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Question: I am on Lexapro 40 mg, Klonopin 2 mg, Keppra 1500 mg and Amisulpride (Solian) 100 mg. I have some OCD symptoms due maybe to Solian and his effects on 5HT7 and 5HT2b receptors and some dopaminergic activity. I am on Lexapro 40 mg since two months and i feel 80 % better or even a little bit more, so i would like to know if a little higher dosage of Lexapro can help to a full recovery (say 10 mg more for example). My psychiatrist tried Luvox (fluvoxamine) with bad results and i don't tolerate Anafranil. I tolerate well Lexapro, with no side effects, even it seems to me that anti OCD effects arrive after six weeks (maybe because i am probably poor metabolizer for cyp2c19).
Thanks beforehand
Thanks beforehand
Brief Answer:
Dose higher than 40 mg are not recommended.
Detailed Answer:
Hello
Welcome to HCM.
You have mentioned that your OCD has improved to more than 80% on lexapro 40 mg. I would consider this as a wonderful recovery because only around 10-20% of OCD cases reach this level of recovery.
About the complete recovery of OCD, only 5-10% of cases of OCD show complete recovery from symptoms.
I would not advise the increment of doses of lexapro to 50 mg. Doses of 40 mg are already on higher side. Doses more than this might cause adverse effects common being dry mouth, diarrhea and sexual dysfunctions (and the serious one being serotonin syndrome on rare occasions).
I would suggest you to continue with 40 mg of lexapro and wait further, say for 1 more month. I am sure you will have more improvement with this dose only.
Hope this answers your query.
Any further queries are welcome.
Take Care.
Dr. Shubham Mehta,
M.D. (Psychiatry).
Dose higher than 40 mg are not recommended.
Detailed Answer:
Hello
Welcome to HCM.
You have mentioned that your OCD has improved to more than 80% on lexapro 40 mg. I would consider this as a wonderful recovery because only around 10-20% of OCD cases reach this level of recovery.
About the complete recovery of OCD, only 5-10% of cases of OCD show complete recovery from symptoms.
I would not advise the increment of doses of lexapro to 50 mg. Doses of 40 mg are already on higher side. Doses more than this might cause adverse effects common being dry mouth, diarrhea and sexual dysfunctions (and the serious one being serotonin syndrome on rare occasions).
I would suggest you to continue with 40 mg of lexapro and wait further, say for 1 more month. I am sure you will have more improvement with this dose only.
Hope this answers your query.
Any further queries are welcome.
Take Care.
Dr. Shubham Mehta,
M.D. (Psychiatry).
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Dear Dr. Mehta
Thank you very much for your answer. It means that i can expect from Lexapro a cumulative effect and more improvement in one month? What happens after 12 weeks?
Thanks beforehand, XXXXXXX
Thank you very much for your answer. It means that i can expect from Lexapro a cumulative effect and more improvement in one month? What happens after 12 weeks?
Thanks beforehand, XXXXXXX
Brief Answer:
The duration of response may vary in individuals.
Detailed Answer:
Good to hear from you again.
Yes you can expect more improvement in next one month.
Most of the treatment guidelines and clinical experience suggest that 2-3 months are required for a particular drug/dose to show its optimum effects.
The exact biological mechanism is not known for this. It may be time taken for receptor occupancy, cumulative effects, neurotransmitter release or may be anything else. But mainly its clinical experience.
Please continue with same dose even if the improvement remains to 80% or so. Extreme caution (for serotonin syndrome) would be required at doses more than 40mg.
Hope this helps.
Please close the query if you are satisfied with my response and kindly give your valueable feedback.
If you have any further queries, you are most welcome.
Wish you good health.
Thanks.
The duration of response may vary in individuals.
Detailed Answer:
Good to hear from you again.
Yes you can expect more improvement in next one month.
Most of the treatment guidelines and clinical experience suggest that 2-3 months are required for a particular drug/dose to show its optimum effects.
The exact biological mechanism is not known for this. It may be time taken for receptor occupancy, cumulative effects, neurotransmitter release or may be anything else. But mainly its clinical experience.
Please continue with same dose even if the improvement remains to 80% or so. Extreme caution (for serotonin syndrome) would be required at doses more than 40mg.
Hope this helps.
Please close the query if you are satisfied with my response and kindly give your valueable feedback.
If you have any further queries, you are most welcome.
Wish you good health.
Thanks.
Note: For further guidance on mental health, Click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
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