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Re: Indivduals w social phobia have too much serotonin

Posted by SLS on June 20, 2015, at 11:36:52

In reply to Re: Indivduals w social phobia have too much serotonin, posted by Hugh on June 20, 2015, at 9:14:07

> Serotonin has certainly never done my anxiety or depression or insomnia any good. Perhaps I have far too much of it already.

When you say "serotonin", Hugh, do you mean reuptake inhibitors only? Have you tried Paxil?

Are you able to tolerate SSRIs, despite not responding to them? What side effects are most difficult to tolerate?

Not all SSRIs/SNRIs (SRIs) are created equal. If they were, we would only need one of them. They often do other things in addition to transporter inhibition. I just want to make sure you have explored enough SRIs to decide to forever exclude them from your treatment plan. Viibryd is a SRI, but adds 5-HT1a partial agonism. Brintellix is a SRI, but adds 5-HT1a complete agonism with 5-HT7 and 5-HT3 antagonism. Combining a standard SRI with one of these two drugs is not necessarily foolhardy, despite the concerns regarding serotonin syndrome. I have seen people taking multiple SRIs - Effexor and Lexapro for example. I think I prefer Viibryd. Being a partial agonist at 5-HT1a probably works to stabilize the synapse more than a complete agonist.

If you are bipolar, you might do well combining Abilify with Lamictal and possibly Trileptal (oxcarbazepine) or Aptiom (eslicarbazepine). If you are unipolar, you can add reuptake inhibitors - Wellbutrin and Pristiq (or Effexor), perhaps.

I don't remember your history, so you might already have tried all of these.

- Scott

Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw




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