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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by SLS on September 16, 2015, at 6:38:38
Comparison of the SSRIs:
http://www.emedexpert.com/compare/ssris.shtml
- Scott
Posted by Lamdage22 on September 16, 2015, at 14:01:18
In reply to Comparison of the SSRIs:, posted by SLS on September 16, 2015, at 6:38:38
Thanks Scott.
I am reluctant to try all. My former doctor said that the others either have QT issues or cause more of akathisia than what i had already been on. (I think Sertraline).
I sure hate akathisia. But Sertraline cut out suicide thoughts for me and made me more hopeful. (If there hadnt been that nasty akathisia).
My next "experiment" will be cannabidiol in october.
Posted by Lamdage22 on September 16, 2015, at 14:03:23
In reply to Re: Comparison of the SSRIs:, posted by Lamdage22 on September 16, 2015, at 14:01:18
As my antipsychotic dosages decline i may be able to try the SSRIs with QT issues? escitalopram and citalopram i believe.
I am very skeptical.
Posted by SLS on September 17, 2015, at 7:43:33
In reply to Re: Comparison of the SSRIs:, posted by Lamdage22 on September 16, 2015, at 14:03:23
Hi Lamdage.
I think that as long as you continue to have an open mind and patience, you will eventually figure out how to effectively treat your condition with the minimum number of drugs at the lowest dosages.
Do you have a plan beyond CBD? CBD is an interesting choice. As you know, it has antipsychotic properties. What else does it do? What are your reasons for taking it? I will be interested to see how you respond to it.
Regarding SSRIs, Luvox (fluvoxamine) is supposed to be good for treating psychotic depression. It is also the SSRI least apt to cause akathisia according to what I have read. Your inclinations to avoid Zoloft (sertraline) in particular for fear of akathisia is justified in my opinion.
It is too bad that you cannot tolerate higher dosages of Effexor. I would consider taking a look at Pristiq, the active metabolite of Effexor. Lower dosages can produce a robust antidepressant response. I would expect it to help with anxiety disorders, too.
Effexor + CYP2D6 (liver enzyme) = Pristiq
It is possible that you are sensitive to Effexor but not to Pristiq. That is my hope, anyway.
- Scott
Posted by Lamdage22 on September 17, 2015, at 13:37:13
In reply to Re: Comparison of the SSRIs: » Lamdage22, posted by SLS on September 17, 2015, at 7:43:33
> Hi Lamdage.
>
> I think that as long as you continue to have an open mind and patience, you will eventually figure out how to effectively treat your condition with the minimum number of drugs at the lowest dosages.
>
> Do you have a plan beyond CBD? CBD is an interesting choice. As you know, it has antipsychotic properties. What else does it do? What are your reasons for taking it? I will be interested to see how you respond to it.Hmm for the antipsychotic properties i probably cant take it due to the cost of the required dosages. I havent thought of it.
I guess i expect some kind of comfortable effects (calming and/or mood lifting).> Regarding SSRIs, Luvox (fluvoxamine) is supposed to be good for treating psychotic depression. It is also the SSRI least apt to cause akathisia according to what I have read. Your inclinations to avoid Zoloft (sertraline) in particular for fear of akathisia is justified in my opinion.
It may be worth a shot. I wish i knew what the name is in german. They have that med here. With Sertraline i only needed low dosage for the effects (more hopeful, no suicide thoughts). Maybe it is that way with Luvox, too.
> It is too bad that you cannot tolerate higher dosages of Effexor. I would consider taking a look at Pristiq, the active metabolite of Effexor. Lower dosages can produce a robust antidepressant response. I would expect it to help with anxiety disorders, too.
Also worth consideration.
>
> Effexor + CYP2D6 (liver enzyme) = Pristiq
>
> It is possible that you are sensitive to Effexor but not to Pristiq. That is my hope, anyway.
>
>
> - ScottYou mean that Pristiq might have less anorgasmia? This is the big concern for me with Serotonergic drugs.
Posted by Lamdage22 on September 18, 2015, at 2:16:38
In reply to Re: Comparison of the SSRIs:, posted by Lamdage22 on September 17, 2015, at 13:37:13
i suppose a drawback is that i would have to visit my psychiatrist way more often.
What do you think Scott, might low dose luvox be efficient?
Posted by SLS on September 18, 2015, at 5:29:00
In reply to Re: Comparison of the SSRIs:, posted by Lamdage22 on September 18, 2015, at 2:16:38
> What do you think Scott, might low dose luvox be efficient?
I don't have enough of a "feel" for using Luvox to make any predictions. Sorry.
The dosage range for OCD is 100 to 300 mg/day. One is supposed to start at 50 mg/day.
It is interesting that you should respond at all to 37.5 mg/day of Effexor. Perhaps 50 mg/day of Luvox would be enough. However, if you are tolerating it well, I would not wait longer than two weeks before increasing the dosage according to the manufacturer's recommendations.
http://www.rxlist.com/luvox-drug/indications-dosage.htm
- Scott
Posted by Lamdage22 on September 18, 2015, at 12:40:34
In reply to Re: Comparison of the SSRIs: » Lamdage22, posted by SLS on September 18, 2015, at 5:29:00
> It is interesting that you should respond at all to 37.5 mg/day of Effexor.
Its funny, huh? I also responded to minimal Sertraline Dosages.Much more so than Effexor.
Perhaps 50 mg/day of Luvox would be enough. However, if you are tolerating it well, I would not wait longer than two weeks before increasing the dosage according to the manufacturer's recommendations.
Is it possible that luvox (or pristiq) lacks sexual side effects for me?
>
> http://www.rxlist.com/luvox-drug/indications-dosage.htm
>
>
> - Scott
>
Posted by Lamdage22 on September 19, 2015, at 8:17:34
In reply to Re: Comparison of the SSRIs:, posted by Lamdage22 on September 18, 2015, at 12:40:34
i see that Luvox has a warning for hostility as a side effect.
Posted by bleauberry on October 2, 2015, at 15:08:31
In reply to Comparison of the SSRIs:, posted by SLS on September 16, 2015, at 6:38:38
I always found charts like these very interesting. Excellent distractions from my pain. Get me thinking. Armchair quarterback. You know the drill.
I find that information helpful to narrow down choices, but I never found them helpful for choosing the med that was going to help me more than another one. Might as well toss a coin for similar results.
Interesting though.
I think some of the old time theories they still cling to are wrong. For example, the elevation of neurotransmitters leads to improved mood. That is purely false. It it were true, then a single dose of 5HTP would work miracles. Or tyrosine. But that doesn't happen. The 6 to 12 week thing still applies, which means that theory is off base.
It could be the down regulation thing. Others would say that is just a polite way of saying brain damage, since 60% of the serotonin receptor sites disappeared during that supposed down regulation. Who knows.
Good charts. Thank you Scott.
This is the end of the thread.
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