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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by g_g_g_unit on February 1, 2010, at 0:39:30
i was just curious if any of the SSRI/SNRI drugs could be regarded as a 'lesser evil' in this regard?
i experienced the most dreadful restless leg symptoms on Luvox and Lexapro - not just at night, but also during the day, to the point where it was uncomfortable to sit still for more than twenty minutes. i also have lingering myoclonic jerks from a Nardil trial.
does Zoloft's putative effect on dopamine, for instance, make any difference? is the only real solution augmenting with parkinson's drugs?
Posted by linkadge on February 1, 2010, at 6:52:34
In reply to SSRI's + extra pyramidal s/e's, posted by g_g_g_unit on February 1, 2010, at 0:39:30
Theoretically, zoloft would be better, but I've never seen data to support this.
>is the only real solution augmenting with >parkinson's drugs?
This side effect may be more pronounced in people with 'low dopamine' to begin with. You may try a lesser dose of the SSRI. You might augment with something like mirtazapine (or cyproheptadine / low dose TCA) (which blocks inhibitory serotonin receptors). Bupropion augmentation might offset this effect. You might also get relief with a benzodiazapine.
Another option is to switch to a TCA, mirtazapine or bupropion.
A stimulant may help, but it may end up depleting dopamine more in the long run. An agent like coenzyme q10 might be beneficial as it has the ability to ameleorate drug induced catecholamine disturbances.
Other options include tyrosine, caffiene or a dopamine agonist.
Linkadge
Posted by g_g_g_unit on February 1, 2010, at 7:43:57
In reply to Re: SSRI's + extra pyramidal s/e's, posted by linkadge on February 1, 2010, at 6:52:34
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> This side effect may be more pronounced in people with 'low dopamine' to begin with. You may try a lesser dose of the SSRI.i can't remember if it only occurred on higher doses or not .. but i'll keep that in mind this time. i think it was worst on Luvox, and i did take a higher dose of that. i didn't notice it as much on Lexapro.
> You might augment with something like >mirtazapine (or cyproheptadine / low dose TCA) >(which blocks inhibitory serotonin receptors). >Bupropion augmentation might offset this effect. >You might also get relief with a benzodiazapine.
remeron might be a good option because i also have difficulty with insomnia
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> Another option is to switch to a TCA, mirtazapine or bupropion.
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> A stimulant may help, but it may end up depleting dopamine more in the long run. An agent like coenzyme q10 might be beneficial as it has the ability to ameleorate drug induced catecholamine disturbances.i know next to nothing about pharmacology but i was thinking of revisiting Memantine as an augmentation agent for OCD. since it's a D2 agonist and 5HT3 antagonist, is there any reason to think it might help the restless legs etc?
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> Other options include tyrosine, caffiene or a dopamine agonist.
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> Linkadge
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Posted by linkadge on February 1, 2010, at 9:57:22
In reply to Re: SSRI's + extra pyramidal s/e's » linkadge, posted by g_g_g_unit on February 1, 2010, at 7:43:57
>i was thinking of revisiting Memantine as an >augmentation agent for OCD. since it's a D2 >agonist and 5HT3 antagonist, is there any reason >to think it might help the restless legs etc?
possibly
Linkadge
Posted by Phillipa on February 1, 2010, at 11:04:46
In reply to Re: SSRI's + extra pyramidal s/e's, posted by linkadge on February 1, 2010, at 9:57:22
forgive my ignorance but been on low dose luvox and benzos for years and where is the dopamine in luvox or is the point there is none just serotonin? Phillipa
Posted by herpills on February 1, 2010, at 21:13:14
In reply to SSRI's + extra pyramidal s/e's, posted by g_g_g_unit on February 1, 2010, at 0:39:30
I used to have really bad akathisia when I was on a higher dose of Lexapro. I found a low dose of Klonopin useful for this. herpills
Posted by inanimate peanut on February 2, 2010, at 22:25:08
In reply to Re: SSRI's + extra pyramidal s/e's, posted by herpills on February 1, 2010, at 21:13:14
You could try Mirapex. It's been shown to work in depression and is a primary treatment for restless leg syndrome.
Posted by g_g_g_unit on February 3, 2010, at 6:04:15
In reply to Re: SSRI's + extra pyramidal s/e's, posted by inanimate peanut on February 2, 2010, at 22:25:08
i did it a bit of research and it seems like Sinemet is the frontline med prescribed where i live. Requip is also available, but no Mirapex.
anyone know anything about Sinemet?
Posted by Phillipa on February 3, 2010, at 19:35:44
In reply to Re: ; Sinemet, posted by g_g_g_unit on February 3, 2010, at 6:04:15
Isn't it an older Parkinson's med? Phillipa
This is the end of the thread.
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