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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Prefect on April 1, 2018, at 11:34:58
I took Luvox for 20 yrs with good results. It pooped out on me a year ago and been on 150mm zoloft, which isn't doing much for me at all.
I suspect Luvox helped me more due to sigma 1 agonism rather than its SSRI properties. Zoloft is in fact a sigma 1 antagonist.
I want to experiment taking maybe 25mg Luvox at night to see if it'll have a positive effect.
Is this a dangerous move, wrt serotonin syndrome?
Posted by Christ_empowered on April 1, 2018, at 15:54:59
In reply to Zoloft and Luvox Together?, posted by Prefect on April 1, 2018, at 11:34:58
i wouldn't do it, personally. maybe a switch to luvox w/ something added to enhance response, like low dose abilify or something? Even buspirone can help, for some people, and its a relatively inexpensive generic.
just a thought. i hope things work out OK for you.
Posted by Joe f on April 1, 2018, at 18:50:51
In reply to Re: Zoloft and Luvox Together?, posted by Christ_empowered on April 1, 2018, at 15:54:59
What was your normal dose of luvox
Posted by Prefect on April 1, 2018, at 22:06:44
In reply to Re: Zoloft and Luvox Together?, posted by Joe f on April 1, 2018, at 18:50:51
Before it pooped out? 100 mg
What I don't like about zoloft is that it's not only a sigma 1 antagonist, it also reduces glutamate uptake and is likely to increase excitotoxicity.
The fact that I respond well to clonazepam and alcohol (both NMDA antagonists) tells me much of my symptoms might be due to excitotoxicity.
Posted by Prefect on April 1, 2018, at 22:09:49
In reply to Re: Zoloft and Luvox Together?, posted by Christ_empowered on April 1, 2018, at 15:54:59
I've actually been abilify a lot of thought. A lot of my condition is sort of a derealization/perceptual change due to severe anxiety where I fully lose executive functioning and become catatonic. I'm hoping low dose abilify might help with that.
Posted by linkadge on April 2, 2018, at 6:54:00
In reply to Re: Zoloft and Luvox Together? » Christ_empowered, posted by Prefect on April 1, 2018, at 22:09:49
I read about the sertraline glutamate reuptake effect. However, was the dose used to elicit neurotoxocity within the therapeutic range?
Linkadge
Posted by Joe f on April 2, 2018, at 12:55:00
In reply to Re: Zoloft and Luvox Together? » Prefect, posted by linkadge on April 2, 2018, at 6:54:00
I take 200 Luvox along with 2mg of rexulti and 1.5 klonopin have you considered this
Posted by Prefect on April 2, 2018, at 16:50:26
In reply to Re: Zoloft and Luvox Together? » Prefect, posted by linkadge on April 2, 2018, at 6:54:00
I've read if there's preexisting neurotoxicity therapeutic doses can exasperate it.
https://www.sciencedirect.com/science/article/pii/S0161813X15300140
Posted by rjlockhart37 on April 2, 2018, at 21:58:54
In reply to Re: Zoloft and Luvox Together? » linkadge, posted by Prefect on April 2, 2018, at 16:50:26
i researched on this question, actually it's not dangerous, i thought it was, because say like taking Paxil with Prozac, that is dangerous, serotonin syndrome.
http://www.socialanxietysupport.com/forum/f30/luvox-and-zoloft-thread-for-major-depression-1509594/
i think lower dose of luvox would not hurt, because if you type that question, there's alot people on net that take it.....but first, ask your doctor because they would know the best
Posted by Lamdage22 on April 3, 2018, at 10:16:47
In reply to Re: Zoloft and Luvox Together?, posted by rjlockhart37 on April 2, 2018, at 21:58:54
Have you tried low dose lithium? I wouldnt combine either.
Posted by Prefect on April 3, 2018, at 11:08:36
In reply to Re: Zoloft and Luvox Together?, posted by Lamdage22 on April 3, 2018, at 10:16:47
I'm more inclined to try low dose abilify first. I take zoloft in the morning and would likely take abilify at the same time too rather than night time because it's likely stimulating.
Posted by SLS on April 3, 2018, at 15:59:44
In reply to Re: Zoloft and Luvox Together?, posted by Prefect on April 3, 2018, at 11:08:36
> I'm more inclined to try low dose abilify first. I take zoloft in the morning and would likely take abilify at the same time too rather than night time because it's likely stimulating.
Abilify can produce akathisia, as you know. Zoloft, being a sigma antagonist, can make akathisia worse. By contrast, Luvox can quell akathisia.
- Scott
Posted by Christ_empowered on April 4, 2018, at 11:26:09
In reply to Re: Zoloft and Luvox Together?, posted by Christ_empowered on April 1, 2018, at 15:54:59
hi. the 1st, big recommendation is: talk to the prescriber (yes, its me; captain obvious).
Luvox+Abilify seems relatively common. I think luvox has a lot more drug-drug interactions trickiness going on, so that's something your prescriber should probably keep up with.
Buspar/buspirone is a cheap generic that sometimes helps bring about enhanced response to ssri/ssnri antidepressants. its your life, your body, your call, but I'd personally see about the buspar first, since its been generic forever and its not a tranquilizer/neuroleptic, but I seem to recall reading that it has some overlap w/ the 'atypicals.'
the long term TD risk w/ the 'atypicals' might actually not be all that much better than w/ carefully selected, carefully dosed 'conventional' tranquilizers. apparently, high dose, high potency old school tranquilizers were en vogue for a long time, and that's part of what caused the older drugs to get such a terrible reputation. point is...
i don't know your budget, insurance coverage, preferences, etc., but some of the older tranquilizers might be worth considering. perphenazine helps a lot of people, so does loxapine. i seem to recall reading someone on here writing about navane being OK, but I don't know anything about that particular drug.
-if- you opt for a tranquilizer, my personal advice (its what I do, actually) would be to consider supplements w/ the neuroleptic. high dose antioxidants, b-vitamins, taurine, gingko, etc...there are a number of supplements available that -might- improve tolerability and reduce some long term risks. my preference is for full on, high dose, old school Orthomolecular, but...clearly, that doesn't appeal to everyone.
hope this helps.
Posted by SLS on April 4, 2018, at 13:16:55
In reply to luvox+abilify (maybe), posted by Christ_empowered on April 4, 2018, at 11:26:09
Hi C_E.
> -if- you opt for a tranquilizer, my personal advice (its what I do, actually) would be to consider supplements w/ the neuroleptic. high dose antioxidants, b-vitamins, taurine, gingko, etc...there are a number of supplements available that -might- improve tolerability and reduce some long term risks. my preference is for full on, high dose, old school Orthomolecular, but...clearly, that doesn't appeal to everyone.What about vitamin E? It was a long time ago, but there were some investigations into vitamin E to prevent or treat TD.
A friend of mine has been taking Navane (thiothixene) in combination with Saphris for a long time. No problems.
- Scott
Posted by Prefect on April 4, 2018, at 19:29:57
In reply to Re: luvox+abilify (maybe), posted by SLS on April 4, 2018, at 13:16:55
I;m very tempted to taper down from zoloft and start luvox again for its sigma 1 agonism and add abilify on top of it. I'm on 150mg zoloft now. Would you say a 50mg drop a week would be a safe taper? The moment I hit zero I'm going to start 50 mg luvox and work up to 150 mg per day and then add 5 mg abilify in the mornings. Does this sound reasonable? I think a lot of my symptoms are due to neroexcitotoxicity.
Posted by Christ_empowered on April 4, 2018, at 19:40:04
In reply to Re: luvox+abilify (maybe), posted by SLS on April 4, 2018, at 13:16:55
hi. vitamin E is still fairly popular, I think. I take it, as part of my Orthomolecular cocktail. 1600 IU natural form per day.
a former shrink told me that she recommends 800 IU vitamin E and...I think amantidine...to people with TD.
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