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Zoloft Vs Prozac


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#1 KarenRB53

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Posted 08 May 2008 - 04:12 PM

Is there a big difference in how Zoloft works compared to Prozac? My Prozac has definitely stopped working and I'm looking at several options from my doctor. He has suggested trying Zoloft.....he has suggested adding Wellbutrin to the Prozac...he has suggested trying Imipramine. Wondering about the Zoloft.
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#2 thief of light

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Posted 09 May 2008 - 08:23 PM

One big difference is that Zoloft can affect dopamine, where Prozac doesn't affect it. For some folks, the little kiss to the dopamine receptors is what they need.
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#3 KarenRB53

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Posted 10 May 2008 - 06:23 PM

Is there a big difference in how Zoloft works compared to Prozac? My Prozac has definitely stopped working and I'm looking at several options from my doctor. He has suggested trying Zoloft.....he has suggested adding Wellbutrin to the Prozac...he has suggested trying Imipramine. Wondering about the Zoloft.


Check out the graph on this page .
It will give you a comparison of neurotransmitter actions for the SSRIs.

jook




Thanks for the information. My main problem is that Prozac has always caused that "inner restlessness and agitation" and I want to stay away from that. In your opinion would Zoloft cause the same feelings or be less likely to compared to Imipramine. I've pretty well decided that adding Wellbutrin to the Prozac might just be too stimulating for me.

Karen
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#4 KarenRB53

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Posted 10 May 2008 - 07:08 PM

My main problem is that Prozac has always caused that "inner restlessness and agitation" and I want to stay away from that. In your opinion would Zoloft cause the same feelings or be less likely to compared to Imipramine. I've pretty well decided that adding Wellbutrin to the Prozac might just be too stimulating for me.


"Inner restlessness and agitation" could be a number of things.
It could be akathisia. It could be side effects from overstimulation of any number of neurotransmitters. It could be your illness.
If I were bipolar, I would forget SSRIs and try Wellbutrin alone. (this is only my opinion based on anecdotal evidence)
Chances are good that Zoloft will give you a similiar or worse response than Prozac (if the drug is the culprit).
Imipramine can cause mania/hypomania in bipolar patients (which may be what you are describing, I don't know)

jook



I do believe that Prozac is the culprit. I've tried other AD's and this only happens with Prozac. I did try Wellbutrin alone and it was awful. I couldn't think straight, it affected my speech, not good, however I have to say at the time my doctor had said I could just stop the Prozac and start the Wellbutrin immediately, so could have been that but when I stopped the Wellbutrin 4 days later and started taking Prozac again I felt fine.
My newest pdoc has diagnosed me with Dysthymia with Major Depressive episodes.
Thanks for your help.

Karen
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#5 Jerod Poore

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Posted 11 May 2008 - 09:59 AM

One big difference is that Zoloft can affect dopamine, where Prozac doesn't affect it. For some folks, the little kiss to the dopamine receptors is what they need.


Stahl writes that Zoloft affects dopamine enough that it should be in its own class of multiple reuptake inhibitor antidepressants. It's more than a little kiss.

As jook writes Prozac affects dopamine, just nowhere near as much as Zoloft. Prozac is the least "selective" of the SSRIs. Prozac is damn sloppy. Its method of action is more like a TCA, spilling over onto everything, which is why combining Prozac and Zyprexa into Symbyax really is the best combination of antidepressant and antipsychotic for bipolar and other refractory depression. The two are just so broad-spectrum.
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#6 KarenRB53

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Posted 11 May 2008 - 05:16 PM

One big difference is that Zoloft can affect dopamine, where Prozac doesn't affect it. For some folks, the little kiss to the dopamine receptors is what they need.


Stahl writes that Zoloft affects dopamine enough that it should be in its own class of multiple reuptake inhibitor antidepressants. It's more than a little kiss.

As jook writes Prozac affects dopamine, just nowhere near as much as Zoloft. Prozac is the least "selective" of the SSRIs. Prozac is damn sloppy. Its method of action is more like a TCA, spilling over onto everything, which is why combining Prozac and Zyprexa into Symbyax really is the best combination of antidepressant and antipsychotic for bipolar and other refractory depression. The two are just so broad-spectrum.



Because Prozac has stopped working and I have to find another medication, as I said, my doctor suggested...Zoloft (which from the postings I don't think is the way to go because I think it will cause the horrible inner restlessness that I already get from Prozac......Prozac with a low dose of Wellbutrin because even though I have the inner agitation I also have no motivation to do anything (struggle to get out of bed most mornings).....or lastly he suggested trying Imipramine. Can I ask, in your opinion, which would be the best to try??? This new pdoc thinks the Prozac causes akathasia and that I'm not bipolar. I certainly have been on Prozac long enough to know that if this is as good as it gets, I 'd rather not be here. Its almost becoming an obsession, I just keep looking and looking and trying to find the answer. Feeling very fragile, like I'll split apart eventually. Sorry for rambling.
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#7 KarenRB53

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Posted 12 May 2008 - 08:55 AM

This new pdoc thinks the Prozac causes akathasia and that I'm not bipolar.



This is what I suspected by your description of 'inner restlessness'.

Maybe it's time to try something completely different. Maybe Lamictal ot lithium? Or God forbid, Abilify?

jook



I talked to pdoc this morning and he wants me to try one more thing with Prozac...he wants me to add WellbutrinSR to see what happens. Any opinions on this?

Karen
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#8 remote_swimmer

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Posted 12 May 2008 - 12:13 PM

I have a similar diagnosis and Prozac made me feel hazy (it was difficult to think) and more anxious at the same time.

Have you thought of Paxil? It tends to be pretty sedating which makes it good for anxiety symptoms. I found it to be a pretty effective for anxiety and depression.

One big difference is that Zoloft can affect dopamine, where Prozac doesn't affect it. For some folks, the little kiss to the dopamine receptors is what they need.


Stahl writes that Zoloft affects dopamine enough that it should be in its own class of multiple reuptake inhibitor antidepressants. It's more than a little kiss.

As jook writes Prozac affects dopamine, just nowhere near as much as Zoloft. Prozac is the least "selective" of the SSRIs. Prozac is damn sloppy. Its method of action is more like a TCA, spilling over onto everything, which is why combining Prozac and Zyprexa into Symbyax really is the best combination of antidepressant and antipsychotic for bipolar and other refractory depression. The two are just so broad-spectrum.



Because Prozac has stopped working and I have to find another medication, as I said, my doctor suggested...Zoloft (which from the postings I don't think is the way to go because I think it will cause the horrible inner restlessness that I already get from Prozac......Prozac with a low dose of Wellbutrin because even though I have the inner agitation I also have no motivation to do anything (struggle to get out of bed most mornings).....or lastly he suggested trying Imipramine. Can I ask, in your opinion, which would be the best to try??? This new pdoc thinks the Prozac causes akathasia and that I'm not bipolar. I certainly have been on Prozac long enough to know that if this is as good as it gets, I 'd rather not be here. Its almost becoming an obsession, I just keep looking and looking and trying to find the answer. Feeling very fragile, like I'll split apart eventually. Sorry for rambling.


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#9 KarenRB53

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Posted 12 May 2008 - 12:48 PM

I have a similar diagnosis and Prozac made me feel hazy (it was difficult to think) and more anxious at the same time.

Have you thought of Paxil? It tends to be pretty sedating which makes it good for anxiety symptoms. I found it to be a pretty effective for anxiety and depression.


No, I've never tried Paxil and its never been suggested either. I think thats partly because part of my depression is that I have no motivation whatsoever, have to force myself to even take a shower most days. I feel as if I weight a million lbs and its an effort to move.
Did you find that it worked as well as Effexor? Do you mind my asking why you stopped taking it?

Karen








One big difference is that Zoloft can affect dopamine, where Prozac doesn't affect it. For some folks, the little kiss to the dopamine receptors is what they need.


Stahl writes that Zoloft affects dopamine enough that it should be in its own class of multiple reuptake inhibitor antidepressants. It's more than a little kiss.

As jook writes Prozac affects dopamine, just nowhere near as much as Zoloft. Prozac is the least "selective" of the SSRIs. Prozac is damn sloppy. Its method of action is more like a TCA, spilling over onto everything, which is why combining Prozac and Zyprexa into Symbyax really is the best combination of antidepressant and antipsychotic for bipolar and other refractory depression. The two are just so broad-spectrum.



Because Prozac has stopped working and I have to find another medication, as I said, my doctor suggested...Zoloft (which from the postings I don't think is the way to go because I think it will cause the horrible inner restlessness that I already get from Prozac......Prozac with a low dose of Wellbutrin because even though I have the inner agitation I also have no motivation to do anything (struggle to get out of bed most mornings).....or lastly he suggested trying Imipramine. Can I ask, in your opinion, which would be the best to try??? This new pdoc thinks the Prozac causes akathasia and that I'm not bipolar. I certainly have been on Prozac long enough to know that if this is as good as it gets, I 'd rather not be here. Its almost becoming an obsession, I just keep looking and looking and trying to find the answer. Feeling very fragile, like I'll split apart eventually. Sorry for rambling.


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#10 sorrel

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Posted 12 May 2008 - 12:54 PM

I feel as if I weight a million lbs and its an effort to move.


This is a specific symptom called "leaden paralysis" and is a clue to what kinds of drugs you may respond to. This type of depression often responds to mood stabilizers, and also to MAOIs.

I'm sorry, I don't remember your history but have you tried Lamictal?
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#11 KarenRB53

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Posted 12 May 2008 - 01:00 PM

I feel as if I weight a million lbs and its an effort to move.


This is a specific symptom called "leaden paralysis" and is a clue to what kinds of drugs you may respond to. This type of depression often responds to mood stabilizers, and also to MAOIs.

I'm sorry, I don't remember your history but have you tried Lamictal?




Yes, I've tried Lamictal twice. Both times it caused anxiety and agitation. I started at 12.5mg and got up to 25mg but had to stop taking it. I was taking it with Prozac though so I don't know if that makes a difference. My pdoc hesitates to try MAOIs because I have high blood pressure which is well treated and consistently at a good level with medication.

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#12 remote_swimmer

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Posted 12 May 2008 - 01:38 PM

No, I've never tried Paxil and its never been suggested either. I think thats partly because part of my depression is that I have no motivation whatsoever, have to force myself to even take a shower most days. I feel as if I weight a million lbs and its an effort to move.
Did you find that it worked as well as Effexor? Do you mind my asking why you stopped taking it?

Karen


I know how you feel and if you have been on Zoloft for a while then it might not be the med for you. I found that Zoloft eventually pulled me out of my depression, but it took a really long time and it also made me feel more medicated than any other AD I've ever taken.

They affect me slightly differently. Paxil made me feel better but also kind of demotivated and unambitious. I don't mean "apathetic" or "unmotivated," but mostly like everything was just fine and I didn't have to put much effort into anything. It also made me gain weight. Given the alternative of depression and anxiety though, I'd be happy with that mental state.

Effexor is more motivating but slightly inconsistent. By that I mean that it works 95% of the time, but I will have breakthrough anxiety every now and again. The anxiety never escalates very much, but it can be annoying for a day or so. On the other hand, Effexor is more transparent (that is, I feel less medicated and more like my normal self). It is also very activating--that is, I feel like I've had a cup of coffee and I want to do stuff. In constrast, Paxil is somewhat sedating which is good if you're anxious.

These are my experiences, and as you know, YMMV.

I stopped taking Paxil because I tried to get off meds (with the consent of my pdoc). That didn't work out so well. Anyways, I decided to go back to Effexor because I found it more motivating and it is weight-neutral for me.
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#13 KarenRB53

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Posted 12 May 2008 - 04:37 PM

Yes, I've tried Lamictal twice. Both times it caused anxiety and agitation. I started at 12.5mg and got up to 25mg but had to stop taking it. I was taking it with Prozac though so I don't know if that makes a difference.


Sure it would make a difference if Prozac is causing these symptoms alone.
The only way to get rid of the symptoms is to counteract the mechanism in Prozac that is causing the symptoms and Lamictal won't do it.
If it is akathisia, Wellbutrin may do it.
A sure bet would be a beta blocker such as Inderal.

But I go back to my last post.
Try Lamictal or Li or (eek) Abilify, ALONE.

jook




How does a beta blocker such as Inderal counteract the akathisia? Or Wellbutrin for that matter?
Thanks so much,
Karen
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#14 In_Remission_SherryAR

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Posted 17 July 2008 - 06:00 PM

One big difference is that Zoloft can affect dopamine, where Prozac doesn't affect it. For some folks, the little kiss to the dopamine receptors is what they need.



The dopamine is great for my ADD!


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