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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by joe f on December 19, 2014, at 11:52:07
which ssri's effect serotonin only with no dopamine or norephineprine effect?
Posted by Phillipa on December 19, 2014, at 12:07:34
In reply to ssri's-serotonin only, posted by joe f on December 19, 2014, at 11:52:07
I would say prozac, lexapro, luvox, zoloft, celexa, I bet there are others now also. Phillipa
Posted by SLS on December 19, 2014, at 17:38:50
In reply to ssri's-serotonin only, posted by joe f on December 19, 2014, at 11:52:07
> which ssri's effect serotonin only with no dopamine or norephineprine effect?
SSRI: citalopram (Celexa) / escitalopram (Lexapro)
To the best of my knowledge, vilazodone (Viibryd) and vortioxetine (Brintellix) are devoid of direct effects on dopamine (DA) and norephineprine (NE) neurotransmission.
Why do you want to avoid DA and NE?
- Scott
Posted by joe f on December 19, 2014, at 23:55:35
In reply to Re: ssri's-serotonin only » joe f, posted by SLS on December 19, 2014, at 17:38:50
because of activation
Posted by SLS on December 20, 2014, at 0:45:22
In reply to Re: ssri's-serotonin only, posted by joe f on December 19, 2014, at 23:55:35
> because of activation
Which drugs did you find the most activating?
Which drugs produced some degree of improvement?
- Scott
Posted by joe f on December 20, 2014, at 1:03:45
In reply to Re: ssri's-serotonin only » joe f, posted by SLS on December 20, 2014, at 0:45:22
luvox ---dr. won't prescribe--best
Posted by SLS on December 20, 2014, at 1:31:06
In reply to Re: ssri's-serotonin only, posted by joe f on December 20, 2014, at 1:03:45
> luvox ---dr. won't prescribe--best
What is your doctor's concern with Luvox?
- Scott
Posted by rjlockhart37 on December 20, 2014, at 10:22:47
In reply to Re: ssri's-serotonin only » joe f, posted by SLS on December 20, 2014, at 1:31:06
prozac does effect lightly dopamine and NE but it's going to be good for acivation, i don't think there's many cases of anxiety with prozac.....
it would be a good option, maybe you can ask about it
i been on prozac since 2005, body adapted to it so it's not as potent as it used to be......
luvox is sedating, maybe lexepro?
Posted by tom2228 on December 20, 2014, at 12:12:09
In reply to Re: ssri's-serotonin only, posted by rjlockhart37 on December 20, 2014, at 10:22:47
Lexapro is the most selective SSRI for serotonin that's on the market. It is closest you can find to a pure 5-HT reuptake inibitor.
Celexa is a close second but has slight antihistamine action. Perhaps this would be best for minimizing activation if you can't go for Luvox -- or maybe Paxil?
Luvox: additional blockade of sigma-1 receptor (more strongly than that of Zoloft)
Paxil: additional effets on muscarinic acetylcholine receptors, slight NE reuptake inhibition, and inhibition of nitric oxide synthase
Zoloft has additional effects on sigma-1 receptors and is a slight dopamine reuptake inhibitor. I found it pretty peaceful but kind of jittery, although this isn't the same as the activation I experienced on Prozac.
Prozac additionally blocks 5-HT2c receptors and slightly inhibits NE reuptake. Activating but less peaceful and clear than Zoloft; more stimulating; more "comfortable" but more busy in the mind.
But remember these neurochemical properties do not necessarily equate to the preconceived notions we have about neurotransmitter "feelings" when it comes to how the drug will feel for us.
Here's more information on their comparative mechanisms of action--
--complicated: http://www.preskorn.com/books/ssri_s3.html
--more simple: https://books.google.com/books?id=BBtMzTV8OMgC&pg=PA296&lpg=PA296&dq=ssri+differences+stahl&source=bl&ots=HforscSoMW&sig=vEcJlb18eYiSWRFBdnMExeP5kNU&hl=en&sa=X&ei=p7iVVJqRNsKvggSvqILICA&ved=0CDEQ6AEwBQ#v=onepage&q=ssri%20differences%20stahl&f=falsecomparison of most-prominent side effects and efficacy:
http://www.preskorn.com/books/ssri_s5.html
Posted by joe f on December 21, 2014, at 8:06:46
In reply to Re: ssri's-serotonin only, posted by tom2228 on December 20, 2014, at 12:12:09
dr says luvox to many interaction....pharmacist calls it ia dirty drug
Posted by SLS on December 21, 2014, at 22:30:09
In reply to Re: ssri's-serotonin only, posted by joe f on December 21, 2014, at 8:06:46
Tell your doctor that Luvox only interacts with those drugs that it interacts with. Let him do his homework and determine the interactions between only those drugs that *you* take.
Tell your pharmacist that you would eat dirt if it would cure you.
- Scott
Posted by burial on December 23, 2014, at 14:05:02
In reply to Re: ssri's-serotonin only » joe f, posted by SLS on December 21, 2014, at 22:30:09
Paxil is the most effective anxiolytic and sedative agent among the SSRI and it is least likely to produce mania according to Stahl, but as far as something like luvox would it would look more like lexapro with sigma receptors having in mind
Posted by SLS on December 23, 2014, at 14:11:20
In reply to Re: ssri's-serotonin only, posted by burial on December 23, 2014, at 14:05:02
> Paxil is the most effective anxiolytic
When it comes to anxiety disorders per se, I would agree with you. I don't know about situational anxiety, though. BZDs and CBT seem to work well for that. I did not find Paxil at all sedating. I would guess that Luvox would be more sedating, although probably not as effective as Paxil for anxiety disorders.
- Scott
Posted by Phillipa on December 23, 2014, at 20:08:50
In reply to Re: ssri's-serotonin only, posted by SLS on December 23, 2014, at 14:11:20
Scott I found the very first ad I took paxil to not rid me of anxiety. I find Luvox more sedating although after all these years I doubt it's doing a thing just brain used to it. You take benzos or did do you feel it can or does lead to brain damage or Dementia as the google searches say? Or a drug company ploy to have people take more expensive meds? Thanks Phillipa
Posted by SLS on December 24, 2014, at 0:32:13
In reply to Re: ssri's-serotonin only » SLS, posted by Phillipa on December 23, 2014, at 20:08:50
> Scott I found the very first ad I took paxil to not rid me of anxiety. I find Luvox more sedating although after all these years I doubt it's doing a thing just brain used to it. You take benzos
I take lorazepam (Ativan) occasionally for sleep.
> or did do you feel it can or does lead to brain damage or Dementia as the google searches say?
I'm not sure. I think it possible that chronic use of BZDs over a period of years can impact memory function measureably, although not robustly. Unfortunately, I doubt there are any studies to show if memory function recovers after an extended period of abstinence.
Do people who ultimately go on to develop Alzheimers suffer from anxiety and agitation as a prodrome? If so, then there would probably be a positive association between BZD use and Alzheimers, even though the relationship is not causal.
> Or a drug company ploy to have people take more expensive meds? Thanks Phillipa
I doubt there is a conspiracy among the competing drug companies to devote money to fund this research. I can't be sure, of course. Perhaps I am not yet jaded enough to capitulate to such thoughts.
- Scott
Posted by Phillipa on December 24, 2014, at 9:20:07
In reply to Re: ssri's-serotonin only » Phillipa, posted by SLS on December 24, 2014, at 0:32:13
In what way do you feel it impairs memory? I just know the older I get the more I see what was considered safe with no long term side effects is now something that could,does. But the bottom line is that those that get Alzheimers are agitated so benzos are given to them to calm them. So then they are used to treat. Seems even they don't work now since I read the studies. I used to trust them inexplicably. I find I don''t trust doctors anymore. Why because when I discuss what I've read they have said they haven't heard of this at all. And if they now know this why do they continue to give new patients benzos . My comment of the new meds was that I've read on here or seen not really in life where now the new antipsychotics are prescribed. I think this trend is dying out also. Soon I feel that meds will again be reserved for those with chronic mental illness such as schizophrenia and the worse of the bipolars. I often wonder what would have happened if that mistake hadn't been make with you as you have mentioned early on with some med. Daily I see people hairdresser, so many people taking SSRI's & SNRI's for shall I call them complaints that wouldn't have necessitated a med years ago. Now society is filled with working , functional people taking meds for things that wouldn't have called for a med years ago. LIke prozac for PMS. Oh well will stop now. I am angry at me for believing this stuff when young and angry now that what I thought was safe is now toted as nonsafe basically. Phillipa
Posted by Christ_empowered on December 24, 2014, at 9:24:29
In reply to Re: ssri's-serotonin only » Phillipa, posted by SLS on December 24, 2014, at 0:32:13
I don't know if I'd call it a "conspiracy," BUT...
...as soon as the atypicals came out, shrinks started being brutally honest about the problems with the conventional drugs, maybe even exaggerrating (then again, with old school, heavy handed dosing, those can be horrid drugs).
As soon as the ADs caught on for anxiety and OCD, shrinks started demonizing the benzos, at least for a while.
I think all psych drugs have the potential to cause serious problems, especially with long term, high dose use and/or in cocktails. That's the nature of the beast...you're altering brain chemistry by artifical means.
When drugs are on patent, there seems to be some kind of shield of invincibility that protects them from too much scrutiny. Soon as the drug (and others in its class) are available in generic and new options come out, suddenly...
...scrutiny. For instance, the SSRI drugs are available in generic. Newer drugs aren't. Suddenly, docs are being open about apathy and sexual dysfunction and weight issues. Wellbutrin wasn't popular in the US for a while, largely because of messed up dosing early on that led to some seizures and the unique mechanism of action. Now, the SSRI drugs are old hat and there are patent-protected forms of wellbutrin, and the serotonin model of depression isn't necessarily the dominant paradigm, and...
...wellbutrin is surprisingly popular.
I think psychiatry is particular influenced by money, social factors, and dogma.
Posted by SLS on December 24, 2014, at 10:02:15
In reply to Re: ssri's-serotonin only, posted by Christ_empowered on December 24, 2014, at 9:24:29
> I think psychiatry is particular influenced by money, social factors, and dogma.I tend to agree with you.
- Scott
Posted by SLS on December 24, 2014, at 10:07:26
In reply to Re: ssri's-serotonin only » SLS, posted by Phillipa on December 24, 2014, at 9:20:07
How do you think your life would have been different were you to never take Valium?
- Scott
Posted by Phillipa on December 24, 2014, at 18:42:28
In reply to Re: ssri's-serotonin only » Phillipa, posted by SLS on December 24, 2014, at 10:07:26
I think if my ex-husband had let me take the limited amount prescribed living in Florida at the time that I wouldn't have ended up taking them long term. And most like would still be living in Florida. Hard to say where would have gone from there meaning emotionally. As I"d done something there that came home to haunt me. Phillipa
Posted by baseball55 on December 24, 2014, at 20:54:45
In reply to Re: ssri's-serotonin only, posted by Christ_empowered on December 24, 2014, at 9:24:29
> I think psychiatry is particular influenced by money, social factors, and dogma.
Of course it is. But not in particular. Read some articles about drugs for heart conditions, diabetes, hepatitis, cancer, gastric reflux, on and on. The same thing. Drug reps bring lunch to doctor's offices, meet with them, take them to dinners, pay them to speak or do research, give them free samples and, boom, all of a sudden prilosec is replaced with nexium, etc., etc.
This is the end of the thread.
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