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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Rambler on April 24, 2011, at 3:45:16
Hi
My pdoc has had me cross taper from Lexapro to Remeron in the following way.
- Reduce my Lexapro dose from 20mg to 10mg.
- Stay on 10mg for two days
- Start with 30mg Remeron in conjunction with 10mg of Lexapro for seven days.
- After seven days drop the Lexapro and continue on with the Remeron.I've been off Lexapro for three days now and the withdrawal effects have kicked in hard.
I called my pdoc yesterday and was told to up the Remeron to 45mg due to the state I'm in (major depressive disorder).
The reason I'm feeling terrible is Lexapro withdrawal.
I've read on this forum that a single dose of Prozac (20mg) will alleviate the withdrawal symptoms.
My question is, since I have about a weeks worth of Remeron in my system, am I likely to experience serotonin syndrome from a single dose of Prozac ?
Thanks
Posted by Jerseygal on April 24, 2011, at 9:02:20
In reply to Lexapro withdrawal and starting Remeron, posted by Rambler on April 24, 2011, at 3:45:16
Taking prozac with remeron should not present any problem at all. Many doctors prescribe remeron in combination with an SSRI. I am taking lexapro with remeron and it has not been a problem. Wondering why are you stopping lexapro - did it not work for you?
Posted by Phillipa on April 24, 2011, at 11:16:42
In reply to Re: Lexapro withdrawal and starting Remeron, posted by Jerseygal on April 24, 2011, at 9:02:20
I'm also on low dose lexapro 2.5mg with starting dose of luvox 50mg and benzos. Cutting down on the luvox been on too many years as well as benzos. Hey at what dose did lexapro work for you both as years ago couldn't tolerated the side effects and now feel nothing. Can't figure it out? Thanks Phillipa
Posted by Rambler on April 24, 2011, at 18:13:07
In reply to Re: Lexapro withdrawal and starting Remeron, posted by Jerseygal on April 24, 2011, at 9:02:20
> Taking prozac with remeron should not present any problem at all. Many doctors prescribe remeron in combination with an SSRI. I am taking lexapro with remeron and it has not been a problem. Wondering why are you stopping lexapro - did it not work for you?
Lexapro (20mg) worked great for a few years and then pooped out in me early this year.
I thought I'd keep going with it but the depression and anxiety got so bad recently that my pdoc decided to move me to Remeron. Thinking about it now I should have moved to another med earlier as I've been suffering for months now.
I've only been on Remeron for just over a week so it hasn't kicked in and I've been off Lexapro for a few days which has been enough for withdrawal symptoms to start.
Posted by Rambler on April 24, 2011, at 18:22:17
In reply to Re: Lexapro withdrawal and starting Remeron, posted by Phillipa on April 24, 2011, at 11:16:42
> I'm also on low dose lexapro 2.5mg with starting dose of luvox 50mg and benzos. Cutting down on the luvox been on too many years as well as benzos. Hey at what dose did lexapro work for you both as years ago couldn't tolerated the side effects and now feel nothing. Can't figure it out? Thanks Phillipa
I found that I had to take 20mg for Lexapro to help with both major depressive disorder and severe anxiety. At one stage during my poop out my pdoc put me up to 30mg but that didn't help either. People taking 40mg is also heard of.
I would check with your pdoc but 2.5mg might not be enough. From my readings over the years, most people need at least 10mg to lift depression and 15 or 20mg for the anxiety busting effects of the medication to start working.
I've had sweating and weight gain as my main side effects of Lexapro but have put up with them as Lexapro worked great in the past and allowed me to live my life.
Posted by Jerseygal on April 24, 2011, at 20:11:37
In reply to Re: Lexapro withdrawal and starting Remeron, posted by Rambler on April 24, 2011, at 18:22:17
I was on prozac for a long time, about 8 years, before it pooped out on me. I started taking lexapro at the end of January. The doc started me at 10 mg. and has been upping the dose to the point where I'm now at 40 mg, as lower doses were not working. I really don't have much faith that it's going to work for me at this point - I'll give it a few more weeks before I ask my doc to try another SSRI. I guess lexapro just isn't the SSRI for me. I've been lucky though in that I really haven't had any side effects from it.
Posted by Rambler on April 24, 2011, at 20:27:10
In reply to Re: Lexapro withdrawal and starting Remeron, posted by Jerseygal on April 24, 2011, at 20:11:37
> I was on prozac for a long time, about 8 years, before it pooped out on me. I started taking lexapro at the end of January. The doc started me at 10 mg. and has been upping the dose to the point where I'm now at 40 mg, as lower doses were not working. I really don't have much faith that it's going to work for me at this point - I'll give it a few more weeks before I ask my doc to try another SSRI. I guess lexapro just isn't the SSRI for me. I've been lucky though in that I really haven't had any side effects from it.
I went to 30mg and it didnt help. Lexapro just wasnt working anymore for me.
I think that if 40mg isnt working then its time for a switch.
I guess I dont know your symptoms and there are ssri's that work for anxiety, panic, ocd etc in addition to depression. its just a matter of talking with your pdoc and choosing the right one and hoping it will work.
If anxiety is your main problem be careful of more activating ssri's which will cause issues with anxiety. For me Prozac and Wellbutrin are no no's as theyre activating and will cause havoc with my anxiety.
lexapro is one that works well for depression and anxiety. My symptoms are a mix of anxiety/panic and depression when the anxiety gets over bearable. Unfortunately after 5 years it pooped out.
When I saw my pdoc I suggested Luvox or Zoloft for my anxiety but she suggested Remeron for its anxiety busting properties.
Posted by Jerseygal on April 25, 2011, at 16:25:13
In reply to Re: Lexapro withdrawal and starting Remeron » Jerseygal, posted by Rambler on April 24, 2011, at 20:27:10
I also have anxiety issues which then leads to obsessive thinking and feeling depressed about how I feel. It's interesting that, even though anxiety is an issue with me, prozac was the first SSRI I ever took and it was great. When I first started treatment with it, it did cause more anxiety but eventually my body got used to it and I was fine. It was great for me for 8 years - it controlled my anxiety and obsessive thinking to the point where I felt "normal"(even got me through some tough times in my life). Wellbutrin was also a no-no for me. I tried it for a short time and that was enough for me. Anyway, I'm thinking about asking my pdoc about Zoloft as my next option.
Posted by Rambler on April 25, 2011, at 20:55:57
In reply to Re: Lexapro withdrawal and starting Remeron, posted by Jerseygal on April 25, 2011, at 16:25:13
> I also have anxiety issues which then leads to obsessive thinking and feeling depressed about how I feel. It's interesting that, even though anxiety is an issue with me, prozac was the first SSRI I ever took and it was great. When I first started treatment with it, it did cause more anxiety but eventually my body got used to it and I was fine. It was great for me for 8 years - it controlled my anxiety and obsessive thinking to the point where I felt "normal"(even got me through some tough times in my life). Wellbutrin was also a no-no for me. I tried it for a short time and that was enough for me. Anyway, I'm thinking about asking my pdoc about Zoloft as my next option.
It sounds like you have the same problems as me.
I've been diagnosed with severe anxiety and obsessiveness, but not OCD.
I tend to get anxious and obsess over the same issues over and over again until I wear myself down into a depression.
My earlier diagnosis was major depression disorder and it wasn't until I went to a university run research facility here in Aus that they actually diagnosed my anxiety disorder.
Pdocs here in Aus are very reluctant to prescribe benzo's so I've been on a few anti psychotics to try and control my anxiety and obsessive thinking and finally my pdoc has added Valium into the mix.
From my readings Luvox and Zoloft are good for anxiety. I suggested these but my pdoc said although Remeron and Paxil get a bad rap these days they are actually very good for anxiety, obsessiveness and depression.
I've only been on Remeron for 12 days now and haven't had the increased appetite that most complain about. That's most likely to a loss of appetite and nausea due to lexapro withdrawal.
I've come off 10mg of lexapro and it's been four days and feel really bad. Im taking benadryl and Valium every 4 hours and took one dose of Prozac to try and relieve the withdrawal symptoms. It's helping to some extent but I still feel rotten.
Today's the first day I've been out of the house so I'm going to buy some omega 3 fish oil and b complex vitamins and see if that helps. I've got to go to work tomorrow so I need all the help I can get.
Posted by Jerseygal on April 26, 2011, at 15:11:54
In reply to Re: Lexapro withdrawal and starting Remeron, posted by Rambler on April 25, 2011, at 20:55:57
Sorry to hear about the difficulty you're having coming off of lexapro. I wonder if I'll have to face that also if I have to switch from lexapro to another SSRI. It really is terrible what we have to go through with all of this. Not only do we have a psychiatric disorder but then we're faced with awful withdrawal symptoms when we try to come off a medication. You'd think that medical science would be able to come up with better alternatives.
I'm taking remeron in addition to lexapro and I did not have any increased appetite from it so it affects everyone differently. I did gain 10 lbs. though. I think it somehow slows down your metabolism or something. But I haven't gained any more weight, luckily, and it's been five months. I'm wondering if my pdoc should've tried remeron by itself for me. He mostly gave it to me for sleep along with the lexapro. Something to think about.
I hope the remeron kicks in and you feel better soon. I'll be thinking about you.
Posted by Rambler on April 26, 2011, at 15:56:50
In reply to Re: Lexapro withdrawal and starting Remeron, posted by Jerseygal on April 26, 2011, at 15:11:54
> Sorry to hear about the difficulty you're having coming off of lexapro. I wonder if I'll have to face that also if I have to switch from lexapro to another SSRI. It really is terrible what we have to go through with all of this. Not only do we have a psychiatric disorder but then we're faced with awful withdrawal symptoms when we try to come off a medication. You'd think that medical science would be able to come up with better alternatives.
>
> I'm taking remeron in addition to lexapro and I did not have any increased appetite from it so it affects everyone differently. I did gain 10 lbs. though. I think it somehow slows down your metabolism or something. But I haven't gained any more weight, luckily, and it's been five months. I'm wondering if my pdoc should've tried remeron by itself for me. He mostly gave it to me for sleep along with the lexapro. Something to think about.
>
> I hope the remeron kicks in and you feel better soon. I'll be thinking about you.I don't think you'll have any issues from going from one ssri to another. I tried many different ones and never had a problem until I had to come of them completely or switch to a different class.
The reason I'm having problems now is that I've switched from lexapro which is a ssri to Remeron which is a tetracyclic. I also had problems switching from effexor in the past to a maoi.
Lexapro in the past was ok with weight but as it started to poop out I began to get depressed and not do anything. Coupled with comfort eating I put on a lot of weight.
Maybe it's a bit early but I haven't had the increased hunger that most people have when they start with Remeron. As I mentioned before it's probably being depressed and anxious that has affected my appetite.
It's Wednesday morning here in Aus and I've got to face the day after having a week off. My job is the main cause of my anxiety and depression at the moment as I work in a government setting in an office full of nasty people and a horrible boss.
I'll be doing my best and thanks for the support.
This is the end of the thread.
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