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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 20 to 44 of 49. Go back in thread:
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.
Posted by Franz on March 16, 2011, at 13:37:38
In reply to Not sure if escitalopram (Lexapro) is working, posted by Franz on December 12, 2010, at 21:16:05
First day on agomelatine. Nightmare like with melatonin. I woke up after 4-5 hours of sleep.
I hope this improves because I need something better then escitalopram and not worse, especially in price, too expensive.
Posted by Cydnie on March 16, 2011, at 13:51:47
In reply to I started agomelatine, posted by Franz on March 16, 2011, at 13:37:38
Franz - did your doctor ask you about how you do with melatonin? My doc thought, when I told him how fast melatonin worked to get me to sleep, that it would mean I would respond well to agomelatine. But I did not used to respond to melatonin like I do currently, so my guess is that things could very well change for you. What kinds of things are happening since you've been on this?
Hoping that things get better very soon, take care.
Cydnie
Posted by Franz on March 16, 2011, at 13:56:55
In reply to Re: I started agomelatine, posted by Cydnie on March 16, 2011, at 13:51:47
> Franz - did your doctor ask you about how you do with melatonin? My doc thought, when I told him how fast melatonin worked to get me to sleep, that it would mean I would respond well to agomelatine. But I did not used to respond to melatonin like I do currently, so my guess is that things could very well change for you. What kinds of things are happening since you've been on this?
> Hoping that things get better very soon, take care.
> CydnieI told the doctor melatonin gives me nightmares and replied agomeaaalatine is different.
I only took it once so the only thing I can tell is that it screwed upmy sleep, and day.
I will update as days pass.
Posted by Franz on March 19, 2011, at 1:30:00
In reply to Dr suggests switching to agomelatine, posted by Franz on March 1, 2011, at 16:52:42
Agomelatine makes it easy to:
*fall asleep
*wake up after onaly 4, 2 hours
*have nightmaresMaybe it is more stimulant during the day, or it is that I lowered escitalopram to 5 mg (half the dose).
Anyway, it is early to be sure, I took agomelatine only 4 times.
Posted by ((Vibe)) on March 21, 2011, at 17:03:17
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
Wow, it was a lot of work to register onto this site. Just wanted to say that:
Lexapro is pretty much the only SSRI that is overdosed. There is a lot of evidence that 5mg's will be almost if not as effective as 10mg's. Increasing the dose past 5mg's seems to increase side effects more than anything.
Don't have time to provide sources, but PubMed is always a click away for those who are interested. (There are also a lot of great posts on the topic by the poster Ex Dubio at Mind and Muscle as well)
Cheers
Posted by ((Vibe)) on March 21, 2011, at 17:08:39
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
Wow, it was a lot of work to register onto this site. Just wanted to say that:
Lexapro is pretty much the only SSRI that is overdosed. There is a lot of evidence that 5mg's will be almost if not as effective as 10mg's. Increasing the dose past 5mg's seems to increase side effects more than anything.
Don't have time to provide sources, but PubMed is always a click away for those who are interested. (There are also a lot of great posts on the topic by the poster Ex Dubio at Mind and Muscle as well)
Cheers
Posted by Franz on March 21, 2011, at 17:45:23
In reply to Re: It seems 5 mg is effective in some cases for SAD, posted by ((Vibe)) on March 21, 2011, at 17:03:17
> Wow, it was a lot of work to register onto this site. Just wanted to say that:
>
> Lexapro is pretty much the only SSRI that is overdosed. There is a lot of evidence that 5mg's will be almost if not as effective as 10mg's. Increasing the dose past 5mg's seems to increase side effects more than anything.
>
> Don't have time to provide sources, but PubMed is always a click away for those who are interested. (There are also a lot of great posts on the topic by the poster Ex Dubio at Mind and Muscle as well)
>
> CheersI gave my Doc a copy of the abstract about the use of 5 mg escitalopram but could not convince him.
Posted by Franz on March 26, 2011, at 23:28:31
In reply to Not sure if escitalopram (Lexapro) is working, posted by Franz on December 12, 2010, at 21:16:05
net week I have an appointment with my Doc afteralmost two weeks on agomelatine (as a replacement to escitalopram).
The experience was not good: short sleep length, nightmares, daytime irritability. Add high price and that I read ago is not so free of toxicity.
I am not sure what to do. Keep trying? Go back to escitalopram?. Take both? Take alprazolam? venlafaxine (I tried it before with not much success)?
Anyone with experience or knowledge please comment. Thanks
Posted by sigismund on March 29, 2011, at 12:35:39
In reply to not sure what to do with agomelatine. worried, posted by Franz on March 26, 2011, at 23:28:31
I can't see that agomelatine would be a good replacement for an SSRI. It makes more sense to me as an add on to a low dose SSRI, but I know nothing about that family of drugs.
I found with agomelatine that I liked it from day 1, so I wonder if it will get any better for you?
I do think people tend to ramp up the dose too quickly. I should have stayed on half a tablet a day for at least 2 months, but that is just my system.
After a couple of weeks there came the afternoon anxiety type thing that was different to anxiety I had felt before and was perhaps from increased NE. I could have avoided all that by taking haldf a tablet at night until my system was comfortable with that.
I don't think it is free from toxicity either. It has an acrid taste and people talk about damage to their gut lining.
I still take it though...............25mg
Posted by Franz on April 3, 2011, at 16:06:19
In reply to Dr suggests switching to agomelatine, posted by Franz on March 1, 2011, at 16:52:42
Posted by Franz on April 15, 2011, at 9:16:14
In reply to Dr suggests switching to agomelatine, posted by Franz on March 1, 2011, at 16:52:42
I did not like agomelatine, took it for 14 days.
I went to the doctor and I am back on escitalopram.
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