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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by nihocl on December 3, 2007, at 15:08:31
I'm having a hard time with depression right now. I am taking 20mg of Lexapro. My pdoc wants to add Effexor XR to it. I have taken Effexor in the past and don't really remember anything good or bad about it except how hard it was to get off of it. He has me starting on the starter pack at 37.5mg and wants me to go up to 150mg. I'm not sure about taking both of those together.
One other option that he suggested if the Effexor does not work is to stay on Lexapro and add Cytomel to it. I don't have any thyroid problems but he said that might help my get up and go come back. I'm tired of sitting in one chair so long that I grow roots.
I'd like to hear from anyone who has done either option...
thanks
Posted by Racer on December 3, 2007, at 23:24:06
In reply to Lexapro and Effexor, posted by nihocl on December 3, 2007, at 15:08:31
In general, taking two SRIs together risks serotonin syndrome -- a potentially fatal drug reaction caused by overstimulation of certain serotonin receptors. It's not something to play around with, and I'm a bit surprised that your doctor is suggesting it.
That said, sometimes low doses of two serotinergic drugs can safely be taken -- it's just not something to try lightly. Especially since you don't remember benefiting from Effexor in the past, I'd be thinking in terms of other options.
Did your doctor discuss with you why he wanted to try this combination? What his goals were? Also, are you getting any benefit from Lexapro? Maybe switching to another drug entirely makes more sense?
Good luck.
Posted by Phillipa on December 4, 2007, at 0:27:59
In reply to Effexor and Lexapro should not be taken together » nihocl, posted by Racer on December 3, 2007, at 23:24:06
Took relly small doses of two SSRI's same time but really tiny 5mg of paxil with l2.5mg of luvox it did work pretty well with xanax. Long time ago. Phillipa
Posted by yxibow on December 4, 2007, at 1:16:33
In reply to Re: Effexor and Lexapro should not be taken together, posted by Phillipa on December 4, 2007, at 0:27:59
Two serotonergics can be taken but not lightly, you're right. I currently take 200mg of Luvox and 150mg of Trazodone and 400mg of Seroquel, but the latter two deal with serotonin in a different way, forming a blockade.
Posted by nihocl on December 4, 2007, at 9:27:44
In reply to Re: Effexor and Lexapro should not be taken together, posted by Phillipa on December 4, 2007, at 0:27:59
Lexapro has worked well for me. Not sure if it's pooped out or if I'm just really stressed in life right now. Last time I went off Lexapro I ended up in the hospital. Even though I don't feel like it's doing much now, I have different depression symptoms than before. I have so many bad reactions to meds that it's hard to find anything to try. I have been on nortriptyline and Lexapro at the same time before. Doctor wasn't crazy about the cardiac issues with that and wanted to try Effexor instead.
With me no bad reaction is almost as good as a good reaction and maybe the 2 together will help. I have an appointment for 2 weeks from now in case I still need it. If I'm not doing well on this combo his next thought is to keep the Lexapro and add Cytomel to it. That is something that I haven't tried at least.
Posted by stargazer2 on December 5, 2007, at 21:56:03
In reply to Lexapro and Effexor, posted by nihocl on December 3, 2007, at 15:08:31
What are your current symptoms? If you need more energy, you may discuss wellbutrin with your doc or a stimulant. They can both be given safely with Lexapro. I took Celexa (similar to Lexapro) first with wellbutrin and adderall and had a good response. Personally I think it was the Wellbutrin and adderall that did more to help me than the Celexa.
I wouldn't take Lexapro and Effexor together. Ask your doc what he knows about serotonin syndrome since you have heard this can occur when 2 meds with similar effects on serotonin are combined. He should know this and comment on it immediately in response to this question.
Take a list of questions to ask him at your next appt. Start doing this and question anything you are not comfortable even if it means taking a few days to read more about his suggestions.
Over time this gets easier and becomes a nice exchange to discuss options and next steps. My doc may have a suggestion or two but I might have found something else I want to try first. I was a compliant patient for a long time but it wasn't until I started taking an active part in my treatment that things changed for the better. You need to feel involved with any decisions made on your behalf.
*gazer
Posted by nihocl on December 6, 2007, at 9:17:51
In reply to Re: Lexapro and Effexor, posted by stargazer2 on December 5, 2007, at 21:56:03
Unfortunately I've been on about every medication you can think of and am just prone to crappy side effects. I've tried all the stimulants. Adderall makes me mean, any form of dex keeps me up all night. He will give me some kind of Ritalin once I am mood stabilized. He doesn't want to change more than one thing at a time.
I have taken nortriptyline and Lexapro together before without issues. I have been told by many pdocs that I am very hard to medicate and this doc is great with me. I do have ADD so the stimulant will have to come back in some form. His next step was / is going to be Cytomel if I don't respond to the Effexor/Lex combo.
I'm glad that he gives up part of his lunch hour to see me if I say I need it. He knows that I'm serious if I cry out for help. I'm also thankful that he doesn't tell me that he's done all he can for me and pass me off to someone else....I've had that happen more than once.
This is the end of the thread.
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