Posted by linkadge on January 13, 2013, at 13:40:24
In reply to Re: Pooped out SSRI - No discontinuation problems? » linkadge, posted by Prefect on January 12, 2013, at 19:28:00
As far as efficacy. SSRIs are powerful medications (at least in terms of altering brain chemisty - for good or bad).
Reducing the dose could upset brain chemistry and increasing it might not immediately restore that ballance. You can try the 50mg of luvox again for a longer period of time.
As far as fear extinction you are right. The medications can possibly block the aquizition of new fear (by blunting stress hormones). But, they interupt emotional processing (REM supression). Basically the placticity of the amygdala is impaired.
Exposure therapy for very specific phobias can be effective. Social phobia is complex however. Improvement requires not just the blunting of reaction to social situations, but improving skills that make you feel in control socially.
I would personally go back to 50 mg of luvox. Can you add a benzodiazapine?
poster:linkadge
thread:1035302
URL: http://www.dr-bob.org/babble/20130112/msgs/1035389.html