Zoloft/cymbalta/lexapro Dosing?

[starry16]

Hi all,

I know there have been many posts about SSRI's/SSNRI's (and I think I've read all of them), but was wondering if people could share their experiences on doses.

Basically, I'm trying to decide which one to go with. I've taken both lex and cym in the past, but when my POTS symptoms were not as bad, so I don't know how much they'd help now. For both, the side effects were a problem (though tolerable), but my doctors were pushing me to go to a higher dose and I wonder whether a lower dose for a longer time would be more effective with POTS.

So I'm wondering what kinds of doses people have found to be effective for each of these?

Thanks!

P.S.: My doctor mentioned a study about using Zoloft with POTS people, but I've not found it. If you have, could you pass along or direct me?

[lorrie]

I'm not familiar with the study you mentioned, but I do take Zoloft. I have been on 50 mg. for a little over a year. I have had no side affects. I am thinking of asking to go to 100 mg. because of late, I have been easily tearful and a little down. This is a new thing because in the beginning, I couldn't cry if I wanted to. Some of the depression is due to the feeling of isolation I have from this disorder and some from trying to accept that this diagnosis is for real.

Hope you find a medication that is right for you. Let us know!!

[Carly87]

I was prescribed both Zoloft in the past. It was prescribed for anxiety & depression, however, not POTS.

If you take Zoloft, make sure to start at a smaller dose...I mean even smaller than what they tell you is the "starting dose." I took the 25mg (smallest starting dose) and got sooo sick. Hot flashes/sweats/Panic attacks all night long. The next day I was incredibly nauseas and aching all over. I was extremely depressed so I continued taking it because I felt like it was my last hope for feeling better if I made it through the initial few weeks. I broke it up and increased my dosages up to 25 mg and stayed there for almost half of a year. I tolerated the medication a lot better by titrating it up much more slowly than my doctor would have recommended. Overall, I felt like it really didn't do anything though, so I'm thinking so maybe low doses for long periods of time is not the answer for Zoloft. I must say though, everybody is so different when it comes to these drugs, you just have to find one that fits with your own particular body chemistry.

I eventually weaned myself off the zoloft and have been off of it and all SSRIs for over a year now.

I guess I have no success story, but I wanted to share my experiences and I look forward to seeing the other responses you get!

[pat57]

I was put on 10 or 20 mg of Zoloft then 10 or 20 mg of paxil, then I went to full dose of St. Johns wort.

I'm sorry, I don't remember the exact dose, but I do remember that the Dr. said it was below the minimum used for depression. I had intolerable

side effect from both , even at those levels. Hyper sexual. I am backwards apparently.

All three did/do help my NCS.

[goldicedance]

I have been taking Zoloft for about 8 years. I started with a smal dose, and then very slowly worked up to 250 mg. I take it in the morning. Zoloft helps with the POTS, especially migraine headaches.

Dr. Low told me that 250 mg is the dose actually needed by most people when taking Zoloft for POTS. My intern had been worried about the massive amount.

I hope that this is helpful.

Lois

[starry16]

Thanks to all who responded. Hopefully more people will chime in! It's really confusing to know what dose will help with these because all of the doses quoted out there are for depression, not POTS.

Lois, that's really interesting about what Dr. Low said because that's a very high dose, but the doses I just read about in Dr. Grubb's most recent article for Cymbalta and Lexapro are quite low (less than the normal "therapeutic" depression dose). I wonder why the Zoloft one would be so much higher. That actually makes me think that it might be better for me to go with one of the other ones. Since I tolerate SSRI's so poorly, I can't imagine that I'd ever get to that high a dose of Zoloft!

I have been taking Zoloft for about 8 years. I started with a smal dose, and then very slowly worked up to 250 mg. I take it in the morning. Zoloft helps with the POTS, especially migraine headaches.

Dr. Low told me that 250 mg is the dose actually needed by most people when taking Zoloft for POTS. My intern had been worried about the massive amount.

I hope that this is helpful.

Lois

[turtlefairy5]

I have been prescribed several anti-depressants over the years to treat depression and anxiety. Unfortunately, when not used in tandem with an anti-psychotic, they tend to make me walk-around-in-circles anxious and restless, complete with accompanying panic attacks. It may be that I could ween off of the anti-psychotic after moving past the side-effects phase that come with starting anti-depressants, but I've never tried that. The anti-psychotic helps me sleep, and really helps with my OCD/intrusive thoughts. I've recently learned, though, that anti-psychotics can aggravate POTS.

Anyhoot, to answer your question, or, um, not-answer it still, I've tried just about every anti-depressant and have yet to find one that absolutely makes me feel better, less tired, etc. Still searching. When I can afford it, I'm going to try Wellbutrin next.

I'd be interested in what others have to say about this as well. Any recommendations for one over the other?

I suppose there really isn't any magic bullet, as it were.

Amber

[jbrian00]

I have tried several dosages of both Zoloft and Cymbalta over the last 3 years since I became symptomatic. Sometimes you have to take side effects into effect. For example, while on 100mg Zoloft or 60mg Cymbalta, I was yawning like crazy and was tired all the time. I was also taking klonopin, though, to add to the mess. But actually, I felt the best when I was off the klonopin and taking 30mg of Cymbalta. For me there was no need to take higher than 30mg of cymbalta. High doses are not always better.

James

[pat57]

starry, the dose my EP ordered is 10 or 20mg when used as a vasoconstrictor.

[juliegee]

Hi There,

My son takes 20mg of Lexapro daily and it has helped his dysautonomia so much. He is not clinically DXed with depression or anxiety. The Lexapro is to balance his autonomic nervous system exclusively. However, Mack was experiencing anxiety symptoms before he began the Lexapro, but his Dr. insists the anxiety was due to phsyiological, not psychological changes. Mack's BP was crashing several times thoroughout the day prior to the Lexapro, florinef and thermotabs.

Carly's advice about starting an antidepressant is right on the money. Please read it carefully. Definately start at the lowest possible dose and slowly titrate up. Expect lots of negative side effects. Even with the lowest dose, Mack experienced awful headaches, lightheadedness, vomiting, shaking, etc. Working through the side effects aws awful. Mack's PT theorized that his body was so deficient in serotonin that it "freaked out" when it was finally introduced to his system. Try to work through those initial side effects before you give up.

Mack was stable on 10mg of Lexapro, but Dr. Rowe at Johns Hopkins upped him to 20mg to help with his chronic fatigue. Lexapro has helped stablize Mack's BP, balnce his autonomic nervous system, and improve Mack's chronic fatigue.

Best of luck!

Julie

[ajw4790]

Hi,

I take 100 mg Zoloft. Lexapro/celexa was not helpful for me. Have not tried Cymbalta... Next on the list to add is Wellbutrin (SNRI).