Posted by Scleme1 on September 14, 2015, at 20:22:22
In reply to Re: Switching from Sertaline to Luvox CR. Thoughts?? » scleme1, posted by SLS on September 14, 2015, at 17:06:01
Scott - thanks for the response. I appreciate your input. I do hope that Phiddipus chimes in, as I would love to hear how he is doing on the Brintellix. I'll try to answer a few of your ?'s below.
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> I am a little surprised that Zoloft worked well for you with respect to OCD and anxiety.Quite honestly, I'm not even sure the meds are doing much for me anymore. I've only ever been on the 2 SSRI's - Paxil and Zoloft. I've been on them so long, I don't remember what it was like to be without them. It seems like they both have worked relatively well, but I feel like Paxil did work a little better for me. On the Zoloft, I feel like I get agitated a little easier, and of course - I'm having this terrible insomnia/agitation/akathisia side effect. I don't remember ever having anything like that while on the Paxil.
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> You may need to consider polypharmacy. Phidippus is pretty good with OCD. He has some personal experience with several different treatment strategies. I believe he has reported success with the use of vortioxetine (Brintellix) at a dosage of 40 mg/day.It's funny you mention Brintellix. I have a friend that is a nurse practitioner, and she recently suggested Brintellix to me. She's been seeing great results using it for anxiety at her office.
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> Have you tried one of the atypical antipsychotics? 5-HT2a receptor antagonism might be helpful. Nortriptyline also does this. I don't know of anyone who has combined nortriptyline with a SSRI for OCD, but it might be worth doing a quick literature search.I haven't tried any atypical's yet. I'm a little worried about full blown akathisia with the atypical's, since that is the very thing I'm trying to avoid and the reason I'm abandoning the Zoloft.
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> At this juncture, you can either continue with sertraline and make dosage adjustments and/or add other agents, or switch from sertraline to a different treatment strategy.I think I'm going to give Luvox CR a try for a few weeks. My doctor is also willing to let me try clomipramine, so that's another option. She has had great success combining low dose clomipramine with several of the other SSRI's.
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> It appears that fluvoxamine can produce either initial somnolence or insomnia. I don't know how persistent these side effects are. I hope they are only startup effects. I have never tried fluvoxamine.I've read reports of both - somnolence and insomnia, but like you suggested...it looks like those side effects subside pretty quickly.
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> One step at a time, I guess.One step at a time indeed. Thankfully, there are hundreds of options out there for me to try. It's just a little scary taking the first few steps away from something you've known for so long.
poster:Scleme1
thread:1082469
URL: http://www.dr-bob.org/babble/20150901/msgs/1082482.html