Chat Now!   Member Gallery   Anxiety Zone Wire   Games   Social Groups   AZ Member Blogs   Health News  Bored?

Author Topic: Lexapro dosage (or any ssri)  (Read 272 times)

0 Members and 1 Guest are viewing this topic.

Offline LynnC

  • Jr. Member
  • **
  • Posts: 69
  • Rec's: 0
  • Personal text
    • Poke This Member
Lexapro dosage (or any ssri)
« on: December 27, 2013, 06:01:43 PM »
Can someone tell me how the brain knows when you are at a therapudic dose of your medication? I've been on lexapro at 5, 7.5 and now 10mg...what stops the brain from needing more dosage increases indefinitely?
Bookmark and Share

Offline MobileChucko

  • Try? Try not! There is no try...
  • Global Moderator
  • Sr. Member
  • *****
  • Posts: 440
  • Country: us
  • Rec's: 16
  • Gender: Male
  • Mood: Curious
    Curious
  • Personal text
    • Poke This Member
Re: Lexapro dosage (or any ssri)
« Reply #1 on: December 27, 2013, 07:00:13 PM »
Hi Lynn...  Dosing of SSRI's/anti-depressants differ from most medications.  With a drug such as aspirin, you won't give a child the same dose as you would an adult.  With aspirin you would go by weight/age.  With SSRI's the therapeutic dose is the same for everyone.  This refers to the dosage needed to promote the actual growth of new brain cells.  With Lexapro, the therapeutic dose range is between 10 and 20 mg.  People are often started on a lower dosage to avoid side effects, and then the anti-depressant is slowly increased every 1 to 2 weeks.  Since you have been increased to 10 mg, you are now on the lower therapeutic dose of Lexapro.  Once you reach a therapeutic dose it may take some 3 to 12 weeks to see degrees of improvement.  Depending on how you respond to the 10 mg, your doctor may consider increasing the dosage again.  The maximum dosage of Lexapro, as indicated by the manufacturer, is 20 mg.  Doctors will occasionally prescribe dosages greater than this.  I hope this helps to answer your questions.  The best to you, Lynn!...  Chuck
Bookmark and Share

Offline insights

  • Hero Member
  • *****
  • Posts: 3183
  • Country: au
  • Rec's: 67
  • Gender: Male
  • Mood: Curious
    Curious
    • Poke This Member
Re: Lexapro dosage (or any ssri)
« Reply #2 on: December 27, 2013, 07:10:41 PM »
Can someone tell me how the brain knows when you are at a therapudic dose of your medication? I've been on lexapro at 5, 7.5 and now 10mg..

It doesn't. Antidepressants work by encouraging the growth of new brain cells and the connections between cells in the hippocampal regions of the brain to reverse the damage caused there by chronic stress hormone exposure. It is the new brain cells and interconnections which produce the therapeutic effect, not the med itself. A certain quantity of the drug is required to initiate and sustain this. Taking more than is needed has no additional effect (except maybe in side-effects), but taking less does.

Quote
what stops the brain from needing more dosage increases indefinitely?

Doses may need to be increased if stress levels go up, and tolerance may also develop over time, particularly with SSRIs. I've been at the same dose of my tricyclic antidepressant for about 20 years.

Ian
Bookmark and Share
NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline LynnC

  • Jr. Member
  • **
  • Posts: 69
  • Rec's: 0
  • Personal text
    • Poke This Member
Re: Lexapro dosage (or any ssri)
« Reply #3 on: December 28, 2013, 03:57:09 PM »
Thanks for the clarification. Next question is what stops the brain from spiraling back down into depression again as you taper your medicine down in time? I'm nowhere near ready for this but I was curious since I've read about many people that just can't get off the medication due to the horrendous withdrawals and having to stay on the medicine indefinitely. Why do some people seem to respond to only 5mg of lexapro when 10mg is the minimum therapeutic dose? How does one encourage the growth I'd new brain cells?
Bookmark and Share

Offline insights

  • Hero Member
  • *****
  • Posts: 3183
  • Country: au
  • Rec's: 67
  • Gender: Male
  • Mood: Curious
    Curious
    • Poke This Member
Re: Lexapro dosage (or any ssri)
« Reply #4 on: December 28, 2013, 07:41:30 PM »
Next question is what stops the brain from spiraling back down into depression again as you taper your medicine down in time?

Nothing, if the stress is still there. Depression is usually a chronic condition and antidepressants aren't cures, only treatments. It is likely that you will relapse at some point if you stop taking the antidepressant.

Quote
I'm nowhere near ready for this but I was curious since I've read about many people that just can't get off the medication due to the horrendous withdrawals and having to stay on the medicine indefinitely.


There are two aspects to this, yes, some antidepressants, particularly paroxetine (Paxil) and venlafaxine (Effexor) are difficult to quit because of their short half-lives, however, there are ways of making it easier, notably by switching to fluoxetine (Prozac) which has a half-life (with its metabolite) measured in weeks.

Quote
Why do some people seem to respond to only 5mg of lexapro when 10mg is the minimum therapeutic dose?

Why do about 30% respond to the placebo? 10mg is the minimum therapeutic dose even for children.

Quote
How does one encourage the growth I'd new brain cells?

Firstly, by reducing the chronic stress that kills them and inhibits the growth of new ones. Exercise and omega-3 fatty acids/fish oil promote neurogenesis.

Ian
Bookmark and Share
NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline LynnC

  • Jr. Member
  • **
  • Posts: 69
  • Rec's: 0
  • Personal text
    • Poke This Member
Re: Lexapro dosage (or any ssri)
« Reply #5 on: December 28, 2013, 07:56:55 PM »
Thanks for your replies Ian. So technically if you stay on a anti'd for a year'ish and the stress is gone and you're in a better place mentally, you won't spiral back down into a depression right away? I know the rates of a relapse are pretty high when suffering from a severe depression once and goes up from each incident on. When tapering though, do many people spiral back down just in the small tapers alone? My only experience is with Paxil...quit cold turkey about 18 years ago and it was disastrous but I didn't know any better at the time. How does one know if you are suffering from withdrawal effects of tapering or if your depression is back and just lying there waiting to return?
Bookmark and Share

Offline AncientMelody

  • Sr. Member
  • ****
  • Posts: 470
  • Rec's: 9
  • Personal text
    • Poke This Member
Re: Lexapro dosage (or any ssri)
« Reply #6 on: December 28, 2013, 08:05:49 PM »
That can be tough to know..... When I was going through withdrawal from zoloft, I experienced irritability,l depression and panic attacks. I thought it was due to withdrawa. Turns out the panic attacks WERE due to just that. However exactly one month later, and again one month after that I developed the extreme irritability and mood issues again so I realized that it wasn't the zoloft withdrawal but the depressive symptoms....largely but not soley hormone mediated in my case.

That's why it's important to continue with your psychiatrist even if you decide to go off the meds, they can help sort those things out for you.
Bookmark and Share

Offline insights

  • Hero Member
  • *****
  • Posts: 3183
  • Country: au
  • Rec's: 67
  • Gender: Male
  • Mood: Curious
    Curious
    • Poke This Member
Re: Lexapro dosage (or any ssri)
« Reply #7 on: December 28, 2013, 10:26:48 PM »
So technically if you stay on a anti'd for a year'ish and the stress is gone and you're in a better place mentally, you won't spiral back down into a depression right away?

Probably not. I can say about depression because I've never been depressed apart from a short-lived episode of mild rebound depression when quitting too fast, but on the three occasions I've stopped taking antidepressants for panic disorder the attacks have restarted about six, eighteen and 5 months later. So I decided my life would be much easier if I stayed on meds continually. Given the growing evidence recently that antidepressant efficiency seems to drop off the more often they are discontinued and restarted and that they may stop working altogether, this was probably a good move.

Quote
How does one know if you are suffering from withdrawal effects of tapering or if your depression is back and just lying there waiting to return?

A very good question, but one for which there probably isn't a very good answer. At this stage the only clue may be if it diminishes after a few weeks then it's probably, though not certainly withdrawal. However, generally depression isn't a significant withdrawal symptoms, though, from personal experience rebound depression may be if you wean off far too quickly. Mostly, the withdrawal symptoms are anxiety, brain zaps, depersonalization and derealization.

Ian
Bookmark and Share
NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Tags:
 

Related Topics

  Subject / Started by Replies Last post
5 Replies
1688 Views
Last post September 09, 2007, 08:00:03 PM
by itsmeesindee
1 Replies
971 Views
Last post April 22, 2009, 09:36:46 AM
by cubmanben
7 Replies
881 Views
Last post November 17, 2010, 05:48:48 PM
by BrambleRose
10 Replies
11693 Views
Last post August 10, 2011, 10:34:39 AM
by sayfay73
1 Replies
1104 Views
Last post June 20, 2012, 09:23:30 PM
by insights
4 Replies
426 Views
Last post December 03, 2012, 06:23:27 PM
by insights