Conversation with my GP today. What do you think?

[whirlpool86]

In my sig I have my Lexapro history....

Yesterday I ran out of Lexapro so today I went to my GP to get a new prescription.

I told him my history, and how I'd been weaning off over the past few months and then two weeks ago I started to feel horrible again.

He said that for an anxiety problem I should be on the medication for a minimum of 12 months before trying to wean off.

He said that 5mg Lexapro really wouldn't do much at all to help me, and that anything below 5mg is really completely useless, and that the 2.5mg dose I was on was pointless.

He asked me what dose I last felt okay on. I said 5mg. He then said that really he'd recommend I take 10, not 5, but that if I want to continue on 5 then to do so.

He gave me a prescription for 6 months of 10mg.

What do you think about what he said? I was surprised that he said anything under 5mg is useless.

Does he mean that once I get to 5mg that it will stop having a noticeable effect on my serotonin, but that when I decide to taper off I will still need to taper off slowly from 5mg to 0mg?

[carolyn]

Originally Posted by whirlpool86

Does he mean that once I get to 5mg that it will stop having a noticeable effect on my serotonin, but that when I decide to taper off I will still need to taper off slowly from 5mg to 0mg?

That's how I interpret it. At least for Paxil, I think anything under around 5mg is too low a dose to be "helping", but you still definitely need to taper slowly even after this point since the changes to the brain have already been made.

I don't agree with or understand his comment about needing to be on medication for 12 months before weaning off, though. That doesn't make sense to me at all, considering these drugs don't "cure" anxiety. It's not like taking an antibiotic where you have to take a full dose to kill off all the germs.

The only reason I can think of for these types of comments from docs is that they think that having a set period of time (6 months, a year, whatever) of relieved anxiety can fool the brain into thinking that it's not anxious anymore -- in other words, the pills break the cycle of anxiety and then you can taper off having broken that cycle. While that might be true for some people, I don't think it is for everyone, and thus it doesn't make sense that one would have to take the pills for a minimum amount of time.

[Ezin]

Hello,

A friend of mine was on 5mg Lexapro, never anything higher. Not for that long.

Prescribed for the death of a friend. She was grieving. Not nice, but nothing more.

Her reduction protocol from her doctor... was just to stop. She was 'only' on 5mg, after all.

She is now about a year and a half into her cold turkey withdrawal.

She can now concentrate for about 1-2 hours at a time, before the fatigue flattens her. A distict improvement compared with a year ago.

She started off with the (pretty usual) 6 week window of 'all seems okay' after the cold turkey stoppage, before the (also usual) main withdrawal kicked in. A little simple questioning revealed the (quite standard) mild hypomania and withdrawal flu she had experienced during those six weeks.

Then the gut, heart, acute fatigue, depression, sleep, hypersensitivity problems began to emerge. Majorly.

It's not withdrawal, apparantly. Medical profession are quite sure. Because the drug's out of her system. Got nothing to do with the antidepressant. At all.

A coincidence.

After many hospital visits (the usual sets of tests and soundings and scopings), she's written off as 'chronic fatigue.'

So, please be aware of what cold turkey withdrawal from 5mg of Lexapro did to my friend, someone who didn't appear to have negative side-effects whilst on the medication. Someone who had an active, busy social life, and enjoyed the contact of friends... and who post-drug became a chronically tired, agorophobic anti-social hermit displaying multiple physical symptoms and cognitive / concentration impairment. As well as the distress of knowing she was rejecting those about her...

"He said that 5mg Lexapro really wouldn't do much at all to help me, and that anything below 5mg is really completely useless, and that the 2.5mg dose I was on was pointless."

OOPS.

That's the level of academic what-not my friend encountered.

Do be aware that 5mg of Lexapro can actually be very potent; the swift removal of it effectively crippled and disabled someone I know. Big-time. Long-term.

[Aeroman]

Lexapro is a Hell of a Drug...

[Lucy]

I remember reading something on the lexapro withdrawal thread on drugs.com -- the poster said that her doc had prescribed maybe 5 mg, but she was cautious, started at 2.5 and never took more than 2.5. But she still complained of withdrawals when she quit.

What do I think about what your doctor said? I think he doesn't understand what a potent drug he is prescribing, and what the true effects are.

[Aeroman]

Originally Posted by Lucy

I remember reading something on the lexapro withdrawal thread on drugs.com -- the poster said that her doc had prescribed maybe 5 mg, but she was cautious, started at 2.5 and never took more than 2.5. But she still complained of withdrawals when she quit.

What do I think about what he said? I think he doesn't understand what a potent drug he is prescribing, and what the true effects are.

Oh yes, Julia!!! She is on my Facebook...she was on 2.5mg for a couple of years and got off one month before I did, which was January 2008. She is still not recovered but has improved!

[Lucy]

Do you know if she is still on 2.5 or did she quit,?

Oh, never mind that question-- I see now that you said she quit about the same time you did. I'm glad to hear she is improving.

[Norma]

I was hospitalized once after having tried a too fast taper and a brief stint on prozac...

While there the "doctor" switched me to lexapro without even telling me. Felt better for a couple of weeks... then started having panic attacks (which I never had prior to taking anti-depressents). My regular doctor switched me back to paxil and I stabalized.

So my opinion of lexapro is not a good one... of course I also hate paxil.

The bottom line, its best to take things slowly no matter which poison your on.

Norma

[scotty]

Whirlpool....what is your goal? Do you want to get off Lexapro, or do you want to stay on it?

That the question that you need to answer.

[whirlpool86]

Originally Posted by scotty

Whirlpool....what is your goal? Do you want to get off Lexapro, or do you want to stay on it?

That the question that you need to answer.

I want to be off it and be at a healthy level of anxiety.

I think I need to begin CBT again. I think I should stay on the lexapro at least until I've had a few CBT sessions.

Then I will try to taper off again, and see how it goes.

Sigh.

Thanks for the responses

[LCrawford67]

Originally Posted by whirlpool86

I want to be off it and be at a healthy level of anxiety.

I think I need to begin CBT again. I think I should stay on the lexapro at least until I've had a few CBT sessions.

Then I will try to taper off again, and see how it goes.

Sigh.

Thanks for the responses

There's no need to sigh, WP. I think that's a great idea! Find ways of dealing with your original issue BEFORE you quit and while you're tapering. That's just good planning!

Remember, the reason you were put on Lexapro will still be there once you've stopped, so now is the time to nip that issue in the bud and that way, you'll be prepared once you're med free

[scotty]

The thing you have to remember is that just because a doctor says it, doesn't make it fact. If you ask most where they get their information, it's from the drug rep, or based on random use in their patients.

[whirlpool86]

Thanks LC You're right. God I can't even begin to imagine what it must be like for people who've been doing this for five, ten, twenty, or thirty years.

scotty yeah you're right, and my GP that I went to today is actually a close family friend and he is generally considered a fantastic doctor. He's also the coroner for this side of the country. So he's well respected. But no matter who the GP is, I can't help but think of them as jacks of all trades but masters of none. I trust any info I get from people who themselves have been through it before I would trust any "experts."

[Songbird]

5mg of Lexapro is about equivalent to 10mg Paxil, and would be the lowest dose that doctors would consider to be 'effective' or 'therapeutic', the normal therapeutic dose would be twice that. That is why he is saying that. However, that doesn't mean that the body won't feel the removal of that dose. Most docs seem to know very little about anti-depressant withdrawal.

I don't get the set time period thing either, I got told 6 months minimum first time, 12 months minimum second time, I don't understand how they think using it for a set amount of time cures anything, when we all know it just suppresses symptoms and doesn't actually fix anything.

[Juwane]

Originally Posted by whirlpool86

He said that for an anxiety problem I should be on the medication for a minimum of 12 months before trying to wean off.

When I was prescribed Paxil by my psychiatrist, he told me to keep taking it for at least 5 months before weaning off.

Two weeks later I went to another psychiatrist to ask his opinion. He said I have to take it for a minimum of 12 months before deciding whether I will be able to get off this drug or continue it.

EDIT: In the leaflet that comes with the box of Seroxat 20 mg tablets, it says:

In a placebo-controlled trial, the efficacy of SEROXAT in the treatment of panic disorder has been maintained for at least one year.

The date of issue of the the leaflet is 31 January 2008.

[scotty]

Originally Posted by Juwane

When I was prescribed Paxil by my psychiatrist, he told me to keep taking it for at least 5 months before weaning off.

Two weeks later I went to another psychiatrist to ask his opinion. He said I have to take it for a minimum of 12 months before deciding whether I will be able to get off this drug or continue it.

EDIT: In the leaflet that comes with the box of Seroxat 20 mg tablets, it says:

In a placebo-controlled trial, the efficacy of SEROXAT in the treatment of panic disorder has been maintained for at least one year.

The date of issue of the the leaflet is 31 January 2008.

And then they tell you you need it for life.