Hello, my name is Peter

[OtterB]

I stumbled across this forum looking for some information on Cipralex which I have been taking for about a week now. I was on Zoloft for about 20 years and was quite high functioning but some thought was nagging at me that I needn't be on it forever. I told my GP that I was reducing from 200 mg to 100 and he was supportive - maybe indifferent would be more accurate. I kept cutting back and he asked how I was doing and I was doing fine.

I finally stopped about 3 months ago. Things were fine but I got bronchitis and couldn't shake it and started to obsess that I had lung cancer or something. Well no lung cancer but now I'm extremely anxious and depressed. Mainly I'm thinking "What have I done?". I was doing ok on Zoloft. My GP assures me that cipralex will be as good or better than Zoloft and effort act quicker with fewer side effects.

Although I've had some periods of normalcy I'm extremely concerned about getting my life back and wish I had never stopped the Zoloft. Well that's my rant. Quite a way to say hello. I hope someone has comments. Thanks for your patience.

 

[Cat Dancer]

Just wanted to say welcome to Psychlinks.

 

[Retired]

Hello Peter and welcome to Psychlinks.

Having taken Zoloft for twenty years, many doctors would probably consider withdrawing the medication to determine if you might be able to carry on without it. In some people their neurotransmitters might have "reset" and they would no longer require the SSRI to restore their brain chemistry imbalance.

Cipralex (escitalopram) belongs to the group of medications called selective serotonin reuptake inhibitors (SSRIs) the same group, incidentally as Zoloft (sertraline). It is used to treat depression, obsessive-compulsive disorder (OCD), and generalized anxiety disorder (GAD). It works by increasing levels of the neurotransmitter serotonin in the brain. Increased serotonin levels is thought to lead to an improved mood.

Mainly I'm thinking "What have I done?".

You need not be hard on yourself, Peter. Perhaps it was the stress of dealing with the bronchitis that resulted in a temporary relapse of symptoms, and hopefully a course of therapy with your new medication can help.

Many people do very well with it and it is a more recent addition to the selection of SSRI's.

As you may know, this type of medication usually begins to work in about 2 to 4 weeks; however, it may take several weeks of treatment before the full effects for symptom relief are seen.

How long have you been taking your new prescription of Cipralex and how have you been tolerating it so far?

Do you have a follow up visit planned with your doctor to discuss your progress?

 

[rdw]

Welcome! Just wanted to share with you that I am currently taking Cipralex and find that I tolerate it very well. I wish you well on this medication.

 

[OtterB]

Wow, thanks for the quick and thorough response Steve. I've been on 10 mg for a week and just saw the DR today to see if I should increase. My wife came along and she said she's seen glimpses of my old self although today I was not doing well. My Dr said he usually waits 10 days to see if the dosage looks like it is ok. I want to go to 20 mg mainly because my anxiety is quite bad. He said it would be ok but it feels like I'm rushing him. I'm tolerating the 10 mg ok. I was a bit drowsy the first couple of days when I started the 10 mg(taking it in the morning). Thanks so much for your help.

 

[Retired]

It's better to increase the dose gradually, if needed. Altering the dose after one week might be a tad early because this medication takes a week to achieve steady state, meaning the it reaches a state of equilibrium where the amount ingested equals the amount excreted. Doctors usually like to wait until the medication reaches steady state to evaluate how well the patient is tolerating the medication.

Your doctor is taking a sensible approach, so you would be advised to follow the advice being offered.

It is possible, though that the 10 mg dose might even be sufficient to control your symptoms, but you wont know that for another few weeks.

It is sound medical practice use the lowest possible dose required to relieve symptoms.

 

[grapefruit968]

Welcome aboard, Peter! Best of luck with the new medicine

 

[AmZ]

Welcome

 

[OtterB]

Have read in other forums that cipralex can work quickly but then stop working for some people. I am anxious about this medication working for me and have noticed some improvement. Any comments?

 

[David Baxter PhD]

Have read in other forums that cipralex can work quickly but then stop working for some people. I am anxious about this medication working for me and have noticed some improvement. Any comments?

Everyone is different.

1. As with SSRI, it works more quickly for some than for others. Given that you were previously on another SSRI, it will probably work more quickly for you (assuming that you haven't been off the medication for very long).

2. There are some people for whom any SSRI/SNRI may stop working after a while on it, but that's not true for the majority of people. Cipralex is not different from other SSRIs in that respect.

 

[OtterB]

Thanks David. I guess I'm having a bit of trouble with the ups and downs in the early stages. I've been on 10 mg for 10 days now. Yesterday was good - today not so much.

 

[Retired]

As has been said, you probably wont know this medication will actually relieve symptoms for another few weeks. That's because it takes that long for the clinical effects of an SSRI/SNRI to begin their effectiveness.

Steady state I referred to earlier is only one phase of determining how this medication is tolerated. Your doctor seems to be following a rational approach in not modifying the dose prematurely, until the dose has stabilized and you know how you tolerate the drug.

Once that is established, the next step is to evaluate symptom relief, and you have to wait until the medication resets your neurological chemical balance, to determine if any dose adjustment is required.

In the meantime, you may experience a relapse in symptoms and have some bad days among the good days.

It must be understood that SSRI/SNRI medications (like Cipralex) take time to relieve symptoms ( 2 to 4 weeks at least) unlike taking an aspirin, or even a minor tranquilizer like a benzodiazepine (eg Ativan) that relieve symptoms an hour or two after taking it.

The mechanism of action is entirely different, so your patience in allowing the medication to work would be your best course of action.

 

[OtterB]

Well I've been on 20 mg now for 6 days in consultation with my dr. Although the first couple of days were OK I've hit a wall now and have had a couple of my worst days. It's been 10 days on 10 mg and 6 days on 20 mg. My dr is suggesting he will bump me up to 30 next week. I was on 200 mg of Zoloft for many years which may be why I need a higher dosage of ciprallex. This process is the worst though - it's so hard on everyone. Thanks for listening. You guys are great.

 

[Retired]

Because one compound required you to be at the maximum dose for relief of symptoms does not necessarily mean another compound would need its particular maximum dose. Each of these compounds have different properties in the way they act on neurotransmitters, so your doctor will be more interested in how you tolerate the medication and how well your symptoms are controlled.

As has been said, it is sound medical practice to use the lowest possible dose to achieve a therapeutic effect. You never want to be taking a higher dose of any medication than is absolutely necessary to relieve your symptoms.

Be certain your doctor knows about all other medications you are taking, both prescription meds as well as all over the counter preparations as and/or herbal remedies if applicable, because Cipralex/Lexapro has interaction potential with some medications which might affect the way it is absorbed in your system.

 

[Andy]

Welcome to Psychlinks Pme! :2thumbs:

 

[Missed Link]

Hi Peter and welcome. I want to share something that has helped me tremendously and only takes a few seconds to do. I have found from experience that worrying and becoming anxious about how my meds will work has been consistently counterproductive for me. It fuels the anxiety and depression and makes it hard to objectively determine how well (or not) the meds are helping me. So to relieve my worry and anxiety, I've learned to keep a chart to bring with me to my doctor, you could even use a calendar with boxes big enough to write in. I make very brief notes as to the days I've felt better or more anxious or more depressed or even angry or irritable. I also record how many hours sleep I've had when I notice a change for better or worse since sleep is a big factor for me--too much or too little is not good for me. Thunderstorms can be quite severe and frequent in summer where I live and and I have found an incoming storm affects my well-being. Using the chart has helped me relax about my medications because I have something concrete to show my doctor and reveals a pattern for me too--either I'm improving on the meds or I'm not--and sometimes it shows that the meds have been working but I had a few days of too little sleep or too many thunderstorms or too much coffee, etc. I hope this helps you as much as it has me.

 

[David Baxter PhD]

You could also record that information on the form attached here: Daily Mood Log.

 

[OtterB]

Thanks for the suggestions. I've been rating my days on a scale of 1 to 10 along with a journal summarizing each day. A common pattern is for poor mornings and much improvement in the afternoon and evenings. It's a lot of work but gives me something to do when I'm anxious. I'll check out the chart for sure - might be a simpler approach.

 

[Banned]

Hi Peter,

Just thought I'd throw in my two cents and tell you about my experience with Cipralex. I was on 10mg for about 18 months consistently (off and on for the previous 18 months). I started to feel better after about 4-6 weeks but really felt awesome around the six month mark. This past March my doc bumped me up to 20mg to help with my anxiety and OCD which it has done a great job of. So basically what I am saying is give it time to work before you panic that it isn't. It does have to build up in your system which does take time. My side effects also dissipated quite quickly but of course everyone is different.

 

[OtterB]

Thanks Turtle, I think I am seeing improvement - I know it's still early. The last few days have been pretty good. I felt so good last night I couldn't fall asleep - was just about drifting off and then a bunch of fireworks went off (I live in Canada and it's Canada day so I suppose someone thought at the stroke of midnight it would be a good idea to celebrate). That's the first time I've had that problem. Appreciate your support and glad to hear you're doing well on Cipralex.