Been on Luvox for 14 Days. Looking for advice...

[Kobayashi]

Hi All,

So I've been on Luvox now for 14 days. I'm also still on cipralex, though that dosage has been decreased. I started with 20mg of Cipralex and added 50mg of Luvox. For the fist 5-6 days, things were fine. I've since decreased the Cipralex to 15mg and upped the Luvox to 75mg. I've had ok days and bad days. Past few have been just horrible....Increased anxiety, OCD, etc. I see my Doc on the 1st of March. Wondering if I should just go back to the Cipralex or stick it out a bit more with the Luvox.

Any suggestions?

KOB

 

[Daniel E.]

Past few have been just horrible....Increased anxiety, OCD, etc.

For the anxiety and anxiety-related OCD, you may also benefit from exercising more in addition to the CBT methods described in Feeling Good by Dr. Burns and the behavior therapy methods ("The Four Steps") described in Brain Lock by Dr. Schwartz.

Wondering if I should just go back to the Cipralex or stick it out a bit more with the Luvox

I would call my doctor about any med adjustments and/or wait for the next appointment.

 

[Banned]

Hi Kob,

Can you get in to see your doctor earlier? I understand that Monday is only a few days away but if you are really struggling you may want to get in sooner. I would definitely not alter my medications without at least speaking to him first (even by phone) but I'm glad you're getting in in a few days to get this looked after.

I hope you feel better soon.

 

[Kobayashi]

Yeah - can't get in until Monday - I can totally hang on until then. Thing is, I'm starting this Luvox because my cipralex wasn't very effective anymore. I recall feeling high anxiety for a few days when I started cipralex, but then felt great on it after that. (Until it slowly pooped out on me that is). Of course I will consult with my Dr. but I want to make sure I give her the right information. I'm just wondering if anyone has any similar experience with the increase in anx etc while starting this med and if it is supposed to subside. I don't want to continue taking a med that isn't going to help. I suppose the other option is to suggest to my Dr. that I try going back on a higher dose of the Cipralex. The OCD isn't bugging me so much, except that meds etc are all that I think about. The anx is really uncomfortable and at least I have a few loraz my Dr. gave me for the transistion.....

 

[Daniel E.]

I'm just wondering if anyone has any similar experience with the increase in anx etc while starting this med and if it is supposed to subside. I don't want to continue taking a med that isn't going to help.

Personally, I've never knowingly had an increase in anxiety due to a SSRI, though it's certainly possible for some people (especially since some people feel more anxious when they are less depressed). However, Cipralex, also known as Lexapro, is (generally speaking) one of the most well-tolerated SSRIs. In any case, you may benefit from using a mood log to keep track of your anxiety levels before, during, and after taking a new medication.

The OCD isn't bugging me so much, except that meds etc are all that I think about.

A point made in Brain Lock is that people with OCD have problems "shifting gears":

It's like having your car stuck in a ditch. You spin and spin and spin your wheels, but without traction you can't get out of that ditch. With OCD, too much energy is being used in a frontal part of the brain called the orbital cortex. It's as if the orbital cortex, which has an error-detection circuit, becomes stuck in gear. This is probably why OCD causes people to get a "something is wrong" feeling that won't go away. You have to do the work to get it out of gear--to shift the gears.

http://forum.psychlinks.ca/obsessiv...our-steps-dr-jeffrey-schwartz-brain-lock.html

 

[David Baxter PhD]

You're still working up to an effective dose of Luvox while weaning off the Cipralex. In all likelihood, you will need to increase the Luvox to the 100 to 150 mg range.

At the moment, I think it's probably not so much that the Luvox is creating anxiety as it is that you're feeling the effects of the Cipralex reduction and you're not yet up to a therapeutic dose of Luvox.

(Hope that sentence makes sense - tired tonight.)

 

[Kobayashi]

Hi All - Thought I'd post an update. As of Friday I am now up to 150mg of Luvox. Under my Drs direction, I've been slowly cutting down my dose of Cipralex as I've been increasing the Luvox. I am supposed to be down to 5mg of cipralex while I'm on the 150 of Luvox.

For the past two months I have been doing really well. The anxiety and OCD are still there, but much "quieter" and in the background, allowing me to focus on my life. So much so, that I haven't been visiting the forums as I haven't felt the need. I have been using Ativan very sparingly - typically, only when reducing the cipralex for a few days and only in very small amounts (.5mg or less).

Past week or so has been a bit rough. Especially after coming down to 5mg of cipralex. I've found myself to be having increased anxiety, and to some degree OCD - mostly rumination about my condition. Not sure if the Luvox needs increasing, or if I'm having a tough time coming off the cipralex. I've been reading that coming off of cipralex can be a rough go. What surprises me, is that the Luvox isn't taking care of this. Today I woke up feeling terrible, so I've bumped up the cipralex slightly to 7.5 mg. Hoping this helps. Perhaps i need a bit more time adjusting to the lower dosage?

Things have been going so well, I just hope I can get back on track.

Cheers all....

Kob

 

[David Baxter PhD]

Talk to your doctor about this.

There are several possibilities, one being that you take a moderate dose of Cipralex with a moderate dose of Luvox - both SSRIs so dosages would need to be considered.

 

[Kobayashi]

I think I've discovered a pattern or my anxiety and OCD on these meds. I just looked at my last post and can recall not feeling so well about a month ago. Rumination, anxiety, etc - all bubbling to the surface at once. It lasts for a few weeks, spikes, then subsides. I'm in the middle of another spike right now and have been feeling "off" for about a week. I certainly hope this spike subsides anyway.

A week or so after my last post, I felt great. I haven't changed my med regime. I wonder why I feel fine for a time, then feel so low. I wish these cycles would level off. When I'm feeling good, its not a scary good as in the bipolar kind...its just good and as normal as one would want to feel.

Sometimes I feel as though these meds are holding me back from recovering. Kind of like they are prolonging things. Wish I had the answer - trying to figure it all out is so exhausting.

 

[David Baxter PhD]

I think I've discovered a pattern or my anxiety and OCD on these meds. I just looked at my last post and can recall not feeling so well about a month ago. Rumination, anxiety, etc - all bubbling to the surface at once. It lasts for a few weeks, spikes, then subsides. I'm in the middle of another spike right now and have been feeling "off" for about a week. I certainly hope this spike subsides anyway.

A week or so after my last post, I felt great. I haven't changed my med regime. I wonder why I feel fine for a time, then feel so low. I wish these cycles would level off. When I'm feeling good, its not a scary good as in the bipolar kind...its just good and as normal as one would want to feel.

Sometimes I feel as though these meds are holding me back from recovering. Kind of like they are prolonging things. Wish I had the answer - trying to figure it all out is so exhausting.

It's unlikely to be the medication that's holding you back.

The key, I think, is to look at what's different during the times you are feeling depressed or anxious vs. the times when you are feeling better. What are you doing differently? What are people around you doing differently? Sleep patterns? Eating patterns? Activity patterns? Hormonal variations? Also, have your thyroid levels tested if that has not been done in a while since you may be experiencing thyroxin cycles which could account for exactly what you describe.

Try keeping a log and make sure you fill it out relgiously every day. This will help you determine what patterns exist and their time course.

If indeed there are no external or physical differences, it would be worth taking the log to your therapist at some point to ask about the possibility of a cyclical mood disorder (cyclothymia, bipolar II).

 

[Kobayashi]

Thanks for the tip David.

I've often wondered if I may have some sort of bipolar. buying expensive cars and making quick life changing decisions while on a high were never part of my symptoms so I figured I was an enigma. I'll keep a log and see what my doc says next time I see her. She did screen me for Bipolar I and it came back negative. What I will say though is that these valleys and "lovely" plateaus have only been part of my life since being on meds.