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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by rculater on October 25, 2010, at 11:26:29
Sorry a bit long winded - I suffer from dysthemia.atypical depression
I always struggle on SSRis at about the month mark and panic that im going to gain weight, or get paranoid that im turning into a unmotivated apathetic procrastinating lazy being - this usually leads to an abrupt discontinuation.
I've discovered that after a day or 2 after discontinuation, I feel great. This as happened on long term and short term failed treatments.
The good mood obviously doesn't last long, a few days maybe then im back to stage 1.
I was wondering if alternate dosing would be an answer. Currently been on 10mg lexapro for a month and im at the stage where im wondering if its worth it - I was thinking about taking one every other day ? Is that feasible ?
Posted by bleauberry on October 25, 2010, at 17:13:47
In reply to Alternate dosing question help, posted by rculater on October 25, 2010, at 11:26:29
I used to experience this same phenomenon, and others here have too. No one knows, but my best guess it is a dopamine/norepinephrine rebound. It only lasts a short time because that happens to be about the time it takes the feedback loops to figure out what is going on and then adjust to their genetic commands.
What this points to is the need for a catecholamine agent in conjunction with your ssri. Nortriptyline, Desipramine, Milnacipran, or Ritalin are good candidates.
Bottom line, the ssri is only hitting part of the problem. You are worried about ssri apathy, and for good reason. You just need to treat dopamine and norepinephrine with the same attention you are giving serotonin.
> Sorry a bit long winded - I suffer from dysthemia.atypical depression
>
> I always struggle on SSRis at about the month mark and panic that im going to gain weight, or get paranoid that im turning into a unmotivated apathetic procrastinating lazy being - this usually leads to an abrupt discontinuation.
>
> I've discovered that after a day or 2 after discontinuation, I feel great. This as happened on long term and short term failed treatments.
>
> The good mood obviously doesn't last long, a few days maybe then im back to stage 1.
>
> I was wondering if alternate dosing would be an answer. Currently been on 10mg lexapro for a month and im at the stage where im wondering if its worth it - I was thinking about taking one every other day ? Is that feasible ?
>
Posted by Phillipa on October 25, 2010, at 19:24:52
In reply to Re: Alternate dosing question help, posted by bleauberry on October 25, 2010, at 17:13:47
I feel it can work. Phillipa
Posted by 49er on October 27, 2010, at 8:11:21
In reply to Alternate dosing question help, posted by rculater on October 25, 2010, at 11:26:29
> Sorry a bit long winded - I suffer from dysthemia.atypical depression
>
> I always struggle on SSRis at about the month mark and panic that im going to gain weight, or get paranoid that im turning into a unmotivated apathetic procrastinating lazy being - this usually leads to an abrupt discontinuation.
>
> I've discovered that after a day or 2 after discontinuation, I feel great. This as happened on long term and short term failed treatments.
>
> The good mood obviously doesn't last long, a few days maybe then im back to stage 1.
>
> I was wondering if alternate dosing would be an answer. Currently been on 10mg lexapro for a month and im at the stage where im wondering if its worth it - I was thinking about taking one every other day ? Is that feasible ?
>In my opinion, alternate dosing would be a huge mistake as you would be putting your body into withdrawal with an every other day schedule.
Abrupt discontinuation will lead to withdrawal symptoms that look like a return of the illness but aren't. If you have only been on a med for 30 days, you don't need to taper as slowly as I usually recommend which is 10% of current dose every 4 to 6 weeks. But you still need to taper.
If you're interesting in taking Lexapro, ask for the liquid form so you can try it at a lower dose.
Jay Cohen, a psychiatrist who is definitely not anti meds advocates the start low approach on this site:
http://www.medicationsense.com/
Good luck.
49er
This is the end of the thread.
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