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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by crazyjoe on July 8, 2011, at 22:29:50
what other ssri would you say is the closest in chemical makeup and properties as luvox?
Posted by desolationrower on July 8, 2011, at 23:19:37
In reply to closest to luvox, posted by crazyjoe on July 8, 2011, at 22:29:50
probably paroxatine, as it is sort of a 'downer' too. really, most SSRIs are pretty similar.
-d/r
Posted by SLS on July 9, 2011, at 6:34:59
In reply to closest to luvox, posted by crazyjoe on July 8, 2011, at 22:29:50
> what other ssri would you say is the closest in chemical makeup and properties as luvox?
I guess that depends on what clinical features predominate in the presentation of your illness. Depression? Anxiety? OCD?
Paroxetine (Paxil) is the most potent SSRI (stickiest on receptors) while citalopram and escitalopram are the most selective (avoids other receptors). If you haven't tried escitalopram (Lexapro) yet, it might be worth a trial, as so many people report that the latter two drugs "feel" very different. I have taken Lexapro, and did not find it stimulating. For me, it was somewhat calming. One thing peculiar about escitalopram is that it can produce a brief period of anxiety (2-5 days) that occurs between days 14-21 of treatment. Recently, there has been concern raised that paroxetine, when given during early pregnancy, can produce birth defects of the heart and pulmonary hypertension*. Still, it is a powerful drug that is worth consideration if other SSRIs are otherwise excluded as treatment choices. I would consider venlafaxine (Effexor) to be closer in clinical properties to paroxetine than to citalopram.
For OCD, I would say that fluoxetine (Prozac) given at high dosages might be rated third in efficacy to clomipramine (Anafranil) and fluvoxamine (Luvox). Fluoxetine can produce anxiety or stimulation early in treatment. I really couldn't produce statistics as to how often this anxiety occurs and persists, but I have not seen it often leading to discontinuation.
* By the way, Linkadge predicted that SSRIs might be liable to producing heart defects at least five years ago. He was a lone voice at the time. We still have yet to quantify this phenomenon, but I read that the defects were of the septum. There may also be an increase in the risk of pulmonary hypertension in neonates.
- Scott
Posted by crazyjoe on July 9, 2011, at 8:04:14
In reply to Closest to luvox - Acknowledgement of Linkage » crazyjoe, posted by SLS on July 9, 2011, at 6:34:59
it would be used for ocd/anxiety--do you think luvox or paxil would be a better choice---what do you mean by a "downer"...
Posted by jms600 on July 9, 2011, at 8:54:40
In reply to closest to luvox, posted by crazyjoe on July 8, 2011, at 22:29:50
I guess Seroxat is the one to go for. However, it does have the worst side effect profile out of all the SSRIs. I certainly found it to be the most troublesome. Weight gain, loss of sex drive and excessive daytime sleepiness were the real problems for me with Seroxat. Furthermore, they didn't seem to improve with time either. Still, I did find the drug more effective than Cipralex.
Posted by Phillipa on July 9, 2011, at 10:37:49
In reply to Closest to luvox - Acknowledgement of Linkage » crazyjoe, posted by SLS on July 9, 2011, at 6:34:59
SLS the newsletters still getting have also been publishing studies on the dangers of SSRI's in pregnancy also. Yes heart is the main one. Link was on to something early on then. Phillipa
Posted by Phillipa on July 9, 2011, at 10:40:18
In reply to closest to luvox, posted by crazyjoe on July 8, 2011, at 22:29:50
First SSRI ever took was l0mg of paxil with xanax and had to take 25mg of lopressor first as the doc at the time said I would need it. It took me three months to adjust to paxil. It did seem to work. Luvox was the only never had a side effect on and I still don't know why? Strange. Phillipa
Posted by morgan miller on July 9, 2011, at 11:18:22
In reply to Re: Closest to luvox - Acknowledgement of Linkage, posted by crazyjoe on July 9, 2011, at 8:04:14
> it would be used for ocd/anxiety--do you think luvox or paxil would be a better choice---what do you mean by a "downer"...
Luvox! Sorry I had to jump in here. Many believe Paxil to be the worst SSRI as far as both side effects and efficacy.
Scott's suggestion to maybe try Lexapro is a good one.
If your OCD is really really bad, Luvox may be a good idea. Start low for a few weeks and see if it is enough. The raise the dose if it isn't, hopefully Luvox will give you what you need.
Morgan
Posted by morgan miller on July 9, 2011, at 11:21:19
In reply to Re: Closest to luvox - Acknowledgement of Linkage, posted by crazyjoe on July 9, 2011, at 8:04:14
I personally believe you should just start with a very low dose of Lexapro/escitalopram, 2.5 mg for a few weeks. See how that goes, they start upping the dose if it is not enough. With lexapro, you would be starting off with an SSRI that is more likely to come with less side effects and may be easier to get off of if you choose to.
Posted by Phillipa on July 9, 2011, at 19:51:17
In reply to Re: Closest to luvox - Acknowledgement of Linkage, posted by morgan miller on July 9, 2011, at 11:21:19
Have had no problem upping and downing the lex. When given luvox it was raised by 50mg daily til up to 250mg and seriously no side effects. Had benzos ativan on board then. Phillipa
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