Posted by undopaminergic on April 13, 2008, at 21:52:29
In reply to Re: lexapro or paxil?, posted by Dopamine123 on April 13, 2008, at 11:03:59
> They both have the same mechanism of action inhibit serotonin uptake, so they are probably interchangable. All the SSRI's do essentially the same thing. However its still worth trying a few different ones if you don't respond to one. Each one has slightly different properties that could affect your response.
>
> I would expect the efficacy and side effect profile to be pretty much the same for each of them.
>The differences can actually be quite significant, although the SSRIs all share the effects associated with serotonin reuptake inhibition.
Some of the differences I've noted:
Paroxetine is the most potent SSRI; it has anti-cholinergic side effects and is somewhat noradrenergic. It's the most likely to cause weight gain and sedation. Although its half-life is not much shorter than that of sertraline, it appears to be the SSRI most often implicated in difficult withdrawal issues - probably due to its potency.
Sertraline is the second most potent of the SSRIs, and has a slight dopaminergic action. It lacks most of the sedative properties of paroxetine, and is more likely to cause insomnia. Weight gain is rare in comparison with paroxetine, but somewhat more common than with fluoxetine.
Fluoxetine has the longest half-life, but is the least selective and potent SSRI. It has the least incidence of sexual side effects and weight gain, and is probably the easiest to quit.
In my experience, none of them are effective, but fluoxetine is the easiest to tolerate, followed by sertraline. Paroxetine made me sleep most of the time, and quitting it abruptly after finally running out of it was a relief.
poster:undopaminergic
thread:822168
URL: http://www.dr-bob.org/babble/20080412/msgs/823155.html