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What Ssri Do You Use?


julieph85
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Im thinking of trying an SSRI because there is a definite anxiety component to my pots. I have taken Paxil before pots and was thinking of trying it again. I'm nervous about taking drugs from this class because I'm scared it is going to make my tachy worse. What has been others experiences with these drugs? Has it helped?

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hi julie,

i'm on paxil too. before paxil my hr would go up from about 65-70 on sitting to about 185 on standing. starting off with 10mg brought it down to about 100-110 on standing. my neuro decided to go for the best effect and wanted me to be on 20mg daily and it works really well. my hr goes up just a little to bring up bp (which comes up through the octreotide injections) which is normal i think. the combination of octreotide works best for me.

hope this helps,

corina

btw i'm in the netherlands, paxil = seroxat here!

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I take Zoloft recommended by my Cardiologist EP I think it has helped a little bit. If the only thing i feel like i have more energy. my heart rate still gets really high some days and some days its ok.... yesterday when i was sitting my hr was 80 when i stood up it would go up to 156 i stayed in bed all day, but today has been a little better.

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the only time i could ever tolerate a ssri or an snri was years ago when lexapro first came out. It worked for about 9 mths for me, gained 35 lbs, but i LOVED who i was on that stuff..... it worked great for 9 mths, then after that, it just didn't work anymore. Tried everything in the sun since and all ssri and snri drugs have a very dangerous effect on me, and makes me more sick i might add. I finally had to come to terms that klonopin was best for me and had the least amount of side effects by far...... i just seem to have very very bad reactions to those specific type meds.... my mother is the same.... she can only handle prozac for anxiety, but she has celiac and chrons.... not dys though.

:)

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I started Lexapro (Cipralex out of the US) 2.5 months ago.

The first 2 weeks were absolutely awful - my anxiety felt much worse as did all of my symptoms. But then, the side effects started going away and I started feeling better. It took a full 6-8 weeks until I felt "back to normal", but I am feeling much much better now.

You have to see if you can handle those first few weeks, some people can't. There are some side effects that are longer lasting, but for me, they are worth it. (I don't have any of them that badly.)

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http://ajpregu.physiology.org/content/286/3/R584.full

This study explains why when you start taking the ssri's it makes the symptoms worse in the beginning, but then improves after about 2 weeks. I'm about to start Paxil this week. The study says that initially the SSRI's increase norepinephrine activity but after 2 weeks the reverse happens and this is why we feel better :) I'm praying the first 2 weeks aren't terrible because I have horrible NE overactivation.

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I don't want to discourage, but I took Zoloft for 2 days. After all that I have been through over the last 3 years those 2 days were the worst in my life. I felt like I was plugged into a light socket. I had soooo much adrenaline and then when it would finally calm I just felt mentally unstable. I have never felt mentally unstable a day in my life except for then. I can see where it would give more energy if it weren't such a harsh feeling. There is no way I would have been able to "get through" for a few weeks.

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From what I've read, and from what my doctor said, most doctors give something to calm you down for those first few days. I took Lorivan (I am not in the US, it is called Ativan in the States). I was really scared to take a sedative, but it was the only way I did not think that I was going to jump out my skin or explode or SOMETHING! I took a half a pill once a day for the first few days, then I was able to manage with half a pill once or twice a week, then none. But without something to sedate my nervous system, I never would have been able to get through it either. (I think half a pill was enough for me because I am quite small - 5'1" and 106 lbs.) I have gained weight since I started, but I don't know if that's because my IBS is getting better, or from the SSRI.

I did not mean to imply that anyone else was "not tough enough" to push through those days. I never would have been able without a sedative, and even then it was pretty horrific. I remember those two weeks as a blur of heart-pounding jittery misery. And everyone responds differently to meds.

But now, on the other side, I feel like I have my life back, and I hope that others can gain information from my experience.

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Julie85, that's really interesting about the initial rise in norepi but the subsequent decline in norepi after 2 weeks. I did have the traditional symptoms when starting paxil (anxiety, flushing, and my burning skin pain got worse - that one never quit). But after 2 weeks, my usual orthostatic hypertension turned into dramatic OH (SBP was in the 50's after standing for a few seconds). Normally I can't tolerate midodrine because of hypertension, chest pain, etc. But I was taking midodrine 10-15mg 4 times a day from weeks 2 through 8. After week 8, my BP leveled out, but I had worsening flushing, feeling burning hot all the time, skin was so painful, and was having BM's over 10 times a day.

By the way, I did call my doctor a few times and it seems her nurse miscommunicated the severity of my symptoms. When I got in for a follow-up, the doctor was alarmed at my BP's after starting paxil and said she was never told I had such severe OH.

During week 12, I was having near-constant flushing, nausea, horrible fatigue, and felt like my skin was on fire. I called my doctor's office and let them know I had to get off of this drug. The only reason I stayed on it for so long was because my doctor is doing everything she can to help me, and she had a lot of confidence in this medication.

My reaction to most drugs is quite unusual, so don't take my experience as a reason not to try something your doc recommends. And with my mom's carcinoid syndrome and my flushing issues, I wonder if I may produce too much serotonin (although my 5HIAA's have been normal several times).

But my doc said she'd never seen BP like mine caused by an SSRI. However, your comment makes me understand more about why this could be happening. It's been proven that my orthostatic hyperstension is mainly compensatory, so if you lower my norepi levels my BP will drop.

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Julie as a heads up I can absolutely not tolerate ssris. I don't think this is common amongst pots patients they seem to help but for me they give me weird side effects that aren't even listed. Example: my heart starts to flutter in a way that isn't pots related. Those palpitations my doctor told me can't be caused by them but when I stop the drugs every time the palpitations go away.

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Julie as a heads up I can absolutely not tolerate ssris. I don't think this is common amongst pots patients they seem to help but for me they give me weird side effects that aren't even listed. Example: my heart starts to flutter in a way that isn't pots related. Those palpitations my doctor told me can't be caused by them but when I stop the drugs every time the palpitions go away.


Me too Jangle. I never could take anything that affected my brain function - until I tried Tramadol
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hi all,

so, I've been on Citalopram (celexa) for one week and then based on the symptoms I got my dr advised me to stop it. Speaking of symptoms: my bp and hr would fluctuate wildly - the bp was anywhere from 90/50 to 145/98 I was unable to get out of bed, let alone exercise or do anything around the house, unable to get any sleep, I'd get these heat waves coming over me at the most unexpected times, my blood would rush to my head, my palms would sweat a lot, I'd also have this burning kind of pain across my upper chest, my arms, my legs, my scalp, my throat, my whole body would shake etc... Sometimes it felt like my worst panic attack x 10. Two days after discontinuing the meds I'm back to "normal". I still have some swings in bp but nowhere near what I experienced while taking Celexa. Now I'm just waiting for my body to completely eliminate it, and it looks like I'm on the right track as last night I actually slept through the night -8 hours straight, not to mention that I've been able to move around a bit, do some exercise etc. I guess I'm one of those people who don't tolerate SSRI's.

here is a quote from an article published in Ireland - sorry I don't have the link:

"despite ssris being documented as useful treatment option for pots, this is anecdotal and there is no experimental evidence of efficacy. Conversely, there is documented evidence that the cardiovascular side effects include tachycardia, palpitations, OH, and an increase in mean arterial pressure."

the article is called "a review of postural orthostatic tachycardia syndrome" and was published in 2009 - amongst the authors: Sheila Carew, Richard Conway, Declan Lyons from the Mid Western Regional Hospital in Limerick Ireland.

I hope you take this with a grain of salt (no pun intended) and realize it's only been my unfortunate experience.

Alex

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