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Re: Dr. Bob & others - your opinion re SSRIs

Posted by Matt on February 24, 1999, at 1:55:02

In reply to Dr. Bob & others - your opinion re SSRIs, posted by paul frank on February 23, 1999, at 19:19:26

> I suffer from GAD with some symptoms of depression. My doc first put me on prozac 20mg. After 4 weeks, the depressive symptoms had improved, but the anxiety continued, so she switched me to Zoloft. I have been at 100 mg for two weeks now and depressive symptoms have not returned, but I remain anxious and worried. I have had minimal side effects from both drugs, other than excessive nervousness. In your opinion, if Zoloft doesn't work, should we go to a third SSRI (my doc says she will next try Paxil) or would it make more sense to switch to another class of anti-depressant (ie Effexor? Serzone?) My main problem has always been GAD.
>
> Thank you for your response.

Have you considered Remeron? It is terrific on anxiety. There is more weight gain at 15mg than at 30mg. All the SSRIs can be quite helpful for GAD. Prozac helped me significantly. New studies on Celexa are showing that it is very good with anxiety.

If I may say, 4 weeks on an SSRI probably isn't a sufficently long trial to determine if it will help with your GAD. Also, if anxiety is your main problem, why not consider a benzodiazepine like Klonopin in addition to the SSRI. This would have the advantage of allowing you to avoid some of the weight gain that probably would come with Remeron. Also, once the depression has been gone for a sufficiently long period of time, you might consider the benzodiazepine as a better long-term solution to your GAD.

I'm not a Serzone fan, and I'm not the only one who feels this way. I think that BM-Squibb is quite good at marketing Serzone, though. (Somehow one always hears this drug mentioned in connection with anxiety; I'm really curious if any double blind studies have been done comparing it to SSRIs and TCAs as far as anxiolytic effects go.)

Matt


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URL: http://www.dr-bob.org/babble/19990201/msgs/3184.html