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Lexapro Pooped Out On Me. Is It Unlikely To Work Again After A Break From It?


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#1 In_Remission_blindfaith

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Posted 04 February 2012 - 03:20 PM

I took Lexapro for a little over a year, at which point I went off of it because it appeared to be "pooping out" on me. It no longer seemed to be doing much for me, and i didn't know if there was any point in taking it anymore. I went off of it with no withdrawal effects (fortunately).

It's about 7, almost 8, months later, and my anxiety is not good (generalized anxiety). If I go back on Lexapro, is it unlikely to work again given that it pooped out before? I know in cases where a med DOESN'T poop out it's still a toss up whether it'll work a second time around. Not sure whether I should try Lex again or try a completely different SSRI.

I'm very nervous about side effects (particularly weight gain/inability to lose weight) and Lexapro didn't impede weight loss for me, but I need to get my anxiety under control again.

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#2 Tryn

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Posted 04 February 2012 - 04:17 PM

Well, if you went off of it because it seemed to be pooping out on you then I'm guessing that you didn't ask your pdoc or PCP what to do about your returning symptoms so you can't be sure if it really pooped out on you or if you just needed for your dosage to be raised.

It's hard to tell what level of effectiveness Lex would have on you without knowing if it actually pooped out on you or not. At any rate, when you see a pdoc you should tell them about this and the dosage that you were taking so they can make an educated decision about whether to try the Lex again or to switch you to another antidepressant.
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#3 In_Remission_blindfaith

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Posted 04 February 2012 - 05:23 PM

Well, if you went off of it because it seemed to be pooping out on you then I'm guessing that you didn't ask your pdoc or PCP what to do about your returning symptoms so you can't be sure if it really pooped out on you or if you just needed for your dosage to be raised.

It's hard to tell what level of effectiveness Lex would have on you without knowing if it actually pooped out on you or not. At any rate, when you see a pdoc you should tell them about this and the dosage that you were taking so they can make an educated decision about whether to try the Lex again or to switch you to another antidepressant.


Thank you. You are correct, I didn't really speak to my doctor about the returning symptoms; I just figured I would manage without it and taking Klonopin as needed. I was taking Lexapro 10mg. I guess "pooping out" by definition means that even with a dosage increase it no longer works, in which case, having not tried a higher dosage, we can't say for sure it pooped out? Am I understanding correctly?

My PCP (no pdoc - I live in Canada and seeing a pdoc is much more difficult where I am) will probably think we could try Lexapro at a higher dosage or a whole new AD. It seems this is so "your mileage may vary" it may just be a trial and error thing?

#4 arieswmn

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Posted 04 February 2012 - 09:34 PM


Well, if you went off of it because it seemed to be pooping out on you then I'm guessing that you didn't ask your pdoc or PCP what to do about your returning symptoms so you can't be sure if it really pooped out on you or if you just needed for your dosage to be raised.

It's hard to tell what level of effectiveness Lex would have on you without knowing if it actually pooped out on you or not. At any rate, when you see a pdoc you should tell them about this and the dosage that you were taking so they can make an educated decision about whether to try the Lex again or to switch you to another antidepressant.


Thank you. You are correct, I didn't really speak to my doctor about the returning symptoms; I just figured I would manage without it and taking Klonopin as needed. I was taking Lexapro 10mg. I guess "pooping out" by definition means that even with a dosage increase it no longer works, in which case, having not tried a higher dosage, we can't say for sure it pooped out? Am I understanding correctly?

My PCP (no pdoc - I live in Canada and seeing a pdoc is much more difficult where I am) will probably think we could try Lexapro at a higher dosage or a whole new AD. It seems this is so "your mileage may vary" it may just be a trial and error thing?


What you say is correct. You could still try increasing Lexapro to 20mg. Some people don't respond to the lowest dose, I never do. If you were feeling pretty good on Lexapro before your symptoms returned it me be worth trying a higher dose.
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#5 In_Remission_blindfaith

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Posted 05 February 2012 - 09:45 AM



Well, if you went off of it because it seemed to be pooping out on you then I'm guessing that you didn't ask your pdoc or PCP what to do about your returning symptoms so you can't be sure if it really pooped out on you or if you just needed for your dosage to be raised.

It's hard to tell what level of effectiveness Lex would have on you without knowing if it actually pooped out on you or not. At any rate, when you see a pdoc you should tell them about this and the dosage that you were taking so they can make an educated decision about whether to try the Lex again or to switch you to another antidepressant.


Thank you. You are correct, I didn't really speak to my doctor about the returning symptoms; I just figured I would manage without it and taking Klonopin as needed. I was taking Lexapro 10mg. I guess "pooping out" by definition means that even with a dosage increase it no longer works, in which case, having not tried a higher dosage, we can't say for sure it pooped out? Am I understanding correctly?

My PCP (no pdoc - I live in Canada and seeing a pdoc is much more difficult where I am) will probably think we could try Lexapro at a higher dosage or a whole new AD. It seems this is so "your mileage may vary" it may just be a trial and error thing?


What you say is correct. You could still try increasing Lexapro to 20mg. Some people don't respond to the lowest dose, I never do. If you were feeling pretty good on Lexapro before your symptoms returned it me be worth trying a higher dose.


Thank you. I think I will do this. I'm seeing my doctor soon so I will discuss this with him - I'm open to trying other meds, but since I was doing well on Lexapro before my symptoms returned it makes sense to give it another go at a higher dosage first. Thank you!

#6 Rockie

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Posted 05 February 2012 - 01:09 PM

Here's Jerod's expansive explanation of SSRI poop-out. Yes, I'd try Lex again if you didn't try raising the dosage when your symptoms returned.
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#7 In_Remission_blindfaith

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Posted 06 February 2012 - 02:39 PM

Here's Jerod's expansive explanation of SSRI poop-out. Yes, I'd try Lex again if you didn't try raising the dosage when your symptoms returned.


Thank you! Would you try it at the same dosage (10mg) or would you want to move to a higher dosage right away/shortly after starting?

#8 Rockie

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Posted 06 February 2012 - 04:44 PM


Here's Jerod's expansive explanation of SSRI poop-out. Yes, I'd try Lex again if you didn't try raising the dosage when your symptoms returned.


Thank you! Would you try it at the same dosage (10mg) or would you want to move to a higher dosage right away/shortly after starting?


I'd try it at the same dosage, if only to minimize side effects. You've also had almost eight months off meds to allow your brain to return to baseline, so I think it's reasonable to think that the lower dosage could work for you again.

Also (per my pdoc), there's increasing data showing that lower dosages are as effective, over time, as higher dosages. In other words, it's not necessarily true that moving directly to a "therapeutic" dosage will work better than a sub-therapeutic dosage. The exception being that you do actually need more of the med to feel better, at which point you'd raise the dosage. The big take-away here is greater tolerability at lower dosages, but with the same efficacy.

If you do see some improvement after three or four weeks, but not enough, you can always raise the dosage or let it soak a while longer. If there's no improvement at all, I'd start thinking about switching to a different med.

Hope this makes sense and the Lex works out for you (again).

Edit: Just wanted to add that the stuff about lower dosage efficacy is obviously not entirely true for meds that do different things at different dosages. For example, Seroquel is an antihistamine at lower dosages, an AD at mid dosages, and blockades dopamine at high dosages, though I'd think that the same rule would apply within each dosage range.

Edited by Rockie, 06 February 2012 - 04:55 PM.

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AD's: Prozac, Zoloft, Paxil, Luvox, Celexa, Cymbalta, Effexor, Lexapro, Wellbutrin, Remeron, Emsam, Imipramine, Nortriptyline,Trazodone, Viibryd, Nefazadone
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#9 In_Remission_blindfaith

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Posted 06 February 2012 - 07:10 PM



Here's Jerod's expansive explanation of SSRI poop-out. Yes, I'd try Lex again if you didn't try raising the dosage when your symptoms returned.


Thank you! Would you try it at the same dosage (10mg) or would you want to move to a higher dosage right away/shortly after starting?


I'd try it at the same dosage, if only to minimize side effects. You've also had almost eight months off meds to allow your brain to return to baseline, so I think it's reasonable to think that the lower dosage could work for you again.

Also (per my pdoc), there's increasing data showing that lower dosages are as effective, over time, as higher dosages. In other words, it's not necessarily true that moving directly to a "therapeutic" dosage will work better than a sub-therapeutic dosage. The exception being that you do actually need more of the med to feel better, at which point you'd raise the dosage. The big take-away here is greater tolerability at lower dosages, but with the same efficacy.

If you do see some improvement after three or four weeks, but not enough, you can always raise the dosage or let it soak a while longer. If there's no improvement at all, I'd start thinking about switching to a different med.

Hope this makes sense and the Lex works out for you (again).

Edit: Just wanted to add that the stuff about lower dosage efficacy is obviously not entirely true for meds that do different things at different dosages. For example, Seroquel is an antihistamine at lower dosages, an AD at mid dosages, and blockades dopamine at high dosages, though I'd think that the same rule would apply within each dosage range.


Thank you so much for the detailed responses. I really appreciate it. I'm starting Lexapro again at the same 10mg dosage. The reason I asked if I should use the same dosage is because it seemed to stop working for me last time - but, as you said, perhaps my brain has had time to get back to "baseline" again :mad: I'll give this a good 3 - 4 weeks and then talk to my doctor about dosage if needed. Thank you! I hope this works for me too.

I hate that this stuff is so "your mileage may vary" and individual. The prospects of trying new medications are always scary!

#10 In_Remission_blindfaith

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Posted 07 February 2012 - 04:41 PM

Just one more question - when it comes to real poop out (where even higher dosages no longer work for you), is there any chance the med will work for you again in the future after a break from it, or does it typically not work ever again?

#11 Rockie

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Posted 07 February 2012 - 09:55 PM

Just one more question - when it comes to real poop out (where even higher dosages no longer work for you), is there any chance the med will work for you again in the future after a break from it, or does it typically not work ever again?


That's a hard one. I think the short answer is that no one really knows.

Given the lack of knowledge on the specific cause of med poop-out - not to mention the numerous variables involved between initial treatment and re-treatment - I think the question becomes more of a logic puzzle than anything else. That is unless your pdoc subscribes to a particular school of thought on the subject and will give you a simple yes/no answer.

Personally, I'd probably be averse to re-trying a med that pooped out on me at the highest dosage unless there was strong evidence in favor. That and if the initial side effects didn't suck so bad. For instance, I'm currently in the process of re-trying meds, now that I'm on a mood stabilizer. Hopefully I'll get different responses this time around other than just general dysphoria.

Paxil and Viibryd? Never again.
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AD's: Prozac, Zoloft, Paxil, Luvox, Celexa, Cymbalta, Effexor, Lexapro, Wellbutrin, Remeron, Emsam, Imipramine, Nortriptyline,Trazodone, Viibryd, Nefazadone
AED's: Topomax, Trileptal, Klonopin, Ativan, Lamictal, Oxazepam, Triazolam
AP/AAP's: Seroquel
Other: Buspar, Ambien, Nadolol, Propranolol, Pramipexole, Hydroxyzine

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