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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by whitmore on January 4, 2013, at 8:28:46
Hi guys:
I'm looking to capitalize on the cortisol enhancement properties of serotonin boosting medications. I've tried zoloft and, at very high doses it seems to work--my hypoglycemia starts to go away. But weight gain is a problem.
I'm wondering if there is another medication with more serotonin boosting at lower (relative) doses? I'm giving Pristiq a trial, but am about to give up, since it seems to make my fatigue and brain fog worse.Is Prozac considered 'stronger' than Zoloft?
I'm also thinking about possibly taking a stimulant in conjunction with the AD for an additional boost.
Current problems are fatigue, hypoglycemia, lack of motivation, cognitive difficulties. This has been made worse by my taking Cytomel for a complex thyroid issue as it appears to have unmasked a degree of hypoadrenia.
Regards.
Sue
Posted by SLS on January 4, 2013, at 9:58:15
In reply to Which AD boosts serotonin the most?, posted by whitmore on January 4, 2013, at 8:28:46
Jono or Linkadge would be better at answering your question.
I don't have time to research this thoroughly, but off the top of my head... and that's no guarantee of accuracy.
In order of potency:
1 Paxil
2 Lexapro
3 Effexor
4 Clomipramine
5 Prozac
6 Cymbalta
7 Zoloft
8 LuvoxI would start with Lexapro first, followed by Effexor, followed by Zoloft, followed by Paxil.
I would consider adding either nortriptyline or Wellbutrin to these if you wish to optimize your chances of finding an effective treatment. You would remain on either of these drugs while you try the various SRI (SSRI + SNRI) drugs.
- Scott
Posted by Phillipa on January 4, 2013, at 10:11:53
In reply to Which AD boosts serotonin the most?, posted by whitmore on January 4, 2013, at 8:28:46
Are you seeing an endocrinologist? Since I also have thyroid disease and at the time cytomel made me anxious. I'm curious about this hypoadrenia. Have not heard of this. Does you doc have a doc he works with for psychiatic issues since the thyroid seems to go hand in hand with psychiatric disorders? Phillipa
Posted by Phillipa on January 4, 2013, at 10:18:17
In reply to Which AD boosts serotonin the most?, posted by whitmore on January 4, 2013, at 8:28:46
I did a quick google search and seems like its adrenal fatigue. Sites say it's lifestyle and diet and not meds that will help. Pleanty of sleep, healthy foods etc. A Link I hope will be of help. Phillipa
Posted by jono_in_adelaide on January 4, 2013, at 15:42:59
In reply to Re: Which AD boosts serotonin the most? » whitmore, posted by SLS on January 4, 2013, at 9:58:15
I agree with Scott, paroxetine (Paxil, Aropax, Seroxat) is said to be the most potent seretonin reuptake inhibitor, but to be honest, i dont think that the differences are massively significant.
Rather than a stimulant, try adding Welbutrin (300mg) to Zoloft or Lexapro, this is a very usefull combination indeed.
Posted by jono_in_adelaide on January 4, 2013, at 15:44:08
In reply to Which AD boosts serotonin the most?, posted by whitmore on January 4, 2013, at 8:28:46
Also, if you have a deficit of cortisol, wouldnt taking hydrocortisone or somthing similar make more sense than antidepressants?
Posted by whitmore on January 4, 2013, at 16:16:21
In reply to Re: Which AD boosts serotonin the most?, posted by jono_in_adelaide on January 4, 2013, at 15:44:08
I do not have adrenal fatigue. I have low pituitary function, so if I embark on hydrocortisone supplementation it will need to be complete replacement, which is a major lifetime commitment. Since AD's are known to boost cortisol and I have had some success in diminishing symptoms in the past, it might be the way to go.
Incidentally, taking cortisol for me is like the patients in 'Awakenings' taking l-dopa. I become a completely normal, happy person. Vyvanse also was a great antidepressant, but caused rebound depression when it wore off.
Problem with cortisol is, it can cause severe osteoporosis and there's always the risk of an adrenal crisis. Plus, once my own production starts to wane, I get fluctuations in mood due to the short half-life of the drug.
Wish I could find studies that show the relative potencies of meds. out there, though sounds like Lexapro would be a good option to try. For some reason I thought Prozac was stronger.
Sue
Posted by jono_in_adelaide on January 4, 2013, at 16:30:47
In reply to Re: Which AD boosts serotonin the most?, posted by whitmore on January 4, 2013, at 16:16:21
paroxetine is the strongest seretonin reuptake inhibitor, so I'd start there, but keep in mind that the effect is also a function of dose, and also that individual variation plays a part, while (say) paroxetine might be the most potent for the statisticaly avarage person, it might not be for you, so some experimentation might be called for
This is the end of the thread.
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