SSRIs

[Lra888]

Is there a major difference between the different SSRIs (Zoloft, Lexapro, Prozac etc) or are they all similar?

Zoloft made me feel worse & had bad side effects so I stopped taking it. Doctor thinks I should now try Lexapro instead. Aren't these things almost the same?

 

[Johnnythefox]

I was on prozac to begin with at the start of August and found the side effects too much, was put on Zoloft and didn't feel much benefit so back on prozac again. I think they are mostly the same, but apparently it's a lottery finding the one that works for you... The prozac isn't doing much after a month now.

 

[Susannah]

There are so many different SSRIs. Remember, SSRI drugs "work" with your brain/ neurotransmitters like serotonin, dopamine, norepinephrine. Since our brains are unique, the effect of the drug naturally varies. I used Efexor for some years (Venlafaxine). Didn't help and withdrawel was awful. Good luck.

 

[Armadillo]

SSRI stands for selective serotonin reuptake inhibitor, all those drugs selectively block the reuptake of the neurotrasmitter serotonin allowing its levels to build up in the synapses.

Why are they called selective? Because they do not have, contrary to other antidepressants, a "dirty" pharmacology (wich is not always a bad thing), wich means they don't do much more than inhibiting serotonin reuptake, thus having in theory less side effects (and efficacy, they're just a little superior to placebo).

There are some differences between them altough they're not very important (in fact if treatment with a SSRI fails, changing it will probably not make things better).
For example half life, an SSRI with a short half life, like Paroxetine, will reach steady blood concentrations sooner than one with a very long one like Fluoxetine (Prozac), this means that it will kick in faster but the whitdrawals will be generally worse too.

The dosage needed to reach therapeutic potential, wich means a blockade of SERT (serotonin transporter) between 80-90%, varies between drugs.

Other actions besides SERT blockade: Sertraline (Zoloft) in high doses can increase dopamine levels too, Paroxetine is a weak anti-muscarinic, Fluvoxamine is a sigma receptor agonist and so on.

Ask your doctor to switch AD class, even a SNRI would be better than trying another SSRI.

 

[ouvreyes]

I don't have any fancy science to offer, but I had taken prozac a while back and it had made me all weird and numb to everything. After trying some other stuff that didn't do jack, I'm now on Lexapro, and I honestly can't tell if it's doing anything. I guess I think it is and I just kinda assume I need it now lmfao. Don't understand why and stuff but it's affecting me differently than the Prozac.