SSRI Drugs

[misterzero]

I recently posted about the mental health difficulties my brother was suffering from with regard to Asperger's and prolonged anxiety/panic attacks .He seemed better last week ,but things seem to have regressed again .He was thinking about asking the doctor to prescribe a SSRI type drug .
Looking at these there seems to be quite a lot of side effects and it can be difficult to find the appropriate drug and correct dosage and also it can take time for the drug to work .
I was wondering if anybody has thoughts on this and any experiences good or bad they would be willing to share .

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[TaketheCannoli]

I'm aware of the difficulties some people have with SSRIs however mine have been life-changing. Initial side-effects included headaches and nausea but perseverance was the key, along with reducing my dosage and then incrementally increasing it until I felt I was getting sufficient benefit.

Quite honestly, I can't imagine not using them now. I know I'll have to come off at some point though.

My advice would be for your brother to give them a go but don't expect instant results, it takes around twelve weeks to feel the benefit.

Best of luck and please PM if you'd like to discuss.

[canuck]

There is a wide array or different drugs available. In my limited experience (11.5 years) there is a group of people who may need to try 2 before they get the right one for them.

My only advice would be if the first one has too many negative side effects which outweigh the positives, try another.

However, gold standard treatment is combination of medicine and talk therapy. Given your brief description, working with a clinical psychologist will likely be useful and perhaps some may say even necessary if the desire is there.

[mowflow]

Both my mother an I have the same issue as your brother.

I was on citalopram for a number of years in my late 20s - early 30s. Can't say much more than it worked, it was unnoticeable and I had no side effects. I now feel I've found my own way of coping.

My mother has recently been moved off of citalopram after being on it for what must be 15 years. She also had no side effects. Toward the end of last year she started going through a particularly bad "episode" where it was clear the citalopram was not working, they changed the dosage but it still had no effect. Eventually they switched her on to something else (I can ask her what it is). Within a few weeks she was in control. It was incredible. However, yesterday I learned that she has stopped taking the new medicine as it was giving her sore eyes (I guess she means headaches). We also noticed a bit of a personality change. She was a lot more assertive (read as aggressive according to my dad) than her normal self.

My mother has tried seeing several clinical psychologists over the years who all seem to use cognitive behavioural therapy which she has always said has been useless. Might work for others.

[pugster]

my own view is that he will just have to try a few until he finds one where the benefits outweigh the side effects , whether any improvement is due to placebo doesnt really matter if they are helping in some way , the use of drugs to control autism symptoms is pretty controversial and the effectiveness is often overstated by publication bias within the pharmaceutical industry .

* antidepressant drugs are often not really that effective in controlling anxiety disorders , any one that has had long term multiple panic attacks and general anxiety will tell you this - there are other drugs out there that do a better job such as benzos (diazepam etc) and lyrica (pregablin) - although drugs like benzos have addiction problems you have to balance quality of life into the equation if the problems have gone on for a long time and are severely affecting someones life ( doctors will usually prescribe these short term anyway )

[Nytol]

Citalopram or Escitalopram seem to have the best efficacy to side effect ratio in both my personal experience and the experience of others I know.

Many Dr's are quick to push the dosage up, which is often not needed and brings more side effects without much more benefit, each person has different requirements, but more is not always better.

Propranolol is a beta blocker often used to help anxiety attacks, and may be worth looking into.

Benzos are a slippery slope, and very few Dr's will prescribe more than a few 2.5mg diazapam, which are not good for much tbh.

[odyseus10]

I've tried
Sarxoat (Paroxetine) - worked but terrible withdrawal symptoms
Sertraline - didn't do anything
Citalopram - worked and the best of the bunch
Escitalopram - worked but made me sleep a lot.
Fluoxetine - didn't do anything.
Venlafaxine - low dose helped, higher dose weird side effects. Terrible withdrawal symptoms.

So Citalopram although not the most effective wrt anxiety, has the advantage that you can stop taking it, without withdrawal symptoms. In fact when I came off Venlafaxine I suffered very bad withdrawal symptoms and after a few days realised I still had some Citalopram. So I started taling that, and this got rid of the side effects. I was then able (after a month or so) to stop taking the Citalopram, without withdrawal.

All the SSRI's greatly reduce anxiety, but at the expense of making you more sleepy. I always needed a sleep at about 6pm for a hour or two. I never experienced weight gain and only had really bad withdrawal symptoms with Sarxoat and Venlafaxine (the higher dose of Venlafaxine gave me weird vivid dreams and night sweats and so came off it back to Citalopram).

Using Propranolol only effects the physical side of anxiety, because it blocks the release of Adrenaline. So mentally you can be anxious and over thinking, but you won't get physical panic attacks.

[misterzero]

Thanks for all the replies ,lots of good information there and plenty of food for thought .

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