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Old 10-13-18, 02:57 AM
andyb1205 andyb1205 is offline
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Sensitive to even Small Dose SSRI

So I had previously titrated my Zoloft 25mg to 50mg and 100mg thinking it would help even out the Adderall, to help with depression and especially anxiety/OCD. As worsening ADHD simply made those worse, Iíve been back on 25mg Zoloft for a month now.

I also recently had Cytomel (T3) added to the Synthroid for the thyroid. Iíve been puzzled as to how it still seems like I have a tad bit too much Serotonin, with weakening of Adderall and borderline mild serotonin syndrome symptoms, such as dilated pupils, anxiousness, brain fog and tremors. Then I read that Cytomel can supercharge SSRIs which makes sense. Have switched to taking Zoloft at night for a week now but hasnít made much difference.

Is there some sort of ranking of anti-depressants by how much they increase serotonin? Iím thinking about trialing low dose 5mg Lexapro, but well. I know I need something to balance out the Adderall only a tiny bit, I am very sensitive to these medications!

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Old 10-14-18, 03:09 PM
Alphawave Alphawave is offline
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Re: Sensitive to even Small Dose SSRI

Hi there,

I've looked at those numbers for all kinds of drugs before. For SSRI's, wikipedia has it on their SSRI page. The chart is near the bottom and the lower the number, the more strongly it binds to the site/receptor:

https://en.wikipedia.org/wiki/Select...take_inhibitor
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Old 10-14-18, 05:31 PM
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Re: Sensitive to even Small Dose SSRI

You could try an SNRI like cymbalta.
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Old 10-15-18, 11:12 PM
andyb1205 andyb1205 is offline
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Re: Sensitive to even Small Dose SSRI

According to that chart, seems like Lexapro and Luvox are good options to trial. Will talk to my doctor about trialing 5mg Lexapro first. Luvox is interesting as it’s supposedly for OCD, but I’d be taking the lowest dose. I’m assuming it’s a mild inhibitor of CYP2D6 similar to Zoloft and Lexapro.

I have looked at the SNRIs, especially Cymbalta and Pristiq. Is the chart for SNRIS on Wikipedia accurate in saying that Cymbalta increases norepinephrine at a higher ratio compared to Pristiq?! The main reason I’d prefer to try an SSRI first is the lower half life of the SNRIs, not sure if it’s clinically significant.

Also, my psychiatrist at our last meeting a month ago (when I had Zoloft reduced to the 25mg) suggested I look up Buspar to discuss at our next meeting (in 6 weeks). From what I’ve read it’s a hit and miss and needs to be taken twice a day. Works surprisingly well for some though.
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