Lexapro poop out

[sunny1018]

Hello.  I am new to this forum but unfortunately not new to anxiety.  A little background...I was first diagnosed with GAD and PD about 13 years ago.  A psychiatrist put me on Paxil which helped a lot with anxiety but I gained 25 lbs in 8 months.  It also made me feel blah and no real interest in sex.  Of course that could have been the weight gain.  After talking to him we decided to try Lexapro.  Lexapro also worked well with little side effects.  Mostly just being tired.  After feeling pretty good for over a year he weaned me off per my request.  No bad withdrawal and I was off for a whole year.  Then the anxiety came back.  He put me back on Lexapro and again it worked well.  I was on 10 mg for 8 years then 5 mg for 2 years.  In December I started having anxiety again.  Unfortunately my podcast moved out of the area a few years ago so I have been seeing my family doc for this.  She raised me to 10mg which worked about 50% for a few weeks then it stopped.  I got in with a new psychiatrist (who I don't like) and he raised me to 20 mg.  I was on that for 2 weeks and still no better.  Now he has prescribed Effexor XR.  I have been on 37.5 mg for 3 days while stepping down of the Lexapro.  Today my anxiety reached a fever pitch.  I hate to take benzos but I needed Ativan today.  Is this normal?  Should I stay with Effexor?  I just wish my Lexapro would work again.  Thanks for any advice!

[sunny1018]

Thank you so much for your advice!  I start 75 mg Effexor today.  I'm going to give it a few weeks.  If I don't like it Zoloft will be my next move.  If the pdoc doesn't want to do that I'll go back to my family doc until I can get in with another pdoc.  I'm not sure why he would'nt prescribe Zoloft in the first place.  Do you think I would have trouble getting of Effexor after a short period of time?  Who knows, maybe I'll like the Effexor.

[sunny1018]

Hello.  I'm glad to hear Effexor works for you.  450 mg effexor and 4 mg Klonopin daily?  That sounds like a lot.  How does that make you feel?

[Paxiled]

It's very individual.  The reason I don't like Effexor is it's a very stimulating antidepressant and along with Paxil the most difficult to stop taking.  I also think we should save the ones we know are the most difficult for last.  But it's very individual how one does on any particular medication -- not much science here, just trial and error and unfortunately a lot of ignorance from pharmaceutical company marketing.  From this website the medication that seems to work the best that people can actually succeed in stopping appears to be Zoloft, but this site isn't obviously very representative, it's a small sample.  But that's what I'd probably try.  If that didn't work I might try a tricyclic like imipramine -- the side effects are annoying, such as dry mouth and constipation, but they're easier to stop taking.  You could even try Celexa, which is easy to switch to from Lexapro as it's pretty much the same drug but sometimes you do better on one than the other and there's little problem switching, but again, they are pretty similar drugs made by the same manufacturer from the same basic stuff.  

[Black_Hair_Princess]

Hi,  I take Effexor XR 150 milligrams 3 times per day and also 2 milligrams of Klonopin 2 times per day.   You have to gradually get it increased.  It will finally help.

[sunny1018]

Thanks.  I'm not crazy about Effexor either.  No depression just severe anxiety.  Do you have any med suggestions?  Lexapro was great.  Maybe something similar?  I'm going to call the pdoc office Monday to see if I can switch docs.

[Paxiled]

This sounds more like a psychiatrist!  Maybe you should see this person since he knows about slow tapering.  I still don't know that I like Effexor for anxiety, but sometimes you've exhausted other options.  

[sunny1018]

I'm trying to.  Every other psychiatrist office I have called have a 3 month waiting list.  I'm waiting for one of them to call me back.  My pdoc office called me back last night.  My pdoc is on vacation I guess so one of his partners called me.  He believes my increased anxiety is due to coming of the Lexapro and not the Effexor.  He said I have weaned to quickly.  Per his partners instructions I was to drop from 20 to 10 mg for one week then 5 mg for one week then stop.  All while titrating up on Effexor.  I have been on Lexapro for 10 years and he said this to fast of a taper.  He told me to go back to 10 mg Lexapro and start the 75 mg Effexor.  I'm so confused!

[Paxiled]

Then find another.

[sunny1018]

Thanks for the reply.  After a week on the 20 mg I felt better for a few days then not so much.  My new pdoc was pushing the Effexor pretty hard.  I told him I was hesitant because of everything I read about withdrawals.  I felt more comfortable trying Zoloft (as was suggested by my family doc) but he said this was a better choice.  I asked to try some Klonopin in the meantime and he said no I could just use the Ativan I had at home.  I only have (12) .5 mg pills left and he said that was enough.  My fam doc gave me some Klonopin anyway.  I called the pdoc office and let them know about the increased anxiety.  They had me leave a voicemail for the doc.  That was 24 hrs ago and no return call.  I'm so afraid now that since the Lexapro pooped out nothing will work.  The pdoc said that is possible and I might always feel like this.  Again I don't care much for him.

[Paxiled]

You should have stayed on the Lexapro 20mg for longer than just two weeks -- it takes longer than that to notice a difference when starting a drug or when changing the dose, sometimes 4-6 weeks.  Effexor is a very stimulating antidepressant, as it targets norepinephrine (essentially adrenalin) as well as serotonin, so if your anxiety is your primary problem this drug can make you more anxious.