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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by banga on March 28, 2005, at 10:49:06
I asked/described this once in the past, I am still having trouble with this and wondering if someone has some advice.
I am not an aggressive person overall, but last summer I developed some disturbing signs of spontaneous aggressive impulses. Not long, drawn out thoughts or fantasies about aggressive acts, just a reflex around people that if they annoy/upset me, I feel an impulsive urge to hit or kick them. Most disturbingly , this is directed often at children. Luckily I do not act on it! but its existence disturbs m. I think it is clear why this is very upsetting.
It seemed to start when last summer I went up to 20 mg Lexapro (from 10mg). When this symptom manifested, I immediately went back to 10mg. These impulsive urges lessened, but never went away.
I know the relationship of SSRIs and violence are complex but clearly there.
Does anyone experience this; anyone find something that helps? I am on desipramine, adderall, lamictal, abilify, luvox--in moderate amounts. They have not seemed to neither improve nor worsen this disturbing symptom.Otherwise this combo is doing so well for me. I feel good (though it has been so long that I did not feel well, I am not sure at what point I can say I am not deressed...). I still have anxiety and avoidance but it could be construed as fairly normal given where I am in life. Still in a fog but better.
But this aggression! could I hope this med combo will chip away at this? Or should I actually stimulate the serotonin system a tad, say with clomipramine? Maybe the emergence of this while on Lexapro was just coincidence? Not that i need more drugs, but this really disturbs me.....
Posted by scatterbrained on March 28, 2005, at 15:17:50
In reply to Aggression and SSRIs, posted by banga on March 28, 2005, at 10:49:06
I've found that some of the SSRI's can cause agression, especially zoloft, I haven't noticed this with paxil however, nor with celexa
Posted by Phillipa on March 28, 2005, at 17:02:40
In reply to Re: Aggression and SSRIs » banga, posted by scatterbrained on March 28, 2005, at 15:17:50
Just to add a note of humor. If the children are anything like the ones I see on SuperNanny, I'd want to kick them too! I didn't know zoloft caused aggressive impulses. I'm taking a small amt. What doses cause this? Fondly, Phillipa
Posted by scatterbrained on March 28, 2005, at 17:59:48
In reply to Re: Aggression and SSRIs, posted by Phillipa on March 28, 2005, at 17:02:40
If it hasn't happened to you, I wouldn't worry about it. For me I felt sort of tempermental the first few days I was on it which subsided after a few more days(unfortunately the antidepressant affect went away as well)
Posted by HappyGirl on March 28, 2005, at 18:40:42
In reply to Aggression and SSRIs, posted by banga on March 28, 2005, at 10:49:06
Hi:
>>> I know the relationship of SSRIs and violence are complex but clearly there.
Does anyone experience this; anyone find something that helps? <<<<--- For me, Zyprexa is a 'good' answer for this form of problems, ... in my case, 'dysphoric' due to my dx. with Bp II. However, as far as I know, the Zyprexa/minimum dosage, like 2.5 mg. might help in that area, 'uncontrollable' anger/aggression. ---
>>> I am on desipramine, adderall, lamictal, abilify, luvox--in moderate amounts. <<<<
--- It seems to me like your med. coctail is mostly consistent with stimulant efficacy. In my guess, ... that might be a 'big' problem, because any form of anger/rage needs some 'calming' effect to subdue those 'urge.' However, this is completely based on my 'personal' experience, then I can NOT be sure the 'calming/sedating A.P., like Zyprexa might be a good choice for your 'uncontrollable' urge.
H.G.
Posted by banga on March 29, 2005, at 11:55:07
In reply to Re: Aggression and SSRIs » banga, posted by HappyGirl on March 28, 2005, at 18:40:42
Hi, thanks for the comments!
Yes, you are right that my formula is quite acvitation-oriented. But this problem began when I was not on such a fromula; and it has continued through various changes, including a longer period where I was only on Lamictal.
Otherwise I do not feel overactivated or agitated, indeed this formulation is working quite well overalll and I am not a slug anymore.It is difficult to describe this aggression....I almost feel it is less about true internal anger/rage, more based on a non-empathetic, irritable tick-like reaction. I almost feel it is truly more related to apathy/nonfeelings of deep empathy and caring---sounds very SSRI-like! but I am not on much of a powerful SSRI (only recently added a very small dose of Luvox). I just dont undewrstand why it has not abated....
Posted by HappyGirl on March 29, 2005, at 13:56:09
In reply to Re: Aggression and SSRIs » HappyGirl, posted by banga on March 29, 2005, at 11:55:07
Hi:
>>> sounds very SSRI-like! but I am not on much of a powerful SSRI (only recently added a very small dose of Luvox). I just dont undewrstand why it has not abated.... <<<<--- Even though a VERY small/miniscule dosage of SSRI, other meds., Abilify, Adderall and even Lamical makes things 'magnify,' ... just like you're taking more than twice its dosage. Particularly, any A.P.s, both a mildest or strongest APs has 'augumental' property. For that reason, some of 'unipolar' folks prefer to take a miniscule dosage of A.P. to get a 'real' effect.
Although this is my 'personal' experience through the years on med. combo., any 'stimulant/activating' med. brings up not only insomnia and anxiety but also other 'nasty' problem, 'anger/aggression.'
First, try to eliminate any of SSRI meds. to see whether it helps or not. If the problem is still there, then you may need to consult with your pdoc. about your 'anger' problem.
H.G.
Posted by theo on March 29, 2005, at 17:12:27
In reply to Re: Aggression and SSRIs » HappyGirl, posted by banga on March 29, 2005, at 11:55:07
How small of a dose of Luvox are you taking? Are you taking it bedtime or mornings?
Posted by banga on March 29, 2005, at 17:32:02
In reply to Re: Aggression and SSRIs » banga, posted by theo on March 29, 2005, at 17:12:27
I take 50mg Luvox at bedtime. The actual blood levels though are most certainly higher--desipramine, abilify and Luvox all use the same liver enzyme to be metabolized, so they all potentiate each other--hence the low doses of each med.
I have only been taking the Luvox for 3 weeks--this problem has not become worse or better.
Posted by theo on March 31, 2005, at 10:02:20
In reply to Re: Aggression and SSRIs » theo, posted by banga on March 29, 2005, at 17:32:02
> I take 50mg Luvox at bedtime. The actual blood levels though are most certainly higher--desipramine, abilify and Luvox all use the same liver enzyme to be metabolized, so they all potentiate each other--hence the low doses of each med.
> I have only been taking the Luvox for 3 weeks--this problem has not become worse or better.Has 50mg at night helped? I was thinking about trying it for anxiety, mild OCD and depression.
Posted by banga on March 31, 2005, at 11:35:12
In reply to Re: Aggression and SSRIs » banga, posted by theo on March 31, 2005, at 10:02:20
I am not sure, I am pretty sure it is helping...I had started Abilify not too long before, so it may be a bit confounded. But I did start it becaue I felt Abilify was not taking care of the problem fully.
It seems Luvox is under-mentioned as a help for anxity/OCD. Perhaps because it does interact with other meds, as well as caffeine.
Posted by Phillipa on April 1, 2005, at 16:53:41
In reply to Re: Aggression and SSRIs » banga, posted by theo on March 31, 2005, at 10:02:20
Banga, I didn't realize it potentiated the effects of so many other meds. I knew it did xanax which I was on at the time. I had gotten up to 250mg when combining it with lmg ativan 3=4 times a day. I thought it was a great drug. I guess most pdocs are afraid of the above interactions and that is why it is not popular any more. But I hear Anafranil has very bad side effects so that should outweigh the above if the pdoc knows his stuff. I guess they don't want to be bothered. I'm so glad the 50mg is working so well for you. I'm sure that's whats working. Fondly, Phillipa
This is the end of the thread.
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