![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by McPac on June 23, 2003, at 22:20:06
As many of you here may know, I'm trying to switch from Zoloft to another SSRI (Celexa).
Zoloft INDUCES BAD anger and irritability in me. I'm hoping that Celexa will not. Celexa is SUPPOSED to have milder side effects. So PLEASE tell me, all you folks that have tried Celexa, or have switched from another ssri to Celexa, did you find Celexa to have less side effects? And, has ANY Celexa user here felt REALLY bad anger/irrit. on Celexa? (I'm not talking little, tiny, minor irritability, I mean BAD ANGER/IRRIT.? Lastly, if ANY of the people here that know their psychopharmacology could PLEASE tell me, after looking at what Zoloft and Celexa each do in the brain, WHAT are the main differences between the two (i.e. is Celexa really likely to cause less side effects than Zoloft?) ALL responses are greatly appreciated!!!!!!!!
Posted by ace on June 23, 2003, at 22:43:25
In reply to Re: Celexa Users/SSRI Users/Anybody!!! NEED your Help! (nm), posted by ace on June 23, 2003, at 22:39:30
Woops! I pressed no message! Here is what i wrote..
Hey McPacterisalegend!,
For differences between SSRIs check out this article...
http://www.preskorn.com/books/ssri_s6.html
Als dude, I have a great article on SSRIs at home- has a diagram which shows what SSRIs 'hit' what neurotransmitters...Let me know if you want the link.
Here's my poem for you!
There once was this guy
His name was McPac
Searching for the best SSRI
Man, this guy was a cool kat!!Like it?! Could i be a poet or what Mcpac!?
Ace.
Posted by Sebastian on June 23, 2003, at 23:06:33
In reply to Celexa Users/SSRI Users/Anybody!!! NEED your Help!, posted by McPac on June 23, 2003, at 22:20:06
Celexa makes me very happy and melow. I've been taking it for a year, It's great!
Sebastian
Posted by Caleb462 on June 24, 2003, at 0:09:43
In reply to Re: Celexa Users/SSRI Users/Anybody!!! NEED your Help!, posted by Sebastian on June 23, 2003, at 23:06:33
Well... of the 3 (4 if you count Effexor) SSRIs I've tried... Paxil, Zoloft, and Celexa... I'd say Celexa was my least favorite. I felt more numbed on Celexa than on Paxil, Zoloft and Effexor, fatigue was an issue... and fairly severe anorgasmia/mild to moderate loss of libido was another one. It did seem a bit "gentler" than Paxil... but I just didn't like it. This is just my experience, and I have a feeling you would react differently... as we seem to respond to SSRIs differently (I don't have anger problems on them - I have worse anger problems OFF of them).
McPac... have you thought about adding a mild sedative or anxiotylic to your regimen in order to lessen the anger on Zoloft? Neurontin perhaps? Or maybe Gabitril?
Did you have anger problems with Anafranil? Just curious.
Or maybe try using Niacinamide?
Posted by McPac on June 24, 2003, at 0:10:12
In reply to Re: Celexa Users/SSRI Users/Anybody!!! NEED your Help!, posted by ace on June 23, 2003, at 22:43:25
Als dude, I have a great article on SSRIs at home- has a diagram which shows what SSRIs 'hit' what neurotransmitters...Let me know if you want the link.
>>>>>>>>>Thanks Ace but I'm not too sure that I always interpret that biochemistry info very well! But I sure appreciate the help!
Here's my poem for you!
There once was this guy
His name was McPac
Searching for the best SSRI
Man, this guy was a cool kat!!Like it?! Could i be a poet or what Mcpac!?
>>>>>>LOLOL!!!!!You are a character Ace! Man, I can tell you feel great on that Nardil Ace! Somebody could not take Nardil AND an SSRI correct?
Posted by ace on June 24, 2003, at 0:15:49
In reply to Ace, Users/SSRI Users/Anybody!!! NEED your Help!, posted by McPac on June 24, 2003, at 0:10:12
> Als dude, I have a great article on SSRIs at home- has a diagram which shows what SSRIs 'hit' what neurotransmitters...Let me know if you want the link.
>
> >>>>>>>>>Thanks Ace but I'm not too sure that I always interpret that biochemistry info very well! But I sure appreciate the help!
>
> Here's my poem for you!
>
> There once was this guy
> His name was McPac
> Searching for the best SSRI
> Man, this guy was a cool kat!!
>
> Like it?! Could i be a poet or what Mcpac!?
>
> >>>>>>LOLOL!!!!!You are a character Ace! Man, I can tell you feel great on that Nardil Ace! Somebody could not take Nardil AND an SSRI correct?
>
No way bro- unless they want to end up in the emergency department! Actuall I had a moderate serotonin syndrome after restarting Nardil two days after Anafranil. You should have seen me bro! I was worried like hell, gave the ambulance a bell and konked myself out on Nardil. For about a week I had mild serotonin syndrome- anyhow I survived and here to tell all my fans the story!You will miss me when I'm gone!
Ace.
>
>
>
Posted by ace on June 24, 2003, at 0:17:08
In reply to Re: Ace, Users/SSRI Users/Anybody!!! NEED your Help! » McPac, posted by ace on June 24, 2003, at 0:15:49
Somebody could not take Nardil AND an SSRI correct?
> >
> No way bro- unless they want to end up in the emergency department! Actuall I had a moderate serotonin syndrome after restarting Nardil two days after Anafranil. You should have seen me bro! I was worried like hell, gave the ambulance a bell and konked myself out on Nardil. For about a week I had mild serotonin syndrome- anyhow I survived and here to tell all my fans the story!
>
> You will miss me when I'm gone!
>
> Ace.
> >
> >
> > I KONKED MYSELF OUT ON VALIUM NOT NARDIL!!!!!ACE.
>
Posted by Caleb462 on June 24, 2003, at 0:22:02
In reply to Re: Ace, Users/SSRI Users/Anybody!!! NEED your Help! » McPac, posted by ace on June 24, 2003, at 0:15:49
About Celexa... it is considered the most selective SSRI, because it has the least potency at uptake sites other than serotonin... the norepinephrine and dopamine sites (though Luvox has a very low potency for the dopamine site as well). The dose it would take to effect NE or DA with Celexa is GIGANTIC, basically.
In regard to other effects on the brain... chollinergic, histaminic, etc. It really doesn't differ much from the other SSRIs.
So basically, what it boils down to is that if you were going to be on a high dose of celexa, or were med sensitive... you wouldn't have to worry about possible noradrenergic or dopaminergic effects - like you might with say, Paxil or Zoloft.
One more question McPac... have you thought about maybe adding a low dose atyptical anti-psychotic? Perhaps Zyprexa? It could definitely keep the anger in check, and might very well help out with the OCD as well. Obviously I would understand why you would not want to go this route.. but it is something to think about.
Posted by McPac on June 24, 2003, at 0:27:10
In reply to Re: Celexa Users/SSRI Users/Anybody!!! NEED your Help!, posted by Caleb462 on June 24, 2003, at 0:09:43
Caleb, just the dude I was hoping would respond!
Check this out...I don't get this at all....Dr. Heller said that the ssri's all can raise, or overstimulate, the 5HT1a receptor site.....now, I found this info on Celexa AND Zoloft where it said that neither showed an effect at the 5HT1 site (I'm pretty sure I interpreted that right but I'm NOT sure)....HOW CAN THAT BE? Could you tell me what Celexa AND Zoloft each do at that 5HT1a site?McPac... have you thought about adding a mild sedative or anxiotylic to your regimen in order to lessen the anger on Zoloft? Neurontin perhaps? Or maybe Gabitril?
>>>>>>>I've thought about Klonopin; but I KNOW that the Zoloft causes/exacerbates this problem and IF I could substitute the Zoloft for, perhaps Celexa, and NOT get that anger s/e then I might not even NEED the Klonopin....I'd like to try without it first.
Did you have anger problems with Anafranil? Just curious.
>>>>>>>>>>>>NO!! And I don't know why (I would have thought its effects would be very similar to Zoloft but I've had different effects between the two meds....but NO anger at all from Anafranil...go figure???
Or maybe try using Niacinamide?
>>>>>>>>>>I can't (long story) take niacinamide.
At this point I really don't care what s/e's Celexa would cause as long as I don't get this anger-induced crap! Would Lexapro have even LESS s/e's than Celexa (isn't it 'supposed' to?) ANY truth to Lexapro having less s/e's...due to the fact that I believe you only need a LOWER DOSE?
ANY help is appreciated!
Posted by McPac on June 24, 2003, at 0:38:21
In reply to McPac, posted by Caleb462 on June 24, 2003, at 0:22:02
"Can Zoloft Cause Anger?
QUESTION:Dear Dr. Heller,
I would like to know if you have ever heard of Zoloft causing someone to feel anger. I have been on Zoloft for about one week and feel tremendous anger. I was on Prozac and did not feel that way at all.
Thanks, Sue.
ANSWER:
While any individual can get an individual reaction to any medication, those with the cognitive generalized anxiety disorder (GAD - mind always going and thinking) get an increased anxiety level from SSRI medications. Many individuals perceive Zoloft as the worst for causing this side effect. Usually anger is triggered as part of dysphoria (anxiety, rage, depression and despair) in the borderline disorder (BPD).
If the GAD, particularly the cognitive component, is present, BuSpar will allow the individual to take the SSRI medication without the increased anger".>>>>>>>>>>>>Caleb, I don't know if Buspar works like Doc Heller says it does, but here is just ONE more example of Zoloft driving someone nuts with that anger crappola! NOTICE where he says....Zoloft...perceived by many..to be THE WORST! (I've read this BEFORE different times...Prozac also did it BADDDD (worse for me)
Posted by Caleb462 on June 24, 2003, at 0:50:20
In reply to CALEB, Re: Celexa Users/SSRI Users/Anybody!!! , posted by McPac on June 24, 2003, at 0:27:10
> Caleb, just the dude I was hoping would respond!
> Check this out...I don't get this at all....Dr. Heller said that the ssri's all can raise, or overstimulate, the 5HT1a receptor site.....now, I found this info on Celexa AND Zoloft where it said that neither showed an effect at the 5HT1 site (I'm pretty sure I interpreted that right but I'm NOT sure)....HOW CAN THAT BE? Could you tell me what Celexa AND Zoloft each do at that 5HT1a site?
>Celexa and Zoloft... the chemicals themselves, have no effect on the 5-HT1a site. It is the extra serotonin in the synapse, provided by Zoloft/Celexa, that activates 5-HT1a receptors.
Buspar, on the other hand, and I'm talking about the chemical itself here (buspirone), directly bonds to and activates 5-HT1a receptors. I don't understand Dr. Heller's logic.
> McPac... have you thought about adding a mild sedative or anxiotylic to your regimen in order to lessen the anger on Zoloft? Neurontin perhaps? Or maybe Gabitril?
>
> >>>>>>>I've thought about Klonopin; but I KNOW that the Zoloft causes/exacerbates this problem and IF I could substitute the Zoloft for, perhaps Celexa, and NOT get that anger s/e then I might not even NEED the Klonopin....I'd like to try without it first.Quite understandable.
>
> Did you have anger problems with Anafranil? Just curious.
>
> >>>>>>>>>>>>NO!! And I don't know why (I would have thought its effects would be very similar to Zoloft but I've had different effects between the two meds....but NO anger at all from Anafranil...go figure???
>Well... there could be a lot of reasons Anafranil did not. The sedating anti-histaminic/anti-adrenergic effects may have helped. 5-HT2a antagonism could have been a factor... anti-chollinergic effects could also be a factor I would imagine.
> Or maybe try using Niacinamide?
>
> >>>>>>>>>>I can't (long story) take niacinamide.
> At this point I really don't care what s/e's Celexa would cause as long as I don't get this anger-induced crap! Would Lexapro have even LESS s/e's than Celexa (isn't it 'supposed' to?) ANY truth to Lexapro having less s/e's...due to the fact that I believe you only need a LOWER DOSE?
> ANY help is appreciated!
>
>
>Personally, I don't believe there is ANY truth at all in the whole "lexapro has less side effects" thing. It's a marketing ploy. Check the side effect profiles of the two drugs... they don't look much different do they? The only advantage to Lexapro is that it requires a lower dose... and uh, that is not much of an advanatage in my opinion.
Posted by Caleb462 on June 24, 2003, at 0:54:22
In reply to Caleb, Re: McPac, posted by McPac on June 24, 2003, at 0:38:21
> "Can Zoloft Cause Anger?
> QUESTION:
>
> Dear Dr. Heller,
>
> I would like to know if you have ever heard of Zoloft causing someone to feel anger. I have been on Zoloft for about one week and feel tremendous anger. I was on Prozac and did not feel that way at all.
> Thanks, Sue.
> ANSWER:
> While any individual can get an individual reaction to any medication, those with the cognitive generalized anxiety disorder (GAD - mind always going and thinking) get an increased anxiety level from SSRI medications. Many individuals perceive Zoloft as the worst for causing this side effect. Usually anger is triggered as part of dysphoria (anxiety, rage, depression and despair) in the borderline disorder (BPD).
> If the GAD, particularly the cognitive component, is present, BuSpar will allow the individual to take the SSRI medication without the increased anger".
>
> >>>>>>>>>>>>Caleb, I don't know if Buspar works like Doc Heller says it does, but here is just ONE more example of Zoloft driving someone nuts with that anger crappola! NOTICE where he says....Zoloft...perceived by many..to be THE WORST! (I've read this BEFORE different times...Prozac also did it BADDDD (worse for me)
>Well... Buspar may help with Zoloft anger.. I don't doubt it, though I'm not educated enough as of yet to really understand it. I don't think Dr. Heller has quite got the mechanism right... but I certainly believe it is possible.
On the other hand... I could see where Buspar could INTENSIFY SSRI anger, due to some pharmacological things... but actual experience is what matters in the end, not the pharmacology and chemistry of a drug.
Posted by McPac on June 24, 2003, at 1:31:53
In reply to Re: CALEB, Re: Celexa Users/SSRI Users/Anybody!!! , posted by Caleb462 on June 24, 2003, at 0:50:20
> Caleb, just the dude I was hoping would respond!
> Check this out...I don't get this at all....Dr. Heller said that the ssri's all can raise, or overstimulate, the 5HT1a receptor site.....now, I found this info on Celexa AND Zoloft where it said that neither showed an effect at the 5HT1 site (I'm pretty sure I interpreted that right but I'm NOT sure)....HOW CAN THAT BE? Could you tell me what Celexa AND Zoloft each do at that 5HT1a site?
>Celexa and Zoloft... the chemicals themselves, have no effect on the 5-HT1a site. It is the extra serotonin in the synapse, provided by Zoloft/Celexa, that activates 5-HT1a receptors.
>>>>>>>>Thank you for that explanation!
Buspar, on the other hand, and I'm talking about the chemical itself here (buspirone), directly bonds to and activates 5-HT1a receptors. I don't understand Dr. Heller's logic.
>>>>>>>>>>I don't either! Not at all!
> McPac... have you thought about adding a mild sedative or anxiotylic to your regimen in order to lessen the anger on Zoloft? Neurontin perhaps? Or maybe Gabitril?
>
> >>>>>>>I've thought about Klonopin; but I KNOW that the Zoloft causes/exacerbates this problem and IF I could substitute the Zoloft for, perhaps Celexa, and NOT get that anger s/e then I might not even NEED the Klonopin....I'd like to try without it first.Quite understandable.
>
> Did you have anger problems with Anafranil? Just curious.
>
> >>>>>>>>>>>>NO!! And I don't know why (I would have thought its effects would be very similar to Zoloft but I've had different effects between the two meds....but NO anger at all from Anafranil...go figure???
>Well... there could be a lot of reasons Anafranil did not. The sedating anti-histaminic/anti-adrenergic effects may have helped. 5-HT2a antagonism could have been a factor... anti-chollinergic effects could also be a factor I would imagine.
>>>>>>>Caleb, Remeron is one of the VERY few non-ssri anti-ocd meds that there is....I would LOVE to try to see if Remeron could replace the Zoloft! Some folks w/ ocd HAVE been helped by Remeron (usually higher doses of Remeron seems to be indicated).....what effect does Remeron have on 5HT1a receptors (at higher doses)? Any idea?
> Or maybe try using Niacinamide?
>
> >>>>>>>>>>I can't (long story) take niacinamide.
> At this point I really don't care what s/e's Celexa would cause as long as I don't get this anger-induced crap! Would Lexapro have even LESS s/e's than Celexa (isn't it 'supposed' to?) ANY truth to Lexapro having less s/e's...due to the fact that I believe you only need a LOWER DOSE?
> ANY help is appreciated!
>
>
>Personally, I don't believe there is ANY truth at all in the whole "lexapro has less side effects" thing. It's a marketing ploy. Check the side effect profiles of the two drugs... they don't look much different do they? The only advantage to Lexapro is that it requires a lower dose... and uh, that is not much of an advanatage in my opinion.
>>>>>>>>>>Lower dose often means less side effects doesn't it? For example, 50 mg of Zoloft gives me less s/e's than 100? Thanks!!!!
Posted by McPac on June 24, 2003, at 1:50:11
In reply to Re: Caleb, Re: McPac, posted by Caleb462 on June 24, 2003, at 0:54:22
"Well... Buspar may help with Zoloft anger.. I don't doubt it, though I'm not educated enough as of yet to really understand it. I don't think Dr. Heller has quite got the mechanism right... but I certainly believe it is possible.
>>>>>>>>>>>>I have no idea!!
On the other hand... I could see where Buspar could INTENSIFY SSRI anger, due to some pharmacological things
>>>>>>>>>>I could too!
... but actual experience is what matters in the end, not the pharmacology and chemistry of a drug".
>>>>>>>>>>I just may have to try switching to Celexa! I know that some people can take one ssri, feel lousy on it w/ various s/e's, then switch to another ssri and feel differently....hopefully I'll switch and feel differently (less anger).
Posted by Caleb462 on June 24, 2003, at 9:35:36
In reply to CALEB, Re: Celexa Users/SSRI Users/Anybody!!! , posted by McPac on June 24, 2003, at 1:31:53
> > Caleb, just the dude I was hoping would respond!
> > Check this out...I don't get this at all....Dr. Heller said that the ssri's all can raise, or overstimulate, the 5HT1a receptor site.....now, I found this info on Celexa AND Zoloft where it said that neither showed an effect at the 5HT1 site (I'm pretty sure I interpreted that right but I'm NOT sure)....HOW CAN THAT BE? Could you tell me what Celexa AND Zoloft each do at that 5HT1a site?
> >
>
> Celexa and Zoloft... the chemicals themselves, have no effect on the 5-HT1a site. It is the extra serotonin in the synapse, provided by Zoloft/Celexa, that activates 5-HT1a receptors.
>
> >>>>>>>>Thank you for that explanation!
>
> Buspar, on the other hand, and I'm talking about the chemical itself here (buspirone), directly bonds to and activates 5-HT1a receptors. I don't understand Dr. Heller's logic.
>
> >>>>>>>>>>I don't either! Not at all!
>
> > McPac... have you thought about adding a mild sedative or anxiotylic to your regimen in order to lessen the anger on Zoloft? Neurontin perhaps? Or maybe Gabitril?
> >
> > >>>>>>>I've thought about Klonopin; but I KNOW that the Zoloft causes/exacerbates this problem and IF I could substitute the Zoloft for, perhaps Celexa, and NOT get that anger s/e then I might not even NEED the Klonopin....I'd like to try without it first.
>
> Quite understandable.
>
>
> >
> > Did you have anger problems with Anafranil? Just curious.
> >
> > >>>>>>>>>>>>NO!! And I don't know why (I would have thought its effects would be very similar to Zoloft but I've had different effects between the two meds....but NO anger at all from Anafranil...go figure???
> >
>
> Well... there could be a lot of reasons Anafranil did not. The sedating anti-histaminic/anti-adrenergic effects may have helped. 5-HT2a antagonism could have been a factor... anti-chollinergic effects could also be a factor I would imagine.
>
> >>>>>>>Caleb, Remeron is one of the VERY few non-ssri anti-ocd meds that there is....I would LOVE to try to see if Remeron could replace the Zoloft! Some folks w/ ocd HAVE been helped by Remeron (usually higher doses of Remeron seems to be indicated).....what effect does Remeron have on 5HT1a receptors (at higher doses)? Any idea?
>Remeron, being an alpha-2 antagonist, increases serotonin release. Remeron also blocks the 5-HT2 and 5-HT3 serotonin receptors. Thus much of the increased serotonin that is released, not able to bond to 5-HT2 or 5-HT3, gets directed to the 5-HT1a site. Remeron itself has no direct effect on 5-HT1a.
> > Or maybe try using Niacinamide?
> >
> > >>>>>>>>>>I can't (long story) take niacinamide.
> > At this point I really don't care what s/e's Celexa would cause as long as I don't get this anger-induced crap! Would Lexapro have even LESS s/e's than Celexa (isn't it 'supposed' to?) ANY truth to Lexapro having less s/e's...due to the fact that I believe you only need a LOWER DOSE?
> > ANY help is appreciated!
> >
> >
> >
>
> Personally, I don't believe there is ANY truth at all in the whole "lexapro has less side effects" thing. It's a marketing ploy. Check the side effect profiles of the two drugs... they don't look much different do they? The only advantage to Lexapro is that it requires a lower dose... and uh, that is not much of an advanatage in my opinion.
>
> >>>>>>>>>>Lower dose often means less side effects doesn't it? For example, 50 mg of Zoloft gives me less s/e's than 100? Thanks!!!!
>Well... yes. Let me see if I can explain this right... ok Celexa contains citalopram. It contains both the S- and R-enantiomers of the chemical. 50% of a celexa pill is the S- enantiomer and 50% is R-enatiomer. So 40 mg of Celexa would be 20 mg S, and 20 mg R. The R-enatiomer is inactive. Lexapro removes the R-enatiomer and leaves only S-citalopram. So instead of taking 40 mg of Celexa to get 20 mg of S-citalopram, you simply take 20 mg of Lexapro.
Understand? Sorry if it isn't explained well.
So anyway... there should be no difference in side effects whether you are taking 40 mg Celexa or 20 mg Lexapro - either way you are taking 20 mg of S-citalopram.
The whole "less side effects" is based on the assumption that R-citalopram causes additional side effects. Which I find unlikely. R-citalopram has no affinity for the serotonin uptake pump, thus it causes no serotonergic side effects nor does it cause any theraputic effect. If R-citalopram causes any side effects, they would have to be mediated through some other action - and no action has been discovered.
So basically, the only advantage with Lexapro is that you are removing 10 or 20 mg of inactive material from the pill... I say, who cares?
Posted by McPac on June 24, 2003, at 16:52:18
In reply to Re: CALEB, Re: Celexa Users/SSRI Users/Anybody!!! , posted by Caleb462 on June 24, 2003, at 9:35:36
Hi Caleb!
"Well... yes. Let me see if I can explain this right... ok Celexa contains citalopram. It contains both the S- and R-enantiomers of the chemical. 50% of a celexa pill is the S- enantiomer and 50% is R-enatiomer. So 40 mg of Celexa would be 20 mg S, and 20 mg R. The R-enatiomer is inactive. Lexapro removes the R-enatiomer and leaves only S-citalopram. So instead of taking 40 mg of Celexa to get 20 mg of S-citalopram, you simply take 20 mg of Lexapro.
Understand? Sorry if it isn't explained well.
So anyway... there should be no difference in side effects whether you are taking 40 mg Celexa or 20 mg Lexapro - either way you are taking 20 mg of S-citalopram.
The whole "less side effects" is based on the assumption that R-citalopram causes additional side effects. Which I find unlikely. R-citalopram has no affinity for the serotonin uptake pump, thus it causes no serotonergic side effects nor does it cause any theraputic effect. If R-citalopram causes any side effects, they would have to be mediated through some other action - and no action has been discovered.
So basically, the only advantage with Lexapro is that you are removing 10 or 20 mg of inactive material from the pill... I say, who cares?
>>>>>>>>>>>>>>>>You explain that stuff VERY well! Thank you so much for your time...it sure helps me to be able to understand the rationale....mucho appreciato, lol!
This is the end of the thread.
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