Upping the Lexapro dose

Hi all-

I started on Lexapro in September, at 10 mg, for anxiety and depression. My root 'thing' has always been anxiety (I'm a worrier), but this year, thanks to a bunch of strong external triggers, it all sort of devolved into depression.

Initially the Lex kicked in at about 3.5 weeks. I felt good for all of October, like my old self, and looking forward to the future. Then, coming into the middle of November, I felt myself slipping into a funk for no particular reason. My doc (family doc) suggested upping it to 20 mg. Right after upping it, I found out some very bad news about my husband (which is ongoing but we're dealing with it) and also that my daughter was having some issues at school (very minor at the time and it turned out to be much of nothing, but for someone prone to anxiety, it felt HUGE). It was like two lead pipes hitting me in the knees in succession. Then, a week or so after trauma #2, I actually started to feel better. Like I could come up with plans to deal with the crap life had thrown at me, even optimistic. Again, I felt like my old self. I figured this was the 20 mg kicking in but who knows.

Now it's been a month since the 20 mg. This past weekend I felt myself slipping again. I don't know if it's that 20 mg wasn't quite enough, or if I'm still latently processing those external events. I guess it doesn't really matter- I feel pretty down.

I did finally have an appointment yesterday with a psychiatrist. I liked him, felt like he took his time with me and got the big picture. He's affiliated with a major research hospital and knows his stuff. He suggested that even 20 mg might not be an adequate dose for me, and that I should go up to 30, possibly even 40. He says that current studies are showing that for many, 30-40 mg works very well. He's confident that because I've responded well in the past, that it's probably just a question of finding the right dose. In other words, it *was* working, but not optimally.

I forgot to ask him- if this is indeed what I need to feel better, how long will it take? It took almost 4 weeks before I felt completely myself when I started off- will it take that long again when increasing?

I'm just so frustrated. I feel like I had a wonderful taste for a few weeks of what it felt like to be "me" again, and I lost it.

Any input/advice/shared experience is warmly welcomed.

Never been on Lexapro but it seems like most meds for depression take at leat two weeks to start working. At least, that's my experience.

My experience with Lexapro is similar to yours. I started at 10mg felt like is was working but not enough. The same thing happened at 20mg, so I am now on 30mg and feel pretty good. My pdoc said the same this as yours, that 30-40 works better for some people. I'd say try out a high dosage, there's really nothing to loose and if the higher dosage doesn't work you can try a different med in a couple months.

FYI - since anxiety is my main issue too, I've added klonopin to the mix and like the Lexapro & klonopin combination.

It is frustrating to finally give the green light to yourself and your doc to take meds, and then not have them work. I think it is a big process of trial and error for those patients taking psychoactive meds. I have heard some doctors say that they think a patient really could have been helped by meds but they don't stick with this approach long enough to find the right dose and med(s). Many patients abandon meds after just a month or so when they do not get the results they had hoped for. Since you have responded well to Lexapro, it really may be worth it to stick with it and try a higher dose. Hang in there with it. As Lemon said, if it doesn't work, you can always try something different. That might be a different med, psychotherapy, exercise, meditation, a combination of all these, etc. Good luck.

Thank you all for your replies- it really helps to hear from people who've BTDT.

Lemon- do you take Klonipin regularly or prn? Both my family doc and my psychiatrist reassure me that I am not going to get addicted, but I am uncomfortable with the idea of taking a benzo regularly. I have 1 mg Ativan that I take when the going is really rough, and even then, I only take it once during the day, as I have trazodone to help me sleep. My thought is that if the Lexapro is doing it's job as it should, I shouldn't *need* the Ativan...kwim?

Today is my 5th day on 30 mg...and I think the anxiety is letting up somewhat. Mornings are the worst. Funny, when I first started on Lex at 10 mg, I remember that the morning anxiety was the most persistent of all my depression/anxiety symptoms. As the Lex started to work, those periods of morning anxiety became shorter and shorter until one sunny morning I woke up not at all anxious. I think that might have been one of the happiest days of my life. I'm hoping that this is what's happening this week. I'm trying not to overexamine and overthink all of this, but it's tough.

And yes Sunrise, I'm a big believer in all of those other healthy-lifestyle measures like exercise and meditation, especially as a maintenance thing over the long run. I have a great therapist too. I see the meds as being what I need to be able to do all the real work I need to do, not a quick fix solution at all. I have known too many people who take the meds, start to feel better, and then don't do any therapy or exercise or eat properly or whatnot.

Thanks all again for your replies, they really help.

Ever time you increase your dosage you will experience a couple of weeks with INCREASED anxiety - that's how lexapro works.
30-40mg is a really high dosage, most stick to 10-15. I once knew a girl who had serious anxiety problems, and she used 20.
If it's not even remotely working by now, I'd say that it's never going to work. Worth a shot though, but you need to give it time - 1-2 months, and then you can start asking yourself it it's working or not.

Hm, well I take 20mg and it works well, but I'm not entirely sure I'm at the right dose either. Good luck!