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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 Giorgio Prager on May 27, 2014, at 9:45:20
I'm 61, male, suffering from life long anxiety states and from depression the last 10 years or so. I've been on a very low dose of Lexapro (5mg) for 8 years and it's been working very well indeed. In the last few weeks I'm observing not only a marked lowering of mood and heightened anxiety (not unexpected after 8 years) but symptoms I have never had before, namely, low level agitation, jitteriness, shallow breathing and tingling of the soles of my feet. I realize these could be unrelated and will have them checked by my physician but my question to the board is - could these symptoms (which mimic poop-out) be related to the lowering of efficient blood levels of Lexapro in the system? I have started taking 10mg daily, which as I understand is usually the starting therapeutic dose anyway.
Posted by Phillipa on May 27, 2014, at 10:30:31
In reply to Lexapro new symptoms, posted by Giorgio Prager on May 27, 2014, at 9:45:20
You say you are 60. I am also in 60's and now the max dose is recommended to be l0mg for older adults. Glad it has worked so well for you for so many years. Hoping the higher dose also give you back what you had. Phillipa
Posted by Phillipa on May 27, 2014, at 11:53:44
In reply to Re: Lexapro new symptoms » Giorgio Prager, posted by Phillipa on May 27, 2014, at 10:30:31
61 sorry. Do you have diabetes? As the tingling in feet sounds like could be peripheral neuropathy. Have you have a medical physical lately? I would check your physical status first. As for poop out from lexpro I haven't heard of anything but maybe increaded agitation if lexapro was helping anxiety. What did you begin it for initially? Phillipa
Posted by Giorgio Prager on May 27, 2014, at 11:58:34
In reply to Re: Lexapro new symptoms » Phillipa, posted by Phillipa on May 27, 2014, at 11:53:44
Hey Philipa, thanks for the reply. No diabetes, my blood sugar is normal, as are all other values as of last January. Going to have a physical in a month, though, so will recheck everything. I started the Lexapro mostly for what can best be described as anxious depression (probably about a 70/30 mix - more anxious than depressed) Also a long history of obsessional thinking, though no compulsions
Posted by poser938 on May 27, 2014, at 12:42:19
In reply to Re: Lexapro new symptoms, posted by Giorgio Prager on May 27, 2014, at 11:58:34
It could be that your med just stopped working.
Also, the past few years there has been talk that chronic use of Antidepressants, even after they benefit the mood at first, but eventually they cluld have a "pro-depressant" effect due to changes in the brain.
http://www.ncbi.nlm.nih.gov/m/pubmed/21459521/
(Hopefully these links work on your device, im on a mobile tablet and my links sometimes dont work in regular computers.)
Abstract BACKGROUND: Treatment-resistant and chronic depression appear to be increasing. The recent identification of antidepressant tachyphylaxis, the loss of antidepressant efficacy over time, is only a partial explanation. This is an emerging evidence that, in some individuals, persistent use of antidepressants may be prodepressant.
METHODS: A literature search of PubMed utilizing the terms: antidepressant tachyphylaxis, treatment-resistant depression, chronic depression, and antidepressant tolerance was performed, and relevant articles were used.
RESULTS: Depressed patients who ultimately become treatment resistant frequently have had a positive initial response to antidepressants and invariably have received these agents for prolonged time periods at high doses. Parallels between this course and tardive dyskinesia are noted. It is proposed that neuroplastic processes related to dendritic arborization may underlie the treatment resistant depression that occurs in the setting of chronic antidepressant use. Since the prodepressant effect is seen after prolonged antidepressant use, the term tardive dysphoria is proposed.
CONCLUSIONS: Tardive dysphoria, needs to be considered in studies of treatment resistant depression, and should be examined in blinded, randomized antidepressant discontinuation trials.
Posted by europerep on May 27, 2014, at 13:52:46
In reply to Re: Lexapro new symptoms, posted by Giorgio Prager on May 27, 2014, at 11:58:34
Hi,
Before you make "big" decisions, such as to switch meds, I would recommend that you either try escitalopram at your usual dose from a different manufacturer or, alternatively, that you look for a different batch of the escitalopram product you currently take. You'll find the batch number right next to the best before-date on the box. (At least that's the way it is over here.)
"Bad batches", while very rare, do happen, as do recalls of medical drugs because of variations in the amount of active ingredients. I have made that experience myself, and switching to a new batch resolved the issue.
Posted by phidippus on May 31, 2014, at 21:38:49
In reply to Lexapro new symptoms, posted by Giorgio Prager on May 27, 2014, at 9:45:20
>symptoms I have never had before, namely, low level agitation, jitteriness, shallow breathing and tingling of the soles of my feet
these symptoms sound suspiciously like a limited symptom attack-where you get some of the symptoms of panic.
>could these symptoms (which mimic poop-out) be related to the lowering of efficient blood levels of Lexapro in the system?
Hard to say because you were on a sub therapeutic dose of the medication anyway. The worsening of your anxiety and depression may be more due to psychological factors-have things become more stressful?
Eric
Posted by Giorgio Prager on June 1, 2014, at 9:44:19
In reply to Re: Lexapro new symptoms » Giorgio Prager, posted by phidippus on May 31, 2014, at 21:38:49
thanks for the input, phidippus. Indeed, many of the symptoms have now abated, ten days on the higher dose (10mg Lexapro) Still a little bit of foot tingle but the restlessness is better. As you say, it's very difficult to discern sometimes between actual anxiety symptoms and side-effects. And true, times have been very stressful.
This is the end of the thread.
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