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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4070
Experience:  MD Psychiatry
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I have been on Lexapro for a little over 2 weeks. One week

Customer Question

I have been on Lexapro for a little over 2 weeks. One week on 2.5.mg and one week on 5 mg. I have GAD a mild OCD. I had some side effects off and on and I have had some good moments where my mind was clear, however the last couple days my mind won't settle down (I talk to myself constantly - it's uncomfortable). I go back to the doctor tomorrow. Is this drug not working for me? not the right dose? Not long enough time? Is there a better drug to stop these constant obsessive/intrusive thoughts (mostly about my anxiety/state of being)?
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Kaushik replied 1 year ago.

Greetings !

 

Welcome to the site.

 

I am Dr. Kaushik and i believe i can help you with your problem.

 

Well you see Lexapro is a very effective anti depressant used for managing GAD as well as Obsessive / compulsive disorder, so I will suggest that you continue on the same.

 

Now coming to the reason why your symptoms are not being controlled despite you being on this drug for past 2 weeks and the reason is that first of all you are still taking a sub-standard dose which is ineffective for controlling GAD and OCD symptoms in most adults therefore a good effective dose for your conditions will be 10 mg/day which may further be raised to a maximum safe dose of 20 mg / day but as of now you got to ask your doctor to raise your current dose to 10 mg / day .

 

The second reason for poor response to the drug is that it is actually too early to expect any effective control over your underlying symptoms since it takes at least 2-3 weeks on the minimum effective dose ( which is 10 mg for an adult like you with these mentioned underlying conditions ) for the drug to start it's action against GAD and OCD and this much time is required by the drug to settle down in the body system which is essential for any drug to produce the desired results.

 

So to summarize it is both lower dose and not enough time having been passed which are responsible for poor control over your symptoms , so I reckon that in your meeting with your doctor ask for dose increment to 10 mg / day and stay on this for another 2 weeks until you think of further raising the dose to 20 mg / day. You shall however begin to appreciate positive results within 2 weeks of being on 10 mg dose but for complete recovery you got to complete the course by taking the drug for 4-6 months and thereafter come off it by tapering it in a systematic manner.

 

I hope this helps.

 

Wish you all the best.

 

Please kindly leave a Positive rating if you are satisfied with the answer.

 

If there is any further assistance needed please feel free to ask using the reply button.

 

Regards.

Customer: replied 1 year ago.

Thank you. I hope I find relief soon. I experienced a couple health traumas last year and it sent me into this hyper vigilant state. I used to take Tranxene periodically but never at high doses. I have been able to stop that completely for the past ten days so I am happy with that. I thank you for assuring me that I will see improvement soon. I'm a teacher and have 5 weeks left of summer to get myself together! I think I might be stressing over that as well and keep dwelling on whether I will be able to teach again! (my mind goes in negative directions sometimes).

Expert:  Dr. Kaushik replied 1 year ago.

I believe you will recover enough just in time to resume your duties. I however will still encourage you to go up the much desired dose of 10 mg / day so as to fasten the process of remission.

 

I hope this helps.

 

 

Wish you all the best.

 

Please kindly leave a Positive rating if you are satisfied with the answer.

 

Regards

Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4070
Experience: MD Psychiatry
Dr. Kaushik and 3 other Mental Health Specialists are ready to help you
Customer: replied 1 year ago.

As a follow up my doctor did up me to 10 mg. of Lexapro and I go back in 3 weeks. Every time I think about talking in front of my class I start to get anxiety. I am a single mom and cannot quit teaching. Do you think this feeling will go away with the Lexapro?? I am so desperate to feel like myself again. It's been so long.

Expert:  Dr. Kaushik replied 1 year ago.

Yes I believe that Lexapro will do a lot of good to boost up your moral and confidence and make you much less anxious in a social setting like a classroom but this shall take some time as the improvement will start within 2-3 weeks time ( may be earlier ) and once this happens you will be on the road to recovery from this underlying condition.

 

So please stick to the regime and have some patience.

 

I hope this helps.

 

Wish you all the best.

 

Regards..

Customer: replied 1 year ago.


Isn't it amazing that I have been teaching for 10 years and I do not have social anxiety at all. As a matter of fact I would be considered a social butterfly and now because of some health issues I have what has turned into this uncontrolled anxiety. I will trust all the advice but it is hard to believe how far into this anxiety loop I have gotten. I think maybe some of it is side effects from the Lexapro and I seem to be a little more anxious at time than when I began. I hope once my body gets used to it I do not have the ups and downs and things will even out to normal. At least that is what I pray for.I thank you for your words of encouragement.

Expert:  Dr. Kaushik replied 1 year ago.

I am hopeful that you will get over this anxiety in the coming days to weeks so hang in there patiently.

 

Regards..

Customer: replied 1 year ago.

Can I ask you one more question? I've been on the 10 mg for 4 doses now and I am getting restless feelings on the morning with some shaking/dizziness. In the afternoon it levels off a bit but still vision is off. Are these side effects that will go away soon?

Expert:  Dr. Kaushik replied 1 year ago.
Well initial side effects like these happen with lexapro but they usually subside as time passes by. So I suggest that you to wait for 1 more week and if these symptoms increase in intensity and frequency then it will be matter of concern and you shall ask your doctor to review the dose perhaps lowering it to half. However it is more likely that in the next week your symptoms will wane off on their own.

Regards.

Customer: replied 1 year ago.

Yes I am hoping the side effects will go away, I had a bit of trouble getting to sleep last night which only happened when I first started taking the drug. DO you think there is a difference between the brand name and generic? I read online that some people think so. I have Tranxene to take to help the anxiety but am loathe to take it.

Expert:  Dr. Kaushik replied 1 year ago.
Greetings !

Well there is a slight difference in the quality of a branded drug as compared. to the generic version with the branded version having an egde in the quality, but usually this quality difference is marginal and does not make any major difference in the outcome.

Also the episode of insomnia that you had to endure some time back is most likely to be an occasional event so unless and until this does not become generalized you shall continue. on the drug regime as it is. As far as use of tranxene is concerned as of now you shall refrain self from trying it since soon lexapro is likely to kick in and from there on it. will take care of your symptoms.

Regards.
Customer: replied 1 year ago.


Hello"


My doctor raised my dose to 15 mg. yesterday as I was still having "earworms" and still being a bit too focused about myself. I feel a little nauseous and uneasy but not as much as when I started on the 10 mg. Are these again some side effects that will go away in a few days? I'm really starting to think maybe Lexapro won't help me but then again I have improved since I've been taking it? More patience??

Expert:  Dr. Kaushik replied 1 year ago.
Greetings !

Well yes the initial side effects of nausea and uneasiness that you are experiencing will eventually go away within a few days so i will urge you to not give up on this drug as it is has great potential and you have not yet reached the optimal dose of this drug that is 20 mg / day which will provide you great benefit in the future. So kindly stay on this drug and soon you will adjust to the dose increment and hopefully you will begin to appreciate it's efficacy even more.

I hope this helps.

Regards
Customer: replied 1 year ago.

Thank you so much. ALso, I had diarrhea this morning that I have never had before.Will this be temporary a well?

Expert:  Dr. Kaushik replied 1 year ago.
While diarrhea can occur as a side effect of this drug but as a protocol you got to get this diarrhea evaluated by your family doctor to rule out organic cause first more so because diarrhea did not occur with this drug previously ( although this does not rule out it's chances of occurrence with dose increase ). Once the doctor rules out organicity then we can relate this diarrhea with the drug and in this case it shall be self limiting and subside on it's own in a few days, but you got to keep yourself well hydrated with lots of fluids and electrolyte intake and take something from your doctor to stop the diarrhea.

I hope this helps.

Wish you all the best.

Regards.
Customer: replied 1 year ago.

I just called my pdoc and he said if it's only a couple loose stools then it should resolve itself but he never has seen this with this drug even though he said it could happen. He said if I'm going 6-7 times then it's a matter of concern. I only went once this morning. I understand what you say but do you think I could just wait and see what happens tonight/tomorrow?I just took one Loperamide that I had in the cabinet

Expert:  Dr. Kaushik replied 1 year ago.
Yes one episode of loose stool does not imply that is a side effect of this drug and i think you can wait and watch for the frequency and i feel the loperamide shall also help in stopping any more episodes. I will agree with your pdoc as he is making sense.

So as of now since it has been only once that is has happened and also the fact that you have taken loperamide so you shall wait and watch as it is quite likely that the loose stools may not occur again. Meanwhile keep yourself well hydrated and do not hesitate to go to emergency if the need arises such as when diarrhea becomes too frequent, but i feel that situation is unlikely to occur.

I hope this helps.

Regards.
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4070
Experience: MD Psychiatry
Dr. Kaushik and 3 other Mental Health Specialists are ready to help you
Customer: replied 1 year ago.

Hello again!


The diarrhea only was a one time incident but I alternate between constipation and looser stools. I think the Lexapro is definitely messing with my GI Tract. I have now been on 15 mg, for 10 days -- total time on Lexapro almost 7 weeks (4 weeks on therapeutic doses). I am still feeling those icky yucky stomach issues and some burning sensations on my skin. I don't feel overly anxious as i am assuming these are still side effects. I start back to school (I'm a teacher on Wed) on Wednesday and my pdoc is out of town right now. Do you think I should cut back to 10 mg or just ride this out and see if the side effects will go away. My pdoc says it is still anxiety and not side effects but I don't think so. It is the same feelings I had went I first started and then upped the dosage. I would appreciate you opinion you have helped me very much. Is this normal or is this not the proper drug for me do you think?

Expert:  Dr. Kaushik replied 1 year ago.
Greetings !

Welcome to the site.

Well, lexapro can cause gastro-intestinal side effects such as those you are having right now and it has been quite a long time that these side effects have persisted so they are not related to anxiety but instead they are actually side effects caused by lexapro.

So you shall come down the dose of lexapro to 10 mg / day and inform about the same to your pdoc as early as possible.

Once your dose has been reduced to 10 mg / day then we shall assess in few days how you respond to lower doses and whether your side effects subside or not. If the side effects still persist then i reckon that you need to ask your pdoc to bring you off the lexapro completely and replace it with another anti depressant such as remeron or cymbalta.

I hope this helps

Wish you all the best.

Regards.
Customer: replied 1 year ago.

Ok. After I wrote to you I did have an episode of diarrhea so yes I think tomorrow when my dose is due I will cut down to 10 mg. and see if it helps. I hope it helps in a couple days!! I do not think it is anxiety. I am so ready to move on and not be anxious anymore!! I'm ready to get back to work. These side effects have persisted all summer -- although they have gotten very tolerable -- except for the gastro stuff. Thank you again. I hope I can get a handle on this, I would hate to switch to a new drug and have to go through a whole different set of side effects!

Expert:  Dr. Kaushik replied 1 year ago.
Yes you do that and hopefully things will fall back into place.

Regards.
Customer: replied 1 year ago.

You've been very helpful. One more question if you please. I just want to make sure that these other things are side effects as well --- 1) tremor - slight 2) sometimes I feel like I have to keep taking deep breaths -- like I need an inhaler -- and I have apnea where when I am about to go to sleep I actually stop breathing for a minute. These have also been disconcerting. This has really been a roller coaster but the anxiety has lessened since I started

Expert:  Dr. Kaushik replied 1 year ago.
No, these two -- tremors and hyperventilation that is deep and pressured breathing are components of anxiety and not side effects of lexapro. this implies that although psychologically your anxiety may have started to wane off but still the physical components of anxiety are remaining thereby implying need for continuation of a drug like lexapro or any other if lexapro continues to produce side effects.

I hope this helps.

Regards.
Customer: replied 1 year ago.


You know I hate to keep asking you questions but I think of other things when I get off. This "foggy head" feeling and lack of concentration and lack of motivation --- is this a side effect of the drug?? It really helps me to distinguish between any anxiety and side effects so I can know when I reduce the dosage. ALso this whole experience of anxiety started with what I perceived to be (don't know for sure) a reaction to a botox injection between my brows -- that was one year ago -- do you think this "physical" anxiety could be my nervous system is messed up from that injection or just what you say physical components?? Thank you thank you thank you!

 

ANd the breathing issues only happen when my stomach is tight and upset -- I burp a lot and want to take deep breaths because there feels like there is pressure there.

Expert:  Dr. Kaushik replied 1 year ago.
Yes they are related to the drug side effects that is the foggy head, lack of concentration and motivation.This physical component is of anxiety.

Regards
Customer: replied 1 year ago.

Thank you. You don't have to reply unless I am wrong but the burning skin sensations/sweating I am assuming is also a side effect. If I don't hear back I will take that as a yes. I did forward a bonus for you. Thanks for your time

Expert:  Dr. Kaushik replied 1 year ago.
Yes they are side effects.

Regards.
Customer: replied 1 year ago.

Good morning. I cut the Lexapro down to 10 mg this morning and now I'm feeling anxious/sweaty. Should I keep it at 15 mg? I could take a little Tranxene

 

I'm coming back to edit this. I do feel a bit better now. It subsided. I hope cutting it down will relieve the anxiety. I think Lexapro causes me to have anxiety at times.

Expert:  Dr. Kaushik replied 1 year ago.
Greetings !

So finally is the reduced lexapro working fine or are you having problems right now ?

Regards.
Customer: replied 1 year ago.


I feel fine now. Just a bit of a headache. Better than this morning and better than yesterday. I will keep it at the 10 mg. and maybe tomorrow will be even better!

Expert:  Dr. Kaushik replied 1 year ago.
Yes it seems like you are tolerating at this dose much better so you shall keep yourself on this dose only and discuss about this with your doctor as soon as he is available.

Regards.

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