There's a whole chemistry system in the brain related to the production and subsequent "reuptake" (dunno why they don't just say "uptake") of the neurotransmitter seratonin. I don't understand the chemical cycle very well, but what I gather is that the brain creates seratonin and uses it in neural functions, but that a portion of the seratonin created is simply sucked back up, broken apart, and not used. Deficiencies in available seratonin are tied in several medical studies to depression, difficulty sleeping, weight gain, aggression, and difficulty focusing. The suggestion is that some people who are depressed may simply have brains that "reuptake" too much seratonin relative to the amount their brains create.

SSRI drugs like Lexapro, Prozac, Zoloft, and Paxil all work by selectively inhibiting seratonin reuptake (thus the name, S S R I), causing more seratonin to be available to neurons for transmitting and processing information. Older SSRIs have tons of side effects; I think, for the most part, pharmaceutical companies do a lot of experimentation and guesswork to find drugs, so often the drug isn't targeted very well at the symptom and affects other chemical balances in the body. Lexapro is a third generation "SSRI" antidepressant, similar to but more precisely targeted than drugs like "Prozac". Lexapro and the other third-generation SSRIs appear to be much more specific and thus cause fewer side effects.

MDMA, or "E", also suppresses the reuptake of seratonin. People who have taken "E", and thus have a large surplus of seratonin, report an extreme sense of wellbeing and acceptance, the suppression of all anxiety, nearly unlimited energy, and no inhibition. This is why people use it at raves and parties to let go. So seratonin levels definitely have an impact on mood.

From January through March, I was fighting a lot of depression, anxiety, and confusion. It was suggested that a prescription antidepressant might work for me. After all, when I have a headache or joint pain, I take Advil, so why not fix my depression with a pill? I was skeptical until I read a bunch of books on seratonin and researched it online, and spoke with my psychologist. I thought, "well, maybe a small surplus of seratonin might help." Finally, my regular doctor said she thought of Lexapro more as a "mood stabilizer" than a happy pill, so she recommended it.

I started in the middle of March. My doctor said I might not feel the effects until one to four weeks after starting. By the next week, I was feeling better. Now, after a little more than four months, I can definitely say depression shows its ugly head very very rarely of late. Certainly I've also made decisions lately that have gone a long way towards improving my life, so it's a little bit debatable how much this drug is responsible.

The popular perception of antidepressants seems to be that they make you foggy, or ditzy, or you don't seem like yourself anymore. But I feel *more* like myself, maybe because the anxiety and sadness that made me focus on irrelevant things in my life has faded. My perception is that I still get sad, I still get anxious, I still get angry, I still get happy, I still solve complex problems at work and get lots of positive feedback for my performance, and, best of all, I still think about things a lot. But negative emotions now don't own me. I would put it like this: Lexapro helps me take anxiety and depression less seriously so that I can fix the things causing me to be anxious or depressed. To use a very nerdy metaphor, it's like the voltage in my brain has been turned up a little, so that I just don't brown-out as much.

No one has remarked that I seem in the least impaired. However, one friend remarked to me yesterday that stimulation seems to impact me less now than it used to - I don't jump at loud noises any more. I definitely feel that I reach a point of overstimulation a lot less often. I can stay at parties longer and I'm not as bothered by environmental issues like temperature, brightness, and volume. (I'm still bugged by stimulation more than most, it seems, just not as much as I was.) One thing in particular I have felt is more self-esteem. I definitely don't let myself get hurt as much, and I don't blame as much on myself, and I take action to improve my own sitution more often. I owe a great debt to the ex-girlfriend who said she thought antidepressants could work for me.

Ten milligrams is the smallest dose available in a single pill of Lexapro. My doctor said that it's the amount she would recommend for a 70-year-old grandma with depression, but that I had demonstrated a lot of sensitivity to chemicals under her care and she'd start me on 10mg. Most people take more, like up to 50 mg a day. But it's safe to start low, says my doctor, because Lexapro appears to have an all-or-nothing result; too low a dose doesn't appear to help much, so you can keep increasing the dose until it becomes effective, and then there's not much improvement in increasing it beyond that.

Lexapro (as well as other SSRIs) has a very long half-life in the bloodstream, so it takes several days of daily doses to ramp up to effective levels, and it slowly ramps down when you stop. Thus the body doesn't treat it as an addictive drug, unlike alcohol, for example, which has an almost immediate result and triggers whatever mechanism the brain has for setting up cravings for chemicals. (It's still not recommended that you stop Lexapro without a doctor's recommendation.)

Two side effects reported often are weight gain and difficulty achieving orgasm. I certainly gained weight, but I was having trouble eating and was losing weight fast beforehand anyway. My weight has leveled off and I actually weigh about as much now as I did a year ago. As far as the latter, it definitely happened to me at first, and that was quite frustrating, but it doesn't seem to be a problem any more. I think it may take a couple of months for the brain to understand its new chemical balance, after which response to sensation returns to normal.

Perhaps my seratonin levels are low because that's just the way my body works. But they might also be lowered by poor nutrition, poor exercise, and extended constant stress. I've gotten rid of a lot of stress in my life, I exercise regularly, and I've changed my diet to include more vegetables and fish. I've started taking vitamin supplements. I hope that I can soon stop taking Lexapro and have my seratonin levels naturally elevated. That will be an experiment for another month!

I hope this is useful for someone. I am also getting a kick out of being a little exhibitionist, as always.

Added Sep 12, 2007: I'm not a doctor, I'm not prescribing Lexapro, and I'm not recommending it. I've simply detailed my experience with it.

As of September 2007, I'm still taking 10 mg Lexapro daily. It still seems to be working for me. Perhaps one day in the near future I may try stopping.

Last modified:
Wed Sep 12 00:53:56 PDT 2007