Sensitivity to SSRI's (recommendations)

[godlovesatrier]

Hi all,

Like a lot of pwme pwlc I've got a bad sensitivity to SSRI's in the sense that they reactivate my ebv within a few days - it's got something to do with the interaction with the glucocorticoid receptors.

So awhile back many of you gave me recommendations for ones to try. I've tried zoloft and citalopram, both of which reactivated my ebv and gave me insomnia. I looked into effexor but felt like it might be a mistake to go on that. My dr totally gave up on me after i chose not to take the effexor which wasn't helpful.

I keep getting bouts of anxiety especially post covid where I just feel like I end up obsessing over certain things in my life, it could be a friend of a friend I don't fully agree with, a comment at work, a colleague has a bad day or is having a bad month and I take it personally as something I've done wrong. Or someone genuinely says someting a bit nasty and that sets me off into quite a bad fight or flight flare which can take a week or two to calm down. All this has been made worse by covid though.

Essentially any stimulating ssri seems to interact too much with the glucocorticoid receptors and causes me to end up pretty sick very rapidly (even if I titrate small amounts over a week).

At the same time I find anti inflammatory supplements help to calm me down, which makes me think I am suffering possibly from inflammation driven anxiety maybe more than anything. Years ago I used to have excellent control over my emotional state, being resilient to most of the bullshit of life, but these days it just feels a lot harder - maybe ME made me feel super vulnerable to things.

Thanks,

 

[JES]

The recommendation is usually to start with an SSRI and only if they don't work move to an SNRI like Effexor because SNRI's tend to cause more side effects or are at least harder to come off. On the other hand, since you have already tried two, the chances aren't that great a third one (fluoxetine?) would work either.

I struggled with tolerating SSRI's (or any drug for that matter). After years of trial and error, I eventually settled for one third starting dose of citalopram, that is, about 7 mg per day. At that dosage it doesn't cause weird side effects like increased hypoglycemia for me while also doing something to reduce the feeling of ME/CFS brain fatigue/inflammation.

 

[ilivewithcfs]

Any stimulating drugs (including antidepressants) can cause problems for PWME. After years of trying and failing, I found fluvoxamine to be the best fit for me. It's sedating and antiinflammatory, which is exactly what I need. I started to feel better after 2-3 weeks on it, and the effect stayed with me through the years. It's not a cure, but it makes my life much more tolerable.

 

[godlovesatrier]

Thanks JES. I even had issues at 5mg citalopram, I did debate taking 2.5 for a month and then trying 5 for another month. Just to see if I could get on it. Very annoyingly stimulating must admit.

Interesting livewith, that's also the drug that appears to preferentially block sars-cov2 entry into cells and has effects on the intestinal microbiome as well - good and bad I think.

I'll look it up thank you.