[Hopeful 285]

Lexximom,
You are tapering too fast. You need to get off both pills (one at time).
People on this thread are only tapering 5 percent at a time. Some of them on their 1st decrease may taper 10 percent.
I am not an expert with tapering since I quit cold turkey. I quit in November and progressively got worse and ended up in the Emergency almost a month later and I still haven't recovered. I'm better than I was. My doctor told me It wouldn't hurt me and I would just be sick for a few days.
Someone else that tapered will help you get off but for now until someone else answers you, shave off a little with a fingernail file each day. You really have to go slow.
You usually spend as much time getting off of these drugs as you've spent taking them. You may need to go slower since you are so sick.
Read the other posts. There is a lot of information on tapering. Someone will answer soon.

[Hopeful 285]

Thank you Elizabethmaria,
That was so sweet of you. You don't know how much that meant to me that you said the Chaplet of Divine Mercy for me.
They used to have the Divine Mercy picture at my church and I loved it. It was a great visual for me when I prayed. They removed it because our priest thought we had too many pictures. He is a wonderful priest. I wish he hadn't taken the picture down.
St. Faustina showed great faith through her illness. She is a great example.

I am glad you like the posts.

[Hopeful 285]

Hairyarmadillo,
I just wanted to say if you are considering the 2 prozac pills as TNB suggested, remember you are on only 2.5 mg and according to the article you are supposed to take the equivalent of what you are taking, not a whole pill. So if my math is right, it would be 10 mgs of Prozac. If you are wanting to do this, you could wait until you cut your dose more so you would be taking less of the Prozac.
I don't know if I would recommend taking the Prozac, but I don't want you to take too much and cause yourself deeper problems.
There are people who have only taken one Prozac and had problems.
Everyone is different and this states that you may have a problem. Before doing anything pray about it, think about it.

Lexapro (escitalopram)-Very similar to Celexa. Ten milligrams of Lexapro is equivalent to 40 mgs of Celexa.

MANAGEMENT OF WITHDRAWAL

Withdrawal from SSRIs is something to be done in consultation with your physician. You may wish to show this to your GP. Over-rapid withdrawal may even be medically hazardous, particularly in older persons.

Convert the dose of SSRI you are on to an equivalent dose of Prozac liquid. Seroxat/Paxil 20mg, Efexor 75mg, Cipramil/Celexa 20mgs. Lustrat/Zoloft 50mgs are equivalent to 20mg of Prozac liquid. The rationale for this is that Prozac has a very long half-life, which helps to minimise withdrawal problems. The liquid form permits the dose to be reduced more slowly than can be done with pills.

Stabilise on the Prozac for a week, then halve the dose.

If there has been no problem with step 2, the dose can be further halved. Alternatively if there has been a problem from this point on the dose can be reduced even more slowly in weekly increments.

From a dose of Prozac 10mgs liquid, consider reducing by 1mg every few days over the course of several weeks - or months if need be. With Prozac liquid this can be done by dilution.

If there are difficulties at any particular stage the answer is to wait at that stage for a longer period of time before reducing further.

Withdrawal and dependence are physical phenomena. But some people can get understandably phobic about withdrawal particularly if the experience is literally shocking. If you think you may have become phobic, a clinical psychologist may be able to help manage the phobic problem.

Self-help support groups can be invaluable. Join one. If there are none nearby, consider setting one up. There will be lots of other people with a similar problem.

There is anecdotal evidence and some theoretical grounds to believe that another option is to substitute St John's Wort for the SSRI. If a dose of 3 tablets of St John's Wort is tolerated instead of the SSRI, this can then be reduced slowly - by one pill per fortnight or even per month.

[tavee]

Hopeful And Hairyarmadillo- Let Me Add My Comments By Saying

Do Not Take St. Johns Wort While U Tapering From This Drug Until U Are Off It One Year. It Can Be Deadly. That Also Is The Case With Sam E.

Dr Tavee

[Hairyarmadillo]

Hopeful I am tearing up over your post where you said "I really felt like my spiritualality was damaged. I couldn't feel the Holy Spirit." I have shared many things on this forum but don't think I ever got up the nerve to mention this. I know I even started a post on my spiritual issues but think I stopped halfway through. I have been in the same state spiritual wise and am on the totally different side of the spectrum now than I was prior to the Paxil/Lexapro. I have a hard time praying. I have a hard time even believing anymore. I have to force my spiritual interaction and I know this is not helping. I can pray for other people but my daily prayer life has changed greatly. I used to be in almost constant conversation with God -took time throughout the day to give praise. Now it just doesn't come easily.

I have been off the 2.5 mgs since Tuesday. I know this was a big drop after only a little over a week, but the pill size was not the same size since I could not get the same amount slivered off. I felt like I was doing more harm than good by taking a slightly higher dose one day, then a lower dose the next. I am off this next week for Spring Break so I am going to sleep as much as needed, hoping this will help. I do think the Prozac dosage makes sense and am suspecting this is way to go. I had wondered after reading that article but tmb's post leans even more credibility to that theory. I am going to try to tough it out though. I had thought I had the "Lexapro flu" and have been sleeping a lot. Then today I woke up with stomach issues and throwing up. I am thinking I have picked up one of the bugs my students had. So, maybe I am lucky and some of these feelings are a stomach virus. LOL I never thought I would be happy to have a stomach virus! I would rather have that than be suffering from withdrawal effects. I guess time will tell

[quitter]

Hi I'm new here. About 3 weeks ago I stopped taking my Lexapro (20mg) and Wellbutrin (300mg). I've been on them for nearly 2 years, and finally decided it was time to stop. I want to handle things myself instead of relying on pills. I'm doing pretty well considering the dosages I was on and the fact that I just quit cold turkey. I haven't had any physical symptoms (I definitely did 2 years ago when I got off Effexor--and that was with a step-down program from my doctor--that was terrible). I've been a little short-tempered and weepy (and I overreact to things)--ok and I had a SMALL panic attack yesterday--which I think is partially due to the withdrawal, but I can't be sure the extent because I'm on my period too, so that's a part of it...

My question is, have any of you had the same experience as me? I didn't have any reactions getting on the Lexapro or Wellbutrin, didn't have any problems on the drugs, and haven't really had any problems *yet* after stopping. Am I off scott-free or will I start having problems later on? Does anybody know? I want to be prepared for what I might experience.

Any help would be greatly appreciated!

[sctschk]

Hi everyone. I have been reading this thread for the past few weeks to see if I could find anyone else who has the same Lex withdrawal symptoms I am. While I have had most of the same, I also have some that are unique and I'm freaking out a bit.

A brief history - I am female, 30yrs old, mom of three kiddos (9yrs, 2yrs, 1yr). At five months after the birth of our third child (last two TOO close together!) I started having panic attacks due to major health anxiety. I have always been the cool collected one of the family, never overreacting and could handle anything life threw our way. I wasn't the crying or overemotinal type, so this panic and anxiety really caught us all by surprise. This is month ten with this anxiety and I'm losing my marbles.

Anywho, I was desperate for help and although I'm not a drug person (the only thing I've ever taken is migraine otc meds) I was prescribed Lexapro. I have never been on an anti-depressant and was scared to take it, but desperation convinced me I had to try SOMETHING. I took 5mg for about 5wks and the side effects were horrendous. The very first dose made me extremely agitated and mad. A few days later, I woke up in the middle of the night with a raging headache. A day or so later I got extreme restless legs at night - they just wouldn't sit still. I knew there would be some side effects, but they kept coming, always worse than the last. Next followed extreme hot flashes and burning feet and legs. I just hoped it would get better. By the end of the first week, I did notice that my anxiety improved during the day but I was still having panic attacks at night because the side effects scared me so badly. Next came the limb jerks - I couldn't sleep because my arms and legs would just jerk away, as well as my head. I called the doc at this point to ask about the twitching and she just said to keep taking them. Another few weeks of this and I had had it. I thought for sure it was giving me some kind of brain damage as I never had these feelings before. When you have health anxiety, any new symptom could have been a fatal disease for me. I was terrified.

At 5 weeks, I had had enough and decided to taper myself off these things. Although 5mg is not a high dose, it seemed too high for me. I then started cutting my pills in half (2.5mg) for about a week and then stopped altogether. I knew it wasn't enough time, but I couldn't stand it anymore. The withdrawal side effects were as horrible, if not worse than being on it. They started at day 3 or 4. I can go on an on about all the stuff I went through during those first two weeks off Lex, (the most disturbing is the jerking and a burning feeling in my feet) but at about a month, they finally relaxed a bit. I thought I was done, but nope. I had one week of feeling better, and then out of the blue, I started having this electrical feeling of buzzing at the bottoms of my feet, totally different from the burning I got used to. This really freaked me out. This has been going on for two weeks now. The buzzing sensation also came with crawling feelings on my left calf - just the one leg. My legs and arms have had periods where they feel like dead weights and I worry about neuroligical problems. Now, I have twitching - it's mostly in my legs, but the other night, it was in my hand that really wigged me out.

I am now 7 weeks off Lex and I'm still scared to death. I even went so far as to have an MRI done just this Friday which I'm still waiting the official results. The technician did tell me he didn't see anything that should concern me. None of this "extra" stuff used to happen until I started taking (and stopping) Lexapro. Is it normal to feel better at one point and then all of a sudden start getting new withdrawal symptoms. My anxiety has skyrocketed through the roof again worrying about all the physical sensations. I woke up just sobbing today not feeling like I can take another day of this hell. My husband is seeing my downfall and is recommending I go back to the doc and get another drug since even he's getting scared. After 7 weeks of this torture, that's the last thing I want to do.

I am taking magnesium and omegas and a multivitamin. Am I the only one who has had this feet buzzing and jerking problem coming off Lex? And why did it suddenly come on out of the blue when I was doing so well? I will never take this again and would rather live with panic attacks, but does it ever end?!!?

Sorry so long - I've been holding this post in for quite some time. HELP.

-Jo

[auntybiotic]

Hi,

Here is more info on testing. You can call the Mayo Clinic and speak with DR. Black's secretary and she will give you the numbers to request for the P 450 Testing on the forms that you take to any hospital lab that is affilated with the Mayo Clinic.thenBlue Cross or any insurance will pay all costs.

Antidepressants: Test shows which may be your best bet
Your genes dictate how you process medications like antidepressants. A blood test can reveal if you process them normally or too slowly or quickly. This helps guide your antidepressant choices.
Figuring out which antidepressant may be best for you has been a matter of trial and error to some extent. To be sure, doctors could make a pretty solid choice based on your medical history, your symptoms and even how your relatives may have responded to the same antidepressant.

But they couldn't predict how the antidepressant would affect you — if you'd wind up with nausea, insomnia or some other side effect, for instance. And you might take a certain antidepressant for several weeks, only to realize your symptoms haven't improved. Doctors also couldn't predict that. So you may have been stuck trying out several different medications over a period of months or even years to find one with the fewest side effects and biggest benefits.

Now the process of choosing an antidepressant may be easier. A relatively new genetic test may help end the sometimes frustrating process of trial and error. This test, called the cytochrome P450 (CYP450) genotyping test, may help you find out how an antidepressant will affect you before you ever swallow the pill.

Testing how your body reacts to antidepressants,

[auntybiotic]

Here is rest of message. Seems like this new forum only allows a certain number of characters.

Testing how your body reacts to antidepressants
The CYP450 test is among a handful of tests that can analyze specific genes that play a role in how your body metabolizes certain medications. It's part of an emerging field called pharmacogenomics, or personalized medicine.

Each of your body's cells contains genes. These genes instruct your body to produce enzymes that control how cells process (metabolize) the medications you take. The CYP450 test identifies the genes responsible for producing enzymes that play an important role in processing certain antidepressants and other medications.

Not everyone processes the same medications the same way. This processing difference is what makes you react differently to an antidepressant than does someone else.

Processing antidepressants too slowly
Your genes may produce enzymes that metabolize an antidepressant too slowly. This means that the medication stays in your body longer than it should. As a result, the medication can build up in your body, possibly leading to intolerable side effects or even a toxic reaction. This, of course, may prompt you to stop taking the medication.

Processing antidepressants too quickly
Your genes may produce enzymes that metabolize an antidepressant too quickly. In this case, the medication is eliminated from your body before it has a chance to work fully. This means that you may not see much improvement in your depression symptoms.

Achieving a balance with antidepressants
If your doctor knows in advance how your body is likely to process an antidepressant, he or she can make a better selection for you or adjust your dose appropriately — before you ever start taking the antidepressant. Your medication choice is personalized to your body's genetics. For instance, if you process an antidepressant too slowly, your doctor may suggest taking a lower dose so that it doesn't accumulate in your body and cause severe side effects.

CYP450 test helps predict reactions to antidepressants
This is where the CYP450 test may help. The test checks to see if two specific genes produce normal enzymes or variants of these enzymes. Which ones you have determine how your body processes certain antidepressants.

Before prescribing an antidepressant, your doctor may discuss with you the option of having the CYP450 test. If you have the test, you and your doctor may know what to expect before you take certain antidepressants. The test helps predict if you're likely to experience harsh side effects or if the antidepressant has little chance of working for you.

The CYP450 test requires only a simple blood draw from a vein in your arm. You don't need to fast before the test or follow other special preparation procedures. You and your doctor will review the results of the test and see how they factor into your choice of antidepressant medication.

Here's how genetic variations can affect processing of an antidepressant and how you and your doctor can decide how to handle them:

Normal metabolizer Slow metabolizer Fast metabolizer
Genetic variation Your genes produce a typical amount of enzyme. Your genes produce too little enzyme. Your genes produce too much enzyme.
Effects on you The antidepressant helps your depression and causes few side effects. The antidepressant builds up in your body, causing intolerable side effects. The antidepressant is eliminated too quickly, providing little or no improvement in depression.
Treatment options Follow the recommended dosage. Switch antidepressants or reduce your dosage. Switch antidepressants or increase your dosage.

Drawbacks of genetic testing for antidepressants
Although it may be a good start in better personalizing treatment to individual situations, the CYP450 genotyping test does have some drawbacks.

One major drawback is that the test can't actually predict if certain antidepressants will improve your depression symptoms. The test can only show which antidepressants probably won't work.

In addition, the test can be used only for certain antidepressants, not all of them. That's because the test is able to check only for two genes that are responsible for metabolizing certain antidepressants. Other genes affect how your body responds to other antidepressants, and the CYP450 test isn't able to check for them.

Here are the antidepressants the CYP450 test can be used for, with their generic names followed by available brand names in parentheses:

Desipramine (Norpramin)
Fluoxetine (Prozac, Prozac Weekly)
Imipramine (Tofranil)
Nortriptyline (Aventyl, Pamelor)
Paroxetine (Paxil, Paxil CR)
Venlafaxine (Effexor, Effexor XR)
These two genes may also influence your reaction to two other medications that haven't been FDA approved for use in depression but that are often used off-label to treat depression. These medications are:

Clomipramine (Anafranil)
Diazepam (Valium, Diazepam Intensol)
Finally, although the cytochrome P450 test has been FDA approved for certain situations, it may not be available in all communities yet. In addition, not all psychiatrists and other doctors routinely use the test.

Other factors also important in selecting antidepressants
If you opt for testing, keep in mind that the cytochrome P450 genotyping test isn't meant to be the only way to determine which antidepressants to try. A thorough medical and psychiatric evaluation, as well as consideration of your preferences and lifestyle, is still important.







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Apr 8, 2007

[auntybiotic]

If you read all the portions on this site it will direct you to the testing. Best to call the Mayo Clinic Psych Department and speak with Dr. Black's secretary. She is so helpful.
Below the list of drugs that are metabolized by a specific cytochrome P450 isoform are the published inhibitors, inducers and genetic influences on that isoform. Drug names are hyperlinks to specific literature references, most of which now include a link to the abstract of the article in the NLM's PubMed database. Also, you click on the PubMed link after the drug name to perform a live MedLINE search of articles possibly related to that drug and Cytochrome P450.

:: View clinically relevant table ::

A quick way to find a specific drug on this page is to use your web browser's Search feature: press Ctrl-F and type all or part of the drug name.

Last Updated: 10/17/2006 15:13:48


1A2 2B6 2C8 2C19 2C9 2D6 2E1 3A4,5,7
amitriptyline
caffeine
clomipramine
clozapine
cyclobenzaprine
estradiol
fluvoxamine
haloperidol
imipramine N-DeMe
mexilletine
naproxen
olanzapine
ondansetron
phenacetin=>
acetaminophen=>NAPQI
propranolol
riluzole
ropivacaine
tacrine
theophylline
tizanidine
verapamil
(R)warfarin
zileuton
zolmitriptan bupropion
cyclophosphamide
efavirenz
ifosfamide
methadone
paclitaxel
torsemide
amodiaquine
cerivastatin
repaglinide
Proton Pump Inhibitors:
lansoprazole
omeprazole
pantoprazole
rabeprazole
E-3810

Anti-epileptics: diazepam=>Nor
phenytoin(O)
S-mephenytoin
phenobarbitone

amitriptyline
carisoprodol
citalopram
clomipramine
cyclophosphamide
hexobarbital
imipramine N-DeME
indomethacin
R-mephobarbital
moclobemide
nelfinavir
nilutamide
primidone
progesterone
proguanil
propranolol
teniposide
R-warfarin=>8-OH NSAIDs:
diclofenac
ibuprofen
lornoxicam
meloxicam
S-naproxen=>Nor
piroxicam
suprofen

Oral Hypoglycemic Agents:
tolbutamide
glipizide

Angiotensin II Blockers:
losartan
irbesartan

Sulfonylureas:
glyburide/
glibenclamide
glipizide
glimepiride
tolbutamide

amitriptyline
celecoxib
fluoxetine
fluvastatin glyburide
nateglinide
phenytoin=>4-OH
rosiglitazone
tamoxifen
torsemide
S-warfarin Beta Blockers:
carvedilol
S-metoprolol
propafenone
timolol

Antidepressants:
amitriptyline
clomipramine
desipramine
imipramine
paroxetine

Antipsychotics:
haloperidol
perphenazine
risperidone=>9OH
thioridazine
zuclopenthixol

alprenolol
amphetamine
aripiprazole
atomoxetine
bufuralol
chlorpheniramine
chlorpromazine
codeine (=>O-desMe)
debrisoquine
dexfenfluramine
dextromethorphan
duloxetine
encainide
flecainide
fluoxetine
fluvoxamine
lidocaine
metoclopramide
methoxyamphetamine
mexilletine
minaprine
nebivolol
nortriptyline
ondansetron
oxycodone
perhexiline
phenacetin
phenformin
promethazine
propranolol
sparteine
tamoxifen
tramadol
venlafaxine Anesthetics:
enflurane
halothane
isoflurane
methoxyflurane
sevoflurane

acetaminophen
=>NAPQI
aniline
benzene
chlorzoxazone
ethanol
N,N-dimethyl formamide
theophylline
=>8-OH Macrolide antibiotics:
clarithromycin
erythromycin (not 3A5)
NOT azithromycin
telithromycin

Anti-arrhythmics:
quinidine=>3-OH (not 3A5)

Benzodiazepines:
alprazolam
diazepam=>3OH
midazolam
triazolam

Immune Modulators:
cyclosporine
tacrolimus (FK506)

HIV Antivirals:
indinavir
nelfinavir
ritonavir
saquinavir

Prokinetic:
cisapride

Antihistamines:
astemizole
chlorpheniramine
terfenidine

Calcium Channel Blockers:
amlodipine
diltiazem
felodipine
lercanidipine
nifedipine
nisoldipine
nitrendipine
verapamil

HMG CoA Reductase Inhibitors:
atorvastatin
cerivastatin
lovastatin
NOT pravastatin
simvastatin

Steroid 6beta-OH:
estradiol
hydrocortisone
progesterone
testosterone

Miscellaneous:
alfentanyl
aprepitant
aripiprazole
buspirone
cafergot
caffeine=>TMU
cilostazol
cocaine
codeine- N-demethylation
dapsone
dexamethasone
dextromethorphan
docetaxel
domperidone
eplerenone
fentanyl
finasteride
gleevec
haloperidol
irinotecan
LAAM
lidocaine
methadone
nateglinide
odanestron
pimozide
propranolol
quetiapine
quinine
risperidone
NOT rosuvastatin
salmeterol
sildenafil
sirolimus
tamoxifen
taxol
terfenadine
trazodone
vincristine
zaleplon
ziprasidone
zolpidem



Inhibitors compete with other drugs for a particular enzyme thus affecting the optimal level of metabolism of the substrate drug which in many cases affect the individual's response to that particular medication, e.g. making it ineffective.


1A2 2B6 2C8 2C19 2C9 2D6 2E1 3A4,5,7
amiodarone
cimetidine
ciprofloxacin
fluoroquinolones
fluvoxamine
furafylline
interferon
methoxsalen
mibefradil
thiotepa
ticlopidine trimethoprim
quercetin
glitazones
gemfibrozil
montelukast
trimethoprim
chloramphenicol
cimetidine
felbamate
fluoxetine
fluvoxamine
indomethacin
ketoconazole
lansoprazole
modafinil omeprazole
oxcarbazepine
probenicid
ticlopidine
topiramate amiodarone
fenofibrate
fluconazole
fluvastatin
fluvoxamine
isoniazid
lovastatin
phenylbutazone
probenicid
sertraline
sulfamethoxazole
sulfaphenazole
teniposide
voriconazole
zafirlukast amiodarone
bupropion
celecoxib
chlorpromazine
chlorpheniramine
cimetidine
citalopram
clomipramine
cocaine
doxepin
doxorubicin
duloxetine
escitalopram fluoxetine
halofantrine
red-haloperidol
levomepromazine
metoclopramide
methadone
mibefradil
midodrine
moclobemide
paroxetine
quinidine
ranitidine
ritonavir
sertraline
terbinafine

ticlopidine
histamine H1 receptor antagonists
diphenhydramine
chlorpheniramine
clemastine
perphenazine
hydroxyzine
tripelennamine diethyl- dithiocarbamate
disulfiram HIV Antivirals:
delaviridine
indinavir
nelfinavir
ritonavir

amiodarone
aprepitant
NOT azithromycin
chloramphenicol
cimetidine
clarithromycin
diethyl- dithiocarbamate
diltiazem
erythromycin
fluconazole
fluvoxamine
gestodene
grapefruit juice
imatinib
itraconazole
ketoconazole
mifepristone
nefazodone
norfloxacin
norfluoxetine
mibefradil
star fruit
verapamil
voriconazole



Inducers stimulate the production of the enzyme thus increasing the rate of metabolism causing the substrate drug to clear out of the system faster. This will also affect the individual's response to the medication, i.e. making he drug ineffective because it has not been in the system long enough to have an effect.


1A2 2B6 2C8 2C19 2C9 2D6 2E1 3A,4,5,7
broccoli
brussel sprouts
char-grilled meat
insulin
methyl cholanthrene
modafinil
nafcillin
beta- naphthoflavone
omeprazole
tobacco
phenobarbital rifampin rifampin carbamazepine
norethindrone
NOT pentobarbital
prednisone
rifampin rifampin
secobarbital dexamethasone
rifampin ethanol
isoniazid HIV Antivirals:
efavirenz
nevirapine

barbiturates
carbamazepine
efavirenz
glucocorticoids
modafinil
nevirapine
phenobarbital
phenytoin
rifampin
St. John's wort
troglitazone
oxcarbazepine
pioglitazone
rifabutin


1A2 2B6 2C8 2C19 2C9 2D6 2E1 3A4,5,7
Chromosome 15 Chromosome 19 Chromosome 10 Chromosome 10 Chromosome 10 Chromosome 22 Chromosome 10 Chromosome 7
N/A Polymorphic Polymorphic Polymorphic Polymorphic N/A N/A
N/A 3-4% Caucasians PMs 3-5% Caucasian PMs , 15-20% Asian PMs 1-3% Caucasian PMs 5-10% Caucasian PMs N/A N/A

[auntybiotic]

Lexapro inhibits the following P 450 Cytochromes:

CYP2CY 19
CYPO 3A
CYO 2D6 by lesser extent
CYP 1 A2

Some charts will not mention all of these Pathways but after extensive research and speaking to many P 450 Cytochrome researchers I have found out the above pathways used by Lexapro.

Do not take any medication that work thru the same pathways or you could run into problems.

[auntybiotic]

Hre is a link to the testing but by getting it done thru any hospital affilated with the Mayo Clinic........most insurance including Blue Cross and Blue Shield will pay. You will need to call the Mayo Clinic to get the request number to ask for the tests. I can't find them right at hand.
Pharmacogenetics
Personalizing Medicine today!

Would you like an information package? Simply complete the request form.
New Web Seminars: Coumadin (warfarin) Genetics and the Prevention of “Oversteer” and Clinical Pharmacogenetics in the Practice of Medicine

Sign up to receive E-mail updates on advances in pharmacogenetics.

Pharmacogenetic testing is the alternative to "one size fits all" and "trial and error" prescribing. Knowledge of patient drug metabolizing gene variants, found in more than half of patients, can help determine the appropriateness and dosage of many of the most commonly prescribed drugs including:

SSRI & TCA antidepressants
opioid pain medications
beta blockers
Type I antiarrhythmics
warfarin
Genelex currently offers straightforward genetic tests that reliably identify and classify CYP2D6, CYP2C9 (with VKORC1 for warfarin),CYP2C19, CYP1A2, and NAT2 into their slow, normal, and ultra-fast metabolizing forms.

Physician Benefits

Maximize treatment success by individualizing patient treatments to match their unique genetic make-up.


Opportunity to build your practice.


Minimize liability by reducing "trial and error" prescribing.


Keep current with the latest advances in genetic science.
Patient Benefits

Increased effectiveness of medication and nutritional supplements.


Optimized safety of prescription regimens.


Improved health.


Proactive in treatment choices.


Pharmacogenetic Effect of
Cytochrome Genotypes



A. PM poor metabolizer, absent or greatly reduced ability to clear or activate drugs.
B. IM intermediate metabolizer. Heterozygotes for normal and reduced activity genes.
C. EM extensive metabolizer. The norm.
D. UM Ultra Metabolizer. Greatly increased activity accelerating clearance or activation

Population Frequency of Cytochrome p450 (CYP) genotypes

Gene PM IM EM UM
CYP2D6 10% 35% 48% 7%
CYP2C9 4% 38% 58% N/A
CYP2C19 3-21% N/A 79-97% N/A

Currently Available Tests

Individualized Patient Reports based on patient drug, herbal and diet regimens

DNA Testing and personalized medicine

ADRs a serious medical problem

The role of genetics in drug metabolism

Ordering Tests

Currently Available Tests
CYP2D6 (cytochrome P450 2D6) is the best studied of the DMEs and acts on one-fourth of all prescription drugs, including the selective serotonin reuptake inhibitors (SSRI), tricylic antidepressants (TCA), betablockers such as Inderal and the Type 1A antiarrhythmics. Approximately 10% of the population has a slow acting form of this enzyme and 7% a super-fast acting form. Thirty-five percent are carriers of a non-functional 2D6 allele, especially elevating the risk of ADRs when these individuals are taking multiple drugs. Drugs that CYP2D6 metabolizes include Prozac, Zoloft, Paxil, Effexor, hydrocodone , amitriptyline, Claritin, cyclobenzaprine, Haldol, metoprolol, Rythmol, Tagamet, tamoxifen, and the over-the-counter diphenylhydramine drugs, Allegra, Dytuss, and Tusstat. CYP2D6 is responsible for activating the pro-drug codeine into its active form and the drug is therefore inactive in CYP2D6 slow metabolizers.

CYP2C9 (cytochrome P450 2C9) is the primary route of metabolism for Coumadin (warfarin) and Dilantin (phenytoin). Approximately 10% of the population are carriers of at least one allele for the slow-metabolizing form of CYP2C9 and may be treatable with 50% of the dose at which normal metabolizers are treated. Other drugs metabolized by CYP2C9 include Amaryl, isoniazid, sulfa, ibuprofen, amitriptyline, Hyzaar, THC (tetrahydrocannabinol), naproxen, and Viagra.

CYP2C19 (cytochrome P450 2C19) is associated with the metabolism of carisoprodol, diazepam, Dilantin, and Prevacid.

CYP1A2 (cytochrome P450 1A2) is associated with the metabolism of amitriptyline, olanzapine, haloperidol, duloxetine, propranolol, theophylline, caffeine, diazepam, chlordiazepoxide, estrogens, tamoxifen, and cyclobenzaprine.

NAT2 (N-acetyltransferase 2) is a second-step DME that acts on isoniazid, procainamide, and Azulfidine. The frequency of the NAT2 "slow acetylator" in various worldwide populations ranges from 10% to more than 90%.

Warfarin (Coumadin)Target Dose Safety Test (2C9 and VKORC1) predicts the maintenance dose of warfarin to within 1.5 mg per day, or less.


Individualized Patient Reports based on patient drug, herbal and diet regimens
DNA test reports can include patient specific information on potential drug drug interactions (DDIs) mediated by the tested polymorphic drug metabolizing enzymes, taking into account patient dietary, OTC and botanical medicines. Testing patients for drug metabolizing enzyme genotypes provides physicians with immediate insight into the vagaries of their patients' drug processing ability, leading to improvements in efficacy and safety of prescribed treatments. This information will be especially valuable when potential drug-drug interactions (DDIs) are a possibility.

DNA Testing and personalized medicine
Genelex's DNA Drug Reaction Tests for the highly polymorphic cytochromes, CYP2D6, CYP2C9, CYP1A2, and CYP2C19. These enzymes process half of the most commonly prescribed drugs, including many with narrow therapeutic indices and frequent participation in drug-drug interactions. (Drug Interaction Principles for Medical Practice, 2nd ed. APPI, 2003) Half of your patients have genetic variations in these genes that lead to altered or absent function resulting in elevated patient susceptibility to adverse drug reactions. Genotyping to avoid ADRs is a dependable tool to improve your practice today and begins your transition to the practice of tomorrow.


ADRs a serious medical problem
In 2000, Genelex began offering physicians an alternative to the "one size fits all" and "trial and error" prescribing of drugs. All too often, a serious adverse drug reaction (ADR) is the result. ADRs are not medical errors, but events that occur in spite of compliance with dosage recommendations. A 1998 meta-analysis of thirty-nine prospective studies in US hospitals estimated that 106,000 Americans die annually from ADRs. (JAMA, 279;1200 1998) Adverse drug events are also common (50 per 1000 person years) among ambulatory patients, particularly the elderly on multiple medications. The 38% of events classified as serious are also the most preventable. (JAMA, 289;1107 2003)

The role of genetics in drug metabolism
It is now clear that virtually every pathway of drug metabolism, transport and action is susceptible to genetic variation. It is estimated that 20 to 95 per cent of individual variability is genetic based. (NEJM 348;529 & 538 2003) Within the top 200 selling prescription drugs, 59% of the 27 most frequently cited in ADR studies are metabolized by at least one enzyme known to have gene variants that code for reduced or non-functional proteins. This compares with 7% of a random selection from the top 200 list. (JAMA, 286,2270 2001) Many other factors such as age, physiological functioning and concomitant disease are known and can be accounted for, leaving the genotype of the patient as a major unknown factor in the prescribing of medicines.

Ordering Tests
Now you can add another dimension to providing safer and more efficacious care to your patients by ordering DNA Drug Reaction Profiles for them. Each pharmacogenetic test is only $250.00, $600 for a standard panel that includes 2D6, 2C9, and 2C19, or $1000 for all five. Five-day stat testing is available for an additional $100. The process couldn't be simpler, we provide you with a cheek swab collection kit and prepaid shipping to return samples to our laboratory. Call 800 523-3080 for more information or to obtain collection kits.

[lexximom]

Thank you so much hopeful 285. wow, i didn't know i'd have to go that slowly. Today i took one whole 25mg , a have of 25mg and a quarter 25mg (excuse my math !) Now i'm thinking i should cut the other quarter in half and take it too.

[sarita-sarita]

elizabethmarie,
thanks for the support. i guess i'm at the 3 month withdrawal? i slept all weekend. it was awesome. i feel much more relaxed and happy so i'm hoping that's all it was. they say making love releases endorphons and seratonin, so my husband was happy to help.

thanks for the quotes. prayer is definetly helpful. i know my spirit was tampered with cause i'm usually very intune but it's finally coming back...

so, aunty says check certain things at the doctor. what do you mean seizures? like shaking pass out things? i used to have those when i was a little girl. why don't you sue? what's happening to your thyroid?

[elizabethmaria]

Dear sctshck (that's a hard one!)

Yes, your reactions are NORMAL! I had the jerking -- really really bad, and so have others on the site here -- it's really embarassing too, I know, and nearly impossible to hide - but it will go away - your nervous system is totally fried and shocked, and it is going to take time to heal...
Yes, you will go through periods of time when you feel almost completely fine, then Wham! sick as a dog ... but that is normal too - so don't spend energy worrying about the symptoms... we'll all be able to write novels about the strange things that happen to us as our bodies heall!! burning sensations I have not had (seizures though).. but I've heard they are a common problem too...

Also, please do not go on any more meds! You need to heal from this drug interaction, your body is VERY damaged, but will heal itself fine (can tell from all your 'withdrawal' symptoms that there is a lot of healing needed - mine were awful, I'm at 4 months 2 weeks almost, and am still having problems.. Things will clear up slowly one by one, sometimes coming back, but over TIME, eventually go away =- but don't let anyone put you on anything as you are sooooo sensitive right now... just water, healthy fruits and veggies, and a little meat and starch... organic is BEST...please check out the website www.antidepressantsfacts (spelling correct) and look for the page on how to recover from an adverse reaction to an SSRI which you've had...It's a survival guide for all of us here - explore the site to learn more about what these drugs are doing in your body, it will help you in the healing process...

As for anxiety attacks -- are you SURE that you haven't taken any drugs before??? Over the counter sleeping medication gives me horrible horrible delayed panic attacks, but a doctor wouldn't know that -- perhaps you may have reacted to medication given at the time of your last child's birth even... many drugs have anxiety as a side effect, and most people underestimate the POWER of that particular side effect, as it can be delayed for weeks, and seem to be just yourself reacting... if you've not had a history, then something caused it, it's so hard to be so careful, but now that I'm totally free of those meds, I never have any panic or anything and feel very normal again...so.... that's my 2 cents, .l.. or more like 5 bucks.. sorry!!
take care, you're in my prayers!
Elizabethmarie..

[elizabethmaria]

Dear sctschk
One more thing-- I think that the actual anxiety about getting a disease, or dying, is actually a withdrawal symptom in itself (am I right everyone??) I think many people here have had strange intense fears right after their reaction about getting cancer or other diseases -- not just because of how you feel, (pretty bad anyways!) but beyond that... so just remember that too!
hope this helps!
Elizabethmarie

[elizabethmaria]

THANK YOU AUNTY!!!!
Oh my gosh, that is such good info!! It is so good for those of us who had that bad reaction like that, thank you!!!!!!!!!!!!!!!!!!!!!!!!! I hope to talk with my doctor soon about this - when I'm a little stronger -- thank you!! I think you are an angel ... there are so many drugs there listed on that pathway, it's scary! does anyone know how common it is to have a problem with that pathway? It's going to take a while to go through all that info - it is so great!!!!

Sarita --It's Hopeful's thyroid that we have to pray for -- she has nodules develop from the Lex (is that right?), and the doctor has to check for cancer -- So we need to pray that she's all clear! I'm glad you are feeling better - but just be careful, it may get worse again before it really gets better -- I got worse and worse to the 4th month mark, and seem to be holding there... waiting, waiting! I don't want to seem like a downer, but just don't be scared if that happens!

It is so hard spiritually with these drug reactions - but I tell myself that it's at these times we get to feel like Christ, when all, even seemingly His Father, seemed so far away - even though they are not... so to pray and trust without feelings is of greatest worth! though it is sooo hard ! sometimes it's like being in the dark valley -- but He'll get us through !

Ok, I know it's silly, but one time I thought... gosh, maybe all these kind people on the forum aren't even real.. but are angels there to help me through this... ok ok.. now maybe I was truly hallucinating ... oh well... everyone is so wonderful here!
take care, and this is the LAST post, sorry!! I think I'm going manic with the posting - take care, HAPPY EASTER!!!!
Elizabethmarie

[Hairyarmadillo]

"gosh, maybe all these kind people on the forum aren't even real.. but are angels there to help me through this... ok ok.. now maybe I was truly hallucinating "


WHAT??!!??? Are you saying these people AREN'T really angels!!!

Just joshing, but I know how you feel. Thank goodness I haven't had the worst of the symptoms, but I still feel scared and shaken up. It is so good not to go through this alone. I am on day 5 of NO lexapro and scared to death-waiting for the next shoe to drop.
Aunty, I don't care what she says-you ARE an angel. Your depth of knowledge surrounding this never ceases to amaze me. Thanks for sharing the wealth of wisdom!

[Getting Better]

Well the six month mark was yesterday, so that's nice. I spent it in bed. I'm still very tired. My back pain has subsided significantly. My anxiety hasn't come back.

One weird new thing: I am very short of breath. I feel like my heart is beating faster and harder than normal, and I'm easily exerted. Is anyone else experiencing this?

Aunty: Do you know if this is normal around the six month mark? This is actually strating to scare me.

Anyway, I'm going to get a lot of blood work done, test myself for everything under the sun, and either stop worrying about diseases I don't have, or start treating ones I do.

Happy Passover, Easter, or just Spring to everyone.

[auntybiotic]

An angel.............maybe just a mother who is truly trying to help her daughter thru this ordeal............................and helping others learn as well.

Regarding the fast heartbeat and feeling exerted......keep a eye on your bloodpressur and blood sugar levels. Lexapro can cause extremely high blood pressure which would cause the paulse to race. It can be sporatic.

The exertion and fatigue .........if you are tapering is similiar to taking "speed" away from your body. Lexapro increases cortisol levels by 50%.....this causes adrenaline surges which is exactly what happens when one takes speed. You are actually taking the "spped" away and your body is crashing.
Google SSRI's and Cortisol and you will read many great explanations.

Happy esater

[auntybiotic]

Adverse SSRI Reactions (PDF)
Stress or depression can be detected by elevated levels of cortisol, yet one single 30mg ... obvious is that increased cortisol impairs the development and ...www.seroxatusergroup.org.uk/Adverse SSRI Reactions.pdf - 52k - View as html - More from this site


I could not get this article to paste so go to Google under search
ADVERSE SSRI REACTIONS

Loss of spirtuality is a listed symptom along with so many others....a MUST READ!!!

If anyone can get this to PASTE please do for others.

Thanks
aunty

[auntybiotic]

NO OTHER BOOK ON THE MARKET
EVEN BEGINS TO COMPARE!!!
AVAILABLE ONLY BY
DIRECT ORDER
NOT AVAILABLE IN BOOKSTORES
THE REST OF THE STORY ON
THE NEW SSRI ANTIDEPRESSANTS
(INCLUDING DRUGS LIKE PROZAC, ZOLOFT, PAXIL, LUVOX, EFFEXOR, SERZONE, ANAFRANIL, CIPRAMIL / CELEXA
THE DIET PILLS - FENFLURAMINE FEN-PHEN and REDUX)


--------------------------------------------------------------------------------

WARNING:

Withdrawal can often be more dangerous than continuing on a medication. Please click here before proceeding!


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PROZAC: PANACEA OR PANDORA? is the product of five years of intensive research, and the cases of approximately 1000 patients on a long-term basis. The author, Ann Blake Tracy holds a Doctorate in Health Sciences with the emphasis on Psychology, and is the director of the International Coalition for Drug Awareness. She has specialized in adverse reactions to serotonergic medications (such as Prozac, Zoloft, Paxil, Luvox, Celexa, Effexor, Serzone, Anafranil, Buspar, Fen-Phen, and Redux to name a few) and has testified before the FDA and congressional subcommittee members on Prozac. She has testified since 1992 as an expert witness in Prozac and other SSRI related court cases around the world. Her first book on the issue was published in 1991. During the last nine years she has participated in innumerable radio, television, newspaper and magazine interviews. We know of no one with such extensive experience and expertise on all of these issues surrounding the SSRI antidepressants as Ann Blake Tracy.

LEARN MORE THAN PROFESSIONALS ABOUT THE SSRI ANTIDEPRESSANTS . . . SAFE METHODS TO GET OFF DRUGS, STAY OFF, AND TAKE CONTROL OF LIFE . . . IF YOU KNOW SOMEONE ON PROZAC, ZOLOFT, PAXIL, LUVOX, SERZONE, EFFEXOR, ANAFRANIL, FENFLURAMINE (Fen-Phen and Redux), DESERYL, MERIDIA, OR ANY OTHER DRUG DESIGNED TO INCREASE SEROTONIN, YOU AND THEY BOTH NEED THE INFORMATION CONTAINED IN THIS BOOK.



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TITLE: PROZAC: PANACEA OR PANDORA? "The Rest of the Story" on the New Class of SSRI Antidepressants (Prozac, Zoloft, Paxil, Lovan, Luvox, and more)
AUTHOR: Ann Blake Tracy
424 pages
Trade Paper - 9" x 6"
ISBN: 0-916095-59-2
PUB. DATE: June, 1994
Features and Description

Comments from the Medical Community and Readers



--------------------------------------------------------------------------------

LATEST MEDICAL DOCUMENTATION REVEALS THESE SERIOUS PROBLEMS:
"I am alarmed at the monster that Johns Hopkins neuroscientist Solomon Snyder and I created when we discovered the simple binding assay for drug receptors 25 years ago. Prozac and other antidepressant serotonin-receptor-active compounds may also cause cardiovascular problems in some susceptible people after long-term use, which has become common practice despite the lack of safety studies.

"The public is being misinformed about the precision of these selective serotonin-uptake inhibitors when the medical profession oversimplifies their action in the brain and ignores the body as if it exists merely to carry the head around! In short, these molecules of emotion regulate every aspect of our physiology. A new paradigm has evolved, with implications that life-style changes such as diet and exercise can offer profound, safe and natural mood elevation."

Candace B. Pert, Research Professor, Georgetown University Medical Center, Washington;

Letter to the Editor of TIME Magazine, October 20, 1997, page 8.


Back up to links to Other Informative Sites and start of text.



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"I started having bad reactions . . . Oct '96 (almost one year ago) I found Prozac to be causing joint and muscle pain itself. I also became concerned that I was developing signs of Cushing's Syndrome.
". . . I was very pro-Prozac until last October and wouldn't have listened to anything said against it until I got problems (thought it was saving my life, while all the time it was insidiously and slowly killing me!) When I first heard about your book (Prozac: Panacea or Pandora?) on the Internet I was interested but quite skeptical. However, since reading it and having suffered so many problems with Prozac, I have come to the conclusion that the book is brilliant, and a life-line as far as I am concerned. I tried to fault the research and reasoning, but could not and still can't. I would like to extend my thanks to you for your heroic stance on this enormously important issue. I have tremendous respect and admiration for your hard work, determination and courage in pursuing this subject so vigorously, against so much powerful opposition for the benefit of people like me. Your integrity puts many, if not most doctors and psychiatrists to shame. It is reassuring to find that there are a few people in the world who are prepared to fight for the truth for the benefit of mankind. . . ."

A.S., A British Nurse

Excerpt from a letter received September, 1997.

Click here for more personal experiences reported to Dr. Tracy.

Back up to links to Other Informative Sites and start of text.



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TURNING THE 90's UPSIDE DOWN TO RELIVE THE 60's



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SEROTONIN - THE KEY TO THE PSYCHEDELIC EXPERIENCE:





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*RECENT MEDICAL STUDIES



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SOME OF THE MOST COMMON REACTIONS REPORTED BY PATIENTS:
PDR (Prescription Drug Reference) listed side effects. Drugs that have been on the market longer will often have a more complete side effect listing. Do not be suprised if any side effect listed for any of the drugs below occurs with any of the other drugs. Bookmark this page and then click on the drug name: (The pages below do not have return links.)

Prozac or Sarafem (fluoxetine hydrochloride)

Paxil or Seroxat (Paroxetine hydrochloride)

Zoloft (Sertraline)

Zyban or Wellbutrin (Bupropion hydrochloride)

Luvox (Fluvoxamine maleate)

Effexor (Venlafaxine hydrochloride)

Desyrel (Trazodone hydrochloride)

Anafranil (Clomipramine hydrochloride)

Serzone (Nefazodone hydrochloride)

Cipramil or Celexa (Citalopram hydrobromide)

Lexapro (Escitalopram Oxalate)


Medical writer Thomas J. Moore provides additional insight. Click Here.

Dr. Dolan also has some valuable information. Click Here for http://www.medicalaccountability.net/



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Addiction. Some of the firms making this class of drugs are being forced to admit that patients may become addicted. See Drug firm issues addiction warning in the Guardian.



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HYPERSEROTONEMIA



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SEROTONIN SYNDROME



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The Aftermath Of Prozac, Zoloft, Luvox, Fen-Phen, And Many Other Serotonergic Drugs



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* * * WARNING * * *

Dropping "cold turkey" off any of these medications can be more dangerous than staying on the drugs. Tapering off very, very, very slowly has proven the safest and most effective method of withdrawal.



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An informative site maintained by Charly Groenendijk

[auntybiotic]

How Cortisol Can Interfere With Your Overall Health




Ø Thyroid Function

Ø Liver Function

Ø Digestion

Ø Immunity/Allergies

Ø Blood Sugar Imbalances

Ø Reproductive Function

Ø Sleep Difficulties

Ø Depression, Anxiety, ADD/ADHD

Ø Exercise and Over-training



Stress and cortisol have a far-reaching impact on our health, affecting much more than just our ability to lose weight.



We know that stress triggers our adrenal glands to produce more cortisol and adrenaline, which are our primary stress hormones. It is the initial increase of cortisol and adrenaline that triggers our body to burn calories from carbohydrates and proteins, instead of fats. In addition, we need to understand that excess cortisol and adrenaline will also have an impact on our overall health by interfering with your thyroid, liver, digestion, blood sugar, immune system, sleep and reproductive hormones.





Thyroid Function


Let’s first talk about thyroid function, because millions of people, predominately women, suffer from a sluggish thyroid and are taking medications such as Synthroid or Levothroid, to support their thyroid and help with fatigue and weight gain.



The thyroid produces hormones, which regulate our metabolism. Our metabolism is the rate at which our body burns calories to produce energy. Since fatigue and weight gain are a growing problem, we need to look beyond the thyroid, because elevated levels of cortisol will interfere with the production of our thyroid hormones. When this happens we reduce the number of active thyroid hormones, which explains why we get fatigued and gain weight, not to mention cold hands and feet, brittle nails and hair and constipation associated with decreased thyroid function.



Unfortunately, the typical response is to take thyroid medications that increase those hormones, but don’t do anything about the real cause (cortisol), which decreases the production of our thyroid hormones, thereby interfering with normal thyroid function.



The real cause of poor thyroid function can often be attributed to stress, which overworks your adrenal glands, causing them to continually produce more cortisol. This process continues until it reaches a point where it can’t produce enough cortisol -- this is when health problems become more severe and interfere with normal metabolic function.





Liver Function



Our liver is the main detoxifying organ in our body and performs over 500 functions! One of the liver’s primary functions is to remove or package harmful fat-soluble toxins into less harmful water-soluble toxins, which can then be excreted. When liver function is interfered with, or overwhelmed, we become susceptible to fatigue, headaches, allergies, acne, PMS, menopausal symptoms and weight gain.



Elevated cortisol will interfere with normal liver function by disturbing the detoxifying process. It does this by literally unwrapping the toxins that have been packaged for elimination and throws them back into our bloodstream. Just like thyroid function – liver function is disturbed by cortisol.



The negative effects you feel from your liver not functioning properly is a result of the additional poisons that are circulating in your bloodstream. These additional toxins will cause “auto-intoxication”, meaning your body is continually self-poisoning. How can you become healthier if your body is constantly in a state of pollution? It all originates from stress and the effect cortisol has on the liver and its ability to disrupt the detoxification process?





Digestive Function



Millions of people suffer from bloating, gas, indigestion, heartburn, acid reflux and other irritable bowel problems. All of these can be linked to stress and cortisol.



The reason for this is simple… when you’re under stress, you produce more cortisol and adrenaline. Constant surges in cortisol erodes the intestinal lining of your digestive tract. It begins to irritate and inflame your intestinal lining, which can ultimately lead to ulcerations in your digestive tract. These ulcerations make it easier for undigested food particles to pass or leak across your intestinal lining, into your blood stream. When this happens, it makes your body more susceptible to food allergies and other harmful pathogens such as; yeast overgrowth, candida, and parasites. These things are commonly, associated with bloating, gas, indigestion, heartburn and irritable bowel problems.







Blood Sugar Imbalances



Cortisol affects our ability to regulate our blood sugar for two simple reasons.



1. Elevated levels of cortisol will make your cells more resistant to insulin. This means your body will have to produce more insulin to stabilize your blood sugar. This is a huge reason for the increase of reactive hypoglycemia, insulin resistance, Syndrome X and diabetes. When our cells become resistant to insulin, our pancreas now has to make more insulin…the result is all that extra insulin will disrupt normal metabolic function.



After a meal, Insulin takes the sugar (carbs) out of the bloodstream and moves it into the cells, to be used for energy. This is a good thing! The problem occurs when our body produces too much insulin as a result of eating too many carbohydrates, which causes your blood sugar levels to drop too fast. This leads to cravings, lightheadedness, headaches, mid-morning and mid-afternoon slumps, difficulty concentrating, moodiness, irritability if your meals are missed or delayed, and worst of all -- it makes you gain weight.



The reason excess insulin makes you gain weight is that it is a ‘fat storage hormone’. But remember, Insulin, like cortisol, is not a bad hormone – it simply does what it is supposed to do, but it needs to be balanced.



2. Cortisol also functions to raise our blood sugar when it is dropping. But, if our adrenals are overworked and exhausted they can reach a point in time where they can’t make enough cortisol to help stabilize our blood sugar and that’s when the cravings, lightheadedness, irritability, etc. begin.



It’s all about balance…too much, or too little cortisol is not good. Healthy adrenal function will help keep cortisol in balance.





Sleep Difficulties



Sleep is so important to our health, yet it is so often disregarded. During sleep, we release many different hormones, which repair and regenerate our body.



The two classic problems associated with sleep, both are stress-related:



1. The inability to fall asleep. This is a sign that your body is in the ‘fight or flight’ mode. Your adrenaline and cortisol levels are elevated – your body is still running in high gear! The increased amount of adrenaline, a stimulatory neurotransmitter, overrides the production of your 'inhibitory' neurotransmitters such as GABA, glycine, taurine and serotonin, which need to be produced in order to calm, relax and slow the body down...especially late in the day.



2. You fall asleep quickly, but wake up in the middle of the night and can’t go back to sleep. This is a sign that your cortisol levels are probably low, due to depleted or exhausted adrenal function. The reason you awaken in the middle of the night is you don’t have enough cortisol to stabilize your blood sugar. Now your body will have to produce adrenaline, a ‘stimulatory hormones’, to raise your blood sugar which then stimulates your brain and causes you to wake up and NOT fall back asleep because your mind is now racing.



The reason sleep is so important is because that is when your body releases hormones (growth hormones, IGF-1, melatonin and testosterone) that repair and regenerate your body. Elevated levels of cortisol will interfere with the production of these hormones.



Depression, Anxiety, Mood Swing, Irritability

The constant production of cortisol and adrenaline because of stress will create imbalances with serotonin and dopamine. Two primary neurotransmitters that are manipulated by drug manufacturers to help with depression and anxiety. Anti-depressants and anti-anxiety medications, like the popular SSRI's (selective serotonin reuptake inhibitors) are designed to manipulate serotonin and or dopamine.



These two neurotransmitters have a profound affect on our mental outlook because they effect mood and pleasure. Decreased levels of serotonin are found because of excess stress and adrenaline. Serotonin is produced in the gut and is a precurssor to the production of melatonin, a hormone that helps us sleep.





Stress, cortisol and adrenaline have a profound effect on our health, not just our ability to lose weight. It could be at the root of so many of the health complaints that are affecting our nation. If you suspect stress might be a problem and a cause to your health complaint, let me invite you to take our Stress Test.



Secondly, you need to identify what types of stress are affecting your body. Stress is more than just mental and emotional. If you want to learn more about the other types of stress, we encourage you to read “To Burn or Not to Burn, Fat is the Question”.

[elizabethmaria]

Thank you Aunty for all this info, it is such a lifesaver....!!! Does anyone know how to print off this site, without getting all the posts together??

Yes, I know you are all ANGELS ... !!! and I'm sure aunty is an archangel

hope all are ok today,
love Elizabethmarie

[sctschk]

Originally Posted by elizabethmaria

Dear sctshck (that's a hard one!)

R
Yes, your reactions are NORMAL! I had the jerking -- really really bad, and so have others on the site here -- it's really embarassing too, I know, and nearly impossible to hide - but it will go away - your nervous system is totally fried and shocked, and it is going to take time to heal...
Yes, you will go through periods of time when you feel almost completely fine, then Wham! sick as a dog ... but that is normal too - so don't spend energy worrying about the symptoms... we'll all be able to write novels about the strange things that happen to us as our bodies heall!! burning sensations I have not had (seizures though).. but I've heard they are a common problem too...

Also, please do not go on any more meds! You need to heal from this drug interaction, your body is VERY damaged, but will heal itself fine (can tell from all your 'withdrawal' symptoms that there is a lot of healing needed - mine were awful, I'm at 4 months 2 weeks almost, and am still having problems.. Things will clear up slowly one by one, sometimes coming back, but over TIME, eventually go away =- but don't let anyone put you on anything as you are sooooo sensitive right now... just water, healthy fruits and veggies, and a little meat and starch... organic is BEST...please check out the website www.antidepressantsfacts (spelling correct) and look for the page on how to recover from an adverse reaction to an SSRI which you've had...It's a survival guide for all of us here - explore the site to learn more about what these drugs are doing in your body, it will help you in the healing process...

As for anxiety attacks -- are you SURE that you haven't taken any drugs before??? Over the counter sleeping medication gives me horrible horrible delayed panic attacks, but a doctor wouldn't know that -- perhaps you may have reacted to medication given at the time of your last child's birth even... many drugs have anxiety as a side effect, and most people underestimate the POWER of that particular side effect, as it can be delayed for weeks, and seem to be just yourself reacting... if you've not had a history, then something caused it, it's so hard to be so careful, but now that I'm totally free of those meds, I never have any panic or anything and feel very normal again...so.... that's my 2 cents, .l.. or more like 5 bucks.. sorry!!
take care, you're in my prayers!
Elizabethmarie..

Thank you Elizabeth for responding to my post and for helping me rest a little easier! You have brought me a lot of relief and I managed to give my kids a decent Easter without having to crawl in my hole for the day. It was a nice day. I'm so, so happy to hear I'm not the only one who has gone through these freaky muscle jerks, twitching, and weirdo symptoms! I do agree with you that perhaps I am one of those who has had an adverse reaction - and a bad one. I kept searching and couldn't find much on others who had the same thing and I knew it just wasn't right. The stuff was supposed to HELP me, not make me feel 1000x worse! Knowing now that I'm not alone really helps me keep plugging on. Wow - four and a half months for you huh? I'm only reaching my two month mark, but I know I will NEVER, EVER touch Lexapro again and will just keep struggling through these scary and mind wrenching withdrawals. I don't think I will ever touch another anti-depressant/anti-anxiety or mood disorder drug again. My first experience did not leave a very good impression. It's really tough as my husband is gone four days a week at work and I'm home alone taking care of my kids (two of which are still in diapers!) - sometimes I have a really hard time coping, but I've been doing the withdrawal/kids thing on my own. Probably why I'm so overwhelmed. I told hubby today that after going through the hell I did, and coming this far that there's no chance I'm getting on anything again. He will go along with whatever I decide but he's never seen me so fallen apart. '

Yikes - seizures?! I feel for you - I'm so sorry! I sometimes feel like these small shakes and jerks are some type of seizure but what do I know? I've never had a seizure of any kind. That must be terrifying! I should count myself lucky that only my feet buzz and parts of my body feel on fire at random.

As for taking any other drugs, yes, I'm sure I have never taken anything else that could have caused this anxiety, or at least I don't think so. I had my first two children naturally & unmedicated so there were no drugs there. My second (born 9/04) was four weeks premature and they DID have me on an IV of magnesium due to pregnancy related high blood pressure. I got really zoned out on that. I got preg. again with my third when my second was only 6 months old, so I was wondering if the two pregnancies so close together really wacked out my body. With my third, I had an epidural (never had one before), and that's about the only thing that has gone into my body before she was born. Nothing afterwards, except Excedrin Migraine which I've been taking for several years. Could the epidural cause anxiety? And five months later? I was wondering about hormones with the two pregnancies so close together, but I had bloodwork done in December (after five months of anxiety) to include a full hormone panel but those were all in normal range so that wasn't it...

Mostly, the last few years have been extremely stressful on our family which I believe caused the anxiety rather than a drug effect. To name a few - hubby was diagnosed with MS in late 2003 just as we found out we were pregnant with #2 (hubby's first) after 2yrs of infertility and SIX, yes, SIX miscarriages. This pregnancy had me in preterm labor twice, and baby born 4 weeks early. Baby then developed a life threatening bowel obstruction at 5wks and almost died. He had three surgeries, four months at Children's, and came home on IV's and tube feedings. We never knew if he would ever be able to eat normal food. Hubby left us during the hospitalization for two months as he couldn't deal with both this and his dx and our marriage crumbled. It was extremely rough. He came back, and needless to say, we made up which resulted in our daughter. Very hard pregnancy caring for a 6 month baby on tubes and wondering how I could have another... but she was a full term although she had terrible colic for the first four months - ACK! Then, another crisis - my first son's bio father who had not spoken to him for five years resurfaces out of the blue wanting his custody rights back. All due to child support and had nothing to do with him wanting to see him. I left him due to abuse way back when my oldest was only 2 and I was terrified I would have to hand him over for visitation - my oldest has only known my husband as his dad - this guy was a stranger to him, and he was scared too. The court battle was extremely hairy, trying, and this is when my panic attacks started. All actually turned out ok (hubby is fine, boy #2 had a miraculous recovery, court ended in our favor, marriage healed) but the anxiety and panic attacks stayed. Like my brain forgot how to be the calm and collected one after all that.

The therapist I've been seeing says she understands HOW I became so anxious. I've been through quite a bit. But, come on - isn't ten months enough!! Thanks to my docs, I now have Lexapro fun to also add to the mix. For now, I'm just trying to get off this Lex, and if I can survive all that above, I can survive this, right? Just one more hill to climb, but I'll get there. Thanks again for the support. I'll be reading a lot and checking out that adverse reaction - I do think I had a bad one. Hugs to you! Hope you get better yourself too!!

-Jo
(sctschk - that's "Scott's Chick" - Yep, still married to him. LOL).

[Hairyarmadillo]

I sure hope this is worth it. I was almost asleep last night when I had anxiety and had to get up and read. Then,when I did sleep, the nightmares began. After waking up terrified the second time, I decided I was going to go to my doctor first thing this morning and try using the Prozac method for withdrawal. After sleeping until 8 and waking up without having to force myself to, I decided MAYBE, just maybe I can make it after all. I feel like a wimp because my symptoms are so minor but I feel like my life is put on hold until I get this out of my system. And, then, who knows when it will hit again? I even started to go back on my sliver of a pill but gonna just keep going on this track since tomorrow will mark a full week off of it. I feel like puking and can't tell if the stomach symptoms are related to lexapro, a stomach virus or my irritable bowel. All I know is, this reall sucks

[elizabethmaria]

Hi Sctschk,
I'm so glad you found this site -- stay on here and we will all help you get through this...! Remember, if you are at month 2, things will probably get better, but most likely something will get worse at your 3-4 month period so don't be surprised if anxiety / depression come back, plus new symptoms... but it is SO common, that we're all going through it - its just the healing process and goes funny that way..Lots of people get scared and run back to the drug at that time thinking that their problems have returned, but they haven't! I got soo scared, because I was getting so much worse all of a sudden, but it's getting slowly better FINALLY, for good I think... so hang in there!!!!
One more thing -- I know you've had a bad reaction to this drug, so it is most likely that you, like myself, are probably what they call 'very slow metabolizers' of these drugs through the P450 pathway in your liver (right aunty?)... read Auntybiotics post on this page - it's a lot of info , but probably really important for you and I... I'm going to do the genetic test, because if it does show up that I'm that way, there are TONs of drugs which use this pathway and will give us bad reactions...

This could be important ... I mentioned before that sleeping drugs give me delayed panic attacks.. Looking at the list of drugs that use the same pathway as ssri's etc.. is listed diphenylhydramine -- that's what is in many over the counter sleeping meds, AND headache meds, etc.. as it is an antihistimine -- also acetominophen is listed as well, which is in everything, your reg. aspirin, etc... So I was soo happy to see WHY I react so much to those drugs -- I think because we don't metabolize them, and they end up staying in our system and building up over time, my body reacts by pumping out a ton of adrenaline/cortisol, which results in panic feelings/or attack... specifically its the P450 2D6 pathway - one of the best studied pathways, and 10% of the population has a slow acting form, while 35% carry a non functioning allele which could cause problems with adverse reactions when drug combinations arise...

Anyways, just thought to share this with you - as it might relate to what happened to you - I noticed that it was when I had taken the sleeping meds over a period of time, and they had built up a bit, that that was when the attacks happened...I was so happy to read this as it finally all began to make sense - it's so nice not to have to worry about that anymore...
I think there is a huge difference between anxiety and a true panic attack/extreme anxiety induced by drugs... the latter is terrible, you can't calm yourself down, as it is your body reacting... thats why its so painful!
so nice to be free!
hope this helps, it really helped me a lot, so if it helps someone else I'll be sooo happy!
take care,
Elizabethmarie

[quitter]

I've always had really good hearing--I can hear anything and everything. I had a hearing test a while back because I was having some problems with ear infections and they wanted to make sure that everything was ok. Well, when the results of that came back, the lady said they could pretty much calibrate the machine using my ears...

All that to say, my hearing today has been sooo sensitive! I have had my tv turned down almost all the way down, and the commercials are still hurting my ears! What the hey!! This is not cool--I am contemplating wearing ear plugs to work tonight so my nerves aren't totally frazzled by the end of the night. Have any of you had this happen? Is it part of the withdrawal or something else? I am confused!

[elizabethmaria]

Hi Quitter,
Completely withdrawal - well documented that you become more sensitive to light, sound, etc. etc.. earplugs do help, esp. sleeping while you are so sensitive... no worries! Hey, just think of all the things that won't pass your attention now - any whispered conversations nearby? too bad it isn't Christmas and people are talking about presents
Elizabethmarie

[elizabethmaria]

Hi again sctschk,
Just did a quick search on excedrin migraine medicine -- panic and anxiety are a common side effect -- there are a bunch of people reporting problems with that ... I don't know if it means anything, but is something to think about -- also found a research article that says that intolerance, or bad reactions to acetominophen can develop in time... who knows.. just looking around! could be so many things, or a combo...
take care,
Elizabethmarie