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Lexapro and Caffeine...

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#1 jen5276



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Posted 31 December 2005 - 11:12 AM

Hi everyone!

Does anyone here know if drinking coffee and taking Lexapro is a bad combination?  I have noticed in the past few weeks that if I drink more than my one cup EARLY in the morning (for instance, if I have a cup in the afternoon) I totally can't sleep that night.  I know I have read about how caffeine can cancel out the anti-anxiety effects of an SSRI, particularly Lex, but this seems a little extreme.  I can't even enjoy my Friday afternoon cup of Joe anymore!!

I know I should switch to decaf, but what can I say?  I enjoy the little buzz I get from the coffee, I just would appreciate if it would go away at some point so I can catch some zzzzzzzzzzzs.

Last night I had to take a Lunesta to get to sleep which is unusual for me on the weekends.  Usually I only take my sleep meds during the week when I have to get up for work, on weekends I give myself a break from them.

Any info please!! Thanks and HAPPY NEW YEAR TO EVERYONE!!! ;)
Teenage angst has paid off well - Now I'm bored and old.

- Nirvana "Serve the Servants"
Drifting body it's sole desertion
Flying not yet quite the notion
Into the flood again
Same old trip it was back then
So i made a big mistake
Try to see it once my way
Am i wrong?
Have i run too far to get home?
Have i gone?
And left you here alone?
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#2 scream_phoenix



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Posted 31 December 2005 - 05:56 PM

you may just be having difficulty falling asleep on the lexapro regardless, and the caffeine is just one more thing preventing you from falling asleep.  how long have you been on the lexapro?  i know when i switched from luvox (which does have interactions with caffeine) to lexapro (which i'm pretty sure doesn't) the 50 mg of seroquel i took for sleep didn't cut it anymore.  i think it was because lexapro has a longer half-life, so it just never wore off and i never felt sleepy at night. 

that was the beginning of last year, but i've been off of an ssri for four months, and just stopped the seroquel two weeks ago - but i still have a really hard time falling asleep.  it takes me till around 3 or 4 at night to fall asleep, and i sleep until eleven.  so falling into a normal sleep pattern on or off the meds can be hard.  you may need something else for sleep like seroquel.  but if you can stand it, i would cut out the afternoon coffee and see if that helps any.  i don't think there's anything special to lexapro when you drink coffee that makes you stay awake, but falling asleep on an ssri is tough regardless and an afternoon shot of caffeine is probably only going to make things worse. 

Dx: OCD, PTSD (Depression and Anxiety throughout)

Rx: Klonopin 1mg x 2.5 day, Celexa 60 mg, Lamictal 200 mg, Seroquel 300 mg

#3 whitenoise



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Posted 31 December 2005 - 09:04 PM

It's an interesting question. Personally, I've also found that caffeine and SSRIs (including Lexapro) do tend to interact. I've thought up two reasons why this might be the case -

Firstly, some SSRIs inhibit the liver enzyme that breaks down caffeine. This means that caffeine stays in your system for longer. Compared to other SSRIs, Lexapro apparently doesn't affect liver enzymes very much, but it could still be a factor here.

Secondly, caffeine causes the release of serotonin (along with many other neurotransmitters). SSRIs, to state the obvious, block the reuptake of serotonin. Put these two together, and you potentially get a lot of serotonin floating around, which might keep you awake and cause agitation. 

I'm on 5mg lexapro, and take a moderate amount of caffeine (200-300mg/1 cup) in the morning only and I can sleep okay. I don't think you need to quit coffee completely, just take it in moderation. It's probably a bad idea to drink coffee in the afternoon regardless, because caffeine has a half life of 3-10 hours so by night-time there will still be a lot of it floating around your system.

Happy New Year and good luck with it.

EDIT: Corrected half life. Sorry about that!  ;)

Edited by whitenoise, 04 January 2006 - 01:40 AM.

#4 Stasis


    Uncle Duke is up off the floor

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Posted 31 December 2005 - 09:51 PM

I seem to
Spend too much
to Stay awake.
can trigger some agitation,
Lots of times,
I swear,
I can drink,
"Float a horse-shoe Strong"Coffee
go crash for hours.
I'm on 20 mg Lex,
The benzo's might(ya think)
have something
to do with this.
my Various Anx's and OCD
have been
lots of stress.
more Klonopin+ativan
mmm.(the ativans don't taste very good anymore)
I've been lots
of help.

Wake me up,
if you need
something else.

Never turn your back on Nature,
She is a cruel,demanding Bitch

#5 chimpmaster


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Posted 31 December 2005 - 11:36 PM

The only ssri that has a reported significant interaction with caffeine is luvox.  Studies show it can increase the effect of caffeine by 5 times and last 5 times as long (approx).

With other ssris like lexparo, caffeine may be agitating for some people but there are no conclusive studies that I have heard of or read.

Caffeine can certainly cause agitation in some people, so if you feel its upsetting you, its probably wise to drop it or cut down (changing from coffee to tea, or tea to green tea are some examples).

I personally drank coffee whilst on luvox and found it to be fine, and I drink it now on paxil (60mg) and enjoy it daily.  I would never have more than 2-3 cups per day though, and I suspect high quantities could be more problematic.

Dx : Schizophrenia, paranoid type with panic attacks. Obsessive Compulsive Personality Trait, epilepsy

Rx : 300mg Clozapine, 1500mg Keppera, 60mg Prozac, 160mg Zeldox, 4mg Reboxetine, 3 oxazepam morning and lunch, 3 in the evening
Ex Rx: Luvox, Paxil, Risperdel, Xanax, Seroquel, Abilify, Zyprexa, Tolvon, Mirtazapine, diazepam.

#6 jonathanupr



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Posted 02 January 2006 - 10:24 PM

Lex makes me sleepy..........i have drunk caffeine on it before i got on Adderal.......while on Lex, drinking coffee was decent, my OCD didnt flair up as much......i didnt see much interaction between the Lex and caffeine.

#7 crazychic



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Posted 03 January 2006 - 02:03 AM

I second that. Lexapro makes me tired & sleepy 24/7. Even if I drink my usual 3-4 Diet Coke's a day. Which is why I am getting off this Lex soon...
Thoughts are like ghosts - you can't see them, but they can scare you to death.

#8 whitenoise



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Posted 03 January 2006 - 06:34 AM

AFAIK, whilst Luvox is indeed the only SSRI that significantly inhibits the "CYP1A2" enzyme (which breaks down caffeine), other SSRIs may have a marginal affinity for it too.

Also, this is an interesting paper - "Possible serotonin syndrome arising from an interaction between caffeine and serotonergic antidepressants" http://www3.intersci...087387/PDFSTART. Although this case involves very high caffeine consumption, it does suggest that pharmacodynamic (i.e. in the brain, not just in the liver) caffeine/SSRI interactions are possible.

#9 scream_phoenix



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Posted 03 January 2006 - 07:11 PM

it appears you need to pay $25 to register and view that article.  or maybe you can register for free, but either way we can't view the article directly.  can you summarize it for us?

and just to be clear, luvox is the only ssri that is metabolized by the same enzyme that metabolizes caffeine.  so when you're on luvox, you essentially can't metabolize caffeine at the same time - so it stays in your system for up to 8-10 hours (as opposed to 2-3 regularly, that is at least what a pdoc told me once, i'm not really sure what the half-life of caffeine is) and it amplifies the effect up to five times.

  i realize that's essentially saying the same thing, but i just wanted to reiterate that because as a former luvox/caffeine abuser - i wish i would have learned that out when i started taking it, instead of six years later.  because for awhile i think i was unwittingly abusing this property - and it made me feel really really good when i drank caffeine.  but i think it also hollowed out my brains dopamine receptors.  and eventually it just gave me a headache when i drank caffeine.  i've been off of luvox for a little over a year now - and i assume things have equilibrilized at this point, but i still wonder if that repeated caffeine intoxication had any long term effects. 

i'm curious to what your article says though too

Edited by scream_phoenix, 03 January 2006 - 07:12 PM.

Dx: OCD, PTSD (Depression and Anxiety throughout)

Rx: Klonopin 1mg x 2.5 day, Celexa 60 mg, Lamictal 200 mg, Seroquel 300 mg

#10 whitenoise



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Posted 04 January 2006 - 01:39 AM

That's odd, the link works fine for me and I haven't registered or anything. Anyway, here is the last 2 paragraphs (which falls under fair use, I should hope)  -

The tachycardia, tachypnoea and increased CPK level in this case can be interpreted as results of a caffeine overdose, but the hyperthermia, diaphoresis, myoclonus and muscle rigidity cannot be explained by the effects of a caffeine overdose. On the other hand, if we assume that the patient had developed the serotonin syndrome because she was taking paroxetine and amoxapine, the above symptoms can be explained easily (Mills, 1997). Paroxetine is a selective serotonin reuptake inhibitor, and amoxapine also has a serotonin reuptake inhibiting effect, although it is relatively weak (Richelson and Pfenning, 1984). The doses of these two drugs, however, were too small to have caused the serotonin syndrome. The results of experimental studies (Okadaet al., 1997; Yamato et al., 2002) have shown that caffeine has an action that promotes serotonin activity. Therefore, even though the doses of paroxetine and amoxapine in our case were small, the serotonin activity in the brain may have been increased by the caffeine overdose and caused the serotonin syndrome to develop.

Since over-the-counter products containing caffeine are readily available to the general public, clinicians should remain alert to their adverse effects and their interaction with other drugs. Specifically, it must be borne in mind that large doses of caffeine taken with antidepressants that have a serotonergic effect put patients at risk of developing the serotonin syndrome.

#11 scream_phoenix



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Posted 04 January 2006 - 02:22 PM

are you using a university computer?  cause it looks like on the website you need to be an institutional subscriber to get the articles for free. 

Edited by scream_phoenix, 04 January 2006 - 02:23 PM.

Dx: OCD, PTSD (Depression and Anxiety throughout)

Rx: Klonopin 1mg x 2.5 day, Celexa 60 mg, Lamictal 200 mg, Seroquel 300 mg

#12 Guest_Damon_*

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Posted 28 December 2010 - 09:07 PM

I am on zoloft 50mg daily for anxiety and depression. I have tried to stay away from caffeine in general since my anxiety has recently increased. Today I had a much smaller amt of caffeine than I used to have, but probably more than I've been having in several mos. I definitely notice a difference! A doc told me that some SSRIs work on norepinephrine in addition to seretonin, which accounts for the insomnia some people experience on SSRIs. I think there are individual differences and some people are fine while it has an effect on others.

#13 colinmichaels



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Posted 29 December 2010 - 09:45 AM

I'm on Lex about 3 months and sleeping great-using the same amount of caffiene as before no problem whatsoever-I drink two cups of regular coffee and I cup of regular green tea. I probably should'nt because i have GAD-but when i quit in the past for several months I became noticably more depressed. I am a big beleiver in the positive mood enhancement of caffeine-ya just gotta watch how much- a little goes a long way. I like to stretch it out over a period of about 6 hours> I make a pot of tea first thing with 4 decaf bags and one regular bag. That gives me a little dose of caffeine. Then about 2 hours later I make a big pot of coffee. I use several TBs of decaf and 2 level TBs of regular. This way I can sip it for a couple hours and the caffeine is doing its job. Caffeine all at once will give me panic attacks in certain circumstances so got to be very careful and in some situations i forgo caffeine altogether.
ColinMichaels - currently taking ativan as needed-upped Lexapro from 10 to 15 mg as of 01/28/11-EPA fish oil 1200 MG-vitamin d 1000 i.u, taurine-500mg, green tea 5-6 cups (source of theanine)-chamomile tea 3 cups

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