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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 39. This is the beginning of the thread.
Posted by RetiredYoung on July 31, 2004, at 10:44:24
Hi all - My Lexapro continues pooping-out; I'm up to 40mg/day and experiencing diminishing effectiveness. I've been on every SSRI now except... Luvox.
Is this SSRI still being used very much and could folks share their experiences or info on this med?? I'm considering recommending that I try it to my pdoc, combined with a low-med dose of a TCA. Recommendations on that would also be appreciated. Thanks.
Posted by SLS on July 31, 2004, at 11:16:10
In reply to Luvox??, posted by RetiredYoung on July 31, 2004, at 10:44:24
> Hi all - My Lexapro continues pooping-out; I'm up to 40mg/day and experiencing diminishing effectiveness. I've been on every SSRI now except... Luvox.
Just as an observer, it would be kind of neat to see what 600mg of lithium would do if you were to take if for a week or so.
Effexor?
Add Wellbutrin?
Add Remeron?
Wait for better suggestions?
:-)
Good luck!
- Scott
Posted by chemist on July 31, 2004, at 16:12:44
In reply to Luvox??, posted by RetiredYoung on July 31, 2004, at 10:44:24
> Hi all - My Lexapro continues pooping-out; I'm up to 40mg/day and experiencing diminishing effectiveness. I've been on every SSRI now except... Luvox.
>
> Is this SSRI still being used very much and could folks share their experiences or info on this med?? I'm considering recommending that I try it to my pdoc, combined with a low-med dose of a TCA. Recommendations on that would also be appreciated. Thanks.hello there, chemist here...Scott (SLS), Sad Panda, King Vultan, and Larry Hoover are folks who seem to be up on their game, in my opinion, with all this stuff: perhaps point a post specifically at them, or read their other posts? i'll jump in on the luvox bit, as it's been very good to me at the 200mg/day (divided doses) range. i had a run of it years ago, then many switches, and then back to luvox a few months ago. i can report a painless titration, minimal side effects that are par for the course (dry mouth, some sweating, a little stomach upset, etc.) that abate in time, and a pretty easy taper when/if you go off the drug. wide dosing range, so you do end up spending more time getting your personal dose dialed-in (as opposed to more narrow therapeutic windows for other ADs in general). i like it, and it has been appearing in subject threads with greater frequency in the past month or so, although i have only been on this board since march, so i cannot be a judge of whether this is a cyclical thing or if the newer drugs are less promising than originally thought. anyhow, from my personal experience, it has been just fine in every regard for mild to moderate depression/OCD and it takes a bit of anxiety out of me, too. i do encourage you to check in with the wiser contingent in re: TCAs and other meds here, as my experience in this area is quite limited and my knowledge base is not nearly as great as many others on this board....all the best, chemist
Posted by Racer on July 31, 2004, at 17:27:41
In reply to Re: Luvox?? » RetiredYoung, posted by chemist on July 31, 2004, at 16:12:44
If the other SSRIs worked for you, then pooped out, you might also try one of those again. Sometimes, drugs will poop-out, but be effective again if you go off them for a time.
I know, it's not directly related to your question about Luvox, but since you're also experiencing serial SSRI poop-out, I thought I'd mention it. It's at least worth discussing with your doctor.
Best luck.
Posted by cpallen79 on July 31, 2004, at 21:50:52
In reply to Re: Luvox?? » RetiredYoung, posted by chemist on July 31, 2004, at 16:12:44
I have to agree with Chemist on this one. Luvox has helped me quite a bit. I'm also working up to 200 and will divide my dose between mornings and evenings. I expereinced the same problem with LExapro... it didn't really "poop out" per say, however it jsut didn't seem effective enough. So far I'e had some results with Luvox at just the 100 MG dose, and that is pleasing. Best of luck.. perhaps add in an AP or Mood stabilizer too.
Posted by chemist on August 1, 2004, at 9:22:26
In reply to Re: Luvox??, posted by cpallen79 on July 31, 2004, at 21:50:52
hey chris, glad to hear that the luvox is working: can you report any side effects? that would be useful, as there have been a few posts that indicate that a few folks are looking into trying luvox, and if you could give a little shout about how it's working and what the nature of any side effects are, that would be great...i am curious on a personal level, as i have found it to be a pretty ``clean'' drug in that regard, but we are all different.....thanks much, all the best, chemist
> I have to agree with Chemist on this one. Luvox has helped me quite a bit. I'm also working up to 200 and will divide my dose between mornings and evenings. I expereinced the same problem with LExapro... it didn't really "poop out" per say, however it jsut didn't seem effective enough. So far I'e had some results with Luvox at just the 100 MG dose, and that is pleasing. Best of luck.. perhaps add in an AP or Mood stabilizer too.
Posted by RetiredYoung on August 1, 2004, at 10:20:17
In reply to Re: Luvox?? » cpallen79, posted by chemist on August 1, 2004, at 9:22:26
cpallen, chemist - Are you both using Luvox primarily for depression? I've recently ascertained my long-diagnosed dysthymia is actually atypical depression (I'm very reluctant to attmept to switch to an MAOI).
I'm considering moving to Luvox and a low-mid dose of nortriptyline, imipramine, or clominpramine.
Best regards,
Jim
Posted by Sad Panda on August 1, 2004, at 11:15:06
In reply to Re: Luvox??, posted by RetiredYoung on August 1, 2004, at 10:20:17
> cpallen, chemist - Are you both using Luvox primarily for depression? I've recently ascertained my long-diagnosed dysthymia is actually atypical depression (I'm very reluctant to attmept to switch to an MAOI).
>
> I'm considering moving to Luvox and a low-mid dose of nortriptyline, imipramine, or clominpramine.
>
> Best regards,
>
> Jim
>
>Hi Jim,
If you are adding a TCA to an SSRI I would recommend Nortriptyline at therapeutic doseages & the two should combine to give less side effects than therapeutic Clomipramine. Low doseages of Amitriptyline or Doxepin are really only good sedatives & low doseages of Clomipramine or Imipramine don't really have any purpose as they aren't very sedating for most people.
Cheers,
Panda.
Posted by Racer on August 1, 2004, at 12:15:03
In reply to Re: Luvox??, posted by cpallen79 on July 31, 2004, at 21:50:52
I'm one of those interested in hearing more about others experiences on Luvox -- especially my big bugaboo: weight gain. (Yeah, I know, everyone reacts differently. I've gone up to 180 pounds on every anti-depressant I've ever been on, and I just can't take it again. Whether the drugs work or not, being that humongous is too distressing, so it limits the therapeutic benefits of the treatment.)
Can you tell us what your unexpected effects were? Any weight gain? Dry mouth? Constipation? Etc?
Thank you so much! I'm looking forward to reading your answers.
Posted by Larry Hoover on August 1, 2004, at 12:26:50
In reply to Seconding chemist's request » cpallen79, posted by Racer on August 1, 2004, at 12:15:03
> I'm one of those interested in hearing more about others experiences on Luvox -- especially my big bugaboo: weight gain. (Yeah, I know, everyone reacts differently. I've gone up to 180 pounds on every anti-depressant I've ever been on, and I just can't take it again. Whether the drugs work or not, being that humongous is too distressing, so it limits the therapeutic benefits of the treatment.)
>
> Can you tell us what your unexpected effects were? Any weight gain? Dry mouth? Constipation? Etc?
>
> Thank you so much! I'm looking forward to reading your answers.Well, I can tell you what Luvox done for me. Ya.
Totally lost the ability to sleep. Totally lost my abstinancy from alcohol. Went psychotic-manic, two realms I did not previously know.
I lost weight, all right. But maybe that was from dancing in bars for hours without end. I previously neither went to bars nor danced, so it's kinda hard to know fer sure.
Lar
Posted by cpallen79 on August 1, 2004, at 12:30:37
In reply to Re: Luvox?? » cpallen79, posted by chemist on August 1, 2004, at 9:22:26
Hi chemist,
So far in the way of side effects, it hasn't been bad. There's been some sedation and stomach aches, but it's gone away for the most part. I still ahve some light brain "snaps" from switching the two SSRIS but I'll probably have them awhile, who knows. Luvox seems to be a med I can tolerate more than the Lexapro. I had also gained about 5 lbs on the Lexapro and that is starting to come off. I think Luvox is a more weight neutral med.
> hey chris, glad to hear that the luvox is working: can you report any side effects? that would be useful, as there have been a few posts that indicate that a few folks are looking into trying luvox, and if you could give a little shout about how it's working and what the nature of any side effects are, that would be great...i am curious on a personal level, as i have found it to be a pretty ``clean'' drug in that regard, but we are all different.....thanks much, all the best, chemist
>
>
> > I have to agree with Chemist on this one. Luvox has helped me quite a bit. I'm also working up to 200 and will divide my dose between mornings and evenings. I expereinced the same problem with LExapro... it didn't really "poop out" per say, however it jsut didn't seem effective enough. So far I'e had some results with Luvox at just the 100 MG dose, and that is pleasing. Best of luck.. perhaps add in an AP or Mood stabilizer too.
>
Posted by chemist on August 1, 2004, at 12:54:12
In reply to Re: Luvox??, posted by RetiredYoung on August 1, 2004, at 10:20:17
hello there, chemist here....in my case, it's depression plus anxiety: i've found it to handle part of the anxiety pretty well, although xanax is still on-board....all the best, chemist
> cpallen, chemist - Are you both using Luvox primarily for depression? I've recently ascertained my long-diagnosed dysthymia is actually atypical depression (I'm very reluctant to attmept to switch to an MAOI).
>
> I'm considering moving to Luvox and a low-mid dose of nortriptyline, imipramine, or clominpramine.
>
> Best regards,
>
> Jim
Posted by chemist on August 1, 2004, at 13:01:10
In reply to Re: Luvox?? » chemist, posted by cpallen79 on August 1, 2004, at 12:30:37
hello there, thanks for the report...it seems luvox induced some dancing/mania/weight loss for larry....i have not had those effects, fortunately, as i cannot dance sober or drunk....okay, seems like this one is shaping up to be one of those ``different for everyone'' kind of meds....thanks again, and all the best, chemist
> Hi chemist,
> So far in the way of side effects, it hasn't been bad. There's been some sedation and stomach aches, but it's gone away for the most part. I still ahve some light brain "snaps" from switching the two SSRIS but I'll probably have them awhile, who knows. Luvox seems to be a med I can tolerate more than the Lexapro. I had also gained about 5 lbs on the Lexapro and that is starting to come off. I think Luvox is a more weight neutral med.
>
>
> > hey chris, glad to hear that the luvox is working: can you report any side effects? that would be useful, as there have been a few posts that indicate that a few folks are looking into trying luvox, and if you could give a little shout about how it's working and what the nature of any side effects are, that would be great...i am curious on a personal level, as i have found it to be a pretty ``clean'' drug in that regard, but we are all different.....thanks much, all the best, chemist
> >
> >
> > > I have to agree with Chemist on this one. Luvox has helped me quite a bit. I'm also working up to 200 and will divide my dose between mornings and evenings. I expereinced the same problem with LExapro... it didn't really "poop out" per say, however it jsut didn't seem effective enough. So far I'e had some results with Luvox at just the 100 MG dose, and that is pleasing. Best of luck.. perhaps add in an AP or Mood stabilizer too.
> >
>
>
Posted by RetiredYoung on August 1, 2004, at 13:07:07
In reply to Re: Luvox?? » RetiredYoung, posted by Sad Panda on August 1, 2004, at 11:15:06
Thank you Panda for that specific piece of advice. Perhaps I'll shoot for Luvox and nortriptyline then.
The reason I'm considering the Luvox portion of this combo is that it's the only SSRI I have not already tried - Lexapro is pooping out now, and the others either worked and pooped out, or had bad side effects.
Jim
Posted by Lex Luthor on August 1, 2004, at 23:55:46
In reply to Re: Luvox?? » Sad Panda, posted by RetiredYoung on August 1, 2004, at 13:07:07
The same thing (Lexapro pooping off) just happened to me last month. Lexapro is a drug that very often poops off. It's not as good as the marketing says. Celexa is actually better (probably because it has a slightly longer half - life).
The thing is, I've been in all SSRI's except Paxil (which I don't even want to try,). I've tried also Effexor, Remeron and Wellbutrin and all of then cause me horrible side efects except Prozac, but that one is the onew that gives me the worst sexual side effects, so it's also out of question.
Last week, I started Luvox (I'm also OCD). It inmediately works for depression and has the least sexual side effects of all the SSRI's, but causes me incredible tiredness, somnolence in the mornings, and CRAZINESS in the afternoons. Yes, in the afternoons, the drug kind of gets eliminated from the body (short half life, I've heard) and I get very angry, crazy, uncomfortably hyperactive, rude, worried, uncomfortable with everyone and I get the same vertigo that I felt when Effexor and Zoloft starts to get eliminated or withdrawed. I'm only taking 50 mg in the nights. I am and look tired and have big eyeshadows (sorry, I forgot the english word for that, but you get the idea) during almost the whole day. With the slightest physical effort I get extremely tired, sweaty and out of breath. I have also seen that it has a horrible interaction with just a litle alchohol intake. Will those efects go away with time or with a dose increase?
I'm also taking Trileptal and I'm currently trying to stop Clonazepam (main reason I quit Celexa to then start Lexapro, then start Zoloft and then start Luvox).
If this side effects don't go away, I'm going back to Celexa, even if I can't quit the benzo with it.
Posted by Lex Luthor on August 2, 2004, at 0:27:57
In reply to Same experience with Lexapro and now on Luvox, posted by Lex Luthor on August 1, 2004, at 23:55:46
Oh, one more thing I'm noticing: Tonight I'm having insomnia. I'm tired, but I'm having insomnia at the same time. Feeling hyperactive.
On a side note, I'm enjoying music more. I have musical euphorias.
But overall, this is not being a very good drug for me. I'll still give it a chance for a little while longer.
Dude, I'm feeling SO CRAZY!!!
Posted by cpallen79 on August 2, 2004, at 1:33:58
In reply to Same experience with Lexapro and now on Luvox, posted by Lex Luthor on August 1, 2004, at 23:55:46
Hi there, I've noticed some similar stuff /w Luvox, though not nearly to the extent you've had... It's your body adjusting to the med I'd say. Divide your dose of Luvox evenly in the evenings... It has a half life of about 16 hours, So it may not be the luvox causing that afternoon anxiety, then again it could... if you're tapering the benzo this could also be causing soem of the anxiety.
> The same thing (Lexapro pooping off) just happened to me last month. Lexapro is a drug that very often poops off. It's not as good as the marketing says. Celexa is actually better (probably because it has a slightly longer half - life).
>
> The thing is, I've been in all SSRI's except Paxil (which I don't even want to try,). I've tried also Effexor, Remeron and Wellbutrin and all of then cause me horrible side efects except Prozac, but that one is the onew that gives me the worst sexual side effects, so it's also out of question.
>
> Last week, I started Luvox (I'm also OCD). It inmediately works for depression and has the least sexual side effects of all the SSRI's, but causes me incredible tiredness, somnolence in the mornings, and CRAZINESS in the afternoons. Yes, in the afternoons, the drug kind of gets eliminated from the body (short half life, I've heard) and I get very angry, crazy, uncomfortably hyperactive, rude, worried, uncomfortable with everyone and I get the same vertigo that I felt when Effexor and Zoloft starts to get eliminated or withdrawed. I'm only taking 50 mg in the nights. I am and look tired and have big eyeshadows (sorry, I forgot the english word for that, but you get the idea) during almost the whole day. With the slightest physical effort I get extremely tired, sweaty and out of breath. I have also seen that it has a horrible interaction with just a litle alchohol intake. Will those efects go away with time or with a dose increase?
>
> I'm also taking Trileptal and I'm currently trying to stop Clonazepam (main reason I quit Celexa to then start Lexapro, then start Zoloft and then start Luvox).
>
> If this side effects don't go away, I'm going back to Celexa, even if I can't quit the benzo with it.
Posted by Sad Panda on August 2, 2004, at 2:11:40
In reply to Re: Luvox?? » Sad Panda, posted by RetiredYoung on August 1, 2004, at 13:07:07
> Thank you Panda for that specific piece of advice. Perhaps I'll shoot for Luvox and nortriptyline then.
>
> The reason I'm considering the Luvox portion of this combo is that it's the only SSRI I have not already tried - Lexapro is pooping out now, and the others either worked and pooped out, or had bad side effects.
>
> Jim
>Hi Jim,
Have you tried going back to drugs that have pooped out?
Cheers,
Panda.
Posted by zeugma on August 2, 2004, at 4:44:03
In reply to Re: Luvox?? » Sad Panda, posted by RetiredYoung on August 1, 2004, at 13:07:07
> Thank you Panda for that specific piece of advice. Perhaps I'll shoot for Luvox and nortriptyline then.
>
> The reason I'm considering the Luvox portion of this combo is that it's the only SSRI I have not already tried - Lexapro is pooping out now, and the others either worked and pooped out, or had bad side effects.
It sounds like this is a good combination. I would be sure to get a plasma level done on nortriptyline (which should be done as a routine matter anyway), as Luvox can inhibit the ancillary routes of nortriptyline's metabolism.>
> Jim
Posted by RetiredYoung on August 2, 2004, at 7:01:06
In reply to Re: Luvox?? » RetiredYoung, posted by Sad Panda on August 2, 2004, at 2:11:40
Nope - have not tried any of the drugs that have worked for me, but went on to poop out. It's my understanding that there is a good chance that they might work again.
re: Luvox. I've read on Crazy Meds that Luvox can greatly magnify the effects of caffeine (5-6x). That is causing me to re-think whether I want to try it.
Jim
Posted by SLS on August 2, 2004, at 7:23:32
In reply to Luvox??, posted by RetiredYoung on July 31, 2004, at 10:44:24
Is Luvox more likely to cause insomnia than the other SSRIs?
Thanks.
- Scott
Posted by Lex Luthor on August 2, 2004, at 8:22:04
In reply to Re: Luvox?? - Insomnia ?, posted by SLS on August 2, 2004, at 7:23:32
Hard to believe, but true. Luvox causes somnolence, but at the same time insomnia.
It also makes me to wake up early in the mournings feeling tense and out of breath, but still very tired.
About caffeine, I still don't know, but take ONE beer while on Luxox and you're a finished man.
I'm hangovered half of the day anyway.
On a side note, this drug dishinibits a big deal, for good and for bad.
It has been not good overall.
Short half life meds just kill me, and Prozac destroys my sex life. I think I'm going back to Celexa, even if it sucks for anxiety, for quitting benzos and also makes me to wake up in the mornings with a nervous attack.
Posted by cpallen79 on August 2, 2004, at 10:10:02
In reply to Re: Luvox?? - Insomnia ?, posted by Lex Luthor on August 2, 2004, at 8:22:04
Hi Lex, I tihnk you should either up your luvox, or add something else in. Another option is to add Trazodone into the mix for sleeping. If you haven't been taking it long, it's not working yet to its full potential;. If the SSRIs don't work, perhaps try a TCA instead.
If that doesn't work, go back to prozac but add in Wellbutrin or Buspar to offset the sexual SE (the prozac should help with anxiety caused by Wellbutrin). Sounds like your cortisol levels are high in the morning... have you perhaps considered a mood stabilizer? that can help from my understanding.
Posted by chemist on August 2, 2004, at 10:31:26
In reply to Re: Luvox?? - Insomnia ?, posted by SLS on August 2, 2004, at 7:23:32
> Is Luvox more likely to cause insomnia than the other SSRIs?
>
> Thanks.
>
>
> - Scotthey scott, i am not aware of luvox being dinged for more insomnia triggers than other SSRIs. it doesn't stand out in that regard, insomnia is right there with anxiety, dry mouth, etc. in side effects. i have tended to go with dosing earlier in the day because this is what was recommended years ago when i first tried luvox, and have stuck to that routine for historical purposes and because tweaking the dose for a while can swing one around a bit, so better off early in the day that later, in my and my pdoc's opinion. i believe another poster takes a heavy dose late in the day: to each their own. i just get it over with by noon or 1 pm, usually.....all the best, chemist
Posted by Lex Luthor on August 2, 2004, at 13:46:10
In reply to Re: Luvox?? - Insomnia ? » Lex Luthor, posted by cpallen79 on August 2, 2004, at 10:10:02
I am already taking Trileptal 300 mg twice a day. Before that, I was taking Tegretol.
Prozac and Wellbutrin? It is my experience that both cause anxiety. Prozac doesn't cause anxiety with a mood stabilizer, but I don't know what the mix with Wellbutrin would do. Anyway, when I took Wellbutrin I wasn't taking Trileptal, so mayby it's worth a try.
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