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Is it unusual to try only 1 SSRI?


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How common is it to try only one SSRI before deciding that I'm too sensitive to the seratonin SSRIs hit?

Basically, a year ago we tried me on Zoloft. It hit me hard by day 2 even at only 12.5mg. My pdoc had a feeling I was sensitive to meds before we even started, so he put me on the Zoloft low and slow. From the beginning, I was having extremely vivid nightmares and would snap at people much quicker than usual (and a lot more intense). I stayed at 12.5mg for a week before we upped me to 25mg. I got even worse on the 25mg. We finally attempted to get me to 50mg, but I didn't last more than a day. I got to the point where I was scared to go to sleep because of what was going on in my head while I slept. ;) That put an end to the Zoloft. I went off it even slower than I started to keep me from having any of those withdrawl side effects. He commented that he was surprised that I lasted as long as I did based on what was happening to me.

After that, we switched me to Wellbutrin XL where I still am. It doesn't completely take care of everything, but it kind of helps a little. Yet at almost every appointment he mentions how he wished he could put me on an SSRI, but because of my immediate reaction to Zoloft at such a tiny dose, I was just too sensitive for SSRIs.

Is it normal to exclude all SSRIs based on one bad experience at a low dose? :)

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Depends on your diagnosis.

If you have a manic reaction, then it would be dumb to try another one.

What's weird is he thought you were going to be sensitive and told you that, thereby suggesting that you might have that reaction and then was disappointed when you had that reaction. Honestly, I find it hard to believe that it did anything at all at that dose in that little time. It just doesn't work that way. It sounds like it could of have been the power of suggestion on his part, or that was part of it anyway.

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Depends on your diagnosis.

If you have a manic reaction, then it would be dumb to try another one.

What's weird is he thought you were going to be sensitive and told you that, thereby suggesting that you might have that reaction and then was disappointed when you had that reaction. Honestly, I find it hard to believe that it did anything at all at that dose in that little time. It just doesn't work that way. It sounds like it could of have been the power of suggestion on his part, or that was part of it anyway.

Oh...he didn't tell me before I started that he thought I might be too sensitive. He told me after he had me start tapering down. His hypothesis was based on what I had told him happens to me on other drugs (synthroid, benedryl, etc). If he thought it was some sort of manic reaction, he sure didn't tell me. In fact, my only dx's from him are GAD and Asperger's, not anything BP. But then again, who knows if he has that in the back of his mind. I sort of have my suspicions that he does, but isn't ready to make it a dx (because of family history). We'll see. I just keep reading about other people who go SSRI to SSRI until they run out. I haven't read on here about someone only getting one SSRI to try unless it is an obvious manic reaction. If that is what it was, it sure wasn't obvious to me and I would think he'd go straight for a mood stabilizer if he thought I was manic.

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Pdocs usually start with them because most of the time they have the least side effects. If they don't work after 2-3, it makes sense to assume that serotonin imbalance isn't part of the problem and move on to something else. Trying one SSRI after another doesn't make a lot of sense when there are other options that you haven't tried.

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