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Re: Low dose SSRI for anxiety?

Posted by Mistermindmasta on July 21, 2005, at 23:15:21

In reply to Re: Low dose SSRI for anxiety? » Franz, posted by KaraS on July 21, 2005, at 21:55:43

> > Hello,
> >
> > I want to avoid long term use of benzodiazepines for anxiety.
> >
> > The problem I have with SSRIs is that at antidepressant doses I do not get much antidepressant effect but they are sedating.
> >
> > I would like to know if someone knows if it is possible to use a SSRI but at a lower dose to help with anxiety but not get a sedating effect.
> >
> > I have tried Zoloft and Effexor and the last gave me the less side effects. Any other is better for what I want?.
> >
> > What about low dose SSRI plus some 5HTP?.
> >
> > Thanks
>
>
> Zoloft and Effexor took care of my anxiety without making me feel sedated. Were you on them long enough for your body to adjust? Sometimes the sedation will go away completely in time. If you have given it an adequate trial, then maybe SSRIs are just not for you. If I were you I'd try Prozac as it's one of the most stimulating SSRIs. If that doesn't work, I'd look elsewhere. The TCAs or mood stablizers might work for you if you don't want to use a benzo.
>
>

True... Prozac can be more stimulating. In fact, there's an article on medscape that rates SSRI's by how sedating they are. Maybe I'll come across it again soon. Anyway, I would tend to believe that you might be able to lower or raise the doses of your SSRI's to eliminate the sedation. This depends on many biochemical pathways which I can't quite remember now, but let's put it this way... we all know SSRI's inhibit the reuptake of serotonin. But they also effect the reuptake of norepinephrine (weakly), they effect histamine levels, muscarinic acetylcholine activity (? think so), 5-HT3C receptors and other receptors, but again, can't remember specifics. Bottom line though, your sedation more likely depends on SSRI activity at some of these other sites than the serotonin reuptake site itself. By upping or lowering your dose, you could gain a more stimulating effect and / or a less sedating effect. I really, at this point in time, can't be more specific with any recommendations though.


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URL: http://www.dr-bob.org/babble/20050718/msgs/531270.html