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What Are The Effects Of High Dose Of Lexapro?

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Posted on Tue, 30 Sep 2014
Question: I am on Lexapro 10 mg since two weeks, Klonopin 3 mg, Keppra 1000mg as mood stabilizer and Solian (amisulpride) 100 mg. I've been told that Solian in low dosage (100 mg) can cause some OCD symptoms, it happens to me and it happens to at 200 mg (worse than 100 mg). Against these OCD symptoms cause by antagonism of 5HT7 and 5HT2b and maybe dopaminergic activity my psychiatrist decided to give me a higher dosage of Lexapro, 10 mg, since i was on 2.5 mg. I am a poor metabolizer for cyp2c19 and probably mild por cyp2d6, so i would like to know if since i am poor metabolizer Lexapro 10 mg means to me that in fact i am taking a higher dosage (maybe 20 mg, more or less).
Thanks beforehand, XXXXXXX
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Answered by Dr. Dr. Chintan Solanki (4 hours later)
Brief Answer:
Yes,actual serum concentration will be high

Detailed Answer:
Hi XXXXXXX

Welcome back.Thanks for using healthcaremagic and thanks also for intelligent and clear question.

Lexapro is metabolised by the cytochrome P450 (CYP) isoenzymes CYP2C19, CYP2D6 and CYP3A4.

Studies suggest that the genetic polymorphisms in CYP2C19 may be influencing escitalopram(Lexapro) serum concentrations, and that specific CYP2D6 polymorphisms may be predicting patient treatment outcomes based on gene dosage analyses.

In your case you are taking 10 mg dose at present.Being poor metabolizer for CYP2C19, your serum concentration of active metabolite gonna be high.Exactly how much that can not be mentioned without tests but roughly 45-50% higher than them who has normal metabolism.

In OCD symptoms generally higher dose of SSRI required as I mentioned in our last conversation.I was already aware about your CYP problem and that's why I told you to go up to 20 mg which ultimately at pharmacological level is equivalent to 30 mg.

Hope I have answered your query, I will be happy to help further.

Regards.
Dr.Chintan Solanki.
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Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Dr. Chintan Solanki

Psychiatrist

Practicing since :2007

Answered : 2407 Questions

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What Are The Effects Of High Dose Of Lexapro?

Brief Answer: Yes,actual serum concentration will be high Detailed Answer: Hi XXXXXXX Welcome back.Thanks for using healthcaremagic and thanks also for intelligent and clear question. Lexapro is metabolised by the cytochrome P450 (CYP) isoenzymes CYP2C19, CYP2D6 and CYP3A4. Studies suggest that the genetic polymorphisms in CYP2C19 may be influencing escitalopram(Lexapro) serum concentrations, and that specific CYP2D6 polymorphisms may be predicting patient treatment outcomes based on gene dosage analyses. In your case you are taking 10 mg dose at present.Being poor metabolizer for CYP2C19, your serum concentration of active metabolite gonna be high.Exactly how much that can not be mentioned without tests but roughly 45-50% higher than them who has normal metabolism. In OCD symptoms generally higher dose of SSRI required as I mentioned in our last conversation.I was already aware about your CYP problem and that's why I told you to go up to 20 mg which ultimately at pharmacological level is equivalent to 30 mg. Hope I have answered your query, I will be happy to help further. Regards. Dr.Chintan Solanki.