Posted by yxibow on November 23, 2006, at 20:21:31
In reply to Re: SSRI EPS, posted by med_empowered on November 22, 2006, at 0:05:22
> the whole eps from antidepressant thing is interesting in part b/c its been noted since the days of the tricyclics...alot of the problems that were "discovered" after ssri use (a discontinuation syndrome, eps/td, drug-induced mania/psychosis, apathy, etc.) were noted years and years ago with TCA use. I guess the assumption was that these new, perfect drugs wouldn't cause the same problems as old, "dirty" drugs?
>
> Anyway...I've read of cases of prozac induced TD and celexa induced TD and effexor induced movement problems (which makes sense, since docs can ramp up the dosage to crazy levels). I wasnt able to find anything about 1 ssri doing it more often than other...I would imagine that it would be kind of like TD with old neuroleptics: the agent used is less important than the dosage, amount of time used, and patient characteristics (age, gender, ethnicity, other meds, etc.)
I believe Zoloft may cause more TD cases (these are very rare, by the way, and are more case reports than mainstream amounts, naysaying discounted about SSRIs in general) because of its slight action on dopamine.Tricyclics have more possibility of TD, although even this is in the noise level, such as Seroquel and other low potency atypicals.
EPS like symptoms are possible, this is true, and your surmising about sky high dosage is probably related to SSRI induced akathisia. Again, you have to account for the millions of people who have been lifted out of dysthymia or OCD or other disorders by SSRIs who aren't on the board here because the medicine "works" for them. I've posted that trend before, but it is true that unfortunately for those of us who require polypharmacy, there is naturally going to be a greater amount of complaint and upset over medication.
And that isn't to reduce the dignity of those who have trouble with MDD and other serious depressive disorders -- its just to say that complaints as a human factor are higher.
-- Jay
poster:yxibow
thread:705905
URL: http://www.dr-bob.org/babble/20061123/msgs/706550.html