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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by linkadge on August 8, 2022, at 11:30:34
Yeah, I know. You're supposed to give it 6 weeks. F*ck that. I just started having major flashbacks to how sh*tty SSRIs are. I couldn't take another day.
Disconnected from myself, floaty, apathetic, more impulsive, tired, spacy, akathesia.
When will they start making good meds?
Linkadge
Posted by SLS on August 8, 2022, at 18:01:45
In reply to Thus ends the escitaliopram trial, posted by linkadge on August 8, 2022, at 11:30:34
Maybe zuranolone.
https://www.drugs.com/history/zuranolone.html
What about the triple-reuptake inhibitors? I haven't been following the pipeline.
- Scott
Posted by Jay2112 on August 8, 2022, at 20:27:26
In reply to Thus ends the escitaliopram trial, posted by linkadge on August 8, 2022, at 11:30:34
> Yeah, I know. You're supposed to give it 6 weeks. F*ck that. I just started having major flashbacks to how sh*tty SSRIs are. I couldn't take another day.
>
> Disconnected from myself, floaty, apathetic, more impulsive, tired, spacy, akathesia.
>
> When will they start making good meds?
>
> LinkadgeHave you tried other SSRI's?? Like Zoloft in particular. It is very. very different than escitalopram. Zoloft has strong dopamine reuptake properties.
Jay
Posted by undopaminergic on August 9, 2022, at 8:37:25
In reply to Re: Thus ends the escitaliopram trial » linkadge, posted by Jay2112 on August 8, 2022, at 20:27:26
>
> Have you tried other SSRI's?? Like Zoloft in particular. It is very. very different than escitalopram. Zoloft has strong dopamine reuptake properties.
>Sertraline (Zoloft) is a very modest dopamine reuptake inhibitor. It's nothing like methylphenidate or cocaine.
-undopaminergic
Posted by linkadge on August 9, 2022, at 12:04:19
In reply to Re: Thus ends the escitaliopram trial » linkadge, posted by Jay2112 on August 8, 2022, at 20:27:26
citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline ... all pretty much the same thing.
Posted by Jay2112 on August 9, 2022, at 12:12:15
In reply to Re: Thus ends the escitaliopram trial » Jay2112, posted by linkadge on August 9, 2022, at 12:04:19
> citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline ... all pretty much the same thing.
Now have you tried them all with mood stabalizers, antipsychotics, benzos. etc??
Jay
Posted by SLS on August 9, 2022, at 15:32:25
In reply to Thus ends the escitaliopram trial, posted by linkadge on August 8, 2022, at 11:30:34
> Yeah, I know. You're supposed to give it 6 weeks. F*ck that. I just started having major flashbacks to how sh*tty SSRIs are. I couldn't take another day.
>
> Disconnected from myself, floaty, apathetic, more impulsive, tired, spacy, akathesia.
>
> When will they start making good meds?
>
> Linkadge
Since we are going through drugs old and new, have you tried Nardil or Parnate?Which drug(s) have you tried that produced the best antidepressant effect for you?
Combining Parnate with lithium is an old treatment strategy. I felt an improvement within 6 hours upon my first dose of lithium when it was added to an ongoing trial of Parnate. Unfortunately, the improvement was insufficient to rationalize continuing with the Parnate. I kept lithium onboard for many years with the hope that it would help reduce the risk of my contracting Alzheimer's Disease. Fortunately, I was still taking lithium when I added Nardil. I tried discontinuing lithium as an experiment to see if my libido was being reduced by it. Well, I was surprised that I relapsed into such a severe depression within 48 hours.
- Scott
Posted by linkadge on August 9, 2022, at 18:29:33
In reply to Re: Thus ends the escitaliopram trial » linkadge, posted by SLS on August 9, 2022, at 15:32:25
Again, the problem is that I don't have access to a psychiatrist in Canada. My regular doctor doesn't prescribe anything but escitalopram and paroxetine (essentially).
Linkadge
Posted by Jay2112 on August 10, 2022, at 21:11:23
In reply to Re: Thus ends the escitaliopram trial, posted by linkadge on August 9, 2022, at 18:29:33
> Again, the problem is that I don't have access to a psychiatrist in Canada. My regular doctor doesn't prescribe anything but escitalopram and paroxetine (essentially).
>
> LinkadgeCan you not get a pdoc here? If you snoop hard...you can get one. Your GP should have referred you long ago. Do you want one? Like Scott say's, the MAOI's may be strong candidates for you. Plus you can add your cannabis.
Jay
Posted by gman22 on August 10, 2022, at 21:31:02
In reply to Thus ends the escitaliopram trial, posted by linkadge on August 8, 2022, at 11:30:34
ok
Posted by SLS on August 11, 2022, at 8:57:35
In reply to Re: Thus ends the escitaliopram trial, posted by linkadge on August 9, 2022, at 18:29:33
Hi, Linkadge.
> Again, the problem is that I don't have access to a psychiatrist in Canada. My regular doctor doesn't prescribe anything but escitalopram and paroxetine (essentially).
>
> Linkadge
I forgot about the roadblocks that leave you fundamentally untreated.
Generally speaking, paroxetine (Paxil) is the most efficacious SSRI. However, it is also the SSRI having side effects of the greatest magnitude. It is also hell to discontinue. Its robust anticholinergic properties might contribute to the greater therapeutic efficacy of paroxetine. However, this is the property that is most responsible for the higher side-effect load of paroxetine compared to the other SSRIs.There is another disadvantage to choosing to be treated with paroxetine.
1. Paroxetine is the SSRI with the highest rate of relapse.
2. Paroxetine the least capable of recapturing an antidepressant response once a successful treatment has been discontinued.
An obvious question emerges:
If one is treated successfully with paroxetine, but ultimately relapses, does he then become less responsive to all SSRIs?
If this is true, then it is insanity to place paroxetine near the top of a list of drugs to be trialed.
Along the way, there were two treatments that my doctor suggested that I thought had no chance of working... but they did.
1. Prazosin 30 mg/day as 10 mg t.i.d. (I don't remember why I discontinued it).
2. Monocycline (I don't remember the dosage).
* I had to discontinue monocycline when I developed hyperpigmentation of my shins and feet.
- Scott
Posted by linkadge on August 11, 2022, at 13:06:51
In reply to Re: Thus ends the escitaliopram trial » linkadge, posted by SLS on August 11, 2022, at 8:57:35
I just won't take any more SSRIs.
What little cognitive capacity I have to solve my problems is wiped out by them. What little joy I had is replaced by numb. They suck (qualifier - for me) period.
Linkadge
Posted by SLS on August 12, 2022, at 9:28:51
In reply to Re: Thus ends the escitaliopram trial, posted by linkadge on August 11, 2022, at 13:06:51
Hi, Linkadge.
> I just won't take any more SSRIs.
>
> What little cognitive capacity I have to solve my problems is wiped out by them. What little joy I had is replaced by numb. They suck (qualifier - for me) period.
>
> Linkadge
I think you made the right decision.One day, I hope your name doesn't appear so often on Psycho-Babble, even though I consider you to be its most valuable member.
Remain vigilant. Your perseverance is amazing.
- Scott
This is the end of the thread.
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