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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by saturn on November 21, 2006, at 17:00:16
Are any SSRI's more or less likely to generate EPS than others? The following paragraph I took from an article quoted in a prior babble thread (if interested in reading the entire article):
http://www.dr-bob.org/babble/20020215/msgs/94841.html
>>>>On the other hand, there are differences among the effects of SSRIs on DA-reuptake inhibition. For example, sertraline (Zoloft) exhibits a direct augmenting effect on DA-reuptake inhibition (Koe et al., 1983); inhibitory serotonergic input to dopaminergic systems would be mitigated by such direct augmentation. Paroxetine and fluoxetine have lower potencies than sertraline for DA-reuptake inhibition in vitro (Richelson, 1994). Paroxetine also has anticholinergic properties in vitro, which may contribute to reducing the likelihood of EPS as compared to some of the other SSRI's.
I'm particularly interested in (es)/citalopram.
Posted by Quintal on November 21, 2006, at 17:04:01
In reply to SSRI EPS, posted by saturn on November 21, 2006, at 17:00:16
I had a mild dystonic reaction to paroxetine when I was 17. Had no problem with citalopram, escitalopram or the other SSRIs.
Q
Posted by iforgotmypassword on November 21, 2006, at 18:39:04
In reply to Re: SSRI EPS » saturn, posted by Quintal on November 21, 2006, at 17:04:01
Posted by Phillipa on November 21, 2006, at 19:28:52
In reply to Re: SSRI EPS » saturn, posted by Quintal on November 21, 2006, at 17:04:01
Paxil was my first AD. It was given to me at l0mg. Took three months with lopressor and xanax til I could function at all. But then it worked for 2 years when I stopped it. And then the thyroid when. Wonder is there is a coincidence? Love Phillipa
Posted by Quintal on November 21, 2006, at 20:23:28
In reply to Re: SSRI EPS, posted by Phillipa on November 21, 2006, at 19:28:52
Phillipa, here is a link about paroxetine that may interest you: http://society.guardian.co.uk/mentalhealth/story/0,,707016,00.html
I'm not a fan of the Guardian but this article does seem to contain some info relevant to what what we are discussing here.
Q
Posted by Phillipa on November 21, 2006, at 21:03:01
In reply to Re: SSRI EPS, posted by Phillipa on November 21, 2006, at 19:28:52
Not quite sure what you mean but SSRI's do nothing in my opinion as when the paxil seemed to work I was consuming 4-6 beers a night after work. Seems from my readings that alchohol negated the antidepressant so maybe the paxil did nothing at all? But the thyroid is a different story. Love Phillipa
Posted by Quintal on November 21, 2006, at 23:15:57
In reply to Re: SSRI EPS » Phillipa, posted by Phillipa on November 21, 2006, at 21:03:01
I'm a little confused Phillipa. Are you saying you now think it was the beer that was responsible for relaxing you and lifting your mood, when you attributed this to Paxil at the time? It sounds possible. Did the Paxil give you alcohol cravings or was this just your usual habit?
I'm not sure Paxil has any effect on the thyroid gland but I'll look in to it.
Q
Posted by med_empowered on November 22, 2006, at 0:05:22
In reply to Re: SSRI EPS » Phillipa, posted by Quintal on November 21, 2006, at 23:15:57
the whole eps from antidepressant thing is interesting in part b/c its been noted since the days of the tricyclics...alot of the problems that were "discovered" after ssri use (a discontinuation syndrome, eps/td, drug-induced mania/psychosis, apathy, etc.) were noted years and years ago with TCA use. I guess the assumption was that these new, perfect drugs wouldn't cause the same problems as old, "dirty" drugs?
Anyway...I've read of cases of prozac induced TD and celexa induced TD and effexor induced movement problems (which makes sense, since docs can ramp up the dosage to crazy levels). I wasnt able to find anything about 1 ssri doing it more often than other...I would imagine that it would be kind of like TD with old neuroleptics: the agent used is less important than the dosage, amount of time used, and patient characteristics (age, gender, ethnicity, other meds, etc.)
Posted by Phillipa on November 22, 2006, at 18:26:51
In reply to Re: SSRI EPS » Phillipa, posted by Quintal on November 21, 2006, at 23:15:57
Yes Quintal I am as at the end of the day when on the paxil I would drink the beer and my mood would immediately lift. And I don't think it the paxil had any effect on my thyroid. Sometimes I wonder if man was correct in using alchohol in the beginning. Love Phillipa ps never drank during the day and worked the whole time. Since none not able to work. Makes you wonder doesn't it?
Posted by Quintal on November 22, 2006, at 20:56:26
In reply to Re: SSRI EPS » Quintal, posted by Phillipa on November 22, 2006, at 18:26:51
I just rediscovered my own fondness for alcohol tonight Phillipa. Am drinking a can of Carlsberg Special Brew as I type and it is wonderful ;-)
Q
Posted by Phillipa on November 22, 2006, at 21:05:05
In reply to Re: SSRI EPS » Quintal, posted by Phillipa on November 22, 2006, at 18:26:51
Oh no I've not had a drink in the ll years. Heck have one for me and let me know how you feel in the morning. Babblemail me. Love Phillipa
Posted by yxibow on November 23, 2006, at 20:21:31
In reply to Re: SSRI EPS, posted by med_empowered on November 22, 2006, at 0:05:22
> the whole eps from antidepressant thing is interesting in part b/c its been noted since the days of the tricyclics...alot of the problems that were "discovered" after ssri use (a discontinuation syndrome, eps/td, drug-induced mania/psychosis, apathy, etc.) were noted years and years ago with TCA use. I guess the assumption was that these new, perfect drugs wouldn't cause the same problems as old, "dirty" drugs?
>
> Anyway...I've read of cases of prozac induced TD and celexa induced TD and effexor induced movement problems (which makes sense, since docs can ramp up the dosage to crazy levels). I wasnt able to find anything about 1 ssri doing it more often than other...I would imagine that it would be kind of like TD with old neuroleptics: the agent used is less important than the dosage, amount of time used, and patient characteristics (age, gender, ethnicity, other meds, etc.)
I believe Zoloft may cause more TD cases (these are very rare, by the way, and are more case reports than mainstream amounts, naysaying discounted about SSRIs in general) because of its slight action on dopamine.Tricyclics have more possibility of TD, although even this is in the noise level, such as Seroquel and other low potency atypicals.
EPS like symptoms are possible, this is true, and your surmising about sky high dosage is probably related to SSRI induced akathisia. Again, you have to account for the millions of people who have been lifted out of dysthymia or OCD or other disorders by SSRIs who aren't on the board here because the medicine "works" for them. I've posted that trend before, but it is true that unfortunately for those of us who require polypharmacy, there is naturally going to be a greater amount of complaint and upset over medication.
And that isn't to reduce the dignity of those who have trouble with MDD and other serious depressive disorders -- its just to say that complaints as a human factor are higher.
-- Jay
Posted by linkadge on November 24, 2006, at 8:45:43
In reply to Re: SSRI EPS » med_empowered, posted by yxibow on November 23, 2006, at 20:21:31
For me, zoloft caused markedly less akathesia and dystonia than other SSRI's.
I was under the impresson that its action as a dopamine reuptake inhibitor worked to ameliorate some of the SSRI like movement problems.
Posted by saturn on November 24, 2006, at 12:34:38
In reply to Re: SSRI EPS, posted by linkadge on November 24, 2006, at 8:45:43
>> I was under the impresson that its action as a dopamine reuptake inhibitor worked to ameliorate some of the SSRI like movement problems.That was my understanding also (referring to Zoloft).
Posted by linkadge on November 24, 2006, at 12:53:30
In reply to Re: SSRI EPS » linkadge, posted by saturn on November 24, 2006, at 12:34:38
Sometimes drugs like ritalin can cause tics due to dopamine reuptake inhibtion, but thats a different pathology than TD isn't it?
Linkadge
Posted by Phillipa on November 24, 2006, at 19:33:15
In reply to Re: SSRI EPS » Phillipa, posted by Phillipa on November 22, 2006, at 21:05:05
Why is zoloft different if it's an SSRI and what would you include for anxiety? Love Phillipa
This is the end of the thread.
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