First: I'm 22, and I took 5mg/day of
Lexapro for 2.5 months.
I was prescribed Lexapro for treating depression a few months ago. I remember that prior to taking the Lexapro I felt very bad, but had what I'd call only very "distant" thoughts of "not being around."
However, within the first few days of taking Lexapro, and particularly during the first 2 weeks, I experienced SIGNIFICANT AND ALMOST CONSTANT suicidal ideation (thinking of killing myself).
In addition, the suicidal ideation was of a particularly strong type... not only was I thinking of killing myself, but I was thinking of many different ways to do it and trying to ensure that if/when I went through with it, it would be effective and permanent. According to medical literature, this is the worst kind of suicidal ideation (short of an actual attempt) because you have progressed to the active "planning" stage.
I cannot emphasize enough how frequent and strong the thoughts and "urges" were, but I kept "hanging on."
Also, the suicidal thinking never really stopped though the 2 months I was taking it, though it was slightly less than the first 2-3 weeks.
Another thing worth mentioning: I took 10mg the first day, and because of its strong effects I cut my dose to 5mg the next day and kept it at 5mg every day.
Another side effect that developed other than the suicidal thinking was constant sleeping and even more lethargy than I had before going on medication. At first I thought I was just sleeping all the time and lazy, but I gradually realized after a few 15-18 hour "nights" that it couldn't just be me!
I was also seeing a therapist throughout the entire process and the therapist could not help me work my way "out of" the suicidal thinking, despite alot of effort on both her part and mine.
Finally, almost as a "last attempt at life" before offing myself, I concluded that I would ask a local clinic to prescribe
Wellbutrin after alot of research.
I selected Wellbutrin because I knew that it worked on a different part of the brain than most other antidepressants: it targets dopamine (reward chemical) rather than seratonin (feel good chemical). Wellbutrin is the only antidepressant in the US that targets dopamine primarily (it is NOT an SSRI or SNRI like most of the other antidepressants). Dopamine is associated with addictive drugs, though Wellbutrin has no abuse potential. Dopamine is also what is targeted in ADD/ADHD drugs.
So I got prescribed 300mg/day of Wellbutrin SR (not XL), starting with 150mg/day for the first 3 days, then upping to 150mg/twice-daily. I've been taking for nearly a month now. I "weaned" off of Lexapro by taking approx 2.5mg every day for two weeks, then stopping (I used a pill splitter).
Too my surprise, I began actually feeling better within days of taking the Wellbutrin, and gradually got better and better despite poor things going on in my life that actually worsened in some ways. It helped me to actually deal with these ongoing problems (still going on now).
I was also kind of shocked when I realized that I hadn't had any suicidal ideation for a few days consecutively (after taking Wellbutrin for about a week). It's now been a month since I've been on Wellbutrin, and even with some really bad news that made me feel very sad -- I didn't think about suicide.
It's actually kind of traumatic thinking back to my Lexapro days and strong suicidal urges and planning. They felt very real and as though I was wanting to do it because of myself (not some drug). I now know that the drug played a major role in my thinking, and very real desire to kill myself. It feels very strange thinking about my state of mind over all of those weeks.
Suicidal ideation are apparently pretty common with SSRI/SNRI's like Lexapro,
Paxil,
Prozac,
Effexor,
Zoloft, so much so that warning labels are required by the FDA on these medications. Wellbutrin also got thrown into the group when the FDA issued suicide warnings, though I've googled about the internet for people reporting (new or greater) suicidal urges on Wellbutrin and I've found no forum postings of that nature. However, such postings abound for the other drugs like Lexapro, with people reporting increased suicidal thinking. Wellbutrin is prescribed very frequently (comparable to Lexapro), so you'd expect at least a few postings if that was a common side effect.
Anyways, perhaps Wellbutrin does increase suicidal ideation for some people, but my experience was exactly the opposite, fortunately.
I should note that the factors in my life haven't really changed, and if anything they have worsened in several respects. Yet, I'm feeling better and I can better manage these things. I'm now working on consolidating my view of life and trying to develop positive outlooks within my own thinking, with the support of Wellbutrin.
- Texan, 22 years old.
Other notes:
I stopped seeing the therapist before I started Wellbutrin, so therapy had nothing to do with recovery. I also used none of the techniques from therapy, because I found them useless over the months I went. I attribute my improvement completely to the Wellbutrin and nothing else.
I specifically insisted on taking the branded form of Wellbutrin and not the generic
bupropion substitute because of many incidental reports on the internet that the generic form didn't work when some patients taking Wellbutrin switched to it (to save money). When those same patients went back on the branded Wellbutrin, the got better again. Maybe it was a bad batch, or poor production process used with the generic.
However -- I am planning on trying the generic form at some point in the next few months, but I want to get a few good months behind me before I "risk" switching to the generic. I DO NOT want to be in the depths of depression or suicidal thinking, and I'm not ready to explore that possibility right now if the generic in fact doesn't work.
Some quick facts from wikipedia:
SSRI's:
*
citalopram (Celexa, Cipramil, Emocal, Sepram, Seropram)
* escitalopram oxalate (Lexapro, Cipralex, Esertia)
*
fluoxetine (Prozac, Fontex, Seromex, Seronil, Sarafem, Fluctin (EUR))
* fluvoxamine maleate (Luvox, Faverin)
*
paroxetine (Paxil, Seroxat, Aropax, Deroxat, Rexetin, Xetanor, Paroxat)
* sertraline (Zoloft, Lustral, Serlain)
* dapoxetine (no known trade name)
SNRI's:
*
venlafaxine (tradenames Effexor XR®, Effexor®) is the first and most commonly used SNRI. Although it also works on dopamine somewhat at high dosages, the majority of its effect is on serotonin and norepinephrine.
* desvenlafaxine (tradename Pristiq®) is the active metabolite of venlafaxine and is believed to work in the same manner. It will be introduced by Wyeth in late 2007-early 2008.
* sibutramine (tradenames
Meridia®, Reductil®) is an SNRI which failed to show antidepressant activity in animal tests, but instead has been widely marketed as an appetite suppressant drug for weight loss.
* nefazodone (tradename
Serzone®) is an antidepressant with efficacy similar to SSRIs, but without the sexual side effects. In fact, Serzone at times may act similarly to Wellbutrin in its neutral or at times positive effect on function. It has been discontinued in several countries due to rare cases of liver failure. The tradename "Serzone®" has been discontinued, however generic nefazodone is currently available (May 06). However, the liver failure is rare, and a simple blood test every 6 months to assess liver enzyme levels is sufficient. Nefazodone has an active metabolite which at higher doses (> 250mg/day) can increase anxiety.
* milnacipran (tradename Dalcipran®/ Portugal; Ixel®/ France) has shown to be significantly effective in the treatment of depression and Fibromyalgia syndrome (FMS). Although it has not yet been approved by the Food and Drug Administration (FDA) for use in the United States, it has been commercially available in Europe and Asia for several years.
* desipramine (tradenames Norpramine®, Pertofraneis®) is technically a tricyclic antidepressant, and is usually categorized as such. It works, however, on both serotonin and norepinephrine, so it can also be considered an SNRI.
* duloxetine (tradename
Cymbalta®) by Eli Lilly and Company, also inhibits serotonin reuptake and has been approved for the treatment of depression and neuropathic pain in August of 2004.
Lexapro related suicide? 
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