Lexapro

My doctor recently (as in Tuesday) started me on Lexapro for depression and generalized anxiety. Although I have struggled with it before this is the first time I have gone to the doctor. I was already have a awful time sleeping and now the insomnia is getting even worse. I read this is the most common side effect, does it eventually subside? Currently I am taking at night because it was easy to remember but I think I will switch to morning. I take Topamax at night which can increase drowsiness so maybe it will counter it if I don't have the Lexapro? I just want to be me again and I know the doc said it won't happen overnight with a pill. I am scared about the weight gain but hoping since I am not very hungry I will be okay. I will deal with that if it happens, right?

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Originally Posted by Aggie_Ama

I was already have a awful time sleeping and now the insomnia is getting even worse.

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Aggie, just the opposite for me. I was on Lexapro for several years and initially had an easy time adjusting to it. It did help me get through a really tough time in my life when the depression was all-consuming. However, as time passed, I became more and more lethargic, sometimes taking 3 to 4 hour naps during the day as well as sleeping 9-10 hours per night. This is no exaggeration. I could not function this way. When I decided to get off the drug, it took me forever to titrate down.

My husband is an OB/Gyn and has found that many of his patients on Lexapro have reacted the same way as I did. He only prescribes it now as a last resort or when other medications are contraindicated. I also had significant weight gain during the time on this drug. We were talking about this just the other night. This is just my personal experience, but I wanted to share.
However, my older sister has taken it for years without complications.

Aggie_Ama - have you talked to your Pharmacist? I had a chat with mine when I was put on Topomax - or rather, she was waiting for me when I came to pick it up. Anyway, they'd be the ones to discuss the timing for taking meds, side effects and all that. Sometimes I think they know more about the meds than the Docs do.

When I first started taking Lexapro I had a bit of a problem getting to sleep as well. My doctor initially put me on Ambien and after a few weeks I switched to benadryl (an OTC antihistamine which is also the sleep aid ingredient in the "PM" versions of many pain relivers). Over the course of a couple of months I was gradually able to stop taking the benadryl to get to sleep. I've been on Lexapro for about 3 years now and it's improved my quality of life significantly. I gained some weight over that time but that could be due as much to my crummy eating habits and generally getting older. :p

You would of course have to check first with your MD or pharmacist to make sure there are no contraindications w/ the Topamax, but you might want to consider taking benadryl as a sleep aid for a little while until you've adjusted to the Lexapro.

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Originally Posted by bmccasland

Aggie_Ama - have you talked to your Pharmacist? I had a chat with mine when I was put on Topomax - or rather, she was waiting for me when I came to pick it up. Anyway, they'd be the ones to discuss the timing for taking meds, side effects and all that. Sometimes I think they know more about the meds than the Docs do.

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Pharmacists do know more about meds than doctors do. They are always the best people to ask when you have questions about when to take a dose, side effects, etc.

Good luck.

Ama - Sorry, I can't help you with your meds question, but I hope you start feeling better. Try not to worry about the potential weight gain side effect. If the meds help you, it's well worth it.

AA, I would talk to the pharmacist, but I also am leery of primary care docs prescribing psychotropic meds. PM'ing you.

I don't have any experience with Lexapro, but Zoloft has been a life saver for me. It has the anti-anxiety properties that Lexapro has. At first it made me sleepy so I just took it at night. I also lost 40 lbs in 2 months (I had it to lose) because it completely curbed my apetite. I pretty much lived off smoothies and Boost because the thought of food made my stomach turn.

I used to be one of those people who cringed at taking medication. My mom was the one who urged me to see my Dr after she started to really notice the symptoms of depression in me. Apparently it runs in my family, but I didn't know it because it was kept "hush hush." My depression was so gradual that I didn't realize just how bad I was feeling until I started to feel better. Anti-depressants have given me my life back :D

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Originally Posted by skinimini

...as time passed, I became more and more lethargic, sometimes taking 3 to 4 hour naps during the day as well as sleeping 9-10 hours per night. This is no exaggeration. I could not function this way. When I decided to get off the drug, it took me forever to titrate down.

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I had the exact same reaction. I was falling asleep at stop lights and having to pull over after dropping my daughter off at school into a parking lot so I could take a nap, or I'd never had made the 20-minute drive back home. It was horrible.

I also found out that I was glucose intolerant during this period. I don't know if they're related. I can't eat white bread or rice without getting really sleepy. (I really miss Chinese food, and I only got to have one slice of my daughter's birthday cake because it knocked me out.)

I hope your doctor can help you find an alternative medication, Aggie. And good luck weaning off of this one.

Roxy

There are quite a few drugs for depression and anxiety with varied responses that are quite individualized. It is unclear from your post, but I too have the feeling you are talking about a GP prescribing this. I would highly encourage a specialist. They work with these drugs every day and are far better informed to play around and find the one that works for you. And when you find the right one, it can be a real godsend!

And definitely talk to a pharmacist if you are worried about drug interactions or have any general drug questions.

Not that I'm biased or anything - Possegal, PhD (Dr of Pharmacology) ;)

I've read Ama's post a few times and I didn't see anything that suggested that she was being prescribed by a GP. (For what it's worth, in my own post I referred to my "doctor", but that doctor happens to be a specialist in psychiatric medicine)

And I just want to echo Possegal's sentiments - anti anxiety/depression treatments work differently for different people. It's kind of a crapshoot, unfortunately. Part of the reason why I put off getting treatment for so long was because I dreaded the potential trial and error involved. Now, as it turned out, I was very fortunate that after a short adjustment period (namely, the insomnia that I experienced, which responded very well to sleep medication and which went away entirely within couple of months) I adjusted very well to Lexapro, and I didn't have to try any other medication. And it really has greatly improved the quality of my life.

All I'm trying to say is that if it didn't work well for you, that doesn't necessarily mean it won't work well for someone else.

I did get prescribed my GP but he did do a thorough 45 minute sit down and talk about what was really going on. He knows about my neurological factors (my tremor disease that is not under control) that could be coming into play. I felt very comfortable with talking to him about how I was feeling. And while I have had a friend who went to the gyno and said "I am such a b*tch when I pms" and was immediately given anti-depressants this was a lot more thorough. He did suggest I try other routes but we discovered working out didn't curb the anger and crying. He also wants to see me again in 3 weeks to see how I am doing. He refused to treat my tremors because he isn't a neurologist and they won't touch my husband's crohn's issues. I have a feeling he felt it was something he could handle addressing for me because he often refers us if he finds it is in our best interest.

I also have an appointment with my neurologist next week and I am going to discuss that the last time I felt like this for so long was when my tremors went haywire which they have started to do. It feels like my own fault because when they came out of remission I was hesistant to go back on anti-convulsants.

FWIW- The insomnia subsided thanks to a cold and nyquil. I have slept like a baby the last two nights but I would rather not be sick. But I will check with the pharmacist if it returns.

I think there are quite a few GPs/family practitioners out there who are very well qualified to prescribe, follow, and change antidepressants. Sounds like yours is one of them.

I heard that GP's prescribe most antidepressants. If it's working, don't mess with it. I DO believe that if it isn't working, or if you need a combination of drugs or you are trying something "off label" (meaning that the primary intended action of the drug isn't for depression/anxiety, etc., but it's been shown to help those conditions) a good psychiatrist is worth his/her weight in gold. I've become a non-responder to most antidepressants, so I'm using another med off-label and it is incredible. Even DH remarked that he's seen a huge change in me.

Finally, don't forget talk therapy. Once your depression & anxiety abates, it may become easier to see where you get off-track. For me, my thoughts are not always my friend. Sometimes my brain wants to take me to a bad neighborhood where I worry about everything. :mad:

I feel like a different person. At first I thought it was the placebo effect but I am back in control and "I don't know who is in my head" feeling. I go back to the doctor in two weeks, only bad thing is now no insomnia but I am tired now but we had upped my topamax so there is no telling what is the cause.

The pharmacist recommended playing around with when I take the meds since my doctor did not say to take it at a certain time. My neurologist took me off topamax and agreed my tremors aren't helping my depression, jeez you think?

That being said I am not opposed to therapy and my new insurance at my new job will allow for it at some level so once it kicks in I may consider it.

Ama.... as being a former fellow lexapro taker... i COMPLETELY understand how you feel. You need to definately talk with your doctor. When I was on it, I didn't care about life or what was going on. I'm quite the snuggling/touchy feely person, and I didn't want to hold hands with my boyfriend. (So if you have a partner, talk with them and tell them how you feel on it and that you are trying to fix it.

Maybe you need to change the pill overall. Please keep my posted.... I'm here for you.

Polly- I am actually feeling quite well on it so far but my doc wants to constantly monitor because this is my first try on anti-depressants. I am actually quite loving towards my husband which I hadn't been for months. He is so happy I am no longer shying away from his hugs.

I am trying to track my sleeping to see if it is abnormal because I have always enjoyed a good nap. :) I think I took a 3 hour one yesterday but then I went to bed at 11 and got up at 5:30 so really I am not sleeping that much, just should go to bed early so I don't need that nap.

I meant the "I don't know who is in my head feeling" has gone away finally. I feel so much better just a bit sleepy in the afternoon.

I took lexapro for about eight months. It definitely short-circuited the crying jags and really helped, but after six months my husband was concerned because not only had I stopped crying, I'd stopped laughing. I didn't have sleeping issues while on it, but when I came off of it I had terrible terrible vertigo. My doctor actually decided I could cold turkey because the draw down was just prolonging the dizziness. I think I was dizzy for about 6 - 8 weeks.

Glad you're getting help and beginning to feel better.

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Originally Posted by chatterbox

, but after six months my husband was concerned because not only had I stopped crying, I'd stopped laughing. .

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yes... i understand.

Ama... i'm glad that it's working out well for you and the hubby.... i don't know what to tell you.... but good luck.

Well, I'm a relatively long-time Lexapro user and I think my sense of humor and my ability to laugh is still intact.

In fact, I think I find it easier to laugh nowadays. But that's just me.

It's different for everyone. Looks like I'm in a minority here, as a satisfied Lexapro user, but, there you have it. I sympathize with those of you for whom it hasn't worked out, I guess my particular brain chemistry & what-have-you are compatible w it. I hope you've been able to find something else suitable, be it drug or talk therapy. I did talk therapy for a while but it didn't work well for me - maybe it was the therapist I was seeing, but this was before trying Lexapro. I'm not inclined right now to try talk thereapy again, but I'll never say never ...

(To be honest I was rather hesitant to talk about my experiences with the drug, but since the trend on this thread was somewhat negative, I thought I would add my own positive experience as a counterpoint. Who knows, maybe I'm the only satisfied Lexapro user out there ... :D )

Aggie, I'm glad that the Lexapro is helping you. I hope that the insomnia is only a temporary adjustment thing and that you don't experience any other bad side effects.

FWIW, there is a website http://www.askapatient.com where you can typically find a lot of anecdotal information on how well specific drugs have worked for people and what side effects they've experienced. I found it to be pretty helpful a few years ago when my then-doctor told me that there was absolutely no way that the headaches I was getting were due to the birth control I was on...I eventually stumbled upon that site and what do you know, there were a ton of people reporting killer headaches while on that pill.

Anyway, once again, best of luck with this treatment!

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Originally Posted by jobob

(To be honest I was rather hesitant to talk about my experiences with the drug, but since the trend on this thread was somewhat negative, I thought I would add my own positive experience as a counterpoint. Who knows, maybe I'm the only satisfied Lexapro user out there ... :D )

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Well Jobob...I have to eat my words...chomp chomp, slurp, swallow...

My Pdoc tried to take me off Lexapro. Big mistake. I started to get p*ssy about everything. Even on my bike rides, I'd play the "conversation" game - You know, "I'll say this...then he'll say that...then I'll say this..." etc. Completely missed what a beautiful day it was because my head was in a very bad neighborhood. When I can't relax on my rides, I know I'm in trouble.

I'm on a super low dose, 5 mg, but it is just the dusting of SSRI I need to keep sane. My anxiety & depression just takes over my life. That's one reason why I started riding & working out. I don't think I need as much med as most people.

I do talk therapy too. Depression & suicides run in my family & I don't really want to continue the family tradition. My bike would cry & rust...so sad.:(

Well, I eat my words all the time. Everyone needs a hobby, I likes to say. :)

I might go for a lower dose at some point. I actually missed a few days during my current "adventure" (hospital etc after biking accident) and I didn't notice anything off ... altho I wasn't in much position to notice such stuff, heh.

Then again, at least for the moment anyhow, it ain't broke so why fix it ... (just a rhetorical question) .

Everyone's experience with a drug can be mixed but usually people who have a very negative response remember it more. When my tremors first started I was on Neurontin. I was also extremely depressed. I thought it was the Neurontin and was convinced it was the devil's drug. Now that I have had the same depression feelings I had in 2004 and my tremors were coming out of remission I know it probably wasn't Neurontin. Although I felt like an idiot on it (many people say that), it gave me hot flashes and made me really loopy if I took anything else but the depression wasn't the Neurontin. Oh and quitting Neurontin made me feel really out of it, I would say wacko but that isn't the word. I was even more depressed, irritable and frustrated for the two week taper. Many people take Neurontin for tremors and are quite happy with the results, so there you go.

I appreciate everyone's stories and cautions about their experience. I go back to the doctor next week to see what he thinks but I feel less irritable, more in control and overall content. I guess for me, for now it is the right choice.

Oh and the sleeping? I realized I always take a lot of naps in the spring, have since I was 15 I guess it could be the time change and not a thing to do with the Lexapro. The insomnia has stopped. Sometimes we want to blame something when it probably has nothing to do with it. :rolleyes:

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Originally Posted by Aggie_Ama

Sometimes we want to blame something when it probably has nothing to do with it. :rolleyes:

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Jumping to conclusions is how I get my exercise when I can't ride. :D

Neurontin made me scrub my kitchen floor at 2AM. I just knew the grout had to be cleaned...or else. My ortho surgeon put me on it because I had neuropathy in my hands. I finally just had the cervical fusion & decided the grout would have to get dirty.

I'm confused & hope a chemist/pharmacy expert might be able to answer this question. Why is it that all of the drugs that are supposedly supposed to help folks(the type of illness/disorder/etc etc does not matter as there are drugs to help each one) have so many side effects? It's the 21st century & I would assume there's the technology...

It doesn't seem fair to create more conundrums for folks when all they want is a solution to their illness/disorder/etc etc.

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Originally Posted by crazycanuck

I'm confused & hope a chemist/pharmacy expert might be able to answer this question. Why is it that all of the drugs that are supposedly supposed to help folks(the type of illness/disorder/etc etc does not matter as there are drugs to help each one) have so many side effects? It's the 21st century & I would assume there's the technology...

It doesn't seem fair to create more conundrums for folks when all they want is a solution to their illness/disorder/etc etc.

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My best friend is a chemist for a very large pharmaceutical company. I've asked her similar questions. Why aren't they trying to find cures? Why are there so many side-effects? Etc.

Basically, she said, that the money is in treating symptoms--not in curing them. If there's more symptoms to treat, there's more money to be had . . .

This is why I now see a Doctor who practices Functional Medicine. I was on Lexapro for YEARS. It was great in that it really gave me my life back, but I suffered from so many side-effects. I was told that I would be a lifer on Lexapro. Now, I'm off all SIX of the prescription drugs I started taking at 25. And I feel better than I've ever felt. My doctor manages my depression symptoms naturally through supplements and diet. I won't go back on prescriptions--I can't stand the thought of being under the influence of something that was designed to rip me off, not make me better.

Aw, come on, let's get real - don't you think that if BigPharmaCo came up with a cure (for anxiety, depression, hangnails, what-have-you) without any sort of side effects they'd market it out the wazoo and make a fortune?

The reality is, science is (still) imperfect, and hasn't yet progressed to the point that it can mimic and predict all of the outcomes of any particular agent on a person it is meant to treat.

That is why there are clinical trials for new drugs, and why trials are in (at least) three phases. The first phase is to determine the safety and tolerability of the drug, figure out a safe dosage range (not effective - safe) and to determine if any side effects are present. In Phase II the drug is given to a larger group of patients to figure out what the effective dose range is and to further monitor side effects and tolerability. In Phase III, the drug is given to an even larger group of patients to determine its effectiveness relative to currently used drugs for that condition (if there are any), and to further monitor safety & side effects. The length, size and the precise nature of the clinical trials depend in large part on the disease/disorder being treated by the drug. But in general, clinical trials involve lots of people, lots of trials, and lots of bucks spent to conduct those trials.

Now, that said, does BigPharma have a profit motive? Of course it does. That is why there are treatments out there to cure such life-threatening conditions such as baldness and erectile dysfunction. :D (OK, that was snarky of me, those are traumatic situations for those involved ... but you know what I mean ...)

And if the clinical trials for a certain disease are very lengthy and/or involve vast quantities of patients, some companies (especially smaller companies) might shy away from attempting to develop treatments for that disease, or at the very least try to partner with a Big(ger)PharmaCo with deeper pockets. Companies survive and fail based on the outcomes of these trials, so yes, it's big bizzness.

So, it's not as simple as it sounds. Like everything else. :rolleyes:

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Originally Posted by jobob

Aw, come on, let's get real - don't you think that if BigPharmaCo came up with a cure (for anxiety, depression, hangnails, what-have-you) without any sort of side effects they'd market it out the wazoo and make a fortune?
:rolleyes:

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I'm just passing on what my friend told me--word for word. I wasn't trying to be cynical and if you knew me personally, you would know that I'm not into conspiracy theories, etc. Sadly, this has been my personal experience with commercial medicine. Its a cycle I see my parents going through--being prescribed prescription drug after prescription drug to satiate side-effects while no one bothers to investigate the origin of the problem.

You can roll your eyes, that's fine. I just want people to be aware that there are other options out there and they are worth being explored. Prescription drugs are NOT the only solution.

Well I work in the field too and I would strongly disagree that companies prefer to have drugs with side-effects so that they can make more money.

The reason there are so many side effects is that the drug acts at many more places other than where you need it to act for its benefit. They aren't really "side effects" but are what we would call extensions of the pharmacology of the drug or exaggerated pharmacology. So you need a drug to act at point B in order to benefit you. Unfortunately, point B exists at more parts of the body than just the one you are looking for. Or point C and D are physiologically very similar to point B and so the drug has effects there too.

The body is a very complex thing and finding a drug that does one thing only at one point only in the body, is damn near impossible. But trust me when I say that companies are definitely trying to find more exact mechanisms.

I'm sorry you took offense to my comments, limewave, but to be honest I took a bit of offense to your friends'.
(Or I would have, were I still in the lab trying to work on such things.)

She says the money is in treating symptoms, not curing them. In one respect she's right. The bar is much higher for cures than for treatments. What defines a cure? Absence of symptoms or absence of the physiological marker for the disease - but, for how long? Forever? So if a patient has a relapse after 5 years, then it's not a cure? The devil is in the details.

Plus, how safe and tolerable is a "treatment" as opposed to a "cure"?

It's easy to be cynical about pharma - lawd knows I am, often!! - but sometimes when I boil it down to the basic problems and issues and realities, I can (grudgingly) realize that there are a lot of factors in play and it's not a big 'ol conspiracy.

I'm glad that you found an alternative that works for you.

And I'm sorry that your folks have had a difficult time with their prescriptions. It can get mind-boggling. But do you really know that no-one has bothered to investigate the origins of their problem(s)? That's painting with an awfully broad brush, isn't it?

Perhaps the dispensing physician or pharmacist are not giving you (or your folks) the kind of information you/they desire? Just wondering.

I'm in the industry too and can only back up what they said. Pharma bashing is convenient but not always backed by logical thinking.

If any of the big Pharmas *could* develop a miracle drug that with one dose or one course, could make depression go away, forever - they would go to FDA, NIH, and health insurance companies etc. and tell them look, we can save you tens of 1000s of bucks per person for doctors fees, chronic medication, psychotherapy, even institutionalization - we'll charge 20'000 (or insert any other, largish amount) a course and the patient is done.*
It would be fair, and it would be nice to have.
Unfortunately depression like many other chronic illnesses is poorly understood, possibly multifactorial and can't just be switched off by finding the right button. At least not yet. Therefore, this is an example for a disease where only symptoms can be treated.

Bacterial infection? Other issue entirely. As long as the strain is not resistant (which is an almost inevitable consequence of the development and use of these drugs, it is "directed evolution"), the course of antibiotics will cure the disease and not just gloss over the symptoms.

Or you vaccinate. Maybe, one day, there will be a vaccine against depression. Who knows.


*they cannot just give the drug away. It's a business to make profit.
A drug costs between 0.5-0.8 billion $ to develop. You have to recoup that, and a profit on top. And if it only takes one shot, that shot is gonna cost.

Jobob--sorry, I was in a defensive mood this morning. Didn't mean to come off harsh.

I am not anti-medication, but I think we need to be very informed. There are other ways to treat depression, or at least use in conjunction with meds, until you can wean off of them, and I am not talking about quackery here. It's just that the development of these medications has changed the field of psychotherapy so much, that meds are the only thing many think of, in terms of treatment. It scares me when one of my close friends has been prescribed Lexapro by her gyn. She has a mess of issues and has not had any counseling. The medication does not seem to be effective (there was some good response in the beginning), but after 5-6 years, she just takes her dose and wonders why no one can stand to be around her. How is her case being monitored?
I know that Aggie is not in that position, but many people are.

No sweat, limewave! :cool: :)

And Crankin, you're making a very good point. Is your friend willing to look into counseling? When one is in that sort of position, it's very hard to take those kinds of steps (been there, avoided that) but sometimes one has to take the bull by the proverbial horn and be a bit self-reliant to get the kind of help one needs. Much easier said than done, unfortunately.

agree with jobob here - what is a gyn doing prescribing antidepressants?

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Originally Posted by Crankin

I am not anti-medication, but I think we need to be very informed. There are other ways to treat depression, or at least use in conjunction with meds, until you can wean off of them, and I am not talking about quackery here. It's just that the development of these medications has changed the field of psychotherapy so much, that meds are the only thing many think of, in terms of treatment. It scares me when one of my close friends has been prescribed Lexapro by her gyn. She has a mess of issues and has not had any counseling. The medication does not seem to be effective (there was some good response in the beginning), but after 5-6 years, she just takes her dose and wonders why no one can stand to be around her. How is her case being monitored?
I know that Aggie is not in that position, but many people are.

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I agree with this. Yes, the meds have their place, but too often people look for the "quick fix" of a pill instead of trying other things (like counseling and lifestyle changes) as the first line of treatment. This really applies to a lot of things (weight loss, cholesterol, blood pressure) and not just depression. Sometimes the meds are still necessary, but in many cases I think things can be solved without them and that eliminates the possibility of side effects.

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Originally Posted by alpinerabbit

agree with jobob here - what is a gyn doing prescribing antidepressants?

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In defense of gynecologists--they are primary care physicians, just as internists and family practitioners. Most have done advanced work in psychopharmacology and are highly qualified to prescribe antidepressants. Reputable physicians of all sorts know when to refer to specialists and do so regularly--including to psychiatrists, psychologists, therapists, etc. It's true that I am married to a very well-respected gynecologist, so I suppose I'm a little biased.

Since depression occurs in more women than men, it is not unreasonable for a gyne to prescribe antidepressants. Depression can be triggered by hormonal imbalance, such as post-partum depression, and ob-gyne docs are trained to diagnose and treat this illness.

I guess he prescribes it for her because he is her primary care physician. I know him socially (not a friend, but belongs to my temple) and he is a good doc, but I think it needs to be monitored.
Jobob, my friend has had counseling in the past, when things were really bad in her marriage and when there were kid issues. That was quite awhile ago. It is a long and complicated story. I truly think that she knows she has issues, but she is so rigid in her thinking that she just says, well, this is the way it is. Eventually, I may say something to her, but even as a therapist in training, I know I shouldn't be "counseling" a friend. For me, it's a situation of not being able to cut off ties all the way, for many reasons, but not being able to stand being around her, either. So, I limit my phone calls to 1-2x a month and we rarely get together socially as opposed to in the past. She also has ADD and can't remember anything. It's getting worse, or maybe I didn't notice it before. If something was a certain way, like 10-15 years ago, that's how she remembers it. Like, if when my son was 12, he liked something or did something, then she thinks thats how it is today, even though he's an adult. She thinks she has to do things the way "mommy and daddy (her words)" did them, even though, she overtly hostile to her mother and says how judgmental and demanding she is; guess what? She is exactly the same.
OK, enough of my example. I will end with this: She came to yoga with me one time last year. At the end, she said, "Oh, I never get this relaxed. This is really great." I told her that's a good reason to practice yoga and that it might help her in various ways. Her reply was, "Oh, I don't really believe in this stuff."