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Old 12-09-2006, 12:27 PM   #1
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Question Lexapro Dosage - Moving Up

My doctor wants me to move up to 20mg Lexapro from 10mg. He says he thinks it will do more for my anxiety. But, 20mg is the highest dose, is it not? I've been taking 15mg for the past two weeks, and I've done ok with that. I took 20mg for the first time today, and it made me so groggy and tired. I didn't think that moving up just 5mg would affect my energy levels so much. I was a little tired when I started Lexapro, and also when I went up to 15, but it wasn't to the point where it affected my focus so much. I had to take a nap around noon. It's just hard to guage how much I need because I haven't been in many stressful situations lately. I know I should follow doctor's orders and stay with 20mg. I want to be able to have a job and live a normal life without getting so anxious and stressed over every little thing.

Like I've said, I've been doing better on Lexapro overall, but I still go through spells where I'm thinking about suicide and feeling hopeless, crying. The spells are rare (I used to get like this every day before Lexapro) I'm not sure if being on 20mg is going to help much more. I'm just worried with these side effects today - I don't want to take on a new personality, or feel like I'm being controlled by drugs. The psychiatrist I saw at the hospital {I went through an incident (about a month and a half into Lexapro) that led me to feel suicidal and go to the hospital} actually prescribed 25mg Lexapro. Since it's not available in that dose, he was going to have me get 10mg pills, and double up on them. I hesitate to do this because it's so expensive - I'll be going to the pharmacy twice as much. We agreed that I'd follow-up with my regular doctor - he's the one who suggested 20mg instead. I agreed with this, but didn't get a new prescription - I had the one for 10mg that the psych gave me, and I figured I'd do 10 for awhile and go up to 15. But, now I think it would be cheaper and easier to buy a 20mg bottle, since I assume I'd pay the $30 a bottle that my insurance calls for, rather it's a 10mg bottle or 20. I'm just not sure how they'll work this, and it would be best to go with a 10mg bottle if I decide to go back to 15mg. I know this has probably got you very confused by now. The main issue is that I'm unsure what to do with dosage. I know that 20mg doesn't sound like a lot, but I'm a petite person, and medicine seems to affect me more than the average person. I can't get back into my doctor until March. I was supposed to come back in 4-6 weeks, but there was a scheduling error with the original appt. they made, and now March is the earliest they have an opening. They're having me call in to check for cancellations, but unless by some miracle I can get into the doctor in this century, I have to deal with this medicine on my own. This whole medicine situation has me even more anxious because I just want it resolved -my friend's Dr. specializes in mental health issues and also seems to have less patients so it would easier to get an appt. I don't know if it would be more beneficial just to stick with my doctor who I know and trust, or find someone (and not in the short-term, but maybe after this next appointment) who has a better handle on depression and isn't in such a busy practice?

 
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Old 12-09-2006, 10:40 PM   #2
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Re: Lexapro Dosage - Moving Up

Hi there,

20 mg. is the top published dose, but I know a couple of people who have been up to 30 or 40 mg., with their psychiatrist's say so.

The initial side effects, even from a dose increase like you are having, generally go away within a week. Has that been your experience in the past, say, when you first started it? I guess if it were me, I'd give it a couple of days (not even a whole week) to see if the tiredness passes. It's a little scary making changes in dose etc. if you've never done it before.

As for the prescriptions, it is cheaper to by the larger dose. I didn't realize it was possible to split Lexapro? Oh, maybe so, as the one friend was taking 5 mg. most recently. For saving some money, supposedly by federal law, anyone can get their rx filled at Costco's pharmacy, at their much reduced rates. If there is one within an hour of you, it could be worth the drive.

 
Old 12-10-2006, 06:56 PM   #3
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Re: Lexapro Dosage - Moving Up

Ms. ***z - When I first went on Lexapro, I didn't really have side effects, other than mid-day tiredness for the first week or so. I know I probably shouldn't have done this, but I went back to 15mg today. I was in such a fog yesterday that I couldn't get anything done. I slept in until 10am today because I was just that tired and groggy. I know it probably wouldn't have lasted more than a week, but I didn't want to take that chance. When I went from 10mg to 15mg, I only had a short period of tiredness (but nothing like I went through yesterday) and an increased appetite. I wonder why going to 20mg gave me major medicine head?

I think I'm going to get the 20mg tablets next time and break them down to 15mg. Yes, you can cut Lexapro tablets - the 10mg pills have a line down the middle where you can cut them easily. I've never tried to cut them into fourths - that could prove to be more difficult. I just don't want to spend the same amount for 10mg pills as 20. It makes no sense, and maybe I will try going back to 20mg again, if I stay on 15mg for awhile longer and feel it's neccessary to move up. I just hope the pharmacy will be able to work this out with my prescription. I should've had my doctor write me up a new one. Also, I don't think there is a Costco around here (I'm in Ohio). I've heard of them, but I don't think they've reached this area yet. Thanks for your advice.

 
Old 12-10-2006, 09:57 PM   #4
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Re: Lexapro Dosage - Moving Up

Looks like there are 4 in Ohio. Use the search thing at the top of this board.

It is kind of different that going from 15 to 20 mg. has given you more noticable side effects. ANything else going on? Monthly? Cold etc.? You're probably right about you being sensitive to meds--one's own intuition and all. I hope things improve soon.

 
Old 12-11-2006, 10:49 AM   #5
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Re: Lexapro Dosage - Moving Up

Quote:
Originally Posted by ms***z
Looks like there are 4 in Ohio. Use the search thing at the top of this board.

It is kind of different that going from 15 to 20 mg. has given you more noticable side effects. ANything else going on? Monthly? Cold etc.? You're probably right about you being sensitive to meds--one's own intuition and all. I hope things improve soon.
I did a search by zip code for Costco, but it said there weren't any within a 50mile radius of my town. There may be one in Columbus which is an hour from here, but an hour is a little far unless they have really good deals. Do they just do this on a certain list of meds, or is it on everything? Wal-mart sells certain generic drugs for $4, and I think Giant Eagle does something like that, too. If Lexapro only had a generic, that would be great. I doubt these $4 deals cover AD's, but generics are so much cheaper than regulars as it is.

No, I don't have anything else going on that could cause the grogginess. It's strange, too, that I was feeling fine yesterday when I went back to 15mg, but I've been feeling very groggy today. I had to crawl out of bed. Maybe my body is just now getting used to the increase to 15mg? I was talking with my mom about it and she said, "whatever you do, don't go back to 20mg. You were a complete mess that day - laughing all the time and not making any sense at times." It's a scary thing since sometimes I don't even realize changes in myself from medicine. When I first began Lexapro, I didn't notice any changes after 2 weeks other than I was less negative. My family and friends said that my attitude was much better and I was just not so sensitive and edgy all the time. I guess I just have to take it day by day because there's no way to know what to expect.

 
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