How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Vikas Your Own Question

Dr. Vikas
Dr. Vikas, Psychiatrist
Category: Mental Health
Satisfied Customers: 2207
Experience:  MBBS ; M.D Psychiatry, MS. Health Informatics
Type Your Mental Health Question Here...
Dr. Vikas is online now
A new question is answered every 9 seconds

how do i come off lexapro

Resolved Question:

how do i come off lexapro
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Vikas replied 1 year ago.

Dr Vikas :

Hello

Dr Vikas :

First of all, you need to tell your doctor about this as soon as possible and then discuss with him or her about tapering it down.

Dr Vikas :

Lexapro need to be taper down slowly to avoid discontinuation / withdrawal symptoms as you must be knowing.

Dr Vikas :

Most patients are able to taper it down by reducing 5 mg per 4 to 5 days or may be 10 mg per 4-5 days depending on the toleribility.

Dr Vikas :

For example, if a patient is taking 10 mg per day, he or she can start tapering by taking 5 mg for 4 to 5 days and then discontinuation.

Customer:

My doctor said the other day that it is not a true anti-depressant that it is not meant to make you feel happy like other anti-depressants is that true? I feel numb all the time, disconnected, not in my body, so far away from from everything and he said that is the whole point of it. I hate that. I have no emotion. I can't connect with anything or feel any emotion. He said the whole point of it is so I so don;t get upset with situations etc. All I am doing is existing and I hate it.

Dr Vikas :

I slightly disagree with your doctor here as it is an antidepressant just like all other available in the market.

Dr Vikas :

what is the dose you are currently taking?

Dr Vikas :

are you there?

Customer:

yes I am here

Customer:

I am on 20 mg

Dr Vikas :

some patients who are taking SSRI antidepressant like Lexapro may complain of emotional numbness. You started noticing it after starting Lexapro or it was already there before you started this medicine?

Customer:

I would have with periods coupled with high anxiety

Customer:

now I am numb all the time

Customer:

so it has been good for that

Customer:

now I am a zombie

Dr Vikas :

OK, you need not to worry about this a bit as the situation will improve very soon. Do you think that Lexapro is helping with your anxiety and depressive symptoms or not?

Customer:

I hate because I am not really phased when say bad things happen in the world, it is not as though I don't care

Customer:

I been on it for about two and half years now

Dr Vikas :

and it is helping a bit or not?

Customer:

my anxiety denfinetly

Customer:

my depression--i am flat all the time

Dr Vikas :

OK good, then there are two possible alternative in your case which can be very helpful in controlling this emotional numbness.

Customer:

but i do get a lot of suicidal thoughts

Dr Vikas :

your doctor knows about it?

Customer:

that get quite disturbing and i have to push them out of my mind

Customer:

yes

Customer:

i have tried four times on lexapro

Dr Vikas :

OK, see, you just discuss with your doctor about adding Bupropion (Wellbutrin) along with Lexapro.

Dr Vikas :

have you tried it already?

Customer:

i don't think we have this in my country because i already asked

Customer:

that was in 2010

Dr Vikas :

I don't think so,let me check

Customer:

that i asked, i think you can only get it in the states and a few other countries

Dr Vikas :

http://www.pbs.gov.au/medicine/item/8465M-8710K

Dr Vikas :

check this link

Customer:

australia?

Customer:

has it?

Dr Vikas :

have you gone through the link

Customer:

okay i will

Dr Vikas :

just click it now

Customer:

checking

Dr Vikas :

to check

Dr Vikas :

OK

Customer:

oh wow

Customer:

yes you can get it

Customer:

i will have to talk to him

Dr Vikas :

OK, so you can discuss with your doctor about it and the combination of Lexapro with Bupropion can be very useful in your case in my view

Dr Vikas :

the other thing which you can do right now is to try Cognitive Behavior Therapy

Dr Vikas :

have you tried CBT?

Customer:

i discussed changing and combinations but he was hesitant--the only one he was think was the new form of effexfor

Dr Vikas :

OK, he must be talking about Pristiq (Desvenlafaxine)

Customer:

i started if but the therapist wasn't that great because my home-town we have a lot of psychologists etc--but not a lot that are experienced in cbt so willing to do it but with someone that can actually do it so will have to travel a little bit further. As if I am going to do it I rather do it with someone that has the proper training. I go to a psychiatrist but I don't think he has the time to do cbt (he isn't in my home town anyway)

Dr Vikas :

You now have the option of trying CBT for free online from your home.

Dr Vikas :

would you like to try that

Customer:

I was put on effexor when I was 15 and had a horrible experience so I rather not try it---thanks for the info about well

Customer:

really?

Dr Vikas :

YES

Customer:

yes!

Dr Vikas :

:)

Customer:

:-)

Dr Vikas :

here is the link

Customer:

anything to make my life better

Customer:

your amazing

Dr Vikas :

and the other one is from Australia

Dr Vikas :

MoodGYM: Welcome

Dr Vikas :

you can try any one of them.

Customer:

this is so cool

Dr Vikas :

Cognitive Behavior Therapy can bring long lasting benefit in your thinking pattern and the resultant depression and negativity.

Dr Vikas :

and should be helpful for emotional numbness also.

Customer:

yes I heard it is good

Dr Vikas :

great

Dr Vikas :

A combination of CBT with medicines can be very useful in your case

Customer:

wow that is cool because I find it hard going out

Customer:

yes medications don't do everything

Dr Vikas :

don't worry and most important, don't loose hope at all :)

Dr Vikas :

you will be back to normal very soon

Customer:

no I won't, its really hard,

Customer:

will this chat be printed online?

Dr Vikas :

I really do appreciate that.

Dr Vikas :

yes, you can see the whole chat once we have finished and you have rated my answer.

Dr Vikas :

you can even print it out also.

Customer:

i mean do you make it public?

Customer:

so other people can read it?

Dr Vikas :

it is for you. If you have any concerns about privacy you can discuss this issue with the JA moderators / management. I dont think your personal details are mentioned anywhere in this chat.

Dr Vikas :

:)

Customer:

i have medical conditions so would wellbritrun be suitable for them?

Dr Vikas :

?

Dr Vikas :

which one?

Dr Vikas :

In my view, you can first try CBT and see if helps

Customer:

narcolepsy and epilepsy

Customer:

yep double whammy

Dr Vikas :

OK, Bupropion is not prescribed if a patient has Epilepsy.

Customer:

oh damn

Dr Vikas :

In that case Lexapro with CBT should do the job

Dr Vikas :

:)

Dr Vikas :

otherwise, Pristiq is a newer antidepressant which has to be taken in singly daily dose, is acting on two neurotransmitters and is better then Effexor

Dr Vikas :

in my view.

Dr Vikas :

so you can discuss with your doctor about it also.

Customer:

is that just a caution they go with because the same thing is on the packet with lexapro

Dr Vikas :

well, it is a sort of contraindicated because Bupropion lowers seizure threshold.

Customer:

well with effexor i had first seizure ever within six weeks of taking the medication- so i be worried taking anything remotely like effexor

Dr Vikas :

no it is not like Effexor

Customer:

so would pristiq lower my threshold

Customer:

is pristiq an ssri

Dr Vikas :

it is a modified form of Venlafaxine (Effexor)

Dr Vikas :

no, it is SRNI antidepressant just like Cymbalta or Effexor.

Customer:

oh okay

Dr Vikas :

if you are worried about Effexor, you can discuss with your doctor about Cymbalta also.

Customer:

oh okay so what is the run down of that?

Customer:

is it new?

Dr Vikas :

no it is also a bit old but a very good alternative to Effexor. I personally prefer Duloxetine (Cymbalta) over Effexor.

Customer:

oh okay cool

Dr Vikas :

:)

Customer:

you know reboxetine

Dr Vikas :

and you can start CBT from today itself.

Customer:

i was on that just on its own before i went to the pychiatrist

Dr Vikas :

ya, but I don't found it very useful in depression honestly speaking.

Customer:

but he took me off it because he said studies say it doesn't work for depression

Dr Vikas :

:)

Customer:

i asked him what about combining them (to kind of lift my mood) but he doesn't think it will work

Customer:

not too keen

Dr Vikas :

well, if you are looking for combination, a SNRI antidepressant is a much better option

Customer:

it kind of got me going i guess

Customer:

oh okay

Customer:

so basically i am better on something than nothing

Dr Vikas :

in combination with CBT

Dr Vikas :

:)

Customer:

i am scared by all the horrific stuff i am reading about lexapro, its a lot i am reading--is it true

Dr Vikas :

who knows, after some time your medicines may be stopped once you are back to your normal self.

Customer:

can you also build a tolerance to your drug

Dr Vikas :

Escitalopram (Lexapro) is one of my favorite antidepressant along with Zoloft (Sertraline)

Dr Vikas :

both of them are well tolerated by most of the patients

Dr Vikas :

and the response is also usually good.

Dr Vikas :

SSRI antidepressant as such has less side effects in comparison to other antidepressants.

Customer:

zoloft makes you fat though doesn't---like he mention a few drugs that would just blow me up and i think that was on his list

Customer:

and does modafinil affect these drugs

Dr Vikas :

no, Zoloft and Fluoxetine (Prozac) does not cause weight gain as seen clinically

Customer:

oh okay

Dr Vikas :

We frequently combine Modafinil with SSRI antidepressants.

Customer:

prozac sends people crazy though

Dr Vikas :

no :)

Customer:

are you in america or aus

Customer:

because here modafinil can only really be prescribed for strict criterias

Dr Vikas :

Prozac is also a very good antidepressant. It is an activating antidepressant and is specially useful in patients complaining of weight gain or are concerned about gaining weight.

Dr Vikas :

I am not from Australia.

Customer:

such as diagnosed sleep disorders

Dr Vikas :

but you have Narcolepsy.

Dr Vikas :

right

Customer:

yes but i was meaning

Customer:

why does is commonly prescribed with anti-depressants?

Dr Vikas :

usually 100 or 200 mg to augment the action of antidepressant.

Customer:

augument--does that mean counter act?

Customer:

oh that would be would be very beneficial because you are very tired generally with depression

Customer:

i only got diagnosed recently

Dr Vikas :

yes, it is specially useful in patients complaining of fatigue, lethargy, poor concentration etc.

Customer:

i was always just give the diagnoses of chronic fatigue and they think maybe my depression will get better when i able work my dosages better

Customer:

we are very strict here on prescribing it so i was a bit confused that it all

Dr Vikas :

you can always discuss with your doctor about it.

Customer:

i know i had to jump through a lot of hoops--mlst's etc

Customer:

i got it though--for cheap

Customer:

people can still get it off label if they have a good enough reason just pay a fortune

Dr Vikas :

Oh

Customer:

just unforunately people will abuse it so they have to be tight about it

Dr Vikas :

can understand.

Customer:

which is sad because it prob help people with depression

Dr Vikas :

it can in certain cases.

Customer:

uni students, shift workers abuse it

Dr Vikas :

it does has some potential for abuse but unusual in clinical practice.

Customer:

it just keeps me awake it really doesn't change my mood but i guess i am able to do more things is that normal?

Dr Vikas :

well, what is the dose you are taking?

Dr Vikas :

The dose range is from 200-800 mg per day.

Dr Vikas :

for problem concentrating and fatigue, dose range of 50-200 mg per day is usually sufficient.

Dr Vikas :

but can be increased further depending on the clinical condition.

Customer:

i know a few american girls who came here on exchange-uni students can't get ritalin like they can in the states--you only get ritalin if you see a doctor that has prescribing rights and you have a diagnosis of add. So they try other things like modafinil. I keep mine at the pharmacy because if I loose it I will not get another one for six months. That is how strict they are.

Customer:

we get funded for 400mg

Dr Vikas :

OK

Customer:

after that we pay for off label

Dr Vikas :

any how, I guess we are drifting from our topic :)

Customer:

my doctor says i should be sitting around the 300mg and wouldn't be concerned if I take 400mg

Customer:

I do believe that it has stirred some of my seizures so i try to manage on 200mg but it is hard

Customer:

is there a link between modafinil and lower seizure threshold

Dr Vikas :

50 -200 mg per day is sufficient in my view.

Dr Vikas :

I don,t think so.

Customer:

basically its the groggy/drunk tiredness that gets me

Customer:

if i can get myself out of that i am okay

Dr Vikas :

You are taking Lexapro in morning or at night?

Customer:

if i am sleep deprived, i don't take much of the modafinil

Customer:

night

Dr Vikas :

then your tiredness is probably because of depression and should respond to CBT and or adding another medicine.

Dr Vikas :

or shifting to SNRI antidepressant.

Customer:

well since i have been on modafinil i i haven't been in situations where i suddenly i just fall alseep

Dr Vikas :

good

Dr Vikas :

:)

Customer:

my neck used to be a slinky

Customer:

where it is was all just floppy and i been sitting there and just fall off to sleep and now I can keep my eyes wide open. I know it sounds dumb but sometimes when i was talking to people it was though i had these heavy weight on my eyelids and they were dragging them down and i was just dopey all the time and my legs were jelly.

Dr Vikas :

it is characteristic of Narcolepsy.

Customer:

i don't feel as dumb

Dr Vikas :

you are responding to Modafinil which is a good thing. Now you just have to start CBT and discuss with your doctor about either adding an antidepressant or shifting you on a SNRI antidepressant.

Dr Vikas :

and hopefully everything will be alright once again.

Customer:

but i still have a few crazy dreams

Customer:

but not as bad

Customer:

well thank you for your help

Customer:

i will do the online stuff

Customer:

everything looks so much better

Dr Vikas :

you are most welcome.

Dr Vikas :

Thanks for coming to JA.

Customer:

no problems

Dr Vikas :

I wish you a very early and speedy recovery. :)

Customer:

thank you

Dr Vikas :

I really enjoyed working with you – please feel free to request me again when you come back to ask another question

Customer:

yes i will

Dr Vikas :

If you are satisfied with my answer, please rate one of the positive ratings (3,4,5) as this is the only way how we are compensated for our time and expertise.

Please take a moment to rate the answer.

Kind regards

Vikas

Dr Vikas :

Thanks

Customer:

thank you, XXXXX XXXXX!

Dr. Vikas, Psychiatrist
Category: Mental Health
Satisfied Customers: 2207
Experience: MBBS ; M.D Psychiatry, MS. Health Informatics
Dr. Vikas and other Mental Health Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/Dr.Keane/2013-8-20_204325_drkeane.64x64.jpg Dr. Keane's Avatar

    Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
  • http://ww2.justanswer.com/uploads/RE/resolutions66/2011-1-17_05728_IMG8202smilingeditedforJustAnswer.64x64.jpg Elliott, LPCC, NCC's Avatar

    Elliott, LPCC, NCC

    Psychotherapist

    Satisfied Customers:

    5024
    35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
  • http://ww2.justanswer.com/uploads/formybunch/2010-12-06_191055_img_0975.jpg Kate McCoy, M.Ed, NBCC, LPC's Avatar

    Kate McCoy, M.Ed, NBCC, LPC

    Therapist

    Satisfied Customers:

    3733
    Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
  • http://ww2.justanswer.com/uploads/DR/DrAkiraOlsen/2012-2-20_746_AkiraADpicmain.64x64.jpg Dr. Olsen's Avatar

    Dr. Olsen

    Psychologist

    Satisfied Customers:

    2336
    PsyD Psychologist
  • http://ww2.justanswer.com/uploads/norriem/2009-5-27_134249_nm.jpg Norman M.'s Avatar

    Norman M.

    Psychotherapist

    Satisfied Customers:

    2193
    UK trained in hypnotherapy, counselling and psychotherapy and have been in private practice. ADHP(NC), DEHP(NC), UKCP Registered and ECP.
  • http://ww2.justanswer.com/uploads/PsychologyProf/2010-07-15_171248_logos060400409.jpg Dr. Michael's Avatar

    Dr. Michael

    Psychologist

    Satisfied Customers:

    2177
    Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
  • http://ww2.justanswer.com/uploads/KURTEMMERLING/2010-07-23_215531_just_ask_picture1.jpg Steven Olsen's Avatar

    Steven Olsen

    Therapist

    Satisfied Customers:

    1727
    More than twenty years of expertise in counseling, psychological diagnosis and education
 
 
 

Related Mental Health Questions