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Question: I am on Lexapro 30 mg. Solian (amisulpride) 100 mg, Klonopin 2 mg and Keppra 1000mg as mood stabilizer. I have some phobia and OCD symptoms due to some effect of amisulpride in 5HT7 and 5HT2b receptors and dopaminergic activity. I was on Lexapro 20 mg until last week and since some days i am on Lexapro 30 mg, because my psychiatrist decided a higher dosage since at 20 mg my improvement is more or least 70 % but i still have effects od some phobi/OCD. Now i feel an improvement of 80 % but my psychiatrist said that if i don't have next week a full improvement, he will try a higher dosage of Keppra to help the metabolism of Lexapro. My question is: if there's no a 100 % improvement, a higher dosage ok Keppra is good, or it's better a higher of Lexapro ( i am probably poor metabolizer for cyp2c19)?
Thanks beforehand
Thanks beforehand
Brief Answer:
I think higher dose of lexapro better option
Detailed Answer:
Hello,
Thanks for using Healthcaremagic.
I read your query and understand concerns expressed by you.
In my view improvement in OCD takes more time in compare to other psychiatric disorders and enough time should be given before going to higher dosage. I mean to say that you only had one week with 30 mg and plan to increase the dose of one or another in a week seems somewhat rapid which is unwarranted. I feel that with a particular dose, especially higher dose, more time should be given to the patient with a dose. With 30 mg lexapro I recommend three to six weeks or average four weeks before making a prescription of higher dose.
If you ask me to choose one of the option, that you provided, I will go for the higher dose of Lexapro rather than Keppra. I agree that Keppra alters the metabolism of lexapro to some extent but from the experience of last two months we know more about the beneficial effect of Lexapro rather than Keppra. Similarly Lexapro is anti OCD medication while keppra is just an adjunctive medication in OCD.
'Hope I have answered your query. If you have any further questions I will be happy to help".
Thanks
I think higher dose of lexapro better option
Detailed Answer:
Hello,
Thanks for using Healthcaremagic.
I read your query and understand concerns expressed by you.
In my view improvement in OCD takes more time in compare to other psychiatric disorders and enough time should be given before going to higher dosage. I mean to say that you only had one week with 30 mg and plan to increase the dose of one or another in a week seems somewhat rapid which is unwarranted. I feel that with a particular dose, especially higher dose, more time should be given to the patient with a dose. With 30 mg lexapro I recommend three to six weeks or average four weeks before making a prescription of higher dose.
If you ask me to choose one of the option, that you provided, I will go for the higher dose of Lexapro rather than Keppra. I agree that Keppra alters the metabolism of lexapro to some extent but from the experience of last two months we know more about the beneficial effect of Lexapro rather than Keppra. Similarly Lexapro is anti OCD medication while keppra is just an adjunctive medication in OCD.
'Hope I have answered your query. If you have any further questions I will be happy to help".
Thanks
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Above answer was peer-reviewed by :
Dr. Raju A.T
Answered by
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