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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10547
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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I've been on lexapro and cymbalta 2 yrs. in April of 2015 I

Customer Question

Hi. I'm Chris. I've been on lexapro and cymbalta for about 2 yrs. in April of 2015 I went off lexapro cold turkey. This spun me back into my depression and anxiety. Went back on lexapro 20mg on aug 23 and to date I don't see a change. I'm struggling with depression and its destroying my marriage and affecting my kids
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Z replied 1 year ago.

Hello and thank you for your question. I am very sorry that you are still struggling with this level of depression, I can understand how distressing this can be for you. So it does seem like the 20mg dose of Lexapro is not effective for you so your doctor can try a few adjustments to help lessen your depressive symptoms. 1) Add either a low dose of Abilify or Remeron to your regimen as this can be used as an augment to improve the effectiveness of your Lexapro. 2) Add Wellbutrin to your regimen as this atypical antidepressant is very effective in helping to lessen depressive symptoms along with the Lexapro 3) add a temporary dose of Modafinil as this psychostimulant will increase dopamine and increase your energy and euphoria 4) Switch you away from Lexapro entirely and try you on a different SSRI or SNRI antidepressant completely. Or try you on higher doses of Remeron of Wellbutrin instead of as augments. Or lastly try Lamictal which is a mood stabilizer that is very effective in lessening depression.

Customer: replied 1 year ago.
I am also on 60mg of cymbalta which I've been on for the 2 yrs along with the lexapro 20mg
Expert:  Dr. Z replied 1 year ago.

Okay you only mentioned going back on the Lexapro not the Cymbalta so I assumed you did not go back on Cymbalta. Cymbalta is generally considered a weaker antidepressant so it would be best to consider tapering off it and trying the other augments I mentioned.

Expert:  Dr. Z replied 1 year ago.

Or if you still want to stay on the Cymbalta, it may be possible to increase to 90mg/day but this puts you at a much higher risk for Serotonin Syndrome and most likely any benefit from this increase will be minimal so I do not think it is worth the risk.

Expert:  Dr. Z replied 1 year ago.

Adding Wellbutrin right now to your regimen will most likely not cause any interaction effects unless you have a history of a seizure disorder or eating disorder. Adding Lamictal to your present regimen though poses no risk in terms of interactions with both the Lexapro and Cymbalta

Expert:  Dr. Z replied 1 year ago.

Please let me know if you have any further questions or concerns that I can assist you with regarding this issue. If you are satisfied with my answer please remember to leave a positive rating at the top of the screen. Thank you, ***** ***** appreciate it.

Expert:  Dr. Z replied 1 year ago.

Hello, I noticed that you viewed my answer and I was checking in to see if you have any further questions or concerns that you would like me to address on this issue?

*Please do not forget to leave a positive rating at the top of the page so that I can get credit for helping you. Thank you, ***** ***** appreciate it.

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