Re: Fluoxetine for 3rd time
Thanks for your help unfortunately I am tapering of zopiclone now so was hoping it might not be impacting the AD. It’s the mirtazipine that got me in this mess. So lorezapam I was on all the way through till week 8 and been on zopiclone since but just started tapering like you said I should of tapered lorezapam slower but the doctors here just won’t have it he wanted it quicker but I was struggling. Fingers crossed the zopiclone isn’t stopping it but it was only last week was the first time my mood had improved and feeling motivated and positive. So hoping that’s the escitalopram kicking late and the lorezapam slowing things down. I will think on upping the dose just got in my head the lorezapam and zopiclone are more to do with my recovery in a negative way but 100% escitalopram is working and got me out the house after 5 months even tapering of that rubbish.
Re: Fluoxetine for 3rd time
Thanks for all your advice, a friend of mine is on escitalopram and has been on benzos all the way through advised by his doctor crazy. I told him to get of the benzo which that’s all done but he keeps changing his dose 1 week he’s on 10mg and says it’s not working any goes up 15mg stays for 4 weeks says it’s not working then goes back down unbelievable. Now he’s on 7.5mg and he’s telling me he’s depressed no motivation ect. I try telling him this is messing the brain around to much. Do you mind giving a small explanation on why you shouldn’t do that and the complications it can cause
Thanks
Re: Fluoxetine for 3rd time
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Originally Posted by
Ayresstew
like you said I should of tapered lorezapam slower but the doctors here just won’t have it he wanted it quicker but I was struggling.
Sigh. There should be a place in the deepest, hottest part of hell reserved for such <expletive> clowns! :mad:
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but 100% escitalopram is working and got me out the house after 5 months even tapering of that rubbish
:) Long may this continue :emot-nod:
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a friend of mine is on escitalopram
...but he keeps changing his dose 1 week he’s on 10mg and says it’s not working any goes up 15mg stays for 4 weeks says it’s not working then goes back down unbelievable. Now he’s on 7.5mg and he’s telling me he’s depressed no motivation ect. Do you mind giving a small explanation on why you shouldn’t do that and the complications it can cause
As per a previous post, ADs don't have a direct immediate impact on anxiety, or depression, but work by encouraging the growth of new brain cells which produce the mood improvement, not the med, so upping the dose for a few days or weeks achieves little positive. ADs need to be taking at a consistent dose, day after day for as long as he's on them. If a dose isn't working then it will likely take 4-12 weeks for a dose increase to start having an effect.
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and the complications it can cause
As I've previously mentioned ADs become progressively less effective each time they are stopped and restarted. Two *studies, Amsterdam JD, 2016 and Amsterdam JD, 2009, found the likelihood of ADs working after each restart drops by between 19-25%. Chopping and changing the dose as your friend is doing could be creating a similar effect which may increase the risk of the med quitting altogether. Even worse a few then fail to respond to many other ADs. Antidepressants are not meds to be played with.
Re: Fluoxetine for 3rd time
That’s if you keep using the same antidepressant that it loses it’s effect or any ?
I’ve been on citalopram one time and fluoxetine 3 times now escitalopram. I’ve never been above 20mg on any and now 10mg escitalopram but I think that is 20mg strength.
Re: Fluoxetine for 3rd time
Does it make any difference that I take two does one in the morning and half in the evening. Or do you get extra serotonin from having it in one go
Re: Fluoxetine for 3rd time
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Originally Posted by
Ayresstew
That’s if you keep using the same antidepressant that it loses it’s effect or any ?
No, it is every time you stop taking an AD for a while and then restart it. However, ADs can also lose effectiveness, i.e. poop-out or tachyphylaxis, after some years of continuous use. The SSRIs are more prone to this than SNRIs (except venlafaxine which is really only a SSRI), TCAs and MAOIs. I've been on my current TCA for 30 years without a break an if anything it's working better now than back at the beginning.
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I’ve been on citalopram one time and fluoxetine 3 times now escitalopram. I’ve never been above 20mg on any and now 10mg escitalopram but I think that is 20mg strength.
Then I suggest you discuss remaining on escitalopram for the rest of your life. Also, the dose taken doesn't seem to make any difference to the propensity of an AD quitting provided it's in the therapeutic range. Taking sub therapeutic doses can be a recipe for early failure, however.
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Does it make any difference that I take two does one in the morning and half in the evening.
In theory it shouldn't with a long half-life AD like escitalopram. However, in practice it sometimes does. Fwiw, I take my AD in 3 divided doses, though this is more because of the very high dose I'm on than trying to extract some extra efficiency from it.
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Or do you get extra serotonin from having it in one go
Fortunately, no. Anxiety and depression aren't caused by a lack of serotonin. Despite the myths, serotonin isn't a "feel good" neurotransmitter. It is just the opposite. The side-effects experienced when first taking serotonergic ADs are mostly created by the initial surge in serotonin forced by the med, however, after a few weeks bio-feedback mechanisms kick-in and reduce serotonin synthesis and expression to baseline or well below it in some areas of the brain which manifest anxiety and depression symptoms. See my: Serotonin - The 'chemical imbalance' myth
Re: Fluoxetine for 3rd time
I wish I never come of fluoxetine as working perfectly for 14 years but I came of. Hoping escitalopram can give me the same and I will stay on it but I do see a lot of people saying it’s pooped out which is a shame but I’ve never had one stop working just once I stopped it didn’t want to work the last time. I don’t think another 2 weeks to take me to 12 will get me back to where I was I’m probably 65-70% better which is great but 30% in two weeks is a lot to ask. I just would like to stay at this then if it stops working I’ve got some room to go up.
Re: Fluoxetine for 3rd time
Well I never knew that so serotonin doesn’t correct anxiety and depression. So all the people out there trying to increase there serotonin naturally for anxiety and depression are waisting there time.
Re: Fluoxetine for 3rd time
Your on a TCA I’ve never known about that but that’s great it’s helped for 30 years and still working amazing
Re: Fluoxetine for 3rd time
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Originally Posted by
Ayresstew
I just would like to stay at this then if it stops working I’ve got some room to go up.
Cool, that's a choice though personally I don't see the point of being on a med at a dose that isn't adequately controlling what it's being taken for. There is also no guarantee that upping the dose if escitalopram stops working will kick it back into gear.
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So all the people out there trying to increase there serotonin naturally for anxiety and depression are waisting there time.
Yep, and not only because a supposed lack of serotonin isn't the problem. The two main things taken, the amino acid l-tryptophan and its metabolite 5-HTP have had and almost certainly continue to have potentially fatal contamination issues as I noted in the serotonin myth post I linked to.
Plus, just to take the implausibility of what they are doing to another level, the brain is not the most serotonergic organ of the body. In fact it is only a minor serotonin synthesiser and user. By far the most serotonergic organ is the gut which makes about 50 times more serotonin than the brain, not only for its own use (mostly by the enteric nervous system, the mini brain which controls the gut), but also for all the other bodily functions mediated by serotonin such as wound repair. So most of the L-Tryptophan/5-HTP will be scavenged by the gut which gets the first crack at it. Plus, only about 3% of dietary L-Trytophan, and presumably also 5-HTP is converted to serotonin. About 90% of dietary L-Tryptophan is converted to kynurenine, the precursor of kynurenic and quinolinic acids and most of the rest goes to making proteins.