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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 949 to 973 of 8406. Go back in thread:
Posted by grace on October 20, 2002, at 12:18:01
In reply to Re: Claritin?, posted by ANXIETY ANN on October 19, 2002, at 17:57:02
Okay, since I've started a mini-thing with this, I figured I'd better pull out the article that my doc gave me when we decided to put me on Claritin to give it a try.
I'm not sure what publication it came from, but the bottom of the page she copied for me says "J Clin Psychiatry 63:6, June 2002", p. 534.
It is from a Russel V. Brubaker, M.D. at Michigan State University in Alto, MI.
It is titled Fluoxetine-Induced Sexual Dysfunction Reversed by Loratadine.Basically, this Dr. had a male patient with major depression who had sexual s/e with fluoxetine at 5mg/day and started taking loratadine, 2.5mg/day for allergic rhinitis. He was on low
dosages because he didn't handle meds well. Whereas he had reported dulling of penile sensation and delayed erection and ejaculation with the loratadine all of the side effects went away and stayed away.So, over the next 9 months, this doc prescribed loratadine for 9 additional patients (5 men & 4 women) with a diagnosis of major depression who were also on fluoxetine and had sexual dysfunction.
The dosage of loratadine varied rom 2.5 to 15 mg depending on patient...most were 10mg/day. Seven of the 9 patients had complete reversal of sexual s/e within 2 days and the other 2 had significant improvement
of the side effects.There's more to this article, but I don't want to type the whole thing right now....
Hope it helps - it's definitely helped me - not completely, but enough to continue to take it!
Posted by bridgette on October 20, 2002, at 12:20:12
In reply to Re: Went from Celaxa to Lexapro, notice irriatbility » CuriousJane, posted by Alan on October 19, 2002, at 22:56:04
Are you saying that it is doubtfull that Lexapro will even work. I hope not because I do want to give it a fair trail. I have been on it for 3 and 1/2 weeks
and have had a few really good days and the rest seem normal (normal for me). I am thinking if it's the same at a month to go to 15 mg. Is a month a fair trail or should one wait for 6 weeks????> I have noticed headaches as well. It started about the same time as the irritability. I am thinking about switching back if this doesn't get better soon!
> ===========================================
> YMMV but - A close relative told me about his experience with switching over to Lex. from Celexa for an anxiety disorder and it esentially went something like this:
>
> ....Been on Celexa since it came onto the market and it has helped me better than anything else I have ever taken (the list is to long to even think about). PDoc recently asked me to consider switching to Lexapro, which is similar to Celexa without the isomer that causes most of the side effects. However, the Lexapro made me extremely anxious so possibly the sleepiness side effect of Celexa was what I needed. I went back on the Celexa feel better but back to the usual sedation problem....
>
> In response, I didn't want to say anything about the whimsical idea that all of the side effects would reside in the (removed) mirror image molecule and all the therapeutic effect would reside in the remaining molecule, but it's not surprising he discovered that on his own.
>
> Doctors will fall for some pretty flimsy lines if delivered with a straight face and a pert attitude. Any biologist could tell them that when mirror-image isomers of molecules exist, it tends to be so that most of the biological activity resides in one isomer and the other is nearly inactive. However, the isolated-isomer version of Prozac never made it to market because it turned out to be dangerous, so the "one isomer active" rule may apply more to naturally occurring substances than it does to synthetic drugs.
>
> Judging from the public statements I've heard, few authorities who are financially independent of Forest Pharmaceuticals expect Lexapro to be systematically better than Celexa for anything except the maker's bottom line. (There could be a few individual exceptions.) Same goes for Nexium compared to Prilosec and all these other analogous "next-generation" pills.
>
> Interesting how the next generation always makes it to market just as the previous one's patent is expiring.
>
> Alan
>
>
>
>
>
Posted by grace on October 20, 2002, at 12:20:25
In reply to Re: Went from Celaxa to Lexapro, notice irriatbility » Alan, posted by CuriousJane on October 20, 2002, at 11:14:56
I'll be interested to hear how those of you with anxiety work out with lexapro. My doc switched me two days ago because I have a lot of tiredness with celexa and she says that it can't really hurt to try the lexapro because it's "supposed" to have less of the unnecessary stuff in it which may be causing some side effects. It's not guaranteed to work at all, but just worth a shot. Since I'm only on day two (so far no probs), I would like to continue to hear how others have faired.
Thanks!
Posted by Alan on October 20, 2002, at 15:41:53
In reply to Question for Alan, posted by bridgette on October 20, 2002, at 12:20:12
> Are you saying that it is doubtfull that Lexapro will even work. I hope not because I do want to give it a fair trail. I have been on it for 3 and 1/2 weeks
> and have had a few really good days and the rest seem normal (normal for me). I am thinking if it's the same at a month to go to 15 mg. Is a month a fair trail or should one wait for 6 weeks????
>
============================================
I'm not a doctor (or a pharmrep) and am not completely sure that your primary diagnosis is anxiety disorder.I have simply observed on bboards and in the research that I've seen, that one either responds best to an AD or bzd (or MAOI in some cases) and the running the gamut of AD's *before* trying any of these other two in monotherapy *on an equal footing* is simply the result of AD's being so commercially driven. The co's own stats re: efficacy bear that out for anxiety disorder - 30 - 50% - marginally better than placebo as to be almost negligible.
BZDs on the other hand hover in the 70 - 80% success rate catagory for the general population.
Why aren't the two offered along side one another in seperate clinical trials - head to head.
The reasons seem obvious to everyone that takes the time to listen.
Also, that the very thing eliminated from celexa to manufacture lexapro is what may have been providing sedating qualities that were helping you (minimally) in the first place.
Docs try so hard to convince a patient to try to fit the medicine when it should be the other way around...the patient is not at fault if the medicine doesn't fit their commercially perceived agenda, that's all. Doctors need to listen to what their patients are telling them rather than going with the supposed latest and greatest that's received the most or persuasave "face time", provided stats and all.
Alan
Posted by jrbecker on October 20, 2002, at 15:48:33
In reply to Re: testosterone was a viable treatment » jrbecker, posted by ant-rock on October 19, 2002, at 16:25:53
i tried both 1% and .5% levels. .5% seemed sufficient for me. it's very easy to use. it comes in small packts (like ketchup condiment packs). You tear it open and rub on your upper extremities (shoulders, arms). It absorbs quickly int the skin. You should apply nightly.
Posted by ZeeZee on October 20, 2002, at 17:06:03
In reply to Re: Question for Alan » bridgette, posted by Alan on October 20, 2002, at 15:41:53
Posted by Milla on October 20, 2002, at 20:02:06
In reply to Re: 2 days? » Milla, posted by pharmrep on October 15, 2002, at 22:38:58
Pharmrep:
For each of my former medications, there was a lengthy period of time that I took them. Some I tried for six months at the least and others were for around a year & a half. At one time I was on prozac for four years and a year on celexa and I wasn't too happy with any of them. Even though my doctor said that the side effects would pass and I was aware that all medications take atleast two weeks to take affect (sometimes even months)I took Lexapro for a couple days until I had enough.
I tired of being a guinea pig and getting nothing out of it but confusion and unhappiness; so I attempted an alternative method and I'm very happy with the results.
I had difficulty with ssri withdrawl at first, but now I'm very stable with the help of my behavioral psychologist and through my part in Cognitive Therapy. There is no medication in my body and I'm actually happier and more balanced than I was on the pills. In 1995 I took my first pill and after all these years on medicine, I am now free from pills and so much better.
Thankyou though for your reply and good advice.
Posted by shakingoscar on October 21, 2002, at 3:12:48
In reply to Went from Celaxa to Lexapro, notice irriatbility, posted by CuriousJane on October 18, 2002, at 20:59:25
after two months of complete agony in trying to switch from 60mg celexa to lexapro, I have finally gone back to celexa.
I hate lexapro!
15mg was too little and 20mg made me feel like I was in continual panic attack mode.
I tried the following doses: 10mg 15mg 20mg 30mg.
The 30mg was a prescribing error on my doctors part.
Posted by yeltom on October 21, 2002, at 18:42:07
In reply to Re: Went from Celaxa to Lexapro, notice irriatbility, posted by shakingoscar on October 21, 2002, at 3:12:48
That doesn't sound promising. I've been on lexapro for 3 and 1/2 weeks and am still having problems. Headaches, nausea, even constipation, irritability, poor sleep/fatigue. I was hopeful that it would go away until I read this. Hard to believe the transition from Celexa to Lexapro would be so rough, considering that Celexa basically contains lexapro. I would like to hear from more who've made the switch. Has anyone had better luck?
> after two months of complete agony in trying to switch from 60mg celexa to lexapro, I have finally gone back to celexa.
>
> I hate lexapro!
>
> 15mg was too little and 20mg made me feel like I was in continual panic attack mode.
>
> I tried the following doses: 10mg 15mg 20mg 30mg.
> The 30mg was a prescribing error on my doctors part.
Posted by emmalie on October 22, 2002, at 1:45:53
In reply to Re: Went from Celaxa to Lexapro, notice irriatbility » shakingoscar, posted by yeltom on October 21, 2002, at 18:42:07
Well, I must admit that I'm not the best person to respond to this question but . . . I was taking Celexa for a month and then switched to Lexapro to see if my side effects (severe head/jaw tension) would diminish. Lexapro was INTENSE for me. Felt like I was leaving my body, felt totally spacey yet more anxious for a few days. I realize that these symptoms can go away and often do. I kind of wanted to ride it out, but then I kept logging on to these types of discussion boards and reading people's comments. The bottom line: I switched back to Celexa and am MUCH happier. Still have the jaw tension but at least I'm HERE and feel like a normal human being. Plus, no one really knows the more long-term effects of lexapro, whether or not it is easy to withdraw from or more difficult (like Paxil).
For now, I must say that I am content to let other people try out the new drug and then comment on their experiences. It was too scary for me.
Posted by shakingoscar on October 22, 2002, at 2:23:25
In reply to Re: Went from Celaxa to Lexapro, notice irriatbility, posted by emmalie on October 22, 2002, at 1:45:53
Well, I am five days into being back on Celexa, and I feel already much better.
I worked out exactly how long I withstood the pain of lexapro. My first prescription was on the 29th July. I switched back last friday - so that is approximately 10 weeks of real pain.
Its cost me a week off work and numerous mini panic attacks at work, which I havent had in TWO YEARS!
I estimate that I was on 30mg for 4 weeks, 10mg for 1 week (depression came back quickly on that dose), 15mg for 2 weeks - again depression continued to stay, and 20mg the rest of the time - but 20mg gave me constant panic attacks.
I WILL NEVER TOUCH LEXAPRO AGAIN.
And no-one can say I havent give it a good long chance to work.
I would say that lexapro has caused me more pain than when I started PAXIL, and that was awful.
Thank god for celexa.
Posted by shakingoscar on October 22, 2002, at 9:23:53
In reply to Re: Went from Celaxa to Lexapro, notice irriatbility, posted by shakingoscar on October 22, 2002, at 2:23:25
For the last year I have been on 60mg of celexa for anxiety disorder, panic attacks, and depression... Before that, I have taken Paxil, Prozac, Dothiepin, Immipramine and Zoloft. I became ill just over 2 years ago.
I was impressed by all the hype about lexapro, so switched... Here is my account of the last 10 weeks (repeated from an ealier message).
---Well, I am five days into being back on Celexa, and I feel already much better.
I worked out exactly how long I withstood the pain of lexapro. My first prescription was on the 29th July. I switched back last friday - so that is approximately 10 weeks of real pain.
Its cost me a week off work and numerous mini panic attacks at work, which I havent had in TWO YEARS!
I estimate that I was on 30mg for 4 weeks (mistake of doctor who overprescribed - this dose made me VERY ILL after 2 weeks and I thought my illness had blown up again), then 10mg for 1 week (depression came back quickly on that dose), 15mg for 2 weeks - again depression continued to stay, and 20mg the rest of the time - but 20mg gave me constant panic attacks.
I WILL NEVER TOUCH LEXAPRO AGAIN.
And no-one can say I havent give it a good long chance to work.
I would say that lexapro has caused me more pain than when I started PAXIL, and that was awful.
Thank god for celexa.
Posted by Phyl on October 22, 2002, at 9:24:48
In reply to Re: Went from Celaxa to Lexapro, notice irriatbility » CuriousJane, posted by Alan on October 19, 2002, at 22:56:04
I have been on Lexapro for three weeks now. I have a very chronic problem with insomnia and lately have had a fear of being in a car in heavy traffic. Was given 10 mg of Lexapro along with 50 mg of Trazodone for sleep. The first night I took the Trazodone, it left me barely able to function and I was taken off of it. I was always so exhausted on 10 mg. of Lexapro that my internist said I could go to 5 mg. I have been on 5 mg from Day 2 and I still find that I am extremely tired from about 6:00 p.m. on. The Lexapro seems to act as a sleeping pill for me. I don't notice any other side effects. I have noticed that I don't feel thirsty anymore, and drink very little water/liquids. I don't know if this is because of the Lexapro...
I function Ok during the daytime (much as I did eveng bein sleep-deprived.) Occasionally, I take Lorezepam when I can't get back to sleep. I am not quite sure if I belong on Lexapro...I have never been diagnosed with depression and other than the car thing, I have no other anxieties. I am a worrier (five children)
Posted by sjb on October 22, 2002, at 10:17:03
In reply to Any older people on Lexapro?, posted by Phyl on October 22, 2002, at 9:24:48
What do you call older??? I'm 42 and on Lexapro only. I don't have daytime drowsiness, if anything, maybe a little anxious, but do sleep more than I used to. I take 10mg, first thing in the morning and started on 9/11. I had some insomnia the first week, but that has faded.
Posted by sjb on October 22, 2002, at 10:20:31
In reply to Re: Went from Celaxa to Lexapro, notice irriatbility, posted by emmalie on October 22, 2002, at 1:45:53
No one really knows the long-term effects of any of the drugs we are taking.
Posted by yeltom on October 22, 2002, at 12:01:16
In reply to Re: Went from Celaxa to Lexapro, notice irriatbility, posted by shakingoscar on October 22, 2002, at 2:23:25
So how come you didn't switch back to Celexa sooner? My problem is that I'm not sure how long is a fair trial. As I said, I've been taking lexapro for almost 4 weeks, and it still aint pleasant. I'd switch back right now, but before doing so, I want to be confident that things aren't likely to suddenly get better in the next few days. Don't want to have gone through all this shit for nothing. But I'm thinking that it's unlikely to improve much. I know that for some ssri's, you need to give it 6 to 8 weeks. But it would seem that it shouldn't take that long with Lexapro, especially considering that I'm switching from Celexa rather than from an unrelated drug or starting from scratch. And with Celexa, I felt good in less than 2 weeks. Clearly, you think you should have switched back to Celexa sooner, but why didn't you? How do you know when enough is enough? Are there any docs or pharm reps out there who might be able to give me some insight?
> Well, I am five days into being back on Celexa, and I feel already much better.
>
> I worked out exactly how long I withstood the pain of lexapro. My first prescription was on the 29th July. I switched back last friday - so that is approximately 10 weeks of real pain.
>
> Its cost me a week off work and numerous mini panic attacks at work, which I havent had in TWO YEARS!
>
> I estimate that I was on 30mg for 4 weeks, 10mg for 1 week (depression came back quickly on that dose), 15mg for 2 weeks - again depression continued to stay, and 20mg the rest of the time - but 20mg gave me constant panic attacks.
>
> I WILL NEVER TOUCH LEXAPRO AGAIN.
>
> And no-one can say I havent give it a good long chance to work.
>
> I would say that lexapro has caused me more pain than when I started PAXIL, and that was awful.
>
> Thank god for celexa.
Posted by CuriousJane on October 22, 2002, at 14:18:08
In reply to Re: Went from Celaxa to Lexapro, notice irriatbili » shakingoscar, posted by yeltom on October 22, 2002, at 12:01:16
I am dealing with the same question...how much is enough. I've only been on it 2 weeks, and my doc doesn't think its long enough, but then he doesn't have to live my life. 30mg of Celexa really seemed to help ease my neck tension, anxiety and depression, but after a week on 10mg Lexapro it all came back. 15mg doesn't seem to be doing it either. Going from Paxil to Celexa was MUCH easier than this.
Posted by Phyl on October 22, 2002, at 16:19:25
In reply to Re: Any older people on Lexapro?, posted by sjb on October 22, 2002, at 10:17:03
I'm 20 years older....62! I find that I am ok all day but very tired at night. And altho I seem to fall asleep easier with the Lexapro, people comment that I "look tired." I don't think it is "good" sleep. I'm not sure if it is suppoed to help me stop worrying (?) or cure me of my being afraid to be in heavy traffic (?). I didn't think it was supposed to be a sleeping pill. Sometimes I feel, too, like chucking it and struggling with the sleep problem, but will give it a couple more weeks.
Posted by SMM on October 22, 2002, at 21:11:07
In reply to Re: Complete Knowledge Not Always Available » dr. dave, posted by IsoM on August 21, 2002, at 13:28:26
Is it possible for a person to experience seizure-like activity after one week of lexapro? i.e muscular convulsions, clammy skin, altered mental status, teeth clenching, biting tongue ( no post- ichtal state or other seizure behaviors)Our 17 year old daughter is experiencing this and the drug is the only recent change in her lifestyle. Please respond ASAP.
Posted by Ritch on October 22, 2002, at 22:26:47
In reply to Re: Complete Knowledge Not Always Available, posted by SMM on October 22, 2002, at 21:11:07
> Is it possible for a person to experience seizure-like activity after one week of lexapro? i.e muscular convulsions, clammy skin, altered mental status, teeth clenching, biting tongue ( no post- ichtal state or other seizure behaviors)Our 17 year old daughter is experiencing this and the drug is the only recent change in her lifestyle. Please respond ASAP.
Seizures can happen with any antidepressant in a susceptible individual. I would take her to the ER now and find out what is going on to be safe. If it isn't a seizure it certainly sounds like serious enough side effects to warrant investigating.
Posted by SMM on October 22, 2002, at 23:37:09
In reply to Re: Complete Knowledge Not Always Available » SMM, posted by Ritch on October 22, 2002, at 22:26:47
Our 17 year old has been to the ER for seizure-like activity, had a CT scan, MRI, bloodwork and there are no answers. As I stated, the Lexapro has been the only recent change in her life (which they instructed us to stop at the ER. Since stopping the Lexapro, the severity of these "fits: seem to have decreased, as well as the duration. She goes to a neurologist tomorrow, but I have a feeling it will again be a negative test. They are telling us it is due to stress and anxiety. It is scaring the hell out of us so any input would be greatly appreciated.
Posted by lmblec on October 23, 2002, at 0:36:46
In reply to Re: Went from Celaxa to Lexapro, notice irriatbility » CuriousJane, posted by Alan on October 19, 2002, at 22:56:04
> > I have noticed headaches as well. It started about the same time as the irritability. I am thinking about switching back if this doesn't get better soon!
> ===========================================
> YMMV but - A close relative told me about his experience with switching over to Lex. from Celexa for an anxiety disorder and it esentially went something like this:
>
> ....Been on Celexa since it came onto the market and it has helped me better than anything else I have ever taken (the list is to long to even think about). PDoc recently asked me to consider switching to Lexapro, which is similar to Celexa without the isomer that causes most of the side effects. However, the Lexapro made me extremely anxious so possibly the sleepiness side effect of Celexa was what I needed. I went back on the Celexa feel better but back to the usual sedation problem....
>
> In response, I didn't want to say anything about the whimsical idea that all of the side effects would reside in the (removed) mirror image molecule and all the therapeutic effect would reside in the remaining molecule, but it's not surprising he discovered that on his own.
>
> Doctors will fall for some pretty flimsy lines if delivered with a straight face and a pert attitude. Any biologist could tell them that when mirror-image isomers of molecules exist, it tends to be so that most of the biological activity resides in one isomer and the other is nearly inactive. However, the isolated-isomer version of Prozac never made it to market because it turned out to be dangerous, so the "one isomer active" rule may apply more to naturally occurring substances than it does to synthetic drugs.
>
> Judging from the public statements I've heard, few authorities who are financially independent of Forest Pharmaceuticals expect Lexapro to be systematically better than Celexa for anything except the maker's bottom line. (There could be a few individual exceptions.) Same goes for Nexium compared to Prilosec and all these other analogous "next-generation" pills.
>
> Interesting how the next generation always makes it to market just as the previous one's patent is expiring.
>
> Alan
>
> i am lexapro three weeks, had to drop it back to 15 mg from twenty because all i do i sleep on it- the 20 mg reduced my anxiety almost to normal- i think i have to get it 30 mg (that ought to be fun)to get at the ocd - maybe be the add prozac at some point. this is going on for a year,drug after drug. paxil was the worst-40 mg could not sleep on it -took medication to sleep an needed two hours to wake up-
THE BEST DRUG FOR ALL THIS IS PROZAC IF YOU CAN GET ON IT- IF I CAN GET BACK ON IT, THIS ANXIETY AND OCD AFTER A YEAR WOULD BE DOWN TO 10MG- EMAIL ME IF YOU WANT AND ILL TELL YOU HOW TO GET ON IT- YOU MUST BE ABLE TO TAKE IMIPRAMINE WITH OUT THE URINE RETENTION PROBLEM-THEN ADD PROZAC AFTER THE ANXIETY IS UNDER CONTROL LMBLEC@AOL.COM>
>
>
Posted by shakingoscar on October 23, 2002, at 2:04:43
In reply to Re: Went from Celaxa to Lexapro, notice irriatbili » shakingoscar, posted by yeltom on October 22, 2002, at 12:01:16
I didnt switch back for one simple reason.
I was pinning all my hopes on this wonder-drug and I didnt want to give it up with out a real trial. That trial actually lasted 10 weeks.
Not even prozac took that long and it is known that prozac takes 1-2 months to level out in your system.
I obviously feel very deflated by all this lexapro hype.
Posted by shakingoscar on October 23, 2002, at 2:06:27
In reply to Re: Went from Celaxa to Lexapro, notice irriatbili » yeltom, posted by CuriousJane on October 22, 2002, at 14:18:08
here here... I agree totally.
Posted by bridgette on October 23, 2002, at 17:36:02
In reply to Re: Went from Celaxa to Lexapro, notice irriatbili, posted by shakingoscar on October 23, 2002, at 2:06:27
I just hit 4 weeks and I think I am feeling less anxious, less angry and less irratible and believe me, I was losing patience, too. Does anyone out there have anything positive to say???? I also have energy and I think feel generally better and calmer.
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