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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by olysi79 on May 20, 2008, at 11:50:19
Hey Guys... need help here
Ok,
I'm wondering where I went wrong here....
First of all, I tried to switch from 50 MGS of Zoloft to 10 MGS of Lexapro. It was a bust. Hence we decided to go back to the old Zoloft, but at a slightly lower dose of Zoloft (37.5)
Here is what my cross taper schedule looked liked
1) 7.5 MGS LEX/ 12.5 MGS Zoloft (7 days)
2) 5 MGS LEX/ 12.5 MGS Zoloft (7 days- we held here because we were doing a lower dose of the Zoloft.)
3) 2.5 MGS LEX/25 MGS Zoloft (4 days)
4) 37.5 MGS Zoloft
I've been holding at 37.5 MGS zoloft now (where I want to be) and have been experiencing really bad side effects since yesterday afternoon.... feel like I am going to jump out of my skin, hypervigilant nervousness, panicky, insomnia, etc... Zoloft can be very agitating (I know the drug well), but what gives? Is this because the Lexapro was a bust that my body has to readjust to the having the Serotonin (as though I'm startign over), or any other ideas? Could this be Lexapro withdrawal symptoms? I'm completely confused by where we went wrong in this, or if we did anything wrong in the first place. Any ideas, thoughts I can talk with my PDOC about? I take Valium now, and it's not doing a heck of alot.
Posted by Phillipa on May 20, 2008, at 12:38:56
In reply to Need the experts- the 'cross taper' faux paux, posted by olysi79 on May 20, 2008, at 11:50:19
Gee I would have thought you could just switch???? Love Phillipa
Posted by olysi79 on May 20, 2008, at 12:55:52
In reply to Need the experts- the 'cross taper' faux paux, posted by olysi79 on May 20, 2008, at 11:50:19
Scott-
Do you have any ideas on what could be happening?
Sincerely,
Oly
> Hey Guys... need help here
> Ok,
> I'm wondering where I went wrong here....
> First of all, I tried to switch from 50 MGS of Zoloft to 10 MGS of Lexapro. It was a bust. Hence we decided to go back to the old Zoloft, but at a slightly lower dose of Zoloft (37.5)
> Here is what my cross taper schedule looked liked
> 1) 7.5 MGS LEX/ 12.5 MGS Zoloft (7 days)
> 2) 5 MGS LEX/ 12.5 MGS Zoloft (7 days- we held here because we were doing a lower dose of the Zoloft.)
> 3) 2.5 MGS LEX/25 MGS Zoloft (4 days)
> 4) 37.5 MGS Zoloft
> I've been holding at 37.5 MGS zoloft now (where I want to be) and have been experiencing really bad side effects since yesterday afternoon.... feel like I am going to jump out of my skin, hypervigilant nervousness, panicky, insomnia, etc... Zoloft can be very agitating (I know the drug well), but what gives? Is this because the Lexapro was a bust that my body has to readjust to the having the Serotonin (as though I'm startign over), or any other ideas? Could this be Lexapro withdrawal symptoms? I'm completely confused by where we went wrong in this, or if we did anything wrong in the first place. Any ideas, thoughts I can talk with my PDOC about? I take Valium now, and it's not doing a heck of alot.
Posted by SLS on May 20, 2008, at 13:35:01
In reply to To Scott- the 'cross taper' faux paux, posted by olysi79 on May 20, 2008, at 12:55:52
I think you might be right about the Lexapro withdrawal scenario. 37.5mg of Zoloft is probably equal to 2.5mg of Lexapro. You did not raise the Zoloft fast enough nor high enough. As of today, I would go to Zoloft 50mg and target 100mg over the next week.
I wish I could give you more evidence to work with.
- Scott> > Hey Guys... need help here
> > Ok,
> > I'm wondering where I went wrong here....
> > First of all, I tried to switch from 50 MGS of Zoloft to 10 MGS of Lexapro. It was a bust. Hence we decided to go back to the old Zoloft, but at a slightly lower dose of Zoloft (37.5)
> > Here is what my cross taper schedule looked liked
> > 1) 7.5 MGS LEX/ 12.5 MGS Zoloft (7 days)
> > 2) 5 MGS LEX/ 12.5 MGS Zoloft (7 days- we held here because we were doing a lower dose of the Zoloft.)
> > 3) 2.5 MGS LEX/25 MGS Zoloft (4 days)
> > 4) 37.5 MGS Zoloft
> > I've been holding at 37.5 MGS zoloft now (where I want to be) and have been experiencing really bad side effects since yesterday afternoon.... feel like I am going to jump out of my skin, hypervigilant nervousness, panicky, insomnia, etc... Zoloft can be very agitating (I know the drug well), but what gives? Is this because the Lexapro was a bust that my body has to readjust to the having the Serotonin (as though I'm startign over), or any other ideas? Could this be Lexapro withdrawal symptoms? I'm completely confused by where we went wrong in this, or if we did anything wrong in the first place. Any ideas, thoughts I can talk with my PDOC about? I take Valium now, and it's not doing a heck of alot.
Posted by olysi79 on May 20, 2008, at 14:29:44
In reply to Re: To Scott- the 'cross taper' faux paux, posted by SLS on May 20, 2008, at 13:35:01
Wow, for real Scott?
I wa only on the Lex for 4 weeks and it didn't work, and I was told it was equiv to 50 MGS of Zoloft...eek, now I am in a real pickle. I was on 50 MGS of Zoloft for almost a year and it worked fine, I wonder why they switched me over to the lex at such a high dose! Do you know where I can find more information on this?
Chris> I think you might be right about the Lexapro withdrawal scenario. 37.5mg of Zoloft is probably equal to 2.5mg of Lexapro. You did not raise the Zoloft fast enough nor high enough. As of today, I would go to Zoloft 50mg and target 100mg over the next week.
>
> I wish I could give you more evidence to work with.
>
>
> - Scott
>
>
>
> > > Hey Guys... need help here
> > > Ok,
> > > I'm wondering where I went wrong here....
> > > First of all, I tried to switch from 50 MGS of Zoloft to 10 MGS of Lexapro. It was a bust. Hence we decided to go back to the old Zoloft, but at a slightly lower dose of Zoloft (37.5)
> > > Here is what my cross taper schedule looked liked
> > > 1) 7.5 MGS LEX/ 12.5 MGS Zoloft (7 days)
> > > 2) 5 MGS LEX/ 12.5 MGS Zoloft (7 days- we held here because we were doing a lower dose of the Zoloft.)
> > > 3) 2.5 MGS LEX/25 MGS Zoloft (4 days)
> > > 4) 37.5 MGS Zoloft
> > > I've been holding at 37.5 MGS zoloft now (where I want to be) and have been experiencing really bad side effects since yesterday afternoon.... feel like I am going to jump out of my skin, hypervigilant nervousness, panicky, insomnia, etc... Zoloft can be very agitating (I know the drug well), but what gives? Is this because the Lexapro was a bust that my body has to readjust to the having the Serotonin (as though I'm startign over), or any other ideas? Could this be Lexapro withdrawal symptoms? I'm completely confused by where we went wrong in this, or if we did anything wrong in the first place. Any ideas, thoughts I can talk with my PDOC about? I take Valium now, and it's not doing a heck of alot.
>
>
>
Posted by SLS on May 20, 2008, at 15:57:14
In reply to Re: To Scott- the 'cross taper' faux paux » SLS, posted by olysi79 on May 20, 2008, at 14:29:44
Some people say that Zoloft 100mg is equivalent to Lexapro 10mg. I would equate Zoloft 200mg with Lexapro 30mg. I guess it is best to use:
Zoloft 37.5mg = Lexapro 5.0mg
Zoloft 50mg = Lexapro 7.5mg
Zoloft 100mg = Lexapro 15mg
Zoloft 200mg = Lexapro 30mgIn reality, you have to titrate clinically. I don't see that there should be any pharmacokinetic interactions between the two drugs. They don't rely on the same cytochrome P450 enzymes to metabolize them. They do have in common a small and insignificant processing through P450-3A4 the pathway.
- Scott
Posted by olysi79 on May 20, 2008, at 17:54:17
In reply to Re: To Scott- the 'cross taper' faux paux » olysi79, posted by SLS on May 20, 2008, at 15:57:14
Hey Scott,
This makes sense. My brother bounced from 15 MGS of Lex to 100 MGS of Zoloft (I think) years ago.
I talked to my PDOC today and indeed, they told me they were sure it was SSRI w/d syndrome, because the Lex is stronger than the Zoloft. i was good on the 50 MGS Zoloft and switched because of some annoying, but not uber bad side effects.... my treat to endure now.
We're waiting it out for awhile for the stuff to settle and I'll have to hold still, and I'll ramp back up to 50 MGS of Zoloft in time.
I think I'll be ok... I've done the med merry go round for a long time, so I know thwe score.
Thanks for your help!!!> Some people say that Zoloft 100mg is equivalent to Lexapro 10mg. I would equate Zoloft 200mg with Lexapro 30mg. I guess it is best to use:
>
> Zoloft 37.5mg = Lexapro 5.0mg
> Zoloft 50mg = Lexapro 7.5mg
> Zoloft 100mg = Lexapro 15mg
> Zoloft 200mg = Lexapro 30mg
>
> In reality, you have to titrate clinically. I don't see that there should be any pharmacokinetic interactions between the two drugs. They don't rely on the same cytochrome P450 enzymes to metabolize them. They do have in common a small and insignificant processing through P450-3A4 the pathway.
>
>
> - Scott
Posted by bleauberry on May 21, 2008, at 17:39:34
In reply to Need the experts- the 'cross taper' faux paux, posted by olysi79 on May 20, 2008, at 11:50:19
Just opinion here, based on personal experiences, but when a drug is swapped for another, even with a careful taper, profound weird things can happen. I mean, despite both drugs being ssris, they are different molecules and have an array of different effects throughout the brain and genes and hormones, other than simply serotonin. Sometimes people get lucky and do a cross taper with no bumps, but other times it can be a real rough ride. I was lucky in that I went from 5mg lexapro to 25mg zoloft straight across with no taper and had no ill effects from it. Actually felt a little better on the first day. Never felt any lexapro withdrawals. Other drugs, other tapers, not so lucky.
Someone might have marvelous anti-anxiety with lexapro, but terrible pro-anxiety with zoloft. Or the other way around, someone might have marvelous anti-anxiety with zoloft, but terrible pro-anxiety with lexapro. It varies so much. Some people have great anti-anxiety with either one, and some people have terrible pro-anxiety with either one.
One thing for sure though is that the more time passes the smoother things should get. I agree with Scott in that the zoloft dose should go up a bit higher at this point. Time will tell which med is doing what.
Posted by olysi79 on May 22, 2008, at 22:43:12
In reply to Re: Need the experts- the 'cross taper' faux paux, posted by bleauberry on May 21, 2008, at 17:39:34
I definetely agree with this. So much variables to take into consideration. I am going to opt out of upping the Zoloft for now and see how I feel for a few weeks unless I feel truly awful, then up it'll go. I've been doses as high as 125 MGS, so I know the med well. 50 MGS was fine too.
From this recent cross taper experience, as well as another, I now oppose cross tapering unless it's a crisis situation. I am going to ask my doctor to not do that from now on, and to allow me to taper down, and then over to the new one, and just eat any side effects of the new med so i don;t have to deal with cross tapering issues.
At least you have a general idea of what is causing what side effects then.> Just opinion here, based on personal experiences, but when a drug is swapped for another, even with a careful taper, profound weird things can happen. I mean, despite both drugs being ssris, they are different molecules and have an array of different effects throughout the brain and genes and hormones, other than simply serotonin. Sometimes people get lucky and do a cross taper with no bumps, but other times it can be a real rough ride. I was lucky in that I went from 5mg lexapro to 25mg zoloft straight across with no taper and had no ill effects from it. Actually felt a little better on the first day. Never felt any lexapro withdrawals. Other drugs, other tapers, not so lucky.
>
> Someone might have marvelous anti-anxiety with lexapro, but terrible pro-anxiety with zoloft. Or the other way around, someone might have marvelous anti-anxiety with zoloft, but terrible pro-anxiety with lexapro. It varies so much. Some people have great anti-anxiety with either one, and some people have terrible pro-anxiety with either one.
>
> One thing for sure though is that the more time passes the smoother things should get. I agree with Scott in that the zoloft dose should go up a bit higher at this point. Time will tell which med is doing what.
This is the end of the thread.
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