Posted by Gary Engel on October 2, 2007, at 16:24:18
In another scenario, the patient is intolerant of the SSRI and a "paradoxic" reaction develops that may include the "jitteriness syndrome." The paradoxic reaction consists of marked sensitivity to the SSRI with development of increased anxiety, jitteriness, or a feeling of "jumping out of one's skin," worsening depression, and irritability. The paradoxic reaction may be responsible for the emergence of suicidal ideation in the context of SSRI administration.5,16
The occurrence of a paradoxic reaction to an SSRI does not bode well for future SSRI treatments, and we include it as a possible side effect when communicating information before we begin treatment with an SSRI. This form of treatment resistance is best managed by starting with an atypical antipsychotic or an anticonvulsant, such as gabapentin or topiramate (although neither is particularly effective in bipolar disorder), or lamotrigine. An SSRI can be added later with reduced likelihood of a paradoxic reaction.
The above excerpt came from an article I found online from http://www.psychiatrictimes.com/topic/Anxiety/showArticle.jhtml?articleID=193500624&pgno=2&topic=Anxiety
Should I ask my pdoc to give me Lamictal and then try the SSRI as the Paradoix reaction is totally me?
poster:Gary Engel
thread:786528
URL: http://www.dr-bob.org/babble/20070929/msgs/786528.html