![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by porkpiehat on July 23, 2021, at 20:26:02
My doctor recently suggested luvox to me to replace my lexapro, which I take with 100 mg lamictal. The two together seem to create a racy obsessiveness.
The obsessiveness is far less with just one or the other. I was on just lamictal for a while but I really couldn't handle the social anxiety, depression, and lack of motivation, so I went back on celexa/lexapro...which in turn ramped my obsessive thinking, irritability, and persecuted thinking.
My knowledge of luvox is that it is the most serotonergic of the SSRIs, so I'm expecting more apathy, weight gain, and sexual problems.
To me, it doesn't make sense to replace lexapro with luvox to treat the obsessiveness caused by the combo of the ssri and lamictal. But I wanted to vet the idea before discarding it offhand.
anyone have thoughts? thanks!
Posted by undopaminergic on July 24, 2021, at 6:43:14
In reply to luvox vs other SSRI's, posted by porkpiehat on July 23, 2021, at 20:26:02
>
> My knowledge of luvox is that it is the most serotonergic of the SSRIs, so I'm expecting more apathy, weight gain, and sexual problems.
>I think escitalopram is the most serotonin-selective of the SSRIs. The most interesting feature of fluvoxamine (Luvox) in my view is its agonism at sigma1-receptors.
> To me, it doesn't make sense to replace lexapro with luvox to treat the obsessiveness caused by the combo of the ssri and lamictal. But I wanted to vet the idea before discarding it offhand.
>It does not make much sense to replace a SSRI with another SSRI, except to the extent that the different SSRIs differ in their secondary mechanisms of action.
-undopaminergic
Posted by porkpiehat on July 24, 2021, at 9:11:40
In reply to Re: luvox vs other SSRI's, posted by undopaminergic on July 24, 2021, at 6:43:14
I used to think the same thing but I've found them to having differing effects, but I'm quite sensitive.
Posted by linkadge on July 24, 2021, at 11:45:41
In reply to Re: luvox vs other SSRI's » undopaminergic, posted by porkpiehat on July 24, 2021, at 9:11:40
SSRIs are not all directly interchangeable. There are many reports of people responding to one but not the other.
As mentioned, luvox is a sigma-1 agonist. This activity has antidepressant / anti-OCD effects in its own right. MG per MG, escitalopram would be much more potent on the serotonin reuptake system than luvox.
I would give it a try. I actually found less sexual dysfunction with luvox.
Linkadge
Posted by undopaminergic on July 24, 2021, at 12:35:23
In reply to Re: luvox vs other SSRI's, posted by linkadge on July 24, 2021, at 11:45:41
>
> As mentioned, luvox is a sigma-1 agonist. This activity has antidepressant / anti-OCD effects in its own right. MG per MG, escitalopram would be much more potent on the serotonin reuptake system than luvox.
>Per unit (mg) of weight is not the only way to look at potency. The dose-response curve is probably more relevant than affinity. I don't have any data on how the different SSRIs compare in this regard, but I know paroxetine is considered the most potent, followed by sertraline. What I mean, is that it is possible to reach near 100% serotonin transporter inhibition with these drugs (without the need for megadoses), whereas this is not possible with drugs that have a flattening dose-response curve.
-undopaminergic
Posted by rjlockhart37 on July 24, 2021, at 15:03:48
In reply to Re: luvox vs other SSRI's, posted by undopaminergic on July 24, 2021, at 12:35:23
luvox is potent serotonin reptake inhibtor, it's good for OCD
Prozac compared to other SSRI's is lesser effective
Posted by Lamdage22 on July 25, 2021, at 0:33:01
In reply to Re: luvox vs other SSRI's, posted by linkadge on July 24, 2021, at 11:45:41
Luvox is supposed to be less detrimental to bedroom acitivities than other SSRI's.
Posted by porkpiehat on July 29, 2021, at 15:19:11
In reply to Re: luvox vs other SSRI's, posted by undopaminergic on July 24, 2021, at 6:43:14
" The most interesting feature of fluvoxamine (Luvox) in my view is its agonism at sigma 1-receptors."
>This is interesting. I'm wondering how it would interact with Lamictal, which reduces glutaminergic and NMDA signaling. Sigma 1 appears to also affect NMDA signaling.
A lot of drugs that may have been helpful to me unfortunately create serious cognitive problems (I suspect) in combination with the Lamictal. If I go over 200mgs I'm useless
Posted by porkpiehat on August 11, 2021, at 15:49:03
In reply to Re: luvox vs other SSRI's, posted by linkadge on July 24, 2021, at 11:45:41
I just gave my doc the thumbs up. Did you find less SSRI apathy with the luvox also?
Right now I'm dying to get off the lexapro because at the low doses it creates crazy irritability (Celexa also) and yet I don't want the apathy and sexual problems that come with higher doses.
Posted by linkadge on August 16, 2021, at 10:18:16
In reply to Re: luvox vs other SSRI's » linkadge, posted by porkpiehat on August 11, 2021, at 15:49:03
I probably found a little less apathy, but this was dose dependent.
Linkadge
Posted by porkpiehat on August 17, 2021, at 12:26:21
In reply to Re: luvox vs other SSRI's, posted by linkadge on August 16, 2021, at 10:18:16
The most recent and pressing reason for me wanting to switch is irritability and agitation I get at low doses of celexa/lexapro (5-10mgs) and then the compulsive urges, perhaps hypomania that I get at higher doses.
Now I'm reading that fluvoxamine is particularly known for creating "stimulation,
mania and aggression" compared to the other SSRIs.http://breggin.com/wp-content/uploads/1990/01/fluvoxamine.pdf
This has me concerned!
Posted by undopaminergic on August 18, 2021, at 11:33:54
In reply to Re: luvox vs other SSRI's » linkadge, posted by porkpiehat on August 17, 2021, at 12:26:21
> The most recent and pressing reason for me wanting to switch is irritability and agitation I get at low doses of celexa/lexapro (5-10mgs) and then the compulsive urges, perhaps hypomania that I get at higher doses.
>
> Now I'm reading that fluvoxamine is particularly known for creating "stimulation,
> mania and aggression" compared to the other SSRIs.
>
> http://breggin.com/wp-content/uploads/1990/01/fluvoxamine.pdf
>
> This has me concerned!Isn't this (the author of the document you linked to) the same Peter Breggin who claims ADHD doesn't exist? Or am I confusing him with someone else?
-undopaminergic
Posted by porkpiehat on August 25, 2021, at 13:26:44
In reply to Re: luvox vs other SSRI's, posted by undopaminergic on August 18, 2021, at 11:33:54
Spent a week taking 25mgs Luvox at night and discontinuing lexapro. Assumed the drop in obsessive lashing out, combative thinking was a the onset of the luvox.
Went up to 50mgs and spent the next day jumping between rage and sadness. Went down to 25mgs last night and today isn't much better. I think the few days of quiet had more to do with lexapro discontinuation.
Does anyone think this is transitory?
Posted by linkadge on August 29, 2021, at 14:33:33
In reply to Re: stopping this nonsense...I think, posted by porkpiehat on August 25, 2021, at 13:26:44
Personally, I liked luvox more than escitalopram, but (to be honest) I don't like SSRIs in general.
If it's not working for you, don't force it.
What all meds have you tried?
Linkadge
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.