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Author Topic: Any other options besides SSRIs for antidepressants? HELP!  (Read 113 times)

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Offline kittykat22

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Any other options besides SSRIs for antidepressants? HELP!
« on: August 28, 2014, 09:07:52 PM »
Hey all,
I have very bad anxiety and mild depression. I am currently on .5 mg of clonezapam to take as needed for my anxiety, but I have had such bad attacks that I have had to use it every day, I know that this is a benzo and I dont want to become reliant on it so I decided to try and start taking an anti depressant along with it. My doctor prescribed me 10 mg of lexapro, after just 3 days I had major side effects, panic attacks so bad that I thought I was going to need to go to the hospital. Also made me lose 2 lbs (I am already very skinny, was 95 lbs at that time and went down to 93). My doctor said maybe it would be best to try another one, so she put me on 25 mg of zoloft, the side effects were horrible, lost another 4 lbs in a week and on day 6 just before my dosage was going to be upped to 50 mg, I started having racing suicidal and homicidal thoughts, horrible thoughts that I never think of. I called my doctor right away and she told me go to a hospital for a psych eval. I was cleared and they said it was a reaction from the zoloft. My psych told me to stop the zoloft immediately and the thoughts should go away in 72 hours at max. It was a horrible experience, and now I am afraid to take another anti depressant. My doctor said maybe SSRIs just dont agree with me but what else is there? My anxiety is so bad and my thoughts are becoming so intrusive that I need to get on an anti depressant to level it out. What do you all recommend? Thank you ::)
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Re: Any other options besides SSRIs for antidepressants? HELP!
« Reply #1 on: August 28, 2014, 10:40:50 PM »
My doctor prescribed me 10 mg of lexapro, after just 3 days I had major side effects, panic attacks so bad that I thought I was going to need to go to the hospital.

...My doctor said maybe it would be best to try another one, so she put me on 25 mg of zoloft, the side effects were horrible, lost another 4 lbs in a week and on day 6 just before my dosage was going to be upped to 50 mg, I started having racing suicidal and homicidal thoughts, horrible thoughts that I never think of.

For most with anxiety the Lexapro dose was too high, 5mg would have been better, and given you subsequent experience with Zoloft, 2.5mg might have been the best start dose. The 25mg starting dose for Zoloft was better, but again, 12.5mg would probably have made the experience more comfortable for you. Taking the benzodiazepine (BZD) would have helped too.

The fact is that antidepressants will often make anxiety much worse in the first few weeks. The only way of limiting this is to start on a small dose and to ramp it up by the same small amount every 7-10 days until you get to the initial target dose.

If you want to give SSRIs another shot then I suggest Celexa (citalopram) would be your best option starting at 5mg/day and using the BZD to ease you through any rough spots. Celexa contains the same active chemical as Lexapro, but also contains a mostly inactive form of it too, so the dose is twice that of Lexapro.

However, if you can't bring yourself to try a SSRI again, then one of the older tricyclic antidepressants (TCAs) would be worth a shot. The usually produce fewer initial side-effects and have much smaller dose tablets relative to the therapeutic dose range which makes it much easier to start on very low doses. Most come in a 10mg splittable tablet, but their minimum effective dose is usually 75mg, so starting on half a 10mg tablet would be the equivalent of taking 0.7mg of Lexapro. You're unlikely to have any serious side-effect issues starting on such a small dose and ramping it up by the same amount. The TCAs have short half-lives so the dose can be increased every 4-5 days. BUT you need to be aware that these antidepressants produce more ongoing side-effects such like dry-mouth and constipation. The TCA least likely to do so is desipramine (Norpramin). Your psychiatrist may also be unwilling to prescribe a TCA because of your suicidal thoughts as TCAs are less safe than SSRIs in overdose.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline Tiffycook89

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Re: Any other options besides SSRIs for antidepressants? HELP!
« Reply #2 on: August 29, 2014, 02:29:07 AM »
I really liked trazodone. Similar to TCAs, less potent I think? It was nice for quite awhile. Remeron was just lovely, especially for worried bedtime thoughts. It was wonderful except the weight gain part. I did do imipramine, a TCA for awhile, but couldn't handle the dry mouth and inability to urinate after a month or two. Just some ideas to look into.
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