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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Spiro Ghetti on January 9, 2006, at 8:25:07
I was wondering if someone would be kind enough to answer an SSRI question. I summary: Is there more harm than good in taking an SSRI below effective blood levels for a long time?
Let me explain....
About 8 years ago I was put on 25 mg/night LUVOX for vague mental fatigue symptoms (dizziness, etc) that came on out of the blue. The symptoms went away a couple of years ago, and even though I don't think the LUVOX had anything to do with the symptom resolution, I continued taking the 25 mg/night anyway just to be safe. (For the past 8 years!)
About 8 months ago I developed Agoraphobia/Anxiety. I raised my dose to 50 mg/night with no results, but haven't dosed up any further; I've been getting better result from graded exposure and want to avoid over-medicating myself so that I get effetive results from exposure. But I've still continued taking the 50 mg/night LUVOX to avoid complicating my recovery with withdrawal symptoms.
So, again, my question is this: Am I doing more harm than good taking this med below effective blood levels for such a long time? Should I cut it off? Or should I just keep taking the 50 mg/night?
Thanks in advance.
Posted by blueberry on January 9, 2006, at 17:49:32
In reply to SSRI question, posted by Spiro Ghetti on January 9, 2006, at 8:25:07
The thing about long term psychiatric drug use is that no one really knows the long term effects in the brain. Low dose, high dose, whatever, I don't think that matters as much as the length of time. It's my guess that changes do take place in the brain over months and years, having to do with the number of receptors either increasing or decreasing, the density of the receptors, the responsiveness of the receptors, how the genes interact or get modified, and who knows what.
Why after 5 years of 20mg prozac and being fine did it slowly start to change? Why did that 20mg which seemed like candy slowly become too powerful for me to handle after all that time? Did my condition change? Did the drug cause changes in the brain, to where the prozac was no longer treating the same brain that it started with 5 years earlier? I think maybe a little of both.
Posted by Phillipa on January 9, 2006, at 19:31:41
In reply to Re: SSRI question, posted by blueberry on January 9, 2006, at 17:49:32
Luvox at low dose it the only Ad I can handle with severe anxiety. Luvox is supposed to be the most sedating SSRI. Fondly, Phillipa
Posted by mogger on January 9, 2006, at 21:15:11
In reply to SSRI question, posted by Spiro Ghetti on January 9, 2006, at 8:25:07
I have been on Zoloft for 12 years (for ocd) and my well respected doctor assures me that it will be completely safe for the rest of my life!
mogger
Posted by yxibow on January 10, 2006, at 2:10:22
In reply to SSRI question, posted by Spiro Ghetti on January 9, 2006, at 8:25:07
> About 8 months ago I developed Agoraphobia/Anxiety. I raised my dose to 50 mg/night with no results, but haven't dosed up any further; I've been getting better result from graded exposure and want to avoid over-medicating myself so that I get effetive results from exposure. But I've still continued taking the 50 mg/night LUVOX to avoid complicating my recovery with withdrawal symptoms.
>
> So, again, my question is this: Am I doing more harm than good taking this med below effective blood levels for such a long time? Should I cut it off? Or should I just keep taking the 50 mg/night?
>
> Thanks in advance.
>It is the most sedating of SSRIs, I know, it was selected for me for that reason since others tended to hype up my anxiety. It has a very broad range of efficacy, up to and including 400mg / day (although that is in split dosage).
It is entirely possible that you are a low metabolizer for Luvox and 50mg is enough. It is a low dose, and barely on the clinical side some doctors would say, but if it works for you then so much the better. It is excellent for OCD and is cheap and generic now.
I don't think at that dose that there would be any long term effects, we just don't know these things though. If a drug is doing more good in your opinion, whether real or placebo effect, then there's no reason to suddenly stop it. Our history of SSRI effects on the general population is 19 years old (not to mention the years of clinical trials before), and I am sure there are still people out there on Prozac from the beginning in 1987. It is extremely rare, but there have been a few reported cases only on Zoloft of tardive dyskinesia, simply because of its slightly different effects with dopamine. But that is in the handful of case reports at most and the individuals may have been exposed to other medications before.tidings
This is the end of the thread.
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