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Dr. Bob is Robert Hsiung, MD,
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Posted by FLGolfer on September 30, 2002, at 22:11:48
In reply to Anyone switched to Lexapro? « ggrrl, posted by Dr. Bob on June 11, 2002, at 7:52:48
I switched to Lexapro Sept 18th and really love it. I was on effexor and had TOO many side effects. I also have MS and this seems to work great with my therapy.
Posted by cody on October 1, 2002, at 17:51:56
In reply to Re: What is the best time to take, posted by alaskagirl on September 30, 2002, at 18:45:43
Alaskagirl, thanks for your support. Sometimes I feel like I'm groping in the dark. It's good to hear other's experiences. I started Lexapro at 5mg. this morning. Decided against doing the 2.5mg. Rather get the adjustment over with. So far, so good. Not too many s/e. Mild headache, tightness in chest, some palpatations. Will keep you posted.
Thanks again!
Posted by NML on October 1, 2002, at 18:29:50
In reply to Re: What is the best time to take, posted by cody on October 1, 2002, at 17:51:56
I have been reading this board for months and never posted. I was on 20mg Celexa and loved it except for the sexual s/e (I am female - no orgasm). So I tried 10mg of Lexapro for 3 weeks, no s/e but very high irritability and irrational screaming/yelling YUCK - so my Dr. has increased me to 20mg as of yesterday. I can't find anyone else on this dosage. Just looking for some support. Thanks.
NML
Posted by kimc on October 1, 2002, at 18:59:42
In reply to pharmrep , a question about Lexapro dosage, posted by johnnylex on September 28, 2002, at 18:13:37
This is for Pharmrep or anyone: I have been on lexapro for 18 days at 10mg. Stopped taking Celexa around Nov 01 due to thinking it added to my protatisis probelm which I still have most of the time. I was on Zoloft 100mg for 7 or 8 years and switched because it wasn't working quite as good but was working. Anyways I started Remeron 15 mg and my protatisis (seems to be related to tension) got much better for a week and when I tried to raise it my vision was blurry so could'nt go to 30 mg which is what I needed. When lexapro came out I wanted to try it. It seems to stimulate me alot (or the prostate area muscles) and I take it in the morning 5mg and 5mg in afternoon and 7.5 Remeron at night. My prostate seems to tightened up more on all the antidepressants except Remeron which is very sedating ( which I don't like) DO you think it will get better after a month or any suggestions from anyone. If I take Xanax with it that helps my prostate condition too but being a recovering alcoholic can't take that much and doctor wouldn't give me much either and Flomax seems to help relax the prostate muscles too.
Thanks everyone for your time
Mr. Kim Cummings
Posted by yeltom on October 1, 2002, at 21:48:34
In reply to Anyone on 20mg?, posted by NML on October 1, 2002, at 18:29:50
I've definitely heard of people taking 20 mg, but it's equivalent to about 80 mg of Celexa, quite a high dose. If you were doing fine on 20 mg of celexa, it seems more likely that 10 mg of Lexapro was too much, rather than not enough. Since celexa and lexapro are very similar, it would seem that the screaming had something to do with adjusting to a more potent dose.
> I have been reading this board for months and never posted. I was on 20mg Celexa and loved it except for the sexual s/e (I am female - no orgasm). So I tried 10mg of Lexapro for 3 weeks, no s/e but very high irritability and irrational screaming/yelling YUCK - so my Dr. has increased me to 20mg as of yesterday. I can't find anyone else on this dosage. Just looking for some support. Thanks.
> NML
Posted by sjfd on October 2, 2002, at 3:59:45
In reply to Re: Anyone on 20mg? » NML, posted by yeltom on October 1, 2002, at 21:48:34
> I've definitely heard of people taking 20 mg, but it's equivalent to about 80 mg of Celexa, quite a high dose. If you were doing fine on 20 mg of celexa, it seems more likely that 10 mg of Lexapro was too much, rather than not enough. Since celexa and lexapro are very similar, it would seem that the screaming had something to do with adjusting to a more potent dose.
>
> > I have been reading this board for months and never posted. I was on 20mg Celexa and loved it except for the sexual s/e (I am female - no orgasm). So I tried 10mg of Lexapro for 3 weeks, no s/e but very high irritability and irrational screaming/yelling YUCK - so my Dr. has increased me to 20mg as of yesterday. I can't find anyone else on this dosage. Just looking for some support. Thanks.
> > NML
>
>
So . . . yeah, I was recently switched from Celexa 80 mg/day to Lexapro 20 mg/day. I take one 10/mg pill in the morning and one 10/mg pill in the evening, as opposed to 40/mg pill Celexa in the morning and one 40/mg pill Celexa in the evening. I'm not sure if the changes I am experiencing are due to the Celexa/Lexapro switch or perhaps because of something else. I also take Wellbutrin and at this moment, 2:35 a.m., I'm not sure of that dosage; I think maybe 200 mg/day. Anyway, the biggest thing with me since the switch from Celexa to Lexapro is insomnia via restless leg syndrome. I know, it sounds weird, but is an actual thing. I was so relieved to discover this as I have experienced it for years. Still, I would like to sleep and am not sure what to blame for this malady. Also, my depression does not seem to be much improved since the switch. I've been taking Lexapro for about 3-4 weeks now. Not sure. Once I discovered for sure that I had mental issues, it has been difficult to decide whether or not my disturbances are drug related or perhaps are due to this or that extra stress; maybe this kid or that mother or this added responsibility or that one over there. Who knows? Not me.
Posted by NML on October 2, 2002, at 8:02:26
In reply to Re: Anyone on 20mg? » NML, posted by yeltom on October 1, 2002, at 21:48:34
I was ok at 20mg Celexa but was about to increase to 40mg Celexa b/c of this irrational irritability. 20mg Celexa was just not doing it for me. I have not tried many other SSRI's (Paxil CR and Wellbutrin) which really had no effect on me at all whatsoever. I'm trying to stick to the Lexapro because at least the Celexa worked a little bit?? This is frustrating.
NML
Posted by shakingoscar on October 2, 2002, at 10:04:11
In reply to Re: Anyone on 20mg? » NML, posted by yeltom on October 1, 2002, at 21:48:34
Hi,
Ive been taking THIRTY (30) MG of lexapro for about 6 weeks now. I was on 60mg of Celexa before. I am thinking of dropping my lexapro because I feel really buzzed-up and I think its too high a dose.However, my doctor (in SWITZERLAND) just cut my celexa dose in half to determine my Lexapro (cirpalex) dose. I now think he has made a mistake.
I am dropping my dose from 30mg lexapro to 20mg as from tomorrow.... I just hope it works.
Because of the high doses of both celexa and lexapro, I cant honestly say anything good on the sex front - both cripple my orgasm (32yr, male).
BTW, I suffer major depression and anxiety.
Regards,
Oscar
Posted by shakingoscar on October 2, 2002, at 10:19:25
In reply to I TAKE 30MG LEXAPRO, posted by shakingoscar on October 2, 2002, at 10:04:11
> Hi,
> Ive been taking THIRTY (30) MG of lexapro for about 6 weeks now. I was on 60mg of Celexa before. I am thinking of dropping my lexapro because I feel really buzzed-up and I think its too high a dose.
>
> However, my doctor (in SWITZERLAND) just cut my celexa dose in half to determine my Lexapro (cirpalex) dose. I now think he has made a mistake.
>
> I am dropping my dose from 30mg lexapro to 20mg as from tomorrow.... I just hope it works.
>
> Because of the high doses of both celexa and lexapro, I cant honestly say anything good on the sex front - both cripple my orgasm (32yr, male).
>
> BTW, I suffer major depression and anxiety.
>
> Regards,
> OscarI would also like to add, that the last 2 weeks, I have been feeling pretty dreadful on 30MG lexapro. It is only from this message board have I come to the conclusion that it could be that 30MG lexapro is a lot more potent than the 60mg celexa that I was on for 9 months. Im hoping that PHARMREP is right in what she says about equivalent doses and that I will feel better lowering my dose.
It is also interesting that (as I am from the UK), my UK doctor ALSO backed up the dose of 30mg lexapro to equal the 60mg celexa that I was on. Do these doctors know what they are doing?
Lexapro (cipralex) has been available in the UK for about 4-6 months and longer in Switzerland. Sureley they would know that half the celexa dose of lexapro would be too much, but yet both doctors have prescribed me 30mg lexapro because I was on 60mg celexa...
If I dont feel better soon, I will go back to 60mg celexa because I felt more-or-less ok on that dose of celexa, yet I feel cr*p on 30mg lexapro.
Cheers
Posted by yeltom on October 2, 2002, at 10:19:40
In reply to I TAKE 30MG LEXAPRO, posted by shakingoscar on October 2, 2002, at 10:04:11
You might even want to drop to 15 mg. Supposed to be 4 times as strong. (It's not clear why this is the case, since the lexapro isomer and the less active isomer exist in a 1:1 ratio in Celexa. This is probably why your doc put you on 30, but I think 30 is above the maximum recommended dose.
> Hi,
> Ive been taking THIRTY (30) MG of lexapro for about 6 weeks now. I was on 60mg of Celexa before. I am thinking of dropping my lexapro because I feel really buzzed-up and I think its too high a dose.
>
> However, my doctor (in SWITZERLAND) just cut my celexa dose in half to determine my Lexapro (cirpalex) dose. I now think he has made a mistake.
>
> I am dropping my dose from 30mg lexapro to 20mg as from tomorrow.... I just hope it works.
>
> Because of the high doses of both celexa and lexapro, I cant honestly say anything good on the sex front - both cripple my orgasm (32yr, male).
>
> BTW, I suffer major depression and anxiety.
>
> Regards,
> Oscar
Posted by shakingoscar on October 2, 2002, at 10:22:12
In reply to Re: I TAKE 30MG LEXAPRO, posted by yeltom on October 2, 2002, at 10:19:40
Thanks for the quick reply. I would do that, but Im really worried about dropping just 10mg after 6 weeks because of withdrawal effects, which I get badly with SSRIs... I'll try a drop of ten first though..
Why dont the doctors know this already? Theyve had long enough to work it out..
(see my updated post).
Cheers
Posted by Cletus2 on October 2, 2002, at 10:29:29
In reply to Anyone on 20mg?, posted by NML on October 1, 2002, at 18:29:50
> I have been reading this board for months and never posted. I was on 20mg Celexa and loved it except for the sexual s/e (I am female - no orgasm). So I tried 10mg of Lexapro for 3 weeks, no s/e but very high irritability and irrational screaming/yelling YUCK - so my Dr. has increased me to 20mg as of yesterday. I can't find anyone else on this dosage. Just looking for some support. Thanks.
> NML
In the past I was on 100mg of Celexa (for OCD) for a period of about a year. It worked fairly well and I had only minor but annoying side effects (i.e. drowsiness and slight libido issues - nothing too drastic). Anyway, I stopped Celexa in order to try and find a med with fewer s/e but nothing was quite as effective as Celexa. Recently, I asked my doctor about Lexapro and he said that he has started some patients on it and has received extremly positive feedback on it. Well, since I use to take such a high dose before, he started me on 20mg this weekend and I am really liking it so far. It definetly has a quicker onset than other meds I have tried and I really dont notice any side effects at this dose. It has a very "clean" feel to it. My doctor is planning on raising my dose to 25mg next week if need be, but I feel pretty darn good now. However, I have a high tolerance for drugs so my body may adjust to it requiring an increase in the dose. We'll see. Good luck!!!!
Posted by Cletus2 on October 2, 2002, at 10:31:52
In reply to Re: I TAKE 30MG LEXAPRO - ALSO, posted by shakingoscar on October 2, 2002, at 10:19:25
My doctor told me that he finds the ratio to be 4 to 1 between Celexa and Lexapro.
Posted by dr dave on October 2, 2002, at 12:07:31
In reply to Re: I TAKE 30MG LEXAPRO - ALSO, posted by Cletus2 on October 2, 2002, at 10:31:52
This is really interesting. The '4 to 1' story first emerged from Forest because the Burke study failed to show any difference in efficacy between escitalopram 10mg, escitalopram 20mg and citalopram 40mg. This led to the statement that escitalopram 10mg was at least as effective as citalopram 40mg.
But if escitalopram 10 mg and 20 mg come out the same in this trial, isn't it likely citalopram 20mg and 40mg would as well? There is, it seems, a little added efficacy for 20mg rather than 10mg of escitalopram, which is seen in other studies. This study wasn't sensitive enough to pick it up. There is no reason to think it would have been picked up for citalopram 20mg and 40mg. It's just they didn't collect this data.
No other data supports this '4 to 1' idea. Plenty of data support the much more logical '2 to 1' ratio. Escitalopram is twice as potent as citalopram in several studies. There is no explanation of how this could translate into a 4 to 1 difference in efficacy.
The problem is that if the 2 to 1 ratio is true, which logic and the overwhelming body of evidence points to, it has to be admitted that there is no difference in side-effects. I have received Lundbeck's data on relative side-effects in all comparative studies and I quote '...there were no statistically significant differences for incidences of these events between the escitalopram and citalopram treatment groups.' These data are from 1123 patients treated in trials, and refer to the twelve commonest side-effects. Not one of these was different.
> My doctor told me that he finds the ratio to be 4 to 1 between Celexa and Lexapro.
Posted by Phil on October 2, 2002, at 12:22:35
In reply to I TAKE 30MG LEXAPRO, posted by shakingoscar on October 2, 2002, at 10:04:11
But why are you taking both of them? You can stop the Celexa today and switch to Lex tomorrow.
Maybe I missed something here.
Posted by dr dave on October 2, 2002, at 12:32:21
In reply to Don't know why dr dave didn't address this..., posted by Phil on October 2, 2002, at 12:22:35
> But why are you taking both of them? You can stop the Celexa today and switch to Lex tomorrow.
> Maybe I missed something here.I don't think they are taking both at the same time, are they? You're quite right about just swapping one to the other.
Posted by yeltom on October 2, 2002, at 13:07:26
In reply to Re: I TAKE 30MG LEXAPRO - ALSO, posted by dr dave on October 2, 2002, at 12:07:31
I'm afraid logic doesn't explain everything. If 10 mg of lexapro was found to be equivalent to 40 mg of Celexa (which my and a lot of other people's experience confirms), you need to accept this. Perhaps the inactive isomer affects the absorption or otherwise interferes with the effectiveness of the active isomer. Just because we don't understand the reason does not make it not so. And your comparison is not valid. If 20 mg lexapro is no more effective in the study than 10 mg, that doesnt suggest that 40 mg of celexa would be no more effective than 20 mg. Rather, it suggests (but does not necessarily mean) that 80 mg of Celexa would be no more effective than 40.
Posted by yeltom on October 2, 2002, at 13:21:21
In reply to Re: Don't know why dr dave didn't address this... » Phil, posted by dr dave on October 2, 2002, at 12:32:21
Another thing that does not make sense logically: the idea that the switch from 40 mg of celexa to 10 mg of lexapro would be rocky. But in fact, I totally noticed the change and so have many others. Theoretically, it could be withdrawal from the inactive isomer in Celexa or (under your theory) withdrawal because your moving to a less potent dose, but it's not the withdrawal type of feeling. Rather it's that familiar buzzed feeling of coming on to an antidepressant: heart seeming to beat faster, slightly extra sweating, insomnia, being spaced out. If anything, I would say 10 mg of Lexapro is MORE potent than 40 mg of celexa. In fact, I read a study (funded by Forest) that said 10 mg of lex was "at least" as potent as 40 mg of celex. If you still don't accept this, how do you explain the fact that people who switched from 60 mg of celex to 30 mg. of lex feel totally buzzed out?
Posted by kinikia on October 2, 2002, at 14:33:13
In reply to Re: What is the best time to take, posted by cody on October 1, 2002, at 17:51:56
Cody,
I just started on 5mg Lexapro yesterday too. I'm new here and found the group by searching for lexapro. I was happy to see your post. This is my second try at antidepressants. I had a very tough time on zoloft and now I'm apprehensive about this one too. Since we started the same day maybe we can be lexapro buddies :-)and help each other get through it. It's hard to judge my s/e because I had been feeling pretty bad the last few days. I just feel kind of out of it.> Alaskagirl, thanks for your support. Sometimes I feel like I'm groping in the dark. It's good to hear other's experiences. I started Lexapro at 5mg. this morning. Decided against doing the 2.5mg. Rather get the adjustment over with. So far, so good. Not too many s/e. Mild headache, tightness in chest, some palpatations. Will keep you posted.
>
> Thanks again!
Posted by dr dave on October 2, 2002, at 15:14:56
In reply to Re: I TAKE 30MG LEXAPRO - ALSO » dr dave, posted by yeltom on October 2, 2002, at 13:07:26
No, logic doesn't explain everything but it's pretty useful in trying to sort out complicated issues. I'm sure no-one would advocate deliberately not being logical.
It's difficult to generalise from the individual experience of a relatively few people, which is why scientific trials exist. It's an attempt to answer questions without bias as far as possible. My view is that if research has been done which fails to support a given argument, one should not treat it as proven fact, and I am concerned that this is what is happening. If there were clear evidence for the 4 to 1 argument I would of course accept it, as I accept very many things in psychiatry for which a mechanism is unknown. But the evidence isn't really there.
I'm not sure I really follow your argument about the implications of the results for 10 and 20mg of escitalopram being the same. I compare them with 20 and 40 mg of citalopram because these represent the same amounts of escitalopram, just in the presence of r-citalopram.
80mg of citalopram would be 40mg of escitalopram plus 40mg r-citalopram, and we have no 40mg escitalopram group to compare it to. I'm not sure why one would pick this particular dose to compare with anything.
> I'm afraid logic doesn't explain everything. If 10 mg of lexapro was found to be equivalent to 40 mg of Celexa (which my and a lot of other people's experience confirms), you need to accept this. Perhaps the inactive isomer affects the absorption or otherwise interferes with the effectiveness of the active isomer. Just because we don't understand the reason does not make it not so. And your comparison is not valid. If 20 mg lexapro is no more effective in the study than 10 mg, that doesnt suggest that 40 mg of celexa would be no more effective than 20 mg. Rather, it suggests (but does not necessarily mean) that 80 mg of Celexa would be no more effective than 40.
Posted by cody on October 2, 2002, at 15:46:00
In reply to Re: What is the best time to take, posted by kinikia on October 2, 2002, at 14:33:13
Kinikia,
I'd be happy to be your Lexapro buddie. This is my 2nd try at Lexapro and I really hope it works. So far, I don't feel too bad. A little hyper during the day, but last night around 8 pm I got so sleepy I couldn't keep my eyes open. Still not sure if I'm having withdrawal from the Remeron I was on. What are you taking the Lex for? Depression, anxiety, both? Keep me posted on how your doing.
Posted by yeltom on October 2, 2002, at 15:52:34
In reply to Logic and evidence » yeltom, posted by dr dave on October 2, 2002, at 15:14:56
The study that Forest did and that the FDA oversaw indicated that 10 mg Lexapro was equivalent in antidepressant effect to at least 40 mg. (Are you suggesting that there was no such study and that Forest's claims are fraudulent?) This is why psychiatrists (American ones at least) have been instructed to prescribe at a 1 to 4 ratio. And so far, it seems to be working. It's the patients who've been prescribed at a 1 to 2 ratio that are reporting problems. That's why I'm comparing 10 and 20 mg lex to 40 and 80 celex. I thought it was strange at first as well and certainly did not expect to feel any changes when I switched meds. The hypothesis is that the inactive isomer inhibits the effectiveness of the active one. Have you tried both drugs?
Posted by corrina on October 2, 2002, at 21:46:12
In reply to Logic and evidence » yeltom, posted by dr dave on October 2, 2002, at 15:14:56
Hi all im also new to this board and rather new with depression pills as well, I came to the net trying to get some info on this medicine and found this link! I was put on Lexapro 10mg and started taking it for the first time on sunday, everything was going well untill today and im not sure if its a concern or normal feeling, the dizzyness and feeling like I have to throw up.
should this be a concern I should talk to my doctor about or is this normal? any responce would be very helpful, Thank you
Corrina
Posted by moxy1000 on October 2, 2002, at 23:31:56
In reply to Logic and evidence » yeltom, posted by dr dave on October 2, 2002, at 15:14:56
My understanding of what Dr. Dave is saying is that since Lexapro 10 mg and Celexa 20 mg contain the same amount of the s-isomer, then they would be therapeutically equivalent. But every study done to date shows that Lexapro 10mg is at least as effective as Celexa 40mg, and that is what many people on this board have expressed their experience has been as well.
Just because the s-isomer is proportionally present in both doses, this doesn't make them therapeutically equivalant because that theory does not take into account the presence of the r-isomer in Celexa, which Lexapro dose not possess. The r has been proven to be ineffective in treating depression, but we do not know if it hindered the active agent. (This would probably take a lot of money and time to prove. I don't even know if it's possible to prove scientifically.) No one has clearly proven that it hindered, but many theorize that it must have, since 10mg Lexapro is at least as effective as 40mg Celexa (NOT 20mg) as one would expect.
Posted by pharmrep on October 3, 2002, at 1:36:27
In reply to Re: Logic and evidence, posted by moxy1000 on October 2, 2002, at 23:31:56
> My understanding of what Dr. Dave is saying is that since Lexapro 10 mg and Celexa 20 mg contain the same amount of the s-isomer, then they would be therapeutically equivalent. But every study done to date shows that Lexapro 10mg is at least as effective as Celexa 40mg, and that is what many people on this board have expressed their experience has been as well.
>
> Just because the s-isomer is proportionally present in both doses, this doesn't make them therapeutically equivalant because that theory does not take into account the presence of the r-isomer in Celexa, which Lexapro dose not possess. The r has been proven to be ineffective in treating depression, but we do not know if it hindered the active agent. (This would probably take a lot of money and time to prove. I don't even know if it's possible to prove scientifically.) No one has clearly proven that it hindered, but many theorize that it must have, since 10mg Lexapro is at least as effective as 40mg Celexa (NOT 20mg) as one would expect.
>** hi there...there are studies that show r-cit doesnt work...(sanchez study). the r-cit can attach to receptor sites not allowing the s-cit to attach, therefore inhibiting metabolization.
ps...i dont know where this 4-to-1 ratio thing is coming from...its not forest. Lexapro is twice at potent as celexa (or any other AD). so yes..10mg lexapro is at least as efficacious as 40mg of celexa. does this mean 15mg=60 or 20mg=80? not necessarily...the math seems that way, but patients so far dont always need more...i know of many 80mg celexa pts doing fine on 10mg lexapro, (or higher doses fo prozac, paxil, zoloft, effexor as well)
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