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Dr. Bob is Robert Hsiung, MD,
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Posted by qbsbrown on November 3, 2005, at 17:31:50
In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » Glydin, posted by ed_uk on November 3, 2005, at 17:11:25
Well after speaking to my doc about it, i belive i will resume the 40mg celexa. This is the highest dose, correct?
He thinks that it is just as beneficial as lex.He was recently at a conference, and a speaker claimed, "they took a perfect drug (celexa), and changed it".
I hope im able to eat and not have brutal headaches.
Thanks guys and gals
Brian
Posted by qbsbrown on November 3, 2005, at 17:39:29
In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial??, posted by qbsbrown on November 3, 2005, at 17:31:50
Ed, how much lexapro would you say is equal to 40mg of celexa? 15-20?
Posted by Glydin on November 3, 2005, at 18:51:39
In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » Glydin, posted by ed_uk on November 3, 2005, at 17:11:25
How are you?
Lv,
Glydin
Posted by ed_uk on November 5, 2005, at 10:25:39
In reply to Ed - my question » ed_uk, posted by Glydin on November 3, 2005, at 18:51:39
Hi G!
>How are you?
Sorry for not replying earlier - I'm often tired after work.
I'm doing quite well thank you. My mental health is good at the moment. I'm taking citalopram (Celexa) 80mg in the morning and amitriptyline (Elavil) 20mg at night. I'm working at the moment, didn't return to university.
Ed xx
Posted by ed_uk on November 5, 2005, at 10:28:55
In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial??, posted by qbsbrown on November 3, 2005, at 17:31:50
Hi Brian,
If you were taking Lexapro 10mg, I'd switch to 20mg generic citalopram the following day. I don't recommend the Celexa brand (too expensive) - there doesn't appear to be anything wrong with the generics.
Stay on 20mg citalopram for a couple of weeks then increase the dose in steps to 10mg as required. Most people end up taking 20-60mg per day.
Kind regards
Ed
Posted by qbsbrown on November 5, 2005, at 18:26:17
In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » qbsbrown, posted by ed_uk on November 5, 2005, at 10:28:55
Hi Ed. Well i did 20mg for a week, then 40mg for 3 days, then did lexapro 10mg for 3 days.
Now i switched back over to 40mg generic celexa.
Is it normal to have increased anxiety initially? I get highly energized and anxious in the evenings. Other than that, i can tell that im obsessing less, and depression isn't as bad.I have no insurance, so it is much cheaper. How long do i give 40mgs to gauge whether or not to go up to 60mg? Is it more effective for highly anxious people, GAD, very obsessive people?
I pray for no sexual side-effects, fingers crossed.
kind regards,
Brian
Posted by ed_uk on November 5, 2005, at 18:57:39
In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial??, posted by qbsbrown on November 5, 2005, at 18:26:17
Hi Brian
>Is it normal to have increased anxiety initially?
Yes, especially when the initial dose is too high. You could decrease to 30mg for a while, then increase back up to 40mg if necessary.
>How long do i give 40mgs to gauge whether or not to go up to 60mg?
That depends on whether or not you want to find the minimum effective dose - which should reduce the risk of side effects. For me, the maximum effect takes a couple of months to develop. You could increase the dose much sooner if you want to - but the risk of sexual side effects increases with the dose.
Kind regards
Ed
Posted by qbsbrown on November 5, 2005, at 19:07:10
In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » qbsbrown, posted by ed_uk on November 5, 2005, at 18:57:39
Well i can already tell that 40mg of celexa has been more beneficial than 10 or 20mgs of lexapro. I never felt anything from it, felt like placebo.
So 40mg is a good effective dosage that i should try out for at least a month?
Thanks
Posted by ed_uk on November 6, 2005, at 14:36:41
In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial??, posted by qbsbrown on November 5, 2005, at 19:07:10
Hi Brian
>So 40mg is a good effective dosage that i should try out for at least a month?
40mg is a fairly 'standard' dose. I'd give it more than a month, the full effect can take longer to develop. Some benefit should occur after a few weeks though.
Kind regards
Ed
Posted by qbsbrown on November 6, 2005, at 16:42:09
In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » qbsbrown, posted by ed_uk on November 6, 2005, at 14:36:41
I think i just realized that i went up way too fast.
Started at 20mgs for 5 days, then to 40 for the past week.
No wonder i've lost 10lbs and am not eating, although hunger is beginning to come back, bus insomnia seems to be getting worse, which i get from all ssris, or am insomniac anyway (klonopin) helps. Hopefully with the celexa, my anxiety will be at bay, i can wean off the klonopin, and finally have a couple of drinks w/o feeling damn tired.
Posted by ed_uk on November 7, 2005, at 14:28:48
In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial??, posted by qbsbrown on November 6, 2005, at 16:42:09
Hi Brian :-)
>I think i just realized that i went up way too fast.
I agree. You can decrease the dose if necessary, and increase it more gradually next time.
Kind regards
Ed
Posted by qbsbrown on November 9, 2005, at 14:08:52
In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » qbsbrown, posted by ed_uk on November 7, 2005, at 14:28:48
Well Ed, the original "better" feeling i was getting on 40mgs has dissappated. Albeit i never felt anything on 20mgs of lexapro (which i took for months).
Think it is time to move on to 50, then perhaps 60? Chase the dragon.Typically w/ me, i react to ADs quickly or not at all. Paxil, 9 years ago, panic disorder ended from day one i took it. It is now ineffective for me.
Lamictal, i took, felt amazing after one week, only for it to go away, and chase the dosage up, never to reach that feeling again.So i was enthused that after a couple days at 40mgs, that i felt a difference. Lexapro just felt like a placebo. Or perhaps i have a correlation w/ side effects, and medications working.
Any offers?
I know you take 80mgs. Everywhere i read says that it's never been found that 60mg is any more beneficial that 40mg (which im sure is a bunch of crap in individual cases).
Regards,
Brain
Posted by ed_uk on November 9, 2005, at 16:30:31
In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial??, posted by qbsbrown on November 9, 2005, at 14:08:52
Hi Brian,
>Everywhere i read says that it's never been found that 60mg is any more beneficial that 40mg (which im sure is a bunch of crap in individual cases).
Exactly. Individual differences and all that. Are you currently having any side effects on 40mg?
Ed
Posted by qbsbrown on November 9, 2005, at 17:57:10
In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » qbsbrown, posted by ed_uk on November 9, 2005, at 16:30:31
No side effects. Perhaps loss of hunger still, but it's regaining. If you've heard of derealization, that is probably my worst and most prominent symptom. Usually SSRis seem to aggrivate it, although i typically don't give them enough of a chance or time.
Posted by qbsbrown on November 9, 2005, at 18:14:39
In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial??, posted by qbsbrown on November 9, 2005, at 17:57:10
the main thing that i am worried about celexa, is that 20mg of lexapro did nothing for me. What in your estimate is dosage of celexa equal to 20 mg of lexapro? Most would say 80, but i know you disagree.
Posted by ed_uk on November 10, 2005, at 13:41:26
In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial??, posted by qbsbrown on November 9, 2005, at 18:14:39
Hi Brian,
>If you've heard of derealization, that is probably my worst and most prominent symptom. Usually SSRis seem to aggrivate it, although i typically don't give them enough of a chance or time.
Does anything help? Perhaps surprisingly, some people find stimulants helpful.
>What in your estimate is dosage of celexa equal to 20 mg of lexapro?
40mg. 40mg Celexa *contains* 20mg escitalopram (Lexapro) and 20mg R-citalopram.
Kind regards
Ed
Posted by qbsbrown on November 10, 2005, at 13:44:29
In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » qbsbrown, posted by ed_uk on November 10, 2005, at 13:41:26
What type of stimulants? There is no current treatment for Derealization/depersonalization disorder. I believe that mine is completely anxiety based, so i still have hopes for an ssri to assist me in changing back my paradigms and perceptions.
Regards,
Brian
Posted by ed_uk on November 12, 2005, at 12:10:20
In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial??, posted by qbsbrown on November 10, 2005, at 13:44:29
Hi Brian
Some people on p-babble (such as Zeugma) have reported that psycho-stimulants such as Ritalin and Dexedrine/Adderall have relieved DP/DP. Zeugma does find that Ritalin aggravates his anxiety though, even though it relieves his DP/DP. Not everyone suffers increased anxiety on stimulants though, a few people even find them anxiolytic, especially Dexedrine.
Kind regards
Ed
Posted by zeugma on November 12, 2005, at 12:56:00
In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » qbsbrown, posted by ed_uk on November 12, 2005, at 12:10:20
> Hi Brian
>
> Some people on p-babble (such as Zeugma) have reported that psycho-stimulants such as Ritalin and Dexedrine/Adderall have relieved DP/DP. Zeugma does find that Ritalin aggravates his anxiety though, even though it relieves his DP/DP. Not everyone suffers increased anxiety on stimulants though, a few people even find them anxiolytic, especially Dexedrine.Hi Ed (and Brian),
Yes, Ritalin definitely relieves DP/DR even as it makes me tremble uncontrollably with anxiety. My DP is definitely a perceptual deficit of some kind. The locus of self-perception is in the temporo-parietal junction and Ritalin stimulates that region, while benzodiazepines, antidepressants, and miscellaneous drugs do nothing there. I know my DP is not produced by anxiety as I experience it on its own, just as I know my anxiety is not caused by depression, as I have experienced anxious states in the absence of depression. But I don't doubt you when you say your DP is anxiety-related. I have to say that the DP is at a lower level when my anxiety is controlled. It is more a feeling of bodily numbing and not being completely 'there' which persists, not the full-fledged feeling of 'nothingness' that severe DP produces.
-z
>
> Kind regards
>
> Ed
Posted by ed_uk on November 12, 2005, at 13:41:20
In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » ed_uk, posted by zeugma on November 12, 2005, at 12:56:00
Hi Z
I'm still wondering whether you'd be better served by Dexedrine than Ritalin!
Kind regards
Ed
Posted by zeugma on November 12, 2005, at 18:23:38
In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » zeugma, posted by ed_uk on November 12, 2005, at 13:41:20
Hi again Ed,
I think DP/DR is somewhere in that vague spectrum of 'negative symptoms' which are common (more or less) to schizophrenia and severe depression, and which are known to be (in the case of schizophrenia) responsive to stimulants but at the cost of exacerbating positive symptoms. I experienced some relief, much more mild than I received from Ritalin, when i increased the Provigil dose to 300 mg. Unfortunately, my insurance will only cover 200 mg, so that experiment has come to an end.
I did feel more social on 300 mg, and also less socially anxious. But that could be because I felt more awake at 6 pm, and less in a stumbling haze. The DP is really a physical feeling of not being there at all, unsettling like a dream from which you're completely absent.
I think my best hope os when Sparlon comes out early next year. It's just Provigil but in higher doses. Hopefully I can get my insurance to cover it.
-z
Posted by ed_uk on November 13, 2005, at 10:38:36
In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » ed_uk, posted by zeugma on November 12, 2005, at 18:23:38
Hi Z
>I think DP/DR is somewhere in that vague spectrum of 'negative symptoms' which are common (more or less) to schizophrenia and severe depression, and which are known to be (in the case of schizophrenia) responsive to stimulants but at the cost of exacerbating positive symptoms.
How did perphenazine affect your DP/DR? Did it make it worse? I wonder what a dopamine agonist would do..... (unfortunately, dopamine agonists sometimes cause 'sleep attacks' - notably ropinirole and pramipexole)
>Unfortunately, my insurance will only cover 200 mg, so that experiment has come to an end.
We have generic modafinil in the UK now, 100mg and 200mg tablets. Do you have the generic in the US yet? It might be a lot cheaper.
>I think my best hope os when Sparlon comes out early next year. It's just Provigil but in higher doses.
What strengths of tablet will Sparlon come as?
Kind regards
Ed
Posted by zeugma on November 13, 2005, at 12:06:25
In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » zeugma, posted by ed_uk on November 13, 2005, at 10:38:36
Hi Ed
>
> >I think DP/DR is somewhere in that vague spectrum of 'negative symptoms' which are common (more or less) to schizophrenia and severe depression, and which are known to be (in the case of schizophrenia) responsive to stimulants but at the cost of exacerbating positive symptoms.
>
> How did perphenazine affect your DP/DR? Did it make it worse? I wonder what a dopamine agonist would do..... (unfortunately, dopamine agonists sometimes cause 'sleep attacks' - notably ropinirole and pramipexole)It's very hard to say how perphenazine affected DP/DR. First, the dose of perphenazine was way too high -mean dose around 32 mg, with 48 mg reached at one point. At these doses it caused incredible fatigue. However, I think perphenazine had an anxiolytic effect that lessened the manifestations. It didm't affect the core symptom of feeling detached from my body. I do remember perphenazine being anxiolytic- until it made me so sleepy that anxiolysis was beside the point. FWIW, I tolerated perphenazine better than molindone, spoken highly of by some here. That's not to say I cared for either. I also required a lot of Cogentin to manage the EPS, which set in immediately. perphenazine did have one favorable property- it was antipanic by lessening sensations of nausea, which tended to trigger panic attacks reliably.(That is why I had panic attacks when taking SSRI's.)
> >Unfortunately, my insurance will only cover 200 mg, so that experiment has come to an end.
>
> We have generic modafinil in the UK now, 100mg and 200mg tablets. Do you have the generic in the US yet? It might be a lot cheaper.
>I don't think modafinil is available in the U.S. as generic yet. From what I have heard Cephalon has it on patent in the U.S. until next year (very convenient since Sparlon is coming out). .
> >I think my best hope os when Sparlon comes out early next year. It's just Provigil but in higher doses.
>
> What strengths of tablet will Sparlon come as?
>It will come at a starting dose of 85 mg, with target doses of 340 and 425 mg. (Can't remember the intermediate dosages offhand.)From my experience, 340 mg would be about right.
BTW, I took 30 mg Ritalin instead of Provigil today. Less DP :-)
-z
> Kind regards
>
> Ed
Posted by qbsbrown on November 13, 2005, at 17:04:26
In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » ed_uk, posted by zeugma on November 13, 2005, at 12:06:25
Well Ed, after further consideration w/ my doc, im going back to ole trusty paxil for me. It has worked great in the past. There goes my sex life. Does welbutrin help counter the sexual side effects? Although it is terrible for people w/ anxiety i hear. Might have to do the viagra thing, sigh, im only 28.
As far as DP/DR is concerned, i am a frequent visitor of dpselfhelp.com, the biggest community around.
There currently is no treatment for the disorder. Some have had sucess w/ ssri + lamictal, and klonopin helps many.
There is currently a big investigation going on right now, and i know from an inside source that the intention of the surveys, is to get permission to try OPIATE ANTAGONISTS (namely naltrexone)in studies.
I know that mine is anxeity based, as are most. Seems that 50 percent got it after a big panic attack, and the other 50 from drugs. So obviously the brain is dissasociating from the extreme stress. It is on self defense 24/7, everything become a threat. For me w/ DR, the environment feels and seems extremely odd. Huge perceptual shifts.
So although it was anxeity based, doesn't mean that my chemistry hasn't changed in other parts of the brain that ssris can't touch.
So tryin to hang in there til there is an effective treatment out.Regards,
Brain
Posted by ed_uk on November 14, 2005, at 12:50:06
In reply to Re: Lexapro: 10mg vs 20mg. Any more beneficial?? » ed_uk, posted by zeugma on November 13, 2005, at 12:06:25
Hi Z :-)
>the dose of perphenazine was way too high
Understatement of the year ;-)
>FWIW, I tolerated perphenazine better than molindone, spoken highly of by some here.
How did you find molindone? Btw, who speaks highly of it? I've never known anyone on babble to take molindone.
What was the lowest dose of perphenazine you ever took? How did you find it?
Kind regards
Ed
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