Speed up SSRI`s

[shroomcloud]

I got prescribed citalopram today and I know it takes 1-2 weeks for it to work but I was wondering if you could speed the process up by taking a double dose of the medication for the first couple of days.

I understand that the amount of ssri in your blood has to reach a threshold level for it to work as an antidepressant, which usually takes nearly two weeks. Thought maybe if I take 40mg/d the first week, I might feel the effects sooner, and as soon as I feel it working I would take 20mg/d, which is the dosage Im prescribed.

Would this work? I`m thinking no, but I don`t know why not.

 

[Smyth]

Well with SSRI's the biochemical actions begin immediately after the first adminstration, it is the antidepressant effect that can take weeks to manifest in some patients. I would not recommend you intentionally OD, as the medicine might have side effects on other organs not including the brain. This is more with reference to someone just starting the medicine as oppose to someone who has already taken it in the past.

 

[hugo24]

But then there have been studies showing no significant AD effect from the 20mg dose,only with 40mg.

 

[Therapeutic]

Another reason why I don't understand the reason so many people on here are "anti-SSRI" everything except for citalopram on bluelight. Advertising promotions perhaps from forest pharmaceuticals?

Makes me wonder.

 

[nanobrain]

please rethink as the acute effects of SSRI overdose are less than pleasant. agitation, anxiety, serotonin syndome.

it is not piracetam, 'attack' doses could prove to be your undoing.

 

[shroomcloud]

I dont think I would overdose if I were to take 20mg in the morning and 20mg at night.(It is considered relatively safe in overdose, although fatal cases of dosages 840 mg to 1960 mg have been reported. Wikipedia) But I wont do it because I took 20mg this morning right after writing my first post, and got some nasty side effects but it wasnt too bad so I`m continuing my treatment. I`m ok now though,and it does seem like the antidepressant-effect of the drug is taking place already, after just a couple of hours. It could be placebo though I`m not sure.

I wasnt really planning on taking 40mg anyway, it was just a hypothetical question. Can someone elaborate on why it should take so long for SSRI`s to work? My doctor said it was because the dosage in your body has to be built up slowly or something, but when I think about it, Ive learnt at Pharm school that it was because the serotonin autoreceptors need to be desensitized first???

Should I take 10mg in the morning and 10mg at nite, wouldnt that minimize the side effects and ensure that the amount of citalopram in my blood remains at a more constant level?

@Theraputic
I was not aware that everyone hates SSRI`s. Seems to me like more than half of bluelight is taking an antidepressant of some sort, and SSRI`s are by far the most popular. Dont think theres much difference between the SSRI`s either. Only reason why they might like cit. better here is because its the least likley to give interactions with other drugs.

 

[Smyth]

Cit has a funny interaction with allosteric binding sites actually which is unique in this regard. One explanation for the time delay is due to the time taken to effect underlying adaptions to 5HT/NE neurocircuitry, another reason is due to the time time taken to increase mesocorticolimbic DA transmission through indirect pathways. I'll elaborate on this in due course.

 

[colors]

use a benzo or opiate for instant gratification. you are not going to get quick results for depression with an ssri, no matter how much you take. their action in the 'big picture' department is so slow and subtle, that i doubt you'll notice anything for quite a while. there is no sensation of it 'kicking in'. you just kind of get used to it. it's like watching grass grow.

 

[shroomcloud]

Well actually I havent been depressed today at all since I popped the first pill, but that might have been placebo or whatever.

But thank you Colors for clarifying so scientifically WHY it takes so long for a SSRI to work,pff

@Smyth, I`ll be anticipating your explaination

 

[BilZ0r]

Yeah, most people find the effects of SSRIs quite unpleasant (or at least very odd) for the first couple of days. That's why a lot of doctors start people on half, or even quarter doses to begin with, and work up to a full dose.

I felt the anxiolytic effects of citalopram by day 3, which was the first day I took 20mg.

The exact reason why SSRIs take "so long to work" is unknown. In reality, the "fact" that they take 2-6 weeks to work isn't even agreed on. There is mounting evidence that if the SSRI is going to work, it's going to work within the first week.

That makes more classical pharmacological sense. You probably don't reach steady state plasma concentrations for about 4-6 days anyway (and probably longer for fluoxetine). Add on top of that, that most doctors start people on half doses, and it's not surprising that there is some idea that there is a therapeutic lag.

 

[colors]

sry i don't usually post in ADD because i really have no insight into chemistry (as you pointed out) ... but i was just giving you some advice since you clearly don't understand how an ssri is supposed to take action. fo

 

[shroomcloud]

I got prescribed citalopram today and I know it takes 1-2 weeks for it to work

Well dude this is the first thing i said in my topic so you figure out if i know how its supposed to work.

BilZor thanks.
I guess it has to do with reaching the appropriate plasma level. But if the amount of serotonin increases in the synaptic cleft wont the autoreceptor downregulate the neuron? Because then the autoreceptor would have to be desensitized for the SSRI to work. That would probably take a couple of days/weeks.

And why are the side effects less if you take it slowly and it builds up in your system. If its in your blood it will cause side- effects right ? Doesnt make sense, Im guessing it has must have something to do with the autoreceptor

 

[colors]

look, what i'm saying (from experience, without a scientific explanation) is that the effect is cumulative. your whole definition of 'working' is totally off base.

if you'd experienced an ssri, you'd know that the effect is not something initially detectable ... there is no magic moment. you are not going to be high ... you are not going to feel great. dark things just start to fade ... veryyy slowly (along with your personality and sex drive). it will take months. and the action is probably not what you're expecting ... it will cause an evolution in personality, not a happy nod. so, no, i don't think you understand.

do it right and stick to the fucking program or suffer the gas, limp dick, sweating, etc. if you're too impatient or need an immediate release, use a suitable chemical.

edit: i forgot to add that kickstarting with this shit has been known to cause the 'rage' in many patients (i felt it myself), and as such there is now a known 'suicide risk' associated with starting on heavy doses of ssri's. i can see you already have a temper, so you might want to keep that in mind.

 

[shroomcloud]

haha, okay thank you for clarifying but

you are not going to feel great. dark things just start to fade

is exactly what I am expecting and it will make me a happier person in general if it works in this way.

 

[nanobrain]

^oh yes, everything is 23C, your affect is flattened, you cant have proper sex - nor want to, really, addiction...

getting off SSRIs is hard going, your locomotorics get shot, hot/cold flashes, electric head tingles, nausea, etc etc.

took ~2 years to get back to a semblance of personality and ability to feel emotion in a proper context after i quit.

 

[shroomcloud]

So what, your advising me to stop taking it because SSRIs are crap? What do you suggest then ? How long had you been taking it, and at what dosage before you quit? Will there be nasty withdrawls if I taper down slowly?

 

[BilZ0r]

I found SSRIs made me horney as fuck for the first couple of weeks, then I got limp dick for a week, and now I'm back to normal.

Sure, decreased sex drive is a common side effect, but it's not garunteed, and I don't really see the problem. Limp dick is a problem; there you want to have sex, but can't.

BilZor thanks.
I guess it has to do with reaching the appropriate plasma level. But if the amount of serotonin increases in the synaptic cleft wont the autoreceptor downregulate the neuron? Because then the autoreceptor would have to be desensitized for the SSRI to work. That would probably take a couple of days/weeks.

No one knows if the autoreceptor theory is correct. To me, the stimulation of brain cell formation makes more sense.

And why are the side effects less if you take it slowly and it builds up in your system. If its in your blood it will cause side- effects right ? Doesnt make sense, Im guessing it has must have something to do with the autoreceptor

It just gives time for the body to adjust to high serotonin levels. Think of it like, if you jumped straight into really hot water, it feels like it's going to burn you, but if the water is slowly heated to that temperature, you feel fine.

It's probably to do with postsynaptic receptor downregulation and serotonin transporter downregulation.

 

[Jamshyd]

Isn't it that SSRIs take long to do their job because any "improvement" is actually due to long-term adaptive changes in the affected areas? Please correct me if I'm wrong...

 

[shroomcloud]

What in the hell is a limp dick ? Im sorry, Im not familiar with your americain slang expressions :D

I cant possibly think of anything making me less horny, and if the meds decrease my libido that will only be a good thing, maybe then I`ll stop thinking about sex 24/7. I`ve also heard that SSRI`s stop you from having an orgasm, and I really cant picture that one happening, but perhaps they`ll help with my slight PE and I`ll be able to last longer ! yeah!

While we are on this subject, I heard something on the news about a new drug for premature ejaculation thats kind of a fast acting SSRI. Wouldn`t a fast acting ssri be potentially dangerous and make you "tripp ballz"?

 

[BilZ0r]

Isn't it that SSRIs take long to do their job because any "improvement" is actually due to long-term adaptive changes in the affected areas? Please correct me if I'm wrong...

No one knows. Neurogenisis is the leading theory AFAIK.

A limp dick? There's nothing american about that. Use a dictionary to figure it out.

LIMP 1. a. Wanting in firmness or stiffness, flaccid; flexible, pliant. Of a textile fabric: Unstiffened.

DICK 1. b. The penis. coarse.

Yeah, I think you'll find, at least innitially, you will go for longer (infact you might even find it hard to bust a load (I had to fake it once)).

No ones ever reported use of a fast acting SSRI, so we don't know if it would make you high, but I personally doubt it.