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Are all SSRI's basically the same?


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I just switched from high dosage zoloft to prozac (I'm actually taking them both together now), and I seem to notice basically the same effects as with the zoloft...a calm, numb feeling, suppressed libido, severe night sweats(these are the worst!). There seems to be somewhat of benefit for depression, but this does not at all seem like an ideal long-term remedy. I would guess that any other SSRI would provide basically the same effects. Is there any hope of finding a good long-term solution?

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while all the SSRIs do basically the same thing, their side effects vary.  unfortunatley, the only way to find out which one will work best for you is to give them all a good go.

also, you're still on the zoloft, so you may still have lingering side effects from that.

no med is perfect, and sadly it's a trial and error process... but usually in the end people can find one that works fairly well for them.

there are also the SNRIs like Effexor and Cymbalta... but they too have side effects, of course.

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I just switched from high dosage zoloft to prozac (I'm actually taking them both together now), and I seem to notice basically the same effects as with the zoloft...a calm, numb feeling, suppressed libido, severe night sweats(these are the worst!). There seems to be somewhat of benefit for depression, but this does not at all seem like an ideal long-term remedy. I would guess that any other SSRI would provide basically the same effects. Is there any hope of finding a good long-term solution?

Essentially all SSRIs have the same therapeutic benefits and a similar side effect profile.

However, hese benefits and cons vary significantly from individual to individual. 

So just because prozac and zoloft effected you similarly, it does not mean that the other ssris may have different effects - maybe better, maybe not.  Paxil, Celexa, Lexapro & Luvox are all options.

I personally take paxil and find it to be excellent. I wouldnt recommend luvox though as it seems to typically have worse side effects than the other ssris.

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Does this mean that all SSRI's vary in the side effects they produce, but they all really have the same mechanism of action? What I mean to say is, if I am taking Lexapro, and I have no side effects, but I am not seeing any benefit either (ie no reduction in symptoms) - is it pointless to try another SSRI to see if it helps me? Do you really only switch to another SSRI to see if you tolerate side effects better?

I hope this makes sense.....

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No, people sometimes switch from one to another because one has stopped working or doesn't work to begin with.  They all do essentially the same thing -- they selectively inhibit serotonin reuptake -- but they appear to do this in different ways which no one entirely understands yet.  There's a lot of good research on this, but far less than the namby-pamby happy-ever-after TV ads would have you think.  We don't really know, but we're getting there. 

My point?  Yes.  If you have no effect on SSRI A, SSRI B is still worth trying.  And C.  And D.  Also, people who take an SSRI to good effect for a while and find that it stops working (aka SSRI poop-out) often benefit from switching to another SSRI.  It's mostly if you get manic on SSRIs that you'd need to entirely rethink your diagnosis, and your treatment plan along with it.

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I don't know. I've taken Paxil for so long now...

My mom (BP1 manic end) and I compared notes on our trials of SSRIs. It seems that Lexapro and Paxil (of the SSRIs) made us feel the most manic, while Zoloft made her numb and sedate. None gave us sweats. I felt like I had electricity shooting in my brain with the Paxil.

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