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SSRI Augmentation of Antipsychotic

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SSRI Augmentation of Antipsychotic

Postby andrew112 » Mon Jun 20, 2022 5:37 am

It's been five months since I last made any med changes. I think it's time to increment one of my meds. I am just not sure which one to raise the dosage of. I am currently on 30mg Olanzapine (Zyprexa) and 20mg Escitalopram (Lexapro). When I was on a higher dose of Lexapro, I felt overmedicated. But when I reduced it, I became symptomatic and still am. It doesn't make sense that I would have to be overmedicated in order to feel more normal but with side-effects. I could try raising my Zyprexa. Does anyone have experience?
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Re: SSRI Augmentation of Antipsychotic

Postby Wally58 » Tue Jun 21, 2022 5:19 pm

Discuss this with your doctor. 5 months isn't long enough for the body to adjust to some meds. Most treatment plans start out slow and let your body & mind adjust to the new chemistry with periodic increases of dosage.

Your doctor may want to observe how you do at the present dose & on the present class of drugs. Any notable side-effects or feelings? Intense dreams? Weight gain?
I was asked at every appt if I had any intentions of hurting myself. I didn't, but I understood why they had to ask this.

You have options. Discuss them at your next appt. Keep us informed on what is decided for short-term as well as long-term goals.
Best of luck to you. :D
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Re: SSRI Augmentation of Antipsychotic

Postby andrew112 » Tue Jun 21, 2022 8:25 pm

Thanks for the input. I agree that it may take longer for my present dose to work, and that my doctor may want to see how I do on my present regime. I have been feeling pretty okay, lately. I am definitely feeling better than the way I was feeling before I made my med increase five months ago. I have side-effects, but that's the way it has been no matter what antipsychotic I was on. I have dreams, but not intense ones. I also have not had any abnormal weight gain. I will keep you posted.
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Re: SSRI Augmentation of Antipsychotic

Postby andrew112 » Mon Jun 27, 2022 4:08 am

I have been feeling paranoid, delusional, and anxious lately. I don't like the idea of having to schedule an appointment with my psych doc just to tell him that I want to increase my Lexapro, and having him say "Ok", and then that's it. It's really ridiculous, IMO.
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Re: SSRI Augmentation of Antipsychotic

Postby Wally58 » Mon Jun 27, 2022 3:09 pm

Don't make meds the main point of seeing him for an appointment. Talk about your feelings and what is going on with you first.
Ask what can be done. The doctor may be the one who suggests an increase, or a switch of meds. If not, you can bring up the topic.
Keep everything on the table for discussion and keep an open mind.

I am a recovering alcoholic & drug addict. I felt guilty about asking for more drugs. But my desire for recovery was stronger. I knew that doctor-ordered & supervised medication was allowed.

You have to ask for what you need. Doctors & social workers aren't mind readers. Matter-of-factly ask if increasing dosage might help with the paranoia, delusions & anxiety. Then listen carefully to the answer.
After all, it is your recovery & check-in session. If you think it may help, ask about it.
If an increase in dosage isn't the answer, you can always step back and try something else. :D
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Re: SSRI Augmentation of Antipsychotic

Postby andrew112 » Mon Jun 27, 2022 7:17 pm

I appreciate your kind support, Wally58. You made good points with the sharing of my feelings with my psychiatrist, listening carefully, and being proactive by bringing up topics myself if necessary. The next appointment I have with him is in about another month, so I will see what he says then. Thanks.
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Re: SSRI Augmentation of Antipsychotic

Postby andrew112 » Tue Jun 28, 2022 5:08 am

I feel like I am in "no man's land". Like I am not improving that much but I am also not really getting worse. I remember when I had reduced my Olanzapine ODT from 30mg to 25mg back in January 2021, it took a year for the lesser amount of medication to really start to "kick in" for me. And by "kick in" for me, I mean become symptomatic. It was pretty sudden. So maybe that's the case with increasing the medication. It may take a year for me to see the added benefits of being on a higher dose.
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Re: SSRI Augmentation of Antipsychotic

Postby andrew112 » Tue Jul 05, 2022 5:26 am

I feel like progress is pain-stakingly slow. I just want to be better already. I remember when I was on a higher dose, I was better. I had no psychotic symptoms. But now I just feel irritated all the time. And I do not feel fully stable. But it is what it is, I guess. I guess I will just have to mention it to my psychiatrist in about three weeks from now.
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Re: SSRI Augmentation of Antipsychotic

Postby andrew112 » Wed Aug 03, 2022 12:24 am

It's been more than six months since I increased my Olanzapine from 25mg to 30mg. I have been feeling paranoid, delusional, irritated, agitated, hallucinatory, and obstinate. The thing that sucks about seeing a psychiatrist is that, when I see him, I may not be feeling symptomatic so I will not report to him my symptoms. But then maybe a week later, I will experience a resurfacing of symptoms. But at that point, there is no point to scheduling another appointment with him because I just saw him. So now I will just have to wait almost two months before I see him again. And he is the one that told me to schedule to see him in another two months. I wish I could just go back to the psychiatrist I was seeing before my current psych doc, but I cannot because it would be too much for my Mother to be thinking about. She has a full plate as it is. And the psychiatrist I was seeing before my current psych doc was out of network.
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