Posted by Tony P on March 12, 2004, at 14:05:35
In reply to Alcoholism and SSRI Poop-Out/Link/Tolerance?, posted by qbsbrown on March 11, 2004, at 16:26:20
> I had a poop-out of paxil and effexor about 2.5 yrs ago after it had worked wonders for about 5 years. I was an alcoholic during the time it was working and the poop out. I do understand that drinking increases the effect of the medicine, and then the next day, your serotonin levels are dropped.
> Nothing seems to work any more. Tried the paxil, lexapro 20mg, effexor, now the zoloft.
>
> Do you think I need higher doses due in part, to my brain being used to the high levels of serotonin from the alcohol mixed with the ADs?--------------------
I haven't been on SSRI's for any long periods, but from what I read here, poop-out is poop-out -- increasing the dose may help a little, but with diminishing effectiveness.Have you/your pdoc considered atypical antidepressants?
If Serzone is still available where you live (not in Canada any more), it is a mild but effective atypical SRI and helps with sleep and agitation as well. However, it can cause liver damage, so liver function should be monitored, and you should avoid it within a few weeks of any heavy drinking. I never had any problem with liver toxicity even though my liver is borderline from old alcolholic hepatitis (although I did get liver symptoms with the older relative of Serzone, Trazadone).
I am having quite good success with Lamictal (lamotrigine) for about 3 months now. It is gaining a reputation as both a mood stabilizer and an antidepressant at doses from 100-400 mg/day. Very low side effect profile. There are lots of recent postings here.
BTW, Wellbutrin is best avoided for anyone with alcohol or benzodiazepine problems, in both my experience and according to a pdoc I saw once (her word was "disastrous", I wouldn't go quite that far). The dopamine boost and nervousness/insomnia can both be triggers for those of us with the above dependencies (recent or ancient), and anyway its effect on serotonin is slight.
Tony P
poster:Tony P
thread:323302
URL: http://www.dr-bob.org/babble/20040308/msgs/323650.html