OK to stop Lexapro after one dose?

November 6, 2008 10:48 AM

I was just prescribed Xanax 0.5 mg, 3x daily and Lexapro 10 mg. once a day for major anxiety and sleeplessness. Took only the Xanax for 2 days and felt markedly better. Slept well, and the pounding heartbeat and breathlessness were gone. Added the Lexapro today and am feeling exhausted. I took a nap at 10:00 in the morning!. Called my MD, haven't heard back yet. Question is if I don't hear back by tomorrow morning is there a problem with stopping the Lexapro and just keeing up with the Xanax until (probably) Monday when I can get in touch with the doc? YANMD, etc.
posted by mmf to health & fitness (13 comments total)

If you've only been taking it a day, stopping probably won't hurt, but will caution that sometimes it takes your body a bit of time to adjust.

Had a friend being treated for bipolar disorder, and he had a drug that he called a "horse tranquilizer." I don't remember the name of the drug. Anyway, at first it knocked him out, but after a while he was able to function under it, and got to where it helped a lot.

Just saying I'd encourage you to stay the course until you get in to see your MD.

Beats having him say, "Let's just do what I said for a while and see how things work out." He can then make adjustments as he sees fit, rather than having to adjust your adjustments. That make sense?

You're not your doctor either. You really should talk to him before making any changes.
posted by cjorgensen at 10:56 AM on November 6, 2008 [1 favorite]

Drowsiness is a side effect of Lexapro, and most other SSRIs. It will also take time for your body chemistry to adjust - possibly 4-6 weeks. If your doctor did not explain this or the potential side effects properly, please find a new doctor.
posted by Cat Pie Hurts at 11:11 AM on November 6, 2008 [1 favorite]

Well you started out by not taking the medicine as prescribed, so it isn't like you're off to a great start. "Self-medicating" includes not only taking things which a doctor has not prescribed for you but not taking the things which have been.

Take your meds. If you don't take them as prescribed, your doctor won't have any idea how to recalibrate.
posted by valkyryn at 11:21 AM on November 6, 2008

Hm well the Xanax took away your anxiety because it's a tranquilizer. They're my friends too, don't get me wrong, but they certainly don't treat any underlying ongoing cause of anxiety. You may want to give the Lex a further try -- maybe take it before bed if it's causing your sleepiness? I found Lex was no good for me before bed, but obviously YMMV. Talk to your doctor about specifically these issues and don't assume the Xanax is going to cure you -- it is a Benzodiazepene and as such is highly addictive and, like, the WORST drug to detox off of, because withdrawal can last weeks or even YEARS. Scary fun. Great for the occasional freak out though.
posted by Soulbee at 11:35 AM on November 6, 2008

What time of day do you take it? If you take it in the morning, you could ask your doctor if s/he'd be okay with you taking it at night. I've seen it prescribed both ways.

I do agree with what others have said about continuing to take your medication until you hear from the doctor. Does your doctor have an urgent line, pager, or answering service? If you don't hear from him/her by the end of the day today, I would call that number. You might also want to try to call again about an hour before the office closes.
posted by catwoman429 at 11:36 AM on November 6, 2008

You should take the drugs as your doctor prescribed. The side effects you experienced with the Lexapro are normal will very,very likely go away if you keep taking the recommended dose at the recommended rate for the next couple weeks.

I know the Xanax makes you feel better instantly, but your doctor prescribed the Lexapro as a long-term solution to your symptoms. It is much more important that you try to make the Lexapro work for you in the long run - and you do that by just taking it and having to work through the side effects at first.
posted by emyd at 11:46 AM on November 6, 2008

Lexapro is often prescribed to be taken with your night-time pills so the drowsy effects can be used to help you sleep, but doctors often fail to mention that the drowsiness will continue for a while as your brain adjusts.

If you're already taking at night (and, if not, ask your doc if you should be), it depends on how quickly your brain "translates" - some folks need a week, some need a month. Lexapro is also one of those build-up drugs, where you need to take for at least 6wks to know how it's really going to work for you...or at least that's how it was explained to me when prescribed and it definitely took about a month for the effects to settle into my system*.

*it didn't end up working for me, ultimately, but just wanted you to know it takes a while
posted by batmonkey at 11:56 AM on November 6, 2008

I took Lexapro for about a year before stopping it. It was making me sleep on the order of 14 hours a day, and obviously that's unacceptable. I know this doesn't really help you, but I just wanted to let you know that the sleepiness you're experiencing is definitely not an uncommon side effect.
posted by Ephilation at 12:44 PM on November 6, 2008

Er, in short - no, it's not ok to not take it. Your Dr will have been expecting side effects like that.

The reason your Dr will have given you both, is that xanax is fast-acting, but only for SHORT TERM use.

The Xanax is intended to keep you ticking over until the LEXAPRO kicks in, which will be within 1-4 weeks.
In the meantime, the sleepiness and symptoms are common short term side-effects, see crazy meds, and they will *usually* wear off in a few weeks. Give it a couple of months, and if you are one of the small proportion of people for whom it doesn't, go talk to your Dr, and they'll put you on something else..

If you took the lexapro in the morning, take it in the afternoon or evening instead. Figure out when you can take it that will help - ie knock you out at night, rather than during the day, and just deal with the extra sleepiness for a few weeks. Extra naps won't hurt much, especially if you've been stressed and anxious of late.

If you want to make any modification to how you take Lexapro at all, as suggested on Crazy meds - ring your Dr and leave a message asking if you can take *5mg* for two weeks, before going up to 10mg, as you've been feeling too sleepy.


I know you liked the xanax.
You probably really liked it. I know I did.
I know it probably made you feel instantly better, no, worse, not better - but NORMAL.
And that's pretty damn seductive, especially as it doesn't seem as 'bad', but it will be less helpful over the long run, and if you've put 2+2 together, you've probably figured out it's slightly addictive.
Your Dr may well cut you off it if you only want to take the xanax.
Just putting it out there.

I'm giving you a roundabout manipulative justification for taking the lexapro here, but - if you take your medications AS DIRECTED, and don't bug the Drs, you'll probably have better chances of being given small amounts of Xanax etc, in future, as you 'need' it. Ok?
The more responsible you've been with taking your meds, and not taking too much, the more likely that will happen.

No, I am not a Dr.
Go wiki, crazymed etc to confirm the info I have given you here, and please do talk with your Dr.
posted by Elysum at 1:12 PM on November 6, 2008 [1 favorite]

I am a doctor and couldn't have said it better than Elysum. In fact, I *just* had this conversation with someone about almost the identical drugs.

Some symptoms with Lexapro really do get better quickly, within a few days and I would really make a strong effort to "get over the hump." If it is really too much to deal with, I would talk with your doctor about starting at 5 and just going up in smaller increments. But yeah, be very wary of Xanax. And keep trying with the doctor.
posted by Slarty Bartfast at 1:48 PM on November 6, 2008 [1 favorite]

Until Monday, you'll probably be fine. In the meantime, that's a lot of Xanax...I bet you are feeling better!

Just call him Monday and talk to him. You're not going to die from not taking Lexapro for a few days. And not taking Lexapro won't magically make Xanax non-addictive.

I wouldn't be worried that he'll think you're a pill freak just because you feel better on Xanax. That's, you know, the point. If you start asking him to triple your dosage or something, yeah, he'll probably have some questions about your usage. But feeling better? Completely normal.

In the meantime, AVOID BOOZE. Alcohol is not your friend.

Best of luck.
posted by sondrialiac at 5:22 PM on November 6, 2008

Thanks to all responders.

Each answer here helped me feel like a I have a slightly better handle on my situation. I did get in touch w/ the office and will be taking the Lexapro at night for now and checking in with the office on Monday again. I am so grateful to all of you for your thoughts when I am feeling overwhelmed. Really, thanks...
posted by mmf at 5:51 PM on November 6, 2008

Hey mmf,
glad you've taken those steps to getting it sorted out.

;)

And to clarify, I wasn't saying you were a pill freak because you were on xanax, or that your Dr will think you are.
Whoops! o_)
I wasn't meaning to come across that harshly, so my apologies - I was just going from my own experience where the small amounts of benzos I was given 'just worked' and it was a little disappointing (actually, freaking heartbreaking) to find out that I couldn't just be on them, as I was already really emotionally attached to them.

I was just trying to reassure you that your current side-effects from lexapro are completely normal, and that even if being on lexapro or one of the other anti-anxiety/depressant medications sucks at first, you should try to stick with it, and I thought it was really important to let you know xanax is probably only the short term solution (aka the 'letting you down quickly' theory of dashed hopes), I thought it might help you not feel too attached, too quickly.

And y'know, every little step you're taking at the moment? Giant freaking leaps.
Congratulations!
posted by Elysum at 6:45 PM on November 6, 2008