Social Anxiety Forum

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-   -   Starting Luvox (https://www.socialanxietysupport.com/forum/f30/starting-luvox-1923889/)

NotShyButSociallyAnxious 12-17-2016 06:49 PM

Starting Luvox
 
Hey everybody. I've been an avid reader of these forums but never felt the need to post until now. However I've been very impressed with the knowledge most of these members have and need some advise.

Some brief background I've suffered from social anxiety and depression since college. My senior year I only left my room to go to class from fear of having to make small talk with my roommates. I'd skip meals because I knew they were downstairs and couldn't near the idea of having to interact with them. I began taking lexapro which helped a little bit but was drinking heavily in order to socialize. I ended up also self medicating with methadone. This combo worked moderately but I still had bouts of anxiety and especially depression.

I ended up going to rehab for the booze and methadone and have been clean for 5 months. However my anxiety has returned 10 fold. I can barely function at work and have this weird warming sensation in my head and these crazy gagging spells throughout the day.

My psych initially prescribed me zoloft which made me so anxious and depressed I could only tolerate it for 2 weeks. He then tried prozac and symbiax which didn't do much either. He then tried effexor and gave me klonopin and of course only the Klonopin helped. I gave the effexor 6 weeks with no positive change so we did that GeneSite test and he took me off the Effexor and put me on Seroquel. Seroquel wasn't doing much for the anxiety which ended up getting just as bad when my doc wanted me weaning off the klonopin.

So now based off this GeneSite test he's got me on Luvox and won't refill my Klonopin which I've got about 20 left. Long story short should I even try with the Luvox? I'm on day 2 of 50 mg and already feeling nausea and somnolence. I've had about 10 gagging spells today. I do not have OCD, just pretty intense social and general anxiety/depression. I did find a doctor that would prescribe nardil or parnate but she doesn't take insurance and runs $375 a visit! Just wanted to see what yall thought. Thanks for the time!

Gillman fan 12-17-2016 11:32 PM

I am curious, how did you find a doc that would do MAOI? I didn't find one, I just convinced my existing doctor that it was a good idea.

I think one of the SA people on these forums can give you better advice re: meds. I would just recommend you learn to bargain with your psychiatrist. You say "I want X" and he says "No I am putting you on Y," then you can say "OK, how about I do Y, and if it fails I trial X." This has generally worked for me.

You can try to convince him to prescribe an MAOI. Just understand that you need to do his job for him. You need to learn everything you can about MAOIs, their side effects, efficacy etc. so that when you talk to him you can explain that his reservations are based on incorrect hearsay. Although I wouldn't tell him that directly!

NotShyButSociallyAnxious 12-18-2016 08:39 AM

I just called around told them what I wad looking for and what I've tried and one responded. I don't see my current doc prescribing an MAOI. When I mentioned it to him he told me to find another psychiatrist of that was what I was looking for.

Anyways anybody here have experience with luvox? I'm on day 3 and having a rough time. Has anyone found out to be worth it?

Cassoulet94 12-18-2016 06:02 PM

1 Attachment(s)
Quote:

Originally Posted by NotShyButSociallyAnxious (Post 1087992801)
Hey everybody. I've been an avid reader of these forums but never felt the need to post until now. However I've been very impressed with the knowledge most of these members have and need some advise.

Some brief background I've suffered from social anxiety and depression since college. My senior year I only left my room to go to class from fear of having to make small talk with my roommates. I'd skip meals because I knew they were downstairs and couldn't near the idea of having to interact with them. I began taking lexapro which helped a little bit but was drinking heavily in order to socialize. I ended up also self medicating with methadone. This combo worked moderately but I still had bouts of anxiety and especially depression.

I ended up going to rehab for the booze and methadone and have been clean for 5 months. However my anxiety has returned 10 fold. I can barely function at work and have this weird warming sensation in my head and these crazy gagging spells throughout the day.

My psych initially prescribed me zoloft which made me so anxious and depressed I could only tolerate it for 2 weeks. He then tried prozac and symbiax which didn't do much either. He then tried effexor and gave me klonopin and of course only the Klonopin helped. I gave the effexor 6 weeks with no positive change so we did that GeneSite test and he took me off the Effexor and put me on Seroquel. Seroquel wasn't doing much for the anxiety which ended up getting just as bad when my doc wanted me weaning off the klonopin.

So now based off this GeneSite test he's got me on Luvox and won't refill my Klonopin which I've got about 20 left. Long story short should I even try with the Luvox? I'm on day 2 of 50 mg and already feeling nausea and somnolence. I've had about 10 gagging spells today. I do not have OCD, just pretty intense social and general anxiety/depression. I did find a doctor that would prescribe nardil or parnate but she doesn't take insurance and runs $375 a visit! Just wanted to see what yall thought. Thanks for the time!


Hey !

Luvox is an SSRI. You should find some reviews on this website using the search tool. I am not very familiar with it but it seems not to be different from any other SSRIs... Which means it seams a little weird to try it after having failed with two others (zoloft and prozac) and one SNRI (effexor).

That being said, you can't really say yet that you are a non responder to SSRIs, because you have only tried zoloft for two weeks, which is not enough to assess its efficiency. How long did you take prozac ?

You have too keep in mind that the first few weeks on most AD are usually crap. So unless it's really unbearable, try to "toughen up", have some benzo to help with anxiety and be patient.

Try to give a real chance to luvox, like a few weeks. Nausea and dizziness are quite frequent and tend to subside pretty quickly. Since prozac and zoloft are quite activating compared to luvox, maybe you will have a better response to it. If it fails then you and your doc will probably consider alternatives to SSRIs/SNRIs.

Then you have things like wellbutrin, tricylics, MAOIs... Which one is the best suited ? We can only guess. What is your main problem ? Depression or SA ? Are you lethargic or too activated ? Do have trouble sleeping ? Do your depression had an impact on your appetite/libido ? Importantly, For how long have you felt bad ? Is it a life long problem ?

MAOIs indeed seem to be among the most effective treatment for SA but since you complain that you feel crap on SSRIs, be aware of the fact that MAOIs have a worse side effects profile and that some people can't tolerate them. It's usually not an easy ride at first.

NotShyButSociallyAnxious 12-19-2016 05:59 PM

Thanks for the reply! I'm going to tough it out and give luvox the old college try. I'm feeling terrible right now, serious nausea, increased anxiety, tiredness but can't sleep straight through the night but it's only been 4 days.

As far as my symptoms go I feel like I have them all checked off heh. I'd say as of right now my anxiety is higher than my depression, especially my SA. Like I am spending the weekend with my in laws for xmas and the idea of it terrifies me. Or like the idea of going to hang out with my wife and her friends seems unbearable. However I'm also pertty lethargic and am content with just being on the couch all day even though that's when I feel worse - doing nothing

I've had issues with my self esteem and confidence since high school but no real SA until college. It's just right now the physical symptoms are really getting to me and have been since I got out of rehab 5 months ago. These gagging spells and constant heat in my head are terrible! I don't put a lot of stock in SSRIS given what I've read on here but hey, I was on lexapro for 10 years and made it through. Any other thoughts on luvox/ssris?

Cassoulet94 12-19-2016 06:35 PM

1 Attachment(s)
Quote:

Originally Posted by NotShyButSociallyAnxious (Post 1088013409)
Thanks for the reply! I'm going to tough it out and give luvox the old college try. I'm feeling terrible right now, serious nausea, increased anxiety, tiredness but can't sleep straight through the night but it's only been 4 days.

As far as my symptoms go I feel like I have them all checked off heh. I'd say as of right now my anxiety is higher than my depression, especially my SA. Like I am spending the weekend with my in laws for xmas and the idea of it terrifies me. Or like the idea of going to hang out with my wife and her friends seems unbearable. However I'm also pertty lethargic and am content with just being on the couch all day even though that's when I feel worse - doing nothing

I've had issues with my self esteem and confidence since high school but no real SA until college. It's just right now the physical symptoms are really getting to me and have been since I got out of rehab 5 months ago. These gagging spells and constant heat in my head are terrible! I don't put a lot of stock in SSRIS given what I've read on here but hey, I was on lexapro for 10 years and made it through. Any other thoughts on luvox/ssris?


Well if you made it trough with lexapro, it is not unlikely that luvox will produce the same kind of effects once the side effects have subsided (if they do, which is likely).

If luvox give you some relief but you feel you're still not motivated enough, you can try augmenting it with things like bupropion (wellbutrin), which affects noradrenaline and dopamine (a little). Too bad you could not tolerate zoloft because it's one of the better ssris, it seems. Paxil (paroxteine) is also good, despite its nasty sexual side effects and withdrawals symptoms if you quit too fast. It's the most potent SSRI (=/= most efficient) and at 40mg (high dose) I felt pretty relaxed but not too motivated. At 40mg sometimes I felt a little too good physically so I just wanted to stay on my couch to enjoy the feeling.

Then you could consider MAOIs: nardil (considered better for SA) or parnate (better for depression). You have to be disciplined, at least at first, because you must learn how you react to tyramine food and drink. Plus hypotension can be annoying. But these are efficient meds, more than SSRIS for a lot of people. The main problem with such meds is that it is hard to find a doc willing to prescribe them. So you have to find an open minded doc and to show him you know the stuff and won't screw around with the diet and interactions.

Are you doing therapy ? About self esteem I would suggest a good book by a famous french psychiatrist who is specialized in SA (it's called "imperfect, free and happy"). The title sounds like any other self development book but the author was a psychiatrist in a famous hospital in Paris (Saint Anne), so it's mainly based on science and he has a really good understanding of self-esteem mechanisms. I could relate a lot to what he was writing. Reading books are a good thing to do when your depression and anxiety has lifted a bit, so if you're not there yet, just wait some time before reading it. And no, I am not a friend of the author or the editor. I'm sure there are plenty of other good books, I just found this one to be the best among those I read.

SSRIManiac 12-21-2016 12:08 PM

Luvox is one of the taboo SSRI's. It got a social anxiety approval in 2008 for its extended release formula. I don't think I've heard too much success stories with it. It's also sedating like Paroxetine.

The only good thing is less sexual side effects and it's weight neutral.. It's like a Prozac derivative, it looks a bit similar on the chemical structure but the complete opposite in some ways, the half life is very short..

Anyway, doctors can be real asholes sometimes and abruptly take people off Benzos. If this one isn't willing to prescribe more if its helping then I suggest you find a different one.

Gillman fan 12-21-2016 08:02 PM

I think Luvox has crazy pharmacodynamic interactions... it affects your metabolism of other drugs, which is a bad thing.

As far as SSRI induced anxiety, you could try adding a drug that antagonizes serotonin receptor 5HT2A. Most doctors Rx antipsychotics to achieve this, right now I am using the tricyclic Nortriptyline which is made of pure win. Helps with both SSRI anxiety and apathy.

Putting someone on the third SSRI is a sign of a bad psychiatrist IMO. It is time for you to move on and try drugs with a different mechanism of action.

Aviator11 10-20-2019 11:58 AM

Luvox, fluvoxamine, OCD, Anxiety
 
Hi everyone! I want to share my experience in hopes that you find OCD and/or anxiety relief without overwhelming fear of overdoing it. I ask that you please not judge the decisions of my excellent psychopharmacologist. Since a symptom of OCD is “significant worry and rumination”, I’d like to help any of you make the decision to be fearless and think outside the box when it comes to taking high-doses of medications or trying cocktails. Over the past decade I’ve tried [in order]:

1. ALL SSRI’s and Clomipramine.
2. SSRI’s with atypical antipsychotics
3. SSRIs, SNRIs, Atypicals + Benzos [all brands]
4. SSRI’s with ALL forms, flavors, and dosages of stimulants [Adderall, Dexedrine, Ritalin, ect.]
5. MAOI: Nardil💞 [120mg] + Klonopin [3mg]
6. 1.5 years of NO medicine&only diet/exercise
7. Luvox [50mg-600mg]
8. Luvox Cr [600mg] + Tranxene + Ritalin
9. Luvox Cr [600mg] + Tranxene + Mydayis

As you can see, I take double the FDA’s maximum recommended dose of Luvox Cr. Please understand that dosage recommendations and just that—recommendations, not rules! This decision came shortly after having all “GeneSight” tests run and results interpreted.

For those of you not familiar with GeneSight testing, I’ll offer a brief explanation. My pdoc swabbed my mouth with a cotton swab, sent my DNA to GeneSight to have it analyzed, and GeneSight sent back several pages of simplified, yet very scientific, information. I had all three tests run: 1. Antidepressants, 2. Mood Stabilizers/Antipsychotics, 3. ADHD Stimulants. Each test organizes and lists all available medications, from each respective category, under a GreenLight [no gene-drug interaction], a YellowLight [moderate gene-drug interaction], and a Red-Light [significant gene-drug interaction].

Now here’s the kicker, Luvox came back under the RedLight [significant gene-drug interaction] for my body chemistry, but it told me WHY. I’m homozygous for ”ultra-rapid” metabolizing activity of liver enzyme CYP1A2, which metabolizes Luvox; hence, the test concluded that I’d need extremely high doses of the particular drug for it to be effective and to maintain steady-state plasma concentrations. Now, all of you understand why I take such a high dose of Luvox Cr.

Having failed all SSRI’s, Tricyclics, and Atypicals in the Green and Yellow columns, I decided to take a chance of the Luvox. I’m glad I did. It’s been such a significant contributor to the sustained success I’ve been experiencing. I’m now able to leave the house, be extremely social, travel abroad, and work.

With all that being said, please understand that we all have different body chemistries, and we will all respond differently to medications across all dose ranges. So, I encourage you to be pro-active and explore all available medication options. As a psychopharmacologist myself, I strongly encourage you to stop searching the web for medication descriptions and/or patient experiences; it will only make your ocd/anxiety worse. Neuropsychology is a field of medicine which we know VERY LITTLE about; we only have theories, unrealizable MRI data, and ever-changing predictions on “mechanisms of action” of medications. We’ve come a long way, but we still DON’T REALLY KNOW ANYTHING!

I wish you all the best of luck. You have all been here for me, and I’m here for you! 🙂

Aviator11 10-20-2019 12:16 PM

Luvox high-dose
 
Hi everyone! I want to share my experience in hopes that you find OCD and/or anxiety relief without overwhelming fear of overdoing it. I ask that you please not judge the decisions of my excellent psychopharmacologist. Since a symptom of OCD is “significant worry and rumination”, I’d like to help any of you make the decision to be fearless and think outside the box when it comes to taking high-doses of medications or trying cocktails. Over the past decade I’ve tried [in order]:

1. ALL SSRI’s and Clomipramine.
2. SSRI’s with atypical antipsychotics
3. SSRIs, SNRIs, Atypicals + Benzos [all brands]
4. SSRI’s with ALL forms, flavors, and dosages of stimulants [Adderall, Dexedrine, Ritalin, ect.]
5. MAOI: Nardil💞 [120mg] + Klonopin [3mg]
6. 1.5 years of NO medicine&only diet/exercise
7. Luvox [50mg-600mg]
8. Luvox Cr [600mg] + Tranxene + Ritalin
9. Luvox Cr [600mg] + Tranxene + Mydayis

As you can see, I take double the FDA’s maximum recommended dose of Luvox Cr. Please understand that dosage recommendations are just that—recommendations, not rules! This decision came shortly after having all “GeneSight” tests run and results interpreted.

For those of you not familiar with GeneSight testing, I’ll offer a brief explanation. My pdoc swabbed my mouth with a cotton swab, sent my DNA to GeneSight to have it analyzed, and GeneSight sent back several pages of simplified, yet very scientific, information. I had all three tests run: 1. Antidepressants, 2. Mood Stabilizers/Antipsychotics, 3. ADHD Stimulants. Each test organizes and lists all available medications, from each respective category, under a GreenLight [no gene-drug interaction], a YellowLight [moderate gene-drug interaction], and a Red-Light [significant gene-drug interaction].

Now here’s the kicker, Luvox came back under the RedLight [significant gene-drug interaction] for my body chemistry, but it told me WHY. I’m homozygous for ”ultra-rapid” metabolizing activity of liver enzyme CYP1A2, which metabolizes Luvox; hence, the test concluded that I’d need extremely high doses of the particular drug for it to be effective and to maintain steady-state plasma concentrations. Now, all of you understand why I take such a high dose of Luvox Cr.

Having failed all SSRI’s, Tricyclics, and Atypicals in the Green and Yellow columns, I decided to take a chance of the Luvox. I’m glad I did. It’s been such a significant contributor to the sustained success I’ve been experiencing. I’m now able to leave the house, be extremely social, travel abroad, and work.

With all that being said, please understand that we all have different body chemistries, and we will all respond differently to medications across all dose ranges. So, I encourage you to be pro-active and explore all available medication options. As a psychopharmacologist myself, I strongly encourage you to stop searching the web for medication descriptions and/or patient experiences; it will only make your ocd/anxiety worse. Neuropsychology is a field of medicine which we know VERY LITTLE about; we only have theories, unrealizable MRI data, and ever-changing predictions on “mechanisms of action” of medications. We’ve come a long way, but we still DON’T REALLY KNOW ANYTHING!

I wish you all the best of luck. You have all been here for me, and I’m here for you! 🙂[/QUOTE]

Canyoufeelit 10-20-2019 01:21 PM

You shouldn't be afraid of luvox, it is a good drug and very underused, I don't understand why some people say it is only good for OCD because it is approved for social anxiety and depression too.
Please keep in my mind that in china it is undergoing approval solely and only for social anxiety disorder and not OCD.
I don't think they would waste time with it if it was not effective.
Luvox has shown (robust in some trial) efficacy for social anxiety in 5 clinical trials.

Captainmycaptain 10-22-2019 04:49 AM

Please keep us regularly updated on how things are progressing with Luvox.

NotFullyHere 10-23-2019 01:48 AM

Quote:

Originally Posted by Captainmycaptain (Post 1093823895)
Please keep us regularly updated on how things are progressing with Luvox.


I'm interested too!


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