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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by Janelle on August 2, 2003, at 14:23:18
My mother is in a DEEP depression, following a major stressor in her life, and her pdoc started her on 10 mg of Lexapro, which I understand is the *usual* dose -- he has since been increasing her dosage and now she's at 30 mg of Lex.
Is 30 mg considered a *high* dose of Lex and has anyone here ever gone to this dosage of Lex? And if so, did it kick in and help?
So far, no change in her depression. I think if nothing happens in the next few weeks at 30 mg of Lex, the pdoc will change her a-d.
Thanks for any info.
Posted by Ame Sans Vie on August 2, 2003, at 16:50:08
In reply to 30 mg of LEXAPRO??, posted by Janelle on August 2, 2003, at 14:23:18
FWIW, I didn't receive much benefit from Lexapro until I reached 40mg/day. I only stayed on it a month at that dosage though, due to sexual dysfunction.
Posted by Janelle on August 2, 2003, at 17:51:33
In reply to Re: 30 mg of LEXAPRO??, posted by Ame Sans Vie on August 2, 2003, at 16:50:08
Thanks for the info. I wonder if the pdoc will push it to the max, which I have heard is 40mg, or try something else. (sadly, I don't think sexual dysfunction is an issue in this case, so she could go to 40 mg Lex before trying another a-d)
Posted by Ame Sans Vie on August 2, 2003, at 18:22:15
In reply to 40 mg of LEXAPRO ... Hmmm! » Ame Sans Vie, posted by Janelle on August 2, 2003, at 17:51:33
Actually, my doctor was willing to go up to 80mg for me, so higher doses must be safe. On the other hand, if she doesn't feel any relief from 40mg, higher doses are likely to not do any good and just cause nausea.
Posted by Janelle on August 2, 2003, at 18:40:26
In reply to Re: 40 mg of LEXAPRO ... Hmmm!, posted by Ame Sans Vie on August 2, 2003, at 18:22:15
Hi,
I had heard that 40 mg is considered a maximum dose of Lexapro, just as 60 mg is considered the max for Celexa (Lex's sister so to speak!).
I guess I heard wrong since you said your doc was willing to push your dose up to 80 mg!
Thanks for mentioning nausea - I didn't know that this can be a side effect from high doses of Lex. I wouldn't want her to start having that on top of the suffering she's already going through which so far 30 mg of Lex does not seem to be helping.
By the way, just curious - about your posting name here - I am guessing you might be from France because I know that "sans vie" means without life in English, but what does the "Ame" mean?! Thanks, just curious.
Posted by Ame Sans Vie on August 2, 2003, at 19:08:19
In reply to 80 mg of LEXAPRO ... wow ... » Ame Sans Vie, posted by Janelle on August 2, 2003, at 18:40:26
Not from France, but you're right--"sans vie" is "without life". "Âme" means "soul"... so essentially, it means "lifeless soul". Uplifting, huh? lol Needless to say, this pseudonym was created before I was put on my current meds, which have completely "cured" me.
Also, regarding the max dose of Lex, it probably is 40mg, officially. In other words, that's probably what the FDA put forth as the maximum *recommended* daily dose. But my psychiatrist had sad she'd had another patient with severe OCD on 80mg and was willing to go at least that high with me. She mentioned that there was more and more nausea as his dose increased, though.
Posted by Janelle on August 3, 2003, at 16:16:43
In reply to Re: 80 mg of LEXAPRO ... wow ..., posted by Ame Sans Vie on August 2, 2003, at 19:08:19
Ah, so you're like me, not from France, but you must have studied French! I like that name "Lifeless Soul" - yeah, it's a downer for a pseudonymn, but unfortunately, many people, me being one of the, can relate to it!
I am SO glad that you are completely "cured" on your current meds - if you don't mind, what are you taking? Med/dose. Thanks!
As for Lex, I think you are right - the max RECOMMENDED dose probably is 40mg but obviously, based on your psychiatrist's experience with that other patient with severe OCD going to 80mg, that dose (which is double the 40!) must be somewhat *safe* but then again, there seems to be a nausea problem if a person takes more than 40mg of Lex a day.
Actually, I'm surprised your pdoc didn't switch the person with major OCD over to Luvox, which is an SSRI known for its effect on OCD! It does not do much for depression, and if that other patient was depressed on top of OCD, this could be why the pdoc just kept increasing the Lex.
In my mother's case, my guess is that at her next pdoc visit, he will either max the Lex out to 40mg for a few weeks, or he will taper her off Lex and onto something else.
Posted by Ame Sans Vie on August 3, 2003, at 17:04:24
In reply to Lexapro dosing ... more re meds... » Ame Sans Vie, posted by Janelle on August 3, 2003, at 16:16:43
> Ah, so you're like me, not from France, but you must have studied French! I like that name "Lifeless Soul" - yeah, it's a downer for a pseudonymn, but unfortunately, many people, me being one of the, can relate to it!
Yeah, unfortunately, I assume many of us here can relate...
Just out of curiosity, how good is your French? I always like finding francophone penpals to correspond and learn with. :-)> I am SO glad that you are completely "cured" on your current meds - if you don't mind, what are you taking? Med/dose. Thanks!
Thank you! I haven't felt this wonderful since I was a youngster (well, okay, I'm 20 years old, so I suppose I'm still a youngster in the eyes of most people, lol). My current meds are 100mg Ultram four times daily (for severe depression and moderate OCD) and 6mg Xanax XR each morning (for social phobia, agoraphobia, panic disorder, and avoidant personality disorder). I also have ADD, and I just discontinued the Desoxyn that I was taking for that... I think I'll ask my doctor to go back on it.
In addition, I take a ton of supplements everyday... see this post for my current regime:
http://www.dr-bob.org/babble/20030728/msgs/247399.html
> As for Lex, I think you are right - the max RECOMMENDED dose probably is 40mg but obviously, based on your psychiatrist's experience with that other patient with severe OCD going to 80mg, that dose (which is double the 40!) must be somewhat *safe* but then again, there seems to be a nausea problem if a person takes more than 40mg of Lex a day.
>
> Actually, I'm surprised your pdoc didn't switch the person with major OCD over to Luvox, which is an SSRI known for its effect on OCD! It does not do much for depression, and if that other patient was depressed on top of OCD, this could be why the pdoc just kept increasing the Lex.Actually, she'd mentioned that she *had* tried him on the convential OCD medications (i.e. Anafranil and Luvox) to no avail.
> In my mother's case, my guess is that at her next pdoc visit, he will either max the Lex out to 40mg for a few weeks, or he will taper her off Lex and onto something else.
Well, I wish her, and you, the best of luck!
Posted by Janelle on August 3, 2003, at 17:26:58
In reply to Re: Lexapro dosing ... more re meds..., posted by Ame Sans Vie on August 3, 2003, at 17:04:24
Hi,
I wish I could say my French is good, but alas it stinks. I used to be basically bilingual with it but that was too many years ago. Now I remember isolated words. I wish I could be a francophone penpal for you to correspond in French and learn with. I'd be willing to try ...?
Ah yes - you still are a youngster in the eyes of most people! I'm older than you, but by NO MEANS *old*!!
I've never heard of Ultram (for severe depression and moderate OCD) -- do you live in Canada or something? What's the brand name for that, or is Ultram the brand name!??!!
I've also never heard of Desoxyn for ADD; I don't have that but I have friends who do and they're not on it. So again, I'm wondering where you live! I'm in the good ol' U S of A!
Thanks for the link to that post - I will check it out, and I bet I will be come VERY ANXIOUS when I see all the SUPPLEMENTS you take since I only take a multi-vitamin. EEEEK!
Ah-ha, so your pdoc DID tried that patient with severe OCD on the convential OCD medications (i.e. Anafranil and Luvox) to no avail. I'm sorry they did not work, and that the high dose of Lex made him nauseus. I think I have read that Prozac (or is it Zoloft or ist it Paxil?!) can help with OCD.
Thanks again for responding. I'm going to click on your link now!
Posted by Ame Sans Vie on August 3, 2003, at 17:37:43
In reply to Continued ... meds ..., posted by Janelle on August 3, 2003, at 17:26:58
> Hi,
>
> I wish I could say my French is good, but alas it stinks. I used to be basically bilingual with it but that was too many years ago. Now I remember isolated words. I wish I could be a francophone penpal for you to correspond in French and learn with. I'd be willing to try ...?Well, no pressure or anything, but my e-mail addy is:
aedigheduirmott at AOL dot com
It's always a good idea to post e-mail addresses like that on these boards to prevent automated spam.
> Ah yes - you still are a youngster in the eyes of most people! I'm older than you, but by NO MEANS *old*!!
>
> I've never heard of Ultram (for severe depression and moderate OCD) -- do you live in Canada or something? What's the brand name for that, or is Ultram the brand name!??!!Ultram is the brand name -- its generic is tramadol. I live in the U.S., Texas to be precise. You most likely haven't heard of it because it's rarely employed in psychiatry. It's an opioid pain-killer with pharmacological effects that make it very similar to a cross between codeine and Effexor.
> I've also never heard of Desoxyn for ADD; I don't have that but I have friends who do and they're not on it. So again, I'm wondering where you live! I'm in the good ol' U S of A!
lol, once again, Desoxyn is not widely prescribed. The reason for this is primarily because of its generic name -- methamphetamine hydrochloride -- and the unfortunate stigma attached to it. Same thing as the meth one might buy on the street, except pharmaceutical grade.
> Thanks for the link to that post - I will check it out, and I bet I will be come VERY ANXIOUS when I see all the SUPPLEMENTS you take since I only take a multi-vitamin. EEEEK!
lol, well a multivitamin can be a big help, but it's also a good idea to at the very least add a full-spectrum B-complex vitamin. B vitamins are extremely important to nervous system health.
> Ah-ha, so your pdoc DID tried that patient with severe OCD on the convential OCD medications (i.e. Anafranil and Luvox) to no avail. I'm sorry they did not work, and that the high dose of Lex made him nauseus. I think I have read that Prozac (or is it Zoloft or ist it Paxil?!) can help with OCD.
Yes, all the the SSRI drugs (i.e. Prozac, Zoloft, Paxil, Luvox, Celexa, Lexapro) can help with OCD, though the dose required is generally higher than that used for depression.
> Thanks again for responding. I'm going to click on your link now!
You're very welcome, and keep posting! :-)
Posted by Janelle on August 3, 2003, at 18:14:38
In reply to Re: Continued ... meds ..., posted by Ame Sans Vie on August 3, 2003, at 17:37:43
Hi!
Thanks so much for posting your e-mail address and I understand how you did it because I've read that it's a good idea to spell it all out on message boards to avoid spam.
I am going to write it down and when I'm at a computer with email access again, I will contact you, probably in broken French! LOL!
I don't have online access at home yet, having recently moved, so I have to go to the library (where there's a 30-minute limit for email) but a good supply of Internet only computers (no email) or my sister's house which is a bit of a distance from where I live!
Wow - that is some long first part of the email address you have! I am guessing some of it might be your last name? Hmmmm ...! (you don't have to answer that on here ... you can do so when I email you!)
Just for the heck of it, I did a quick search on Ultram and realize that it is a US product (American manufacturer!)
Wow - you live one state over from me - I'm in AZ! I'm glad you explained how Ultram is like a cross between codeine and Effexor because all I got from what I read was that it's a strong PAIN KILLER! I wondered how on earth it could help with depression. This is a new one on me.
I know that the anti-seizure meds help with BiPolar/mood cycling, but never heard of a pain killer helping with depression!
I also searched Desoxyn and was shocked that its generic name is methamphetamine hydrochloride precisely because of what you mentioned -- the unfortunate stigma attached to it. However, what I read DID indicate that Desoxyn is used for ADD!
I've heard that it's also a good idea to at the very least add a full-spectrum B-complex vitamin because vitamins are extremely important to nervous system health because they help with stress - when you're under stress, you deplete B vitamins.
Do you have a recommendation of what formulation of B vitamin to get, for example, should I get a bottle of B-100, where there is 100 mg of each B vitamin in the pill? (I would then just add the B vitamin each morning to my am multivitamin and meds - take them all at once; I take so many darn pills, what's one more!)
Thanks!
Posted by Ame Sans Vie on August 3, 2003, at 18:42:19
In reply to Continued ... meds ... vitamins... » Ame Sans Vie, posted by Janelle on August 3, 2003, at 18:14:38
> Hi!
>
> Thanks so much for posting your e-mail address and I understand how you did it because I've read that it's a good idea to spell it all out on message boards to avoid spam.
>
> I am going to write it down and when I'm at a computer with email access again, I will contact you, probably in broken French! LOL!lol!
> I don't have online access at home yet, having recently moved, so I have to go to the library (where there's a 30-minute limit for email) but a good supply of Internet only computers (no email) or my sister's house which is a bit of a distance from where I live!
>
> Wow - that is some long first part of the email address you have! I am guessing some of it might be your last name? Hmmmm ...! (you don't have to answer that on here ... you can do so when I email you!)Actually, Aedighe Duirmott is my pagan name.
> Just for the heck of it, I did a quick search on Ultram and realize that it is a US product (American manufacturer!)
>
> Wow - you live one state over from me - I'm in AZ! I'm glad you explained how Ultram is like a cross between codeine and Effexor because all I got from what I read was that it's a strong PAIN KILLER! I wondered how on earth it could help with depression. This is a new one on me.
>
> I know that the anti-seizure meds help with BiPolar/mood cycling, but never heard of a pain killer helping with depression!Oh, it's actually fairly common these days for painkillers (especially Ultram, methadone, and buprenorphine) to be prescribed for treatment-resistant depression. After all, they tend to cause a sense of well-being, and sometimes outright euphoria. And before the development of the first antidepressants in the 50's, tricyclics and MAOIs, the only antidepressants were painkillers and amphetamines!
> I also searched Desoxyn and was shocked that its generic name is methamphetamine hydrochloride precisely because of what you mentioned -- the unfortunate stigma attached to it. However, what I read DID indicate that Desoxyn is used for ADD!
>
> I've heard that it's also a good idea to at the very least add a full-spectrum B-complex vitamin because vitamins are extremely important to nervous system health because they help with stress - when you're under stress, you deplete B vitamins.
>
> Do you have a recommendation of what formulation of B vitamin to get, for example, should I get a bottle of B-100, where there is 100 mg of each B vitamin in the pill? (I would then just add the B vitamin each morning to my am multivitamin and meds - take them all at once; I take so many darn pills, what's one more!)Definitely don't buy any of the "numbered" B-complexes. Requirements for each B vitamin are totally different, so buying a supplement that contains the same amount of each vitamin is pretty ridiculous... I don't personally even understand why they manufacture those.
My suggestion is that you take a sublingual liquid B-vitamin complex. The pills mostly don't absorb in your system; the sublingual form, held under the tongue for a while and then swallowed, allows the vitamins to be directly absorbed into the bloodstream through the thin lining of the mouth. Walmart sells a good one for seven or eight dollars, if memory serves me correctly. Just take one dropperful two or three times daily.
> Thanks!
No problemo! :-)
Posted by stefl on August 4, 2003, at 21:01:03
In reply to 30 mg of LEXAPRO??, posted by Janelle on August 2, 2003, at 14:23:18
Hi there. Never posted here before, but saw the question & thought I'd share my shock at the high doses of Lexapro that people referred to! I was on 30mg also, and had major mania symptoms, as I am bipolar. But when I consulted other dr's & pharmacists to see if it was due to the lexapro, they all told me that 30mg was far too high a dose for anyone to be on & that they were surprised a pharmacist would even fill that high a dose. One of my dr's even said that anything over 20mg is considered an overdose by the manufacturers themselves. So I guess I would just be cautious as to any side effects that arise.
This is the end of the thread.
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