It’s too early, right? Or maybe it’s not...

[GoGo]

Hello,

I’ve been telling myself it’s too early to tell if Lexapro is working for my anxiety, but maybe it’s not. Maybe I should be feeling something by now?

Here’s the story... I’ve been in Lexapro for years for anxiety. It always worked well. I’ve been on doses as high as 40 mg, but last year it was down to 20 mg. Then in January I decided perhaps I didn’t need it anymore. Maybe I didn’t need to stay on meds forever. So I tapered off.  No discontinuation syndrome or anything. It seemed pretty easy.

Then in mid March my anxiety came roaring back. Bad. Like it was making up for lost time. My earlier PDoc had retired, but I found a new doc who put me back on Lexapro on April 9 (22 days ago). He told me to take 10 mg for the first five days and then go up to 20, which I did. So I’ve been on 20 mg for 17 days. He did warn me that sometimes it doesn’t work again after stopping. And that is my big fear. It worked so well before!

I tell myself to wait at least 4 weeks, but should I be feeling a bit better? If anything, the anxiety is worse. That tends to be how my episodes go: they get worse before they get better. 

So, if not Lexapro, what is next? Another SSRI or something different? I was prescribed daily Ativan to get me through this time, but I’m afraid to take it and reserve it only for absolute emergencies.

 

 

[CeremonyNewOrder]

Meds rarely work for me when I try them for a second time which really, really sucks. I'm sorry for your experience. It sounds like you may need to try another SSRI if you don't get some relief soon.

[BrianOCD]

Don't be afraid of Ativan, I've taken it on and off for 15 years or so without problems, withdrawals can be bumpy but it's relatively safe if you're not abusing.

I was on Lexapro for 7 years, then tried a bunch of others before landing on Effexor.  Might just be time for a new medication.

[HydroCat]

Don't be afraid to try a different SSRI.

I've never been on Lexapro, but have have been on (and off) Zoloft and Prozac - above the recommended max dose.

Both were good for my anxiety/depression, had no side effects at all and no discontinuation issues when switching.

Eventually, SNRIs were better for me, so even if a different SSRI doesn't work you still have other options.

Good luck!

[GoGo]

Thanks everyone! I meet with my PDoc Monday and we’ll see what he says. I’m still holding out hope it is just too early. I recall it took at good 4 weeks at 20 mg to feel anything before. So maybe it’s just that again. If not, will try other options. I just love how Lexapro gave me so few side effects (dry mouth for a month or so, and that was it).

[GoGo]

Update: I saw my PDoc yesterday. He sees some progress because my appetite has returned, my sleep is better, and most of the panic is gone. He reminded me that I haven’t yet been at a full 4 weeks at the 20 mg dose, and sometimes it takes more than 4 weeks to see the full benefit. This has been my experience: I am slow to see the full benefit of Lexapro (although I seem to be a fast metabolizer of the Ativan—it doesn’t kick in for an hour and then it’s gone in another 3-4 hours).

Because of this, he wants to keep me at 20 mg for now. I’ve been on as much as 40 in the past (different doc),  but this new doc doesn’t believe the higher doses do better. Plus insurance can be reluctant to pay for higher doses (why do these companies insist on giving MORE anxiety to people already suffering...) 

He also prescribed 20 mg of buspirone (10 mg twice a day). I’ve heard it’s not really effective, but he said that is mostly by itself, and he has seen good results with it as an add on to an SSRI. We’ll see. I’ll give it a shot. 

I see him again in three weeks. In the meantime, I am working with my therapist who has been a true life saver. 

Keeping my fingers crossed!

[Iceberg]

Good luck!!

[browri]

On 5/8/2018 at 6:25 PM, GoGo said:

He also prescribed 20 mg of buspirone (10 mg twice a day). I’ve heard it’s not really effective, but he said that is mostly by itself, and he has seen good results with it as an add on to an SSRI. We’ll see. I’ll give it a shot. 

Your pdoc is right. Buspirone does seem to be relatively useless on its own but it has proven to be a very effective booster to an antidepressant. They've tested this theory by coming out with Viibryd (vilazodone) and Trintellix (vortioxetine) which both are not only SSRIs but also 5HT_1A agonists like buspirone which accelerates the time to effect. Take the buspirone regularly like your pdoc says and you'll likely find that things start kicking in faster.

[notloki]

I took it for years by itself and it works just fine by itself.