I'm posting this question about SSRI side effects on a couple different boards, because I suspect several of us on here have taken them.

I started back on Lexapro in November after being off a short while. I had weaned off very slowly over a course of several months and finally stopped altogether for about a month when some things happened in my life (you on the DV board know the story) that caused me to revert back into anxiety/depression.

So, I started back at a very low 5mg for a week or so, then 10mg for about that same amount of time, and then finally back up to my original 20mg dose, maybe 2 weeks ago at best.

My Dr. says it will take 2-3 weeks at 20mg for me to feel better which would be about now, but I feel really rotten still. And a lot of the "rotten" is constant anxiety and nervousness and stomach pain.

I originally just thought I wasn't getting better and that it was related to the depression, but now I'm wondering if it could be side effects of the medication. I've had anxiety when starting SSRI's in the past, but generally it was gone in a week or two. However, this is the first time I've actually started on Lexapro. I switched to from Celexa before.

Anyone experience anxiety, shakes, nervousness, stomach pain, loss of appetite with an SSRI that lasted for this many weeks? I've been on it 6 weeks total, and 2 of those weeks at my present dose.

LL

LL, I was on Lexapro and I can only relate how it was for me. I took a psychopharm class several yrs. back and the professor said that Lexapro was one of the cleanest ADs around. Meaning it has the least amount of side effects. I got on it 2 weeks after the truth-telling began and I was an unbelievable mess. I think my doc started me on 20 mgs and I was shocked at how fast it kicked in. I could feel the effects after several days, but the full effects were several weeks later. Truthfully I still sat at this computer and sobbed most days. I also had to take sleep meds for a while. However, it decreased my anxiety and diminished my crying. Basically it took me out of the major depressive episode H had put me in. It helped me think more clearly so I could do the whole Plan A.

I did just remember one thing. I wasn't sleeping well at all. It turns out I should have been taking the drug in the morning and not at bedtime. Once I switched to morning I slept better. The only adverse effect for me was a sexual side effect. Have you called your doctor to check the symptoms out you are having? CV

LL,
Stomach upset and loss of appetite is a very common SE with lexapro. in fact it is so common that the company recommends pts take it at night so that the GI se occur while asleep. The anxiety and nervousness is perhaps 50/50 in my experience. I've also notice in my experience that people respond to SSRI's differently (one that works for your friend may not be the one that works for you) so it may be that you might need to try out different SSRI's. My Psych'st friend said that he usually tries to pick the SSRI based on what he thinks the pt will respond to best but on average may take upto 3rd try to get to the best one. Good thing about switching between SSRI's is that you don't need to taper off of one before starting on another one, usually they can be substituted one for another... Key thing is that once you start try to commit yourself to taking for @ least 9-12 mo before considering tapering off because stopping too early can increase chance of relapse.
This if for information only, the decision must be made between you and your doctor...

Stu:

I just wanted to add that I am happy you are participating and providing many answers to people's questions regarding health/medicinal concerns.

I personally don't have the knowledge and experience in primary care (like you do) and am learning alot myself in reading your posts.

Thanks again, it is greatly appreciated.

Lem

stu, do you know anything about using Omega 3 for depression? I suffered from depression all of my adult life until 1999 when I dramatically changed my regimen. I cleaned up my diet, cut out all refined, processed foods, and starting taking vitamins: essential oils and a multi.

I had started exercising daily and quit smoking a year before this, and that did not make a dent in my depression.

I always thought eliminating the refined sugar did the trick up until recently, [I was hypoglycemic before I changed my diet and now have normal glucose levels] however, I noticed that when I laid off those essential oil pills, my depression came surging back.

I then pinpointed it down to Omega 3 and once I started taking 2000-3000 mg a day, I started having even feelings of joy coupled with a steady and comfortable energy.

Depression runs in my family, so I have suggested to my brother and uncle that they might get some benefit from Omega 3, and amazingly they have! It seems to have relieved their depression.

I know that depression has many different causes, though. I do think that mine was related to an Omega 3 deficiency just through years of trial and error. [and probably not helped by my low blood sugar on a junk food diet]

I found some recent studies that have linked Omega 3 deficiency with depression and wondered if you had heard of this: http://www.mercola.com/2004/feb/14/omega_3_depression.htm

Thanks all of you for the advice so far. I do take my pill in the morning, simply because I do a better job remembering to take it then than at night. But maybe I should try switching to see if that would get rid of the stomach upset and not give me insomnia in it's place.

It seems strange that I was on Lexapro before without difficulty, but I'm having difficulty starting back on it. (The key: I should have never gone off, but thought since things were good I'd be okay.) Paxil and Serzone I've tried in the past with very bad side effects. Celexa was the best for me, but my insurance quit paying when Lexapro came out.

I may try and give my doctor a call tomorrow and ask as well. It would seem like I should be past the side effects, having taken it now for almost 6 weeks, but granted, only at the 20mg dose for 2 weeks now.

ML,

Thanks for your post. I have to admit I'm not nearly as dedicated as you are to maintaining a good diet. But something you said caught my eye.

I had been taking fish oil capsules for a good 6 months or so (actually by recommendation of someone who had heard they might be beneficial for arrhythmias which I have from time to time). I went off the A/D's in October. Then some things happened that pushed me into anxiety/depression. Thinking back, once I stopped the A/D's, I pretty much quit taking the fish oil and my vitamins, too.

I haven't taken the fish oil in a good month. Maybe I should start back on it. It can't hurt. Might help?

Depression runs in my family, too. This isn't my first episode, but is a particularly troubling one that has left me wondering if I'll ever feel normal. And I'm just trying to determine if it's just the depression/anxiety that is making me feel so rotten, or if the meds could be making it worse instead of better.


LL

Good to see you, LL! <img src="/ubbt/images/graemlins/smile.gif" alt="" />

Personally, I did not get relief from anti-d's. I know that many others do, but for me, I just felt a flat affect for that year and simply do not remember it. That whole year is blacked out. While I did not feel any depression, neither did I feel anything else. I just felt......DEAD. And that is not living to me.

For me, the answer was found in natural solutions. Maybe it wouldn't hurt to start taking the Omega 3's again and just see what happens?

You know what else happened on anti-d's? Things that normally meant alot to me, no longer bothered me. For example, I am a very clean person who must have a clean home. I am very proud. That year on the anti-d's I no longer CARED.

I shudder TO THIS DAY remembering that a neighbor boy spent the night in my son's room and came out and asked for a fresh set of sheets for his bed because there were crumbs in his bed. It was SO BAD THAT A BOY NOTICED!

That pains me to remember this. I always made sure my sons had clean bedding and a clean home and cannot imagine allowing some kid to spend the night and sleep in a dirty bed in a dirty room. I did very out of character things on anti-d's. And while I remember virtually nothing frm that, things like this pierce my conscience. It was like I LOST MY PRIDE that year.

I had the feeling of not being present in my life, if that makes any sense.

Lordslady, I had the same effect with AD's as Mel. I tried 5 of them. I cannot however live without my vitamins. If I miss a few days of them I notice and can go right back to depression quickly. I cannot possibly eat enough food to put the vitamins in my body that it needs. The b-complex helps the most with stress/nervousness. And yes the Omega 3 are very helpful too. I would recommend you start your regimen of vitamins w/ iron, and fish oil again. And I hope you feel better soon. Oh, and lots of water, preferably bottled Spring water (easier on the stomach).

Blessings,
Lady

Last year I was taking Xanax for anxiety due to WH. It seemed to be working quite well for me. I did not take it on any regular basis. Mostly when I needed it, which, was alot. It really helped my panic attacks due to everything I was going through with WH.

A friend of mine told me that Ativan worked real good for her. She suggested me trying that one. Talked to my dr. about it and he was sceptacle about it but gave me some.

Well, let me tell you that was a huge mistake . Never, ever in my whole life have I ever been depressed. And I was on this med. I took it for about 4 or 5 days and never have I felt so low and so unalive. I did not care if I lived or died. No feelings whatsoever. In a way it was scary but at the time, I did not care if it was scary or not. I quite taking it after that short time and I returned to my usual ( ?? ) not saying normal, self.

So, yes, in my instance some of those meds can really cause depression. I now understand what someone is talking about when they say that they are clinically depressed. Scary stuff. Sometimes I think it is alot of trial and error. What works for one will not work for another.

Best regards - Carnation

As an aside regarding the Omega 3's. I believe that VERY soon you will see National Guidelines adventing the use of Omega 3 Fatty Acids in ALL people regardless of CAD, etc...risk factors.

I PERSONALLY think the risk/benefit for taking these supplements is weighted heavily on the "benefit" side. We don't know everything about these supplements, but with the data we have...I would not be suprised to see them touted as a Primary Prevention treatment for CAD in the near future. I'll be interested to see what Stu thinks as a Primary Care Provider who probably deals with this stuff every day.

I truthfully have never heard of the use of these supplements for antidepressive treatment, but I'll check out the references. Seems interesting.

Lem <img src="/ubbt/images/graemlins/smirk.gif" alt="" />

Thanks for the input, LM! When I told my brother about them, he said that his cardiologist had already recommended them for his heart ailments.

The only problem I have with the capsules is the horrible "heartburn" aftertaste of the capsules after I ingest them. If you know what I mean.

Maybe I will try different ways to take them so that my GI system does not try and kick em back up...LOL

Lem

You know what else happened? Things that normally meant alot to me, no longer bothered me. For example, I am a very clean person who must have a clean home. I am very proud. That year on the anti-d's I no longer CARED.

Actually I've heard this with ppl on SRI or SSRI's but I think most don't complain because even flat feel much better then down or anxious all the time. I hear this with Buspar as well.

As far as omega-3's I've not seen any large placebo controlled double blind studies on it with regard to depression. Most data seem epidemiological which has its inherent bias'. We do know that O-3's are beneficial to CV health so I'd say as long as it makes you feel better with depression then take it. Main stream medicine usually don't catch up with this type of thing until much later.

LM
You're much too modest...Your knowledge in primary areas of medicine is quite amazing. Most trauma surgeons I know don't even know what to take to treat a sinusitis. I'm glad to help anyway I can...

I have been taking Salmon Oil since right after D-Day. I bought them for WH the week before, since he seemed depressed. I then found out about the A and figured I needed them more. I have battled several major episodes of depression in my adult life, and so far, have not felt the need for prescription AD's with the affair and D stuff. I think the Salmon Oil has kept my head above water.

I also have Psoriasis and stress wrecks havoc on my skin. My skin has been holding up pretty well, not worse by any means. So I think the Salmon Oil is helping with that too.

I have considered starting meds for my obsessiveness, I have had to take meds for that before. But, they really dampen all my thought processes, and I need to keep my head with me right now.

Well, Stu...I hate to agree with you...but many of my surgical breathren unfortunately fit the "dumb surgeon" hospital stereotype.

I have never even been comfortable consulting Internal Medicine for "routine medical management"....and have been chastised for this by colleagues.

Who knows, maybe I would have been happy being a country GP? One never knows.

Lem

T/J over...sorry <img src="/ubbt/images/graemlins/grin.gif" alt="" />

stu, the reason I think it was Omega 3 is through a process of elimination. See, back then I had never heard that such a deficiency was connected to depression. I had been programmed to think that refined sugar and irregular blood sugar levels had caused my depression. [there are studies that link refined sugar to depression]

So, imagine my surprise when my depression came roaring back again yet I had not touched a drop of refined sugar or junk carbs. My glucose was perfectly normal. The only thing I had changed was the elimination of a daily essential oil pill which contained a mixture of Omega 3, Omega 6 and borage oil. I started back on those pills and within 3-4 days, I felt good again. So I decided to play around with it and find out which one made the difference or if they all did. It turned out the Omega 3 was the one that always made the difference.

After I discovered this effect, I found an article about studies linking Omega 3 deficiencies to depression.

SSRI's...

Yea, I took one for 3 mos. during divorce hearings...lexapro. It made me rather...bland...but good. I didn't care about the trials...or that much more else...life was like the pink floyd song "comfortably numb" for me during those 3 mos.

But I got thru the trials and kept my wits. So it's a good thing I suppose! Lexapro did well by me <img src="/ubbt/images/graemlins/smile.gif" alt="" />

And he knows the dif between HDL and LDL!! <img src="/ubbt/images/graemlins/grin.gif" alt="" />

I never thought of them as "dumb surgeons". I have great admiration for all of them for their excellent surgical skills. My surgeon friends can manage the post-op just fine but just want to have a good relationship with the IM referral sources plus someone for the RN's to call for the tylenol orders etc.