SSRI

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Consider this too


Its so hard to tell what medication is the best for someone. The only way to tell is by using it unfortunately. Personally, the best drug there is in my opinion is Stablon (tianeptine). I've been researching alot about how the brain works and used most of my energy of the last year doing just that. I have to admit, it became a little bit of an obsession for me, allthough i rather like to call it a survival mechanism. I lived a crappy life due to this disorder so my one and only priority is/was to get better. I don't want to brag but my psychiatrist admitted I probably know more about my condition then she does.

Anyway theoraticly speaking stablon is the number one drug to try because:

- It's proven to induce neurogenisis ("brain healing") in areas of the brain that are damaged by stress. Other antidepressants do this aswell, and it is now believed it might be there sole mechanism of action. Stablon however does this in a stronger degree.

- Stablon doesn't mess with your monoamine transporters or responders. It does enhance the reuptake of serotonin (opposite of an ssri) and thereby increasing dopamine by a small amount. This means stablon has hardly any side effects, if not none. It doesnt cause agitation in the first weeks, it doesn't cause sedation, it doesn't cause sexual side effects and it doesn't cause cognitive problems.

- Stablon lowers cortisol levels where SSRI's higher them. Cortisol is one of the reasons we get anxiety symptoms.

- Stablon doesnt cause dependance or withdrawal effects.

- Stablon's toxicity is extremely low. Some people have taken over 60 amounts of the recommended dose without serious problems.

- Stablon usually starts working a little faster then SSRI's. For some people in less then a week. The long term benefits however take time.

So why its not available in the US? I garantuee you the only reason is money. For detail about this story and more info on this drug, look at the independant website tianeptine.com. I ordered it from the internet, and while i dont recommend this without really researching this drug i'm glad I did. I'm on it for 2 weeks and i begin to notice the first subtile changes, especially regarding mental clarity and a slight decrease in depression and anxiey. My pdoc knows i'm using it, and she's understanding. She admitted this drug seems like a very good one and also agrees about the reason it is not available in some countries.

And of course, medication alone will note cure you. But combined to therapy and/or coping stategies it can be a very useful tool.

Really glad it's working for you! Keep me updated!

I don't have any doubts that Tianeptine can be effective, but so can SSRIs. There's just no argument about that. I got a prescription for Citalopram and may give it a shot if other alternatives continue to not work.
 
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I see I double posted the study, here is what I wanted to add:
T3 augmentation of SSRI resistant depression

T3 augmentation of SSRI resistant depression. - PubMed - NCBI

I have only anecdotal evidence regarding the low-dose/upping neurosteroid approach, and it's with Sertraline, with which 10-15mg seem sufficient. I have tested it on myself and I occasionally pop 10-15mg of Sertralin before sleep when I expect a very stressful day. It induces a nice calm and is in act energizing. But I only do this maybe a dozen times a year.

Here is a study of dose-equivalents of SSRIs, don't know if this is applicable:
http://www.jad-journal.com/article/S0165-0327(15)00151-2/abstract

40mg of Flux = 98,5mg of Sert. So maybe 4-5mg of Flux? Try it out and see if you notice any effects.

Hey thanks for your input, I'll have a look at those studies. I discussed Sertraline with my doctor but we opted for Citalopram for now.
 
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I remember Ray saying in a KMUD-interview that the "irritation in the brain" from the SSRIs would be the mechanism for increasing the neurosteroids. I don't know the sources for making that claim, but it's something to consider.

I should probably listen to more of those interviews but, to be honest, in spite of Ray Peat's incredible articulacy and precision, I find him very hard to listen to.

That doesn't sound like a very good way to increase neurosteroids, but perhaps the ends justify the means!
 
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TurtleNeck

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Really glad it's working for you! Keep me updated!

I don't have any doubts that Tianeptine can be effective, but so can SSRIs. There's just no argument about that. I got a prescription for Citalopram and may give it a shot if other alternatives continue to not work.

To clarify I am not on them yet. Still very scared for assosiation with my over supplement use (spent thousands of dollars on the crap)

Hope to work on it. If I go on Tianeptine I will log it for sure
 

Richiebogie

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Hi @waldenpond, have you tried a daily aspirin (100mg to 200mg)?

Haidut posted a study on its antidepressent qualities.

If you take it with coffee or coffee powder it is supposed to be gentler on the stomach.
 
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Hi @waldenpond, have you tried a daily aspirin (100mg to 200mg)?

Haidut posted a study on its antidepressent qualities.

If you take it with coffee or coffee powder it is supposed to be gentler on the stomach.

I've taken aspirin occasionally, but it's really anxiety I suffer from, not depression, so I'm not sure it would help. I need the strong stuff because I'm stuck in a trap, so have just started a course of SSRIs in the hope they can afford me a few good months to build up strength and courage again.
 
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I have decided to try a course of antidepressants, and have been taking Citaloptam for 5 days. No effect yet, but it's not expected until about 2 weeks.

It may be that there are certain circumstances which merit the use of drugs like SSRIs. In my case, it is severe anxiety, which can spread like a wildfire if not dealt with promptly.

My hope is that the SSRI will give me some time to build up a sense of confidence again, and reduce the constant stress, until I'm ready to taper off them and focus on getting better without drugs. We shall see.
 

khan

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How much low dose of Fluoxetine is required in mg's to
increase brain neurosteroid content without inhibiting 5ht?
@haidut please give your opinion on micro-dosing of ssri like prozac for brain neurosteroid content without inhibiting 5ht?
 
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@waldenpond , what is your magnesium intake? Do you supplement it?

I eat spinach occasionally and dark chocolate, as well as some coffee, so don't think I'm suffering a deficiency. In my case, the anxiety is definitely not food related. I had a massive trauma a few years back and have just struggled to get over it.
 

Giraffe

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I eat spinach occasionally and dark chocolate, as well as some coffee, so don't think I'm suffering a deficiency. In my case, the anxiety is definitely not food related. I had a massive trauma a few years back and have just struggled to get over it.
Maybe consider supplementing it? When you are stressed you lose magnesium easily. You might need a lot more, than you can get from food. Magnesium has anxiolytic-like properties.
 
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Maybe consider supplementing it? When you are stressed you lose magnesium easily. You might need a lot more, than you can get from food. Magnesium has anxiolytic-like properties.

I will keep that in mind, thanks.
 

haidut

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@haidut please give your opinion on micro-dosing of ssri like prozac for brain neurosteroid content without inhibiting 5ht?

I think it may work but I don't know how safe it would be due to the serotonin effects. Raising brain allopregnanolone levels by using a direct precursor steroid is probably much safer. Here is one option.
5α-Dihydroprogesterone (5α-DHP) - Pro-hormone And Neurosteroid For R&D

If you are young, not under stress, and not overloaded with PUFA your 5-AR enzyme is probably well working and you can also try regular progesterone as a precursor. There are human studies using 50mg progesterone orally twice a day for a total of 100mg daily, and showed that blood allopregnanolone levels rose as a result.
 

zztr

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Why are you so anxious? The intial assumption seems to be you need a drug or different food when it's quite possible you just don't like the people you're around, the lifestyle where you are, or your job, or whatever. It apparently never even came up.
 
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Maybe consider supplementing it? When you are stressed you lose magnesium easily. You might need a lot more, than you can get from food. Magnesium has anxiolytic-like properties.

How would I go about increasing my magnesium? Epsom salt baths? If, as you say, magnesium is lost during stress, I must have lost a lot. I drink a lot of OJ, which Peat has said should increase Mg, but perhaps I am deficient. Aside from the ridiculous anxiety and palpitations, I've noticed for a while that my voice is higher than normal, which in itself could potentially signal a magnesium deficiency. Worth a shot anyway!
 
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raypeatclips

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How would I go about increasing my magnesium? Epsom salt baths? If, as you say, magnesium is lost during stress, I must have lost a lot. I drink a lot of OJ, which Peat has said should increase Mg, but perhaps I am deficient. Aside from the ridiculous anxiety and palpitations, I've noticed for a while that my voice is higher than normal, which in itself could potentially signal a magnesium deficiency. Worth a shot anyway!

Peat talks about magnesium a few times on the youtube channel here:

Ray Peat Clips
 
OP
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Why are you so anxious? The intial assumption seems to be you need a drug or different food when it's quite possible you just don't like the people you're around, the lifestyle where you are, or your job, or whatever. It apparently never even came up.

It's none of those things. I like my job and the people I'm around. I had my first panic attack a few years ago and it was profoundly traumatic. Since then I've had some good periods of a few months where I feel my health has been restored, but recently it's cone back with a vengeance and I'm really struggling to put an end to it. I'm in a state of alert and hypervigilance now most of the time which is very exhausting - alert, particularly, to physical symptoms which might confirm my irrational suspicion that I have a heart problem or I'm going mad.
 

LeeLemonoil

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Direct inhibition of retinoic acid catabolism by fluoxetine. - PubMed - NCBI

New Study about Fluoxetine preventing Retinoic Acid from breaking down too early/too much in neurons.

Retinoic acid plays a major role also in Androgen metabolism, Progesterone and so forth ... Progesterone helps retaining Magnesium, Magnesium is needed to prevent overexitatory NMDAr actions and so forth .. it's all closely interlinkes. I think low doses Fluoxetine can be regarded as a net positive, even if not all possibe effects are desirable.

Magnesium: Look into Magnesiumbicarbonate and Magnesiumacetate .... There is a threa somewhere here called "stoking the furnace" where the advantages of both forms are discussed. I thin MgBicaronate is the ***t.
 

Stevie

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I've had agoraphobia since I was 19 and I remember having panic attacks as young as 5 (my brother rolled me up in the hearth rug) (the little bastard). At 30 I took 20mg then 30mg peroxatine for 15 years. It was a godsend at first, although it didn't stop the fearful thoughts, I became a lot better at dealing with the panic attacks. Then I stopped dreading the attacks so much because I was confident I could manage them. Still agoraphobic to a certain extent, but I could travel enough to function happily. This is when I should have stopped the drug. 14 years later I felt nothing, I had no interest in anything and became withdrawn.

It took a year to wean myself off peroxetine, I experienced some unpleasant side effects including acute anxiety and the occasional suicidal thought, all in all a lot worse than when I started. Which brought me to this forum.

My fears are all based around 'feeling trapped'. CBT doesn't work well for this fear, or indeed any where there is no escape route, i.e. flying. In England we get a lot of fog and I am absolutely terrified of it, have been since childhood. I cannot run from this fear and I never know when it will end. I pretty much have to stay put and face it, something CBT says you must do in order for therapy to work. Yet I've carried this fear, intact, into my forties.

Last nights fog caused the worst panic attack I can remember, I dealt with it so badly that it triggered anticipatory anxiety in me today, even though its a clear day. The times when I've made the most progress with my panic attacks have always been when I've felt confident that I can deal with them, even just adequately, which has a knock on effect. However, when I have a bad one it also has it's knock on effect.
In a panic attack, I feel like I've taken a whopping great lung full of air, except I haven't, I've exhaled everything. This feeling alone makes me feel like I'm in 'fight or flight' mode, and I just want run. I do 478 breathing often but this doesn't work in a panic. If I could just deal with that physical part of panic, maybe with a drug or supplement, I think it would be easier then to distract myself from the real fear which is in my head. These two things seem to feed off each other.

I absolutely do not want to go back onto ssri's, and I don't mind taking something as and when because I know exactly when I'm going to have a panic attack, in fact I often schedule them in. (I must stop listening to the shipping forecast).
 

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