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Dr. Bob is Robert Hsiung, MD,
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Posted by Minsc22 on December 14, 2010, at 17:21:59
In reply to Re: Not sure if escitalopram (Lexapro) is working, posted by bleauberry on December 14, 2010, at 16:37:47
Hello, does a serotonin med can boost the action of a noradrenagic med ie more energy, motivation?
For example, if the action of wellbutrin decreases or stop, does a small dose of zoloft can boost the action of wellbutrin ?
Posted by linkadge on December 14, 2010, at 18:58:36
In reply to Re: Not sure if escitalopram (Lexapro) is working, posted by bleauberry on December 14, 2010, at 16:37:47
>"Motivated" and "outgoing"....these are not >typically results seen with any of the SSRIs.
Not necessarily true. See the thread above re paxil studies. The most pronounced effect of paxil was in turning introverts to extroverts - little effect on core depression, however.
Linkadge
Posted by morgan miller on December 14, 2010, at 21:27:50
In reply to Re: Not sure if escitalopram (Lexapro) is working, posted by bleauberry on December 14, 2010, at 16:37:47
>"Motivated" and "outgoing"....these are not typically results seen with any of the SSRIs. Serotonin is more of a calming, serene, everything is ok neurotransmitter. Once in a while someone on an ssri will have an astounding response and feel great, motivated, born again. Those are kind of rare. More common is the apathetic flat line emotion....no lows, but no highs either, flat motivation. Apathy.
Have to been to Revolutionhealth or Ask a Patient or any other medication review sites? There are plenty of people reporting uplifting feel good responses from SSRIs. This response does not just happen rarely or once in a while. The apathetic reaction is focused so much on sites like babble because this is the place people go to when they are not responding well to medication and need some help and support. I have said it before here, I personally know enough people that are kinda loving their SSRI. I have a hard time believing that all the people I have known to do well on SSRIs are just part of this small population that has a rare positive reaction.
I do believe some SSRIs are more likely to leave someone feeling numb and apathetic, without feeling warm happy and vigilant. I think Zoloft is one SSRI that is much less likely to leave someone feeling numb and apathetic and much more likely to have an overall positive antidepressant response.
Posted by morgan miller on December 14, 2010, at 21:34:29
In reply to Re: Not sure if escitalopram (Lexapro) is working, posted by linkadge on December 14, 2010, at 18:58:36
> >"Motivated" and "outgoing"....these are not >typically results seen with any of the SSRIs.
>
> Not necessarily true. See the thread above re paxil studies. The most pronounced effect of paxil was in turning introverts to extroverts - little effect on core depression, however.
>
> LinkadgeI have both experienced, read about, and been told of people feeling more outgoing and also less inhibited on SSRIs. Some people that I talked to that experienced this were not comfortable with it.
That's interesting about Paxil. It was one of the few drugs I would not stick out the side effects with, it turned me into a complete Zombie for 10 days.
We all obviously know that everyone responds so much differently to medications due to unique brain chemistry's. There are few antidepressants that we can just say have a specific response in most people.
Posted by Phillipa on December 14, 2010, at 22:29:27
In reply to Re: Not sure if escitalopram (Lexapro) is working, posted by morgan miller on December 14, 2010, at 21:34:29
SSRI's do work for people I know Daughter included whos on prozac 20mg and she's not only lost weight but for her anxiety is gone and she takes things in stride. Now she did go through six weeks of anxiety on the way. But gone now. Phillipa
Posted by linkadge on December 17, 2010, at 18:28:14
In reply to Re: Not sure if escitalopram (Lexapro) is working, posted by morgan miller on December 14, 2010, at 21:34:29
At first I liked the SSRI effect, now I realize its just not me.
I don't like to be a "social butterfly".
I go home and think about how foolish social butterflys are for wasting so much mental energy on just trying to be liked.
Linkadge
Posted by morgan miller on December 24, 2010, at 1:00:48
In reply to Re: Not sure if escitalopram (Lexapro) is working, posted by linkadge on December 17, 2010, at 18:28:14
>I go home and think about how foolish social butterflys are for wasting so much mental energy on just trying to be liked.
Maybe some people are simply more social and have realized that they are much happier and life is much fuller if they are connected with people. Being very social and extroverted can be fun, stimulating, and therapeutic.
Being a bit of a social butterfly does not mean you are starved for attention or you need others to like you. Besides, who doesn't need SOMEONE to like them. If one claims to be free of this need, they are in complete denial. It's like when someone says they don't need to be around people in order to be happy. That person is lying to themselves and likely has something quite wrong going on.
Posted by roscopeeco on December 26, 2010, at 3:03:42
In reply to Re: Not sure if escitalopram (Lexapro) is working, posted by Phillipa on December 14, 2010, at 22:29:27
> SSRI's do work for people I know Daughter included whos on prozac 20mg and she's not only lost weight but for her anxiety is gone and she takes things in stride. Now she did go through six weeks of anxiety on the way. But gone now. Phillipa
Prozac did wonders for my father. If Parnate proves to be a failure to me then that might be the SSRI I turn to.
Posted by Franz on January 11, 2011, at 9:57:17
In reply to Not sure if escitalopram (Lexapro) is working, posted by Franz on December 12, 2010, at 21:16:05
Thanks to all for the comments.
For some days the effect get better but now I am getting sleepy or lethargic again. Ias escitalopram supposed to make you feel more energetic?
What I notice is that I do not feel so down when I think in my problems.
I asked the Dt if I can take 0.5 mg instead of 10 mg but he says it is not an effective dose. I am not sure if he is right. Is anyone here taking 0.5?
A side effect I notice is in the ears, difficult to explain, like numb.
Today I took only 0.5 mg and I feel more alert.
Posted by Franz on January 11, 2011, at 10:07:14
In reply to Re: Not sure if escitalopram (Lexapro) is working, posted by Franz on January 11, 2011, at 9:57:17
> Thanks to all for the comments.
>
> For some days the effect get better but now I am getting sleepy or lethargic again. Ias escitalopram supposed to make you feel more energetic?
>
> What I notice is that I do not feel so down when I think in my problems.
>
> I asked the Dt if I can take 0.5 mg instead of 10 mg but he says it is not an effective dose. I am not sure if he is right. Is anyone here taking 0.5?
>
> A side effect I notice is in the ears, difficult to explain, like numb.
>
> Today I took only 0.5 mg and I feel more alert.
>
>Where I wrote 0.5 I should have written 5 mg, sorry.
Posted by Phillipa on January 11, 2011, at 18:42:48
In reply to Re: Not sure if escitalopram (Lexapro) is working, posted by Franz on January 11, 2011, at 10:07:14
Franz I'm also on 5mg can't really say if working or trying to a lot of external stresses at the time. But I'd say yes it can work for some as we all are different. Phillipa
Posted by Franz on January 12, 2011, at 15:45:10
In reply to Re: Not sure if escitalopram (Lexapro) is working » Franz, posted by Phillipa on January 11, 2011, at 18:42:48
> Franz I'm also on 5mg can't really say if working or trying to a lot of external stresses at the time. But I'd say yes it can work for some as we all are different. Phillipa
It seems 5 mg is effective in some cases for SAD:
Efficacy and tolerability of escitalopram in 12- and 24-week treatment of social anxiety disorder: randomised, double-blind, placebo-controlled, fixed-dose study.
Lader M, Stender K, Bürger V, Nil R.
Institute of Psychiatry, University of London, London, SE5 8AF, UK. m.lader@iop.kcl.ac.uk
AbstractSelective serotonin reuptake inhibitors are the pharmacological treatment of choice for the treatment of social anxiety disorder (SAD). The efficacy and tolerability of fixed doses of escitalopram were compared to those of placebo in the long-term treatment of generalised SAD, using paroxetine as an active reference. Patients with a DSM-IV diagnosis of SAD between 18-65 years of age were randomised to 24 weeks of double-blind treatment with placebo (n = 166), 5 mg escitalopram (n = 167), 10 mg escitalopram (n = 167), 20 mg escitalopram (n = 170), or 20 mg paroxetine (n = 169). Based on the primary efficacy parameter, Liebowitz Social Anxiety Scale (LSAS) total score at Week 12 (LOCF), a significantly superior therapeutic effect compared to placebo was seen for 5 and 20 mg escitalopram and for all doses for the OC analyses. Further improvement in LSAS scores was seen at Week 24 (OC and LOCF), with significant superiority over placebo for all doses of escitalopram, and 20 mg escitalopram was significantly superior to 20 mg paroxetine. Response to treatment (assessed by a Clinical Global Impression-Improvement score < or = 2) was significantly higher for all active treatments than for placebo at Week 12. Clinical relevance was supported by a significant decrease in all the Sheehan disability scores, and the good tolerability of escitalopram treatment. It is concluded that doses of 5-20 mg escitalopram are effective and well tolerated in the short- and long-term treatment of generalised SAD.
PMID: 15274173 [PubMed - indexed for MEDLINE]
Posted by Phillipa on January 12, 2011, at 21:39:22
In reply to It seems 5 mg is effective in some cases for SAD, posted by Franz on January 12, 2011, at 15:45:10
Franz anything about Gad or PTSD latest diagnosis from pdoc?
Posted by Franz on January 13, 2011, at 8:22:45
In reply to Re: It seems 5 mg is effective in some cases for SAD » Franz, posted by Phillipa on January 12, 2011, at 21:39:22
> Franz anything about Gad or PTSD latest diagnosis from pdoc?
He did not give me a diagnose. I was always prone to worry with some social phobia and obsessive traits in my opinion. Lately I think due to these tendencies and life events (health problems in the family, work problems, girlfriend breakup) I have been feeling depressed.
He started me on clonazepam (which I do not like very much) but as mood was not better we talked about an antidepressant and he gave me escitalopram 10 mg. This is my second month approx. I notice I do not get so low and that I can switch from bad thoughts more easy but I do not feel much more energy and many times I am lethargic. No bad side effects except from ear discomfort.
I am seeing a therapist too.
Thanks Phillipa for your interest.
Posted by Phillipa on January 13, 2011, at 20:06:21
In reply to Re: It seems 5 mg is effective in some cases for SAD » Phillipa, posted by Franz on January 13, 2011, at 8:22:45
Franz since also taking and at 5mg it's of great interest to me. Phillipa
Posted by Franz on January 13, 2011, at 20:30:46
In reply to Re: It seems 5 mg is effective in some cases for SAD » Franz, posted by Phillipa on January 13, 2011, at 20:06:21
> Franz since also taking and at 5mg it's of great interest to me. Phillipa
I took 5 mg only for two days.
Today I took 5 mg in teh morning and 5 in the evening.
I feel better today. The difference:
1) Last night I took 0.2 mg clonazepam.
2) I slept well.
3) Exposure to intense sun.
4) I went out of my house, walked.
4) No vitamins today but yesterday I took vitamin C.
5) I talked to people, no discussions: parents, the therapist
Posted by Phillipa on January 13, 2011, at 21:47:13
In reply to Re: It seems 5 mg is effective in some cases for SAD » Phillipa, posted by Franz on January 13, 2011, at 20:30:46
Franz I would take the full l0mg if not already on luvox 50mg for many years. Afraid of serotonin syndrome. I do take vitamins. You feel better without them? Intense sun in a warm climate? That surely would help. Phillipa
Posted by Franz on January 14, 2011, at 5:04:07
In reply to Re: It seems 5 mg is effective in some cases for SAD » Franz, posted by Phillipa on January 13, 2011, at 21:47:13
> Franz I would take the full l0mg if not already on luvox 50mg for many years. Afraid of serotonin syndrome. I do take vitamins. You feel better without them? Intense sun in a warm climate? That surely would help. Phillipa
I did not take the vitamins these days because they have B6 and I thought they can augment serotonin but generally I feel better on them, Bs are a bit stimulant.
I believe going out and talking with people, not staying at home, is very important for not feeling lethargic.
Anyway, at the end of a good day I had a terrible nightmare. Maybe dividing the dose in 5 mg morning and 5 mg evening does not work and the last dose increased dreams. :(
Are you switching from Luvox to escitalopram Phillipa?. It is strange for me that you take 2 SSRIs. I heard that escitalopram can be combined with bupropion but never heard of two SSRIs but these drugs are not pure SSRIs except for esctalopram it seems so it can make sense.
Posted by creepy on January 14, 2011, at 12:44:35
In reply to Re: Not sure if escitalopram (Lexapro) is working, posted by Franz on January 11, 2011, at 9:57:17
the problem with celexa and lexapro is they can give you side effects which mirror those caused by depression.
Fatigue, apathy, sedation can be caused by depression and the medication itself.
It was really hard to pick apart which symptoms came from what. I did this by adjusting the dose and keeping track my symptoms.
Most of my problems were from undertreated depression, but some of it was from celexa.
After while especially, the drug pooped out and I became more depressed without noticing. It wasnt sedation for me, it was the depression.
Posted by Phillipa on January 14, 2011, at 20:27:35
In reply to Re: It seems 5 mg is effective in some cases for SAD » Phillipa, posted by Franz on January 14, 2011, at 5:04:07
I also find B complex stimulating stopped that a long time ago. I know strange to take both but the luvox I'm addicted to. So it's combo or just the luvox I guess. Phillipa
Posted by Franz on February 19, 2011, at 16:20:05
In reply to Not sure if escitalopram (Lexapro) is working, posted by Franz on December 12, 2010, at 21:16:05
Today I started my third box (28 pills each). In the packed insert it reads it takes 3 months to show clear and stablea result so I will make the effort to continue.
The side effects are the same: sleepy, ear discomfort ,maybe less libido, less mentally sharp. On the good side: less deep bad feelings.
Posted by Franz on March 1, 2011, at 16:52:42
In reply to Not sure if escitalopram (Lexapro) is working, posted by Franz on December 12, 2010, at 21:16:05
Hi, Dr is thinking I could try agomelatine after I finish my third box of escitalopram. He is interested but I am not sure.
It is very expensive. I will search the board for experiences but please comment if you have tried agomelatine alone or after escitalopram and how it compares.
Thanks
Posted by sigismund on March 6, 2011, at 19:57:07
In reply to Dr suggests switching to agomelatine, posted by Franz on March 1, 2011, at 16:52:42
I have never taken SSRIs so I can't compare it to agomelatine.
Bear in mind that you can combine them.
To my mind it makes some sense for people to take quite low dose SSRIs with agomelatine.
Posted by Cydnie on March 14, 2011, at 8:59:53
In reply to Re: Dr suggests switching to agomelatine, posted by sigismund on March 6, 2011, at 19:57:07
I'm sorry if you already wrote about this here, but I didn't see it in this post anywhere - can I ask you where you get your agomelatine (even if you can't list the site, can you list the country?) My doc thinks I would respond really well, and just told me I could buy it from Canada, but told me it's cost prohibitive (then I saw it was over $150 at antiaging, so I whole heartedly agreed). He told me because I respond so well to melatonin, I will respond to agomelatine, but it will be years before I can try it, he says. I can't believe it! Would love to know how things go for you!
Posted by sigismund on March 14, 2011, at 15:51:47
In reply to Re: Dr suggests switching to agomelatine, posted by Cydnie on March 14, 2011, at 8:59:53
It has just become available on prescription in Australia. We pay a little less than A$60 which is pretty much US$60.
It is OK. Servier makes nice humane drugs. My sleep is still poor, though it certainly helped to begin with.
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