SSRIs for anxiety - bullshit?

[Synaps3]

OK, so I'm on an antidepressant (amitryptaline) for social phobia (it happens to be a tricyclic, but the same would apply to SSRIs as well). I noticed that after a few weeks of taking this med and slowly upping the dosage to 100mg per night, I began to notice that my sleep was much worse (waking up every half hour) and that during the day I feel twitchy and my hands have a bit of a tremor. BTW on the plus side, it caused me to have like 10 lucid dreams in one night, but I still didn't sleep much cause I would wake up after each. Anyway, I began researching the receptor binding profiles of antidepressants because I happen to be interested in pharmacology. During my research, I came across something that makes absolutely no sense to me. Basically all SSRIs and trycyclics target serotonin, dopamine, AND norepinephrine. Norepinephrine is adrenaline, so all SSRIs cause adrenaline re-uptake and that is supposed to decrease anxiety? - WHAT kind of bullshit is that?! You want to lower adrenaline, not increase it. What are they thinking? My thought is that it is simply big pharma trying to push these cure-all types of drugs for so many different conditions. Am I right?

 

[Mysterie]

whats the difference between social phobia and social anxiety?

there will be people who say that ssri's have helped them with anxiety, so i don't think you can say they don't work for anyone.

i think as you up the dosage it takes a little while to even out the bumps and might take a month or two to get adjusted, also everyone reacts differently to each antidepressant so you may need to try a different one if this one doesn't work out.

of course you are in charge as the patient and don't have to accept any meds being pushed onto you, but its worth talking to your doctor about the side effects which are bothering you and see what they think.

 

[Synaps3]

whats the difference between social phobia and social anxiety?

There is not really any difference except social phobia usually refers to more extreme cases.

there will be people who say that ssri's have helped them with anxiety, so i don't think you can say they don't work for anyone.

I see what your getting at, but the whole thing seems backwards to me. Adrenaline is the main chemical that induces the fight or flight response. So trying to increase that to reduce anxiety makes no sense.

Do you know of any SSRIs that only target dopamine and serotonin?

 

[Kittycat5]

I dont know what you were reading but SSRIs are far more selective for SERT than they are for NET or DAT. The tricyclics do have affinities for all of them to various degrees, however. By inhibiting the reuptake of any of the neurotransmitters, more is available to act post-synaptically which may lead to downregulation of the receptors located there. When they are downregulated, there are less available to exert the effects of serotonin, NE, and DA leading to lessened anxiety.

While this is a commonly put forth mechanism of action of antidepressants for anxiety and depression, it really isnt the whole story, given how infrequently ADs work among other things.

 

[Johndoedoe.junk]

In my experience SSRIs can help with anxiety at the low level in other words give you a constant level of somewhat lessened anxiety although it seems that those with severe anxiety end up needing a benzo too whether it be for rescue meds or a therapeutic dose. The of course for some SSRIs can increase anxiety. I was on Zoloft for a number of months and the entire time it jacked up my anxiety like crazy. As a matter of fact this is what lead me to first be prescribed a benzo, to mask the anxiety brought on by the Zoloft. Bass ackwards, right?

Eventually we switched to another SSRI that works better without the added anxiety but I've needed therapeutic benzos ever since. Thanks Zoloft. Another MediCal doc btw.

 

[manboychef]

Zoloft helps me, but it is in concert with other meds./

 

[hexagon]

I never felt that SSRIs were anxiolytic. They're mildly empathogenic during the first few months of taking them, but certainly not enough to obviate true anxiety.