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Lexapro - Inital Side Effects Question


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#1 dooger

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Posted 13 June 2008 - 08:29 AM

This may have been covered before, but I just needed a little help. I am trying Lexapro again. I tried it a few weeks ago for 4 days, taking 10mg around lunchtime, after being of all meds for a month. (I was already in a very intense depressive and anxious state when I started the Lexapro). The biggest problem I experienced the 4 days I was on it was insomnia; that bad kind that keeps you up with super anxious and depressive thoughts, thinking your whole world will end. Nighttime had always been a kind of solace for me, a time of day when I usually felt better and could easily drift off to sleep. But not on the Lexapro. Obsessions, anxiety, depression filled my head into the wee hours of the morning. I started shaking my foot, nervously. I finally had to take a Xanax to get to sleep. Great, more meds for the meds! During the daytime, my arms felt really weak. I couldn’t lift anything remotely heavy.

I’ve read in forums like this one, that going on AD’s can initially bring about hightened anxiety and depression, and insomnia. But have not read this specicially in books on meds, or more ‘official’ web sites about this being a temporary thing when first trying ADs. One site also wrote, “One thing I did find, which makes Lexapro stand out among all the meds we discuss here: if the early side effects suck, just move on. Really, don't stick it out. Apparently Lexapro (escitalopram oxalate) turns out to be no better than placebo with bad side effects. Not mild side effects, just really suck-*** ones.”

So I guess I need some handholding and reassurances here from people who had these bad side effects initially (higher anxiety and insomnia), but then they went away and the drug is working.

Things have gotten so bad again (depression, anxiety), that I started the Lexapro again yesterday, this time at 5mg, and took it at 11 am. Another terrible night as before. Really, really bad. Not sure what to do. I don’t want to have to take Xanax to sleep every night. But I don’t know if I can tough it out. Work is really busy right now. Thanks for you help

#2 Burgy

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Posted 13 June 2008 - 11:40 AM

:hearts: to DF, (((((dooger)))))

I'm sorry to hear you're having a tough time with the startup side effects, but rest assured (no pun intended) that they will fade over the first few weeks. I had insomnia too, and night sweats, and a terrible restless feeling in bed, where the pressure of the bed against my body would drive me nuts, so I was constantly tossing and turning.

The first 2 weeks on an AD are usually the hardest, because the side effects are strongest, and you're not feeling any therapeutic effects yet. After 2 weeks, the side effects with begin to fade. The 4-8 week period is usually when you'll notice the positive effects kicking in, as the side effects drop off even more. Most people are fully adjusted in 8 weeks.

I know that each day can be agony when you're depressed and anxious, and adding side effects to that can be very discouraging. Please try to be patient and distract yourself any (healthy) way you can, and know that relief is coming soon. Use the Xanax you were prescribed if you need to during this time...it won't be long before you won't need it any longer.

I really don't appreciate what that person said on the other site about just giving up at the first sign of discomfort. That's a disservice to the countless people who would have success with Lexapro after getting through the first few weeks. I just want to tell everyone to ignore the way they feel during the first month! It's not how you'll feel after two months! Hang in there, and please keep us posted on your progress.


P.S. One trick that helped to smooth out the startup process for me was to split the tablets in half, and take a half dose every 12 hours, instead of the full dose every 24. You can break them with your fingers, but it's difficult with those small tablets, so I got a pill splitter for about $5 at the pharmacy. After about 8 weeks, I was able to switch to the full dose once a day with no problem.

Edited by suburgatory, 13 June 2008 - 11:53 AM.

Posted Image We are what we think. All that we are arises with our thoughts. With our thoughts, we make the world. ~Buddha

#3 Nole

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Posted 13 June 2008 - 11:49 AM

I agree the first 2 weeks are tough but managable if you have the right outlook and realize these side effects will ease up over time. It will increase your anxiety and probably the insomnia as well, but this should pass. By the second week I was feeling pretty good. I am 6 weeks into Lex and overall feel really well, and I dont think I have the full effect of the meds totally in me yet as I heard it can take 2-3 months. I take my meds at night as they make me sleep well. Maybe you should try taking them when you first get up so by bedtime you are tired.

#4 Rahul

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Posted 13 June 2008 - 01:25 PM

I'm in my fourth week of generic lexapro. The first three days I slept well because I was depressed. Then the insomnia crept in. However I have noticed improvements in my sleep over the last week. So be rest assured that your body and mind will adjust to the insomnia and develop its own rhythm over time (I've read elsewhere that the mind has an amazing power to redress sleep deprivation situations). However, I agree with suburgatory that there is no harm in using a crutch like xanax. I myself use clonazepam. Once the side effects ease and you are feeling better, you can always taper from these benzos (even it takes a 28 weeks taper -- the longest -- it does not matter for time is not a factor). Even in the worst case scenario, you'll be back with insomnia after you taper from the benzo but at least you will be emotionally better equipped to deal with it. No point exacerbating the SE's right now with unwanted insomnia. Further, xanax will reduce your anxiety till the ssri kicks in.

Edited by Rahul, 13 June 2008 - 01:27 PM.

I'm not a doctor or a health professional and any advice in my post is purely my personal opinion and anecdotal.

Dx: MDD
Rx: 10 mg escitalopram + 15mg mitrazapine + 20 mg chlordiazepoxide (all
at bedtime)

#5 dooger

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Posted 13 June 2008 - 02:30 PM

Thanks for all your help. I'm on day two, of attempt 2, and having the same side effects as mentioned before. And I'm only 5 mg. This seems quick and the dosage seems small to already be having these side effects. And I forgot about this other one I had before and am getting now:

Heart chest area is weird, anxiety can be felt there when I have a specific worry. (Warm sinking feeling) Heart beat a little bit more prominent, and I feel it racing a bit when I stand up after sitting (not something I usually notice).

I am worried about the Xanax. If I just take it at night, I worry I will get withdrawal effects during the day since I am not keeping a consitent level in my body? Maybe the taking the Xanax at night make the Anxiety worse during the day?

I want to quit. I have people depending on me big time round the clock for the next 2 months and I can't be this bad off. I guess it's really hard to go on AD's when you're already at rock bottom. I just don't remember it being this hard going on them before. I'm thinking about going back on Cymbalta, which stopped working this December, but had been working well for years.

Thanks for all your help. I know I'm all over the place now. I'm so scared, as I have been many times over the past 6 months, and this board has been helpful.

Edited by dooger, 13 June 2008 - 02:33 PM.


#6 Rahul

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Posted 13 June 2008 - 03:13 PM

Heart chest area is weird, anxiety can be felt there when I have a specific worry. (Warm sinking feeling) Heart beat a little bit more prominent, and I feel it racing a bit when I stand up after sitting (not something I usually notice).


This is a common symptom of anxiety/depression. Regardless of whether it is a symptom of a SE or the parent condition, it should resolve quickly (lifted in 3/4 days for me -- though everyone is different).

I am worried about the Xanax. If I just take it at night, I worry I will get withdrawal effects during the day since I am not keeping a consitent level in my body? Maybe the taking the Xanax at night make the Anxiety worse during the day?


I don't want to sound like I'm encouraging meds but I was on 0.25 X 3 times daily dose of xanax for 5 years and I never developed tolerance for it. I had no side effects (like feeling groggy during the day/morning). It felt perfectly natural and a) calmed me, and b) gave me good sleep. Unfortunately, a doctor made me quit cold turkey. I was naive and so was my doc. I fell into a severe depression for which I now take lex. I should have tapered. I feel like tearing my hair out 'cos ten years ago, I was in a similar situation with xanax and another doc. had me taper off them over a month and I felt no withdrawal. Having been there, I should not have suffered this time around. Regardless, I still have a lot of fondness for xanax (in low doses) and I feel it is very light on the system, very effective and easy to taper off and without any side effects (unlike other benzos like diazepam etc.).
I'm not a doctor or a health professional and any advice in my post is purely my personal opinion and anecdotal.

Dx: MDD
Rx: 10 mg escitalopram + 15mg mitrazapine + 20 mg chlordiazepoxide (all
at bedtime)

#7 ricky59

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Posted 13 June 2008 - 03:17 PM

Don't quit. Hang in there with it. I am right where you are. I am 9 days in and still having terrible insomnia, but it will get better. It's a crappy reality that the side effects of these meds usually start right away, but the benefits take longer. It will be worth it in the long run and staying consistent with taking your meds every day will work much better than starting and stopping.

Hope you feel better soon
still trying to attain my hearts desire

#8 HopefulOne

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Posted 13 June 2008 - 03:24 PM

Dooger --

Try to hang in there. When I started Lexapro last fall, I had the added anxiety and insomnia... and a multitude of other hateful SE's. My build-up was rugged and frightening, but I attribute that, in part, to the profound depression and distress I was already in at the time (from taking care of my father in hospice and dealing with painful neck/spine injury from lifting him). Like you, I started in a very hard place emotionally. I was in such a state in the beginning of my Lex adjustment, that I was fearful I'd never feel like myself again. I, too, questioned if I'd ever emerge from the fog and feel sane and "normal". But I did. And so will you.

The warm sinking feelings are a function of anxiety -- and they're standard... as is a prominent heart beat. Those are generally transient. By quitting Lex this early and jumping to another AD you'd be doing yourself a huge disservice. The first couple weeks are when side effects are most intense and are no indication of the therapeutic benefits that the medication can give you in the long run. AD's are not an immediate magic bullet -- you have to let them build in your system. And to do that, you have to give them a chance beyond the first couple weeks. It's hard when you're suffering so much, but try to hang in there. Each day WILL get easier.

You should not feel any next day "withdrawal" from having taken a Xanax the night before. Xanax has a short half-life and shouldn't leave you groggy like sleeping medications might do. Try not worry yourself about having to using a Xanax to help you sleep. Doctor's commonly prescribe benzos to help adjusting patients get over the initial side-effect hump. Think of it as temporary. I took Clonazepam (similar to Xanax) to help me weather the anxiety (and sleeplessness, if necessary) of the first few weeks. After week 3, I didn't need them any longer. I haven't taken one since.

I can empathize with your fear, dooger, but I assure that you WILL come out the other side of this rough patch. I've been on Lex now for 7... going on 8 months and I feel good. It's worth the wait.

Hang in there...
Best,
HopefulOne

Edited by HopefulOne, 13 June 2008 - 03:30 PM.


#9 dooger

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Posted 13 June 2008 - 04:58 PM

Thank you all.

I love my pdoc, but he doesn't think this added anxiety and insomnia are normal side effects for just starting. That's what's been confusing me.

It's been a rough year, since November, really, when one morning I just woke up very depressed. I had been on Cymbalta for a two years and Anafranil for 10 years before that, to combat OCD and mild depressio & anxiety. (The previous September, we tried adding Abilify to the Cymbalta, but it made me too scatterbrained. A few weeks after going back on only Cymbalta is when the darkness hit.) I've been trying to get myself out of this hell ever since. Reading this forum certainly helps me not feel like I am alone in this suffering.

I've was on effexor this winter, spring, but it didnt' seem to help. I came of meds completely in the beginning of May. Researched Sam-e Theasine, 5-HTP and ST. JW. Bought all of them, but never tried them.

I havd barely worked in 6 months. I am now away from home, working at a summer camp with wonderful friends and kids. I have spent all spring trying to be mentally ready for this usually fun expereince (that I do every year). But I haven't gotten out of the abyss, and the season's off and running. This is not the optimal time to try a new AD, but when is really.

Thanks again for your thoughts. I look forward to a time in the future when I won't be so focused on me, me, me and can really enjoy being around and helping others again. I hate beeing so self-involved and in crisis mode, which I'm sure you all can relate to.

#10 HopefulOne

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Posted 13 June 2008 - 07:38 PM

Heaven's sake, dooger! I might expect to hear your pdoc's beliefs about SEs more from a general practitioner (with lack of specialized knowledge!) than from a pdoc. Has your pdoc been practicing long? I'd imagine that the abundance of posts here from fellow pilgrims with similar start-up side effects are making you feel less alone. That you're not some strange anomaly! Rest assured that your SEs are VERY normal. (As frustrating as they may be!)

It sounds like you're in a VERY high energy, demanding social environment at camp -- that can be difficult when you feel so lousy. Understood! Try to take it easy on yourself -- grab rest where you can, eat well (nutritiously) and don't be afraid to take your Xanax as you need to for sleep. If you take it during the day for anxiety, remember that it has sedating properties and *may* make you one sleepy camper :hearts: . (You may try taking a half a pill for the high anxiety moments during the day til you know how it will affect your functioning.)

As you begin to feel better, you'll be able to move past feeling so self-focused 24/7. When I started Lex, I remember being obsessed with every little symptom going on in my body. I felt like I was counting the minutes. That's typical too. But try to give yourself some grace and remind yourself that this phase WILL pass. If it helps, feel free to continue posting on this site. I've found that the online community here is a supportive bunch -- I hope you'll find that to be the case too.

Best,
HopefulOne

Edited by HopefulOne, 13 June 2008 - 07:40 PM.


#11 ricky59

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Posted 15 June 2008 - 05:30 PM

I have found that doctors tend to not believe their patients when it comes to side effects. My doc rolls her eyes every time I tell her about a side effect. I had an allergic reaction to blood pressure meds a year ago and when I went into the office and told her, she gave me the usual eye roll, but then I took off my shirt and my torso was covered with welts, her jaw dropped and she immediately agreed that I was absolutely correct.

She has been a little more attentive to my comments since then, but I just find that since many patients do not tell the doc about the side effects. the doc's think they are not happening. I found a site called askapatient dot com that lists peoples experiences with different meds. Pretty much every one who posts a review of AD meds lists many of the same side effects. There are some negative reviews of all meds, be even the positive reviews say they had start up side effects.

Just a ray of hope, mine are getting better, little by little. You'll get there.

Edited by ricky59, 15 June 2008 - 05:30 PM.

still trying to attain my hearts desire

#12 krappelt

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Posted 15 April 2013 - 08:58 PM

These postings, although dated, really helped me to understand that side effects of Lexapro WILL eventually pass (usually I guess)  I've been on 10 mg for a week and getting frustrated at the nausea, some anxiety and just weird feelings.  I'm happy to discover this site as I join my fellow travelers.



#13 Wattz

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Posted 21 April 2013 - 10:01 AM

Just to add my 2cents, personally I didn't experience insomnia. My symptoms were pretty straight forward: headache, tightness around the chest, some pain in my neck and back, fogginess, dizziness. Also a strange disconnectedness. Most of these symptoms started lessoning after a week and by the end of the second week I think I'd pretty much levelled off. However I did feel like the lexapro heavily numbed my emotions (which was actually a relieve) but I had little motivation and concentration. A week ago I started wellbutrin and it seemed almost to counter act a lot of the side effect (and effects) of lexapro.



#14 Talwen

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Posted 24 April 2013 - 01:34 PM

These postings, although dated, really helped me to understand that side effects of Lexapro WILL eventually pass (usually I guess)  I've been on 10 mg for a week and getting frustrated at the nausea, some anxiety and just weird feelings.  I'm happy to discover this site as I join my fellow travelers.


Same on pretty much all counts. I'm ten days in and feeling quite anxious, down and fatigued. Looking forward to and end of this starting period and onto a time when I start to feel better.

#15 snack_pack

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Posted 21 May 2013 - 02:51 PM

Hi all,

 

I just wanted to chime in and say that I'm in exactly the same situation that is described in this thread.  I am struggling with depression and social anxiety.  I am 6 days into starting Lexapro 5mg, and the first few days went OK, but now as of yesterday I am incurring some of the increased anxiety that I have been fearing. 

 

For the past month or so, I have been trying different antidepressants and have abandoned each one because of early onset of initial side effects.  The first was Luvox 50mg, which started to give me insomnia after about 2 days - on top of that, I had a very disconnected feeling from reality and overall confusion.  I took the Luvox for a total of 8 days before quitting.  Next, I tried Wellbutrin XR 150mg which turned out to be completely the wrong med for me - it was so activating that I felt speedy, very bad anxiety, and generally terrible.  Also, gave me tinnitus and a twitch in my eye.  I only took that one twice before stopping.  The twitch in my eye went away after a couple of days, but the tinnitus has remained still.  Has anyone else experienced that side effect - even after just taking a few doses of a medication?  And when can I expect it to go away?  My psychiatrist says I need to wait for my system to settle down, which could take a while.  Next, I tried Trazodone 50-150mg for around 2 weeks - mainly just to attempt to sleep.  The insomnia that I initially developed with the Luvox was continuing to hang around and I thought Trazodone may be a good bet because of its sedating properties.  However, I eventually developed a similar confusion/disconnected feeling with that medication as well, and discontinued it.

 

I suppose that last paragraph is just a bit of a background to say that I have bounced around to many diffent medications within the past month and feel that I am very sensitive to them in general as well as very nervous about the potential side effects.  Now, being on Lexapro, I was enthusiastic after the first couple of days feeling generally good and wanting to interact with people.  However, the anxiety that has now crept back in has me very worried and I suppose I'm looking for some encouragement from the thread about their experiences. 

 

Talwen, were you able to adjust OK to the medication?  How about you Krappelt?

 

I should also mention the insomnia continues to be a problem for me and I really haven't slept that well in about a month.  I have been trying various sleep aids - Ativan 1mg was working for a bit but now seems to have lost its effectiveness.  I saw my pdoc today, and she gave me Ambien CR to try tonight - we will see how that goes.  All I would like is for this insomnia to go away and the tinnitus to settle down and then I feel like I could kick the anxiety that is creeping in.  I really want Lexapro to work for me, but I don't know how much more I can handle if I don't adjust pretty quickly...it seems like about 2 weeks is the bogey I should shoot for? 

Thanks so much!



#16 pinkdaisy23

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Posted 15 June 2013 - 12:32 AM

I'm so glad its not just me with these side effects. I literally felt like I was dying and went to hell. I went from sleeping about 10-12 hours a day(I liked to sleep as an escape) to two...no joke TWO hours a night. I'd feel physically exhausted, but my mind was racing and my anxiety was beyond extreme. I'm more depressed than anxious but I feel like this brought out the worst in me. I as well  used to love night time, the day was over and my escape aka sleep has arrived. Now I fear it. No one is awake to keep me sane, just me and my thoughts. I have xanax (unprescribed, one of the drugs I used to take to knock out/get high) however, even when I take it what used to take like 20 mins to knock me out now takes over an hour with zero relaxing side effects. I also get like the cold sweats at night. My appetite is gone as well, I'll feel my stomach growl but when i look for food I can't find anything desirable. I also have this weird nausea as well.






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