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Re: Thus ends the escitaliopram trial linkadge

Posted by SLS on August 11, 2022, at 8:57:35

In reply to Re: Thus ends the escitaliopram trial, posted by linkadge on August 9, 2022, at 18:29:33

Hi, Linkadge.

> Again, the problem is that I don't have access to a psychiatrist in Canada. My regular doctor doesn't prescribe anything but escitalopram and paroxetine (essentially).
> Linkadge

I forgot about the roadblocks that leave you fundamentally untreated.

Generally speaking, paroxetine (Paxil) is the most efficacious SSRI. However, it is also the SSRI having side effects of the greatest magnitude. It is also hell to discontinue. Its robust anticholinergic properties might contribute to the greater therapeutic efficacy of paroxetine. However, this is the property that is most responsible for the higher side-effect load of paroxetine compared to the other SSRIs.

There is another disadvantage to choosing to be treated with paroxetine.

1. Paroxetine is the SSRI with the highest rate of relapse.

2. Paroxetine the least capable of recapturing an antidepressant response once a successful treatment has been discontinued.

An obvious question emerges:

If one is treated successfully with paroxetine, but ultimately relapses, does he then become less responsive to all SSRIs?

If this is true, then it is insanity to place paroxetine near the top of a list of drugs to be trialed.

Along the way, there were two treatments that my doctor suggested that I thought had no chance of working... but they did.

1. Prazosin 30 mg/day as 10 mg t.i.d. (I don't remember why I discontinued it).

2. Monocycline (I don't remember the dosage).

* I had to discontinue monocycline when I developed hyperpigmentation of my shins and feet.

- Scott

Some see things as they are and ask why.
I dream of things that never were and ask why not.

The only thing necessary for the triumph of evil is that good men do nothing.




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