![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by gadman on February 2, 2005, at 10:51:00
I am going from Cymbalta back to Effexor until I can see my Doc. When I see him, I am going to suggest going to a mild SSRI for long term treatment of my GAD.
In your opinions, what is the least harmful, least side effects, SSRI on the market today?
Thanks
gadman
Posted by lunesta on February 2, 2005, at 12:00:48
In reply to Least Intrusive SSRI, posted by gadman on February 2, 2005, at 10:51:00
Lexapro
Posted by Spriggy on February 2, 2005, at 16:27:08
In reply to Re: Least Intrusive SSRI » gadman, posted by lunesta on February 2, 2005, at 12:00:48
I think that totally depends on you.
I have had a horrible reaction to Lexapro so I couldn't give that answer.
Posted by gadman on February 2, 2005, at 16:29:59
In reply to Re: Least Intrusive SSRI, posted by Spriggy on February 2, 2005, at 16:27:08
I have been hearing great things about Lexapro... What kind of horrible reaction did you have?
Posted by whoami on February 2, 2005, at 16:31:19
In reply to Least Intrusive SSRI, posted by gadman on February 2, 2005, at 10:51:00
I had no reaction at all to Lexapro. The only thing it did was leave a "bad taste" in my mouth.
Posted by Phillipa on February 2, 2005, at 18:12:42
In reply to Re: Least Intrusive SSRI, posted by whoami on February 2, 2005, at 16:31:19
Neither my husband or I could take it. It made him giggle inappropriately, and I just was wound up on top of my usual anxiety. Fondly, Phillipa
Posted by gadman on February 3, 2005, at 7:39:09
In reply to Re: Least Intrusive SSRI, posted by Phillipa on February 2, 2005, at 18:12:42
Are there any others I might look at besides Lexapro?
I am suffering from GAD and would like to try life without so many Meds but I think I will need a seratonin boosting agent to help me in the long run.
I would probably supplement with Tryptophan or other alternative to get me by the real tough days.
gadman
Posted by Emily Elizabeth on February 3, 2005, at 8:23:19
In reply to Re: Least Intrusive SSRI, posted by gadman on February 3, 2005, at 7:39:09
I don't have a good suggestion of what to take, but I have one I wouldn't reccomend: Paxil. It was only somewhat helpful and the withdrawal was a nightmare. Withdrawal was over one month of physical symptoms (nausea, dizziness) and emotional symptoms (severe depression, mental fogginess, suicidal thoughts). My pdoc said that she doesn't like to prescribe it anymore for just that reason. I thought that I'd mention it b/c I could see a doc trying to push it on you b/c of anxiety.
Best,
EE
Posted by gadman on February 3, 2005, at 8:31:10
In reply to Re: Least Intrusive SSRI, posted by Emily Elizabeth on February 3, 2005, at 8:23:19
Thanks Emily... Yep, Definitely not Paxil... I am on Effexor now, so I don't want to go from bad to bad... :-)
gadman
Posted by Ritch on February 3, 2005, at 9:02:58
In reply to Re: Least Intrusive SSRI, posted by gadman on February 3, 2005, at 7:39:09
> Are there any others I might look at besides Lexapro?
>
> I am suffering from GAD and would like to try life without so many Meds but I think I will need a seratonin boosting agent to help me in the long run.
>
> I would probably supplement with Tryptophan or other alternative to get me by the real tough days.
>
> gadmanMaybe half a tablet of Luvox at bedtime (25mg)? Haven't heard as much about Luvox withdrawals. Another idea might be a half tab of nefazodone at bedtime. That's fairly weak.
Posted by dove on February 3, 2005, at 9:14:19
In reply to Re: Least Intrusive SSRI » Emily Elizabeth, posted by gadman on February 3, 2005, at 8:31:10
I have responded quite well to only two SSRIs, Effexor and Prozac. None of the others seemed to do anything positive in regards to depression or anxiety.
The only reason I'm adding my experience here is because you have had a positive response to Effexor, which has a wider effect on nore and serotonin, which also coincides with Prozac being a broader SSRI than the other SSRIs.
However, I don't know what dosage of Effexor you have been taking? Don't recall reading it anyway--and cannot really offer any insight without that info. You also stated that Cymbalta isn't working for you, mood-wise or just blood pressure-wise?
Supposedly, Cymbalta also works the serotonin and nore spectrum, but even for all of the negative responses to Effexor--it seems to beat Cymbalta for those great positive responses. Although, maybe it has merely been more extensively marketed.
Anyway, Lexapro is probably the least intrusive according to eye-witnesses who should know. Another one to consider would be Zoloft, didn't help me much but I know many people with anxiety and depression who have benefited greatly from it with minimal or no side-effects.
Hope this helps in some manner...
dove
Posted by gadman on February 3, 2005, at 10:22:19
In reply to Re: Least Intrusive SSRI, posted by dove on February 3, 2005, at 9:14:19
Thanks Dove... I have been taking 75 mg of Effexor for three years. It was my first experience with such a drug until the Doc wanted to switch me to Cymbalta appr 1 month ago.
Cymbalta alone was flattening my mood more than anything where on Effexor I feel ALIVE... No other way to put it. So Mood wise, I guess I felt more like my old self on Cymbalta... Kinda flat, agitated easily, Social Anxiety, etc...
So the question that keeps coming up in my head, is do I want to go back to the way I was before prior to Effexor (very introverted, Kept in my own little world, depressed, etc....) Or do I want to feel alive?
Posted by Spriggy on February 3, 2005, at 11:16:56
In reply to Re: Least Intrusive SSRI » dove, posted by gadman on February 3, 2005, at 10:22:19
Don't shoot down Lexapro just because it didn't work for me (or a few others). My mother has good success with it.
It put me into an extreme agitated depression accompanied with suicidal thoughts. I've never experienced depression like that before or suicidal thoughts.
I went on it for anxiety/panic attacks and it sent me into the worst anxiety depression of my life. I took it for 5 weeks and finally weaned off according to my pdoc's advice.
Apparently for a few people, SSRi's can make them worse according to my pdoc. I just happen to be one of those chosen few.
You can give Lexapro a try. It may work for you. No matter what drug you go on, there will always be someone who had a horrible reaction and other people who say it saved their life.
Our brain chemistry is so different- it's really individual basis.
Posted by olysi79 on February 3, 2005, at 11:30:50
In reply to Re: Least Intrusive SSRI, posted by Emily Elizabeth on February 3, 2005, at 8:23:19
Hmm, I found PAxil to be a cakewalk getting off of in comparison to Effexor. If you switch from one to the other directly, the withdrawals are minimal.
> I don't have a good suggestion of what to take, but I have one I wouldn't reccomend: Paxil. It was only somewhat helpful and the withdrawal was a nightmare. Withdrawal was over one month of physical symptoms (nausea, dizziness) and emotional symptoms (severe depression, mental fogginess, suicidal thoughts). My pdoc said that she doesn't like to prescribe it anymore for just that reason. I thought that I'd mention it b/c I could see a doc trying to push it on you b/c of anxiety.
>
> Best,
> EE
Posted by medhed on February 4, 2005, at 5:21:24
In reply to Re: Least Intrusive SSRI » Emily Elizabeth, posted by olysi79 on February 3, 2005, at 11:30:50
I like Prozac for least amount of side effects. It pooped out on me after a few years I got up to 80mg. for OCD.
Now I'm on Effexor and it's a nightmare.
But I don't even care...
Posted by dove on February 4, 2005, at 9:16:57
In reply to Re: Least Intrusive SSRI, posted by medhed on February 4, 2005, at 5:21:24
Effexor at a dosage of 75 mg supposedly doesn't push the nore so much as just the serotonin, so you should probably look at Zoloft, Prozac, Lexapro and lastly Paxil for the social anxiety/GAD.
Lexapro is the newest of that grouping, with a milder side-effect profile than Paxil. Paxil is known as the worst offender when it comes to sexual side-effects and dysfunction. Paxil also seems to cause weight gain more often than Zoloft or Lexapro (Prozac being the most weight neutral of all SSRIs). Zoloft is older than Lexapro, so more firsthand experiences and anecdotal advice will accompany it.
Lexapro is one of the few SSRIs I have not had to try, but my pdoc did not think it would be very beneficial to me due it being "very mild" and "serotonin specific". Which might make it a good choice for you :o)
Zoloft is broader than Lexapro, and Prozac is known as the broadest SSRI as well as being the most activating. Prozac also has the longest half-life, is easy to discontinue if needed with little if any withdrawal symptoms. Prozac's activating profile does lend itself to initially increase anxiety, but within a few weeks its anti-anxiety effects should kick in.
I know I'm rambling and I apologize, I didn't get much sleep last night (took my Effexor before bed--not a good idea). Personally, I would look at Zoloft, Prozac, and then Lexapro.
Hope this ramble helps in some way, best of luck to you!
dove
Posted by gadman on February 4, 2005, at 9:40:49
In reply to Re: Least Intrusive SSRI, posted by dove on February 4, 2005, at 9:16:57
Thanks dove... What do you mean by "broadest"?
Posted by Rosee on February 6, 2005, at 23:43:21
In reply to Least Intrusive SSRI, posted by gadman on February 2, 2005, at 10:51:00
> I am going from Cymbalta back to Effexor until I can see my Doc. When I see him, I am going to suggest going to a mild SSRI for long term treatment of my GAD.
>
> In your opinions, what is the least harmful, least side effects, SSRI on the market today?
>
> Thanks
Hi. I had a good response and no serious side effects from Prozac. It takes time to fully get into your system, however.
>
> gadman
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.