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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by Annie on March 16, 2000, at 20:14:48
Here's my story: I have taken too numerous to mention antidepressants for several problems. I wanted to just be able to take one drug for everything and celexa did not do it but it helped my depression. It did not help my ocd or ptss symptoms. So I went back to taking risperdal for the ptss and still some other symptoms were giving me the blues-no pun intended! I recalled that paxil helped for ocd but not for depression much-it stopped working for that. So recently I requested to be able to take celexa (10 mg.) with paxil (10 mg.) and the riperdal (1 mg.). I am curious about the combined effects related to how often serotonin syndrome happens and at what known doses of the ssri's. I read about the warning signs of the syndrome and am glad to know them but what is most important to me is if anyone has heard of the effect of these 2 drugs mixed at a low dose-celexa and paxil that is. I asked for this combo because I am desperate to alleviate the symptoms I have so I can become functional enough to get a job and keep it. {I have been suffering from these illnesses too long and yes, I've had lots of therapy and use what worked, too.} I would do good work but I fear getting fired for having embarrassing syptoms. So I want to get better and am willing to try something new to see if it helps.
Posted by JohnL on March 17, 2000, at 4:15:39
In reply to Please Answer This: Mix 2 SSRI's in low doses?, posted by Annie on March 16, 2000, at 20:14:48
I've often wondered the same thing about mixing SSRIs. Though they all do basically the same thing, they do so in very different ways. At a molecular level they are completely different drugs and have completely different effects on more things than just serotonin.
I don't think you'll find a doctor who will endorse mixing SSRIs, so it would be self experimentation if you do it.
I have heard of a SSRI combined with Effexor, which is very similar to mixing SSRIs. Or mixing a SSRI with a serotonin TCA like Clomipramine. In Dr. Bob's Tips one phsycian reports a patient who takes 60mg Prozac + 75mg Effexor.
At the low doses you mention I can't foresee any serotonin syndrome risks. I mean, what's the end result difference between say 10mg Paxil plus 10mg Celexa compared to 20mg Paxil alone or 20mg Celexa alone. I think if you combined say 40mg Celexa with 40mg Paxil you would be asking for trouble. But at conservative doses it seems OK to me. Just my opinion though.
What might be more unpredictable is side effects. There's no telling how each drug will interfere with each other's metabolism and maybe cause wierd side effects, like anxiety or headaches or something. Who knows. While it's probably safe, and to me makes sense like you suggested, it would be self experimentation and not likely endorsed by a physician. As I always say, dip your toes in the water first before jumping in. I think 5mg of each would be a good start to feel it out, rather than 10mg. But again, that's just my guess. No more than a guess. Who knows, it might work wonderful, or it might not. It does kind of make sense, to me, to get the subtle unique benefits of two different drugs, even though they are in the same class. If you try it, I hope it goes well. Maybe it'll work out as good as you expected and maybe not. Just have to try it and see. I personally wouldn't be afraid of trying it, but I would definitely start at lower doses than you mentioned, just to feel it out first before going higher. I've tried stranger more dangerous things without problems.
Posted by Annie on March 17, 2000, at 19:40:44
In reply to Re: Please Answer This: Mix 2 SSRI's in low doses?, posted by JohnL on March 17, 2000, at 4:15:39
My doctor has already agreed to it and at those dosages and at my suggestion. We are both cautious and careful about this. The 10 mg. of celexa will stay at 10 because that amount helps my depression and I see no need to change that. He had suggested an increase in the celexa for ocd but it only made my ocd worse and me nervous. So I went back to where it helped the depression in the first place as I usually require very low does of medicine for my sensitivity. Then I thought up the idea of the celexa and paxil. I don't know if he will up the paxil but it will depend on how I'm doing at 10 I'm sure and I can see going to 20 possibly. I've started the new regimen and so far so good-time will tell if it will help the ocd. We are monitoring this very carefully, too. I appreciate your input very much. Anne
This is the end of the thread.
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