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After Prozac - which SSRI to try

Posted by Babysnakes on May 13, 2003, at 12:29:51

Brief history: 35 years old. Realize now that I've been dysthymic most (all?) of my life - but last five years I've completely stalled in both my personal and professional life. Definitely slipping into a periodic depression that is much worse than normal. Eating and sleeping more than normal, and completely avoidant of almost any other activity that would be considered by most to be productive and/or pleasurable, but I am still capable of having a good time should something actually stumble into my path (atypical depression?).

In addition - there is a strong history of bipolar in my family with two suicides (grandfather and uncle) and I strongly suspect one parent with undiagnosed bp. Though to the best of my knowledge, I've never experienced a manic or even sustained hypomanic phase in my 35 years.

Finally, in my early twenties, I started to have periodic anxiety attacks. Bad ones at first. I went to a cardiologist when I thought I was going to have a heart attack and he correctly diagnosed panic and started me on Xanax. The panic attacks are mostly under control and I use Xanax only occasionally (0.25 - 0.5mg once every couple of weeks to couple of months) just to prevent a bad night or very rarely, to escape the day to day pressure of life (like someone else might have a drink or smoke a joint).

OK, so I went to a PDoc and gave the above history. I have tried talk thereapy already and found it to be expensive and not very helpful. I wanted to try an AD. Given family history of BP, Pdoc suggested starting with Wellbutrin and I concurred. Found it to be way to stimulating for me. So after 3 weeks as a low dosage, I gave it up. PDoc and I discussed going to SSRI. His first suggesstion was Paxil. But after reading all the horror stories on the internet I opted for Prozac, knowing that it may be too activating at first.

And well, it is. At least for now, I've been on 10 mg/day for a week now and the only way I can get to sleep is to take a Xanax, which makes me feel sedated for much of the following morning. Plus, I really don't want to become addicted to the Xanax that I've been able to use for long time (over 10 years) without abuse.

Although I intend to give Prozac a full month to adjust to, I'm thinking of switch SSRI's already and the question is which one to try next given the above history. I am willing to try the Paxil - but don't want to feel like a space cadet and I guess would be a little nervous about the withdrawal symptoms that some people seem to have. But I'm open to ideas on the others as well. Has anyone else tried prozac - found it to be too activating and switched to another SSRI that they are happy with. Or, has anyone found Prozac to be too activating at first, but eventually adapted to it. Also, will eventually consider Serzone, but I'm putting that one further down on my list for now.
Sorry for the long post, but it all seems like important information.

Thanks in advance.


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poster:Babysnakes thread:226333
URL: http://www.dr-bob.org/babble/20030505/msgs/226333.html