Posted by JohnL on March 17, 2000, at 4:15:39
In reply to Please Answer This: Mix 2 SSRI's in low doses?, posted by Annie on March 16, 2000, at 20:14:48
I've often wondered the same thing about mixing SSRIs. Though they all do basically the same thing, they do so in very different ways. At a molecular level they are completely different drugs and have completely different effects on more things than just serotonin.
I don't think you'll find a doctor who will endorse mixing SSRIs, so it would be self experimentation if you do it.
I have heard of a SSRI combined with Effexor, which is very similar to mixing SSRIs. Or mixing a SSRI with a serotonin TCA like Clomipramine. In Dr. Bob's Tips one phsycian reports a patient who takes 60mg Prozac + 75mg Effexor.
At the low doses you mention I can't foresee any serotonin syndrome risks. I mean, what's the end result difference between say 10mg Paxil plus 10mg Celexa compared to 20mg Paxil alone or 20mg Celexa alone. I think if you combined say 40mg Celexa with 40mg Paxil you would be asking for trouble. But at conservative doses it seems OK to me. Just my opinion though.
What might be more unpredictable is side effects. There's no telling how each drug will interfere with each other's metabolism and maybe cause wierd side effects, like anxiety or headaches or something. Who knows. While it's probably safe, and to me makes sense like you suggested, it would be self experimentation and not likely endorsed by a physician. As I always say, dip your toes in the water first before jumping in. I think 5mg of each would be a good start to feel it out, rather than 10mg. But again, that's just my guess. No more than a guess. Who knows, it might work wonderful, or it might not. It does kind of make sense, to me, to get the subtle unique benefits of two different drugs, even though they are in the same class. If you try it, I hope it goes well. Maybe it'll work out as good as you expected and maybe not. Just have to try it and see. I personally wouldn't be afraid of trying it, but I would definitely start at lower doses than you mentioned, just to feel it out first before going higher. I've tried stranger more dangerous things without problems.
poster:JohnL
thread:27247
URL: http://www.dr-bob.org/babble/20000312/msgs/27308.html