Posted by SLS on July 9, 2011, at 6:34:59
In reply to closest to luvox, posted by crazyjoe on July 8, 2011, at 22:29:50
> what other ssri would you say is the closest in chemical makeup and properties as luvox?
I guess that depends on what clinical features predominate in the presentation of your illness. Depression? Anxiety? OCD?
Paroxetine (Paxil) is the most potent SSRI (stickiest on receptors) while citalopram and escitalopram are the most selective (avoids other receptors). If you haven't tried escitalopram (Lexapro) yet, it might be worth a trial, as so many people report that the latter two drugs "feel" very different. I have taken Lexapro, and did not find it stimulating. For me, it was somewhat calming. One thing peculiar about escitalopram is that it can produce a brief period of anxiety (2-5 days) that occurs between days 14-21 of treatment. Recently, there has been concern raised that paroxetine, when given during early pregnancy, can produce birth defects of the heart and pulmonary hypertension*. Still, it is a powerful drug that is worth consideration if other SSRIs are otherwise excluded as treatment choices. I would consider venlafaxine (Effexor) to be closer in clinical properties to paroxetine than to citalopram.
For OCD, I would say that fluoxetine (Prozac) given at high dosages might be rated third in efficacy to clomipramine (Anafranil) and fluvoxamine (Luvox). Fluoxetine can produce anxiety or stimulation early in treatment. I really couldn't produce statistics as to how often this anxiety occurs and persists, but I have not seen it often leading to discontinuation.
* By the way, Linkadge predicted that SSRIs might be liable to producing heart defects at least five years ago. He was a lone voice at the time. We still have yet to quantify this phenomenon, but I read that the defects were of the septum. There may also be an increase in the risk of pulmonary hypertension in neonates.
- ScottSome see things as they are and ask why.
I dream of things that never were and ask why not.
poster:SLS
thread:990576
URL: http://www.dr-bob.org/babble/20110630/msgs/990606.html