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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by vic80 on March 17, 2010, at 12:15:52
Ok, my lexapro has been upped from 15 to 20 mg yesterday, plus Lunesta 1mg has been added for insomina.
I asked my pdoc not to prescribe me any benzos or ambien as I suspect them to aggravte my depression, so he gave me lunesta.
I come home and google it only to find people screaming about lunesta worsening depression....
What should I expect?
Also is it normal for an increase in suicidal ideation/inner restlessness at the start of a Lexapro dosage increase?
Posted by Phillipa on March 17, 2010, at 12:27:43
In reply to Lunesta and Lexapro, posted by vic80 on March 17, 2010, at 12:15:52
Well I can answer the question on lunesta I took 3mg for a while with additional benzos and it was easy to stop just decided to and didn't depress me. Phillipa
Posted by bleauberry on March 17, 2010, at 16:44:49
In reply to Lunesta and Lexapro, posted by vic80 on March 17, 2010, at 12:15:52
Lunesta may or may not worsen depression. We all respond differently. If it makes you feel worse, stop taking it.
A better sleep med in my opinion is ultra low dose Remeron. 1mg to 7.5mg, by cutting pills to size. There is some carryover drowsiness into the next day for a week or so, but that goes away. Who knows, at higher doses it might even help your depression, since I think it does a better job combined with ssris than it does by itself.
I agree with you on the benzo/sleep thing. Others might have different opinions, but I personally do not see benzos as good first choices for insomnia. Very low dose remeron or amitriptyline, sometimes nortriptyline, are much better starting points. My opinion.
SSRIs of all kinds can worsen depression, especially at the start of treatment. Some people feel a lot better almost right away, as their systems seem to love the extra serotonin. But others feel a lot worse right away, or on dose increases, as maybe they already have too much serotonin. Too much serotonin would be squashing out dopamine and norepinephrine, which is a reliable way to create depression or worsen it if those neurotransmitters are more deficient than serotonin. An ssri is probably not going to be very helpful to someone with a low norepinephrine or low dopamine depression.
I am not a fan of SSRI monotherapy, so I can't really help much on that topic. I think increasing any single neurotransmitter at the expense of the others, or at the ignorance of the others, is asking for trouble sooner or later.
Some people say it is normal to feel more depressed on dose increase, but the recovery and feeling good comes later. I personally disagree with that. Too many people kill themselves in that stage. Not a good benefit/risk balance. And no guarantee that they ever will get out of the funk given more time.
For now I guess you kinda have to do what your doctor says, as long as he is a real good doctor you trust completely, and see what happens. At some point though if things get really bad, you gotta put your foot down and speak up.
This is the end of the thread.
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