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Ask Dr. Ed Wilfong Your Own Question
Dr. Ed Wilfong
Dr. Ed Wilfong, Psychologist
Category: Mental Health
Satisfied Customers: 1528
Experience:  Twenty-five years treating all ages; Specialities: psychopharmacology & diagnosis, MMPI-2, testing.
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Can Cipralex (20mg taken for one year) have like an opposite

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Can Cipralex (20mg taken for one year) have like an "opposite effect"? ie. my anxiey and oc issues are resolved, in fact, I seem to not care or be anxious by anything - quite the opposite. I am tired have put on 25 pounds and am very "flat"

Other medicatons ie Prozac and Effexor have not worked lately (generic brands anyway).

I also take 300 mg Wellbutrin.

Should I stop cipralex, increase, decrease dose or perhaps add dexedrine or something?

Thank you for your time and consideraton.
Celexa (Cipralex) doesn't exactly have an opposite effect, but can make you feel somewhat emotionally constricted. It cuts the major bad feelings of anxiety and depression, but many people feel like their range of emotions. It is called an apathetic recovery. Fatigue and weight gain are happen on Celexa, but not as often as some other medications. Wellbutrin is the first choice for treating this.
I need a little more information to make any recommendation.

  • How long have you been on Wellbutrin? Has it made any difference?
  • What is maximum dosage of Prozac you were on and for how long? What did it do, why quit?? Same for effexor.
  • Are you in US or another country (it makes a difference in what doctors will prescribe).
  • What are your priorities in improving the treatment (what can you live with, what is highest priority
Let me know, I am around for another hour or so, and will be back later, so please be patient if you miss me initially.
Customer: replied 6 years ago.
Hi, thank you for your response,

The max. dosage I was on for Prozac was 40-60 and 300 for Effexor - it seems to me the generic meds don't work for me, thus when in Canada, when the patents are up, our medicares system only covers generic, then they seem to stop working. Quite frankly, they all seem to stop working after a year or so which sometimes corresponds to the patent time. Effexor was the best but I had quite uncomfortable side-effects; sweating, blood pressure problems, but it helped the best for depression, fatigue, energy.

I have been on Wellbutrin, 300mg., for a year too (as a counterbalance to sexual side-effects of the Cipralex). I am in Canada - I believe it may be Lexapro in US?

I only been on Wellbutrin, 300mg. alone once, and it seemed to worsen my anxiety.

My biggest issues are anxiety, fatigue, lack of energy, stress management. I have also put on 25 pounds this year, since being on the Cipralex.

I only seem to get majorly depressed,occasionaly, as a result I believe of the anxiety and obsessive compulsive/ruminations the anxiety can bring on. When I do become depressed it is very bad - I have been virtually bedridden a few times for approx. 6 months in the last 10 years. I was also off work those times on disabiliity. I definately know I cannot handle stress. I have moved, changed careers lifestyle etc. to manage that, which has helped to some degree. As has therapy.

Thank you.
Yes, my mistake, it is Lexapro in US. We have same off patent policy here in US. Although there a couple drugs that we used to use where generics have different response, but I have not heard that on any of the drugs you are taking. You mentioned before that Anxiety and Depression were pretty much resolved on Lexapro. Well butrin alone is definite not helpful for anxiety.

As your history would indicate, a combination of medication and psychotherapy will give you best result. Medication would help with stress tolerence. Sometimes, as I mentioned there is an emotional constriction with treatment. Although this happens, sometimes it seems medication related, other just people are so used to living with anxiety and depression, it just feels odd not to have them.

Since the Wellbutrin doesn't seem to be doing much for energy and weight, you might ask doctor about Modafinil may work. It doesn't interact with the lexapro (wellburin has helpful interaction) and is a good try for weight and energy. It is pretty much a stimulant, but not as dangerous as Dexamphetamine (which might be next step, if you doctor doesn't think you are nuts for asking. Here it as restricted as narcotics.

The burning out after a year on each medication (Prozac) is not unusual, especially if underlying personal issues are not worked out. I don't think that has happened yet with lexapro so I would look at Modafinil instead of stopping lexapro.
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