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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by h on August 3, 2004, at 17:15:56
I started Lexapro in early June and I was the happiest camper going. 10 mg a day. No more Sunday blues or Monday morning misery, no more dysthymia, much, much less anxiety.
However I'm beginning to think that the reason I was doing so well was because I am (was) also on 800 mg of cimetidine a day as a cancer preventative. (I've had breast cancer 3x)
However a standard blood check up at my oncologists' showed that my kidneys are in danger from the combined Lexapro and cimetidine
SIDENOTE: She (my oncologist) sent me to a wonderful alternative care doctor who put me on the cimetidine and other meds to help prevent a recurrence. My primary care doc, was the one who put me on Lexapro. Three different docs here. So she's kind of the ring master and doing a darn good job too.ANyway, my oncologist looked up the effects of the cimetidine with the lexapro and said it's too much for your kidneys. Essentially I had to pick one to go off of.
I picked to go off the cimetidine. This is depressing enough. I don't mean to feel sorry for myself but it's like I have to pick cancer prevention or depression prevention and I can't have both.
But here's the worst part. (And where I could use some science help) Was the 800 mgs (a much higher dose than normal) of cimetidine actually pumping up the effects of the Lexapro, the way the Lexapro was pumping up the effects of the Cimetidine? If so, I'm in for a bad time. Aren't I? I'm trying not to anticipate how I'll feel but I was so happy and now I'm not.
I can''t take Paxil, Zoloft or Effexor, they all make me sick. Wellbutrin does nothing for me. SAMe did nothing and was expensive.
Has anybody else been in a situation like mine? Any thoughts? Any ideas? All appreciated.
h
Posted by greenwillow on August 3, 2004, at 19:22:38
In reply to New development that is bumming me out (longish), posted by h on August 3, 2004, at 17:15:56
You are in my thoughts. Be strong. Don't give up, and keep the faith. I don't know about the meds, but hopefully there will be a different cancer med that your docs or other readers will come up with. Let us hear back from you.
Posted by King Vultan on August 3, 2004, at 19:45:51
In reply to New development that is bumming me out (longish), posted by h on August 3, 2004, at 17:15:56
There is an interaction between Celexa and cimetidine that Lexapro likely shares to at least some extent. "Mosby's 2004 Drug Guide" indicates that 400 mg of cimetidine increased the blood plasma level of a dosage of 40 mg Celexa by about 40 %. So there may be a reduction in antidepressant effect with the elimination of the cimetidine. However, if this does turn out to be the case and causes you problems, I would think you could just increase the dosage of the Lexapro a little bit.
Oncology and these types of interactions are totally outside my area of knowledge, as I don't really understand why there would be a kidney issue with Lexapro and not with some of the other drugs you mentioned. Your experience seems to indicate that an SSRI is the right kind of drug for your depression, but that you are unfortunately sensitive to the nausea side effect these drugs can cause. I believe that Celexa and Lexapro may be the two best ones that way. There are other drugs that are skewed towards serotonin as the SSRIs are, but you would need to switch drug classes, and I have no idea how compatible those drugs would be with the cimetidine.
Todd
Posted by h on August 4, 2004, at 13:44:18
In reply to Re: New development that is bumming me out (longish) » h, posted by King Vultan on August 3, 2004, at 19:45:51
Your posts are so helpful, thank you.
I am also wondering if there are any vitamins that can increase the effect of the lexapro. Any ideas? thanks so much for all your help.
h
Posted by tanner257 on August 4, 2004, at 14:28:22
In reply to New development that is bumming me out (longish), posted by h on August 3, 2004, at 17:15:56
Don't know if this is helpful or even related, but I have tried to take Lexapro twice within the past year and developed severe UTI infections within the first 2-3 days.
Anyway, good luck to you.
Posted by Bill LL on August 5, 2004, at 9:00:11
In reply to How much lexapro would I have to increase by?, posted by h on August 4, 2004, at 13:44:18
B12 and folate can help if taken every day. All women of child bearing age should take at least 400 units of folate daily anyway.
> Your posts are so helpful, thank you.
>
> I am also wondering if there are any vitamins that can increase the effect of the lexapro. Any ideas? thanks so much for all your help.
>
> h
Posted by greenwillow on August 5, 2004, at 22:21:38
In reply to New development that is bumming me out (longish), posted by h on August 3, 2004, at 17:15:56
> I started Lexapro in early June and I was the happiest camper going. 10 mg a day. No more Sunday blues or Monday morning misery, no more dysthymia, much, much less anxiety.
>
> However I'm beginning to think that the reason I was doing so well was because I am (was) also on 800 mg of cimetidine a day as a cancer preventative. (I've had breast cancer 3x)I ran across a website about Folic Acid that states certain cancer treatments can cause a deficiency in folic acid, and that folic acid deficiency may be linked to depression. It may also help with the breast cancer issue. I have just been pxd an anti-cancer medication myself, and my doctor prescribed high potency folic acid to take along with it. Maybe this is something you or your doctor could look into to cover both issues. Scroll down on this link till you get to the section "Folic acid linked to depression." Kind regards.
http://vvv.com/healthnews/folate.html
Posted by greenwillow on August 7, 2004, at 23:06:28
In reply to New development that is bumming me out (longish), posted by h on August 3, 2004, at 17:15:56
> I started Lexapro in early June and I was the happiest camper going. 10 mg a day. No more Sunday blues or Monday morning misery, no more dysthymia, much, much less anxiety.
>
> However I'm beginning to think that the reason I was doing so well was because I am (was) also on 800 mg of cimetidine a day as a cancer preventative. (I've had breast cancer 3x)I ran across a website about Folic Acid that states certain cancer treatments can cause a deficiency in folic acid, and that folic acid deficiency may be linked to depression. It may also help with the breast cancer issue. I have just been pxd an anti-cancer medication myself, and my doctor prescribed high potency folic acid to take along with it. Maybe this is something you or your doctor could look into to cover both issues. Scroll down on this link till you get to the section "Folic acid linked to depression." Kind regards.
http://vvv.com/healthnews/folate.html
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