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Mental Health discontinuing fluvoxamine

hydroazuanacaine

bluelighter
Joined
May 17, 2007
Messages
8,497
on 03/19 i started fluvoxamine at 25mg. i went up to 50mg four or five days later. on 3/30 i went up to 100mg. it is giving me headaches, making it so i can’t sleep, and tearing up my stomach.

can i just stop taking it? seems like too short a time for physical dependence to develop, but i do not know this and cannot figure it out with google. i’ll call and ask my doc tomorrow too.

anyone taken remeron? what did and didn’t you like about it? would you rather take remeron / mirtazapine or lamictal / lamotragine?

thanks
 
A guess putting the half-life at ~20 hours.

Luvox is a good med for OCD, I've read.

These kind of symptoms are a bit troubling. I guess there's the everyday "did you tell your doctor" thing.

That's the way to go, telling your provider, unless it's extreme that you can't wait 1-2 days for a response.

When you say "tearing up your stomach" that sounds awful, like you have an ulcer or are forming one (from the breakdown of the mucous membrane that protects the stomach, a lining on the outisde).

Insomnia is no good, too. When we get tired, our daily challenges and grievances are greatly magnified. Sleep is a must, especially for people who are in the mental health system and who are trying to improve their emotional well-being.

If you can wait until you tell your doctor without injury (which is impossible for me to guess or gauge, but I guess can be roughly estimated by your comfort) then I'd do so.

Well we all have our own meds that have worked for us. There are many meds of the same class because they all have variants that aren't well-explained by pure science. Anecdotes are likely less useful than general mechanism.

I was on Remeron for a bit. It's a tetracyclic, I believe. It tends to work a bit earlier than many other AD's. Its penchant for inducing sleep follows a relatively unique array of mechanisms. Some downstream opioidergic activity may have to do with its antidepressant effects. I believe it being an adrenergic autoreceptor agonist action essentially mimics how opioids reduce NE/E, also, along with being soporific. Similarly in histaminergic action, which it has gnarly strength at H1. This has the effect of classical conditioning on these latter two, and close comparison on the former, forming quite a med just by these effects for opioid withdrawal.

We see its range of effects on the wikipedia page. 5-HT2a antagonist is said to lead to more D1 binding in the neocortex and to facilitate cognition. I'm guessing it is an anti-emetic.

Well lamictal is a mood stabilizer. We're talking mostly different ballgames here, as mirtazepine is an antidepressant.

Some said that lamictal is better for depression than for mania, but I think that was since disproved. As other mood stabilizers, it has some effect to increase the GABA:glutmate ratio, or, more inhibitory and less excitatory activity (the two being the main inhibitory and excitatory nt's in the CNS, respectively). Yeah so blocking axonal NA+ channel influx effectively reduces the chance that a given neuron will fire and pass on the neurochemical message. But we see on Wikipedia that apparently it doesn't have some mechanisms that other mood stabilizers have.

I'd rather take remeron if I was depressed, and rather take lamictal if I more so had issues with mood stability.
 
thanks for the reply. i’ll call tomorrow. i’m not gonna take my dose in the morning and see what he says when calling back around 5 - 6pm.

ssris — at least the two that i’ve taken — make my stomach hurt. and this one is giving me diarrhea. back when i was a teen, prozac would often cause me to throw up in the morning.

after getting off prozac, i very much do not want to take any of these medications and have refused to for the last decade. that’s not working out great. so i’m giving it a try. i want to start with the least invasive options when trying to find one that works.

the line between unipolar depression and bipolar ii is thin. if i leave it up to him, he’ll probably choose lamictal. that’s what he wanted, but i said i’d prefer treating it as depression. he thinks i might have ocd as well, so luvox made sense.
 
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Well SSRIs can be difficult.

My always go-to is due what the doc recommends. Use their knowledge, as it's more qualified than yours, and more qualified than mine. No offense meant.

Could you at least try the lamictal?

Here are some other ideas:

Zoloft has some (at least mild) DRI effects, mostly due to its metabolite.

Any experience with SNRIs? Effexor (the SNRI) is great for anxiety, too, and it also has some downstream opioidergic effects. They call remeron and effxor as used together "california rocket fuel". No real idea why save both with some opioid activity--which is itself kind of vague.

Have you ever tried bupropion? It's stimulating, and technically in the same class as amphetamine as a phenethylamine, but its great for bipolar depression and depression overall. Since it lowers the seizure threshold, doses should be carefully administered by the doc. I think it's at 300 mg that the dopamingeric effects actually become significant. They have a 450 mg XR version. The highest I've ever known one to be prescribed is 600 mg, but this would be someone without proclivity to seizures.

Lithium can work wonders, too, but its a mood stabilizer. It's also a standard medication to try down the line of antidepressants don't offer significant relief.

They have trintillex/brintillex that is an SSRI plus.

MAOIs parnate and nardil can be very powerful antidepressants. Parnate is stimulating, while nardil is more anxiolytic.
 
the doc is out sick so i couldn’t talk to him today. didn’t feel like talking to the covering doc, since he’s not gonna write anything anyway.

thanks for the options for consideration.

i don’t want anything too stimulating, in fear of agitation and/or insomnia as side effects. i think remeron or lamictal are good next options. from what i’ve read, tolerance is a problem with long term use of lamictal. but if i am bipolar ii, it sounds like the first line of defense.

we’ll see what he says. if neither lamctical nor remeron work out, i’ll probably move on. three is giving medication plenty of a chance. beyond that i’m just playing guinea pig.

last time he was talking about dual medications, but i’m not open to that.
 
Never heard tolerance to be a big issue with lamictal...yeah mood stabilizers are good for bipolar. Sometimes *mild, as it were, antipsychotics, can help more so with the inner symptoms. These include seroquel and abilify.

In fact antipsychotics are very effective against agitation and insomia. For the former, it's their specialty. Don't let the name fool you. Antipsychotics can be very, very medicinal.

Most of us play guinea pig, to be honest, though.

Please at least consider what your doctor recommends. We can help you troubleshoot, but chances are that neither you nor I nor anyone on this site can give you a more qualified opinion than a good psychiatrist.
 
good to know you did not encounter a tolerance issue with the lamictal, thanks.

when the doc was out, i stuck with my idea to discontinue the luvox without taper.

i have zero interest in the antipsychotics, atypical or not. their developers are reaching because they spent so much money getting drugs approved for an ailment with so few sufferers. they include high incidence of unacceptable side effects.

as said, i’ll try remeron and lamictal. not at the same time. if neither works, i’m moving on. if one is less invasive / safer than the other, i’d prefer to try that one first.

edit:
my psych called from home. said if i'm not experiencing any wd symptoms from having discontinued the luvox, i'm in the clear by now. he's calling me in a script of mirtazapine 15mg to start tonight.
 
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With me, lamictal (and basically all mood stabilizers) make me feel so terribly depressed. Lithium is a sort-of exception, but it ruins my memory, which effect is no good for me these days.

I'd urge you to let your doctor treat you. Antipyschotic the word sounds heavy and has a negative connotation, but but they 100% have their place in psychiatry. Abilify, Seroquel, and others are routinely given for bipolar disorder.

They have different applications.

Well, see how it works. Rather, how did it work? I didn't quite resurrect this thread but the last time you posted it was 11 days ago. How are you?
 
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