paul_harris_105

Hi All,

So about 2.5 weeks ago I got a prescription for up to 3mg Xanax XR/day
as well as 20mg lexapro. I told my pdoc that I was going to wait up
to a month to start taking the lexapro cause I was going through a
real stressful time and just couldn't afford any SSRI startup anxiety
and other side effects.

I started up at 1mg first thing in the morning, which I could feel but
didn't really do much. I'd wake with terrible anxiety and it'd take
about 2 hours for the XR to kick in. I stayed at 1mg for a couple
days (with lots of .25/.5 mg reg xanax as needed) and moved up to 2mg.

At 2mg my panic attacks were very much reduced, but I was still very
anxious driving and had a horrible time in the morning. Things were
more or less berable and I only had to take a few .25 mg boosters.
The biggest problems were mornings which again seemed to be real
anxious time until about 2 hours or so after I took the XR.

After about 3 days I finally went up to 3 mg. I was still pretty
anxious driving and out in certain public places, but I could
definetly deal with it. Long drives were uncomfortable but I could
muddle through them (though I'd end up sweating a ton, light nausea
and anxiety). Still had the morning anxiety though not quite as bad
as with the other dosages.

This was all during probalby one of the worst weeks of my life and
with having to drive about an hour + a day (which is a lot more then I
usually do). After 6-7 days I decided I was either going to have to
up the dosage to 4 mg or just start taking the Lexapro and have a
horrible time until it finally kicked in (if it ever did).

I decided to start up the Lexapro at 2.5 mg right before bed. I don't
recall if it was the very next morning or the morning after that but I
woke up with no anxiety. I was able to drive around with no
PAs/anxiety/nausea. Couldn't feel any of the usual side effects of
SSRI, I just felt more or less normal. I had taken a single 10 mg
pill of Paxil a few weeks before to see if I could go back on it (40
mg was my previous dosage and that worked well) and that caused me a
good 3-4 days of nausea and horrible anxiety.

I've been at this for about 5 or so days now, 2.5 mg Lexapro with 3 mg
Xanax XR and have felt fine and this is all with tons of driving and
lots of normally PA inducing situations.

Anyways sorry for the long build up but does anyone have any idea what
stopped the PAs? I can't imagine an SSRI at such a low dosage would
do anything let alone within a few days. Did the Xanax XR just take a
week to really kick in? My situation hasn't changed as far as amount
of driving and being out in public places (if anything I've been
driving and going out more), but I'm still feeling fine.

I'm not really complaining just very curious as to what could've done
it. About the only side effect of all this is sleepiness in the later
afternoon (3-4 PM) but that goes away after about 30 minutes or so if
I don't take a nap.

I'm trying to decide what to do next. I figured I could up the
Lexapro to 5 mg, cut the XR to 2 or 2.5 mg or a combination of the
two. I don't want to cut the XR only to start back up with the PAs
but I'm rather curious to see if 2.5 mg of Lexapro could possibly be
enough for me.

Anyone out there have any experience with this combo? Anyone have a
low dosage of Lexapro stop your PAs and/or Xanax XR taking a week to
kick in?

On a somewhat related note I have to give 2 ****** up to Xanax XR
compared to the regular Xanax, its by far much less of a roller
coaster ride, no up and down every 4-5 hours which I think tended to
make things worse sometimes.

Anyways thanks for reading,
---
Paul

thunderbird70

I would assume that the Xanax XR (Time Release Xanax) did the trick for
you. The Lexapro takes 2-3 weeks for it to get into your system to work
(unless Lexapro works faster than the other SSRI's, this I am not
certain of). Xanax is a proven drug to prevent panic attacks, while
Lexapro is still a fairly new drug, and I dont believe that all the
reports are in from people taking this drug.

Why not just stick with the Xanax? The less medicine you take, the
better, and I have a feeling that the Xanax is preventing your panic
attacks. This is just my opinion, and I remember taking Lexapro for one
month, and was feeling fine, but then I felt awful...and the doctor and
I can't figure out what happened. I still believe that the benzo's are
far better than the SSRI's, and Klonopin or Xanax are the drugs to
control panic and anxiety. The anti-depressants , I feel, are for people
who are feeling very sad and suicidal. Prozac turned me into a living
zombie, but I finally stopped taking that horrible drug. I take Ativan
and Klonopin, but I think the Ativan works better for me.
Keep feeling well Paul.

Rick A

paul_harris_105

Thanks for the reply.

Well my experience with Xanax (both reg and XR) was that it tended to
reduce many of the symptoms of the PAs/anxiety but not stop them. It
basically tuned down all the symptoms, but I still felt them. When I
was on Paxil it eventually (took a few months and lots of startup side
effects specially anxiety) stopped the PAs cold. I would drive and
not even think about having any problems.

I'm not anti benzo or pro SSRI, but again the main point is that it
seemed that the PAs only stopped when I started taking the very low
dosage Lexapro. There's not that much out there (or at least that I
could find) on people taking Xanax XR. It just seemed odd that I take
3 mg XR for 1 week and feel one way (anxiety reduced, but real bad in
the morning) and then just add 2.5 mg of the Lexapro and no more
anxiety even in the morning.

If I knew it was totally the Xanax XR and it just took over a week to
kick in then I'd be fine sticking with the Xanax XR.

If I knew it was the Lexapro just kicking in real fast then I'd start
tapering off the Xanax and upping the Lexapro as/if needed.

My goal is to take just one medication and at the minimum dosage that
works. I don't doubt that I'll eventually get the right mix, I just
posted here so that I could avoid making any mistakes that would cause
the PAs/anxieties to kick back up.
---
Paul