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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by borderliner21 on February 9, 2002, at 15:12:30
I am taking risperdal for schizoaffective disorder. I want to add an ssri sometime soon for depression and low self confidence. Which ssri would be the best for me? Celexa maybe?
Posted by OldSchool on February 9, 2002, at 15:42:02
In reply to what ssri is least likely to cause mania/psychosis, posted by borderliner21 on February 9, 2002, at 15:12:30
> I am taking risperdal for schizoaffective disorder. I want to add an ssri sometime soon for depression and low self confidence. Which ssri would be the best for me? Celexa maybe?
They all can cause mania in susceptible individuals (bipolar disorder). However if you have tendencies towards that and need to take SSRIs anyway, your best bet is to take an antidepressant with an extremely short half life like Paxil. That way, if the AD does induce mania/psychosis in you, it doesnt take long for the drug to get out of your system after you go off it. Luvox is another one that has a short half life. Prozac you want to avoid because it takes forever to get out of your system cause it has such a long half life.
And of course Wellbutrin SR is the preferred antidepressant in bipolar. Its supposed to cause mania the least of all antidepressants.
Old School
Posted by borderliner21 on February 9, 2002, at 17:07:49
In reply to Re: what ssri is least likely to cause mania/psychosis, posted by OldSchool on February 9, 2002, at 15:42:02
I want to add an ssri is because I have ptsd. Would become full blown manic on an ssri? Or would risperdal work against the celexa if it caused mania?
Posted by OldSchool on February 9, 2002, at 18:29:12
In reply to Re: what ssri is least likely to cause mania/psychosis, posted by borderliner21 on February 9, 2002, at 17:07:49
> I want to add an ssri is because I have ptsd. Would become full blown manic on an ssri? Or would risperdal work against the celexa if it caused mania?
Man, I dont know. These are specific questions for your doctor. Ask them this stuff.
Posted by Mr. Scott on February 9, 2002, at 18:50:02
In reply to what ssri is least likely to cause mania/psychosis, posted by borderliner21 on February 9, 2002, at 15:12:30
Paxil, Effexor, WB, Sinequan, Surmontil
Are mostly the recommendations I've heard.
Posted by borderliner21 on February 9, 2002, at 18:51:27
In reply to Re: what ssri is least likely to cause mania/psychosis » borderliner21, posted by Mr. Scott on February 9, 2002, at 18:50:02
Thank you. Sorry for all the questions
Posted by Ritch on February 9, 2002, at 21:24:37
In reply to what ssri is least likely to cause mania/psychosis, posted by borderliner21 on February 9, 2002, at 15:12:30
> I am taking risperdal for schizoaffective disorder. I want to add an ssri sometime soon for depression and low self confidence. Which ssri would be the best for me? Celexa maybe?
Celexa is a good choice because it is quite *weak* compared to the others. Paxil is also a good choice due to short half-life. Just keep the dose TINY. I have had quite intense hypomania from SSRI's. But, in small doses they are helpful for anxiety, etc.
Mitch
Posted by Blue Cheer 1 on February 10, 2002, at 0:50:58
In reply to what ssri is least likely to cause mania/psychosis, posted by borderliner21 on February 9, 2002, at 15:12:30
> I am taking risperdal for schizoaffective disorder. I want to add an ssri sometime soon for depression and low self confidence. Which ssri would be the best for me? Celexa maybe?
You might want to consider MAOIs or even TCAs. I remember many persons who were diagnosed as "schizoaffective" who did great on the combination of Mellaril and Elavil. Of course, now you'd want to use an atypical like the one you're using. I think I just read somewhere that Risperdal, in a large study, was superior to the other atypical APs.
Blue
Posted by paulb on February 11, 2002, at 13:28:14
In reply to what ssri is least likely to cause mania/psychosis, posted by borderliner21 on February 9, 2002, at 15:12:30
> I am taking risperdal for schizoaffective disorder. I want to add an ssri sometime soon for depression and low self confidence. Which ssri would be the best for me? Celexa maybe?
I got a page that states clinicians ranking of SSRI antidepressants from most agitating to the least if that is of any interest? It reads:
Fluoxetine
Sertraline
Citalopram
Fluvoxamine
ParoxetineI would add that Sertraline is often favoured because it is less agitating than Fluoxetine.
Paulb
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