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Re: Lexapro poop-out mattye

Posted by azalea on October 11, 2008, at 12:54:49

In reply to Lexapro poop-out, posted by mattye on October 11, 2008, at 6:05:37

This is an unfortunately all-too-common phenomenon referred to in the literature as tachyphlaxis. Perhaps one of the SNRIs like Effexor (venlafaxine) or Cymbalta (duloxetine) would be beneficial. See journal article below . . .

J Clin Psychiatry. 2005 Jun;66(6):705-7.

Dual reuptake inhibitors incur lower rates of tachyphylaxis than selective serotonin reuptake inhibitors: a retrospective study.

Posternak MA, Zimmerman M.
Department of Psychiatry and Human Behavior, Brown University School of Medicine, Rhode Island Hospital, Providence, 02905, USA.

BACKGROUND: The notion that selective serotonin reuptake inhibitors (SSRIs) may be associated with higher relapse rates than other antidepressants during maintenance treatment (tachyphylaxis) has been discussed for years, but to date there is little or no empirical evidence confirming this phenomenon. In this study, we systematically assessed prior anti-depressant treatment history in a cohort of depressed patients who presented for outpatient psychiatric treatment. Rates of tachyphylaxis were compared in venlafaxine and tricyclic antidepressants (TCAs), which act as dual reuptake inhibitors, versus SSRIs. METHOD: 237 patients who presented for treatment at the Rhode Island Hospital Department of Psychiatry's outpatient practice and were diagnosed with DSM-IV major depressive disorder were interviewed with the semistructured Treatment Response to Antidepressant Questionnaire. This cohort reported having undergone 326 prior SSRI trials, 47 prior venlafaxine trials, and 35 prior trials with a TCA. Rates of tachyphylaxis as a function of antidepressant class were compared. RESULTS: Rates of tachyphylaxis were significantly lower (chi(2) = 6.77, df = 1, p = .01) with the dual reuptake inhibitors venlafaxine and TCAs (3 [3.7%] of 82) compared to rates of tachyphylaxis with SSRIs (46 [14.1%] of 326). CONCLUSION: These results provide preliminary evidence that dual reuptake inhibitors may incur lower rates of tachyphylaxis than SSRIs. By virtue of the retrospective and non-random design of the study, these results warrant confirmation.

> I'm relapsing on my depression. I can no longer deny it. I was doing so well. I haven't told my doctor because (I know this sounds weird), I'm afraid he will get upset. Like all the work he put in was for naught. I always feel like I'm a whiner when I'm depressed. Like I can't just deal with life when it gets a little tough. Suck it up, right. I swear I try to suck it up for so long until you are on the floor crying because you can't motivate yourself to fold a basket of laundry.
> Anyway, the good news is I've been here before and I know I can get through it. Lexapro was good to me. I am no longer have panic attacks. Just melencholia. Maybe time to switch it up? Suggestions?
> Matty E




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