Posted by JohnL on October 16, 2000, at 3:56:04
In reply to Changing SSRIs, posted by Marvin on October 15, 2000, at 16:42:57
Marvin,
You could switch from Prozac to Paxil without a washout. If you do, you could start the Paxil at 5mg per day for perhaps 4 to 7 days, then increase it by 5mg every 4 to 7 days. Be aware that some Prozac will still be in your system up to 4 weeks after you stop it. It is half gone in one week. That's why it's important to keep the Paxil at conservative doses until the Prozac is all gone.From what you describe, it might be questionable whether serotonin antidepressants are even the right avenue for you. There are multiple systems in the brain that can each cause your symptoms. Low serotonin is just one of them. The percentage of patients who found a complete cure of your symptoms are listed below:
Serotonin antidepressants (low serotonin) 37%
Other antidepressants (low norepinephrine) 11%
Benzodiazapines (low GABA) 24%
Lithium (chemical instability) 22%
Stimulants (norepinephrine/dopamine failure) 14%
Antipsychotics (elevated dopamine) 13%
Depakote (electrical instability) 11%
Tegretol (electrical instability) 3%
Thyroid (even if blood tests were OK) 24%
Beta adrenergic blockers like Inderal were not recorded, but were sometimes helpful, mostly for palpitations.What's interesting is that vague clinical symptoms did NOT justify the use of lithium, stimulants, antipsychotics, or anticonvulsants...regardless, they worked completely with lasting results. Different brain chemistries were at fault. The malfunctioning system was discovered by trying different medication classes. I would guess most people in your shoes would be prescribed antidepressants and benzodiazapines. If that's true, then according to these statistics, that would mean at least 50% of patients would not be satisfied with treatment. I point this out merely to let you know that your ultimate perfect medication could exist in any psychiatric class, not just the ones you are currently trying. Obviously it takes a knowledgeable and open-minded doctor to figure out if it's low serotonin, elevated dopamine, electrical instability, or whatever. Clues from your medication responses can help to figure it out.
I would think the most logical thing right now is to do what you suggested...switch to another SSRI. But if that doesn't help, then the odds increase dramatically that the problem is a different brain chemistry, not serotonin, and that some other medication classes could be tried. Too often we see people beat themselves to a pulp by going through the entire spectrum of medications all within just one class, never considering that the underlying problem might be something else that would respond to a different kind of medication instead.
John
poster:JohnL
thread:46425
URL: http://www.dr-bob.org/babble/20001012/msgs/46462.html