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Dr. Bob is Robert Hsiung, MD,
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Posted by kreedi on April 4, 2002, at 22:53:42
Should underweight patients take correspondingly lower doses of ADs? I'm on Celexa, 20 mg, 3 weeks or so, only a slight improvement. Contemplating moving up to 30 mg. But not sure because of (i)increase in sexual side-effects (already significant ejaculatory delay) and (ii) the fact that I'm pretty underweight -- 110 pounds, 5'8" (29 male). Do skinny people require lower doses of meds or don't ADs work that way?
Also, reading the literature on citalopram, it seems that 20 mg wasn't too effective in trials, and most people (on this board at least) seem to take at least 40 mg. Yet, I've read elsewhere that 20 mg is the ideal therapeutic dose. Why the discrepancy in information? Should I try a higher dose to get my depression in remission and then go back down to 20 mg as prophlaxis?
Any comments welcome,
Kreedi
Posted by TSA West on April 5, 2002, at 1:42:03
In reply to SSRI (celexa) dosing and weight, posted by kreedi on April 4, 2002, at 22:53:42
Table 3.7 on Dr. Preskorn's site (http://www.preskorn.com/cgi-bin/sp.pl?words=citalopram&wt=be&bl=an&IMAGE1.x=0&IMAGE1.y=0&d=/books/ssri_s3.html) claims that 40 mg is the usually effective dose of citalopram, because it creates a minimum of 60% inhibition of the 5-HT uptake pump. Body weight has little to do with efficacy of a drug at a Site of Action--rather a person's natural levels of serotonin, norepinephrine, or dopamine determines how much medicine is needed for a clinical response. Its too bad that that cannot be measured by a simple blood test.
Once you have maintained a year's remission of depressive symptoms then you can consider lowering a previously effective dose in order to gain sexual normalcy.
((((((((((kreedi))))))))))))
Posted by lizzyg on April 5, 2002, at 3:36:30
In reply to SSRI (celexa) dosing and weight, posted by kreedi on April 4, 2002, at 22:53:42
Kreedi - I was just wondering if the Celexa might also be having a negative effect on your weight, as it sounds like you don't want to lose any more.
I was on Citalopram (20mg) for a couple of weeks but gave it up because of worsened anxiety and agitation. During that time, I lost five pounds in weight, and I'm pretty small, too. I normally love my food, but found I just didn't want to eat with the Citalopram, and had to force myself.
Taking into account your other side effects, do you think you'll persevere or try something else?
Best wishes
Lizzy
Posted by kreedi on April 5, 2002, at 4:55:57
In reply to Re: SSRI (celexa) dosing and weight, posted by lizzyg on April 5, 2002, at 3:36:30
I wonder whether the weight loss (lost 10 pounds or so in the last few months, been on Celexa for only three weeks) is due to the citalopram, or a result of the stress and depression I've been undergoing. But I'm still losing some weight, I think; I'm pretty sure that SSRI's make me lose weight, and prevent my gaining much -- this happened when I was on Prozac for a year.
I'm a pretty fidgety person -- twirling a pencil in my hand, moving my tongue about along my teeth, tapping with toes and fingers etc. I think this "fidgeting" has gone up recently. Is this (one of) the things people mean when they say that a drug makes them more "agitated"?
Think I'll stick with with citalopram, at least for the present -- the sexual side-effects aren't too bad (MUCH better than sertraline and paroxetine, comparable to fluoxetine). No other side effects. I'm just worried about my weight, yes, I don't want to lose any more.
Kreedi
This is the end of the thread.
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