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Mental Health  (Expert Forum)
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switching medications
Answered by
Roger Gould, M.D. - Mental Health, Wellness
Questions posted in the Mental Health forum are being answered by Dr. Roger L. Gould, author of the Mastering Stress and Depression program and affiliated with the UCLA. Department of Psychiatry. Topics covered include anger, attention deficit disorder (ADD) , bipolar disorder , dementia , electroconvulsive therapy (ECT) , learning disabilities, memory, obsessive compulsive disorder (OCD) , panic , personality disorders, phobias , post-traumatic stress disorder (PTSD) , schizophrenia , stress , transitions, and work problems.

switching medications

by leelou, Apr 17, 2006 12:00AM
I WROTE:have been on 10-20 mg lexapro for 11 months tha 10 didnt seem to do the complete job, but the 20 made me feel like i was going to come out of my skin. so to make a long story short i ask my very wonderful and smart family dr. if i could switch prozac, as i was on it about 10 years ago and did very well. and he said lets give it a try if it did well before it probably will again...even though he is not a physciatrist whom specializes in these drugs i do trust him so if he made a mistake on the adjustment i would surely not blame him. any ways he said to stop the lexapro for 2 days and start the prozac 20mg so that is what i did i feel very WRONG i feel buzzing feelings in different parts of my body i feel like my whole body is shakeing if i sit still i feel like i am vibrateing, any thoughts or ideas on this would be so welcome, i just want to go to bed and hide from it, but i know that is not the answer, besides how can you hide from your self??!! is it the absence of the lexapro that cause this? or the prozac doing it??? help leslie

AND YOU WROTE ME BACK AND SAID:
  leelou It is recommended that you go off the lexapro over a three week period, gradually reducing the dose so that in the third week you are taking smallest dose every third day...then stop. that is what is causing these symptoms...they are very commonn withdrawal symptoms.
  

  SINCE THIS MY DR. TOLD ME TO STOP THE PROZAC FOR 7 DAYS AND TO START EFFEXOR XR.IN 7 DAYS....I MADE AN APPOINTMENT WITH A PHYSC. DR SO I COULD SEE SOME ONE WHOM KNOWS MORE ABOUT THE MEDICATION. I DONT THINK THE LEXAPRO WAS EVER DOING THE JOB IT WAS SUPPOSE TO,,,,,,,,,NOW I AM A MESS WITH THIS CHANGE BEING DONE WRONG....FEELS LIKE I AM DIEING... I KNOW I AM NOT BUT I HAVE ALOT OF VERY INTENSE PHYSICAL SYMPTOMS. I SEE HER TOMORROW AT 8:30, HOW LONG WILL IT TAKE BEFORE I SEE SOME OF THE WITHDRAWALS START TO LEAVE. IT IS LIKE MY WHLE SYSTEM IS SOOOOOOOOOO MIXED UP....IS THAT THE COMMON IN MY SITUATION. THANKS LESLIE


by Roger Gould, M.D., Apr 18, 2006 12:00AM
Ask your doctor about going back on low dose of lexapro to get rid of symptoms of withdrawal, then slowly withdraw from the lose dose, then you won't have to suffer.
Member Comments (8)

by Mandybell, Apr 18, 2006 12:00AM
I was on lexapro and I dont understand why he told you to stop it in two days. You have to wing yourself off that medication. Its best to do it over a 2 to 3 week period. Have you tried Wellbutrin. Thats working great for me. Prozac (my pys. told me is a last resort these days because it has such strong side effects. I hope they get it straight for you because I know how you feel. Good luck to you.

by sdc1213, Apr 18, 2006 12:00AM
I feel your pain man. I'm currently going through the withdrawal symptoms of Lexapro. IT IS ALWAYS smart to wean yourself off of any type of SSRI instead of going cold turkey. I'm getting those brain zaps of a somewhat of a vibrating feeling. It's actually very scary in my opinion but from what my psychiatrist told me it's normal and will subside in about a week.

P.S. MY family doctor told me the exact samething about stopping the lexapro cold turkey and start the wellbutrin. I felt it was a wrongful decision since I have taken multiple SSRIs in a 6 year period, so I got a second opinion (from my psychiatrist.) I would say yes a lower dose would be a pretty good idea for the first couple weeks to help with the horrible withdrawals.

I'm not a doctor, just personal experience so everything I state is truely opinions. Good Luck

by Rotty, May 04, 2006 12:00AM
I can TOTALLY relate and would warn anyone who is taking or who is considering taking psychiatric meds  to NOT go through your family doctor or internist no matter how good they are or how much you trust them but to go to a GOOD psychiatrist to deal with taking these.  Regular doctors do not understand these medicines like a psychiatrist does.  And even some psychiatrists are questionable in their knowledge I think.  

Three years ago this summer, I went to my regular doc because the prozac I had been on for years didn't seem to be working any longer.  He had me go off prozac cold turkey and switched me to another antidepressent.  That didn't work so he switched me to ANOTHER antidepressent.  By this time I was physically and mentally going absolutely nuts and didn't know why.  I tried going back on the prozac myself to try to relieve my symptoms.  They only got worse.  I ended up in the psych ward hallucenating for a couple of weeks and got put on tons and was so drugged up when I came out I didn't know if I was coming or going.  For three months I couldn't work and couldn't even get myself out of a chair.  I was able to find a good therapist who I had to see several times a week and she helped me find a very good psychiatrist who literally saved my life by getting me off of much of what the psychs in the hospital put me on and got me on meds that worked.  He saw me weekly for months and I had to call him in between times.  It took a very long time until I felt better from that experience.  I literally hung on by my findernails for dear life.  I eventually went back to work slowly half days and eventually full.  It was months before things settled down.  

I hope this never happends to anyone out there.  The whole reason it did was my regular doctor switching meds on me and taking my off cold turkey and putting me on several different meds that made me nuts.  I am now working with my same psychiatrist who is working with me now to see if I can come off the ssri's and switch to Wellbutrin as the ssri's have always left me feeling flat and I've gained weight.  I'm also looking at weaning off of Depakote which I understand is not easy.  

The moral of the story,  easy does it and go VERY slow with these meds and with switching or discontinuing them!!!!

by slandis75, May 10, 2006 12:00AM
You should definitely be seeing a psychiatrist who will transition you off the lexapro slowly.  Withdrawal symptoms are something that is unavoidable, but should not be as extreme as what you are describing.  Instead, it should be taken in increments over a long period of time which can be adjusted by your doctor if need be.  That is why it is important to see a specialist who is current with the latest procedures and findings, as well as any new medications that may be a better choice for you.  When I switched meds, I saw my doctor around one or two times a week to monitor my feelings and any physical symptoms I was dealing with.  This is important because it allows the doctor to see whether she is pulling you off the meds too quickly, which should be avoided.  In fact, there are even some people that take a month to a year to completely get off a med, and that's okay too.

by jenjer, May 16, 2006 12:00AM
I tried going off Lexapro for about a week & 1/2 now. I took 1/2 of my 10mg for about 8 or 9 days. I was going to start taking a 1/2 of a 1/2 but last night I felt like I was starting to have a panic attack. I felt this same way this morning. I felt so depressed & unable to concentrate. I started crying for no reason. I too had headaches for the first few days. I felt extremly nauseated this morning. As soon as I started crying, I decided to take a full 10mg of Lexapro & a xanax & felt much better. Got very sick though later on in the afternoon with nausea & diarrhea. I don't know if it was from going back to a full pill or because I ate out at a fast food restaurant. I will probably continue to stay on Lexapro because I can't stand panic attacks. I hate the feeling when you can't breathe & feel like someone is smothering you.

by Rosesarered, May 20, 2006 12:00AM
I went to my internist Friday and she decided to stop my 20 mg Lexapro, which I have been on for over 2 years, cold turkey for 3-4 days and start me on Effexor xr. Has anyone had a switch over like this?

by soyamada, Jun 06, 2006 12:00AM
i kinda had the same situation but a little different...i had been on zoloft for about 8 months..and all of a sudden it stopped working so my dr switched me to wellbutrin and now im starting to wonder if maybe i should of came slowly off of one to start the other...i am only on day 4 and i know its soposed to take a week to 10 days to get in your system but i dont feel im myself....im flippin out on everyone..let alone some of the uneven feeling ive been having...i feel like im crazy.my first day on it i had anxiety attacks one  after another..one min im fine the next im screaming and upset...then im so dizzy i feel like im going to fall or i walk into stuff...is this normal
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