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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by invisiblemanpa on March 10, 2005, at 15:37:00
I was switched from Effexor XR to Remeron, 30mg and Lexapro 10 mg.and Klonopin. It was from my own request because of all the effexor scare talk and my cholesterol had skyrocketed, I am very active, all most a vegetarian and the bad cholesterol had been around 160, it went well over 200 plus the good cholesterol went way down.
Anyway, I switched to cymbalta with no success then to Lexapro. I still am experiancing pretty frequent preiods of depression and anxiety, the klonopin helps greatly with anxiety to keep me functional and the depression is not the deepest I have been through...I am still up out of bed, exercising, reading, actively looking for work, etc...just the blues and bad moods have started to creep back in. My psy doc says that Lexapro has not been effective over 10 mg, he feels the ssris are pretty much all the same....he said the next step might be ECT...no freakin way! I remember old Jack in the Cuckoos nest, plus I know people that have had it done and they say that they have had permanent memory loss...anyway...has anyone had Lexapro prescribed at a higher dosage and have they had success with relief of depression symptons and or control of anxiety??
Thanks,
e
Posted by Chris O on March 10, 2005, at 16:56:46
In reply to Lexapro Users???, posted by invisiblemanpa on March 10, 2005, at 15:37:00
Of course, I don't know you, don't know your history, all the intricacies, etc. But from SSRIs to...ECT?!? Seems kind of extreme. And, I was just taking Lexapro for 8 months. My pdoc says it has mostly been shown to be effective at doses of 20mg-40mg, which I basically confirmed. Lexapro was worst for me at 10mg (did not much of anything) and best for me at 40mg (felt more of the full effect, even though I still think it was a weak drug). I also think that, compared to Effexor, Lexapro would tend to feel/be "weaker," that's my intuition at least from taking both drugs. I just can't understand your pdoc's thinking; he seems...not like a good pdoc, from the information you've given. From my experience, I think it's worth trying the Lexapro in higher doses, even though you may find it "weak" even at those higher doses. My main side effect on 8 months of the Lex was weight gain (about 8-10 pounds), which is annoying, which is one of the reasons I stopped, in addition to it not really being strong enough.
I wish you luck,
Chris> I was switched from Effexor XR to Remeron, 30mg and Lexapro 10 mg.and Klonopin. It was from my own request because of all the effexor scare talk and my cholesterol had skyrocketed, I am very active, all most a vegetarian and the bad cholesterol had been around 160, it went well over 200 plus the good cholesterol went way down.
> Anyway, I switched to cymbalta with no success then to Lexapro. I still am experiancing pretty frequent preiods of depression and anxiety, the klonopin helps greatly with anxiety to keep me functional and the depression is not the deepest I have been through...I am still up out of bed, exercising, reading, actively looking for work, etc...just the blues and bad moods have started to creep back in. My psy doc says that Lexapro has not been effective over 10 mg, he feels the ssris are pretty much all the same....he said the next step might be ECT...no freakin way! I remember old Jack in the Cuckoos nest, plus I know people that have had it done and they say that they have had permanent memory loss...anyway...has anyone had Lexapro prescribed at a higher dosage and have they had success with relief of depression symptons and or control of anxiety??
> Thanks,
> e
Posted by TamaraJ on March 10, 2005, at 17:33:45
In reply to Lexapro Users???, posted by invisiblemanpa on March 10, 2005, at 15:37:00
My psy doc says that Lexapro has not been effective over 10 mg, he feels the ssris are pretty much all the same....he said the next step might be ECT...no freakin way!
-- That is absolutely ridiculous! Even if all SSRIs are the same, everybody responds differently to each SSRI (some may do well on Prozac, but have no response to Celexa for example). Regardless of his SSRI theory, there are other AD options that can be pursued - tricylics (TCAs) and MAOIs. I did not have sufficient response to Paxil (second time), Effexor, Celexa and Anafranil (partial response but could not get up to a therapeutic dose). I am now trying nortriptyline and it seems to be working well. I also have anxiety, sometimes very severe, and nort has not aggravated that. As a matter of fact, I have heard that it can actually be anxiolytic and can help with panic disorder.
If I were you I would tell that pdoc that you want to try a TCA. If he refuses to prescribe a different type of AD, then you definitely need to find a new pdoc because that one has got his head in the sand (to be polite :-)).
Good luck.
Tamara
Posted by Chris O on March 10, 2005, at 18:39:07
In reply to Lexapro Users???, posted by invisiblemanpa on March 10, 2005, at 15:37:00
And another thing. I was discussing this in another post up above "Why don't pdocs know meds?" There are too many "impatient" pdocs out there. Yes, I know we with anxiety and depressive disorders can be a handful. But hey, if you're going to choose psychiatry as a career, you should be prepared to deal with that, and deal with it in a compassionate, incredibly empathic way. Your pdoc sounds so typical--uneducated about all the altnatives, unwilling to try, to exhaust every option and to treat you as an individual. That just, it ticks me off, to put it mildly. It's so unfair that many of us go to these people in a state of utter helplessness and...they treat us, they bully and exploit us, basically. I hope you can find a better pdoc.
Good luck again,
Chris
Posted by mike13 on March 10, 2005, at 20:34:34
In reply to And another thing. Too many impatient pdocs » invisiblemanpa, posted by Chris O on March 10, 2005, at 18:39:07
He's either extremely ignorant about his profession, or just gave up trying.
Posted by med_empowered on March 10, 2005, at 21:02:44
In reply to Fire your pdoc, posted by mike13 on March 10, 2005, at 20:34:34
No person is perfect, no doc is perfect, and some docs and patients don't "match." That said, your current doc sounds intolerably insensitive, callous, and incompetent. Some docs, it is true, are now recommending ECT earlier in the course of depression treatment. Fair enough, I suppose--if ALL the benefits (including financial benefits doc experiences) and ALL the risks (honest explanation of potential memory loss and the possibility that "maintenance" ECT may be desired or drug treatment necessary) are openly and honestly laid out for the patient. Your doc seems impatient and more than a little bit scary. I think you would do yourself an ENORMOUS favor by going to different doc. If all else fails, there are always compassionate GPs to consider (GPs write 70% of all psychotropic RXs in the US)...I've gone the GP route, and its really not that bad...they usually tend to be waaaay less self-important and arrogant than shrinks.
Posted by invisiblemanpa on March 11, 2005, at 8:11:50
In reply to And another thing. Too many impatient pdocs » invisiblemanpa, posted by Chris O on March 10, 2005, at 18:39:07
I agree...I am not very pleased, but finding a psy doc. as many of us know is sometimes next to impossible. I had to change from my first because of some change in insurance coverage...she wasn't very good anyway...basically just wrote whatever I asked for....why are there so many Indans (India) in psy med in the states..no disrespect intended to Indian immigrants......but??? It took me days of calling just to find one that was taking new patients.....then I had to switch three times in a row to find one that would prescribe a benzo.....just nuts........and yes my current doctor....I don't care for and plan to change...but for now he is like so many...check in every one or two months for 5 minutes....he is a Russian immigrant, was head of the urology dept. in a major hospital in Russia, now he is a psy doc in the STates....go figure.....but I do get a good laugh every time I see him...he could be the classic KGB agent out of a spy movie...maybe he is........the clinic that I am in is just like a machine....move em in ..get em out as soon as possible...when you live in an area where there are few choices (western PA)....you have to work with what you have access to and what your insurance will allow you to have access to......yeah the system sucks....and I to have from the beginning questioned the knowledge of all of the doctors...family practioners or psy docs....I started out with my family dr..and he had no clue....just passing out whatever med., the latest pharm. rep had brought in...with the best catered lunch..........as time goes on I am leaning more towards dumping all of the meds and trying it clean again.....
e
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