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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by marcus1968 on October 22, 2013, at 11:48:02
Hello, I am at my wits end. I have been on Lexapro 5mg(any higher and I get more anxious)for depression and anxiety for 7 years, klonopin 1.5 day for 7 years and super low remeron at night for insomnia(4 months) I have hit a very bad depression, anxiety is through the roof and I seem to get no benefit from my Lexapro at all anymore actually seems to make me worse.ssri's have always seemed to only help depression not anxiety at all. I most bothersomely have seemed to have lost my feelings of love for my children and family and feel emotionless and no motivation and like an empty shell. I am so upset I feel like I cant recover from this... any med suggestions will be so gratefully appreciated. I am seeing my pdoc in a week. thanx so muchhhh
Posted by ihatedrugs on October 22, 2013, at 12:30:24
In reply to lexapro making me worse BAD DEPRESSION, posted by marcus1968 on October 22, 2013, at 11:48:02
I take Lexapro and it also lost its therapeutic effect. I added Abilify and the depression is now gone, though still working on dosage as it seems to cause some initial restlessness. Good luck.
Posted by doxogenic boy on October 22, 2013, at 13:41:58
In reply to lexapro making me worse BAD DEPRESSION, posted by marcus1968 on October 22, 2013, at 11:48:02
Welcome to Babble.I added Seroquel when my escitalopram (Cipralex/Lexapro) didn't work, and that combination helped me, both for depression, anxiety and sleep. I take the whole Seroquel dose at bedtime, to avoid being tired at daytime.
- doxogenic
Posted by SLS on October 22, 2013, at 15:25:26
In reply to lexapro making me worse BAD DEPRESSION, posted by marcus1968 on October 22, 2013, at 11:48:02
> Hello, I am at my wits end. I have been on Lexapro 5mg(any higher and I get more anxious)for depression and anxiety for 7 years, klonopin 1.5 day for 7 years and super low remeron at night for insomnia(4 months) I have hit a very bad depression, anxiety is through the roof and I seem to get no benefit from my Lexapro at all anymore actually seems to make me worse.ssri's have always seemed to only help depression not anxiety at all. I most bothersomely have seemed to have lost my feelings of love for my children and family and feel emotionless and no motivation and like an empty shell. I am so upset I feel like I cant recover from this... any med suggestions will be so gratefully appreciated. I am seeing my pdoc in a week. thanx so muchhhh
Apparently, you can no longer tolerate Lexapro at dosages that are usually needed to treat depression. However, we do see people here on 5.0 mg/day. I really haven't seen too many people for whom Lexapro was chosen to treat depression with a comorbid anxiety disorder.It is my layman's opinion that you should ask your doctor whether or not it makes sense to switch from Lexapro to another antidepressant. I like Pristiq or Effexor for treating depression with anxiety. They do not tend to produce apathy and amotivation like Lexapro can. Nardil is often chosen when nothing else works. In both cases, you can keep taking Klonopin.
The suggestions given to you to add Abilify or Seroquel are good ones. When Abilify is administered, it often produces anxiety and insomnia in the beginning - components of a mild akathisia side effect. It usually dissipates by two weeks. If you remain on the Klonopin, this might not be an issue. Abilify is the better choice if depression is prominent; Seroquel when anxiety is more severe.
Doctors are getting better at choosing drugs, but much still depends upon trial-and-error. Without knowing anything more about you, it is difficult to suggest anything.
Have you ever thought to get a second opinion?
Keep us apprised of your progress.
- Scott
Posted by ed_uk2010 on October 22, 2013, at 16:45:45
In reply to lexapro making me worse BAD DEPRESSION, posted by marcus1968 on October 22, 2013, at 11:48:02
SSRIs such as Lexapro can produce an emotional numbing effect in some people (feeling no love, etc). It sounds to me like a non-SSRI antidepressant would be more appropriate.
The old tricyclic med nortriptyline might be appropriate (so long as you don't have any kind of heart condition). It does not numb your emotions. It's an effective antidepressant and it can also help improve your sleep. You could ask your doc about tapering off both Remeron and Lexapro and trying nortriptyline. Some people find it helps anxiety too. If you are very anxious, a brief course of a benzodiazepine could be added temporarily.
Nortriptyline cannot be started at a full therapeutic dose. You need a start low and increase gradually according to response and side effects.
The problem with SNRIs like Effexor, which SLS suggested, is that they do sometimes numb your emotions just like SSRIs. Certainly, that was my personal experience (their serotonergic effects are very potent).
Do take care, and I hope you feel better soon.
ed
Posted by ed_uk2010 on October 22, 2013, at 16:47:21
In reply to Re: lexapro making me worse BAD DEPRESSION, posted by ed_uk2010 on October 22, 2013, at 16:45:45
Sorry, I missed the fact that you're already taking the benzo, clonazepam.
Posted by SLS on October 22, 2013, at 17:39:25
In reply to Re: lexapro making me worse BAD DEPRESSION, posted by ed_uk2010 on October 22, 2013, at 16:45:45
> The problem with SNRIs like Effexor, which SLS suggested, is that they do sometimes numb your emotions just like SSRIs.
Hmm. Okay.
- Scott
Posted by Phillipa on October 22, 2013, at 18:52:23
In reply to Re: lexapro making me worse BAD DEPRESSION, posted by SLS on October 22, 2013, at 15:25:26
Scott interesting as a former poster kept at me till I did take it. But it does nothing for me. Thanks was down to 2.5mg will dc it totally tonight. The only med that I was paying for the brand. Scratch it. Phillipa
Posted by SLS on October 23, 2013, at 6:10:27
In reply to Re: lexapro making me worse BAD DEPRESSION » ed_uk2010, posted by SLS on October 22, 2013, at 17:39:25
> > The problem with SNRIs like Effexor, which SLS suggested, is that they do sometimes numb your emotions just like SSRIs.
> Hmm. Okay.
I didn't mean that to be a sarcastic remark. It was meant to be an acceptance of what you said regarding Effexor. You see more people taking these drugs than I do. Nevertheless, Effexor was more stimulating for me. I experienced no apathy or amotivation. I have taken it several times; once for over 6 months. For whatever reason, I have not seen too many people on Psycho-Babble complain of these effects with Effexor. I may be wrong, but I had the impression that these things happened more with SSRIs, particularly with Paxil and Lexapro, but seen with all of them.
- Scott
Posted by marcus1968 on October 23, 2013, at 9:13:12
In reply to Re: lexapro making me worse BAD DEPRESSION, posted by ed_uk2010 on October 22, 2013, at 16:45:45
thanx ed and scott for suggestions. nortryptiline?
vs. Effexor?? much difference I have ocd (mild) bad anxiety and bad depression which gets worse in winter.
Posted by Phillipa on October 23, 2013, at 10:13:34
In reply to Re: lexapro making me worse BAD DEPRESSION, posted by marcus1968 on October 23, 2013, at 9:13:12
SAD same here never used light theraphy but they say it helps. Phillipa
Posted by doxogenic boy on October 24, 2013, at 8:17:49
In reply to Re: lexapro making me worse BAD DEPRESSION, posted by Phillipa on October 23, 2013, at 10:13:34
> SAD same here never used light theraphy but they say it helps.
Could SAD mean both social anxiety disorder and seasonal affective disorder? (Sometimes I am in doubt what it is, but since you mention light theray, i understand this is seasonal affective disorder.)
- doxogenic
Posted by doxogenic boy on October 24, 2013, at 8:33:05
In reply to Re: lexapro making me worse BAD DEPRESSION, posted by marcus1968 on October 23, 2013, at 9:13:12
> thanx ed and scott for suggestions. nortryptiline?
> vs. Effexor?? much difference I have ocd (mild) bad anxiety and bad depression which gets worse in winter.For OCD, you need a serotonergic antidepressant. If you don't want an SSRI, Effexor could work, but also clomipramine (Anafranil) works for OCD. (I think clomipramine was the first anti-OCD drug.) It can give dry mouth though. If you would like to change from Lexapro to another antidepressant, it is probably best to start with monotherapy first, to see if it works alone. If that doesn't work, you may add Seroquel.
- doxogenic
Posted by ed_uk2010 on October 28, 2013, at 18:07:19
In reply to ed_uk2010 - Not sarcastic. Sorry., posted by SLS on October 23, 2013, at 6:10:27
Evening Scott,
>I didn't mean that to be a sarcastic remark.
No problem. I have a lot of respect for your opinions.
>Nevertheless, Effexor was more stimulating for me. I experienced no apathy or amotivation. I have taken it several times; once for over 6 months.
I get the impression that pt response to venlafaxine is even more variable than to SSRIs. Interestingly enough, one might expect higher doses to be more stimulating, but in clinical trials, profound fatigue has been an issue at very high doses - I think perhaps the serotonergic effects can become overwhelming.
Best,
ed
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