Question: Dr Cho, my prescribing psychiatrist, last night recommended that I cut back the Lexapro dose to 5 mg, if I am having so much trouble. Okay, it's 1100 am, and I am not feeling so drunk as I had been yesterday, so now instead of feeling drunk, I am feeling anxiety. Should I take another 2.5 mg? Or wait until tomorrow and take 7.5 mg Lexapro?

I am still taking 100 mg Trazodone for sleep because that is the only way I have any hope of getting my sleep. I want to get off Trazodone, but I first need Lexapro to work well for me to feel well enough to do that. Dr Cho is aware of this, and feels that I should continue using it if that's the only way I can sleep.

My mind feels like it's just a horrible mess, all day. Life is very very difficult now. Just living hour by hour, wondering what will happen next, or what to do. I need to stay in touch with both you and Dr Cho that can coach me through this, I need a lot of help in these realy hard days right now.

Not that I would ever want to have to change medications (because I want to believe Lexapro will eventually work for me), what would be the next best medication for me to try, if Lexapro fails to work for me? I'm asking for an 2nd opinion in case this subject comes up when I see the psychiatrist this coming Friday. But of course I'd much rather be reporting to her that I'm still continuing to improve with Lexapro.

Generally speaking, I just can't stand medications that cause too much drowsiness, sedation, drunk feeling, etc., during the day. It seems like most all of the older SSRIs do that.

I went ahead and took that 2.5 mg anyway, about 3 hours after the first 5 mg. I think the day worked out better that way. I've informed my psychiatrist about this. She'll advise me what to do next.

When I stop bothering you with so many questions, then you know I'm getting better. Right now, this is like having a 500 pound anvil sitting on my foot---what am I likely to be talking about?

Dr Cho emailed me this morning, checking to see how I'm doing, which she is doing more often now. She's sent to my pharmacy a prescription for Lexapor in liquid form to make it easier to adjust dosage. Currently I am at 7.5 mg. All today I have not taken anything else, so that I can see more clearly what happens with just Lexapro alone. What I am finding out is that while I am no longer "bouncing off the walls" from out of control anxiety, I am suffering from "strange and drunk feelings" that seems to be worse now than in previous weeks. If I just sit here tight in my chair, those feelings abate.

Dr Cho is not addressing those problems, she is simply telling me to adjust my dose if "Lexapro is giving you so much trouble". Even my therapist will only tell me 1) see your psychiatrist about this, or 2) check with your PCP or ER to see if other things are causing this.

That leaves just you.

Right now, you are the only one actually addressing this problem. Of course I want to believe that Lexapro will help with this, and that this will go away eventually. You say these "strange and drunk feelings" is not from the Lexapro, but from my anxiety. Okay, I'm serious about trying to do the right or best thing to do, otherwise why am I listening to you? I do see and feel that things have changed since I started Lexapro 3 weeks ago. But right now, I am suffering from "strange and drunk feelings"....what is your advice on how to deal with that? I've heard of "derealization" and "depersonalization", but nobody is explaining to me how that works or how to deal with it, if that's what the problem is. How does one "stop a derealization attack"? A mystery to me.

If I could somehow abate this problem, I do believe I am on my way to recovery.

I agree, patience, 4-6 weeks, stay engaged, exercise, shower, read, go outside, trust the process. All of that. But right now, this "strange and drunk" feeling is persisting the entire day. If I can feel anxiety relief coming from Lexapro without suffering from this drunk malady, then I will be much more encouraged and motivated to move on with this.

If Lexapro has a half life of about 30 hours, then at 5 mg it nearly reaches an equilibrium level of about 12 mg in about 4 or 5 days. Once 10 mg started, it nearly reaches equilibrium level of 24 mg in about 4 or 5 days... but it spikes very fast at the start. Too fast. Now that I've reduced it to 7.5 mg 2 days ago, then in about 2 days so it'll drop to 18 mg. The point is, I think the rise from 12 mg to nearly double in just a few days was too much for me, so I'm going to opt for a more gradual rise to target equilbrium level of 24 mg. And try to stay in the optimum range between feeling anxious all day and feeling drunk all day. I've got a computer to help me work this out, too hard to do this by hand. Remember, desperate people do desperate things.

If I am right, I will feel better in the next few days. And that will mean that this is not "derealization" that I am suffering so much from as I am from a too-quick of a boost in Lexapro. Otherwise I'll be proven wrong.

Of course I will explain all this to and work closely with Dr Cho.

Is there a question in this? No, I'm just carefully keeping you up to date of my plans to deal with what I hope will be the last major problem, before I start getting net benefits.


I'll ask a question here just so I can close this out and start another thread.

"I used to be a funny guy. Will I be funny again?"