Posted by Dispossessed on March 3, 2014, at 21:05:35
In reply to Re: Sudden sensitivity to SSRIs/side effects? » Dispossessed, posted by SLS on March 3, 2014, at 20:31:02
> I'm sorry to interrupt and ask a question that may have already been addressed, but how does your OCD manifest? Is it obsessions and ruminations only, or is there a compulsive counterpart including rituals?
Its pure OCD only. Basically, it is a fear that I lose control and either main/hurt myself or somebody else, even though its the last thing I want to do. Obviously, I have never lost control before but when the anxiety is bad I do fear that I would.
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> I don't know. I am still looking at Latuda if you are ruminating and not experiencing compulsions. I have not researched this possibility well enough to recommend it, though. I would try the Brintellix first.Unfortunately both these medications are not available in the UK. The psychiatrist mentioned risperidone at the lowest possible dose, but only if I had titrated up an SSRI with only a partial response. I have concerns with antipsychotics, given the akathisia risk and the fact that most of them hit a lot of receptors (contributing to their huge side effect profile).
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> How did you respond to Luvox and clomipramine?Fluvoxamine appeared to reduce the appearance of the thoughts somewhat, though conversely, it increased my anxiety/restlessness/sense of dread. I was also very careful to avoid anything that could potentially increase anxiety, like caffeine/alcohol, which may have played a role. The good aspects of fluvoxamine were its limited effect on cognition, vision and sexual function. Clomipramine I only took for 11 days. Even though I was only taking 25mg, I experienced severe blurred vision and dizziness that prevented me driving, delayed ejaculation, GI problems and a lot of flatulence, and a general sense of somnolence.
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> Perhaps Phiddipus can comment on combining Brintellix and nortriptyline. You would be adding NRI + 5-HT2a antagonism. Both drugs are metabolized by the same enzyme (CYP450 2D6), though. You might have to reduce the dosage of nortriptyline. With nortriptyline, you can get blood tests to use as a guideline for dosing. Adding the nortriptyline might help with depression, ruminations, and the anxiety that accompanies depression (as opposed to an anxiety disorder).I would definitely be open to trying another tricyclic, but the cognitive/visual side effects would be the killer. For some reason I experience adverse effects from drugs that antagonise histamine or muscarinic receptors. Sertraline (25mg) caused a lot of cognitive problems, blurred vision, a general sense of fatigue (went walking one day and I struggled climbing a hill) - though incidentally it improved sexual functioning slightly. I gave it 4.5 weeks before deciding the side effects were preventing me from getting on with my studies. How long should I have given these side effects to fade? Should I have given it 2-3 months?
Citalopram made me feel pretty sedated - was great for the anxiety/OCD, but again, it had some pretty nasty cognitive and visual problems, owing to its mild antihistamine effect. I took it for 5 months at a very low dose and these side effects didn't go away.
Anyone got any reason why I'm sensitive to these side effects?
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> - Scott
poster:Dispossessed
thread:1061454
URL: http://www.dr-bob.org/babble/20140214/msgs/1061794.html