SSRI Differences (Sertraline Escitalopram Citalopram Fluoxetine Fluvoxamine Paroxetine)
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- čas přidán 19. 06. 2024
- Explore the differences between SSRIs, including Sertraline, Escitalopram, Citalopram, Fluoxetine, Fluvoxamine, and Paroxetine.
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The video provides a detailed comparison of six Selective Serotonin Reuptake Inhibitors (SSRIs): Sertraline (Zoloft), Escitalopram (Lexapro), Citalopram (Celexa), Fluoxetine (Prozac), Fluvoxamine (Luvox), and Paroxetine (Paxil). It highlights their pharmacokinetic and pharmacodynamic properties, including receptor interactions, FDA approvals, off-label uses, and potential side effects. Sertraline primarily blocks serotonin reuptake and is beneficial for atypical depression but may cause diarrhea. Escitalopram is the purest SSRI, causing minimal side effects, but may slightly increase QTc interval. Citalopram has a racemic mixture with antihistaminergic properties and may prolong QTc interval. Fluoxetine is known for its long half-life, suitability for bulimia, and activating properties, while Paxil has antimuscarinic effects, is linked to birth defects and dementia, and has a notorious discontinuation syndrome. Each drug is summarized with its unique characteristics, FDA approvals, and notable side effects, providing a comprehensive understanding of their differences and clinical applications.
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#depression #ssri #psychopharmacology
00:00 The More You Know (About Pharmacology) The Better
00:10 Introducing the 6 SSRIs
01:05 Sertraline (Zoloft)
03:56 Escitalopram (Lexapro)
07:12 Citalopram (Celexa)
08:35 Fluoxetine (Prozac)
11:11 Fluvoxamine (Luvox)
11:59 Paroxetine (Paxil)
13:20 One-liner Review
Amazing video! I’m a psych intern, and there just aren’t enough resources like this online. Please keep it up!
👍 Appreciate people who work in mental health.
the deadpan humor, the super nuanced yet concise information, and the obvious hip hop knowledge. 11/10 video, W content creator. thank you for all that u do 🙌
Thank you for posting this. I’ve been looking for this info.
Unreal video. I was looking for this exact information all over the internet but I had trouble finding it
Your videos are just the best, thank you for all the hard work, research, and incredible effort you put into these!
Seriously really appreciate this
I just had to leave a message at this point. You're making the best psychopharm series out right now. Currently listening to this video quite often so I can commit it to memory. This information is so relevant to my needs and so perfectly packaged.
This is an incredible video, the only one on the web that aims to explain the various SSRIs differences. Keep up the great work! 👏🏼
You have no idea how long I’ve waited to know the REAL differences in these drugs.
As an MS3 highly interested in psych, this video was awesome! Keep up the good work.
this is amazing! Would love to see a chart version! Thank you again for making this information available!
Thank you so much for this detailed video! My psychiatrist did not go anywhere near this amount of detail when prescribing my medication. Now I have the knowledge to make the best choice for my mental health
Thanks for this info. I’ve been looking for this exact information which is hard to find
Strange how Luvox is only indicated for OCD in the US while it is one of the most prescribed SSRI's in Europe and Japan against depression (approved in a total of 80 countries world wide for this), as well for anxiety and panic disorders and is generally pretty successful at that. The side effects are usually very mild. Cognitive and sexual function are barely decreased if at all for example.
It is true that you should not take it with other prescribed medications but if its the only medication you take it should be fine. You can still take over the counter painkillers with it.
I guess it all comes down to lobbying and marketing in the US.
Wow that was so awesome and the most informative video on SSRIs 🤓
Well explained, thank you. A similar video for a/typical anti-psychotics would be appreciated.
Fantastic !! Well done !
Awesome video, thank you sir!
Bro!! Omg. Your videos man. 💯. My brain loves the way you explain things. I love the language and humor man. Bringing me so much knowledge to try to learn.
Most useful video about SSRI
Wow who are you
Bravo from resident in South Korea
Thank you so much for your dedication
Amazing video. I can tell once this channel has a larger library of videos behind it, it is going to pop off. Can't wait for a similar video on other psychotropic drugs like SNRIs.
Clearly one of the best SSRI lectures. Also worth mentioning at approx 8 minutes into video, “Cimetidine- contraindication w citalopram, but also 3A4 inhibitors such as omeprazole/Prilosec.
Hello! Is fluvoxamine activating or sedating? Are you able to wake up early in the morning to go the university / to your job? How much do you sleep each night? I have been on Paxil for 5 years. Amazing drug, but too sedating. I tried sertraline but it made me even more drowsy than paroxetine, even with a very low dose (perhaps because I am a poor CYP2C19 metabolizer). I would love to have your review on fluvoxamine's side effects.
Could you please do a video on the serotonin modulators? Loved this video!
I LOVE your descriptions! First from a professional standpoint but i love,love,.love that I must laugh so hard inbetween because of your humor and irony.:D
Very best explained
Paroxetine (Paxil) is an excellent medication and have helped many people, included me. For me it is sedating but not as much as other SSRIs that you just listed. Moreover, it helped tremendously for my depression and anxiety.
PLEASE do one of these videos with SNRI's
I had no idea that zoloft can cause diarrhea. Since I've taken it I get diarrhea very often I thought I eat something wrong. Thanks a lot.
Thank you!
Eacitalopram 15 mg/day + lamictal 100 mg/day combined with psychotherapy has really helped me. I suffered and overachieved for 15 years. Now I am more stable and active and present, not stuck in venomous mental loops.
Feels great not wanting to die 24/7.
Im in that current mood, don't want to die but I feel extreme anxiety /fear every minute of the day. Im also taking opiods, quite low dose for pain. I have been on Lamictal for some months, like 6 year's ago, didn't felt so much, does it help you with your moods? And does the SSRI esci, helps you enough to take them? (I don't want to take anything that will worsen my case that's why Im asking ❤🙏. I may suffer from panoc disorder?.. I have a feeling Im in danger all the time. All help is appreciated❤. Is Lexapro a good serotonin med?
Great 👍
And its working for my issues I do y. Are what my ex says. . u try going to school caring fr a elderly dad and his brother who was also dying I do my vest ....I went through a hard time after both their. Deaths ...I'm just glad and blessed I have a roof over my head god bless drs .thru do save lives
Very helpful, thank you
Thanks for commenting!
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 including Lexapro and Zoloft made me too drowsy in the past which led me to switch to SNRI's. Unfortunately the SNRI's have been less effective for my anxiety. I need a medication that isn't too sedating but works well for anxiety. Do you think Prozac is the better option?
Luvox did wonders for me against anxiety, depression, light OCD and panic atracks. They really don't seem to like it in the US, but in Europe it is one of the most prescribed SSRI's.
Thank you! Very valuable info, I didn’t know that paroxetine is anticholinergic and is linked to dementia. Thank you again 🙏
Excellent video (from a non medical person / inquisitive patient who loves understanding how these things work under the hood!)
Much appreciated!
Great video
Great video . I really appreciate the detailed breakdown. I was scared to try Lexapro because of my bad experience with Zoloft. I like that Lexapro doesn't touch the dopamine receptor because I don't have a lack of energy. Zoloft made me feel like a Zombie and I used it for 3 months.
I had to change to citalopram because Zoloft made my stomach bleed and I love the zombie effect lol
I'm switching to fluvoxamine , Zoloft makes me feel like a zombie
@@Judgedbyall how'd you find out your stomach was bleeding ?
A video explaining Buproprion with this kind of detail would be great!
i had a terrible time using sertraline and citalopram. Both caused bladder weakness and tremors in my arms and legs and my hair started falling out!
I just love your content, wealth of knowledge that's easy to understand. Great that you slid some Kanye theory in there😅
Glad you enjoy them! Kanye theory permeates all
Luvox was the best for me , I have since been doing mushrooms on occasions and is amazingly helpful
Hello! Is fluvoxamine activating or sedating? Are you able to wake up early in the morning to go the university / to your job? How much do you sleep each night? I have been on Paxil for 5 years. Amazing drug, but too sedating. I tried sertraline but it made me even more drowsy than paroxetine, even with a very low dose (perhaps because I am a poor CYP2C19 metabolizer). I would love to have your review on fluvoxamine's side effects.
@@vegetossgss1114 for me there hasn’t been any side effects to speck of. I have been on 50mg that take at night and sleep well. Maybe initial first week may have been a increase in anxiety but nothing bad and then it just helps me with the negative thoughts which gets you into the anxiety of worry. Also take buspirone 5mg once a day that is also beneficial. Never tried Paxil. I truly hope you find what works best for you
@@jasonb8407 Thanks brother!
do one for SNRI, and then another for atypical antidepressants!
thank's a lot
Can we say that the best predictor of a success antidepressant for a patient is if he / she is a normal metabolizer of the drug (and not a poor or an ultra rapid metabolizer)?
Thanx.
Hi . I’m on citraline & amitriptyline. I’m finding that the have joint & muscle pain. Which one is causing this please.
What’s your opinion on them causing long term harm after stopping them?
I stopped SSRIs. I tried them all. They just made me numb. No laughter. Now I microdose magic mushrooms and I feel great.
Fuckin loved Tony sayin "ere we go" on prozac
I’ve been on 100 mg of Zoloft for months and didn’t help me at all!! I’m now on week 2 of switching to Prozac. I’m only on the 20 mg of Prozac right now and still no change but I know it can take awhile. At this point it feels as if I’ll never feel better
How do you explain being held hostage on Zoloft? Taken for 22 years. When I try to decrease or increase by any amount (5%, 10%, 25%, 50%) I get very irritable, anxious, can't sleep, and also tired. I believe there's permanent damage that's been done. I have constant jaw movements (dystonia).
is fluvoxamine (luvox) affective in treating GAD and Panic? Was prescribed this for anxiety and ocd but i only see it treats ocd
How significant is 5 ht2c receptor blockade in the effects of prozac?
I couldn’t tolerate citalopram, does that mean I will have the same problem with escitalopram as they are similar?
Hey I wanted to know how these react differently when clubbed with clonazepam(0.25mg). I have been given 2 meds, one in the past both had clonazepam with the main part of a each ssri
Not sure if anyone knows but like from this which one would be most like fluoxetine? I was waiting to see if another of the 6 had the 5ht2c aspect, as fluoxetine is the only one I have tolerated so far, but was wondering about trying paroxetine
Could you do a snri difference and snri vs ssri
I could have sworn I've seen this one before. I remember you mentioning your hypothesis that Lexapro caused Kenye West's manic episode. Am I crazy?
You’re right.. I revamped it and slowed it down so it’d be easy listening. Or maybe you just came off your lexapro…
@@PsychoFarm Can You add Lexapro (escitolapram) to Concerta ( methylphenitade oros long acting) Dr ?
This video is epic
So my doc gave me Paxil - it works great, but I'm scared to stop it, and scared of the dementia thing. Also, the anxiety isn't going away but the depression is.
Why is zloft used for anxiety when it can make it worse?
Because it's pseudoscience
Fluvoxamine is Sigma 1 agonist, Sertraline a Sigma 1 antagonist. Covid long haulers are recommended to take Fluvoxamine. Based on the description Sertraline fits better for me. Would sertraline also have anti inflammatory benefits for long covid?
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Why Lexapro 10 mg stopped working for me after one year. Do i need to increase or change other SSRI or any other type anti depressant?
I had an absolutely horrific time trying to get used to citalopram and had to quit. I am also very allergic to some things so it might have to do something with that histamine property. Great video btw, this information is actually quite hard to find and I really wanted more information on these differences.
Did you do better on a different SSRI? I also couldn’t tolerate citalopram
@@100rebeccaleanne Hey I was wondering which SSRI you ended up using? because citalopram also doesn't agree with me
@@100rebeccaleanne Lexapro worked great for me, but we are all different. Wish you the best
@@xxvvyyyy Lexapro worked great for me and I had no side effects, but everyone is different. I wish you the best
@@southerngirl1408 I have lexapro now but have been scared to take it. Did you try celexa/citalopram before the lexapro?
Which is best for high anxiety?
What does mildly activating mean?
Great Video, very informative and easy to follow. Not sure if it’s a common side effect, worth mentioning that Lexapro stripped me of all sexual drive, made arousal and completion near impossible, and severely blunted my emotions. So, not a fan.
hey pysch, ive had 2 seperate cases of severe panic disorder for about 3 years on and off, i used to take lexapro on the smallest dose, 2.5mg and then 5mg and it really helped me overcome my disorder completely the first time (end of 2019 into 2020) but when i got panic disorder a second time (end of 2020) from smoking weed, I noticed not much of an impact on the same dose 2.5mg but i was told multiple times to up my dose for it and i was too scared to so i quit the medication cold turkey, and got insane migraines/headaches (thinking someting in my head was gonna pop it was so bad) as a withdrawal i think and for the past year I’ve been medicine free but I still get panic attacks everyday (heart races everyday nonstop, evil bad thoughts), and I’m ready to get back on something, my doc prescribed me celexa but I’m very unsure about trying it Bc I’ve been so used to take lexapro and I’m just wondering what ur opinion would be, thank u so much for the video also u rock!!
I've had the same. Extreme general anxiety and depression as well. Luvox got rid all my symptoms.
What about sexual side effects, especially permanent ones like PSSD (post ssri sexual dysfunction)
Excellent discussion. One error: in your summation you accidentally say sertraline, because of its NET, is especially good for atypical depression. But as you clearly know from your initial detailed discussion of sertraline, you mention its DAT, which is correct, thereby providing a mechanism suited for atypical depression. As far as I know, sertraline has minimal if any actions at NET.
Hello! Is fluvoxamine activating or sedating? Are you able to wake up early in the morning to go the university / to your job? How much do you sleep each night? I have been on Paxil for 5 years. Amazing drug, but too sedating. I tried sertraline but it made me even more drowsy than paroxetine, even with a very low dose (perhaps because I am a poor CYP2C19 metabolizer). I would love to have your review on fluvoxamine's side effects.
Am I an SSRI at heart because I think of Parm when I see Pram?!!!
I've been on fluoxetine since 2015. I stopped taking fluoxetine on 12/05/23. I feel a lot better without it. Has anyone had withdrawal symptoms from stopping the fluoxetine?
I switched to Zoloft . Must better 😌👌
Do any of these meds cause tinnitus??
"Previous research has suggested limited improvement in tinnitus with SSRIs and that use of these drugs with tinnitus patients should be limited to the application of treatment of the co-morbid anxiety/depression and not for tinnitus directly. There are also reports of tinnitus onset or exacerbation with SSRI."
www.audiology.org/ssri-and-tinnitus/#:~:text=Previous%20research%20has%20suggested%20limited,and%20not%20for%20tinnitus%20directly.
Can you talk about dementia risk with these SSRIs
Fluvoxamine. COVID. Side effects: common cold symptoms. Hijacks the transmission system.? Keeps the changes “residue” out of an infected brain at the same time?
tame impala intro
“Here comes the Prozac!”
you didnt speek about vortioxetin (trintlex) ?
No worth doing it is a useless AD.
Interesting, I was wondering how my psychs picked the ssri for me. I would love to see a video explaining mirtazapine and its mechanisms since i was on that for 8 months but it did literally nothing for me lol
everyone’s brain have diff needs so it’s not a one-size-fits-all
@@KAFaye-nk5tl ... but why? *Now that chemical imbalance theories have been debunked.
Lmao ask your doctor's pharma rep
What happens once the patient finds a SSRI that works for him/her? Do they take it for life? Aren't these meds difficult to taper off?
That’s my fear to even start
@@alltheglory7854 as someone who's tapering off of paxil after decades of use, I would recommend only using psych drugs as a last resort (talk therapy, meditation, journaling, inner child work, EMDR... lots of non-drug treatments are available!) Then, if you're still suffering, I would recommend working with someone knowledgeable in both nutrition/supplements to make sure there isn't some physical ailment, gut issue, or allergy causing the mental health issues. Read up on how childhood trauma affects us as adults. "The Body Keeps the Score" is a popular book on this. If the problems still persist, I would suggest cannabis or psilocybin over psych drugs.
Psych drugs disconnect us from ourselves. This can be life-saving during a particularly distressing time in life, but reconnecting must happen for true healing. And it's difficult to connect with yourself and your emotions when on an emotion-blocking (or dulling) drug. I wish you all the best.
I was taking cbd
@@alltheglory7854 right they monitor how you feel and keep track of you when doing cbt and see how you are doing on the medication, bit of exposure therapy too going through the triggers that make you anxious 1/10 how do you feel.
First you have to adjust to the drug before it even takes effect, that’s the one part I hated
Love the videos, though I'm a little confused about sertaline working best for atypical depression. From what I've read in research, sertraline has the best efficacy in melancholic depression.
everyone’s different. literature can say one thing but…. in real life it’s always diff. how they choose antidepressant is heavily dependent on symptoms as no 2 people with depression are an exact copy of another. saying sertraline is the best is downright dangerous for others whom sertraline have not worked well on.
Zoloft was the most commonly prescribed antidepressant in the USA in 2018 with over 38 million prescriptions.
How worried should someone with no heart issues worry about QT prolongation, I want to take Lexapro but I have heart/health anxiety
Not. It’s only clinically relevant in those with significant heart issues, and even then the link is inferred and hasn’t necessarily been proven to have adverse effects.
Definitely talk to your doctor about it, as they can answer specific questions and confirm your health. If you have a family history of heart issues or take other medications that prolong the QT segment, you might want to discuss this with your doctor. It's worth noting that Lexapro is pure escitalopram, while it is believed that arcitalopram (the opposite of escitalopram) is responsible for the QT prolonging effects. Citalopram is a mixture of both the es- and ar- molecules.
hahaaaa i thought i was the only one who referred to it as "squirtraline"! guess i'm not that clever. and yes, during the first few months the diarrhea was crazy. it did eventually subside though.
Did you mean nitric oxide synthase* ?
Hello! Is fluvoxamine activating or sedating? Are you able to wake up early in the morning to go the university / to your job? How much do you sleep each night? I have been on Paxil for 5 years. Amazing drug, but too sedating. I tried sertraline but it made me even more drowsy than paroxetine, even with a very low dose (perhaps because I am a poor CYP2C19 metabolizer). I would love to have your review on fluvoxamine's side effects.
What Qtc mean
So.... lsd or acid?
The awareness that taking antidepressants sooner or later will result in their discontinuation, which will result in a withdrawal syndrome, is not optimistic about this method of treating depression.
Secondly - each antidepressant causes that the neurotransmitter system on which the drug affects becomes reactive and dominant during pharmacotherapy, e.g. drugs from the SSRI group cause that when we take them, the serotoninergic system begins to dominate over other neurotransmitter systems, pushing them to the defensive - while taking The defensive SSRI is a dopaminergic system - it results, among others, in apathy, cognitive impairment, emotional blunting, and sexual dysfunction. After discontinuation of SSRIs, the serotonergic system becomes overly reactive, in the initial period of abstinence there is a failure of this system, but over time (after a long time after discontinuation of the SSRI) its excessive activity will occur, unfortunately the dopaminergic system is defensive all the time after the discontinuation of the SSRI because there are changes in histone levels that promote the serotoninergic system in relation to the dopaminergic system.
😣Damn….
Any advice for me, I appreciate it. Just curious 😐👍🏻
I’m 45 , diagnosed with ADHD this week. Most likely going on some stimulant, and I’m okay with that. But I’m concerned about the co-morbidity, of depression, getting perscribed SSRI ( maybe Zoloft)…
Hard to say, I know.
I just feel like I can possibly push through with the help of stimulant. And avoid being on an SSRI? I’ve often heard what you comment on, & it sounds like another added problem.. the withdrawal and etc.
Sorry if I made no sense. And I thank you .
Do antidepressants really change the situation that causes depression? No.
But do they change you to allow you to better cope or fix them? Sometimes.
Me looking at my class notes i wrote fluvoxamine as the purest ssri and it has the shortest half life 😢 guess i wasnt paying much attention
I still love you for your flaws
What about Clomipramine (Anafranil)?
Have you heard of charlesmyco?
He gat some psychedelic products.
@charlesmyco
👆👆👆 deliver all kinds of 💊💉 to any destination
I have a severe case of ocd but only recently (1y ago) I started taking drugs for it. First it was sertraline which stopped working after some time, then venlafaxine which also stopped working after a few months. Then I went to another psychiatrist who prescribed me fluvoxamine + risperidone. It was terrible, one night I woke up feeling something is going on with my heart, my body was hot and I honestly thought I was going to die. Could anybody please explain why it was such a bad combination? (I'm not coming back to that psychiatrist :))
Fluoxetine is also a s1r agonist, sertraline a s1r antagonist.
Sertraline if horrible. I was only able to take it for three days before the massive sedation and crippling headaches became too much. Citalopram felt exactly the same as amphetamine complete with dilated pupils, violent shaking, not sleeping for days at a time, dripping with sweat. Nasty stuff.
u have used all type of ssri but sertraline is the best
No citalopram and sertraline are first line SSRI’s.
Intro song?
less I know the better
@@marsh357 high-yield facts and high-yield music, i like it
Tame impala
I think Prozac caused my retinas to detatch