Posted by Ame Sans Vie on April 15, 2004, at 6:59:15
In reply to Prozac vs. Lexapro to perk up a depressed BP, posted by Random on April 14, 2004, at 21:21:31
Prozac and Lexapro are probably the most gentle (yet still powerful) of the SSRIs, so it's good that you at least have it narrowed down to that. I'm not sure that I agree with your pdoc's assessment to try an SSRI as they so commonly cause emotional blunting, but if you're going to give it a shot I'd say you have a much better chance with Prozac. It is an atypical SSRI (i.e. it raises extracellular levels of dopamine and norepinephrine, in addition to inhibiting serotonin reuptake). I tried it at 20mg for a while and though it didn't do much, it was a bit of a "lift". Two weeks ago I went up to 40mg and the difference is enormous; I take Adderall and Klonopin as well, but the stimulating effect of Prozac is an animal all its own (though YMMV). Just to put things into perspective, I've tried all the currently marketed SSRIs in the U.S. (Prozac, Paxil, Luvox, Celexa, Lexapro, Zoloft) and Prozac, in my opinion, is undeserving of that horrible title "SSRI" which just sends shivers up my spine.
You mentioned Ritalin, and I feel that a stimulant would actually be the better way to go here... the problem of course is convincing your pdoc the same thing. But what about first trying some stims that aren't C-II? The C-II's would include Ritalin, Concerta, Methylin, Metadate, Adderall, DextroStat, Dexedrine, Desoxyn, and phenmetrazine. Perhaps your doctor would be less reluctant to try a C-III or C-IV? Provigil certainly comes to mind, but it may be *too* gentle for you.... however it's also the one doctors feel most comfortable prescribing. I don't have any firsthand experience with the other stims except for Bontril SR (phendimetrazine) which my GP started me on yesterday to help with a plateau I've hit in my dieting -- lost 50 lbs. over the course of two months, and now I haven't dropped a pound in six weeks. Phendimetrazine is C-III and it itself has been shown to have no significant effect on neurotransmitter systems, but it is a prodrug of phenmetrazine which is a C-II drug that was taken off the market around the same time as Quaaludes due to extremely high rates of abuse (it was best known by its brand name "Preludin"; another brand of phenDImetrazine is "Prelu-2"). I took my first dose yesterday and my second a couple hours ago. I wasn't expecting much, especially considering that I'm used to the powerful amphetamine punch of Adderall, but I was quite pleasantly surprised at how potent this drug is. I normally take 30mg Adderall twice a day, but after taking my usual 30mg yesterday morning along with 105mg Bontril SR I felt *way* too euphoric, so I cut my Adderall dose in half later in the day. Works great! I'm probably an idiot to think that a doctor resistant to prescribing you Ritalin would give you a "diet drug" but it's worth a shot... amphetamines used to be "diet drugs" until they came out with "less abuseable" (?????!!!!) alternatives. The fact remains that these drugs are powerful CNS stimulants in their own right and should be treated as such by psychiatrists, IMHO. Other stimulants to consider are Didrex (benzphetamine -- C-III), Sanorex/Mazanor (mazindol -- C-IV), Ionamin/Adipex-P/etc. (phentermine -- C-IV), Tenuate/Tenuate Dospan (diethylpropion -- C-IV), and perhaps even Meridia (sibutramine -- C-IV).
poster:Ame Sans Vie
thread:336477
URL: http://www.dr-bob.org/babble/20040412/msgs/336553.html