Lexapro(Escitalopram) working perfectly but not able to tolerate!

Medications
1

I take
clozapine 175mg
paroxetine cr 37.5mg
clobazam 10mg
escitalopram 10mg

10mg lexapro(escitalopram) at 8am is working so damn well for ocd but I’m so tired/sleepy that i wake up at 3-4pm on it.

I have tried all the different timings of taking the meds like divided dosing, all dose at bedtime etc - they don’t work. I believe bedtime dosing doesnt work cuz clozapine decreases serotonin and lexapro increases it, so they prolly cancel each other out ? Only 10mg at 8am works perfectly.

What should i do about tiredness and being sleepy ? Modafinil and coffee worsens my psychosis.

My next option would be to stop lexapro and add prozac - but it inhibits 2d6 and 3A4 - which would further increase clozapine and paroxetine blood levels. Increasing clozapine is bad - cuz it worsens ocd and anxiety and makes me less likely to tolerate any SSRI.

2

You just started on it so maybe give it some time to see if the sleepiness goes away.

Edit: Can you take it at night ?

3

For some reason it does not work that well if taken at night cuz i take it along with my antipsychotic clozapine. If you read the literature clozapine has anti-serotonin properties while lexapro has serotonin increasing properties, so they prolly cancel each other out.

1 Like
4

Update: My meds were not fake. Lexapro 10mg is not working for OCD, and 15mg makes me cry. I will ask pdoc to reduce clozapine to 150 and add risperidone. After reducing clozapine to 150, i will try increasing lexapro again. If that fails, i will try prozac.

5

Green tea gives effect similar to modafinil.

6

does the lexapro help intrusive thoughts at all?