Posted by JLM on January 1, 2004, at 23:27:26
In reply to Re: Lexapro dose related headaches? » JLM, posted by maximum-doser on January 1, 2004, at 20:38:23
> I take 320 (three-hundred-twenty) milligrams/day of Lexapro. Naturally I worked up to that dosage.
>
> Before that, I was on an equally high dose of Celexa with the only significant problem being erectile dysfunction, although that is major in itself.
>
> My suggestion is to give the Lexapro more time for your body to adjust to it. If you already have, I would still stick with it. I think most patients would agree that an increase from 2.5mg to 5.0mg is not all that significant.
>
> Since you are supposed to increase your dose even further, try taking your dose before bedtime, or with meals, or simply give your system more time to adjust to it.
>
> Something really exciting that 2004 will bring is a new anti-depressant called Cymbalta (duloxetine HCL), manufactured by Lilly. It targets serotonin AND norepinephrine; it is the first dual-reuptake inhibitor, and shows promise for giving patients total remission. Hopefully we will see that in the 1st quarter of 2004.
>
> Bill
> Encino, CA
>
>
> > Hi all,
> >
> > I recently upped my does of Lexapro (slow titration) from 2.5 mgs/day to 5mgs/day. Since being on the 5mg dose, I have noticed that I have a headache almost every day now. Headaches are NOT a common thing for me, in fact I rarely get them, and have NO history of migraine.
> >
> > Has anyone else here ever experienced this with Lexapro, or for that matter Celexa? Eventually I'm supposed to titrate up even higher, but I suspect its the drug that's causing it, and thought maybe some of you possibly had a similiar experience.
> >
> > Thanks!
> >
> >
>
>Umm Bill, did you say 3 HUNDRED 20? If so, what's the rationale for that? I frankly can't see one, because ALL SSRI's have a flat dose response curve, while the adverse effects are dose dependant. Translated into english, past a certain maximum dose, there is no additional drug benefit, and increased side effects.
http://www.preskorn.com/columns/9601.html
"All members of this class of antidepressants have a flat dose-antidepressant response curve. The usually effective minimum dose of each of these drugs produces 70%-80% inhibition of the serotonin uptake pump using the platelet as a surrogate marker for what is happening in the brain. Although these drugs have a flat dose-antidepressant curve, they have an ascending dose-adverse effects curve, meaning that the incidence and severity of adverse effects of these drugs increase with increasing doses even though antidepressant efficacy does not."
Preskorn knows of what he speaks:
http://www.preskorn.com/cv.html
That's his CV, which gives you his professional credentials, quite considerable. Also, he was involved in the clinical trials for ALL the currently marketed SSRI drugs.
In regards to Cymbalta, I have far less enthusiasm. It was a mothballed drug that Eli Lilly shelved as far back as the early 90, due to lack of effectiveness. However, it was VERY effective at ONE thing, treating urinary incontinence, and has been on the market in several European countries for years for that indication, not as an AD. With the failure of r-fluoxetine due to heart problems, Lilly had to pull something out to retain their market share, and that was duloxetine. I for one don't believe Lilly's spin about 'remission'. That claim has allready been made for other drugs, and in the end never proved to be true. There is a reason that Lilly spends more money on marketing and advertising than on research my friend.
Not trying to be negative, just trying to be objective. The claims of 'remission' I believe were from an open label study, in which typically nobody gets placebo. IE, there is no control group. So, you are then subject to investigator bias, and a myriad of other problems.
Happy New Year.
poster:JLM
thread:295248
URL: http://www.dr-bob.org/babble/20031231/msgs/295589.html