Posted by ed_uk2010 on February 9, 2012, at 18:42:42
In reply to Re: SSRIs etc., posted by Maisey on February 9, 2012, at 17:30:28
Hello,
>I'm sure I read that Paxil is the only one (SSRI anyway) to be approved for OCD, but they could be wrong.
You probably did read it, but it's not true :) There is quite a lot of incorrect information out there on psych meds. This is even more of a problem with psych meds than with meds in general. You can see the FDA approved uses of drugs on the website RxList, or on the manufacturer's websites.
>It seems as if medicines in general aren't much good for this.
They might be, but there's not a great deal of research to say one way or another, or to show which meds are most effective.
>I've tried therapy - not this type - but I just hated it. It was $$$$ and I felt like I wasn't getting anywhere. I only did 2 visits at the most to two different therapists, BUT I've read that short-term therapy or accelerated is most effective by far.
The thing about therapy is that the type of therapy and the personality of the therapist are extremely important. You could hate one therapist but really benefit from another.
>I had some funky affects from Delsym last night (heart rate changes and shakiness) and later read that it can cause mental changes.
Very high doses of dextromethorphan (in cough suppressants) can cause severe psychiatric disturbances, so I assume that milder symptoms can occur when it's taken at therapeutic doses. It is not recommended to take dextromethorphan in combination with antidepressants.
>I've had what I thought was mania at times, but I'm not sure.
You could be somewhere on the bipolar spectrum, rather than having full blown bipolar disorder. This is often the case when there's a family history.
>I wonder why my doctor prescribed Paxil if it cannot be taken with Elavil?
Paxil could be used cautiously in combination with amitriptyline (under close medical supervision), but the dose of amitriptyline would need to be kept very low.
Here is what the manufacturer of Paxil says...
'Co-administration of PAXIL (paroxetine hydrochloride) with other drugs that are metabolized by this isozyme (CYP2D6), including certain drugs effective in the treatment of major depressive disorder (e.g. amitriptyline....) should be approached with caution.'
Here is an extract from a medical journal...
http://www.ncbi.nlm.nih.gov/pubmed/8968657
'Due to its (Paxil's) potent CYP2D6 inhibiting properties, comedication with this SSRI can lead to an increase of tricyclic antidepressants in plasma, as shown with amitriptyline....'
>I'm not saying I doubt you - I don't - but, you would think he would at least have indicated when to take it.
Perhaps he didn't think it was significant since you're only on 25mg of amitriptyline. Personally, I would want to be cautious and reduce the amitriptyline dose down to 10mg or less initially. Still, it would be easier just to use a different SSRI.
>It wouldn't have been enough to get anything out of it, though I don't remember grogginess or anything.
Good to know that you don't recall a bad reaction to sertraline (Zoloft). It gives you an extra option.
Take care!
poster:ed_uk2010
thread:854446
URL: http://www.dr-bob.org/babble/20120202/msgs/1009849.html