Posted by yxibow on May 19, 2009, at 23:41:19
In reply to Avoid serotonergics after bad SRI reaction?, posted by sowhysosad on May 19, 2009, at 20:02:11
> Some of the sites of the "paxil progress" variety claim that after a negative serotonin-mediated reaction to an SRI you should avoid all serotonergics for a year. I was a bit sceptical when I read this as there was no indication of where they got this rule of thumb from.
Sounds a bit good to be skeptical.
> However, I'm now starting to think they might be onto something! Back in October I had akathisia after raising my generic Zoloft dose too quickly, and since then even mildly serotonergic meds (escitalopram/mirtazapine/imipramine) have made the resulting depression worse.
Zoloft is one of the few SSRIs known to cause things like akathisia because it has a slight blockade at D2.
> The last few of weeks I've been med-free but experimenting with 5-HTP supplements. Despite some transient good moods, as I've increased the dose I've mostly had increased anxiety, fear and depression and early awakening. It feels almost identical to the startup anxiety I had when starting Paxil, as if I can't tolerate the sudden boost of serotonin.
>
> Is there any evidence - scientific or anecdotal - that the SSRI alarmists might have a point? Does a bad SRI reaction somehow fry the serotonin receptors and make them more sensitive, making other serotonergics intolerable?Not in my belief... there are a fair number of SSRI/SRI/SNRIs out there and you just may not be on the right one. They're definitely not all created equal.
> Surely, if anything, the receptors would downregulate so you'd be less sensitive to the effects of serotonin, not more!They can possibly after a while downregulate dopamine actually. Something that may have contributed to help in my case, but that's another story.
-- Jay
poster:yxibow
thread:896671
URL: http://www.dr-bob.org/babble/20090515/msgs/896729.html