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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by Baseball85 on March 7, 2013, at 9:23:51
Hey Scott,
So my doc upped me to 20mg of lexapro. I had been taking 15 in the morning with still some morning anxiety. Prior to that my doc had me splitting my 10mg, 5 morning and 5 night. That had gotten rid of my morning anxiety but it wasn't great during the day. When he upped me to 20mg, he told me take 15 in the morning and 5 at night and slowly work that evening dose to where you can take all 20 in the morning. I did that for 4 days and had no morning anxiety. I took the full 20mg for the first time yesterday and woke up with morning anxiety. Do I just need that evening dose to hold me through the night? How long should I stay with the 20mg in the morning before I know if it will help the morning anxiety or not? Thanks!
Posted by Phillipa on March 7, 2013, at 9:56:03
In reply to SLS...another question, posted by Baseball85 on March 7, 2013, at 9:23:51
Baseball I know I'm not SLS but since also working with lexapro are you finding yourself extremly tired at night and falling asleep when reading? Do you find the lack of anxiety almost like not caring? Thanks I kind of hyjacked your thread but I just need answers also. Thanks. But it looks like you are doing well. Phillipa
Posted by tensor on March 7, 2013, at 10:00:51
In reply to SLS...another question, posted by Baseball85 on March 7, 2013, at 9:23:51
> Hey Scott,
> So my doc upped me to 20mg of lexapro. I had been taking 15 in the morning with still some morning anxiety. Prior to that my doc had me splitting my 10mg, 5 morning and 5 night. That had gotten rid of my morning anxiety but it wasn't great during the day. When he upped me to 20mg, he told me take 15 in the morning and 5 at night and slowly work that evening dose to where you can take all 20 in the morning. I did that for 4 days and had no morning anxiety. I took the full 20mg for the first time yesterday and woke up with morning anxiety. Do I just need that evening dose to hold me through the night? How long should I stay with the 20mg in the morning before I know if it will help the morning anxiety or not? Thanks!I'm not Scott, but I think you'll need to be a little patient (not easy, I know), it takes escitalopram a week just to reach steady-state. Which is the point where the level of the drug no longer increases in your body. There's also a latency in the response with ADs like SSRIs, they are not like benzos.
Personally, I would take the full dose at either morning or at evening, whatever works best. Splitting shouldn't be necessary.Hope that helps,
tensor
Posted by Baseball85 on March 7, 2013, at 10:56:28
In reply to Re: SLS...another question » Baseball85, posted by tensor on March 7, 2013, at 10:00:51
Thanks Tensor. I'm going to give it time. The morning anxiety just sucks so bad and starts my day off terrible. I don't know if taking the 20mg at night would be better or not.
Posted by SLS on March 7, 2013, at 11:28:11
In reply to Re: SLS...another question, posted by Baseball85 on March 7, 2013, at 10:56:28
> Thanks Tensor. I'm going to give it time. The morning anxiety just sucks so bad and starts my day off terrible. I don't know if taking the 20mg at night would be better or not.
I'm not Tensor...
:-)
...but I agree with him in every respect. It is unlikely that you would need to split your daily dose. If the morning anxiety continues to be a problem, I'm sure people can offer you some suggestions. One of mine would be to add nortriptyline at night if you have a melancholic depressive component to your condition.
- Scott
Posted by Baseball85 on March 7, 2013, at 11:37:43
In reply to Re: SLS...another question » Baseball85, posted by SLS on March 7, 2013, at 11:28:11
Thanks Scott. How long would you give it on 20 in the morning before changing times?I do feel much better during the day.
Posted by jono_in_adelaide on March 7, 2013, at 17:27:10
In reply to SLS...another question, posted by Baseball85 on March 7, 2013, at 9:23:51
Baseball,
you could ask your doc for a script for hydroxyzine (Atarax, Vistaril)
It is a safe, non addictive anti anxiety drug that can be very usefull.
Usual dose 25-50mg three times a day as needed
Posted by Phillipa on March 7, 2013, at 20:14:40
In reply to Re: SLS...another question, posted by jono_in_adelaide on March 7, 2013, at 17:27:10
Or a low dose benzo till the side effects abate. Phillipa
Posted by CamW on March 7, 2013, at 23:20:59
In reply to Re: SLS...another question » Baseball85, posted by SLS on March 7, 2013, at 11:28:11
Scott: Could taking 20mg in the morning be causing enough of a spike in blood levels to cause the anxiety; whereas 15mg might just raise blood levels just below the anxiety level?
It may just be a matter of semantics, but after a week or so it will be a moot point, as the start-up side effects will have subsided, anyway.
- Cam
Posted by SLS on March 8, 2013, at 3:53:52
In reply to Re: SLS...another question » SLS, posted by CamW on March 7, 2013, at 23:20:59
> Scott: Could taking 20mg in the morning be causing enough of a spike in blood levels to cause the anxiety; whereas 15mg might just raise blood levels just below the anxiety level?
>
> It may just be a matter of semantics, but after a week or so it will be a moot point, as the start-up side effects will have subsided, anyway.
>
> - Cam
If I am hearing right, the anxiety subsides rather than escalates post-dose. I am hoping that this is a good sign that the drug will soon produce a more consistent robust effect. Your idea regarding spiking might still apply, though. Perhaps there is too precipitous a drop in blood levels that occurs as one approaches the end of a dosing period, thus allowing for the emergence of break-through or rebound anxiety. This would argue in favor of administering the drug in divided doses. I would take 10 mg twice a day.
- Scott
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