Lexapro - What is the mildest antidepressant with the least amount of side effects?

Xanax (generic=alprazolam) is a benzodiazepine ("a class of drugs with sedative, hypnotic, anxiolytic, anticonvulsant, amnestic and muscle relaxant properties") not an antidepressant. It is commonly prescribed/used to relieve anxiety... it is fast acting (within approx. 30 minutes of taking single dose) but the duration of anxiety relief is also short (typically lasting only about 4-5 hours).

When first diagnosed with OCD (and postpartum depression) about 1 year after the birth of my 1st child (over 12+ years ago), I took 200 mg of Zoloft and 50-100 mg of Trazadone for 6+ years to treat my OCD and associated anxiety, along with .5 to 1 mg of Xanax daily (either at bedtime or as needed for panic attacks). At the time... this seemed to work for me.

When I became pregnant with my 2nd child over 6 years ago, I discontinued all mede. When my 2nd child turned 3, and my OCD and anxiety symptoms were beyond what I could overcome on my own... I sought treatment again. I tried to resume my previous medication regime (200 mg Zoloft+Trazadone+Xanax). Since my "chemical/hormonal make-up" had substantially changed... this combination of meds did not work. My prescribing Dr discontinued the Zoloft & Trazadone, and replaced them with 10 mg of Lexapro and increased my Zanax to 1.5 to 2 mg daily, at bedtime or as as needed.

I am presently taking 10mg of Lexapro daily, 1mg of Klonopin and 1.5 to 2 mg of Xanax (usually at bedtime). Based on my personal experiences with both Zoloft and Lexapro (both are SSRI antidepressants)... I would STRONGLY suggest trying Zoloft first.

Both antidepressants can have side effects for some (and none for others). However, the half-life of Zoloft is much shorter than Lexapro... meaning that if you decide to discontinue the Zoloft (at some point) or to switch antidepressants... it will be much easier to do so and you would likely experience minimal (and milder) withdrawal symptoms, if any at all. Lexapro has a much longer half-life (meaning you may not experience any "discontinuation withdrawal" symptoms for 4-7 days) after discontinuing the Lexapro or switching to another antidepressant). However, the "discontinuation" withdrawal symptoms from discontinuing or tapering your Lexapro dose is a much longer process... the withdrawal symptoms from Lexapro are much more extreme and can last for months. Further, if you do not have health insurance and cost if a factor... Zoloft is available as a generic ($7-8 at Costco) and Lexapro does not have a generic equivalent (and won't until 2012) and thirty 10 mg tablets (at Costco) costs around $90. Other pharmacies (CVS, Walgreen's or even Wal-Mart) charged over $135 for the same monthly dose/supply.

I know I have provided a long answer to your question... so in summary... I would STRONGLy SUGGEST trying ZOLOFT FIRST and allowing 4-6 weeks (if not up to 8 weeks) to see if it works for you. My Dr. suggested Lexapro as it was studied and "proven" to be the most effective SSRI antidepressant for OCD and GAD (generalized anxiety disorder). Yet, in my personal opinion, Lexapro is minimally effective against my particular symptoms.

I have also tried to switch from Lexapro to Celexa, along with trying to slowly taper my dose of Lexapro (to discontinue altogether)... only to experience the most intense and debilitating withdrawal symptoms I could have ever imagined and ended up resuming my daily Lexapro dosage (despite the higher cost and uncertainty of its effectiveness). Had my prescribing Dr. told me about the possible side effects and/or withdrawal symptoms... and if knew then what I know now), I would have NEVER even tried Lexapro.

I would also avoid Wellbutrin and Effexor as I have read (and heard from other frieds) that they both have unpleasant side effects and are also very difficult/uncomfortale to discontinue.

Best of luck to you in whatever decision you make... but again strongly suggest trying Zoloft first.