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Author Topic: DP from Lexapro Does it go away  (Read 1932 times)

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Re: DP from Lexapro Does it go away
« Reply #30 on: August 30, 2014, 02:24:07 AM »
Though it might be unlikely I'm just hoping the medication connectedness feeling, dp/dr will eventually lift.

Depersonalization and derealizations are most often a anxiety or depression symptom which antidepressants may exacerbate, but in almost all cases when the anxiety/depression is bought under control so are DP/DR. I'll be very surprised if they continue once the med becomes effective.

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.

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Re: DP from Lexapro Does it go away
« Reply #31 on: August 30, 2014, 02:15:34 PM »
Ian,

Thanks for the great info. I have noticed a massive increase in sleep and fatigue since I increased the dose. Including some slight itchiness on 2 spots on my body. Do these side effects go away? I guess I will be in the side effect zone since I'm increasing my dosage by 25mg each week until I'm I therapeutic range.do you think 25mg each week is to much?

-frustrated
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Re: DP from Lexapro Does it go away
« Reply #32 on: August 30, 2014, 06:05:36 PM »
I have noticed a massive increase in sleep and fatigue since I increased the dose. Including some slight itchiness on 2 spots on my body.

The sedation should ease considerably, but may not completely go away. Most of the TCAs are powerful antihistamines and as such are moderately to very sedating. Doxepin, for example, is probably prescribed more often for insomnia than anxiety and depression. Nortriptyline is comparatively one of the weaker histamine blockers so the sedation should only be mild once you're stabilized on a therapeutic dose.

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I therapeutic range.do you think 25mg each week is to much?

That should be fine. You would probably tolerate a 50mg increase, but stick with what you're comfortable with. Confidence is very important.

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.

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Re: DP from Lexapro Does it go away
« Reply #33 on: August 31, 2014, 08:09:53 PM »
Ian,

I think I'm coming to the conclusion that possibly I have had DR for the last 14 years since I took Ativan 1mg daily, but didn't notice it because I wasn't depressed.. However, is there a possibility that the BZD has permanently changed my chemistry of my brain since I took it repeatedly for 14 years? I know I'm psychologically dependent on the drug since it really helped me out in 2001, so it has always been in my life.

However, what I think I have to come to believe is that I'm getting the spaced out feeling from nortrip confused with increased DR which is always there. I just seems like when I take the Nortrip I get more DR, or maybe it's just spaciness?

I know I'm probably trying to split hairs to figure out my problems are but it seems my doctors don't have a clue of what's going on..  :angry:

PS Did you have spaciness when you were taking the TCA? Also, do you think when nortip is fully effective will/can it assist me in dealing with the withdrawls from BZD. I'm currently taking a maintenance level of 2.5mg of valium daily to stave off BZD w/d effects.

-Frustrated
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Re: DP from Lexapro Does it go away
« Reply #34 on: August 31, 2014, 08:43:48 PM »
I have had DR for the last 14 years since I took Ativan 1mg daily, but didn't notice it because I wasn't depressed.. However, is there a possibility that the BZD has permanently changed my chemistry of my brain since I took it repeatedly for 14 years?

You have been on Ativan all your life, it is found naturally in most foods. There is no evidence that BZDs create permanent brain changes, though they do while being taken and for a few weeks after discontinuation.

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I just seems like when I take the Nortrip I get more DR, or maybe it's just spaciness?

Maybe. I can't judge whether your symptoms are DP/Dr or "spaciness."

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Did you have spaciness when you were taking the TCA?

No. But this doesn't mean it isn't possible. Everyone's biology is different.

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Also, do you think when nortip is fully effective will/can it assist me in dealing with the withdrawals from BZD.

Only in as much as it will help dampen any increased anxiety. Antidepressants and benzodiazepines work on completely different brain pathways.

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I'm currently taking a maintenance level of 2.5mg of valium daily to stave off BZD w/d effects.

This is a tiny dose so you should have few problems getting off it. Reducing by 0.5mg every 3-4 weeks would be a good way of tapering off.

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.

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Re: DP from Lexapro Does it go away
« Reply #35 on: September 02, 2014, 07:05:31 PM »
Ian,

I'm feeing more derealized on the notrip then when I started. It's only been 1 week at 75mg, but close to 3 weeks total from 25 -> 50 -> 75mg.  Typically do these side effects go away over time?

I feel that it's helping with my depression but still have the spaciness associated with it. I'm thinking if continuing it for the next couple of weeks.. In your opinion, do you think I need to increase the dosage to get therapeutic, and typically what mg is that?

-Thanks
Frustrated
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Re: DP from Lexapro Does it go away
« Reply #36 on: September 02, 2014, 07:48:01 PM »
I'm feeing more derealized on the notrip then when I started. It's only been 1 week at 75mg, but close to 3 weeks total from 25 -> 50 -> 75mg.  Typically do these side effects go away over time?

They usually do, but a few can have ongoing issues. You need to give it more time. It typically takes 3-12 weeks for antidepressants to kick-in from when you begin taking a therapeutic dose which for nortriptyline is at least 50mg.

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In your opinion, do you think I need to increase the dosage to get therapeutic, and typically what mg is that?

You may need to go higher, most take 100-125mg/day, however, give the 75mg a chance to work first.

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.

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Re: DP from Lexapro Does it go away
« Reply #37 on: September 04, 2014, 07:22:03 PM »
Ian,

Thanks for the information so far been a great help :) I have been on 75mg for a week now.. Looks like my pdoc want's to stay on it for another week hoping the good days outweigh the bad. He also said if the bad > good then updose to 100mg next week. From your experience is 75mg low on the therapeutic level? Also, is there a blood test that can determine the level of Nortriptyline in the blood?

Thanks,

-Frustrated
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Re: DP from Lexapro Does it go away
« Reply #38 on: September 04, 2014, 08:14:32 PM »
From your experience is 75mg low on the therapeutic level?

Most would be on 100-125mg/day, but you may do well on 75mg. It all depends on your biology and how you metabolize it.

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Also, is there a blood test that can determine the level of Nortriptyline in the blood?

There are for all the TCAs. While they can tell you if plasma levels are in the therapeutic range, they won't necessarily indicate the most effective dose. Antidepressants don't have a direct therapeutic affect on anxiety and depression in the way say benzodiazepines do. It is the new brain cells they help to grow which provide the therapeutic response, not the antidepressant itself. You can have high plasma levels of the med yet fail to respond.

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.

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Re: DP from Lexapro Does it go away
« Reply #39 on: September 07, 2014, 05:19:40 PM »
Ian,

thanks for the additional information. Questions, though. Does Nortriptyline also assist with Anxiety for example GAD? I have noticed a little reduction in the depression.. I know I'm not a patient person but was curious are there better TCAs for Anxiety then then Nortriptyline? Or Nortriptyline might work and will need to wait?

Also, this is my first week on 75mg therapeutic. When will I start dramatic changes, or does the medicine work over-time and I won't necessarily notice since improvements are subtle.

Thanks,

-Frustrated

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Re: DP from Lexapro Does it go away
« Reply #40 on: September 07, 2014, 08:56:30 PM »
Does Nortriptyline also assist with Anxiety for example GAD? I have noticed a little reduction in the depression.. I know I'm not a patient person but was curious are there better TCAs for Anxiety then then Nortriptyline?

No antidepressant is intrinsically any better than the others, either generally, or for a specific disorder, though one or two may be for an individual. Plus, anxiety and depression are mediated by the same underlying biological deficits. They are just different points on a spectrum. However, anxiety disorders seem to respond a little less to antidepressants so you may require a higher dose to resolve it than the depression.

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Or Nortriptyline might work and will need to wait?

You've only been on a therapeutic dose for a week. You're unlikely to see a positive results this soon. It typically takes 3-12 weeks.

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When will I start dramatic changes, or does the medicine work over-time and I won't necessarily notice since improvements are subtle.

Some wake up to a whole new world, others notice a gradual linear improvement and for some the antidepressant begins working in fits and starts, good one hour/day, not so great the next. It all depends on your biology.

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.

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Re: DP from Lexapro Does it go away
« Reply #41 on: September 11, 2014, 02:57:59 PM »
Ian,

Thanks for the information. My doctor decided to bump me to 100mg only after of being on 75mg (been on Nortriptyline for a month)  for 2 weeks. It's back to the dose increase side effects :(. Anyways, I did notice some slight improvement with my DP/DR.. it seems less depressed, less of the DR.

I get frustrated that he keeps bumping me up versus letting one dose settle. His explanation since I'm tolerating the drug is and increase.. I will be seeing him on the Sept 25th for status and changes. I guess I just need to be more patient with the drug and stop over analyzing every mood I'm in.

Also, do you think taking the drug during the day is better before bed?  I have been taking it before bed and it seems to have less effect versus taking it during the day.. But probably to early to see the difference.

Thanks,

-Frustrated

 
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Re: DP from Lexapro Does it go away
« Reply #42 on: September 11, 2014, 05:52:35 PM »
Also, do you think taking the drug during the day is better before bed?

Ideally, because of their shortish half-lives the TCAs (and most of the SSRIs, IMHO) should be taken in 2-3 spit doses, however, doctors are reluctant to prescribe them this way because compliance and missed doses become an issue with multiple daily dosing. I'm on 225mg of my TCA so take 75mg in the morning, mid afternoon and evening.

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.

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Re: DP from Lexapro Does it go away
« Reply #43 on: September 12, 2014, 01:28:43 PM »
Ian,

Thanks once again. So since I'm on 100mg do I have to wait a number if weeks before I see improvement ? I did notice though that each level of increase generated more anxiety hence more derealization.

I'm wondering is there is something more activating about the drug which could induce it?  Also, what the max dose on nortriptyline?

Thanks
 -Frustrated
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Re: DP from Lexapro Does it go away
« Reply #44 on: September 12, 2014, 06:12:21 PM »
So since I'm on 100mg do I have to wait a number if weeks before I see improvement ?

Yes, I'd give it at least a month, 6-7 weeks would be even better.

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I did notice though that each level of increase generated more anxiety hence more derealization.


Unfortunately, antidepressants will often make anxiety worse in the first few weeks and when increasing the dose.

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Also, what the max dose on nortriptyline?


The recommended maximum is 150mg/day, but some take more.

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.

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