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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by PeachLovie on May 30, 2006, at 19:52:13
Hi everyone,
I'm new to the board!
I have a question about antidepressnts. I've been on Lexapro 20mg for almost 3 years. My depression and anxiety are horrible right now.
My GP doctor wants me to take 5mg on Paxil along with the Lexapro. I also take Ativan prn for anxiety.
Does anyone on the board take more than one antidepressant? If so, what do you take? Does it help with depression/anxiety?
Should I ween off the Lexapro and then start Paxil, instead of taking them together?
Also, does anyone take more than 20mg of Lexapro?
Thanks for your help! Take care, Lovie
Posted by blueberry on May 30, 2006, at 20:24:25
In reply to Are you on more than one antidepressant med?, posted by PeachLovie on May 30, 2006, at 19:52:13
Yes, lots of people take more than one antidepressant. However, hardly anyone takes more than one that are very similar. Usually the second antidepressant is one with a different mechanism and working on different neurotransmitters than the first one.
Combining lexapro and paxil makes little sense to me since they are very similar. If you wanted to add another antidepressant, it would be more common to add remeron, wellbutrin, cymbalta, or nortriptyline. Very often people find what makes their first antidepressant work better is not another antidepressant, but a low dose of an antipsychotic like zyprexa or seroquel, or a mood stabilizer like lamictal or depakote.
The general idea is to add a second medication that works in a significantly different way than the first one.
Posted by fca on May 30, 2006, at 20:39:50
In reply to Are you on more than one antidepressant med?, posted by PeachLovie on May 30, 2006, at 19:52:13
Is he/she preparing you for a shift to paxil from lexapro--it would not be unusual to gradually taper the original drug (or keep it constant for a short period)while introducing the new drug (paxil)--5 mg would generally be the initial dosage if you were being switched to paxil from another ssri--5mg is almost subtherapeutic. Otherwise--it would be unusual to give two ssris (but who knows--I am sure stranger things have happened and it may even work)
Posted by bassman on May 30, 2006, at 20:44:26
In reply to Re: Are you on more than one antidepressant med?, posted by blueberry on May 30, 2006, at 20:24:25
But then, maybe your doc is thinking of weaning you off the Lexapro onto the Paxil-so you'll be taking them both only for awhile. My experience is that when one SSRI fizzles out, another one works for me. So I started on Paxil (which was wonderful!) and when they pooped out, I took Lexapro, which worked for a couple years and now I'm taking Prozac, which works. Maybe you should ask your doc what he/she is doing. :>}
Posted by Phillipa on May 30, 2006, at 22:29:43
In reply to Re: Are you on more than one antidepressant med?, posted by bassman on May 30, 2006, at 20:44:26
Good idea. Love Phillipa
Posted by PeachLovie on May 30, 2006, at 22:57:48
In reply to Re: Are you on more than one antidepressant med? » bassman, posted by Phillipa on May 30, 2006, at 22:29:43
Hi,
Thank you very much for all your responses!!!!
The rational behind my doctor starting the Paxil with the Lexapro is to help with my panic attacks. However, I don't feel comfortable taking two of the same type of SSRI's. My doctor wants me to take both and hasn't mentioned weaning off the Lexapro. I'm going to call her tomorrow to discuss going on another antidepressant.
I'm just so depressed, sad, anxious. I can't even think straight. I don't know what to do. I can't cope...and I'm medical leave from work.
I feel like such a failure!!!
I just want to give up...I'm tired of all this!!
Now, more meds...ugh!!Thanks again for all your help!
Posted by bassman on May 31, 2006, at 6:41:02
In reply to Re: Are you on more than one antidepressant med?, posted by PeachLovie on May 30, 2006, at 22:57:48
Wow, do I ever know what you are going through-3 nightmarish years of my life in the intense phase. I'm a fellow panic disorder person. Don't worry about taking two SSRI's at the same time in those amounts-maybe worried about "serotonin syndrome" or been reading too many drug insert cautions (they're enough to cause panic in themselves!:>})? Not withdrawing one med until the other has been introduced at a therapeutic level is pretty common-maybe the reasoning is that [1] it is a bad time to find out if the person will show nasty withdrawal symptoms and/or [2] maybe the existing med is providing some degree of relief, no matter how small. I also found that when my panic disorder was the worst, I was most scared/averse to taking meds-I don't know why-well, maybe I do. When you feel awful, you don't need anything to make you feel worse in the short term and also make you feel like your life is even MORE out of control! As terrible as you feel right now, meds can help panic immensely and you'll have your life back. It's just the suffering that goes on while you find the right meds for you. Paxil is a great choice for panic disorder and Lexapro is also a great choice (many people get relief and less chance of sexual side effects)-but if they don't work, they are others. It really sounds like your doc is making reasonable choices; just tell him, "give me some benzos, damn it! I'm anxious and depressed!" :>}
Please have hope, even though you're discouraged (and I'll bet, very scared, maybe even all the time) right now. Very best wishes-it is a horrible affliction-but when it relents, you will be so relieved. Promise.
Posted by fca on May 31, 2006, at 11:10:29
In reply to Re: Are you on more than one antidepressant med?, posted by bassman on May 31, 2006, at 6:41:02
Posted by Robert35 on May 31, 2006, at 14:19:52
In reply to Are you on more than one antidepressant med?, posted by PeachLovie on May 30, 2006, at 19:52:13
> Does anyone on the board take more than one antidepressant? If so, what do you take? Does it help with depression/anxiety?
Hi PeachLovie,
I do: Prozac and Cymbalta (I don't own Lily stocks by the way ;) and my opinion about both drugs is mixed :( ).
I began, weaning off Cymbalta, taking Prozac again (used that before taking Cymbalta for many years); I found out that continuing taking Cymbalta in half the dose I used to take (60 mgs per day) is helpfull because Prozac makes me feel so stressed I cannot handle it.
Still taking Cymbalta enables me to manage to do my job at some level.
Apparently there is some antidepressant action of Cymbalta and the action of Prozac is like a 24 hours per day working stimulant (but one making me completely unfocused) at this stage.
Cymbalta made me feel depressed (and nauseous and like having an stomach/intestinal flu) but to a moderate amount only (didn't feel like I was loosing my grip on everything and falling in an abyss).
I really hope the combination of Paxil and Lexapro will work for you.
I haven't dived in the matter (and don't have an opinion about it) but some people on this board are positive about adding Zyprexa to a ssri.
(Maybe other possibilies mentioned on this board maybe a good augmentation; I will soon discuss adding nortryptiline to Prozac with my gp; I want to take it slow if I can.)
Wishing well for you, take care too,Robert
Posted by PeachLovie on May 31, 2006, at 15:50:33
In reply to Re: Are you on more than one antidepressant med?, posted by bassman on May 31, 2006, at 6:41:02
bassman,
Thank you so much for your response and well wishes. I appreciate them more than I can say!
I was worried about serotonin syndrome....and like you, I HATE having to take more medications! I feel like I should be able to work through my anxiety/depression through therapy. ARGH...so very frustrated right now. It is hard to concentrate on anything...and I feel very lonely....
Again, thank you for you taking the time to help me! Hugs, PeachLovie
Posted by PeachLovie on May 31, 2006, at 15:56:49
In reply to Re: Are you on more than one antidepressant med?, posted by Robert35 on May 31, 2006, at 14:19:52
Robert,
Thank you for telling me your story and for your well wishes.
I'm really nervous to take both meds. I would rather just take the Ativan when I get nervous. Luckily, my doc increased my doseage today!
I will talk to my therapist on Friday. She is the one who suggested taking the Paxil and my GP agreed. However, she also suggested Wellbutrin.
Oh, I'm so confused...I don't know what to do...
I just want to feel normal again....
Thanks again and take care! Hugs, PeachLovie
Posted by bassman on May 31, 2006, at 18:00:57
In reply to Re: Are you on more than one antidepressant med?, posted by PeachLovie on May 31, 2006, at 15:50:33
My pleasure...I have been (and occasionally revisit :>}) Panicland, or "Hell" as I prefer to call it. I think you'll find the right med makes a HUGE difference...I could tell you a long story, but the summary is that I went from being unable to walk in a mall or sit in a train station to some of the biggest changes in my life, no problem-it was kind of fun. Here's the point: I went to three years of therapy and it did me no good whatever and then boink! 5 mg Paxil from my GP and I was better than normal. I think panic can just be that much of a biochemical imbalance and you can't talk or think your way out of it. You might want to check in with Remedyfind.com to see what other people think of the meds they are taking. I did mean it about seeing about getting some Ativan, Klonopin, or Xanax to calm you while the SSRI's are being tried...I think you'll find that really helpful. Best of luck and try to just take the meds with the attitude that [1] they are probably better for you than what your body is doing to you without them and [2] you aren't out of control, you're in control: you are doing something to try and feel better, and [3] you can stop taking meds later on if you want to. Again, best of luck!
Posted by bassman on May 31, 2006, at 18:06:06
In reply to Re: Are you on more than one antidepressant med?, posted by PeachLovie on May 31, 2006, at 15:56:49
Wellbutrin makes a lot of people that have panic episodes a bit nuts above about 150 mg/day (it isn't recommended for panic). It might be good for countering the sexual effects of the Paxil, if need be. Oh, and one more thing-sometimes panic responds to low doses of SSRI's; I have a friend that went from pacing the floor 24 hours a day to O.K. with 5 mg Prozac...so low doses are worth trying first, esp. since you are a fellow med-hater.
Posted by Colleen D. on May 31, 2006, at 19:44:21
In reply to Are you on more than one antidepressant med?, posted by PeachLovie on May 30, 2006, at 19:52:13
I take 20mg of Lexapro along with 50mg of doxepin (tricyclic AD). I also take clonazepam for anxiety and it doesn't seem to make me any more depressed. For now, I've fopund a good combo for me.
Good luck,
Colleen
MDD, GAD, OCD and SP
Posted by TJO on June 1, 2006, at 12:52:56
In reply to Are you on more than one antidepressant med?, posted by PeachLovie on May 30, 2006, at 19:52:13
hi
I take 5 different meds
Neurontin, Seroquel, Abilify, Wellbutrin, and Topamax, all for bipolar disorder. Does not matter how many meds you have to take as long as you are well :-).Tam
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