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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by rculater on August 4, 2010, at 6:17:47
Been on Celexa for 4 weeks and about to throw the towel in - Its the insomnia.
I am on an ultra low dose (5mg)
Tried to go to 10mg for 3 days but could not tolerate.
Stuck at 5mg and its been 4 weeks of terrible insomnia.
Not going down the Benzo road.Should I give it another week or so ?
I thought the insomnia would have gone by now.
Posted by morgan miller on August 4, 2010, at 11:58:08
In reply to Is 4 weeks a fair trial of celexa ? Insomnia, posted by rculater on August 4, 2010, at 6:17:47
I would either give it another month or switch to Lexapro if you haven't tried it already. I think Lexapro is superior to Celexa. You may only need as low as a 2.5 mg dose of Lexapro. I say tell your doc you want to switch to Lexapro and give 2.5 mg a good 8 weeks and see what happens. If the insomnia subsides substantially but after 8 weeks you still feel like you need more relief from anxiety, you would then go to a 5 mg dose and stay on that for another 3 or 4 weeks.
Is this the first SSRI you've tried? I'm assuming you are treating anxiety since you mention benzos.
In the meantime, there are some things you can buy at your local health food/vitamin store that may help with sleep.
Melatonin-time release
GABA
Glycine
Magnesium-glycinate or aspartate
Lemon Balm
Lithium orotate or aspartate(Solary and NOW make good lithium supplements)-need to buy over the internet. Lithium in very low doses is not toxic. It has a calming effect for several reasons including increasing serotonin. Lithium is also neuroprotective, neurogenic, and has antiviral and antibacterial properties. Just food for thought
Posted by Phillipa on August 4, 2010, at 13:16:17
In reply to Re: Is 4 weeks a fair trial of celexa ? Insomnia, posted by morgan miller on August 4, 2010, at 11:58:08
Morgan don't want to hyjack but knew none or not a lot of the things you say about lithium do you have link or site? Thanks and sorry for the hyjack. No more Phillipa
Posted by manic666 on August 4, 2010, at 13:39:32
In reply to Is 4 weeks a fair trial of celexa ? Insomnia, posted by rculater on August 4, 2010, at 6:17:47
5mg of celexa for 4 weeks, your going nowhere on that dose.If you carnt go higher get off the med. As for 2.5 of lexapro its near on the same med, 2.5 is going to do nothing if your thinking of staying that low.Unless in some sort of combo
Posted by morgan miller on August 4, 2010, at 14:07:28
In reply to Re: Is 4 weeks a fair trial of celexa ? Insomnia » morgan miller, posted by Phillipa on August 4, 2010, at 13:16:17
> Morgan don't want to hyjack but knew none or not a lot of the things you say about lithium do you have link or site? Thanks and sorry for the hyjack. No more Phillipa
I know we have discussed lithium in this respect before here on psycho-babble, so you may be able to find those discussions in the archives.
Here are a few links to pubmed studies on lithium.
Couldn't find anything on lithium being antibacterial but I think it is possible and read it a few places. Just can't find anything solid on Pubmed.
Posted by morgan miller on August 4, 2010, at 14:10:37
In reply to Re: Is 4 weeks a fair trial of celexa ? Insomnia, posted by manic666 on August 4, 2010, at 13:39:32
> 5mg of celexa for 4 weeks, your going nowhere on that dose.If you carnt go higher get off the med. As for 2.5 of lexapro its near on the same med, 2.5 is going to do nothing if your thinking of staying that low.Unless in some sort of combo
That's not necessarily true. Lexapro is very powerful. Sure the studies done on Lexapro were done using 10 to 20 mg(I think???). Still, because of Lexapro's power, certain more sensitive individuals may do very well on a low dose like 2.5 or 5 mg. I KNOW there are some doctors out there that are prescribing these lower doses and ignoring protocol, I have a pdoc that is one of them.
Posted by morgan miller on August 4, 2010, at 14:18:19
In reply to Re: Is 4 weeks a fair trial of celexa ? Insomnia, posted by morgan miller on August 4, 2010, at 14:10:37
I know this is just one person and is anecdotal, but here is one example of a 2.5 mg dose working very well for an anxiety sufferer. Go down to the 3rd review on this Revolution Health link.
I'm sure there are others here on PB that will back me up on the use of a 2.5 mg dose of Lexapro(BB comes to mind).
Posted by ed_uk2010 on August 4, 2010, at 15:50:34
In reply to Is 4 weeks a fair trial of celexa ? Insomnia, posted by rculater on August 4, 2010, at 6:17:47
> Been on Celexa for 4 weeks and about to throw the towel in - Its the insomnia.
In the absence of Celexa, do you ever suffer from insomnia? Or is this entirely due to the Celexa?
The fact that it's causing severe insomnia proves that even the low dose is 'doing something'. 5mg Celexa is not normally an effective dose but if, for some unknown reason, you are extremely sensitive to SSRIs, there is the possibility that you may be able to obtain benefit from a low dose.
What condition is the Celexa being used to treat? And have you tried any other SSRIs or other psych meds to treat it?
Posted by rculater on August 4, 2010, at 16:24:00
In reply to Re: Is 4 weeks a fair trial of celexa ? Insomnia, posted by ed_uk2010 on August 4, 2010, at 15:50:34
> > Been on Celexa for 4 weeks and about to throw the towel in - Its the insomnia.
>
> In the absence of Celexa, do you ever suffer from insomnia? Or is this entirely due to the Celexa?
>
> The fact that it's causing severe insomnia proves that even the low dose is 'doing something'. 5mg Celexa is not normally an effective dose but if, for some unknown reason, you are extremely sensitive to SSRIs, there is the possibility that you may be able to obtain benefit from a low dose.
>
> What condition is the Celexa being used to treat? And have you tried any other SSRIs or other psych meds to treat it?Hello.
Ive tried most SSSris, Snri a TCA and Moclobomide on and off with mixed results over a 10 year period for atypical/dysthimia.I missed out on celexa years ago for some reason. Lexapro made me gain weight rapidly and sleep lots.
Yes I am very sensitive to meds. Actually today even on 5mg 4 weeks in I am suffering all the S/Es ......Nauseous, head pains, body aches, anxiety, restlessness. etc etc.
I'm thinking that because I'm on such a low dose the main start-up S/E's are only kicking in now, at week 4 rather than in week 1- 2 as it normally should on a normal dose.
I have read reports of responders on 5mg.
thanks and good luck
Posted by rculater on August 4, 2010, at 16:25:38
In reply to Re: Is 4 weeks a fair trial of celexa ? Insomnia, posted by rculater on August 4, 2010, at 16:24:00
> > > Been on Celexa for 4 weeks and about to throw the towel in - Its the insomnia.
> >
> > In the absence of Celexa, do you ever suffer from insomnia? Or is this entirely due to the Celexa?
> >
> > The fact that it's causing severe insomnia proves that even the low dose is 'doing something'. 5mg Celexa is not normally an effective dose but if, for some unknown reason, you are extremely sensitive to SSRIs, there is the possibility that you may be able to obtain benefit from a low dose.
> >
> > What condition is the Celexa being used to treat? And have you tried any other SSRIs or other psych meds to treat it?
>
> Hello.
> Ive tried most SSSris, Snri a TCA and Moclobomide on and off with mixed results over a 10 year period for atypical/dysthimia.
>
> I missed out on celexa years ago for some reason. Lexapro made me gain weight rapidly and sleep lots.
>
> Yes I am very sensitive to meds. Actually today even on 5mg 4 weeks in I am suffering all the S/Es ......Nauseous, head pains, body aches, anxiety, restlessness. etc etc.
>
> I'm thinking that because I'm on such a low dose the main start-up S/E's are only kicking in now, at week 4 rather than in week 1- 2 as it normally should on a normal dose.
>
> I have read reports of responders on 5mg.
>
> thanks and good luck
>
> And no, no insomnia like this previously.
>
>
>
>
Posted by morgan miller on August 4, 2010, at 16:30:52
In reply to Re: Is 4 weeks a fair trial of celexa ? Insomnia, posted by rculater on August 4, 2010, at 16:24:00
Have you tried Zoloft? 100 mg hit the spot for me after 3 months or so.
When you tried lexapro, how long did you take it for? And, did you try a low dose like 2.5 or 5 mg?
Posted by rculater on August 4, 2010, at 16:45:34
In reply to Re: Is 4 weeks a fair trial of celexa ? Insomnia, posted by morgan miller on August 4, 2010, at 16:30:52
I was on Zoloft for 2 years with good results however I gained so much weight on it and felt zombiefied after that time.
I tried to go back on it a year later but failed because of bad startups.
I was on Lexapro for 8 weeks at standard dose. Not long enough but I craved carbs, slept, napped, gained 8 pounds and became very lazy. Oh it also made me itch.
I do remember the startup was bearable though.
Maybe I will try low dose of that....
Posted by ed_uk2010 on August 4, 2010, at 16:54:29
In reply to Re: Is 4 weeks a fair trial of celexa ? Insomnia, posted by rculater on August 4, 2010, at 16:45:34
I get the impression that you've suffered a lot of side effects from SSRIs previously. Unfortunately, Celexa may end up causing similar effects in the long run.
Perhaps an entirely different type of antidepressant would be better. Time to make an appointment with your doctor?
Posted by Phillipa on August 4, 2010, at 20:32:38
In reply to Re: Is 4 weeks a fair trial of celexa ? Insomnia, posted by morgan miller on August 4, 2010, at 14:07:28
Thanks Morgan really appreciate you taking the time. Phillipa
Posted by morgan miller on August 4, 2010, at 22:37:15
In reply to Re: Is 4 weeks a fair trial of celexa ? Insomnia » morgan miller, posted by Phillipa on August 4, 2010, at 20:32:38
> Thanks Morgan really appreciate you taking the time. Phillipa
Your welcome! Take care Phillipa.
Posted by manic666 on August 5, 2010, at 3:21:02
In reply to Re: Is 4 weeks a fair trial of celexa ? Insomnia, posted by morgan miller on August 4, 2010, at 22:37:15
the reason the low doses can upset you , there doing something but not enough.There like lingering waiting for you to move up the med so they can start helping. Its like putting a plaster cast on a brocken leg ,without setting the bone.Im on 100mg of sertraline used to be 150, but 150 no better than 100mg.It was 12 weeks before i felt relief ,thats how long my body takes to ajust.12 week of unbelievable side effects ,but i alway stick out 12 week trail,in the end i came good, weight gain yes but you have to have some down pay offs. what im saying if i had stayed on 5mg an move monthly i would still not be up to the recomended dose a year later.no pain no gain.
Posted by manic666 on August 5, 2010, at 3:21:30
In reply to Re: Is 4 weeks a fair trial of celexa ? Insomnia, posted by morgan miller on August 4, 2010, at 22:37:15
the reason the low doses can upset you , there doing something but not enough.There like lingering waiting for you to move up the med so they can start helping. Its like putting a plaster cast on a brocken leg ,without setting the bone.Im on 100mg of sertraline used to be 150, but 150 no better than 100mg.It was 12 weeks before i felt relief ,thats how long my body takes to ajust.12 week of unbelievable side effects ,but i alway stick out 12 week trail,in the end i came good, weight gain yes but you have to have some down pay offs. what im saying if i had stayed on 5mg an move monthly i would still not be up to the recomended dose a year later.no pain no gain.
Posted by rculater on August 5, 2010, at 7:15:18
In reply to Re: Is 4 weeks a fair trial of celexa ? Insomnia, posted by manic666 on August 5, 2010, at 3:21:30
> the reason the low doses can upset you , there doing something but not enough.There like lingering waiting for you to move up the med so they can start helping. Its like putting a plaster cast on a brocken leg ,without setting the bone.Im on 100mg of sertraline used to be 150, but 150 no better than 100mg.It was 12 weeks before i felt relief ,thats how long my body takes to ajust.12 week of unbelievable side effects ,but i alway stick out 12 week trail,in the end i came good, weight gain yes but you have to have some down pay offs. what im saying if i had stayed on 5mg an move monthly i would still not be up to the recomended dose a year later.no pain no gain.
God i don't know. I feel real bad had to leave work and didnt take my 5mg. I don't know if I have the flu or ive got some bad reaction to the C. I ache all over, my lower back hurts and im paranoid my kidneys or liver are in trouble, I cant concentrate, sore throat, headache.
I dont know if i should go up to 10mg or just quit as a bad idea.
Posted by manic666 on August 5, 2010, at 12:37:15
In reply to Re: Is 4 weeks a fair trial of celexa ? Insomnia » morgan miller, posted by Phillipa on August 4, 2010, at 20:32:38
If it dont suit you get off it,But 4 weeks at 5mg is not moveing forward . only standing still in no man,s land
Posted by Phillipa on August 5, 2010, at 19:06:30
In reply to Re: Is 4 weeks a fair trial of celexa ? Insomnia, posted by manic666 on August 5, 2010, at 12:37:15
Took 20mg when new and felt so bad hit a mailbox with my car. After four weeks my pdoc decided to take me off the med. And I'd felt fine on 200mg of luvox prior to that. He needed ten guinea pigs to trial the med when it was new and I was one of the lucky ones. Phillipa
Posted by bleauberry on August 9, 2010, at 17:00:53
In reply to Is 4 weeks a fair trial of celexa ? Insomnia, posted by rculater on August 4, 2010, at 6:17:47
I haven't followed this post. I am just looking at the title...Is 4 weeks a fair trial of celexa?
Answer = no.
8 weeks minimum, 12 weeks better, 16 even better. I know, that's hard when things are rough. But for a fair trial, it takes that long for the longterm brain adaptations to take place.
Sleep. IMO one of the best insomnia aids is tiny dose remeron. We're talking a 15mg tab and literally cutting off crumbs...maybe 1mg to 6mg. In the sleep med category my personal favorite was lunesta. I never took it continuously though. Only to break the cycle and get a good sleep for a night. The tiny dose remeron is a better longterm route. Many use seroquel but I personally do not favor that approach for a variety of reasons. Antipsychotics are for special purpose, and I do agree with using a potent med like that merely for sleep.
My insomnia from paxil and later prozac never really went away. I mean, it got better over the months, but I never slept deep. I tried all kinds of stuff. I mention remeron because of them all, it was the best. Pros and cons with everything. Mileage varies. But you need some sleep! I think you could get a free sample of lunesta from your doc and use it just once or twice a week. You could get a cheap generic script for 15mg remeron and using only tiny crumbs it would last for months.
Having said all that, I do not favor a pure serotonin approach to treating any kind of depression. Celexa is a pure serotonin approach. Something like 5mg to 20mg of Nortriptyline added to it would probably boost the antidepressant speed and thoroughness a great deal as well as give you better sleep. Actually, that's probably what I would try first before anything else. It covers a lot more bases than just sleep. And the dose is low enough to not be much of a burden in terms of side effects. The minimum dose is 10mg, but I personally found half a capsule (5mg) to be a good dose for me. Slept good, a lot of aches and pains disappeared, and zoloft seemed to kick in pretty quick which it did not do until the nortriptyline was added.
You have already shown that you are sensitive to celexa doses. You can't go higher. So it makes sense to add in a complimentary med, which nortriptyline is, also at a low dose. One plus one equals three in this case. Synergism. Different mechanisms that compliment each other and allow lower doses to be effective.
A general rule of thumb in my book, as evidenced by a couple studies on milnacipran, is that low doses can work just as good as higher doses.....but...they take longer.
This is the end of the thread.
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