Lexapro for Anxiety & effects on OSA

MissAmethyst2U · Post by **MissAmethyst2U** » Thu Oct 20, 2005 9:13 pm

Will, and everyone else, Prozac was not a first choice. I do know that it can cause anxiety BUT, after trying many different meds some of which were HORRIBLE and horrible side effects Prozac was about midway down the list and I have taken everything out there just about. Prozac helped but I gained weight, I decided to try other meds and nothing worked so I went back to the prozac, gaining weight was a downside and I dont blame it totally on the prozac because with depression and well not knowing I had OSA and add in some other factors who the heck felt like exercising I stuck with the prozac as at least I was abole to leave my house on it. A lil over a yr ago, I got fed up with sexual side effects and told my doc I wanted off the meds completely and I would just keep Ativan handy as needed. In my case this worked well for me. I dont think the prozac did too much for the anxiety but its great for depression. And for whoever it was that said something about isnt it a great feeling to be off the meds and whatnot...OMG yes it is, to feel 'normal' for the first time in yrs, just to be able to go to the mall or grocery store without freaking out and thinking I am gonna die...it''s such a great sense of accomplishment...I wish everyone on here that deals with anxiety/depression the best and it IS possible to overcome it!

cat-a-tonic · Post by **cat-a-tonic** » Thu Oct 20, 2005 9:18 pm

Hi crazyone - I am also on Lexapro and a low-dose of Ativan. I was concerned about a decrease in REM sleep that some antidepressants and anxiety meds can cause, so I checked with my psych doctor and he suggested I start taking my Lexapro earlier in the day, rather than in the evening. I have been doing that for a week and notice my sleep has been deeper, so I think it might be helping. Also, he mentioned that if I did not see an improvement on my sleep, then I should take the ativan earlier in the day as well (I normally take this at night). Although I hope to be off these medications some day, I am in no hurry at the moment as they are helping me a great deal. I also second the opinion to be cautious about going off of these medicines without some guidance from your doctor.

WillSucceed · Post by **WillSucceed** » Fri Oct 21, 2005 6:17 am

Hi Stohje:
I'm not a Dr. so did not do any prescribing of meds. Patients in the ER would be seen by the crisis team (me and colleagues) and then the psychiatrist (and psych. residents, fellows, med. students) would be called in to see the patient.

The hospital that we worked in was in the downtown core of a very large city; we would get patients that had no previous experience with mental health treatment as well as many, many patients that had a chronic mental health condition and had been on meds for many years.

The staff psychiatrists had all been practicing for many years and all seemed to have their 'favourite' meds that they liked to prescribe. One of the psychiatrists refused to prescribe SSRI's, preferring tri-cyclics and MAOI's. No amount of cajoling from her colleagues would get her to let go of the tricyclics -could not get her to prescribe the reversible MAOI's either.

Anyway, we would see lots of folk with depression and anxiety disorders, (both panic and GAD) and I would hear over and over again the staff doctors telling the fellows, residents and med. students to not prescribe Prozac if anxiety was a significant factor -they leaned heavily on Paxil and Zoloft.

So, that's why I made the comment that I did. I think the important thing, as I commented, is that the patient stay in really close contact with the Dr. regarding meds.

stohje · Post by **stohje** » Fri Oct 21, 2005 12:21 pm

Hi WillSucceed,

That's really interesting. That doc that prescribed only tri-cyclics and MAOIs must have been a dinosaur! I've been working in a large hospital pharmacy since 1988 and have seen MAOIs prescribed for depression maybe twice! But psychiatrists, as you are well aware, are a strange lot themselves. Like I said there is nothing I could dig up in the literature precluding use of Prozac in anxiety related conditions, but real world experience is the real test of course. The docs you worked with must have seen it, and been sufficiently scared off of Prozac.

[Extreme sarcasm upcoming] Of course maybe it's just that the Prozac you get in Canada is tainted. I mean since the US government won't allow importation of drugs from Canada because they can't ensure the safety or the source. And we all know that the US government has the people's best interests at heart and is not in the pocket of big business at all. [End extreme sarcasm]

I absolutely agree with you that patients on these meds should stay in close contact with the Dr. I was very alarmed to read that crazyone had just stopped her lexapro because of something she read on a chat board! It is extremely dangerous to abruptly stop any SSRI.

Thanks for your reply,
best wishes,
Jeremy

SnoreNoMore2005 · Post by **SnoreNoMore2005** » Fri Oct 21, 2005 7:49 pm

Hi Crazy,

I hope you don't get hit by Hurricaine Wilma ('cause if you get hit, I'll get hit).

I've been taking Effexor for anxiety for about four months... the same time I started APAP. I believe 99.9% of my anxiety was a result of my body being totally exhausted from not sleeping properly. If your body and mind are wiped out from lack of proper sleep, all the anti-anxiety medicines or anti-depressants in the world are not going to cure you. You have to get at the cause of your problem which could be that your body is not renourishing itself during sleep.

I've noticed no ill effects or positive effects from Effexor. My problem is/was OSA but I'm still humoring my shrink by taking the Effexor to rule out any possibility that my anxiety is some chemical imbalance which I seriously doubt. I'll give my shrink another month or two and then I'm afraid I'll have to let him go for lack of work for him.

Taking anti-anxiety medicine so you can sleep is far better than letting your body get so run down from lack of sleep you can't function.

Good luck to you... give my best to Mayor Pam.
Sorry you don't feel well... I still think your pic is hot (just ask Lori)
SnoreNoMore2005
Tampa

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CPAPopedia Keywords Contained In This Post (Click For Definition): APAP

Jere · Post by **Jere** » Fri Oct 21, 2005 8:13 pm

stohje wrote:DO NOT STOP TAKING LEXAPRO WITHOUT CONSULTING YOUR DOCTOR

After years on and off anti-depressants I can only repeat: DO NOT STOP TAKING ANY ANTI-DEPRESSANT WITHOUT CONSULTING YOUR DOCTOR The stuff can be really difficult to stop, especially cold turkey, and the rebound depression can be dangerous.

SnoreNoMore2005 · Post by **SnoreNoMore2005** » Fri Oct 21, 2005 8:34 pm

I agree in principle with the notion that you should not stop taking a prescribed medicine without consulting your doctor.

But being a devil's advocate, you have to consider that a doctor telling you it's OK to stop taking a medicine he prescribed for you is like him saying "He/She's not going to make any money off of you anymore". If you think doctors won't do that, you would be terribly naive.

I'm just not that trusting of doctors. I think you have to take control of your health and not leave it up to people who have a profit motive when they advise you. My parent's generation would never question what a doctor said, but people are much more educated today... or at least they should be.

I always look at all the angles. I think that comes from being a business owner.

SnoreNoMore2005

p.s. I am not recommending you stop Lexipro. In fact, I would recommend that you take an anti-Anxiety or some other medicine if it would help you sleep.

Jere · Post by **Jere** » Fri Oct 21, 2005 8:47 pm

SnooreNoMore -

I agree 100%. However, these antidepressants - which are given out like candy - are typically prescribed without providing the patient adequate information regarding either side-effects (which can really, really suck) or the difficulty of getting off the stuff (which can really, really, really suck). The drug companies (which make all of the $$$) refuse to admit the withdrawal problems and even most doctors just give you a blank stare and a shrug when you complain about withdrawal problems.

Not sure how this thread wandered to this point ...

neversleeps · Post by **neversleeps** » Fri Oct 21, 2005 9:32 pm

SnoreNoMore2005 wrote:I agree in principle with the notion that you should not stop taking a prescribed medicine without consulting your doctor.

But being a devil's advocate, you have to consider that a doctor telling you it's OK to stop taking a medicine he prescribed for you is like him saying "He/She's not going to make any money off of you anymore". If you think doctors won't do that, you would be terribly naive.

Taking yourself off antidepressants without the guidance of a physician is stupid and dangerous. To suggest that one must take the initiative to do so without a doctor's supervision under the pretense that the doc is only continuing to prescribe antidepressants as a money-making venture is even more stupid and dangerous.

Please read the following.*

A gradual reduction is recommended to prevent discontinuation effects and to allow adaptation at the receptor level. A rule of thumb is 6-8 weeks after 6-8 months treatment3 or 3-6 months after maintenance therapy. Many patients, particularly those on lower doses, may be able to stop more quickly without adverse effects.

Patients must be warned that as depression is typically a recurring disorder, stopping medication is always a trial and may lead to symptoms reappearing. They also need to be instructed to contact their doctor as soon as any symptoms start to recur. The assistance of a key family member can play a crucial role in this respect. The doctor may need to continue to monitor patients periodically after medication has been stopped.

Discontinuation symptoms from abrupt cessation of tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs):
Gastrointestinal effects, flu-like symptoms, affective symptoms and sleep disturbance are the most common problems after stopping a TCA. Discontinuation effects are also common after withdrawal of MAOIs and include disorientation, confusion, myoclonus, ataxia, agitation, cognitive impairment, catatonia, paranoid delusions, aggressiveness, hallucinations, depression, suicidality, slowed speech and sleep disturbance.

Symptoms associated with withdrawal of tricyclic antidepressants:
Gastrointestinal nausea, vomiting, abdominal cramps, diarrhoea
General somatic distress lethargy, flu-like symptoms, headache
Sleep disturbance insomnia, abnormal dreams including nightmares
Affective symptoms anxiety, agitation, low mood
Less commonly movement disorders, mania, hypomania, arrhythmias, tachycardia, ventricular ectopic beats

Symptoms associated with withdrawal of selective serotonin reuptake inhibitors:
Gastrointestinal nausea, vomiting, diarrhoea, loss of appetite, abdominal pain, abdominal distress
General somatic distress lethargy, flu-like symptoms
Sleep disturbance insomnia, abnormal dreams including nightmares and decreased need for sleep
Affective symptoms irritability, anxiety symptoms, agitation
Problems with balance dizziness, vertigo, light-headedness, ataxia
Sensory abnormalities paraesthesia, numbness, blurred vision/diplopia, 'electric shock', visual lag
______________________________________________________________________

A potential result of the unsupervised cessation of antidepressants is suicide. This is a very serious subject. Let's not play devil's advocate with this one.

*Source:Stopping Antidepressants

crazyone · Post by **crazyone** » Sat Oct 22, 2005 3:38 am

Snore No More and Jere,
I agree in that I do not trust any doctors (for that matter I don't trust anyone "DTA"), so therefore, I do not entirely rely upon their advice. Prior to knowing that I had GAD, I was miss diagnosed multiple times times by multiple doctors.

Note: This will be my first lenghty post and I ask that everyone not interested or very bored, please move on. For, I just started back on the Lexapro, I've got a crap load on my mind, and I'm listening to Bill Maher. Not to mention my husband is out of town, which means I have the house alarm on because I'm paranoid that someone will try to steal my beautiful little girl. Still I will try to keep to my original point. Also, Please excuse my late night grammar while trying to type on a laptop - which I hate - but am to lazy to go to my desktop.

Continuing......
After being told I had post-partum depression (almost nine years ago), then chronic mono(epstein bar virus), chronic fatigue syndrome was next (of course), IBS, chron's, fibromaylagia, and some other crazy disease - I finally started my own studies. I let the docs know that my symptoms and family history were pointing to GAD and Sleep Apnea. They said, oh yeah, that's a good possibility. I wish I could get paid $$$$$ for pulling diagnostics out of my rear!

So finally, everything stays under control as long as I stick with the treatments. My problem is, I want to be in control of when and if the treatments are necessary. Last week I was invincible and didn't need anything. This week I'm humble again and begging everyone to forgive me for biting their heads off.

Jere, You are right in that I should not have stopped my meds. I believe I experienced 75% or the withdrawl symptoms that neversleeps posted. Thank you for posting those, Neversleeps, for I was not aware. What a mistake that ended up costing major set backs in my cpap therapy. And what a task it will be to get back on track.

Thanks to this forum, my interest in my treatment stays active and causes me to consistently re-evaluate my health and make serious efforts to stay on track. Mostly because I enjoy seeing others make improvements in their lives by being healthy. I need to be a role model for my daughter in that way.

From now on I am going to try very hard to stay focused in continuing what I know works best for me. It sucks when you feel like crap and you know it's your own damn fault.

Snore No More,
I hope Wilma does hit! I'm way inland on the Hills/Pasco line, so it won't affect me much. But it will get me out of work on Monday and I'm always up for that. Not to mention, I sleep better when it's storming.
Thanks for the picture compliment. That was on a night in ybor when I actually put effort into looking nice. That doesn't happen too often, although, my husband wishes it did.

Oh 2 breathe · Post by **Oh 2 breathe** » Sat Oct 22, 2005 5:42 am

I'm so glad to see some good information posted here about various meds and their dangers.

While I think medication has an important place in the treatment of anxiety and depression, combining these with working with a therapist can be even more effective. This is the kind of work I do and I have had excellent results using cognitive behavioural and interpersonal therapy approaches. Every person is unique and sometimes the underlying issue is an unresolved loss or trauma that can be helped through counselling.

I agree wholeheartedly that no medication should be stopped abruptly and that all medication changes should be done under the supervision of a doctor. But if the medication is not meshing well with the sleep apnea, it would be good idea to consider alternative, less intrusive approaches such as counselling that may well be as effective if not more effective than meds in many situations.

~OTB

Moxie Chick · Post by **Moxie Chick** » Sat Oct 22, 2005 11:17 am

I had a totally good experience with Lexapro and it didn't cause any problems with my CPAP.

I had hormonally-caused depression/anxiety (menopause) a couple of years ago. I totally agree, Oh 2 Breathe - my therapist and doctor both told me that combining medication with talk therapy was the best treatment for my problem. What a godsend therapy was! For the first couple of months on Lexapro, the only effects I felt were the side effects - I think nausea was one (which were temporary). The therapist helped me to identify things and behaviors that were adding to my stress, and some really good things have come out of it.

The thing I really liked about Lexapro was that, other than treating my depression, it didn't significantly change my personality, behavior, etc. - my husband also noticed this. I didn't feel "drugged". Once it kicked in, I couldn't even tell I was on medication. It never seemed to cause any problems with my CPAP, either. My doctor keeps herself pretty well educated about treatments, medications, etc. and I doubt if she would have prescribed Lexapro if it interfered with CPAP. As my year on Lexapro was winding down, we talked about how to gradually come off the meds so I wouldn't experience any bad effects.

Carol Lee

Guest · Post by **Guest** » Sat Oct 22, 2005 4:06 pm

crazyone wrote:Jere, You are right in that I should not have stopped my meds. I believe I experienced 75% or the withdrawl symptoms that neversleeps posted. Thank you for posting those, Neversleeps, for I was not aware. What a mistake that ended up costing major set backs in my cpap therapy. And what a task it will be to get back on track.

From now on I am going to try very hard to stay focused in continuing what I know works best for me. It sucks when you feel like crap and you know it's your own damn fault.

I konw exactly what you mean, for I also stopped my own antidepressants without a doctor's supervision. That's why I know how stupid and dangerous it is.

The good news is you are a bright, vivacious woman and you learned from it. I hope you feel a sense of relief and wisdom in knowing what you now know.

Oh 2 breathe wrote:While I think medication has an important place in the treatment of anxiety and depression, combining these with working with a therapist can be even more effective.

Absolutely! Medication alone may work, CBT alone may work, but the combination of both can only improve your odds.

neversleeps · Post by **neversleeps** » Sat Oct 22, 2005 4:08 pm

ARRRRGH!!!!!!!!!!!!! "Guested" again!

The previous post was mine.

Jere · Post by **Jere** » Sat Oct 22, 2005 10:07 pm

Crazyone -

Somewhere back a few weeks ago I posted my story (or at least the short version of it). I have had your experience (in my own way) over the last 20 years.

It's funny, each time the meds make me feel great, that little voice in my head says - I am cured! - and I go off the stuff. Then the rebound comes and I kick myself in the butt and the cycle starts over.

In the past year, I have had some adjustments made to my meds that truly help, and I feel better than I have in years (without the side effects). I think (I hope) I have learned my lesson enough to keep taking the meds. We are only human, though; you and I and a whole lot of people, we are in the same boat. So, keep paddling (even if it is upstream sometimes) - it's worth it.

Jerry

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