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Dr. Bob is Robert Hsiung, MD,
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Posted by kara lynne on November 19, 2002, at 19:55:21
In reply to Re: How to cut Lexapro?, posted by melinda on November 19, 2002, at 18:04:36
Posted by suevl on November 19, 2002, at 20:50:10
In reply to Anyone switched to Lexapro? « ggrrl, posted by Dr. Bob on June 11, 2002, at 7:52:48
Has anyone had any success in cutting Lezapro pills in half? My pill splitter makes them crumble, and I'm one of those drug sensitive people who can't take more than 5mg. I was on 5mg Celeza, but at least those were nicely scored. Any suggestions?
Posted by Ritch on November 19, 2002, at 21:51:30
In reply to Cutting Lexapro pills?, posted by suevl on November 19, 2002, at 20:50:10
> Has anyone had any success in cutting Lezapro pills in half? My pill splitter makes them crumble, and I'm one of those drug sensitive people who can't take more than 5mg. I was on 5mg Celeza, but at least those were nicely scored. Any suggestions?
I always have used bare carpet razorblades or utility blades (box cutter blades) to snap pills into (by eyeballing them on a wooden butcher block). You have to watch your fingers a lot more closely! However, I have found them far superior to the cheapo pill splitters that are generally available. I haven't had experience trying to chop Lexapro pills, but Celexa pills were fairly easy to divide 10mg (half of 20mg tabs) into halves (of roughly 5mg). You could also use a pill crusher (those work fairly well, however), and make your own liquid. You will have to ask your pdoc about how to go about doing that. In my case I had to use small amounts of vodka (ethanol solvent) since citalopram isn't sparingly water soluble.
Posted by ayuda on November 19, 2002, at 22:00:34
In reply to Cutting Lexapro pills?, posted by suevl on November 19, 2002, at 20:50:10
> Has anyone had any success in cutting Lezapro pills in half? My pill splitter makes them crumble, and I'm one of those drug sensitive people who can't take more than 5mg. I was on 5mg Celeza, but at least those were nicely scored. Any suggestions?
Try taking them to the pharmacist and asking them to split the pills. I would think that pharmacists would have something better than the pill-splitters we can get on the market. At least it wouldn't hurt to ask.
Posted by ayuda on November 19, 2002, at 22:08:56
In reply to Re: Question for Pharmrep regarding Lexapro Anxiety » ayuda, posted by Ward on November 19, 2002, at 15:25:01
Ward -- thanks for that info. I've never heard of Trazadone, so I have a question: is it something that is considered to be habit-forming? I ask because that it the issue my doctor has with Ativan, and I don't want to bring up a drug that she's going to argue about.
From the recent posts, I am hoping to have as much success on Lexapro as some of the rest of you all.
> My doctor prescribed Trazodone to help me sleep and it really has worked for me. I usually take 50 mg. about 2 hours before bedtime, if I'm really anxious I'll take 100 mg. Before I started taking Trazodone I was waking up every 1 to 1 1/2 hours in the night and dreaming vivid dreams in between. You might ask your doctor if he thinks Trazodone might work for you.
>
> > > re: question for pharmrep concerning somnolence. I take zyprexa for schizophrenia which i believed was caused by chronic insomnia. i recently tried celexa (50mg) and was pleased by the sleepiness it caused. The celexa didn't address the panic attacks, and gave me low libido, however, so my doc suggested lexapro. The lexapro cured the panic attacks and renewed my sexual interests, but i'm back to insomnia. To me, the insomnia is worse, so i lowered my dosage of lexapro to 2.5mg from 10mg. How low can i go on lexapro? i become very irritable when i am tired, and i can't fall asleep, even when exhausted. The celexa is the only medication which has worked for this. cst.
> >
> > I would also like info on Lexapro and insomnia. My shrink wants to get me off the Ativan, but even with it, I am having a lot of trouble getting and staying asleep. She (my doctor) isn't convinced that my insomnia is because of the ADs, and thinks that I am dependent on the Ativan. I would love nothing more than to get a good night's sleep on my own -- but if she takes me off the Ativan, I think I'll have to go to another doctor who will prescribe it, because my doctor isn't the one up all night and exhausted all day. I am a PhD student, I don't have time to waste on the mental confusion and exhaustion from the AD -- there's enough of that just connected to going to school!
> >
>
>
Posted by Mr.Scott on November 20, 2002, at 1:30:00
In reply to Re: Question for Pharmrep regarding Lexapro Anxiety » Ward, posted by ayuda on November 19, 2002, at 22:08:56
Just an interesting note...My doctor said his rep is giving him free pill cutters with the stuff because it's hard to cut and my doc is giving them out to his patients.
So Pharmrep... if your around I'd suggest you have your marketing team donate some of their funds to pill cutters. Even if they must have the Forest or Lexapro logo on it, it will be a good cause and marketing all in one! Not to mention a much needed excuse to see your high prescribers.
Scott
Posted by mills on November 20, 2002, at 10:42:34
In reply to Cutting Lexapro pills?, posted by suevl on November 19, 2002, at 20:50:10
...or you guys could be really crazy like me and need 30 mg and have no pill cutting problems; i hate you people who talk about taking 2.5 mg; there, i said it...
> Has anyone had any success in cutting Lezapro pills in half? My pill splitter makes them crumble, and I'm one of those drug sensitive people who can't take more than 5mg. I was on 5mg Celeza, but at least those were nicely scored. Any suggestions?
Posted by Ward on November 20, 2002, at 11:13:02
In reply to Re: Question for Pharmrep regarding Lexapro Anxiety » Ward, posted by ayuda on November 19, 2002, at 22:08:56
ayuda - Trazodone is an antidepressant that has the main side effect of causing sleepiness. To find out more information about it, use the search engine www.google.com and type in Trazodone (it is spelled with an "o" in the middle). You'll find sites with all the information you can digest and some more besides. I did not find any warnings about it being habit forming. My doctor had me on Ativan for just a week before switching me to Trazodone. I hope this helps. Good luck!!
> Ward -- thanks for that info. I've never heard of Trazadone, so I have a question: is it something that is considered to be habit-forming? I ask because that it the issue my doctor has with Ativan, and I don't want to bring up a drug that she's going to argue about.
>
> From the recent posts, I am hoping to have as much success on Lexapro as some of the rest of you all.
>
> > My doctor prescribed Trazodone to help me sleep and it really has worked for me. I usually take 50 mg. about 2 hours before bedtime, if I'm really anxious I'll take 100 mg. Before I started taking Trazodone I was waking up every 1 to 1 1/2 hours in the night and dreaming vivid dreams in between. You might ask your doctor if he thinks Trazodone might work for you.
> >
> > > > re: question for pharmrep concerning somnolence. I take zyprexa for schizophrenia which i believed was caused by chronic insomnia. i recently tried celexa (50mg) and was pleased by the sleepiness it caused. The celexa didn't address the panic attacks, and gave me low libido, however, so my doc suggested lexapro. The lexapro cured the panic attacks and renewed my sexual interests, but i'm back to insomnia. To me, the insomnia is worse, so i lowered my dosage of lexapro to 2.5mg from 10mg. How low can i go on lexapro? i become very irritable when i am tired, and i can't fall asleep, even when exhausted. The celexa is the only medication which has worked for this. cst.
> > >
> > > I would also like info on Lexapro and insomnia. My shrink wants to get me off the Ativan, but even with it, I am having a lot of trouble getting and staying asleep. She (my doctor) isn't convinced that my insomnia is because of the ADs, and thinks that I am dependent on the Ativan. I would love nothing more than to get a good night's sleep on my own -- but if she takes me off the Ativan, I think I'll have to go to another doctor who will prescribe it, because my doctor isn't the one up all night and exhausted all day. I am a PhD student, I don't have time to waste on the mental confusion and exhaustion from the AD -- there's enough of that just connected to going to school!
> > >
> >
> >
>
>
Posted by kara lynne on November 20, 2002, at 11:14:02
In reply to Re: Cutting Lexapro pills?, posted by mills on November 20, 2002, at 10:42:34
...ahem, some of us are really crazy and wish we could stomach 30 mgs.
Posted by mills on November 20, 2002, at 11:46:45
In reply to Re: really crazy, posted by kara lynne on November 20, 2002, at 11:14:02
"count my blessings, name them one-by-one; count my blessings name them one-by-one..., la la la la...."
> ...ahem, some of us are really crazy and wish we could stomach 30 mgs.
Posted by pharmrep on November 20, 2002, at 12:03:07
In reply to Re: really crazy, posted by mills on November 20, 2002, at 11:46:45
1-...for those not sleeping well... do you take lex at night or in morning? I would suggest taking in morning, it might help.
2-...trazodone....might help if your dr says ok (lowest dose possible should do fine).
3-...possible probs w/ trazodone...only 1 in 10000, but look up priapism for the guys...it might look ok, but not a fun s/e.4-...breaking pills...good news and bad...bad=they are scored, but are pretty small and sometimes crumble...try a razor/non-serated knife on the score-line on a flat surface (press slowly/lightly until broken)
good= there are plans to make a 5mg pill (also scored) so titrating up will be easier (15mg vs going all the way to 20mg, and of course not having to chop up the 10mg, and also, for those who are very sensitive...getting a 2.5mg without having to use a microscope...hang in there folks and keep posting)
Posted by Roger Santiago on November 20, 2002, at 12:11:20
In reply to Re: really crazy, posted by mills on November 20, 2002, at 11:46:45
Celexa is the first SSRI Ant-dep., I could tolerate from 20mg to 40mg. However, after being
on Celexa 40mg at bedtime for slightly over 2 months, I have not noticed improvement of sleep patterns, "feeling good", appetite..... Its like a
dry drill. The only other ant-dep., I can tolerate
is trazodone at bedtime. Here again, after 6 weeks of taking 100mg to 150mg at bedtime for over 6 weeks, I feel no better. I have developed
daily anxiety with agoraphobia since starting the
Celexa and later taking the trazodone. I had a sample of Serzone 100mg., and was confident I would benefit and or tolerate it due to its close
chemical relation to trazodone. I was wrong . The serzone caused visual problems the day after with vertigo. What would be a way to manage the daily anxiety and agoraphobia ? I can not even go to the doctor , sit in the office then wait to be
seen due to the severity of this anxiety.
Posted by mills on November 20, 2002, at 12:22:29
In reply to Re: really crazy, posted by Roger Santiago on November 20, 2002, at 12:11:20
roger, sorry bro, sounds like you've got it rough; i feel for you; but do not hesitate to call your shrink though and get some help on your meds by phone; if they can't do that for you given your condition, then you need a new doc; hang in there; there's something out there for you
> Celexa is the first SSRI Ant-dep., I could tolerate from 20mg to 40mg. However, after being
> on Celexa 40mg at bedtime for slightly over 2 months, I have not noticed improvement of sleep patterns, "feeling good", appetite..... Its like a
> dry drill. The only other ant-dep., I can tolerate
> is trazodone at bedtime. Here again, after 6 weeks of taking 100mg to 150mg at bedtime for over 6 weeks, I feel no better. I have developed
> daily anxiety with agoraphobia since starting the
> Celexa and later taking the trazodone. I had a sample of Serzone 100mg., and was confident I would benefit and or tolerate it due to its close
> chemical relation to trazodone. I was wrong . The serzone caused visual problems the day after with vertigo. What would be a way to manage the daily anxiety and agoraphobia ? I can not even go to the doctor , sit in the office then wait to be
> seen due to the severity of this anxiety.
Posted by Roman on November 20, 2002, at 12:23:36
In reply to all-in-1 info for my lexapro friends, posted by pharmrep on November 20, 2002, at 12:03:07
I'm planning on talking with my doc about the switch due to daytime fatigue on Celexa 40 mg. I tried taking it a night, but it caused insomnia.
What do you all think? Is the switch a smart move?
I've been on Celexa for a few months and it helps with depression, but I can't continue this sleeping 12 hours a day and still feeling tired!
Also, what is the equivalent dose of Lexapro to 40 mg Celexa? I've read both 10 and 20 mg were correct.
Thanks for your input.
Posted by Mr.Scott on November 20, 2002, at 12:28:23
In reply to Re: really crazy, posted by Roger Santiago on November 20, 2002, at 12:11:20
Obviously I don't know your history, but have you considered another diagnosis such as bipolar II?
Frequently people with BP II become variously activated with AD's. Some develop agitation or anxiety while others develop a more clear manic activation. Regardless BP II's are generally depressed most of the time. Check out this one guys site www.psycheducation.org for more info.
Posted by pharmrep on November 20, 2002, at 12:46:25
In reply to Should I suggest a switch from Celexa to Lexapro?, posted by Roman on November 20, 2002, at 12:23:36
> I'm planning on talking with my doc about the switch due to daytime fatigue on Celexa 40 mg. I tried taking it a night, but it caused insomnia.
>
> What do you all think? Is the switch a smart move?
>
> I've been on Celexa for a few months and it helps with depression, but I can't continue this sleeping 12 hours a day and still feeling tired!
>
> Also, what is the equivalent dose of Lexapro to 40 mg Celexa? I've read both 10 and 20 mg were correct.
>
> Thanks for your input.******** 10mg of lex is similar to 40mg celexa. it is the starting and maintenance dose, and so far seems to cause less insomnia and somnolence that celexa (and other ssri's too). if celexa was doing the job, but with just the sleep issue, lexapro should be a good fit. Lex has only been out since 9/5/02 and that is why your dr didnt offer it then..., ask your dr. if you can try 10mg...keep us posted.
Posted by Roman on November 20, 2002, at 15:23:36
In reply to Re: switch from Celexa to Lexapro? » Roman, posted by pharmrep on November 20, 2002, at 12:46:25
Thanks for the info pharmrep. Is it more common to switch straight away or cross-taper from Cel to Lex?
Cheers,
Roman
Posted by pharmrep on November 20, 2002, at 18:03:20
In reply to Re: switch from Celexa to Lexapro? » pharmrep, posted by Roman on November 20, 2002, at 15:23:36
> Thanks for the info pharmrep. Is it more common to switch straight away or cross-taper from Cel to Lex?
>
> Cheers,
>
> Roman** no taper needed...next day is fine...same was true for celexa (even from prozac with it's long half-life)
the only concerns with tapering come from paxil and effexor (short half-lifes)...with that said...I have heard of some dizziness/nausea/vomitting/g.i. disturbances, etc in the 1st week or 2 when switching from either paxil or effexor to another antidepressant, Lexapro included. As long as a person knows about the "discontinuation syndrome" with paxil and effexor, and doesnt blame the new med for any "withdrawal side effects" that occur...just give it some time and it should get better with time.
******* anybody out there experience paxil's or effexor's "discontinuation syndrome?" How long did it take for the old meds side effects go away?
Posted by oldhand on November 20, 2002, at 19:36:44
In reply to Re: switch from Celexa to Lexapro » Roman, posted by pharmrep on November 20, 2002, at 18:03:20
I had horrible withdrawal from Effexor. Electric sinews, headache, nausea, anxiety attack, shakes. itches, sleeplessness and on and on. Only place I was comfortable was in the shower. It was worst thing I've ever experienced
Posted by pharmrep on November 20, 2002, at 19:40:28
In reply to Re: switch from Celexa to Lexapro » Roman, posted by pharmrep on November 20, 2002, at 18:03:20
> > Thanks for the info pharmrep. Is it more common to switch straight away or cross-taper from Cel to Lex?
> > Cheers,
> > Roman> ** no taper needed...next day is fine...same was true for celexa (even from prozac with it's long half-life)
> the only concerns with tapering come from paxil and effexor (short half-lifes)...with that said...I have heard of some dizziness/nausea/vomitting/g.i. disturbances, etc in the 1st week or 2 when switching from either paxil or effexor to another antidepressant, Lexapro included. As long as a person knows about the "discontinuation syndrome" with paxil and effexor, and doesnt blame the new med for any "withdrawal side effects" that occur...just give it some time and it should get better with time.
> ******* anybody out there experience paxil's or effexor's "discontinuation syndrome?" How long did it take for the old meds side effects go away?
Posted by ANXIETY ANN on November 20, 2002, at 20:45:03
In reply to anybody have withdrawal s/e with paxil or effexor?, posted by pharmrep on November 20, 2002, at 19:40:28
> > > Thanks for the info pharmrep. Is it more common to switch straight away or cross-taper from Cel to Lex?
> > > Cheers,
> > > Roman
>
> > ** no taper needed...next day is fine...same was true for celexa (even from prozac with it's long half-life)
> > the only concerns with tapering come from paxil and effexor (short half-lifes)...with that said...I have heard of some dizziness/nausea/vomitting/g.i. disturbances, etc in the 1st week or 2 when switching from either paxil or effexor to another antidepressant, Lexapro included. As long as a person knows about the "discontinuation syndrome" with paxil and effexor, and doesnt blame the new med for any "withdrawal side effects" that occur...just give it some time and it should get better with time.
>
>
> > ******* anybody out there experience paxil's or effexor's "discontinuation syndrome?" How long did it take for the old meds side effects go away?
>
> Hi,I took Effexor for about 3 years and discountined taking it about a year ago. I had a hard time getting off it because of the discontinuation syndrome. Weird head twitches, upset stomach, headaches. It took about 3 months to completely get off of the effexor and feel normal again. I tapered down each week and it was still hard.
Anxiety Ann
Posted by ayuda on November 20, 2002, at 20:52:51
In reply to all-in-1 info for my lexapro friends, posted by pharmrep on November 20, 2002, at 12:03:07
Thanks for the all-in-one answer.
I do take my ADs in the morning, first thing after I get up (I take all my meds in the a.m. except, of course, Ativan). Still have complete insomnia (without the Ativan, I don't sleep more than 3 hours a night). With the Ativan, I am up and down all night but get at least 5-6 hours, and have been having those vivid dreams many have discussed (some are quite pleasant, actually). I don't know that I want to take another AD in addition to the Lexapro -- do you recommend another non-habit-forming drug that would help with the insomnia and would work well with the Lexapro? I used to take Neurontin as a mood stabilizer, and one of the s/e's is sleepiness, though I don't recall if it made me sleepy or not (took it at night time). Also, just info on me in particular, I am a 37-yr-old female, and not particularly worried about any s/e other than insomnia and weight gain. Oh, and nausea/GERD (caused by the Effexor and still not gone).
> 1-...for those not sleeping well... do you take lex at night or in morning? I would suggest taking in morning, it might help.
>
> 2-...trazodone....might help if your dr says ok (lowest dose possible should do fine).
>
> 3-...possible probs w/ trazodone...only 1 in 10000, but look up priapism for the guys...it might look ok, but not a fun s/e.
>
> 4-...breaking pills...good news and bad...bad=they are scored, but are pretty small and sometimes crumble...try a razor/non-serated knife on the score-line on a flat surface (press slowly/lightly until broken)
> good= there are plans to make a 5mg pill (also scored) so titrating up will be easier (15mg vs going all the way to 20mg, and of course not having to chop up the 10mg, and also, for those who are very sensitive...getting a 2.5mg without having to use a microscope...hang in there folks and keep posting)
Posted by ayuda on November 20, 2002, at 21:07:35
In reply to anybody have withdrawal s/e with paxil or effexor?, posted by pharmrep on November 20, 2002, at 19:40:28
> > > Thanks for the info pharmrep. Is it more common to switch straight away or cross-taper from Cel to Lex?
> > > Cheers,
> > > Roman
>
> > ** no taper needed...next day is fine...same was true for celexa (even from prozac with it's long half-life)
> > the only concerns with tapering come from paxil and effexor (short half-lifes)...with that said...I have heard of some dizziness/nausea/vomitting/g.i. disturbances, etc in the 1st week or 2 when switching from either paxil or effexor to another antidepressant, Lexapro included. As long as a person knows about the "discontinuation syndrome" with paxil and effexor, and doesnt blame the new med for any "withdrawal side effects" that occur...just give it some time and it should get better with time.
>
>
> > ******* anybody out there experience paxil's or effexor's "discontinuation syndrome?" How long did it take for the old meds side effects go away?
>
>I am still coming off the Effexor -- my first week on the Lexapro, I took 5mg Lex (and my pill cutter did pretty good on them) and 150 mg Effexor (had been up to 225 mg Effexor), the following week 10 mg Lex and 75 mg Efexor, and this week 10 mg Lex and 37.5 Effexor.
S/e's: dizziness mostly. Some mental confusion with the dizziness. Blurred vision. The g.i. problems were much worse when I was on the Effexor -- I really developed an ulcer (though Effexor caused an increase in my appetite, which made life hell). The GERD is still pretty bad, I'm taking OTC Pepcid complete 2x every day -- but at least it is working. When I was on the full dose of Effexor, nothing worked.
About Celexa withdrawal, though: I went off Celexa at the end of 2000 (the first time I was on it) after I could not afford the doctor or Rx (changed jobs, worse benefits). I had to taper over a 2 month period. I tried a shorter taper, but dizziness was massive. I got down to where I was cutting the 10 mg tablets into 2.5 (approx), needing some Celexa in my system to not have the dizzy spells. I think it's easier to switch from one AD to another than to quit altogether. When I switched from Zoloft to Celexa (the first time -- I've done both Rx's 2 times), I tapered over one day, then off the Zoloft, no s/e's. I had gone into Seratonin shock at 50 mg of Zoloft at that time, so my shrink had to get me off it fast, and onto Celexa at the same time.
Speaking of the difference between Effexor and Lex, though -- I am enjoying the decrease in my appetite. I hope it stays around. I can't afford to have the appetite and g.i. problems of the Effexor.
Posted by samenewme on November 20, 2002, at 21:22:26
In reply to Should I suggest a switch from Celexa to Lexapro?, posted by Roman on November 20, 2002, at 12:23:36
> I'm planning on talking with my doc about the switch due to daytime fatigue on Celexa 40 mg. I tried taking it a night, but it caused insomnia.
>
> What do you all think? Is the switch a smart move?
It COULD be a smart move. One thing I'd suggest, though, before switching, is taking the Celexa in the afternoon instead of at night. Maybe it'll be cleared out enough that you can sleep, without giving you daytime fatigue.
Posted by Roman on November 20, 2002, at 22:36:38
In reply to Re: Should I suggest a switch from Celexa to Lexapro?, posted by samenewme on November 20, 2002, at 21:22:26
I tried taking it in the afternoon and in the evening. The daytime drowsiness was the same, the difference was my ability to sleep soundly.
Thanks for the suggestion.
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