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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 Uncouth on October 21, 2011, at 9:41:14
My doc has me on Paxil for OCD and mood but so far I'm dealing with hunger weight gain and maybe even edema. Loss of libido a bit too although sex drive was one of the obsessional issues. Ugh. Mood was better last week, now I am fatigued and blah. Stupid ssri.
How would Luvox compare in terms of OCD and mood compared to Paxil? Why don't you near of more people on it? Does it have weight gain or other side effects....why is it differentialky better for OCD? What is the impact of sigma receptor affinity?
Posted by Phidippus on October 21, 2011, at 10:18:25
In reply to Luvox vs Paxil for OCD and mood, posted by Uncouth on October 21, 2011, at 9:41:14
Luvox is a monocyclic SSRI, making it unique among the SSRIs. In Europe Luvox is used as monotherapy to treat psychotic depression. Luvox isn't used as much because it is FDA approved only to treat OCD, though it works great to treat mood.
Side effects most commonly observed with fluvoxamine include nausea, vomiting, drowsiness, insomnia, dizziness, nervousness, feeling anxious, dry mouth, abdominal pain, constipation, diarrhea, heart burn, loss of appetite, muscle weakness, pins and needles, abnormal taste, headache, faster heart beat, sweating, weight gain, weight loss or unusual bruising.
Luvox has a lot more data backing it up as a treatment for OCD-that's what makes it differentially better.
The sigma receptor is a type of neurosteroid that is implicated in OCD. σ1 regulates ion channels and the release of glutamate, dopamine, serotonin, norepinephrine, and acetyl-coline, among other neurotransmitters.
Eric
Posted by Phillipa on October 21, 2011, at 10:27:08
In reply to Re: Luvox vs Paxil for OCD and mood » Uncouth, posted by Phidippus on October 21, 2011, at 10:18:25
I do think luvox works for OCD as when first started low dose years ago used to be a counter and that cut down a lot. I never heard of it used for psychotic depression. I used to take 250mg of it with ativan years ago. Stuck for years on 50mg the starting dose. Seems my brain likes it. What's this about abnormal taste? If luvox was only approved originally in the beginning for OCD what is luvox CR now approved for? Same med in extende release. Never any weight gain on it. Phillipa
Posted by SLS on October 21, 2011, at 10:28:51
In reply to Re: Luvox vs Paxil for OCD and mood » Uncouth, posted by Phidippus on October 21, 2011, at 10:18:25
Hi Eric.
Great information.
Can you post some references regarding the function of sigma receptors?
Thanks.
- Scott
> Luvox is a monocyclic SSRI, making it unique among the SSRIs. In Europe Luvox is used as monotherapy to treat psychotic depression. Luvox isn't used as much because it is FDA approved only to treat OCD, though it works great to treat mood.
>
> Side effects most commonly observed with fluvoxamine include nausea, vomiting, drowsiness, insomnia, dizziness, nervousness, feeling anxious, dry mouth, abdominal pain, constipation, diarrhea, heart burn, loss of appetite, muscle weakness, pins and needles, abnormal taste, headache, faster heart beat, sweating, weight gain, weight loss or unusual bruising.
>
> Luvox has a lot more data backing it up as a treatment for OCD-that's what makes it differentially better.
>
> The sigma receptor is a type of neurosteroid that is implicated in OCD. σ1 regulates ion channels and the release of glutamate, dopamine, serotonin, norepinephrine, and acetyl-coline, among other neurotransmitters.
>
> Eric
Posted by uncouth on October 21, 2011, at 10:30:27
In reply to Re: Luvox vs Paxil for OCD and mood » Phidippus, posted by SLS on October 21, 2011, at 10:28:51
I take DHEA< doesnt that have SIgma interactions? What is the implication for also taking Luvox then? Do they counteract? Or...?
Posted by Phillipa on October 21, 2011, at 11:56:10
In reply to Re: Luvox vs Paxil for OCD and mood, posted by uncouth on October 21, 2011, at 10:30:27
Luvox and psychotic depression and sigmi l. Phillipa
http://www.annals-general-psychiatry.com/content/8/1/26#sec5
Posted by Phidippus on October 21, 2011, at 13:18:55
In reply to Re: Luvox vs Paxil for OCD and mood, posted by uncouth on October 21, 2011, at 10:30:27
There no sigma interactions. DHEA will not counteract Luvox.
Eric
Posted by Phidippus on October 21, 2011, at 14:17:38
In reply to Re: Luvox vs Paxil for OCD and mood » Phidippus, posted by SLS on October 21, 2011, at 10:28:51
> Can you post some references regarding the function of sigma receptors?
Yep
http://www.anavex.com/files/Maurice%20Su%20Pharm%20Ther%202009.pdf
http://anavex.com/Sigma_Receptors.html
http://cancerres.aacrjournals.org/content/64/15/5029.full
Eric
Posted by Brainbeard on October 21, 2011, at 18:46:08
In reply to Luvox vs Paxil for OCD and mood, posted by Uncouth on October 21, 2011, at 9:41:14
Paxil gave me a couple of wonder years but at a high price (relationship-destroying bouts of indifference, massive weight gain, a debilitating withdrawal syndrome and lingering sexual dysfunctions).
Luvox is more apathizing to me, unless augmented by other activating meds. I found Luvox to be a good antidepressant. It didn't do all that much for my OCD, but neither did Paxil.
Paxil gave me horrible dreams about filthy public toilets. Luvox is milder and more subtle, with less side-effects.
Posted by uncouth on October 21, 2011, at 19:26:43
In reply to Re: Luvox vs Paxil for OCD and mood, posted by Brainbeard on October 21, 2011, at 18:46:08
Ugh. I hate SSRIs. I feel so blase and not even well on them but maybe it will kick in in a few weeks.
Does anyone know if Tianeptine has ever ever shown any efficacy in OCD???
Posted by Phidippus on October 21, 2011, at 20:57:19
In reply to Re: Luvox vs Paxil for OCD and mood - Tianeptine?, posted by uncouth on October 21, 2011, at 19:26:43
I could only find a case report saying Tianeptine worsened OCD symptoms
http://www.tianeptine.com/ocd.html
Eric
Posted by crazyjoe on October 22, 2011, at 9:34:57
In reply to Re: Luvox vs Paxil for OCD and mood - Tianeptine? » uncouth, posted by Phidippus on October 21, 2011, at 20:57:19
i think dr's dont like to use it because of its many drug drug interactions..and for me personally i believe it needed to be at at least 200 mg
Posted by Brainbeard on October 22, 2011, at 14:21:13
In reply to Re: Luvox vs Paxil for OCD and mood - Tianeptine?, posted by crazyjoe on October 22, 2011, at 9:34:57
> i think dr's dont like to use it because of its many drug drug interactions..and for me personally i believe it needed to be at at least 200 mg
That's correct, Luvox' CYP 1A2 enzymes inhibition can pose a challenge for drug combinations, but with sound knowledge and experience, this is rather manageable. For instance, several benzo's cannot be combined with Luvox because their half-life would be drastically prolonged, but oxazepam has a totally different elimination route and CAN be safely combined with Luvox, as can lorazepam (Ativan). There are often possibilities and alternatives for a thinking brain.
I think the accepted minimum effective dose is about 125 or 150mg. From 125mg and upwards, the antidepressant effect became apparent for me. At 250 or 300mg, I was farthing all day, which kind of spoiled the fun.
Tianeptine doesn't work for OCD.
Posted by Phillipa on October 22, 2011, at 18:31:56
In reply to Re: Luvox vs Paxil for OCD and mood - Tianeptine?, posted by Brainbeard on October 22, 2011, at 14:21:13
I do know about the ativan not being contraindicated with luvox. But I've been on low dose luvox and valium and xanax for many years. How much ativan would be needed to switch benzos if taking .25xanax and 7.5mg of valium at night only? Thanks Phillipa
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