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Dr. Vikas
Dr. Vikas, Psychiatrist
Category: Mental Health
Satisfied Customers: 2207
Experience:  MBBS ; M.D Psychiatry, MS. Health Informatics
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I have started taking Lexapro 5 mg for depression and Buspirone

Customer Question

I have started taking Lexapro 5 mg for depression and Buspirone 15 mg for anxiety starting on 6/6/2013. When will I start to feel a difference from these medicines? I have a second question. I am also taking Lorazepam 5 mg BID and Geodon 80 mg. I am bipolar so Lexapro could cause mania so then I am taking Geodon. My second question is that when Buspirone will take its full effect, can I stop taking Lorazepam?
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Vikas replied 1 year ago.

Dr Vikas :

Hello ! Thank you for your question, I’m Dr. Vikas (M.D Psychiatry) and I’ll try to help you today.

Dr Vikas :

Most patients start noticing improvement in their symptoms within 7-14 days after starting the Lexapro. You are currently on a comparatively low dose as the usual dose range is from 10-20 mg per day. If you are not noticing significant improvement in your symptoms, you can request your doctor to increase the dose to 10 mg per day.

Dr Vikas :

Same is the case with Buspirone also. It may take 2-3 weeks to start noticing improvement. Buspirone is just an adjuvent medicine which can complement Lexapro in controlling your anxiety symptoms.

Dr Vikas :

Once you are able to notice improvement in your symptoms, you can request your doctor to taper down and then stop Lorazepam completely.

Dr Vikas :

My goal is to provide you with excellent service and I hope I’ve provided the information you were seeking, if not, please let me know so that l can continue to help you. If you need more help, please use the reply tab to continue our conversation.

If you do not require further assistance,please rate one of the positive ratings (3,4,5 / smiley faces) 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

JACUSTOMER-14kglj5g- :

Since 4 days, I have also started taking Buspirone 7.5 mg in mornings. I take 15 mg at night. This medicine has showed side effects as dizziness, lightheadedness. I experienced these for 2 weeks when I was taking 15 mg at night. Now psychiatrist added 7.5 for morning. I was fine the first 3 days, but today after I took the morning dose I felt dizzy and lightheaded with low energy. I wanted to fall asleep. Will I have side effects for two more weeks? I did have a disturbed sleep last night. Could that have been the reason for the dizziness also?

Dr Vikas :

Dizziness, lightheadedness are the commonly reported side effect of Buspirone. These side effects may appear while starting the medicine or after increasing the dose. But don't worry, these side effects usually go away within 5-7 days of increasing the dose. Yes, of course, disturbed sleep can also be the reason behind your feeling lightheaded.

JACUSTOMER-14kglj5g- :

At the end this is what my medications will look like:

JACUSTOMER-14kglj5g- :

Lexapro 5 mg in morning

JACUSTOMER-14kglj5g- :

Buspirone 7.5 mg mid morning

JACUSTOMER-14kglj5g- :

Buspirone 15 mg at night

JACUSTOMER-14kglj5g- :

Geodon 80 mg at night

JACUSTOMER-14kglj5g- :

I would like to get pregnant while taking these medicines. Are these safe for pregnancy? I know Lorazepam is not so that is why I will not be taking it in the end.

Dr Vikas :

Buspirone is a Pregnancy risk category B medicine while Geodon and Lexapro are risk category C medicines. Nearly all the medicines used for mental disorder are generally not recommended in pregnancy specially during first trimester.

Dr Vikas :

For all these medicines, your treating doctor must weigh the risk of treatment to the child against the risk of no treatment to the mother and child. Ultimately the decision can be done only by your treating doctor.

JACUSTOMER-14kglj5g- :

So I will eventually hope to be on Buspirone alone. Does Buspirone have some SSRI in it? Does it lift mood? It will help with my anxiety I know. If Buspirone will lift my mood, then I can stop Lexapro. If I will not be taking a SSRI like Lexapro, maybe Geodon will not be needed. Can you tell me more about what Buspirone does?

Dr Vikas :

No Buspirone, is not a SSRI antidepressant. It is mainly useful for anxiety symptoms but theoretically it enhance serotonergic activity and may contribute to antidepressant action of another antidepressant. It may have a mild action of elevating mood in some patients.

Dr Vikas :

If you have not yet tried Cognitive Behavior Therapy for depression, CBT can also be a good option in your case.

JACUSTOMER-14kglj5g- :

Do you think Cognitive Behavior Therapy can be a substitute of Lexapro? I will ask my psychiatrist to refer me to some good therapist. I live in Sacramento, CA. Can you give me some good names of therapists.

Dr Vikas :

CBT is specially useful in patients who are not able to take medicines due to any reason. There is a website where you can try free online CBT by yourself and see if it helps.

Dr Vikas :

I am giving you the link below to that website where you can register yourself and try CBT.

Dr Vikas :

MoodGYM: Welcome

JACUSTOMER-14kglj5g- :

Thanks. I joined MoodGYM. Could you also give me names of medicines for anxiety and depression which are safe in pregnancy? I have bipolar disorder. So a mood stabilizer that is safe in pregnancy will be good too. I really do appreciate your answers.

Expert:  Camille-Mod replied 1 year ago.

Hello,

I'm Camille, and I’m a moderator for this topic. I sent your requested professional a message to follow up with you here, when they are back online.

If I can help further, please let me know. Thank you for your continued patience.

Best,

Camille

Customer: replied 1 year ago.

 


Thanks. I joined MoodGYM. Could you also give me names of medicines for anxiety and depression which are safe in pregnancy? I have bipolar disorder. So a mood stabilizer that is safe in pregnancy will be good too. I really do appreciate your answers.

Expert:  Dr. Vikas replied 1 year ago.
As such there are no medicines which can be considered safe in pregnancy.

We usually stop all medicines few weeks before if a patient want to get pregnant. Specially during first trimester we try to avoid all medicines.

For medicines used in Bipolar disorder, your treating doctor must weigh the risk of treatment to the child against the risk of no treatment to the mother and child. Ultimately the decision can be done only by your treating doctor.

You are already taking Geodon which is preferable to anticonvulsant mood stabilizer like Sodium Valproate, Carbamazepine and other mood stabilizer like Lithium if treatment is required during pregnancy.

So you can discuss with your doctor about Geodon.

CBT as such is another good treatment option in pregnancy.
Customer: replied 1 year ago.


Is Lexapro safe in pregnancy? I read on MayoClinic that Citalopram is safe. So Lexapro should also be safe. How about Buspirone? It is category B.

Expert:  Dr. Vikas replied 1 year ago.
See, both of them are Category C medicine while Buspirone is Category B medicine.

We usually try to avoid prescribing antidepressant in female patients who want to get pregnant. Medicines are prescribed only if it is very necessary to do so.
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
Customer: replied 10 months ago.
I have stopped taking Buspirone in mornings because it made me dizzy off and on even two months down the road. Dr increased Lexapro to 10 mg. I felt dizzy for two days. Then was fine for 5 days. Then again dizzy for two days. Is this because I stopped taking Buspirone in morning or because I increased Lexapro to 10 mg following doctor's advice?
Expert:  Dr. Vikas replied 10 months ago.
Hello Stacy,

Thanks for the followup. Stopping Buspirone should not cause dizziness. Most likely it could be because of increasing the dose of Lexapro provided all other possible medical causes of dizziness are excluded.

Assuming that it is indeed because of Lexapro, this symptom should subside shortly as most side effects which appear after increasing the dsoe are transient in nature.

Kind regards

Vikas
Customer: replied 10 months ago.

What do you mean by transient in nature? And is Lexapro 10 mg going to show effects in 4-6 weeks? I have also reduced Geodon from 80 to 60 mg. I have started feeling slower since then. I don't get sleepy in mornings like I used to with 80 mg. But I have become sluggish in my behavior. Is that a side effect of reducing Geodon?

Expert:  Dr. Vikas replied 10 months ago.
Stacy,

Some side effects like sedation, dizziness,nausea etc appear after starting the medicine or increasing the dose of that medicine but usually subside within 1-3 weeks and therefore are transient in nature.


Lexapro may take 1-3 weeks to start showing its improvement. The usual dose range of Lexapro is from 10-20 mg per day. If you still feel sad, tired, sleepy, lethargic, irritable, having poor motivation to do things, anxious, in that case it is likely that you are not responding to 10 mg of Lexapro and your doctor should consider increasing the dose further by 5 mg making it 15 mg per day.

Since Geodon can be sedative in some patients so reducing the dose of Geodon can be the cause behind your not feeling sleepy in the morning.

Kind regards

Vikas


Customer: replied 10 months ago.

I am wondering whether I need to increase Lexapro to 15 mg. From a scale of 1 to 10; 1 being the lowest, my mood is at a 7. I get my daughter ready while being little anxious whether she will be at school on right time. She is a bit stubborn when getting ready. But I hug her and give her kisses. Now I am going to start cooking. I got trained in making sabji, daal, and chapatis two months back. I have started back at it. Then I am going to walk on the treadmill for an hour. And tonight we are going to a Diwali party. I am looking forward to it.

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