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Dr. Bob is Robert Hsiung, MD,
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Posted by Phillipa on November 16, 2010, at 10:11:42
In reply to Minimum Dose of Lexapro?, posted by merpmerp on November 16, 2010, at 8:00:53
Differant doses for a year is to me long enough for a trial and you say you have been on different doses. If you and your doc discuss this why hasn't he/she tried a differant med. What meds have you been on. Are you high functioning? Do you need an ad? Are there other problems more psychological that could be causing you to feel depressed? Phillipa
Posted by merpmerp on November 16, 2010, at 12:59:38
In reply to Re: Minimum Dose of Lexapro? » merpmerp, posted by Phillipa on November 16, 2010, at 10:11:42
Hi there, thanks for responding. Well this gets complicated.
I tolerated 10 mg Lex at first for a few months, it was making me tired so we went down to 5 mg.
5 mg worked pretty well for me. No real problems. A little unmotivated, can't necessarily blame the med, though. Again, it worked for several months.
My doc and I both thought maybe I should increase back to 10 mg, even though I felt okay, because I am living alone in the winter for the first time. That's when everything went to pieces and I was getting extreme anxiety/panic attacks (never had them when not on a med), restlessness, indescribable black terror. I stayed on that for 1 month, and it never went away, so we decreased me back to 5 mg.
I have been on 5 mg now for 2 weeks and I feel 90% back to normal, but still a little restless. My question is, I guess, should I give the 5 mg more time to settle in, or is it worth considering at some point lowering the dose further?
I have been on Prozac twice in the past. Once, it was a miracle drug for me. But stopping and restarting it was a nightmare. I have my theories about that being an issue of one generic working for me and one not working. Anyway, we switched me to Lexapro.
Posted by morgan miller on November 16, 2010, at 13:33:45
In reply to Minimum Dose of Lexapro?, posted by merpmerp on November 16, 2010, at 8:00:53
If you search around enough, you will find a good amount of people taking 2.5 mg of Lexapro and liking it. Lexapro is very powerful, 2.5 mg is definitely enough to have a positive impact.
Posted by merpmerp on November 16, 2010, at 13:58:55
In reply to Re: Minimum Dose of Lexapro?, posted by morgan miller on November 16, 2010, at 13:33:45
Thank you morgan miller, I have very occasionally seen online where people are taking 2.5 mg Lex, but I didn't know if that was a long term thing or they were titrating up.
My doc is pretty med-heavy sometimes, she said that 20 mg was the standard dose for Lexapro (I have read on numerous sites and even in medical journals at 10 mg is generally the standard dose) so she tends to try and push me upward. I can't even imagine how wigged out I would feel on 20 mg!
Posted by morgan miller on November 16, 2010, at 14:22:46
In reply to Re: Minimum Dose of Lexapro?, posted by merpmerp on November 16, 2010, at 13:58:55
> Thank you morgan miller, I have very occasionally seen online where people are taking 2.5 mg Lex, but I didn't know if that was a long term thing or they were titrating up.
>
> My doc is pretty med-heavy sometimes, she said that 20 mg was the standard dose for Lexapro (I have read on numerous sites and even in medical journals at 10 mg is generally the standard dose) so she tends to try and push me upward. I can't even imagine how wigged out I would feel on 20 mg!She's just not doing all here research and operating outside the box of conventional psychiatric wisdom. I think 10 mg is plenty high enough for most. I would push using 5 or 2.5 mg and see what she says. It's worth a try if it means less side effects with just as much success.
Posted by merpmerp on November 16, 2010, at 15:04:38
In reply to Re: Minimum Dose of Lexapro?, posted by morgan miller on November 16, 2010, at 14:22:46
Today I met with her and brought in a detailed chronology of all my recent med changes and how they have affected me, so she could see it all on paper. She agreed that I could stay on the 5 mg. (Whew! I thought we'd have to argue about it.)
Our plan is to stay on the 5 mg for a month or so and then re-evaluate. At that time, I may raise to her the idea of going to 2.5 mg, or switching to some low dose of Celexa (since it's less potent, I'd imagine I can have more ability to tweak the dosing). Of course if I'm feeling fine, then I'll just stay on the 5 mg of Lex... I've learned from this experience that if it ain't broke, don't fix it.
Posted by merpmerp on November 18, 2010, at 9:18:23
In reply to Re: Minimum Dose of Lexapro?, posted by merpmerp on November 16, 2010, at 15:04:38
All along, I've been wondering if Lexapro has been messing with my blood sugar. Lately it's been bothering me more than usual. (I feel like I constantly have low blood sugar. Lexapro also does tend to give me mild to moderate diarrhea no matter what I do, which doesn't help things.)
So I will be doing some looking online to see if this is a possible side effect, but if anyone has insight, that would be appreciated.
I will stay on this dosage of 5 mg for a few more weeks, then if I'm still having these blood sugar symptoms, I may ask the doc to decrease it to 2.5 mg and at least give that a try.
Thanks everyone for your answers to me in this thread and others.
Posted by emmanuel98 on November 18, 2010, at 18:54:06
In reply to Re: Minimum Dose of Lexapro?, posted by merpmerp on November 18, 2010, at 9:18:23
Why do you feel you have low blood sugar? If you did, the symptoms are shakiness, hunger, sweating, confusion, inability to speak. Untreated, can lead to coma. Have you seen a doctor or gotten a glucose finger-stick kit?
Posted by merpmerp on November 20, 2010, at 11:03:41
In reply to Re: Minimum Dose of Lexapro?, posted by emmanuel98 on November 18, 2010, at 18:54:06
I was having "crashes" (my term) a few times a day, before meals, when I get shaky and sweaty, my mood feels very low, and I have this roaring empty hunger in my belly that's like nothing I've ever felt when not on meds - a roaring hunger that only huge quantities of food will satiate, and then only for like an hour or so. Also on the higher Lex dose, I was having bad diarrhea a few to several times a day.
I did describe all this to my doc, and she said it sounded like low blood sugar, but she was very surprised. She said she's seen this happen to people on Paxil or Prozac before, but not Lex, because it's supposed to be "cleaner". *shrug* anyway, the symptoms seem to be slowly clearing up now on the lower (5 mg) dose, so it's less of an issue.
Posted by merpmerp on November 20, 2010, at 11:13:04
In reply to Re: Minimum Dose of Lexapro? » emmanuel98, posted by merpmerp on November 20, 2010, at 11:03:41
I am curious, though, if anyone's had similar symptoms on Lex. My doctor's expression of bafflement when I described this to her didn't exactly fill me with confidence! I did think about getting a glucose meter, but read that they are not as accurate for low blood sugar as for high blood sugar. By the way, my diet is moderately healthy, I do exercise semi-regularly (although I'd say I'm about 10 pounds overweight), and there's no history of blood sugar problems in me or my family, except my maternal grandma who was obese and developed Type 2 diabetes late in life. (I'm 25 years old.)
Posted by Phillipa on November 20, 2010, at 18:58:03
In reply to Re: Minimum Dose of Lexapro?, posted by merpmerp on November 20, 2010, at 11:13:04
Seriously I've never heard that the meters are less effective for low blood sugar than high. Where did you learn that if I might ask? Phillipa
Posted by merpmerp on November 20, 2010, at 19:27:06
In reply to Re: Minimum Dose of Lexapro? » merpmerp, posted by Phillipa on November 20, 2010, at 18:58:03
Wikipedia... yeah I know... *blushes*
"Although the apparent value of immediate measurement of blood glucose might seem to be higher for hypoglycemia than hyperglycemia, meters have been less useful. The primary problems are precision and ratio of false positive and negative results. An imprecision of ±15% is less of a problem for high glucose levels than low." (Does not cite any sources though.)
> Seriously I've never heard that the meters are less effective for low blood sugar than high. Where did you learn that if I might ask? Phillipa
Posted by Phillipa on November 20, 2010, at 20:25:24
In reply to Re: Minimum Dose of Lexapro? » Phillipa, posted by merpmerp on November 20, 2010, at 19:27:06
This is strange as was an RN for a long time and we always used them for both? Based insulin on them also? Lexapro? That's what I'm trying low dose also with luvox 50 and low dose benzos and tired and wired at same time and fear? I don't get it? Phillipa and thanks there must be a reason? Something new maybe since I nursed?
Posted by bleauberry on November 20, 2010, at 23:42:07
In reply to Minimum Dose of Lexapro?, posted by merpmerp on November 16, 2010, at 8:00:53
My doctor has had good results with doses as low as one drop per day of liquid lexapro (that is the same as 1/10th of a mg). Common target doses in his office are....whatever works....which ends up being in the 1mg to 5mg frequently. He says most of the side effects and failures come from doses too high. On the flip side, lower doses take longer to work.
The therapeutic dose is not what is stated in a textbook or instruction label. It is whatever dose works the best for an individual.
There was someone else here months ago that did ok with just a couple crumbs of lexapro a day. Someone else might need 60mg.
Whatever works best for you is the right dose.
Posted by merpmerp on November 21, 2010, at 10:19:50
In reply to Re: Minimum Dose of Lexapro?, posted by bleauberry on November 20, 2010, at 23:42:07
Thank you bleauberry. Your doctor has a very commonsense approach and you are blessed to have him. Since I am stablized at the 5 mg/day, having a lower dose take long to work isn't a problem for me. And I have a feeling that for me, I need only a very light touch on serotonin (I say this from past experience with Prozac), so my maintenance dose may be less than 5 mg/day.
Posted by merpmerp on November 21, 2010, at 10:23:47
In reply to Re: Minimum Dose of Lexapro? » merpmerp, posted by Phillipa on November 20, 2010, at 20:25:24
I have a minor in statistics, so I think I understand what the problem with the meters is. I think the issue is that the margin of error on the meter is the same across its whole range of values. Say that it gives you a value of X +/- 20. This is not much an issue if the value is on the high end of the range, but that error (20) is a much larger percentage of a low value than it is of a high value. I don't know if I'm explaining this too well...
Posted by Phillipa on November 21, 2010, at 17:47:49
In reply to Re: Minimum Dose of Lexapro? » Phillipa, posted by merpmerp on November 21, 2010, at 10:23:47
Merpmerp don't worry about horrible at math. If I can't see it it doesn't exist. Just to get through algebra for nursing had to just do and not think if this makes any sense? The important thing is that you be well. Phillipa
Posted by merpmerp on November 21, 2010, at 18:37:58
In reply to Re: Minimum Dose of Lexapro? » merpmerp, posted by Phillipa on November 21, 2010, at 17:47:49
Thank you Philipa :)
> The important thing is that you be well. Phillipa
Posted by Phillipa on November 21, 2010, at 19:56:35
In reply to Re: Minimum Dose of Lexapro?, posted by merpmerp on November 21, 2010, at 18:37:58
Please post follow ups as seems some docs are using lower doses of meds now. Phillipa
Posted by merpmerp on November 27, 2010, at 13:20:53
In reply to Minimum Dose of Lexapro?, posted by merpmerp on November 16, 2010, at 8:00:53
Well I am doing okay in the sense that I'm not depressed, but I feel exhausted and completely unmotivated to do anything at all. Even things that need to be done, are not getting done. My schoolwork (I'm a Ph.D. student) is suffering greatly because I can't focus for more than a few minutes at a time. I think even 5 mg may be too high for me. This is completely unlike me. I meet with my doc in about 10 days. Until then, I will be doing some reading on the efficacy of lower doses of Lexapro and bring my findings to her, as I would like to try 2.5 mg for a while. Will post updates back here occasionally.
Posted by merpmerp on November 27, 2010, at 20:52:16
In reply to Re: Minimum Dose of Lexapro?, posted by merpmerp on November 27, 2010, at 13:20:53
Update, well I feel so crappy today that I think I will email my psychiatrist on Monday. I want this dosage decreased or I want off it to something else. I feel very very bad today and don't know why. The apathy is really, really dragging me down.
Posted by Phillipa on November 27, 2010, at 21:16:22
In reply to Re: Minimum Dose of Lexapro?, posted by merpmerp on November 27, 2010, at 20:52:16
I'm so sorry yes get the pdoc. Phillipa
Posted by merpmerp on November 27, 2010, at 21:48:49
In reply to Re: Minimum Dose of Lexapro? » merpmerp, posted by Phillipa on November 27, 2010, at 21:16:22
I will continue to post updates as events unfold. My symptoms have been EXTREME anhedonia and lack of motivation, but today I had a crying fit and felt very, very dark for no reason. That scared the crap out of me and motivated me to want to contact the pdoc ASAP.
Posted by Phillipa on November 27, 2010, at 22:04:46
In reply to Re: Minimum Dose of Lexapro?, posted by merpmerp on November 27, 2010, at 21:48:49
Definitely. So do you feel the lexapro stopped working for you? Phillipa
Posted by merpmerp on November 28, 2010, at 8:10:40
In reply to Re: Minimum Dose of Lexapro? » merpmerp, posted by Phillipa on November 27, 2010, at 22:04:46
it's hard to say... I really can't tell. My relationship with Lexapro has always been slightly strained, and I guess I'd be more inclined to say it hasn't stopped "working", but after a year of this, my patience with it has run out :) It's always made me really, really tired, a little on edge, and given me some GI symptoms. These issues have not entirely gone away. I want to talk to my doc and try the step of reducing my dose to 2.5 mg before I kick it to the curb entirely, though.
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