SSRIs

Question:

Anyone know of an on-line pharmacy where I can get prozac (generic) w/o a prescription?  I’ve been taking it for years, but don’t currently have health insurance.

Response:

> Anyone know of an on-line pharmacy where I can get prozac (generic) > w/o a prescription?  I’ve been taking it for years, but don’t > currently have health insurance.

Those online pharmacies that will prescribe for you will end up costing you more than a doctor’s visit without insurance. They have a high "consultation fee", charge more (in most cases) for the drug than your local pharmacy, and there are rumors that often they are selling outdated meds. ALSO, if you go to a doctor, they may be able to hook you up with a program for reduced cost meds. All the drug companies have some kind of program.

Response:

> Anyone know of an on-line pharmacy where I can get prozac (generic) > w/o a prescription?  I’ve been taking it for years, but don’t > currently have health insurance.

healthcarepharma.com has 30 caps x 20 mg fluoxetine for $31. Is that a good price?

Response:

> > Anyone know of an on-line pharmacy where I can get prozac (generic) > w/o a prescription?  I’ve been taking it for years, but don’t > currently have health insurance. > healthcarepharma.com has 30 caps x 20 mg fluoxetine for $31. Is that a good > price?

Yes, that’s a good price.  Have you ever used them? The Dr.’s consult alone would cost me $180.  Some of the on-line places do it w/o consult or prescription.  That is if they’re legitimate.

Response:

> healthcarepharma.com

Hmmm I dunno, I don’t trust any site I can’t find any contact info on.

Response:

> healthcarepharma.com has 30 caps x 20 mg fluoxetine for $31. Is that a good > price? > Yes, that’s a good price.  Have you ever used them?

Yes, they’re an offshore supplier, mostly European pharmaceutical products, based on what I’ve gotten from them. Guaranteed delivery, and they seem to bend over backwards on the customer service side. That said, there’s a risk with any importation. I believe there’s a discussion of the issues, and their experience with US customers on the site, after you register. – Hide quoted text — Show quoted text -> The Dr.’s consult alone would cost me $180.  Some of the on-line > places do it w/o consult or prescription.  That is if they’re > legitimate.

Response:

Not all online pharmacies charge a consultation fee. I’ve used two of them. One from Mexico and one from India. Neither charged a consult fee. The one from Mexico is www.medsmex.com. – Hide quoted text — Show quoted text -> Those online pharmacies that will prescribe for you will end up costing you > more than a doctor’s visit without insurance. They have a high "consultation > fee", charge more (in most cases) for the drug than your local pharmacy, and > there are rumors that often they are selling outdated meds. > ALSO, if you go to a doctor, they may be able to hook you up with a program > for reduced cost meds. All the drug companies have some kind of program.

Response:

I’ve bought several prescriptions at www.medsmex.com. You can pay with Paypal and they’re shipped promptly. No prescription needed. Generic Prozac is $29.95 for 28 pills of 20 mg. strength.

– Hide quoted text — Show quoted text -> Anyone know of an on-line pharmacy where I can get prozac (generic) > w/o a prescription?  I’ve been taking it for years, but don’t > currently have health insurance.

Response:

Here’s another online pharmacy that does not require a consultation to order meds: www.1drugstore-online.com They have brandnames and generics. They carry Prozac, Paxil, Buspar, Wellbutrin, Celexa, etc.

– Hide quoted text — Show quoted text -> Anyone know of an on-line pharmacy where I can get prozac (generic) > w/o a prescription?  I’ve been taking it for years, but don’t > currently have health insurance.

Response:

Here’s another one. Try www.1drugstore-online.com No prescription needed. They have Prozac, Buspar, Wellbutrin, Celexa, Paxil, etc. both brand names and generics. 100 tabs of Prozac, 20 mg each, is about $75. You don’t need an online consultation to order.

– Hide quoted text — Show quoted text -> Anyone know of an on-line pharmacy where I can get prozac (generic) > w/o a prescription?  I’ve been taking it for years, but don’t > currently have health insurance.

Response:

http://www.medicinedrugstore.com/ Kills www.xenu.net

Response:

Question:

Anyone reading tried both the brand name and generic Prozac? Noticed any difference? (Question also applies to doctors who have prescribed both, or pharmacists who have heard feedback from customers.)

Response:

> Anyone reading tried both the brand name and generic Prozac? Noticed any > difference? (Question also applies to doctors who have prescribed both, or > pharmacists who have heard feedback from customers.)

They are identical.  All generic brands must be bioequivalent to the original.  There are a couple of medications, like morphine, for which different brands have genuinely different properties, but not fluoxetine (prozac).

Response:

> They are identical.  All generic brands must be bioequivalent to the > original.  There are a couple of medications, like morphine, for which > different brands have genuinely different properties, but not fluoxetine > (prozac).

Ahh…but the pretty packaging and higher cost of the Prozac(tm) will exert a nice placebo effect of its own, moreso i suspect than the generic fluoxetine… They should definately make the capsules bigger too or coat them in a really bitter tasting goo just for fun. Regards, Andrew Austin. — NLP, Neurology, Schizophrenia:  http://www.23NLPeople.com

Response:

>> They are identical.  All generic brands must be bioequivalent to the > original.  There are a couple of medications, like morphine, for which > different brands have genuinely different properties, but not fluoxetine > (prozac). >Ahh…but the pretty packaging and higher cost of the Prozac(tm) will exert >a nice placebo effect of its own, moreso i suspect than the generic >fluoxetine…

Or you could pay top dollar for Serafem…

Response:

> They are identical.  All generic brands must be bioequivalent to the > original.  There are a couple of medications, like morphine, for which > different brands have genuinely different properties, but not fluoxetine > (prozac).

Of course the active ingredient is identical. But can’t there be a difference in the fillers, excipients, etc. used in the tablets, and couldn’t that make a difference in absorption, etc.? With time-released the difference could be greater, no, as there could be a different method of time-releasing the med to the bloodstream?

Response:

Here is what Lilly says about generic prozac on their web site: "Generic fluoxetine is not identical to brand name Prozac in appearance. The generic prescription you pick up at the pharmacy won’t look like brand name Prozac. Receiving medication with a different color or shape may be unsettling or cause concern." So is the therapeutic effect of prozac due to its color and shape? Is it just a placebo effect after all? Also, the sarafem web site says nothing about sarafem being equivalent to prozac. Apparently, they don’t want the sarafem users to know that actually they are taking an antidepressant! cem

– Hide quoted text — Show quoted text ->> They are identical.  All generic brands must be bioequivalent to the >> original.  There are a couple of medications, like morphine, for which >> different brands have genuinely different properties, but not fluoxetine >> (prozac). >Ahh…but the pretty packaging and higher cost of the Prozac(tm) will exert >a nice placebo effect of its own, moreso i suspect than the generic >fluoxetine… > Or you could pay top dollar for Serafem…

Response:

> "Generic fluoxetine is not identical to brand name Prozac in appearance. The > generic prescription you pick up at the pharmacy won’t look like brand name > Prozac. Receiving medication with a different color or shape may be > unsettling or cause concern."

This is actually true.  The expensive brands say that ’substitution causes confusion’, and it actually does in my experience.  I’d still prescribe generically, though. > So is the therapeutic effect of prozac due to its color and shape? Is it > just a placebo effect after all?

Placebos can cure 1/3 of people who are cured by antidepressants.

Response:

> Of course the active ingredient is identical. But can’t there be a > difference in the fillers, excipients, etc. used in the tablets, and > couldn’t that make a difference in absorption, etc.?

It could, yes.  That’s why almost all medications must have the same pharmacokinetics to be approved for sale. > With time-released the difference could be greater, no, as there could be a > different method of time-releasing the med to the bloodstream?

Yes, definitely.  Some anti-inflammatories and narcotics are available in such preparations.

Response:

>This is actually true.  The expensive brands say that ’substitution causes >confusion’, and it actually does in my experience. > How much confusion? Difficulty finding the right word? Forgetting > where you live?

I find that many patients – in the order of 40% – cannot name their medications and doses.  And a similar number don’t know what their meds are for. Given this, I doubt very much that these patients are in fact taking their meds properly. Changing the colour and brand name on a packet every time they fill their prescription is just going to make this worse.

Response:

> I find that many patients – in the order of 40% – cannot name their > medications and doses.  And a similar number don’t know what their meds are > for.

That is amazing. If true, quite sad. > Given this, I doubt very much that these patients are in fact taking their > meds properly.

Yes, that could be dangerous. Hard to believe it’s true, though. > Changing the colour and brand name on a packet every time they fill their > prescription is just going to make this worse.

Why would the color change each time? If they are regularly taking the generic equivalent, wouldn’t it be the same each time?

Response:

I have not noticed any difference at all. Jackie Davidson

– Hide quoted text — Show quoted text -> Anyone reading tried both the brand name and generic Prozac? Noticed any > difference? (Question also applies to doctors who have prescribed both, > or > pharmacists who have heard feedback from customers.) > They are identical.  All generic brands must be bioequivalent to the > original.  There are a couple of medications, like morphine, for which > different brands have genuinely different properties, but not fluoxetine > (prozac).

Response:

the requirements on generic also include release time, the fillers may be different but they still have to come close to putting out the same dose at the same time in the same manner, although ive read w/ some meds just that extreemly brief difference could cause problems if your allready conditioned to one or the other for a long term and then try to switch….but this was said to be rare…

– Hide quoted text — Show quoted text -> I have not noticed any difference at all. > Jackie Davidson > > Anyone reading tried both the brand name and generic Prozac? Noticed any > > difference? (Question also applies to doctors who have prescribed both, > or > > pharmacists who have heard feedback from customers.) > They are identical.  All generic brands must be bioequivalent to the > original.  There are a couple of medications, like morphine, for which > different brands have genuinely different properties, but not fluoxetine > (prozac).

Response:

>> I find that many patients – in the order of 40% – cannot name their > medications and doses.  And a similar number don’t know what their meds > are > for. > That is amazing. If true, quite sad.

From my experience, I’d say its a bit lower. Maybe around 20% in my neck of the woods, but still staggeringly high. I sure as hell wouldn’t be popping pills just ‘cuz the doctor said so. > Given this, I doubt very much that these patients are in fact taking > their meds properly. > Yes, that could be dangerous. Hard to believe it’s true, though. > Changing the colour and brand name on a packet every time they fill > their prescription is just going to make this worse. > Why would the color change each time? If they are regularly taking the > generic equivalent, wouldn’t it be the same each time?

Not necessarily. Where I work, the corporation must be constantly reevaluating and renegotiating purchasing contracts. They frequently switch manufacturers for many of the generics, so not only do we confuse the patient when going from brand to generic, but also when the generics used are switched from one manufacturer to another.

Response:

> From my experience, I’d say its a bit lower. Maybe around 20% in my neck > of the woods, but still staggeringly high. I sure as hell wouldn’t be > popping pills just ‘cuz the doctor said so.

Check this – i used to nurse in cardiac surgery.  I guess it`s the age group we typically dealt with but the first question on admission i`d ask all patients was, "Tell me why you think you are here" to check their understanding of what was going on. At least once a week i`d have a patient who honestly didn’t have a clue – "Well, Son," they`d say, "my doctor thought it was best that i came in, i`ve been having trouble you see." Ok, i`d say, so any idea what we are going to do for you? "To get me some more of those tablets, right?" Wrong. One  guy came in for cardiac angiography didn`t have a clue – his doc gave him the appointment, he came in.  Never occured to him to ask, never occured to his doctor to explain.  Strange, strange world. Mind you, we had one lady who asked for one of those big jelly tablets for her constipation.  A suppository? I asked her.  "No, one of those big jelly things in a plastic wrapper." Turns out she`d been swallowing her glycerin suppositories for about 4 years. Apparently, it works quite well that way. Just a ramble. Regards, Andrew Austin. alive in Southampton, UK. — NLP, Neurology, Schizophrenia:  http://www.23NLPeople.com

Response:

says… – Hide quoted text — Show quoted text -> Of course the active ingredient is identical. But can’t there be a > difference in the fillers, excipients, etc. used in the tablets, and > couldn’t that make a difference in absorption, etc.? > It could, yes.  That’s why almost all medications must have the same > pharmacokinetics to be approved for sale. > With time-released the difference could be greater, no, as there could be > a > different method of time-releasing the med to the bloodstream? > Yes, definitely.  Some anti-inflammatories and narcotics are available in > such preparations.

What does "pharmacokinetics" actually mean in plain English?  I’m asking because I’ve definitely had different reactions to generics and brand name drugs with things other than ADs and I don’t really understand it. For example, one time I had a special fungal cream for a rash.  The DAW was fine and caused no problems.  Then my doctor wrote a prescription without DAW and I got a generic.  Perhaps it was the same active ingredient but the cream was loaded with perfume – it irritated the skin and therefore, the generic cream was not only useless, it was actually making things worse.  Supposedly they were the same thing but even the pharmacist recognized the problem and exchanged it for me. Louise

Response:

> What does "pharmacokinetics" actually mean in plain English?

Doctors differentiate between ‘pharmacokinetics’ and ‘pharmacodynamics’, and it’s a bastardization of the language.  Suffice to say, they’re a description of how a drug interacts with the body.  Specifically, how much of it is absorbed, how fast, how it is eliminated, how fast,whether it has active metabolites, etc. > ingredient but the cream was loaded with perfume – it irritated the skin > and therefore, the generic cream was not only useless, it was actually > making things worse.  Supposedly they were the same thing but even the > pharmacist recognized the problem and exchanged it for me.

When you’re talking about creams and things, it’s likely that companies will branch off and add their own ingredients.  People tend to buy over-the-counter medications on the strength of everything except its pharmacological value.

Response:

I have asked quite a few people taking various meds, what exactly are you taking? Their response was "I don’t know, I just take them cause I need them for my problem" It seems to me that most people are just to lazy to investagate or ask the Doctor what they are taking. They just like the idea of a quick fix to their problem, like the so called majic bullet and go on with their life.

Response:

>Here is what Lilly says about generic prozac on their web site: >"Generic fluoxetine is not identical to brand name Prozac in appearance. The >generic prescription you pick up at the pharmacy won’t look like brand name >Prozac. Receiving medication with a different color or shape may be >unsettling or cause concern."

I remember a hospitalized schizophrenic man who was given generic Thorazine instead of his usual brand name, and then next day he told us he had been given "Thorazine in Spanish" and refused to take anymore.

Response:

>>Here is what Lilly says about generic prozac on their web site: >"Generic fluoxetine is not identical to brand name Prozac in appearance. The >generic prescription you pick up at the pharmacy won’t look like brand name >Prozac. Receiving medication with a different color or shape may be >unsettling or cause concern."

Comment: Not if you look at it first in the bottle it usually comes in.  You’ll notice that Barr has done an *unusually* clever thing with their generic fluoxitine. The Barr product comes in capsules identical in shape to Prozac, but done in blue and light blue. When viewed through the yellow anti-UV of the standard pill bottle, these look EXACTLY like yellow-green brandname Prozac. SBH — I welcome email from any being clever enough to fix my address. It’s open book.  A prize to the first spambot that passes my Turing test. .

Response:

> Of course the active ingredient is identical. But can’t there be a > difference in the fillers, excipients, etc. used in the tablets, and > couldn’t that make a difference in absorption, etc.?

Generic brands must be *bioequivilant* – which means that there should not be a significant difference in absorption, etc. I’ll give you a little example. If you’re prescribed Prozac in Australia you can purchase Lovan, which is a generic brand on the Prozac prescription, providing that the doctor hasn’t checked the "Brand name only" box. There are propoxyphene tablets in Australia under the brand name of "Digesic" which contain 32.5 propox HCl and 325 mg paracetamol (acetaminophen.) The generics, Capadex and Paradex contain the SAME concentration of propoxyphene and paracetamol and yet cannot be purchased on a "digesic" script owing to the fact that the generic preparation is more bioavailable. > With time-released the difference could be greater, no, as there could be a > different method of time-releasing the med to the bloodstream?

With fluoxetine, I don’t believe this is an issue as there is only generic immediate release fluoxetine on the market (where I reside at least). The pharmacokinetics of fluoxetine (ie: its long half life, etc.) also make any difference owing to a change in the speed of absorption pretty irrelevant. -Mike — "Understand that legal and illegal are political, and often arbitrary, categorizations; use and abuse are medical, or clinical, distinctions." — Abbie Hoffman

Response:

> Also, the sarafem web site says nothing about sarafem being equivalent to > prozac. Apparently, they don’t want the sarafem users to know that actually > they are taking an antidepressant!

A short note on: http://www.sarafem.com/can_sarafem.html "Sarafem contains the same active ingredient as Prozac(R)" So the question is – are people (and the prescribing physicians) stupid enough to pay top dollar for a drug where there are generics available for cents a capsule? -Mike — "Understand that legal and illegal are political, and often arbitrary, categorizations; use and abuse are medical, or clinical, distinctions." — Abbie Hoffman

Response:

I had problems immediately with generic Prozac.  I had also been on Celebrex for 1 year and had been doing fine with the combination of Celebrex and brand name Prozac.  As soon as I started generic Prozac, I haddaily problems with nausea.  Cut out the Celebrex and I was OK.  Also, recently, I went into a bad depression.  Doc asked me how long I had been on generic Prozac. I told him several months.  He said to up my dose of generic, from 80 mg. to 100 mg. daily.  (He said, however, the best solution was to go back on brand name Prozac.  I told him there was no way I could do that ($$$).)   I increased the generic Prozac and I’m feeling better.  (Doc had also told me that 1 out of 4 of his patients have had problems with generic Prozac not being as effective as the brand name.) Editor

– Hide quoted text — Show quoted text -> Anyone reading tried both the brand name and generic Prozac? Noticed any > difference? (Question also applies to doctors who have prescribed both, or > pharmacists who have heard feedback from customers.)

Response:

> I had problems immediately with generic Prozac.  I had also been on Celebrex > for 1 year and had been doing fine with the combination of Celebrex and > brand name Prozac.  As soon as I started generic Prozac, I haddaily problems > with nausea.  Cut out the Celebrex and I was OK.

Celebrex has more of a reputation for causing stomach trouble than Prozac. > 100 mg. daily.  (He said, however, the best solution was to go back on brand > name Prozac.  I told him there was no way I could do that ($$$).)   I > increased the generic Prozac and I’m feeling better.  (Doc had also told me > that 1 out of 4 of his patients have had problems with generic Prozac not > being as effective as the brand name.)

I seriously doubt that statistic.  In order for the generic stuff to be licensed, it must be demonstrably identical to Prozac in every chemical property.

Response:

Question:

Myself, I find Prozac makes me lose weight, while I was on Lustral (Zoloft) I gained 2 stone. take care

– Hide quoted text — Show quoted text -> I am new to this newsgroup and needing some advice.  I’ve just been > prescribed prozac for the first time in my life and am wondering about > the potential side effects, particularly weight gain. > Some people report weight gain on Prozac, but it seems the most common > side effect is weight *loss*. Just like some people report feeling sleepy > on Prozac, while for most people it seems to reduce sleep. > I’ve just spent > months in the gym trying to get the weight off from being on > prednisolone for Crohn’s Disease and I really don’t want to start taking > something that is just going to put it all back on after all my hard > work. I’ve read conflicting reports about Prozac and weight gain and was > wondering what people’s personal experiences were. > For me it did’nt do much, as far as I remember, it might have suppressed > my appetite somewhat. I know people who take it and they all have > experienced weight loss. > Now, from what I understand, if your depression makes it so you eat more, > then taking Prozac will make you eat less. If depression makes you eat > less, then expect the opposite. That’s just a guess.

Response:

Changes in weight during a 1-year trial of fluoxetine by Michelson D, Amsterdam JD, Quitkin FM, Reimherr FW, Rosenbaum JF, Zajecka J, Sundell KL, Kim Y, Beasley CM Jr Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN 46285, USA. Am J Psychiatry 1999 Aug; 156(8):1170-6 ABSTRACT OBJECTIVE: Fluoxetine has been associated with weight loss during acute treatment, but no controlled studies of weight change during long-term treatment with fluoxetine or other selective serotonin reuptake inhibitors have been reported. Weights were assessed for patients whose depressive symptoms had disappeared with acute fluoxetine treatment. Patients were then randomly assigned to continuation treatment with fluoxetine or placebo. METHOD: Patients whose illness had remitted after 12 weeks of treatment with fluoxetine, 20 mg/day, were randomly assigned to receive up to 38 weeks of treatment with fluoxetine or placebo. Weight was assessed at each visit. Change in weight was analyzed during the initial 12 weeks of acute treatment and after 14, 26, and 38 weeks. Relationships between weight change and body mass index and between weight change and appetite change were assessed. RESULTS: During the initial 4 weeks of therapy, a mean absolute weight decrease of 0.4 kg was observed for all patients. Among patients who completed 50 weeks of therapy, the mean absolute weight increase during continuation treatment was similar for both the placebo- and fluoxetine-treated groups. Weight increase was not related to initial body mass index but was related to both poor appetite at study entry and to improvement in appetite after recovery. No patients discontinued therapy because of weight gain. CONCLUSIONS: Acute therapy with fluoxetine is associated with modest weight loss. After remission of depressive symptoms, weight gain for patients taking fluoxetine for longer periods is not different from that for patients taking placebo and is most likely related to recovery from depression. Prohibition Funds Terrorism

Response:

hey-   i’ve been on prozac off and on for 3 years. everytime i go on, i completely lose my appettite. i have HUGE problems with not even thinking about eating and losing so much weight!!! not healthy at all!! if u have an increased appettite just tell your doctor IMMEDIATELY. u don’t have to be taking it if it does that to you   Hope this helps!! -Katie

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Hi all, I am new to this newsgroup and needing some advice.  I’ve just been prescribed prozac for the first time in my life and am wondering about the potential side effects, particularly weight gain.  I’ve just spent months in the gym trying to get the weight off from being on prednisolone for Crohn’s Disease and I really don’t want to start taking something that is just going to put it all back on after all my hard work. I’ve read conflicting reports about Prozac and weight gain and was wondering what people’s personal experiences were. Thanks Karen

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Question:

BULLSHIT Joe

Response:

> BULLSHIT > Joe

Therapy can be very good. I know because I have tried it. I know about this sort of thing. Really.

Response:

WASHINGTON (Reuters) – Therapy is at least as effective in treating depression as drugs are, and its effects last longer, scientists said on Thursday in a report sure to annoy drug companies that make millions selling antidepressants. The cost of therapy is about the same as drugs short-term, and cheaper over the long term, the researchers told a meeting of the American Psychiatric Association. "This will be a surprising, controversial finding for many psychiatric professionals," Robert DeRubeis, chair of the psychology department at the University of Pennsylvania, said in a statement. "Most believe quite strongly in the efficacy of medication, and psychiatric treatment guidelines call unequivocally for medication in cases of severe depression." An estimated 20 million Americans suffer from depression, which can lead to suicide. DeRubeis and Steven Hollon of Vanderbilt University in Nashville studied 240 patients with depression to see if drugs or therapy worked better. "The question that has most often been asked in studies is, ‘What gets people better faster?"’ DeRubeis said. "We asked, ‘What will keep depression away over the long term?"’ Their patients got one of three treatments — 16 weeks of cognitive therapy, 16 weeks of antidepressants plus visits to a professional, or 16 weeks of placebo pills plus visits. Cognitive therapy is a type of talking-out treatment in which patients are helped to question their negative views of themselves. "By the 16-week post-treatment assessment, response rates were identical (57 percent) for both pharmacotherapy and cognitive therapy," the researchers said in their report. "Thus, these findings suggest that cognitive therapy may work more slowly in effecting change than does pharmacotherapy, but that by the end of a four-month course of treatment, patients who receive cognitive therapy fare as well as those who receive pharmacotherapy." Most — 75 percent — of the patients who got cognitive therapy avoided a relapse, compared to 60 percent of patients on medication and 19 percent of those receiving a placebo pill, they told the group’s annual meeting in Philadelphia. "These results suggest that even after termination, a brief course of cognitive therapy may offer enduring protection comparable to that provided by ongoing medication," DeRubeis said. THERAPY IS CHEAPER The 16 weeks of drugs cost an average of $2,590, compared with $2,250 for cognitive therapy, the researchers said. Over time, therapy may prove to be cheaper because patients have to continue taking antidepressants, the researchers said. "Some proponents of medication for severely depressed patients have suggested that cognitive therapy is impractical on the basis of cost," DeRubeis said. "Our study indicates that isn’t true, especially over the long term." The study is a sharp contrast to dozens of others being presented at the meeting that show the efficacy of one antidepressant over another. The market for antidepressants is huge — and profitable. Eli Lilly and Co. earned nearly $2 billion in 2001 from Prozac and Sarafem, two brand names of a drug known generically as fluoxetine used to treat depression and severe premenstrual syndromes. The study is not the first to challenge the assumptions underlying the use of drugs to treat depression. The idea behind the drugs is to change levels of brain chemicals — in the case of fluoxetine and related drugs the targeted chemical is serotonin, linked with mood. But two recent reports suggest that placebos not only work as quickly as drugs short-term, but affect the same areas of the brain.

Response:

BULLSHIT Joe

Response:

> BULLSHIT > Joe

Therapy can be very good. I know because I have tried it. I know about this sort of thing. Really.

Response:

WASHINGTON (Reuters) – Therapy is at least as effective in treating depression as drugs are, and its effects last longer, scientists said on Thursday in a report sure to annoy drug companies that make millions selling antidepressants. The cost of therapy is about the same as drugs short-term, and cheaper over the long term, the researchers told a meeting of the American Psychiatric Association. "This will be a surprising, controversial finding for many psychiatric professionals," Robert DeRubeis, chair of the psychology department at the University of Pennsylvania, said in a statement. "Most believe quite strongly in the efficacy of medication, and psychiatric treatment guidelines call unequivocally for medication in cases of severe depression." An estimated 20 million Americans suffer from depression, which can lead to suicide. DeRubeis and Steven Hollon of Vanderbilt University in Nashville studied 240 patients with depression to see if drugs or therapy worked better. "The question that has most often been asked in studies is, ‘What gets people better faster?"’ DeRubeis said. "We asked, ‘What will keep depression away over the long term?"’ Their patients got one of three treatments — 16 weeks of cognitive therapy, 16 weeks of antidepressants plus visits to a professional, or 16 weeks of placebo pills plus visits. Cognitive therapy is a type of talking-out treatment in which patients are helped to question their negative views of themselves. "By the 16-week post-treatment assessment, response rates were identical (57 percent) for both pharmacotherapy and cognitive therapy," the researchers said in their report. "Thus, these findings suggest that cognitive therapy may work more slowly in effecting change than does pharmacotherapy, but that by the end of a four-month course of treatment, patients who receive cognitive therapy fare as well as those who receive pharmacotherapy." Most — 75 percent — of the patients who got cognitive therapy avoided a relapse, compared to 60 percent of patients on medication and 19 percent of those receiving a placebo pill, they told the group’s annual meeting in Philadelphia. "These results suggest that even after termination, a brief course of cognitive therapy may offer enduring protection comparable to that provided by ongoing medication," DeRubeis said. THERAPY IS CHEAPER The 16 weeks of drugs cost an average of $2,590, compared with $2,250 for cognitive therapy, the researchers said. Over time, therapy may prove to be cheaper because patients have to continue taking antidepressants, the researchers said. "Some proponents of medication for severely depressed patients have suggested that cognitive therapy is impractical on the basis of cost," DeRubeis said. "Our study indicates that isn’t true, especially over the long term." The study is a sharp contrast to dozens of others being presented at the meeting that show the efficacy of one antidepressant over another. The market for antidepressants is huge — and profitable. Eli Lilly and Co. earned nearly $2 billion in 2001 from Prozac and Sarafem, two brand names of a drug known generically as fluoxetine used to treat depression and severe premenstrual syndromes. The study is not the first to challenge the assumptions underlying the use of drugs to treat depression. The idea behind the drugs is to change levels of brain chemicals — in the case of fluoxetine and related drugs the targeted chemical is serotonin, linked with mood. But two recent reports suggest that placebos not only work as quickly as drugs short-term, but affect the same areas of the brain.

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Question:

Here is a link to the 7 May 2002 article in The Washington Post regarding placebos versus antidepressants. http://www.washingtonpost.com/wp-dyn/articles/A42930-2002May6.html Cut and paste it into the address spot in your Internet browser.

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As if you didn’t know?

Response:

> But hasn’t EACH ONE of these anti depressants undergone trials for > effectiveness before approval and use by the general public? Part of that is > to be better than placebo. What am I missing?

Evidently the FDA requires that the drug manufacturer furnish data from at least 2 studies (so usually only data from 2 studies are provided) showing the drug to be better than placebos.  Sometimes manufacturers must conduct 5 studies (maybe even more!) to obtain 2 that show their drug has qualities that exceed those of the placebo. The studies not sent to the FDA to gain approval for the drug may show that the placebo performed better than the drug, or that the drug was not found to be better than the placebo with suitable statistical significance (based on the number of patients involved in the study, etc.). Evidently patients who learn they improved using the placebo are prone to sudden reversal of the gains of the non-drug placebo!  So how much of "getting better" is in the mind of the patient, that "thinking one has gotten better" is a major part of "getting better"?  We must all wonder…

Response:

But hasn’t EACH ONE of these anti depressants undergone trials for effectiveness before approval and use by the general public? Part of that is to be better than placebo. What am I missing?

– Hide quoted text — Show quoted text -> Placebos & Antidepressants Work the same Way > Antidepressants also cause additional brain changes > http://mentalhealth.about.com/library/weekly/aa050502a.htm > We have known for some time that patients given placebos (pills with no > active ingredient) often respond the same way that patients given > antidepressants. Their depression often lifts as a result of either > treatment. A new study (5/02) shows us that these two treatments both > cause similar changes in the brain. > Helen Mayberg, M.D., and her colleagues at the University of Texas > Health Science Center, San Antonio, used functional brain imaging to > study glucose metabolism in different parts of the brain following > treatment with either fluoxetine or placebo. The study was a > randomized, double-blind trial of 17 middle-aged men who were > hospitalized for unipolar depression. The researchers found that their > depressed male subjects who got better (four in each condition) > responded with increased cortical activity and decreased limbic > activity after six weeks of either treatment. Patients receiving > fluoxetine also showed changes in lower parts of the brain – in the > brainstem, striatum and hippocampus. These changes were not seen in > patients who received placebo. > A graphic illustration of the changes shows the similarities and > differences between the two conditions. > Composite PET (positron emission tomography) scan data, superimposed on > MRI (magnetic resonance imaging) scans, show brain areas that increased > (red) or decreased (yellow) in activity in men who responded to placebo > (top row) and fluoxetine (bottom row). Both groups shared a pattern of > increased activity in the cortex (e.g., prefrontal, posterior > cingulate) and decreased activity in limbic regions (e.g., subgenual > cingulate), which the researchers suggest is necessary for therapeutic > response. Men who responded to the active medication, in addition, > experienced decreased activity in certain lower brain areas (e.g., > hippocampus, anterior insula) thought to sustain the cortical/limbic > changes and prevent relapse. (Graphic and key courtesy of NIMH, 2002) > What does this all mean? There are several ways to think about this > study. One conclusion that we can draw is that the placebo effect is > real – and that the act of taking an inert substance (along with other > aspects of a hospital treatment program) can trigger certain changes in > the brain. In an interview with NIMH Dr. Mayberg cautioned against > equating antidepressants and placebos. "Our findings do not support > the notion that antidepressants work merely via a placebo effect. > Patients on active medication who failed to improve did not sustain the > brainstem, striatal and hippocampus changes unique to antidepressant > responders." Rather, the authors speculate that "clinical improvement > in the group receiving placebo as part of an inpatient study is > consistent with the well-recognized effect that altering the > therapeutic environment may significantly contribute to reducing > clinical symptoms. The additional subcortical and limbic metabolism > decreases seen uniquely in fluoxetine responders may convey additional > advantage in maintaining long-term clinical response and in relapse > prevention" (Mayberg, et.al., 2002). > This study is important because it helps us begin to understand how > antidepressants and other treatment techniques change the brain. We > are just beginning to understand the brain at this level, and further > research will undoubtedly build upon this foundation. We already know > that both psychiatric medications and psychotherapy result in changes > in the brain. This study begins to tell us how the brain changes. > Reference: > Helen S. Mayberg, J. Arturo Silva, Steven K. Brannan, Janet L. Tekell, > Roderick K. Mahurin, Scott McGinnis, and Paul A. Jerabek, The > Functional Neuroanatomy of the Placebo Effect, Am J Psychiatry 2002 > 159: 728-737. [Abstract available Online]

Response:

This surprises me. Worries me for some reason also. On one hand I think that my anti depressant probably works for me. (Indeed, speculation is that too much antidressants can set off a manic cycle.) On the other hand I KNOW that my other medications do control my mania.

– Hide quoted text — Show quoted text -> Placebos & Antidepressants Work the same Way > Antidepressants also cause additional brain changes > http://mentalhealth.about.com/library/weekly/aa050502a.htm > We have known for some time that patients given placebos (pills with no > active ingredient) often respond the same way that patients given > antidepressants. Their depression often lifts as a result of either > treatment. A new study (5/02) shows us that these two treatments both > cause similar changes in the brain. > Helen Mayberg, M.D., and her colleagues at the University of Texas > Health Science Center, San Antonio, used functional brain imaging to > study glucose metabolism in different parts of the brain following > treatment with either fluoxetine or placebo. The study was a > randomized, double-blind trial of 17 middle-aged men who were > hospitalized for unipolar depression. The researchers found that their > depressed male subjects who got better (four in each condition) > responded with increased cortical activity and decreased limbic > activity after six weeks of either treatment. Patients receiving > fluoxetine also showed changes in lower parts of the brain – in the > brainstem, striatum and hippocampus. These changes were not seen in > patients who received placebo. > A graphic illustration of the changes shows the similarities and > differences between the two conditions. > Composite PET (positron emission tomography) scan data, superimposed on > MRI (magnetic resonance imaging) scans, show brain areas that increased > (red) or decreased (yellow) in activity in men who responded to placebo > (top row) and fluoxetine (bottom row). Both groups shared a pattern of > increased activity in the cortex (e.g., prefrontal, posterior > cingulate) and decreased activity in limbic regions (e.g., subgenual > cingulate), which the researchers suggest is necessary for therapeutic > response. Men who responded to the active medication, in addition, > experienced decreased activity in certain lower brain areas (e.g., > hippocampus, anterior insula) thought to sustain the cortical/limbic > changes and prevent relapse. (Graphic and key courtesy of NIMH, 2002) > What does this all mean? There are several ways to think about this > study. One conclusion that we can draw is that the placebo effect is > real – and that the act of taking an inert substance (along with other > aspects of a hospital treatment program) can trigger certain changes in > the brain. In an interview with NIMH Dr. Mayberg cautioned against > equating antidepressants and placebos. "Our findings do not support > the notion that antidepressants work merely via a placebo effect. > Patients on active medication who failed to improve did not sustain the > brainstem, striatal and hippocampus changes unique to antidepressant > responders." Rather, the authors speculate that "clinical improvement > in the group receiving placebo as part of an inpatient study is > consistent with the well-recognized effect that altering the > therapeutic environment may significantly contribute to reducing > clinical symptoms. The additional subcortical and limbic metabolism > decreases seen uniquely in fluoxetine responders may convey additional > advantage in maintaining long-term clinical response and in relapse > prevention" (Mayberg, et.al., 2002). > This study is important because it helps us begin to understand how > antidepressants and other treatment techniques change the brain. We > are just beginning to understand the brain at this level, and further > research will undoubtedly build upon this foundation. We already know > that both psychiatric medications and psychotherapy result in changes > in the brain. This study begins to tell us how the brain changes. > Reference: > Helen S. Mayberg, J. Arturo Silva, Steven K. Brannan, Janet L. Tekell, > Roderick K. Mahurin, Scott McGinnis, and Paul A. Jerabek, The > Functional Neuroanatomy of the Placebo Effect, Am J Psychiatry 2002 > 159: 728-737. [Abstract available Online]

Response:

Question:

August 2, 1996. This date will forever be engraved upon my mind. Prozac is responsible for the rape of my soul. I am struck with horror at the pain, the despair… the physical and mental torture that I experienced. And yet, even these words do not adequately describe the suffering that I endured from the effects of Prozac (fluoxetine).  

Response:

Question:

According to Vitriholic <dracodeprofundis<spam, spam, eggs, bacon and spam>: > Welcome to paradise: www.bltc.com

I think that site has some inaccuracies, but it’s infinitely better informed than certain Luddite mentalities regarding the subject. Chris.

Response:

Welcome to paradise: www.bltc.com Vitriholic

– Hide quoted text — Show quoted text -> Wow, really? You’ve spoiled it for me now: all that research, and it means > nothing? None of it’s true? Oh well, let’s just hold hands and put our faith > in the lord. > Although…now that I think about it, I’d rather take my chances with > medicine. > Vitriholic > www.btlc.com > -> > ->Not to be confused with an NARI, but it depends on this week’s > ->current official abbreviations, I think.  :)  Seriously, though, > ->it has about equal potency for serotonin and noradrenaline, in > ->theory a bit like a tricyclic without the unwanted gubbins like > ->antihistamine and anticholinergic effects; IME it seems to do > ->something else, maybe direct 5HT2C stimulation a la fluoxetine > ->as it seems to have the potential to be an anxiogenic. > The kind of "thinking" that goes on in these biopsychiatry posts is so > overloaded with ignorance of neurochemistry, fallacies about what > conclusions follow from what premises, groundless assertions, > breathtaking leaps of illogic, wishful thinking, appeals to authority, > and just flat-out horseshit that it’s hard to know where to even begin > dismantling them. > It’s just astounding that people believe this stuff.  Scratch that — > it’s astounding that people think this stuff even *means* anything. > Cortisol levels?  Oxidative stress?  Neurotransmitters?  Huh?  Do > these people just believe whatever they’re told? > Christ.  Basing your life around a cesspool of fantasy being passed > off as "science" is really not the best approach to living. > Here’s the truth: no one has any idea how the brain works.  No one has > any idea how psychotropic drugs work.  There are no "mental > illnesses." Talking about "serotonin levels" as if you could put a > dipstick in your brain and measure them is laughable.  Don’t be such a > bunch of suckers. > The relationship between consciousness and neurochemistry probably > won’t be unraveled with another thousand years of research. > Just for starters (assuming anyone is willing to think):  When SSRIs > were new, we were supposed to believe that they corrected the specific > "chemical imbalance" that "caused" depression.  They were "selective." > Leaving aside the fact that (1) pharmacodynamic selectivity was > deliberately conflated with selectivity for mood states for marketing > purposes, (2) the causality between neurochemistry and consciousness > isn’t even *slightly* understood, and (3) the phrase "chemical > imbalance" doesn’t actually mean anything, we are now supposed to > believe that these drugs also "cure" "generalized anxiety disorder," > "post-traumatic stress disorder," "obsessive-compulsive disorder," > "social anxiety disorder," an d even fucking PMS for god’s sake.  Wow. > That sounds *really* "selective."  What are the odds that the same > "chemical imbalance" is responsible for virtually every feeling that > someone doesn’t like? > How does "zero" sound? > Stop being such a bunch of idiots being led around by the nose.  Smart > people buy drug company stock.  Dumb people buy drug company products. > This is because there are always more dumb people than smart people.

Response:

> 1) SSRI > selective seratonin reuptake inhibitator…same things as prozac

No it isn’t, it’s an SNRI, also inhibiting the reputake of noradrenaline with about the same potency.  That said, fluoxetine isn’t as selective as the tag suggests, it also has some NRI activity, but to a much lesser extent than venlafaxine. > 3) long term use of SSRI’s is never a good idea unless you MUST have them.

True of any medicine.  Probably most of the bad press about drugs comes from people taking stuff (benzos in particular) that they don’t need; the real killer is that these issues completely overshadow the needs of someone who really *does* need some sort of medication but has a bad adverse reaction to it, who get all but ignored because of the heavy politics surrounding the problems caused by the former situation. Chris.

Response:

> 1) SSRI > selective seratonin reuptake inhibitator…same things as prozac > No it isn’t, it’s an SNRI, also inhibiting the reputake of noradrenaline > with about the same potency.  That said, fluoxetine isn’t as selective > as the tag suggests, it also has some NRI activity, but to a much lesser > extent than venlafaxine.

Effexor IS a SNRI??  If so I am quite mistaken and apoligize. – Hide quoted text — Show quoted text -> 3) long term use of SSRI’s is never a good idea unless you MUST have them. > True of any medicine.  Probably most of the bad press about drugs comes > from people taking stuff (benzos in particular) that they don’t need; > the real killer is that these issues completely overshadow the needs of > someone who really *does* need some sort of medication but has a bad > adverse reaction to it, who get all but ignored because of the heavy > politics surrounding the problems caused by the former situation. > Chris.

Response:

> Effexor IS a SNRI??  If so I am quite mistaken and apoligize.

Not to be confused with an NARI, but it depends on this week’s current official abbreviations, I think.  :)  Seriously, though, it has about equal potency for serotonin and noradrenaline, in theory a bit like a tricyclic without the unwanted gubbins like antihistamine and anticholinergic effects; IME it seems to do something else, maybe direct 5HT2C stimulation a la fluoxetine as it seems to have the potential to be an anxiogenic. Chris.

Response:

Wow, really? You’ve spoiled it for me now: all that research, and it means nothing? None of it’s true? Oh well, let’s just hold hands and put our faith in the lord. Although…now that I think about it, I’d rather take my chances with medicine. Vitriholic www.btlc.com

– Hide quoted text — Show quoted text – > -> > ->Not to be confused with an NARI, but it depends on this week’s > ->current official abbreviations, I think.  :)  Seriously, though, > ->it has about equal potency for serotonin and noradrenaline, in > ->theory a bit like a tricyclic without the unwanted gubbins like > ->antihistamine and anticholinergic effects; IME it seems to do > ->something else, maybe direct 5HT2C stimulation a la fluoxetine > ->as it seems to have the potential to be an anxiogenic. > The kind of "thinking" that goes on in these biopsychiatry posts is so > overloaded with ignorance of neurochemistry, fallacies about what > conclusions follow from what premises, groundless assertions, > breathtaking leaps of illogic, wishful thinking, appeals to authority, > and just flat-out horseshit that it’s hard to know where to even begin > dismantling them. > It’s just astounding that people believe this stuff.  Scratch that — > it’s astounding that people think this stuff even *means* anything. > Cortisol levels?  Oxidative stress?  Neurotransmitters?  Huh?  Do > these people just believe whatever they’re told? > Christ.  Basing your life around a cesspool of fantasy being passed > off as "science" is really not the best approach to living. > Here’s the truth: no one has any idea how the brain works.  No one has > any idea how psychotropic drugs work.  There are no "mental > illnesses." Talking about "serotonin levels" as if you could put a > dipstick in your brain and measure them is laughable.  Don’t be such a > bunch of suckers. > The relationship between consciousness and neurochemistry probably > won’t be unraveled with another thousand years of research. > Just for starters (assuming anyone is willing to think):  When SSRIs > were new, we were supposed to believe that they corrected the specific > "chemical imbalance" that "caused" depression.  They were "selective." > Leaving aside the fact that (1) pharmacodynamic selectivity was > deliberately conflated with selectivity for mood states for marketing > purposes, (2) the causality between neurochemistry and consciousness > isn’t even *slightly* understood, and (3) the phrase "chemical > imbalance" doesn’t actually mean anything, we are now supposed to > believe that these drugs also "cure" "generalized anxiety disorder," > "post-traumatic stress disorder," "obsessive-compulsive disorder," > "social anxiety disorder," an d even fucking PMS for god’s sake.  Wow. > That sounds *really* "selective."  What are the odds that the same > "chemical imbalance" is responsible for virtually every feeling that > someone doesn’t like? > How does "zero" sound? > Stop being such a bunch of idiots being led around by the nose.  Smart > people buy drug company stock.  Dumb people buy drug company products. > This is because there are always more dumb people than smart people.

Response:

> Hello, I have been on prozac for a few years for anxiety and depression. I > heard that Effexor was newer and worked on different chemicals than the > older ssris.  I am thinking of trying new meds.  Has anyone made the switch > to Effexor and if so, was it better?  How is effexor different?  Does it > work better for anxiety then Prozac, is there less side effects (sex drive > etc)?  Any comments appreciated > Thank You

1) SSRI selective seratonin reuptake inhibitator…same things as prozac 2) are you having trouble with prozac? 3) long term use of SSRI’s is never a good idea unless you MUST have them. 4) ask your doctor.

Response:

Hello, I have been on prozac for a few years for anxiety and depression.  I heard that Effexor was newer and worked on different chemicals than the older ssris.  I am thinking of trying new meds.  Has anyone made the switch to Effexor and if so, was it better?  How is effexor different?  Does it work better for anxiety then Prozac, is there less side effects (sex drive etc)?  Any comments appreciated Thank You

Response:

>Hello, I have been on prozac for a few years for anxiety and depression.  I >heard that Effexor was newer and worked on different chemicals than the >older ssris.  I am thinking of trying new meds.  Has anyone made the switch >to Effexor and if so, was it better?  How is effexor different?  Does it >work better for anxiety then Prozac, is there less side effects (sex drive >etc)?  Any comments appreciated >Thank You

BACKGROUND: This was an 8-week, multicenter, randomized, double-blind, parallel-group study of the efficacy and tolerability of venlafaxine and fluoxetine. METHOD: Outpatients with DSM-III-R major depression, a minimum score of 20 on the 21-item Hamilton Rating Scale for Depression (HAM-D), and depressive symptoms for at least 1 month were eligible. Patients were randomly assigned to treatment with venlafaxine, 37.5 mg twice daily, or fluoxetine, 20 mg once daily. The dose could be increased to venlafaxine, 75 mg twice daily, or fluoxetine, 20 mg twice daily, after 3 weeks for a poor response. The primary efficacy variables were the final on-therapy scores on the HAM-D, Montgomery-Asberg Depression Rating Scale (MADRS), and Clinical Global Impressions Severity of Illness (CGI-S) and Improvement (CGI-I) scales. RESULTS: Three hundred eighty-two patients were randomly assigned to therapy and included in the intent-to-treat analysis. Both venlafaxine and fluoxetine produced significant reductions from baseline to day 56 in mean HAM-D, MADRS, and CGI-S scores, but no significant differences were noted between groups. Among patients who increased their dose at 3 weeks, significantly (p < .05) more patients taking venlafaxine than taking fluoxetine had a CGI-I score of 1 (very much improved) at the final evaluation. The most frequent adverse events were nausea, headache, and dizziness with venlafaxine and nausea, headache, and insomnia with fluoxetine. CONCLUSION: These results support the efficacy and tolerability of venlafaxine in comparison with fluoxetine for treating outpatients with major depression. IOW – YMMV — Catholic Church Primer: http://www.nambla.de

Response:

>Hello, I have been on prozac for a few years for anxiety and depression.  I >heard that Effexor was newer and worked on different chemicals than the >older ssris.  I am thinking of trying new meds.  Has anyone made the switch >to Effexor and if so, was it better?  How is effexor different?  Does it >work better for anxiety then Prozac, is there less side effects (sex drive >etc)?  Any comments appreciated

I haven’t tried Prozac, but I have been on Effexor XR 150mg for the last 9 months.  I have gone off of it for a week or two because I think it has raised by blood pressure to dangerous levels (170!). Next week I get another test so I will know if it is the cause.

Response:

Question:

- Hide quoted text — Show quoted text -> > > >Correct me if I’m wrong, but I know that benzodiazepines work by > >  suppressing > > > >the CNS. So why are they addictive? And first of all, what is the > >  definition > > > >of addiction? Effexor and Paxil has terrible withdrawal symptoms; why >are > > > >they not considered addictive, for example?? > > > There are two kind, psychological and physical. Which do you mean? > > both > I agree with all the above about benzos.  However, antidepressants are > not addictive. > Basically, addictive psychiatric drugs (i.e. benzodiazepines) are all > like alcohol and all the other well known addictive drugs.  The exact > reason they are addictive, on a molecular/biochemical level, is a > mystery. >OK. I drop my request for a molecular/biological level description of >addiction. All I ask is, why do you call alcohol and benzos addictive, and >the AD’s not addictive! What is the behavioural difference between the >addicts to benzos and patients strugling to withdraw Effexor? >cem

I suppose you could start with saying you can’t take xanax for a year and NOT have withdrawal, but can stop Paxil abruptly and be just fine. It doesn’t fit.

Response:

>I suppose you could start with saying you can’t take xanax for a year >and NOT have withdrawal, but can stop Paxil abruptly and be just fine. >It doesn’t fit.

But people have sued the manufacturers of Paxil and won because they didn’t reveal the severity of withdrawal.  There have been scores of Paxil anecdotes here, some people have no problem while others say it was the worst experience of their lives. One subtle difference between Xanax and Paxil is that one produces a mildly euphoric experience while the other simply restores a normal state of being.  But Xanax is HIGHLY addictive!!!  I can’t describe the sensation, but Xanax made me feel like I always had to take another dose.  There was no pain or suffering, just a mental compulsion to take another dose.  I was lucky that I only took it for 5-6 months, long-term users report absolute hell in withdrawal.

Response:

> But people have sued the manufacturers of Paxil and won because they > didn’t reveal the severity of withdrawal.  There have been scores of > Paxil anecdotes here, some people have no problem while others say > it was the worst experience of their lives.

I’m one of the former, although I had such horrible side-effects when I was taking it that any withdrawal may have been compensated for by the diminished side-effects once I’d given it the boot. > One subtle difference between Xanax and Paxil is that one produces a > mildly euphoric experience while the other simply restores a normal > state of being.  But Xanax is HIGHLY addictive!!!  I can’t describe > the sensation, but Xanax made me feel like I always had to take > another dose.  There was no pain or suffering, just a mental > compulsion to take another dose.  I was lucky that I only took it > for 5-6 months, long-term users report absolute hell in withdrawal.

I’m curious about this one.  I’d taken lorazepam for about 2 years, which is supposedly one of the most "addictive" benzos, and when I decided it wasn’t really useful so I may as well stop it I experienced 2 or 3 weeks of slightly increased anxiety, agitation and so on, but certainly a long way from "absolute hell."  I’m wondering if I’m somehow more resistant to withdrawal than most others, or if it’s more a case of how much aggro someone’s prepared to tolerate?  In my case I think I took the rather morbid line that life was already so crap that some extra horribleness was no big deal. Chris.

Response:

> >Correct me if I’m wrong, but I know that benzodiazepines work by suppressing >the CNS. So why are they addictive? And first of all, what is the definition >of addiction? Effexor and Paxil has terrible withdrawal symptoms; why are >they not considered addictive, for example?? >cem > They all are addictive.

Before proceeding on this, does anyone know why the ASAP people, of whom one at least has visited here, are vociferously against the position that benzos are addicting?  And why, this group does not go bezerk if you mention benzo addiction? Squiggles

Response:

- Hide quoted text — Show quoted text ->Before proceeding on this, does anyone know >why the ASAP people, of whom one at least has >visited here, are vociferously against the position >that benzos are addicting?  And why, this group >does not go bezerk if you mention benzo addiction? > Because unlike you, they just can’t admit addiction. It’s like walking > in a bar at 11 a.m. and telling people they are alcoholics. > It’s the flip side of anti-med —- pro-med. So blinded and in denial > they can’t see the forest for the trees. > Did you notice they now have a message board for people who want to > debate things that may be "disruptive", IOW – addiction? > Just go to ASAP and ask if benzos are addictive, and report back your > results.

I’ve been there – if you check the Google correspondence between Ian and me, you will see the acrimonious nature of the debate. It’s hard to believe that all of them are blinded to the possibility of addiction.   Interesting that they now have a "disruptive" room – maybe I should go there, LOL!   Squiggles

Response:

>Correct me if I’m wrong, but I know that benzodiazepines work by suppressing >the CNS. So why are they addictive? And first of all, what is the definition >of addiction? Effexor and Paxil has terrible withdrawal symptoms; why are >they not considered addictive, for example??

I can only say from personal experience that benzos are incredibly addictive.  Especially Xanax.  In a way they are similar to methamphetamine, neither makes you think you’re addicted.  Like meth, benzos create a pure mental desire to take another dose, you always find some rationale to do more, thee is no actual physical withdrawal involved.  Perhaps there is some withdrawal, it tends not to be painful, just a dramatic increase in anxiety, the very thing benzos are prescribed to treat.

Response:

>Correct me if I’m wrong, but I know that benzodiazepines work by suppressing >the CNS. So why are they addictive? And first of all, what is the definition >of addiction? Effexor and Paxil has terrible withdrawal symptoms; why are >they not considered addictive, for example?? > There are two kind, psychological and physical. Which do you mean?

both

Response:

> Not true, Chris.  The benzodiazepine Klonopin (clonazepam HCl) has a > half-life of between 30-40 hours–a half life typical of the SSRIs (except > fluoxetine).

Okay, maybe I missed out the phrase "generally speaking."  Of course there are exceptions with a minority of benzos with atypically long half-lives and antidepressants with very short ones, but IMHO using one of the exceptions to say the basis is "not true" is nitpicking (of course it may be inaccurate in other more valid aspects) Chris.

Response:

> > >Correct me if I’m wrong, but I know that benzodiazepines work by >  suppressing > >the CNS. So why are they addictive? And first of all, what is the >  definition > >of addiction? Effexor and Paxil has terrible withdrawal symptoms; why are > >they not considered addictive, for example?? > There are two kind, psychological and physical. Which do you mean? > both

I agree with all the above about benzos.  However, antidepressants are not addictive. Basically, addictive psychiatric drugs (i.e. benzodiazepines) are all like alcohol and all the other well known addictive drugs.  The exact reason they are addictive, on a molecular/biochemical level, is a mystery. Antidepressants aren’t.  They seem to work by putting a floor under one’s mood state, so that you don’t go spiraling downwards.  But you won’t see people on the street because of being hooked on antidepressants – it just doesn’t happen. The people who deny that benzos are addictive are either in an addictive denial state or in some other peculiar denial state. There’s no doubt that benzos are highly addictive.

Response:

- Hide quoted text — Show quoted text -> > >Correct me if I’m wrong, but I know that benzodiazepines work by >  suppressing > > >the CNS. So why are they addictive? And first of all, what is the >  definition > > >of addiction? Effexor and Paxil has terrible withdrawal symptoms; why are > > >they not considered addictive, for example?? > > There are two kind, psychological and physical. Which do you mean? > both > I agree with all the above about benzos.  However, antidepressants are > not addictive. > Basically, addictive psychiatric drugs (i.e. benzodiazepines) are all > like alcohol and all the other well known addictive drugs.  The exact > reason they are addictive, on a molecular/biochemical level, is a > mystery. > Antidepressants aren’t.  They seem to work by putting a floor under > one’s mood state, so that you don’t go spiraling downwards.  But you > won’t see people on the street because of being hooked on > antidepressants – it just doesn’t happen. > The people who deny that benzos are addictive are either in an > addictive denial state or in some other peculiar denial state. > There’s no doubt that benzos are highly addictive.

I think the word "addiction" has a special pharmaceutical meaning and a literal one; it is the literal one that gets people or riled up.  Regarding the ADs however, it seems that some of the new ones leave their mark, if you discontinue the drug; hence the neologism:  "discontinuation syndrome" – how similar that is to "addiction" is something a competent pharmacologist should be able to figure out. Squiggles — Truth has become a commodity.              - Squiggles

Response:

– Hide quoted text — Show quoted text -> > >Correct me if I’m wrong, but I know that benzodiazepines work by >  suppressing > > >the CNS. So why are they addictive? And first of all, what is the >  definition > > >of addiction? Effexor and Paxil has terrible withdrawal symptoms; why are > > >they not considered addictive, for example?? > > There are two kind, psychological and physical. Which do you mean? > both > I agree with all the above about benzos.  However, antidepressants are > not addictive. > Basically, addictive psychiatric drugs (i.e. benzodiazepines) are all > like alcohol and all the other well known addictive drugs.  The exact > reason they are addictive, on a molecular/biochemical level, is a > mystery.

OK. I drop my request for a molecular/biological level description of addiction. All I ask is, why do you call alcohol and benzos addictive, and the AD’s not addictive! What is the behavioural difference between the addicts to benzos and patients strugling to withdraw Effexor? cem

Response:

Correct me if I’m wrong, but I know that benzodiazepines work by suppressing the CNS. So why are they addictive? And first of all, what is the definition of addiction? Effexor and Paxil has terrible withdrawal symptoms; why are they not considered addictive, for example?? cem

Response:

> Correct me if I’m wrong, but I know that benzodiazepines work by suppressing > the CNS. So why are they addictive? And first of all, what is the definition > of addiction?

Because the CNS adapts to compensate after prolonged suppression, so once the suppression ends the CNS becomes overactive resulting in various nasties like anxiety and insomnia.  Or something like that. > Effexor and Paxil has terrible withdrawal symptoms; why are > they not considered addictive, for example??

Much longer half-life.  Benzos wear off after a few hours leading to the chronic user to be continuously aware that they need to take another dose.  Most ADs take several days (at least) before any withdrawal effects are likely to appear, which doesn’t have quite the same immediacy about it. Chris.

Response:

>Correct me if I’m wrong, but I know that benzodiazepines work by suppressing >the CNS. So why are they addictive? And first of all, what is the definition >of addiction? Effexor and Paxil has terrible withdrawal symptoms; why are >they not considered addictive, for example?? >cem

They all are addictive.

Response:

Not true, Chris.  The benzodiazepine Klonopin (clonazepam HCl) has a half-life of between 30-40 hours–a half life typical of the SSRIs (except fluoxetine).

– Hide quoted text — Show quoted text -> Correct me if I’m wrong, but I know that benzodiazepines work by suppressing > the CNS. So why are they addictive? And first of all, what is the definition > of addiction? > Because the CNS adapts to compensate after prolonged suppression, so > once the suppression ends the CNS becomes overactive resulting in > various nasties like anxiety and insomnia.  Or something like that. > Effexor and Paxil has terrible withdrawal symptoms; why are > they not considered addictive, for example?? > Much longer half-life.  Benzos wear off after a few hours leading to > the chronic user to be continuously aware that they need to take > another dose.  Most ADs take several days (at least) before any > withdrawal effects are likely to appear, which doesn’t have quite > the same immediacy about it. > Chris.

Response:

Question:

I need to know when Prozac will be available in cheaper generic form. I can’t afford the brand name stuff and my state mental health service cut me off from free treatment. They decided I wasn’t sick enough. As if they had a clue of what’s going on in my brain. Anyway, as soon as anyone knows anything definite about when it will be available generically, please e-mail me as soon as possible! This message will disappear eventually, so please save it and remember to e-mail me when you find out something definite. My future is at stake. Thanks in advance.  ROGER HANE       NO E-MAIL SOLICITORS

Response:

I believe it’s already available.

– Hide quoted text — Show quoted text -> I need to know when Prozac will be available in cheaper generic form. I can’t > afford the brand name stuff and my state mental health service cut me off from > free treatment. They decided I wasn’t sick enough. As if they had a clue of > what’s going on in my brain. Anyway, as soon as anyone knows anything definite > about when it will be available generically, please e-mail me as soon as > possible! This message will disappear eventually, so please save it and remember > to e-mail me when you find out something definite. My future is at stake. Thanks > in advance. >  ROGER HANE >       NO E-MAIL SOLICITORS

Response:

>I need to know when Prozac will be available in cheaper generic form. I can’t >afford the brand name stuff and my state mental health service cut me off from >free treatment. They decided I wasn’t sick enough. As if they had a clue of >what’s going on in my brain. Anyway, as soon as anyone knows anything definite >about when it will be available generically, please e-mail me as soon as >possible! This message will disappear eventually, so please save it and remember >to e-mail me when you find out something definite. My future is at stake.

I thought generic prozac was already available in the U.S.  Anyway, it is definitely available in Canada and Americans can easily purchase it through the Canadian Drugstore, http://thecanadiandrugstore.com . I buy all my meds (except controlled substances) through them and they offer savings of 30%-50% over American pharmacies.  It is wonderful if you have to pay for your own meds!  All you do is fill out their online questionaire and fax it along with your prescription and they send it to you within 10 days.

Response:

It’s definitely available now.  I have a bottle in my medicine cabinet, which I got from my local Safeway pharmacy (in the US). I think it’s been available for six months or more.

– Hide quoted text — Show quoted text -> I believe it’s already available. > I need to know when Prozac will be available in cheaper generic form. I > can’t > afford the brand name stuff and my state mental health service cut me off > from > free treatment. They decided I wasn’t sick enough. As if they had a clue > of > what’s going on in my brain. Anyway, as soon as anyone knows anything > definite > about when it will be available generically, please e-mail me as soon as > possible! This message will disappear eventually, so please save it and > remember > to e-mail me when you find out something definite. My future is at stake. > Thanks > in advance. >  ROGER HANE >       NO E-MAIL SOLICITORS

Response:

www.medicinedrugstore.com VERY cheap:) THUS SAYETH WithBACON

Response:

> I need to know when Prozac will be available in cheaper generic form.

It’s available now.  I’m not in the US, but I’ve read quite a number of posts on various NGs and MBs referring to the fact that Americans are taking generic fluoxetine. Here in the UK whether you get branded "Prozac" or generic fluoxetine seems to depend entirely on which pharmacy you take your prescription to.  Some of them don’t seem to keep the branded Eli Lilly version at all, so it was a long time before I actually received a box marked "Prozac". The pharmacy I went to last week gave me my first box which is actually branded "Prozac".  The packaging says that it is "manufactured for Moss Pharmacy by the Product Licence holder Eli Lilly". Jamie

Response:

Question:

Hello. I’ve been using Zoloft + Buspar for a little while now to control a mix of general anxiety and the uncommon panic attack. Because Zoloft has recently gone nonformulary or whatever, I have to switch to something else. I was thinking of just staying on the Buspar, but I have a stressful summer coming up, and I’m worried that Buspar wouldn’t be of any use in fending off potential panic attacks. My doctor suggested Zoloft as a replacement for the Zoloft. I’ve tried Prozac before. The first time was a long-time ago, before I was subject to panic attacks, and I don’t remember any negative effects. Then I tried it again almost two years ago. I was fine for about a month, I think, when I had my first panic attack in a couple of years. Whether the attack was due to the Prozac or to the fact that I had started an internship that week (or both, probably), I don’t know, but I switched to something else. Anyway, I’m thinking of trying Prozac (generic fluoxetine, actually) + Buspar this time. I’ve found info online suggesting that Buspar may help to augment fluoxetine in the treatment of depression. However, I’m wondering how the two interact to affect anxiety and panic attacks. My doctor seems to think they’ll be OK, but I’m not sure. I found one blurb that said the combo helped in three cases, and another blurb describing how the combo actually worsened anxiety in one case. I guess my question, then, is whether any of you have tried or are currently taking both Prozac and Buspar, and whether there were any effects on anxiety and panic. Any help would be appreciated, including any online reference materials that you might be able to point me toward. Thanks much, Mike

Response:

– Hide quoted text — Show quoted text -> Hello. I’ve been using Zoloft + Buspar for a little while now to control a > mix of general anxiety and the uncommon panic attack. Because Zoloft has > recently gone nonformulary or whatever, I have to switch to something else. > I was thinking of just staying on the Buspar, but I have a stressful summer > coming up, and I’m worried that Buspar wouldn’t be of any use in fending off > potential panic attacks. My doctor suggested Zoloft as a replacement for the > Zoloft. > I’ve tried Prozac before. The first time was a long-time ago, before I was > subject to panic attacks, and I don’t remember any negative effects. Then I > tried it again almost two years ago. I was fine for about a month, I think, > when I had my first panic attack in a couple of years. Whether the attack > was due to the Prozac or to the fact that I had started an internship that > week (or both, probably), I don’t know, but I switched to something else. > Anyway, I’m thinking of trying Prozac (generic fluoxetine, actually) + > Buspar this time. I’ve found info online suggesting that Buspar may help to > augment fluoxetine in the treatment of depression. However, I’m wondering > how the two interact to affect anxiety and panic attacks. My doctor seems to > think they’ll be OK, but I’m not sure. I found one blurb that said the combo > helped in three cases, and another blurb describing how the combo actually > worsened anxiety in one case. > I guess my question, then, is whether any of you have tried or are currently > taking both Prozac and Buspar, and whether there were any effects on anxiety > and panic. Any help would be appreciated, including any online reference > materials that you might be able to point me toward. > Thanks much, > Mike

I’m fixing to try both in about a week. Anxious to see if anyone responds. — Amelia Leave out ‘TheJunk’ before replying

Response:

> >I guess my question, then, is whether any of you have tried or are currently >taking both Prozac and Buspar, and whether there were any effects on anxiety >and panic. Any help would be appreciated, including any online reference >materials that you might be able to point me toward. > It can cause seizures.

That’s the 1st I’ve heard of *that and I must say I’m rather doubtful. What are you basing the commment on? — Amelia

Response:

>> >I guess my question, then, is whether any of you have tried or are currently > >taking both Prozac and Buspar, and whether there were any effects on anxiety > >and panic. Any help would be appreciated, including any online reference > >materials that you might be able to point me toward. > It can cause seizures. >That’s the 1st I’ve heard of *that and I must say I’m rather doubtful. >What are you basing the commment on?

I think even nospam got carried away. AFAIK, there is no heightened risk of seizure associated with any of the two drugs mentioned. Ask your pdoc or doc to be sure, but even that is a first for me.

Response:

After 9 years, my 40 mgs/day of prozac pooped out. I went up to 60mgs for 6 weeks but there was no appreciable difference. I have an awful lot of anxiety, too. My shrink put me on 60 mgs of buspar/day which he says will possibly boost prozac’s effect, help with sex, and reduce anxiety. Has anyone had experience with this combination for these symptoms?

Response:

> After 9 years, my 40 mgs/day of prozac pooped out. I went up to 60mgs for 6 > weeks but there was no appreciable difference. I have an awful lot of anxiety, > too. My shrink put me on 60 mgs of buspar/day which he says will possibly boost > prozac’s effect, help with sex, and reduce anxiety. > Has anyone had experience with this combination for these symptoms?

BuSpar worked miracles on my anxiety. I take 10 mg/day. I’m rather surprised your doctor started you at 60, but it’s his call. I get bad gastrointestinal symptoms at 20 mg. Fortunately, 10 works just fine. BuSpar has a reputation for helping with sex drive. It didn’t help me. The only fix I found for sexual problems was to take medications away, not add new ones. As for BuSpar boosting Prozac’s effect, I hope he’s right. Again, BuSpar didn’t do that for me. Mood stabilizers (esp. Lamictal) are good for rejuvenating pooped-out SSRIs. I’m not questioning your doctor’s treatment plan, only letting you know how it went for me. Good luck.

Response: