# SSRI for someone who can't tolerate SSRI's?



## Thomas Paine (Mar 29, 2008)

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## meyaj (Sep 5, 2009)

Lexapro and Zoloft are widely regarded as having the best efficacy/tolerability profile.


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## JayDontCareEh (Jul 16, 2007)

Yea I'm fairly sensitive to ssri's too. After having tried pretty much all of them I can say that the easiest one on the system for me is Celexa (Citalopram). 

All of the side effects pretty much disappeared after about 3-4 months and I didn't gain weight or nothing. 

I have no complaints, really.


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## Jcq126 (Jan 11, 2010)

I've been on Celexa for close to 6 weeks and it's changed my life. I had side effects for the first 3 days but since then it's been smooth sailing. I have ZERO weight gain, zero ejaculation problems and have no apathetic behaviour etc I highly recommend Celexa (i'm on 20mg currently).


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## meyaj (Sep 5, 2009)

Lexapro and Celexa are basically the same drug. The difference is that Lexapro is one side of the mirror image, while Celexa is both sides. If the other side is inactive, you would think Lexapro is twice as potent, but it's actually 3-4 times, because what's interesting is that the other side of the mirror image in Celexa opposes the "Lexapro" side and makes it substantially weaker. So you will get a lot less effectiveness from a similar dose of Celexa, but not necessarily side effects lessened to match accordingly. Celexa is pretty universally considered to be the weakest of the SSRIs, and a dose like 20mg is so weak that you can't even get a dose of Lexapro like that without breaking the weakest tab in half.

So it really depends what you want. Both Lexapro and Zoloft are considered the most effective of the bunch for a given level of side effects. The fact that Celexa comes in doses equivalent to almost a quarter of the smallest Lexapro pill will probably mean less side effects, but it will certainly mean less effectiveness as well. Once you push the Celexa dose up to the potency of a normal Lexapro dose, if anything you can expect to deal with a bit more in terms of side effects.


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## jim_morrison (Aug 17, 2008)

meyaj said:


> Lexapro and Celexa are basically the same drug. The difference is that Lexapro is one side of the mirror image, while Celexa is both sides. If the other side is inactive, you would think Lexapro is twice as potent, but it's actually 3-4 times, because what's interesting is that the other side of the mirror image in Celexa opposes the "Lexapro" side and makes it substantially weaker. So you will get a lot less effectiveness from a similar dose of Celexa, but not necessarily side effects lessened to match accordingly. Celexa is pretty universally considered to be the weakest of the SSRIs, and a dose like 20mg is so weak that you can't even get a dose of Lexapro like that without breaking the weakest tab in half.


Yeah Celexa is a racemic mixture of R-citalopram and S-citalopram. 
S-citalopram being what lexapro is and the active part of celexa. And R-citalopram basically causes antihistaminergic effects, CYP2D6 inhibition and SSRI-opposing effects. So Lexapro or S-citalopram is basically the quintessential SSRI, since it's the purest SSRI on the market.


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## meyaj (Sep 5, 2009)

Thomas Paine said:


> Lexapro sounds like my best bet, at the lowest possible dose.


It may be worth it to start at the lowest dosage unit available, and work your way up if you need to, although for the record, Lexapro was my first SSRI or psychiatric prescription ever and even then I was put on the highest dose immediately and experienced no side effects whatosoever. It's a vey tolerable drug, I'd even give the 20mg if I just wanted to get it over with.



Thomas Paine said:


> And I can get that for free since I have *no insurance.*


Is that a typo or is it opposite land? April Fool's was 3 days ago!


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## meyaj (Sep 5, 2009)

Thomas Paine said:


> No typo. I *don't* have a job *or* insurance. My parents help me out quite a bit, and I try not to pay for any health service unless the doctor forces me to pay at the time of service. I actually owed my last doctor about $3k. Probably why she treated me like ****. And it's the reason I have to use the ER more then I'd like to.
> 
> Anyway, when you don't have insurance the drug companies will send you the name brand drugs for free though. You and your doctor just have to fill out a form. For instance - Provigil costs almost $500/month without insurance, but I will be getting it for free in a couple of weeks. Same with Zyprexa. And soon to be with Lexapro. The only ones I will have to keep paying for are Clonazepam and Vicodin generics, which are both dirt cheap.
> 
> Here is the website for it: http://www.pparx.org/


Ah, I've heard the actual spots available in these programs are quite low. I'm on Disability anyways lol I can think of one person here who has a stroke just hearing this :lol) so I get the vast majority of my drugs free. Including meds I'm on for pain (and one to protect against ulcers FROM one of the meds), I'm on 7 medications right now  but I only pay for the zopiclone, $35/month.

My parents were paying a fortune and they're kind of anti-medication to begin with, so they gave me a LOT of grief over it. Having them covered by Disability takes a ton of stress off, the $1,000 I get each month is really just a bonus that I could easily just as well do without (being housebound I don't really have a ton of things to spend on), but they WON'T let me just take the benefits. But... even though my parents aren't paying for them anymore they still act like it's their business and don't make it clear at every possible opportunity that they don't approve of ANY medication


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## IllusionalFate (Sep 10, 2008)

I recommend trying Lexapro, but since it's under patent it's an expensive med. Zoloft is much cheaper though and also is very tolerable, so try whichever one you can afford.


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## Rymdis (Mar 14, 2010)

Ive been on Celexa, Lexapro and Zoloft. Zoloft and Celexa didnt do anything for my SA. Lexapro which is more potent than Celexa did *something* anyway  Took the edge of it but not more 

No weight gain on these. A bit tired on Lexapro and celexa if i can remember right. Was a long time ago.

If you dont want side-effects, stay away from Paxil!!!!  Its the best of the SSRI's, for me anyway. But not worth it.

/R


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## Arisa1536 (Dec 8, 2009)

i would suggest zoloft as its stronger well in my experience it was stronger and worked better but zoloft is basically paxil or so my doctor told me anyway, back in 2005 my old doctor said that paxil (arapax) was basically zoloft so unless she is lying and why would she? they are all relatively the same

SSRI's all work the same
some are lower in potency than others

personally being honest here, try an SNRI
they work great for people who do not respond well to standard SSRI antidepressants and they will not usually put you on an MAOI straight away, the doc would most likely go down the SNRI path first


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## Canadian4Life (Sep 27, 2010)

Took celexa,paxil,effexor,mirtazapine and zoloft. Only zoloft left me feeling like myself. I don't feel like i'm taking an ssri at all. It is helping my SA and depression alot too. It's a really calming med for me. celexa is said to be the softest but it gave me as much side effects as paxil did..and at least paxil let me sleep!


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## wjc75225 (Jul 24, 2010)

Luvox didn't really help my SA, but it did help my OCD when I was younger. It had the least side-effects of any of the SSRI's I took, and I've taken most of them.


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