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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by pablo1 on July 14, 2004, at 15:12:38
Can anyone recommend a mild SSRI for anxiety?
I've never been suicidal but have always had a low grade depression and repressed anxiety. Quite possibly I have a permanent chemical imbalance after 40 years of this. I've always self medicated with weed & alcohol. So about 6 months ago my career ground to a complete halt causing a divorce, visiting a psychiatrist for depression (years of talk therapy didn't do much).
Wellbutrin -felt icky, couldn't sleep, energetic so not really depressed but...
Then I learned inattentive type ADD may be part of my scenario...
Ritalin, Adderall -just made me more hyperfocussed & obsessive and still avoiding things
then I learned anxiety may be my main problem making me stubborn, uptight and worried therefore avoiding things...
Effexor -immediately sedated any worries I had but still avoiding things & concerned that's such a powerful drug... quitting now and happy to have my emotions back...
Now, my thought is the seratonin thing seems helpful but effexor is such a wicked brew & maybe too much for my needs. I didn't like the noradrenalin effect of wellbutrin & effexor has that too, interfering with my sleep.
I'm thinking an SSRI plus a stimulant for dopamine minus the noradrenaline and trying to mix up a combo that works for me. Lexapro seems a popular SSRI but also sounds wicked in terms of withdrawl & side effects. Prozac? Any other ideas?
Somehow I'm not interested in the whole sleeping pill thing and the SSRI is probably good for me maybe in smaller doses to balance out my brain chemistry a bit without transforming me drastically since I'm not in that bad shape.
Posted by nicky847 on July 14, 2004, at 15:20:34
In reply to Mild SSRI for anxiety?, posted by pablo1 on July 14, 2004, at 15:12:38
I would recommend Celexa. I was on 40 mg for about a year and loved it. Great stuff. I'm on Lexapro now and am Ok with it too.. but since you wanted something mild I would go with Celexa, Lexapro is a little more concentrated.
Posted by pablo1 on July 14, 2004, at 16:11:12
In reply to Re: Mild SSRI for anxiety?, posted by nicky847 on July 14, 2004, at 15:20:34
> I would recommend Celexa. I was on 40 mg for about a year and loved it. Great stuff. I'm on Lexapro now and am Ok with it too.. but since you wanted something mild I would go with Celexa, Lexapro is a little more concentrated.
Sounds like Celexa & Lexapro are essentially the same. I was just looking through a med chart and Paxil stood out as something that only effects seratonin. Lexapro also leaves noradrenaline alone so might be a good choice if there is any validity to this approach. Others like Prozac aren't as narrowly targeted. Zoloft might be OK???
Posted by almondjoy on July 14, 2004, at 16:12:09
In reply to Re: Mild SSRI for anxiety?, posted by nicky847 on July 14, 2004, at 15:20:34
Lexapro would prolly be a good start. Celexa and Lexapro are basically the same, but (as i understand it) after selling Celexa the pharmaceutical company realized that not all the medicine in it was helping. They isolated one part, which is sold as Lexapro now. Lexapro then has less incident of side effects without the extra junk, but it's not necessarily more medicine because it's prescribed at lower dosages.
Lexapro is usually prescribed for people with anxiety and depression. I've been on it since August and feel much better (in general)--alot less anxiety (though i still have some) and my moods are alot more stable. It took a long time, months, before i could say for sure that it was helping.
good luck
d
Posted by pablo1 on July 14, 2004, at 16:37:55
In reply to Mild SSRI for anxiety?, posted by pablo1 on July 14, 2004, at 16:11:12
Any comparisons between Lexapro, Paxil & Zoloft?
Lexapro & Zoloft seem to have some dopamine effects (especially ZOloft), Paxil acts on acetylcholine muscarinic receptor whatever that is (see below).
http://www.bol.ucla.edu/~nwoolf/
"Acetylcholine has been suggested to play a prominent role in the mediation of memory (Woolf et al., 2001) and conscious activity in brain (Woolf, 1997; Perry et al., TINS, 22:273, 1999; Woolf and Hameroff, 2001). Acetylcholine muscarinic receptors affecting the phosphorylation of MAP-2 has implications for quantum computing. Quantum computing in brain microtubules may be tuned by MAP-2 according to Penrose-Hameroff Orch OR (Penrose, 1994; Penrose and Hameroff, 1995). Quantum computing in microtubules, and classical computing involving electrophysiological events around the membrane, may work together (see figure below)."Obviously I don't know what I'm getting into here but neither do the psychiatrists so I might as well try to research what I know is important for me.
Posted by nicky847 on July 14, 2004, at 16:40:43
In reply to Lexapro/Paxil/Zoloft, posted by pablo1 on July 14, 2004, at 16:37:55
Don't know a whole lot about Zoloft but I would avoid Paxil..its been known to be the worst as far as weight gain goes..
Posted by pablo1 on July 14, 2004, at 16:55:42
In reply to Lexapro/Paxil/Zoloft, posted by pablo1 on July 14, 2004, at 16:37:55
Hmm...
"Forest Laboratories has announced the results of a six-month study demonstrating that Lexapro (escitalopram oxalate) is as effective as Paxil (paroxetine HCl) in patients with generalized anxiety disorder (GAD). Results of the 123-patient study found that, although both Lexapro and Paxil were associated with improvement in anxiety symptoms, three times as many Paxil-treated patients withdrew from the study due to adverse events than did Lexapro patients, and more than twice as many Paxil-treated patients experienced weight gain."
Posted by Glydin on July 14, 2004, at 17:40:22
In reply to Lexapro/Paxil, posted by pablo1 on July 14, 2004, at 16:55:42
Paxil actually started my road of finding out what a panic attack entails and anxiety, in general, through the roof. Very weird, but true. Trying is the only way to REALLY find out.
Posted by cpallen79 on July 14, 2004, at 19:45:12
In reply to Lexapro/Paxil/Zoloft, posted by pablo1 on July 14, 2004, at 16:37:55
Pablo, I think it's great that you are doing your homework. Lexapro, theorhetically, is a "clean" med that really hits serotonin only (in theory)... Others such as Prozac and Zoloft may not be as selective (hence you hear that they may be more activating. Paxil tends to be sedating, as does Luvox. I tihnk a stimulant combo might be a good idea, initially you may feel really icky as you will experience sudden drops in dopamine during the peaks and valleys, but that should smooth out eventually. Perhaps something like adderall and Lexapro would work? Another idea would be to add a very low dose of wellbutrin in to an ssri. Alone, wellbutrin can definetely increase anxiety, but with an SSRI, it might be "just right"
> Any comparisons between Lexapro, Paxil & Zoloft?
>
> Lexapro & Zoloft seem to have some dopamine effects (especially ZOloft), Paxil acts on acetylcholine muscarinic receptor whatever that is (see below).
>
>
> http://www.bol.ucla.edu/~nwoolf/
> "Acetylcholine has been suggested to play a prominent role in the mediation of memory (Woolf et al., 2001) and conscious activity in brain (Woolf, 1997; Perry et al., TINS, 22:273, 1999; Woolf and Hameroff, 2001). Acetylcholine muscarinic receptors affecting the phosphorylation of MAP-2 has implications for quantum computing. Quantum computing in brain microtubules may be tuned by MAP-2 according to Penrose-Hameroff Orch OR (Penrose, 1994; Penrose and Hameroff, 1995). Quantum computing in microtubules, and classical computing involving electrophysiological events around the membrane, may work together (see figure below)."
>
> Obviously I don't know what I'm getting into here but neither do the psychiatrists so I might as well try to research what I know is important for me.
Posted by pablo1 on July 14, 2004, at 20:54:28
In reply to Re: Lexapro/Paxil/Zoloft, posted by cpallen79 on July 14, 2004, at 19:45:12
Thanks for the thoughts. I should have tried some of my left over wellbutrin with the effexor before I quit to be surer. My thinking is I just didn't like the wellbutrin & effexor has some of that. I liked the sedation of effexor and hope to get that from a 'clean' SSRI with a clean DA (dopamine) and skip the icky wellbutrin NA (noradrenaline) all together then I realized adderall and all those stimulants act on NA also. Amineptine is a French stimulant with no NA in it, just dopamine. It's supposed to be fairly mild because none of that edgy NA adrenaline stuff I'd guess. But who knows maybe it was the DA in wellbutrin that I didn't like. Strattera is pure NA which I've not tried. Cylert (pemoline) is another which I think is available here. Hmm, now I read pemoline is really bad for your liver and considered sort of a last resort thing.
> Pablo, I think it's great that you are doing your homework. Lexapro, theorhetically, is a "clean" med that really hits serotonin only (in theory)... Others such as Prozac and Zoloft may not be as selective (hence you hear that they may be more activating. Paxil tends to be sedating, as does Luvox. I tihnk a stimulant combo might be a good idea, initially you may feel really icky as you will experience sudden drops in dopamine during the peaks and valleys, but that should smooth out eventually. Perhaps something like adderall and Lexapro would work? Another idea would be to add a very low dose of wellbutrin in to an ssri. Alone, wellbutrin can definetely increase anxiety, but with an SSRI, it might be "just right"
Posted by pablo1 on July 15, 2004, at 2:04:25
In reply to Mild SSRI for anxiety?, posted by pablo1 on July 14, 2004, at 15:12:38
So... my latest thinking is a small dose of Prozac since it's long acting, it's slow going on & easy to get off. I don't know why the docs insist on pushing up the doses when just a little bit has an effect without overwhelming you.
Posted by pablo1 on July 15, 2004, at 2:05:48
In reply to I don't see anything quite like amineptine, posted by pablo1 on July 15, 2004, at 2:04:25
darn titles sticking from the previous post... hmmm
Posted by krybrahaha on July 15, 2004, at 3:08:29
In reply to Mild SSRI for anxiety?, posted by pablo1 on July 14, 2004, at 15:12:38
I would suggest Luvox. Luvox is awesome for anxiety and only affects serotonin
This is the end of the thread.
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