Posted by dr dave on October 10, 2002, at 14:43:23
In reply to Re: Lexapro and Celexa relative side-effects » dr dave, posted by johnj on October 10, 2002, at 13:22:02
There are some guidelines at
http://www.nhslothian.scot.nhs.uk/lothianformulary/appendices/append5.htm#
They are adapted from the Maudsley Prescribing Guidelines, which are my favourite reference. The advice here is, if swapping from tricyclic to citalopram, to halve the dose of tricyclic and introduce citalopram, before gradually withdrawing the tricyclic. This seems sensible to me, but ASK YOUR DOCTOR FIRST! I would continue with this process even if you feel rough and get side-effects, because in a few weeks the side-effects may go and the antidepressant effect kick in.
The higher dose you start on the greater risk of side-effects but the greater probability of an effect. The usual starting dose of Lexapro is 10mg, so I would start on that unless you have a history of being particlarly susceptible to side-effects. Then you could start on five for a week or two and go up to ten.
Best of luck.
> Thanks Dr. Dave, I appreciate your time and opinion. I do have a few questions in general about AD's. When a person is switching how does one go about doing this? Is there a chart some where that describes how to switch from one class to the another. For ex, I take pamelor and for various reasons need a change. It has not been confirmed and frankly I don't know how it could be, but I have serious s/e after excercise on the TCA.
> I have been given some lexapro samples and will not start for another few weeks due to an exam. Is is generally accepted to take the new AD and see if the reaction/remission occurs before reducing the current AD? Or do you titrate down while you titrate up on the new? Lastly, does it matter if one starts at 2.5 mgs, 5 mg or 10 mgs of lexapro, or any other AD for that matter? Could there be higher/harsher s/e at a lower dose?(kind of like you get with remeron). Thanks for any input. I will see my doc again before starting, but I wanted to get another opinion from someone in the field that has seen and has directly worked with such examples. Thank you
> johnj
poster:dr dave
thread:109458
URL: http://www.dr-bob.org/babble/20021006/msgs/123089.html