lexapro Dose

[beatles86]

So I know the maximum recommended use of lexapro is 20mg, but it seems that is pretty low when in comparison to other ssri's.  On crazy meds, they have a ssri equivalent chart and it shows 2.5mg of leapro being equal to 10 mg of zoloft and 5mg of prozac.  So basically, if prozac goes up to 80mg, then the equivalent lexapro dose would be 40mg, and if zoloft goes up to 200, then lexapro dose would be 50 for that. 

I am asking this because I am not on 25mg of lexapro and I am worried that is high, but it seems that it isn't that high when compared to what other ssri's go up to.  Perhaps the comparison chary on crazymeds is wrong.  Does lexapro go past 20?  Why is 20 the maximum dose?  Does this comparion on crazymeds seem accurate?  Is 25 mg an okay dose?  Thanks guys!

[insights]

So I know the maximum recommended use of lexapro is 20mg, but it seems that is pretty low when in comparison to other ssri's.  On crazy meds, they have a ssri equivalent chart and it shows 2.5mg of leapro being equal to 10 mg of zoloft and 5mg of prozac.  So basically, if prozac goes up to 80mg, then the equivalent lexapro dose would be 40mg, and if zoloft goes up to 200, then lexapro dose would be 50 for that.

It doesn't work like this. Different drugs have different potencies, do slightly different things in the brain and also different effects on the body. For example, the maximum Lexapro dose was originally 30mg until it was discovered that it can affect the electrical system of the heart at higher doses (not a problem at <=20mg, and also probably not that important even at 30mg if you don't have heart disease).

The only drug you can compare Lexapro to is Celexa as they are essentially the same drug. The difference is that Lexapro only contains the active isomer of the two that make up the Celexa chemical, hence you only need half as much.   

Is 25 mg an okay dose?  Thanks guys!

As per above, if your heart is in good condition then you might be okay up to 30mg. However, if Lexapro isn't working well enough at 20mg then it probably won't be significantly more effective at 25mg, or even at 30mg. IMHO, you'd probably be better switching to something else.

Ian

PS: For anyone taking either Celexa or Lexapro (or Zoloft) who is worried about the risk of prolonged QTc interval, unless you have an existing heart condition it shouldn't be a problem. I've been taking the most cardiotoxic antidepressant, dothiepin, aka dosulepin, at well above the maximum recommended dose for 15-16 years and so far it isn't causing any issues despite my heart being under greater than usual strain following the removal of a lung some years ago. There are many other drugs that may affect QTc interval including drugs used to treat heart disease.

If you are concerned ask your doctor for an EKG, aka ECG, which will show if the drug is affecting your heart in any way.

[beatles86]

When I first started lexapro a few years ago I worked my way up to 30mg with great success.  I remember now feeling much on 20, but a ton on 30 without any side effects.  I eventually weaned down to 20 and was fine on that. 

I went off the lexapro for a few months then went back on it.  I don't feel much at 20, so my doctor said it would be better to stay with lexapro instead of switching since I have had great results with it and no side effects.  He said 25 or 30 is not that high of a dose and many people take doses that high.  He said I have nothing to worry about, and that I will most likely get good results going up just like I did the first time.  So I am trying that now.  of course, if that doesnt work then I will have to switch.