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Mental Health What's the most powerful ssri?

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psychlo0015

psychlo0015

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Right now the psych has me on lexepro. I hardly notice anything from it and it doesn't help with anxiety at all. I've been trying to research anti depressants so I could ask him for something else but all I find is that lexepro is supposed to be the most effective.

I don't want to go on an MAOI because I dont want to risk dieing.

I don't want anything that will mess with my coordination or vision because I want to get back into truck driving one day.

I'm thinking of asking for some Wellbutrin to get me some dopamine going on.

Now I'm thinking about switching to Zoloft.

Taken from Wikipedia.

Sertraline is an SSRI, but, uniquely among most antidepressants, it shows relatively high affinity for the DAT in addition to the SERT.As such, it has been suggested that clinically it may weakly inhibit the reuptake of dopamine, particularly at high dosages. For this reason, sertraline has sometimes been described as a serotonin–dopamine reuptake inhibitor (SDRI).This is relevant as dopamine is thought to be involved in the pathophysiology of depression, and increased dopaminergic neurotransmission by sertraline in addition to serotonin may have additional benefits against depression.​
​
 
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Not the right place to ask because of the subjective nature of your post.

My own subjective opinion:

Psych meds will mostly have side effects like lethargy, sexual dysfunction, etc. You don't want an MAOI or anti-psychotic, but you think you have a choice. Psychiatrists don't just let you choose what medication you want to be on. If you say you need Wellbutrin to "get me some dopamine going on", there is absolutely no way it'll be prescribed to you.

Also it takes several weeks to see results with psych meds, so a medical professional would tell you to stay on the Lexapro for 2-3 weeks
 
It doesn't really work the way your thinking it does. The effectiveness of anti depressant is dependent on your individual brain chemistry. The best thing to do is work with your phychiatrist to find a drug and dose that is effective. The best way to do that is by being completely honest and completely compliant with taking the meds. It can be a long journey but with patience it can work well.
 
I've been on ssri and snri for 9 years.

It has fucked me.

I started on Lexapro and put on 40kg I couldn't get off. Then Dr switched me to Cymbalta which has been worse.

Getting off this med is worse then getting off meth, smoking and booze plus more.

Get off and exercise. There is no simple solution to beating mental health.

This garbage will make it worse it will make you numb and forget all the things from your past whilst a psych sucks you dry.


https://www.livestrong.com/article/202075-long-term-lexapro-side-effects/
 
^ I understand that you have a low opinion of psychiatry and psychiatric medications, but making blanket pronouncements condemning the entire profession is counterproductive in a mental health forum IMO.

As CJ said, antidepressants need time to be shown whether they are effective, or not. There are 7 families of 5-HT receptors and subfamilies within those families that make for a total of 14 currently known 5-HT receptors. No single antidepressant are going to hit them all, and it takes a bit of trial and error to know which one is going to affect the receptors that are going to elevate your mood and bring relief from your anxiety. My advice would be to listen to your doctor, give the medication a chance to work (or not work, so you can be switched to something else) and to stop playing AD roulette, scrambling your brain chemistry even further.
 
I too put on 40+ lbs after going on Lexapro but I was also put on lithium and risperidone so those also contributed. Now I'm just under 300 lbs and really trying hard to stay under 2000 calories per day to lose weight.
All I'm asking is which ssri is the most powerful? The psych has me on lexapro, lithium, risperidone, (wanted me on xanax) and buspar.

I just wanted some sugestions for something better than lexapro because it seems to be really weak and garbo.

Right now I'm looking at zoloft. Any oppinions on zoloft? in comparison to lexapro
 
I second that. Please don't tell people to just get off their medication. Please edit that post, noonoo, or I will.

^Risperdal is usually the culprit in that kind of situation. But when prescribed, it's also usually pretty important. I'd begin an exercise routine. Start small and comfortable. Talk to your PCP about setting up a regimen that works for you and is effective.

For the record, SSRI's aren't agonists.

The reason that there are so many SSRIs is that they all work a bit differently. The scientific data isn't clear, and the science overall is incomplete. There isn't precise data on how they all work. That's why there are so many. If one was much more effective than the others, then it would generally be known. But official indications shed some light, albeit not in a natural sciences sort of manner. For example, Luvox is indicated for OCD and Paxil for anxiety disorders. But all SSRIs can be used for depression/anxiety.

MAOIs are good for treatment-resistant depression/anxiety.

So there's no "most powerful" or "best" SSRI. For you specifically, especially because this is an internet forum, your doctor will try the best one for you at this time. If what you're taking isn't working, given that you're clean, tell the doctor. This is your best route.

If you try to trust your provider, things will turn out best. Being a self-biopsychologist doesn't really work. So, for example, "getting your dopamine going" or the like won't lead to you finding what's best for you. So that you know, all dopaminergics that boost mood, stimulants, like Ritalin or Adderall, don't boost mood effectively in the long-term. They are too primitive to trick the brain into producing a long-term antidepressant effect. They only can trick the brain into giving you more energy and focus, long-term. And this isn't the "laser-like" focus that may occur in the start of treatment.

Do you drink caffeine? I'd recommend black tea.
 
Again, there is no such thing as one AD being stronger than another. They all have different receptor binding profiles which is why one might be a miracle drug for some, and don't do squat for others. Your problem might also be related to dose as well. We don't know your case history. A good psychiatrist who knows your case history can make an educated guess of which serotonin receptors need adjusting for your specific case. These are really questions best asked a psychiatrist, not anonymous people on an Internet forum.
 
So I found this...

As such, it seems unlikely that sertraline would produce much inhibition of dopamine reuptake even at clinically used dosages well in excess of the recommended maximum clinical dosage.
This is in accordance with its 86-fold selectivity for the SERT over the DAT and hence the fact that nearly 100-fold higher levels of sertraline would be necessary to also inhibit dopamine reuptakeIn accordance, while sertraline has very low abuse potential
and may even be aversive at clinical dosages a case report of sertraline abuse described dopaminergic-like effects such as euphoria, mental overactivity, and hallucinations
only at a dosage 56 times the normal maximum and 224 times the normal minimum. For these reasons, significant inhibition of dopamine reuptake by sertraline at clinical dosages is controversial, and occupation by sertraline of the DAT is thought by many experts to not be clinically relevant.


So Zoloft sounds like a pile now...

The reason I'm asking you guys is because I have to wait a month each time I see him and I just want to try to get it right the first time but like you guys said I'll have to just ask him.

I don't think this Lexapro shit is working can you give me something a lot stronger?​
 
We can't...

This isn't up to us. It's up to your doc.

Thread answered. I don't see much point further than this. Closed. PM for questions.
 
A month isn't long enough to decide if a AD is effective or not. Your just going to cycle from med to med if you give up that fast on a drug. Finding the right dose is just as important as the right drug.

I'm all for doing your research on meds. But reading the abstract of a couple studies doesn't make you an expert. Between school and residency a phychiatrist trains for around a decade. So the best thing to do is find one you trust then come to the appointment armed with questions. It works works best as a collaborative effort between doctor and patient
 
cj said:
A month isn't long enough to decide if a AD is effective or not. Your just going to cycle from med to med if you give up that fast on a drug. Finding the right dose is just as important as the right drug.

I'm all for doing your research on meds. But reading the abstract of a couple studies doesn't make you an expert. Between school and residency a phychiatrist trains for around a decade. So the best thing to do is find one you trust then come to the appointment armed with questions. It works works best as a collaborative effort between doctor and patient
Click to expand...

Sertraline is probably one of the better SSRI's for specific issues (namely OCD) but all SSRI's have questionable efficacy for depression; if they don't work, none of them are likely to work. However, this isn't necessarily true. I knew people who went manic from one SSRI but responded 100% correctly to a different one (not entirely sure why; I think lexapro was the one that worked for them). They were quite happy and lived a very full life while I knew them on lexapro.
 
^No this person was talking about weight gained while using the substance, pretty sure.


Captain.Heroin said:
Sertraline is probably one of the better SSRI's for specific issues (namely OCD) but all SSRI's have questionable efficacy for depression; if they don't work, none of them are likely to work. However, this isn't necessarily true. I knew people who went manic from one SSRI but responded 100% correctly to a different one (not entirely sure why; I think lexapro was the one that worked for them). They were quite happy and lived a very full life while I knew them on lexapro.
Click to expand...

It's not true. More commonly is people getting off their antidepressant because they're happy, then not finding it to work again, or needing a much higher dosage.
 
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