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Dr_Anderson
Dr_Anderson, Doctor
Category: Mental Health
Satisfied Customers: 335
Experience:  Psychiatrist
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deffrence between ssris in ptsd

Resolved Question:

deffrence between ssris in ptsd
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr_Anderson replied 1 year ago.

Dr_Anderson : Greetings, and thank you for your question. The short answer is, there is no appreciable difference in the various SSRI's when it comes to PTSD. (As an aside, much of the research to date shows that medications like SSRI's are actually second to therapy, specifically cognitive behavioral, exposure, and EMDR therapies.) That being said, anecdotally I have found some SSRI's to be better than others in my PTSD patients. Since PTSD is a syndrome which manifests, among other things, with hyperarousal, SSRI's which tend to be activating (such as Zoloft) are less desireable than ones that tend to be neutral or calming (like Prozac or Paxil).
Dr_Anderson : Another unsung hero in the SSRI family is Luvox. While it's major indication is for OCD, in patients with PTSD it may be quite useful if the memories and emotions associated with the memories have an intrusive and recurrent nature to them.
Customer:

ok


 

Customer:

here my proble


m

Customer:

which cause me problem with my dr


 

Customer:

i am doing emdr


 

Customer:

and will start cbt


 

Customer:

but we are not in the same way in midicine


 

Customer:

i have emotilional block


 

Customer:

caused by ptsd


 

Customer:

he give me luvox


 

Customer:

i have terrible anixety becuase of ptsd


 

Customer:

am taking luvox for 1 month

Customer:

for 150mg


 

Customer:

and feel improve in deffrent feeld


 

Customer:

but not emotinonal


 

Customer:

it is still i cant feel anything


 

Customer:

so am asking my dr to change it for me

Customer:

becuase i know that zoloft is better than luvox in ptsd


 

Customer:

i think you are american and have good information so can you help me?


 

Customer:

in all sites they wrote that zoloft are the best

Dr_Anderson : In your case, Zoloft may be a better fit. Since you described feeling emotionally stuck, Zoloft is good to "kick start" a person. That can work both ways, though, so something important to keep an eye on is that it does not overactivate you - meaning that it makes your anxiety worse.
Customer:

!!!!


 

Dr_Anderson : Zoloft is very customizable, too, doses ranging from 25 mg to 250 mg. The average doseis somewhere around 150 mg for most people.
Customer:

and i have ocd as well

Dr_Anderson : So, yes, Zoloft (sertraline) would be a reasonable treatment. Since you also have OCD, it may be necesary to go to higher doses of the Zoloft (like 200 mg or more). It is not at all unusual for higher doses of an SSRI to be necessary in OCD.
Customer:

but how deffrence between them between luvox and zoloft?


 

Customer:

is there much deffrence?


 

Dr_Anderson : Both are SSRI's, but Luvox tends to be more sedating and calming than does Zoloft. But, both are good for treating anxiety. I have found Zoloft is better than Luvox at treating Depression, though.
Dr_Anderson : Other than that? Not much difference, to be honest.
Dr_Anderson : Also, in the end, what really matters is that the medicine work for you - no matter how well or not it worked for others.
Customer:

ok


 

Customer:

but i feel lost now


 

Customer:

you are saying luvox is better


 

Customer:

what is my case is ptsd


 

Dr_Anderson : Another thing to consider, if you are open to it, is to increase the Luvox from 150 mg to 200 mg or more. That is aother option.
Customer:

causeing emotional block


 

Customer:

becuase of phsycial combat trauma


 

Dr_Anderson : Luvox is not necessarily better, just better for some people. Since you have not gotten the benefit from it that you need, it is a good idea to consider another medication option. Zoloft would be a reasonable option to consider.
Customer:

but maybe 150mg do nothing

Customer:
Customer:

because my dr is asking me to go to 300


 

Dr_Anderson : Zoloft, plus EMDR and CBT, will help to overcome that block.
Customer:

but i fear that luvox be useless and wast of my time


 

Dr_Anderson : Then in that case, talk to your doctor about Zoloft. Let him know you don't feel it is working for you, that you want to try Zoloft.
Dr_Anderson : Let him know that while the Luvox has helped in some ways, it has made things no better or even worse in others.
Customer:

no ifeel improve with luvox realy


 

Customer:

but until now i feel problem of emotional block


 

Customer:

when i take 15mg remeron it kick all that feeling away


 

Dr_Anderson : Well, if you have improvment with it, why not try 300 mg for a month? If you feel the 300 mg has made no difference, then you know you have a "back-up" plan of Zoloft.
Customer:

ok


 

Customer:

i give how long?


 

Customer:

1 month


 

Customer:

?


 

Dr_Anderson : Yes, one month. If you see improvement even more with the 300 mg, then hold off on switching, since it can take even up to 12 weeks for some patients to note the full benefits of a medication. If you see NO benefit in that time, then Zpoloft is a good idea to discuss with your doctor.
Customer:

i need something like remron it was suprier i feel again with just 15mg of it,so what is there something can do remeron job?


 

Customer:

but weight gain was horrible i gain 30lbs


 

Dr_Anderson : Is the Remeron being used to augment the Luvox, or all by itself?
Customer:

no just by itself

Customer:
Customer:

and it kick everyhting


 

Customer:

so i need something give me that effect plz


 

Customer:

i cant take remron because of it is side effect


 

Dr_Anderson : Remeron is in a family all by itself, but ones similar to it include trazodone and nefazodone.
Customer:

remron is best midcine ever


 

Customer:

for ptsd


 

Customer:

ok


 

Customer:

ok now if i combine them how it will be?

Dr_Anderson : Another to consider is Viibryd - an SSRI, but it shares spme things in common with Remeron.
Customer:

ok 7.5mg of remeron increase weight?


 

Dr_Anderson : Well, it is usually best to see if just one medicine will do the hjob, but if it does not then the purpose of the second one is to augment the first - and thus get a person closer to feeling 100% better than the one did all by itself.
Customer:

or 7.5mg like 30mg in weight gain


?

Dr_Anderson : It can, yes.
Dr_Anderson : Typically it is dose dependent, but you can see weight gain with smaller doses.
Customer:

so more of remeron more ability to gain more weight?


 

Dr_Anderson : Correct. :)
Customer:

mmm


 

Customer:

do you know ppl succseded in luvox

Customer:

?


 

Customer:

or it is useless


 

Customer:

for treating ptsd


 

Dr_Anderson : Yes, I have a number of patients for whom Luvox has been a real life-saver.
Customer:

mmm


 

Customer:

ok then i have my last q


 

Customer:

why zoloft is better in treating ptsd than luvox?


 

Customer:

how is that?


 

Customer:

explain it please to me


 

Dr_Anderson : I don't think it is. Zoloft is tried more often than Luvox, so of course more people are going to find it helpful. They work equally as well.
Customer:

!!!!


 

Dr_Anderson : But, as mentioned earlier, at the end of the day, it doesn't mater what has worked for others, only what is going to work for you.
Customer:

yes


 

Customer:

but there is reaserches about that


 

Customer:

what i want is to get the best effect for ptsd

Customer:

so that not after 1 year i change midcine agian and again


 

Customer:

if they have the same effect then i go on on luvox


 

Customer:

even if they are the same


 

Dr_Anderson : Very true, but there is not a lot of research on Luvox because it is not used as much as Zoloft. It's kind of like Mr. Pibb soda and Dr. Pepper. Both taste great and very similar, but hardly anyone knows about Mr. Pibb. They are both very similar, but only one of them is popular.
Dr_Anderson : So, it is a "selection bias" of sorts, where the research on Zoloft is strong only because there is so much of it. Not knocking Zoloft, it is a very good medicine, but my advice would be to try the 300 mg of Luvox for a month and see if it gets you to where you want to be. If not? Then try the Zoloft.
Dr_Anderson : Hope this helps! Please let me know if I may be of further service.
Dr_Anderson : Regards,
Dr_Anderson : Dr. Anderson
Customer:

sorry for disconection


 

Customer:

are you there?


 

Dr_Anderson : Yes.
Customer:

but it working well for me


 

Customer:

so it is just like that it is matter of popular?

Customer:

i thought it is matter of effective


 

Dr_Anderson : In essence, yes, since in head-ti-head triials, there is no significant difference between most SSRIs, liike Luvox amd Zoloft.
Dr_Anderson : So, in sum, I'd stick with the 300 mg of Luvox for a month, to give it a chance and see if it will help with the emotional block. If it does not, then switching to a new SSRI, like Zoloft, would be ok to do.
Customer:

and how i know?


 

Dr_Anderson : You will know. Consider how you felt before the PTSD, and that will give you some idea as to what you are looking for.
Customer:

ok just 1 month?


 

Customer:

to be fair


 

Dr_Anderson : Yes, exactly.
Dr_Anderson : Best wishes to you! Please let me know if I may be of further service - and positive feedback is most welcome!
Customer:

realy dr i cant take a discion about that

Customer:
Customer:

ok can i ask another q?

Dr_Anderson : You won't have to make that decision alone. It is one you and your doctor, together, will be able to make as to how close to wellness you are.
Dr_Anderson : Of course!
Customer:

he want luvox


 

Customer:

but i told him that zoloft is better


 

Customer:

ok then last q

Customer:

luvox is nearly the same as luvox in ptsd?


 

Customer:

or suppose to be the same

Dr_Anderson : Zoloft and Luvox, yes, but so is Paxil, Prozac, Celexa, and Lexapro. They all work equally well in PTSD, although the research that you found appears to favor certain SSRI's, like Zoloft.
Customer:

ok thank you

Customer:

bye


 

Dr_Anderson, Doctor
Category: Mental Health
Satisfied Customers: 335
Experience: Psychiatrist
Dr_Anderson and 3 other Mental Health Specialists are ready to help you
Expert:  Dr_Anderson replied 1 year ago.
You are welcome! Best wishes to you.

Regards,

Dr. Anderson

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