Posted by SLS on February 28, 2013, at 11:14:12
In reply to SLS...Question, posted by Baseball85 on February 28, 2013, at 9:59:48
> Hey Scott, in my thread about my Lexapro dosage being too high you said this "I would think it more likely that your dose is too low. Instead of languishing for an extended period of time trying to finesse the dosage between 10 - 15 mg/day, perhaps you should do a quick experiment and go to 20 mg/day. I think your tiredness and irritability are the result of the breakthrough of the underlying illness. I could be wrong, but without knowing more about you, I would think it a possibility. Would your doctor allow you to go to 20 mg/day?"
> What did you mean by my tiredness an irritability being the result if a breakthrough of my illness?I apologize. I should have elaborated. Treatment "breakthrough" describes the phenomenon wherein someone's illness re-emerges, despite previous success at a given dosage of medication. This often happens when an external stressor occurs or even when someone experiences an infection. It sometimes resolves by itself, especially when the stressors resolve.
It is not unusual for someone to experience a transient treatment response at a low dosage early in treatment. However, sometimes a dosage increase is necessary to produce a more reliable improvement.
> Sorry, this is my first time on any medication.
I'm sorry that you should find yourself in such a position as to need treatment. I can understand your trepidations and confusion. I bet your doctor is confused at times. I hope he is right, though. It would be great if a dosage of 10 mg/day were optimal for you, and that you should need a only a short course of treatment.
It is quite possible that the "tiredness" or fatigue you experience is a side effect of Lexapro. It was with me. It may or may not persist. Unfortunately, few if any doctors would be able to predict this for you. If the tiredness does persist, you can change drugs. I don't think Zoloft is as likely to produce the tiredness, but it might not treat the anxiety as well. Perhaps others can offer some insight into this. Again, though, you would be relegated to trial-and-error. Interestingly, insomnia is a possible side effect of Lexapro.
Lexapro is known to produce anxiety and/or agitation briefly, sometimes occurring for a few days between days 14 - 21 of treatment.
> I started having terrible anxiety about 4 months ago after my first daughter was born. I'm 28 and just trying to figure all this out. I guess I'm scared to try 20 bc I think that means I am really "i'll" and don't want to admit it.
Sort of yes and sort of no. You don't necessarily have to be considered more sick if you require higher dosages of a drug. It might depend on how rapidly your body eliminates the drug - how long it stays in the blood stream. I really don't know all of the variables that would contribute to needing higher dosages of Lexapro. However, your anxiety does sound substantial.
In what ways has the anxiety impacted your life?
Is depression a problem?
> Since dropping to 10 a couple days ago I have felt less tired but anxiety has been back up. Does the tiredness go away with time in these meds?
Again, I doubt even your doctor could tell you with certainty. He may have a good idea, though - certainly better than I do. It would be worth asking him how often the tiredness disappears with continued treatment.
So, it is possible that a dosage of 20 mg/day will be necessary to produce a stable improvement, but that tiredness and fatigue become troublesome side effects. They might disappear after a few weeks or they might linger.
> When I was 15 I think I was mistaking the tiredness, and physical agitation with anxiety. Plus I only gave the 15 4 weeks.
That should be a long enough period of time to evaluate the effectiveness of that dosage. If Lexapro is going to be a good match for you, you may find yourself stabilizing at 20 mg/day. That's just my first impression.
Did your doctor offer any other avenues of treatment? Did he discuss benzodiazepine drugs like Klonopin or Ativan?
How long was it that you experienced anxiety before beginning treatment with Lexapro? Perhaps the anxiety will be self-limiting as your hormonal systems reestablish balance.
It is possible that the anxiety you experienced from reducing the dosage from 15 mg/day to 10 mg/day was actually a form of withdrawal.
All of this stuff might be overwhelming at first. As you can see, there is much to consider.
Each person on Psycho-Babble will have his own biases when offering you feedback. My biases incline me to suggest working out with your doctor a trial of Lexapro at 20 mg/day if the 10 mg/day dosage proves worthless.
There are alternatives. However, since you are already taking Lexapro, you might as well explore it fully before changing treatments. Your doctor made a reasonable choice starting with Lexapro.
I wish you the best of luck. You'll be okay.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1039075
URL: http://www.dr-bob.org/babble/20130222/msgs/1039078.html