SSRI

[member 2106]

I've reached a point where my panic disorder is so debilitating that I'm strongly considering SSRI treatment. I've refused it for three years, but after trying everything else, particularly a Peat-style diet, I think it's time to try what's generally considered the first line of treatment for panic disorder. I don't want to become agoraphobic, and I need to reduce my stress, which some days is so strong that only drugs can stop it.

I know that SSRI are pretty much anathema in this community because they increase serotonin, although some people tend to think that they may have other actions which may not be quite so harmful, eg. neurosteroid effect.

Who hear has taken an SSRI and what was your story? Does anyone have a positive story? I may well start treatment regardless of the response, but I do place a lot of value on this community, and your opinions may help to make my decision.

P.S. Tianeptine and Phenibut out of the question.

 

[Sucrates]

I'm curious why Tianeptine is out of the question?

 

[member 2106]

I'm curious why Tianeptine is out of the question?

I'm in the UK so would have to get it online, and is there ever a really reliable online supplier of Tianeptine?
If it was something my doctor could prescribe and supervise, I'd have no problems taking it. Plus I hate buying drugs online - maybe that's a bit irrational. I get anxious at the idea that I can't just request a repeat prescription and pop down to the pharmacy under my apartment to pick it up. I don't know, maybe it's something I should consider again.

 

[Sucrates]

I'm in the UK so would have to get it online. If it was something my doctor could prescribe and supervise, I'd have no problems taking it. Plus I hate buying drugs online - maybe that's a bit irrational. I get anxious at the idea that I can't just request a repeat prescription and pop down to the pharmacy under my apartment to pick it up. I don't know, maybe it's something I should consider again.

Fair enough, seems a safer substance to me. I'm not sure the effects of SSRIs aren't in some aspect anti-serotonin, they seem to increase anxiety initially, probably correlated with an increase in brain serotonin, followed by lowering anxiety (and brain serotonin) in response to the higher serotonin maybe 6 weeks later.
I'd have a read of this paper on serotonin and SSRI's before doing anything.
http://sci-hub.cc/10.1016/j.neubiorev.2015.01.018

 

[PeatThemAll]

Have you tried Methylene Blue? It works rather powerfully as an antipsychotic, and I strongly recommend trying it in small increments.

Also watch out if you're currently taking Benadryl before taking MB, as MB amplifies its sedative effect (there's also a couple of websites warning about serotonin shock, that could be induced by MB + diphenhydramine (Benadryl)).

 

[member 2106]

Fair enough, seems a safer substance to me. I'm not sure the effects of SSRIs aren't in some aspect anti-serotonin, they seem to increase anxiety initially, probably correlated with an increase in brain serotonin, followed by lowering anxiety (and brain serotonin) in response to the higher serotonin maybe 6 weeks later.
I'd have a read of this paper on serotonin and SSRI's before doing anything.
http://sci-hub.cc/10.1016/j.neubiorev.2015.01.018

That's interesting. If the theory is correct, you'd have to assume it lowers brain serotonin quite significantly (after increasing it). I have read that article before. But there's definitely a lot more going on, because I've taken anti-serotonin agents before and they haven't really worked to reduce anxiety. I think Peat said SSRI are more like tranquilisers than anything else.

 

[member 2106]

Have you tried Methylene Blue? It works rather powerfully as an antipsychotic, and I strongly recommend trying it in small increments.

Also watch out if you're currently taking Benadryl before taking MB, as MB amplifies its sedative effect (there's also a couple of websites warning about serotonin shock, that could be induced by MB + diphenhydramine (Benadryl)).

I haven't tried Methylene Blue, but will look into it. Thanks. Though I don't know if it's an anti-psychotic I need.

 

[Sucrates]

That's interesting. If the theory is correct, you'd have to assume it lowers brain serotonin quite significantly (after increasing it). I have read that article before. But there's definitely a lot more going on, because I've taken anti-serotonin agents before and they haven't really worked to reduce anxiety. I think Peat said SSRI are more like tranquilisers than anything else.

It's certainly complicated. Serotonin's anxiogenic effects seem in part due to increasing CRF(CRH), so other mechanism to increase CRF could produce serotonin independent anxiety, and lowering CRF might be another thing to try. If you've used pregnenolone in higher doses you might have some idea about that already.
http://www.nature.com/nature/journal/v537/n7618/full/nature19318.html
https://raypeatforum.com/community/...ent-inhibitor-of-the-stress-signal-crh.10105/

 

[CJ_87]

I am currently prescribed an SSRI - Citalopram. It seems to work insofar as I don't feel like everything is pointless any more. Tianeptine made me scared and regretful. Phenibut made me emotionally-numb, and withdrawal caused me to inhabit a nightmarish depression-world of Hell. Tianeptine literally drained the happiness hormone from my brain and caused me to feel guilt and depression. Perhaps this was necessary, as after taking one pill, I emailed a speech-tutor in gratitude before she died, and came to realise just how much I loved my parents (before taking Tianeptine I had let misophonia and complacency turn me against them), both due to the hopelessness and regret they made me feel. The anti-serotonin Tianeptine caused me to pre-mourn them, which is a hell of a lot better than mourning them after they've gone. I think some depression is sometimes necessary, and can reveal your true priorities. But in my experience, mainstream serotonin drugs are indeed causers of brain states that make you confident and self-assured, whereas anti-SSRI drugs cause guilt, regret and hopelessness. To put this "advice" into perspective, I have only been taking the SSRI Citalopram for a week, and I am a very hard case - stubbornly pessimistic, relatively stupid (in spite of high-ish IQ score) and devoid of a history of personal successes.

 

[Sucrates]

I am currently prescribed an SSRI - Citalopram. It seems to work insofar as I don't feel like everything is pointless any more. Tianeptine made me scared and regretful. Phenibut made me emotionally-numb, and withdrawal caused me to inhabit a nightmarish depression-world of Hell. Tianeptine literally drained the happiness hormone from my brain and caused me to feel guilt and depression. Perhaps this was necessary, as after taking one pill, I emailed a speech-tutor in gratitude before she died, and came to realise just how much I loved my parents (before taking Tianeptine I had let misophonia and complacency turn me against them), both due to the hopelessness and regret they made me feel. The anti-serotonin Tianeptine caused me to pre-mourn them, which is a hell of a lot better than mourning them after they've gone. I think some depression is sometimes necessary, and can reveal your true priorities. But in my experience, mainstream serotonin drugs are indeed causers of brain states that make you confident and self-assured, whereas anti-SSRI drugs cause guilt, regret and hopelessness. To put this "advice" into perspective, I have only been taking the SSRI Citalopram for a week, and I am a very hard case - stubbornly pessimistic, relatively stupid (in spite of high-ish IQ score) and devoid of a history of personal successes.

Was this standard dosing of Tianeptine (3x12.5mg)?

 

[CJ_87]

Nyet, it was a 30mg tablet taken 2 times a day. But sometimes just one 30mg tablet was enough to make be feel hopeless and... incompetent.

 

[Sucrates]

Nyet, it was a 30mg tablet taken 2 times a day. But sometimes just one 30mg tablet was enough to make be feel hopeless and... incompetent.

It seems to have very different effects at higher doses.

 

[member 2106]

I am currently prescribed an SSRI - Citalopram. It seems to work insofar as I don't feel like everything is pointless any more. Tianeptine made me scared and regretful. Phenibut made me emotionally-numb, and withdrawal caused me to inhabit a nightmarish depression-world of Hell. Tianeptine literally drained the happiness hormone from my brain and caused me to feel guilt and depression. Perhaps this was necessary, as after taking one pill, I emailed a speech-tutor in gratitude before she died, and came to realise just how much I loved my parents (before taking Tianeptine I had let misophonia and complacency turn me against them), both due to the hopelessness and regret they made me feel. The anti-serotonin Tianeptine caused me to pre-mourn them, which is a hell of a lot better than mourning them after they've gone. I think some depression is sometimes necessary, and can reveal your true priorities. But in my experience, mainstream serotonin drugs are indeed causers of brain states that make you confident and self-assured, whereas anti-SSRI drugs cause guilt, regret and hopelessness. To put this "advice" into perspective, I have only been taking the SSRI Citalopram for a week, and I am a very hard case - stubbornly pessimistic, relatively stupid (in spite of high-ish IQ score) and devoid of a history of personal successes.

Thanks for your input. Citalopram is what my doctor has recommended for me as well, at a dosage of 10mg. I hope it continues to work for you.

 

[Blossom]

Perhaps mirtazapine would be worth reading up on? It's one that you might be able to get from your doctor without much of a problem.
Anxiety And Depression, Need Advice

 

[member 2106]

Perhaps mirtazapine would be worth reading up on? It's one that you might be able to get from your doctor without much of a problem.
Anxiety And Depression, Need Advice

Yeah, that's another one to consider, thanks. Oddly enough, Ray Peat thinks (or used to think) that the older, tricyclic antidepressants are safer, despite bad interactions with certain foods. Although he has a pretty cynical view on the way drugs are marketed.
At least there's plenty of options.

 

[CJ_87]

Thanks for your input. Citalopram is what my doctor has recommended for me as well, at a dosage of 10mg. I hope it continues to work for you.

Thank you. My current prescribed dose is 10mg too. The reason for prescribing was that I have never been able to take independent action. When I said that my fear of seeing people I knew from school had kept me from applying for a real job had kept me back all these years, my GP acknowledged my deep problems and prescribed me a month's worth of 10mg Citalopram as a starting point. So far it's alright.

 

[member 2106]

Thank you. My current prescribed dose is 10mg too. The reason for prescribing was that I have never been able to take independent action. When I said that my fear of seeing people I knew from school had kept me from applying for a real job had kept me back all these years, my GP acknowledged my deep problems and prescribed me a month's worth of 10mg Citalopram as a starting point. So far it's alright.

I think it's pretty common to wait a month or so before it's at its peak effectiveness, so if it's having mild beneficial effects already, that probably bodes well. My girlfriend has been taking it for a month for mood swings, and she's reported good effects from it and seems more stable.
Let me know how it goes.

 

[LeeLemonoil]

Low dose SSRI (subtherapeutic in a mainstream sense) have helped some people, and this study, published in an important journal, seems to explain why:
http://link.springer.com/article/10.1007/s00213-005-0213-2

Also consider asking a doctor for adjuvant therapy with t3:
Fluoxetine and norfluoxetine stereospecifically and selectively increase brain neurosteroid content at doses that are inactive on 5-HT reuptake
Liothyronine - Wikipedia

 

[InChristAlone]

I thought you said panic disorder is something we need to solve within ourselves? But clearly that approach is not working for you. And it is generally not working for me during this flare. I've studied it for 2.5 yrs now and I'm not so sure it is ever simple. But you could try the SSRI and please report back! Could you list things you've tried?? Panic attacks can be caused by an overactive stress response. What is your diet like? I think I definitely react to foods and causes my nervous system to be on fire. Now to find out what those sensitivities are you just have to keep a very detailed food log which I've been doing now for a long time since this started. One thing that is very common in all them are things like chocolate, too much caffeine, too much protein like beef, in fact I think the beef yesterday is why my nervous system is crazy today. But it wouldn't happen so strongly if I was well fueled to begin with which I'm not. How many calories do you typically eat?

 

[LeeLemonoil]

And there are differences between the indivdual SSRI's. Sertralin has some action on one dopamine-receptor that Citalopram hasnt, different subforms may better ract to different SSRIS, can't remember exactly but the info should be found easily