Waves,

I apologize.

I do not understand.

Mari

I expect that most of the time I do not make sense.

You make sense. Your words make sense.

What I didn't understand is what you were replying to. (Maybe you weren't replying, you were just posting. Fine)

What I further don't understand, is why NOBODY seems the slightest bit concerned or interested in my starting a new med.

I am being absurd. This is absurdly needy.

But it really really hurts.

waves. It's OK.

I've known you a very long time now and yet I'm not sure how to answer because I know very little about Lexapro.

Are you wanting to increase because you feel the dose is not high enough to help you at the moment or has your doctor told you to increase and you're not sure that you want to do that because it might make your nausea worse?

How is your nausea after being on it a week now at the 3mg dose?



We all care about you.

Thanks Lara.

Lexapro is an SSRI and I do not react well to all SSRIs -- Zoloft is fine; Paxil makes me manic. I've taken Celexa before, which is the "unrefined" version of Lexapro, but it was 20 years ago and I react differently to some drugs now.

Celexa gave me nausea. Lexapro is the same drug as Celexa, chemically, minus the the nasty non-therapeutic side-effect causing molecules. Statistically, Lexapro causes nausea in fewer patients than does Celexa, so the hope is that it might be fine.

The usual starting dosage is 10 mg. Therapeutic range is usually between 10 and 20 mg. We agreed on starting low, at 5 mg (below therapeutic range), to be cautious in case of side effects (mania, nausea). Then we found an itneraction with my stomach med and so tweaked it down to 3mg.

I am having intermittent nausea. It was quite bad on the first few days but it could have been food related. I had nausea at times before starting the med, so it is hard to say. It doesn't seem to fall at the peaks after taking the medication, but still hard to say.

I'm leaning on increasing to 5 mg... either the nausea will get worse or stay about the same. Usually one doesn't increase until reaching steady state, which won't be for another 3 days, but I am in a hurry, and it seems reasonable if nothing horrible has happened.

I should not hurry but I'm very interested in the anti-OCD effects besides the anti-depressant ones -- and they take longer to kick in.

=========
All of my fingertips are raw and nailbeds are starting to get ruined from my biting them. I cannot get it under control. I cannot stop ripping them apart (and they hurt! ). This is a type of hypergrooming behavior and it is a compulsion. I even interrupt typing to bite and pick. Only time I do not is when I cook -- and then it usually hurts like mad, esp when I have to cut lemons, onions, garlic.... but even just wetting them hurts.

waves

5mg is not that much more than 3mg especially if you were prescribed 10mg as starting dose.

I was on Zoloft for a while many years ago and I know that gave me nausea at the dose I was told to start on, but I remember taking it down and going up very slowly.

Have you ever thought about CBT for some of these issues? 3 of us here have various degrees of obsessive compulsive behaviours. I'm good these days. Daughter struggles and she does the same thing to the nails as you're doing right now. Actually when my son was little he used to bite his nails so badly they'd bleed. I tried all sorts of things to stop it including putting that liquid they sell for nail biting that is bitter. In the end he just had to put bandaids on all of them to stop them bleeding more.

Just curious but have you always had this problem or is it relatively new? I was wondering if maybe some other med you might be taking needs tweeking.

I understand the concerns you have about the SSRIs and mania.

You're in a bit of a pickle really aren't you.

I was prescribed 5mg to start, not 10, which is the usual. Then the 5 was changed, because my taking 3 is really like taking 5, due to a med interaction.

I think I will go up to 5mg, and then see. I really should go up to 6 which would be about the 10mg dose, but I have 5 halves of 10mg pills (I cut them and took one before reading about the interaction, and getting the drops that are 1mg per drop).

My doctor intends for me to titrate upwards. I am to manage the timing based on side effects. I am only meant to report back what I am doing, and if there is any problem.

Yeah, that's partly why I was started low, because the Celexa is known to cause me nausea in the past. Zoloft only gives me nausea at high doses but if I take it with food it helped somehow, even if that actually increases the levels. Zoloft has given me headaches when starting the past few times, even at 25mg, hence the decision to try the Lexapro.

Lexapro isn't affected by food, absorption-wise, but my eating is erratic so I haven't bothered trying to synchronize it with a meal.


waves

My therapist supposedly does a CBT-based thing, but when I asked him about the skin eating/picking, he said he had never been presented with this sort of problem! We did talk about it a bit. I can't see him regularly now anyway I can't afford it.

All of my fingers are bleeding. I don't bite the nails -- I bite the skin.

The bitter stuff didn't help me. 1) it hurts on bleeding skin. 2) It's only a deterrent until I put it in my mouth the first time. After the first horrible bite, the bitter taste lingers in my mouth, so sticking my fingers in there again doesn't make it much worse... nothing to lose.

I've bitten as long as I can remember. As a child, I went through phases with my knuckles as well. I would bite/pick the feet too. For about a year when I was 8 I also plucked out my eyebrows and eyelashes but that stopped completely. The fingertips have always been a target though. From my teens on, I was able to get control of it. I'd have spells where it would get bad, and then I could focus and get it under control.

I am doing the things I usually do that help, but still can't get it under control this time. It is worse than it has ever been in my adult life. It has now been going on/escalating for a year. While I was in the US, I was using a strong anxiolytic. Even that didn't stop me. I've deformed several more nailbeds over this past year.

Sounds awful waves.
Try the bandaid trick.
Another distraction is rubber bands around the wrist.
This will probably sound strange, but if you catch yourself biting you can ping the rubber band. It will change the pattern of the biting after you've done it over time. You don't need to hurt yourself with the rubber band pinging, just fairly gently. It's like side tracking a circuit.

p.s. long past my bed time here.
I wish you all the best with putting up your dose of the Lexapro.
I hope you have a much better day and that things will improve for you.

night.