Posted by SLS on April 4, 2022, at 7:41:33
In reply to Re: Combining Prozac and Paxil.... » SLS, posted by Jay2112 on April 3, 2022, at 20:46:46
> > > > People don't do this. Why? Spinning off the 2 MAOIs at once thread...but....
> > >
> > > Well, it is actually showing up in the research.
> > > https://pubmed.ncbi.nlm.nih.gov/34728290/
> > > This is with youth, but just type in combine ssri pubmed in google, and you will find a whole span.
> > >
> > > My take, from actually combining Paxil and Prozac, was that is was good...to a point. Paxil has a mellowing anticholinergic action (not as strong, but similar to Elavil (Amitriptyline). Prozac also works on norepinephrine, and GABA. So...with a small dose of Paxil (5mg) and a regular dose of Prozac (20mg), I was able to get a bit more of a calming effect. But, the caveat, is that for some reason (maybe because of Paxil's stronger effect on serotonin) I developed some severe akathisia...inner restlessness. BUT, this was 15 or so years ago, and my dose of Prozac may have been much higher and/or the Paxil dose was higher.
> > > It also could have been serotonin syndrome, so you do have to be careful. But, this is not unconventional territory.
> > >
> > > Best,
> > > Jay
> > >
> >
> >
> >
> > I think the title of the paper you cited is confusing. What the paper is about is combining one SSRI with cognitive-behavioral therapy. I may have missed something, though.
> >
> >
> >
> > - Scott
>
> Oppps...sorry. I had bookmarked a few studies with SRI/SRI combos, but now when I need them, I can't find them..urrgghh..lol. Yes, the study I referenced was a CBT/SRI study.
>
> But, my personal, subjective experience is only n=1, but I swear, I came across a few studies talking about both SRI/SRI and SNRI/SRI combos. One in particular, citalopram and venlafaxine, eased me right out of a horrid mixed episode.
>
> Sorry...
You ought to be!<grin>
I found that my supposition regarding the possibility of there being subtypes of the serotonin transporter (SERT) has a factual basis."The human serotonin transporter gene (5-HTT) demonstrates two polymorphisms with possible functional impact: a 44-bp insertion/deletion polymorphism of the promoter region and a 17-bp variable number of tandem repeat polymorphism (VNTR) in intron 2 (STin2)."
https://www.nature.com/articles/4000821
I propose that two different serotonin transporters might need two different drugs (ligands) to block both of them robustly. Of course, one drug might be able to attach to both SERT subtypes equally.
For you, Jay, the question is whether or not venlafaxine and citalopram are each selective for a different serotonin transporter subtype. If so, that would explain your superior response to a combination of both drugs.
- Scott
Some see things as they are and ask why.
I dream of things that never were and ask why not.The only thing necessary for the triumph of evil is that good men do nothing.
poster:SLS
thread:1119194
URL: http://www.dr-bob.org/babble/20220128/msgs/1119259.html