reason, it seems that the med was indeed revving me up. (I didn't feel manic, I have no history of bipolar, but I felt terrified all the time.)
My therapist suggested that I may want to talk to my doctor about decreasing the dose even further, to 2.5 mg. I will wait a week or two (I have been on the 5 mg for 2 weeks now) and then think about that. Does anyone know if that would even be effective at all or would it not have any action?
Thank you.
Posted by g_g_g_unit on November 18, 2010, at 22:42:58
In reply to Re: Lexapro and Norepinephrine?, posted by merpmerp on November 15, 2010, at 7:40:38
Does anyone know if that would even be effective at all or would it not have any action?
>
> Thank you.Yes, there are people who see benefits with 2.5mg
Posted by merpmerp on November 21, 2010, at 18:36:08
In reply to Re: Lexapro and Norepinephrine? » merpmerp, posted by g_g_g_unit on November 18, 2010, at 22:42:58
Thank you for your feedback. It was hard for me to grasp at first but the more I read about it the more I am coming to understand that no, one size definitely doesn't fit all when it comes to these meds.
> Does anyone know if that would even be effective at all or would it not have any action?
> >
> > Thank you.
>
> Yes, there are people who see benefits with 2.5mg
>
>
Posted by emmanuel98 on November 24, 2010, at 0:49:07
In reply to Redirect: Lexapro and Norepinephrine?, posted by Dr. Bob on November 12, 2010, at 0:39:37
Welcome to psycho-babble. Maybe someone else can give you more advice than me. I took lexapro for a few years at 20mg/day and had no problems with it. It didn't really stop my depression, but it helped me a lot with anxiety and irritability . I had no side-effects at all. These medications affect everyone differently. Maybe another SSRI would help.
Posted by merpmerp on November 24, 2010, at 0:49:09
In reply to Re: Redirect: Lexapro and Norepinephrine?, posted by emmanuel98 on November 12, 2010, at 21:12:09
Hi and thanks for responding,
Well I met with my doctor today, and she thinks that the 10 mg was too high for me. (I wrote about it in another thread here on the Medications board.) We will keep me at the 5 mg and see how that goes. Of course there's a lot of stress in my life right now aside from the meds (e.g. my car's in the shop for major repairs) so I probably won't be feeling very well for a while...
Fingers crossed that the 5 mg is good for me...
Posted by bearfan on March 8, 2011, at 21:02:45
In reply to Lexapro and Norepinephrine?, posted by merpmerp on November 10, 2010, at 20:18:54
No, what you are feeling is just the initial side effects which can cause an increase in anxiety. Lexapro primarily works on Sertonin and has very little impact on other neurotransmiters. Hence the name 'Celexa' or 'Lexapro' ie "Selective' to Serotonin.
Posted by desolationrower on April 4, 2011, at 3:27:20
In reply to Re: Lexapro and Norepinephrine?, posted by bearfan on March 8, 2011, at 21:02:45
agree w/ bearfan.
probably related to 5ht2.
-d/r
Posted by samuel on May 8, 2011, at 0:58:42
In reply to Lexapro and Norepinephrine?, posted by merpmerp on November 10, 2010, at 20:18:54
i had the exact same problem on lexapro with the panic atacks and dread and i agree that it could be due to an increase in norepinephrine because i recently experienced another attack were i though i was going to go crazy and it was after a month of taking a new pain med called nucynta it is a combo of an opioid and norepinephrine and i stopped taking it and feel much better so i cant help but asume there is a connection.
Posted by samuel on May 8, 2011, at 1:02:42
In reply to Lexapro and Norepinephrine?, posted by merpmerp on November 10, 2010, at 20:18:54
i had the exact same problem on lexapro with the panic atacks and dread and i agree that it could be due to an increase in norepinephrine because i recently experienced another attack were i though i was going to go crazy and it was after a month of taking a new pain med called nucynta it is a combo of an opioid and norepinephrine and i stopped taking it and feel much better so i cant help but asume there is a connection.
Posted by desolationrower on June 24, 2011, at 21:11:04
In reply to Re: Lexapro and Norepinephrine?, posted by samuel on May 8, 2011, at 0:58:42
> i had the exact same problem on lexapro with the panic atacks and dread and i agree that it could be due to an increase in norepinephrine because i recently experienced another attack were i though i was going to go crazy and it was after a month of taking a new pain med called nucynta it is a combo of an opioid and norepinephrine and i stopped taking it and feel much better so i cant help but asume there is a connection.
IIRC there is a downstream locus in the PAG so multiple anxiogenic drugs could feel the same despit edifferent proximate actions.-d/r
This is the end of the thread.
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