Posted by Ame Sans Vie on November 7, 2003, at 20:27:24
In reply to Re: Just a little warning..., posted by HoosierDaddyTim on November 7, 2003, at 19:30:05
If the Paxil is working well for you, why do you want to try another SSRI? Side effects? Curiosity? If you're just curious about the effects of the other drugs or are hoping for greater symptom relief than Paxil is providing, then I wholeheartedly encourage you to try out the others. By switching to another SSRI, you avoid the Paxil withdrawal: withdrawal from Ultram felt exactly like Paxil or Luvox withdrawal to me, but *much* worse. Makes sense because of Ultram's serotonin reuptake inhibiting properties. I tried tapering down several times without any alleviation of the discontinuation symptoms; I threw caution to the wind and tried cold turkey once or twice but couldn't even make it through the first miserable 24 hours. That's why I brought up the Prozac idea to my psychiatrist -- I've read here and elsewhere that Prozac is commonly used to cheat withdrawal from SSRIs due to the ultra-long half-lives of it and its metabolites. It takes at least a week for a single dose of Prozac to completely rid itself from your body; by contrast, Paxil is in and out in under a day. Apparently this gives Prozac a rather smooth, gentle withdrawal for many people, and since it's performing similar functions in the brain to the other SSRIs it can often be substituted easily for the discontinuation period. Having gone through withdrawal from all the SSRIs, I can say with fair certainty that if an SSRI can stop the withdrawal from Ultram, it can do the same for any other SRI-type drug.
If you want to try one of the other options, I might be inclined to suggest Luvox, based solely on the fact that you like Paxil's effects, and I found Luvox to be indistinguishable in manner of effect but far stronger than Paxil. Apart from that, all I can really tell you based on my experiences is that Lexapro worked great for me even though Celexa didn't do a thing. The side effects ultimately caused me to discontinue it though. Zoloft slightly inhibits dopamine reuptake, if I recall correctly, which may be part of the reason that some people prefer it (though it threw me into a hyperagitated homocidal sort of mania when I tried it, and my aunt responded exactly the same way).
Have you tried Effexor? It's possible that it could be more effective at ridding you of some of your pain -- drugs that inhibit norepinephrine reuptake along with that of serotonin are often great for dulling chronic pain. A great example is the muscle relaxer Flexeril, which is really nothing more than a tricyclic antidepressant when you get down to it. It inhibits NE and 5-HT uptake and has strong anticholinergic and antihistamine activity, making it very similar to Elavil (which is used quite often in treating fibromyalgia).
On the other hand, if there are side effects from the Paxil that are causing you trouble, it's quite probable that you won't avoid them by switching to another SSRI (or Effexor, for that matter). Some side effects can be reversed by additional medication though -- sexual side effects and apathy may respond to some type of pro-dopaminergic drug (e.g. Wellbutrin, Buspar, amphetamines, Ritalin, Mirapex) or, in the case of sexual side effects, Periactin or bethanechol.
poster:Ame Sans Vie
thread:273743
URL: http://www.dr-bob.org/babble/20031105/msgs/277612.html