Advice please re dosage
Posted , 4 users are following.
Hi all been taking Escitalopram now for 4 weeks at 5mg. Ive been suffering with Social Anxiety and GAD and for the first 3 weeks i was feeling ok with no major side effects apart from some dizziness which i was getting before i started tablets and which i put down to anxiety, but overall the bad anxiety i was getting day to day seemed to be easing although i was still getting in public places.
When I last visited my doctors 2 weeks ago he said to carry on at 5mg, but if i feel after 4 weeks that they are not quite working then i can take 2 tablets to increase to 10mg so has really left it up to me to decide.
The last few days i seem to have been going a bit downhill again with my dizziness and anxiety returning a bit which wasn't helped by a bad dizzy panic attack at a supermarket.
So my question is really should i stay on 5mg for a bit longer or should i up dosage?
Any advice would be most greatfully received.
0 likes, 11 replies
matts4912 paul32149
Posted
Paul,
Lexapro, like all other anti depressants will take between 8-12 weeks to reach peak blood level. Before that the start-up symptoms will mask any progress. You will feel zaps, anxiety, dizziness and other things no doubt, but this is the lexapro starting to change parts of your brain.
5mg is a small dose, but if you are new to anti depressants I would be inclined to wait at least another 4 weeks, 6 or 8 if you can. At that point I would consider moving up to 10mg. Most people feel worse before they feel better, but you only want to be on a dose sufficient to make you feel better and no more. Taking a higher dose DOES NOT mean you will get better sooner, nor will it mean that this dose is more suited for you. Taking too much of a dose will result in too many chemicals going round your brain, which is just as bad as too little.
Keep us posted and let us know how you get on...
Matt
paul32149 matts4912
Posted
Thanks Matt, thats great advice thank you think i will wait another couple of weeks then it was just that i was reading the leaflet that came with my tablets and it said for anxiety it should be 10mg so wondered why i wasn't on that dose.
Many thanks for the reply
matts4912 paul32149
Posted
Paul - 10mg is considered the therapeutic dose, but the bottom line is we simply do not know. Anti depressants are not a "one size fits all". A good example is H1 antagonists for me. If I take the right dose, my hayfever will subside - take too much and I will get tachycardia!
I don't want to tread on Jim's toes (and he is absolutely right about talking to the doc), but going to high to then come down is, in my opinion, creating more trouble for yourself. Speaking on behalf of your brain, it is better to go up-up-up-stop than up-up-up-down-stop. These drugs block pathways in the brain - they don't then "unblock" - they have to re-grow and re-route. Once you have scrambled an egg - you can't unscramble it!! If you block too many, it will only confuse your system further.
It may be that you do need a higher dose, in which case Jim is right on the money, but I do feel we need to know and see for sure.
jim55850 paul32149
Posted
Hi Paul, welcome. Personally, if at 5mg you are still feeling you are close to the edge, I'd up it to 10mg. It sounds like you have tolerated the initial period well but it's not getting you in the clear yet. While we always want to take the minimum dosage to get the job done, some need higher dosages that others. I started at 20mg once a day and have been at that level for a year, it's a lifesaver for me. Going to 10mg won't hurt you, but anytime you change this medications dosage (up or down) you can have a few days of side effects such as sweats, dizzy ,increased anxiety, etc., so if you do that and have a week that is uncomfortable, that is not uncommon. Keep in touch and if you get really concerned with anything, keep the doc in the loop too.
Best,
Jim P
paul32149
Posted
Thanks for replies, think i will stay on 5mg for another 2 weeks then that will be 6 weeks and the reassess then, Not much point going back to my docs at the moment as he really did say it was up to me if i wanted to increase ( not much help really). My head just seems to be feeling a bit foggy this week which i didn't have before.I didn't realise it took so long before the tablets were at full strength so guess could be still settling.
Thanks again
ann55375 paul32149
Posted
i have a question, i have anxiety, controlled by diazepam until recently but now i have depression too. Lexapro has been suggested as it may help both. i cannot use prozac so might this be worth talking to dr about, has it helped anxiety and depression for you, i know it takes some weeks.
matts4912 ann55375
Posted
Ann,
Any benzo like diazepam should only be used short term as they can have horrible withdrawal, and whilst they help with anxiety they will do little for depression, so an anti-depressant might be the way to go. However, all anti-depressants will have different effects on different people - what works for one may not work for another. It is a game of trial and error and a lot of patience, but make sure you give each one a fair trial - at least 10-12 weeks before moving on otherwise you only make things worse by stopping and starting. Personally, lexapro has not done much for me now at 10 weeks, but again this doesn't mean it won't work for you, or others.
ann55375 matts4912
Posted
yes i seem to be in benzo tolerance at 12mg now its just not working. i heard good reports for LEXAPRO but i have tried sertraline which is a member of same group and was sick and very over anxious, had to discontinue. looking for an anti depressant which might lift anxiety and now feeling depressed about it all. there must be something out there which helps sleep and anxiety.
matts4912 ann55375
Posted
Ann - sleep will need to be treated separately from the anxiety. I would suggest looking into supplements - melatonin is a good and safe route and it encourages the brain to get back into its own circadian rhythm.
ann55375 paul32149
Posted
how are you doing now.
paul32149 ann55375
Posted
Hi doing ok thanks, increased to 10mg last week as although 5mg had done some good felt like i needed a bit more. Had hardly any side effects so fingers crossed will feel the benefit soon.