posted
After much personal despair, friendly advice and professional counselling, I finally went to see a doctor about my depression. The doctor put me on Lexapro, a drug that, "helps to restore the brain's chemical balance by increasing the available supply of serotonin, a substance in the brain believed to influence mood." The slogan for Lexapro? "Well-tolerated strength."
Wait a minute! Hold the presses! What is that supposed to mean? Well-tolerated? Excuse me? Yep; that's right, "Lexapro is well tolerated by most people."
So, does this little wonder-drug relieve the symptoms of depression? Statistically speaking, yes it does. Not only that, most people aren't affected by the most common side effects: "nausea, insomnia, problems with ejaculation, somnolence, increased sweating, and fatigue."
I thought I had experienced insomnia before. I was wrong. I can't sleep! This really sucks. From what I understand, I think what's happening is something a little like this:
Me:
LEXAPRO!
Serotonin:
Me:
Bedtime.
Serotonin:
Me: not
Well, at least I'm happy...*
So, the next time you must take medication of any kind and you don't suffer any nasty side effects, remember: you are just a statistic. Be proud -- you're average!
Serotonin:
* Don't worry, the doc says most side effects diminish in time. Plus I get to see him again soon to talk about how happy I now despite my lack of proper rest.
posted
((Godric)) I have struggled with sleep disorders off on and on ever since I hit adolescence. Lots of insomnia. There are few things more frustrating than being tired yet still finding sleep an elusive phantom, forever just out of reach as you fitfully toss and turn.
The last few months as I've been out of work and hence had little to keep me in phase, I've started to sleep at essentially random times, for semi-random lengths. This is even more maddening. I should have posted this as the Professor, or Grandpa Simp--
posted
I got abdominal pains pretty badly when I tried Lexapro, and since I was already feeling a lot better by the time I finally got on it, I just stopped. Hopefully you will be like me and not need anything during most times, only in extraordinary circumstances. The side effects are bearable for short periods of time, or at least preferable to the side effects of taking nothing, i.e. death.
I started with the sleep disorders too, during adolescence. I found that running first thing in the morning when I wake up (at the regular time) will always fix that problem. I've read a lot about biological clocks, and the problem is resetting them each day. So the exercise wakes your body up and the sunshine (I run outside) resets your clock each day. Lack of sunshine in the optic nerve (and you get like 20 times more light outside even on a cloudy day than in, just your eyes adjust so you don't notice this fact) is the main cause of sleep disorders. Get outside for an hour a day. Run. It fixes sleep disorders.
[ October 02, 2003, 06:45 AM: Message edited by: ana kata ]
Posts: 968 | Registered: Sep 2003
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As I was saying before I was so rudely awoken by AK, ((Godric)).
Side effects suck. "Problems with ejaculation"--ouch! I'll take some insomnia any day.
Just count yourself fortunate if you never get Tardive Dyskinesia, the most horrifying side effect (ouside of death or permanant retardation) I've ever heard of, though I'm sure Claudia Therese or Theca or other doctors know of similar and worse ones.. From the link, bolds added:
quote: Tardive dyskinesia is a neurological syndrome caused by the long-term use of neuroleptic drugs. Neuroleptic drugs are generally prescribed for psychiatric disorders, as well as for some gastrointestinal and neurological disorders. Tardive dyskinesia is characterized by repetitive, involuntary, purposeless movements. Features of the disorder may include grimacing, tongue protrusion, lip smacking, puckering and pursing, and rapid eye blinking. Rapid movements of the arms, legs, and trunk may also occur. Impaired movements of the fingers may appear as though the patient is playing an invisible guitar or piano.
Is there any treatment? There is no standard treatment for tardive dyskinesia. Treatment is highly individualized. The first step is generally to stop or minimize the use of the neuroleptic drug. However, for patients with a severe underlying condition this may not be a feasible option.
What is the prognosis? Symptoms of tardive dyskinesia may remain long after discontinuation of neuroleptic drugs; however, with careful management, some symptoms may improve and/or disappear with time.
So you get treated for one medical problem, and get this nightmare? If you get the side efect on the mild side you get to be a permanant air guitarist, forever soloing. The worst cases resemble spastic chimps. It used to be a potential life sentence, fortunately these side effects are extremly rare or the drugs would have never been used. Now they have some treatment options. A total cure remains elusive, sadly.
Before I totally freak you out, Godric (bet I took your mind off insomnia, though), SSRIs (Selective Serotonin Reuptake Inhibitor) are not generally associated with tardive dyskinisia, as far as I know (ask a doctor!) The higher risks come in the anti-psychotic class, including Thorazine and Stellazine. Even there the incidence is rare. Here's a good side effect webpage: http://www.rxlist.com/cgi/generic/lexapro_ad.htm.
Lots of medical jargon to wade through. Pay close attention to drug interactions, that is crucial.
quote:[concerned brother of patient]>Keep in mind, of course, that it is highly unlikely that my bro has TD, since he only took Lexapro for 4 days. Also, does a drug like Lexapro (an SSRI) affect the brain as described above?
[Dr.Bob.org]>:Yes, but to a much smaller extent that anti-psychotics. SSRIs cause excess activation of seroton receptors - which leads to all kinds of side effects. Activation of 5-HT2 receptors, in particular, leads to a drop in dopamine activity.
[brother]>There is one other concern that I have. Some sources I have checked out claim that ingesting DXM (dextromethrorphan) while taking an SSRI, no matter how small the dosage, can be extremely harmful. My brother may have taken some (contained in TheraFlu, 30 mgs) just prior to starting his Lexapro treatment. Could this drug combination be causing his symptoms?
[Dr Bob.org]>Actually, I meant to ask you if he had consumed any other medication - particularly anything containing DXM. DXM is known to raise serotonin levels, so combining DXM and an SSRI can cause serotonin syndrome. However... in this case it seems unlikely, since his symptoms have continued even after he has stopped taking Lexapro. A case of serotonin syndrome usually clears up once the agents causing the syndrome are removed
So watch out for cough medicine! I need my lackies healthy, or I'll lay you off faster than an alcoholic sexual harasser with B.O. Seriously, good luck with the treatment, bro. Morbo
Posts: 111 | Registered: Jun 2003
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quote:Lack of sunshine in the optic nerve. . . is the main cause of sleep disorders.
AK. As much as I hate to dispute with such a nice lady, I would question this, certainly in my particular case. Sleep disorders can be caused by many things, including hormonal and neurochemical imbalances, emotional disorders, respiratory problems, etc.
That said,
quote: Get outside for an hour a day. Run. It fixes sleep disorders.
I have tried to get out of the house more, unfortunately I have a mild case of agoraphobia/social avoidance. And I have bad knees. I will try to walk in the morning, it couldn't hurt.
[ October 02, 2003, 08:19 AM: Message edited by: the Professor ]
Posts: 111 | Registered: Jun 2003
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posted
Haven't tried Lexapro. But I had some side affects when I first started Prozac. The most significant ones all had to do with sleep. I think I had problems falling asleep (or was it staying asleep?) for a while. I also had nightmares. That was not fun. I also noticed that my reaction time was slowed down, so do be careful driving until your body adjusts to the medication. All these side effects went away pretty quickly, though; I've now been on Prozac for almost a year, and I have no side effects.
Posts: 1805 | Registered: Jun 1999
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posted
Lexapro and other SSRI's are really, really not known for causing TD. Those are usually caused by the old school antipsychotics (Haldol, Thorazine) and some of the newer atypical antipsychotics (Zyprexa, Seroquel, Risperdal, etc). THe atypicals have less chance than the old-school, but still WAY more of a chance than an SSRI (lexapro, celexa, zoloft, paxil, prozac,etc).
SSRI's can cause either abdominal trouble or abdominal relief. Why? There are freaking serotonin receptors in your intestines. So if youre serotonin levels are already okay there (Like I'm betting with anne kate), then it'll give you abdominal trouble (pain, nausea, etc). If your adbominal cavity is screwed up (like irritable bowel syndrome, pain, etc), the extra serotonin might FIX it.
Damned if you do and damned if you don't.
Lexapro is a good SSRI because it's made mostly of just the active component of Celexa, an already proven SSRI. Because there's less "extra stuff" the SSRI is more targeted and affects less unwanted parts of the brain. Because the science is still guessing about exactly how the brain works and why some of these meds fix it (or they'd have a cure for psychiatric illnesses by now), the meds bop other parts of the brain and give us side effects.
Godric, have you tried benadryl for sleep? How long has the insomnia gone on?
The other thing about lexapro vs. other SSRI's is that it tends to work faster. You can start to see lifting of symptoms in two weeks rather than four. Posts: 14745 | Registered: Dec 1999
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posted
Ah, to clarify, sleep disorders and insomnia are a huge problem for lots of people in western technological societies, mainly because the human body and brain were not designed to function with so little sunlight, and not only do we not go outside all day long, but we have lights on at night too, just to screw us up that much more.
I'm sure there can be sleep disorders for reasons other than this, but that's the big problem for most people since hardly anyone (in the U.S., etc.) gets enough sunshine in the optic nerve to reset their clocks each day.
Human biological clocks typically run 25 hours or more per day in the absence of external cues to reset them. People in cave experiments usually run rather longer days, and are always surprised when their 3 months are up already. The cues that reset clocks are several: light, activity, body temperature, but primarily light. Sunlight, even on a cloudy day, is very much brighter than indoor lighting. I sometimes wonder if corporations just installed more windows and bright full-spectrum lighting in their office buildings, if most of the depression and mental illness of the people who work there wouldn't simply disappear.
Secondarily, activity will also help a great deal. So if you get up and run at the same time every day this really works great. Especially if you run outside during daylight hours. You get the double whammy reset power.
Tertiarily, body temperature will also help reset your internal clock. That's why getting up at the same time each morning and taking a hot bath or shower can work fairly well too. Running makes you hot as well so that's a three way whammy, in fact.
Running helps mood disorders, too, by releasing endorphins. Most of the distance runners I know do it mainly to treat their mood disorders, in fact. <laughs> Running also is about the best cardiovascular exercise you can do. And it takes very little equipment, basically shoes. Running has a lot of advantages. Give it a try! Posts: 968 | Registered: Sep 2003
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posted
Hey, mack, have you heard of Cymbalta? In trials, significant changes were seen within a week. And, since it is an SNRI (serotonin and norephinephrine) it is not only targeting depression, but also anxiety, PTSD, neuropathic pain associated with depression, and get this, urinary stress incontinence!
Finally, one med that will stop the pain and at the same time, allow me to sneeze without wetting my pants! Man, I can't wait for this one. Posts: 9871 | Registered: Aug 2001
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quote:Godric, have you tried benadryl for sleep? How long has the insomnia gone on?
I haven't tried benadryl, but I might. I was just put on the med on Monday, so just a couple days, but I've only had about 4 hours of sleep since then. I got the insomnia right away and I'm also smiling a lot -- very strange. Is it normal for effects to be seen this quickly? I'm going back to see my doctor next week.
Morbo:
quote:I need my lackies healthy, or I'll lay you off faster than an alcoholic sexual harasser with B.O.
Happy, depressed or anywhere inbetween, I am here to serve, your Morboness!
posted
I loves me Zoloft. It, too is an SRI. I take it at bed time and have not had any trouble sleeping, usually. I do have troble sleeping when I have something with caffiene after 4pm. but not otherwise, usually.
Delay of orgasm or ejaculation is a common side effect of SRI's because of the seratonin spike that usually accompanies orgasm. The med raises seratonin levels, so the spike doesn't always occur on schedule, or so I'm told. This has not been a problem for me, but I know people whose lives have suffered because of this particular side effect.
Same with the sleeplessness. It may go away with time, or the bendryl may help. If not, you can always try something else, so don't give up.
I guess I'm unusually lucky to have my problem taken care of by a very low dose of the first medication I tried, and with no negative side effects so far. Wow.
Posts: 9293 | Registered: Aug 2000
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quote: Is it normal for effects to be seen this quickly?
Strangely, side affects can appear before the actual effectiveness of the treatment for depression is known. My wife has been happily on anti-deppressants for a year now and at first had some sexual side effects (be happy you don't have those) but over time they have diminished and the effects of the drug overall have improved.
Good luck with your treatment and remember these two things:
1. Don't quit cold turkey no matter what. I'll start a collection plate for you and we can paypal the money to you if you are running low. Quitting cold turkey is a BAD idea.
2. Stay in contact with your doctor. If things aren't working the way you want there are several other medications out there and differing versions of each, so don't be afraid to try and find the one that works best for you. My wife switched from the standard to a timed release version and her nights are much better now than they were at first, since she was taking them in the morning and they were wearing off.
Yeah, try the benadryl. It's what I was always told to try (before they figured out it wasn't the SSRI causing the insomnia, the SSRI was causing hypomania o_O). It works. You get drowsy, you fall asleep.
Is the problem that you can't fall asleep or that you keep waking up, or just wake up too early?
Kayla:
No! Hadn't heard of it. I know that strattera is a norepinephrine inhibitor. Psychiatrist mentioned that for treating my ad/hd but thinks it could trigger hypomania. Posts: 14745 | Registered: Dec 1999
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