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Author Topic: Would I rather be anxious or fat? My move from 10mg Lexapro, to 15, to 5.  (Read 342 times)

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Offline Snoopy10

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I was on a steady dose of 10mg Lexapro and my anxiety was well under control. Unfortunately I had constant dry mouth and had gained 10lbs. Then I had some serious breakthrough anxiety symptoms before a work trip (I even canceled my flight!) and my doctor bumped me up to 15mg.  15mg was great but my underlying negative thought cycle was still there, I could tell, and I realized more CBT is in order so I gave started seeing a therapist again. I also gained more weight (getting close to my plumped out college weight!) and had a desert of a mouth, was bloated all the time (maybe from eating so much, not sure), and was having memory problems.

So now I am seeing what 5mg is like. Here is what I have noticed:

Pros
-I don't feel like eating all the time
-I am more motivated to work and to work out
-I don't feel like drinking as much (weird. maybe has to do with the food thing)
-My mouth has saliva in it
-Klonopin works better (also weird)

Cons
-I feel like everyone hates me, again
-I am obsessively thinking about negative things, again (did I offend that person? Did I do something bad? Am I dying of a horrible disease?)
-I am back to second-guessing (did I lock the door? Did I forget to email that person at work?)
-Nightmares and teeth clenching at night

I am going to try one more week on 5mg (I think it's only been 2 weeks on this lower dose) and if the "Cons" continue I am going to try 7.5mg.  'Cause there is No Way I am going to go back to my "crazy"!!

I won't lie, my anxiety feels like an old friend. The old me that I remember. It's not all bad. I realized this week that I have been ignoring my husband (not on purpose) and suggested a weekend away with the two of us, he brightened up, that feels great!

But the obsessive thinking is HORRIBLE. And impossible for me to stop without pharmaceutical intervention. I know this. My friend obsessive thinking and I have been hanging out for 42 years.

Insights, does it take awhile to stabilize when you go down on dosage just like it does when you go up? 
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Offline MobileChucko

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Hi Snoopy...

Unfortunately, you are doing with your Lexapro (Escitalopram), SSRI anti-depressant, exactly what you shouldn't be doing with it.  I am making an assumption here that you didn't tell your doctor that you have adjusted your dose down to 5 mg.  If your doctor told you to do that, I'd be looking for another physician.

It is one thing to be titrating your dose of an anti-depressant down, if you are planning on completely coming off the medication, but anti-depressants are not good medications to play the "up and down" game with.

The lowest therapeutic dose for Lexapro is considered 10 mg.  Therefore, by adjusting your Escitalopram down to 5 mg, you are no longer in a therapeutic range.  Doing this can actually cause your system to completely reject the Lexapro, and you can end-up getting no benefit from the medication, even at a therapeutic dosage.

Your doctor should always be in charge of any dose changes, on any medication that you are taking, and you should have a doctor that knows the facts behind anti-depressants.  Psychiatrists are the best medical doctors for prescribing and regulating anti-depressants, as they are the experts in this area.

The very best to you, Snoopy!...  Chuck :grinning-smiley-003:
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Offline stevo1111

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I cannot comment on the dosage, but can comment on the weight gain.

Personally, I am actively choosing to be heavy and not anxious, vs. normal weight and neurotic.

I got creative in weight management though. I started lifting weights rather than doing cardio and forced myself to choose protein over carbs (burger over cheesecake, I guess). The weight still came on, as it always does, with an antidepressant but this time I was able to keep the weight gain almost 50/50 muscle and fat. Now I look like a lineman, rather than a blob. I've gained 50lbs in the past year on my medication, but I'm able to function. For me, its a worthwhile trade off.
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Offline joe2014

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So why do we gain weight with antidepressants? Do they make us eat more?
Joe
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Offline MobileChucko

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Hi Joe...

To my knowledge, they don't really know why anti-depressants make many individuals gain weight, but there are a number of theories.

One of the theories is that anti-depressants actually decrease the body's metabolism.  To me this would make sense since I have gone from an anxious, hyper-state, in which I was actually losing weight, to a calm, relaxed one where I am gaining weight.

Another theory is that since anti-depressants make us feel better, we return to a zest for life, and that includes a better appetite.

I think that both of these theories make sense, are are probably both true.

And Stevo, I really liked what you wrote.  At this point, quality of life is more important to me than how long I live.  So that is great that you actually embrace your weight gain, but you are still exercising and taking care of yourself.

The very best to all of you!...  Chuck :grinning-smiley-003:
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Offline joe2014

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I think that it's healthier to be heavier than to have max stress all the time.
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Offline Snoopy10

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MobileChucko, joe2014 and steveo111, thanks for the input!

I agree its better to be mentally well with a few extra pounds than anxious and thin. I also agree with MobileChucko's theory on weight gain.  On antidepressants I am not necessarily hungry all the time, but do feel like eating all the time.  And food tastes great!  And I don't stress out about eating it (until my jean size went up and then got tighter and tighter!    :goofy: )

But I didn't know it was bad to go down in dosage.  My med management is done by a psychiatrist ( I have been with this psychiatrist for 7 years) and yes your are correct, I didn't ask him.  I just chose to do it.  But when I raised the dose a month ago he did say that if the 15 mg side effects were too much for me, I could go back to 10mg, so I thought going back to 5 would be an option.  It's not?  I do have some friends who are on 5 mg and stayed on 5mg (my sister was on 5mg).  But I don't want the Lexapro to stop working of course. 

I would call my psychiatrist but he costs $365 an hour, a phone call is $220.  So I would then be fat, anxious AND poor  :laugh3: (just kidding) - I know every dollar is worth it. if I should call, I'll call.
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Offline joe2014

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But a lot of men like tight jeans.
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Online insights

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Insights, does it take awhile to stabilize when you go down on dosage just like it does when you go up?

Yes. It takes 7 days for plasma levels to stabilize, perhaps several weeks for anxiety (and/or depression) levels to do so. As for the dry-mouth, etc, you could try switching to Celexa (citalopram). It and Lexapro share the same active chemical, but Celexa also contains a mostly inactive isomer of it which in theory shouldn't make any difference, but often does in subtle ways.

Ian
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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 Snoopy10

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Thank you Insights! That is helpful.
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Offline Snoopy10

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And Joe2014,  :laugh3: :laugh3:

I guess if we can't laugh, what else is there to do??,
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Offline joe2014

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Absolutely!  And you seem like you have a good sense of humor. Take care.

Joe
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Offline Snoopy10

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I wanted to do another quick ask on this, is what MobileChucko saying correct about lowering the Lexapro dosage? Meaning will I receive no therapeutic benefit from 5mg of Lexapro now that I have been on 10mg?

I am doing okay on 5mg. 10mg was better from an anxiety perspective but worse from a side effect perspective.  But if 5mg no longer has a therapeutic benefit then maybe I will ask my doctor to switch me to low dose of something else.

I can't really tell if the 5mg is having any benefit at all.  A lot of my anxiety symptoms are back (nervous talking to people at work), but if the 5mg is doing anything at all then I want to stick to it.  5mg is giving me some awesome, sheet drenching, night sweats and I am clenching my teeth at night but I would prefer more than just side effects to give me some indication that it is doing something more.

MobileChucko and Insights, what are your opinions?

(I have anxiety so of course I have obsessively been thinking about what MobileChucko said!  B-; )

P.s. My current solution to "tight jeans syndrome" - wear a dress! Much more forgiving and quite flattering for summer!

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Online insights

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I wanted to do another quick ask on this, is what MobileChucko saying correct about lowering the Lexapro dosage? Meaning will I receive no therapeutic benefit from 5mg of Lexapro now that I have been on 10mg?

....I can't really tell if the 5mg is having any benefit at all.  A lot of my anxiety symptoms are back (nervous talking to people at work),

Seems to me that you've answered your own question. If a med is ineffective at the maximum dose you can tolerate then what is the point of taking it?

Quote
But if 5mg no longer has a therapeutic benefit then maybe I will ask my doctor to switch me to low dose of something else.

Given that obsessive thinking seems to be a significant part of your disorder your best bets might be either the SSRI Luvox (fluvoxamine), or the TCA Anafranil (clomipramine) as they have a proven superiority in treating OCD.

Ian

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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 Snoopy10

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Hi insights, good point. (If 5mg isn't working then there is my answer)

My doctor told me obsessive thinking was a symptom of GAD, not OCD.  Or is it both?

Just wondering.
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