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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 919 to 943 of 8406. Go back in thread:
Posted by pharmrep on October 18, 2002, at 18:24:51
In reply to Re: Benzodiazapines vs. AD's for anxiety disorder, posted by Grace on October 18, 2002, at 16:33:01
> I am diagnosed with panic/anxiety disorder and mild
> depression (mostly because of the effect the panic/
> anxiety has had on my life).
>
> I have tried MANY different meds and am currently taking:
> 30 mg celexa (at night)
> .5 mg 2x day klonopin
> 10 mg claritin (for sexual side effects)
>
> my doctor recently added the claritin to my meds
> because of the sexual side effect problem, which
> nothing else fixed (buspar, ginko, wellbutrin, etc.).
> She had a study that another doctor had done with his
> own practice of 9 patients on SSRI's and sexual side
> effects. Of those 9, 7 reported their sexual s/e went
> away with the claritin and 2 had some improvement.
> I figured it was worth a try and amazingly it has
> had some effect.
>
> I now have some desire for sex (which was non-existent before)
> and am able to orgasm without it taking 2 hours and more work
> than it was worth. I figure I'm a tough case, so maybe you
> can bring this up with your docs.
>
> Also, I've just been switched today to Lexapro because of
> being very sleepy for the whole time I've been on Celexa.
> I'm starting out with 10mg (anytime) and moving up to
> 15....we'll see.*** why go to 15mg? 10mg of lexapro is very potent and demonstrating efficacy compared to 40mg of celexa...dont titrate just to "see" (ps...try taking lex in morning...since you probably wont have that tired feeling you got from celexa...i hear mornings work better for most)
Posted by pharmrep on October 18, 2002, at 18:27:27
In reply to Is Lexapro helping anyone with anxiety, posted by cody on October 18, 2002, at 12:43:43
> I've been on Lexapro about 2 1/2 weeks now. Started at 5mg for 10 days, then 7.5 for 10 days. I haven't gotten any relief from my anxiety yet. In fact, it seems to make me more anxious and I think I'm starting to get depressed over it. I'm thinking about going back to Remeron, although I don't like the s/e, it at least seems to help more with the anxiety. Any thoughts on this would be helpful.
*** 10mg is the starting dose...can you try it?
Posted by cody on October 18, 2002, at 18:46:17
In reply to Re: why only 5, then 7.5mg? » cody, posted by pharmrep on October 18, 2002, at 18:27:27
> > I've been on Lexapro about 2 1/2 weeks now. Started at 5mg for 10 days, then 7.5 for 10 days. I haven't gotten any relief from my anxiety yet. In fact, it seems to make me more anxious and I think I'm starting to get depressed over it. I'm thinking about going back to Remeron, although I don't like the s/e, it at least seems to help more with the anxiety. Any thoughts on this would be helpful.
>
> *** 10mg is the starting dose...can you try it?>>>I seem to be very chemical sensitive. It's not only the physical s/e that bother me. I feel like I'm in a fog, can't think straight, have a harder time just functioning. Also, the Lexapro seems to make me nervous on top of the anxiety.
Posted by pharmrep on October 18, 2002, at 19:17:51
In reply to Re: why only 5, then 7.5mg?, posted by cody on October 18, 2002, at 18:46:17
> > > I've been on Lexapro about 2 1/2 weeks now. Started at 5mg for 10 days, then 7.5 for 10 days. I haven't gotten any relief from my anxiety yet. In fact, it seems to make me more anxious and I think I'm starting to get depressed over it. I'm thinking about going back to Remeron, although I don't like the s/e, it at least seems to help more with the anxiety. Any thoughts on this would be helpful.
> >
> > *** 10mg is the starting dose...can you try it?
>
> >>>I seem to be very chemical sensitive. It's not only the physical s/e that bother me. I feel like I'm in a fog, can't think straight, have a harder time just functioning. Also, the Lexapro seems to make me nervous on top of the anxiety.*** for most people...1-2 wks is all they need...and for others 4-6...why, i dont know, everyone responds differently...perhaps it might take a little longer for you but lexapro does help with anxiety too...hang in there and keep us posted
Posted by Phil on October 18, 2002, at 19:28:19
In reply to Re: adjustment time » cody, posted by pharmrep on October 18, 2002, at 19:17:51
Posted by pharmrep on October 18, 2002, at 19:49:48
In reply to pharmrep..Ever been on meds for depression? (nm), posted by Phil on October 18, 2002, at 19:28:19
Posted by Phil on October 18, 2002, at 20:53:12
In reply to nope (nm) » Phil, posted by pharmrep on October 18, 2002, at 19:49:48
I feel like you understand what patients are feeling. When did you get the ability to empathize but also be aware of where people are on the steps out of hell? People don't usually have that ability if they've never been around suffering.
That's a compliment pharmrep. : ^ )
Posted by momof3 on October 18, 2002, at 20:53:13
In reply to Re: adjustment time » cody, posted by pharmrep on October 18, 2002, at 19:17:51
Cody,
Hi-I am the mother of three children and have suffered depression and anxiety for several years now. I am on 10mg lexapro and felt the fog and sleepiness,sick,headache etc. This lasted for about two weeks and I thought I could not continue. I know how it feels to feel as though you are barely hanging on and these children are looking to you and you have nothing to give. I am at three plus weeks now and am up at 6:30 in the morning and not in bed till a "normal time". This is the first time in a long time I feel like I can be there for my family. If you can work through the icky feeling at 10mg, you may just feel like there is hope. I also can hardly tolerate most meds. Hang in there!Laura
Posted by CuriousJane on October 18, 2002, at 20:59:25
In reply to Anyone switched to Lexapro? « ggrrl, posted by Dr. Bob on June 11, 2002, at 7:52:48
I switched from 30mg of Celexa (which worked fine aside from the total lack of sex drive) to 10mg Lexapro about 7 days ago, and for the last few days I have noticed myself becoming increasingly impatient and frustrated (no one seems to be able to drive right! :). Today I was so frustrated at work I started to cry, which hasn't happened in ages. I have also noticed tension headaches the past few days. No new stresses in my life, so I can only imagine its the meds.
called my doc and he said, "Well, you could need less, or more." Great. So he suggested dropping to 5mg for a few days, and then if that doesn't work, going to 15mg.
Anyone have any similar problems switching?
Posted by lmblec on October 18, 2002, at 21:12:31
In reply to Re: Is Lexapro helping anyone with anxiety » cody, posted by SLS on October 18, 2002, at 14:52:30
i am at 20 mg 2 weeks helps with anxiety but not completely - i tend to sleep much to much and makes tired. anyone have a suggestions. did i go up to fast
i went to twenty mg after one week on ten
lmblec
Posted by Dr. Bob on October 18, 2002, at 21:35:37
In reply to Re: raw boy/see bottom » Phil, posted by pharmrep on October 17, 2002, at 10:27:40
> why are you ripping on me? Im here to help, not be your punching bag.
Please don't post anything that could lead others to feel accused. The last time you were blocked, it was for 1 week, so this time it's for 2.
Bob
PS: Follow-ups regarding posting policies should be redirected to Psycho-Babble Administration; otherwise, they may be deleted.
Posted by Abacus on October 18, 2002, at 22:07:01
In reply to dosing » Grace, posted by pharmrep on October 18, 2002, at 18:24:51
Mornings may work better for most, but for me, evenings are the time to take the lex since it makes me so sleepy and dull. I wake refreshed.
> > I am diagnosed with panic/anxiety disorder and mild
> > depression (mostly because of the effect the panic/
> > anxiety has had on my life).
> >
> > I have tried MANY different meds and am currently taking:
> > 30 mg celexa (at night)
> > .5 mg 2x day klonopin
> > 10 mg claritin (for sexual side effects)
> >
> > my doctor recently added the claritin to my meds
> > because of the sexual side effect problem, which
> > nothing else fixed (buspar, ginko, wellbutrin, etc.).
> > She had a study that another doctor had done with his
> > own practice of 9 patients on SSRI's and sexual side
> > effects. Of those 9, 7 reported their sexual s/e went
> > away with the claritin and 2 had some improvement.
> > I figured it was worth a try and amazingly it has
> > had some effect.
> >
> > I now have some desire for sex (which was non-existent before)
> > and am able to orgasm without it taking 2 hours and more work
> > than it was worth. I figure I'm a tough case, so maybe you
> > can bring this up with your docs.
> >
> > Also, I've just been switched today to Lexapro because of
> > being very sleepy for the whole time I've been on Celexa.
> > I'm starting out with 10mg (anytime) and moving up to
> > 15....we'll see.
>
> *** why go to 15mg? 10mg of lexapro is very potent and demonstrating efficacy compared to 40mg of celexa...dont titrate just to "see" (ps...try taking lex in morning...since you probably wont have that tired feeling you got from celexa...i hear mornings work better for most)
Posted by ANXIETY ANN on October 18, 2002, at 22:27:36
In reply to Re: dosing, posted by Abacus on October 18, 2002, at 22:07:01
Hi Cody,
I too suffer from severe anxiety and panic attacks. I had my first panic attack in 1996 and suffered from anxiety since I was a little girl. I have tried almost every anti-depressant out there and took xanax daily. I've been in counseling twice a month for four years. Right now I take 10mg of Lexapro in the morning and adivan as needed. (usually twice a day). I am also very sensitve to meds and when I first started talking Lexapro I was extremely anxious and could'nt sleep. Ive been on Lexapro for two weeks now, and I feel so much better.(aside fron the sexual s/e). Hang in there, it will get better. Try taking the Lexapro in the am if your not already and give yourself a break, it sounds like your too hard on yourself.
stay in touch
Posted by Alan on October 18, 2002, at 23:16:48
In reply to Re: Is Lexapro helping anyone with anxiety, posted by cody on October 18, 2002, at 18:23:44
> Alan,
> Thank you for the helpful information. No, I have not been offered bzd as monotherapy. In addition to the Remeron, I have also been asked to try Paxil and Celexa, but was unable to tolerate either. My doctor has always seemed willing to prescibe the ativan and has told me to increase the dosage while adjusting to the Lexapro. As hard as I try, I just don't seem to be able to tolerate any AD except Remeron. I don't know why, but I have always tried to avoid taking any bzd. After reading the info on the subject, I now have a better understanding of my illness and ways to treat it. Thank you so much for your help.
============================================You're welcome.
There is a distinctive trend amongst anxiety sufferers - those that respond best to bzds and those to AD's (the AD' as I mentioned before are in the distinct minority).
Both drugs have tolerance ("poop-out" is the euhpemism used by the pharmecticals for AD's) and withdrawal ("discontinuation syndrome" used by AD co's.) so it's a wash.
So, if you've run a sufficient amount of clinical trials with the new AD's sounds like it's time to try the bzds in monotherapy. Remember that each of them will give you a different response so your doctor should give you the latitude to try any one of them either as a single type or combining a long acting (klonopin or Valium) with a shorter one PRN (xanax or ativan) for breakthrough panic or anxiety attack. Either way, it sounds like you are a good candidate.
Remember that there are sedating side effects at first but that will wear off over the course of the first week or so. DO NOT confuse the decrease of the sedating side effect with the med losing any of it's anti anxiety effect. Keep upping the dose (under the docs supervision of course) until either the med has enough benefit without too much side effect to enable you to stick with it.
If one type doesn't work, go to the next one....that's the beauty of it, the med works right away so you can go from one to the other until you find the one that YOU feel best on. DON'T feel bound to some arbitrary starting dose that's on some chart or is preconceived that is not individual to you. Only YOU will know by listening to your body what med at what dose works for you and in what situation. The dose may fluxuate too to trace the waxing and waning of the underlying anxiety disorder.
Leave the commercial interests standing between you and a good doc that understand these meds behind. YOU are the boss and the doc is YOUR employee. As long as you remember that, you'll be in control of your health and the hopelessness of things being out of control will lessen.
Second and third opinions are sought after on a daily basis in medicine. Why should psychiatry be immune to these standard practices? Find someone that is not benzophobic and beyond that understands and has experience treating with these very safest of drugs for anxiety disorders!
Best,
Alan
Posted by Alan on October 18, 2002, at 23:22:50
In reply to Went from Celaxa to Lexapro, notice irriatbility, posted by CuriousJane on October 18, 2002, at 20:59:25
> I switched from 30mg of Celexa (which worked fine aside from the total lack of sex drive) to 10mg Lexapro about 7 days ago, and for the last few days I have noticed myself becoming increasingly impatient and frustrated (no one seems to be able to drive right! :). Today I was so frustrated at work I started to cry, which hasn't happened in ages. I have also noticed tension headaches the past few days. No new stresses in my life, so I can only imagine its the meds.
>
> called my doc and he said, "Well, you could need less, or more." Great. So he suggested dropping to 5mg for a few days, and then if that doesn't work, going to 15mg.
>
> Anyone have any similar problems switching?
=============================================
No but a close friend did...I posted some reasons why I thought it was happening up earlier in this thread. It may be worth looking into. It's only a little technical but seems especially apropos to your situation....http://www.dr-bob.org/babble/20021012/msgs/123451.html
Alan
Posted by ayrity on October 19, 2002, at 0:57:07
In reply to Re: Careful with that T, was Re: orgasms... » ayrity, posted by Seamus2 on October 17, 2002, at 21:32:52
Hey Seaumus:
I guess I've been using the shots for a long time now, so I'm used to them. I don't get mood swings with the injections, though I know many that do. I tried a testosterone patch but couldn't continue it because of severe skin irritation. I haven't tried the gel yet, but I heard from others that it might not produce adequate T levels for someone in my position (though it seems to work well for those with modestly low levels).Testicular atrophy is not a problem in my case- they never grew much to begin with. I can take FSH/LH later, if a desire, which has been sucessful in stumulating testicular growth and function in many people with my condition. I have a hypothalamic condition (very rare), which means my brain never tells the pituitary to make FSH and LH, so no testicular function. I could give more details if interested.
> Ayrity, why aren't you using a transdermal gel instead of the shots? It evens out the fluctuations in T levels and if you get it compounded it's not that expensive. (Androgel, OTOH, is).
>
> What do you do about testicular atrophy?
Posted by ayrity on October 19, 2002, at 0:59:27
In reply to Re: orgasms/testosterone, posted by pharmrep on October 17, 2002, at 21:40:57
Sorry Pharmrep. You're right, you were just asking, not recommending.
> *** I am not recommending this...I merely asked what everyone thought about it. (and if you read closely...I am referring to males only..for those who think girls with mustaches will appear)
>
> > > *** anyone heard of this one? I asked this one DR what hid did for people having difficulty w/ orgasms...and he told me that for guys, he would give an injection once a month of testosterone (250-500mg)...he said that after that his male pts didnt have ejac. probs anymore.
> >
>
Posted by ayrity on October 19, 2002, at 1:06:01
In reply to Re: Careful with that T, was Re: orgasms... » ayrity, posted by Seamus2 on October 17, 2002, at 21:32:52
btw, do you mind telling me how low were your testosterone levels before you started treatment. Mine are at 200-300 before I'm due for another shot. I suspect they'd go lower if I stopped treament indefintely.
Posted by grace on October 19, 2002, at 9:46:34
In reply to dosing » Grace, posted by pharmrep on October 18, 2002, at 18:24:51
Why claritin? It is an allergy med, but in the doctor's study that he did in office, they found, by accident, that one of his patients happened to be taking an SSRI and had significant sexual side effects.
So he started taking the claritin and his sexual side effects went away. So his psychiatrist thought, what the heck and tried it on a few other patients and it worked. My doctor only has the one study published
to go from, but since it can't really hurt to try it (unless you're allergic or something) it was worth a shot and it seems to have helped. Kinda weird, but I've seen stranger things :-)As for the 15 mg.....we'd been talking about upping my Celexa a bit due to some more depressive issues, so she's said try the 10mg of Lexapro and if I do okay on that (i.e. it doesn't give me weird feelings), then go
up to 15 and stay there for awhile to see how it goes....knowing full well that I can decrease to 10 or whatever I need to do.
Posted by Seamus2 on October 19, 2002, at 10:18:50
In reply to Re: Careful with that T, was Re: orgasms..., posted by ayrity on October 19, 2002, at 1:06:01
I don't know the exact numbers; she just said there wasn't much. Being pretty conservative, I imagine she found them well below low, whatever that is.
Posted by yeltom on October 19, 2002, at 12:56:13
In reply to Re: Went from Celaxa to Lexapro, notice irriatbility » CuriousJane, posted by Alan on October 18, 2002, at 23:22:50
I switched from 40 mg celexa to 10 mg lexapro 3 weeks ago, and I feel more prone to headaches and irritability as well. Would like to hear from anyone else who has had this problem and, hopefully, from someone who had this problem but no longer does. Is this just an adjustment problem that I will get over?
> > I switched from 30mg of Celexa (which worked fine aside from the total lack of sex drive) to 10mg Lexapro about 7 days ago, and for the last few days I have noticed myself becoming increasingly impatient and frustrated (no one seems to be able to drive right! :). Today I was so frustrated at work I started to cry, which hasn't happened in ages. I have also noticed tension headaches the past few days. No new stresses in my life, so I can only imagine its the meds.
> >
> > called my doc and he said, "Well, you could need less, or more." Great. So he suggested dropping to 5mg for a few days, and then if that doesn't work, going to 15mg.
> >
> > Anyone have any similar problems switching?
> =============================================
> No but a close friend did...I posted some reasons why I thought it was happening up earlier in this thread. It may be worth looking into. It's only a little technical but seems especially apropos to your situation....
>
> http://www.dr-bob.org/babble/20021012/msgs/123451.html
>
> Alan
>
>
Posted by Phyl on October 19, 2002, at 13:44:24
In reply to Anyone switched to Lexapro? « ggrrl, posted by Dr. Bob on June 11, 2002, at 7:52:48
I am a chronic insomniac..that is my main problem. I have had it for 30 years. In the past year or so, I have developed a fear of being in a car at nighttime in heavy traffic. (Common with senior citizens, which group I belong to.) Other than this, I have no real anxieties. I am a worrier (5 grown children), but have never considered myself to be depressed -- when you are sleep-deprived, it's difficult to always be upbeat. I could always manage to get through the day, even on just 2-3 hours of sleep. Altho I was pretty tired, it didn't affect my energy level; people didn't believe I had such a chronic problem because I was able to keep going...better than others with no sleep problem.
I went to my internist for help with sleep and he put me on 10 Lexapro and 50 Trazodone. Told me it was Ok to take 2 Trazodone at night. The first day that I went on Lexapro, I took one Trazodone and after staying awake for two hours, I took a second one. Immediately my nasal passages dried up (I didn't realize it was the medication) and after another hour, I fell asleep and slept for about five hours. When I woke up, I felt sick; I was so tired, I was slurring my words and practically shuffled when I walked. My head felt very "fuzzy." I could barely function the entire day. It was terrible. The doctor took me off the Trazodone immediately, but asked me to stay on the Lexapro. For the first few days, I was totally exhausted at 6:00 p.m. I asked him if I could cut the pill in half and he said that was ok. (I am very sensitive to most meds.)
Even on one-half a pill (for almost two weeks), I find that I am extremely tired in the early evening (7:00 on) and I have to retire early. I also fall asleep much easier than I ever have, but when I wake up I am very tired. As the day goes on, I feel like myself.
Other than this fear of being in a car, I have no other anxieties. I am on no medications other than BP med, and I have never been treated for any anxiety or depression problems.
I am not quite sure I belong on this med. It seems to act as a sleeping pill for me. I don't notice much difference during the daytime, other than a slight lightheadedness. I don't notice any "improvement" during the daytime. What is this supposed to do for me? Cure me of my fear of driving? Allow me to worry less?
I will return to the internist in two weeks and will stay on this half pill til then. I just wondered what you think of my situation.
Thanks!
Posted by bridgette on October 19, 2002, at 14:39:49
In reply to Re: Lexapro and Celexa relative side-effects, posted by shakingoscar on October 11, 2002, at 1:06:19
I am responding to the message from the person who said that Claratin (the allergy med?) would helps w/sexual side effects---did I understand correctly. When I was on prozac I found that Buspar relieved the sexual side effects. Has anyone tried Buspar w/the Lexapro?
Posted by bridgette on October 19, 2002, at 14:49:22
In reply to Re: Is Lexapro helping anyone with anxiety ?cody, posted by Alan on October 18, 2002, at 23:16:48
I am still waiting for something to happen---I will say I have had a few (probably 3 days) where I felt a real sense of well being and I assume that's what we are striving for. Is this the way it works---that it's a gradual climb, up one day and then back to the same, Is it a gradual climb? I will stay w/it---I just want to hear if this is normal. I am definatley hoping for some improvemenet in the eext couple weeks or I but will consider 15 mg (I',m on 10mg now).
Posted by sparkinark on October 19, 2002, at 15:28:59
In reply to Re: Benzodiazapines vs. AD's for anxiety disorder, posted by Grace on October 18, 2002, at 16:33:01
I've never heard of using something like Claritin to help with SSRI side-effects. Is there any documentation on this or is this just someone's hunch? All I can take is Allegra because of really bad side-effects to other anti-allergy drugs, but I've not taken Allegra since I started Lexapro. I'll see if the combo does anything for me.
Claritin? Go figure...
> I am diagnosed with panic/anxiety disorder and mild
> depression (mostly because of the effect the panic/
> anxiety has had on my life).
>
> I have tried MANY different meds and am currently taking:
> 30 mg celexa (at night)
> .5 mg 2x day klonopin
> 10 mg claritin (for sexual side effects)
>
> my doctor recently added the claritin to my meds
> because of the sexual side effect problem, which
> nothing else fixed (buspar, ginko, wellbutrin, etc.).
> She had a study that another doctor had done with his
> own practice of 9 patients on SSRI's and sexual side
> effects. Of those 9, 7 reported their sexual s/e went
> away with the claritin and 2 had some improvement.
> I figured it was worth a try and amazingly it has
> had some effect.
>
> I now have some desire for sex (which was non-existent before)
> and am able to orgasm without it taking 2 hours and more work
> than it was worth. I figure I'm a tough case, so maybe you
> can bring this up with your docs.
>
> Also, I've just been switched today to Lexapro because of
> being very sleepy for the whole time I've been on Celexa.
> I'm starting out with 10mg (anytime) and moving up to
> 15....we'll see.
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Dr. Bob is Robert Hsiung, MD,
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