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Suggest treatment for depression inspite of taking lexapro

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Posted on Thu, 17 Jul 2014
Question: I have not yet seen a psychiatrist. It seems nearly impossible to get into to see one in Las Vegas that accepts my insurance and doesn't have a 3 month waiting list. I'm seeing a physician who has had a lot of success with depression and I think she great. I took Lexapro first and for nearly 5 weeks I suffered through the severe tiredness,sweating, insomnia and some weird change in my sexual thinking that I can't even explain. The tiredness had subsided enough to continue but I did not see any positive results. My Doctor recommended rather than increasing from 10mg to 20; we should try something else. We went with Wellbutrin 150mg and after exactly 16 days I feel not better if anything worse. I'm not tired which was the biggest problem with Lexapro but now I still have the sweating, teeth grinding, extra bowel movement, hearing strange noises, and I'm hallucinating if I ever sleep at all, oh yeah Insomnia as well.

It appears that with both drugs I"m getting unlucky with "very rare' Side effects. What would be your recommendation at this point? Should I stick out with Wellbutrin for 30 days or stop? If I were to try something different would you have a recommendatio? I know I need help with or without any of these drugs I'm still having suicidal thoughts, but I do not have a plan, I have no intention of acting on it because I don't want to and I would NEVER harm anybody else.

I know I'll probably go back to doc next week but a vague second opinion would be nice.

Thank you,
XXXXXXX
doctor
Answered by Dr. Sunil Gupta (38 minutes later)
Brief Answer:
Increase in dose to 300 mg should be considered

Detailed Answer:
Dear XXXXXXX

I read your query in detail and completely understand your distress with the fact that you are not seeing any improvement with the medications that you are taking.

Depression usually takes some time to respond to medications. Most of the anti-depressants do need at least 10-20 days to even start showing effect. Regarding the side effects, it usually happens in the initial few days, most of the side effects you have mentioned can also occur due to anxiety which is part of depression.

Had I been your psychiatrist, at this stage, I would have recommended an increase in dose of Wellburin (Bupropion) to 300 mg/day. I do hope that you are taking it in the morning as taking in at bed time can cause insomnia. I would then wait for another 3 weeks at 300 mg/day dose and assess the response. If you are responding, I will continue with it or else will think of another agent like venlafaxine (effexor). I think you can discuss these options with your physician.

I am glad that you are sure about not acting on the suicidal thoughts and I hope you keep it that way and respond very soon to treatment. You should also consider exercising daily as that will help you feel a bit relaxed.

I do hope I was able to answer your query. Please feel free to ask any further query that you might have.

Best wishes for speedy recovery,

Dr. Sunil Gupta




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sunil Gupta (8 minutes later)
If we increase the dosage will that increase the side effects such as; insomnia and sweating?
doctor
Answered by Dr. Sunil Gupta (16 minutes later)
Brief Answer:
Please see details below.

Detailed Answer:
Dear XXXXXXX

Thanks for following up.

Bupropion is quite a safe anti-depressant. The most important side effect with Bupropion is insomnia. Increasing the dose can cause it. But it can be taken care of it the medication is taken in the morning. Other common side effects of bupropion includes slight anxiety or restlessness, nausea. Most of these side effects do go off on their own and you really don't need to worry much about them.

It doesn't have any sexual side effect. A very rare side effect is seizures which usually occurs only in people predisposed like a person with family history of seizures or head injury.

I think if the medicine starts working and shows response decreasing your depressive symptoms, you won't notice any of the side effects.

Hope that answers your query. I will be glad to answer any more queries that you might have. In case you don't please close the discussion and rate the answer.

Best wishes,

Dr. Sunil Gupta

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Sunil Gupta

Psychiatrist

Practicing since :2005

Answered : 637 Questions

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Suggest treatment for depression inspite of taking lexapro

Brief Answer: Increase in dose to 300 mg should be considered Detailed Answer: Dear XXXXXXX I read your query in detail and completely understand your distress with the fact that you are not seeing any improvement with the medications that you are taking. Depression usually takes some time to respond to medications. Most of the anti-depressants do need at least 10-20 days to even start showing effect. Regarding the side effects, it usually happens in the initial few days, most of the side effects you have mentioned can also occur due to anxiety which is part of depression. Had I been your psychiatrist, at this stage, I would have recommended an increase in dose of Wellburin (Bupropion) to 300 mg/day. I do hope that you are taking it in the morning as taking in at bed time can cause insomnia. I would then wait for another 3 weeks at 300 mg/day dose and assess the response. If you are responding, I will continue with it or else will think of another agent like venlafaxine (effexor). I think you can discuss these options with your physician. I am glad that you are sure about not acting on the suicidal thoughts and I hope you keep it that way and respond very soon to treatment. You should also consider exercising daily as that will help you feel a bit relaxed. I do hope I was able to answer your query. Please feel free to ask any further query that you might have. Best wishes for speedy recovery, Dr. Sunil Gupta