easy child, Apt, Depression, medications

[hearts and roses]

We moved easy child into her new apt with her boyfriend yesterday. It's a nice place (we all cleaned it last week). I like the boyfriend, I spoke with him in private and I know he loves easy child and everything, I am just worried that they're not rishing into something bigger than they can handle. But you know they both want to be there, so we helped easy child out and made sure she has all she needs. She talks with me constantly, so I think I will know if something goes awry. H had some bonding time with the boyfriend, whom he also likes as do I.

This past week easy child called me and wanted me to make an appointment with our DR because she said she was depressed. Now, easy child has had anxiety attack that come and go for a few years now and there was one time she was put on Lexapro, but stopped after one week and refused to take anything again. She was afraid she'd end up becoming like difficult child (she's traumatized). Sooooo, if she actually called and asked me and then the Dr about it, she must be feeling really bad, right?

When I saw her yesterday, it was alarming. Her hair was all greasy, her face was in a permanent frown, and she was kind of like on auto pilot. I was truly horrified (but couldn't let her know) and now I'm worried sick about her. Her face looked so drawn! Everything that came out of her mouth seemed forced. I sat with her for a while in the closet just to talk. I reminded her that no matter what she could always come home, that the apt is nice, and we like her boyfriend a lot, but that if she changed her mind, that was okay. I don't want her to feel trapped, you know? Anyway, we talked about other things and she got to laughing a little and I saw a snippet of my old easy child, which was a relief. I'm glad that I pulled her in for some one on one time with mom. She takes on so much and doesn't realize sometimes that it's too much.

Anyway, our Dr does not have any afternoon appts available until April, so she consulted with easy child on the phone and the DR started her on 20mg of celexa. She told easy child that she checked my file and history as well as her sisters (difficult child) and decided that this would be the best medication. She also told easy child to get out in the sun everyday for at least 20 minutes.

I'm glad that easy child is finally doing something about this, but I am wondering about the DR's choice of mg start dose. difficult child is on 15mg, was on 10mg to start because if she goes over 15mg, she gets a little mania going. And I take wellbutrin 150mg.

Why would the DR START easy child on 20mg?? Wouldn't 10mg be a more prudent starting dose and then progress from there? I am going to call her tomorrow to ask her, but thought I'd look for some feedback here first. Thanks.

♥ to all.

 

[flutterbee]

I'm sorry to hear about easy child. I'm glad she recognizes it and is willing to get help.

If memory serves, 20mg is a pretty common starting point for celexa. I started out on 20mg when I took celexa years ago. The rule of thumb for those switching from lexapro to celexa, for example (and usually for insurance purposes as they are closely related and there is a generic for celexa), is 20mg celexa or 10mg lexapro.

Hope that helps.

 

[Sara PA]

My son was 14 when he was started on 10 mg. That was upped to 20 then 30 then back down to 20. The psychosis began to show when he was on the 20 the first time. Naturally I agree with you that 10 would be the best starting place.

 

[smallworld]

I have kids younger than yours, but we have very conservative psychiatrists and always start lower than recommended. When my kids trialed Lexapro, we started them at 2.5 mg (a 5 mg tablet split in half). When my daughter M trialed Prozac, she started at 2 mg (it comes in liquid). Because you never know how someone will react to any medication, there is never any reason to start high and increase rapidly unless there is a psychiatric emergency.

 

[Wiped Out]

I don't know about the medications. Just wanted to say I'm glad easy child is seeking help. Hugs.

 

[hearts and roses]

It is my understanding that 30mg of celexa is equal to the 10mg tablet of lexapro. When difficult child was switched from 15mg celexa to 10mg of lexapro, she could not tolerate it at that level.

Should I wait and see how easy child does or should I call the DR and see why she didn't start her at the 10mg. I just think it's better to start low, especially with a person who will give up if she gets spooked by her body's reaction (if its too much for her)? What would you do?

 

[smallworld]

I would definitely ask the psychiatrist about starting easy child lower. As I said above, there's really no reason not to. The only downside is that it can take longer to get to a therapeutic dose.

 

[jannie]

I don't know much about the starting dosage of celexa...but I'm really glad that easy child is reaching out to you and keeping you involved. It sounds like she really needed that 1:1 with mom. Keep on checking in with her and letting her know you're always there. She's lucky to have you !!

I'm sure there is no harm in starting at a lower dosage...I hope she's feeling happier soon...

 

[flutterbee]

From rxlist.com:

Initial Treatment

Celexa (citalopram HBr) should be administered at an initial dose of 20 mg once daily, generally with an increase to a dose of 40 mg/day. Dose increases should usually occur in increments of 20 mg at intervals of no less than one week. Although certain patients may require a dose of 60 mg/day, the only study pertinent to dose response for effectiveness did not demonstrate an advantage for the 60 mg/day dose over the 40 mg/day dose; doses above 40 mg are therefore not ordinarily recommended.
Celexa should be administered once daily, in the morning or evening, with or without food.

http://www.rxlist.com/cgi/generic/citalo_ids.htm

My doctor told me it was a 2:1 ratio, so 20 mg of celexa was equal to 10 mg of lexapro. However, it appears when they studied lexapro they compared 10 mg lexapro to 40 mg celexa.

 

[hearts and roses]

Thank you Heather! That is the perfect information I needed.

The primary reason for my concern is of course due to my experience with difficult child and her dose of celexa. She can't go higher than 15mg because she gets a little manic at any higher of a dose, but 10 is too low. All three of us are very sensitive to medications. For example, when I take xanax, I take HALF of a .25mg tablet - my DR can't even believe that I feel anything at all its such a low dose. But it's just enough to help me drift off to sleep or get my blood taken without passing out! Hahaha~ Anyway, I was just thinking that if easy child is anything like difficult child and me, she may have an exaggerated reaction to the 20mg and that starting at 10 may have been more prudent. But with this information you've provided, perhaps I will wait until the end of the weekend and see how easy child is doing. She's supposed to come home for a day this weekend so I will get to see her again.

Thanks again~

 

[Coookie]

Jo,

Just a thought here. Maybe the doctor started her off on that dose to get her leveled off quicker and then plans to reduce it? That is what my doctor did with me when I took it. Like I said, just a thought.

Glad she is seeking the help she needs. Would be wonderful if our difficult children would do that...but...then they probably wouldn't be difficult children.

Hugs

 

[hearts and roses]

Thanks Robby - that is something I hadn't considered. You know, for easy child to even go so far as to admit she was dealing with something greater than she could handle is HUGE, so I'm grateful that she had the sense to reach out. Now I just hope that when she begins to feel better she sticks with it and doesn't just stop. By then, however, she will have seen the DR and hopefully DR will explain to easy child how it all works in the world of medications.

I just hope her boyfriend isn't a toad about her moodiness and stops asking her "what's wrong?" all freakin day long! He's so insecure that if easy child isn't all smiley and lovey he things it's about him. Ugh, men.