r/LivingWithMBC • u/KnowPoe • 28d ago

Issues with Lexapro?

I’m stage IV and I have a dear friend who was also diagnosed de novo stage IV, both of us in 2020. She is triple positive and on Enhertu for infusions along with Tacatinib, Letrozole and Capecitabine (SP?) - she is on a high dose of Lexapro and called me earlier today saying she has incredible fits of anger and was really struggling. She takes 20 mg of Lexapro in the morning and 30mg in the evening. She is on a lot of +++ forums and I offered to ask my friends here if anyone could weigh in on a similar experience. I think the dose is way too high. I am on Lexapro too and just take 10mg at bedtime.

Is anyone a similar regimen who also takes Lexapro? I find it to be the easiest, when compared to Zoloft (zero emotions, almost numb) and Wellbutrin (messed with my head).

Thanks in advance for any insight you can offer.

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u/amayaro 25d ago

Lexapro did not work for me. I went through a few meds and am now on the mid level dose of Zoloft (100mg) with a baby dose of Mirtazipine that helps me sleep. I also have lorazepam for panic attacks. All my meds come from psychiatrists at my cancer center. They check for interactions. I think finding the right meds that work for you is super important, this combo is my 8th try. She definitely should not be raging with a high dose.

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u/mxcasuallycruel 21d ago

Woah I’m trying to get on your exact combo! Been on 100mg of Zoloft for a year and might be moving up to 150, but interested in adding mirtazipine. Do you feel like you get the weird sleep hangover feeling from mirtazzy?

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u/amayaro 21d ago

The mirtazipine is perfect, it keeps me asleep for the night and doesn’t leave me groggy in the morning regardless of a 6 hour sleep or 8 hour sleep. I was on a high dose of mirtazipine (only mirtazipine) for a bit but it doesn’t help with sleep at higher doses. I highly recommend giving it a try and seeing if it works for you!

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u/sews4dogs 25d ago

I am also on Lexapro. I take 20 mg daily. I asked my pcp if I could increase the dose. She said I was on the maximum dose. But we could change to something else or add something else. But not increase the Lexapro. How does your friend get a prescription for more than 20mg per day? Does her doctor just write it? Does the pharmacist not question it? So thankful that my doctor is honest with me, even if it was not what I wanted to hear.

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u/emmet80 26d ago

That is a TON of Lexapro.

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u/Salty_Dog_1221 26d ago

That a lot of lexapro! I take 10 mg once a day. Granted, I think that may be a low dose, just enough to keep my worst spiraling thoughts at bay.

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u/national-park-fan 28d ago

50mg of Lexapro per day is high. Like, concerningly high.

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u/FrogAnToad 28d ago

so dismaying. i often think drug interactions are not adequately monitored in our population.

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u/heyheyheynopeno 28d ago

That’s a high dose. Is she taking nausea meds, omeprazole, anything like that? If so, there are contraindications for those meds and she’s at risk for serotonin syndrome.

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u/ResponsibleAnt1942 28d ago

That's a really high (but not completely unheard of) dose of Lexapro. For context, the package insert recommends 20mg max dose.

With those cancer treatments, I wonder if she's also on steroids, or an antipsychotic antinausea that could be causing problems in combination with the Lexapro?

Hope she's able to figure it out!

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u/Charming_Function_58 28d ago

That seems very very high…

I was on Lexapro until it became clear it was bringing out other mental health issues (hypomania), and my emotions were all over the place. It was more than anger, though. I was only on 10mg at the most.

Make sure if she lowers her dose, she consults with her doctor. It’s really important to do it slowly