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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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on lexipro and have been for 5 years had gotten all the way

Resolved Question:

on lexipro and have been for 5 years had gotten all the way down to 2.5 but in may took some kelp and triggered my chemicals out of contro; went back to 10 then weened myslf to 5. almost a month to the day have been having onn off good days, a coule of nervous nights where i took a 1/2 klonipin and just blah days after a day or so of good ones all at that time , I started my menstral plus had taken a new bottle of lexipro? can any of these two be a reason for how i am ? hate this
Submitted: 5 years ago.
Category: Mental Health
Expert:  Dr. Ed Wilfong replied 5 years ago.

Dr. Ed Wilfong :

A couple possibilities. If you taper too slow, you get only side effects and no benefit. You should be able to stop from 10 mg and side effects gone in a3-4 days, if you have any at all. Varying sub-therapeutic dosages can be very uncomfortable. Often it is just an indication you still need medication. I would give second thought to quitting. Sometimes the symptoms of needing medication are delayed after quitting.

Dr. Ed Wilfong :

Sometimes after a long period of time, Lexapro can lose effectiveness, in which case a different agent (med.) may be needed. Neurotransmitters are hormones and some theorize the need is greater during menstrual period. I doubt the kelp theory, but honestly don't really know.

Dr. Ed Wilfong :

I would either just quit it, or get back on therapeutic dosage (my recommendation). If the latter does not work, I would ask MD to change meds.

Dr. Ed Wilfong :

From your "already tried" sounds like Lexapro was doing well.

Customer:

i would love to get off but now i just want to feel "normal" and i like when i have a reason why my chemicals go off for a couple of days but this has been 3 weeks and dint ave a legitimate answer

Dr. Ed Wilfong :

3 weeks since what?

Customer:

since i have been feeling on n off

Customer:

chemically

Dr. Ed Wilfong :

It is not discontinuation problem. Serotonin does normalize the amount of serotonin. You should feel normal on it. Some people feel like emotions are blunted somewhat on medications, but you are most likely off chemically because you need the medication. It does not technically add serotonin, it just make what you have last longer. An analogy - it doesn't give you more gas, it just make what you have more efficient.

Customer:

so i should go back to 10

Dr. Ed Wilfong :

was that your usual dosage (20 is typical)

Customer:

10

Customer:

yes

Dr. Ed Wilfong :

Yes. Give it 3-4 weeks to be stable then re-evaluate how you want to proceed.

Customer:

and can it have to do with female hormones (perimenopausal)

Customer:

im 45

Dr. Ed Wilfong :

Yes, but lexapro should help, not make it worse. If 10mg does not help, it may be you need to increase to 20 mg.

Customer:

only thing i feel better chemically but i definitely have less energy cant imagine what 20 would do. right now, my face and neck are completely flushed, which sometimes scares me to not know if it can ever be better again

Dr. Ed Wilfong :

That may be other hormones. You may want to have OB-GYN run labs.

Dr. Ed Wilfong :

If lexapro is too sedating, something like cymbalta or Pristiq (one of the SNRIs) usually are not fatiguing.

Dr. Ed Wilfong :

I would still try 10mg of lexapro first.

Customer:

ok i appreciate the advice! thank u n God bless

Dr. Ed Wilfong :

you are welcome and best wishes to you

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