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Anna, Mental Health Professional
Category: Mental Health
Satisfied Customers: 1945
Experience:  Licensed Clinical Social Worker with 29 years in addictions and mental health.
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I started using Cpralex two weeke ago for depression and anxiety.

Resolved Question:

I started using Cipralex two weeks ago for depression and anxiety. I started on 5mg and I am now on 10mg. I am feeling more depressed now than before and very tired. Is this normal? Could it be a sign that its not working for me? Is it normal to feel worse before feeling better?
Submitted: 7 years ago.
Category: Mental Health
Expert:  Anna replied 7 years ago.
Hello & Welcome to Just Answers.

You've been taking it for a total of 2 weeks? How long on the 10 mg? Does your doctor have you increasing the dose soon, and if so, to what dose?

Customer: replied 7 years ago.
Hi Anna, I've been on 10mg for a week now. My Doctor said I can go up to 20 mg after two weeks but I'm concerned as I read that is the maximum recommended dose and the medication is also causing fatigue.

Customer: replied 7 years ago.
Also what I noticed is that on the first day that I took the medication, I felt better almost immediately, but then on the second day I was down again. The same thing happened when I increased the dose from 5mg to 10mg
Expert:  Anna replied 7 years ago.

Hey Michael,

Hmmm. You're at a crossroads right now, and it could go either way because you're still new on this medication. It could be exactly as you think - maybe this is a sign that it isn't the right med for you or that it is just taking your body time to get used to it and the fatigue will pass.

It can take up to 4 weeks to see the benefits of Cipralex, so I would recommend staying at the 10 mgs for at least another week or two. If the fatigue and depression don't lift, then you've got your culprit and your answer: it isn't the right one for you. If things clear up and it starts to work better, then it was just the adjustment period and the phase of 'getting worse before it gets better' (which is common). If you want to try to move it to the 20mg dose, I think it would be perfectly fine to try...especially with your experience of having felt better when the dose increased before.

You're early on in this right now and everything hasn't settled into place yet, so a little more time is justified. But if it incapacitates you, then it isn't helping, and it would be best to try another medication. There are plenty to choose from, so you don't want to experiment longer than 4-6 weeks on any one of them that isn't showing some promise. says the following about the dose:
DOSING: The usual starting dose of escitalopram is 10 mg once daily in the morning or evening. The dose may be increased to 20 mg once daily after 1 week. Benefit may not be seen until treatment has been given for up to 4 weeks. Escitalopram can be taken with or without food.

My best to you,
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