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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by Diirk on July 31, 2009, at 10:53:00
I am having terrible anxiety after taking my first 5mg Lexapro tablet. I've heard there can be an increase in anxiety when starting Lexapro, but didn't think it would happen so quickly. I have successfully taken Zoloft in the past with some start up anxiety, but nothing compared with this.
Is this normal?
Posted by Phillipa on July 31, 2009, at 12:25:59
In reply to Lexapro Startup Anxiety, posted by Diirk on July 31, 2009, at 10:53:00
Happened to me and I was already on benzos. Lots take a benzo to start. Phillipa and welcome to babble.
Posted by morganpmiller on July 31, 2009, at 17:09:11
In reply to Lexapro Startup Anxiety, posted by Diirk on July 31, 2009, at 10:53:00
Lexapro is VERY powerful. Many people experience anxiety in the beginning with Lexapro, even at a low dose. Sometimes the anxiety does not go away with time and dosage increase.
Why lexapro instead of zoloft or prozac?
How was your experience with zoloft?
Posted by Diirk on July 31, 2009, at 20:12:42
In reply to Re: Lexapro Startup Anxiety, posted by morganpmiller on July 31, 2009, at 17:09:11
> Lexapro is VERY powerful. Many people experience anxiety in the beginning with Lexapro, even at a low dose. Sometimes the anxiety does not go away with time and dosage increase.
>
> Why lexapro instead of zoloft or prozac?
>
> How was your experience with zoloft?
>
I was taking Zoloft for anxiety, rather than depression. I initially did well on Zoloft, 50mg, but after a few years it didn't seem to be working and I wanted to try to go it without meds, so I stopped taking it. That was about 1 year ago.Now my anxiety has returned and I thought I'd try a different SSRI that might work better, heard a lot of good things about Lexapro and asked my Dr. if I could try it. He was fine with it, so here I am. Now I'm wondering if I should have just gone back on the Zoloft, maybe trying a higher dose.
I've heard positive things about Prozac, too, but know it's less targeted, and sticks around a long time, which I know can be good for withdrawal symptoms, but don't like the thought of having something in my system that long if I have a bad reaction to it.
For now the plan is to keep on the Lexapro until (if) it gets totally unbearable, at which point I think I'll just go back on Zoloft.
Any luck with Effexor for anxiety? Again, I've heard both good and bad stories...
Posted by Phillipa on July 31, 2009, at 20:41:43
In reply to Re: Lexapro Startup Anxiety, posted by Diirk on July 31, 2009, at 20:12:42
If it was me I'd go back on the zoloft and raise the dose. Love Phillipa
Posted by morganpmiller on July 31, 2009, at 21:59:22
In reply to Re: Lexapro Startup Anxiety, posted by Diirk on July 31, 2009, at 20:12:42
I understand where you are coming from. Zoloft may have been more helpful at a higher dose, maybe not. After years of being on a medication, one thing we have to remember is that other things may be causing our anxiety, and maybe it is not that the medication is not working anymore.
I always say this; Do you workout/exercise? how are your relationships/friendships? Do you do yoga? Do you have hobbies/activities you enjoy?
And, did you try upping the dose a bit. You know you can do 75mgs of Zoloft pretty easily. Even if you don't have the 25mg prescription.
Posted by morganpmiller on July 31, 2009, at 22:04:13
In reply to Re: Lexapro Startup Anxiety, posted by morganpmiller on July 31, 2009, at 21:59:22
I don't blame you for trying something new. Sometimes it works great, sometimes not so much. I made the mistake of trying new meds that did not work as well as a few oldies but goodies. We all do that.
I hope lexapro works well for you. Good luck.
Posted by morganpmiller on July 31, 2009, at 22:07:58
In reply to Re: Lexapro Startup Anxiety » Diirk, posted by Phillipa on July 31, 2009, at 20:41:43
Yeah I kinda agree, I'm not crazy about the lexapro craze that has lasted for so long and is still going strong. I'm mean, I'm sure it works great for many, I just prozac and zoloft work just as good for many or better.
Also remember, there is no magic bullet and there never will be. Your medication takes you so far, then you take yourself further.
Posted by SLS on August 1, 2009, at 5:37:06
In reply to Lexapro Startup Anxiety, posted by Diirk on July 31, 2009, at 10:53:00
> I am having terrible anxiety after taking my first 5mg Lexapro tablet. I've heard there can be an increase in anxiety when starting Lexapro, but didn't think it would happen so quickly. I have successfully taken Zoloft in the past with some start up anxiety, but nothing compared with this.
>
> Is this normal?I think it is unusual to have additional anxiety so early in Lexapro treatment. Often, anxiety appears around the end of the second week and is gone by the end of the third. If your anxiety remains elevated by then, I would consider that Lexapro is not the right drug for you. In actuality, I doubt Lexapro is as good for anxiety as is Effexor and some of the other SSRIs. Either Lexapro is not used that often for anxiety disorders, or it is just not that effective. Of course, if Effexor does not work for you, it is more difficult to discontinue than would be Lexapro or Prozac. Paxil works too, but its withdrawal syndrome is no bargain either. There are ways of mitigating withdrawal symptoms that I'm sure you will get help with should you really find it difficult to discontinue these drugs. Some people do not experience much withdrawal at all.
You might actually have started with too low a dosage of Lexapro, although this is only a suspicion of mine. I have no evidence to support it. If it were me, though, I would go up immediately to 10mg and see what happens. If it makes things worse after a few days, I would drop it. If things calm down, I would then wait another week and go up to 20mg, knowing that there might be another brief worsening of anxiety.
What dosage of Zoloft did you take?
Are you particularly anxious in social situations?
What is your official diagnosis?
Ever have a panic attack?
- Scott
Posted by morganpmiller on August 1, 2009, at 17:14:12
In reply to Re: Lexapro Startup Anxiety » Diirk, posted by SLS on August 1, 2009, at 5:37:06
Scott,
I believe that low of a dose of Lexapro could be the cause of extra anxiety. My old therapist, my new therapist, and a psychiatrist have all had patients that had this reaction to lexapro. The explanation that the psychiatrist gave me is that it's power does not sit well with some pSeople. So, Lexapro could be causing this anxiety, even at such a low dose. If you search the internet you may find similar experiences.Lexapro is so clean and powerful maybe it gets to where it needs to much faster without anything getting in it's way.
There are cases where a 5 mg dose was enough to treat someone's depression/anxiety. So, it would make sense that a low dose could also cause anxiety.
Posted by Diirk on August 1, 2009, at 17:15:53
In reply to Re: Lexapro Startup Anxiety » Diirk, posted by SLS on August 1, 2009, at 5:37:06
> > I am having terrible anxiety after taking my first 5mg Lexapro tablet. I've heard there can be an increase in anxiety when starting Lexapro, but didn't think it would happen so quickly. I have successfully taken Zoloft in the past with some start up anxiety, but nothing compared with this.
> >
> > Is this normal?
>
> I think it is unusual to have additional anxiety so early in Lexapro treatment. Often, anxiety appears around the end of the second week and is gone by the end of the third. If your anxiety remains elevated by then, I would consider that Lexapro is not the right drug for you. In actuality, I doubt Lexapro is as good for anxiety as is Effexor and some of the other SSRIs. Either Lexapro is not used that often for anxiety disorders, or it is just not that effective. Of course, if Effexor does not work for you, it is more difficult to discontinue than would be Lexapro or Prozac. Paxil works too, but its withdrawal syndrome is no bargain either. There are ways of mitigating withdrawal symptoms that I'm sure you will get help with should you really find it difficult to discontinue these drugs. Some people do not experience much withdrawal at all.
>
> You might actually have started with too low a dosage of Lexapro, although this is only a suspicion of mine. I have no evidence to support it. If it were me, though, I would go up immediately to 10mg and see what happens. If it makes things worse after a few days, I would drop it. If things calm down, I would then wait another week and go up to 20mg, knowing that there might be another brief worsening of anxiety.
>
> What dosage of Zoloft did you take?
>
> Are you particularly anxious in social situations?
>
> What is your official diagnosis?
>
> Ever have a panic attack?
>
>
> - ScottI was on 50mg Zoloft. My anxiety is mostly situational (meetings, appointments, public transportation, etc., places I feel I can't escape easily or without embarrassment), but I also have anxiety for no apparent reason, just sitting at home. I have had panic attacks (worst ones when starting SSRI meds), but usually I can get through a situation without totally losing it - I've got a pretty good poker face when freaking out inside.
I've decided to stick with the Lexapro long enough to see if it's going to work, or until it becomes unbearable - so far I'm able to handle the start up anxiety (with the help of some Klonopin).
Posted by morganpmiller on August 1, 2009, at 18:56:23
In reply to Re: Lexapro Startup Anxiety, posted by Diirk on August 1, 2009, at 17:15:53
I have been told by a psychiatrist that benzos like klonopin can interfere with the efficacy of SSRIs as they are CNS depressants. It's the same reason why you would not want to treat your anxiety with alcohol while you are taking an SSRI.
If you can, I would see what a week off klonopin is like. Your goal should be to have the lexapro treating most of the anxiety alone, without any other drug intervention. You have to consider there is a possibility that klonopin may interfere with this goal. If you can tolerate it, it appears that you can, you should try to go with lexapro alone for a few weeks. Just go to the gym, run, or do something the quell that anxiety in the mean time.
Posted by Alexanderfromdenmark on August 1, 2009, at 19:05:57
In reply to Lexapro Startup Anxiety, posted by Diirk on July 31, 2009, at 10:53:00
> I am having terrible anxiety after taking my first 5mg Lexapro tablet. I've heard there can be an increase in anxiety when starting Lexapro, but didn't think it would happen so quickly. I have successfully taken Zoloft in the past with some start up anxiety, but nothing compared with this.
>
> Is this normal?Insomnia, akathasia? I wouldn't stick it out if it isn't right for you.
Posted by Phillipa on August 1, 2009, at 20:40:03
In reply to Re: Lexapro Startup Anxiety, posted by morganpmiller on August 1, 2009, at 18:56:23
It is a very common practice to start an ad with a benzo. Where I used to work seemed all the pdocs on the unit used klonopin. Me it doesn't work for but other benzos did work real well. Also drank beer and it helped. No depression from the three either felt happy and great after a while. But that is me. Phillipa
Posted by morganpmiller on August 1, 2009, at 22:28:10
In reply to Re: Lexapro Startup Anxiety » morganpmiller, posted by Phillipa on August 1, 2009, at 20:40:03
You're right, it is a common practice. I just believe that it is one of many "bad" common practices.
Posted by Phillipa on August 2, 2009, at 18:21:40
In reply to Re: Lexapro Startup Anxiety, posted by morganpmiller on August 1, 2009, at 22:28:10
Morganmiller why do you feel it's bad? Some could not tolerate the side effects of an ad without a benzo in the beginning of treatment? Just curious. Phillipa
Posted by morganpmiller on August 2, 2009, at 20:24:28
In reply to Re: Lexapro Startup Anxiety » morganpmiller, posted by Phillipa on August 2, 2009, at 18:21:40
I just think that in many cases, the benzo could interfere with the start up efficacy. Basically, the patient may start feeling better with the AD alone much sooner if there were no benzodiazepine intervention.
Also, there is always that risk of developing a dependency on the benzo.
How does one ever know how much an SSRI is helping them if they are consistently treated with a benzo. How does one know if they could have been relieved of anxiety 70 percent and were able to treat the rest of it through other means if they were on a benzo from the get-go?
I have spoken to 4 doctors, 3 psychiatrists, 1 primary care, that are not crazy about the use of benzos for these reasons.
Buspar was developed in the hopes that it would replace benzos. It ended up not being so successful. The idea was to stop giving depressed patients something that strongly depressed the CNS.
Posted by elanor roosevelt on August 9, 2009, at 15:44:32
In reply to Re: Lexapro Startup Anxiety, posted by morganpmiller on August 1, 2009, at 18:56:23
I'll say it again
when you start Lexapro you must stay busy and avoid boring gatherings--especially those that pin you down at a tablexanax is most useful in these situations if you just carry it with you for the security
Lexapro was my all time favorite
i hope it works for you
This is the end of the thread.
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