# Most effective SSRI/SSNRI?



## ml105 (Jul 8, 2011)

Hi,

I've suffered from social anxiety for a long time and have always been curious about medication for it. So this is long over due, but I've finally made an appointment with a GP doctor.

From the research I've done the four most common drugs are Paxil, Zoloft, Luvox, and Effexor. I'm shying away from Paxil since everyone says it has the highest incidence of weight gain. I've struggled with mild anorexia and binge eating in the past, and I'm at a great weight now so I'd rather not open that can of worms if possible. 

With Zoloft I've read a lot of reviews that it makes people numb. So that's not at the top of my list either.

So I guess that leaves Luvox and Effexor at the top of my list. I'd love to get opinions from those who have tried Paxil/Zoloft as well as Luvox/Effexor and how they compared. Are they all pretty similar as far as effectiveness? Or is there a general opinion that one is more effective than the other? Am I way over-thinking this? lol

Also, I don't even know if the doctor will be open to discussing different drugs with me. Is it ok to express my concerns with Paxil/Zoloft? I don't want to come off seeming argumentative especially since I'm going off Wikipedia knowledge. :um


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## swim (Apr 4, 2011)

don't read too much. you'll never know how is a medication until you take it. then you can say if it's good for you or not.


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## ml105 (Jul 8, 2011)

Yah I know medications effect everyone differently, but I'd still like to get opinions from those who have tried more than one of these drugs, and which one they found to be more effective. It's just my nature to research everything to death and I'd love to hear some personal experiences.


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## vvv (Mar 22, 2011)

Hey my experience with zoloft was great, it felt as if i just started living my life. I felt numb (emotionless) BEFORE taking it because of my anxiety and depression, but 2 weeks into the treatment i felt as if though i had my life back and i was able to laugh, cry, share my feelings and make some really good friends. Just be aware of the weight gain!


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## ml105 (Jul 8, 2011)

^ That's great to hear (the getting your life back  ) but the weight gain part really worries me.

I've read that taking omega 3 capsules can help produce leptin which in turn can help stave off weight gain. Has anyone tried this?

I know I might seem overly worried about this, but weight gain would be a serious problem for me since I get pretty depressed if I'm heavier than my ideal weight.


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## Alduriam (Jun 30, 2011)

Effexor XR has helped me alot personnally.


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## Inshallah (May 11, 2011)

I've taken all 4 of them so ask away. Best for social anxiety: Paxil. Worst for social anxiety out of that bunch: Effexor.

On the weight gain: this seems to keep persisting, count calories and you won't have a problem. Some of these make you overeat when not holding accurate track of food intake. Although typically anything that increases serotonin should decrease cravings/appetite. You HAVE take accountability, otherwise you can blame everything on the pills/chemistry...


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## ThirdEyeGrind (Feb 7, 2006)

Paxil and Zoloft are the two medications that helped me the most out of the SSRI's I was prescribed.


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## michael10364 (Feb 4, 2011)

prozac is probably the best one for social anxiety that i tried. although it numbed my emotions a bit, it made up for it by making me feel more comfortable around people. the other ones i tried were cymbalta, zoloft, and effexor. the effexor numbed my emotions wayyyy to strongly. I also hear about hydroxyzine(brand name called called vistaril) being good for social anxiety with fewer side effects than antidepressants.


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## ml105 (Jul 8, 2011)

Thanks for the replies everyone. So I'm kind of getting the general idea from this forum that Effexor is a real b*tch as far as withdrawal symptoms. That's no bueno; I guess if the doctor wants to prescribe that I'll lobby against it.



> On the weight gain: this seems to keep persisting, count calories and you won't have a problem. Some of these make you overeat when not holding accurate track of food intake. Although typically anything that increases serotonin should decrease cravings/appetite. You HAVE take accountability, otherwise you can blame everything on the pills/chemistry...


This is good to hear. I exercise on a regular basis and I can definitly count calories. As long as the weight gain is something that can be managed then I would be willing to take Paxil.

Anyone have experience with Luvox? Did it help your SA?


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## DistinctlyAmbiguous (Aug 23, 2009)

ml105 said:


> Anyone have experience with Luvox? Did it help your SA?


Yes for about 5 months. It helped with OCD symptoms, but I did not continue as I felt no difference with SA and depression, just zombie like symptoms.


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## Arisa1536 (Dec 8, 2009)

I also have had the most success with Effexor XR
its off label uses include treating binge eating disorders and that was one of the things that led me to accept them and they really work well for eating disorders 

I found fluoxetine terrible, it made me severely manic and overweight but for people without bipolar or manic tendencies its meant to be effective for eating disorders but the people i know on it just said they felt like vomiting all the time on it

Paxil no doubt has the most severe side effects while you are on it
Weight gain, nausea, insomnia and lethargy are bad but on the plus side paxil is actually good for OCD and SA, it was better than any SSRI and TCA i have tried and certainly better than any antipsychotic

I would personally take luvox first just because the side effects do not appear as severe as the rest and withdrawals from it are not horrendous like effexor and paxil

while i tend to advocate effexor, i am aware its not for everyone
it does decrease depression and anxiety slightly and has been brilliant for OCD and Bulimia but you need something to augment it with, however at first it can be rather euphoric and sedating. When they kick in after about a month to a month and a half you feel as though you are floating on a cloud, it lasted six months for me without any need for benzos or other drugs and i was basically to happy and contented to eat large amounts of food:b

with all SSRI/SNRI meds the honeymoon period is short lived and wears off although more people report placebo effects in the weaker SSRIs like celexa and even fluoxetine as opposed to paxil and zoloft

All of the drugs you mentioned have the potential to cause sexual dysfunction (highest in paxil) and off course when you stop taking them there is 
SSRI discontinuation syndrome 

to couteract the discontinuation alot of people switch from say paxil or effexor to fluoxetine to soften the withdrawals and yeah that did help me a lot when i switched from paxil as fluoxetine eradicated the withdrawals despite having its own manic weight gain side effects it was not a physically painful experience


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## ml105 (Jul 8, 2011)

Thanks for the detailed reply! So when you say you had the most success with Effexor was that for treating social anxiety? Or were you talking more about binge eating and OCD?


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## Canadian4Life (Sep 27, 2010)

Have ADHD and social phobia.. I have been on effexor,paxil,zoloft,celexa,mirtazapine. Most gave me a nervous energy, effexor made me depressed and very dysphoric and I tried to overdose...it was bad stuff. All in all zoloft was the only one I could tolerate and it works good too! I'm still on a low dose and feel this is probably the only antidepressant that will work as well for me.


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## Arisa1536 (Dec 8, 2009)

ml105 said:


> Thanks for the detailed reply! So when you say you had the most success with Effexor was that for treating social anxiety? Or were you talking more about binge eating and OCD?


thats okay 
Well Effexor helped GAD and depressive symptoms at first which in turn made my sociability higher but long term its really been more of an appetite suppressant/controller and has been consistent in keeping my OCD down and over all the depression only comes and goes now, its not constantly hovering over me, forcing me to hurt myself or take copious amounts of pills, those episodes still come but they are fewer than before effexor.
on paxil i was anxious and suicidal almost everyday
SSRIs offer little reprieve form depression and bipolar depression

Are you able to ask about trying a non SSRI/SNRI?
Remeron or wellbutrin or something?


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## ml105 (Jul 8, 2011)

> Are you able to ask about trying a non SSRI/SNRI?
> Remeron or wellbutrin or something?


I could, I'm just not familiar with those two drugs. I guess I thought SSRI/SNRIs were the only drugs actually approved for the specific treatment of social anxiety.

I suppose I'm a mild case since I'm functional (well semi) in everyday life, but I'm going to grad school and I think if I could get this under control I would get so much more out of it. As I am now, I'm very very avoidant which makes school participation extremely difficult (pretty much have diagnosed myself with avoidant personality disorder). And public speaking gives me panic attacks.

But I'm open to considering other drugs. I just don't have the knowledge.


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## jim_morrison (Aug 17, 2008)

Everyone's gonna react differently so it's hard to say, but of the few I've tried, I'd probably start off with Lexapro, just because it was fairly mild in the side effect department, whilst still having decent anti-anxiety and antidepressant effects, so it was a decent trade off.


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## Arisa1536 (Dec 8, 2009)

ml105 said:


> I could, I'm just not familiar with those two drugs. I guess I thought SSRI/SNRIs were the only drugs actually approved for the specific treatment of social anxiety.
> 
> I suppose I'm a mild case since I'm functional (well semi) in everyday life, but I'm going to grad school and I think if I could get this under control I would get so much more out of it. As I am now, I'm very very avoidant which makes school participation extremely difficult (pretty much have diagnosed myself with avoidant personality disorder). And public speaking gives me panic attacks.
> 
> But I'm open to considering other drugs. I just don't have the knowledge.


Well effexor is in the more novel class of drugs now similar to that of wellbutrin which is used for depression and GAD and other things. Its good for actually increasing libido rather than decreasing it and it helps weight stabalize rather than gain it

then theres remeron, a highly powerful knock out antidepressant but that comes with tons of annoying side effects


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## CD700 (Apr 22, 2010)

Arisa1536 said:


> Well effexor is in the more novel class of drugs now similar to that of wellbutrin which is used for depression and GAD and other things. Its good for actually increasing libido rather than decreasing it and it helps weight stabalize rather than gain it
> 
> then theres remeron, a highly powerful knock out antidepressant but that comes with tons of annoying side effects


Yeah remeron seems to have a massive success rate but poops out for everyone after around 2 months 
I have to disagree about the weight stabilizing on Effexor 
Its notorious for making people fat


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## mikoy (Aug 12, 2010)

Paroxetine for me.


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## swim (Apr 4, 2011)

the most effective antidepressant is the one I have yet to try.


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## ml105 (Jul 8, 2011)

So I'm officially on Zoloft. I'm starting out on 25 mg but I kind of doubt I'll see much of a change at this dose. Without even mentioning my weight gain concerns my doctor told me she hated Paxil because everyone seems to gain weight on it. She said Zoloft is more neutral as far as weight changes. So hopefully I won't have any issues with this. 

Sooo now I guess I just have to wait and see.


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## Cuauhtemoc (Jul 22, 2010)

I take paxil and it's great as you can read in my thread.
No weight gain, but I'm male and always had trouble keeping myself over 150lbs.
I hated being skinny

And I believe any SSRI will make you feel kinda numb, I mean, what is numb? As in emotionally numb? Sure, that is the point. Not physically numb(like anesthesia) obviously.
Being numb is great, suffering is bad.
I don't know about you guys, but I love feeling kinda like a robot, I mean, I don't care about other peoples suffering anymore, I don't get self conscious about anything, I just enjoy my life to the fullest.


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## CD700 (Apr 22, 2010)

Cuauhtemoc said:


> I take paxil and it's great as you can read in my thread.
> No weight gain, but I'm male and always had trouble keeping myself over 150lbs.
> I hated being skinny
> 
> ...


Yeah i am yet to find a AD that works and when i hear people complain about how the med makes them numb i'm like so effing what! 
That's what I want!!!


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## ml105 (Jul 8, 2011)

Well I hope I don't get to a point where, "I don't care about other people's suffering", since I view this as an essential part of being a good person. I'm not trying to knock you or be sarcastic, and maybe you're being a bit facetious with that comment; I hope so. 

I'm expecting a certain level of numbness of course, and I'm ok with that if it silences that inner nag in me that never let's me get fully comfortable.


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## Cuauhtemoc (Jul 22, 2010)

Haha yes, i thought about that too, but you know what, I prefer being a bad person and happy than being a good miserable person.
I didn't become a psychopath or anything, I don't wish harm on anyone and I can see what could harm people and I act accordingly.

But I mind my own business nowadays, before Paxil I was so conscious about not hurting other people feelings, not anymore, I come first now.
Yes, I'm exaggerating a bit, but that's part of propaganda isn't it? Hahaha, I'm like paxil number one defender.


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## Bacon (Jul 4, 2010)

Paxil is very potent.


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## ml105 (Jul 8, 2011)

Cuauhtemoc said:


> I didn't become a psychopath or anything, I don't wish harm on anyone and I can see what could harm people and I act accordingly.


lol no I wasn't trying to imply that. I guess I just mean that if I get to a point on a drug where I can't feel someone's pain, especially if I'm close to them, then I'd have to reconsider whether the drug is worth it because for me being able to empathize with someone is a big part of being able to connect with them. But I'm glad it's working well for you. I hope I get results that I'm happy with too.


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## BenJohnson (Sep 4, 2012)

25 years ago, I went through psychologists and meditation techniques - finally found relief at a true doctor -- a psychiatrist. He diagnosed severe depression and clinical anxiety. After trying many different meds, I wound up on Valium and Luvox. I first tried 10 different anti-depressants and none helped. 

Finally I came back to Luvox because that seemed to be the best at making me feel normal. I stayed on that medication for a long time at a reduced dose. Combined with some significant life changes to reduce stress, I could lead a normal life for 25 years.

Now, at age 66, I am suddenly feeling increased anxiety and depression - a new doctor has me on Xanax and Paxil. He said the other drugs loose their effectiveness in a short time (fooled me). 

The right combination of drugs is important to reduce the symptoms of both anxiety and depression. Xanax is a strong tranquilizer, so I am calmer. So far (about 1 week), Paxil has not kicked the depression. I am going to finish this prescription and if nothing happens I will go back to Luvox.

The point is there is no magic bullet. You have to look for the meds that help. You may find the answer quickly, or you may suffer through some unsuccessful trials. Just keep trying and be honest with your doctor. 

And don't worry about side effects (such as gaining weight). Exercise helps both conditions, so a good workout can keep the weight off and help you with the depression as well.


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## Inspiron (Nov 30, 2011)

I've tried a wide variety of drugs and most if not all of them were no good. I worry about side effects because those are important factors to consider.


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## basuraeuropea (Jul 25, 2012)

Inspiron said:


> I worry about side effects because those are important factors to consider.


agreed.

sometimes the side effects can be worse than the condition the medication prescribed is attempting to treat. i developed severe suicidal ideation while on lyrica/pregabalin for the treatment of generalized anxiety disorder and had never had thoughts of suicide prior. lyrica's pi sheet lists depression, suicidal thoughts and behavior as potential side effects.

but to answer the OP's question - paxil/paroxetine was amazing until it stopped working.


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