What Is The Difference Between Different SSRIs (Fluoxetine, Fluvoxamine, Paroxetine)

Explore the difference between difference SSRIs such as Fluoxetine, Fluvoxamine, and Paroxetine.
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The video discusses the differences between various SSRIs, focusing on fluoxetine (Prozac), fluvoxamine (Luvox), and paroxetine (Paxil). Fluoxetine is noted for its effects on 5ht2c receptors and its approval for depression, OCD, panic disorder, bulimia, and PMDD. It has the lowest risk for weight gain, a long half-life, and is commonly used in children over eight. Fluvoxamine primarily targets sigma receptors and is FDA-approved for OCD but not depression due to its high risk for drug interactions. Paroxetine affects M1, NET, and nitrous oxide synthetase receptors, approved for a variety of conditions including MDD, OCD, and panic disorder. However, it's known for antimuscarinic effects, weight gain, severe discontinuation syndrome, and potential birth defects. Each SSRI has unique properties and indications. Zoloft is noted for atypical depression and minimal interactions. Lexapro is described as the purest SSRI with fewer side effects but a mild QTc increase. Celexa has some QTc concerns due to its enantiomer. Overall, the video offers concise summaries of each SSRI's characteristics, indications, and potential side effects to aid in clinical decision-making.
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#psychopharmacology #psychnp #psychnp

[@PsychoFarm]

There is an updated version of this video here: kzbin.info/www/bejne/l6rdZaujidCSj5o

[@skaterdude14b]

You are really talented at this. Excellent delivery & voice, interesting, clear & pertinent. I liked the cultural references too, especially mr. yeezus. Also appreciated the lack of outro, lack of call for likes & subscriptions, & general filler. Looking forward to your videos on Anxiety.

[@PsychoFarm]

Thank you for the kind words.

[@polarbear1954]

Thank you for these videos, they're extremely well organized and make complicated material seem so clear.

[@LNum]

Claims to summarize in one line, then literaly writes two lines.😂 Great video! Keep up the good work.

[@MrSpicycat]

I hope this channel takes off. Its very informative and detailed, very well animated. Reminds me of Osmosis. Hopefully with more videos, this will be a great resource for psychiatry residents.

[@slasher298]

best vid on this or source in general I've found. Good work and thank you.

[@PsychoFarm]

Thanks!

[@Tesseract9630]

You are awsome. You should have way more subscribers.

[@jackowacko105]

Excellent resource , would love a video on SNRI comparison as well

[@PsychoFarm]

One day...

[@elaineateoate1020]

Been on prozac off an on for 20 years. I find my insomnia and anxiety return after I am off prozac for some months. Prozac actually helps me sleep and reduces my anxiety. Kind of opposite of what one would expect according to this video.

[@michellet1800]

great video, you have a nice voice. paxil's discontinuation syndrome is really bad, patients can appear as though they have the flu, with nasal congestion and terrible malaise, I've seen patients come off paxil Rx'ed by their P.MD only to show up in the ER for a full medical work up.

[@chantalclarke5305]

How do you come off? I’m experiencing this I was good on it for a full month after I started taking it everyday other day and came of rivotrol completely it’s a nightmare and now I’m back on day 4. I’m in still struggling

[@vegetossgss1114]

Do not underestimate Paroxetine, and overdo its side effects. It is an excellent medication for a lot of people.

[@JABDUDE]

Will you ever make a video about psychedelics?

[@Oliver-tp3hl]

Can I get your thoughts on Viibryd aka Vilazodone?

[@gone.golfing]

Paroxetine (Paxil) is the BEST one! Hands down!

[@vegetossgss1114]

Paroxetine has helped me a lot.

[@gone.golfing]

@@vegetossgss1114 Same. 30mg is my recipe for my paranoia.

[@vegetossgss1114]

@@gone.golfing 40mg for my anxiety :)

[@gone.golfing]

@@vegetossgss1114 Is that the max? I was diagnosed with panic disorder but I’m almost positive I have schizophrenia. Welcome to my life lol.

[@vegetossgss1114]

@@gone.golfing No in certain circumstances, if you are young or middle aged and healthy, and under the supervision of your physician, you can go up to 60mg a day for OCD and up to 50mg a day for general anxiety disorder.

[@yehbuddy4251]

I hate that Paxil is linked to so many problems because it’s the only one that ever worked for me. Prozac was too activating, Lexapro gave me horrible side effects and made me suicidal at the beginning. I have panic disorder and GAD

[@NoNo-ro9gx]

Prozac is good for those with motivational issues

[@bigmichael2765]

1:29 I learned that the hard way, having my first ever panic attack sending me to the hospital.

[@meganleanza1054]

Thanks for the great video! I have a question for you...I'm deciding between Prozac and Luvox to treat depression, body dysmorphia, social and generalized anxiety. Other SSRI's that I've tried made me too drowsy in the past which led me to switch to SNRI's which seemed less effective for anxiety. I need a medication that isn't too sedating but works well for anxiety. Do you think Prozac is the better option?

[@jasonb8407]

I have taken Luvox with success on different occasions. Which did you end up taking

[@aliciac7053]

All SSRIs are super sedating for me too. Lexapro and Zoloft make me so sleepy. Did you find a medication that worked for you?

[@vedatzorro]

İncreasing paroxetine dose from 20 to 30 can cause anxiety?

[@rahuljohar7270]

Does uvox increase weight?

[@blairsterling6141]

Not talked about at all, is, paradoxical reactions... some people get slow and sleepy on Prozac...some get blunted... ..some get lethargic... some in rare occasions developed Tardive Dyskinesia !!!

[@ethankrown]

Interesting that you say Paxil Has the highest sedation affect because it gave me severe insomnia

[@laobejanegra266]

Thats the net bloqueage

[@blairsterling6141]

He skips over paradoxical reactions, which can be quite common....thus, this video is basically ineffective and shows lack of full and truthful information.

[@sevenman9672]

prozac can help anxiety in some people

[@josiepearce5389]

Great video .but spoken too fast to sink in but thank you

[@DjBigmiz]

Excellent content, appreciate the vids. Do you have any ideas on how to help combat the sexual side effects of srris (Lexapro, zoloft). By experience these tend to help mentally but bring bad sexual side effects which tend to bring more depression (lower libido, difficulty reaching orgasm).

[@kalemale3191]

Saffron Extract

[@blairsterling6141]

I too was affected sexually...no hard on,, no orgasms... very depressing... made me more sad, depressed, angry...men need sexual healing !!! It is in our basic needs !!!!

[@gone.golfing]

Simple - some are more activating than others and some are more sedating than others. That’s all.

[@ianmyers5784]

Getting off Prozac has been a living nightmare. It took 22 days for withdrawals to start. 100 days later I’m just starting to feel better emotionally but not so physically. It seems the doctors take their data from the pharmaceuticals, which are biased, short term studies. All of these drugs are in fact ototoxic.

[@OreElect1]

@Ian Myers Most doctor's are clueless about tapering off SSRIs. Taper no more than 2-5% every 2-4 week's is the best information out there. A lot of people, including healthcare practitioners; in fact, I guess, most people-- are operating from entirely the wrong paradigm, or way of thinking, about these meds. They're thinking of them like aspirin--as something that has an effect when it's in your system, and then when it gets out of your system the effect goes away. That's not what happens with medications that alter neurotransmitter function, we are learning. What happens when you change the chemistry of the brain is, the brain adjusts its chemistry and structure to try to return to homeostasis, or biochemical and functional balance. It tries to restabilize the chemistry. For example: SSRI antidepressants work as "serotonin reuptake inhibitors." That is, they cause serotonin to remain in the space between neurons, rather than being taken back up into the cells to be re-used, like it would be in a normal healthy nondrugged brain. So the brain, which wants to re-establish normal signaling and function, adapts to the higher level of serotonin between neurons (in the "synapse", the space between neurons where signals get passed along). It does this by removing serotonin receptors, so that the signal is reduced and changed to something closer to normal. It also decreases the amount of serotonin it produces overall. To do that, genes have to be turned on and off; new proteins have to be made; whole cascades of chemical reactions have to be changed, which means turning on and off OTHER genes; cells are destroyed, new cells are made; in other words, a complex physiologic remodeling takes place. This takes place over time. The brain does not grow and change rapidly. This is a vast oversimplification of the amount of adaptation that takes place in the brain when we change its normal chemistry, but that's the principle. When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long. With multiple drugs and a history of drug changes and cold turkeys, all of this becomes even more complicated. And if a person is started on these kinds of drugs at an early age before the brain has ever completely established normal mature functioning--well, it can't be good. (All of which is why I recommend an extremely slow taper particularly to anyone with a multiple drug history, a history of many years on meds, a history of past cold turkeys or frequent med changes, and a history of being put on drugs at a young age.) This isn't intended to scare people, but hopefully to give you some idea of what's happening, and to help you respect and understand the process so you can work with it; ALSO, because you are likely to encounter many, many people who still believe these drugs work kind of like aspirin, or a glass of wine, and all you need to do is stop and get it out of your system. Now you can explain to them that no, getting it out of your system is not the issue; the issue is, you need to regrow or at least remodel your brain. This is a long, slow, very poorly understood process, and it needs to be respected.

[@sevenman9672]

Some people must metabolise it quicker as within days I feel different if I stop 20mg maybe partly placebo effect

[@sevenman9672]

I do think the slower half life especially of norfluoxetine can prolong the full detox period

[@OreElect1]

@@sevenman9672 A lot of people, including healthcare practitioners; in fact, most people-- are operating from entirely the wrong paradigm, or way of thinking, about these meds. They're thinking of them like aspirin--as something that has an effect when it's in your system, and then when it gets out of your system the effect goes away. That's not what happens with medications that alter neurotransmitter function, we are learning. What happens when you change the chemistry of the brain is, the brain adjusts its chemistry and structure to try to return to homeostasis, or biochemical and functional balance. It tries to restabilize the chemistry. For example: SSRI antidepressants work as "serotonin reuptake inhibitors." That is, they cause serotonin to remain in the space between neurons, rather than being taken back up into the cells to be re-used, like it would be in a normal healthy nondrugged brain. So the brain, which wants to re-establish normal signaling and function, adapts to the higher level of serotonin between neurons (in the "synapse", the space between neurons where signals get passed along). It does this by removing serotonin receptors, so that the signal is reduced and changed to something closer to normal. It also decreases the amount of serotonin it produces overall. To do that, genes have to be turned on and off; new proteins have to be made; whole cascades of chemical reactions have to be changed, which means turning on and off OTHER genes; cells are destroyed, new cells are made; in other words, a complex physiologic remodeling takes place. This takes place over time. The brain does not grow and change rapidly. This is a vast oversimplification of the amount of adaptation that takes place in the brain when we change its normal chemistry, but that's the principle. When we stop taking the drug, we have a brain that has designed itself so that it works in the presence of the drug; now it can't work properly without the drug because it's designed itself so that the drug is part of its chemistry and structure. It's like a plant that has grown on a trellis; you can't just yank out the trellis and expect the plant to be okay. When the drug is removed, the remodeling process has to take place in reverse. SO--it's not a matter of just getting the drug out of your system and moving on. If it were that simple, none of us would be here. It's a matter of, as I describe it, having to grow a new brain. I believe this growing-a-new-brain happens throughout the taper process if the taper is slow enough. (If it's too fast, then there's not a lot of time for actually rebalancing things, and basically the brain is just pedaling fast trying to keep us alive.) It also continues to happen, probably for longer than the symptoms actually last, throughout the time of recovery after we are completely off the drug, which is why recovery takes so long. With multiple drugs and a history of drug changes and cold turkeys, all of this becomes even more complicated. And if a person is started on these kinds of drugs at an early age before the brain has ever completely established normal mature functioning--well, it can't be good. (All of which is why I recommend an extremely slow taper particularly to anyone with a multiple drug history, a history of many years on meds, a history of past cold turkeys or frequent med changes, and a history of being put on drugs at a young age.) This isn't intended to scare people, but hopefully to give you some idea of what's happening, and to help you respect and understand the process so you can work with it; ALSO, because you are likely to encounter many, many people who still believe these drugs work kind of like aspirin, or a glass of wine, and all you need to do is stop and get it out of your system. Now you can explain to them that no, getting it out of your system is not the issue; the issue is, you need to regrow or at least remodel your brain. This is a long, slow, very poorly understood process, and it needs to be respected.

[@sevenman9672]

@@OreElect1 Weed gives you neurogenesis

[@shafiq_ramli]

I'm on fluvox... To treat major depressive disorder here in Malaysia 😳 Taking 100mg daily. Makes me kinda like a zombie - numb my feeling maybe

[@blairsterling6141]

Many of these drugs can make people feel like a vegetable or zombie-like....especially antipsychotics, which are very very toxic and brain damaging.

[@GB-gi6ft]

shit i use paxil

[@jdcreations9643]

Look like this video is against paroxetine just to promote prozac 😆😆

[@vegetossgss1114]

Paroxetine has helped me a lot

[@bhimsingh8942]

Please hindi spike. Iam indian

[@AnandAnand11122]

Hindi use kr lete thodi samajh hum jaise logo ko bhi aa jati har bande ko to English nhi aati na

[@sleepvore]

i'm revising for pre-residency exams right now and your videos are a saving grace. your delivery is so fun too, helps distract me from wanting to give in to the urge to bash my head against a wall. you even uploaded the slides! thank you so much!! 🥹