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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by g_g_g_unit on July 3, 2011, at 8:24:13
So my psychiatrist and I decided to try another SSRI, given that Zoloft was ratcheting up my OCD to insane proportions. He ended up selecting Lexapro and I've been taking 10mg for just over a week. Why - I don't really know. I've been hit with all the same side-effects I had last time, namely cognitive slowing, dissociation, poor sleep and emotional numbing.
Unfortunately, there aren't very many uncharted avenues left for me outside outside of the SNRIs, so I'm trying to be less rash. Given that Lexapro is otherwise working well for panic and irritability, I've been wondering if there's a chance any of these side-effects might pass (though I had been on Zoloft for over 6 weeks, so I'm not sure if some kind of carry-on effect takes place when switching between SRIs). Otherwise, I guess it might also be exacerbating my ADHD, because I'm incredibly hyper and nicotine fixes most of the cognitive problems, though does little for the lack of feeling/desire.
I've actually been wondering if something like Agomelatine might be helpful in this case, which my GP offered to prescribe .. improved sleep, and doesn't it induce catecholamine release in the pFC?
Posted by Phillipa on July 3, 2011, at 10:49:18
In reply to countering lexapro side-effects, posted by g_g_g_unit on July 3, 2011, at 8:24:13
GGG unit since the agomelatonine is new why not give it a try. I'm still playing with the lexapro and luvox and stopped the lex for a while as didn't notice any difference and still don't. When you say cognitive dulling what exactly does that feel like in words and it did help anxiety? Thanks and sorry the zoloft didn't work out for you. Phillipa
Posted by orbital on July 3, 2011, at 13:27:23
In reply to countering lexapro side-effects, posted by g_g_g_unit on July 3, 2011, at 8:24:13
Most of the side effects you mentioned should resolve, particularly the poor sleep.
However, Lex does have a generally "slowing" effect.
The main issue I had with Lexapro was a bad case of anhedonia which crept up on me slowly, after a while I was feeling so mellow that I couldn't be bothered to do anything, and I didn't care.
I tried the Lex + agomelatine combination, it did nothing for me.
In my case, at one point the best add-on turned out to be Provigil.
I really wish I had tried lowering the dose to see if the anhedonia/numbing resolved, instead of increasing it. I was on 20mg and went up to 30 - the anhedonia only got worse. Lex is so clean powerful and selective, I think that 5mg (or even 2.5mg) might clear up this side effect while maintaining the drug's efficacy - something to keep in mind.
HTH.
> So my psychiatrist and I decided to try another SSRI, given that Zoloft was ratcheting up my OCD to insane proportions. He ended up selecting Lexapro and I've been taking 10mg for just over a week. Why - I don't really know. I've been hit with all the same side-effects I had last time, namely cognitive slowing, dissociation, poor sleep and emotional numbing.
>
> Unfortunately, there aren't very many uncharted avenues left for me outside outside of the SNRIs, so I'm trying to be less rash. Given that Lexapro is otherwise working well for panic and irritability, I've been wondering if there's a chance any of these side-effects might pass (though I had been on Zoloft for over 6 weeks, so I'm not sure if some kind of carry-on effect takes place when switching between SRIs). Otherwise, I guess it might also be exacerbating my ADHD, because I'm incredibly hyper and nicotine fixes most of the cognitive problems, though does little for the lack of feeling/desire.
>
> I've actually been wondering if something like Agomelatine might be helpful in this case, which my GP offered to prescribe .. improved sleep, and doesn't it induce catecholamine release in the pFC?
>
>
Posted by g_g_g_unit on July 4, 2011, at 7:31:50
In reply to Re: countering lexapro side-effects » g_g_g_unit, posted by orbital on July 3, 2011, at 13:27:23
> Most of the side effects you mentioned should resolve, particularly the poor sleep.
Sorry, I really don't mean to sound pedantic, but you speculate that most of the side-effects should resolve, and yet claim that Lexapro is known for 'slowing' and, what's more, that you suffered from enduring anhedonia while on it. Again, I'm not trying to be accusatory at all, but out of the side-effects I listed that just leaves sleep (and dissociation, I guess, though I imagine that's linked to the sleep/anhedonia). I'm just trying to keep my expectations realistic before I moan to my psychiatrist next week..
>
> However, Lex does have a generally "slowing" effect.
>
> The main issue I had with Lexapro was a bad case of anhedonia which crept up on me slowly, after a while I was feeling so mellow that I couldn't be bothered to do anything, and I didn't care.Yeah, that's how I feel, though depressingly it's only been a week. Anhedonia/cognitive slowing is such a core part of my condition that I can't afford anymore. But I do need to try and tame my OCD.
>
> I tried the Lex + agomelatine combination, it did nothing for me.Hmm, pity.
>
> In my case, at one point the best add-on turned out to be Provigil.
>
> I really wish I had tried lowering the dose to see if the anhedonia/numbing resolved, instead of increasing it. I was on 20mg and went up to 30 - the anhedonia only got worse. Lex is so clean powerful and selective, I think that 5mg (or even 2.5mg) might clear up this side effect while maintaining the drug's efficacy - something to keep in mind.
>Yeah, I've heard of 2.5/5mg helping. 30mg is huge! Do you mind me asking what you're taking now?
Posted by g_g_g_unit on July 4, 2011, at 7:34:03
In reply to Re: countering lexapro side-effects » g_g_g_unit, posted by Phillipa on July 3, 2011, at 10:49:18
> GGG unit since the agomelatonine is new why not give it a try. I'm still playing with the lexapro and luvox and stopped the lex for a while as didn't notice any difference and still don't. When you say cognitive dulling what exactly does that feel like in words and it did help anxiety? Thanks and sorry the zoloft didn't work out for you. Phillipa
Yeah, it's helping my anxiety and ruminations. By cognitive dulling I'm referring to slow, vague, disconnected thoughts and difficulty registering and processing information while reading.
Posted by orbital on July 4, 2011, at 12:54:19
In reply to Re: countering lexapro side-effects, posted by g_g_g_unit on July 4, 2011, at 7:31:50
> > Most of the side effects you mentioned should resolve, particularly the poor sleep.
>
> Sorry, I really don't mean to sound pedantic, but you speculate that most of the side-effects should resolve, and yet claim that Lexapro is known for 'slowing' and, what's more, that you suffered from enduring anhedonia while on it. Again, I'm not trying to be accusatory at all, but out of the side-effects I listed that just leaves sleep (and dissociation, I guess, though I imagine that's linked to the sleep/anhedonia). I'm just trying to keep my expectations realistic before I moan to my psychiatrist next week..You're right, I meant to say "some of the side effects..". I had poor sleep which resolved within 2 weeks.
I should clarify that, by "slowing, I meant to say that Lex killed my anxiety very effectively, so "mellowing" might be more accurate. didn't mean "dulling" as in cognitively dulling, though I was in a fog initially (maybe this is what you mean by disassociation?) but it lifted quite soon.
> >
> > However, Lex does have a generally "slowing" effect.
> >
> > The main issue I had with Lexapro was a bad case of anhedonia which crept up on me slowly, after a while I was feeling so mellow that I couldn't be bothered to do anything, and I didn't care.
>
> Yeah, that's how I feel, though depressingly it's only been a week. Anhedonia/cognitive slowing is such a core part of my condition that I can't afford anymore. But I do need to try and tame my OCD.Maybe you'll feel more motivated once the startup side effects clear up? Just an idea. That was the case for me anyway, Lex gave me two very good runs once I adjusted to it. The anhedonia struck after approx. 9 months each time.
>
> >
> > I tried the Lex + agomelatine combination, it did nothing for me.
>
> Hmm, pity.
>
> >
> > In my case, at one point the best add-on turned out to be Provigil.
> >
> > I really wish I had tried lowering the dose to see if the anhedonia/numbing resolved, instead of increasing it. I was on 20mg and went up to 30 - the anhedonia only got worse. Lex is so clean powerful and selective, I think that 5mg (or even 2.5mg) might clear up this side effect while maintaining the drug's efficacy - something to keep in mind.
> >
>
> Yeah, I've heard of 2.5/5mg helping. 30mg is huge! Do you mind me asking what you're taking now?
>Only stayed on 30mg for 10 days, then dropped it altogether.
I'm on Paxil now + a few add-ons to counter side-effects. Quite satisfied because it's working well without numbing me out.
hth
Posted by chasethdevil on July 10, 2011, at 16:00:39
In reply to countering lexapro side-effects, posted by g_g_g_unit on July 3, 2011, at 8:24:13
I experienced some rough side effects getting on lexpro. I went up 5 mg at a time because I am quite sensitive to new drugs and usually experience every common side effect and some uncommon ones. I was a bit zombiefied. At every dose I upped these were more difficult.
However, all side effects, even the crazy intense fatigue, went away with some time and now I'm on a high dose of 40 mg. No side effects currently, except for anorgasmia which is nothing new for me; never had an orgasm. I take it paired with wellbutrin. It doesn't completely take away my anxiety but my depression is gone, and my anxiety is toned down to a point that therapy is actually helping me. Without meds, my anxiety is MAJOR. I usually spend about a couple months trying to fight off anxiety while trying to make everything in my life absolutely perfect before the depression hits and I can no longer function.
I'd give it a chance; Lexapro has an excellent reputation for being one of the SSRI's with the least side effects. This has been my experience.
This is the end of the thread.
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