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Should I increase my Lexapro beyond 20mg?

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Posted 12/15/2014 10:30 PM (GMT 0)
I have been on 20mg for 25 days now and I have posted in another post, I had a good 7-8 days and since then, been having mild to moderate anxiety most of the day. It is very uncomfortable. This is along 1mg of Klonopin taken as 0.5mg in the morning, 0.25 at noon and 0.25 at around 6:00pm.
Two pdocs that I have seen recently are asking me to go to 30mg since I had a good week. I am not sure what to do anymore. I am not sure if I should increase the Klonopin to 1.5mg to get more comfortable and wait a bit longer?
This has been going on for 7 months now and I have been on Lexapro for almost 4-5 months at different doses, 5, 7.5, 10, 15, and now 20.

Any suggestions please?
Heartburn scared me initially and caused me to get into this mode. I used to be on 50mg of Zoloft for 12 years and when this started, another pdoc increased it to 112.5mg and Zoloft was just having a completely adverse effect on me and send me into the worst anxiety I have ever experienced. I am much better now than I was just 2-3 months ago, but this nagging level 2-3 anxiety (on scale of 10) does not go away until around 6-7 pm.
Eating lunch still causes me anxiety due to heartburn that I have not had in months now since I take protonix. I am in CBT and I am not sure how much that is helping.
Sorry for the long post.

Thank You
Posted 12/15/2014 10:34 PM (GMT 0)
I need some hopeful answers please. I am truly scared and at times, becoming hopeless.
Posted 12/15/2014 11:21 PM (GMT 0)
Anyone please?
Also, does anyone experience anxiety levels 2-3 most of the day?
Posted 12/16/2014 3:11 PM (GMT 0)
LH,

I would say that if you have had two doctors make the same recommendation for upping your dose, then you can trust this is a sound recommendation for you.

However, this is a personal decision, and one to be made by you. You need to feel comfortable with it, so go with where your comfort zone is leading you.

I encourage you to continue with the CBT. It takes time. I went for weeks before I felt even the starting effects and benefits...and actually found that the healing process extended far past the time I was actually in sessions! It is a long term treatment option, but it is not a quick one! Be encouraged and keep going!

Have you been using the coping skills in our Resources? I believe I posted them for you previously. They are really effective, and self help will increase your chances of feeling your best!

Keep posting, we are here for support!

S.C.
Posted 12/16/2014 4:13 PM (GMT 0)
S.C
Thank you for your reply. I truly appreciate it.
You are not on any medication at all? Have you been on medication?
Also, do you have any daily anxiety, constant anxiety at all any more?

Thanks
Posted 12/16/2014 4:23 PM (GMT 0)
LH.,

When I was first diagnosed, I was given a prescription by my GP for an SSRI (can't remember if it was Lexapro, or Celexa...one of those I believe.)

I kept it, unfilled, and decided to get into CBT first and see how that went.

I literally white-knuckled through the first several weeks of therapy. I was miserable, panicking several times a day, everday. Looking back, I think that taking the medication for a temporary time would have helped me...but I just didn't ever take that step.

Eventually as I said, the therapy tools kicked in, and I found relief...though I still have to manage my anxiety, using the coping skills that I learned along the way. (both in therapy and with self-help.)

I no longer have daily anxiety, (and no more panic attacks!) but I still have to keep up with watching my stress levels, and decompress when I am getting overwhelmed...everyone should, really!

There is hope! Using the treatment options that you have, as well as doing your own self-help (books/programs, CBT workbooks, the links here!) and talking with members here for support will find you making progress soon...I am sure of it.:)

S.C.
Posted 12/16/2014 5:25 PM (GMT 0)
S.C.

I am glad you are in a much better place. I would say that I feel levels of 2-3 anxiety on daily basis, but it starts to go to level 0 around 5-6 pm and stays that way until the morning. I have been dealing with this for 7 months almost and it has gotten so much better but I am trying to keep my hopes high that I will eventually see level 0 of anxiety like I had for years. I was a very happy, jolly person who is very accomplished, but now, I am just coasting and praying that things will get to where they were or at least to a comfortable place.
Levels of 2-3 anxiety is not that bad, but it is still not comfortable. Klonopin has been my savior. I only take 1.0-1.25mg/day.
Have you ever had an episode of this in the past? Do you mind if I ask you how old you are please?

Thanks
Posted 12/16/2014 5:28 PM (GMT 0)
Also, do you know what your triggers are? Are these triggers in your daily life?
Posted 12/16/2014 6:57 PM (GMT 0)
I am not sure that any person can expect to live at level zero in terms of anxiety...it is part of the human condition, an actually has it advantages. (protection/motivation)

If you mean living with the expected amount of stress/anxiety that any regular person would, then, yeah...you can hope to get there.

Of course, since anxiety tends to be a chronic condition...acceptance of ups and downs along the journey, as well as the need for ongoing management is key.

I am 44 and my story started about 10 years ago with a panic attack out of the blue. I did not 'feel' particulary stressed, but realized that I was not aware of how much family conflict had an effect on me. (at the time we were dealing with a blended family and my oldest daughter and my husband were at odds.)

Triggers for me are definitely interpersonal conflict with loved ones and medical/health issues.

I definitely have come so far, but still am learning everyday.:)


S.C.
Posted 12/16/2014 7:08 PM (GMT 0)
C.S. You certainly sound like a strong person. You will get through this and have made amazing improvements.
What I meant by level 0, meaning notmal levels of anxiety that does not interfere with one day to day life.
Thank you also for responding so promptly. I truly appreciate it.
Can you describe your CBT sessions please? Mine are almost becoming talk therapy. It was great at first with the forms etc...
I wished I could attach the form here for you to see.
Posted 12/16/2014 7:27 PM (GMT 0)
I had a combination of talking, doing homework/worksheets/forms...and working on lowering specific challenges through exercises that my therapist would have me try. (exposure type practices)

If you feel that you are not going in the direction that you want to, talk with your therapist about doing more of what you find helpful to you. If he/she is confident, they will appreciate your feedback and pro-active approach.:) The therapy is your show to run...you are paying and have every right to your input!

For now, would you like the links to our therapy worksheet downloads? Supplimenting my therapy work with self-help really made a difference for me.

S.C.
Posted 12/16/2014 8:02 PM (GMT 0)
S.C. I would love that. Please do share them.
Posted 12/16/2014 8:40 PM (GMT 0)
Here you go.:)

Therapy Work Sheets:

http://www.get.gg/freedownloads2.htm

Self Help Printable Work Book for OCD and Intrusive Thoughts

http://www.moodjuice.scot.nhs.uk/obsessioncompulsion.asp

(don't worry about the OCD title...this is helpful for any worrisome thoughts that are causing negative feelings/anxiety)

Posted 12/16/2014 9:51 PM (GMT 0)
S.C., Thank you for links. My sheets are similar but does not have the last column, on the ThoughRecordSheet.pdf file. I am assuming this is the one you are using mostly.
Do you mostly go through the sheet by yourself or with the therapist?
Posted 12/17/2014 3:59 AM (GMT 0)
Yeah, I do these when I feel the need on my own...since I am no longer in therapy.

I usually stick to my regular rotation of breathing and progressive muscle relaxation and postive mantras...

...but if I am stuck with a particular worry or negative thought I will break out the worksheets.:)
Posted 12/17/2014 9:51 PM (GMT 0)
Anyone please, getting back to the original question, has anyone been on lexapro above 20mg, like 30mg or 40mg?
Also, should I give 20mg more time? I am on it for 28 days now. I felt great for a week during this 28 days, the rest of the days, I felt better than I was on 15mg but I still feel the anxiety on daily basis, especially in the morning when I first wake up, I need 0.75mg of Klonopin to get rid of level 2-4 anxiety.

Thank You
Posted 12/18/2014 5:03 AM (GMT 0)
Once more please, anyone?
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