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Dr. Kaushik
Dr. Kaushik, Psychiatrist
Category: Mental Health
Satisfied Customers: 4658
Experience:  MD Psychiatry
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I am on Lexapro 30mg and am feeling very depressed for the

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I am on Lexapro 30mg and am feeling very depressed for the last 2 weeks. Ihave been on Lexapro for 5 months now. I dont know what to do. Very distressed.


Welcome to Just answer !

I am sorry to learn about your condition and i empathize with you.

Well if you have not been responding to 30 mg dose of lexapro , which is in fact an overdose of this drug as 5-20 mg / day dose is the normal safe therapeutic dose range of this drug , then i reckon this drug has become ineffective owing to your body's development of increased tolerance / resistance against this drug.This is not an uncommon phenomenon as almost all the psychotropic medications after prolonged use become ineffective owing to development of such kind of tolerance , but the duration till which they last varies from drug to drug.

However having said that , i believe this recurrence of depressive symptoms, now present since past 2 weeks consistently warrant drug regime revision which can be done in two ways..

a) You shall potentate the effects of lexapro by asking your doctor to add an augmenting agent in the form of Buspar ( buspirone ) at dose of 5-10 mg twice a day or Lamictal ( lamotrigine) at dose of 50-100 mg / day or abilify ( aripiprazole ) at dose of 15-30 mg / day or Seroquel ( quetiapine ) at dose of 25-50 mg / day .

While buspar is an anti depressant and anti anxiety agent used readily as an augmenting agent on the other hand lamictal , seroquel and abilify act as mood stabilizers at their low doses as mentioned above and augment the action of lexapro in case of severe depression . So you shall discuss these options with your doctor and decide on one of them for addition to lexapro , while buspar is the safest of all but is slower in onset of action while others are fast in onset of their actions but comparatively less safer than buspar.

2) An alternative strategy to deal with your condition will be to replace lexapro by another potential anti depressant such as Zoloft ( setraline) at dose of 50-150 mg / day or Anafranil ( clomipramine ) at dose of 75-150 mg / day or effexor xr ( venlafaxine) mg twice a day or remeron ( mirtazapine) 15 - 45mg/ day or wellbutrin xl / Zyban ( bupropion) at dose of 150-300 mg / day. Any one of them can act as an effective replacement for the current lexapro but you will have to come off lexapro albeit slowly by tapering it's dose before starting on any one of these owing to the risk of development of ssri withdarwal symptoms which occur when such an ssri is abruptly stopped or rapidly weaned. So this withdrawal and then replacement will eat into your precious time and test your patience and even may result in worsening of present situation and symptoms , so to me the first option of augmentation seems to be a more plausible solution although the last decision rests with you and your doctor.

Kindly discuss this with your doctor and do the needful.

Wish you all the best.

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