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Dr. Bob is Robert Hsiung, MD,
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Posted by lil' jimi on September 20, 2003, at 11:36:36
In reply to I'm back, maybe on low dose of Lex, need advice!, posted by theo on September 20, 2003, at 10:12:04
hi,
>> NEED ADVICE AND INPUT PLEASE!! >>
busy right now ...
... but i'm better if i take time to think about it a little ...
later,
~ jim
Posted by BLKVETTES on September 20, 2003, at 18:01:37
In reply to PAXIL to LEXAPRO....improve sex?, posted by Micah on September 20, 2003, at 6:05:41
> Hi! I've been taking Paxil for years with great success for relieving depression/anxiety, but with sexual side effects. My Dr. is switching me to Lexapro. She seems that Prozac was the "Grandfather" and that Lexapro is the "newborn" in this class of drugs. She says I should have on minor, passing, sexual side-effects, if any. What do you guys who have been on Lexapro say about the sex thing? Thanx!
Hey this is one of those things where its all trial and error!!! Lexapro saved my life!!!! Im not sure lexapro is any better than any other med out there. It just comes down to what works best for you. I will agree with the prozac statement!!! Not sure about the lexapro one though!!! Also when you change if you do has doctor discussed withdrawal symptoms from the paxil????????? You may get none, then again you might get them all!!!!!! TAKE CARE!!!
WAYNE
Posted by BLKVETTES on September 20, 2003, at 18:13:42
In reply to I'm back, maybe on low dose of Lex, need advice!, posted by theo on September 20, 2003, at 10:12:04
> I read many things about many SSRI's and I know SE's vary from person to person. I'm now taking 150mg of Wellbutrin XL which is working great for drive and motivation for me but in talking to my pdoc, he suggested adding a low dose of an SSRI, 5mg Lexapro OR 12.5mg of Paxil CR to take that little edge of anxiety/constant worrying off. I need to know which combo has had best overall success, Wellbutrin-Lexapro combo OR Wellbutrin-Paxil combo. I'm leaning towards adding the 5mg of Lexapro first but when I tried Lex before by itself about four months ago I started at 10mg and it was six weeks of nausea, tiredness and stiff neck and I discontinued it, but with just 5mg added to the 150mg Wellbutrin XL, maybe these SE's wouldn't be so bothersome, NEED ADVICE AND INPUT PLEASE!! The only hesitation I have about adding the Paxil versus Lex would be the fear of having to go through withdrawal whenever I decided to stop using it. Add 5mg of Lex OR 12.5mg Paxil CR? I've tried benzo's and they make me feel great for a few days and then depressed, so benzo's are not an option for me to treat anxiety.
Darn on not being able to use a benzo, that stinks. Gosh giving advice is almost impossible!!! If you did not have withdrawal from lexapro and your worried about paxil I guess you try the lexapro. But I guess we take chances on every med we try!!! You just try everything until you hit it!!! Your not really talking about that much paxil. But I guess you have read one to many withdrawal stories as I have. Some people dont have withdrawal!!! I think you got a good taste of what will happen when you stopped the lexapro before!!! GOOD LUCK!!!!
WAYNE
Posted by leedsman on September 20, 2003, at 18:45:50
In reply to Re: PAXIL to LEXAPRO....improve sex?, posted by BLKVETTES on September 20, 2003, at 18:01:37
I was taking Lexapro for 6 weeks and really did not have much success , I started getting really bad necka nd muscle pain, I talked to my pdoc and she asked me if I wanted to take Wellbutrin along with Lexapro to give it a boost, but what I have read on the psycho-babble, it makes you high like you are on marijuana or something. I thought I would just try Paxil again and am taking 25mg Paxil CR for 3-4 weeks to see if it helps, can you take Wellbutrin with Paxil also?
I had really good results with regular Paxil, for 5 years, I know there is a time release with the CR , but it's still the same right? What if I get off Paxil after a week can I start right on the Lexapro again or should I wean down. I appreciate your advice and I hope Lexapro is working for all of you,
Posted by PHV on September 20, 2003, at 22:30:58
In reply to re: PHV's Lexapro Side Effects, posted by mph-speedy on September 19, 2003, at 11:22:50
Hi everyone - It's Patty here again. Wow, have I learned a whole lot on this message board this evening. Been on Lex 11 weeks now for depression. Nearly immediate results for the depression - but started with major anxiety last week. Thanks to this board, I was encouraged to go see my doc right away. She put me on Busbar & Xanax. Got me through this week on a stressful business trip okay. Seemed to get better as the week progressed and I was assuming the anxiety (something I've NEVER experienced before) was due to the stress of this trip. Meds were required less and less as the week progressed. Here I am at home today - and I feel like I'm ready to jump out of my skin again. I can't stand this! I'm waiting for the Xanex to kick in - tho it seems to be taking forever right now. This just so isn't me. I'm really troubled and debating the lesser of two evils. Was it worse being depressed, crying every day and feeling down almost constantly - or is it worse now dealing with this anxiety, jaw clenching, weight gain - and I even saw someone mention the constant need to stretch - which is what I started doing recently too??!! I've even seen posts about excessive thirst. My God - I can't believe these are the options we have to deal with to make our depression and/or anxiety go away. I noticed a strange trend on this board. Seems like those of us taking Lex for depression - find ourselves with anxiety side effects - while those taking Lex for anxiety find themselves w/ depression side effects. What's worse??
Anyway, I guess I'm just feeling really discouraged right now. I was initially so impressed with the depression going away so quickly. But these other goofy SE make me feel so not in control of my life - which is so not me.
Since the anxiety started last weekend - and it subsided greatly as the week progressed, I thought it was due to the fact that I would be seeing many ex co-workers, etc. for the first time in years during my conference. Due to my depression in the past year plus, I have gained 20 pounds - and was really nervous that everyone would look at me and see how much weight I put on - which is extremely noticeable due to how thin I used to be. Fortunately, I was the only one who seemed to be cognizant of my weight gain - or at least grateful that no one commented on how heavy I now am. Therefore, I attributed my anxiety to seeing many people I've not seen in years. Yet I woke up this morning at home - and have been feeling as anxious as I was last weekend for the first time and can't seem to come down. The Xanex I took earlier today knocked me out for a few hours, but I woke up clenching my jaw and ready to run a marathon again. I'm STILL waiting for my second Xanex to kick in - along with a Tylenol PM my doc told me I could add if I wasn't feeling the R&R from the Xanex.
This just sucks. I thought taking Lex would improve my life. Now I'm starting to feel that SE's just aren't worth it. I think I need to head back to my doc to try to come up with some other solutions. I just can't imagine continuing this way . . .
Thanks for listening to me vent . . .
Patty
Posted by lil' jimi on September 21, 2003, at 2:18:23
In reply to PAXIL to LEXAPRO....improve sex?, posted by Micah on September 20, 2003, at 6:05:41
hi Micah,
> Hi! I've been taking Paxil for years with great success for relieving depression/anxiety, but with sexual side effects. My Dr. is switching me to Lexapro. She seems that Prozac was the "Grandfather" and that Lexapro is the "newborn" in this class of drugs. She says I should have on minor, passing, sexual side-effects, if any. What do you guys who have been on Lexapro say about the sex thing? Thanx! >
in terms of when these drugs were introduced, yes ...
... lexapro's been out about a year
... prozac ... a whole heck of a lot longer ... ... more than a decade ...however, drugs are better judged by their effectiveness to an individual than by their maturity ... ... old or new, the best drug is the one that works ... for you ...
ah, but you knew that ... ... still, sometimes it would seem like the pharma reps get the docs all buzzed up about the industry's latest ...
and sometimes our hopes get used too ... ...still there has been some progress, after a fashoin ...
paxil versus lex on the issue of sex SEs, brings up two separate personal experiences which make me much less than objective here ...
... anyway ...
about decade ago i guess, my wife was given paxil for her nerves ... in the oh, maybe a year she tried it, we never heard about any side effects ... ... the loss of her libido caused so much more pain because we never suspected the paxil at all ... we are still recovering ...... so i have some idea about paxil SEs, even though i have never taken any ...
last march i began lexapro ... ... i experienced about a week of anorgasmia ... ... no other sexual SEs at all ... although i had a fleet of other SEs that first couple of weeks ... all of the anorgasmia dissappeared by week 2 of lex ...
the posts on this thread have not had a consistent theme of sexual SEs after the initial adujustment phase ... although initially anorgasmia is not uncommon ... ... my doc mnetioned SEs, "possibly delayed ejaculation" ... ... i'd say that three days is a delay alright ... the exceptions have been those with longer term persistent dysfunction ... ... or those on multiple meds ... ... there have been very few reports of sexual SEs among longer term lex-only users, say more than 6 months ... i would say that it may be zero ...
... i recall there were a few reports of a month or more of anorgasmia, but those folks were so relieved from their depression that it seemed to them as insignificant ...
... some of these folks remind me that i'm not that depressed ...
... and i am truly grateful ...... impressive to me, although not particularly representative, and not real impressive to many others either ...is that... since i recovered from my brief bout of anorgasmia, i have experienced improved sexual response ... ... there have been very, very few similar reports, except at my inquiries here i have seen replies from a few who have had my experience ... but not many at all ...
all that said ... you could not pay me to take paxil ... ... it's just caused too much pain in our lives already
... but you could not pay me to Not take lexapro ...
... it's been better than good to me ...
TAKE CARE !!~ jim
Posted by lil' jimi on September 21, 2003, at 2:47:53
In reply to I'm back, maybe on low dose of Lex, need advice!, posted by theo on September 20, 2003, at 10:12:04
hi Theo,
don't i recall your earlier visits here ? ... or is that just the lexapro talking ... ?
> I read many things about many SSRI's and I know SE's vary from person to person. I'm now taking 150mg of Wellbutrin XL which is working great for drive and motivation for me but in talking to my pdoc, he suggested adding a low dose of an SSRI, 5mg Lexapro OR 12.5mg of Paxil CR to take that little edge of anxiety/constant worrying off. I need to know which combo has had best overall success, Wellbutrin-Lexapro combo OR Wellbutrin-Paxil combo. I'm leaning towards adding the 5mg of Lexapro first but when I tried Lex before by itself about four months ago I started at 10mg and it was six weeks of nausea, tiredness and stiff neck and I discontinued it, but with just 5mg added to the 150mg Wellbutrin XL, maybe these SE's wouldn't be so bothersome, NEED ADVICE AND INPUT PLEASE!! The only hesitation I have about adding the Paxil versus Lex would be the fear of having to go through withdrawal whenever I decided to stop using it. Add 5mg of Lex OR 12.5mg Paxil CR? I've tried benzo's and they make me feel great for a few days and then depressed, so benzo's are not an option for me to treat anxiety. >
.... aye, there's the rub ... besides the difference in the effects (and, of course, the side-effects) of paxil and lexaprro on you ... we must factor in the significant impact of your Wellbutrin ... ... no clear answers here tonight ... or this morning anyway ...
... and as we always (?) say around here:
... "You picks your poison
and you takes your chances !!" ...( i don't think anyone's said that here before .)
if you have just read my post to Micah, you know my prejudice against paxil ... plus there's a lot of users of the Well-Lex combo from what i've read here ...
not too much help, huh ? ... ... sorry ...
could be that the Wellbutrin would counteract the paxil SEs that i fear so much ... wellbutrin has been used for those SEs in other SSRIs ... and you have had a negative lex experience ... which might taint your expectations of lex ...
still not much help, though ...
here's what i would do (Your Mileage May Vary!) ...
i'd pick one ... for whatever reason ... but whichever one i'd picked, i'd commit myeslf to giving it a really good long try out, just to see what it's going to be like on the other side of the adaptation SEs ... ... maybe 8 weeks ...
and with the wellbutrin, it shouldn't be so bad ...(maybe i should have taken longer if this is all i got so far here?)
...anyway that's my input .. good luck and ...take care,
~ jim
Posted by theo on September 21, 2003, at 11:08:14
In reply to re: Theo, posted by lil' jimi on September 21, 2003, at 2:47:53
Thanks for the input. Before when I tried Lex I started at 10mg as I was stopping 20mg of Paxil. I stopped the Paxil because I had taking it a while and felt the need to make a change because I had been on it for a long while. Now that I've not taken any SSRI for at least eight weeks now, maybe trying the Lex at 5mg might be a more of a fair evaluation for the Lex. When docs first got their hands on Lex it was "10mg for everyone" which for someone with anxiety is probably to much to start with. Is it OK to break Lex to just take 5mg since they only come in 10mg and 20mg?? My pdoc actually suggested "WellPro" and of course acted like he coined the term, but from what you've read about the Wellbutrin-Lexapro combo have you heard positive results? Not just about offsetting sexual sides but adding something to give a serotonin boost since Wellbutrin doesn't cover that area? Also would 5mg have less sides than 10mg from what you've read?
Posted by lil' jimi on September 21, 2003, at 14:28:02
In reply to re: Theo » lil' jimi, posted by theo on September 21, 2003, at 11:08:14
hi Theo,
> Thanks for the input. >
you're welcome
> Before when I tried Lex I started at 10mg as I was stopping 20mg of Paxil. I stopped the Paxil because I had taking it a while and felt the need to make a change because I had been on it for a long while. Now that I've not taken any SSRI for at least eight weeks now, maybe trying the Lex at 5mg might be a more of a fair evaluation for the Lex. >
i think this is a fair assessment ...
... and i feel it relects the cumulative wisdom from this thread ...> When docs first got their hands on Lex it was "10mg for everyone" which for someone with anxiety is probably to much too start with. >
my sentiments exactly ... ...
... as i've oft repeated here ...
... i (who had never suffered with anxiety) took 10mg ONE day (march 6) and then .... ....> Is it OK to break Lex to just take 5mg since they only come in 10mg and 20mg?? >
... from march 7 for the next month ... i broke the 10mg pills into halves (as best i could) and took only 5mg until sometime in april before i went back up to 10mg ... ...
> My pdoc actually suggested "WellPro" and of course acted like he coined the term, but from what you've read about the Wellbutrin-Lexapro combo have you heard positive results? >
i haven't read enough well-lex reports to have an opinion ... and i don't believe i've seen a well-pax reference before ... ... who knows about these combos nicknames ? ... ... at least "wellpro" sounds encouraging ... ... if that will only help to make us well ...
> Not just about offsetting sexual sides but adding something to give a serotonin boost since Wellbutrin doesn't cover that area? >
i just thought that those offsetting effects might make paxil a more likely candidate ... one i would never choose, but that's just my prejudice speaking ... ... you must, of course, consider all the alternatives which may work for you ... ... wellbutrin may be the redemption of your paxil for you ...
i haven't read any other's personal experiences on which to base this response ... ... nevertheless, that is the theory of the SSRIs' combos with wellbutrin ...
from
http://www.medicinenet.com/bupropion/article.htm"GENERIC NAME: bupropion
BRAND NAME: Wellbutrin; Zyban
DRUG CLASS AND MECHANISM: Bupropion is an antidepressant medication that affects chemicals within the brain that nerves use to send messages to each other. These chemical messengers are called neurotransmitters. The neurotransmitters that are released by nerves are taken up again by the nerves that release them for reuse. (This is referred to as reuptake.) Many experts believe that depression is caused by an imbalance among the amounts of neurotransmitters that are released. Bupropion is unrelated to other antidepressants. It works by inhibiting the reuptake of dopamine, serotonin, and norepinephrine, an action which results in more dopamine, serotonin, and norepinephrine to transmit messages to other nerves. Bupropion is unique in that its major effect is on dopamine, an effect which is not shared by the selective serotonin reuptake inhibitors or SSRIs (e.g. paroxetine, Paxil; fluoxetine, Prozac; sertraline, Zoloft) or the tricyclic antidepressants or TCAs (e.g. amitriptyline, Elavil; imipramine, Tofranil; desipramine, Norpramin). "
... hey, this bupropion sounds great ... why aren't i on it ? .... it'll even help me quit smoking !! (i don't smoke ... HA!) ...
anything that can help folks fight tobacco adiction is strong medicine in my book ...
... and we see here that it works on raising dopamine, norepinephrine ans serotonin levels, all three ...
... adding the ssri effect of lex should be expected to further increase serotonin levels ...
... this is the theory anyway ...> Also would 5mg have less sides than 10mg from what you've read? >
yes ... ... that's practically gospel here
... ... however, i have read posts of folk who take 20mg right off the bat and have no SEs ... which is rare ... ... but it is less rare for folks diving in with 10mg and reporting zero SEs ... not too imply that either isn't uncommmon ... at all... still it is consistent with our posters' report (and it makes intuitive sense) the any SEs would be less with less doseage ...
anyway that is my contribution ...
take care !
~ jim
Posted by theo on September 21, 2003, at 15:19:06
In reply to re: Theo » theo, posted by lil' jimi on September 21, 2003, at 14:28:02
Thanks for the time you took posting. I actually took 2.5mg Lex about noon and after a few days will take 5mg to see what happens. At least if the Lex doesn't work for me I know it won't be to difficult for me to just stop taking as it would be with the Paxil, which luckily wasn't to bad but I definitly felt spun for a few days after discontinuing it. I know it's trial and error but that 6 week trial period can seem like forever can't it! Although I only took 2.5mg Lex, I can feel the med but no nausea and tiredness at all where as before starting with 10mg I was anxious and nauseated. In my research I did find this graph interesting. Look at the effectiveness of Lex at 5mg vs 10mg. 5mg better response than 10mg, then back up when increased to 20mg.
http://images.medscape.com/pi/editorial/cmecircle/2003/2546/images/kent/slide20.gif
Posted by lil' jimi on September 21, 2003, at 16:07:02
In reply to re: Theo » lil' jimi, posted by theo on September 21, 2003, at 15:19:06
hi Theo,
> Thanks for the time you took posting. >
you're welcome ... ... what the heck ... it doesn't seem anyone's using the thread much now ... ... so they shouldn't mind, anyway ...
it's my pleasure ...
> I actually took 2.5mg Lex about noon and after a few days will take 5mg to see what happens. At least if the Lex doesn't work for me I know it won't be to difficult for me to just stop taking as it would be with the Paxil, which luckily wasn't too bad but I definitly felt spun for a few days after discontinuing it. I know it's trial and error but that 6 week trial period can seem like forever can't it! >
excellent ... ... and it does seem like eternity waiting for a med to get our system stabilized ... ... but it is a positive that you're expectaions are prepared ... ...
> Although I only took 2.5mg Lex, I can feel the med but no nausea and tiredness at all where as before starting with 10mg I was anxious and nauseated. >
way good !!
> In my research I did find this graph interesting. Look at the effectiveness of Lex at 5mg vs 10mg. 5mg better response than 10mg, then back up when increased to 20mg.
>
> http://images.medscape.com/pi/editorial/cmecircle/2003/2546/images/kent/slide20.gifthis graph is a surprise ... ... implying as it does that 5mg is more effective for SA than 10 mg ... ... thank you for such valuable information ... ... would you share the url for the article it came with please ... thanks
my best idea for you (took me posting this much to come up with a good one!):
post to the main pBabble thread with a subject line like, "Wellbutrin-Lexapro combo users' reports wanted!" ... and then in the post ask for any experiences with well-lex and well-pax combos ...
... the main board won't be so lexapro specific ... and lots more folks will be able to take noitce ... bigger audience = more feedback ...
good luck!
~ jim
Posted by lil' jimi on September 21, 2003, at 16:39:02
In reply to Re: PAXIL toLexapro and back to Paxil, posted by leedsman on September 20, 2003, at 18:45:50
hi leedsman,
> I was taking Lexapro for 6 weeks and really did not have much success , I started getting really bad necka nd muscle pain, I talked to my pdoc and she asked me if I wanted to take Wellbutrin along with Lexapro to give it a boost, but what I have read on the psycho-babble, it makes you high like you are on marijuana or something. >
hadn't heard that one
> I thought I would just try Paxil again and am taking 25mg Paxil CR for 3-4 weeks to see if it helps, can you take Wellbutrin with Paxil also? >
from what Theo was just posting, that answwr seems to be yes ...
> I had really good results with regular Paxil, for 5 years, I know there is a time release with the CR, but it's still the same right? >well, i'd presume so, but i do not know ... ... the manufacturer's web site should make that clear ...
> What if I get off Paxil after a week can I start right on the Lexapro again or should I wean down. >
i don't have any positive paxil experience to know one way or the other ... ... except that paxil withdrawals are so notorious ... but one week ? ... beats me ... another post for the main board where there will be more folks with paxil experience, maybe ?
> I appreciate your advice and I hope Lexapro is working for all of you >
thanks ... best to you, leedsman ...
... come and visit anytime ... ... it'd be great to hear how you are doing there ...
TAKE CARE !
~ jim
Posted by lil' jimi on September 21, 2003, at 17:00:50
In reply to Anxiety - Jaw Clenching - Weight Gain - What's Up?, posted by PHV on September 20, 2003, at 22:30:58
hi Patty,
you wrote:
....
> Thanks for listening to me vent . . .
>
> Pattysorry to hear things have taken this turn for you there ...
you have just volunteered to be in the post-adjustment SEs group ... with Galkeepinon, Sussus, Banab and maybe Mariposa ... ... Mariposa has yet to response to her candidacy ... ...
it would be appreciated here if you could share with us your pdoc's reactions to your new situation ... ... good doc to provide the benzos for your anxieties ...
thanks for your post(s) ... ... and please keep us posted!
TAKE CARE !!
~ jim
Posted by theo on September 21, 2003, at 17:50:31
In reply to re: Theo » theo, posted by lil' jimi on September 21, 2003, at 16:07:02
There's 15 or so slides in this presentation. I believe slide 20 is the graph I sent you and the info explaining the graph will be under this slide. If you have time I would view the entire deal, some pretty interesting info.
http://www.medscape.com/viewarticle/458647_15?WebLogicSession=P24pQkGWxo3Dw6YdttqMpONZZrpWDrFRXV136u1I2ef5iawzF3aQ|-3360746919023192434/184161393/6/7001/7001/7002/7002/7001/-1
Posted by lil' jimi on September 21, 2003, at 20:00:43
In reply to re: lil' jimi, posted by theo on September 21, 2003, at 17:50:31
hi Theo,
> There's 15 or so slides in this presentation. I believe slide 20 is the graph I sent you and the info explaining the graph will be under this slide. If you have time I would view the entire deal, some pretty interesting info.
>
> http://www.medscape.com/viewarticle/458647_15?WebLogicSession=P24pQkGWxo3Dw6YdttqMpONZZrpWDrFRXV136u1I2ef5iawzF3aQ|-3360746919023192434/184161393/6/7001/7001/7002/7002/7001/-1
... i've only just started this article at
http://www.medscape.com/viewarticle/458647_15
... but i wanted to share it here even before i could finish it ...i would enjoy any of our threadsters' reaction(s) to Dr. Kent's paper ...
and thanks to Theo for providing this information
~ jim
p.s. accessing the paper requires registration with medscape ... which is not any more painful than registration here .
~ j
Posted by lil' jimi on September 21, 2003, at 20:18:54
In reply to SSRIs and Beyond, posted by lil' jimi on September 21, 2003, at 20:00:43
hello everyone,
here are some of the basics about lexapro we can get from online ... ... of particular interest, we have the list of side effects ...
anybody's presciber mention even half of these?
anyone get any of this lowdown from their pharmacist ?have a good week,
~ jimthis is from http://www.medicinenet.com/escitalopram/article.htm
GENERIC NAME: escitalopram
BRAND NAME: Lexapro
DRUG CLASS AND MECHANISM: Escitalopram is an oral drug that is used for treating depression. It is an antidepressant. It works by affecting neurotransmitters in the brain, the chemical messengers that nerves use to communicate with one another. Neurotransmitters are made and released by nerves and then travel to other nearby nerves where they attach to receptors on the nerves. Some neurotransmitters that are released do not bind to receptors and are taken up by the nerves that produced them. This is referred to as "reuptake."Many experts believe that an imbalance of neurotransmitters is the cause of depression. Escitalopram prevents the reuptake of one neurotransmitter, serotonin, by nerves, an action which results in more serotonin in the brain to attach to receptors. Chemically, escitalopram is very similar to citalopram. Both are in the class of drugs called selective serotonin reuptake inhibitors (SSRIs), a class that also includes fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft).
PRESCRIPTION: Yes
GENERIC AVAILABLE: No
PREPARATIONS: White to off-white, round tablets of 5, 10, and 20 mg.
STORAGE: Escitalopram tablets should be stored at controlled room temperature, 59-86°F (15-30°C.)
PRESCRIBED FOR: Escitalopram is used to treat depression. Drugs in the SSRI class also have been studied in persons with obsessive-compulsive disorders, general anxiety disorders, and panic disorders.
DOSING: The usual starting dose of escitalopram is 10 mg once daily. Benefit may not be seen until treatment has been given for up to 4 weeks. Escitalopram can be taken with or without food. Older and younger persons require similar doses.
DRUG INTERACTIONS: All SSRIs, including escitalopram, should not be taken together with any drugs of the MAO (mono-amine oxidase) inhibitor-class of antidepressants, for example, isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and procarbazine (Matulane). Such combinations may lead to confusion, high blood pressure, high fevers, tremor or muscle rigidity, and increased activity. This same type of interaction also may occur with selegiline (Eldepryl), fenfluramine (Pondimin), and dexfenfluramine (Redux). Tryptophan can cause headaches, nausea, sweating, and dizziness when taken with any SSRI. At least 14 days should elapse after discontinuing escitalopram before starting a MAO inhibitor.
PREGNANCY: The safety of escitalopram during pregnancy and lactation has not been established. Therefore, escitalopram should not be used during pregnancy unless, in the opinion of the physician, the expected benefits to the patient outweigh the possible hazards to the fetus.
NURSING MOTHERS: Escitalopram is excreted in human milk. Escitalopram should not be given to nursing mothers unless, in the opinion of the physician, the expected benefits to the patient outweigh the possible hazards to the child.
SIDE EFFECTS: The most commonly-noted side effects associated with escitalopram are agitation or restlessness, blurred vision, diarrhea, difficulty sleeping, drowsiness, dry mouth, fever, frequent urination, headache, indigestion, nausea, increased or decreased appetite, increased sweating, sexual difficulties (decreased sexual ability or desire, ejaculatory delay), taste alterations, tremor (shaking), weight changes. Although changes in sexual desire, sexual performance and sexual satisfaction often occur as a result of depression itself, they also may be a consequence of the drugs used to treat depression. In particular, about one in 11 men given escitalopram report difficulties experiencing ejaculation.
Some patients may experience withdrawal reactions upon stopping SSRI therapy. Symptoms may include dizziness, tingling, tiredness, vivid dreams, irritability, or poor mood. In order to avoid these symptoms, the dose of SSRI can be slowly reduced instead of abruptly stopped.
Posted by oldhand on September 21, 2003, at 20:41:26
In reply to SSRIs and Beyond, posted by lil' jimi on September 21, 2003, at 20:00:43
Hi Theo and lil jimi!
I just got WellbutrinXL, 150mg added to my Lexapro 20mg. It has not been a week yet so I hesitate to try to define any changes.
I told the psychiatrist that though I felt ok on the Lex, I was just not feeling great, noting that one cannot be happy all the time but I still needed to feel better. I questioned whether I would ever feel like "ME" again. Also that I am somewhat irritable, and that the approach of winter weather has me concerned. She promised to Have me "tuned up" long before the bad weather sets in.
Hope to be able to report more in a week or so.
I appreciated the article by Dr. Kent on Medscape though I haven't finished it yet, seems to make sense so far. Anxiety has not been a big problem for me, thank goodness.
Hope there are others out there who will let us know their experiences with the WelLex combo.
Peace to us all.
Posted by Akman on September 21, 2003, at 23:11:03
In reply to Re: SSRIs and Beyond » lil' jimi, posted by oldhand on September 21, 2003, at 20:41:26
I've been taking Lexapro for about 3 weeks and recently began experiencing a pervasive, hallucinatory smell of stale cigars (and I don't smoke either!) Before I start looking elsewhere for an explanation I thought I would ask if anyone else has experienced any olfactory side effects from taking Lexapro.
Posted by PHV on September 22, 2003, at 0:07:41
In reply to Olfactory side effects?, posted by Akman on September 21, 2003, at 23:11:03
> I've been taking Lexapro for about 3 weeks and recently began experiencing a pervasive, hallucinatory smell of stale cigars (and I don't smoke either!) Before I start looking elsewhere for an explanation I thought I would ask if anyone else has experienced any olfactory side effects from taking Lexapro.
Have you ever been a cigar smoker - or around other cigar smokers? The reason I ask, is that I seem to smell cigarette smoke fairly frequently recently- when no one is smoking around me. I gave up cig smoking years ago - but seem to be especially sensitive to its scent. I sometimes smell it in my house - when no one is smoking. Interesting to see if they might be related. Thanks for posting and good luck. I look forward to hearing from you. Thanks.Patty
Posted by galkeepinon on September 22, 2003, at 1:21:05
In reply to escitalopram, posted by lil' jimi on September 21, 2003, at 20:18:54
Hey jim :-) took the weekend off so to speak~not feeling too well. I hope you're doing great!!!!
Anyway......in answer to your questions from my perspective/stance,>>>>>anybody's presciber mention even half of these? Actually I did some research about the med before I went on it, BUT I was sooooo depressed that I was willing to give another SSRI a shot Ha!!! Glad I did:-)
>>>>>anyone get any of this lowdown from their pharmacist? My pharmacist was very unhelpful, thank God my pdoc had started me on Lex and gave me the 2 month samples. She was way more knowledgeable on Lex than my pharmacist was!!When I went and got the script filled, the pharmacist basically said here ya go..
Boy, aren't you grateful we have a brain to think with and computers to do research on ;)
LOL
Have A Great Week jim:-)> hello everyone,
>
> here are some of the basics about lexapro we can get from online ... ... of particular interest, we have the list of side effects ...
>
> anybody's presciber mention even half of these?
> anyone get any of this lowdown from their pharmacist ?
>
> have a good week,
> ~ jim
>
> this is from http://www.medicinenet.com/escitalopram/article.htm
>
> GENERIC NAME: escitalopram
>
> BRAND NAME: Lexapro
> DRUG CLASS AND MECHANISM: Escitalopram is an oral drug that is used for treating depression. It is an antidepressant. It works by affecting neurotransmitters in the brain, the chemical messengers that nerves use to communicate with one another. Neurotransmitters are made and released by nerves and then travel to other nearby nerves where they attach to receptors on the nerves. Some neurotransmitters that are released do not bind to receptors and are taken up by the nerves that produced them. This is referred to as "reuptake."
>
> Many experts believe that an imbalance of neurotransmitters is the cause of depression. Escitalopram prevents the reuptake of one neurotransmitter, serotonin, by nerves, an action which results in more serotonin in the brain to attach to receptors. Chemically, escitalopram is very similar to citalopram. Both are in the class of drugs called selective serotonin reuptake inhibitors (SSRIs), a class that also includes fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft).
>
> PRESCRIPTION: Yes
>
> GENERIC AVAILABLE: No
>
> PREPARATIONS: White to off-white, round tablets of 5, 10, and 20 mg.
>
> STORAGE: Escitalopram tablets should be stored at controlled room temperature, 59-86°F (15-30°C.)
>
> PRESCRIBED FOR: Escitalopram is used to treat depression. Drugs in the SSRI class also have been studied in persons with obsessive-compulsive disorders, general anxiety disorders, and panic disorders.
>
> DOSING: The usual starting dose of escitalopram is 10 mg once daily. Benefit may not be seen until treatment has been given for up to 4 weeks. Escitalopram can be taken with or without food. Older and younger persons require similar doses.
>
> DRUG INTERACTIONS: All SSRIs, including escitalopram, should not be taken together with any drugs of the MAO (mono-amine oxidase) inhibitor-class of antidepressants, for example, isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and procarbazine (Matulane). Such combinations may lead to confusion, high blood pressure, high fevers, tremor or muscle rigidity, and increased activity. This same type of interaction also may occur with selegiline (Eldepryl), fenfluramine (Pondimin), and dexfenfluramine (Redux). Tryptophan can cause headaches, nausea, sweating, and dizziness when taken with any SSRI. At least 14 days should elapse after discontinuing escitalopram before starting a MAO inhibitor.
>
> PREGNANCY: The safety of escitalopram during pregnancy and lactation has not been established. Therefore, escitalopram should not be used during pregnancy unless, in the opinion of the physician, the expected benefits to the patient outweigh the possible hazards to the fetus.
>
> NURSING MOTHERS: Escitalopram is excreted in human milk. Escitalopram should not be given to nursing mothers unless, in the opinion of the physician, the expected benefits to the patient outweigh the possible hazards to the child.
>
> SIDE EFFECTS: The most commonly-noted side effects associated with escitalopram are agitation or restlessness, blurred vision, diarrhea, difficulty sleeping, drowsiness, dry mouth, fever, frequent urination, headache, indigestion, nausea, increased or decreased appetite, increased sweating, sexual difficulties (decreased sexual ability or desire, ejaculatory delay), taste alterations, tremor (shaking), weight changes. Although changes in sexual desire, sexual performance and sexual satisfaction often occur as a result of depression itself, they also may be a consequence of the drugs used to treat depression. In particular, about one in 11 men given escitalopram report difficulties experiencing ejaculation.
>
> Some patients may experience withdrawal reactions upon stopping SSRI therapy. Symptoms may include dizziness, tingling, tiredness, vivid dreams, irritability, or poor mood. In order to avoid these symptoms, the dose of SSRI can be slowly reduced instead of abruptly stopped.
>
Posted by galkeepinon on September 22, 2003, at 1:24:23
In reply to Olfactory side effects?, posted by Akman on September 21, 2003, at 23:11:03
Yep~weird. I experienced this on Topamax also. But with the Lexapro, I found that cigarettes taste/smell like stale cigars. Maybe it will get me to quit!! Hehehe
> I've been taking Lexapro for about 3 weeks and recently began experiencing a pervasive, hallucinatory smell of stale cigars (and I don't smoke either!) Before I start looking elsewhere for an explanation I thought I would ask if anyone else has experienced any olfactory side effects from taking Lexapro.
Posted by theo on September 22, 2003, at 8:12:48
In reply to Re: SSRIs and Beyond » lil' jimi, posted by oldhand on September 21, 2003, at 20:41:26
I'm on 150mg of the new Wellbutrin XL after being on 150mg of the SR for a month. I can tell the XL version is much smoother for me than the SR, and it is suppose to be. I was actually quite surprised because when Glaxo released Paxil CR and I made the switch to it from regular Paxil within two days I was having diarreah cramps about four hours after taking it. Went back to regular Paxil immediately and called my doc and he said it made no sense. I called a pharmacist at Glaxo and she asked me if I was "lactose intollerant" which I am not but she said there is HEAVY LACTOSE in the CR coating and fillers which was causing problems with a lot of people. Anyway that was back in my Paxil days but when I saw the reduced size of the Wellbutrin XL and the similiar shape to the CR, I was fearful of the new coating but it's fine.
Anyway the main reason for the post is my pdoc suggested adding 5mg of Lex to my 150mg of Wellbutrin XL and I started low with 2.5mg yesterday and in a few days will go to 5mg. A few months ago I took Lex by itself for about six weeks but my general doc threw me a bag of samples and said "all you do is just start with 10mg." Well that didn't work so well and I quit because of the sides, so I'm slowly easing into the Lex this time. So far so good but keep me posted on your "WellPro Combo" progress and I will do the same.
Thanks,
Theo aka Ted
Posted by Kacy on September 22, 2003, at 9:13:15
In reply to Re: Olfactory side effects? » Akman, posted by galkeepinon on September 22, 2003, at 1:24:23
Maybe you have a more sensitive nose on the drug. Could you be smelling a lingering odor on some clothes in a closet that you wore somewhere around smokers, or from upholstery that had been subject to the smoke, or to the odor on walls in a room where people have smoked?
Posted by galkeepinon on September 22, 2003, at 15:23:55
In reply to Re: Olfactory side effects?, posted by Kacy on September 22, 2003, at 9:13:15
Hi Kacy, I laughed when I saw this because I was laughing at myself. I spray, spray, and spray, and then some LOL to get rid of this smokey stench!
I have, mmmmm,let's see, Lysol, a nice scent of Glade air freshner, and a Glade 'plug-in' in my wall to help with the smell. I wash my clothes and plop in 2 Bounce sheets too. All these things help me a lot with that nasty 'stench', just think what I'm doing to my lungs. YIKES.
I only smoke when I'm on the computer at night in my room, otherwise I smoke outside. But I got a HUGE headache today, so I need to lay off the cancer sticks for a while!!> Maybe you have a more sensitive nose on the drug. Could you be smelling a lingering odor on some clothes in a closet that you wore somewhere around smokers, or from upholstery that had been subject to the smoke, or to the odor on walls in a room where people have smoked?
>
>
Posted by galkeepinon on September 22, 2003, at 16:02:17
In reply to re: Gal, et al, posted by lil' jimi on September 20, 2003, at 2:28:02
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