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Dr. Bob is Robert Hsiung, MD,
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Posted by ed_uk2010 on February 26, 2012, at 6:35:52
In reply to Ed_uk2010 - are you there?, posted by Maisey on February 25, 2012, at 18:49:54
Hi,
>I opted to buy generic Lexapro from an online pharmacy site - Cipralex 20 (made in India).
Cipralex isn't a generic, it's the brand name for escitalopram in many countries. The problem with buying online from that type of site is that it's very difficult to know whether the medicine is genuine or counterfeit. Some websites sell very sophisticated counterfeits which can make it difficult to tell. I'm not saying that your medicine is a counterfeit, just that it's a possibility. I really can't say.
>I'm just wonder if it's possible that, even though I've been on Lexapro before, I can get a different reaction when re-starting.
Yes, it's possible. We often hear people report that.
>I feel hazy, very like when I took citalopram.
This can happen when starting citalopram or escitalopram, to be fair.
Hope you're OK until you see your doc.
Posted by Maisey on February 26, 2012, at 11:37:31
In reply to Re: Ed_uk2010 - are you there? » Maisey, posted by ed_uk2010 on February 26, 2012, at 6:35:52
>
> Cipralex isn't a generic, it's the brand name for escitalopram in many countries. The problem with buying online from that type of site is that it's very difficult to know whether the medicine is genuine or counterfeit. Some websites sell very sophisticated counterfeits which can make it difficult to tell. I'm not saying that your medicine is a counterfeit, just that it's a possibility. I really can't say.
>I also read that in generics in the U.S., the generic formulation can have up to 20% variance to the original's formulation. And, in tests of some drugs, 30% variance was found! So, that worries me a little bit - not knowing India's standards.
>
> This can happen when starting citalopram or escitalopram, to be fair.
>
I didn't feel this way, I don't think, when I began Lexapro before - maybe a little bit. I started out on 10mg at that time, too, which is 2x what I've been taking.> Hope you're OK until you see your doc.
>
>
I think I'll be ok going off this cold turkey since it's only a 5mg dose. I def don't feel like taking it again! Yesterday evening, I was very weepy and upset over things in the past. I *can* get that way, but usually not that bad. I got strange brain twitches toward evening, and felt almost jerky. I've heard of people getting that way going off an AD, but never experienced it myself.Thanks for your response - I do feel better today.
Posted by ed_uk2010 on February 27, 2012, at 1:25:15
In reply to Re: Ed_uk2010 - are you there? » ed_uk2010, posted by Maisey on February 26, 2012, at 11:37:31
>I also read that in generics in the U.S., the generic formulation can have up to 20% variance to the original's formulation. And, in tests of some drugs, 30% variance was found! So, that worries me a little bit - not knowing India's standards.
India has a substantial pharmaceutical industry. A lot of generics and branded medicines are made (for the rest of the world) in India. The problem isn't where your medication was made, it's the issue of whether it's actually a genuine product. Some medicines sold over the internet are fakes.
Assuming your medicine is genuine, Cipralex is not a generic. Cipralex is the brand name used by the manufacturer, Lundbeck, in many countries, including the UK.
US generics do not differ from the brand by 20% in terms of formulation. The quantity of drug contained in the tablets is exactly the same as the brand. The 20% figure is part of a statistical bio-availability calculation, and is often misquoted.
>I think I'll be OK going off this cold turkey since it's only a 5mg dose.
I think you'll be OK to just stop. To be honest, I think you would feel much safer taking something from your doctor. You could try generic sertraline (Zoloft), starting at a low dose initially. Sometimes people get worse before they get better, but it's generally a useful medicine. Alternatively, you could ask your doctor about taking a higher dose of amitriptyline, since you are already used to this medication.
Posted by Maisey on February 28, 2012, at 17:04:43
In reply to Re: Ed_uk2010 - are you there? » Maisey, posted by ed_uk2010 on February 27, 2012, at 1:25:15
But, could the variance from generic to original matter in terms of side effects? With metformin, for example, I had terrible emotional side effects. I was told to try the brand name, Glucophage, because some people had better luck with it. They even said try met from a different manufacturer because a lot of people who took metformin from Teva had problems with it when they'd never had probs from metformin before. I never tried the brand name metformin b/c I reacted so badly to met, I doubted it would make a difference. But, I wonder if it WOULD make a difference in a medication like an anti-depressant?
When I took Zoloft before, I didn't have any issues, but I don't want to take something that will make me feel worse before I feel better -something that has a reputation of doing that. I'm hesitant to get back on an anti-d now because I really felt unstable on Cipralex, and if I'd felt any more unstable, I probably would have put myself and other people in danger. It is common for me to have passing suicidal feelings and visions, on a normal day, and if I'm going through a bad spell, the feelings are much more frequent and much more real. The difference is, normally when something goes wrong and I have the vision, I'm able to logically think thorugh it and get it out of my mind. If I'm going through a "bad spell," or less commonly, when I take a medication that doesn't agree with me (metformin and birth control pills were ones), I get an inclination to commit this act. I obviously haven't done it or I'd be dead, but the feelings are quite strong. I feel if the right provocation came along when I already felt badly, I would do it. It used to be drowning that I'd think about. Now, it is ramming my car into a semi. I logically thought it through and at some point decided this would be an easier, quicker way, but there is more alarm b/c it possibly puts other people at risk. That is why it's important to me to have the "right" medication - it's why I was so intent on getting Lexapro. It did so well for me before. Now, the problem is I don't know if Cipralex was an exact Lexapro equivalent and I no longer agree with the medicine OR did I get some phony drug and Lexapro prescribed by my doctor is still the best solution? OR, it could be I was going through a bad spell anyway, and the drug had no effect. Lexapro, in the past, though, did seem to help me work out of the bad spells faster. I tend to have the bad spells at the end of my cycle, though I mentally note when they arrive, and I don't see a definite trend.
Anyway, I've been having a pretty stable last couple of days, so I'm taking this time to think about what I want to do.
Posted by Maisey on February 28, 2012, at 19:18:11
In reply to Re: Ed_uk2010 - are you there? » Maisey, posted by ed_uk2010 on February 27, 2012, at 1:25:15
Have you heard anything about elavil working for OCD? I know it's not approved for it. From what I've read, it doesn't sound like it would help (my skin and hair picking issues) - it hasn't at this dose. I like the idea of using elavil for an AD rather than sleep aid, but I actually cut its dose down even more just before adding the Cipralex on. I've still kept it at that dose - I may go back to 25mg. I'm not sure I could function at a higher dose than that, even if I split up the dose b/w day and night.
Posted by ed_uk2010 on February 29, 2012, at 13:36:01
In reply to Re: Ed_uk2010 - are you there? » ed_uk2010, posted by Maisey on February 28, 2012, at 17:04:43
>But, could the variance from generic to original matter in terms of side effects?
It's not likely, but Cipralex is not a generic anyway. Cipralex is the original brand from Lundbeck. The product is sold directly by Lundbeck in most countries. In the US, Lexapro is sold by Forest laboratories under license from Lundbeck.
>When I took Zoloft before, I didn't have any issues, but I don't want to take something that will make me feel worse before I feel better -something that has a reputation of doing that.
All anti-depressants can do that, it is not specific to Zoloft. It can happen with Lexapro/Cipralex and others.
There's no easy way of knowing whether the medication you bought online was real or counterfeit. It's best to get something from your doctor.
Posted by ed_uk2010 on February 29, 2012, at 13:38:59
In reply to Also..... » ed_uk2010, posted by Maisey on February 28, 2012, at 19:18:11
>Have you heard anything about elavil working for OCD?
Amitriptyline is not very effective for OCD.... but you don't have OCD. Trichotillomania is possibly related to OCD but no medication is established as being effective. It's mainly treated psychologically.
Posted by Maisey on February 29, 2012, at 14:43:22
In reply to Re: Also....., posted by ed_uk2010 on February 29, 2012, at 13:38:59
Dermotillmania and trichotillmania are related to OCD and SSRI's (as well as Anafranil) offer at least some support for the disorders. Habit reversal training and Cognitive behavioral therapy do, too, but I doubt that standard CBT would help, and that is the only therapy I have access to. I would not go to it for something like this alone, and probably will never try it again for my depression as it's not something I'm comfortable with at all.
Posted by Maisey on February 29, 2012, at 14:54:06
In reply to Re: Ed_uk2010 - are you there? » Maisey, posted by ed_uk2010 on February 29, 2012, at 13:36:01
I feel that the medicine I got could be a generic posed as Cipralex. I don't know how likely that is, but it seems to me something that could happen, since, at least in the U.S., generics are soooo much cheaper than the original. I would think generics would be easy for the company to obtain, and very cheap to re-sell.
I'm still not sure what to do. I dread calling my doctor's office. I hesitate to fully leave it up to them (which is my only choice if I call them) and end up with something else. I'm thinking of going w/a higher dose of elavil or else trying citralopram (I still have it in the cupboard) at a 5mg dose during the day (since it interfered with my sleep). I even may not give up on Cipralex - it does seem pretty unlikely it's an illegitimate medicine (not Cipralex in general, but what I received)...
Posted by ed_uk2010 on February 29, 2012, at 16:45:14
In reply to Re: Ed_uk2010 - are you there? » ed_uk2010, posted by Maisey on February 29, 2012, at 14:54:06
> I feel that the medicine I got could be a generic posed as Cipralex. I don't know how likely that is, but it seems to me something that could happen, since, at least in the U.S., generics are soooo much cheaper than the original. I would think generics would be easy for the company to obtain, and very cheap to re-sell.
The problem is, because you can't guarantee exactly what it is, it's going to be a cause of anxiety if you continue to take it.
Posted by ed_uk2010 on February 29, 2012, at 16:53:45
In reply to Re: Also..... » ed_uk2010, posted by Maisey on February 29, 2012, at 14:43:22
> Dermotillmania and trichotillmania are related to OCD and SSRI's (as well as Anafranil) offer at least some support for the disorders.
Possibly yes, but the relationship between trichotillomania and obsessive-compulsive disorder is not entirely clear. SSRIs have been tried in trichotillomania but results are mixed. OCD seems to lead to greater disability but response to SSRIs is more reliable and sustained.
Amitriptyline is a well established antidepressant so it could still help you. Do you think you would be able to take a higher dose without unpleasant side effects?
Posted by ed_uk2010 on March 2, 2012, at 1:29:12
In reply to Re: Also....., posted by ed_uk2010 on February 29, 2012, at 16:53:45
Apparently, Mylan pharma, a major generics firm, have just launched the first generic escitalopram (Lexapro) in the US. Perhaps escitalopram will now be more affordable for you.
Posted by Phillipa on March 2, 2012, at 18:52:24
In reply to Re: Also....., posted by ed_uk2010 on March 2, 2012, at 1:29:12
Really? No wonder insurance premium for namebrand went up at first of year. PJx
Posted by ed_uk2010 on March 3, 2012, at 15:02:41
In reply to Re: Also..... » ed_uk2010, posted by Phillipa on March 2, 2012, at 18:52:24
> Really? No wonder insurance premium for namebrand went up at first of year. PJx
The Mylan generic escitalopram has only just been launched PJ, it wasn't available at the beginning of the year.
Posted by Phillipa on March 3, 2012, at 20:40:31
In reply to Re: Also..... » Phillipa, posted by ed_uk2010 on March 3, 2012, at 15:02:41
Ed I'm betting they knew it would soon be available in generic PJx
Posted by Maisey on March 4, 2012, at 16:48:25
In reply to Re: Also....., posted by ed_uk2010 on March 2, 2012, at 1:29:12
Thanks for the info. I don't think now that I want to go with SSRIs at all. I tried Cipralex for a couple of days again, and just not happy with it how it made me feel. I did seem to do better on Lexapro than not, in the past, but it's hard to compare now to then. When I went off it and when I went downhill, I was taking meds on and off for PCOS so the shifts in hormones I think probably accounted more for feeling badly than the absence of Lexapro. Even when I was on 5mg of Lexapro (I took 5mg for several months prior to going off totally.), I had headaches and sexual side effects. I just don't like how I feel on SSRIs. I'd like to be on something simpler like Valerian or Buspar. My doctor brought up Buspar awhile ago, but I didn't want it, and he dropped it.
I've been taking Valerian the past couple of days. It seems to help with anxiety, and not affect my sleep if I take it early in the day. I'm trying to find out if it is a dopamine agonist as herbal "anti-depressants" like vitex tend to be. Progesterone affects dopamine, too. It definitely makes my picking behaviors increase - there is a link b/w dopamine and dermo/trich. I don't think valerian is, but I've read conflicting info. My big thing with SSRIs is sleep. I used to take Lexapro sometimes in the evening or early afternoon, and it never affected my sleep at all. With both Cipralex and Citalopram, unless I take it early in the day, I have palpitations and jerkiness when I'm trying to sleep. So maybe that is something I've developed with SSRIs. Most of the time, I took Lexapro in the morning but I'm sure there were times I took it at night and didn't have probs. But, like you said, one can have a different reaction when going on a drug again.
I just wish there was an anti-d that works temporarialy. I keep going back to that idea. I feel OK when I'm not in the moodswings, though I do have some anxiety almost all the time. That is why I thought Buspar or Valerian may be good, though for depression, they have to be taken long-term, and Buspar isn't approved for depression. I'd like to up my raspberry leaf tea which helps with hormones. Some women even say it helps regulate their cycles. I'm still not sure that what I have is depression/bipolar at all. Though, I never knew that with bipolar, there is a spectrum. I don't really feel that I'm full blown bipolar at any rate.
Posted by ed_uk2010 on March 5, 2012, at 16:19:54
In reply to Valerian » ed_uk2010, posted by Maisey on March 4, 2012, at 16:48:25
Valerian is supposed to be helpful for sleep - that's its most common use.
Posted by Maisey on March 5, 2012, at 17:40:57
In reply to Re: Valerian » Maisey, posted by ed_uk2010 on March 5, 2012, at 16:19:54
I've tried it as a sleep aid before, but it seemed to not help - it made my sleep worse tho I went off elavil cold turkey when trying it (I thought valerian would be a good sleep aid + help more with daily anxiety). Now, I've noticed I haven't slept well the past couple of nights and had terrible dreams, and I wonder if that has something to do with it. I take it in the afternoon. You're not supposed to mix it with elavil as it can be too much sedation. I may try taking it earlier in the day if I continue to have sleep issues. Thanks.
Posted by ed_uk2010 on March 6, 2012, at 14:25:10
In reply to Re: Valerian » ed_uk2010, posted by Maisey on March 5, 2012, at 17:40:57
>I've tried it as a sleep aid before, but it seemed to not help - it made my sleep worse tho I went off elavil cold turkey when trying it (I thought valerian would be a good sleep aid + help more with daily anxiety).
Perhaps you slept worse because you stopped amitriptyline, not becasuse you took valerian?
Posted by former poster on March 6, 2012, at 18:45:45
In reply to Re: Valerian » Maisey, posted by ed_uk2010 on March 6, 2012, at 14:25:10
I'm rather fond of Valerian. I find when it works for sleep, it works good!
Here is an interesting tidbit found in Wikipedia:
(valproic acidan analogue of one of valerian's constituents, valeric acidis used as an anticonvulsant and mood-stabilizing drug). Valerian root generally does not lose effectiveness over time.
One study found valerian tends to sedate the agitated person and stimulate the fatigued person, bringing about a balancing effect on the system.)
Posted by Maisey on March 7, 2012, at 14:32:17
In reply to Re: Valerian » Maisey, posted by ed_uk2010 on March 6, 2012, at 14:25:10
Posted by Maisey on March 7, 2012, at 14:34:35
In reply to Re: Valerian » Maisey, posted by ed_uk2010 on March 6, 2012, at 14:25:10
I clicked the wrong stupid box again. Anyway, I do find valerian def keeps me up and gives me nightmares when I DO sleep - thus I'm only taking it early in the day on days when I think I need it. So I prolly won't get anti-depressant properties from it. It seems to work for anxiety tho.
Posted by former poster on March 7, 2012, at 18:26:43
In reply to Re: Valerian » ed_uk2010, posted by Maisey on March 7, 2012, at 14:34:35
Nightmares..? I seem to recall getting those after taking Valerian too! I wonder if it might cause a bit of depression? How long do you think Valerian's effect lasts? If you take it early in the day has it worn off by bed time?
Posted by Maisey on March 8, 2012, at 16:54:52
In reply to Re: Valerian » Maisey, posted by former poster on March 7, 2012, at 18:26:43
I'm not sure. I took it yesterday, after dinner, and did not notice anything so maybe it was a coincidence the other times I had issues or an adjustment thing, tho like I said, I haven't been taking it every day - just in the past several days on and off when I'm anxious.
Posted by Balanced Concepts on January 20, 2013, at 18:12:57
In reply to Re: Thyroid levels and Serotonin, posted by bulldog2 on September 29, 2008, at 18:39:04
Hello, as a Nutritional Therapist, FDN practitioner, Metabolic Typing Advisor, Herbalist and Specialized Kinesiologist, I am happy with the information in this post. One thing to take note is that over 80% of the Serotonin receptor sites are in the gut. That means that improving gut function is optimal for healthy metabolism. Antibiotics, food sensitivities, chemicals, poor liver detoxification and emotional stress can all cause inflammation in the gut. This can lead to Leaky Gut Syndrome, which then leads to a variety of other symptoms.
Trish
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