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Re: What can you combine with SSRI's? jealibeanz

Posted by Racer on March 29, 2007, at 12:32:49

In reply to What can you combine with SSRI's?, posted by jealibeanz on March 29, 2007, at 4:58:04

>>
> Does this all mean that these "selective" reuptake inhibitors aren't really so selective, rather, they have systems effects as well as CNS?
>

The SSRIs are pretty selective -- it's just that most of the serotonin in your body is in your gut. The increased availability of serotonin in the synaptic gap leads to downregulation of the postsynaptic receptors. That means that your body is getting weaker signals from the receptors that mediate digestion. This leads to decreased bowel motility, and lowered volume on the signals to your brain telling you you're full after eating, among other things. Only about 5% of the serotonin in your body is anywhere near your brain.

There is another drug out there, the name of which I've forgotten, that normalizes one type of serotonin receptor, which should counter weight gain. I'm not sure if it's approved yet, it probably is, and I don't remember the name. It might be worth asking your doctor about a drug that normalizes the type 4 receptors. He might know.

Otherwise, sibutramine might be worth exploring -- that might even be the type 4 receptor drug, come to think of it -- or metformin, or combining an SSRI with Strattera or Ritalin, or there's adding Orlistat. Taking a stool softener can also help. Drinking plain water can help, since the downregulation at some of the type 2 receptors can lead to a lack of moisture in the bowel.

I also have to ask this: I know you've said you don't have an eating disorder, but it sure sounds as though you might. Have you ever been evaluated by someone who has experience with them? It could be that treating the eating disorder would help a lot in finding a way to help you get stable.

Good luck.


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