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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by SheilaC on August 16, 2009, at 14:29:32
Tried Pristiq and liked it except for the severe consitpation - really, really bad, and the numb feeling. Maybe I was getting too much norepinephrine?
I really need a little serotonin. But I have to be careful not to get too much or I start to get bladder spasms and too frequent urination, etc.
What would be the next step? Cymbalta? Effexor or Lexapro? Which antidepressant is mild in the serotonin department?
Maybe one of those would work and a super low dose and I can work up.
Posted by SLS on August 16, 2009, at 15:05:23
In reply to Mildest SSRI or SNRI?, posted by SheilaC on August 16, 2009, at 14:29:32
Zoloft?
- Scott
Posted by Sunbath on August 16, 2009, at 15:18:58
In reply to Re: Mildest SSRI or SNRI?, posted by SLS on August 16, 2009, at 15:05:23
I'd also like to know. I always thought lexapro to be the "mildest" ssri? Being the most selective of the ssris (is that true?) and with a lower affinity to the SERT than paxil, zoloft and prozac? Would that also mean that Lexapro theoretically wouldn't work as good in treating OCD as paxil, zoloft and clomipramine?
Thanks!
Posted by Phillipa on August 16, 2009, at 15:56:05
In reply to Re: Mildest SSRI or SNRI?, posted by Sunbath on August 16, 2009, at 15:18:58
Forgot luvox to me that's the mildest of the SSRI's. Never had a side effect even from the first dose. Love Phillipa
Posted by SLS on August 16, 2009, at 16:22:33
In reply to Re: Mildest SSRI or SNRI?, posted by Sunbath on August 16, 2009, at 15:18:58
> I'd also like to know. I always thought lexapro to be the "mildest" ssri? Being the most selective of the ssris (is that true?) and with a lower affinity to the SERT than paxil, zoloft and prozac? Would that also mean that Lexapro theoretically wouldn't work as good in treating OCD as paxil, zoloft and clomipramine?
For some reason, it is the subjective description of many people that Zoloft is the smoothest of the SSRIs. Of course, there are people for whom this is not true. "Smoothness" may not be directly attributable to the binding affinities at the SERT of the different SRI medications. It might also depend on differences in the location of the brain where the different drugs accumulate. Also, I would guess that the other various properties that these drugs possess affect efficacy and tolerability.
Dosage does not always indicate binding affinity.
http://www.preskorn.com/books/ssri_s3.html
Damned drugs.
- Scott
Posted by Phillipa on August 16, 2009, at 20:39:35
In reply to Re: Mildest SSRI or SNRI?, posted by SLS on August 16, 2009, at 16:22:33
Scott so luvox is unknown? Hard to read for me. That's what I thought it meant. Could you clarify? Phillipa
Posted by Sunbath on August 17, 2009, at 1:05:31
In reply to Re: Mildest SSRI or SNRI?, posted by SLS on August 16, 2009, at 16:22:33
Thanks Scott ;)
Posted by manic666 on August 17, 2009, at 4:31:47
In reply to Re: Mildest SSRI or SNRI? » SLS, posted by Phillipa on August 16, 2009, at 20:39:35
phillipa why do you take luvox,it does nothing for you an you wont up the dose,it probably does you more harm than good , time for a change there has been about 20 new meds while you have been on luvox
Posted by SLS on August 17, 2009, at 6:07:39
In reply to Re: Mildest SSRI or SNRI? » SLS, posted by Phillipa on August 16, 2009, at 20:39:35
> Scott so luvox is unknown? Hard to read for me. That's what I thought it meant. Could you clarify? Phillipa
From what I can see, Luvox is about average for the SSRIs with respect to binding affinity to the serotonin transporter ~ 3.0 Ki (nM)
- Scott
Posted by yxibow on August 17, 2009, at 20:02:13
In reply to Re: Mildest SSRI or SNRI?, posted by manic666 on August 17, 2009, at 4:31:47
Theoretically the "cleanest" SSRI is Lexapro, but that is an individual thing. I couldn't take it, it was so nauseating.
As for SNRIs, I would think Cymbalta is less harsh than Effexor, but that is my -own- experience quite a while ago and not from what I see from a number of people, so again I think the real answer to both questions isn't the best answer.
It's trial and error.
-- Jay
Posted by Phillipa on August 17, 2009, at 20:39:54
In reply to Re: Mildest SSRI or SNRI?, posted by manic666 on August 17, 2009, at 4:31:47
Manic seems my brain likes it just where it is as one pdoc tried to take me off and raise benzo doses very high and didn't sleep for two weeks. Er said return to previous and slept again. I'm much more anxious than depressed. I need to be busy and excercising or going out all the time this seems the opposite of depression to me? Love Phillipa And Scott thanks for the clarification. I always thought luvox was the weakest SSRI.
This is the end of the thread.
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