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Re: Dr. Bob & others - your opinion re SSRIs

Posted by Matt on February 25, 1999, at 2:18:41

In reply to Re: Dr. Bob & others - your opinion re SSRIs, posted by paul frank on February 24, 1999, at 18:43:04

> Thanks for your comments. Its nice to meet another individual with GAD who, like myself, has done some research and wants to be part of the treatment process.
> Remeron is quite new and I live in a community where the medical establishment tends to be somewhat conservative. I agree with you that my doc did not give Prozac a fair chance. If the Zoloft doesn't work, do you think Paxil would be worth a try in light of the fact that 2 SSRIs didn't work?

Well, if the Zoloft doesn't work, you really haven't found that 2 SSRIs don't work, since Prozac probably wasn't given a fair shot. I'd certainly try Celexa before trying Paxil, though. (In fact, I'd try Celexa before trying Zoloft, but that's just based on my own reactions to the two drugs.)

In your experience, how long does it take for an SSRI to kick in for GAD?

Well, I didn't experience full relief on Prozac for 6 months or so, things got bearable after a couple months.

> Every time I take Klonopin (or any other benzo for that matter), I have a favourable response to it. Not only does it eliminate my anxiety, but it also appears to lift my mood (which is probably lousy because of the GAD) and I enjoy my life again. However it will sometimes appear to lose its effectiveness after only an hour or so. The effects appear to last longer if I take it with food. Perhaps my dose is too low (1.0 mg in AM for the whole day - I am a 190lb male)). I would love to switch to Klonopin long term if I weren't so paranoid about the whole dependency thing. I don't take nearly as much of it as I probably should.

Yeah, it does sound as if dosages need to be higher. Klonopin usually is given bid, even though it has a long half-life. In my own case, my doc and I kept upping the dose until I felt better. That number was 2mg for me. I think that the dependency issue is hugely overplayed. Look at this way, with benzos, you need to taper off them slowly when you come off. Go as slowly as you need to. And, btw, Paxil and Effexor can be very tough to get off of, too. Benzos are quite safe, and they're well-known drugs. If I could control my symptoms long-term on just a benzo, I'd be grateful. The SSRIs are quite new compared to the benzos.

> I am certainly hopeful Zoloft works for my GAD and I can once again experience some happiness in my life. However, I am quite concerned about what I have heard regarding "personality changes" with the SSRIs. With all my faults, I am still me and want to remain me - I simply want the anxiety, worry, etc to be brought under control - and nothing else. Do any of the people you know who have responded to the SSRIs, SNRIs and/or the older TCAs feel the meds altered who they were, or just relieved their symptoms?

Many people on SSRIs (and other antidepressants--I wouldn't count on avoiding this by avoiding SSRIs) do feel different than they did prior to the depression. In my own case, I felt much more stable--some of the depths of emotion I had experienced before weren't there with the SSRIs. I regarded this as a negative. But, it certainly was something I was willing to accept for relief from anxiety and depression. There is a section in Tips on SSRIs and apathy. You might want to read it. But, I don't feel as if I'm a fundamentally different person when I'm on an SSRI, or anything like that. So, I wouldn't be too concerned with this; see what happens in your own case after trying the drug, and then you can make a decision (I suspect you'll stick with the drug if it's working).






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