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What causes anxiety and sleep problems while on Lexapro?

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Posted on Fri, 6 May 2016
Question: Been on paroxetine 40mg for 10 years, lost my dad last year & retired from my job, after all of that the medicine didn't seem to be working as good, I don't handle change very well & am a constant worrier.
The doctor switched me to Lexipro but that sent me into a downward tail spin, went back on paroxetine about 3 months ago but still have daily anxiety & sleep problems. Scared to try something else & read a lot of bad stories about the withdrawals from paroxetine. Any suggestions what to do next?
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Answered by Dr. Alexander H. Sheppe (27 minutes later)
Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks for your question.

I'm sorry you've been through so much recently. Here are my thoughts about how to help.

I do indeed recommend staying on your Paroxetine -- if something tends to work once, it's a good idea to continue it. I think for the short term, to help with anxiety and sleep, a short course of Benzodiazepine would be a good idea.

I'd specifically recommend Clonazepam 0.5mg three times daily, which can be adjusted to be weighted more heavily towards the evening if sleep is the major concern. This is an excellent anxiety medication and good for sleep, and can help get you through this troubled time.

In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Follow up: Dr. Alexander H. Sheppe (42 hours later)
How long will it take to see an improvement in my anxiety? Seems like one day I do good & I think the medicine is starting to work & the next day I feel like I'm starting all over with the anxiety, so frustrating!
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Answered by Dr. Alexander H. Sheppe (3 minutes later)
Brief Answer:
Followup

Detailed Answer:
Clonazepam works almost instantaneously. It make take a few days to see the full effect. As you probably know, SSRIs like paroxetine take 4-8 weeks after a dose adjustment to see the full effect.

Please remember to rate and close this answer thread when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by : Dr. Naveen Kumar
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Dr. Alexander H. Sheppe

Psychiatrist

Practicing since :2014

Answered : 2240 Questions

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What causes anxiety and sleep problems while on Lexapro?

Brief Answer: Consultation Detailed Answer: Hello, and thanks for your question. I'm sorry you've been through so much recently. Here are my thoughts about how to help. I do indeed recommend staying on your Paroxetine -- if something tends to work once, it's a good idea to continue it. I think for the short term, to help with anxiety and sleep, a short course of Benzodiazepine would be a good idea. I'd specifically recommend Clonazepam 0.5mg three times daily, which can be adjusted to be weighted more heavily towards the evening if sleep is the major concern. This is an excellent anxiety medication and good for sleep, and can help get you through this troubled time. In the future, for continuity of care, I encourage you to contact me directly at my private link below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers