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Lexapro for Anxiety

Just stumbled over this new study and thought I post it here:

J Affect Disord. 2005 Jun 24; [Epub ahead of print]

Treatment of generalized anxiety disorder with escitalopram: Pooled results from double-blind, placebo-controlled trials.

Goodman WK, Bose A, Wang Q.

Department of Psychiatry, University of Florida, PO Box 100256, Gainesville, FL 32610, United States.

BACKGROUND: Escitalopram 10 mg/day is an effective and well-tolerated antidepressant. Three randomized controlled trials recently evaluated the safety and efficacy of escitalopram in the treatment of generalized anxiety disorder (GAD). METHODS: The trial designs were virtually identical, allowing data to be pooled across studies. Male and female outpatients, ages 18-80 years, with DSM-IV-defined GAD were randomized to double-blind treatment with escitalopram or placebo for 8 weeks. Escitalopram dose was fixed at 10 mg/day for the first 4 weeks, after which increases to 20 mg/day were permitted. The primary efficacy variable was the mean change from baseline in total Hamilton Anxiety Scale (HAMA) score. RESULTS: Approximately 850 patients were randomized to double-blind treatment. In each individual study, escitalopram was significantly superior to placebo (p<0.05) as measured by change from baseline in HAMA score. By-visit analyses of data pooled across studies revealed significantly greater improvement (p<0.05) in the escitalopram group beginning at week 1 or 2 and continuing through week 8 for all primary and secondary efficacy variables. The mean change in HAMA total score from baseline to endpoint also was significantly greater for patients maintained at escitalopram 10 mg/day than for those receiving placebo. Escitalopram was generally well tolerated. LIMITATIONS: The studies included in this analysis were of short-term duration and excluded patients with significant medical and psychiatric comorbidities, such as major depressive disorder. CONCLUSION: Results from the individual trials and the pooled analysis demonstrate that escitalopram is effective and well tolerated for the treatment of GAD.

PMID: 15982747
 
"escitaprolam is much more potent at smaller doses because the enantiomer of the parent compound is even more selective at targeting only the psychoneurological serotonin receptor sights. "

So, 50mg of Celexa (the racemic mixture of both S- and R-enantiomers of citalopram, 25mg of S- and 25mg of R-) should compare to 25mg of Lexapro (the active S-enantiomer only). Thus, Lexapro is essentially twice as potent as Celexa per milligram. But other than the fact that you have to take half the dose to achieve the same [?] effects, what is the benefit of Lexapro? Am I wrong in believing that the R-enantiomer is virtually useless, harmless, without effects, etc, etc.??
 
I am on day 5 of treatement...and I just can't even begin to describe how amazing I feel!!! :D :D :D

It's like a miracle right now. Minor side effects...and when I get back from the the Santana show at the Taste of Chicago...I will give you my full pharmacological side effect/benefit experience so far.

But let me just say this before I run...

After high school (the past 3 years)...I have had extreme clinical anxiety and moderate depression associated with the anxiety.

My anti-socialness, anxiety, lack of motivation, etc...really killed my social life. This is such a breath of fresh air being able to socialize again like this with all my friends/co-workers/family/girls/etc!!! Even strangers!

I'm on day 5 of treatement...and I already feel like a million bucks and got 7 girls numbers last night and made 3 new friends. Lexapro's low mg dose (5mg I'm currently on)...is so selective I'm hardly getting any side effects and only the desired effects. I'll elaborate when I get some more time.

Take it easy for me in the meantime bluelighters...and make sure to party it up this weekend/4th !!!
 
I'm on day 7. I know this is long...but anyone that's taken ssri's/benzo's...let me know how you think my situation is progressing. I would really as much input as possible because I'm learning more about this kind of stuff every day.

I can't even begin to describe to you guys how great I feel. I feel like I've been lifted into the clouds and can plan the rest of my life and enjoy it.

Now when I say this...please don't take it the wrong way. It's been two years since I've been with girls because of my anxiety/depression. But let me say this..I'm not being an ego case or anything...but last night I had one of the best nights of my life and had an (safe) orgy with 5 girls and myself. I can still get hard as a rock...but I'm noticing extremely delayed ejaculation. The sex is enjoyable...but the orgasm isn't as intense or rewarding. But the experience and lasting power makes it totally worth it.

The lexapro makes me not want to drink much anymore which is awesome. I have more regular bowel movements which is a welcome side effect. I find myself yawning a little bit. I've been splitting a 5mg lexapro in half and taking it at seperate times throughout the day.

I'm also taking about 2-3mg xanax on the weekends, and only .5mg on weekdays so I lower the tollerance and stay sharp in the office at work and such. I know how addicting alprazolam can be...so I am going to use my best judgement (along with my psychiatrists "duH" lol....he's really cool by the way). Still haven't told him I smoke herb though...because I thought he might not give me the xanax/lexapro I know I need.

But I'm completely relaxed around ANYONE. I had herb in my pocket last night and I just walked up to a police officer at the Taste of Chicago and had a conversation with him. I swear to god this feels better than the time I tried MDMA.

I'm much more efficient and optimistic. My room is clean...I'm making more friends...and I feel like I can move up in my job now and start my adult life the way I wanted it to be but previously didn't have the neurochemistry to accomplish these things.
 
Thanks my man, I've really appreciated all of your advise and experiences with getting over anxiety/depression.

I feel like a new person.

I'm not even joking when I say that I find escitaprolam even more enjoyable than MDMA. The serotonin pathway is an interesting thing to learn about.

2.5mg twice a day feels smoother/happier and more chilled out and at peace with the world.
 
I found it was doxepin that worked for me, im on 20mg a day, 10 in the morning and ten at night.... and i basically get no anxiety anymore.... i may have a little..... sometimes, but nothing that i worry about.... overall im a happy person now..... just because of doxepin.... really weird...i feel like trying this lexepro stuff or whatever its called though..
 
Hmmm, never heard of doxepin. It's an SSRI?

Lately, my only bad side effect is insomnia. I couldn't sleep at all last night...but that's probably because my cercadian rythem is all messed up from the crazy parties last weekend :D

Gotta get back into the work groove lol
 
OK...

My favorite side effect right now is quite strange.

I am VERY horny every day...and get erections like I was on viagra or something 8o I thought SSRI's did the opposite?! It's wierd...I can have unlimited staying power and I can control the pleasure and climax whenever I want.

I feel like I've turned into James Bond or something...overnight ;). I really don't mean to sound egotistical guys...but going from extreme anxiety/depression for 3 years to complete euphoric days is amazing! Lexapro almost seems recreational to me now right now...it's making the biggest positive change in my life/optimism/confidence/etc.....

I swear to god it feel better/smoother than MDMA to me. Although, I only did x once and it was intensely amazing...but at the same time I was getting nasty physical tension/anxiety from not knowing what to do with all the stress/anxiety I was having at the time I took X :( Good thing I had a couple xanax at the time that a friend gave me.

Also, it's like I've sudenly turned into a complete extrovert also...and I'm constantly hitting on girls all day.

I haven't been able to do this in 2 FUCKING YEARS because of my anxiety. It's like a miracle right now I can't even describe how amazing lexapro is.;) Oh yeah music sounds way better too. I'm constantly jamming out while I prioritize my daily adjenda lol

I think these newer SSRI's are fucking awesome! Anyone know where I can compare different ssri molecular structures and half-life/etc?

Why doesn't Forest Laboratories produce a time released Lexapro?!!?
 
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I was the same way on Paxil for a few months, but after that my dick went dead.

That's the main reason I'm looking for a new one. Completely fucked my sex life since I had no interest since I barely felt anything.
 
Shit...so this will dissapear after a few months? :(

I feel like I'm on MDMA and Viagra 24/7

It's amazing...I'm only on 5mg Lexapro and I've turned from an anxious introvert into a partying extrovert almost overnight :)

I'm feeling so ambitious and motivated.
 
Alas...the side-effects show their ugly head.

I'm getting some hardcore insomnia. It's like I'm awake but experiencing my sleeping state (R.E.M. and slowed breathing). I have constant energy, even though I'm taking the Xanax and Inderal.

I swear this compound gives me a more profound sense of euphoria and ambition than the time I tried MDMA.

Does anyone know of a safe drug to combat the insomnia?! I don't want to just pop more xanax before I go to sleep...because it seems like they wear off after 3 hours or so.

I'm currently taking...

* 5mg Lexapro in the morning.

* .5mg Xanax twice a day (morning and lunch)...to smooth out my days at the office.

* 10mg Inderal twice a day as needed (if I feel jittery/physical stress caused by unnecessary adrenaline being released)

I OFFICIALLY LOST MY DESIRE TO KEEP DRINKING ALCOHOL...it's like I went from a moderately heavy alcohol consumer...to one of those dudes that only drinks an exotic import at special events. I was worried I would become an alcoholic...but liquor and nicotine seem like enemies right now 8o Maybe the insomnia is being caused by the withdrawls from not drinking...even though I'm not having the alcohol cravings?

So far...the bad side effects are dry mouth/dehydration (even though I'm chugging water all day)....and also the insomnia (my worst side effect). The benefits are STRONGLY overpowering the side-effects right now.

But if anyone could help me out with the insomnia thing I would really appreciate it. Maybe a benzo with a longer half-life (klonipin?!)

I really don't want to be taking more drugs than I need...so if anyone knows of a safe non-addicting drug to take for the insomnia that won't have a drug/drug interaction with my other meds... it would be sweet. %)
 
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I think the only way to sleep with less drugs is exercise and reading. Try doing a bunch of pushups and chinups and go for a run or bike ride up some hills an hour or two before you want to sleep. Sometimes when I can't sleep I just stay up and watch tv but reading always makes me tired a lot faster and more relaxed.
 
:( Too bad I'm already an exercise physiology major so I do lots of cardio/weights. And do a shitload of reading both at home and paperwork at the office. They help to an extent...but this Lexapro seems to keep me up all night. Maybe it's the 1mg of xanax wearing off or something?

Is there any safe sleeping drug? Will melatonin help set my circadian rythem back on schedule? Or is it dangerous to combine melatonin with a serotonin reuptake inhibitor?

Also...I've gone from shy/mellow to extroverted/aggressive. It's cool...because I got promoted at my job today and will make more money...but at the same time I feel like I'm becoming too aggressive.
 
Great to hear it's going well for you! It seems the lexapro had quite an effect on you rather quickly, which is generally very uncommon. It can take quite a while to start having positive effects, and stabalization usually occurs after 6 weeks or so. Let us know how it goes...
 
You are hitting the Med merry go round, pills have side benefits AND SEs unfortunately, one reason the ADs lost their favour in my eyes, one pill for mood, one for anxiety, one for sleep....... and you see how this goes.
 
I've always been on a drug merry go round. Never had any serious trouble with any individual drug...with the exception of alcohol. I don't drink or smoke anymore cuz the Lexapro makes it seem unappealing and I'm sociable enough.

I slept great last night...I took 1mg melatonin and worked out right before bed like you guys suggested.

The side-effects are going away I think...
 
Tonight I was fooling around with this girl, and this Lexapro makes me SOOOO horny and gives me huge erections. But here's the thing...I really wanted to have sex but she was on her period...and it was like 2AM so I had to go because her dad wanted me to leave...and my balls started hurting REAL bad. Like, they were being twisted or something, it was excruciating. Is this just from not being able to orgasm when I was so horny? Or is it from the lexapro?

I jacked off and blew a huuuuge load when I got home...so maybe it was just sexual frustration and not the lexapro (I hope).

This stuff seems like a miracle right now, I'm so confident/happy/assertive. But sometimes it seems like I get agressive with people and feel like arguing when I don't agree with someone's position on something.
 
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