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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by woolav on May 11, 2005, at 5:55:16
just wondering.....(trying to get all the info i can before seeing my new pdoc next week)
Thanks
S
Posted by tampagirl70 on May 11, 2005, at 8:28:31
In reply to is prozac an SSRI??, posted by woolav on May 11, 2005, at 5:55:16
yes, it is.
Posted by mike lynch on May 11, 2005, at 15:57:20
In reply to Re: is prozac an SSRI??, posted by tampagirl70 on May 11, 2005, at 8:28:31
and a quick search on google would have confirmed that in about 2 seconds just so you know...
Posted by Shawn. T. on May 11, 2005, at 19:09:54
In reply to is prozac an SSRI??, posted by woolav on May 11, 2005, at 5:55:16
I'm glad that you asked this question. In my opinion, Prozac should be called an SRI rather than an SSRI. This is because Prozac is not selective for the serotonin transporter. It acts as an antagonist at serotonin 5-HT2C receptors. A metabolite of Prozac, norfluoxetine, is a more selective and potent SRI than its parent compound (see http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10379421). The fact that most people still call Prozac an SSRI is an unfortunate habit because it obscures an important element of the drug's pharmacology.
Shawn
Posted by Phillipa on May 11, 2005, at 20:12:22
In reply to Not Really..., posted by Shawn. T. on May 11, 2005, at 19:09:54
It was the first SSRI. It was only available in 20mg capsules when it first came out. Fondly, Phillipa
Posted by Shawn. T. on May 11, 2005, at 20:32:15
In reply to Re: Not Really..., posted by Phillipa on May 11, 2005, at 20:12:22
How could it have been the first selective serotonin reuptake inhibitor if it's not selective? That makes no sense. The first drug to be *marketed* as a selective serotonin reuptake inhibitor was zimelidine. This drug was also not truly selective.
Shawn
Posted by Phillipa on May 11, 2005, at 20:58:42
In reply to Re: Not Really... » Phillipa, posted by Shawn. T. on May 11, 2005, at 20:32:15
Was that marketed in the US? At the time I was working in psych as an RN, and Prozac was the first drug the pdocs called an SSRI. I had a pdoc RX prozac for me. The first day I wallpapered the foyer, the second day I was anxious, and the third day I was in a panic. It took 3 days of xanax to get me back down to normal. I was at the time functioning very well. The pdoc begged me to take it every three days. I refused. Not it comes even in a liquid. Fondly, Phillipa
Posted by Phillipa on May 11, 2005, at 21:00:46
In reply to Re: Not Really... » Phillipa, posted by Shawn. T. on May 11, 2005, at 20:32:15
Shawn, it's scarey what they don't know about drugs when they are first introduced. I couldn't have been the only one to react the way I did or they wouldn't have the lower doses. They believed one size fits all. Fondly, Phillipa
Posted by Shawn. T. on May 11, 2005, at 22:17:23
In reply to Re: Not Really... » Shawn. T., posted by Phillipa on May 11, 2005, at 20:58:42
No, zimelidine was not marketed in the US. It was marketed in Europe but was removed from the market because of several cases of Guillain-Barre syndrome that were associated with its use.
Shawn
Posted by krybrahaha78 on May 11, 2005, at 22:33:06
In reply to Re: Not Really... » Phillipa, posted by Shawn. T. on May 11, 2005, at 22:17:23
Luvox was out in Europe way before prozac came out
Posted by Phillipa on May 11, 2005, at 23:25:06
In reply to Re: Not Really..., posted by krybrahaha78 on May 11, 2005, at 22:33:06
Really? That wasn't popular until years later here. Now they withdrew the brandname and only a generic is available. But none of the docs RX it. And it worked for me. The only one I didn't have side effects with and I tolerated it up to 250mg. Fondly, Phillipa
Posted by krybrahaha78 on May 12, 2005, at 2:51:28
In reply to Re: Not Really... » krybrahaha78, posted by Phillipa on May 11, 2005, at 23:25:06
i dont understand why the docs are not prescribing Luvox---it worked way better for me for my OCD than any of the SSRI's, Remeron, Serzone, or Effexor. It must work differently or something. I just dont understand its lack of popularity.
Posted by darkhorse on May 12, 2005, at 6:29:36
In reply to Re: Not Really..., posted by krybrahaha78 on May 11, 2005, at 22:33:06
> Luvox was out in Europe way before prozac came out
Yes:
1- Fluvoxamine was introduced in 1983!!
2- Citalopram was introduced in Denmark in 1986
3- Fluoxetine in December 1987,then came the rest of the family.Regarding " selectivity" this is a propaganda!
For example :
Paroxetine affect NE,and AC in a moderate- potent
Sertraline affect DA and NE to a lesser extent.
Fluoxetine affect NE and 5ht2c.
Citalopram affect Histamine moderately.The only thing in common is that all affect 5ht potently, but in no way they are selective.
- Venlafaxine& Duloxetine also potently affect serotonin, but Venlafaxine is more like the others because it weakly affect NE.
- Clomipramine is the "Godfather" of all SSRIs, as it is a very potent SRI,but still is not selective
- Even Imipramine is more potent in serotonin than fluvoxamine and venlafaxine!!D.H.
Posted by darkhorse on May 12, 2005, at 6:35:34
In reply to Re: Not Really..., posted by krybrahaha78 on May 12, 2005, at 2:51:28
> i dont understand why the docs are not prescribing Luvox---it worked way better for me for my OCD than any of the SSRI's, Remeron, Serzone, or Effexor. It must work differently or something. I just dont understand its lack of popularity.
It is all about how to sell the product, nothing more!!
Look at how Paroxetine was doing great in the market,and now finally the truth is coming out about its lots of negative effects!
Europeans are simply not as good as Americans when it comes to marketing (Luvox,Survector,Cipram,Stablon,Aurorix,Lexotanil are just few examples).
DH
Posted by SLS on May 12, 2005, at 7:08:35
In reply to Re: Not Really... » Phillipa, posted by Shawn. T. on May 11, 2005, at 22:17:23
> No, zimelidine was not marketed in the US. It was marketed in Europe but was removed from the market because of several cases of Guillain-Barre syndrome that were associated with its use.
>
> Shawn
You are an accomplished historian!
- Scott
Posted by SLS on May 12, 2005, at 7:15:06
In reply to Re: Not Really..., posted by krybrahaha78 on May 11, 2005, at 22:33:06
> Luvox was out in Europe way before prozac came out
It is probably a good thing that Prozac appeared in the US first. It makes for a better antidepressant than does Luvox, and its success helped foster the development and marketing of other "SSRI"s. Despite the similarities that the SSRIs have among each other, it is their individual dissimilarities that gives each drug its unique worth as a pharmacological tool.
- Scott
Posted by darkhorse on May 12, 2005, at 9:48:32
In reply to Re: Not Really..., posted by SLS on May 12, 2005, at 7:15:06
> It is probably a good thing that Prozac appeared in the US first. It makes for a better antidepressant than does Luvox,.
Hello Scott,
I'm not so sure what you mean by *better* >
I think that it is all a matter of individual preferences...For some,Luvox/Faverin is their fav.,for others (including myself)regard Prozac as the best of the SSRis.....but one thing is for sure (IMO)is that if you want anything to become world-wide famous,the USA is the place to start with.e.g. both Luvox and Celexa/Cipram never became world-wide famous until they reached the USA market,and now Celexa is a very popular SSRi in the USA even though it is older than Prozac....
Best regards,
DH
Posted by woolav on May 12, 2005, at 11:30:39
In reply to Re: Not Really... » SLS, posted by darkhorse on May 12, 2005, at 9:48:32
Posted by 4WD on May 12, 2005, at 17:52:27
In reply to Re: Not Really..., posted by SLS on May 12, 2005, at 7:15:06
> > Luvox was out in Europe way before prozac came out
>
> It is probably a good thing that Prozac appeared in the US first. It makes for a better antidepressant than does Luvox, and its success helped foster the development and marketing of other "SSRI"s. Despite the similarities that the SSRIs have among each other, it is their individual dissimilarities that gives each drug its unique worth as a pharmacological tool.
>
>
> - ScottIt seems to me that you should be able to go to your pdoc, tell him/her the specific way you were affected by Prozac, Celexa, Paxil, Effexor, whatver ones you have tried and they should be able to deduce from that how you are likely to react to some other drug. They don't seem to take that into account.
Marsha
Posted by SLS on May 12, 2005, at 21:42:06
In reply to Re: Not Really... » SLS, posted by 4WD on May 12, 2005, at 17:52:27
> > > Luvox was out in Europe way before prozac came out
> >
> > It is probably a good thing that Prozac appeared in the US first. It makes for a better antidepressant than does Luvox, and its success helped foster the development and marketing of other "SSRI"s. Despite the similarities that the SSRIs have among each other, it is their individual dissimilarities that gives each drug its unique worth as a pharmacological tool.
> >
> >
> > - Scott
>
>
>
> It seems to me that you should be able to go to your pdoc, tell him/her the specific way you were affected by Prozac, Celexa, Paxil, Effexor, whatver ones you have tried and they should be able to deduce from that how you are likely to react to some other drug. They don't seem to take that into account.
>
> Marsha
I wish more clinicians would be as inclined as you are to attempt to use a patient's history of specific reactions to specific drugs to deduce an ultimately effective treatment. I guess we are not there yet.I think there are several directions that this line of reasoning could be explored in greater detail. One would employ brain imaging, either functional or static, using a challenge such as a biological probe or a psychometric test. Another would be the use of microarrays to determine gene activity. Perhaps brain electrical activity mapping will provide some utility if employed before, during, and after biological challenge.
I'm just thinking out loud. Eventually, there will be tests available to help guide the clinician in choosing treatments that are tailored to the individual and have the greatest chance of succeeding. I just wish these things would have been developed earlier in my lifetime. However, if they were to be developed by next weekend, I doubt I would spend too much time lamenting the past. I would be too excited and preoccupied with building a future!
- Scott
Posted by 4WD on May 12, 2005, at 22:21:17
In reply to Re: Not Really... » 4WD, posted by SLS on May 12, 2005, at 21:42:06
Scott,
I'd just be happy with some sort of computer program where you could put in the different drugs you've tried, each drug's side effects for you and it's efficacy in different areas - motivation, energy, lack of anhedonia etc. Then the program would scan all the drugs in its database and pull up a nice match for you.I actually did make a spreadsheet for my pdoc for my first visit. I listed and rated each drug I'd tried for efficacy in about seven different areas. Then I made another chart with side effects listed. I rated each efficacy category with a positive number and each side effect category with a negative number. I was so naive. I actually thought he'd be able to look at my chart and say "oh, well since drug X caused this to happen and drug Y caused that to happen, here's what you need to be on."
Ah, well.
Marsha
Posted by mike13 on May 12, 2005, at 23:17:28
In reply to Re: Not Really... » SLS, posted by 4WD on May 12, 2005, at 22:21:17
Jesus ITS AN SSRI AS FAR AS ALL PSYCHATRISTS ARE CONCERNED AND AS FAR AS THE COMPANIES WHO PRODUCE PROZAC IT IS ALWAYS DOCUMENTED AS AN SSRI AND NOTHING WILL CHANGE THAT..
Posted by woolav on May 13, 2005, at 9:15:21
In reply to Re: Not Really... » SLS, posted by 4WD on May 12, 2005, at 22:21:17
I think that would be a great idea too. Sometimes it seems that the pdocs know as much as we do about diagnoses. I always go to my appt with an arsenal of info that I researched myself. Then I tell her what I think and she (most of the time) will say "lets try it and see"..isnt that what i pay her for? I want direction, not some guessing game!!
S
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