as treatments for depression, anxiety & more
I <3 Paxil
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Table of Contents (hide)
1. SSRIs - The World’s Most Popular Antidepressants
- Celexa / Cipram / Cipramil / Citalon / Citapram ( citalopram )
- Lexapro / Cipralex / Seroplex ( escitalopram )
- Luvox / Fevarin / Faverin ( fluvoxamine )
- Paxil / Aropax / Seroxat ( paroxetine hydrochloride) & Pexeva (paroxetine mesylate)
- Prozac / Deprexin / Fludac / Fluxil / Modipran / Prodep ( fluoxetine )
- Zoloft / Atruline / Lustral ( sertraline )
- Viibryd ( vilazodone ) - Viibryd is technically not an SSRI, as it is also a partial 5-HT1A agonist. But when you have a med that is essentially the same as taking Paxil and BuSpar, but with fewer drug-drug interactions, I may as well list it here as well as on the page of Miscellaneous Antidepressants because people are probably going to be calling it an SSRI like they call Effexor an SSRI.
2. Brief history of SSRIs
The original SSRI, zimelidine, made its debut in March 1972. It was developed by Drs. Arvid Carlsson and Hans Corrodi, and is based upon the antihistamines brompheniramine (Dimetapp), chlorpheniramine (Chlor-Trimeton), and diphenhydramine (Benadryl).
Soon other SSRIs were under development. Lundbeck’s citalopram was being developed at about the same time, although it wasn’t approved until 1989. DU 23000 - the designation used prior to the assignment of the generic name fluvoxamine - was being tested for depression as far back as 1977. Solvay released fluvoxamine as Fevarin in Switzerland in 1984, although it wasn’t approved in the US until 1993. According to Wikipedia Upstene (indalpine) was marketed in France from 1982 to 1987. The story about why it was pulled and other details are different than what is in David Healy’s Let Them Eat Prozac, but at least that book confirms Upstene’s existence in France in the 1980s. Indalpine may still be available somewhere.2 Eli Lilly’s Prozac (fluoxetine) received approval from the US FDA in 1987 and the rest quickly followed.
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3. SNRIs - The Antidepressants People Love to Hate.
The data are contradictory regarding how effective Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) are compared with SSRIs. When it comes to treating neuropathic pain SNRIs generally work a lot better, especially the ones that have more of an effect on norepinephrine (NE). Savella (milnacipran) has much greater effect on norepinephrine than serotonin (5HT)3, while Effexor is essentially an SSRI until you’re taking 187.5–225 mg a day, give or take 37.5 mg. Depression and anxiety are something else. On one hand SSRIs are easier to deal with, on the other SNRIs are far less likely to poop out (tachyphylaxis).
- Cymbalta / Xeristar ( duloxetine )
- Effexor / Efexor / Alventa / Efectin / Venlax / Venlift ( venlafaxine )
- Pristiq ( desvenlafaxine )
- Savella / Ixel / Dalcipran ( milnacipran ) - in the US Savella is approved only to treat fibromyalgia. Outside of the US Ixel/Dalcipran is an antidepressant.
- Fetzima ( levomilnacipran ) - Basically an extended-release version of Savella that’s approved as an antidepressant in the US.
4. SSRI & SNRI topics
- What SSRIs & SNRIs are used for.
- Why SSRIs & SNRIs are so popular, but are they right for you?
- Common side effects of SSRIs & SNRIs.
- SSRI/SNRI discontinuation syndrome.
- SSRI/SNRI poop-out (tachyphylaxis) & equivalences.
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1 We prefer Dr. Preskorn's serotonin-selective reuptake inhibitor (as well as norepinephrine-selective and whatever_monoamine-selective) because:
1) It's grammatically correct. "Selective serotonin" is a clumsy way to describe how reuptake inhibitor is supposed work on a single neurotransmitter. Even if most of them fail at being all that selective.
2) It allows for unambiguous initialisms / acronyms. SNRI means Serotonin-Norepinephrine Reuptake Inhibitor and NSRI means Norepinephrine-Selective Reuptake Inhibitor. Otherwise SNRI could mean either Serotonin-Norepinephrine Reuptake Inhibitor or Selective Norepinephrine Reuptake Inhibitor.
2 Several China-based pharmaceutical manufacturers offer Indalpine for sale. E.g. Beijing JHYB Pharm. Tech. http://www.jhyb.com.cn/hc_en/C0515.htm
3 Little wonder Forest went for the fibromyalgia approval instead of banging their heads against the wall for an increasingly difficult to get depression approval. Plus: there's more money in pain than in the overly-saturated depression market. And, prior to the development of Fetzima and subsequent crackdown on such things, they knew doctors would write off-label prescriptions for it in any case.
|Last modified on Friday, 01 May, 2015 at 12:41:34 by JerodPoore||Page Author: Jerod Poore||Date created: 26 November 2010|
All drug names are the trademarks of someone else. Look on the appropriate PI sheets or ask Google who the owners are. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of any trademarks may have changed without my noticing.
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Almost all of the material on this site is by Jerod Poore and is copyright © 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, and 2015 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and something along the lines of following disclaimer, I’m usually cool with it.
All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else. Plus we are big pottymouths and talk about S-E-X a lot.
Know your sources!
Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
All information on this site has been obtained from the medications’ product information / summary of product characteristic (PI/SPC) sheets and/or medication guides - which is all you get from sites like WebMD, RxList,
NAMBLA NAMI, etc., the sources that are referenced throughout the site, our personal experience and the experiences family, friends, and what people have reported on various reputable sites all over teh intergoogles. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or medication guide/patient information leaflet (PIL) that comes with your medications and never ever throw them away. OK, you can throw away duplicate copies, but keep at least one, as that’s your proof of purchase of having taken a med in case a doctor doubts your medical history. Plus they take up less space than a bottle, although keeping one inside of a pill bottle is even better.
Crazymeds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
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‘Everything is true, nothing is permitted.’ - Jerod Poore
1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.
2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.
3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas?* I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion of anonymity. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.
* Yes, I know I’m using open source browsers. I also test the site using the now-defunct IE and Safari browsers. Their popularity - and superiority - killed IE and Safari, so that’s why I rely on the open source browsers. It’s like brand vs. generic meds. Sometimes the generic is better than the brand.