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Suggest Treatment For Depression While On Lexapro
Question: My 19 year old daughter sees a psychologist and she recommended an anti depressant because of suicidal thoughts. She is also scheduled to return to school in a week. Is it reasonable to start such medication when I cannot monitor her. Is Lexapro or Celexa a reasonable start and what is the minimal effective dose?
Brief Answer:
Consultation
Detailed Answer:
Hello, and thanks very much for your premium question.
I'm sorry your daughter is having suicidal thoughts. The doctor who evaluated her must have thought she did not need immediate hospitalization, which is sometimes the case. In cases like this, it is deemed safe for her to return home and start a medication.
Lexapro or Celexa are both very reasonable choices.
The starting dose of Lexapro is 5mg. The minimum effective dose is different for each and every person who takes it. Some people only need 10mg daily. Others need up to 20mg daily. The case is the same for Celexa, though the doses are different: the starting dose is 20mg, and the maximum dose is 40mg.
Both medications are effective at treating depression. If her mood does not improve in 4-6 weeks, she should consider switching to a different medication. This strategy is often helpful. Don't worry, she will get better.
In the future, for continuity of care, I encourage you to contact me at my private link below, because we receive nearly double the payment from this website for direct questions, and after asking a direct question it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, or individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Consultation
Detailed Answer:
Hello, and thanks very much for your premium question.
I'm sorry your daughter is having suicidal thoughts. The doctor who evaluated her must have thought she did not need immediate hospitalization, which is sometimes the case. In cases like this, it is deemed safe for her to return home and start a medication.
Lexapro or Celexa are both very reasonable choices.
The starting dose of Lexapro is 5mg. The minimum effective dose is different for each and every person who takes it. Some people only need 10mg daily. Others need up to 20mg daily. The case is the same for Celexa, though the doses are different: the starting dose is 20mg, and the maximum dose is 40mg.
Both medications are effective at treating depression. If her mood does not improve in 4-6 weeks, she should consider switching to a different medication. This strategy is often helpful. Don't worry, she will get better.
In the future, for continuity of care, I encourage you to contact me at my private link below, because we receive nearly double the payment from this website for direct questions, and after asking a direct question it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, or individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you Doctor! If Lexapro/ Celexa do not work as hoped, do you have a suggestion for an alternate medication. She does have some anxiety, though she is reasonably well functioning socially and is physically in good condition. She is 5'5" and 115-120 lbs so weight gain would be of little concern on specific side effects. She is not sexually active so libido is also of little concern. She rarely drinks, perhaps one or two drinks a few times over the last several months, but I do worry about that at college. We have pretty open communication so I am comfortable with my assessment above. I do worry about sleep issues since school is demanding, a Poly Sci major at Villanova. While she has admitted to suicidal thoughts, I do not believe she has come anywhere near an attempt but she does feel she should go on medication. I welcome your thoughts. Once I use up this session Up, will take you up on your direct site as I feel second opinions are important here. Thanks again
Follow up
Brief Answer:
Followup
Detailed Answer:
You are most welcome!
I have read over your daughter's description in detail. I do have suggestions if Lexapro or Celexa are ineffective. Typically in my practice, I will begin by offering either Lexapro or Zoloft as first-line medications. I then move on to Celexa or Prozac. This exhausts my preferred options in the SSRI class. I would then move on to an SNRI, and would first offer Effexor, followed by Pristiq, followed by Cymbalta. If all of that fails, I would choose the most effective of the above and pursue augmentation strategies such as adding Wellbutrin or Lithium. This strategy would apply to your daughter's case as well.
There are other things I would consider, like specific side effect worries, family history of medication response, and specific depressive symptoms. The more information you provide and the more I learn about your daughter, the more specific my recommendations can be.
I look forward to hearing from you at my private link. I'd be happy to take on your daughter's case in more detail.
Dr. Sheppe
tinyurl.com/DrSheppeAnswers
Brief Answer:
Followup
Detailed Answer:
You are most welcome!
I have read over your daughter's description in detail. I do have suggestions if Lexapro or Celexa are ineffective. Typically in my practice, I will begin by offering either Lexapro or Zoloft as first-line medications. I then move on to Celexa or Prozac. This exhausts my preferred options in the SSRI class. I would then move on to an SNRI, and would first offer Effexor, followed by Pristiq, followed by Cymbalta. If all of that fails, I would choose the most effective of the above and pursue augmentation strategies such as adding Wellbutrin or Lithium. This strategy would apply to your daughter's case as well.
There are other things I would consider, like specific side effect worries, family history of medication response, and specific depressive symptoms. The more information you provide and the more I learn about your daughter, the more specific my recommendations can be.
I look forward to hearing from you at my private link. I'd be happy to take on your daughter's case in more detail.
Dr. Sheppe
tinyurl.com/DrSheppeAnswers
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Raju A.T
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