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Dr. Andrew Rynne

Family Physician

Exp 18 years

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Suggest medicine dosage for depression

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General & Family Physician
Practicing since : 2012
Answered : 2868 Questions
I am on the following treatment for anxiety: Lexapro 5 mg, Keppra 1000mg as mood stabilizer, Klonopin 2 mg and Amisulpride 100mg.
When i was at Lexapro just 2.5 mg (few days ago), i used to take two double expresso coffees in the morning and it helped me a lot. But since i am on Lexapro 5mg, if i take the same dosage of coffee in the morning, i feel bad, with somnolence and even lack of concentration.
I would like to know if since my dosage of Lexapro in the morning is twice the last one (since some days), i need for example half the dosage of coffee, or a different coffee, for example americano, with more water.
I used the morning coffee in a certain way to inhibit Klonopin, and my psychiatrist explained me that it's linked to adenosine's chemistry.
Wed, 27 Aug 2014 in Mental Health
Answered by Dr. Muhammad Sareer Khalil 1 hour later
Brief Answer:

Detailed Answer:
Hello and welcome,
I have read your history carefully

Keppra(leviteracetam- a mood stabilizer)
Lexapro(Escitalopram - an anti depressant
Klonopin(Clonazepam - anti anxiety)
Amisulpride (antipsychotic)

The anti depressants take at least 2 weeks to work. Even though you mentioned about your poor cyp metabolism, I still think the Lexapro dose is quite low to take effect.

The SSRIs firstly take care of anxiety then depression and subsequently obsession symptoms.

I would recommend a XXXXXXX mental state exam to correctly diagnose Anxiety as you are taking too many drugs at once.

The XXXXXXX Mental state exam can pinpoint anxiety whether its Generalized, phobic or panic associated.


You may try the coffee change to see if it takes effect.
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