Misc Are SSRIs Generally Interchangeable?

[User145667]

Its gonna be a few days before I can get a refill and was thinking about taking chlorpheniramine (OTC antihistamine with SSRI properties) for those few days. Will it be as though I have to restart that weird 1-3 month "SSRI induction period" or will it just pick up where the Lexapro left off? Thanks.

 

[SpiralusSancti]

No need for that, you’ll be ok for a few more days.

Answer to your first question is yes and no, depending of which two SSRI’s you are talking as many SSRI’s also have other significant action. So you can talk about certain chem like in your case antihistamine with some SSRI effects (idk anything about chem you named honestly) as tramadol is opiate with some SNRI effects and substituting those two for “real” SSRI or SNRI wouldn’t really work, while mix and matching “real” SSRI’s is quite usual practice in medicine. So if something doesn’t work for a few weeks or months you get new SSRI and if main action is indeed because that medicine is SSRI, in theory new medicine should “kick in” faster but it often isn’t so.

Hope I make sense, all in all, you wont have to wait weeks or months for your medicine to start working again for depression. What are you prescribed? Maybe your SSRI produces most of wanted effects in your case via some other mechanisms so it’s worth looking into that but it’s also possible you feel mild WD. Well in fact, it’s too many variables are unknown so I guess no one answered so far cuz of that..

 

[User145667]

No need for that, you’ll be ok for a few more days.

Answer to your first question is yes and no, depending of which two SSRI’s you are talking as many SSRI’s also have other significant action. So you can talk about certain chem like in your case antihistamine with some SSRI effects (idk anything about chem you named honestly) as tramadol is opiate with some SNRI effects and substituting those two for “real” SSRI or SNRI wouldn’t really work, while mix and matching “real” SSRI’s is quite usual practice in medicine. So if something doesn’t work for a few weeks or months you get new SSRI and if main action is indeed because that medicine is SSRI, in theory new medicine should “kick in” faster but it often isn’t so.

Hope I make sense, all in all, you wont have to wait weeks or months for your medicine to start working again for depression. What are you prescribed? Maybe your SSRI produces most of wanted effects in your case via some other mechanisms so it’s worth looking into that but it’s also possible you feel mild WD. Well in fact, it’s too many variables are unknown so I guess no one answered so far cuz of that..

I'm on Lexapro but the antihistamine in question is Chlor-tab

 

[Noodle473]

If you want to find a different drug that has anti-depressive qualities you could try kratom or the herb lemon balm in tea. Neither are very potent at low doses, and if you only take them for short periods they will not become very habit-forming. I realize these are not SSRIs but they do have a similar effect in neurotic individuals who need a break from all the negative side effects of traditional SSRIs and the like. Similarly, valium and xanax can give you a break from the pain if you can find a doctor who prescribes them without establishing a long case history for you - it's very common and you have a good legitimate reason for asking for a stronger anxiolytic to lessen the negative effects of your meds. Many doctors have some around and give them to patients whose medical history shows a need for stronger meds.

The induction period you mention will not start over with Chlor-tab, but you would feel "off" because they are very different drugs. Strenuous exercise and creative pursuits like drawing and painting will also help you cope with any side effects you get from not having your Lexapro when your body expects it. All SSRIs cause a long, weird sort of "hangover" effect when stopped or changed for another similar drug, so you will want to compensate for that with plenty of hydration. Establish healthier patterns of getting long, deep sleeping when you feel sick from not having what you used to take often.

In any case, think about asking your pharmacist for a less dangerous alternative if you start to feel intensely angry or depressed. This happens A LOT to people who go off their normal SSRI regimen. They tend to cause some problems with brain function and cognition, so it may be in your best interest to get off SSRIs in the near future for your own long-term health.

 

[Dreamflyer]

I've been on 3 SSRIs (and one SNRI) over the years and found them all to be a bit different.

- Paxil was way too strong for me. I yawned all day long and my eyes were always puffy.

- Effexor (the SNRI) was too stimulating and the withdrawal was a nightmare.

- Celexa was easily tolerated and worked very well, but gave me a bit of double vision and brain fog.

- Now I'm on Lexapro, which is basically a "cleaner" version of Celexa.

- I also take Remeron (a tetracyclic), which has been a lifesaver to me.

Everybody's chemistry is different, so sometimes you have to try more than one before you find what works best for you.

Stay well, my friend.

 

[plumbus-nine]

I think SSRIs and SNRIs, respectively, are mostly interchangeable. They have different off-target affinities but the effect at the SERT serotonin transporter is the same. You don't need to wait another latency period. Finding the right dosage can be a bit tricky though.

Even low dose DXM substitutes for S/NRIs (it also blocks the transporters). Or the herbal kanna.

I've been on almost all of the SSRIs and recently managed to quit by switching from venlafaxine to fluoxetine and taper that. Short acting antidepressants like venlafaxine have a brutal withdrawal.

 

[Keif' Richards]

Yes, it's a safe statement to say that they are all interchangeable. Selective Serotonin Reuptake Inhibitors or SSRI's are like Opioids or Benzodiazepines in that there are many different drugs found within a given category, though all share a strict definition of their effects that leaves them essentially interchangeable.

Just like how Fentanyl is an Opioid and Morphine is also an Opioid, they are interchangeable after certain considerations are made. The biggest consideration is going to be the difference in potency, followed by the difference in duration of effects. These are both easy to account for and this would mean applying less Hydromorphone per dose but also administering the drug 4 times per day instead of 3 as Hydromorphone does not typically last as long as Morphine.

The same goes for different SSRI's. The majority of the SSRI's in use today are administered once per day. Some are administered twice per day, but this is often accounted for in the form of a controlled-release form of the drug.

So the answer to your question is yes, but my biggest issue is that I can see no reason why a person takin SSRI's should be put into this position in the first place. These drugs are recognized as being un-abuseable in a world of addiction for which things often lableled as such are abused anyway. These are un-abuseable and there should be no reason for someone not to be able to get a replacement prescription if they've run into trouble.

I've showed up to a CVS or Walgreens on multiple occasions in the history of my life with no prescription and had a pharmacist give me 3 days worth of an antidepressant. Even outside of going to a pharmacy like this, you should be able to call your doctor and get a replacement prescription without too much issue.

As these drugs are often responsible for maintaining a person's long-term mental health, I tend to see this as potentially causing problems where there shouldn't be.

 

[Dreamflyer]

As these drugs are often responsible for maintaining a person's long-term mental health, I tend to see this as potentially causing problems where there shouldn't be.

I worry about that a lot, because I've heard about benzos and antidepressants (even Benadryl) being linked to early-onset Alzheimer's Disease. Unfortunately, I've suffered from bipolar depression, anxiety/panic attacks, OCD, ADHD and PTSD almost my entire life.

I've tried counseling, exposure therapy, prayer, meditation, deep breathing, visualization, exercise and probably every other technique you can imagine, and nothing has even remotely worked besides medication.

I just try to keep it to a bare minimum these days.

 

[SpiralusSancti]

linked to early-onset Alzheimer's Disease. Unfortunately, I've suffered from bipolar depression, anxiety/panic attacks, OCD, ADHD and PTSD almost my entire life.

there are numerous substances linked to neurodgeneretive disease
but so are things you suffer from
so all in all, don’t worry about it and live better trough chemistry