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Re: SSRI's gateway drugs? » rskontos

Posted by Larry Hoover on August 25, 2007, at 21:07:28

In reply to Re: SSRI's gateway drugs?, posted by rskontos on August 25, 2007, at 20:25:33

> I had partial seizures due to a head concussion as a 10 year old. The doctors said I would eventually outgrown them I did. When I was tapering off cymbalta it started them back up. But when I went to the neuro she has in her opinion a high number of patients due to first time seizure activity with AD without any history. She was so familiar with AD's I was shocked. She did say that lexapro was the best one for me to try as it had the lowest likehood but that they still all had the risk. What is troubling to me was my doctor that prescribed to me didn't think or understand that cymbalta was the not the besrt one and that lexapro was the one she should have used for me. Now I have another issue to deal with if that isn't enough already going on with panic attacks and depression but now I will wake up feeling weird because I checked out for 2-3 minutes. Which was a partial seizure or absence seizure is. No one is aware of what is happening but me. I go to the doctor for help and wind up with another problem that had been dormant. All because someone didn't do their homework before prescribing a Class IV drug.

I've been following your posts re: Cymbalta (duloxetine), and I've been biting my tongue. You are generally correct in what you say, but there are embedded comments which do not accord with the references I have, or sometimes basic physiology. For example, there is no accumulation of duloxetine in tissues. It follows first order kinetics, and is eliminated within days of discontinuation. Effects may linger, but that is the nature of pharmacology; the drug itself must disperse before its effects can do so.

I find no reference to seizure induction from duloxetine in the medical literature, other than one mention of a syndrome called SIAHS, which has been observed with many different antidepressants, and drugs of other classes. The duloxetine monograph includes this small and hardly notable mention: " In placebo-controlled clinical trials, seizures/convulsions occurred in 0.04% (3/8504) of patients treated with duloxetine and 0.02% (1/6123) of patients treated with placebo." The difference was not significant, and the incidence was too small to raise any flags, in any case. If you want to find an antidepressant that is known to lower the seizure threshold, take a look at Wellbutrin (bupropion).

I don't know why you're slagging your doctor for not doing homework when there was no homework to do. And, I don't know which definition of "Class IV drug" you're referring to, but duloxetine is not a drug of abuse. Otherwise, I have no idea what you meant.

I'm sorry you've been through this ordeal, but your experience does not seem to be commonplace, notwithstanding your neurologist's comments.

Lar

 

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poster:Larry Hoover thread:777194
URL: http://www.dr-bob.org/babble/20070824/msgs/778650.html