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Dr. Bob is Robert Hsiung, MD,
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Posted by jamie on December 7, 1999, at 4:21:28
Why ssris aren't mixed confuses me. There are cases here and elsewhere where prozac plus effexor have been combined successfully. Effexor is basically an ssri too. Even at higher doses where it has NE and DA reuptake blockade, there is still mostly ssri action taking place.
To me the ssris are not interchangeable. Though they are similar in what they do, the way they do it is completely different. If one ssri doesn't work with someone, another might. Side effects can be quite different. Even though the ssris are in the same family, I don't think they are interchangeable. They are distinctly different drugs.
Prozac has more NE reuptake than the others. Zoloft has more DA than the others. Paxil is the strongest on serotonin while celexa is the most selective. One may cause sexual dysfunction where another doesn't. They just seem like completely different drugs...similar in some ways, but strikingly different in others.So why not mix for example prozac plus zoloft? Serotonin syndrome? What's the difference between 20mg prozac plus 50mg zoloft, versus say 60mg prozac alone or 200mg zoloft alone? I fail to see the serotonin syndrome risk if the doses of the combination are roughly equivalent to a high dose of either alone.
Can we get the best of both worlds by mixing ssris? If someone is partially responsive to zoloft and partially responsive to prozac, maybe they would be totally responsive to both together? It's done with effexor and prozac. This is not something to try, just something for theoretical discussion. Obviously I have nothing better to do in my life right now than to think of weird things like this. :-) regards, jamie
Posted by Noa on December 8, 1999, at 15:36:17
In reply to ssri combinations-questions, posted by jamie on December 7, 1999, at 4:21:28
It seems from reading people's posts on this board, that indeed there are docs who combine SSRIs.
This is the end of the thread.
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