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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by BobS, on April 19, 2004, at 20:06:35
I have a horrible anxiety reaction when starting SSRIs. I have been off SSRIs for several years, but now the depression is back due to a number of large life stressors. My pdoc is not afraid of the benzo gestapo and says I can go to 6 mg in a pinch. Anyone take more 6 mg for the short period 2 to 4 weeks during the SSRI start up period?
I read in the Noonday Demon book on depression that the author took up to 18 mgs.
Any help would be greatly appreciated.
Regards,
BobS.
Posted by chemist on April 19, 2004, at 21:35:10
In reply to Xanax - How much to take when starting SSRI?, posted by BobS, on April 19, 2004, at 20:06:35
> I have a horrible anxiety reaction when starting SSRIs. I have been off SSRIs for several years, but now the depression is back due to a number of large life stressors. My pdoc is not afraid of the benzo gestapo and says I can go to 6 mg in a pinch. Anyone take more 6 mg for the short period 2 to 4 weeks during the SSRI start up period?
>
> I read in the Noonday Demon book on depression that the author took up to 18 mgs.
>
> Any help would be greatly appreciated.
> Regards,
> BobS.hi bob....6 mg xanax is quite a bit, and 18 mg is pushing the limit for revoking your doc's license. starting an ssri can be - and most usually is - cumbersome, and all the untoward side effects (insomnia, anxiety, agitation, dry mouth, etc.) usually abide when you titrate to the best dose for you. looking at the lterature and the white papers for ssris (first and second generation) all indicate that the first few weeks aren't going to be pretty. i can guess that your need for the xanax fix will subside as you reach your therapeutic range on the ssri. what are you taking, by the way, and what dose? all the best, chemist
Posted by KathrynLex on April 20, 2004, at 12:00:55
In reply to Xanax - How much to take when starting SSRI?, posted by BobS, on April 19, 2004, at 20:06:35
Hi Bob,
Xanax is a very potent med. I've found that .25 to .5 mgs is perfect for the initial anxiety you have on SSRI's. I suggest that you don't take it every day, only when you need to. Skipping a day or so will help your body not build up tolerance. If you can, you might try taking Klonopin. People don't build up a tolerance as quickly with it and the chances of being dependent on it are much lower.
K.
Posted by BobS, on April 20, 2004, at 18:55:09
In reply to Re: Xanax - How much to take when starting SSRI?, posted by KathrynLex on April 20, 2004, at 12:00:55
Thanks for your responses. My pdoc thinks I have an idiosyncratic reaction to SSRIs. I never had any real luck with SSRIs (Prozac and Paxil). I was going to give it one last shot with Lexapro, but one dose ended that fantasy today.
I think we will try Remeron and if that doesn't help the pdoc says Zyprexa for my severe anxiety. DX "harm avoidant OCD and atypical depression"
BTW, Lexapro heightened my anxiety exponentially.
Regards,
BobS.
Posted by joebob on April 20, 2004, at 21:49:05
In reply to Xanax - How much to take when starting SSRI?, posted by BobS, on April 19, 2004, at 20:06:35
mood stabilizer with or before the ssri?
having tried both,i can say that i think the depakote was better for the 'lift off' effect of the ssri, in my case lexapro.....for me the 'lift off' is actually like someone turning on bright lights in a dark room while you are sleeping
you might get some info from dr.amen's 'brain place. com' about the inital effects of ssri's in some people
i do know that in the beginning of ssri's it was encouraged to prescribe _azepams with them for the start-up period, and i have been told it is still common pracitce in parts of europe
best,
joebob
Posted by KathrynLex on April 21, 2004, at 15:17:22
In reply to Re: Xanax - Chemist and KLex, posted by BobS, on April 20, 2004, at 18:55:09
Hi Bob,
I'm sorry things didn't go well with Lexapro. Just out of curiosity, how much did you take? I started out at 10 mgs and noticed a significant increase in my anxiety for the first several weeks. If I knew then what I know now, I would start at 2.5 mgs (cut the 10 mgs in half and then cut the halves in half again.) It's just a thought.
If you decide not to try the Lexapro again, and I wouldn't blame you...having a bad experience on meds is terrifying...I hope the Remeron does the trick.
K.
This is the end of the thread.
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