Posted by Cam W. on May 14, 2001, at 12:38:18
In reply to Re: Fluoxetine and Zopiclone, posted by Lisa Simpson on May 14, 2001, at 11:43:54
Lisa - I said that Imovane™ (zopiclone) is weird because of what happened to you. The drug kinda creeps up on you. Imovane does have a short half-life, so your doc was giving you two tabs at bed so that you would be able to sleep throught the entire night. Also, some people, including me, wake up with a very bad, metallic taste in their mouth after taking zopiclone.
The fluoxetine (Prozac™) is similar to, but different from paroxetine (Paxil™). It may work for you where paroxetine didn't. If after 8 weeks you do not notice a difference, a trial of Wellbutrin SR™ (bupropion) or Effexor XR™ (venlafaxine) may be in order, as these antidepressants affect the norepinephrine neurons. If an SSRI doesn't work then you have to try something with a different mechanism of action.
As for weight gain. Of the SSRIs, Paxil seems to be the worst offender for causing a delayed weight gain. This weight gain seems to occur, usually, 12 to 16 weeks after starting an SSRI. I do not see nearly as many people getting as much weight gain from fluoxetine as from paroxetine. This being said, not everyone gains weight while taking SSRIs, but many do.
As for the biochemical problem causing depression, all our activities are biochemical, including our thoughts. Therefore, to the best of our knowledge, purely psychological problems cause biochemical abnormalities in the brain. When the body is overloaded with stress the body's stress response system (the HPA axis) begins to break down or uncouple. This results in a manifestation of the symptoms we collectively call 'depression'. This depression can be caused by a number of different malfunctions of the HPA axis, but the end result (the depression) look similar. Most depressions seem to be due in part to a breakdown in the serotonin nerve system. SSRIs seem to work for these people. Others seem to have a breakdown of the norepinephrine nerve system in which SSRI don't work very well. This is where you would try Wellbutrin, or Effexor (or, if it was available in Canada, reboxetine) which act to some extent on norepinephrine neurons.
The best non-benzodiazepine sleeping pill we have is zopiclone. They use to use Librax and Valium for the insomnia caused by alcohol withdrawl. The new Starnoc™ (zapelon) is only good for those who have trouble falling asleep and don't wake up once asleep. I would stick with the zopiclone if I were you.
Hope this helps - Cam
poster:Cam W.
thread:62497
URL: http://www.dr-bob.org/babble/20010507/msgs/62910.html