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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by LisaMichelle on June 7, 2004, at 20:29:10
I've been taking 10mg Lexapro for almost 3 weeks for anxiety and stress and I'm a zombie! I've been taking naps every chance I get and when I nap for 2-3 hours it feels like it's only been 5 minutes. I'm getting nothing done which is only adding to my stress. I have been taking the Lexapro in the morning and wonder if I should switch it to the night. When do you others take it?? I went to my doctor today and he wants to switch me to Effexor. After reading what everyone has written about the withdrawal of this med, I'm very hesitant to switch. I've tried many meds before the Lexapro and they always seem to sedate me too. Did anyone else have this side effect with Lexapro and did it go away or has anyone had success with anything that hasn't sedated them when all other meds have? I'd really appreciate any advice - I'm not sure what to do at this point and I'd really like help with my anxiety.
Posted by psychodad on June 8, 2004, at 14:32:04
In reply to Help! I'm a zombie on Lexapro-switch to effexor??, posted by LisaMichelle on June 7, 2004, at 20:29:10
I've been on Lexapro for almost a month now and for the first 2 weeks had major fatigue. I could barely keep my eyes open. It didn't help that I was in a training conference for that first week either. But good news, that side effect, fatigue, went away! I have more energy and am feeling a little more normal. It has helped me with anxiety and I'm not experiencing DTs from alcohol as I did when I tried to quit on my own so I'm grateful.
I would stick it out for a few more weeks and maybe try taking it at night. I take it at night and during the day I'm not as tired as at the beginning, although I'm not sure what difference it would make really since I've never tried to take it in the morning.
Try to stick it out for at least six weeks. I wouldn't want to bounce around meds alot and you won't really know if Lexapro is the drug for you or not if you don't give it a real shot.
Good luck!!
Posted by LisaMichelle on June 8, 2004, at 16:21:26
In reply to Re: Help! I'm a zombie on Lexapro-switch to effexor??, posted by psychodad on June 8, 2004, at 14:32:04
Thanks so much for your response. I'm new to this list and really appreciate any advice I can get.
I think you're right that I should stick it out and not switch to Effexor. I read on this list about Provigil for tiredness and talked to my doctor about it and he said he'll write me an rx for it today - hopefully my insurance will pay.
Anyone on a Lexapro/Provigil combo?
Glad you're feeling better on the Lexapro - it seems like it's the best out there for most people right now.
Take care and thanks so much for writing :-)
Posted by Mariposa on June 8, 2004, at 19:02:31
In reply to Re: Lexapro/Provigil, posted by LisaMichelle on June 8, 2004, at 16:21:26
I found Lex to be very sedating in the beginning, but it went away after about 4 mos. for me. I started drinking more coffee, which helped.
Additionally, for me anyway, I found that if I didn't listen to my brain complaining about being tired, and just started moving and doing, that tired feeling evaporated quickly. It's like the body is willing and ABLE, but stupid brain won't motivate until you force it to.
I also agree that 2 mos. is not long enough to know how the med will work for you. Literature says 6-8 weeks, for me it was more than 9 weeks before I could tell anything. Have been on Lex 15+ mos. and still doing well. Hang in there!!!~~~8|8
Posted by beatrix34 on June 8, 2004, at 21:09:04
In reply to Re: Lexapro, posted by Mariposa on June 8, 2004, at 19:02:31
I just started taking Lex and the first day I took it I felt exactly as you described, total zombie. I have been on it a week now and I take it at night right before I go to bed. I am fine the next day and don't need any additional meds at all. It is working for me this way, give it a try. Good luck!
Posted by harryp on June 8, 2004, at 22:44:21
In reply to Help! I'm a zombie on Lexapro-switch to effexor??, posted by LisaMichelle on June 7, 2004, at 20:29:10
I had a similar experience with Lexapro but I only lasted one dose (it made me feel like I had taken an antipsychotic!).
I can't guess how you'd respond to Effexor, but that drug is famous for it's strange side effects.
Have you tried Prozac (fluroxitine)? It remains arguably the best SSRI overall, and made me feel a little dopey, but definitely NOT like a zombie. Many people find it activating.
If you've gone through multiple SSRI's without good effect, many authorities would advise you to go to a different class of drugs.
Are anxiety and stress your only problems (i.e. no depression)? Have you tried a benzodiazapine? They are safe if used properly, well understood, and very effective for anxiety. I have been using low doses (0.5 mg) of lorazapam for anxiety episodes for the past few years. For continuous anxiety, klonopin often works well. The MAOI Nardil is a superb anti-anxiety med, from what I've heard.
Posted by LisaMichelle on June 8, 2004, at 23:30:20
In reply to Re: Help! I'm a zombie on Lexapro-switch to effex, posted by harryp on June 8, 2004, at 22:44:21
Thanks Harryp for responding. I did try Prozac a long time ago and it too, made me extremely tired. I have tried many SSRI's and I have had the same side effect with all - extreme tiredness. All I can ever think about is when I can take my next nap!
Anxiety and stress are mostly my problems although I have some depression too. I feel like if I could get a handle on the top two problems then the depression would go away. I will definitely check out klonopin but not sure I'm ready for an MAOI yet. I want to try other things first although I have read about many successes with it on this board.
My insurance did deny the Provigil today so my doctor is going to call tomorrow to see if he can get it approved with a phone call.For now though, I'm sticking with the Lexapro and switching to taking it at night and hopefully that will help with my sleepiness during the day.
Warmly,
LisaMichelle
Posted by LisaMichelle on June 9, 2004, at 0:05:49
In reply to Re: Help! I'm a zombie on Lexapro-switch to effex, posted by harryp on June 8, 2004, at 22:44:21
Harryp, I wanted to mention that along with the Lexapro I was prescribed Xanax on an as needed basis (.5mg) but I haven't taken it yet. I need time when I can just hang out for a few hours and see how it affects me - according to my doctor.
Is Xanax in the same category as Lorazapam and Klonopin? I know Provigil is different from all of them.
Thanks for any info - very much appreciated :-)
Posted by MGOLDW on June 9, 2004, at 10:48:19
In reply to Help! I'm a zombie on Lexapro-switch to effexor??, posted by LisaMichelle on June 7, 2004, at 20:29:10
Hi! Stick with Lexapro, sedation and the other nasty side effects will eventually subside. You have to hang in there a few more weeks, I know its tough, but you will be glad you did.
Let us know how you are doing, good luck.
Posted by harryp on June 9, 2004, at 16:26:38
In reply to Re: Help! I'm a zombie on Lexapro, posted by LisaMichelle on June 9, 2004, at 0:05:49
> Harryp, I wanted to mention that along with the Lexapro I was prescribed Xanax on an as needed basis (.5mg) but I haven't taken it yet. I need time when I can just hang out for a few hours and see how it affects me - according to my doctor.
>
> Is Xanax in the same category as Lorazapam and Klonopin? I know Provigil is different from all of them.
>
> Thanks for any info - very much appreciated :-)That's right. The benzodiazapines are a family of antianxiety drugs that include Valium, Ativan (lorazapam), Xanax, and klonopin, along with several others (generic names usually end in "pam").
These drugs got an undeserved bad reputation because they became something of a fad in the fifties and onward, and lots of docs prescribed them needlessly at excessive dosages and got their patients (especially women) hooked on them.
Unfortunately, the pendulum has swung the other way, and it's now often hard to get them even if one really needs them. The truth is that they are the gold standard for anti-anxiety meds and are quite safe (as long as you DON'T mix them with alcohol). Regular use can cause dependence, which simply means you should taper off slowly when going off them. They are not "addictive" in the sense that they cause cravings and are very unlikely to cause any trouble to anyone who uses them to control anxiety, as opposed to getting stoned.
I suggest trying .25 mg. (half a pill) of Xanax at first to see how you respond to it. That's roughly equivalent to .5 mg of lorazapam (lorazapam (Ativan) has a milder effect but lasts longer than Xanax--we're still only talking about a couple hours or so. Klonopin can last nearly all day.)
My doc would have prefered to have me on an SSRI for my anxiety, but I couldn't stand the "zombie" effect, and eventually got him to accept the fact that my anxiety wasn't going away, and lorazapam worked great with essentially no side effects. Since I don't want to feel dull or sleepy, I only take the minimum necessary (about 1.5-2mg /day now) and I have not had a problem with tolerance in over four years.
To be quite honest, the SE's of the benzos (when used properly) are zilch compared to Lexapro. I think you'll be impressed--they're one of those rare drugs that reliably do what they are supposed to.
(Most important rule is AVOID alcohol while a benzo is in your system--Xanax should wear off in a couple hours or so)
Posted by LisaMichelle on June 10, 2004, at 22:20:52
In reply to benzos and xanax!, posted by harryp on June 9, 2004, at 16:26:38
Thanks so much for the info Harryp. Now I know why my doctor prescribed the Xanax and I will be trying half a pill soon. I'm very hopeful it will work well with no side effects. My doctor didn't even mention not drinking with it so thanks for the warning.
Glad to hear the Ativan is working for you and it has been for four years. I will keep that in mind in case I need something that lasts longer.
Thanks again so much for you info.
Warmly,
LisaMichelle
Posted by LisaMichelle on June 10, 2004, at 22:25:14
In reply to Re: Help! I'm a zombie on Lexapro-switch to effexor??, posted by MGOLDW on June 9, 2004, at 10:48:19
> Hi! Stick with Lexapro, sedation and the other nasty side effects will eventually subside. You have to hang in there a few more weeks, I know its tough, but you will be glad you did.
> Let us know how you are doing, good luck.Thanks for the encouragement. It's exactly what I need. I've been on the Lexapro for exactly 3 weeks so I'll stick it out even though my doctor was ready to switch me. He was pretty surprised I said I'd stay on it when I had just been in there the other day begging for something new.
This board has helped me immensely to know others are going through it or have gone through it and have been happy with the results.
I will let you know how it goes - now off to bed - yawn! :-)
Posted by bobbiedobbs on June 10, 2004, at 23:28:23
In reply to Re: Help! I'm a zombie on Lexapro-switch to effex, posted by harryp on June 8, 2004, at 22:44:21
I totally agree with the previous poster that suggested benzos and Nardil as alternatives to Lexapro if it provides fatiguing. I was pretty knocked out on Lexapro, but yes, it did subside by about 50% after 2 weeks. I took Ritalin and on-coffee when needed, and this helped. Good luck, Phil
Posted by chemist on June 11, 2004, at 1:34:59
In reply to benzos and xanax!, posted by harryp on June 9, 2004, at 16:26:38
chemist here, hello. comments delineated by **** below.
> > Harryp, I wanted to mention that along with the Lexapro I was prescribed Xanax on an as needed basis (.5mg) but I haven't taken it yet. I need time when I can just hang out for a few hours and see how it affects me - according to my doctor.
> >
> > Is Xanax in the same category as Lorazapam and Klonopin? I know Provigil is different from all of them.
> >
> > Thanks for any info - very much appreciated :-)
>
>
>
> That's right. The benzodiazapines are a family of antianxiety drugs that include Valium, Ativan (lorazapam), Xanax, and klonopin, along with several others (generic names usually end in "pam").
***incorrect. alprazolam is not a true 1,4-substituted benzo: it is a triazolo derivative. it hits a very specific area in the GABA_A receptor with a very small K_{i} and cannot be substituted for the 1,4 - or 1,5-benxos. ******
>
> These drugs got an undeserved bad reputation because they became something of a fad in the fifties and onward, and lots of docs prescribed them needlessly at excessive dosages and got their patients (especially women) hooked on them.
>
> Unfortunately, the pendulum has swung the other way, and it's now often hard to get them even if one really needs them. The truth is that they are the gold standard for anti-anxiety meds and are quite safe (as long as you DON'T mix them with alcohol). Regular use can cause dependence, which simply means you should taper off slowly when going off them. They are not "addictive" in the sense that they cause cravings and are very unlikely to cause any trouble to anyone who uses them to control anxiety, as opposed to getting stoned.
**** dependence is very much an issue with alprazolam. in 6 months, escalation of dose from 0.5 prn to 4 mg is not uncommon. *****
>
> I suggest trying .25 mg. (half a pill) of Xanax at first to see how you respond to it. That's roughly equivalent to .5 mg of lorazapam (lorazapam (Ativan) has a milder effect but lasts longer than Xanax--we're still only talking about a couple hours or so. Klonopin can last nearly all day.)****klonopin had a longer t_max} AUC, but your reference to 0.25 mg xanax == 0.5 mg lorazepam is way off. first off, the potency is roughly the same, but the K_{i} for xanax is much greater than lorazepam, and thus dependence will occur in a shorter time***
>
> My doc would have prefered to have me on an SSRI for my anxiety, but I couldn't stand the "zombie" effect, and eventually got him to accept the fact that my anxiety wasn't going away, and lorazapam worked great with essentially no side effects. Since I don't want to feel dull or sleepy, I only take the minimum necessary (about 1.5-2mg /day now) and I have not had a problem with tolerance in over four years.
>
> To be quite honest, the SE's of the benzos (when used properly) are zilch compared to Lexapro. I think you'll be impressed--they're one of those rare drugs that reliably do what they are supposed to.
>
> (Most important rule is AVOID alcohol while a benzo is in your system--Xanax should wear off in a couple hours or so)
This is the end of the thread.
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