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Re: Eff/Prozac/Mirtaz switch to Lexapro?

Posted by jrbecker on September 27, 2004, at 14:43:34

In reply to Re: Eff/Prozac/Mirtaz switch to Lexapro? dove, posted by Sad Panda on September 27, 2004, at 10:25:18

> > Hey there everyone!
> >
> > I have been somewhat stable for the last year and a half on a med combo of Effexor 225 mg., Prozac 20 mg., and Mirtazapine 45 mg. The original med combo also included Adderal and Klonopin, but I went off those due to getting pregnant (I had the baby this past March).
> >
> > Now, they're talking about weaning me off all those meds in favor of one, Lexapro. How on earth is Lexapro going to cover what my other combo did? I am very leery of this switch, as it has taken me years to find anything that even touches my depression.
> >
> > The other med being talked about is Cymbalta, but they want to try Lexapro first. Should I just say "NO!" ;-)
> >
> > Is Cymbalta similar to the combo of Effexor and Mirtazapine? Would I be able to take one med instead of two? I would love to get rid of the Mirtazapine if at all possible (I've had weight gain and my legs kick all night long).
> >
> > Any thoughts or advice, thanks in advance!!!
> >
> > dove
> >
> >
> Hi Dove,
> Is there a problem with your current meds that is forcing you to change away from Effexor + Prozac? Have you tried not taking Mirtzapine? I have had that feeling in my legs from Mirtazapine & found that it went away at lower doses. I use to use it for sleep & it also covers a few side effects caused by Effexor.
> Cheers,
> Paul.

I think you're right. You will most likely not see the same benefit from Lexapro monotherapuetically. And I think that's pretty dangerous that your doc recommended this. However, as Paul mentioned, you might want to give us a little more info on why the doc thought the med changeup would be good.

But off the top of my head, if I was to foresee a plan to simplify your med cocktail WITHOUT substituting for efficacy, I would shelve the prozac and effexor for a trial of cymbalta. My instincts says that I would keep on the remeron for now, but maybe readjust to 15 or 30mg for a while. There might be a little bit of a noradrenergic reaction b/t the cymbalta and remeron, but I really doubt it since you're already on a high dose of effexor.

I know you didn't want to hear this, since you'd like to get off the remeron. but I think that's probably the next thing to tackle if you still feel you're doing alright. Since I've been in your situation many a time before, I just want to remind you of not being too hasty in your drug changeups. Go slow.

this just my own subjective insight.

good luck




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